Libyan International Medical University Journal

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Objective: The objective of this study is to determine the outcome and efficacy of Mulligan's mobilization with movement (MWM) with Maitland mobilization along with conventional therapy in the patients with knee osteoarthritis (OA). Materials and Methods: A randomized controlled trial study was performed at the Department of Physiotherapy, Mayo Hospital, Lahore, Pakistan. Sixty-two patients were selected for the study. MWM was introduced in half of the patients and Maitland mobilizations in the second half for 2 weeks. The goniometry, visual analog scale (VAS), knee range of motion (ROM), and Western Ontario McMaster OA (WOMAC) Index for knee OA were the assessment tools used to assess all patients before and after 2 weeks of intervention. Paired sample t-test was used for analysis of results. Results: The mean pre- and postdifferences in MWM group were 4.06 ± 0.99, 10.19 ± 3.87, and 19.41 ± 7.58 for VAS, ROM flexion, and WOMAC Index, respectively, while the pre- and postmean difference values for Maitland mobilization group were 3.355 ± 1.05, 10.19 ± 5.5, and 12.28 ± 7.029 for VAS, ROM flexion, and WOMAC Index, respectively. The mean differences of both treatment interventions individually were significant and showed that both were clinically effective in treating the patients of knee OA. Conclusion: It was concluded that patients in both groups showed improvement in pain, ROM, and functions.

Background: Hyperglycemia and hyperlipidemias are common clinical problem among users of glucocorticoids (GCs). The aim of the present study was to explore the effect of oral administration of the aqueous extract of Abelmoschus esculentus peel (AEPE) on hyperglycemia and hyperlipidemia induced in rats by dexamethasone (DEXA). Methods: Twenty-four rats were randomly divided into four equal groups. Each group was treated for 10 days either with 2% carboxymethylcellulose orally (normal control); 10 mg/kg DEXA subcutaneously (hyperglycemic group); 100 mg/kg AEPE orally plus 10 mg/kg DEXA subcutaneously (treatment group 1); or 200 mg/kg AEPE orally plus 10 mg/kg DEXA subcutaneously (treatment group 2). Animals were killed after 10 days of treatments by decapitation, their blood collected for the analysis of blood sugar and lipid profile. Results: Treatment with DEXA induced a significant increase in blood glucose and all lipids and a significant reduction in body weights. After 10 days of treatment, 100 mg/kg of AEPE was able to significantly reduce the effect of DEXA on triglycerides and low-density lipoprotein (LDL) only. 200 mg/kg of AEPE was able to significantly reduce the effect of DEXA on blood glucose levels, cholesterol, triglycerides, and LDL. Both doses of AEPE were able to increase high-density lipoprotein. Conclusion: This study suggests that the AEPE could be beneficial in protecting against GC-induced hyperglycemia and hyperlipidemia.

Purpose: Investigation of the crystallinity of salbutamol sulfate a model drug used in the dry powder inhalation formulation. Materials and Methods: Salbutamol sulfate was supplied kindly by Lindopharm (Hilden, Germany). Salbutamol sulfate was milled using an air jet milling process, the particle size and morphology were determined using laser diffraction and the scanning electron microscopy. The drug was subjected to conditioning through storage at 52.8% and 75% relative humidity for 24 h, 1 week, and 2 weeks, respectively. The drug crystallinity was investigated using differential scanning calorimetry (DSC), X-ray diffraction, and water vapor sorption techniques. Results and Discussion: Conditioning of salbutamol sulfate after micronization lowers the glass transition (Tg) temperature of the amorphous parts present at particle surface, which enhances particle mobility for more rearrangement associated with water expelling. This transformation may result in deviation from the original particle size obtained after milling out of respirable range. DSC and X-ray diffraction show no detectable amorphous drug since no detectable Tg observed. Alternatively, water vapor sorption shows a small amount of amorphous salbutamol sulfate at the particle surface, which recrystallizes at 52.8% relative humidity after approximately 2 weeks of conditioning. Conclusion: The amorphous regions can be generated in crystalline materials during processing. The level of amorphous materials can affect every step of pharmaceutical formulation, storage, and stability. However, quantification of low levels of amorphous content still poses considerable challenge. This study confirms that, the water vapor sorption technique is useful in the quantification of a small amount of drug amorphous content.

Aim: The aim of this study was to evaluate the efficacy and outcome of sutureless and glue-free conjunctival autograft for the management of primary pterygium in terms of complications such as loss of graft, graft dehiscence, and recurrence rate. Materials and Methods: A case series study was carried out in March 2015 at Nastaein private sanatorium, Zlitin, Libya. Twenty-seven eyes of 23 patients with primary pterygium were included in this study. Pterygium excision with conjunctival autografting without using sutures or glue was done to all patients. The patients were followed up postoperatively after 1 h, 1^st day postoperatively, and then 1 week, 4 weeks, 3 months, 6 months, and 12 months. Results: The mean age of the patients was 55.9 ± 8.55 years (range: 43–71 years); 65% were male. Mean follow-up time was 10.2 ± 2 months. Changes of visual acuity were not noticed in any of these patients. Only one patient (3.7%) developed edge recession of the graft on the 1^st postoperative day due to a wrong measurement of the size of the graft, and no other complications were noted. Cosmesis was excellent in all cases and no recurrence was noted. Conclusions: Sutureless and glue-free conjunctival autograft for primary pterygium surgery is a safe and effective way for the management of primary pterygium.

Background: The metabolic syndrome (MS) is defined as a cluster of cardiovascular risk factors, including central obesity, dysglycemia, hypertension (HPN), elevated triglycerides (TGs), and reduced high-density lipoprotein cholesterol (HDL-C). MS increases the risk of cardiovascular disease and all-cause mortality. Objective: This study aims to estimate the prevalence of MS and its components among nondiabetic Libyan females using the definition proposed by National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III). Methods: A total of 122 randomly selected nondiabetic Libyan females were included in the study. Detailed medical history was obtained from all participants. Blood pressure, weight, height, waist and hip circumference were measured. Body mass index and waist–hip ratio were calculated. Fasting blood glucose (FBG) and lipid profile were collected. Standard oral glucose tolerance test with 75 GM glucose was performed. The MS was defined by ATP III and International Diabetes Federation criteria. Results: According to NCEP definition, the prevalence of the MS in the study group was 42.6%. The most common component was abdominal obesity (67.2%). FBG was ≥ 100 mg/dl in 47.5%. The prevalence of both HPN and low HDL-C was 45.9%. About 26.2% of the participants have their TG ≥ 150 mg/dl; all were MS patients. Conclusions: The prevalence of MS and cardiovascular risk factors were high among Libyan females. Public health authorities and health-care providers should implement strategies for prevention, screening, and management of cardiovascular risk factors to reduce the burden of its potential complications.

Online since 20^th December 2017.