Value of dexamethasoneiontophopresis vs. local injection of dexamethasone in the treatment of plantar fasciitis

To evaluate the effect of dexamethasone [DXM] iontophoresis in treating plantar fasciitis compared to the effect of local DXM injection. The study was performed on 21 patients [26 feet] complaining of plantar fasciitis of at least 2 months duration. Patients were selected on the basis of their clinical presentation and confirmed by plain Xray and diagnostic ultrasonography. Patients were classified into 2 groups: Group I [11 patients] received 10 sessions of iontophoresis using solution of 0.4% DXM on alternating days, while Group Ii [10 patients] received one local steroid injection of DXM into the area of maximum tenderness. Reassessment of the patients of both groups was done 3 weeks after starting their treatment program by assessment of pain intensity using numerical visual analogue scale [VAS], assessment of tenderness using Heel Tenderness Index [HTI] and ultrasonography examination. There was high statistical significant improvement of in all patients of group I, and in 7 patients of group II. Two feet had steroid flare in group II. No difference of statistical significance between the 2 groups was detected regarding change in HTJ, or change in ultrasound findings. However, there was a statistical significance difference regarding decrease in pain intensity with higher improvement in group I. Dexamethasone is an effective anti-inflammatory drug in treating plantar fasciitis whether applied by iontophoresis or by local injection. However, lontophoresis has the advantages of painless application with no risk of infection or fascial rupture

Quantitative assessment of rehabilitation results in peripheral arterial disease

Peripheral arterial disease [PAD] patients are commonly classified on the basis of subjective evaluations of pain and fatigue. It could he important to have, at least, an objective measurement ofJƒtigue for better evaluation of muscle performance and exercise tolerance in such patients as well as for serial quantitative assessment of different vascular rehabilitation programs designed for claudications. Median frequency [MDF] analysis has been recently used to monitor electromyo graphic [EMG] power spectrum shift toward lower frequencies due to muscle fati gue. Twenty-five PAD patients and ten control subjects matched for age and sex were studied. Surface EMO was recorded over the medial gastrocnemius muscle along 40 seconds at maximal voluntaty contraction. The median frequency of the electromyoraphic power spectrum was calculated in the first 10 seconds [TO] and the last 10 seconds [T1]. Change from TO to T1 was statistically calculated and considered as the fatigue index [FI]. EMG reassessment was done for the patients' group after completing a physical training program. Significantly lower initial Ti values, compared with initial TO, were found in both the PAD and the control groups. A highly significant difference was documented regarding all the initial MDF parameters between the patient and control groups. Moreover, a highly significant difference was recorded between the initial and the post-rehabilitation FI in the patients' group. EMG frequency analysis can be considered an easy, painless, practical and reproducible method which has a high degree of precision and accuracy in providing objective information on the muscle performance and fatigue in PAD patients

Value of single-photon-emission computed tomography scan in the diagnosis of neuropsychiatric manifestations of systemic lupus erythematosus

The aim of this study was to predict CNS affection in SLE patients using SPECT and to study the previous parameter as prognostic tool for CNS affection in SLE patients. We studied 30 SLE patients diagnosed according to the American College of Rheumatology [ACR] criteria for the classification of SLE. Ten normal healthy subjects were also included as a control group. SLE patients were categorized into 3 groups: Group I: with major NPSLE [n=7]; Group II: with minor NPSLE [n=3] and Group III: without NPSLE [n=20] Abnormal SPECT scan was found in 83% in group I, 33% in group II, normal SPECT scan in 72% in group III and normal SPECT scan in 100% in the control group

Neurological features and anti-myeloperoxidase antibodies in rheumatoid arthritis patients

To determine if there is a relation between the level of anti-myeloperoxidase antibodies [AMP] and the occurrence of peripheral neuropathy [PN] in rheumatoid arthritis [RA] patients. Serum levels of C3, C4 and circulating immune complex [CIC] were also assayed to determine whether their levels are related to RA activity or not. The levels of AMP antibodies as well as that of C3, C4 and circulating immune complex [CIC] were measured in 48 RA patients. All patients underwent electrophysiological studies for both median and radial nerves in the upper limbs and the sural nerve in the lower limbs to detect peripheral neuropathy. Peripheral neuropathy was found in thirteen out of 48 patients. There was a significantly higher level of serum AMP antibodies in patients with PN, the mean being 11.4 +15.1 microg/ml as compared to patients without PN [4.5 + 2.1 microg/ml]. Serum level of C4 was significantly lower in patients with PN [30.9 +10.4 IU/ml] than those without PN [37.2+ 17.1 IU/ml]. No significant difference was found as regards either C3 or CIC between the two groups. Also, a significant correlation was found between AMP and clinical vasculitis. Peripheral neuropathy seems to be a common complication of RA. The high level of AMP anti-bodies in RA complicated with PN suggests that PN is associated with vasculitis that may be fatal if it involves other main organs

Insight on the relationship between osteoporosis and osteoarthritis

In this study, we tried to investigate some of the factors that may have a role in the pathogenesis of osteoarthritis OA and osteoporosis OP, such as BMI, levels of estrogen, IGF-1 and bone mass density. We correlated all these parameters to find the relation between those two pathologic conditions. Forty postmenopausal females were studied, 20 with OP and 20 with OA. Our results showed a significant elevation of estrogen and IGF levels and BMD in OA group in relation to OP group. The mean BMI showed a significant increase in OA than OP. This inverse relation could be explained by the difference in growth factors and estrogen that stimulate bone formation. There is an inverse relationship between OA and OP. Thus OA might have a protective or retarding effect on the development of OP and could be a negative risk factor for OP. This could be an important element in determining patients who at risk developing OP and should take preventive therapy for OP at the time of menopause