Correlation of visual field defects and optical coherence tomography finding in migraine patients

The aim of our work was to detect any structural or functional visual defects during and in between the attacks in patients with migraine. Sixty patients with migraine as well as sixty age and sex matched controls were included. All cases were subjected to full ophthalmological examination. Cases with any previously known optic nerve abnormalities or with history of increased intraocular pressure were excluded from this study. A full threshold 24-2 automated perimetry as well as optical coherence tomography [OCT] were performed for retinal nerve fiber layer [RNFL] thickness. Correlations between results of study group with migraine and controls were analyzed and recorded. There was a statistically significant difference between the patients with migraine and the controls in visual field analysis which was [P < 0.05] for generalized visual field deficits and [P < 0.001] for localized visual field deficits during the attack with no statistically significant difference in visual field in between the attacks [P > 0.05]. OCT RNFL thickness had no statistically significant difference between migraine and control groups [P > 0.05]. Migraine can cause functional ocular disorder without any structural abnormalities

Study of Knowledge; Attitude; Practice towards Epilepsy among Relative of Epileptic Patients in Khartoum State

People with epilepsy are suffering from a lot of un tolded negative impacts on their lives; due to misunderstanding of the disease and from the associated stigma. Objectives: The objective of this study is to assess the knowledge; attitude; and practice among relatives of Sudanese epileptic patients seen in Sheik Mohamed Kheir Neurological clinic and Elshaab Teaching Hospital. Methods: This is a descriptive cross- sectional community based study; 313 respondents were included; the duration of the study was from November 2008 to June 2009. Results: Most of the respondents knew the disease; and had witnessed an attack. One third mentioned a brain lesion as the underlying cause of epilepsy. Most of the respondents mentioned loss of consciousness as the major symptom. More than two thirds mentioned that it is not contagious. Most of the respondents claimed that it can be controlled; and two thirds preferred medical treatment. The study revealed that half of the respondents had shown favourable attitudes and practice. Conclusion: The study revealed that the level of knowledge; attitude; and practice towards epilepsy needs community educational programmes to fill the gaps; and minimize the stigma

Solitary rectal ulcer syndrome: a clinicopathological study of 13 cases

Solitary rectal ulcer syndrome [SRUS] is a rare disorder that has a wide spectrum of clinical presentation and variable endoscopic findings. To further characterize the clinical and pathological features, a retrospective, hospital-based clinicopathological study was conducted. All cases of SRUS diagnosed at Farwania Hospital, Kuwait, between 2002 and 2007 were retrieved from the computerized filing system. The histological slides were reviewed by two authors to confirm the diagnosis. Immunohistochemical stain for smooth muscle actin [SMA] was performed. The clinical files were reviewed for clinical features and endoscopic findings. Thirteen cases were identified: 8 males and 5 females. The age range was 15-85. Rectal bleeding, constipation, and abdominal pain were the most common presenting symptoms and were seen, either alone or in various combinations, in 12 of the 13 cases. Rectal ulceration was the most common endoscopic finding, being seen in 9 of thel3 cases; 3 of these cases had multiple ulcerations. Two patients had rectal polyps, with one of them having multiple polyps. The histological examination revealed surface serration, fibromuscular obliteration of the lamina propria, and crypts' distortion in all the cases. Seven of the cases had diamond crypts. Ectatic mucosal vessels were a common finding. Positivity for SMA in the lamina propria was seen in all examined cases. SRUS is a rare disorder and only 13 cases were diagnosed in Farwania hospital over a 6-year period. The clinical presentation of our patients was variable. The presence of polyps and multiple ulcerations on endoscopy is further evidence that SRUS is a misnomer. Surface serration, fibromuscular obliteration, and crypts' distortion are the most characteristic features. The presence of diamond crypts is an additional diagnostic feature

study of knowledge, attitude, practice towards epilepsy among relative of epileptic patients in Khartoum state

People with epilepsy are suffering from a lot of un tolded negative impacts on their lives; due to misunderstanding of the disease and from the associated stigma. The objective of this study is to assess the knowledge, attitude, and practice among relatives of Sudanese epileptic patients seen in Sheik Mohamed Kheir Neurological clinic and Elshaab Teaching Hospital. This is a descriptive cross- sectional community based study, 313 respondents were included, the duration of the study was from November 2008 to June 2009. Most of the respondents knew the disease, and had witnessed an attack. One third mentioned a brain lesion as the underlying cause of epilepsy. Most of the respondents mentioned loss of consciousness as the major symptom. More than two thirds mentioned that it is not contagious. Most of the respondents claimed that it can be controlled, and two thirds preferred medical treatment. The study revealed that half of the respondents had shown favourable attitudes and practice. The study revealed that the level of knowledge, attitude, and practice towards epilepsy needs community educational programmes to fill the gaps, and minimize the stigma

Validity of platelet count/spleen diameter ratio as a predictor of esophageal varices in patients with liver cirrhosis

Portal hypertension commonly accompanies the presence of liver cirrhosis, and the development of esophageal varices [OV] is one of the major complications of portal hypertension. To evaluate platelet count/splenic size ratio as a non-invasive parameter to predict the presence or absence of esophageal varices in patients with liver cirrhosis. Eighty-six cirrhotic patients who underwent digestive upper endoscopy, were classified into Group 1 which is formed of 60 patients who had endoscopic evidence of OV and Group 2 which is formed of 26 patients who had no endoscopic evidence of OV. All the patients underwent thorough clinical examination, laboratory and ultrasonographic evaluation. Laboratory investigations were done in the form of complete blood count including platelet count [PLT]; liver function tests [aspartate transaminase [AST], alanine aminotransferase [ALT], serum bilirubin and prothrombin time [PT]], schistosomal antibodies, hepatitis B surface antigen [HBsAg] and hepatitis C virus antibodies. Abdominal ultrasonography and upper gastrointestinal endoscopy were done for all patients. Patients with OV had lower mean platelet count and higher mean spleen diameter than patients without OV [p=0.003 and p=0.01 respectively]. The mean values of the ratio of platelet count/spleen diameter was significantly lower among OV group when compared with patients who had no endoscopic evidence of OV [p=0.002]. There was no significant difference in the platelet count/spleen diameter ratio between different grades of OV. Large OV was associated with increased portal vein diameter [p=0.05]. Lower platelet count/splenic size ratio is associated with the presence of OV yet it cannot be used as a predictor of OV and so the endoscopy remains the standard screening test for OV among patients with liver cirrhosis

Effects of intensive rehabilitation on locomotor capacity after total knee replacement

To evaluate the effectiveness of a pre- and post-operative exercise protocols and intensive functional rehabilitation [IFR] program on locomotory capacity in the first three months after primary total knee arthroplasty [TKA] for severe osteoarthritis. The study was conducted on 20 patients-with severe osteoarthritis knees who underwent TKA. They were divided randomly into 2 equal groups. The first group received an intensive rehabilitation program while the second received ordinary rehabilitation program. Before program start all patients were subjected to clinical examination. Postural assessment was done to all patients twice pre-operatively and 12 weeks post-operatively using Computerized Dynamic Posturography including motor control, adaptation and sensory organization tests, The ordinary rehabilitation group showed a statistically significant increase in post-operative weight symmetry p<0.05 compared with normal. There were statistically significant high values in both groups in pre- and post-operative strength symmetry p<0.05 compared with normal. Adaptation test toes down showed a statistically significant difference from normal in both groups of rehabilitation in all trials post-operatively, and in intensive rehabilitation group in trial 1, and trial 3, while in ordinary rehabilitation program in trial 2 pre-operatively p<0.05. Amplitude scaling f with affected side of the lower limb, showed a statistically significant decrease in ordinary rehabilitation group in small / and medium f. p<0.05. Intensive rehabilitation group showed no significant change in comparison to normal. There was more balance affection in toes up position in ordinary rehabilitation group. There was better balance in intensive rehabilitation group on affected side

Effects of intesive rehabilitation on functional ability after total knee arthroplasty

To evaluate the effectiveness of a pre- and post-operative intensive functional rehabilitation [IFR] program in the first three months after primary total knee arthroplasty [TKA] for severe osteoarthritis on functional ability and muscle isokinetics. Twenty severe osteoarthritis knee patients underwent primary total knee arthroplasty. They were divided randomly into 2 groups of 10 each. The first group received intensive program of rehabilitation, the second received ordinary rehabilitation program. All patients were subjected to clinical examination, functional assessment using WOMAC score, knee range of motion, 6 Minute Walk test, Timed Up and Go test, and Isokinetic Assessment, at start, 6 and 12 weeks afterwards. Total WOMAC score, pain, stiffness, and difficulty WOMAC scores showed a significant decrease after 6 and 12 weeks in both groups. The first group showed more decrease than ordinary program. Timed Up and Go test showed a significant decrease after 12 weeks in both groups p=0.003, shorter time in the first group than the second. Isokinetic parameters as peak torque and peak torque per body weight showed significant increase after 6 weeks in first group p=0.01, but not in second p>0.05. After 12 weeks there was a statistical significant increase in both groups p<0.001, higher in first group p<0.05]. Total work, average power, and maximum repetition total work showed better improvement in first group. IRP applied in the first 3 months after TKA is effective in promoting better functional ability, less pain and stiffness and results in better ROM and longer distance walked

Anti-endothelial cell antibodies and soluble adhesion molecules in rheumatoid arthritis complicated with peripheral neuropathy

To examine whether levels of anti-endothelial cell antibodies [AECA], soluble vascular cell adhesion molecule-1 [sVCAM-1 and E-selectin were elevated in rheumatoid arthritis [RA] patients complicated with peripheral neuropathy [PN] as compared to RA patients without neuropathy and healthy controls. Also, to correlate these criteria with the parameters of disease activity. Levels of AECA, sVCAM-1 and E-selectin were determined with ELISA in 30 RA patients with PN, 30 RA patients without neuropathy and 25 healthy controls. RA patients with PN had significantly higher levels of AECA, sVCAM-1 and E-selectin than RA patients without neuropathy and healthy controls. Those three markers significantly correlated with the clinical and laboratory parameters of disease activity. Serum levels of AECA, sVCAM-1 and E-selectin proved to be higher in RA patients with PN than in RA patients without neuropathy. This reflects increased endothelial cell activation in RA patients complicated with neuropathy

Use of psychosocial concerns questionnaire in a sample of patients in different stages of liver disease

The aim of this work was to study psychosocial concerns in patients at different stages with liver disease using a simple questionnaire. Sixty-four [28 males and 35 females with mean age 51.8 SD +/- 8.8 years; only 12 [18.8%] were educated and all were married] liver disease patients were subjected to the Frankfurter Befindlichkeitsskala questionnaire [FBS] which was used to elicit their psychosocial concerns. 47 patients with complete investigation were classified according to child' s score of liver disease staging; among these patients, 15 were qualitatively assessed. The results revealed Child's score was estimated in 47 patients who had full data; of these 10 [21.2%] were in group A, 20 [42.6%] in group B and 17 [36.2%] in group C. As regards FBS, the most common psychosocial concern was feeling slow, followed by feeling tense and the least common complaints were feeling that drugs cause more harm than the illness and not confident to interact. Some psychosocial concerns were significantly associated with illiteracy, having non-governmental jobs, being a female and having children more than 15 years old. As regards Child's score, there was no significant association except for dreams that worry. Individual interview showed a more in depth exploration of these concerns. The results concluded that the nature and number of concerns are useful markers for psychosocial interventions in patients with chronic diseases such as liver diseases. Qualitative assessment is useful and meaningful tool to be incorporated in such studies. Multidisciplinary approach is needed for patient proper management in order to have a favorable impact on patients quality of life

Identification of female characteristics which need counselling services: a community based study in an upper Egyptian rural village

This study aimed to identify factors leading to female mental health problems and to oppression in order to provide counseling services. This is a community based study where 373 females from upper rural Egyptian village were subjected to a specially designed questionnaire to detect some factors related to oppression and were also subjected to the Zung test to assess female mental status. Some of these factors included individual and family factors such as gender role and marital conflict, in addition to macro-level factors such as economic burdens. 60.9% of the cases were oppressed due to battering, an act which was not justified by 65% of women. Severe physical consequences appeared in 11.5% of cases ranging from black eyes to abortion and disability. Gender discrimination acts together with female frustration and oppression prevailed. No single factor explains why female are oppressed as it is the result of the complex interplay of individual, relationship, social, cultural and environmental factors. The study concluded that understanding factors leading to female oppression is one of the important steps to provide counseling services and to empower female which enables her to select healthier choices in life