Evaluation of postural instability in IDDM patients: relationship with staging of diabetic peripheral neuropathy

The objective of this study was to use posturography to assess control of balance under static and dynamic conditions in patients with insulin dependent diabetes mellitus [IDDM], and to investigate relationship between the severity of IDDM peripheral neuropathy [PN] and postural stability. Computerized dynamic posturography [CDP] was used to assess postural stability and to investigate its relationship with staging of PN using sensory Organization Test [SOT]. Sixty IDDM patients were included in the study. According to the clinical and electrophysiological evaluation, patients were divided into four groups: severe, moderate, mild and absent neuropathy. Patients with absent neuropathy were taken as controls for other groups. SOT showed significant dysfunction of somatosensory function of type two diabetic patients with peripheral neuropathy. Posturographic parameters [Dynamic test conditions SOT4, SOT5, SOT6 and Composite Equilibrium score [ES] were all significantly impaired in IDDM patients with PN. ES also showed a direct relationship to the severity of neuropathy. Posturographic study allows a disclosure of the failure of postural control in IDDM patients with PN even in the absence of clinical evidence of postural instability

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

Endothelial and platelet activation markers in early and convalescent phases of ischemic stroke: correlation with clinical and functional disability

The soluble form of selectins in the blood may play an important role in the pathophysiology of atherosclerotic ischemic stroke. To determine whether blood concentrations of the soluble form of selectins are elevated among patients with atherosclerotic ischemic stroke, whether their concentrations in blood correlate with clinical and functional disability and to estimate differences in their levels between lacunar and territorial strokes. We measured the serum levels of soluble E-selectin [sE-selectin] and soluble P-selectin [sP-selectin] during the early and convalescent phases of 37 patients with ischemic stroke compared to controls. We, also did correlation analysis between their levels at baseline and after 3 months with clinical and functional disability scores [National Institutes of Health Stroke Scale-NIHSS-and Barthel Index-BI-respectively]. Levels of sE-selectin and sP-selectin in stroke patients were significantly elevated compared with controls during the early phase, with significant fall in their levels below baseline measurements and below those in controls after three months. sE-selectin levels after 3 months correlated with a better functional status as measured by BI, while sP-selectin levels didn't show any correlation with clinical or functional scores. No significant differences were found in the course of sE-selectin, sP-selectin levels between lacunar and territorial strokes. The evaluation of endothelial and platelet markers would represent the pathophysiological status of stroke. This may offer the possibility of researching the application of antagonists and/ or activity modulators of some of them in ischemic brain disease therapy