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   Table of Contents - Current issue
Coverpage
July-September 2018
Volume 45 | Issue 3
Page Nos. 87-123

Online since Wednesday, July 18, 2018

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ORIGINAL ARTICLES  

Association between microalbuminuria and metabolic syndrome in patients with rheumatoid arthritis p. 87
Samia Abdelmonem, Refaat Eltanawy, Yaser Ismail, Eman Baraka, Asmaa Shoshan
DOI:10.4103/err.err_37_17  
Context Rheumatoid arthritis (RA) is an autoimmune, symmetrical polyarticular disease characterized by chronic inflammation of the synovial joints. Microalbuminuria (MA) occurs as leakage of small amounts of albumin into the urine. Metabolic syndrome (MetS) describes the risk factors for cardiovascular diseases such as dyslipidemia, obesity, hypertension, and diabetes. Aim The aim of this study was to detect the prevalence of MA in patients with RA and study its correlation with disease activity and severity. Our aim extends to identify the association of MA with MetS in RA. Patients and methods This study was carried out on 30 adult RA patients, 30% of them were men and 70% were women (mean±SD: 42.27±10.99 years). Their mean disease duration was 12.8±7.06 years. A total of 20 apparently healthy adults, age-matched and sex-matched served as a control group. All the patients were subjected to full history taking, full clinical examination, laboratory investigations, and assessment of disease activity using the disease activity score for 28 joints score. Urinary microalbumin level was measured in all participants in early morning samples by the immunoturbidometry method. MetS was assessed in all participants according to Grundy’s criteria. Results The frequency of MetS was highly statistically significant in patients with RA compared with the control group. The RA patients’ group had highly significantly elevated mean values of urinary microalbumin and urinary albumin to creatinine ratio compared with the control group. Conclusion MA and MetS are frequent in RA, particularly in those with long-standing disease. Early detection of albuminuria allows early intervention with the goal of reducing inflammation development in RA, cardiovascular risk. MetS is frequent in RA patients with MA.
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Health-related quality of life in Egyptian patients with knee osteoarthritis: correlation with performance-related measures p. 94
Enas A Abdelaleem, Yahia M Rizk
DOI:10.4103/1110-161X.237048  
Objective The aim of this work was to study the correlation between health-related quality of life and performance-related measures in Egyptian patients with primary knee osteoarthritis (OA). Patients and methods One hundred patients with primary knee OA who were attending the outpatient clinic of the hospital were included in the study. All patients had bilateral medial tibiofemoral knee OA. Radiological severity of the disease was evaluated with the Kellgren–Lawrence scale. All patients completed Knee Injury and Osteoarthritis Outcome Score (KOOS); that is a knee-related disorder-specific questionnaire for the assessment of quality of life. The Timed Up and Go test was used for the evaluation of performance-based functional status. Results Eighty-eight (88%) patients were female. The mean age was 57.30±6.37 (50–75) years, and the mean BMI was 36.83±5.37% kg/m2. The mean symptom duration was 8.76±4.71 years. The mean radiological stage was 2.88±0.82. There was a statistically significant negative correlation between all of the KOOS domains and Timed Up and Go (P≤0.01). Conclusion KOOS is not only a good indicator of physical performance in patients with knee OA but also provides information about the impact of knee-related disability on the quality of life and recreational activities.
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The effect of transplantation of adipose-derived stem cells to spinal cord on the recovery of urinary bladder function in patients having spinal cord injuries: a urodynamic study p. 100
Ahmad El Zayat, Yasser Badran
DOI:10.4103/err.err_8_18  
Introduction Stem cells transplantation, as a therapeutic intervention for spinal cord injury (SCI), has been extensively studied by researchers in recent years. Our study aimed to study the effect of transplantation of adipose-derived stem cells into spinal cord by intrathecal injection on the recovery of urinary bladder function assessed by a urodynamics study in patients having SCIs. Patients and methods A total of 69 patients who had cervical incomplete tetraplegia were divided into two groups: group 1 had 37 patients who were treated with adipose-derived stem cells transplanted into spinal cord via intrathecal injection and were assessed by a urodynamic study before stem cell transplantation and then 6 months and 1 year after transplantation, and group 2 had 32 patients who underwent rehabilitation program only and were assessed by a urodynamic study before starting rehabilitation and then 6 months and 1 year after program. Results Eight (21.62%) patients benefitted from stem cells transplantation into spinal cord regarding urinary bladder function as assessed by urodynamics in varying degrees, but there was no significant difference between both groups. Conclusion Stem cells transplantation is a promising treatment for patients having SCI.
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Efficacy of combined paravertebral ozone (O2O3) therapy with physiotherapy in patients with chronic mechanical low back pain p. 106
Samah Alyan, Rabab Zaghlol, Shimaa A Mustafa
DOI:10.4103/err.err_43_17  
Background Many studies have been done on paravertebral–intramuscular ozone therapy in the management of chronic mechanical low back pain and found that it is effective in pain and function improvement, but none of the studies were done to assess the benefit of addition of paravertebral–intramuscular ozone therapy to the traditional physical therapy in the management of chronic low back pain. Patients and methods The study included 160 patients who were diagnosed with chronic mechanical low back pain, and they were divided into two groups: group I included 80 patients treated with paravertebral oxygen–ozone (O2O3), infrared lamp therapy, and exercises, and group II included 80 patients treated with infrared lamp therapy and exercises. They were assessed by pain intensity measures such as visual analog scale (VAS) and verbal rating scale (VRS) and functional status measures such as the disability questionnaire − Roland Morris Disability Questionnaire (RMQ) − and the Revised Oswestry Disability Index (ODI). Patients were assessed before treatment, at the end of the treatment (after 4 weeks), and at a follow-up of 24 weeks. Results Improvement was achieved in all patients of both groups at 1 month, with statistically highly significant differences between the patients of group I regarding VAS, VRS, RMQ, and ODI scales (P<0.001). We found highly significant differences between the patients of group II regarding RMQ and ODI scales (P<0.001) and statistically significant difference between patients of the same group as regarding VAS and VRS (P<0.05) at 6 months. Group I showed continuous improvement in all variables with highly statistically significant difference (P<0.001) when comparing these with the pretreatment variables at all time points, whereas improvement did not continue with group II at the end of the 24 weeks, as no statistically significant differences were found regarding all measures of outcome scales (P>0.05). Conclusion O2O3 paravertebral injections combined with physical therapy in patients with chronic mechanical low back pain can offer significantly longer improvement in pain management and functional status in these patients.
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Serum amylin level in Behçet’s disease and relation to parameters of metabolic syndrome and disease activity p. 112
Shimaa M Abdelwhab, Omima Z Shehata, Yousry A El Magd, Amal Kamal
DOI:10.4103/err.err_42_17  
Background Insulin resistance is found in Behçet’s disease and associated with the development of metabolic syndrome. Our study explored whether amylin, which is involved in insulin resistance and development of metabolic syndrome, is observed in patients with Behçet’s disease. Aim Our aim was to assess serum levels of amylin in patients with Behçet’s disease and evaluate its relation to metabolic syndrome. Patients and methods Thirty Behçet’s disease patients and 30 controls matched by age, sex, and BMI were studied. The disease activity was assessed using the Behçet’s disease Current Activity Form score. Serum amylin level was studied using the enzyme-linked immunosorbent assay method. Results Our result showed that 11 (36.6%) patients under study were diagnosed with the metabolic syndrome, and there were significant differences between Behçet’s cases and control groups in cholesterol, triglyceride, and low-density lipoprotein levels (P<0.05). Amylin level was 392.2 µg/dl in Behçet’s cases compared with 659.9 μg/dl in the control group. The difference was statistically significant at P value less than 0.05. There was a negative correlation between amylin levels and parameters of metabolic syndrome, a significant difference in amylin levels between Behçet’s patients with an active manifestation and patient with an inactive manifestation. Conclusion Amylin serum levels were significantly lower in patients with Behçet’s disease, indicating that this hormone could be a factor for the development of metabolic syndrome in Behçet’s disease.
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Influence of prolactin and estrogen on disease activity in patients with systemic lupus erythematosus p. 117
Marwa Mahmoud Abdelaziz, Samar H Goma, Sohair K Sayed, Dina H El-Hammady, Rania M Gamal, Doaa Samir Sayed
DOI:10.4103/err.err_18_17  
Objective The objective of this paper is to evaluate the role of prolactin and estrogen levels on disease activity in patients with systemic lupus erythematosus (SLE). Patients and methods This study included 60 female patients with SLE, with a mean age of 33.5±13.12 years. It was conducted between November 2014 and October 2015. Disease activity was defined according to Systemic Lupus Erythematosus Activity Index; score of at least 6 was considered as an active disease. Prolactin (PRL) and estrogen levels and other serological markers of lupus disease activity, namely, complement 3,4 (C3 and C4), erythrocyte sedimentation rate, C-reactive protein, and anti-double-stranded DNA (anti-dsDNA) titer were calculated. Results Hyperprolactinemia was present in 25.0% of patients, and low estrogen level was present in 33.3% of patients. There was no significant correlation between either of estrogen or prolactin levels and all clinical and laboratory features, except for a significant positive correlation between anti-dsDNA and hyperprolactinemia. Conclusion There was no significant correlation between either of PRL or estrogen levels and Systemic Lupus Erythematosus Activity Index score. Overall, 80.0% of patients with hyperprolactinemia and 80.0% with low estrogen level had SLE activity. There was a significant difference in the frequency of further indicators of disease activity in SLE such as raised erythrocyte sedimentation rate, raised C-reactive protein, or decrease in complement factors with high serum PRL and low estrogen level.
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