Joint affection in chronic active hepatitis c with correlation to liver biopsy and cryoglobulinemia

This study was carried out to map, in a cohort of consecutive patients with chronic HCV infection, joint affection with correlation to cryoglobulinemia and with viral activity detected through liver biopsy done for those patients. Thirty three patients with hepatitis C infection were recruited for the study. Laboratory investigations involved determination of erythrocyte sedimentation rate [ESR], IgM rheumatoid factor [RF] and its titer, serum aminotransferases, and alkaline phosphatase concentrations. Cryoglobulines detection was done in their blood. State of viral activity and degree of hepatic fibrosis were detected by doing liver biopsy through [Metavir score]. Thirty three hepatitis C patients [15 males and 18 females] with mean age [SD] 43.5 [10.5] with mean disease duration [SD] of 50.8 [24.1] months were recruited for the study. Three patients were found to fulfill at least 4 out of the 7 ACR classification criteria for rheumatoid arthritis. They were excluded from the study. There is highly significant strong positive correlation between arthritis and cryogolbulinemia. There is non significant week negative correlation between arthritis and Metavir score -A liver biopsy. There is significant difference between cryoglobulins-positive and -negative patients as regard arthritis. Rheumatological manifestations constitute part of the extra hepatic manifestations of hepatitis C infection, so that sector of patients may have criteria sufficient for RA classification. Cryoglobulinemia plays an important role in association of arthritis/arthralgia in HCV infection patients. HCV, Hepatitis C virus ; MC, mixed cryoglobulinemia ; ALT, alanine aminotransferase; RTPCR, reverse transcriptase-polymerase chain reaction ; RF, rheumatoid factor; RA rheumatoid arthritis; ACR, American College of Rheumatology; ESR, erythrocyte sedimentation rate; SD, slandered deviation

Clinical and computed tomographic assessment of the effect of lumbar traction

Aim of this current study is to correlate CT assessment with clinical assessment for patients with low back pain due to lumbar disk prolapse / herniation, before and after vertebral axial decompression [VAX-D] therapy. TForty three patients with LDP/ herniation were selected to participate in the study and underwent VAX-D therapy according to Medical Service Advisory Committee [MSAC] for vertebral axial decompression therapy for chronic low back pain. They underwent clinical and CT assessment before and after treatment There was non significant difference in clinical and CT parameters of assessment before and after treatment with expection pf lubmar movement improvement. In 2 cases of pure disk prolapse without degeneration and in central disk herination best clinical and CT response after VAX-D was noticed. Clinical and CT selection of cases lumbar disk prolapse / herniation is mandatory for the best results anticipated from VAX-D therapy