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Background: Athough hypothyroidism has insidious onset and relatively asymptomatic, exertional dyspnea and fatigue can be the presenting complaints.Objectives: To assess functional lung impairment in hypothyroid patients both at rest and during exercise. Patients and methods: A case control study was carried out on 42 patients with newly diagnosed hypothyroidism and 12 control subjects. Hypothyroidism was diagnosed based on high value of thyroid stimulating hormone TSH≥ 6 uIU/ml, and low value of FT4≤ 0.8 ng/dl, both groups had chest x ray, spirometry, diffusing capacity for carbon monoxide DLCO, arterial blood gases(ABG) and symptom limited exercise testing using treadmill. Results: Both groups were comparable as regard age, sex and body mass index. Although ABG and spirometry were within normal in both groups, FVC%, and FEF25-75%were significantly reduced in hypothyroid group(P 0.014, 0.000 respectively), DLCO significantly reduced in hypothyroidism( P 0.005). As regard exercise testing parameters, maximum oxygen consumption VO2%, minute ventilation VE, tidal volume VT, and oxygen pulse VO2/HR were significantly reduced in hypothyroidism (0.005, 0.000, 0.000, and 0.02 respectively). TSH significantly negatively correlated with FEV1%, FEF25-75%, and DLCO while they significantly positively correlated with FT4 Conclusion: Even with presence of normal chest x ray , arterial blood gases, and spirometry in patients with hypothyroidism DLCO and exercise testing parameters can be significantly reduced.

Background: Athough hypothyroidism has insidious onset and relatively asymptomatic, exertional dyspnea and fatigue can be the presenting complaints.Objectives: To assess functional lung impairment in hypothyroid patients both at rest and during exercise. Patients and methods: A case control study was carried out on 42 patients with newly diagnosed hypothyroidism and 12 control subjects. Hypothyroidism was diagnosed based on high value of thyroid stimulating hormone TSH≥ 6 uIU/ml, and low value of FT4≤ 0.8 ng/dl, both groups had chest x ray, spirometry, diffusing capacity for carbon monoxide DLCO, arterial blood gases(ABG) and symptom limited exercise testing using treadmill. Results: Both groups were comparable as regard age, sex and body mass index. Although ABG and spirometry were within normal in both groups, FVC%, and FEF25-75%were significantly reduced in hypothyroid group(P 0.014, 0.000 respectively), DLCO significantly reduced in hypothyroidism( P 0.005). As regard exercise testing parameters, maximum oxygen consumption VO2%, minute ventilation VE, tidal volume VT, and oxygen pulse VO2/HR were significantly reduced in hypothyroidism (0.005, 0.000, 0.000, and 0.02 respectively). TSH significantly negatively correlated with FEV1%, FEF25-75%, and DLCO while they significantly positively correlated with FT4 Conclusion: Even with presence of normal chest x ray , arterial blood gases, and spirometry in patients with hypothyroidism DLCO and exercise testing parameters can be significantly reduced.

Background: Athough hypothyroidism has insidious onset and relatively asymptomatic, exertional dyspnea and fatigue can be the presenting complaints.Objectives: To assess functional lung impairment in hypothyroid patients both at rest and during exercise. Patients and methods: A case control study was carried out on 42 patients with newly diagnosed hypothyroidism and 12 control subjects. Hypothyroidism was diagnosed based on high value of thyroid stimulating hormone TSH≥ 6 uIU/ml, and low value of FT4≤ 0.8 ng/dl, both groups had chest x ray, spirometry, diffusing capacity for carbon monoxide DLCO, arterial blood gases(ABG) and symptom limited exercise testing using treadmill. Results: Both groups were comparable as regard age, sex and body mass index. Although ABG and spirometry were within normal in both groups, FVC%, and FEF25-75%were significantly reduced in hypothyroid group(P 0.014, 0.000 respectively), DLCO significantly reduced in hypothyroidism( P 0.005). As regard exercise testing parameters, maximum oxygen consumption VO2%, minute ventilation VE, tidal volume VT, and oxygen pulse VO2/HR were significantly reduced in hypothyroidism (0.005, 0.000, 0.000, and 0.02 respectively). TSH significantly negatively correlated with FEV1%, FEF25-75%, and DLCO while they significantly positively correlated with FT4 Conclusion: Even with presence of normal chest x ray , arterial blood gases, and spirometry in patients with hypothyroidism DLCO and exercise testing parameters can be significantly reduced.

Abstract: Purpose: To assess the efficacy of levator recession with adjustable sutures in treatment of upper eyelid retraction . Patients and methods: Patients with upper eyelid retraction were included in this prospective, non-randomized ,interventional case series study. All patients underwent correction of upper eyelid retraction with levator recession using adjustable sutures ,and were followed up every week for a month, then monthly for three months. In each visit, the margin reflex distance (MRD1) and palpebral fissure (PF) were measured. Results: The included patients of the present work were classified into 3 groups: Group A: lid retraction secondary to over correction of ptosis, group B: thyroid related lid retraction, and group C congenital lid retraction. Among the 17 patients that participated in the follow-up examination, mean age ± SD was 21.12 ± 13.73 years (range 7–52 years). Eight were males and nine were females. Mean ± SD (range) of central height of the palpebral fissure was 13.79 ± 1.37 mm (10–16 mm) preoperatively, and 11.04 mm(9–12 mm) at follow up. Mean ± SD (range) of MRD1 was 6.77±0.86 mm (5–8 mm) preoperatively, and 4.78 mm (4.5–5 mm) at follow-up. Conclusion Levator recession with adjustable sutures is effective technique in treatment of upper eyelid retraction of all degrees with different causes. However ,increase the number of cases with long term follow up are recommended.

Abstract: Osteoarthritis (OA) is characterized by a progressive degradation of cartilage and loss of joint function. A simple and reproducible animal model that mimics molecular and pathological changes in the articular cartilage of knee joint OA would help in understanding its pathophysiological mechanism and aid in the preclinical assessment of disease modifying drugs. The aim of our study is to evaluate changes in Aggrecan gene expression as a part of molecular events underlying cartilage turnover in monosodium iodoacetate (MIA)-induced knee OA through determination of aggrecan mRNA expression and immunostaining and its relation to disease chronicity and severity. OA was induced by single intra-articular injection of MIA into knee joints of male rats. Histologic and molecular changes in the knee cartilage were evaluated by light microscopy, real-time PCR and immunohistochemistry. Our results showed that injection of an MIA induced typical OA-like lesions in the knee joint within 3 weeks. Furthermore, there was a significant down-regulation of aggrecan gene expression in MIAinduced OA in a time dependent manner, and that reflects the severity of OA in terms of Mankin score. These results were confirmed through estimation of aggrecan content in cartilage by immunohistochemical analysis, which revealed a progressive decrease in aggrecan immunoexpression. In conclusion, intra-articular MIA injection is an animal model that presents reliable profiling of the sequence, chronic and complex nature of OA. This would help studying the OA modifying drugs specially those suggested having anabolic effect and enhancing the PG contents both at early and late stages of the disease.

Abstract: Osteoarthritis (OA) is characterized by a progressive degradation of cartilage and loss of joint function. A simple and reproducible animal model that mimics molecular and pathological changes in the articular cartilage of knee joint OA would help in understanding its pathophysiological mechanism and aid in the preclinical assessment of disease modifying drugs. The aim of our study is to evaluate changes in Aggrecan gene expression as a part of molecular events underlying cartilage turnover in monosodium iodoacetate (MIA)-induced knee OA through determination of aggrecan mRNA expression and immunostaining and its relation to disease chronicity and severity. OA was induced by single intra-articular injection of MIA into knee joints of male rats. Histologic and molecular changes in the knee cartilage were evaluated by light microscopy, real-time PCR and immunohistochemistry. Our results showed that injection of an MIA induced typical OA-like lesions in the knee joint within 3 weeks. Furthermore, there was a significant down-regulation of aggrecan gene expression in MIAinduced OA in a time dependent manner, and that reflects the severity of OA in terms of Mankin score. These results were confirmed through estimation of aggrecan content in cartilage by immunohistochemical analysis, which revealed a progressive decrease in aggrecan immunoexpression. In conclusion, intra-articular MIA injection is an animal model that presents reliable profiling of the sequence, chronic and complex nature of OA. This would help studying the OA modifying drugs specially those suggested having anabolic effect and enhancing the PG contents both at early and late stages of the disease.

Abstract: Osteoarthritis (OA) is characterized by a progressive degradation of cartilage and loss of joint function. A simple and reproducible animal model that mimics molecular and pathological changes in the articular cartilage of knee joint OA would help in understanding its pathophysiological mechanism and aid in the preclinical assessment of disease modifying drugs. The aim of our study is to evaluate changes in Aggrecan gene expression as a part of molecular events underlying cartilage turnover in monosodium iodoacetate (MIA)-induced knee OA through determination of aggrecan mRNA expression and immunostaining and its relation to disease chronicity and severity. OA was induced by single intra-articular injection of MIA into knee joints of male rats. Histologic and molecular changes in the knee cartilage were evaluated by light microscopy, real-time PCR and immunohistochemistry. Our results showed that injection of an MIA induced typical OA-like lesions in the knee joint within 3 weeks. Furthermore, there was a significant down-regulation of aggrecan gene expression in MIAinduced OA in a time dependent manner, and that reflects the severity of OA in terms of Mankin score. These results were confirmed through estimation of aggrecan content in cartilage by immunohistochemical analysis, which revealed a progressive decrease in aggrecan immunoexpression. In conclusion, intra-articular MIA injection is an animal model that presents reliable profiling of the sequence, chronic and complex nature of OA. This would help studying the OA modifying drugs specially those suggested having anabolic effect and enhancing the PG contents both at early and late stages of the disease.