Joint mobility in insulin dependent diabetic children and its relation to microvascular complications

The aim of this study was to evaluate joint mobility in insulin dependent diabetic children and to determine any association between limitation of the range of motion and microvascular complications of this disease. The study was conducted on 60 children suffering of IDDM chosen randomly from regular attendants of the Diabetology Clinic of the Children's Hospital, Ain Shams University. They were subjected to medical history taking and clinical examination laying stress on fundal examination by direct ophthalmoscopy. Clinical assessment of joint mobility qualitatively and quantitatively was performed using a goniometer. Laboratory investigations included glycosylated hemoglobin and detection of microalbuminuria. A control group of twenty apparently healthy children was assessed clinically for joint mobility. The prevalence of limited joint mobility [LJM] in our insulin dependent diabetics was significantly higher than in the control group. Interestingly, this study suggested that ankle range was the most sensitive test for determination of LJM in diabetics. A positive correlation was found between the severity of LJM, negative glycemic control, retinopathy and microalbuminuria. Accordingly, detection of LJM may reflect the development of microvascular changes in IDDM

Congenital indifference to pain: report on two families

Congenital indifference to pain is a rare disorder characterised by absence of normal subjective and objective responses to noxious stimuli in patients with intact central and peripheral nervous systems. In this report, we describe five girls affected by this rare disorder. The five girls are members of two families living in Kuwait. The clinical presentation of this disorder as well as its complications are illustrated