Islamic praying and osteoarthritis changes of weight bearing joints

Find out whether daily physical activities of Islamic praying predispose to or protect from osteoarthritis [OA] of weight bearing joints. Comparison of prevalence of primary OA of knees and/or hips between age and weight matching prayers and non-prayers men. Civil official and employees from different establishments in Erbil City [191 Subjects] and [21 subjects] from out-patient clinics of Rizgary and Erbil Teaching Hospital-Erbil, over a period of eight months starting on Jan 2004. This constituted one hundred and eleven prayers and 101 subjects not practicing Islamic praying. Subjects fulfilling our inclusion criteria underwent clinical evaluation and radiology of their knee and hip joints. We assessed, by Chi-squared test, differences in frequency of OA between prayers and non-prayers, and between the > 20 year prayers who lay hand first on prostrating from erect posture and the same duration prayers who lay their knees first. No single OA of hip was encountered. OA of knees was significantly less [p<0.01] prevalent among prayers than those who did not practice Islamic praying. Differentially, laying knees first on prostrating from erect posture was associated with significantly [p<0.05] higher frequency of OA of knees as compared with those who lay their hands first on the praying rug [ground]. Islamic praying in 46-60 year-old men, of normal or marginal overweight [BMI 20-27 kg/m2], protects from primary OA of the knees. Laying palms first on prostrating from standing position appears to preclude a likely harmful effect on the knee joints presumably form repeated "hitting" of ground under the praying rug if laid first on prostration

Clinical evaluation and diagnosis of hyperthyroidism revisited

Rationale: An attempt to help hyperthyroid patients to circumvent the cost of thyroid function tests, a relatively heavy financial burden for the average Iraqi citizen nowadays. To design a protocol for clinical diagnosis of hyperthyroidism utilizing the Wayne's Thyrotoxicosis Diagnostic Index [WTDI] as a base line. Design: Clinical comparison of hyperthyroid patients and euthyroid subjects. Setting: a. for patients, Hazim-Al-Hafidh Oncology and Nuclear Medicine Hospital, Mosul, b. for subjects, visitors of Ibn Seena Teaching Hospital, Mosul. The study was conducted during the period from December 1997 to August 1998. Participants: One hundred thyrotoxic patients diagnosed by hormonal assays and one hundred clinically euthyroid subjects of similar sex and age. Intervention: History and physical examination pertinent to hyperthyroidism for each patient and each subject including all components of the WTDI. Main outcome measures: Clinical data obtained from both patients and subjects were measured using sensitivity, specificity, and predictive values of each symptom and sign. The WTDI was utilized for assessing the clinical findings of each patient and subject Two symptoms and ten physical signs, including two new signs that were not part of WTDI - the velvety skin and the wide pulse pressure, attained confirmatory value in ruling - in the diagnosis of hyperthyroidism. Two symptoms and four signs did attain a confirmatory value in ruling - out the diagnosis when absent. Both hot hands and tachycardia reached rule - In and rule - out states. Ninety-five of the one hundred patients entered the thyrotoxicosis zone of the WTDI by attaining >/= 19 points. By offering two points and one point to the velvety skin and the wide pulse pressure respectively, all the 100 patients attained >/= 19 points. The highest score attained by any of the 100 subjects was 14 points; the mentioned addition would at most bring the highest score among subjects to 17 points; less than the diagnostic score of WTDI. Heat intolerance did not reach a ruling - in or ruling - out diagnostic value in our study though given the highest diagnostic value in WTDI. The reason[s] for such discrepancy was discussed. Koilonychia was noted in 29% of the patients and 8% of the subjects. WTDI with minor modification is worth to be adopted for the diagnosis of thyrotoxicosis and for follow up reassessment of patients during medical treatment particularly when a patient could not bear the cost of the thyroid function tests with the possible exception of some patients like pregnant women who may need a more elaborate evaluation

Aetiopathogenesis of idiopathic bladder stone disease of childhood: possible role of a temporary state of residual urine

One hundred children with idiopathic bladder stone disease and 33 controls were studied to test an hypothesis that blamed infantile diarrhoea as the cause and postulated also a state of temporary reflex obstruction to urine out-flow. A significant [P. < 0.001] number of patients displayed evidence of anal verge lesions. Early circumcision [during first three months of age] was found in one out of 33 patients. Breast feeding was more common among patients [P < 0.05] and the highest frequency was seen in the fourth child of the family. It is suggested that a temporary state of residual urine preceded the onset of symptoms of stone disease. The recumbent position of infancy was suggested to promote growth of nuclei of stones in the bladder because of the observed coincidence in more than 50% of patients, of the onset of symptoms with the beginning of the child to walk alone

Chemical composition of urinary stone's nuclei and its pathogenetic significance in stone disease initiation

To verify whether the anatomical site of urinary stones or the age of affected patients held a stronger association with the unique ammonium acid urate constituent of endemic urolithiasis, analysis of the nuclei of 146 stones from Northern Iraq was conducted. The age, sex and site where the stone was recovered from was known in each case. The results revealed that the ammonium acid urate content was a feature of stones recovered from patients aged 15 years or younger; their site in the urinary tract proved immaterial. The formation of ammonium acid urate was suggested to result from a bout of gastro-enteritis accompanied by fasting from, e.g., vomiting. Confinement to breast feeding was considered contributory to the formation of ammonium acid urates