Orthostatic hypotension in stroke patients

To assess the incidence of orthostatic hypotension [OH] in stroke patients undergoing rehabilitation and to determine clinical variables associated with it. Thirty patients with a first clinical stroke who underwent rehabilitation within one month of stroke onset were included in this study. They were 17 males and 13 females. Their age ranged from 49 to 68 years [mean +/- SD= 58.1 +/- 6.3]. Patients were subjected to full history taking, thorough clinical examination and investigations. Patients' blood pressure was measured in the supine position and on tilting at 90[0]. OH was defined as a drop in systolic blood pressure [SBP] of 20 mmHg or more. OH was present in 14 [46.7%] patients. Age was highly significantly associated [p<0.001] with OH and admission modified Barthel Index [MBI] score was significantly associated [p<0.05] with OH. There was a non-significant correlation with the site of stroke or the use of anti-hypertensives. OH was common in stroke patients undergoing inpatient rehabilitation especially in older patients who have a lower functional status

Peripheral blood lymphocytes apoptosis in juvenile idopathic arthritis: relation to disease activity and type of onset

Abnormalities in the mechanisms regulating apoptosis may have a role in the pathogenesis of autoimmune disorders. The aim of this study was to evaluate the incidence of apoptosis of peripheral blood [PB] lymphocytes in children with juvenile idiopathic arthritis [JIA] and correlating it with CD95 [APO-1/Fas] antigen expression and serum levels of sFas and interleukin-15 [IL-15] in different types of onset and activity of the disease. PB lymphocytes apoptotic index [AI], CD95 [APO-1/Fas] antigen expression, serum levels of sFas and IL-15 were detected in 30 cases of JIA and 20 healthy controls. Results were correlated with the type of onset, activity of the disease and acute phase indicators [ESR, CRP]. The mean values of AI, CD95, sFas and IL-15 were higher in children with JIA than in healthy controls. Significant difference was only found for AI especially with systemic type of onset and high activity. Also the levels of IL-15 increased with activity especially in the systemic type. Moreover, AI showed a significant positive correlation with ESR and CRP but not with IL-15, CD95, or sFas. AI of lymphocytes was high in systemic onset JIA and in active disease and correlated with ESR and CRP, but not with IL-15, CD95 expression or serum sFas

Factors affecting rehabilitation of elective hip and knee arthroplasty and length of hospital stay

Total hip arthroplasty [THA] and total knee arthroplasty [TKA] are among the most common operative procedures[1]. Over the past 35 years, the use of these procedures has grown dramatically, providing pain relief and improving the quality of life for millions of patients. During this time, the role of rehabilitation has been emphasized as an integral part of the post-operative management of the patient. Instead of spending days in bed waiting for tissue to heal, patients now begin functional activities as early as the first postoperative day [1][2]. The purpose of this study was to predict the factors that affect the length of hospital stay. We also planned to sort out which patients admitted for total joint arthroplasty [TJA] will be discharged to home and which patients will require transfer to a rehabilitation ward at the time the surgery is planned. Sixty-four patients with mean age of 64.9 years [39 women and 25 men] have had 71 operations of elective TJA [43 TKA, 7 bilateral TKA, and 21 THA] by 4 surgeons were studied. All the patients had started early intensive rehabilitation program on the first postoperative day to attain good outcome until discharged to home functionally independent. The correlation of patient's age, sex, marital statues, body mass index, and pre-morbid illness with length of hospital stay in either orthopedic or rehabilitation ward and the need for admission to rehabilitation was studied. It was found that age was the only characteristic factor that significantly correlated to the length of stay in either the orthopedic and rehabilitation ward. The co-morbid illnesses that affect the length of hospital stay and need for inpatient rehabilitation were diabetes mellitus and obesity