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   Table of Contents - Current issue
September-December 2018
Volume 4 | Issue 3
Page Nos. 73-99

Online since Thursday, October 3, 2019

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Study of metabolic syndrome frequency in elderly patients with knee osteoarthritis and its impact on the physical activity p. 73
Suzan N Abou-Raya, Doria E Meyers, Eman A Sayed, Mervat A Kamal-El Deen
Background Obesity is associated with an increased risk of osteoarthritis (OA). Metabolic syndrome (Met S) has been associated with a state of chronic low-grade inflammation and increased macrophages in the fat tissue. Hypertension and hyperglycaemia seem to be important BMI-independent factors of changes in osteoarthritic joints. Moreover, type 2 diabetes mellitus (DM) has been found to be an independent risk predictor for arthroplasty. Aim of the work To determine frequency and association of metabolic syndrome with knee osteoarthritis in elderly patients and its impact on the physical activity in elderly patients with knee osteoarthritis. Patients The study included patients aged above 65 years complaining of primary knee OA. The study included two groups: Gp A: Sixty patients >65 years with primary OA. Gp B: Forty apparently healthy elderly persons without knee OA as a control group. Exclusion Criteria: Patients with secondary knee OA. Methods All Patients were subjected to the following: Complete history taking, self-rated was measured by (SF-36), BMI, complete clinical musculoskeletal examination. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) 1st hr,fasting glucose level, 2 hr-post-prandial glucose level, triglycerides (TG), cholesterol, uric acid, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and radiographic imaging of affected knee joints. Results According to (k/L) score of severity; grade 3 and grade 4 OA were significantly higher in patients with Met S than patients without Met S. The mean WOMAC pain subscale score was significantly higher in patients with OA and Met S than in patients with OA and without Met S with P value (<0.001). There was a significant positive correlation between the both joint pain, stiffness and fasting blood glucose level (r=−0.463 P=<0.001; r=0.324, P=0.012 respectively); systolic, diastolic blood pressure and waist circumference in OA patients (group I) with Met S. Conclusion Elevated systemic markers of inflammation are linked with components of Met S, with an increased prevalence of radiographic OA and joint symptoms.
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Sclerostin level in rheumatoid arthritis patients and its relationship to disease severity and bone mineral density p. 82
Abdel Megid Mona, Barakat Barakat, Ayad Mona, Abdel Ghani Eman, Bakri Heba
Background Bone loss in rheumatoid arthritis is caused by increased bone resorption without increasing bone formation. The Wnt pathway is important in the control of bone formation through the regulation of osteoblast activity. Sclerostin is an important regulator of the Wnt pathway by blocking Wnt binding to its receptor and thereby , inhibiting bone formation. Aim Of The Work was to correlate the relation between level of serum sclerostin and bone mineral density with disease severity in rheumatoid arthritis patients. Subjects The study was conducted on 50 subjects divided into two groups: Group I : Thirty patients of rheumatoid arthritis subjects diagnosed according to 2010 ACR / EULAR diagnostic criteria. Group II : Twenty persons as a control group. Methods All patients were subjected to ; thorough medical history taking, DAS -28, disability Index, complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), RF, antinuclear antibody (ANA), Anti-CCP Antibodies, Human Sclerostin levels using ELISA technique, Plain X- ray on both hands and feets, U/S on both hands, and (DEXA) scan. Results There was a statistical significant difference between the two studied groups regarding the age, gender, sclerostin level, and DAS-28 (P>0.05). Conclusion Most of patients were under treatment with disease modifying anti-rheumatic drugs (DMARDs) as methotrexate, fracture risk was not assessed, and measurements for renal function were not measured. However, it is possible that circulating sclerostin levels may not reflect changes of sclerostin at a local level. Despite the many questions that remain, pre-clinical studies and clinical trial results would imply that sclerostin antibodies will emerge as a dominant first- line treatment in the management of osteoporosis.
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The relationship between adiponectin gene polymorphism and occurrence of obesity at Zagazig University Hospitals p. 90
Abd El-Monem Fathy Zeid, Atef G Hussein, Mohamed M Mahmoud Awad, Mohamed M Atia Ibrahim
Background Obesity is considered a severe rapidly growing health problem all over the world. Adiponectin is an adipokine produced and secreted by adipose tissues and widely known as antidiabetic, anti-inflammatory, antiatherogenic, and cardioprotective factor. The adiponectin gene has various single nucleotide polymorphisms (SNPs). Objective Our aim of this study was to determine the genotype frequency of SNPs (276 G→T) in adiponectin gene and its relationship with the occurrence of obesity and to detect the association between adiponectin gene polymorphism and different degrees of obesity. Patients and methods A total of 96 volunteers were included and divided into the following: group I had 48 healthy nonobese control volunteers, and group II included 48 obese patients not having any disease. Anthropometric parameters were measured by standard procedures. Random blood sample was collected for routine and research investigations. PCR assay with restriction fragment length polymorphism was used to examine the adiponectin gene SNP276G>T polymorphism. Results Genotypes distributions of 276G>T polymorphisms were significantly different between obese and nonobese cases. T allele was significantly associated with obese individuals (P<0.05) with odds ratio (OR) of 2.13 and found to be significantly associated (P<0.05) and risky for BMI more than or equal to 30, with OR 3.86. Both of the genotype TT and allele T were significantly associated and risky for abdominal obesity (P<0.05) with OR of 3.57 for TT genotype and 3.61 for T allele. Conclusion The T allele and TT genotypes at the 276 locus of the ADIPOQ gene were associated with higher risk of obesity.
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