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Background: Rheumatoid arthritis is a systemic rheumatic disease characterized by symmetrical, often erosive and deforming poly-arthritis with extra-articular manifestations in 10–20% of patients, especially those with high titers of rheumatoid factor. Extra articular pathology includes bursitis, tendonitis and neuritis, which results from entrapment, nerve ischemia due to vasculitis or drugs used to treat this condition. Carpal tunnel syndrome is the most common compression neuropathy associated with rheumatoid arthritis. Aim of the Work: To evaluate the efficacy of Neural Prolotherapy and Platelet Rich Plasma in treatment of carpal tunnel syndrome secondary to rheumatoid arthritis. Patients and Methods: Ninety patients with Rheumatoid Arthritis (RA) that were all fulfilling the 2016 ACR/EULAR classification criteria for RA. All were over the age of sixteen years at time of diagnosis, complaining of burning pain or paresthesia in the median nerve distribution of the hand. They were recruited from Rheumatology and Rehabilitation Department at Al-Hussein and Sayed Galal University Hospitals during the period from December 2018 to July 2019. Results: Neural Prolotherapy and Platelet Rich Plasma (PRP) have improved all measured parameters like visual analogue scale (VAS), nerve conduction studies and neuromuscular ultrasonography parameters in carpal tunnel syndrome secondary to rheumatoid arthritis. Conclusion: Neural Prolotherapy and Platelet Rich Plasma proved to be effective treatments of carpal tunnel syndrome secondary to rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Background: early cancers are managed by single modality treatment (surgical excision of the primary tumor or radiotherapy (3DCRT, IMRT or brachytherapy)) with or without elective neck dissection. While locally advanced resectable disease is managed by surgery (excision of the primary tumor with modified radical neck dissection) followed by postoperative radiotherapy with or without chemotherapy. This should be considered for cases with adverse pathological features. Purpose: this is a retrospective study to analyze the epidemiological, pathological and clinical factors in cancer oral tongue and correlate them to clinical outcomes [response to treatment and survival rates (disease free survival, progression free survival and overall survival)] to explore best options of care for the patients. Patients and Methods: at the Department of Clinical Oncology and Nuclear Medicine, Ain Shams University Hospitals and Nasser Institute, Cancer Center; patients with a histologically confirmed diagnosis of oral tongue cancer were included in this retrospective analysis. The study included 40 cases from Nasser Institute, Cancer Center and 18 cases from Ain Shams University Hospitals. The study period was 6 years from January 2011 to December 2016. Results: fifty eight recorded cases were included in the study and subsequent descriptive analysis was performed. One patient who didn't receive any treatment was omitted from the study. Conclusion: as regard treatment; most of the patients underwent surgery followed by adjuvant concurrent chemo radiotherapy especially in patients with close or positive surgical margins or patients who didn't undergo LN dissection. This affected DFS. [ABSTRACT FROM AUTHOR]

Background: the use of antidiabetic drugs to control gestational diabetes was controversial. Some studies suggest a possible link between the use of oral antidiadetics and fetal anomalies, fetal macrosomia and neonatal hypoglycemia whereas others have demonstrated no such relationship. Objective: This study aims to assess the efficacy of metformin in controlling maternal blood glucose level compared to insulin in women with GDM. Patients and Methods: The present study included 116 pregnant women who have been diagnosed as gestational diabetics before 34 weeks gestation with singleton pregnancy. They had FBG level ranging from 90-169 mg/dl or 2-hour postprandial blood glucose level ranging from 110-176 mg/dl. The exclusion criteria include pregnant women with preexisting DM and underlying diseases known to affect fetal growth, preeclampsia, unbalanced chronic disease, twin pregnancy, or refused to participate. Results: Comparison of the baseline characteristics was performed between 2 groups and there were no significant differences between the two groups regarding maternal age, gravidity, parity, GA at time of diagnosis, GA at beginning of treatment, and BMI at time of diagnosis. Analysis of the results revealed that metformin was an effective medication for control of blood glucose in women with GDM who failed to achieve euglycemic with diet only. [ABSTRACT FROM AUTHOR]

Background: With the rising trend of diabetes mellitus and hypertension, there is also a rise in chronic complications like chronic kidney disease (CKD) and end stage renal disease (ESRD). Cardiovascular complications remain the most common cause of death among ESRD patients and those on hemodialysis (HD). Hemodialysis patients behave in a distinct way that they are relatively more prone for bleeding than thrombotic manifestations. In recent days, abnormalities in platelet parameters are found to be an effective tool in risk stratification of patients with chronic kidney disease (CKD) to develop coronary artery disease. Platelet parameters are considered as inflammatory markers. The present study was taken to find the association of various platelet parameters among hemodialysis patients and CKD patients. Objectives: The aim was to study the platelet distribution width (PDW), mean platelet volume (MPV), plateletcrit (PCT) and platelet large cell ratio (PLCR) among ESRD patients undergoing maintenance hemodialysis and compare with CKD patients and healthy age and sex matched controls. Methods: The present study was done on three groups. Group 1 included 20 healthy individuals from hospital staffs and healthy volunteers matched for age and sex, Group2 included 60 CKD patients and Group 3 included 40 ESRD patients on maintenance HD. Results: The mean values of platelet distribution width (PDW), mean platelet volume (MPV), platelet count, plateletcrit ratio (PCT) and platelet large cell ratio (P-LCR) were found to be higher in CKD and ESRD patients when compared to healthy controls. PDW, PCT and L-PCR attained statistical significance, while MPV did not. Conclusions: Abnormality in platelet parameters can be used as a predictor of underlying inflammation and severity of atherosclerosis as all these parameters are lesser than that observed in control population. [ABSTRACT FROM AUTHOR]