Distribution of clinical symptoms in carpal tunnel syndrome

To determine the distribution of clinical symptoms based on the gender and age of patients with Carpel Tunnel Syndrome [CTS]. A cross-sectional observational study. Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from April 2009 to June 2011. Two hundred and twenty seven subjects with carpal tunnel syndrome symptom were recruited. CTS was diagnosed based on the clinical history and examination. For further confirmation of CTS symptoms, nerve conduction studies [NCS] were conducted. There were 67 [29.5%] males and 160 [70.5%] females with mean age of 47.79 A +/- 5.53 years. Distributions of symptoms were 34.3% at the level of whole three lateral fingers, 14.9% were at the level of hand and forearm, was common in males compared to females. However, 48.8% symptoms at the level of whole hand, and 11.3% at the tips of the three lateral fingers were common in females compared to males. Distribution of symptoms in the whole three lateral fingers [41.6%] were significantly higher [p = 0.0001] in patients who were more than 50 years of age and symptoms at the level of wrist region [12.7%] were significantly higher [p = 0.001] in patients with age group less than 50 years. The distribution of CTS symptoms at the level of whole of three lateral fingers, hand and forearm were higher in males compared to females, and symptoms at the lateral three tips of the fingers and whole hand were common in females compared to males. Furthermore, the symptoms in whole three lateral fingers were higher in patients with more than 50 years of age and at the level of wrist region were higher in patients with age less than 50 years

Comparison of the impact of powerpoint and chalkboard in undergraduate medical teaching: an evidence based study

To compare the impact of the PowerPoint multimedia presentation and chalkboard in teaching by assessing the knowledge based on the marks obtained. Cross-sectional study. Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from December 2007 - June 2009. Three-hundred male medical students were divided into three groups and a selected content-based lecture in physiology was delivered. For one group lecture was delivered using PowerPoint presentation, for second group using chalkboard and for third group the lecture was delivered by using both PowerPoint as well as chalkboard. Single-best Multiple Choice Questions [MCQs] paper was used for assessing the knowledge gained. The same exercise was repeated in another medical science school for the confirmation of validity and reliability of the results. Students who attended the class on both PowerPoint and chalkboard obtained significantly higher score in single best MCQ examination compared to those students who attended the same content based lecture on the PowerPoint or chalkboard alone [p = 0.05]. The integrated [PowerPoint and chalkboard] method of teaching was found more suitable tool of teaching and learning than PowerPoint or chalkboard alone

Brainstem auditory evoked potentials and electrocochleographic findings in patients with idiopathic sudden sensorineural hearing loss

To determine the status of cochlea, auditory pathway and hearing threshold by recording brainstem auditory evoked potential [BAEP] and electrocochleography in patients with idiopathic sudden sensorineural hearing loss [ISSNHL]. Observational study. Department of Clinical Physiology at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, from May 2002 to November 2007. Patients diagnosed with idiopathic sudden sensorineural hearing loss [ISSNHL] based on clinical features and pure tone audiometry were studied. Brainstem auditory evoked potential [BAEP] and electrocochleography [ECOG] was performed in them according to standard protocols for assessment of auditory pathway and hearing threshold. Out of 23 patients [14 males and 9 females] left ear was affected in 9 [39.1%] patients, right ear in 13 [56.5%] and both in 1 [4.3%]. Absolute latency of wave I and wave V were significantly prolonged in affected ear compared to unaffected ears [p=0.0031], while interpeak I-V latency was significantly higher in affected ears versus unaffected ears [p=0.0544]. Six patients [26.1%] had type II Diabetes mellitus, five cases [21.7%] had hypertension and 5 cases [21.7%] had dyslipidemia. ECOG revealed absence of summation potential [SP] and action potential [AP] response even at 95 dB in 17 out of 23 cases [73.9%]. Patients with ISSNHL had significant abnormalities in BAEP and ECOG recordings showing predominantly cochlear involvement. Thus, these tests provide useful diagnostic information in patients with ISSNHL in addition to pure tone audiometry

Hypospermatogenesis and spermatozoa maturation arrest in rats induced by mobile phone radiation

To determine the morphological changes induced by mobile phone radiation in the testis of Wistar albino rats. Cohort study. Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from April 2007 to June 2008. Forty male Wistar albino rats were divided in three groups. First group of eight served as the control. The second group [group B, n=16] was exposed to mobile phone radiation for 30 minutes/ day and the third group [group C, n=16] was exposed to mobile phone radiation for 60 minutes/day for a total period of 3 months. Morphological changes in the testes induced by mobile phone radiation for 60 minutes/day caused 18.75% hypospermatogenesis and 18.75% maturation arrest in the testis of albino rats compared to matched controls. However, no abnormal findings were observed in albino rats that were exposed to mobile phone radiation for 30 minutes/day for a total period of 3 months. Long-term exposure to mobile phone radiation can cause hypospermatogenesis and maturation arrest in the spermatozoa in the testis of Wistar albino rats

Validity of F-wave minimal latency of median and ulnar nerves for diagnosis and severity assessment of carpal tunnel syndrome in type II diabetes mellitus

Type II diabetes mellitus is a common problem and is sometimes associated with Carpal Tunnel Syndrome [CTS] due to compression of median nerve at wrist. Electrophysiological tests are frequently used for its diagnosis. In this work, F-wave minimal latency [FWML] difference between median and ulnar nerve and F-ratio is used to facilitate the diagnosis and severity of CTS in type II diabetes mellitus [T2DM]. Thirty control cases were selected who were physically fit for normal electrophysiological values. Thirty-two patients with a long history of type II diabetes mellitus were studied for electro-diagnostic tests. All patients had clinical evidence of CTS. Among all diabetics about 20 cases had poor glycaemic control [HbA1c>7.5]. F-wave minimal latency [FWML] were measured in median and ulnar nerves and F-ratio of median nerve were also noted. The mean values in different groups were compared using t-test and p

Transmission of hepatitis-B virus through salivary blood group antigens in saliva

To determine an association between transmission of hepatitis B virus and secretor and non-secretor status of salivary blood group antigens. Cross-sectional, analytical study. The Department of Physiology and Division of Hepatology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia, from 2007 to 2009. Eighty eight known patients, who were positive for Hepatitis B Surface Antigen [HBsAg] were recruited. Saliva was collected for investigating the secretor and non-secretor status by using blood typing kit number Kemtec Educational Science USA. Hepatitis B Surface antigen test was performed on Enzyme Linked Immunosorbent Assay technique. Polymerase chain reaction [PCR] on saliva was also carried out in High Performance Thermal Cycler-Palm-Cycler[TM] [Corbett Life Science, Sydney, Australia] and enzymatic amplification of extracted viral DNA was performed using primers covering the promoter of the core region of HBV. Out of the 88 subjects, 61 belong to blood group O, 20 to A and 7 subjects to blood group B. Fifty subjects were secretors [salivary blood group antigens positive] and 38 subjects were non-secretors [salivary blood group antigens negative]. Among core gene positive 25 [69.4%] were secretors and 11 [30.6%] were non-secretors. However, in core gene negative 25 [48.1%] were secretors and 27 [51.9%] were non-secretors. The result shows an association [p=0.047] between secretor and non-secretors status of the salivary blood group antigens with core gene positive and core gene negative

Oral and perioral physiological changes with ageing

Ageing is the accumulation of changes over time. Ageing in humans is a multidimensional process including physical and psychosocial changes. Therefore, the management of the oral problems in elderly patients does not depend on the development of new technical skills, but rather on the overall knowledge of age-related and disease-related changes. Moreover, the dentist should be aware of the different modification necessary in the practice to prevent, diagnose and manage different oral conditions in the geriatric patient. Thus, the aim of this article is to gather the oral changes including salivary gland and saliva, tongue and oral sensation, lips, perioral tissues with ageing to enhance dentist's overall knowledge associated with these changes

Entrapment of medial plantar nerve [tarsal tunnel syndrome] in type 2 diabetes mellitus: An electrophysiological study

With increase in type 2 diabetes mellitus patients the complications of diabetes are being seen more frequently. Patients with diabetic neuropathy often present with distressing symptoms such as pain and burning sensation in the feet. Tarsal tunnel syndrome with electrophysiological changes may be a causative or contributing factor. The present study was designed to assess the presence and features of tarsal tunnel syndrome in diabetes mellitus patients. In this study a group of 10 normal volunteers were selected who had no neurological complaints or foot trauma. Another group of 33 patients having longstanding diabetes mellitus with complaints of pain, burning sensation and paraesthesia in the feet were selected for electrophysiological tests and median plantar nerve was studied. In the present study we observed that 15 [45%] of diabetic cases showed abnormal findings e.g., prolonged distal motor latency, decreased amplitude of M-response, low or absent sensory response suggesting tarsal tunnel syndrome. This study shows that the tarsal tunnel syndrome may be present in a significant number of diabetic patients with subjective neuropathic symptoms in the feet. The tarsal tunnel syndrome should be kept in mind during the diagnostic workup and management of diabetes mellitus

F-ratio, a surrogate marker of carpal tunnel syndrome

To explore the correlation of F-ratio and F-wave minimal latency [FWML] in carpal tunnel syndrome [CTS]. This retrospective study was conducted from January 2006 to January 2007 at the clinical physiology lab, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia. Motor and sensory nerve conduction studies, FMW latencies of median and ulnar nerves, and F-ratio were carried out in 54 CTS patients and 30 controls. Out of 54 CTS patients, there were 14 were males [26%], and 40 females [74%], CTS was bilateral in 32 [59%], and unilateral in 22 [41%] patients. Fifty-one patients [94.4%] had involvement of the right hand, 28 patients [51.8%] had dyslipidemia and 20 patients [37%] had hypertension. The FWML [ms] in the right median nerve was 25.46 +/- 2.2, and 25.79 +/- 1.7 in the right ulnar nerve in the control group [p = 0.5224], while it was 29.1 +/- 3.35 in the right median nerve and 26.46 +/- 4.35 in the right ulnar nerve in patients with CTS [p = 0.0008]. A similar statistically significant increase in the median nerve latency was observed in the left hand. A statistically significant reduction in the F-ratio was found consistently in all patients with CTS in both the hands [p = 0.0001]. The present study reveals prolongation of FWML in the median nerve, and a statistically significant reduction of F-ratio in all CTS patients. A significant inverse correlation was found between FWML and F-ratio in CTS patients. Both FWML and F-ratio support the diagnosis of CTS

Electroencephalogram findings in Saudi children with delayed language development

To determine the possible relation between delayed language development [DLD], epilepsy and epileptiform Electroencephalogram [EEG] discharges in Saudi children. This study was conducted in King Abdulaziz University Hospital, King Saud University, Riyadh, Saudi Arabia. In this study 116 pediatric patients with delayed language development and similar number of age and sex matched controls were studied. The age range for both groups was 2-8 years. Children with intelligence quotient less than 70, hearing impairment and radiological evidence of structural cerebral disease were excluded from the study. Sleep and awake EEG was recorded in each case. The EEG was reviewed by a clinical neurophysiologist and a pediatric neurologist. Within the DLD group of children, 12.07% had epilepsy. This is significantly different [p<0.001] from the control group in which none of the children had epilepsy. In DLD group 26 patients [22.41%] had epileptiform discharges in their Electroencephalogram. However, in control group only one child [0.86%] had epileptiform discharges. The delayed language development patients had a significantly higher percentage of abnormal EEGs, p<0.001 compared to the control group. Furthermore, out of the 102 DLD patients, who had no seizure, 12 [11.76%], had epileptiform discharges in their EEG. It is concluded that the children with delayed language development are associated with higher prevalence of epileptiform EEG discharges and epilepsy compared to their control

Attitude, belief and knowledge about blood donation and transfusion in Saudi population

Blood donation and transfusion are remarkably safe medical procedures. However, attitudes, beliefs and level of knowledge associated with blood donation and transfusion may affect such procedures. Therefore, the aim of this study was to determine the attitude, belief and knowledge about blood donation and transfusion in Saudi Population. The present study was conducted in the Department of Physiology, College of Medicine, King Saud University Hospitals, Riyadh, Saudi Arabia. A well structured Arabic questionnaire was used to asses the attitude, belief and knowledge regarding blood donation and transfusion. The sample consisted of 335 male [55%] and 274 female [45%]; the majority of the sample [65.84%] were non-donors. These non-donors [78.98%] were between the ages of 15-30 years. The 88.5% of the people who participated in the study believed that blood donation was not harmful, 20% of them stated that they would refuse blood transfusion even if they were in need because of the risk of acquiring infectious disease. 84.5% preferred direct donation, [49%] of the sample stated that they would accept blood donation only from relatives, 55.1% believed that blood transfusion was safe. However, 11.6% claimed to have acquired infectious disease after blood transfusion, 58% female in addition to 11.34% male preferred to receive blood from female donor and 69.5% did not know if the blood banks were in need of blood or not and 17.4% believed that all surgical procedures require blood transfusion. Different fears, mistrust in hospital and lack of information may serve as an important issue to be addressed when developing donors recruitment programs or campaigns to clear misconceptions about blood donation. In addition, public should know that numerous screening measures are implemented to ensure that blood donation is safe for the donor and that transfusion of the donated blood is safe for the recipient

Assessment of respiratory muscles endurance in diabetic patients

Respiratory muscle endurance is of interest in pulmonary, critical care and many other areas of medicine. The maximal voluntary ventilation [MVV] test is an objective dynamic method for measuring the working capacity of respiratory muscles. Therefore, we designed the present study to determine the effect imposed by diabetes mellitus on respiratory muscle endurance in Saudi diabetic patients. We conducted this study in the Department of Physiology, College of Medicine, King Khalid University Hospital and Diabetic Centre, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia during the year 2002-2004. In this study, we recruited 39 male diabetic patients and equal number of control subjects and all participants were non-smokers with age range of 23-71 years. The subjects were matched for age, height and weight. We determined the respiratory muscles endurance by a direct MVV test during inspiratory and expiratory phases of respiration by using a MP-100 student Bio Pac system and compared the results using a paired t-test. In inspiratory and expiratory phases of respiration, diabetic patients showed a significant reduction in the mean values of direct MVV test [p<0.001] relative to their matched controls. We conclude that in diabetic patients the respiratory muscles endurance is impaired by a decreased in MVV values. This decline in MVV further showed that the diabetic patients have a reduced inhaled and exhaled volumes during consecutive breaths

Lung function in type 2 Saudi diabetic patients

To study the effects of type 2 diabetes mellitus on lung function and to determine its severity in relation to duration of disease. We conducted this study in the Department of Physiology, College of Medicine, King Khalid University Hospital and Diabetic Centre, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia during the year 2002 -2004. A group of 32 apparently healthy volunteer male type 2 diabetic patients were randomly selected with an age range from 24-73 years. We matched the diabetic patients with another group of 40 control healthy male subjects in terms of age, height, weight, and socioeconomic status. Both groups met with exclusion criteria as per standard. Spirometry was performed on an Electronic Spirometer [Schiller AT-2 Plus, Switzerland] and results were compared using the 2-tailed student t-test. Diabetic patients showed a significant reduction in the forced vital capacity [FVC], forced expiratory volume in one second [FEV1] and peak expiratory flow [PEF] relative to their matched controls. However, there were no significant difference in the forced expiratory ratio [FEV1/FVC%] and middle half of the FVC [FEF 25-75%] between the groups. Lung function in type 2 diabetic patients is impaired by a decrease in FVC, FEV1 and PEF, as compared to their matched controls. Stratification of results by years of disease showed a dose-response effect on lung function