Flexor tendon repair in the hand: the use of early postoperative therapeutic exercises alone versus its combination with laser

The aim of the study was to compare between early uses of therapeutic exercises alone versus the effect of its combination with the use of laser after hand flexor tendon repair in zone II. A prospective study was done on a thirty patients operated at Elsahel Teaching Hospital for a flexor tendon repair in zone II using a modified Kessler' technique. Patients have an average age of 25.26+ 6.37 years and they were randomly divided into two equal groups, the first group [A] received only therapeutic exercises, and the same program of exercises in addition to the use of laser therapy was applied in group [B] after operation. In both groups, results after 3 months showed a statistically significance increase as regards duration of post operative rehabilitation program in total active motion [TAM] of P.IP and DIP, [Group A at 3 weeks showed 53 +/- 45.85 and at 3 months 110.33 +/- 32.15, Group B showed at 3 weeks 102 +/- 34.37 and at 3 months 149.66 +/- 26.95]. the same significant results was also seen in case of maximal hand. grip strength [MI-IG], [Group A showed at 3 weeks a result of 17.56 +/- 3.96 and at 3 months 54.01 +/- 15.15 and Group B showed a mean results at 3 weeks of 23.02 +/- 7.06 and at 3 months 82.6 +/- 16, 48. In addition group [B] showed highly significant improvement in TAM and MHG as compared to group [A]. It was concluded that the addition of laser with early therapeutic exercises plays an important roles to improve results at postoperative rehabilitation after hand flexor tendon repair

relation between the duration of inhalation abuse of a volatile substance and its effect on the testis. a histological and biochemical study in adult male albino rats

Volatile substance abuse in general, and toluene inhalation in particular, for their neuropsychological effects, represents a significant problem in many developed and developing countries. The present work was designed to investigate the histopathological changes in the testis of adult male albino rats, induced by toluene vapour inhalation over different periods. The present study was carried out on forty adult male albino rats with body weights ranging from 60-100g. The animals were categorized into two groups: Group I: [Control Group] included ten rats received no treatment, Group II: [Toluene inhalants] included thirty adult rats exposed to toluene vapour inhalation. A clean dry piece of cotton was soaked with toluene liquid and placed in the covered cages three times daily, each for about thirty minutes for six days per week. These animals were subdivided into three equal subgroups according to the exposure period; Subgroup [A]: ten rats exposed to toluene vapour for two weeks, Subgroup [B]: ten rats exposed to toluene vapour for eight weeks, Subgroup [C]: ten rats exposed to toluene vapour for twelve weeks. At the end of each duration of the experiment, animals were scarificed by decapitation using light ether anesthesia after taking blood samples. I- Histological examination: Specimens were taken from the testis of all rats and processed for examination by light microscope using haematoxylin and eosin stain and ultrastructural study using the transmission electron microscope. II. Hormonal assay: The concentration of testosterone level, luteinizing hormone [LH] and follicle - stimulating hormone [FSH] were estimated by radio immunoassay. III. GAS chromatography: Concentration of toluene vapour in the blood was measured by High performance liquid chromatography. IV. Statistical analysis: The one way ANOVA test was applied to estimate the significant values of the hormonal assay for serum testosterone, LH and FSH and the 5% level of significance was chosen. The histopathological changes observed in the testis of rats exposed to toluene inhalation demonstrated its potentials to induce cytotoxic effects on the spermatogenic cells, Sertoli cells and the interstitial cells of Leydig. The severity of the toluene damaging potentials appeared to be dependent on and directly proportionate to the duration of toluene inhalation. So, the histological changes were mild and scattered in the testis specimens of group A [2 weeks inhalation] and was more severe in both eight and twelve weeks groups. The correlation between high performance liquid chromatography for toluene gas in blood, the biochemical gonadal and gonadotrophin hormonal assay and the histological assessment, explored the various mechanisms that were incorporated in the establishment of the toluene induced testicular injury. The present study proved the undoubting evidences for the damage potentials of toluene on the testis as the major reproductive organ in the male. Furthermore, the study showed the direct proportionality between the toxic effects of toluene vapor and the length of the exposure duration. Yet, the observed histological alterations were highly suggestive for a probable impaired reproduction in experimental animals which needs further study

Effects of Cyanobacteria crude extracts on growth and related physiological activities of Chlorococcum humicola and Chlorella vulgaris

This, investigation was concerned with studying the effects of the crude extract of four cyanobacteria on the growth and some physiological activities of two unicellular green algae [Chlorella vulgaris and Chlorococcum humicola]. Two of these cyanobacteria [Microcystis aeruginosa and Nodularia harveyana] are known to produce toxin, while the other two cyanobacteria [Nostoc linckia and Lyngbya valderianum] are known to produce auxin-like substances. The obtained results indicated, in general, that growth and the studied physiological activities, except amino acids biosynthesis, of both Chlorococcum and Chlorella were inhibited by crude extracts of the two cyanobacteria species Microcystis and Nodularia. The increase in amino acid [free amino acids and proline] biosynthesis recorded for both experimented algae treated by crude extracts of M. aeruginosa and N. harveyana might be attributed to certain defense mechanisms in response to toxin stress. The obtained data concerned with the effects of crude extracts of the two cyanobacteria Nostoc and Lyngbya on the algal species under investigation, revealed that the crude extracts in concentrations 5-15 microg/ml, had stimulatory effects on growth and physiological activities of both algae. The highest concentrations, 20 microg/ml, were inhibitory to growth and all physiological activities except for amino acids which were stimulated

Nitric oxide and its relation to blood pressure control and target organ damage in hypertensive patients

Patient with essential hypertension have reduced endothelium dependent vasodilatation, this abnormality has been related to decreased activity of endothelium nitric oxide. To estimate nitric oxide level in hypertensive patients to verify its role in relation to blood pressure control and target organ damage in hypertensive patients. Sixty hypertensive patients participated in this study, 40 of whom without clinical evidence of target organ damage of whom 20 had uncontrolled blood pressure and the other 20 were controlled with antihypertensive therapy. Study also included 20 hypertensives with evidence of target organ damage. Ten normal non-hypertensive subjects volunteered as controls. They were all subjected to full clinical assessment and estimation of nitric oxide levels. Each of the hypertensive groups including controlled hypertensives, uncontrolled hypertensives and hypertensives with evidence of target organ damage had statistically significant lower nitric oxide levels compared to normotensive control subjects [p<0.000]. Controlled hypertensive group when compared to the uncontrolled hypertensive group still had a statistically significant difference of nitric oxide [p value 0.000] While hypertensive patients with evidence of target organ damage had a statistically significant low nitric oxide levels compared the controlled hypertensive group [p value < 0.001], they did not have a statistically significant difference in NO levels when compared to the uncontrolled hypertensive group [p value 0.5]. Hypertensive patients whether controlled or not; whether with target organ damage or not have low NO denoting an underlying endothelial dysfunction. Controlled hypertensives with acceptable blood pressure measurements still have evidence of endothelial dysfunction with low NO. Current antihypertensive therapy, though attaining acceptable blood pressure levels does not seem to tackle endothelial dysfunction in hypertensive patients. NO seems to be playing a crucial role in target organ damage in hypertensive patients

Circulating leptin and tumor necrosis factor: a in patients with sepsis: correlation with microbiologic findings

Forty-six critically ill patients with culture proven bacteremia participated in this study and classified into two groups [30 patients with severe sepsis and 16 patients with septic shock]. The control group composed of 20 subjects before elective surgery. Body mass index [BMI] was calculated for all subjects. Leptin and TNF-alpha concentrations were determined for all participants. Leptin and TNF- alpha were reassessed in eight patients who survived after severe sepsis. Blood cultures were obtained for all patients. Specimens from other sites were obtained as appropriate. All samples were cultured and the isolates were identified by standard microbiologic procedures. All patients received a full standard supportive care and an empiric antimicrobial treatment that was modified to reflect the in vitro susceptibility testing whenever appropriate. The study concluded that septic patients had an elevated leptin and TNF-alpha levels correlating with the severity of the disease. Patients with a pure Gram-negative infection had significantly higher leptin and TNF- alpha levels than those with a pure Gram-positive sepsis

Teratogenic effects of indomethacin on rat embryos

In this study 16 pregnant albino rats was divided into two eaual groups. The first group was injected daily with 1 mg/kg body weight indomethacin intraperitoneally from day 6 to 10 of gestation. Doses of 2 mg/kg body weight or more were tried but were rejected because of high incidence of embryolethality and maternal mortality. One da 12 of gestation [11.5 embryonic age day], embryos were explanted, examined and their morphological parameters were evaluated. The most common development effect observed in embryos of the treated group was intrauterine growth retardation as evidenced by the significant decrease in their morphological score when comared with those of the control group. In embroys of the treated group, there were a decrease in both crown-rump and head lengths, reduction in the numbers of both branchial bars and somites, as well as a delay in the formation of the forelimb bods. Also a significant increase in embryolethality was was noticed in the treated group as proved by the increased number of resorptions. These changes were associated with a decrease in the body weight of the treated mothers when comared with the control ones. On the basis of the findings of the present study, it can be concluded that malnutrition of the pregnant rats caused by gastrointestinal tract dysfunction, constriction of the vessels of the conceptus, viz. uterine, umbilical and vitelline vessels and impariment of cell division of the embryo may contribute in the mechanisms through which indomethacin could affect the rat embryos

effect of proximal versus distal circumferential periosteal release on the rate of growth of the growing and of the tibia: an experimental study in albino rats

Twenty albino rats, each aged 4 weeks and weighting 50-60 gms, were used in this study. They were divided into two groups, each group consisted of 10 rats [five males and five females]. Unilateral tibial circumferential periosteal release was performed proximally in the first group and distally in the second group. In all cases, the periosteum of the shaft was incised 3-4 mm away from the growth plate. X-ray imaging was performed at weekly intervals starting from the day of surgery till the 14th week. Tibial length either on the operated or the control sides was measured for each animal from the X-ray films. The growth zone of the growing end of each tibia was examined microscopically. The surgery was followed by a latent period of two weeks in the first group and three weeks in the second group. During this latent period, there was no observable difference in the growth rates between the operated and control sides. Thereafter, the rate of growth of the side of operation exceeded that of the control side. In the subsequent two weeks, the rate slowed down. By the 14th week, tibiae of proximal periosteal release showed an increase of about 14% more than the control ones, while the corresponding increase in distal release was only 6.3%. Microscopic examination of the proximal epiphyseal plate of the tibiae revealed marked widening of the growth zone in the bibiae of the operated sides compared to the control ones especially in the cases of proximal periosteal release. In can be concluded that proximal circumferential perisoteal release can serve as a reliable and safe means of growth stimulation of the long bones of the growing animal and that can be applied for leg-length inequality. The site of the operation and the age of the child should be put into consideration. The response is inversely proportional to the age and it is more manifest in proximal than distal release

Early controlled mobilization of repaired flexor tendons of the hand

This study was carried out on 92 cases with recent flexor tendon injuries in the hand [156 fingers affected] management by primary repair. Modified Kessler technique was used for suturing the injured tendons. A post operative program was carried for early controlled mobilization using modified Kleinert splint which control the movement of the finger in special position the result were evaluated according to Buck-Gramcko method as it was satisfactory in 139 fingers [89.1%] and non satisfactory in 17 fingers [10.9%]