Background and objective: Atrial fibrillation (AF) is a common cause of ischemic stroke. AF is usually paroxysmal and could escape detection via single lead electrocardiogram ECG recorder. Holter monitoring is useful in this scenario. The objective of this study was to assess the role of 48 hours Holter monitoring in identifying clinically inapparent AF in young patients with ischemic stroke  Methods: A retrospective cross-sectional study was conducted with patient data from November 2019 to February 2021. It was conducted in Neurology department of Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Study contained medical records of 60 patients which were admitted in this time period. Forty-eight hours Holter monitoring was carried out for all the patients. Patient medical records were examined according to predetermined risk factors and criteria. Statistical analysis was done on SPSS version 25.0. Results: Ten out of 60 cases had positive results for AF during Holter’s monitoring. Fifty cases had negative results for AF during Holter monitoring.  While the p value of the data obtained remained non-significant, results depict efficacy of Holter’s monitoring in detection of AF to some extent. Conclusion: Holter monitoring can identify AF, providing aid in prevention of secondary ischemic stroke. However, instead of 48 hours monitoring, a through 72 hours or extended monitoring will increase the effectiveness of this monitoring. In future, a study could be conducted where a large number of cases should be included so that statistical significance of data could be increased.

Background and Objective: Cerebral venous thrombosis (CVT) is a common cause of cerebrovascular accident (stroke). CVT is caused due to blockage in blood flow either in cerebral veins or in dural sinuses. The objective of this study was to determine prevalence of various clinical and imaging characteristics in patients with cerebral venous thrombosis. Methods:  A descriptive retrospective cross-sectional patient data was collected from November 2019 to February 2021. This study was conducted in Neurology Department in Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan. This study contains patient medical histories of 60 patients who were admitted in two and a half year time. Monitoring for any seizure occurrence was carried out for all the patients included in this study. Patient medical histories were examined and CT, MRI and MRV Brain were performed. Results:  Superior sagittal sinus was spotted as a hot spot location for CVT. Mean age calculated was 30 while more frequency was recorded in female patients. Conclusion:  CVT is a condition with more prevalence in younger population with more affected females than males. Most common presentation of CVT is headache. Superior sagittal sinuses involved in majority of cases reported. Specificity of modalities used and neurological manifestations needs a validation through a larger cohort study.

Background and Objective:  Guillain-Barré syndrome (GBS) is an immune system-mediated polyradiculoneuropathy that accounts for approximately 100,000 new patients per year globally. GBS has also been linked to respiratory failure in 20% to 40% of cases. The objective of this study was to find an association between Erasmus GBS respiratory insufficiency score (EGRIS) and the need for mechanical ventilation. Methods:  We conducted our cross-sectional study at department of Neurology, Pakistan Institute of Medical Sciences from November 2019 to February 2020. Sixty patients were selected for this study. Data including demographic profile, variant of GBS, and EGRIS was calculated from all the study participants. Data was entered and analyzed using SPSS version 25. Results:  All 60 patients enrolled in the study underwent continuous monitoring during admission time. Out of 60 patients, three (5%) endured mechanical ventilation with a mean EGRIS of 4.5. Others who didn't need mechanical ventilation had mean EGRIS of 1.5. The three patients requiring mechanical ventilation were one each from Acute Inflammatory Demyelinating polyradiculoneuropathy, Acute Motor Axonal Neuropathy, and Acute Motor and Sensory Axonal Neuropathy variants of GBS. p-value was non-significant for the presented data. Conclusion: EGRIS could not meet statistical significance in identifying the requirement of mechanical ventilation for GBS in this study. This may be due to low sample size.