ackground: Stroke is one of the major causes of permanent disability and mortality in the aging population worldwide. Reduced libido, and poor erection and ejaculation are among common poststroke sexual dysfunctions, which is due to multiple factors, including both organic and psychosocial factors. Objective: We designed the study in order to detect the presence of erectile dysfunction (ED) among male patients with stroke using the International Index of Erectile Function (IIEF-5) and correlate the site of the lesion with the degree of ED. Also, we evaluated the serum total testosterone and prolactin levels among those patients and correlated their levels with the degree of ED using IIEF-5. Patients and Methods: Eighty male patients with ischemic cerebrovascular stroke were included in the study. The patients were diagnosed and divided according to the brain site lesion of cerebrovascular stroke into seven groups. The stroke patients completed the IIEF-5. Serum testosterone and prolactin levels were obtained and compared. Results: The mean age of the patients was 55.35±3.68 years. ED was detected in 53 patients representing 66.3% with variable degrees of severity (22.5% mild, 6.3% mild to moderate, 7.5% moderate, and 30.0% severe), while 27 (33.8%) patients had no ED. The mean testosterone level was lower than normal in basal ganglion affection and multiple areas affection only, while the mean prolactin level was higher than normal in all groups. Conclusion: ED is a common problem that may follow cerebrovascular stroke. We do recommend that counseling by a trained professional should be made part of stroke rehabilitation Keywords Cerebrovascular stroke; erectile dysfunction; international index of erectile function-5; prolactin; testosterone

ackground: Stroke is one of the major causes of permanent disability and mortality in the aging population worldwide. Reduced libido, and poor erection and ejaculation are among common poststroke sexual dysfunctions, which is due to multiple factors, including both organic and psychosocial factors. Objective: We designed the study in order to detect the presence of erectile dysfunction (ED) among male patients with stroke using the International Index of Erectile Function (IIEF-5) and correlate the site of the lesion with the degree of ED. Also, we evaluated the serum total testosterone and prolactin levels among those patients and correlated their levels with the degree of ED using IIEF-5. Patients and Methods: Eighty male patients with ischemic cerebrovascular stroke were included in the study. The patients were diagnosed and divided according to the brain site lesion of cerebrovascular stroke into seven groups. The stroke patients completed the IIEF-5. Serum testosterone and prolactin levels were obtained and compared. Results: The mean age of the patients was 55.35±3.68 years. ED was detected in 53 patients representing 66.3% with variable degrees of severity (22.5% mild, 6.3% mild to moderate, 7.5% moderate, and 30.0% severe), while 27 (33.8%) patients had no ED. The mean testosterone level was lower than normal in basal ganglion affection and multiple areas affection only, while the mean prolactin level was higher than normal in all groups. Conclusion: ED is a common problem that may follow cerebrovascular stroke. We do recommend that counseling by a trained professional should be made part of stroke rehabilitation Keywords Cerebrovascular stroke; erectile dysfunction; international index of erectile function-5; prolactin; testosterone

ackground: Stroke is one of the major causes of permanent disability and mortality in the aging population worldwide. Reduced libido, and poor erection and ejaculation are among common poststroke sexual dysfunctions, which is due to multiple factors, including both organic and psychosocial factors. Objective: We designed the study in order to detect the presence of erectile dysfunction (ED) among male patients with stroke using the International Index of Erectile Function (IIEF-5) and correlate the site of the lesion with the degree of ED. Also, we evaluated the serum total testosterone and prolactin levels among those patients and correlated their levels with the degree of ED using IIEF-5. Patients and Methods: Eighty male patients with ischemic cerebrovascular stroke were included in the study. The patients were diagnosed and divided according to the brain site lesion of cerebrovascular stroke into seven groups. The stroke patients completed the IIEF-5. Serum testosterone and prolactin levels were obtained and compared. Results: The mean age of the patients was 55.35±3.68 years. ED was detected in 53 patients representing 66.3% with variable degrees of severity (22.5% mild, 6.3% mild to moderate, 7.5% moderate, and 30.0% severe), while 27 (33.8%) patients had no ED. The mean testosterone level was lower than normal in basal ganglion affection and multiple areas affection only, while the mean prolactin level was higher than normal in all groups. Conclusion: ED is a common problem that may follow cerebrovascular stroke. We do recommend that counseling by a trained professional should be made part of stroke rehabilitation Keywords Cerebrovascular stroke; erectile dysfunction; international index of erectile function-5; prolactin; testosterone

ackground: Stroke is one of the major causes of permanent disability and mortality in the aging population worldwide. Reduced libido, and poor erection and ejaculation are among common poststroke sexual dysfunctions, which is due to multiple factors, including both organic and psychosocial factors. Objective: We designed the study in order to detect the presence of erectile dysfunction (ED) among male patients with stroke using the International Index of Erectile Function (IIEF-5) and correlate the site of the lesion with the degree of ED. Also, we evaluated the serum total testosterone and prolactin levels among those patients and correlated their levels with the degree of ED using IIEF-5. Patients and Methods: Eighty male patients with ischemic cerebrovascular stroke were included in the study. The patients were diagnosed and divided according to the brain site lesion of cerebrovascular stroke into seven groups. The stroke patients completed the IIEF-5. Serum testosterone and prolactin levels were obtained and compared. Results: The mean age of the patients was 55.35±3.68 years. ED was detected in 53 patients representing 66.3% with variable degrees of severity (22.5% mild, 6.3% mild to moderate, 7.5% moderate, and 30.0% severe), while 27 (33.8%) patients had no ED. The mean testosterone level was lower than normal in basal ganglion affection and multiple areas affection only, while the mean prolactin level was higher than normal in all groups. Conclusion: ED is a common problem that may follow cerebrovascular stroke. We do recommend that counseling by a trained professional should be made part of stroke rehabilitation Keywords Cerebrovascular stroke; erectile dysfunction; international index of erectile function-5; prolactin; testosterone

Egypt displays a high‐hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV‐related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous manifestations remains elusive. Our aim was to find out the prevalence of different dermatological manifestations accompaning HCV infection in Egyptian patients. Also, to highlight the impact of DAAs on such manifestations and any potential dermatological side effects. A descriptive study was carried out at the Department of Tropical medicine and Gastroenterology in collaboration with the Department of Dermatology, Venerology and Andrology, Assiut University Hospitals. Medical history, full general, dermatological examination and photography were performed for all patients before the start of treatment with the full regimen of DAAs, every month and 3 months after reaching sustained virological response (SVR), and the changes of skin lesions were recognized and rated by two blinded dermatologists. Out of 1000 examined patient, 36.9% had skin manifestation. Itching was the commonenst presented in 190 patients (51.5%). Three months after reaching SVR, skin examination revealed improvement in the majority of patients (23 764.22%). Pruritis had significant clinical improvement in 152(80%) of patients with significant change in the Visual Analog Score (P = .000). Also, patients with both cutaneous vasculitis and eczema experienced improvement in their skin manifestations. Skin manifestations are common in Egyptian patients with HCV infection. Pruritis is the commonest. The use of DAAs in treatment of HCV is associated with significant improvement of skin lesions with very limited cutaneous adverse effects.

Egypt displays a high‐hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV‐related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous manifestations remains elusive. Our aim was to find out the prevalence of different dermatological manifestations accompaning HCV infection in Egyptian patients. Also, to highlight the impact of DAAs on such manifestations and any potential dermatological side effects. A descriptive study was carried out at the Department of Tropical medicine and Gastroenterology in collaboration with the Department of Dermatology, Venerology and Andrology, Assiut University Hospitals. Medical history, full general, dermatological examination and photography were performed for all patients before the start of treatment with the full regimen of DAAs, every month and 3 months after reaching sustained virological response (SVR), and the changes of skin lesions were recognized and rated by two blinded dermatologists. Out of 1000 examined patient, 36.9% had skin manifestation. Itching was the commonenst presented in 190 patients (51.5%). Three months after reaching SVR, skin examination revealed improvement in the majority of patients (23 764.22%). Pruritis had significant clinical improvement in 152(80%) of patients with significant change in the Visual Analog Score (P = .000). Also, patients with both cutaneous vasculitis and eczema experienced improvement in their skin manifestations. Skin manifestations are common in Egyptian patients with HCV infection. Pruritis is the commonest. The use of DAAs in treatment of HCV is associated with significant improvement of skin lesions with very limited cutaneous adverse effects.

Egypt displays a high‐hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV‐related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous manifestations remains elusive. Our aim was to find out the prevalence of different dermatological manifestations accompaning HCV infection in Egyptian patients. Also, to highlight the impact of DAAs on such manifestations and any potential dermatological side effects. A descriptive study was carried out at the Department of Tropical medicine and Gastroenterology in collaboration with the Department of Dermatology, Venerology and Andrology, Assiut University Hospitals. Medical history, full general, dermatological examination and photography were performed for all patients before the start of treatment with the full regimen of DAAs, every month and 3 months after reaching sustained virological response (SVR), and the changes of skin lesions were recognized and rated by two blinded dermatologists. Out of 1000 examined patient, 36.9% had skin manifestation. Itching was the commonenst presented in 190 patients (51.5%). Three months after reaching SVR, skin examination revealed improvement in the majority of patients (23 764.22%). Pruritis had significant clinical improvement in 152(80%) of patients with significant change in the Visual Analog Score (P = .000). Also, patients with both cutaneous vasculitis and eczema experienced improvement in their skin manifestations. Skin manifestations are common in Egyptian patients with HCV infection. Pruritis is the commonest. The use of DAAs in treatment of HCV is associated with significant improvement of skin lesions with very limited cutaneous adverse effects.

Egypt displays a high‐hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV‐related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous manifestations remains elusive. Our aim was to find out the prevalence of different dermatological manifestations accompaning HCV infection in Egyptian patients. Also, to highlight the impact of DAAs on such manifestations and any potential dermatological side effects. A descriptive study was carried out at the Department of Tropical medicine and Gastroenterology in collaboration with the Department of Dermatology, Venerology and Andrology, Assiut University Hospitals. Medical history, full general, dermatological examination and photography were performed for all patients before the start of treatment with the full regimen of DAAs, every month and 3 months after reaching sustained virological response (SVR), and the changes of skin lesions were recognized and rated by two blinded dermatologists. Out of 1000 examined patient, 36.9% had skin manifestation. Itching was the commonenst presented in 190 patients (51.5%). Three months after reaching SVR, skin examination revealed improvement in the majority of patients (23 764.22%). Pruritis had significant clinical improvement in 152(80%) of patients with significant change in the Visual Analog Score (P = .000). Also, patients with both cutaneous vasculitis and eczema experienced improvement in their skin manifestations. Skin manifestations are common in Egyptian patients with HCV infection. Pruritis is the commonest. The use of DAAs in treatment of HCV is associated with significant improvement of skin lesions with very limited cutaneous adverse effects.

Egypt displays a high‐hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV‐related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous manifestations remains elusive. Our aim was to find out the prevalence of different dermatological manifestations accompaning HCV infection in Egyptian patients. Also, to highlight the impact of DAAs on such manifestations and any potential dermatological side effects. A descriptive study was carried out at the Department of Tropical medicine and Gastroenterology in collaboration with the Department of Dermatology, Venerology and Andrology, Assiut University Hospitals. Medical history, full general, dermatological examination and photography were performed for all patients before the start of treatment with the full regimen of DAAs, every month and 3 months after reaching sustained virological response (SVR), and the changes of skin lesions were recognized and rated by two blinded dermatologists. Out of 1000 examined patient, 36.9% had skin manifestation. Itching was the commonenst presented in 190 patients (51.5%). Three months after reaching SVR, skin examination revealed improvement in the majority of patients (23 764.22%). Pruritis had significant clinical improvement in 152(80%) of patients with significant change in the Visual Analog Score (P = .000). Also, patients with both cutaneous vasculitis and eczema experienced improvement in their skin manifestations. Skin manifestations are common in Egyptian patients with HCV infection. Pruritis is the commonest. The use of DAAs in treatment of HCV is associated with significant improvement of skin lesions with very limited cutaneous adverse effects.

Objectives: To establish a novel transcranial color-coded sonography (TCCS) grading system for collateral circulation in cases of symptomatic chronic total carotid occlusion (TCO), and to correlate this new grading system with cerebrovascular reserve capacity (CVR) measured by SPECT. Methods: Thirty-four patients with symptomatic chronic TCO recruited from the neurovascular ultrasound laboratory of the department of Neurology at Cairo University Hospital during 3 years' time period and diagnosed by color-coded duplex were subjected to: clinical assessment, grading of cerebral collaterals using a proposed TCCS criteria, Brain SPECT studies at rest and with dipyridamole stress. Results: The new grading system for cerebral collateral circulation showed a significant positive correlation with CVR (P 0.001 and Spearman correlation coefficient 0.686). Conclusion: The current study showed that this new TCCS grading system for cerebral collaterals is a reliable indicator for cerebral perfusion and reserve capacity in cases of chronic symptomatic TCO.