Assessment of nitrosative oxidative stress in patients with middle cerebral artery occlusion

To assess serum levels of nitric oxide and peroxynitrite in patients presenting with cerebral infarction resulting from middle cerebral artery occlusion, at 48 hours from stroke onset. We conducted the study in the Department of Pharmacology and in cooperation with Al-Yarmouk Teaching Hospital and the Department of Medicine, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq from October 2003 to May 2004. Twenty patients presented with neurological deficits of middle cerebral artery occlusion, and we also enrolled 20 healthy individuals to serve as a control group. We obtained venous blood samples from each patient after 48 hours of stroke onset and each healthy individual. We determined the serum level of nitric oxide as well as peroxynitrite. Serum nitric oxide and peroxynitrite were significantly [p<0.001] higher in patients [103.9 +/- 40.2 micro mol and 2.7 +/- 0.6 micro mol] than in healthy individuals [53.3 +/- 20.7 micro mol and 2.3 +/- 0.2 micro mol]. The formation of peroxynitrite directly correlated with nitric oxide in healthy individuals [r=0.84], and patients [r=0.514]. Serum intermediate nitrogen species; nitric oxide and peroxynitrite were significantly increased after 48 hours of stroke onset in patients with middle cerebral artery occlusion. The rate of peroxynitrite formation from nitric oxide was slightly increased

Comparison between intraarticular triamcinolone acetonide and methylprednisolone acetate injections in treatment of frozen shoulder

To compare the effectiveness of triamcinolone acetonide [40 mg] and methylprednisolone acetate [60 mg] in Iraqi patients with primary and secondary frozen shoulder. A total number of 135 [93 males and 42 females] patients with frozen shoulder, allocated at outpatient clinic of rheumatology in Al-Yarmook Teaching Hospital [Baghdad-Iraq] from January 2004 to December 2005, were enrolled in non-controlled clinical trial. The diagnosis of frozen shoulder was made using the guidelines for shoulder complaint issued by the Dutch College of General Practitioners. Intraarticular injections of 40 mg triamcinolone acetonide [46 males and 22 females] or 60 mg methylprednisolone acetate [47 males and 20 females] were given every 3 weeks [not more than 3 injections] by using posterior route. Both triamcinolone acetonide [81.8%] and methylprednisolone acetate [83.3%] were equally effective in primary frozen shoulder. Triamcinolone acetonide is significantly improved diabetic frozen shoulder in comparison to methylprednisolone acetate [69% versus 39%]. Also patients on triamcinolone acetonide required less number of steroid injections and higher percent of severe cases were significantly improved by triamcinolone acetonide in comparison with methylprednisolone acetate. We conclude that triamcinolone acetonide is a good rescue for painful stiff shoulder particularly for resistant cases as with diabetes mellitus, and with long duration of illness. Also, its efficacy can be observed with less frequent injections