Background Data on mechanical thrombectomy (MT) to treat M2 occlusions of the middle cerebral artery (MCA) are sparse. We report the outcome and safety of MT versus intravenous recombinant tissue plasminogen activator (IV rTPA) versus conventional medical treatment (CMT) of acute ischemic stroke (AIS) due to occlusion of the M2 segment of the MCA. This prospective longitudinal intervention study compared the outcomes and safety of MT, rTPA, and CMT in M2 occlusion AIS patients. National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS), and reca nalization rate assessed outcomes. Results 74 AIS patients were recruited (23 MT, 23 rTPA, 28CMT). MT group had significantly higher admission NIHSS (p = 0.018) and mRS (p = 0.023) than rTPA. At 24 h, NIHSS improved more with MT and rTPA than CMT (p < 0.0001). At 3 months, mRS were better with MT and rTPA versus CMT (p < 0.0001). Successful recanalization occurred in 73.9% of the MT group. 69% of the MT group required stent retrieval plus aspiration thrombectomy, and 60.9% required ≥ 3 trials, but outcomes did not differ by technique or number of trials. A good outcome (mRS 0–2) at 3 months was achieved in 69.6% MT versus 65.2% rTPA versus 7.1% CMT (p < 0.0001). Symptomatic intracranial hemorrhage (sICH) rates were slightly, but insignificantly, higher with CMT. Mortality did not significantly differ between groups. Conclusions For M2 occlusions, MT and rTPA achieved better early and 3-month outcomes than CMT; however, MT was not superior to rTPA. MT of M2 is feasible and effective, with a lower hemorrhage rate than rTPA and CMT. Trial registration: This study was prospectively registered in the clinical trial with ClinicalTrials.gov ID (NCT05091320). The link: https:// clinicaltrials.gov/study/NCT05091320 Keywords Mechanical thrombectomy, rTPA, M2 segment, Catheter retrieval

Introduction:Quality of life (QOL) is described as an individual's perception of their current state of affairs in relation to the cultural framework. Congenital heart disease (CHD) assessment will yield important data for identifying risk groups and developing intervention strategies that concentrate on the needs of these children's health. 
Aim of the study: to evaluate the quality of life in children with CHD in patients attending Assiut University Children Hospital and Cardiology Department.
Patients and methods: This study was analytic cross-sectional study, performed at Pediatric Cardiology Outpatient Clinic and Inpatient Pediatric Cardiology Unit in Assuit University Hospital over one year from 1^st January 2020 to 31^st December 2020 (one year study).It included 55 children (2:18 years) who were diagnosed as having heart disease. Results:The most common type of congenital cyanotic heart disease (HD) was tetralogy of Fallot then transposition of great arteries (TGA). Acyanotic HD were divided into two groups; congenital and acquired. The most common congenital acyanotic HD was ventricular septal defect (VSD) and the most common acquired acyanotic HD was rheumatic HD. All patients were assessed by using the Arabic version of the Pediatric qualify of life inventory (PedsQL). There were many cognitive and communication problems in both cyanotic and acyanotic patients.
Conclusion: Children with congenital heart disease (either cyanotic or acyanotic) are at risk of having lower quality of life, which is a common problem in CHD children.