Physiology and Anatomy

The objectives were to determine the DAS28 Us and DAS28 DP , to compare it with DAS28 standard and establish its influence in the assessment of the activity of the rheumatoid arthritis . Materiels and methods : The DAS28 US and DAS28DP were calculated from the four parameters (articular index, mode B or Doppler power synovial index detected in relation to the 28 joints intended for the DAS28 standard , Patient Global Visual Analogue Scale , ESR ). The examination evaluated the ultrasound synovitis and the Power Doppler activity according to the criteria OMERACT. Results: 37 patients of the average age of 50 years ±11 were enrolled. The duration of the evolution was 7,40±0,72 . There was an average correlation between DAS28 standard and the number of the synovitis modeB (r=0,43; p=0,01 )(table 3) . Conclusion: Our study revealed the subclinical synovitis in 41% of the cases. This study showed a strong correlation between the standard DAS28 and the US and DP ultrasounds DAS28. 35% of patients who were reported in clinical remission were reconsidered ill after ultrasound tests. Thus, this study suggests that the ultrasound scores as DAS28US and DAS28DP could be used in clinical practice to evaluate the rheumatoid arthritis activity.

The authors have treated 29 cases of infected pseudarthrosis of tibia: 12 complications of open fractures of legs with loss bone stabilized firstly by external fixator; 09 closed fractures treated traditionally by jbira seen in pseudarthrosis infected, 05 cases of septic nonunion arising after plate osteosynthesis and 03 cases following centromedullary nailing. In all cases, two stage reconstruction: Initial surgery consisted of soft tissue and bone debridement, external fixation completed by Dressing percutaneous a day by antiseptic and intravenously antibiotic. After any remaining infection, at last 6 to 8 weeks, the reconstruction of the soft tissue with a free microsurgical muscle flap and skin graft. The second stage surgery consisted to replace external fixator by intramedullary nailing and the osseous reconstruction was cancellous or corticocancellous grafting. The final result was obtained after an average of 24 months and was excellent in 15 cases, good in 12 and 02 failures were observed. On the infectious; remaining infection were observed in 02 and required amputation of leg. The modified method of Papineau seems superior to any other method used for treatment of infected pseudarthrosis of tibia.

Aims: to determine the prevalence of different ultrasound lesions ( synovial hypertrophy, effusion synovial ,bone erosion, enthesopathy , tendinopathy, osteophytes ) of the hip among patients with rheumatoid arthritis ; to compare these ultrasound lesions of the hip with clinical and biological parameters . Materials and methods: Patients with rheumatoid arthritis were included according to the 2010 ACR/EULAR criteria. The evaluation scores as (Disease Activity Score 28, Heath Assessment Questionnaire) were collected. Ultrasound explorations were performed bilaterally on the hip, according to recommended and appropriate techniques. Examination sought synovial hypertrophy, effusion synovial, bone erosion, enthesopathy, tendinopathy, bursitis, osteophytes. Results: The study included 37 patients, with the average age of 50.30 ± 11 years. A total of 73 hips were explored using ultrasound. During the inclusion of patients, we obtained the frequency of current spontaneous coxo-femoral joint pain, peri coxo-femoral joint pain , limitation of hip , respectively 7(10%) , 4(5%) and 5(7%). For ultrasound data ,the frequency of synovial hypertrophy , effusion joints , and bone erosions were respectively represented in 17(23%) , 12(16%) and 2(3%). Conclusion: Our study revealed 14% of ultrasound abnormalities despite how normal the clinical examinations were. This study suggests that ultrasound is a complement to the clinical examination and it would be desirable to conduct more researches for the evaluation of the Doppler activity in the hips. 

Laser therapy as a kind of treatment and rehabilitation method has been used for many years. This method has great potential for reducing pain, inflammation and neuro-rehabilitation. Researchers showed that laser has an important role on cellular repair, reproduction and inhibition. Resent studies help us better comprehension of these mechanisms for neuro-rehabilitation. The results of these studies are needed to be accompanied with medicine studies which have measurable outcomes. The researches showed the improvement neural system and rehabilitations. Also Laser will help to other parts for improving condition. It can be an important method in treatment of both chronic and acute work related neural injuries. As a result, laser therapy is applicable in the treatment and rehabilitation of pain, inflammation, tissue healing and also neuro-rehabilitation programs after surgery, acute phase of injuries and chronic neural disorders.

The present study was conducted to evaluate 25 hydroxy cholecalciferol levels in newly diagnosed pulmonary tuberculosis patients. Comparative case control study. Department of Medicine, Liaquat University of Medical and Health Sciences Hospital Jamshoro/Hyderabad, from February 2014- October 2015. 100 diagnosed cases of pulmonary tuberculosis and 100 age and gender matched controls were selected according to criteria. 5 ml of venous blood sample was collected and centrifuged at 4000rpm for 10 minutes. The serum obtained was frozen at -20oC and used for estimation of 25-hydroxycholecalciferolon ARCHITECT I 1000 system. The data was analyzed on SPSS version 22.0 at 95% confidence interval (p ? 0.05). Total mean± S.D of 25-hydroxycholecalciferol was noted as 26.1±9.76 and 38.8±7.14 (ng/dl) in cases and controls respectively (p=0.0001). 25-hydroxycholecalciferol <5.4 ng/dl was noted in the tuberculosis cases. Normal, insufficiency and deficiency of 25-hydroxycholecalciferol was noted in 17%, 19% and 64% & 56%, 18% and 26% of cases and controls respectively (p< 0.01). The present study reports significantly low 25-hydroxycholecalciferol in pulmonary tuberculosis cases. However further studies are warranted. Pulmonary tuberculosis patients may be supplemented with vitamin D.

Evaluating the 25-hydroxycholecalciferol and blood lipids and their relationship in type 2 Diabetic subjects. Observational study. Department of Medicine, Isra University Hospital and Consultant Clinics Hyderabad from January2014 to July 2014. A sample of 200 diagnosed type 2 DM were selected through non-probability purposive sampling. Blood lipids, blood urea nitrogen, serum creatinine, fasting blood glucose, alkaline phosphatase, serum calcium and phosphate were detected. 25-hydroxycholecalciferol was detected by ARCHITECT I 1000 system. Data was analyzed on SPSS version 21.0. Data was analyzed on SPSS version 22.0 at 95% confidence interval. Low 25-hydroxycholecalciferol was noted in 94% and dyslipidemia in 66.5% of 25-hydroxycholecalciferol deficient type 2 diabetic subjects. Pearson’s correlation showed negative correlation of 25-hydroxycholecalciferol with LDLc, VLDLc, serum triglycerides, and cholesterol and positive correlation with HDLc. The present study reports 25- hydroxycholecalciferol deficiency and dyslipidemia in type 2 diabetic subjects. 25-hydroxycholecalciferol deficiency showed positive association with high density lipoprotein (HDLc) and inverse association with LDLc, serum cholesterol and triglycerides.

The traditional medicines (i.e. herbal medicines / Spices) are cost effective & have negligible side effects. There is a need for credible research to investigate the proper use, adverse effects and precautions associated with these products. Hence, the current study was carried out to observe the hepatoprotective effect of Curcuma Longa (C.L) in Nitro-Methane Sulfonamide (N-MS) induced hepatotoxicity. 40 male albino wistar rats were divided into four groups. In group A, normal diet was given for 09 days while in group B, N- MS was given for 09 days followed by CL powder for next 09 days; while CL powder for 09 days followed by N- MS for next 09 days was used in group C. Group D received N-MS in adjunct with C.L powder for 09 days. Blood samples from each group were taken for biochemical analysis of serum levels of ALT, AST, Alkaline Phosphatase and GGT. The results of present study have concluded that the administration of C.L significantly offered protection against damaging effects of N-MS.

In order to meet the growing food demand, use of pesticides is a common feature in agriculture now a day but extensive use of pesticide has resulted in global contamination of the environment. Imidacloprid is one of the major representatives of the new generation of neonicotinoid insecticides. The objective of current study is to examine the hematological parameters and developmental defects after exposure of imidacloprid in chick embryos. Present study was carried out on 300 fertile eggs of white leghorn chicken. Imidacloprid exposure increases the risks of developmental defects and mild toxic effects on hematological parameters in chick embryos.

The hydatid cyst is a Antropo-zoonosis caused development in humans of the larval form of Echinococcusgranulosistaenia. It is endemic status in some countries where it is a real public health problem and spares no organ. Hydatid cyst of the kidney (HCK) is rare, indeed it is 2 to 3% of all visceral locations. His clinical semiology is rich but rarely specific. The diagnosis is based on arguments of strong epidemiological suspicion, clinical, biological and radiological. This condition poses therapeutic problems making it difficult to conservative surgery. The aim of this work is to remind this disease has become rare in some countries through the exposure of our results, while insisting on the importance of conservative treatment whenever it is possible. We retrospectively reviewed the records of 20 cases of HCK collected between 2006 and 2013 at the urology department "A" of the University Hospital of Rabat. These 6 men and 14 women whose average age was 37 years (18-56 years). The clinical symptomatology was dominated by low back pain (100%), with 6 cases of hydaturia.Ultrasound, performed in all patients confirmed the diagnosis in 12 patients . Abdominal CT, performed in 8 patients, was necessary whenever the diagnosis remains uncertain. The treatment consisted of 12 resection of the protruding dome, 3pericystectomy, and 5 total nephrectomies. An additional procedure was performed in the same operation (hydatid cyst in the liver in 2 cases. Postoperative course was uneventful. Regular monitoring was done for 12 patients. In light of these twentyHCK , we must insist on the importance of imaging in the diagnosis of and conservative surgical treatment.

The present study intended to evaluate serum homocysteine and serum cobalamin in subclinical hypothyroid patients. Case control study. Jinnah Postgraduate Medical Center Hospital, Karachi from January to August 2015. Subjects were divided into Group A Controls- normal subjects (n=50), Group B Cases – diagnosed cases of subclinical hypothyroidism (n=50). 5 ml of venous blood sample was collected and centrifuged at 4000rpm for 10 minutes. The serum obtained was frozen at -20oC and used for estimation of thyroid hormone profile, serum cobalamin and serum homocysteine. The data was analyzed on SPSS version 22.0. Student’s t test and chi square test was used for continuous and categorical data respectively at 95% confidence interval (p ? 0.05). Mean ±SD age of controls and cases noted was 52.1 ± 5.6 and 51± 8.7 years respectively. Serum homocysteine in controls and cases was found as 6.89±3.75 and 15.9 ±12.3 µM/L respectively (p=0.0001). Serum cobalamin in controls and cases was noted as 298± 56.5 and 199.7±67.9 pg/dl respectively (p=0.0001). Serum homocysteine was raised with low serum cobalamin in subclinical hypothyroidism patients. The present study reports raised serum homocysteine and low serum cobalamin in Subclinical hypothyroid patients.