Analgesia for relie of circumcision pain in children: intramuscular ketamine versus topical lignocaine

Pain is the most common and often a very disturbing immediate sequelae of circumcision in children. Lignocaine, a local anesthetic, and ketamine, an intravenous anesthetic known for its analgesic effect were compared in this respect. This study was performed on thirty otherwise healthy infants undergoing day case circumcision. They were equally divided into two groups: lignocaine group, where induction and maintenance of anesthesia was inhalational with halothane [1.5- 2.5%] and nitrous oxide in oxygen, and analgesia provided intraoperatively with topical lignocaine 2% to a maximum of 10 ml applied with a syringe dripping onto the undersurface of the residual foreskin. In the second ketamine group, anesthesia was induced with intramuscular ketamine 4-8 mg/kg b.w. and maintained with halothane [0.5-1.5%] and nitrous oxide in oxygen. Low incremental doses of ketamine 0.5-1 mg/kg b.w. were given intravenously if needed. Postoperatively, rectal paracetamol [250 mg] was provided whenever the child complained of pain. Only 2 children [13.3%] in the ketamine group and 3 children in the lignocaine group [20%] required paracetamol. There were no statistically significant differences in the pain free periods nor the pain/discomfort scores between the two groups. In conclusion, both methods provided adequate analgesia with equally fast restoration to normal activities

Detection of subclinical CNS affection in patients with SLE

The aim of this study was to evaluate the role of BAEP and EEG in early detection of subclinical CNS affection in cases of SLE. Abnormal BAEPs and EEG were found in [42%] and [48%] of the cases. This study emphasizes the role of neurophysiological testing as integrating part of CNS evaluation in patients with SLE and not more sensitive test

Electromyographic evaluation of the management of Bell's palsy

To evaluate EMG changes in Bell's palsy, 30 patients were randomly collected and classified into 3 groups, each group of 10 patients. Group 1 included patients received medical treatment. Group 2 included patients received physical therapy. And in group 3 patients received no therapy. The patients were subjected to pre-therapy and post-therapy [3 months later] full clinical and EMG examination. The results showed spontaneous recovery in 70% of cases, with no statistical significant difference between prednisone treated, physically treated and control groups as a final outcome [P <0.05]. However, the degree of complications [degree of denervation and autonomic and motor synkinesis] were less in the physically treated group

Sternoclavicular and costovertebral joints changes in ankylosing spondylitis: a computed tomography study

Computed tomography [CT] scan of the sternoclavicular and costovertebral joint has been performed for 22 patients with ankylosing spondylitis. Sixteen out of 22 patients [72.7%] had sternoclavicular joints abnormalities. Eighteen of 22 patients [81.8%] had abnormality changes in their costovertebral joints. The abnormalities changes of the sternoclavicular and the costovertebral joints of the patients with ankylosing spondylitis included: Erosions in both opposing surface of sternoclavicular joints and from the anterior vertebral side of costovertebral joints. Joint space widening and bony proliferation, bony bridges, sclerosis and ankylosis. These changes provide an anatomical basis for the understanding of some of the thoracic symptoms frequently reported by the patients with ankylosing spondylitis. CT has yielded diagnostic accuracy and remains an excellent investigative tool for musculoskeletal disorders

Neuropsychiatric and musculoskeletal abnormalities in giant cell arteritis

Although gaint arteries [GCA] is a common vasculitis and differs from other forms of vasculitis in that skin, kidneys and lungs are rarely involved, mental status changes and higher cortical dysfunction have received limited attention. Out study illustrated that GCA has the potential to produce chronic fluctuating delirium, delusional thinking and memory impairment. In addition, GCA may produce differing symptoms at different times in the same patients e.g. polymyalgia rheumatica [PMR], and arthritis

Incidence of osteoarthritis in Egyptian obese patients

This study was carried out on 168 osteoarthritis [OA], and 50 obese patients to determine whether a correlation existed between OA of various joints and obesity. It was found that knee OA was affecting all obese patients [100%] and was highly significantly correlated with body mass index [BMI]. Low back pain [LBP] was present in 30% of patients and heel pain in 10%, and both were significantly correlated with BMI. Cervical spondylosis and shoulder OA were present in 8% for each, and both were not correlated with BMI. All the obese patients were not having hip or ankle OA. There was also a significant correlation between obesity and both age, female sex and hypertension. Hypercholesterolemia was affecting significantly obese patients [up to 75%] but had no correlation with BMI. The occurrence of OA as a complication of obesity is inferred, and endangers not only the knee but also the lumbar spine and heels as well. Measures taken to reduce obesity in the community may help lessen this disability