Myasthenia gravis response to treatment. Clinical and physiological criteria.

Twenty three patients with myasthenia gravis, eight males and 65% respectively were admitted to Al-Yarmok Teaching Hospital in Baghdad. The most commonly affected age group was between 10-30 years[78%]. A complete clinical examination with special examination with special emphasis on the peripheral and central nervous systems was done. Laboratory investigations included electromyography, CT scanning for thymomas in addition to the routine work. By classification of the patients according to the clinical criteria presented seven patients were found to have stage I myasthenia gravis, six were stage IIA and eight stage IIB, while only two patients with stage IV is recorded. Investigations revealed that six patients only had enlarged thymus gland and two patients had increased immunoglobulins. The Tensilon test was positive in almost all the patients. All patients were treated with Mestinon [Pyridostigmine bromide 100-600 mg/day] eleven of them, any how needed prednisolone in addition. The response to medical treatment was good in 16 patients and moderate in six while poor in only one patient. One patient only needed tracheostomy and other needed surgical removal of the thymus gland [thymomectomy]. These two patients were both of stage III on clinical examination

Influence of duration of diabetes mellitus on the nerve conduction velocity.

150 known diabetic patients [7 males and 79 females] were divided into three groups according to the duration of the disease [below 5,5-9 and 10 and above years], the number of patients in each group was 62,6 and 2 respectively. The sensory conduction velocity of the sural nerve and the sensory and motor conduction velocities of the median, ulnar, peroneal and posterior tibial nerves were measured and compared in the three groups and also with results obtained from a control group of 40 nondiabetic subjects. Results from diabetic patients showed a significant reduction in the nerve conduction velocities, and a clear correlation between the duration of the disease and the severity of the neuropathy. The lower limb nerves were more severely affected, and the sensory conduction velocity was the most sensitive parameter which was affected earlier in diabetes mellitus

case of guillain bare syndrome complicating typhoid fever

In this report a case of Guillain Barre syndrome complicating typhoid fever is presented in a male patient 14 years of age complaining from fever, sweating and generalized weakness for 13 days. He developed later acute and severe weakness of the lower and upper limb muscles. Clinical and laboratory tests[including Widal test and blood culture] confirmed the diagnosis of typhoid fever. Clinical and electromyographic examinations proved Guillain Barre syndrome. The patient was discharged improving after being treated with chloramphenocil intravenously and physiotherapy. To our knowledge this is the first case of Guillain Barre syndrome complicating typhoid fever recorded in Iraq

Trophic influence of sensory nerve: Alpha naphthol acetate esterase activity in normal and enervated rabbit skin.

This work is an attempt to study one histochemical aspect of the trophic influence of a sensory nerve on the skin. Histochemical studies concerned with the analysis of alpha naphthyl acetate esterase activity [ANEA] with and without the use of modifiers in normal rabbit skin and after denervation were carried out. Differentiation of the different skin layers on histochemical basis could be done. The results revealed a deranged spectrum of esterase activity, after denervation, mainly an increased Ach and B- esterases activities, and a decrease in A esterase activity. All these changes may indicate that the sensory nerve does have a trophic influence on the skin it innervates