School Screening for Scoliosis among Male Adolescents in Abha City, Southwestern Saudi Arabia

Aim: To study the prevalence of scoliosis and its associated factors among male adolescents in Abha city intermediate and secondary schools, Aseer Region, Southwestern Saudi Arabia. Methods: Through a cross-sectional study, students were interviewed about personal and demographic data, method of back-bag carriage, and regular practice of any physical exercise. Body mass index (BMI) was measured and student’s bag weight/BMI ratio (%) was computed. Screening for scoliosis was performed using inspection of the vertebral column and Adam’s Forward Bending Test (FBT). Using scolimeter a reading equal or exceed 5 degrees was considered positive. Results: Out of 417 screened adolescents, 90 students were positive giving a prevalence rate of scoliosis of 19.1% (95% CI: 15.7- 23.0). Using multivariable logistic regression analysis, the probability of positive scoliosis was significantly higher in secondary school (aOR=2.304. 95% CI: 1.447-3.676) and obese and overweight (aOR=2.433. 95% CI: 1.565-3.787) adolescents. On the other hand, regular practicing of physical exercises was significantly negatively associated with scoliosis (aOR=0.469, 95% CI: -316-0.695). Conclusion: The present study identified scoliosis as a substantial problem among adolescents. School health authorities need to foster a screening program for scoliosis, particularly among secondary school adolescents. School health promotion programs should address overweight and promote physical exercise to deal with this problem.

Diastolic function abnormalities in rheumatoid arthritis; an echocardiographic study

The aim of this study was to evaluate left ventricular-filling in patients with rheumatoid arthritis [RA], analyzing transmitral flow and pulmonary venous flow, with special regard to disease duration. Forty-five patients affected by RA according to ARA criteria were selected, without evidence of cardiac disease, and compared with matched control subjects. All patients and control group were submitted to M-mode, two- dimensional Doppler and color Doppler [continuous and pulsed wave] echocardiography. Transmitral flow [E/A ratio], pulmonary venous flow [S/D ratio], IVRT and DT. In RA patients, left ventricular filling abnormalities were found to be characterized by a reduced E/A ratio. It was concluded that RA patients, in the absence of clinical evidence of heart disease, show LV diastolic dysfunction characterized by impaired E/A and S/D ratio. The relation with the disease duration suggests a sub-clinical myocardial involvement

Atteenuation of cardiovascular response to emergence from anaesthesa and tracheal extubation by either topical lidocaine, intravenous lidocaine or verapamil

We have examined the effect of either topical lidocaine, intravenous lidocaine or intravenous verapamil on the haemodynamic response to emergence from anaesthesia and endotracheal extubation in 80 adult ASA I or II patients, undergoing a variety of elective surgical procedures. All patients received a standard general anaesthetic. At the end of surgery group A [control group n = 20], received a bolus dose of 10ml normal saline 2 minutes before extubation. Group B [topical lidocaine n = 20], had their larynx and vocal cords sprayed with 10% aerosolized lidocaine [40mg] after induction and 2 minutes before intubation plus 10ml normal saline, 2 minutes before extubation. Group C [IV lidocaine n = 20], received a bolus dose of 1 mg kg-1 lidocaine diluted up to 10mI in normal saline, 2 minutes before extubation. Group D [IV verapamil] received a bolus dose of 0.1mg kg-1 verapamil diluted up to 10ml in normal saline, 2 minutes before extubation. Arterial pressure, heart rate, ECG, peripheral oxygen saturation and end tidal CO2 were recorded at pre induction, end of surgery, 2 minutes before extubation and at 1 and 5 minutes after extubation. The quality of extubation was evaluated using an extubation score. It was found that topical lidocaine, IV lidocaine and verapamil have attenuated the increase in both heart rate and arterial blood pressure following extubation compared with pre induction values and significantly attenuated the cardiovascular response as compared to the control group [p<0.001]. Tracheal scoring however showed that topical lidocaine had the lowest favourable sore [p<0.001] followed by IV lidocaine [p<0.05], while IV verapamil showed no significant change when compared to the control group

Rheumatic disorders in virus-C hepatitis patients

To study the incidence of rheumatologic disorders in chronic hepatitis C infection. Fifty patients suffering from chronic hepatitis C [Positive HCV antibody and PCR] of more than six months duration were included in the study. Another group of twenty-five patients with rheumatic manifestations free of HCV served as a control group. They were identical in gender and age. Among the HCV patients group cryoglobulinaemia was detected in 29 cases [58%], antinuclear antibodies in 1 0 cases [20%] rheumatoid factor in 19 cases [38%], hypocomplementaemia in 20 cases [40%], myalgia in 24 cases [48%], arthralgia in 26 cases [52%] arthritis in 18 cases [36%] enthesitis in 39 cases [78%], fatigability in 46 cases [92%], Raynaud's Phenomenon in 14 cases [28%], xerophthaimia in 1 0 cases [20%], rash in 29 cases [58%], carpal tunnel syndrome in 6 cases [1 2%] and R A in 6 cases [1 2%]. HCV may play a role in the pathogenosis of these auto immune phenomena. This hypothesis is mainly based on the lymphotropism of HCV that can be responsible for a chronic activation of both T and B lymphocytes, leading to complex immune system disorders. But more studies are required to define the extent of this role

Measurement of interlekin-1 in the synovial fluid and serum of rheumatoid arthritis patients

Twenty- five patients suffering from rheumatoid arthritis were included in this study. They were diagnosed according to the ACR criteria. They constituted 23 females and two males, their age ranged from twenty-six to seventy years [mean 48.6 +/- 11.7]. Another ten non rheumatoid patients were chosen as control group. They were eight females and two males with ages that ranged from 27 to 52 years [mean 38.2 +/- 11.3]. Full clinical examination was done as well as measurements of serum and synovial fluid interlekin-1 [IL-1] with immunoenzymatic assey for quantitative measurements. Serum and synovial fluid [IL-1] was significantly higher in the rheumatoid than the non-rheumatoid group. There was a good positive correlation between the serum and synovial interleukin-1 and the disease activity [total joint score, Hb% and ESR]. Interleukin-1 plays a major role in the pathogenesis of rheumatoid arthritis