Electrophysiological study and glutamic acid decarboxylase 65 in detection of subclinical neuropathy in type 1 diabetes mellitus

To evaluate the role of electrophysiological studies and serum glutamic acid decarboxylase [GAD65Ab] in the detection of subclinical neuropathy, in Type 1 diabetes mellitus [TIDM]. This study was conducted on 30 patients of Type 1 diabetes mellitus within the first year of diagnosis and 20 controls. All subjects were evaluated for subjective neuropathy symptoms, neurological examination, electrophysiological findings, GAD65Ab, glycosylated hemoglobin [HbA1], cholesterol and triglyceride in serum. At least two abnormal independent neurophysiological nerve parameters were accepted as the criteria of peripheral nervous system involvement. Electrophysiological study showed peripheral nervous system involvement in 93.3% of patients. The percentages of affection were 90% in sural nerve, 82.4% in peroneal motor nerve, 68.5% in posterior tibial motor nerve, 62.2% in median motor nerve, 59.9% in ulnar motor nerve, 65.2% in median sensory nerve, and 60.5% in ulnar sensory nerve. Antibodies to GAD65 were detected in 18 of 30 patients [60%]. Patients with positive GAD65Ab had slower motor nerve conduction velocities in the median, ulnar, and peroneal nerves and prolonged sural nerve latency. There is a positive correlation between HbA1 levels and peripheral nerve dysfunction in the lower extremity. Highly significant correlation between HhA1 and GAD65 in patients group was noticed. Subclinical diabetic peripheral neuropathy can be detected by electrophysiological tests, especially for nerves of lower extremity. The poor glycemic control and GAD65Ab have an impact on peripheral nerve function

Prevalence of canal paresis and associated disorders in benign paroxysmal positional vertigo patients

The purpose of this work was to study the prevalence of canal paresis and associated abnormalities in patients with posterior canal benign paroxysmal positional vertigo [BPPV]. Retrospective study of patients with BPPV attending the outpatient clinics of ENT and hearing and balance at DSFH, Jeddah, K.S.A. The study group consisted of 108 patients, 63 females and 45 males with unilateral posterior canal benign paroxysmal positional vertigo examined between March 2005, and November 2005. Their age ranged from 27 to 79 years. In this study the male to female ratio was 1: 1.4. The patients had a mean age of 48.6 +/- 12.4 years. Sixty nine patients [63.8%] were idiopathic BPPV and 39 patients [36.2%] had associated disorders with BPPV. The results of caloric test for patients with posterior canal benign paroxysmal positional vertigo revealed that 36 patients [33.3%] had caloric abnormalities, 21 patients [19.4%] had canal paresis, and 15 patients [13.8%] had directional preponderance. Primary BPPV with no associated disorders is more common than BPPV with associated disorders. BPPV is more common in females. Canal paresis may be found in patients with BPPV either on the same side or on the other unaffected side. Consequently, ENG test battery should be a routine test for evaluation of BPPV to detect other associated abnormalities

Intratympanic injection in sudden sensorineural hearing loss

The aim of this study was to evaluate intratympanic corticosteroid injection in cases with idiopathic sudden sensorineural hearing loss [SSNHL]. Sixty patients with SSNHL were included in this study, 35 were females and 25 were males. The age ranged from 14 to 67 years old. The hearing loss was graded into mild, moderate, severe and profound. The patients were classified into 3 groups according to the treatment modality, group I did not receive corticosteroid therapy and included 10 patients, group II received systemic corticosteroid therapy and included 13 patients and group III received intratympanic corticosteroid therapy and included 37 patients. In group I, 30% of patients showed improvement. In group II, 46% of patients showed improvement. In group III, 86% showed improvement of hearing. Intratympanic corticosteroid therapy for SSNHL has a better success rate than systemic corticosteroid therapy and control patients with no treatment. It has a low incidence of complications. Patients with mild and moderate hearing loss have a better prognosis than patients with severe and profound hearing loss

Risk assessment of coronary heart disease for Assiut university staff

A purposive sample of 539 subjects from Assuit University Staff [AUS] was included in this study; of them, 506 were free from coronary heart disease [CHD]. The individuals were subjected to risk score assessment. A computer program was developed to calculate the individual absolute risk score for developing CHD in the next ten years, based on Framingham heart study and coronary heart disease risk prediction chart. The percentage of CHD in AUS was 14.7%. The significant CHD risk factors included age, current smoking among men, diabetes mellitus [DM] and low HDL cholesterol [HDL-C]. The mean risk score was statistically significantly higher in males than in females [14.3 +/- 11.5 vs. 5.9 +/- 3.7]. About two thirds of males were at moderate or high-risk levels to develop CHD, while 82.6% of females were at the low and mild risk levels

Vaginoplasty for congenital absence of the vagina

In this work, several refinements of McIndoe technique were presented which are the dissection of a large pocket using an adjustable vaginal stent and the use of a meshed thick split thickness skin graft for lining the neovaginal pocket. This study included six cases of congenital vaginal agenesis [two patients had testicular feminization syndrome]. The volume of the reconstructed vaginal pockets ranged from 65 to 130 cc. After six-month follow-up period, the percentage of reduction in the size of the neovaginae from their original sizes ranged from 4.25 to 11.5%. These refinements proved to be of a value in improving the final outcome of the McIndoe technique for vaginal reconstruction

Digital function following delayed flexor tendon repair in no - man's land

Between February 1999 and December 2000, 112 fingers in 97 patients with neglected cut both flexor tendons in zone-II of the hand were treated by delayed primary repair. There were 79 males and 33 females with ages ranged from 4 to 68 years with an average age of 21 years. Most of the injuries [65] occurred at work and home accidents due to the careless use of cutting tools in 38 fingers and due to personal behavior factors in the remaining 9 digits. Radiologically, all digits were free from any bone or joint abnormalities and clinically, 19 digits were presented with mild to moderate limitation of passive motion of IP joints. The mean period of lapsing between injury and repair was 10 days with a range of 14-35 days

Long term follow-up of surgically reconstructed flexor tendon system of the hand in complicated cases associated with scarred tendon bed using tendon proshesis

This study aimed to evaluate the long-term functional results in surgically reconstructed flexor tendon system of the hand following complicated injuries associated with scarred tendon bed and loss of integrity of its sheath. The study presented the long-term functional results in 32 patients. Most of the injuries [24] had occurred at work. Cutting tools were the causative trauma in the majority of cases. Radiologically, all the operated digits were free from any bone or joint abnormalities. The cases were selected and the neurovascular bundle was, at least, intact at one side of the involved digit; in addition, many were associated with joint contracture of one or more of the digital joints and limited passive motions

cross - leg flap, is it still a viable option?

This work presented several examples of lower extremity defects, where the cross-leg flap was a viable option and was considered high in the reconstructive ladder among other procedures for the reconstruction of these defects. The study suggested that the cross-leg is still a viable option in the reconstruction of lower leg and foot, where local tissues are not available and is a safe alternative to free tissue transfer

Diagnostic spectrum of puo in Assiut with emphasis on the diagnostic value of ultrasonography

One hundred patients with pyrexia of unknown origin were studied in Assiut University Hospital. The diagnosis was established in 85 cases; 46 with infections, 19 neoplasms, 14 collagen diseases and 6 miscellaneous causes. Infection is the commonest cause of PUO in Egypt but it is less common in western communities. Tuberculosis tops the list of infections affecting 20 out of 46 cases. It is mostly extrapulmonary causing peritonitis in nine cases, pericarditis in four and miliary in one. Intra- abdominal abscesses were revealed sonographically; seven hepatic, two splenic and one pelvic. Rising agglutination titers were diagnostic in three out of four cases of brucellosis and in five cases of salmonellosis; blood cultures establishing the diagnosis in the remaining cases. Subacute infective endocarditis was diagnosed by blood culture in two cases and by therapeutic test in two cases. Echocardiography did not help to detect valve vegetations in any case of SE. Gall stones were detected sonographically in two women. Malignant lymphoma is the commonest neoplastic cause of PUO. Sonography proved to be inevitable in the diagnosis of retroperitoneal lymphoma with no enlarged peripheral lymph nodes. Sternal aspirate was diagnostic in three cases of leukemia with non-revealing peripheral blood. The incidence of collagen diseases in the series is higher than other local or foreign series suggesting undue delay in their diagnosis. Abdominal sonography was conducted for all patients revealing the diagnosis in 20 cases at initial examination with no false positive results and with two false negative discovered one week later on reexamination. Abdominal sonography revealed the diagnosis in peritonitis, abscesses, lymphoma, malignant liver, liver cirrhosis and all gall stones. It was diagnostic in 43.4% of infections and in 42.5% of neoplastic causes of PUO. It was concluded that repeated abdominal sonography is mandatory in the diagnostic workshop of PUO

Study on some factors affecting curd firmness of concentrated recombined milk

The effect of coagulating temperature, amount of rennet addition of calcium chloride and pH, on the properties of concentrated recombined milk containing 40, 50% T.S. and 12,15% fat respectively were studied. Suitable curd of concentrated recombined milk containing 40% T.S. was obtained at a temperature of 35 degree Cent. with the addition of 0.03% Ca CI2 and 0.8 ml of 0.5% rennet powder solution 50 ml milk. The effect of milk pH prior renneting on the properties of the resultant curd was investigated. Firm curd was attained at pH of 6.42, 5.85, 5.55 and 5.25 with 1.2, 0.4, 0.4 and 0.6 ml of 0.5% rennet powder solution/50 ml milk of 40% TS, respectively, but with brittle body and open texture for pH 5.25. On the other hand, the pH and amount of rennet that produced firm and form recombined milk of 50% T.S. were 5.85, 5.55 and 5.25 with addition of 1, 0.6 and 0.6 ml of 0.5% rennet powder solution/50 ml milk, respectively, but of brittle body and open texture with pH 5.25