Background: Stroke is one of the most common, most fatal, and debilitating neurologic diseases. Numerous risk factors are involved in the development of strokes, such as hypertension, cigarette smoking, hyperlipidemia, and diabetes. In addition, other factors may influence the disease's development or course, like uric acid serum level. Objective: To determine the association between serum uric acid (SUA) levels in patients with acute ischemic stroke and clinical outcomes. Material and method: This was a longitudinal descriptive study carried out among one hundred and twenty consecutive patients with acute ischemic stroke (AIS) admitted to the Department of Neuromedicine, Rajshahi Medical College Hospital ( during a period of two years from July'2015 to July' '2017 were included in the study.  12.11 years. Of 120 patients with AIS, 60.8% were male, and 39.2% were female. The study revealed that AIS patients with high SUA levels have significantly lower Glasgow Coma Scale (GCS) scores in comparison to normal SUA levels (p<0.001). There is also a considerably higher modified Rankin Score (mRS) at discharge (4.02 ± 1.47), at one month (4.03 ± 1.01), and at three months (4.21 ± 1.12) (p< 0.001). Thus in our study, mRS analysis showed a significant clinical deterioration in patients with high SUA levels. A comparison of clinical outcomes of AIS patients by MRS between high and normal SUA levels revealed that at three months of follow-up, there is significant deterioration in patients with high SUA levels (p<0.001). There was significantly less improvement with high SUA levels (p<0.001).In this study, a total of 20 patients died at different intervals; at discharge (11), at one month (3), and three months (6). The study showed that patients with high SUA levels had significantly increased mortality in comparison to patients having normal SUA levels. It was statistically significant at discharge and one month (p<0.01 and p<0.05) but not significant at three months (p>0.05). Conclusion: A significant association was found between high serum uric acid levels and the clinical outcome of AIS patients. Estimation of serum uric acid offers a simple, inexpensive, quick, and non-invasive method for identifying such high-risk patients. TAJ 2022; 35: No-1: 63-69

Introduction: Carotid artery stenosis is one of the important causes of ischemic stroke. This may be diagnosed by Doppler Ultrasound and Digital Subtraction Angiogram (DSA) both of which have some advantages and disadvantages. Objective: The aim of this study was to assess extra-cranial carotid artery with the help of DSA among patients of ischemic stroke and transient ischemic attack (TIA). Materials and Methods: This observational cross sectional study was conducted in the Department of Neurology in Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka from July 2013 to June 2015 for a period of two years. This study included a total of 50 patients. Diagnostic performance test of DSA was done at 50%, 50-69%, 70-99%, 100% cut off point of stenosis of right internal carotid artery (RICA) and Left internal carotid artery (LICA). Results: The mean age of cases was 61 ± 11.42 years. Out of 50 vessels, maximum cases were diagnosed as <50% stenosis of carotid artery (26 cases of RICA, 23 cases of LICA. Out of 50 vessels, 50%-69%, 70 but _ less than near occlusion and total occlusion were found among 10, 10, 4 vessels in RICA and 10, 9, 8 vessels in LICA respectively. The present study showed that 50 vessels of RICA was measured by DSA and diagnosed 28 (56%), 10 (20%), 7 (14%) and 5 (10%) carotid vessels as _ 50%, 50-69%, _70% but less than total occluded and total occluded cases respectively. This study also showed that 50 vessels of LICA was measured by DSA and diagnosed 23 (56%), 12 (24%), 8 (16%), 7 (14%) carotid vessels as _ 50%, 50-69%, _ 70% but less than total occluded and total occluded cases respectively. Conclusion: DSA as the gold standard has amply been performed in most diagnostic circumstances of carotid artery stenosis. So, the present study was done to evaluate extra cranial carotid arterial system by DSA in stroke patients in Bangladesh. Medicine Today 2022 Vol.34(2): 121-124

Background: Most people experience headache at some point in their lifetime. Among them a small proportion suffers from migraine. It is difficult to estimate actual prevalence of headache. Objectives: The aim of our study was to measure frequency of migraine among school going children in Rajshahi city and to evaluate different presentations of migraine. Materials and Methods: This is a population based cross-sectional type of descriptive study in which the survey was conducted among school going children aged 12 -16 years at Rajshahi City from January, 2014 to December, 2015. The diagnostic criteria for migraine defined by International Headache Society (IHS) were used. After taking informed consent purposively collected total 271 migraine patients were enrolled for the proposed study. Screening questionnaire (Questionnaire A) was given to total 2000 students (girls 1000 and boys 1000). A detailed Questionnaire B was distributed to those who had headache. Result: Mean (+SD) age of student of migraine was 13(+1) years, highest proportion (43.54%) of student was between 13 to 15 years of age. Higher frequency of migraine was observed in girls (51.4%) as compared to boys (27.8%). Pulsatile headache is the commonest type of headache. Majority of students reported unilateral headache. 80.4% students reported their headache to aggravated by movement. Associated features were photophobia or phonophobia 63.5%, both 26.6%, nausea 82.7%, vomiting 30.6%. Most students (29.5%) reported sleep disturbance as the aggravating factor of migraine and they reported that their attack is relieved by rest. Conclusion: Early diagnosis and treatment of migraine as well as the education of health workers and families are very important. In our environment the numerical importance of this disease suggests the need to perform further and broader epidemiological studies. KYAMC Journal. 2022;12(04): 237-242

Despite recent advances, only two-third of all strokes can be attributed to known causal risk factors. Homocysteine (tHcy), a sulfur-containing amino acid, is now considered to be an important risk factor for vascular diseases, along with the established risk factors like hyperlipidemia, hypertension, diabetes mellitus, and smoking. Elevated homocysteine levels play a causal role in the pathogenesis of atherosclerosis, thromboembolism and vascular endothelial dysfunction with an increased incidence of ischemic stroke.  This study aimed to find out the association of hyperhomocysteinemia with ischemic stroke. A total of 100 subjects were included in this study, 50 were ischemic stroke patients enrolled as case, and 50 were normal healthy individuals enrolled as control. Serum homocysteine level was measured in both case and control groups. The comparison was made in both groups regarding other common risk factors like diabetes mellitus, hypertension, smoking, dyslipidemia, family history, etc.  Among 100 patients, 50 had ischemic stroke and 50 were healthy individuals. In this study, out of all patients, abnormal serum homocysteine level was found in 32% of cases and 12% of controls. The mean (±SD) serum homocysteine level was found 16.50±13.86 μmole/L in cases and 9.46±3.49 μmole /L in the control group. Significant (p<0.05) difference was found between the case and the control. The incidence of hyperhomocysteinemia is higher in ischemic stroke cases than that in age-sex-matched healthy controls. In our study, serum homocysteine was high in both younger age group patients (16.65±14.55 μmole/L vs. 9.52±3.19 μmole/L) and older age group patients (16.33±9.87 vs. 9.35±3.97 μmole/L,) in case and control group respectively. Significant (p<0.05) difference was found between the case and the control. Multiple logistic regression analysis showed that abnormal serum homocysteine is an independent risk factor of ischemic stroke. So we conclude that hyperhomocysteinemia is an important and independent risk factor for the development of ischemic stroke. Hypertension and smoking are important contributory to elevated serum homocysteine. TAJ 2021; 34: No-1: 33-39