Thermal tactile Vs. Neuromuscular electric stimulation in the rehabilitation of stroke-induced dysphagia

To study the effect of neuromuscular electric stimulation on the swallow functional score in stroke patients having dysphagia and compare the effect of neuromuscular and thermal tactile stimulation on its rehabilitation. Fifty patients with dysphagia due to stroke were included. They were divided into two equal groups according to the rehabilitation programs they received. Group I received neuromuscular electric stimulation sessions on the neck one hour daily for 12 weeks. Group II received tactile thermal stimulation on the anterior faucial arch one hour daily for 12 weeks. Swallow functional score for dysphagia assessment using the modified barium swallow [MBS] was done for both groups, at the start and at 4 weeks, 8 weeks and 12 weeks. No statistically significant difference was detected between Groups I and II as regards the swallowing score at the start, 4 weeks and 8 weeks [p>0.05]. But there was a statistically significant higher score at 12 weeks [p<0.05]. There was a statistically significant higher change in the score from the start till 12 weeks in Group I as compared to Group II [p<0.05]. Also, there was a higher dysphagia score with hemispherical lesions over the 12 weeks of rehabilitation program in Group I [p<0.05] which was seen only in patients having chest problems in Group II [p<0.05]. The electrical stimulation has the advantage of being Non-invasive and actively assisting swallowing. Thus it can be used as an alternative treatment for dysphagia. It also helps in the restoration of the normal swallowing mechanism and decreases the incidence of the subsequent complications of dysphagia. To use neuromuscular electric stimulation of the neck muscles instead of thermal tactile stimulation in rehabilitation of dysphagia secondary to stroke. Further studies are needed to detect its long term effect on dysphagia rehabilitation

Serum and synovial fluid insulin like growth factor-1 and its binding protein-3 in rheumatoid arthritis

Insulin-like growth factor-1 [IGF-1] and its binding protein-3 [IGFBP-3] in human synovial fluid play an important role in maintaining articular cartilage metabolism. In this study, we measured serum and synovial fluid [SF] concentrations of IGF-1 and IGFBP-3 in 20 rheumatoid arthritis patients [RA] and 10 matched controls [with traumatic knee effusion] using radioimmunoassay. Also, we tried to correlate serum and synovial levels with each other and with disease activity and severity measures. Our results showed a significant increase in synovial fluid level of both IGF-1 and IGFBP-3 in RA patients as compared to controls. Serum IGF-1 correlated with synovial fluid level but serum IGFBP-3 did not correlate with synovial fluid level. Disease activity markers correlated significantly with synovial fluid IGF-12 and IGFBP-3 levels, but did not show significant correlation with their serum level. In conclusion the pattern of IGF-1 and IGFBP-3 in SF differs in inflammatory versus non-inflammatory joints

Diagnostic value of antikeratin antibodies and serum ICAM-1 in some rheumatic disorders

The aim of this study was to find out whether antikeratin antibodies [AKA] has an additional diagnostic and/or prognostic value when performed with rheumatoid factor [RF] in inflammatory and degenerative arthritis. We also assessed the level of circulating intercellular adhesion molecule-1 [ICAM-1] and correlated serum levels with clinical parameters of disease activity and severity. Moreover, we examined whether AKA have an association with circulating serum ICAM-1. Forty RA patients, 15 SLE patients, 15 OA patients and 15 healthy controls were enrolled in this study. The occurrence of AKA reached 55% in RA while it did not exceed 13.5% in other groups. RA patients who were AKA positive suffered from significantly higher disease activity indices and degree of X-ray severity than RA patients who were AKA negative. Again, serum ICAM-1 was significantly higher in the AKA positive as compared to the AKA negative RA patients. Serum ICAM-1 levels were significantly higher in RA and SLE patients than in OA and controls [p<0.01]. Serum ICAM-1 levels correlated with disease activity in RA and SLE. None of the clinical parameters correlated with ICAM-1 serum levels in OA patients. Therefore, AKA was found to have a diagnostic and prognostic value in RA patients. Moreover, circulating serum ICAM-1 levels may act as a disease activity marker in RA and SLE patients