Evaluation of different biochemical markers in prediction of metabolic syndrome in polycystic ovary syndrome patients

Background: Polycystic ovary syndrome (PCOS) is the commonest cause of chronic hyperandrogenic anovulation. Insulin resistance and compensatory hyperinsulinemia are keys of the pathogenesis of PCOS. It is also considered as a metabolic disorder. Since the components of metabolic syndrome (MBS) namely obesity, glucose intolerance, dyslipidemia, and hypertension are the common features of this syndrome. The association between MBS and PCOS can be explained by different theories as insulin resistance, obesity, and related adipose tissue factors (adipocytokines) independent of insulin resistance are the main pathogenic contributors to both disorders.Methods: A total of 143 women with PCOS were recruited as study subjects. All participants were subjected to anthropometric measurements, clinical assessment, and biochemical tests [fasting glucose, fasting insulin, and homeostatic model assessment-insulin resistance (HOMA-IR)]. Hormonal profile particularly leptin and homocysteine levels were also evaluated.Results: 25 patients (17.4%) out of 143 women with PCOS met the criteria for MBS. Patients with MBS had significantly higher body mass index, blood pressure, HOMA-IR, leptin, and homocysteine levels compared to PCOS only patients. When HOMA-IR cut off was ≥4.3 sensitivity and specificity were 90%, 88.6%, but when leptin level was ≥34.5 the corresponding statistics were 79.6%, 75.5%.Conclusions: Serum leptin, homocysteine, HOMA-IR as well as other biochemical markers are significantly higher in women with PCOS and MBS compared to PCOS only women. PCOS is associated with various factors like insulin resistance, obesity, and dyslipidemia. Consequently, adipocytokines and HOMA-IR play important role in the prediction of MBS in patients with PCOS

Evaluation of selective peripheral neurotomies in the treatment of refractory lower limb spasticity in adults

Background: ‘‘Selective peripheral neurotomies” (SPNs) are indicated for the treatment of refractory focal and multifocal spasticity of lower limbs in adults.Objective: To evaluate the surgical results of selective peripheral neurotomies in 20 adult patients who had refractory focal & multifocal spasticity of the lower limbs, follow up period of one year.Patients and Methods: Prospective study included 20 adult patients who had refractory spasticity of the lower limbs. Preoperative evaluation for muscle tone using Modified Ashworth Score (MAS), muscle power using Medical Research Council Scale (MRCS), functional assessment using Oswestry Functional Scale (OFS) and Range Of Motion (ROM) using manual goniometry were done for all patients. All cases underwent surgery in the form of SPN of tibial, obturator, sciatic and/or femoral nerves. Follow up of the patients was done at 10th day, 3, 6 months and one year postoperatively.Results: The mean age of patients was 31.35 ± 12.42 years. There were statistically significant improvement of muscle tone, muscle power, functional assessment and range of motion between preoperative and one year postoperative values. Improvement of the muscle tone was from a preoperative Mean ± SD of 3.60 ± 0.68 on MAS to a postoperative 2.30 ± 0.86 at one year, improvement of muscle power on MRCS was from preoperative Mean ± SD 3.75 ± 1.08 to postoperative 4.08 ± 0.69 at one year, There was a functional improvement from a preoperative Mean ± SD of 3.0 ± 0.73 on OFS to 3.60 ± 0.60 at one year postoperatively. Also, there was a significant improvement between preoperative ROM Mean ± SD 61.25 ± 15.29 and one year postoperatively 72.25 ± 12.19.Conclusions: Selective peripheral neurotomies could effectively improve muscle tone, muscle power, functional performance & range of motion in patients with refractory focal and multifocal spasticity in the lower limbs.Keywords: Selective peripheral neurotomies, Spasticity, Neuroablative surgeries, Functional neurosurger

Estudio sobre el efecto de la vanillina (aditivo alimentarlo) en algunas reacciones metabólicas de animales experimentales

Vanillin (4-hydroxy-3-methoxybenzaldehyde) was administrated to hypercholesterolemic albino rats at low and high doses (1.0 and 2.0%, respectively) for nine weeks period. Lipid pattern, as well as liver and kidneys functions were determined in normal, hypercholesterolemic and hypercholesterolemic rats administrated vanillin. Hypercholesterolemia was characterized by significant increase in the average levels of total lipids, total cholesterol and triglycerides and a significant decrease in phospholipids content. Also, liver function (S.GOT, S.GPT, alkaline and acid phosphatase) as well as kidneys function were elevated compared to control group. Administration of vanillin significantly reduced liver and kidneys total lipids. Spleen and heart followed nearly the same trend but with moderate effect, while brain was not affected. Liver, kidneys, spleen and heart total cholesterol was significantly reduced while brain total cholesterol was not affected. Triglycerides were significantly decreased in liver and spleen, while that of kidneys and brain was not affected. Also, there was a significant decrease in the high activity of S.GOT, S.GPT, alkaline and acid phosphatase and the values were nearly attained to the initial level. Administration of vanillin exertes potent anabolic effects for protein metabolism as shown from the results of uric acid and creatinine.Se administró vanillina (4-hidroxi-3-metoxibenzaldehído) a ratas albino hipercolesterolémicas en dosis bajas y altas (1,0 y 2,0% respectivamente) por un período de nueve semanas. La forma lipídica así como las funciones hepáticas y renales se determinaron en ratas normales, hipercolesterolémicas e hipercolesterolémicas a las que se les administró vanillina. La hipercolesterolemia se caracterizó por un aumento significativo en los niveles medios de lípidos totales, colesterol total y triglicéridos, y una disminución significativa en el contenido de fosfolípidos. También, la función hepática (S.GOT, S.GPT, alcalina y ácido fosfatasa) así como las funciones renales se elevaron en comparación con el grupo control. La administración de vanillina redujo significativamente los lípidos totales de hígado y riñones. El bazo y corazón siguieron la misma tendencia pero con efecto moderado, mientras que el cerebro no se afectó. El colesterol total en hígado, riñones, bazo y corazón disminuyó significativamente, en tanto que en cerebro no se afectó. Los triglicéridos disminuyeron significativamente en hígado y bazo, mientras que no se alteraron en riñones y cerebro. También hubo una disminución significativa en la alta actividad de S.GOT, S.GPT, alcalina y fosfatasa acida y se alcanzaron valores muy próximos al nivel inicial. La administración de vanillina ejerció efectos anabólicos potentes para el metabolismo de proteínas como se demuestra de los resultados del ácido urónico y creatinina

Diagnostic potential of high resolution ultrasound and nerve conduction study in patients with idiopathic carpal tunnel syndrome

Aim of the work: To evaluate the diagnostic utility of high resolution ultrasound in comparison to nerve conduction study (NCS) in patients with idiopathic carpal tunnel syndrome (CTS). Patients and methods: 40 patients with CTS (56 hands) and 30 matched controls (30 hands) were included. Patients and controls were assessed by clinical examination, ultrasonographic parameters including cross sectional area (CSA), flattening ratio 1 (FR1) at pisiform and FR2 at hamate and NCS including distal motor latency (DML), motor (MCV) and sensory (SCV) conduction velocity, sensory latency and amplitude. Results: The mean age of the patients was 36.02 ± 8.4 years; 39 females and 1 males. This study included 37 right (92.5%) and 3 left-handed (7.5%) patients. Right-hand affection was detected in 17 (42.5%) patients, left-hand in 3 (7.5%) while bilateral hands affection was detected in 20 (50%). CSA and FR2 were significantly associated with CTS severity. CSA significantly correlated with all electrophysiological parameters including DML, sensory amplitude, sensory latency and SCV. FR1 significantly correlated with sensory latency and FR2 with SCV. Regarding sensitivity of ultrasonographic parameters, FR2 was the highest (91.3%) while CSA and FR1 were 80.3% and 50% respectively. Specificity of all ultrasonographic parameters was 100% and the highest sensitivity was for SCV (94.6%). Conclusions: There was an insignificant difference between nerve conduction study and high resolution ultrasound in diagnosis of idiopathic CTS. However, high resolution ultrasound had a superior diagnostic utility in CTS, and is valuable for exclusion of secondary CTS and anatomical variants of the median nerve. Keywords: Median nerve, Carpal tunnel syndrome, Nerve conduction study, High resolution ultrasoun