Hand disability related variables in an Egyptian female RA patients sample

The aim of the present work is to study hand affection in Rheumatoid Arthritis [RA] in an Egyptian female sample to establish a map of lesions underlying the rheumatoid hand dysfunction using clinical, laboratory and imaging techniques. This study comprised 100 adult female RA patients. They were clinically assessed for pain using visual analogue scale [VAS], joint tenderness using Ritchie Articular Index, assessment of grip strength, assessment of functional ability using Health Assessment Questionnaire [HAQ], and assessment of hand function using Sequential Occupational Dexterity Assessment score [SODA] patients were subjected to the following laboratory investigations: full blood picture, ESR, C-reactive protein concentration and rheumatoid factor. Radiological investigations included plain X-ray examination and Magnetic resonance imaging. SODA score for hand dexterity had highly significant correlations with disease duration, morning stiffness, ESR, Ritchie index, VAS, HAQ, Duke index disease activity, and hand grip [p<0.001 for all]. It was significantly higher in patients with muscle wasting, deformity and tenosynovitis of the hand, moreover, it showed highly significant correlations with X-ray score and MRI scores. SODA score for hand dexterity had highly significant correlations with clinical findings. SODA score is valuable for evaluation of hand disability and disclosure of the underlying clinical, laboratory and imaging variables in RA female patients

Non-cancerous thyroid lesions: immunologic and surgical evaluation

The present study was designed to determine T helper-l/T helper-2 [Th[1]/Th[2]] pattern in patients with Graves' disease [GD], benign multinodular goiter [MNG] and Hashimoto thyroiditis [HT] and evaluate the applicability of near-total thyroidectomy as a therapeutic strategy for surgical interference. The study included 75 patients [56 females and 19 males; with mean age of 43.8 +/- 8.2 years] with thyroid swelling and 15 healthy volunteers [control group]. Patients underwent clinical examination including direct laryngoscopy using fiberoptic endoscopy, laboratory investigations and ultrasonographic and [99m] Tc pertechnetate scintigraphy for establishment of diagnosis. Patients with HT received medical treatment and were followed-up, while patients with GD and MNG underwent near-total thyroidectomy. Preoperative blood samples were collected from patients and control subjects for ELISA estimation of serum levels of interleukin-2 [IL-2], IL-18, IL-4 and IL-5. Patients were observed for appearance of postoperative manifestations of recurrent laryngeal nerve [RLN] palsy and/or hypoparathyroidism. Mean operative time, duration of wound drainage and hospital stay were recorded. The study included 43 patients with GD [8 of them had thyroid orbitopathy], 17 patients had MNG and the remaining 15 patients had HT. All patients had smooth intraoperative course and no patient had permanent RLN palsy, but 4 [6.7%] patients had transient unilateral RLN palsies that recovered spontaneously after a mean duration of 24.5 +/- 11.6 days. Temporary hypocalcaemia occurred in 9 patients [15%] and permanent hypoparathyroidism resulted in one [1.7%]. All patients developed wound edema, 7 patients had wound seroma and 2 patients had wound infection. Mean serum levels of lL-2, IL-4 and IL-5 were significantly higher in patients compared to control levels irrespective of the type of thyroid lesion. Mean serum levels of IL-18 were significantly higher in patients with HT and MNG disease and non-significantly higher in patients with GD compared to control levels. Moreover, mean serum levels of IL-2 and IL-18 were significantly higher and mean serum levels of IL-4 and IL-5 were significantly lower in patients with HT and MNG disease compared to those with GD and in MNG patients compared to those with HT. The percentage of postoperative increase of serum IL-2 and IL-18 levels relative to the median control level were significantly higher in patients with HT than in patients with GD or MNG with a significantly higher percentage of increase in patients with MNG compared to those with GD. On the other hand, the percentages of increase of IL-4 and IL-5 were significantly higher in patients with GD compared to patients with HT or MNG with a significantly but non-significantly higher percentage of increase of IL-5 and IL-4, respectively, in patients with MNG compared to those with HT. It could be concluded that there was a disturbed pattern of Th[1]/Th[2] cytokines in patients with non-cancerous thyroid lesion in favor of humoral pattern of immune response in GD with predominance of Th[2] cytokines and a Th[1]-pattern of immune response characteristic of cellular immunity is dominant in HT. Also, near total thyroidectomy was found appropriate therapeutic modality with transient minimal complications for patients with MNG or GD

Furlow's double Z-plasty is a convenient procedure for cleft palate repair

The present study aimed to evaluate and compare the surgical outcome of Von Langenbeck and Furlow's procedures for repair of primary cleft palate. The study included 22 children with mean age of 16.5 +/- 3.1 months allocated into 2 equal groups: Group A underwent Von Langenbeck procedure and Group B underwent Furlow's procedure. Von Langenbeck palatoplasty involved elevation of large mucoperiosteal flaps from the hard palate and side-to-side approximation of the cleft margins of both soft and hard palates with detachment of the levator muscles from their bony insertions and the use of long relaxing lateral incisions without lengthening maneuver. Furlow's procedure involved Z-plasty incision with the cleft is the central limb, lateral limbs end over the hamuli, transposition of the posteriorly based nasal Z-plasty flap brings the palatal muscle posteriorly and across the cleft, insetting the anteriorly based Z-plasty flap closes the front of the soft and hard palates. Then, oral Z-plasty flaps were transposed to overlap the palatal muscles creating a palatal muscle sling. The cleft width, length increase in the soft palate, length of Z-plasty, the frequency of the need for hamulus fracture, duration of surgery and intraoperative blood loss were recorded. The postoperative distance between last molar tooth and the uvula was determined and compared versus preoperative one. Both procedures provided a significant increase of the length of distance between last molar and uvula, with a significant increase of length in group B compared to group A. All patients in group A required relaxing incision irrespective of the preoperative cleft width; while only 2 of patients in group B [18.2%] required relaxing incision with a significant difference in favor of group B. Mean length of Z-plasty incision required in group B was 1.5 +/- 0.17; range: 1.1-1.7 cm. Mean operative time was significantly shorter in group A [76.8 +/- 10.6 min] compared to group B [91.8 +/- 13.1 min] and Furlow's procedure was associated with significantly more blood loss compared to Von Langenbeck procedure. One patient [9.1%] in group B had small fistula, but no patient had wound dehiscence; while in group A, one patient had wound dehiscence and another had oronasal fistula with a postoperative complication rate of 18.2%. It could be concluded that Furlow's palatoplasty improves the outcome of cleft palate repair irrespective of the width of the cleft with acceptable complication rate and significant lengthening of the uvula

Protective role of fennel oil against polychlorinated biphenyls [PCBs] induced oxidative stress in rats

Polychlorinated biphenyls [PCBs] are environmental contaminants that have been widely used for various industrial purposes. Human and animals are exposed to PCBs via oral ingestion of contaminated food. PCBs were found to induce reproductive toxicity, immune suppression, birth defects, cancer, developmental and behavioral changes. The aim of the present study was to evaluate the protective role of fennel oil against PCBs toxicity. Forty male Sprague- Dawley rats were divided into four groups, control group, group treated with PCBs [250 micro g/kg b.w] and the groups treated with fennel oil [5mg/kg b.w.] alone or in combination with PCBs for 15 days. The results indicated that treatment with PCBs resulted in a significant increase in ALT, AST, cholesterol, triglycerides, uric acid, TNFa., LPO, NO and CEA, whereas it significantly decreased GPX and SOD. Histopathological examination of the liver, kidney and testis showed severe histological changes. Animals treated with fennel oil alone or plus PCBs were comparable to the controls regarding the biochemical parameters or the histological picture of liver, kidney and testis. It could be concluded that fennel oil has a protective effect against PCBs toxicity. Moreover, the oil was safe and may be used pharmaceutically to protect against the hazardous effects of PCBs

outbreak of enterica in El-Waledya area Assiut district

61 cases of enterica confirmed by Widal's test were studied in an outbreak in El-Husain Clinic in El-Waledya area [population 41602 census 1986]. They mainly presented with fever, coated tongue, constipation and splenomegaly. It was found that enterica is constantly endemic in this area but it tends to increase in summer and autumn. The highest frequency of cases occur among age group 20 - 30 years which may be related to food intake from food handlers. In a trial to find the source of infection, mapping of the area and determination of residence have been done. Also, the absence of public sanitary disposal may be related to the outbreak. Sensitivity of the organism to chloramphenicol was 85.2%. Mixed infection, i.e. typhoid and paratyphoid, were recorded [3.2%]