About Journal

European Journal of Molecular & Clinical Medicine (EJMCM) is an open access online journal publishing high quality manuscripts covering all aspects of molecular and clinical medicine. Submitted manuscripts are peer reviewed and selection is based on scientific excellence, distinctive contribution to knowledge and importance to the field. Distinctions: The most widely read, cited, and known Molecular & Clinical Medicine journal and website is well browsed with all the articles published. More than 30,000 readers per month. ISSN: 2515-8260 ; Frequency: Rapid at a time publication (6 issues/year) Indexed and Abstracted: Scopus, CrossRef, JISC KB+, SHERPA RoMEO, Cengage Learning, Directory of Open Access Journals (DOAJ), and Google Scholar.  To ensure permanency of all publications, this journal also utilises CLOCKSS, and LOCKSS archiving systems to create permanent archives for the purposes of preservation and restoration. In addition, all journals are available for harvesting via OAI-PMH. Rapid publication: Average time from submission to first decision is 30 days and from acceptance to In Press online publication is 45 days.Open Access Journal: European Journal of Molecular & Clinical Medicine is an open access journal, which allows authors to fund their article to be open access from publication.

Current Issue

Predictive Value of Coronary CT Angiography and Calcium Scoring for Coronary Artery Problems and Adverse Cardiac Events in Low-risk Chest Pain Patients

Aref Albakri; Giso Frhr.von der Recke; Heyder Omran

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 1-4

Background: Current evidence supporting the predictive value of coronary artery calcium scores (CACs) and coronary computed tomography angiography (CCTA) for adverse cardiac events in low-risk CAD patients is based on short follow-up periods. However, a long latency between the onset of coronary artery disease (CAD) and the occurrence of adverse eventswarrants longer follow-up periods. Methods: We reported our experience on the predictive power of CACs and CCTA for cardiac deaths and hospitalization in low risk chest pain patientsfollowed for five years. In total, we enrolled 346 patients (mean age=62.07: male=53%)presenting with chest pain, no prior CAD on CCTA and negative to low CACs. The primary endpoint was cardiac death and hospitalization for cardiac causes. Results: During followup, six patients died due to non-cardiac causes (old age, cancer or stroke) and excluded from analysis (person-time follow-up rate=99.13%). In the remaining 340, none achieved the primary endpoint. There were no reported cases of cardiac deaths or hospitalization for cardiac causes (event rate = 0%). All patients were free of coronary artery problems. Conclusion: In low-risk chest patients, CACs and CCTA is an excellent predictor for up to five year event-freeCAD, cardiac death and hospitalization for cardiac causes.

Genetic and Cell biology Discriminants of Sars-CoV2 Infection and Susceptibility to Covid-19 pulmonary complication

P Scalia; SJ Williams; R Luca’; Antonio Giordano; E Bucci

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 5-9

The agent of Covid19, Sars-CoV-2 has caused thousands of fatalities worldwide and overshadowed the number of deaths of other previous coronavirus outbreaks (Sars-CoV1 2002 and MERS-CoV 2012). Although the new coronavirus pathogenicity is actively under investigation, part of its infectious behavior can be linked to its higher binding affinity to the angiotensin-converting enzyme 2 (ACE2) in the respiratory tracts. However, the expression of ACE2 per se may not be sufficient to justify the individual variability observed among affected patients in terms of clinical outcome in apparently non-immune depressed, non-elders subjects. The present update provides an overview of the most recent scientific findings related to genetic factors involved in the Sars-CoV-2 infectious process and their potential role in affecting the virus pathogenicity. The present update can provide valuable hints towards developing a predictive screening/susceptibility profile testing on individuals not yet infected and/or in non symptomatic positive subjects towards managing the current morbidity and mortality risk and establishing personalized intervention protocols for the early treatment of the Sars-CoV-2-associated life-threatening pulmonary complication.

The COVID-19 Pandemic and Impact on the Cardiovascular Disease Patient: Special Emphasis on Rheumatic Valvular Heart Disease Care

K Prashanth; M Manjappa; A Srinivas

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 10-13

The COVID-19 crisis has surged worldwide putting immense stress on the health care services, leading to institutions deferring elective procedures and struggling to triage the emergency care of the cardiac patient. This has affected the management of the rheumatic valvular heart disease patient especially in Asia and other developing countries, potentially placing these patients at enormous risk for complications like congestive cardiac failure, stroke and death. In this current review, we explore the COVID-19 pandemic and its impact on the cardiovascular disease patient with special emphasis on rheumatic valvular heart disease care. We try to provide a framework that address the procedural considerations of interventions like percutaneous transluminal mitral commissurotomy (PTMC) and mitral and aortic valve surgeries. We also highlight the implications for the outpatient valve clinic and address the safety issues of the patient and health care workers during this on-going COVID-19 pandemic.

The Advent of Artificial Intelligence in Cardiology: The Current Applications and Future Prospects

K Prashanth; M Manjappa; C Srikar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 14-20

The technology of artificial intelligence is emerging as a promising entity in cardiovascular medicine, with the potential to improve diagnosis and patient care. In this article we review the literature on artificial intelligence and its utility in cardiology. We provide a detailed description of concepts of artificial intelligence tools like machine learning, deep learning and cognitive computing. This review discusses the current evidence, applications, future prospects and limitations of artificial intelligence in cardiology.

Influence of Ambient Temperature on Recording of Skin and Deep Tissue Temperature in Region of Lumbar Spine

A.V. Tarakanov; A.A. Tarakanov; S Vesnin; V.V. Efremov; N Roberts; I Goryanin

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 21-26

Medical Microwave Radiometry (MWR) allows non-invasive measurement of human internal body temperature which is potentially useful for diagnosing a range of pathologies. The technique is used to to meaure so-called brightness temperature and it is recommended that investigations are performed in a room with temperature controlled in the range 20 to 24°C. This is not always possible in impromptu investigations or if studies are to be conducted in certain remote facilities or outdoors. We have therefore investigated the influnce of room temperature on brightness temperature (BT) and skin temperature (ST) measurements were obtained using the respective microwave and infra red sensors of the MMWR2020 (former RTM-01-RES) system (www.mmwr.co.uk). MWR measurements of BT and ST were obtained for 93 healthy subjects in the sitting position. Recordings were taken above each of the L1 to L5 vertebral bodies and along corresponding left and right paravertebral lines. The data were subdivided according to whether room temperature was recorded as being from 17.1 to 21.9°С (n=24) (i.e. low temperature), 22.0 to 26.9°С (n =56) (i.e. moderate temperature) or 27.0 to 29.5°C (n=13) (i.e. high temperature). The average value of BT was identical at low and moderate temperatures. No correlation is observed between BT and room temerature. On the other hand average value of ST is linearly proportional to rise in room temperature (R2 = 0.36). In conclusion, the present study has shown that reliable values of BT, but not ST, can be obtained even when room temperature can vary between 17 and 30°C. However, to ensure patient comfort and to support simultaneous measurement of ST, MWR study of the lumbar region should be conducted with room temperature controlled to lie between 22 and 26°C.

Regression of Lumbar Disc Herniation Following Non-surgical Treatment

Eric Chun-Pu Chu; Divya Midhun Chakkaravarthy; Fa-Sain Lo; Amiya Bhaumik

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 27-29

Symptomatic disc herniation is the most common disc pathology and can result in substantial disability and poor quality of life. Here, we present a male patient who was diagnosed as having lumbar disc herniation at L3/L4 and L4/L5 levels with nerve root entrapment. The patient sought chiropractic treatment for severe back pain which lead to trouble walking. After 7 months of a medical/chiropractic intervention, complete pain relief and recovery of muscle weakness were achieved. At 11-month follow-up, the regression of the herniated discs was documented on MR imaging. This case presentation aims to raise a reappraisal of our knowledge of intervertebral disc herniation in regard to the natural history, the components of herniated material and possible mechanisms behind hernia regression, which holds the key to treating this problem. Through the translation of research evidence into practice, current guidelines recalibrate instructions on the diagnosis and treatment of symptomatic disc herniation.

Improvement of adherence to treatment in patients with nonmuscle invasive bladder cancer (NMIBC) by spreading the 12 months maintenance Bacillus Calmette-Guerin (BCG) regimen over 18 months

Rani Zreik; Boris Friedman; Nitza Hirshberg; Gal Rinott Mizrahi; Yael Hod; Ghazi Fari; Freifeld Yuval; Avi Stein; Yoram Dekel

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 30-34

Purpose - To evaluate what effect spreading the maintenance BCG regimen from 12 to 18 months has on the treatment completion rate. Patients and methods - Retrospective data about patients diagnosed with intermediate or high risk nonmuscle invasive bladder cancer were collected. Suggested regimen started with 6 weekly induction intravesical full dose BCG instillations followed by 3 weekly instillations, 3 months after the 6th instillation. Thereafter, 3 weekly instillations were delivered 6 months after the 9th and the 12th instillation. In total, 15 BCG instillations were administered within 18 months. Cystoscopy and urine cytology were performed one month following the 6th, 9th, 12th and 15th instillations and then according to guidelines Results - 195 patients met the inclusion criteria. 190 (97.4%) patients completed the induction instillations and 141 (72.3%) completed the treatment protocol. 39 patients discontinued treatment for medical reasons and 15 patients due to non-compliance. 162 patients completed follow up as recommended for a median of 46±20.1 months. Of those, 45 patients (27.8%) and 8 (4.9%) had disease recurrence and progression, respectively. Conclusion - Spreading BCG instillations during maintenance protocol might achieve a better treatment completion rate, mainly due to improved patient compliance. No impacts on recurrence and progression rates have been observed in our cohort. Prospective randomized trials are warranted before suggesting clinical application.

Depression in Hyperemesis Gravidarum: Determinants and Extent in Al-Nasiriyah, Across sectional study

Alaa Hussein Ali Al Nasir

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 35-43

Background: at a global level and among child bearing age women, the first leading disease burden cause is the depression. Nationally, scarce published data was related to the depression prevalence among pregnant especially with hyperemesis gravidarum women. Aim: to assess the depression extent among hyperemesis gravidarum pregnant Thi-Qarnian women. Methodology: A cross sectional, hospital based, analytical study was carried out in two teaching hospitals (Bent Al Huda and Al Habobi teaching hospitals) in from first week of September /2015 to end of July 2016. All attendants sufferer pregnant from HG to the obstetric outpatients included in this study. Based on previous Iraqi study (37.2%) for of depressive symptoms prevalence in pregnant women sample size had been calculated such prevalence rate with precision of 5%, confidence level of 95%, and added extra sample of 10%, to reach to 322. Beck depression inventory-II (Arabic version) (BDI –II score of > 20 depression was considered) had been used as a specialized questionnaire designed for the achieve the aim of the study. SPSS version 23 had been used for data analysis, P

Effect of Vaginal Trichomoniasis on Women who Suffer from Delayed Pregnancy

Khadeeja Abees Hmood AL-Khalidy; Hiba Riyadh Al-abodi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 44-49

This study aimed determine the effect of Trichomoniasis on women who suffering from a delay in pregnancy despite previous normal pregnancy with vaginal infection, in order to prove the relationship of Trichomonas vagenalis to the obstruction of pregnancy in women, also detect of effect Trichomoniasis to a level of Gonadotropic Hormone:(Luteinizing Hormone LH and Follicle Stimulating Hormone FSH) Which are the most necessary hormones responsible for the composition and maturity of sexual reproduction cells, (200)sample was taken from infected women during the period ( September 2017 to October 2018), these samples examined by wet smear method for diagnostic Trichomonis vagenalis and recorded 51/200(25.5%) positive samples, also these samples examined using Real-time PCR on the basis of 18S rRNA gene and recorded (29.5%)59/200, this study also interested to detect of effect Trichomoniasis to a level of Gonadotropic Hormone:(Luteinizing Hormone LH and Follicle Stimulating Hormone FSH) by serological test, a results showed to a significant decrease in the level of hormones when recorded (17.313± 11.221) MUI / ml and (8.011 ± 7.001) MUI / ml respectively in patients, while their concentration was (21.623 ± 17..156) MUI / ml and (10.388 ± 9.835) in the control group.

Desmopressin Efficacy in Treatment of Nocturic Women- A Single-Blind Placebo-Controlled Study

Mazin Adday Hasoon

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 50-57

Background: Nocturia is night waking for voiding, is a lower urinary tract problem of anxious symptom. nocturnal polyuria, diminished capacity of the bladder either nocturnal and/or global capacity, and sleep impairment are main pathophysiologic subtypes. fluid restriction mainly awhile before the bed time, anticholinergic therapy, diuretics and hormone replacement therapy are main preventive strategies. Aim of Study: To determine the oral desmopressin efficacy and safety of in nocturia of women as a treatment. Patients and methods: - Sixty-four women with18-80 years’ age with nocturia (nocturia index score >1, more than two voids per night) were invited to attend our study. randomly assigned patients into: 32 women received different desmopressin doses (0.2, 0.4, or 0.6 mg) during dose-titration period(three-weeks), and the other 32 ones received single- blind placebo treatment for 6 or 8 weeks according to their response. Results: In single-blind phase, for desmopressin, 30 (93.75 %) patients with fifty percent or more nocturnal voids reduction against the baseline levels in comparison to only 3 (9.7%)placebo-receiving patients where (P < 0.001). The mean nocturnal voids No., sleep period till 1st nocturnal void, nocturnal diuresis, and allover day volumes changed signscantly preferring desmopressin. (P

Nephrology between Reductionism and Complex Systems: the Role of Philosophy – Review of Evidence and Opinion

Natale Gaspare De Santo

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 59-69

Nephrology emerged as autonomous discipline in the 1950s, after the publication of the landmark treatise of Homer Smith entitled The Kidney Structure and Function in Health and Disease (1951). The official foundation took place in 1961. For decades, during the collection of the critical mass of data that granted its autonomy, Nephrology investigated acid–base and electrolyte disorders. However, driven by biopsy, dialysis machines and transplantation its growth has been unstoppable in terms of journals, articles, books, meetings, number of specialists, clinical divisions, university chairs, and specialty schools. The most propulsive force has been, however, the switching of the focus from the care of dialysis patients to the >10% of the population who, in a country, suffer from silent or overt disease leading to chronic kidney disease, requiring a demanding and costly therapy consuming 2–3 % of the total health budget. Historical analysis disclosed that Nephrology as a specialty was born and nurtured in contact zones with other disciplines. These include chemistry, physics, pathology, immunology, pharmacology, genetics, engineering, pediatrics, geriatrics, oncology and cardiology and many more. However research focused on kidney disease, although still lush and appealing, is felt to be stagnant. Another approach based on complexity and holism rather than on strict reductionism – indispensable to provide successful care – may better serve future needs. The potential of complexity is explored along with new techniques, Big Data, and a wider use of artificial intelligence, as well as the links with philosophy, and Systems Biology, Systems Medicine, Systems Pharmacology.

Ease of Intubation While Using Macintosh and (Mccoy’s Type) Laryngoscope Blade Undergoing with Anaesthesiology

N.V. Kanase; Saudamini Gandhi; Saurabh R Todi

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 70-73

Various anesthesia devices have been designed to overcome the difficult airway scenario in anesthesia practice. The ease of intubation, timing, and hemodynamic variability between the two groups during intubation are considered as primary results compare. The study was conducted in two groups, each group set aside of 65 patients, named Group A and Group B with normal physical status I-II to endothelial intubation. Determined to perform surgery under anesthesia by consent. This includes simple rigid laryngoscopes for complex fiber-optic incubating devices; However, there is weak evidence to support the superiority of one device over another. McCoy’s blade shows overall minimal haemodynamic response and provides better glottic view and ease of intubation as compared to Macintosh blade.

Metabolic Syndrome and Framingham Risk Score in Coronary Artery Disease Cases

Ganesh Shankarrao Thorat; Virendra C. Patil

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 74-79

Metabolic syndrome is a group of simultaneous conditions that expanding your risk of heart disease, stroke, and type 2 diabetes. These conditions include increased blood pressure, high glucose level, and abundance muscle versus fat around the abdomen or triglyceride levels. The objective of the study is to demographic, biochemical, obesity indices and angiographic profile (severity of CAD) of patients with coronary artery disease (CAD). A prospective and observational study involving a number of 971 patients who had undergone coronary angiogram (CAG) for the 18-month CAD assessment. In present study about half of population had significant abnormality on coronary angiogram. Amongst abnormal coronary angiogram about 50% of patients had single vessel disease. The FRS had positive correlation with severity of coronary artery disease and waist circumference. FRS and metabolic syndrome had critical contribution as score and risk factors with presence of and severity of CAD. To conclude it was suggested to incorporate FRS and components of metabolic syndrome for better management and risk stratification of coronary artery disease at large.

Serum Magnesium Level in Patients With Chronic Renal Failure

Nitin N. Jadhav; Hardik Mahendra Kumar Patel

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 80-85

Chronic kidney disease (CKD) is an overall medical issue, influencing a huge number of people. Magnesium (Mg ++) is the fourth most abundant and second most important intracellular extract in the body. In patients with CKD and end stage renal disease (ESRD), Mg ++ homeostasis may change. The present study is to assess the levels of serum magnesium in chronic kidney disease patients. The current cross-sectional study was performed to assess serum magnesium levels in cases with CKD and to detect the correlation of serum magnesium with clinical features and severity of renal impairment. The serum magnesium among patients with CKD had hyper magnesium. The serum magnesium level rises as kidney function deteriorates. There is significant fall in serum magnesium level after dialysis. Its estimation helps in evaluating conservative treatment and dialysis in CKD. Hence early evaluation and treatment of underlying cause for CKD is necessary to prevent further complication and kidney damage.

Serum Uric Acid Level and Severity of Ischemic Stroke

Aparna P. Patange; Kapale R.J.

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 86-89

A stroke is the third most common cause of death and the fourth most common cause of infection. Stroke is characterized by the WHO as a clinical condition involving the rapid development of clinical indications of a central aggravation of cerebral capacity lasting more than 24 hours or causing death without a clear reason other than a vascular source. In the present study, a large part of the cases of intense ischemic stroke were found among the males. In the present study, mean cholesterol values, triglyceride values are directly proportional to the severity of the ischemic stroke, among the study subjects. In the present study, 8% cases died, while 92% discharged at home. The current study proved the association of serum uric acid levels with the severity of the acute ischemic stroke.

Immunohistochemical Expression of KI-67 in Ovarian Surface Epithelial Tumors and its Correlation

Vohra Nikita Vinod; Sujata R. Kanetkar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 90-94

The ovaries are unique in the variety of lesions that can arise from them. The complex anatomy and physiology of ovary with constant changes from puberty to menopausal age give rise to number of different cells, which are capable of giving rise to tumors. The present study is a two years, prospective study carried out in a tertiary care hospital. It is a descriptive study which included all specimens of ovarian tumors, diagnosed as surface epithelial origin on histopathological studies. Most patients presented with non-specific and vague symptoms over a period of time. Patient’s education and awareness among primary care physicians with timely attention and further investigations, can help in early detection of ovarian malignancies in this subset of cases, thereby reducing morbidity and mortality associated with diagnosis in advanced stages.

Statistical Analysis on Novel Corona Virus: COVID-19

Vimal Kumar M N; JAYA R; Rubesh C M; Aakash Ram S

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 95-103

A novel coronavirus, 2019nCoV is identified as the root cause for such a deadly outbreak causing respiratory illness. Due to its widespread impact on the global community, stringent measures were implemented to reduce the effect of the outbreak; self-precautionary measures like using face-masks, hand hygiene, and self-quarantine; environmental measures were insisted to follow and also surface cleaning and community measures to prevent the widespread. The pandemic evolved in China towards the end of 2019 and COVID 19 started to spread all over the globe like a typical wildfire capturing over 190 countries. It grows in a human body with common symptoms like common cold leading to respiratory problems and at times even death. The virus grows exponentially. So, based on the symptoms and the activity of the virus various measures have been implemented. The death rate peaked in the USA and Iran at the end of March and due to comorbidities and many medications has helped in cutting down the numbers. The rate of spread did not shoot up in countries like India due to preventive and cautious care and also due to reduced human contact from the countries with incidence or spread of the vector to other countries.

The Role of Pulsed Radiofrequency for Greater and Lesser Occipital Nerves in the Treatment for Migraine

Rida Alkaabi; Haider Shafi Hussein

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 104-109

Background: Migraine pain is a primary headache disorder characterized by recurrent headaches that are moderate to severe. Objective: To evaluate the effect of noninvasive pulsed radio frequency (pulsed RF) in Migraine. Methods: In a prospective study of the intervention performed in adult population with Migraine (Diagnosed by specialists) carried on (30) patients undergone pulsed RF for greater and lesser occipital nerves to control recurrent migraine not responding to conventional treatment (resistant) in a period from Jan. 2017 to Jan 2019 in Al Safeer Hospital for surgical specialties and Alkafeel Hospital for surgical specialties both in Karbala / Iraq. The patients got in prone position under local anesthesia with goal positions with the target sites obvious out using anatomical breakthroughs and the position of greatest ache. Pulsed RF by RF needle to the affected side to reach greater and lesser occipital nerves then got 3 sessions (each for 3 minutes, temperature 42 C, voltage 42 V, resistance with 100 Ohms, Current with 230 mA) Patients monitored post-operatively for 2 hours then discharged. Follow up at intervals of 30 days, 6 months and 1 year by phone call or direct interview to assess the post procedure pain scale. Result: Significant pain relieve by means of no or little pain medication and actual life pattern change and performance in 1-year post procedure. Conclusion: A single trial of pulsed RF is effective for pain reliever.

Effects of Infection with Toxoplasma Gondii to the Levels of Thyroid Hormones

Taghreed Ahmed Mustafa Al-Issawi; Aysir Saleh Mohammed

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 110-114

The present study was designed to detect the effect of toxoplasmosis in the thyroid hormones level Samples were collected during the period from July2019 to January 2020. Where the separated serum was preserved at a temperature (-20) until use. The enzyme-linked immunosorbent technique (ELISA) was used to detect toxoplasmosis. Hormone levels (TSH, TSH, T3 and calcitonin) were also measured using ELISA technology, Hormonal study, the results of the current study showed significant increase (P

Pseudo Bulbar Palsy a Rare NEURO-COVID Presentation

Ahmed Rgeeb; Samer Al-Mudhafer; Hasanain A. Al-Saffar

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 115-120

Background: The Global pandemic of COVID-19 with more than half million people passed away from their families tragically, wide variety of signs and symptoms resulted from this Novel SARS Cov2 virus. Although the respiratory and Gastro-intestinal symptoms are dominant, however, neurological symptoms whether specific or nonspecific have been reported. Till now the extents of knowledge regarding the neurological sequel of COVID-19 infection are finite. Pseudo Bulbar Palsy is a neurological disease characterised by dysarthria, dysphagia, facial and tongue weakness in addition to emotional liability resulted from an upper motor neuron lesion in the corticoid bulbar tracts. Peripheral neuropathy, Demyelisation and vascularise are underlying aetiologies. This will result in deglutition, and speech disturbance. Case presentation: 60 years old male from Najaf, went to the emergency department with three days history of drowsiness and anorexia after COVID-19 related fever and myalgias. He had significant risk factors. He had 2 weeks fever following a contact with COVID-19 patient. Examination revealed drowsiness, dehydration, the patient was not aware for time and place, eye refluxes was symmetrical. The face was normal with exaggerated jaw jerk CT of the chest showed evidence of COVID-19 infection confirmed by positive PCR. Brain CT showed only brain atrophy without signs of localised ischemia. Farther blood investigations confirm activity of infection. During this the patient developed tonic clonic convulsion required anticonvulsant therapy; he remained semiconscious, with difficulty to swallow and dysarthria, Irritability, drowsiness and disorientation. He received anticoagulant, Steroids, mannitol. The condition improved and the patient discharged in better condition with two weeks anticoagulation. Discussion: this is a story for a rare complication belong to COVID-19 infection, treated as a stroke, as mention in literatures, many recorded cases of Neurocovid that required treatment accordingly. Conclusion: neurological symptoms of COVID-19are extreme and might be nonspecific but some time life threatening, these might overlap severe infection. The improvement in the neurological sequel overlap the COVID-19 improvement both clinical aspect and investigation.