Background Central nervous system affection in rheumatoid arthritis is rare. The most frequently encountered neurological complications with rheumatoid arthritis are peripheral neuropathy and atlantoaxial subluxation with subsequent spinal cord compression. Cerebral rheumatoid vasculitis is not a common complication. Case presentation A 60-year-old Egyptian female with history of rheumatoid arthritis for 15 years presented with headache and receptive aphasia. Computed tomography scan of the brain showed recent intracerebral hemorrhage. Digital subtraction cerebral angiography showed moyamoya syndrome angiographic pattern as sequelae of intracranial vasculitis. The patient did well with conservative management. Conclusion Cerebral rheumatoid vasculitis is rare, but can be a life-threatening condition. Early management of rheumatoid arthritis is essential to prevent such serious complication.

Background: Recently, numerous studies have associated polymorphisms in 11beta-hydroxysteroid dehydrogenase type 1 (HSD11β1) gene and T2DM risk. However, there is still a lack in the published literature evaluating the association between HSD11β1gene polymorphism and the risk of T2DM. Objective: The Aim of the study was to assess the association of HSD11β1gene polymorphism (rs846910) with Type 2 diabetes mellitus (T2DM) in a sample of the Egyptian population. Patients and methods: Our study was conducted on 100 subjects; their mean age was 50.26 ± 9.1 years old. They were selected from Diabetes Outpatient Clinics of our institution for 6 months in the period from June 2019 to December 2019. They were divided into two groups: 60 type 2 diabetic obese patients with BMI > 25 kg/m 2 (Group I) and 40 age-and sex-matched controls (Group II). Results: There was no statistically significant difference between cases and controls in terms of HSD11β1 polymorphism (rs846910). The regression analysis showed that the HSD11β1 polymorphism did not significantly increase the risk of diabetes mellitus (DM). Detection of HSD11β1 gene polymorphism in the study showed that homozygous GG genotype was more prevalent than GA genotype. However, there was no significant difference between GG and GA in terms of fasting and postprandial sugar and in terms of lipid profile. Conclusion:The present study showed no significant association between HSD11β1 polymorphism (rs846910) and T2DM. Moreover, the HSD11β1polymorphism (rs846910) is not correlated with glycemic status or lipid profile.

Background Diabetes and stroke prevalence rates are increasing worldwide, and both are major human health threats causing disability and death. Diabetes is a well-known independent risk factor for stroke. In addition, diabetes increases the prevalence of other stroke risk factors; however, few studies evaluate whether diabetes may influence stroke presentation. Aim of the work This study was conducted to assess the risk factors and clinical presentation of stroke in patients with and without diabetes. Patients and methods This cross-sectional study was conducted on 200 patients with radiologically confirmed acute cerebrovascular stroke, selected from tertiary care hospitals in Alexandria, Egypt. They were divided into 2 groups: group 1: 100 patients with diabetes for more than 5 years and group 2: 100 nondiabetic patients. All patients were evaluated for risk factors, stroke types, and clinical presentation. Results Compared with nondiabetic patients, diabetic patients with stroke had a significantly higher prevalence of hypertension (p = 0.031) and dyslipidemia (p = 0.016) and higher incidence of ischemic stroke (p = 0.030), and they were more likely to present with motor deficit (p = 0.045) and dysarthria (p = 0.048). There was a modest difference between diabetic and nondiabetic group regarding OCSP ischemic stroke subtypes, but it was non-significant. Conclusion There was a significant difference in stroke risk factors, pathological types, and presentation between diabetic and nondiabetic patients, but not in ischemic stroke anatomical subtypes.

Background: Inadequate intakes of iodine during pregnancy may cause thyroid dysfunctions that adversely affect pregnancy outcomes. Aim of the work was to evaluate the urinary iodine level as a marker of iodine status in a sample of Egyptian pregnant women during 3rd trimester and assess its relation to thyroid functions.Methods: This cross-sectional study was conducted on 100 pregnant females at their 3rd trimester aged (18-35) years. They were divided according to their urinary iodine concentration into 3 groups; Group (I): Pregnant females with deficient iodine (<150 μg/l), Group (II): Pregnant females with adequate iodine (150-249) μg/l, Group (III): pregnant females including who have above requirements (250-499 μg/l), and excessive (≥500 μg/l). TSH, free t4, free t3, Anti-Thyroglobulin (TgAb) and anti-thyroid perioxidase (TPOAb), medium urinary Iodine concentration (UIC) by ELISA and neck U/S were performed to all participants.Results: 18% of the pregnant women in our study had iodine deficiency during 3rd trimester (UIC<150 ug/l) whereas 55% of pregnant women had excess iodine level, and adequate iodine level was observed in 27%.  Serum TSH was significantly higher in group I with deficient iodine level (p value<0.01). All pregnant women included at group I were suffering from subclinical hypothyroidism. Serum TSH and thyroid volume were inversely correlated with urinary iodine among pregnant females at 3rd trimester (p value<0.01).Conclusions: Serum TSH and thyroid volume were inversely correlated with urinary iodine level among pregnant females at 3rd trimester.

Background PrePubertal children with type 1 diabetes mellitus are shorter than their non- diabetic peers. we aimed to evaluate the role of HbA1c and IGFBP-3 in this phenomenon. Aim of the work: The aim of the study was to evaluate the effect of glycemic control on the growth and IGFBP-3, represented by height, weight, height and weight percentiles for age in a sample of prepubertal Egyptian children with T1DM. Patients and Methods This study was a cross sectional study conducted on 80 pre-pubertal Egyptian children, divided into 25 Males and 25 Females with T1DM and 30 age matched controls (15 Males and 15 Females), the participants were recruited from the Outpatient Clinic of the Pediatric Department of Ain Shams University Hospitals and the National Institute of Diabetes and Endocrinology in Cairo, Egypt during the period from July 2018 to August 2019. Anthropometric measures including height and weight were obtained and used to calculate the height and weight percentiles using the CDC calculators. HbA1c as well as IGFBP-3 levels were tested. Results The mean age (years) of the participants was (9.671±2.24) for male patients, (9.22 ± 2.19) for female patients and (8.39 ± 2.034) for controls. The height found to be lower in the children with T1DM when compared to the disease-free controls with median values of (129.287 ± 13.410) in male patients, (127.727 ±10.155) in female patients and (136.760 ± 13.431) in the controls. the height and weight percentiles (%) were found to be lower in the children with T1DM when compared to the disease-free controls, the height percentile with median values of 14.54 (IQR 27.95) in male patients, 17.93 (IQR 29.20) in female patients and 87.07 (IQR 20.48) in the controls. the weight percentile with median values of 40.68 (IQR 40.83) in male patients, 30.64(IQR 35.59) in female patients and 85.18 (IQR 20.17) in the controls. A negative correlation between HbA1c (%) and serum IGFBP-3 (ng/ml), height and height percentile were found with (0.014, 0.049 and 0.012) as well as a positive correlation between serum IGFBP-3 and height, height and weight percentiles (%), were found with (,0.004, 0.009 and 0.005 respectively). Serum IGFBP-3 levels were also found to be significantly lower in patients (P &lt; 0.001) with a mean value of (198.6 ± 45.335) in male patients and (168.4 ± 44.317) in female patients and (285.333 ± 61.936) in the disease-free controls. Conclusion Serum IGFBP-3 levels (ng/ml) as well as growth are negatively affected in prepubertal children with T1DM in relation to the glycemic control.