Notes

Wnt signaling: A potential therapeutic targeted for persistent soreness.
High rates of surgical site infection-24.2%, readmission rate during 30 days-30.8%, PONV-44.2%, respiratory complication-6.7%, deep vein thrombosis-3.3%, urinary retention-2.5%, prolonged postoperative ileus 16.7%. We included 87 patients in ERAS care group during 2 years. In this group our study showed big reduction of hospital stay days and it was average 5 days. Compared to traditional care group incidence of respiratory complications was 0, postoperative PONV- 6.9%, postoperative ileus-5.7%, deep vein thrombosis-0, urinary retention-0, readmission rate-0, surgical site infection-3.4%.The aim of the study is to establish the effectiveness of mechanical support of blood circulation of patients with end-stage heart failure depending on the method of surgical correction. The results of the study are based on the data of examination and dynamic observation of 73 patients (median age 44 (16-69) years, men 68 patients, women 5 patients) who were treated from 2008-2019 іn the following medical institutions Republican Scientific and Practical Center «Cardiology», Minsk, Republic of Belarus; in the Center of Cardiac Surgery on the Basis of KL «Feofania» DUS. Patients were examined during the initial examination, after 3 months and after a year. The results of surgical treatment of patients with critical heart disease insufficiency after direct UTS 24 (92%) patients were treated with positive result, 2 (8%) patients died. There were 18 (46%) patients performed secondary UTS, patients who were on LVAD therapy. 18 (46%) patients who continue LVAD therapy. On LVAD-therapy 3 (8%) patients died. The cause of death is purulent-septic lesions. Which patients were on BiVAD - therapy secondary UTS performed 4 patients (50%). 4 (50%) patients died on BIVAD therapy. The cause of death in 2 (50%)cases of purulent-septic lesions, and in 2 (50%) cases it is an organ field insufficiency. Analysis of the results of the differential approach to surgical treatment patients with heart failure III-IV FC according to NYHA patients with critical heart failure in the presence of contraindications to direct transplantation heart rate, it is advisable to consider the use of long-term mechanical circulatory support based on LVAD therapy (p less then 0001) and BiVAD - therapy (p less then 0001) as a mechanical bridge to heart transplantation. Applied long-term mechanical support of blood circulation in patients with high indicators of pulmonary hypertension (p less then 0001), allows to normalize the pressure in the pulmonary artery and consider performing a secondary heart transplant.Meningiomas are benign, slow-growing tumors originating from arachnoid gap cells. They constitute 15%-20% of all intracranial tumors in adults and 04%-4% in the pediatric age group. Meningiomas in the posterior fossa in the pediatric period do not initially come to mind. In the case presented here, there was a cystic meningioma showing heterogenous contrast and obstructive hydrocephaly was observed associated with 4th ventricle pressure. the tumor was totally removed, then the ventriculo peritoneal shunt was applied.Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder that is characterized by multiple dome-shaped cutaneous venous malformations on the skin and visceral organs. Typical extra-cutaneous lesions have the appearance of blueish nipple-shaped nodules that can easily compress and refill. We described a rare case of a 23-year-old female with BRBNS and tuberous sclerosis complex (TSC) that presented with central nervous system (CNS) involvement including unprovoked focal impaired awareness seizure. Her BRBNS presents with hemangiomas involving multiple organs in the body including the brain, gastrointestinal (GI) system, and skin. This case highlights the importance of studying and understanding the association between BRBNS and TSC as it may lead to improved understanding.
To present the experience on stroke thrombolysis of a tertiary care center in Riyadh, KSA.

Cross-sectional, observational study of patients thrombolyzed between January 2012 and December 2018.

Thrombolysis was performed in 148 patients (mean age 58.2±14.5 years), 94 (63.5%) of them were men. The median onset-to-door time was 81 minutes, and 25% of the patients arrived within 1 hour. The median National Institute of Health Stroke Scale score upon admission was 13. Hypertension (68.9%), diabetes (56.1%), and dyslipidemia (40.5%) were the most common risk factors for stroke. learn more The most common mechanism of stroke was cardioembolism (43.2%), which was associated with a more severe presentation (
=0.031). Intravenous thrombolysis alone was given to 98 patients (66.2%); the rest received intravenous tissue plasminogen activator plus endovascular therapy or endovascular therapy alone. The median door-to-needle (DTN) time was 70.5 min, with a significant improvement from 2012 (111.6 minutes) to 2018 (69.9 minutesat cardioembolic strokes were the most frequent and had severe presentation and were likely the cause of the slight increase in mortality and sICH.
To compare the clinical outcomes of repetitive paravertebral block (PVB) combining oral medication in the treatment of zoster-related pain (ZP) with different courses.

Sixty-seven patients with ZP were divided into 3 groups based on their course of herpes zoster (HZ). Group I 24 patients with acute herpetic neuralgia (within one month of disease onset); group II 22 patients with subacute herpetic neuralgia (disease onset from 1 to 3 months); group III 21 patients with postherpetic neuralgia (more than 3 months since disease onset). All patients received ultrasound-guided repetitive PVB with oral gabapentin and tramadol sustained-release tablets. The VAS and QS scores and the incidences of hematoma, dizziness, nausea, and drowsiness were compared at 1 day, 3 months, and 6 months after treatment.

Pain intensity and sleep quality of the 3 groups improved to varying degrees after treatment. The best efficacy was achieved in the acute group, followed by the subacute group, and the poorest efficacy was observed in the chronic group.

The efficacy of ultrasound-guided repetitive PVB with oral medication varied with the courses of HZ. The shorter the time since onset, the better the efficacy. This combined treatment showed better efficacy in patients at the acute and subacute stages and significantly improved their pain and sleep quality, while demonstrating limited pain relief in chronic patients.
The efficacy of ultrasound-guided repetitive PVB with oral medication varied with the courses of HZ. The shorter the time since onset, the better the efficacy. This combined treatment showed better efficacy in patients at the acute and subacute stages and significantly improved their pain and sleep quality, while demonstrating limited pain relief in chronic patients.
To study the prevalence of seizures in children with GDD and identify the characteristics of such patients; to examine the association of GDD with epilepsy and to determine the effect of certain risk factors on this association.

A retrospective cross-sectional study conducted at the pediatric neurology and developmental assessment clinic at King Fahad specialist hospital (KFSH), Saudi Arabia. All data were collected by reviewing the electronic medical records of 200 pediatric patients who presented with global developmental delay from February 2016 to April 2018.

The sample includes 200 children (113 males, 87 females) aged zero to 12 years. The largest group of participants came from the Dammam region, representing 27.5% of the sample. The prevalence of epilepsy in GDD patients was 56%; the epilepsy and non-epilepsy groups differed significantly in age. The most common type of seizure was generalized onset motor, which were observed in 37.5% of the sample. Problems during labor occurred in 15% of the sample; consanguineous marriage occurred in 61.6% of the participants. Neither of these factors differed significantly in the epilepsy and non-epilepsy groups. Advanced paternal age did differ significantly in the two groups (
=0.003).

The prevalence of epilepsy is high in children with GDD, and of the factors studied here, the most significant variables affecting this correlation are the type of seizure and advanced paternal age.
The prevalence of epilepsy is high in children with GDD, and of the factors studied here, the most significant variables affecting this correlation are the type of seizure and advanced paternal age.
To assess low dose altepase outcome and safety in comparison with a standard-dose regimen for acute ischemic stroke treatment in Egyptian patients.

An observational prospective cohort non-randomized single blinded study was carried out during the period from November 2017 to December 2018. Eighty Egyptian acute ischemic stroke patients, all eligible for intravenous alteplase, were subdivided into 2 groups (40 patients in each group). Patients were thrombolysed at a dose of 0.6 mg/kg in the first group and 0.9 mg/kg in the second group. Both groups were compared in regard to safety and outcome. Safety was expressed by the rate of symptomatic intracranial hemorrhage (SICH) and 3 months mortality, while outcome was expressed by favorable outcomes at three months (modified Rankin Scale [mRS] of 0 to 2).

In the first group, 69.2% (n=27) achieved favorable outcomes at 90 days compared with 64.1% (n=25) in the second group (
=0.631). Ninety-day mortality was 5% (n=2) in the first group versus 2.5% (n=1) in the second group (
=0.556). Symptomatic intracranial hemorrhage was noted in 3 patients in the second group and zero patients in the first group (
=0.077).

Low-dose alteplase could be a practical alternative for Egyptian populations with acute ischemic stroke especially in 3 to 4.5 hours window.
Low-dose alteplase could be a practical alternative for Egyptian populations with acute ischemic stroke especially in 3 to 4.5 hours window.
To assess the overall and domain-specific quality of life (QOL) in post-stroke patients using the stroke-specific quality of life (SS-QOL) scale and to identify variables that may affect the QOL after stroke.

A prospective cross-sectional study, included 80 stroke patients, was conducted in the Neurology department at King Fahad Hospital of the University (KFHU), Khobar, Saudi Arabia, from December 2019 to February 2020. Stroke patients were interviewed using the Arabic version of the SS-QOL questionnaire and modified Rankin scale (mRS).

The overall quality of life in the surveyed participants was at the level of 3.72 points, which is above the average recognized in the middle of the scale that ranges from 1 to 5. The overall quality of life was not significantly correlated with sex, age, type of stroke, recurrence of stroke, and time since stroke (
>0.05). Hypertension and atrial fibrillation were the only comorbidities that were determined to be significantly associated with the overall quality of life at the level of (3.53), and (2.97) respectively (
<0.05). There was a statistically significant correlation between the mRS score and the overall quality of life (
<0.05).

Performing a comprehensive assessment of the overall QOL in post-stroke patients will result in better health outcomes, particularly in terms of quality of functioning in psycho-social aspects.
Performing a comprehensive assessment of the overall QOL in post-stroke patients will result in better health outcomes, particularly in terms of quality of functioning in psycho-social aspects.
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