Immunohistochemical and histological evaluations of cyclophosphamide-induced acute cardiotoxicity in wistar rats: The role of turmeric extract (curcuma).

Chemotherapy-induced cardiac derangement is a major concern in health sector. Cyclophosphamide as a chemotherapeutic agent induces acute cardiotoxicity through its toxic metabolite, acrolein. This study evaluated the effect of ethanol extract of turmeric on cyclophosphamide-induced acute cardiotoxicity in Wistar rats. Thirty-five healthy Wistar rats, weighing 200-250g were randomly assigned into 7 groups (Groups A, B, C, D, E, F and G) N=5. Group A was the control, group B was negative control, and group C was administered 200mg/kg of turmeric extract (orally) only. While groups B, D, E, F and G were all administered 100mg/kg cyclophosphamide (i.p) for 10 days. Groups D and E were administered 100mg/kg and 200mg/kg of turmeric extract (orally) respectively for 72 hours before cyclophosphamide administration. Groups F and G were concomitantly administered 100mg/kg cyclophosphamide (i.p) with doses of 100mg/kg and 200mg/kg of turmeric extract (orally) respectively. The rats were sacrificed under ketamine anesthesia (30mg/kg i.m). The left ventricle of the heart was excised. One-way ANOVA was used to analyze data. Results revealed that there was statistically significant (P<0.05) difference in body weight change, CK-MB, and LDH across all experimental groups; which were significantly lower in cyclophosphamide group. Histology and Immunohistochemistry revealed that there were morphological alterations in the myocardium of the left ventricle in group B while turmeric extract ameliorated cyclophosphamide-induced damage in the myocardium in other experimental groups. In conclusion, cyclophosphamide-induced myocardial alterations were significantly ameliorated through administration of ethanol extract of turmeric.

Morphometric study of lumbar vertebrae in adult South African subjects / Estudio morfométrico de las vértebras lumbares en sujetos adultos de Sudáfrica

Lumbar vertebral dimensions provide vital clinical information of immense diagnostic benefits to medical experts. The present study provides data for lumbar vertebral dimensions of a cohort of specimens of South African females and males. Measurements were obtained from lumbar vertebrae from the osteological collections in the Discipline of Clinical Anatomy, Nelson Mandela School of Medicine using a digital caliper. The antero-posterior body diameter (APD), interpedicular distance (IPD), midsagittal diameter (MSD) and pedicle length (PL) were measured while ratio of MSD to APD was calculated. Results showed gradual increase from L1 to L5 for mean APD and IPD, and a decrease for mean PL from L1 to L5. Mean MSD was observed to present a "U" curve pattern from L1 to L5, while MSD/APD ratio decreased from L2 downwards. We report that certain lumbar dimensions also showed significant correlation with age at distinct lumbar levels. The present data provides a baseline of lumbar vertebral morphology for the South African adult cohort and requires further investigations with larger cohort.

Las dimensiones lumbares vertebrales proporcionan información vital en la clínica para alcanzar un diagnóstico correcto. El presente estudio proporciona datos de las dimensiones vertebrales lumbares en una cohorte de hombres y mujeres de Sudáfrica. Las mediciones de las vértebras lumbares se obtuvieron de colecciones osteológicas correspondientes a la Cátedra de Anatomía Clínica, de la Escuela de Medicina Nelson Mandela. Se utilizó un calibrador digital. Se midieron el diámetro antero-posterior del cuerpo vertebral (DPA), la distancia interpedicular (DIP), el diámetro sagital mediano (DSM) y la longitud del pedículo (LP); y se calculó la relación de DSM con DPA. Los resultados mostraron un aumento gradual de L1 a L5 para la mediana de DPA y DIP, y una disminución de la media de LP de L1 a L5. La media de DSM presentó un patrón de curva en "U" de L1 a L5, mientras que el índice DSM / DPA disminuyó de L2 hacia inferior. Ciertas dimensiones lumbares también mostraron una correlación significativa con la edad en los distintos niveles lumbares. El presente estudio proporciona datos acerca de la morfología vertebral lumbar para una cohorte de adultos de Sudáfrica, y consideramos que se requieren de más investigaciones con una cohorte más amplia.

Ultrastructural and immunohistochemical effects of aqueous leave extract of Xylopia aethiopica on the stomach in streptozotocin-induced diabetic rats / Efectos ultraestructurales e inmunohistoquímicos del extracto acuoso de la hoja Xylopia aethiopica en el estómago de ratas diabéticas inducidas por estreptozotocina

Gastrointestinal pathology in diabetic patients has become a source of concern in recent times. The aim of this study was to investigate the ultrastructural and immunohistochemical effects of aqueous leaf extract of Xylopia aethiopica on the stomach in streptozotocin-induced diabetic rats. This study was conducted using thirty adult Wistar rats. The animals were divided into three groups (n= 10). Group A was the control animals (administered with equivalent volume of citrate buffer), group B was diabetic animals induced by a single intraperitoneal injection of streptozotocin dissolved in citrate buffer (65 mg/kg) and group C was diabetic animals treated with 200 mg/kg body weight of aqueous leave extract of X. aethiopica for twenty five days. At the expiration of the study, all the animals in each of the groups were sacrificed and the stomach excised and fixed in both 10 % formol and karnovsky fixatives immunohistochemical, light microscopic and electron microscopic studies respectively. The results showed a gradual decline (P<0.05) in the blood glucose level in the extract treated group as against the increment in untreated diabetic group. There was a distortion of the glandular mucosa and epithelium in the untreated diabetic group vis-à-vis the extract treated and control groups. The immunohistochemical staining and percentage immunoreactivity of the stomach of untreated diabetic group showed that the immunoexpression of H+/K+-ATPase were sparse and significantly (p<0.000) lower compared with the control group. There was a better staining pattern for H+/K+-ATPase gastric proton pump in the group treated with aqueous leaf extract of X. aethiopica as compared with the untreated diabetic group. The ultrastructural studies of untreated diabetic group revealed a reduction in the density of mitochondria as compared with the control group. Treatment with leaf extract of X. aethiopica increased the mitochondrial density as well as uniform dispersal of chromatin. It is concluded that diabetes causes gastric pathology thus resulting in morphological changes in the gastric histo-architecture and parietal cells. The aqueous leaf extract of X. aethiopica enhances the recovery/restoration of these defects in streptozotocin induced diabetic rats and as such, may play a significant role in the management of complications associated with diabetes mellitus.

La enfermedad gastrointestinal en pacientes diabéticos se ha convertido en una fuente de preocupación en los últimos tiempos. El objetivo fue investigar los efectos ultraestructurales e inmunohistoquímicos de extracto acuoso de la hoja de Xylopia aethiopica en el estómago de ratas con diabetes inducida por estreptozotocina. Se utilizaron 30 ratas Wistar adultas, divididas en tres grupos (n= 10). El Grupo A, control (se le administró un volumen equivalente de tampón de citrato); el Grupo B, animales diabéticos inducidos por una sola inyección intraperitoneal de estreptozotocina disuelta en tampón de citrato (65 mg/kg) y el Grupo C, animales diabéticos con 200 mg/kg peso corporal tratados con extracto acuoso de X. aethiopica durante 25 d. Luego, todos los animales fueron sacrificados, se les extirpó el estómago y fijó en formol al 10 % y en fijador Karnovsky para anticuerpos monoclonales contra la bomba de protones gátrica H+/K+-ATPasa; las muestras se observaron mediante microscopías óptica y electrónica. Los resultados mostraron una disminución gradual (P<0,05) en el nivel de glucosa en sangre del grupo tratado con el extracto, contra un incremento en el grupo diabético no tratado. Hubo una distorsión de la mucosa glandular y el epitelio en el grupo diabético no tratado vis-à-vis los grupos tratados con extracto y el de control. La tinción inmunohistoquímica del estómago del grupo diabético no tratado, mostró escasas células parietales inmunorreactivas en el grupo diabético no tratado comparado con el grupo control. Hubo un mejor patrón de tinción en la bomba de protones gátrica H+/K+-ATPasa en el grupo tratado con el extracto de hoja acuosa de X. aethiopica, en comparación con el grupo diabético no tratado. Los estudios ultraestructurales del grupo diabético no tratado revelaron una reducción en la densidad de las mitocondrias en comparación con el grupo control. El tratamiento con extracto de hoja de X. aethiopica aumentó la densidad mitocondrial, así como la dispersión uniforme de la cromatina. Se concluye que la diabetes causa una enfermedad gástrica que genera cambios morfológicos en la histoarquitectura de las células parietales gástricas. El extracto de hoja acuosa de X. aethiopica mejora la recuperación/restauración de estos defectos en ratas diabéticas inducidas por estreptozotocina y, como tal, puede jugar un rol significativo en el tratamiento de las complicaciones asociadas con la diabetes mellitus.

Comparison of antioxidant effects of kolaviron and vitamin C interventions on testicular structures following nevirapine administration in Sprague-Dawley rats / Comparación de los efectos antioxidantes en la intervención con kolaviron y vitamina C sobre las estructuras testiculares después de la administración de nevirapina en ratas Sprague-Dawley

Testicular toxicity has been implicated in highly active anti-retroviral therapy (HAART) treatment. Hence there is need to identify an effective antioxidant product that can alleviate testicular necrosis due to HAART administration. Forty eight adult male Sprague-Dawley rats were used in this study. The animals were divided into eight (8) groups: A-H (n= 6). Group A animals received normal saline as the control; Group B was given Nevirapine (Nv); Group C was given Kolaviron (Kv); Group D was given vitamin C; Group E was given Nv and Kv; Group F was given Nv and Vitamin C; Group G was given Nv for 56 d and Kv for 28 d serving as a withdrawal group; Group H was given corn oil. Nv, Kv and Vit. C were given at 1.54, 200 and 250 (mg·kg)/bw respectively while all administrations were through oral gavage. The body weights were taken every other day. Thereafter, they were anaesthetized with halothane. The testes were excised, weighed, fixed in Bouin's fluid and stained with H&E while the epididymes removed for semen fluid analyses. The results showed a significant (P<0.05) decrease in sperm motility in group E (Nevirapine + kolaviron) when compared with group F (Nevirapine + Vitamin C) while Sperm count was not significantly different (P>0.05) across the groups. The testicular histoarchitectural studies revealed indistinct spermatogonia, necrotic interstititial endocrine cells in the altered interstitial space, fragmented spermatids, atrophy of mature spermatocytes, degenerated germ cells, obliterated seminiferous tubules lumen, undifferentiated spermatogonia and cellular debris in the somniferous tubules lumen of nevirapine administered group but normal across the other groups. In the testis, there were no significant reduction in SOD, Catalase and GPx activities but a significant decrease in GST activity (P<0.001) when group E was compared with group F. In conclusion, vitamin C presents a better remediation in nevirapine induced spermiotoxicity compared to kolaviron in Sprague-Dawley rats.

La toxicidad testicular ha sido implicada en la terapia antirretroviral altamente activa (TARAA). Por lo tanto existe la necesidad de identificar un producto antioxidante eficaz que pueda aliviar la necrosis testicular en la administración de la TARAA. Cuarenta y ocho ratas macho Sprague-Dawley adultas fueron utilizadas. Los animales se dividieron en ocho (8) grupos: AH (n= 6). Grupo A, animales recibieron solución salina normal como el control; Grupo B, recibió Nevirapina (Nv); Grupo C, recibió Kolaviron (Kv); Grupo D, recibió vitamina C; Grupo E, recibió Nv y Kv; Grupo F, recibió Nv y vitamina C; Grupo G, recibió Nv durante 56 d y Kv por 28 d como un grupo de retirada; Grupo H, recibió aceite de maíz. Nv, Kv y Vit. C se administraron en dosis de 1, 54, 200 y 250 (mg · kg) de peso corporal respectivamente; todas las administraciones fueron por sonda oral. Los pesos corporales se tomaron cada dos días. A partir de ese momento los animales fueron anestesiados con halotano. Los testículos fueron extirpados, pesados y fijados en solución de Bouin y teñidos con H&E, mientras que el epidídimo se retiró para analizar el semen. Los resultados mostraron un descenso (p<0,05) en la motilidad de los espermatozoides en el grupo E (Nevirapina + Kolaviron) en comparación con el grupo F (Nevirapina + vitamina C), mientras que el recuento espermático no mostró diferencias significativas (P>0,05) entre los grupos. El estudio de la histoarquitectura testicular reveló espermatogonias indiferenciadas, con células intersticiales necróticas en el espacio intersticial y espermátidas fragmentadas. Además, en el grupo que recibió Nevirapina mostró espermatocitos maduros atrofiados, degeneración de células germinales, lumen de los túbulos seminíferos obliterados, espermatogonias indiferenciadas y restos celulares en el lumen de los tubulos seminíferos. En el resto de los grupos los resultados fueron normales. En el testículo hubo una reducción significativa en las actividades de la superóxido dismutasa, catalasa y glutatión peroxidasa, pero una disminución significativa en la actividad glutatión S-transferasa (P <0,001) al comparar los grupo E y F.

Histological studies on the retina and cerebellum of Wistar rats treated with ArteetherTM

Introduction: Arteether TM, a derivative of artemisinin, is among the recent drugs that have given renewed hope for combating malarial menace. The present study investigated the effects of arteetherTM on the histology of the retina and cerebellum of Wistar rats. Materials and Methods: Twenty adult albino Wistar rats weighing 150-200 g, were randomly divided into four groups (A, B, C and D) of five animals each and used for this study. Group A rats were given intramuscular (i.m.) arteetherTM (3 mg/kg b.w.) daily for 3 days. Group B rats were given i.m. arteetherTM (6 mg/kg b.w.) daily for 3 days. Group C rats were also given i. m. of arteetherTM (3 mg/kg b. w.) daily for 3 days, and the same dose was repeated at two-weekly intervals for 4 further weeks; while Group D rats which received normal saline (0.9 % w/v, 3 ml/kg b.w.), served as controls. At the end of the experiment, the rats were sacrificed by cervical dislocation. The retina and cerebellum were excised and processed routinely for histopathology changes, using haematoxylin and eosin stain (H & E), as well as Nissl stain. Results: Results obtained showed normal cellular components of the retina and cerebellum in all groups, and no cyto-pathological changes were observed. Conclusion: Thus, this study showed that under light microscopic examination, therapeutic doses of arteetherTM caused no significant cyto-pathologic changes in the retina and cerebellum of Wistar rats.(AU)

Fatal haemorrhage from an ultrasound guided fine needle aspiration of the liver in a patient with primary hepatocellular carcinoma: case report.

A case of fatal haemorrhage is reported among 72 ultrasound (US) guided percutaneous fine-needle aspiration liver biopsies (FNAB) performed in the gastro- intestinal unit of Medicine Department in a tertiary hospital. The patient had primary hepatocellular carcinoma (PHCC) with advanced hepatic cirrhosis. Death was due to bleeding from liver nodule resulting in intra-peritoneal haemorrhage. Pre-procedure laboratory tests did not reveal the existence of major bleeding disorders in the patient. This event is our first experience, but colour flow Doppler ultrasound guidance has been reported to prevent its occurrence. The use of FNAB for the diagnosis of PHCC should therefore be guided with colour flow Doppler ultrasound scan to prevent haemorrhage. In addition, there should be proper selection of patients for FNAB especially in areas where there are no colour flow Doppler ultrasound scans.

Awareness and knowledge of glaucoma among workers in a Nigerian tertiary health care institution.

PURPOSE: The aim of this study reports the level of awareness and knowledge of glaucoma among selected health care personnel at a health institution in southwestern Nigeria. MATERIALS AND METHODS: Health personnel at the Federal Medical Centre, Owo, Nigeria, a tertiary health care institution were stratified into a clinical and an administrative directorate. One-hundred twenty participants were selected from each directorate by a random sampling technique. A structured questionnaire was used to collect sociodemographic data and data on the level of knowledge and awareness of glaucoma. Statistical analyses included the independent t-test and Pearson's chi-square test for categorical variables. Statistical significance was indicated by P < 0.05. RESULTS: From the target population of 240 participants, 216 (98 males; 118 females) completed the questionnaire. The mean age of the participants was 35.07 ± 07 years. A total of 148 (68.6%) participants had heard of glaucoma comprising all participants from the clinical directorate and 28 participants from the administrative directorate. There was no statistically significant difference between the clinical and administrative directorates about the knowledge of the aspect of vision that is first affected by glaucoma, the painless nature of glaucoma among most Africans and the irreversible nature of glaucoma-related blindness (P > 0.05, all comparisons). CONCLUSION: There is the need to update the knowledge base of these workers if they are to be useful in propagating information of the irreversible blindness that could arise from delay in glaucoma diagnosis and treatment.

Histological and histochemical studies of the aorta and pulmonary trunk in STZ-induced diabetic wistar rats treated with momordica charantia / Estudio histológico e histoquímico de la aorta y el tronco pulmonar en ratas wistar diabéticas inducidas por STZ y tratadas con momordica charantia

Diabetes mellitus (DM) is a serious metabolic disorder with micro and macro-vascular complications that result in a significant morbidity and mortality. The present study investigated the effects of Momordica charantia (M. charantia) on histological changes of the aorta and pulmonary trunk in streptozotocin-induced diabetic Wistar rats. Forty healthy adult Wistar rats of both sexes were randomly assigned into five groups A, B, C, D and E of eight rats each. Group A were the control (normal rats); B were the experimentally-induced diabetic rats; C were diabetic rats treated with methanolic extracts of M. charantia for two weeks (withdrawal group); D were diabetic rats treated with methanolic extracts of M. charantia for four weeks. E was diabetic rats treated glimepiride for four weeks. Tissues were harvested, processed routinely in paraffin wax and stained with routine and special stains. Histological results revealed morphological alterations in the aorta and pulmonary trunk of diabetic rats. Histochemical analysis also revealed abnormal deposition of glycogen in these vessels of diabetic rats. M. charantia and glimperide attenuated the morphological alterations and reduced the glycogen deposits. In conclusion M. charantia has a promising ameliorative effect on the morphology of the aorta and pulmonaty trunk in STZ-induced diabetic wistar rats and by extension, may be relevant in the management of cardiovascular alteration associated with DM.

La diabetes mellitus (DM) es una enfermedad metabólica grave con complicaciones micro y macro vasculares que resultan en una significativa morbilidad y mortalidad. El presente estudio investigó los efectos de Momordica charantia (M. charantia) sobre los cambios histológicos de la aorta y el tronco pulmonar en ratas Wistar con diabetes inducida por estreptozotocina. Cuarenta ratas Wistar adultas sanas de ambos sexos fueron asignadas al azar en cinco grupos A, B, C, D y E, 8 ratas cada grupo. El grupo A fue control (ratas normales); el grupo B fue de ratas diabéticas inducidas experimentalmente; el grupo C fue de ratas diabéticas tratadas con extractos metanólicos de M. charantia por dos semanas (grupo de retirada); grupo D fue de ratas diabéticas tratadas con extractos metanólicos de M. charantia durante cuatro semanas, y el grupo E fue de ratas diabéticas tratadas con glimepirida durante cuatro semanas. Los tejidos obtenidos se incluyeron en parafina y se tiñeron con técnica de rutina y tinciones especiales. Los resultados histológicos revelaron alteraciones morfológicas en la aorta y el tronco pulmonar de las ratas diabéticas. El análisis histoquímico reveló también la deposición anormal de glucógeno en estos vasos de ratas diabéticas. Tanto M. charantia y glimperida atenuaron las alteraciones morfológicas y redujeron los depósitos de glucógeno. En conclusión, la M. charantia tiene un efecto de mejora prometedor sobre los cambios en la morfología de la aorta y el tronco pulmonar en ratas Wistar diabéticas inducidas por STZ y, por extensión, pueden ser relevantes en el manejo de alteraciones cardiovasculares asociadas con la DM.

African traditional medication and keloid formation in herpes zoster ophthalmicus.

Keloid scar complicating herpes zoster ophthalmicus (HZO) has not been much reported among Africans despite the African population having dark skin. We report on a middle-aged Nigerian with HZO who developed keloid scar following use of traditional herbs to the herpetic rashes. A 52-year-old immune-competent Nigerian male presented with a 2-week history of vesicular rashes involving the left side of the forehead down to the tip of the nose. He initially presented to an African traditional healer who had advised application of various herbs to the lesion. When he presented to the eye clinic, he was treated for the associated uveitis with significant improvement. The cicatricial skin change gradually became raised with clinical appearance of keloid at 1 year of follow-up. Cicatricial skin changes in HZO are not unusual, but keloid formation among Africans has not been much described. Late presentation, use of traditional herbs some of which have corrosive effect and secondary bacterial infection are the possible factors that may encourage such abnormal wound healing. The myth associated with HZO in the local African setting as well as the fact that African traditional healers are still widely accepted among most African communities may play a role in increasing the risk of keloid formation among our population following HZO infection.

Histomorphological and morphometric studies of the pancreatic islet cells of diabetic rats treated with extracts of Annona muricata.

Microanatomical changes in the pancreatic islet cells of streptozotocin induced diabetic Wistar rats were studied after treatment with methanolic extracts of Annona muricata leaves. Thirty adult Wistar rats were randomly assigned into three groups (control, untreated diabetic group, and A. muricata-treated diabetic group) of ten rats each. Diabetes mellitus was experimentally induced in groups B and C by a single intra-peritoneal injection of 80 mg/kg streptozotocin dissolved in 0.1 M citrate buffer. The control rats were intraperitoneally injected with an equivalent volume of citrate buffer. Daily intra peritoneal injections of 100 mg/kg A. muricata were administered to group C rats for two weeks. Post sacrifice the pancreases of the rats were excised and fixed in Bouin's fluid. The tissues were processed for paraffin embedding and sections of 5 mum thickness were produced and stained with H & E, Gomori aldehyde fuchsin, and chrome alum haematoxylin-phloxine for demonstration of the beta-cells of islets of pancreatic islets. Histomorphological and morphometric examination of the stained pancreatic sections showed a significant increase in the number, diameter, and volume of the beta-cells of pancreatic islets of the A. muricata-treated group (5.67 +/- 0.184 N/1000 mum(2), 5.38 +/- 0.093 mum and 85.12 +/- 4.24 mum(3), respectively) when compared to that of the untreated diabetic group of rats (2.85 +/- 0.361 N/1000 mum(2), 2.85 +/- 0.362 mum and 69.56 +/- 5.216 mum(3), respectively). The results revealed regeneration of the beta-cells of islets of pancreatic islet of rats treated with extract of A. muricata.

Morphological and morphometric studies of the aorta, pulmonary trunk, and heart of streptozotocin-induced diabetic Wistar rats.

Micro-anatomical changes in the aorta, pulmonary trunk, and left ventricle of Wistar rats were studied after the administration of streptozotocin. Twenty adult Rattus norvegicus were randomly assigned into two groups (control and diabetic) of ten rats each. Diabetes mellitus was experimentally induced in the diabetic group of rats by daily intra-peritoneal administration of multiple doses of 40 mg/kg streptozotocin dissolved in 0.1 M sodium citrate buffer for five consecutive days. The control group was given the equivalent volume of citrate buffer. The animals were monitored for four weeks after streptozotocin administration. Post sacrifice, the left ventricle, aorta, and pulmonary trunk were excised, weighed, and fixed by immersion in 10% formol saline. The tissues were processed for paraffin embedding, and sections of 6 mum thickness were produced and stained with H & E for general histological observations, and Verhoeff-van Gieson elastic fibre stain to demonstrate elastic fibres in these cardiovascular structures. The data obtained were analyzed with descriptive and inferential statistics. Histopathological and morphometric examinations of the stained sections showed a significant increase in the thickness of the tunica intima of aorta (t = -7.49; df = 9; p < 0.05) and pulmonary trunk (t = -10.81; df = 9; p < 0.05) in diabetic rats (14.59 + or - 1.189 mm and 11.307 + or - 0.863 mm, respectively) when compared to that of the control group (3.62 + or - 0.353 mm and 3.22 + or - 0.244 mm, respectively). In addition, the distribution of elastic and collagen fibres was sparse in the hearts of the diabetic group when compared to that of the control group. The findings of this study demonstrated that diabetes mellitus might cause some alterations in the microanatomy of cardiovascular structures.

Effect of Balance Exercise on Selected Kinematic Gait Variables in Patients with Knee Joint Osteoarthritis

The purpose of this study was to investigate the effect of balance exercise on some selected kinematic gait parameters in patients with knee joint osteoarthritis. Forty subjects (18 men and 22 women) participated in the study. They were divided into two groups: Group 1 (experimental) that was treated with balance exercises; thermal therapy and soft tissue massage; Group 2 (control); treated with thermal therapy and soft tissue massage without balance exercise. Gait analysis was done from footprints on a 900cm walking paper and functional balance was assessed using the Berg Balance Scale. The result showed a significant difference (P0.05) in all the gait parameters except step width and foot angle for group 1 and only walking velocity for group 2. The functional balance was significantly different in group 1 and not in group 2 comparing the pre and post treatment variables. It was concluded that balance exercise is effective in improving the functional ambulation of patient with knee osteoarthritis and should be an integral part of the patient rehabilitation