Background Patients with rheumatic diseases significantly suffer during and after infection with ... more Background Patients with rheumatic diseases significantly suffer during and after infection with coronavirus disease (COVID-19). Post-COVID-19 syndrome (PCS) refers to signs and symptoms occurring during or following a COVID-19 infection that continue beyond 12 weeks. The study aimed to assess PCS symptoms in rheumatic disease patients compared to a control group not suffering from a rheumatic disease or any other chronic illness.
Background Pain in osteoarthritis (OA) has been attributed traditionally to local tissue injury c... more Background Pain in osteoarthritis (OA) has been attributed traditionally to local tissue injury causing 'nociceptive pain'. However, recent studies suggest that neuropathic and central sensitization mechanisms may contribute to the pain experience. However, the relationship between these pain mechanisms and physical function has not been thoroughly addressed. This study aimed to assess the association of central sensitization and neuropathic pain with physical function in knee OA.
Background Resilience is the process of adjusting successfully in the face of adversity, trauma, ... more Background Resilience is the process of adjusting successfully in the face of adversity, trauma, threats, or severe stress, such as serious health problems. It is one of the factors that affect recovery from psychiatric disorders. It was suggested that fibromyalgia patients have low resilience. This study aimed to assess the impact of resilience on disease severity and psychiatric comorbidities in patients with fibromyalgia. Results We found that patients with fibromyalgia had a significantly lower resilience and higher prevalence of psychiatric comorbidities than the control group (P < 0.05). Also, fibromyalgia patients with high disease severity had a significantly lower resilience and a higher percentage of psychiatric problems than those with a better disease state (P = 0.0001). Also, there was a significant negative correlation of resilience with disease severity (as assessed by the FIQ score), visual analog scale (VAS) of anxiety, and VAS of depression (P = 0.0001). Conclus...
Background: Resilience is the process of adjusting successfully in the face of adversity, trauma,... more Background: Resilience is the process of adjusting successfully in the face of adversity, trauma, threats, or severe stress, such as serious health problems. It is one of the factors that affect recovery from psychiatric disorders. It was suggested that fibromyalgia patients have low resilience. This study aimed to assess the impact of resilience on disease severity and psychiatric comorbidities in patients with fibromyalgia. Results: We found that patients with fibromyalgia had a significantly lower resilience and higher prevalence of psychiatric comorbidities than the control group (P < 0.05). Also, fibromyalgia patients with high disease severity had a significantly lower resilience and a higher percentage of psychiatric problems than those with a better disease state (P = 0.0001). Also, there was a significant negative correlation of resilience with disease severity (as assessed by the FIQ score), visual analog scale (VAS) of anxiety, and VAS of depression (P = 0.0001). Conclusion: Resilience significantly impacts the severity and psychiatric comorbidities in patients with fibromyalgia. So, enhancing and improving resilience must be considered in the management protocols of fibromyalgia patients.
Background Chronic back pain is a common health complaint among university students. A subset of ... more Background Chronic back pain is a common health complaint among university students. A subset of chronic back pain patients suffer from increased pain sensitivity, a process termed central sensitization. Chronic pain is also associated with cognitive dysfunction, involving attention, memory, and learning. Those are key features of adult attention deficit hyperactivity disorder. This study aimed to assess the associations between adult attention deficit hyperactivity disorder and central sensitization in students with chronic back pain. Results Two hundred twenty-seven students completed the survey, and 90 (39.6%) had back pain for more than 3 months. Students with back pain had significantly higher central sensitization (P<0.01) and higher attention deficit scores (P=0.05). Significant positive correlations were found between scores of the two questionnaires (r= 0.55, P<0.01). Regression analysis adjusted for age and gender showed that higher attention deficit scores were asso...
ABSTRACT AIM: To assess the presence of spinal accessory neuropathy in patients with chronic neck... more ABSTRACT AIM: To assess the presence of spinal accessory neuropathy in patients with chronic neck pain. METHODS: Patients with pain either regional or focal in the neck or shoulders for at least 6 mo (chronic neck pain) were recruited randomly from the Rheumatology and Rehabilitation Outpatient Clinic at the Faculty of Medicine-Suez Canal University. Two groups were compared:30 patients with chronic neck pain with mean age (36.97 ± 12.45 years) and 10 apparently healthy controls. Trapezius muscle examination including inspection and range of motion both active and passive was performed. A full clinical neurological examination was carried out to exclude peripheral neuropathy and motor neuron disease. According to the subject’s type of work, cases were categorized into labor-intensive and non-labor intensive tasks. A nerve conduction study (NCS) was performed on spinal accessory nerves at both sides for all patients and controls. Parameters including latencies and amplitudes of compound motor action potential (CMAP) were compared with the chronicity of neck pain using the neck disability score. This cross sectional study was carried in the Rheumatology and Rehabilitation Department, at Suez Canal University Hospital, Ismailia, Egypt. RESULTS: Physical examination revealed that 80% of cases had spinal trapezius muscle spasm. Restricted neck motion was present in 16.6% of cases. No one suffered from muscle wasting or weakness. Pain was bilateral in 18 patients (60%), localized to the right side in six patients (20%) and localized to the left side in six patients (20%). The causes of neck pain in the patients studied were nonspecific, due to physical stresses, cervical spondylosis and mild cervical disc herniation. Mean disease duration in patients with labor-intensive tasks was (3.9 ± 2.1 years), which was longer than that in patients with non-labor intensive tasks (3.1 ± 1.9 years); however, this difference was statistically insignificant. Spinal accessory NCSs were performed while subjects were in sitting positions and relaxed with naturally suspended arms to minimize muscular movement. The results of electrophysiological studies revealed that mean right and left latencies of the spinal accessory nerve were 2.96 ± 0.69 ms, 2.98 ± 0.61 ms in the patient group and 2.44 ± 0.38 ms, 2.33 ± 0.36 ms in control group respectively. These differences were statistically significant with P = 0.028 and 0.006 respectively. Spinal accessory NCS showed normal CMAP amplitude in both patients and controls. Comparing the results of the neck disability index (NDI) to different characteristics in patients with chronic neck pain, showed that patients with labor-intensive work had a higher NDI score mean (34.7 ± 9.5) compared to those with non-labor-intensive work, with significant statistical difference (P = 0.011). In addition, mean NDI scores were higher in males, and patients aged over 40 years and this difference was statistically significant (P = 0.007 and P = 0.009 respectively). Correlation studies between right and left spinal accessory nerve latencies and disability percent calculated using the NDI revealed a positive correlation. Moreover, there was a positive correlation between age and disability percent. CONCLUSION: This study demonstrates electrophysiological evidence of demyelination in a significant proportion of patients with chronic cervical pain.
The Journal of Hand Surgery (Asian-Pacific Volume), 2020
Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MG... more Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MGA) in healthy Egyptian subjects, and to discuss the available literature regarding MGA subtypes and their clinical implications. Methods: An electrophysiological study was conducted in both forearms of 140 healthy subjects. This included the ulnar and median nerves. Compound muscle action potentials were recorded from abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles. Other measurements included the compound motor action potential amplitude and its innervation ratio. Results: MGA was found in 56 of the 280 forearms. This included 20 men and 36 women. Type II MGA subtype was the most frequent in both genders. The MGA was bilateral in 6 subjects and more frequent on the right side. The highest mean amplitude and innervation ratio were recorded at first dorsal interosseus muscle. Conclusions: The prevalence of MGA in the studied sample of the Egyptian p...
The Journal of Hand Surgery (Asian-Pacific Volume), 2020
Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MG... more Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MGA) in healthy Egyptian subjects, and to discuss the available literature regarding MGA subtypes and their clinical implications. Methods: An electrophysiological study was conducted in both forearms of 140 healthy subjects. This included the ulnar and median nerves. Compound muscle action potentials were recorded from abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles. Other measurements included the compound motor action potential amplitude and its innervation ratio. Results: MGA was found in 56 of the 280 forearms. This included 20 men and 36 women. Type II MGA subtype was the most frequent in both genders. The MGA was bilateral in 6 subjects and more frequent on the right side. The highest mean amplitude and innervation ratio were recorded at first dorsal interosseus muscle. Conclusions: The prevalence of MGA in the studied sample of the Egyptian p...
ABSTRACT Introduction Juvenile Fibromyalgia (JFM) is an idiopathic chronic pain syndrome defined ... more ABSTRACT Introduction Juvenile Fibromyalgia (JFM) is an idiopathic chronic pain syndrome defined by widespread non-articular musculoskeletal pain and generalized tender points. The syndrome is associated with a constellation of symptoms, including fatigue, non-refreshing sleep, irritable bowel, and more [1]. Fi-bromyalgia (FM) is most common in midlife, but may be seen at any age. Girls are affected relatively more often [2]. Using dolorimetry at specific ten-der point sites, boys exhibited less tenderness than girls did; subjects who had FM had a lower tender-ness threshold compared with the subjects who did not have FM. These data demonstrating effects on tenderness associated with gender in children con-firm results previously found in adults [3]. Clark and colleagues [4], reported that the prevalence of JFM in school children in Mexico reached 1.2%, which is fourfold lower than the pre-vious study that evaluated the prevalence of JFM in Abstract
Background Patients with rheumatic diseases significantly suffer during and after infection with ... more Background Patients with rheumatic diseases significantly suffer during and after infection with coronavirus disease (COVID-19). Post-COVID-19 syndrome (PCS) refers to signs and symptoms occurring during or following a COVID-19 infection that continue beyond 12 weeks. The study aimed to assess PCS symptoms in rheumatic disease patients compared to a control group not suffering from a rheumatic disease or any other chronic illness.
Background Pain in osteoarthritis (OA) has been attributed traditionally to local tissue injury c... more Background Pain in osteoarthritis (OA) has been attributed traditionally to local tissue injury causing 'nociceptive pain'. However, recent studies suggest that neuropathic and central sensitization mechanisms may contribute to the pain experience. However, the relationship between these pain mechanisms and physical function has not been thoroughly addressed. This study aimed to assess the association of central sensitization and neuropathic pain with physical function in knee OA.
Background Resilience is the process of adjusting successfully in the face of adversity, trauma, ... more Background Resilience is the process of adjusting successfully in the face of adversity, trauma, threats, or severe stress, such as serious health problems. It is one of the factors that affect recovery from psychiatric disorders. It was suggested that fibromyalgia patients have low resilience. This study aimed to assess the impact of resilience on disease severity and psychiatric comorbidities in patients with fibromyalgia. Results We found that patients with fibromyalgia had a significantly lower resilience and higher prevalence of psychiatric comorbidities than the control group (P < 0.05). Also, fibromyalgia patients with high disease severity had a significantly lower resilience and a higher percentage of psychiatric problems than those with a better disease state (P = 0.0001). Also, there was a significant negative correlation of resilience with disease severity (as assessed by the FIQ score), visual analog scale (VAS) of anxiety, and VAS of depression (P = 0.0001). Conclus...
Background: Resilience is the process of adjusting successfully in the face of adversity, trauma,... more Background: Resilience is the process of adjusting successfully in the face of adversity, trauma, threats, or severe stress, such as serious health problems. It is one of the factors that affect recovery from psychiatric disorders. It was suggested that fibromyalgia patients have low resilience. This study aimed to assess the impact of resilience on disease severity and psychiatric comorbidities in patients with fibromyalgia. Results: We found that patients with fibromyalgia had a significantly lower resilience and higher prevalence of psychiatric comorbidities than the control group (P < 0.05). Also, fibromyalgia patients with high disease severity had a significantly lower resilience and a higher percentage of psychiatric problems than those with a better disease state (P = 0.0001). Also, there was a significant negative correlation of resilience with disease severity (as assessed by the FIQ score), visual analog scale (VAS) of anxiety, and VAS of depression (P = 0.0001). Conclusion: Resilience significantly impacts the severity and psychiatric comorbidities in patients with fibromyalgia. So, enhancing and improving resilience must be considered in the management protocols of fibromyalgia patients.
Background Chronic back pain is a common health complaint among university students. A subset of ... more Background Chronic back pain is a common health complaint among university students. A subset of chronic back pain patients suffer from increased pain sensitivity, a process termed central sensitization. Chronic pain is also associated with cognitive dysfunction, involving attention, memory, and learning. Those are key features of adult attention deficit hyperactivity disorder. This study aimed to assess the associations between adult attention deficit hyperactivity disorder and central sensitization in students with chronic back pain. Results Two hundred twenty-seven students completed the survey, and 90 (39.6%) had back pain for more than 3 months. Students with back pain had significantly higher central sensitization (P<0.01) and higher attention deficit scores (P=0.05). Significant positive correlations were found between scores of the two questionnaires (r= 0.55, P<0.01). Regression analysis adjusted for age and gender showed that higher attention deficit scores were asso...
ABSTRACT AIM: To assess the presence of spinal accessory neuropathy in patients with chronic neck... more ABSTRACT AIM: To assess the presence of spinal accessory neuropathy in patients with chronic neck pain. METHODS: Patients with pain either regional or focal in the neck or shoulders for at least 6 mo (chronic neck pain) were recruited randomly from the Rheumatology and Rehabilitation Outpatient Clinic at the Faculty of Medicine-Suez Canal University. Two groups were compared:30 patients with chronic neck pain with mean age (36.97 ± 12.45 years) and 10 apparently healthy controls. Trapezius muscle examination including inspection and range of motion both active and passive was performed. A full clinical neurological examination was carried out to exclude peripheral neuropathy and motor neuron disease. According to the subject’s type of work, cases were categorized into labor-intensive and non-labor intensive tasks. A nerve conduction study (NCS) was performed on spinal accessory nerves at both sides for all patients and controls. Parameters including latencies and amplitudes of compound motor action potential (CMAP) were compared with the chronicity of neck pain using the neck disability score. This cross sectional study was carried in the Rheumatology and Rehabilitation Department, at Suez Canal University Hospital, Ismailia, Egypt. RESULTS: Physical examination revealed that 80% of cases had spinal trapezius muscle spasm. Restricted neck motion was present in 16.6% of cases. No one suffered from muscle wasting or weakness. Pain was bilateral in 18 patients (60%), localized to the right side in six patients (20%) and localized to the left side in six patients (20%). The causes of neck pain in the patients studied were nonspecific, due to physical stresses, cervical spondylosis and mild cervical disc herniation. Mean disease duration in patients with labor-intensive tasks was (3.9 ± 2.1 years), which was longer than that in patients with non-labor intensive tasks (3.1 ± 1.9 years); however, this difference was statistically insignificant. Spinal accessory NCSs were performed while subjects were in sitting positions and relaxed with naturally suspended arms to minimize muscular movement. The results of electrophysiological studies revealed that mean right and left latencies of the spinal accessory nerve were 2.96 ± 0.69 ms, 2.98 ± 0.61 ms in the patient group and 2.44 ± 0.38 ms, 2.33 ± 0.36 ms in control group respectively. These differences were statistically significant with P = 0.028 and 0.006 respectively. Spinal accessory NCS showed normal CMAP amplitude in both patients and controls. Comparing the results of the neck disability index (NDI) to different characteristics in patients with chronic neck pain, showed that patients with labor-intensive work had a higher NDI score mean (34.7 ± 9.5) compared to those with non-labor-intensive work, with significant statistical difference (P = 0.011). In addition, mean NDI scores were higher in males, and patients aged over 40 years and this difference was statistically significant (P = 0.007 and P = 0.009 respectively). Correlation studies between right and left spinal accessory nerve latencies and disability percent calculated using the NDI revealed a positive correlation. Moreover, there was a positive correlation between age and disability percent. CONCLUSION: This study demonstrates electrophysiological evidence of demyelination in a significant proportion of patients with chronic cervical pain.
The Journal of Hand Surgery (Asian-Pacific Volume), 2020
Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MG... more Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MGA) in healthy Egyptian subjects, and to discuss the available literature regarding MGA subtypes and their clinical implications. Methods: An electrophysiological study was conducted in both forearms of 140 healthy subjects. This included the ulnar and median nerves. Compound muscle action potentials were recorded from abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles. Other measurements included the compound motor action potential amplitude and its innervation ratio. Results: MGA was found in 56 of the 280 forearms. This included 20 men and 36 women. Type II MGA subtype was the most frequent in both genders. The MGA was bilateral in 6 subjects and more frequent on the right side. The highest mean amplitude and innervation ratio were recorded at first dorsal interosseus muscle. Conclusions: The prevalence of MGA in the studied sample of the Egyptian p...
The Journal of Hand Surgery (Asian-Pacific Volume), 2020
Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MG... more Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MGA) in healthy Egyptian subjects, and to discuss the available literature regarding MGA subtypes and their clinical implications. Methods: An electrophysiological study was conducted in both forearms of 140 healthy subjects. This included the ulnar and median nerves. Compound muscle action potentials were recorded from abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles. Other measurements included the compound motor action potential amplitude and its innervation ratio. Results: MGA was found in 56 of the 280 forearms. This included 20 men and 36 women. Type II MGA subtype was the most frequent in both genders. The MGA was bilateral in 6 subjects and more frequent on the right side. The highest mean amplitude and innervation ratio were recorded at first dorsal interosseus muscle. Conclusions: The prevalence of MGA in the studied sample of the Egyptian p...
ABSTRACT Introduction Juvenile Fibromyalgia (JFM) is an idiopathic chronic pain syndrome defined ... more ABSTRACT Introduction Juvenile Fibromyalgia (JFM) is an idiopathic chronic pain syndrome defined by widespread non-articular musculoskeletal pain and generalized tender points. The syndrome is associated with a constellation of symptoms, including fatigue, non-refreshing sleep, irritable bowel, and more [1]. Fi-bromyalgia (FM) is most common in midlife, but may be seen at any age. Girls are affected relatively more often [2]. Using dolorimetry at specific ten-der point sites, boys exhibited less tenderness than girls did; subjects who had FM had a lower tender-ness threshold compared with the subjects who did not have FM. These data demonstrating effects on tenderness associated with gender in children con-firm results previously found in adults [3]. Clark and colleagues [4], reported that the prevalence of JFM in school children in Mexico reached 1.2%, which is fourfold lower than the pre-vious study that evaluated the prevalence of JFM in Abstract
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