Background: Atrial fibrillation (AF) affects over 34 million people globally and is linked to a five-fold increase in the risk of ischemic disease, which is the primary cause of mortality and long-term disability. Aim: identify silent AF prevailing in acute ischemical stroke. Methods: The present research was conducted on (100) ischemic stroke patients. All patients were subjected to complete clinical examination, ECG and CT brain. In 56% of patients, the normal sinus rhythm and 44%, AF were previously diagnosed with 12%, while 26% were newly diagnosed (undiagnosed AF). Results: Average stroke age was 64.19 ± 12.26 with an incidence almost equal between males and females. The heart rate was within the normal range of 89% of the patients and only 11% experienced tachycardia. The bulk of patients (96%) show normal Echo values whereas just 4% show congestion. All patients (9% in ISU versus 91% in ward) were admitted to hospital, 96% of them remained alive and just 4% perished. Roughly 18% of strokes had ECG-assessed AF at presentation and approximately 44% had an earlier AF history. Conclusion: identification of AF is extremely essential in patients with unknown origin after a stroke, especially since the presence or absence of AF is of considerable clinical significance, particularly with respect to the use of oral anticoagulation and possible future episodes of persistent AF.

Hyperglycemia is common event in critical unit including patients with or without history of diabetes . in patients with septic shock , blood glucose level easily elevated by complex of pathophysiological mechanisms , we investigate the effect of normalization of blood glucose in septic shock patients including the morbidity , the mortality, the length of icu stay and the time on mechanical ventilation We included 60 patients divided into two groups.Group1:consist of 30 patients was applied to intensive glycemic control. Group 2: consist of 30 patients was applied to conventional glycemic control. We found that strict normalization of blood glucose have favourable outcome than conventional control in morbidity but not mortality. 20 % in group 1 needed hemodialysis and 80 % of patients required hemodialysis in group 2 which is statistically highly significant. Mortality rate 60% in group 1 and 80% in group 2 which is statistically insignificant. We found that intensive glycemic control have more favourable effects on patient morbidity but have no effect on mortality The misuse of antibiotic and the co-morbidities have direct negative effect in the response to medication and the progression of the disease Hypoglycemia is noticed more in intensive study.