Adalimumab for the treatment of refractory sciatica induced by disc prolapse: Abu Dhabi experience

Ten patients with back pain and sciatica were selected according to certain inclusion criteria for a study to assess the efficacy of the Anti TNF agent Adalimumab in the treatment of refractory sciatica pain induced by a lumbar disc prolapse in patients who failed to improve following lumbar epidural steroid or disc surgery. Each was given a subcutaneous injection of 40 mg Adalimumab repeated after two weeks. Patients were assessed regularly on weeks 0, 2, 4 and 8 employing the Visual Analogue Score [VAS] for leg pain and back pain and the Straight Leg Raising [SLR] test. The median improvement of the leg pain VAS was 55. Median improvements of back pain VAS was 37. Median improvement of the SLR was 45. The study demonstrated the beneficial effect of adalimumab therapy in reducing the back and leg pain associated with sciatica in this difficult to treat group of patients. The improvement of leg pain was more significant than that of back pain. The response was better in patients with symptoms of shorter duration and with less SLR restriction at base line

Outcome of anterior cervical discectomy with cage in cervical disc degeneration

This study evaluates the efficiency and outcome of interbody polyetheretherketone [PEEK] cage implantation in 50 consecutive cases treated, for cervical disc degeneration. This work was conducted in Assiut University Hospital, Neurosurgery Department over 3 ears duration from 2006 to 2009. Fifty patients with cervical disc disease, were treated with cervical discectomy and Cervical interbody fusion using a PEEK cage. PEEK cages were packed with demineralised bone grafts or synthetic bone grafts. Additional plating was not used in any case. The median duration of follow-up was 12 Months [range, 6-36 months]. Cervical x-rays were routinely used in the follow-up to assess the fusion pseudoarthrosis, kyphosis, cage migration, subsidence or breakage. There were 39 male and 11 female patients and the mean age 45 years [range, 30-60 years]. No implant insufficiency or significant complications was observed in any case. The use of a cervical PEEK cage seems to be a good way that does not require additional anterior plating and bone graft harvesting/or achieving cervical interbody replacement. Anterior cervical discectomy and interbody fusion is an effective treatment for radicular pain in selected patients with cervical disc disease after six months follow up. Because of similar clinical outcomes and lack of donor site morbidity when using PEEK, we now prefer fusion with PEEK cage to autologous iliac crest graft

Teratogenic effects of the organophosphate insecticide, malathion, on the skeleton of developing chick embryo gross morphological study

The objective of this study was to document teratogenicity observed in chick embryos following administration of insecticide malathion in a dose of 2mg in 0.1 ml corn oil, and to suggest reasonable explanations for these anomalies. A total number of 300 eggs of Gallus domesticus species were used. After 48 hours of incubation eggs were divided into 5 groups, of 60 eggs each. The individual groups were subdivided into control [20], and treated [40] eggs. The control eggs were injected with 0.1 ml of corn oil, while the treated eggs were injected with 0.1 ml of corn oil in which 2 mg of malathion were dissolved. Eggs of both control and treated groups were examined at the 5[th], 7[th], 10[th], 14[th] and 18[th] days of incubation, for weight, mortality and morbidity, external malformations and body measurements. Embryos were prepared for skeletal examination with Alizarin red stain and Victoria blue stain. It's observed from the present study that lethality; external malformations and growth retardation, are characteristic features for malathion toxicity in chick embryo. It is observed that, malathion mortality is more frequent in higher age groups [14[th] and 18[th] days of incubation] while teratogenicity is more frequent in younger age groups [5[th] and 7[th] day of incubation]. Significant loss of weight in the treated groups is also observed. The characteristic external malformations were in the form of short lower peak, parrot beak, short neck, wry neck, micromelia of both fore limbs and hind limbs. In addition, tibiotarsal angulations and claw toes were also observed. Abnormal feather distribution, persistence of mesencephalic bulge, eye anomalies and visceral herniation could also be detected. It is concluded from this study that malathion injection is teratogenc in chick embryo when given in the 2[nd] day of incubation. The lethality detected in older age groups could be explained to be secondary to marked teratogenicity in vital organs such as heart [congestive heart failure] or neural tube defects. The toxicity of malathion on developing chick embryo could be explained by its anticholinesterase action or its suppressive effect on nicotinamid dinucleotide [NAD] levels. Also, its genotoxicity or mutagenicity could not be excluded

Blood lipid profile study in patients with acute stroke

The accumulation of the lipid in the vascular smooth muscle cell within the arterial intima is a key process of the pathogenesis of atherosclerosis. Atherosclerosis is a degenerative disease of blood vessels leading to stroke.One hundred and ten patients with acute stroke were included in this study 88 patients with ischaemic or infarction stroke and 22 patients with hemorrhagic type] as well as thirty apparently normal healthy subjects as controls . Triglycerides levels and Al only were statistically significant in ischaemic type of stroke [P<0.005] while other lipid fractions were similar so the control values .Acute stroke patients [infarction type] had significantly elevated TG and low Al. While those with hemorrhagic type had more or less similar lipid profile to normal control. In general the higher the TG level th poorer the outcome in patients with acute stroke

Study of obedience of nursing-patient relationship principles from the viewpoints of patients and nurses

Relationship is like an umbrella covering and affecting all interpersonal deals. It is not only for daily life but for the time of diseases when preserving life is crucial. Pain and diseases are reported through interrelation giving the health team information about inside feelings of the patients to be treated. Nurses assess patients' needs by their art of interrelation and plan their interventions. Patients' reliance and security toward health team is made through interrelation which results in patients' anxiety decrease. This is a descriptive analytic two-group one step study in which 126 patients as well as 61 nurses attended and their viewpoints regarding efficient obedience of interrelation principles were measured. This study has focused on comparative study of obedience of nurse -patient interrelation in ALZHRA hospital in Isfahan. The data were analyzed by regression tests, ANOVA and correlation tests in SPSS software. The findings were classified in 5 tables reporting a significant difference between patients, and nurses' viewpoints regarding obedience principles of nurse-patient interrelation [f=10.785, p=0.001]. There was no significant difference in patients' and nurses' viewpoints concerning obedience principles of mutual respectations [f=3.76, p=0.054]. Regarding self-value feeling, there was a significant difference between nurses and patients' viewpoints [f=10.145, p=0.002]. Concerning obedience of sympathetic principles in efficient interrelation, there was a significant difference in patients' and nurses' viewpoints [f=21.76, p=0.000].Since there was a significant difference in patients' and nurses'viewpoints regarding obedience of efficient nurse-patient interrelation, it is a need for nurses to be familiar with patients' viewpoints through programming and follow-up education to have obedience in efficient nurse-patient interrelation. There was no significant difference between patients' and nurses' viewpoints regarding obedience of sympathetic interrelation

Modified laser nephelometric technique to study RBC's aggregation stages

Laser nephelometric technique is developed to study RBC's aggregation. Using this aggregometer, blood aggregation curve is obtained from monitoring the scattering light signal from blood under various shear rates. From this curve, blood aggregation relaxation times [relaxation time of RBC's rouleaux formation T1 and time of network formation T2] and aggregation durability constant [beta] are determined. Results obtained indicate that as the shear rate increases the intensity of backscattered light increases due to increase in disaggregation. The relaxation time of formation of rouleaux [T1] was found to be correlated with HCT [hematocrit], RBC's count and HGB [hemoglobin]. Relaxation time of network formation [T2] and hydrodynamic durability constant [beta] have a weak correlation with hematological parameters

Modified laser viscometer technique to measure blood viscosity

To eliminate human factor errors in measuring the blood viscosity laser viscometer was designed and constructed. Blood viscosity of ten human blood samples were measured using this viscometer. Hematological parameters of these samples [RBC's countt, mean cell volume [MCV] hematocrit [HCT] mean corpuscle haemoglobin [MCH] mean corpuscle hemoglobin concentration [MCHC] hemoglobin[HGB] red cell distribution width [RDW] and serum cholesterol were measured and the relation between the viscosity of whole blood and these parameters were studied. The results obtained show a correlation between blood viscosity and eash of RBC's count [r= 0.78] HCT [r = 0.51] and RDW [r = 0.537] while the other blood parameters are not correlated

Postnatal development of the albino rat superior colliculus

The emergence of laminar organization and the developmental changes in cellular and fibrous components of the layers of the superior colliculus of the newborn five, ten, twenty and sixty-day-old-albino rats [Wester Strain] were studied by using three staining techniques; the gallocyanine- chrom alum method for Nissl bodies, nuclei and nucleoli, the Golgi-Cox method for cell bodies and their processes and Holm's method for axons. The superior colliculus of the newborn rat appeared as a large collection of densely packed cells without any evidence of lamination. At the age of five days, a definite pattern of stratification started to appear transforming it into a six-layered structure. At ten days age, there were certain structural changes in the superficial layers of the colliculus, while the intermediate and deep layers showed no additional structural changes except the increase in the layers' thickness. At twenty days age onwards, there were no additional structural changes except the increase in cellular size and laminar thickness in all layers. It was concluded that the intermediate and deep layers of the superior colliculus reached their maturity earlier than the superficial layers. This could be explained as the intermediate and deep layers were involved in connections controlling the adaptive behaviors essential for the still closed-eyes animal, while the superficial layers responsible for controlling visual reflexes and eye movements were delayed in maturation till the animal's eyes start to open

Cellular immunity changes after splenectomy

This study was performed on 45 patients in whom splenectomy was done for different causes. Twenty one were bilharzial with hypersplenism, twelve with blood diseases and twelve with traumatic rupture spleen, nineteen healthy individuals were included as control. Evaluation of the immunological state of splenectomized patients was done by estimation of T-lymphocyte percentage and its subpopulation T4 and T8 preoperatively and at 1, 4 and 12 weeks postoperatively. The study revealed significant rise through the follow up period postoperatively in the T-lymphocytes percentage. T4 [helper] lymphocytes showed insignificant difference from the preoperative level, while T8 [suppressor] lymphocytes was significantly increased. This means that the post-splenectomy increase T-lymphocytes was due to increase in suppressor cells. This may be a supportive evidence for the role of splenectomy as a cause of decrease immunity with increase incidence of infection

HLA in schistosoma haematobium [Sh]: a special pattern in cancer bladder and hepatosplenomegaly

Estimation of HLA [ABC] antigen frequency was done in 65 patients with various manifestations of SH, in a trial to a possible association of these genetic markers and disease susceptibility to SH and/or in the development of various complications of the disease. It was concluded that, the close association between HLA antigens and S. hematobium infestation can provide some evidence that susceptibility or resistance to schistosomiasis is determined by genetic factors. Susceptibility of individuals may be based on the presence of A11, B21 contributes to resistance to infection. Individuals possessing A30, Cw4 may be prone to the development of the hepatosplenic form of the disease while A30, B35 and CwS more prone to the development of malignant bladder

Depressed cellular immunity in chronic schistosoma haematobium infection may lead to malignancy

The human immune system is actively involved in the host response to schistosome infection as it is exposed to multiple antigens [ova, worms, cercariae] of the parasite. These changes were thoroughly studied in Schistosoma mansoni, but hematobium infection was not equally investigated, since the finding of pure hematobium infection is difficult. The solitary hematobium infection is found only in certain areas of Upper Egypt. The humoral and cellular immune response was thus studied in 65 cases with pure Schistosoma hematobium cases in different clinical stages: Early active and late chronic complicated cases. The study revealed that humoral response was stimulated by Schistosoma hematobium infestation. but was not specific to any of the mentioned complications. Results are given in detail

Retrospective study on iron status using serum iron and iron binding capacity

Laboratory medical reports on 97 patients were analysed. Data obtained included full blood count, haemoglobin electrophoresis, serum iron, total iron binding capacity and percentage transferring saturation. 50 out of 97 patients [51.5%] were found to be hypoferremic. No statistically significant difference with regards to mean haemoglobin level was foun in both hypoferremic and normoferremic groups

Reference values for serum uric acid in Mosul

Reference ranges for many laboratory tests are not representative of the Iraqi population, as they are based on values obtained from European and North American populations. We have tried to establish a reference range for serum uric acid [SUA] in the Iraqi population in Mosul, based on data obtained from 395 apparently healthy volunteers from Mousl city. A reference ragne of 2.8-7.8 mg/ 100 ml is proposed for normal Iraqis; 3.0-7.9 mg/ 100 ml for men and 2.7-6. 1 for women