Electrophysiological evaluation of nerve affection after trauma to the extremities

Evidence of peripheral nerve injury should be sought in all wounds of extremities. Nerve conduction studies [NCSs] and electromyography [EMG] are used to evaluate the nature of pathophysiology, and quantification of severity of involvement, detection of the level of neurological deficit and determining prognosis. The study was conducted to correlate between clinical examination and electrophysiological studies in diagnosis and prognosis of nerve affection. The study was conducted on 36 cases with trauma to the extremities referred to the Department of Physical Medicine. They were clinically examined and electrophysiological study was performed to every case including motor conduction of the relevant and contralateral nerves in addition to EMG of the relevant muscle. The mean age of patients was 30.11 +/- 13.23 years. 44.44% of cases were manual workers. 58.33% of the injuries were accidental, of these 33.33% were occupational accidents. The number of nerves affected in all cases was 49 nerves. The clinical evaluation revealed that 33.33% of cases had partial injury, while 55.56% had complete injury A percent of 11.11% of cases were considered to be clinically free, however the nerves were proved to be affected by electrophysiologic study. Electrophysiologically 80% of cases showed same nerve affection as showed clinically. 10% of cases showed multiple nerve affection electrophysiologically, while clinically they were diagnosed as single nerve affection. Ulnar nerve was the most frequent nerve affected in the studied sample. Evidence of reinnervation was detected in 35% of cases by electrophysiological studies, while clinically they were considered completely paralyzed. It was concluded that in every case of extremity injury requiring medicolegal evaluation, electrophysiological studies should be done beside the clinical examination to discover mild, subclinical or even unnoticed deficits of nerve affection to determine the prognosis

Protective role of antioxidant vitamins [C and E] on DI-2-ethylhexyl phthalate induced testicular toxicity in rats. histological and ultrastructural studies

Di-2-ethylhexyl phthalate [DEHP] is one of the most common synthetic environmental pollutants to which nearly everyone is exposed. It is used as a plasticizer that imparts flexibility, durability and softness to rigid polyvinyl chloride products. The aim of the present work was to study histologically the effects of DEHP on the testis and the role of antioxidant vitamins in prevention of such effects. The present study was carried out on 55 adult male albino rats. The animals were divided into three main groups. Group I served as control group. Group II, received oral daily dose of] gm/kg b.w. of DEHP for 4 weeks. Group III was further subdivided into three subgroups; IIIa, IIIb, IIIc. They received the same dose of DEHP for the same period simultaneously with vitamin C [100 mg/kg b.w.], vitamin E [20 mg/kg b.w.] and vitamin C and E respectively. At the end of the experiments, specimens were taken from the testes of all animals and were subjected to histological and ultrastructural studies Animals of group Ii revealed moderate degenerative changes in most of the somniferous tubules of the testis. Few tubules showed severe atrophy of the germinal epithelium. These tubules appeared lined only with spermatogonia and Sertoli cells. There was a decrease in the number of spermatozoa. Electron microscopic examination revealed considerable vacuolation of the cytoplasm of Sertoli cells. They exhibited dilatation of the smooth endoplasmic reticulum and bizzar shaped dense mitochondria. Degenerative changes were also seen in Leydig cells. Simultaneous administration of antioxidant vitamins with DEHP [group Hi] ameliorated the toxic effects of DEHP on the somniferous tubules of rats. This protective effect was more evident in animals that received both vitamins C and E together with DEHP. The use of vitamin E provided better protection than vitamin C. Conclusion: It could be concluded that DEHP has an injurious effect on the testis of the exposed animals. This effect could be prevented by regular use of antioxidant vitamins

Postmortem diagnosis of diabetes mellitus: comparative study of the diagnostic value of commonly used parameters

In medico-legal practice, undiagnosed diabetes has been suggested as a possible cause of death in otherwise unexplained deaths, and the postmortem diagnosis of diabetes mellitus can be of utmost importance for confirming death from metabolic derangement, or if medical malpractice is suspected. The aim of the present work was to study and compare the usefulness of some markers to diagnose diabetes during postmortem examination, and to ascertain their sensitivity and specificity. The study was conducted on vitreous humor and blood samples collected from 68 cadavers during postmortem examination. Based on medical records, cases were classified into two groups [31 cases with previous diagnosis of diabetes mellitus, and 37 cases without such diagnosis]. Collected samples were analyzed for fructosamine in blood; glycated hemoglobin; fructosamine, glucose and lactate [to determine glucose plus lactate] in vitreous humor. The results obtained in the present study indicate that the measurement of glycated proteins [fructosamine] in vitreous and serum, glycated hemoglobin, and the combined glucose and lactate levels in vitreous humor are useful indicators for diagnosis of diabetes mellitus in postmortem settings. The differences among the discriminatory potentials of the studied parameters were not statistically significant [as determined by comparing the areas under the receiver operating characteristic -ROC- curve]. The diagnostic potential of any of the studied parameters surpasses that of glucose levels in vitreous humor