INSR gene variation is associated with decreased insulin sensitivity in Iraqi women with PCOs

Polycystic ovarian syndrome [PCOS] is a complex, heterogeneous disorder of uncertain etiology with strong genetic background. Insulin resistance is present in the majority of PCOS cases with linkage and association between single nucleotide polymorphisms of insulin receptor [INSR] gene and PCOS. To examine whether the exon 17 of INSR gene contributes to genetic susceptibility to PCOS in Iraqi women and its effects on glucose tolerance test and lipid profile. Sixty-five healthy Iraqi women and eighty-four infertile women with PCOS, divided into two subgroups depending on the BMI were studied. Restriction fragment length polymorphism [RFLP-PCR] analysis was performed to determine the genotypes for the His 1058 C/T polymorphism at the tyrosine kinase domain in the INSR gene. Clinical, anthropometric and biochemical parameters were also estimated. The C/T polymorphism at His 1058 in exon 17 of INSR was associated with PCOS [obese and non-obese]. CC genotype frequency was higher in PCOS patients whereas TT genotype was higher in control women. Those with CC genotype had higher BMI, GTT and lipid profile than those with TT genotype. An association of C/T polymorphism at His1058 of INSR with PCOS in Iraqi women was observed. Its association with indices of insulin resistance and dyslipidemia were also noticed

role of different neurophysiological tests in the differential diagnosis of diabetic axonal neuropathy and lumbosacral radiculopathy

To evaluate the role of different neurophysiological tests in the differential diagnosis of diabetic axonal neuropathy [DAN] and lumbosacral radiculopathy [LSR]. This study was conducted at Al-Kadhimiya Teaching Hospital, Baghdad, Iraq, from July 2006 to February 2007. Twenty-seven healthy subjects, 44 type 2 diabetics, and 36 LSR patients were studied. The HbA1c level, plain x-ray, and MRI of the lumbosacral region and different electrophysiological tests were assessed. The sural sensory nerve action potential [SNAP] amplitude values were reduced in 56.3%, and the sural/radial amplitude ratio [SRAR] values were reduced in 71.8% in the diabetic patients, but not in the LSR group. The peroneal compound muscle action potential [CMAP] amplitude was low in 70.45% DAN patients versus 35.5% LSR patients. Peroneal F-minimum [Fmin] values were prolonged in 56.8% DAN versus 32.25% LSR patients. The Fpersistence [Fp] values were low in 72.7% of DAN, versus 45.2% of LSR patients. However, the Fchronodispersion [Fc] was abnormal in 71% of LSR versus 11.4% of DAN patients. The SRAR was found to be more significant than the sural SNAP amplitude alone in the differential diagnosis of the 2 groups. Abnormal peroneal Fc and Fp seems to be valuable tests in the detection of LSR and DAN patients

Neurophysiologic evaluation of the temporomandibular joint and related masticatory muscle in rheumatoid arthritis patients

To study the effect of rheumatoid arthritis [RA] on the temporomandibular joints [TMJ] and related muscles using CT scan and neurophysiologic tests. Forty-two RA patients referred from the Maxillofacial Clinic at the Special Surgeries Hospital, Medical City, Baghdad, Iraq from February 2006 to September 2006 were included in this study. Thirty-seven of them underwent CT scan of the TMJ and 25 of these patients were neurophysiologically examined. The data were compared to 30 age-matched control subjects. Fifteen patients showed normal TMJ, whereas, abnormal TMJ on CT scan was present in 22 patients. Of these 22 patients, 6 showed decrease in the intra-articular space, 6 exhibited erosion of the condylar head, and 3 had flattening of the condylar head. The remaining 7 patients had all the abnormalities present. Electromyography [EMG] examination showed reduced interference pattern, poor recruitment of motor unit potentials, shift of the power spectra to the lower frequencies, low mean power frequency, and root mean square values, and prolonged blink reflex component latencies. Rheumatoid arthritis patients with positive CT scan findings have poorer neurophysiologic data than those without CT scan detectable lesions. Trigeminal motor neuropathy is suggested to be the cause of the masticatory muscle weakness. Root mean square voltage as a parameter of the EMG power spectra is of great value in diagnosing such weakness

Diabetic hand syndrome clinico electrophysiological study

Diabetic hand syndrome is a condition characterized by association of distinct entities; limited joint mobility, Dupuytren's contracture, flexor tenosynovitis and carpal tunnel syndrome. Evaluate the prevalence of these changes and association to diabetes duration and its complication. We studied 142 non-insulin-dependent and 33 insulin-dependent diabetics and investigated the presence of these hand changes and peripheral neuropathy. The prevalence of limited joint mobility was 28.6%, Dupuytren's contracture 17.7%, flexor tenosynovitis 10.3% and carpal tunnel syndrome 42.9% in all diabetics. Age and duration of diabetes were clearly related to these changes. A clear association between them and peripheral neuropathy was observed. The prevalence of carpal tunnel syndrome and hand changes was higher in non-insulin-dependent diabetics. The association of Dupuytren's contracture and peripheral neuropathy suggests that common factors could contribute to their pathogenesis

Prevalence of neuropathy in patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease is a disease that reduces the expiratory flow, thus resulting in hypoxemia in variable severity. Twenty-one chronic obstructive pulmonary disease patients and 43 age-matched control subjects were included in the study. Nerve conduction study, pulmonary function tests and oxygen saturation were evaluated. The sensory conduction velocities of all the examined nerves were reduced significantly in the patient's group. The motor conduction velocity is reduced but not to a significant level. All the parameters of pulmonary function tests and oxygen saturation were reduced in the chronic obstructive pulmonary disease patients. A clear relationship between the degree of airway obstruction and posterior tibial sensory neuropathy was noticed. The abnormality in the nerve conduction velocity is predominantly of sensory type. Low oxygen concentration appears to be the causative agent

Power spectrum analysis and conventional electromyogram in duchenne muscular dystrophy

A comparative study of automatic electromyogram analysis [power spectral analysis] and manual measurements of the individual motor units potentials parameters in normal and Duchenne muscular dystrophy patients was performed to assess the diagnostic yield of both methods. The analysis of 20 motor unit potentials elicited at weak effort manually by visual assessment and by power spectrum analysis at 1400 Hz Haning window were performed with concentric needle electrode in the biceps brachii and tibialis anterior. The study includes 18 healthy controls and 32 Duchenne muscular dystrophy patients. The primary diagnosis of the patients was based on the clinical criteria, family history and serum creatin kinase activity estimation. Seventeen patients were biopsied for further histological and histochemical examination. The conventional electromyogram of the patient group characterized by condensed, low mean amplitude of the recruited pattern and an increase in the percentage of polyphasic potentials of short duration and low amplitude in comparison to the normal subjects. About 74% of the patients were identified as myopathic patients with this method. Power spectrum analysis showed significant increase [P<0.0005] in the mean power frequently and the relative power at 1400 Hz and a significant decrease [P<0.0005] in accumulated power. About 95% of the patients were identified as being myopathic patients by this method. Statistical correlation analysis revealed no relationship between the power spectrum analysis and motor unit potentials parameters. The electromyogram power spectra was shifted to the higher frequencies in the Duchenne muscular dystrophy patients as compared to the control. The diagnostic yield of the electromyogram power spectrum analysis was higher than the measurement of the motor unit potential parameters. The best parameter of the electromyogram power spectrum is the relative power at 1400 Hz than the other two parameters. The net result of this study is that the electromyogram power spectrum has diagnostic possibilities in the muscles, which showed normal, or few motor unit potential changes