Assessment of Stx-1A gene polymorphism (rs1569061) in relation to the development of multiple sclerosis in Egyptian patients.

Multiple sclerosis (MS) is a multifactorial polygenic disease; results from autoimmune and neurodegenerative processes which lead to multifocal lesions of the central nervous system. Axonal degeneration was found to be prominent in the inflammation period of MS and contribute to the progression of disability. Soluble N-ethylmaleimide sensitive factor attachment receptor (SNARE) complex plays a vital role in the release of neurotransmitter by synaptic vesicle fusion. Stx-1A protein (Stx-1A), a major component of the SNARE complex, is widely expressed in brain tissue. This study intended to evaluate the prevalence of the Stx-1A gene polymorphism (rs1569061) in the Egyptian population with MS and to investigate its association with various clinical factors. This study included 65 adult Egyptian MS patients and 35 age- and sex-matched normal control subjects. Diagnosis of MS was made by an experienced neurologist according to revised McDonald criteria. All Patients underwent full history taking, included Age of onset of MS, disease duration, disease course and degree of disability according to the Expanded Disability Status Scale (EDSS) and family history of neurological diseases. Stx-1A gene polymorphism (rs1569061) genotyping was performed by TaqMan assay based quantitative real time (qPCR) and verified by sanger sequencer. Genotype and allele frequencies of (rs1569061) did not differ significantly between case and control groups. No difference was detected when comparing the genotype frequency and the allele frequency to different disease parameters. Discrepancy of the minor allele frequency (MAF) of Stx-1A gene (rs1569061) between different populations was noted. In conclusion, our study in Stx-1A gene polymorphism (rs1569061) and MS showed that no difference between the patient and control as regards gene frequency and allele frequency. Predicting no association between the studied polymorphism and MS in the Egyptian population. However, discrepancy between different population was noted as regards the MAF for Stx-1A gene (rs1569061).

Telephone-based assessment of multiple sclerosis patients at Ain Shams University Hospital in the coronavirus disease 2019 pandemic.

BACKGROUND: Assessment of multiple sclerosis (MS) patients during the era of the coronavirus disease 2019 (COVID-19) pandemic was confronted with the overwhelmed healthcare facilities in Egypt and fear of the patients to get infected while attending the follow-up visits. This study aimed to assess the value of telephone-based assessments in the follow-up of MS patients. It includes one hundred and five patients who participated in the study and completed 3 telephone-based assessments which are the Hauser Ambulation index, Multiple Sclerosis Neuropsychology Questionnaire (MSNQ), and Symptoms of Multiple Sclerosis Scale (SMSS). RESULTS: The Hauser Ambulation index was significantly correlated with the latest Expanded Disability Status Scale (EDSS) score done within 1 month from the telephone call (r=0.738, P<0.001). The analysis of MSNQ scores showed that one-third of the study population had evidence of cognitive and/or neuropsychological impairment. Post hoc analysis regarding the cognitive and psychological impairment component of SMSS revealed that the patients who answered "Never" had significantly lower MSNQ scores compared to those who answered "Sometimes" (P=0.016), "Often" (P=0.022), and "Always" (P=0.001). The comparison of the EDSS scores of the patients regarding the sensory-motor impairment component of SMSS showed a non-significant difference. CONCLUSION: The Hauser Ambulation index may be a reliable telephone-based tool for the assessment of physical disability. The MSNQ and the cognitive and psychological impairment component of SMSS can be used for the assessment of cognitive and psychological impairment among patients with MS.

Classification of Skin Lesions into Seven Classes Using Transfer Learning with AlexNet.

Melanoma is deadly skin cancer. There is a high similarity between different kinds of skin lesions, which lead to incorrect classification. Accurate classification of a skin lesion in its early stages saves human life. In this paper, a highly accurate method proposed for the skin lesion classification process. The proposed method utilized transfer learning with pre-trained AlexNet. The parameters of the original model used as initial values, where we randomly initialize the weights of the last three replaced layers. The proposed method was tested using the most recent public dataset, ISIC 2018. Based on the obtained results, we could say that the proposed method achieved a great success where it accurately classifies the skin lesions into seven classes. These classes are melanoma, melanocytic nevus, basal cell carcinoma, actinic keratosis, benign keratosis, dermatofibroma, and vascular lesion. The achieved percentages are 98.70%, 95.60%, 99.27%, and 95.06% for accuracy, sensitivity, specificity, and precision, respectively.

Effect of duration and severity of migraine on retinal nerve fiber layer, ganglion cell layer, and choroidal thickness.

PURPOSE:: To investigate the factors in migraine that have the highest significance on retinal and choroidal layers' thickness. METHODS:: Ninety patients with migraine and 40 age-matched healthy participants were enrolled in this observational, cross-sectional study. After full ophthalmological examination, spectral domain-optical coherence tomography was done for all patients measuring the thickness of ganglion cell layer and retinal nerve fiber layer. Enhanced depth imaging technique was used to measure the choroidal thickness. RESULTS:: There was significant thinning in the superior and inferior ganglion cell layers, all retinal nerve fiber layer quadrants, and all choroidal quadrants (except for the central subfield) in migraineurs compared to controls. The duration of migraine was significantly correlated with ganglion cell layer, retinal nerve fiber layer, and all choroidal quadrants, while the severity of migraine was significantly correlated with ganglion cell layer and retinal nerve fiber layer only. Multiregression analysis showed that the duration of migraine is the most important determinant factor of the superior retinal nerve fiber layer quadrant (ß = -0.375, p = 0.001) and in all the choroidal quadrants (ß = -0.531, -0.692, -0.503, -0.461, -0.564, respectively, p < 0.001), while severity is the most important determinant factor of inferior, nasal, and temporal retinal nerve fiber layer quadrants (ß = -0.256, -0.335, -0.308; p = 0.036, 0.005, 0.009, respectively) and the inferior ganglion cell layer hemisphere (ß = -0.377 and p = 0.001). CONCLUSION:: Ganglion cell layer, retinal nerve fiber layer, and choroidal thickness are significantly thinner in patients with migraine. The severity of migraine has more significant influence in the thinning of ganglion cell layer and retinal nerve fiber layer, while the duration of the disease affected the choroidal thickness more.

Clinical characteristics of patients with multiple sclerosis enrolled in a new registry in Egypt.

BACKGROUND: Epidemiological studies of multiple sclerosis (MS) are lacking in Egypt. OBJECTIVE: To study the characteristics of Egyptian patients with multiple sclerosis in a new registry in a major tertiary referral centre in Cairo, Egypt. SUBJECT AND METHODS: Patients were from the project MS database of the Multiple Sclerosis Unit at Ain Shams University Hospitals (N=950). We conducted a detailed medical history and examination including the Expanded Disability Status Scale (EDSS). RESULTS: Females represented 72% of subjects (female: male ratio 2.57:1). The mean age of disease onset was 26.1±7.6 years. Relapsing-remitting MS (RRMS) was the most common presentation (74.6%). Visual or sensory symptoms were the most common at presentation with RRMS, while motor symptoms were the most common presentation in other types of MS. Time to diagnosis was delayed up to 2 years in 27.8% of patients. The mean EDSS score was 3.6±2.1; 55% had EDSS≤3. About half (49%) received a disease-modifying drug. Progressive MS and motor presentation were associated with higher disability. CONCLUSIONS: This is the first documented MS registry from Egypt. The clinical characteristics of MS in Egypt was similar to other Arab countries and western countries. MS is more common among females in Egypt, with RRMS being the most common presentation. Visual symptoms and motor symptoms were the most common presentations in RRMS and progressive MS, respectively. Our findings also highlight the value of establishing registries in Egypt in order to be able to study, prospectively, the clinical course of the disease, the response to various DMD's and the epidemiology of MS in Egypt.

Image registration under illumination variations using region-based confidence weighted M-estimators.

We present an image registration model for image sets with arbitrarily shaped local illumination variations between images. Any nongeometric variations tend to degrade the geometric registration precision and impact subsequent processing. Traditional image registration approaches do not typically account for changes and movement of light sources, which result in interimage illumination differences with arbitrary shape. In addition, these approaches typically use a least-square estimator that is sensitive to outliers, where interimage illumination variations are often large enough to act as outliers. In this paper, we propose an image registration approach that compensates for arbitrarily shaped interimage illumination variations, which are processed using robust M -estimators tuned to that region. Each M-estimator for each illumination region has a distinct cost function by which small and large interimage residuals are unevenly penalized. Since the segmentation of the interimage illumination variations may not be perfect, a segmentation confidence weighting is also imposed to reduce the negative effect of mis-segmentation around illumination region boundaries. The proposed approach is cast in an iterative coarse-to-fine framework, which allows a convergence rate similar to competing intensity-based image registration approaches. The overall proposed approach is presented in a general framework, but experimental results use the bisquare M-estimator with region segmentation confidence weighting. A nearly tenfold improvement in subpixel registration precision is seen with the proposed technique when convergence is attained, as compared with competing techniques using both simulated and real data sets with interimage illumination variations.