Association between acute stroke and COVID-19 infection among patients with acute stroke

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS COV 2) infection is associated with multiple neurological complications. Cerebrovascular accidents are considered as one of the common neurological complications associated with corona virus (COVID-19). It may represent the first presentation of the patients of COVID-19 or may occur anytime during the course of the disease. Results This study included 381 patients after the diagnosis of cerebrovascular accident. The mean age of the participants was 57.1 ± 15 years. 53.5% of the participants were males and 46.5% were females. The participants had COVID-19 infection in past 3 months with mean duration was 35.5 ± 18 days. The mean NIHSS among the participants was 10.5 ± 6.2. Small artery stroke was higher among PCR negative patients and controls, while large artery stroke was higher among PCR positive patients. 26% of patients with stroke and confirmed COVID-19 infection developed stroke immediately after COVID-19 infection (within 1 week). Within 1 month from getting infection with COVID-19, 41.7% of patients developed stroke and 32.3% had developed stroke after 1 month of infection with COVID-19. Female gender, older age of the patients and presence of vascular risk factors were associated with increased severity of infection as evidenced by higher NIHSS and more ICU admission among COVID-19 positive patients. Conclusions COVID-19 infection has been associated with both venous and arterial stroke, especially in elderly patients. COVID-19 infection was associated with increased stroke severity as evidenced by higher NIHSS and more ICU admission. Small vessel disease was higher among COVID-19 negative patients, while large artery stroke was higher among positive COVID-19 patients

Ten years experience with a novel modification of plastibell circumcision

Background: Plastibell device is a satisfactory method of circumcision in infants. However the most common post-operative complication was bleeding (especially from the frenulum site). As a result, we introduce a novel modification of the device to prevent this complication.Patients and Methods: A prospective comparative study of Plastibell circumcision in infants up to the age of 12 months was conducted, using conventional Plastibell device and modified Plastibell device circumcision.In The first group (1000 infants), circumcision was performed with conventional Plastibell device while in the second group (4500 infants), circumcision was done with modified Plastibell device.Results: The mean age was 8 weeks. The mean operating time were 8.5 min and 5.9 min for conventional Plastibell ring and modified Plastibell device circumcision respectively. The most common postoperative  complication in first groups was bleeding. Conclusion: This modified Plastibell device, prevents the most series complication of bleeding. It is fast and ensures excellent cosmoses compared with the standard Plastibell template circumcision. Also it is easyto perform and allows the paediatric surgeon to achieve consistently excellent cosmetic results. Moreover, the shorter operating time makes circumcision by the modified Plastibell device a more practical method. Thetechnique will be described in detail.Key words: Circumcision, Plastibell, Childre