Nerve conduction study findings and their predictors in clinically diagnosed patients with carpal tunnel syndrome in a Saudi population.

BACKGROUND: Despite the reports of carpal tunnel syndrome (CTS) being commonplace in Saudi Arabia, there is scarcity of cross-sectional or prospective studies detailing the profile of nerve conduction study (NCS) findings in patients with CTS. OBJECTIVE: The study aimed to evaluate the neurophysiologic profile of CTS with the view to finding the determinant of abnormal findings in clinically diagnosed cases of CTS in a population of Saudis. METHODS: Nerve conduction study was performed on consecutive patients with clinically diagnosed CTS. Median sensory, ulnar sensory, radial sensory median motor and ulnar motor nerves were assessed. The nerve conduction parameters measured were median and ulnar sensory peak latency, amplitude and velocity. Median conduction velocity, distal latency, and amplitude were also measured. Comparative median-ulnar and median-ulnar-digit 4 studies were done and the severity of CTS was determined. Data was analyzed using STATA software version 12. RESULTS: A total of 152 patients, comprising 59 males and 93 females (mean age of 42.7 years) with clinically diagnosed CTS were seen during the study period. About 72.4% patients had numbness and paresthesia in the affected fingers, 66.5% had pain in the hands, and 10.5% had weakness in the affected hands. Majority of the patients (62%) had bilateral clinical features. Carpal tunnel syndrome was confirmed with NCS in 84 (55.26%) patients. Presence of weakness in the affected hand, positive Phalen' sign, and positive Tinel's sign in patients appear to predict [6.1 (1.2-30.7), 3.9 (1.2-30.2), and 4.9 (1.4-17.0) respectively] abnormal NCS findings after adjustment for age, gender and the presence of DM. CONCLUSION: The study revealed that over half of the patients with CTS had NCS/ Electromyography (EMG) abnormalities. Presence of hand muscles weakness, positive Phalen and Tinel's signs predict abnormal findings on NCS/EMG in patients with CTS.

Non Protease Inhibitor-Based Highly Active Antiretroviral Therapy (HAART) improves micromineral status in HIV positive Nigerians.

Introduction of highly active antiretroviral therapy (HAART) has improved the prognosis of human immunodeficiency virus (HIV) infection. The social burden of HIV infection in Nigeria is well appreciated, but the consequences of this infection and HAART on micro mineral status are unknown in Nigeria. We evaluated these effects in Orlu, Imo State, Nigeria. This prospective study involved 51 adult HIV positive patients (18-56 years). Serum selenium, magnesium and zinc were measured using atomic absorption spectrophotometry before and after 6 months on HAART. Results are presented as means while comparison of variables was done using paired t-tests. P-value < 0.05 was considered significant. Selenium, magnesium and zinc levels in the participants before HAART were 0.23±0.08 mmol/L, 104.61±24.16 mmol/L and 9.04±1.26 mmol/L respectively. Mineral levels 6 months after HAART were 0.25±0.08 mmol/L, 115.57±27.98 mmol/L and 9.41±1.23 mmol/L respectively. Selenium and magnesium levels significantly increased after 6 months on HAART (p < 0.05) while zinc level did not increase significantly (p> 0.05). HAART improved selenium and magnesium status of HIV patients but their zinc status remained the same.

Selenium, zinc and magnesium status of HIV positive adults presenting at a university teaching hospital in Orlu-Eastern Nigeria.

BACKGROUND: Human immunodeficiency virus (HIV) infection is associated with increased nutrient requirement. Information on micro-mineral status in HIV infected in Nigerians is lacking. We evaluated the impact of HIV infection on selenium, zinc and magnesium status of HIV infected adults presenting at Imo State University Teaching Hospital. METHODOLOGY: Fifty one (51) consecutive adult HIV patients (aged 18-56 years), presenting at the HIV treatment unit of the hospital over a period of 3-months who gave informed written consent participated. Also 48 HIV sero-negative adults (aged 19-59 years) were recruited as controls. Blood samples were collected from all subjects for mineral estimation by atomic absorption spectrophotometry. Results were presented as means (+/- SD) and variables compared using unpaired t-test. RESULT: Selenium, zinc and magnesium levels in HIV patients were 0.23 +/- 0.08 mmol/L, 9.04 +/- 1.26 mmol/L and 104.61 +/- 24 mmol/L respectively. Minerals in controls were 0.29 +/- 0.09 mmol/L, 9.73 +/- 1.15 mmol/L and 125.57 +/- 29.55 mmol/L respectively. All minerals were significantly lower in HIV patients (P < 0.05). In male controls, mineral levels were 0.32 +/- 0.08 mmol/L, 9.97 +/- 2.96 mmol/L and 94.93 +/- 28.63 mmol/L respectively. In male HIV patients minerals were 0.02 +/- 0.06 mmol/L, 8.74 +/- 1.23 mmol/L and 93.42 +/- 19.79 mmol/L respectively. All minerals were significantly lower in male HIV patients than male controls. In female controls selenium, zinc and magnesium levels were 0.28 +/- 0.09 mml/L, 9.57 +/- 1.17 mmol/L and 121.39 +/- 29.89 mmol respectively. Minerals in female HIV patients were 0.25 +/- 0.08 mmol/L, 9.17 +/- 1.29 mmol/L and 110.77 +/- 24.42 mmol/L respectively. There were no significant differences in respective micro-mineral level between female controls and female HIV patients. CONCLUSION: Selenium, zinc and magnesium were depleted in HIV infected suburban Nigerian subjects. Depletion was predominant in males possibly due to better health seeking behavior of females than males causing early presentation in females.