Comparison between the effects of insulin versus corticosteroid local injections in diabetic patients with carpal tunnel syndrome

Background: Carpal tunnel syndrome [CTS] is a medical condition due to compression of the median nerve as it travels through the wrist at the carpal tunnel. Carpal tunnel syndrome is the most commonly diagnosed and treated entrapment neuropathy and is a significant cause of morbidity. It is estimated to affect one out of ten people during their lifetime. Diabetic patients have a higher incidence with carpal tunnel syndrome. It has been reported that insulin improves the nerve regeneration and myelination through its role as neurotrophic factor

Aim of the Work: was to compare the short-term effects of insulin and corticosteroid local injections in the treatment of diabetic patients with carpal tunnel syndrome

Patients and Methods: Fifty diabetic patients with clinical and electrophysiological evidence of mild to moderate carpal tunnel syndrome were included in this study. All Patients had been sub-classified into two equal groups:- Group [1]: Twenty five patients have received local insulin injection of 10 IU Neutral Protamine Hagedorn [NPH] \{Insulinagypt N\} into the affected carpal tunnel at the first visit and the same dose of insulin after 2 weeks. Group [2]: twenty five patients have received a single dose of 40 mg triamcinolone acetonide \{Epirelefan\} local injection into the affected carpal tunnel. Nerve conduction study [NCS], Boston Carpal Tunnel Questionnaire [BCTQ] and clinical evaluation were carried out for both groups at baseline and four weeks after second dose of insulin injection and one month after steroid injection

Results: In steroid group, significant improvement in nerve conduction study as regard distal sensory latency and sensory conduction velocity without significant improvement in distal motor latency and motor conduction velocity and significant improvement in [BCTQ]. In insulin group, a more significant improvement in all parameters of nerve conduction study and also in [BCTQ] was observed with insulin injection than steroid done. Also, there were significant differences between results of both groups for insulin injection group

Conclusion: Local insulin injection is an effective treatment for restoring median nerve function in diabetic patients with mild to moderate carpal tunnel syndrome and produce significant improvement in NCS and BCTQ

Deaf children uses of social network sites and their gratifications

Aims: To identify the uses for deaf children social sites and their gratification, and identify the rate of use of the study sample social sites, as well as topics and attributes favored by these children on social sites, as well as to identify the motives for use and gratifications for those deaf children, and to identify the impact of those sites on social relations have, belong to study current studies descriptive approach used media survey, and have been applied to study a sample of deaf children in [Cairo, Monofiya] ranging in age from [12 to 18], and the study sample of 200 deaf children. Results: The more social sites used by deaf children is Facebook, then Youtube and Tweeter, the results showed that the study sample use social sites more than once a day by 51.5% and they are using those sites in the length of time ranging from less than an hour to more than three hours. Results showed the existence of a correlation between rates of uses of deaf children social sites and their gratifications at the level of moral 0.001, followed by the value of the Pearson 0.583, which has a direct correlation of any whenever the rate of use social sites, the more gratifications accruing from such use. The results proved that the use of the study sample social sites for extended periods of time does not affect the links with social realism. There is also a function of statistical differences between the region the study sample rates and deaf children social sites, at the level of moral 0.000, the value of 17.3, and degrees of freedom 198, and for children living in urban areas by an average of my account 2.75, in return for 2.55 for children belonging to the countryside

Role of pelvic floor muscle training and interferntial current in rehabilitation of stress urinary incontinence in women

Stress urinary incontinence [SUI] is a common, disruptive and potentially disabling condition in which the subject complains of involuntary leakage of urine on effort, exertion, sneezing or coughing. To outline a therapeutic approach to the clinical management of stress urinary incontinence [SUI] in women and to evaluate the benefits of combined pelvic floor muscle training and interferential current for its treatment. Thirty female patients diagnosed with SUI were studied. All patients were subjected to a full history taking, general and neurological examinations, complete urine analysis and urine culture, ultrasound and urodynamic study. The urinary rehabilitation program consisted of pelvic floor muscle strengthening exercises [Kegel exercises] for 20 minutes and interferential current for 20 minutes three times per week for 12 weeks. Assessment of quality of life was done with King Health Questionnaire [KHQ] at baseline and after 12 weeks. There were significantly increased cystometric capacity and valsalva leak point pressure after 12 weeks of bladder rehabilitation [p-Value=0.001] and improved quality of life as reflected by reduced scores of KHQ domains. Pelvic floor muscles exercises combined with interferential current therapy promoted significant changes in the urodynamic parameters and it caused significant changes in quality of life index assessed with KHQ