Egyptian students’ guardians knowledge, attitude and predictors of negative attitude of epilepsy in Assiut city

AbstractBackgroundEpilepsy is very prevalent in Egypt, approaching 6.98 per 1000 population. This study was designed to assess the knowledge and attitudes towards epilepsy among guardians of Egyptian high school students.MethodsA cross-sectional study was made among guardians (parents/guardians) of high school students in Assiut city, Egypt. A 15-item questionnaire was self-administered by 1257 students’ guardians who were randomly selected.ResultsAll recruited parents/guardians of high school students had heard about epilepsy. Families with a patient with epilepsy (PWE) had significantly better information about epilepsy and its aetiology than other families. The predictors of negative attitudes towards PWE were: age group ranging from 40 to 49years, no work, skilled work, male sex and incorrect knowledge.ConclusionHaving a patient with epilepsy is a predictor to having greater knowledge and a better attitude towards epilepsy. However, people still have a concept that PWE are stigmatized and are different from others. Raising awareness about epilepsy and its aetiology will increase the knowledge and improve the attitudes towards PWE

Population-based study of acquired cerebellar ataxia in Al-Kharga district, New Valley, Egypt

Wafaa MA Farghaly1, Hamdy N El-Tallawy1, Ghaydaa A Shehata1, Tarek A Rageh1, Nabil Abdel Hakeem2, Noha M Abo-Elfetoh11Department of Neurology and Psychiatry, Assiut University, Assiut, Egypt; 2Al Azhar University, Assiut Branch, EgyptBackground: The aim of this research was to determine the prevalence and etiology of acquired ataxia in Al-Kharga district, New Valley, Egypt.Methods: A population-based study of acquired ataxia was conducted in a defined geographical region with a total population of 62,583. A door-to-door survey was used to identify cases of acquired cerebellar ataxia. Patients with acquired cerebellar ataxia at any age and of both genders were included. Cases of known inherited cerebellar ataxia, acquired neurological disorders with ataxia as a minor feature, or pure acquired sensory ataxia, were excluded.Results: We identified 17 cases of acquired ataxia, of which eight were vascular, six were an ataxic cerebral palsy subtype, and three involved postencephalitic ataxia. The crude prevalence rate for acquired ataxia was 27.16/100,000 (95% confidence interval [CI]: 14.3–40.1). The mean age of the patients at interview was 31.8 (range 4–72) years, with a male to female ratio of 2.1:1. The most frequent presenting complaint was disturbance of gait (90.7%). The majority (92%) were ambulatory, but only 9.3% were independently self-caring.Conclusion: This population-based study provides an insight into acquired cerebellar ataxia within a defined region, and may inform decisions about the rational use of health care resources for patients with acquired cerebellar ataxia. The most common causes of acquired cerebellar ataxia in this region were cerebrovascular injury and cerebral palsy.Keywords: acquired cerebellar ataxia, prevalence, subtypes, Egyp

Pre- and in-hospital delays in the use of thrombolytic therapy for patients with acute ischemic stroke in rural and urban Egypt

BackgroundReducing pre- and in-hospital delays plays an important role in increasing the rate of intravenous thrombolysis (IVT) in patients with acute ischemic stroke. In Egypt, the IVT rate has increased steadily but is still far away from an ideal rate.AimThe study aimed to investigate the factors associated with pre- and in-hospital delays of IVT among patients with acute ischemic stroke coming from urban and rural communities.MethodsThis prospective, multicenter, observational cohort study was conducted from January 2018 to January 2019. Patients with acute ischemic stroke, who did not receive IVT, were included in the study. Patients were recruited from three large university stroke centers in Egypt, Assiut (south of Egypt), Tanta (north of Egypt), both serving urban and rural patients, and the University Hospital in Cairo (capital city), only serving an urban community. All participants underwent the National Institutes of Health Stroke Scale and full neurological assessment, urgent laboratory investigations, and computed tomography or magnetic resonance imaging to confirm the stroke diagnosis. The patients were subjected to a structured questionnaire that was designed to determine the parameters and time metrics for the pre- and in-hospital delays among patients from rural and urban regions.ResultsA total of 618 patients were included in the study, of which 364 patients (58.9%) lived in rural regions and 254 (41.1%) in urban regions. General demographic characteristics were similar between both groups. Approximately 73.3% of patients who arrived within the therapeutic time window were urban patients. The time from symptom onset till hospital arrival (onset to door time, ODT) was significantly longer among rural patients (738 ± 690 min) than urban patients (360 ± 342 min). Delayed onset to alarm time (OAT), initial misdiagnosis, and presentation to non-stroke-ready hospitals were the most common causes of pre-hospital delay and were significantly higher in rural patients. For patients arriving within the time window, the most common causes of in-hospital delays were prolonged laboratory investigations and imaging duration.ConclusionThe limited availability of stroke-ready hospitals in rural Egypt leads to delays in stroke management, with subsequent treatment inequality of rural patients with acute stroke