NULL

NULL

NULL

Introduction: Pelvic sarcomas may present with vague symptoms. The aim of this study was to examine the characteristics and clinical presentations of different types of pelvic sarcoma in children. Methods: This is a retrospective cohort study of patients up to 21 years of age with the diagnosis of pelvic sarcoma between January 2000 and June 2013. Data on demographics, tumor type and location, and clinical presentation were collected from the medical records. Results: A total of 59 patients [37 males (62.7%) and 22 females (37.3%)] were examined in this study. Mean age at presentation was 11.3 ± 5 years (range 0.8–21 years). Thirty-six patients had Ewing sarcoma (61%), 9 osteosarcoma (6.8%), 4 undifferentiated sarcoma (6.8%), 2 (3.4%) rhabdomyosarcoma, 2 synovial cell sarcoma, and one (1.7%) of each fibrosarcoma, dermatofibrosarcoma, fibromyxoid sarcoma, chondrosarcoma, chordoma, and epithelioid sarcoma. Pain at presentation was reported in 41 patients, 13 mass, 8 limping, and 5 neurologic symptoms. Most of the bony tumors were painful (77%), while most of the soft tissue tumors were painless (70%). Nine patients presented with constitutional symptoms. Most patients presented within 4–12 months from symptoms beginning. Twenty-one patients (35.6%) presented with metastases (14 Ewing sarcoma, 6 osteosarcoma, and 1 synovial cell sarcoma). Pelvic radiographs showed lytic lesion in 11 patients, 4 sclerotic lesions, 6 mixed lesion, 6 had only soft tissue mass, 1 radiograph showed osteopenia, and 2 radiographs were reported normal. Conclusion: Ewing sarcoma was the most common pelvic sarcoma tumor in children. In most cases, pelvic sarcoma in children presented with pain mimicking other benign conditions. Some patients presented with metastatic disease with no prognostic clinical or radiographical signs or symptoms. Pelvic sarcoma should be considered a differential diagnosis as part of children work up.

Introduction: Patients with epilepsy (PWE) have poor quality of life (QOL) due to several events. This study is aimed to determine the effect of different anti-epileptic drugs (AEDs) monotherapy; Lamotrigine (LTG), Carbamazepine (CBZ) and Sodium Valproate (VPA) on QOL of newly diagnosed idiopathic generalized epilepsy. Patients and Methods: Thirty-six newly diagnosed patients with idiopathic generalized epilepsy from outpatient’s clinic of Assuit university Hospitals. According to AEDs treatment they were randomly classified into three groups with ratio 1:1:1: LTG, CBZ and VPA groups (N=12 for each). Quality of Life of these patients, using Epilepsy Inventory version 1.0 (QOLIE-31), and serum level of AEDs were assessed at baseline, after one and three months of treatment. Results: There was no significant difference between demographic and clinical data of the studied AEDs groups at baseline and there was a significant decline in frequency of seizures after three months, with significant improvement in overall score of QOLIE-31, social function and emotional well-being subscales, but Energy/Fatigue subscale showed significant improvement in LTG and CBZ groups without changes in VPA group. while the medication effect and overall QOL subscales showed significant improvement in LTG and VPA groups without improvement in CBZ group. The cognitive subscale of QOLIE-31 showed significant deterioration in CBZ group that was not found in LTG or VPA groups. Conclusion: AEDs monotherapy improve QOL of newly diagnosed Epileptic patients while LTG monotherapy was significantly more effective and tolerated for improving several aspects of QOL than VPA or CBZ monotherapy in newly diagnosed epileptic patients after 3 months of treatment.

Introduction: Patients with epilepsy (PWE) have poor quality of life (QOL) due to several events. This study is aimed to determine the effect of different anti-epileptic drugs (AEDs) monotherapy; Lamotrigine (LTG), Carbamazepine (CBZ) and Sodium Valproate (VPA) on QOL of newly diagnosed idiopathic generalized epilepsy. Patients and Methods: Thirty-six newly diagnosed patients with idiopathic generalized epilepsy from outpatient’s clinic of Assuit university Hospitals. According to AEDs treatment they were randomly classified into three groups with ratio 1:1:1: LTG, CBZ and VPA groups (N=12 for each). Quality of Life of these patients, using Epilepsy Inventory version 1.0 (QOLIE-31), and serum level of AEDs were assessed at baseline, after one and three months of treatment. Results: There was no significant difference between demographic and clinical data of the studied AEDs groups at baseline and there was a significant decline in frequency of seizures after three months, with significant improvement in overall score of QOLIE-31, social function and emotional well-being subscales, but Energy/Fatigue subscale showed significant improvement in LTG and CBZ groups without changes in VPA group. while the medication effect and overall QOL subscales showed significant improvement in LTG and VPA groups without improvement in CBZ group. The cognitive subscale of QOLIE-31 showed significant deterioration in CBZ group that was not found in LTG or VPA groups. Conclusion: AEDs monotherapy improve QOL of newly diagnosed Epileptic patients while LTG monotherapy was significantly more effective and tolerated for improving several aspects of QOL than VPA or CBZ monotherapy in newly diagnosed epileptic patients after 3 months of treatment.

OBJECTIVE: To explore the neuropsychological effects and levels of tau protein (TAU), amyloid β 1-42 (Aβ 1-42), and lipid peroxidase after 10 sessions of anodal transcranial direct current stimulation (tDCS) in patients with mild to moderate Alzheimer disease (AD). PATIENTS AND METHODS: A total of 46 consecutive patients with probable AD participated in this study. They were classified randomly into 2 equal groups: active versus sham. Each patient received 10 sessions of anodal tDCS over the left and right temporoparietal region for 20 minutes for each side with the cathode on the left arm. Patients were assessed using the Modified Mini Mental State Examination (MMMSE), clock drawing test, Montreal Cognitive Scale (MoCA), and the Cornell Scale for depression. Serum TAU, Aβ 1-42, and lipid peroxidase were measured before and after the 10th session. RESULTS: There was a significant improvement in the total score of each cognitive rating scale (MMMSE, clock drawing test, and MoCA) in the real group, whereas no such change was observed in the sham group. The Cornell depression score improved significantly in both groups. There was a significant increase in serum Aβ 1-42 ( P = .02) in the real but not in the sham group, with a significant Treatment condition × Time interaction ( P = .009). There was no significant effect on tau or lipid peroxidase in either group but a significant positive correlation between changes of Aβ1-42 and MMMSE ( P = .005) and MoCA ( P = .02). CONCLUSION: The observed cognitive improvements were complemented by parallel changes in serum levels of Aβ 1-42.

OBJECTIVE: To explore the neuropsychological effects and levels of tau protein (TAU), amyloid β 1-42 (Aβ 1-42), and lipid peroxidase after 10 sessions of anodal transcranial direct current stimulation (tDCS) in patients with mild to moderate Alzheimer disease (AD). PATIENTS AND METHODS: A total of 46 consecutive patients with probable AD participated in this study. They were classified randomly into 2 equal groups: active versus sham. Each patient received 10 sessions of anodal tDCS over the left and right temporoparietal region for 20 minutes for each side with the cathode on the left arm. Patients were assessed using the Modified Mini Mental State Examination (MMMSE), clock drawing test, Montreal Cognitive Scale (MoCA), and the Cornell Scale for depression. Serum TAU, Aβ 1-42, and lipid peroxidase were measured before and after the 10th session. RESULTS: There was a significant improvement in the total score of each cognitive rating scale (MMMSE, clock drawing test, and MoCA) in the real group, whereas no such change was observed in the sham group. The Cornell depression score improved significantly in both groups. There was a significant increase in serum Aβ 1-42 ( P = .02) in the real but not in the sham group, with a significant Treatment condition × Time interaction ( P = .009). There was no significant effect on tau or lipid peroxidase in either group but a significant positive correlation between changes of Aβ1-42 and MMMSE ( P = .005) and MoCA ( P = .02). CONCLUSION: The observed cognitive improvements were complemented by parallel changes in serum levels of Aβ 1-42.

OBJECTIVE: To explore the neuropsychological effects and levels of tau protein (TAU), amyloid β 1-42 (Aβ 1-42), and lipid peroxidase after 10 sessions of anodal transcranial direct current stimulation (tDCS) in patients with mild to moderate Alzheimer disease (AD). PATIENTS AND METHODS: A total of 46 consecutive patients with probable AD participated in this study. They were classified randomly into 2 equal groups: active versus sham. Each patient received 10 sessions of anodal tDCS over the left and right temporoparietal region for 20 minutes for each side with the cathode on the left arm. Patients were assessed using the Modified Mini Mental State Examination (MMMSE), clock drawing test, Montreal Cognitive Scale (MoCA), and the Cornell Scale for depression. Serum TAU, Aβ 1-42, and lipid peroxidase were measured before and after the 10th session. RESULTS: There was a significant improvement in the total score of each cognitive rating scale (MMMSE, clock drawing test, and MoCA) in the real group, whereas no such change was observed in the sham group. The Cornell depression score improved significantly in both groups. There was a significant increase in serum Aβ 1-42 ( P = .02) in the real but not in the sham group, with a significant Treatment condition × Time interaction ( P = .009). There was no significant effect on tau or lipid peroxidase in either group but a significant positive correlation between changes of Aβ1-42 and MMMSE ( P = .005) and MoCA ( P = .02). CONCLUSION: The observed cognitive improvements were complemented by parallel changes in serum levels of Aβ 1-42.

OBJECTIVES: Rheumatoid arthritis (RA) is a chronic inflammatory disease, characterized by polyarthritis and systemic manifestations. RA-fatigue is a significant problem and adds on disease burden. Sleep disturbance, depression, and disease activity are suggested contributing factors to RA-fatigue; however, their combined role did not examine before among Egyptian RA patients. The objective of the study was to investigate the presence of fatigue, sleep and mood disturbances in RA patients. Also, to evaluate the possible association of poor sleep, depression, and disease activity with RA-fatigue. METHODS: This cross-sectional study included 115 RA patients diagnosed according to the 2010 ACR-EULAR criteria and 46 age and sex matched controls. Fatigue using the Multidimensional Assessment of Fatigue-Global Fatigue Index, sleep using the Pittsburgh Sleep Quality Index and mood status using Beck Depression Inventory were assessed for all participants. RA disease activity was evaluated using disease activity score-28 joints. RESULTS: RA patients had higher mean fatigue, sleep disturbance, and depression scores (27.2±8.9, 6.4±3.6, and 12.8±7.3; respectively) than controls (22.7±7, 4.8±3, 7.8±5.9; respectively) (P.05). Poor sleep, depression and higher disease activity were significantly correlated with fatigue (r=0.4, r=0.65, r=0.55; respectively) (P.001). The three variables may explain up to 49.1% of the variation in fatigue on multiple regression analysis. CONCLUSION: Fatigue, poor sleep, and depression are more common in Egyptian patients with RA. A remarkably higher fatigue was associated with poor sleep, depression, and high disease activity, thus monitoring these silent comorbidities in clinical practice is required.