Cerebral venous sinus thrombosis (CVST) is a rare cause of stroke that accounts for 0.5–1.0% of all strokes. Clinical presentation, predisposing factors, neuroimaging findings, and outcomes of CVST are extremely diverse, which causes a high index of suspicion in diagnosis. Therefore, early diagnosis of CVST is crucial for prompt treatment to prevent morbidity and mortality. Objective: The purpose of this prospective study is aimed at assessing the clinical characteristics, potential risk factors, and neuro-radiological features along with the topography of venous sinus involved in CVST patients in a tertiary care hospital, Lahore, Pakistan. Material and Methods: Consecutive patients enrolled in this study had a computed tomography (CT) scan, magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) along with a clinical presentation to confirm the diagnosis of CVST. Categorical data were presented as percentages. Continuous variable and categorical data were compared (parenchymal lesions vs. non-parenchymal lesions) using the Student’s t-test and Chi-square test, respectively. Results: A total of 3261 patients with stroke were presented during the study period. Out of all patients, 53 confirmed patients with CVST (1.6%) were recruited; the predominant population was female (84.91%), having a male to female ratio of 1:4. Mean age of the cohort was 28.39 ± 7.19 years. Most frequent symptoms observed were headache (92.45%) followed by vomiting (75.47%), seizures (62.26%), papilledema (54.72%), visual impairment (41.51%), and altered consciousness disturbance (52.83%). The presumed risk factors associated with CVST were puerperium (52.83%), use of oral contraceptives (13.21%), antiphospholipid syndrome (7.55%), elevated serum levels of protein C and S (5.66%), and CNS infection (3.77%). On cranial CT scans, 50 patients (94.33%) showed abnormalities while 32 patients exhibited various parenchymal lesions. Seizures were more frequent in CVST patients with parenchymal lesions compared with subjects lacking parenchymal lesions. Seventy-two sinuses, either single or in combination, were involved in CVST patients, being more common in patients with parenchymal lesions than those without parenchymal lesions. The most frequent locations of CVST were the superior sagittal and transverse sinus. Conclusion: In short, non-contrast CT brain may be used as a first line investigation in suspected cases of CVST. Our study also demonstrates some regional differences in the clinical features, risk factors, and neuroimaging details of CVST as described by some other studies. Therefore, care must be taken while diagnosing and predicting the outcome of the CVST.

Objective: To determine pregnancy outcome in COVID-19 suspected and confirmed women presenting to a tertiary care hospital. Methods: An analytical study comparing clinical outcome of confirmed COVID-19 with suspected COVID-19 pregnant women was carried out during three-month period from 1st July to 30th September 2020 at COVID-19 ward on pregnant women of Sir Ganga Ram Hospital Lahore. Information including clinical features, obstetrical outcome, ventilatory support and mortality was collected on a predesigned Proforma. The data were analyzed by using SPSS version 24. Qualitative data were expressed as frequency, percentages and chi-square, While quantitative variables as mean ± SD. Results: Eighty-three patients were enrolled, including 41 confirmed and 42 suspected COVID-19 cases. The mean age was 28.59 years +4.9. The mean gestational age on admission was 31.98 weeks. Obstetrical complications included miscarriage in 5 (11.6%) cases, preterm labor in 5 (11.6%), PPROM in 1 (2.3%) and IUD in 2 (4.7%) in COVID-19 suspect group. A total of 17/41 confirmed and 19/42 suspected COVID-19 were delivered during the study mostly through caesarean section. Supplemental oxygen, ICU admission, and invasive mechanical ventilation were more common in COVID-19 suspect group compared to confirmed COVID-19 group. There were 12(28.5%) mortalities in COVID-19 suspect group as compared to 2/41 (4.8%) in confirmed COVID-19 group. Conclusion: In patients having epidemiological exposure, clinical features of COVID and suggestive chest X-ray/CT chest findings even with negative COVID-19 PCR, high index of suspicion of COVID-19 must be mainstay to prevent delayed management and disease spread till the availability of more sensitive test.