Reliability and validity of the Arabic version of brief international cognitive assessment for multiple sclerosis in Egyptian pediatric multiple sclerosis patients.

BACKGROUND & OBJECTIVES: About one-third of pediatric-onset MS (POMS) patients report cognitive impairment. This case-control study aimed to assess the reliability and validity of the Arabic version of the Brief International Cognitive Assessment for MS (BICAMS) in Egyptian POMS patients. METHODS: A case-control study was conducted on 30 POMS patients aged 9 to 17 years old and 30 healthy controls. Both groups underwent the following tests: neuropsychological testing using the BICAMS-validated Arabic version battery involving the Symbol Digit Modality Test (SDMT), California Verbal Learning Test 2nd edition (CVLT-II) and revised Brief Visuospatial Retention Test (BVRT-R). Test-retest data were obtained from MS patients and controls 2 weeks following the primary evaluation. Mean variances between both groups were evaluated, controlling for age, gender, and educational level. RESULTS: MS patients scored significantly lower on the SDMT, CVLT-II, and BVMT-R tests than healthy controls (P-value <0.001). Test-retest reliability was satisfactory for SDMT, CVLT-II total, and BVRT-R in MS patients and controls with r values of 0.73, 0.83, and 0.80, respectively. CONCLUSION: BICAMS is a feasible approach to cognitive screening in POMS and adults. The Arabic version of BICAMS is a reliable and valid tool for the cognitive assessment of pediatric MS patients in different clinical and research settings.

Reproductive studies on the carpet clam Paphia textile (Paratapes textilis) (Gmelin 1791) (Family: Veneridae): a guide of aquaculture management along the Egyptian coasts of the Red Sea and Suez Canal.

BACKGROUND: Most aquatic biota's reproductive biology and life cycle are essential to the sustainable management and development of coastal ecosystems and aquaculture. The bivalve Paphia textile (Gmelin 1791), also known as Paratapes textilis, has an economic value in Indo-Pacific waters, including the Red Sea and the Suez Canal lakes, the Egyptian coasts. However, P. textile suffers from extensive fishing and exploitation. AIM: The present work aims to study the Paphia textile's reproductive cycle on the Egyptian coasts of the Red Sea for the first time. It helps to manage and develop the coastal ecosystems and aquaculture. METHODOLOGY: Samples were collected monthly from two saline lakes in the Suez Gulf from December 2019 to November 2020. As part of the comprehensive research study, sex ratio, condition index, sexuality, histological analysis of gonads, shell size, and gonad index were used to investigate the reproductive cycle. RESULTS: The results reveal a male-biased sex ratio, possibly due to anthropogenic stressors. The Paphia textile is dioecious. No hermaphrodite cases were observed in the studied specimens. The condition index in winter and spring indicates periods dominated by mature individuals. Five reproductive maturity stages were assigned for both P. textile males and females. Due to the simultaneous development of several developmental stages monthly throughout the sampling year, warm water may be responsible for non-sequential gametogenic cycles. As measured environmental parameters correlate with maturity stages, temperature, salinity, and chlorophyll a play important role in gonad growth. The size at first sexual maturity at which 50% of the Paphia textile population reached maturity ranged from 28.60 to 31.50 mm for females, and between 31.70 and 34.10 mm for males. As the gonad index increases during the ripe stages, this index decreases during the resting, spawning, and spent phases. CONCLUSIONS: The findings suggest the most suitable temperature for aquaculture spawning is between 20 °C and 30 °C in subtropical waters. Fishing should generally be prohibited at sizes less than 28.60 mm for better management and sustainability of this valuable aquatic resource on the Egyptian coasts of the Red Sea.

New algorithmic approach for easier and faster extended disability status scale calculation.

Background: The traditional paper and pencil method for EDSS calculation (pEDSS) is the cornerstone of multiple sclerosis practice; however, it requires an expert for an accurate calculation, and it takes a lot of time to perform the function scores. A new algorithmic approach (aEDSS) has been developed for easier and faster assessment. Objective: To determine if using aEDSS can achieve good inter-rater agreement and save time compared to pEDSS. Subjects and methods: This study was conducted on 200 MS patients; EDSS was performed twice for each patient by two neurologists on the same day; one used the pEDSS, and the other used the aEDSS in a random order to test the inter-rater agreement regarding functional system scores and the final EDSS score and to detect the difference in the time needed for calculation between both methods. Results: The new algorithmic approach achieved excellent agreement with the traditional method (Kappa > 0.81) with a shorter calculation time (16 ± 2.67 min for aEDSS vs 31 ± 4.3 min for pEDSS, P < 0.0001). Conclusion: The new algorithmic approach could represent a suitable alternative to the traditional method, making EDSS calculation easier and faster.

Neurological Manifestations in a Cohort of Egyptian Patients with COVID-19: A Prospective, Multicenter, Observational Study.

BACKGROUND: The COVID-19 pandemic has reached over 276 million people globally with 5.3 million deaths as of 22nd December 2021. COVID-19-associated acute and long-term neurological manifestations are well recognized. The exact profile and the timing of neurological events in relation to the onset of infection are worth exploring. The aim of the current body of work was to determine the frequency, pattern, and temporal profile of neurological manifestations in a cohort of Egyptian patients with confirmed COVID-19 infection. METHODS: This was a prospective study conducted on 582 hospitalized COVID-19 patients within the first two weeks of the diagnosis of COVID-19 to detect any specific or non-specific neurological events. RESULTS: The patients' mean (SD) age was 46.74 (17.26) years, and 340 (58.42%) patients were females. The most commonly encountered COVID-19 symptoms were fever (90.72%), cough (82.99%), and fatigue (76.98%). Neurological events (NE) detected in 283 patients (48.63%) and were significantly associated with a severe COVID-19 at the onset (OR: 3.13; 95% CI: 2.18-4.51; p < 0.0001) and with a higher mortality (OR: 2.56; 95% CI: 1.48-5.46; p = 0.019). The most frequently reported NEs were headaches (n = 167) and myalgias (n = 126). Neurological syndromes included stroke (n = 14), encephalitis (n = 12), encephalopathy (n = 11), transverse myelitis (n = 6) and Guillain-Barré syndrome (n = 4). CONCLUSIONS: Neurological involvement is common (48.63%) in COVID-19 patients within the first two weeks of the illness. This includes neurological symptoms such as anosmia, headaches, as well as a constellation of neurological syndromes such as stroke, encephalitis, transverse myelitis, and Guillain-Barré syndrome. Severity of acute COVID-19 illness and older age are the main risk factors.

Impact of Ramadan fasting on disease activity in patients with multiple sclerosis: a multicenter study.

BACKGROUND: The safety of Ramadan fasting for Muslim patients suffering from multiple sclerosis (MS) is still a matter of debate. This work aimed to study the clinical course of MS during Ramadan fasting and to clarify the predictors of relapses and symptoms exacerbation. METHODS: This retrospective study included 153 Muslim patients with MS. Data related to the disease course before Ramadan were obtained from patients' files, whereas data related to the disease activity during Ramadan, were collected from patients over the two months following Ramadan. RESULTS: Patients with MS who experienced relapses, exacerbation of symptoms and development of new symptoms during Ramadan had a statistically significant longer disease duration compared to those who did not experience (P < 0.001, <0.001, 0.01 respectively). Also, patients who experienced relapses, exacerbation of symptoms and development of new symptoms during Ramadan had a statistically significant higher expanded disability status scale (EDSS) compared to those who did not experience (P <0.001, <0.001,0.01, respectively). The occurrence of relapses, exacerbation of symptoms and development of new symptoms during Ramadan, were significantly higher in patients who experienced relapses in the preceding year compared to those who did not (P= 0.002, 0.002, 0.01, respectively). Binary logistic regression revealed that each score elevation of EDSS increased the odds of relapse during Ramadan by 1.02 (P-value = 0.04). Also, each month's increase in disease duration increased the odds of relapse during Ramadan by 1.87 (P-value = 0.046). CONCLUSION: High EDSS and long disease duration are independent predictors of relapse during Ramadan.

Testing of Verbal Fluency in Egyptians: Cultural and Educational Challenges.

BACKGROUND: The importance of verbal fluency tasks as a cornerstone in cognitive assessment is now well acknowledged, as they provide fast, reliable tools for assessment of both verbal and executive function abilities. OBJECTIVES: To investigate the effect of age and education on verbal fluency and to develop a verbal fluency task that is culture-oriented and non-education-based to overcome the problem of illiteracy in Egypt. METHODS: Two groups of participants were recruited, a normal cognition control group (n=79) and a clinically demented group (n=32). Phonemic verbal fluency was tested by asking participants to generate as many words as they could think of starting with the Arabic letter Haa; category fluency was evaluated using four semantic categories (animals, fruits, vegetables, and names). RESULTS: Animal, vegetable, and name fluency tasks (unlike phonemic fluency and fruit) were not related to age and education, and they had better criterion validity (area under the receiver operating characteristic curve [AUC]=0.96, 0.91, and 0.92, respectively) than did letters and fruits (AUC=0.74 and 0.86, respectively). Our suggested cutoff points are 11 for the animal fluency task (sensitivity=94%, specificity=93%), 11 for vegetables (sensitivity=84%, specificity=88%), and 18 for names (sensitivity=91%, specificity=82%). CONCLUSIONS: Animals, vegetables, and names are reliable and appropriate categories to be used for culture-oriented and non-education-based verbal fluency tests.