Hepatitis C virus (HCV) infection can affect the neurological system, and neuropathy is one of these manifestations. Hepatitis C virus infection is associated with diabetes mellitus (DM) type II, and diabetic patients are at higher risk of acquiring HCV infection. Sweat function has been proposed to assess early autonomic neuropathy. This study aimed to evaluate small fiber neuropathy in asymptomatic HCV-related cirrhotic patients with or without DM through sweat function assessment by Sudoscan test. Three groups were involved: 47 healthy controls, 48 HCV-related cirrhotic patients without DM (group 1), and 49 HCV-related cirrhotic patients with DM type II (group 2). All participants were subjected to liver panel tests, renal function tests, cell blood counts, HbA1c, and abdominal ultrasound. Sweat function was assessed in all patients and controls by measuring hand and feet electrochemical skin conductance (ESC, microSiemens [µS]) using Sudoscan. Peripheral neuropathy was detected in none of the controls, 39% of group 1 patients, and 62% of group 2 patients (P < 0.0001). The mean feet ESC (FESC) was 88.3 ± 6.8 µS in controls, 67.2 ± 19.2 µS in group 1, and 57.9 ± 19.4 µS in group 2 (P < 0.0001). A significant correlation was observed between FESC and bilirubin, albumin, creatinine, international normalized ratio, transaminases, and splenic size. Electrochemical skin conductance measurement is a valuable, noninvasive method for early detection of small fiber neuropathy in asymptomatic HCV-related cirrhosis, with or without DM.

Article informationBackground: Increased intracranial pressure without a tumor or other disorders is a hallmark of the neurological condition known as idiopathic intracranial hypertension [IIH]. The major concern among patients with this condition is the hazardous effects on the optic nerve; so, prediction of optic nerve involvement is a priority for those individuals. Aim of the work:To assess the predictive value of the optical coherence tomography [OCT] in the follow up of optic disc edema in patients with idiopathic intracranial hypertension, measuring the thickness of the retinal nerve fiber layer [RNFL] and optic disc, and therefore warrant more expedited evaluation and treatment. Patients and methods:A prospective cohort study included 30 patients with IIH. Optical coherence tomography was completed at baseline and follow-up for six months. Results:The mean RNFL thickness was 107.84 ± 21.65 µm with mean ganglion cell complex [GCC] thickness of 89.94 ± 9.33 µm and mean optic nerve head [ONH] thickness was 615 ± 189 µm. There is a significant decrease in intracranial pressure [ICP] associated with a decrease in RNFL thickness and ONH thickness. Conclusion:OCT imaging can be done as non-invasive quantitative method instead of opening pressure in follow up of patients.

Background: Chronic daily headache (CDH) is a headache that lasts at least 15 days, 3 months, and 4 hours a day without treatment. Transcranial Magnetic Stimulation (TMS) uses short magnetic pulses over the head to temporarily alter brain cortical excitability. Prefrontal cortex rTMS has shown analgesic benefits. Objective: The purpose of the current study was to assess the effectiveness of repetitive transcranial magnetic stimulation in the management of chronic daily headache patients.

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