Comparison of MRI and electrodiagnostic study in evaluation of patients with clinical radiculopathy in 501 army hospital, 1387-88

There are different procedures for radiculopathy diagnosis. Considering morbidity of this disease, its diagnosis and treatment is of important.MRI and Electrodiagnostic study [EDX] are of most important ways but they each have advantages and shortcomings. The goal of this study is to determine which way or ways is the best. In an cross-sectional analytic study, we studied patients with suspected radiculopathy and MRI who where referred for Electrodiagnostic study to 501 Army hospital at 1387-88. Analysis was performed with statistical software of SPSS. we studied 114 patients.31 had cervical and 83 had lumbosacral radiculopathy.There were significant agreement between clinic and MRI [72%] and between EDX and MRI [61%] but no between clinic and EDX [52%].The agreement is higher in deffinte group than milder ones. This decline in agreement was significant in EDX but no in MRI. There are no preferred procedure for radiculopathy diagnosis so that MRI and EDX are complementary, yet. Considering higher specifity for EDX Electrodiagnostic study is suggested before inappropriate and risky interventions

[Preliminary study of obtaining H-reflex from opponens pollisis muscle in patients with fibromyalgia in comparison with controls]

Central hypersensitive syndrome is a group disorders with no paraclinic tests to be diagnosed and Fibromyalgia is at top of them. Goal of this study is not only application of opponens pollicis H-Reflex recording as auxiliary paraclinic test for of Fibromyalgia although emphasis on hypercentralization as its probable cause. In this case-control study 30 patients of Fibromyalgia was referred to Physical Medicine and Rehabilitation of Emam reaza and Milad Hospital and 30 healthy subjects were investigated for obtaining H-Reflex of opponens pollicis muscles. Other measure parameters include: Intensity of stimulation and amplitude of H-Reflex. H-Reflex obtaining of opponens pollicis in patients suffer from Fibromyalgia was significant [P-value>0.05]. Besides intensity of stimulation is significantly lower in Fibromyalgia but amplitude comparison of both groups did not show significant change. H-reflex recording opponens pollicis is possible in patients of Fibromyalgia

[Local corticosteroid injection and low level laser therapy [LLLT] in the treatment of lateral epicondylitis: a comparison study]

Background: Lateral epicondylitis is a common problem of upper extremity. There are various modalities of nonsurgical treatment for this disease including: low level laser therapy and local corticosteroid injection. Efficacy of these options is compared in this study

Material and Methods: In this clinical trial, 60 patients with lateral epicondylitis randomly assigned to two groups [1-local corticosteroid injection, 2- low level laser therapy]. At first visit, 4[th] and 8[th] weeks after treatment patient symptoms assessed by VAS, "pain threshold" measured with Algometer, "maximum strength of gripping" assessed by Dynamometer and the Modified Nirschle Stage and QUICK DASH questionnaire completed

Results: In both groups, assessment of symptoms at 4[th] and 8[th] weeks after treatment showed that most patients had better condition in comparison to base status. Only in group 1 "pain threshold" at 4[th] and 8[th] week and "maximum strength of gripping" at 8[th] week and in group 2 "pain threshold" and "maximum strength of gripping" At 4[th] and 8[th] week had no significant difference in comparison to base status. Comparison of severity of symptoms between two groups did not show any significant difference after treatment

Conclusion: Findings of present study show similarity of local prednisolone injection and use of Low Level Laser in the treatment of Lateral epicondylitis

[Comparative study of central motor conduction time by using magnetic stimulation and F-wave study in normal subjects]

Central motor conduction time [CMCT] includes time for excitation of the corticospinal pathways and transmission along those tracts. Data obtained by cortical magnetic stimulation are helpful in some clinical situations such as multiple sclerosis, cervical spondylosis, motor neuron disease, and etc. However, using different methods for peripheral motor conduction time [PMCT] demonsrates two different results. In this study, we used two methods to compare CMCT from F-wave latency and spinal root magnetic stimulation. Also, this study was performed to determine normal values, effects of sex, age and upper limb length. Magnetic stimulation of the cortex and cervical spinal roots was performed on 39 healthy subjects. Responces were recorded from the abductor pollicis brevis [APB] muscle. F-wave study was performed in the median nerve. Subtraction of total motor conduction time [TMCT: cortical response] and PMCT by F-wave and cervical root stimulation, shows CMCT. The results showed 19.7 ms for TMCT, 7.3 ms for CMCT of root stimulation and 4.8 for Fwave based CMCT. CMCT to the APB correlates with upper limb length but no with age or sex. The CMCT calculated by subtracting F- wave latencies measured to APB after transcranial stimulation was shorter than the one obtained after magnetic root stimulation

[Effect of Cervical Spinal Manipulation on Lateral epicondylalgia]

Background: lateral epicondylalgia is relatively a common musculoskeletal problem. Some recent studies have shown the possible relationship between segmental cervical spine dysfunction and lateral epicondylalgia in noticeable portion of patients. The aim of this study was to assess the effects of cervical manipulation on lateral epicondylalgia in the presence of painful minor intervertebral dysfunction [PMID]

Methods and materials: in this randomized double blind clinical trial study, 30 patients with lateral epicondylalgia referred to Physical Medicine and Rehabilitation Clinic of 501 Amy Hospital were studied. 15 patients received rotatory high velocity, low amplitude manipulative therapy in pain free direction. The others received mobilization without thrust [no manipulation]

Results: immediately after manipulation, there was 2.8 cm decrement in VAS and 51.9, and 20.4 increment in PPT and PFG, respectively. After a week, improvement was 2.1 cm in VAS, 30.7% in PPT and 8.5% in PFG

Conclusion: manipulated group produced significant improvement in visual analogue scale and pressure pain threshold not only immediately after treatment but also a week later. Pain free grip strength had no significant increment one week after manipulation in comparison with non-manipulated group. Improvement of all variables decreased with time, justifying the need for repetition of manipulation. Duration of efficacy and correlation between PMID and pain of lateral epicondyl requires longtime evaluation of patients and more studies

[Evaluation of bcl-2 and Bax in Invasive-DuctaI breast carcinoma and its correlation with steroidal receptors and cellular proliferative markers using Immunohistochernistry]

Background: breast carcinoma has been regarded as the most common malignant tumors and the leading cause of death due to cancer in women. Apoptosis plays a central role in both normal cell cycle and tumor biology; it is controlled by family of related proteins including Bax and bcl-2. This study was designed to evaluate the expression of Bax and bcl-2 proteins in 46 cases of Invasive-Ductal carcinoma of breast and their correlation to the expression of ki-67, estrogen and progesterone receptors immunohistochemically

Materials and methods: formalin fixed paraffin embedded-tissue from 46 cases of invasive ductal carcinoma of breast were analyzed by immunohistochimistry [IHC] method. We performed a statistical analysis to investigate the relationship between clinicopathological parameters and Bax, bcl-2, KI-67, ER. PR expressions

Results: forty-six cases of invasive ductal carcinoma of breast with mean age 45 were studied. According to Bloom-Richardson score system of 46 cases. 8.7% were grade 1 1.80% were grade 2 and 11% were grade 3. Eighty-seven percent of cases had 4 or more lymph node metastasis. According to IHC results, 43% were bcl 2 positive, 28% were ER positive, 39% were PR positive , and 95% were Bax positive ,mean KI-67 index was 40% . There was significant correlation between bcl-2 expression and ER, PR and size of tumor. There wasn't any correlation between Bax and PR and ER status .there was statistically correlation between KI-67 index and ER and PR status, grade and metastasis to lymph nodes .There was statically correlation between ER and PR status and size of tumor, grade and metastasis to lymph nodes

Conclusion: Bcl-2, as an anti-apoptotic factor, plays an important role in biology of breast cancer. It may be a mediator in the action of ER and PR or it may have independent role. KI-67 as a proliferative maker. doesn't have any correlation with apoptotic factors, but have prognostic valve through its relation to ER, PR. grade and LN status. Because of high rate of Bax positively, we guess IHC isn't a good way for evaluation of Bax and it is better to use molecular methods