Hongmei Ding, Bilal Muhammad, Xiaolong Wang, Shu Kan, Weiwei Chen, Yingfeng Mou, Ruiguo Dong and Deqin Geng*
Background: The incidence of recurrent stroke and mortality ratio of patients with a transient ischemic attack (TIA) and minor ischemic stroke (MIS) is a challenging issue, especially the long-term recurrence ratio.
Aims: This study aimed to estimate the long-term incidence of ischemic stroke recurrence and identify the risk factors associated with recurrent stroke in the Xuzhou region of China.
Settings and design: This was a cross-sectional study conducted on a group of patients with TIA or MIS between the ages of 20 and 80 years.
Methods and material: A total of 297 individuals participated. Medical records were one of the data sources. The data of patients who meet the selection criteria gathered from the Neurology department, affiliated hospital of Xuzhou medical university Statistical analysis used: Statistical package for Social Science (SPSS) version 23 was used for statistical analysis.
Results: In this study, 297 patients were included for analysis; 30 (9.17%) patients were lost to follow-up at 5 years. Post onset of the TIA and MIS analysis reveals that the cumulative incidences of recurrent stroke at 3,6,12, 36, and 60 months were 6.73% (20/297), 10.77% (32/297), 18.86% (56/297), 25.25% (75/297), and 33.33% (99/297), respectively. Multivariate regression analysis demonstrated that age, current smoking, poorly controlled hypertension, diabetes, vascular stenosis, and plaque vulnerability as independent risk factors for ischemic stroke recurrence. Further analysis based on different vascular stratification of carotid atherosclerosis showed that 5-year cumulative survival was 10% lower in patients with severe stenosis than in patients with plaque vulnerability.
Conclusion: This study aimed to estimate the long-term incidence of ischemic stroke recurrence and identify the risk factors associated with recurrent stroke in the Xuzhou region of China.
Shweta Kalita, Chiraag Ashokkumar* and Alan R. Hirsch
Objective: Pathophysiology behind reduced olfactory ability in hyperosmic individuals.
Background: Covid-19 infection as an enantiopathy to hyperosmia has not been described.
Design/Methods: A 63 year-right-handed male presented with hyperosmia of 150% of normal whereby aromas appeared distorted and disgusting. Shortly, he tested positive for Covid-19 which led to a resolution of his hyperosmia. Alcohol Sniff Test scores fluctuated between zero and three (anosmia). Gradually, his smell improved from 80% and 100% of normal. However, post Covid-19 infection, it returned to 130% of normal.
Results: Neurological abnormalities, Olfatory testing, Odor discrimination memory test, Total 7/12 (hyposmia). Bilateral olfactory threshold testing to phenylethyl alcohol 3 (hyposmia). Taste Threshold and Suprathreshold Testing: Mild hypogeusia to Sucrose. Ageusia to Hydrochloric acid, urea and propothiocarbamide. Olfactometer Identification Testing: Left nostril: 10 (anosmia), Right nostril: 8 (anosmia).
Conclusion: The mechanism whereby Covid-19 acts to reduce olfactory ability in normosmic individuals has been postulated as viral involvement of olfactory nerve at olfactory bulb, pathology of sustentacular cells, olfactory receptor site destruction vasculopathy/arteriopathy of cranial nerve or central connections of olfactory nerve or inflammatory response induced destruction of lamina propria and olfactory nerve apoptosis. The same may have incited a reduced olfaction in hyperosmic individuals-such may be under grouped as understanding the pathophysiology of this subject’s hyperosmia. Perceived hyperosmia is often objectively hyposmic pathology of inhibiting the inhibitory olfactory discharges that result in enhancement of perceived odor. Elimination of hyperosmia reduces functionality of remaining normosmic neurons which then became relatively hyposmic, but were perceived as normal due to lack of the inhibitory factors. Recovery of hyperosmia upon recovery of olfactory function from Covid-19 would be consistent with such a postulation. Of those with preexisting chemosensory dysfunction, query as to impact of Covid-19 on remaining sensory function is warranted.
Jinghong Zhang, Xusheng Huang and Qiang Shi*
Neurological Disorders received 1139 citations as per Google Scholar report
