Study of the relationship between obesity, body mass index and migraine: is it a possible risk factor

To assess the influence of body mass index [BMI] on the prevalence, attack frequency and clinical features of migraine. As well as studying the relationship between BMI and level of migraine-related disability. This is a cross-sectional comparative study of 437 patients reviewing the obesity clinic in primary care center and medical outpatient clinic in general hospital. The participants were divided into 4 categories based on BMI: normal weight [18.5-24.9], overweight [25.0-29.9], obese [30.0-34.9], and morbidly obese [>35.0]. Migraine prevalence and clinical features were assessed as a function of BMI. Among individuals with migraine, very frequent migraine attacks [10-14 d/mo] occurred in 16% of the overweight [OR 1.3], 44% of the obese [OR 2.9] AND 24% [OR 5.7] subjects, compared with 2% of those with normal weight. Among migrainures, 31.1% of those with normal weight had some disability compared with 36.9% of the overweight, 37.8% of the obese and 41.1% of the morbidly obese subjects. Our study support that obesity is an exacerbating factor for migraine and was propose that migraine and obesity may share same path physiological biological mechanisms that would be advices to undergo further researches to explore more about it

Tuberculosis arthritis of the elbow, a diagnostic problem

Recently, there has been an epidemic of tuberculosis, with increasing incidence of infected persons in UK. In the past 20 years, with the pandemic of the human immunodeficiency virus and the increase in immunocompromised people, we have observed a resurgence of tuberculosis. Tuberculosis arthritis of the elbow joint is not commonly seen by orthopaedic surgeons. Spinal and monoarthritis of weight-bearing joints such as the hip or knee are most frequently involved. The aim of this case report is to describe a rare case of occult tuberculous arthritis of the elbow in young Indonesian lady and the diagnostic problems that may arise and lead to a delay in treatmen. It is a case report where we used different laboratory test as CBC, ESR, CRP, hepatitis screening and AIDS Antibody test to help in diagnosis.Plain X-ray for elbow and chest used. CT scan for elbow, aspiration of synovial fluid for culture and synovial biopsy taken. Tuberculous arthritis remains low on the index of suspicion of many clinicians working outside the field of respiratory or infection diseases3 Involvement of the skeletal system is relatively rare. Musculoskeletal TB is responsible for between 1.3% and 5% of all cases of TB. Osteoarticular TB should be suspected in patients of south Asian and African origin presenting with bony and soft tissue infective lesions

Rare case of tuberculous arthritis of the elbow a diagnostic problem. Case report

Recently, there is an epidemic of tuberculosis, with an incidence rising of 1.200 in 100.00 persons in UK. In the past 20 years, with the pandemic of the human immunodeficiency virus and the increase in immunocompromised people, we have observed a resurgence of tuberculosis. Tuberculous arthritis of the elbow joint is not commonly seen by orthopaedic surgeons. Osteoarticular involvement has increased, too. Spinal and monoarthritis of weight-bearing joints such as the hip or knee are most frequently involved. The elbow joint is an uncommon location of osteoarticular tuberculosis. The aim of this case report is to describe a rare case of occult tuberculous arthritis of the elbow in young Indonesian lady and the diagnostic problems that may arise and lead to a delay in treatment. It is a case report where we used different laboratory test as CBC,ESR,CRP, hepatitis screening and AIDS Antibody test to help in diagnosis. Plain X-ray for elbow and chest. CT scan for elbow, aspiration of synovial fluid culture then synovial biopsy taken. Tuberculous arthritis remains low on the index of suspicion of many clinicians working outside the field of respiratory or infection diseases Involvement of the skeletal system is relatively rare. Musculoskeletal TB is responsible for between 1.3% and 5% of all cases of TB. Osteoarticular TB should be suspected in patients of south Asian and African origin presenting with bony and soft tissue infective lesions

Serum phosphorus and magnesium levels in patients with metabolic syndrome

Metabolic syndrome is defined as the co-occurrence of at least three of the following features: hyperglycemia, hypertension, central obesity and dyshpidemia. It is considered an atherogenic cardiovascular risk factor that has recently become a public health problem. Disturbances in phosphate and for magnesium metabolism may have potential pathophysiological implication in the pathogenesis of this duster of cardiovascular risk factors. We performed a cross-sectional study to examine the relationship between serum phosphorus and magnesium levels in Kuwaiti patients with metabolic syndrome. Two hundred Kuwaiti individuals were entailed [109 subjects diagnosed as having metabolic syndrome and 91 as control group]. Their mean age was 48.6 +/- 9.9 years. Both males and females, smokers and non-smokers were included in our study. The diagnosis of metabolic syndrome was based on Adult treatment Panel III guidelines which includes central obesity, hyperglycemia, hypertension and dyslipidemia. Patients with metabolic syndrome showed significantly lower phosphate and magnesium levels compared with controls in addition to non significant differences in the rate of urinary excretion of phosphorus and magnesium between diabetics and control groups. We assume that hypophosphatemia and hypomagnesaemia patients with metabolic syndrome could be attributed to decreased directly intake, as well as internal redistribution of this clement. Kuwaiti Patients with. metabolic syndrome show significantly lower phosphate and magnesium levels compared with healthy individuals. These electrolyte disturbances could be considered as one of the diagnostic criteria for diagnosis of metabolic syndrome. In addition, this electrolyte imbalance may have a role in pre-vention and/or treatment of the metabolic syndrome. Further studies arc needed to support this finding

Comparative study between obese men and obese postmenopausal women [with central obesity]: regarding different metabolic and endocrinal factors

Study the relationship between central obesity and different endocrinal and metabolic parameters among obese men and obese postmenopausal women. A hundred obese patients [fifty men and fifty postmenopausal women] reviewing the obesity out-patient clinic [Reqqae clinic -Ministry of health - Kuwait]. Their mean age was 53.0 +/- 16.8 years. Their assessment included full clinical examination to exclude apparent endocrinal disorders, anthropometric indexes [BMI, body fat% and Waist/ hip ratio. All patients had body mass index [BMI] >29 Kg/m[2] [obese], with waist / hip ratio >0.8 cm. [0.91-1.11] that's to say have central obesity. Blood tests for assessment of serum cholesterol, triglycerides and low density- lipoproteins were carried on. Endocrinal evaluation included measurement of fasting serum cortisol and fasting insulin levels were also done. Postmenopausal women having central obesity had significantly higher total body fat [44.0%] compared with age- matched obese men [37.4%] [P <0.001]. There is significant rise in fasting insulin level and fasting cortisol levels among postmenopausal obese women compared to obese men [P<0.001]. There was no significant difference between both groups regarding the serum cholesterol levels or the low-density lipoprotein values [P=0.44]. Whereas, the postmenopausal obese female group showed significantly higher values of serum triglycerides compared with the group of obese men [P<0.001]. We found significant positive correlation between waist/ hip ratio and fasting increase in serum cortisol and insulin values among postmenopausal obese women, a relation that could not be proved among obese men. Our study found that patients with central obesity [W/H ratio > 0.8 cm. have increased fasting plasma insulin [hyperinsulinemia] and cortisol values [hypercortisolemia]. In addition, in women with central obesity this hyperinsulinemia and hypercortisolemia are positively correlated with the waist/hip ratio. Relation between central obesity and metabolic and endocrinal factors

Our experience with interamuscular injections of botulinum toxin A for the treatment of upper limb flexors spasticity after stroke

Focal spasticity can be a major drawback in the rehabilitation of stroke patients. Previous studies suggest a beneficial effect of Botulinum toxin A[Botox A] for relief of spasticity. To evaluate the therapeutic effects of intramuscular injections of Botox A [Btx A] on spasticity of the upper limb. D e s i g n: An open-label non-controlled trial for a duration of 16 weeks was design to determine the e fficacy and safety of intramuscular Btx A injections in the treatment of 56 patients with spastic hemiparesis after stroke. The patients were assessed at baseline, 2, 4, 12 and 16 weeks after treatment by several outcome measures - modified Ashworth scale, motricity index arm score, limb position at rest, semi-quantitative o rdinal scale for severity of pain, patient's global response to Btx A t reatment, Barthel index of activities of daily living, difficulties encountered during thre e upper limb motor tasks. Significant reduction of muscle tone, spasticity related pain and improvement in the three selected functional tasks [cleaning the palm of the affected hand, cutting the fingernails of the affected hand, putting the affected arm into the sleeve] were observed one week after Btx A injections and were sustained throughout the 16 weeks follow-up period. Botox A is effective and safe adjunctive treatment to on-going rehabilitation for patients with post - stroke localized moderate-to-severe spasticity refractory to physical and medical treatments