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  • ISSN: 2333-7087
    Early Online
    Volume 6, Issue 1
    Research Article
    Grzegorz Gradek, and Halvor Naess*
    Aim: To explore the relation between left atrial pressure (LAP) and volume (LAV) in ischemic stroke patients with or without atrial fibrillation (AF). We hypothesized that there is an association between high LAP and atrial fibrillation.
    Methods: All patients admitted to the Stroke unit, Haukeland University hospital are registered in the Norstroke database. A subgroup of the patients was referred to an out clinic cardiologist for transthoracic echocardiography based on the judgments by the clinician in charge of the patients during the hospital stay. The transthoracic echocardiography included measurement of LAV, LAP and ejection fraction (EF). Risk factors and MRI findings were registered. Univar ate, multivariate and lowess smoother curve analyses were performed.
    Results: In total, 138 patients were referred to the cardiologist and 23 (17%) had documented AF. Linear regression analysis showed that LAP was independently associated female sex, hypertension and increasing LAV (all P<0.05). Linear regression analysis showed that LAV was independently associated with male sex, AF and increasing LAP (all P<.05). Lowess smoother curves showed U-shaped relations between LAV and both AF and old cerebral infarction on MRI.
    Conclusion: We did not find an association between LAP and AF even though LAP correlated with LAV. However, we found U-shaped relations between LAV and both AF and old cerebral infarction on MRI.
    Case Report
    Ramesh Adhikari, Vasanth Kumar Suram, Keerti Deepika*, and Tessy Joseph
    Background: The neurologic potential of COVID-19 in auto-immune disorders is yet to be uncovered. With chronic immunosuppression, patients with Myasthenia gravis are vulnerable in contracting the SARS-CoV-2 virus that may lead to further complications during the course of the disease along with progression towards pneumonia leading to increased mortality.
    Case Report: We report a case of a 33-year-old male with a history of Myasthenia gravis who experienced COVID-19 infection leading to exacerbation of Myasthenia gravis symptoms and succumbed to death due to acute respiratory failure.
    Conclusion: The implications of COVID-19 in auto-immune diseases like Myasthenia Gravis is very complex, with immunosuppressive therapy putting the patients at higher risk of contracting SARS-CoV-2 virus complicating to acute interstitial pneumonia and leading to Respiratory failure. About 15% of Myasthenia gravis (MG), patients are particularly susceptible to infections leading to Myasthenic crisis and evolution of respiratory muscle weakness leading to restrictive respiratory failure due to the combination of reduced neuromuscular safety factors adversely affected by pyrexia and the effect of acute inflammatory mediators compounded by immunosuppression. Viral infections are reported to stimulate autoimmunity through augmentation of T-cell signalling leading to cytokine dysregulation, causing Acute Respiratory Distress Syndrome.
    Original Article
    Inaam N Mohamed*, Hadia I Mohamed and Ilham M Omer
    The aim of this study is to classify neonatal seizures using seizure semiology and identifying the underlying causes and the immediate outcome of seizures among neonates admitted in NICU- Khartoum-Sudan. The study included all neonates with seizure admitted to NICU at three main hospitals in Khartoum-Sudan. One hundred and sixteen neonates were enrolled in the study. Data was collected using designed questionnaire with emphasis on history, physical examination, investigations, management and outcome of seizure.
    Out of 1500 neonates admitted to NICU in the study area 116(7.7%) had seizures as a major presenting symptoms. Forty eight neonates (41.4%) had hypoxic ischemic encephalopathy, Twenty six (22.4%) had evidence of septicemia/ meningitis and primary biochemical abnormalities accounted for 32(27.6%). The most common seizure type was generalized tonic clonic in 51 (44%) followed by 30(25.9%) had focal clonic. Eighty nine (76.7%) neonates were well controlled , 26(22.4%) were partially controlled and one (0.9%) neonates had poorly controlled seizures .Neonates whose mothers had illnesses related to pregnancy , neonates with generalized seizures, preterm delivery, seizures started in the first 24 hours of life and neonates with abnormal brain image, had poorly controlled seizures.
    Facilities for Neonatal resuscitation, prevention of Birth Asphyxia and safe deliveries are mandatory at all levels of health care systems.
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