De quervain's tenosynovitis and occupation: an epidemiological study

A cross - sectional study was carried out in five different occupational settings in City to determine the prevalence of de Quervain's tenosynovitis among workers performing repetitive hand and thumb movements and to identify the potential associated risk factors. Washer women, brick layers, nurses and computer keyboard operators were selected randomly as the exposed group and compared with a group of randomly selected non-exposed workers. A total number of one-hundred and fifty six workers were interviewed using a preconstructed questionnaire. Those workers who were diagnosed as de Quervain's tenosynovitis by clinical manifestations and positive Finklestein's test were subjected to magnetic resonance imaging [MRI] of the wrist. The results revealed that the highest prevalence of de Quervain's tenosynovitis was among washer women [36.4%] and brick layers [30.8%] followed by nurses [17.6%] then computer keyboard operators [15.3%] and the least was 1.3% among the non-exposed group. De Quervain's tenosynovitis symptoms were more frequently reported among exposed workers [59%] compared to the non-exposed [7.7%]. Among those complaining of symptoms suggestive of de Quervain's tenosynovitis, 12.8% were diagnosed as de Quervain's disease by Finklestein's test. MR imaging revealed that increased tendon thickness and thickening and edema of the synovial sheath were the most reliable findings. Multivariate logistic regression analysis revealed that the type of current occupation, actual hours worked per day, older age and female gender were likely to be associated with de Quervain's tenosynovitis. In conclusion, exposure to heavy manual work load in occupations that need repetitive hand motions alone or with forceful squeezing, forceful gripping and/or forceful grasping and turning were associaled with high prevalence of de Quervain's tenosynovitis. This condition was also related more to age, sex and actual hours worked per day. So, administrative regulations and surveillance for de Quervain's tenosynovitis in the work place may be of great benefit for early referral of cases for treatment and to reduce the occurrence of the condition

Chronic bronchitis, work - related respiratory symptoms and ventilatory function among a group of welders in Zagazig area

A cross - sectional study was conducted to determine the respiratory effects of welding exposure. Respiratory symptoms and ventilatory functions were studied in 79 welders exposed to welding fumes and 90 non - welders as a control group. Both groups were matched for age, sex, height and smoking habits. Response to a standardized respiratory symptoms questionnaire, spirometry and across-shift changes in ventilatory function were compared. The results showed that, chronic bronchitis was more frequent in welders [21.5%] than in non - welders [6.7%]. Multivariate analysis revealed that current smoking as well as exposure to welding fumes for more than ten years were likely to be associated with chronic bronchitis. The report of any work-related respiratory symptoms such as dry cough, phlegm production, chest wheeze, dyspnea and chest tightness was significantly higher in welders [48.1%] when compared with non - welders [11.1%]. Multivariate analysis identified only long duration of welding exposure as the main risk factor for reporting these symptoms. Ventilatory lung function testing demonstrated significantly diminished forced expiratory volume in one second [FEV[1]] and mid - expiratory flow rate [MEFR] compared with control values. In the across - shift study. FEV[1] was significantly declined over the work exposure to welding fumes. In conclusion, this study indicates that exposure to welding fumes was associated with chronic bronchitis, work-related respiratory symptoms and ventilatory function impairment. These manifistations mostly related to cigarette smoking and long duration of exposure. So. more efforts should be done to persuade welders to stop smoking. Improving the work environment and proper use of respiratory protective devices can reduce the respiratory health hazards of occupational exposure to welding fumes

Evaluation of left ventricular function in patients with ankylosing spondylitis

This study assessed the prevalence of both systolic and diastolic left ventricular [LV] function and other cardiac abnormalities in patients with ankylosing spondylitis who have no clinical cardiac abnormalities. Eighteen patients underwent full clinical examination, ECG, 2D, M mode, and Doppler echocardiography. An age and sex matched control group of sixteen healthy subjects was also studied. All subjects in both groups had no clinical evidence of heart disease. Diastolic dysfunction was detected in 5 patients. In 3 of them, the abnormality was of prolonged relaxation pattern, while in the other 2 patients, the abnormality was of the restrictive pattern. Mild aortic and mitral regurgitation was seen in 1 and 2 patients respectively. No abnormalities of left atrial size, LV systolic or diastolic dimensions or wall thickness were noted. LV systolic function was within the normal limits. There was no correlation between the presence of LV diastolic dysfunction and age, disease severity, disease duration, or the presence of extra articular manifestations. It was concluded that LV diastolic dysfunction occurs frequently in patients with ankylosing spondylitis, even in the absence of clinical cardiac manifestations

Duodenogastric reflux before and after simple cholecystectomy in patients with gallstone disease

20 gallstone patients were investigated for the occurrence of duodenogastric reflux [DGR] before and after cholecystectomy and compared their results with 20 control subjects. DGR was found in 35% of the control group compared to 70% of the gallstone patients, and the mean bile acid [BA] concentration in the gastric juice of the control group was 1.86 mu mol/hour compared to 7.93 mu mol/hour for gallstone patients before operation and 26.49 mu mol/hour after cholecystectomy. None of the gallstone patients without DGR developed reflux after cholecystectomy. However, in those with DGR, the reflux increased significantly after cholecystectomy. This may be due to the presence of great amount of BA in the duodenum after cholecystectomy which leads to greater reflux through the previously incompetent pyloric sphincter