Biomedical subjects
Publications and source records attributed to M A Hamza.
Antibacterial activity of essential oil of dried inflorescence of Cymbopogon nervatus was investigated. The essential oil remarkably inhibited the growth of tested bacteria except for Salmonella typhi. The maximum activity was against Shigella dysenteriae and Klebsiella pneumoniae.
The analgesic response to percutaneous neuromodulation therapy (PNT) is influenced by the location, frequency, and duration of electrical stimulation. We evaluated the effect of different patterns of stimulation (montages) on the acute analgesic response to PNT when applied at the same dermatomal levels in 72 consenting patients with low back pain. All of the patients received a standardized montage (I) and three alternative montage (II-IV) patterns according to a randomized, single-blinded, crossover study design. All of the PNT treatments were administered at identical alternating stimulation frequencies of 15 and 30 Hz for a period of 30 min, three times per week for two consecutive weeks, with 1 wk "off" between each modality. Pretreatment assessments included the health status survey short form (SF-36) questionnaire, as well as visual analog scale scores for pain, physical activity, and quality of sleep (with 0 = the best to 10 = the worst). The pain visual analog scale was repeated 5--10 min after each treatment session. The daily oral analgesic usage was recorded in a patient diary. All four montages produced significant improvements in pain (42%--64%), physical activity (35%--51%), and quality of sleep (28%--46%), as well as 23% to 47% reductions in the daily oral analgesic usage. However, Montage II was significantly more effective than the standard (Montage I) and the other two montages studied. These data suggest that the pattern of stimulation (i.e., montage) can influence the acute analgesic response to PNT.
OBJECTIVE: To evaluate the short-term effects of percutaneous electrical nerve stimulation (PENS) in the management of three types of chronic headache. BACKGROUND: Traditional electroanalgesic therapies have been reported to be effective in the management of acute headache symptoms. However, no controlled studies have been performed in patients with chronic headache. METHODS: Thirty patients with either tension headache, migraine, or posttraumatic headache symptoms of at least 6 months' duration were randomized to receive PENS (needles with electricity) or "needles alone" according to a crossover study design. All treatments were administered for 30 minutes, three times a week for 2 consecutive weeks with 1 week off between the two different treatments. For the PENS treatments, an alternating electrical stimulation frequency of 15 and 30 Hz was used. Pain, activity, and sleep scores were assessed using a 10-cm visual analog scale, with 0 corresponding to the best and 10 to the worst, during the 48-hour period prior to the beginning of the two treatments, immediately before and after each treatment session, and 48 hours after completing each treatment modality. RESULTS: Compared with the needles alone, PENS therapy was significantly more effective in decreasing the overall VAS pain scores for tension-type headache, migraine and posttraumatic headache (58%, 59%, and 52% versus 20%, 15%, and 20%, respectively). Similarly, PENS therapy produced greater improvement in the patients' physical activity (41% to 58% for PENS versus 11% to 21% for needles only) and quality of sleep (41% to 48% for PENS versus 12% to 20% for needles only). However, there were no differences in the pattern of the response to PENS therapy among the three headache groups. CONCLUSIONS: Percutaneous electrical nerve stimulation appears to be a useful complementary therapy to analgesic and antimigraine drugs for the short-term management of headache. Interestingly, the analgesic response to PENS therapy appears to be independent of the origin of the headache symptoms.
We studied the effect of the location of electrical stimulation on the acute analgesic response to percutaneous neuromodulation therapy in patients with nonradiating neck pain. Sixty-eight patients received three different nonpharmacologic modalities, namely "needles only" (neck), local (neck) dermatomal stimulation, and remote (lower back) dermatomal stimulation in a random sequence over the course of an 11-wk study period. All treatments were given for 30 min, 3 times per week for 3 wk, with 1 wk "off" between each modality. The assessment tools included the health status survey short form (SF-36) questionnaire, as well as 10-cm visual analog scales for assessing pain, physical activity, and quality of sleep. The pain visual analog scale was repeated 5-10 min after each treatment session. The daily oral nonopioid analgesic requirements were recorded in the patient diary during the entire study period. At the end of each 3-wk treatment block, the SF-36 questionnaire was repeated. Compared with needles only and remote dermatomal stimulation, local dermatomal stimulation produced a significantly greater decrease in pain (38%+/-17% vs 9%+/- 16% and 13%+/-18%), increase in physical activity (41%+/-21% vs 11% +/-17% and 16%+/-15%), and improvement in the quality of sleep (34% +/-18% vs 7%+/-17% and 10%+/-18%) compared with baseline values (P<0.05). The need for oral analgesic medications was decreased by an average of 6%+/-15%, 37%+/-18%, and 9%+/-13% during the 3-wk treatment period with the needle only, local dermatomal, and remote dermatomal stimulation, respectively. The posttreatment SF-36 test results revealed that all three modalities produced improvements compared with the prestudy scores for both the physical component summary and mental component summary. However, the magnitude of the changes in the physical component summary and mental component summary with local dermatomal stimulation was significantly greater (+7.9 and +3.6, respectively) than needle only (+3.4 and +1.7, respectively) or remote dermatomal stimulation (+3.7 and +1.9, respectively). No side effects were reported at the needle insertion sites. We conclude that electrical stimulation at the specific dermatomal levels corresponding to the local pathology produces greater short-term improvements in pain control, physical activity, and quality of sleep in patients with chronic neck pain.
OBJECTIVE: To evaluate the use of percutaneous electrical nerve stimulation (PENS) in the management of patients with painful diabetic peripheral neuropathy. RESEARCH DESIGN AND METHODS: A total of 50 adult patients with type 2 diabetes and peripheral neuropathic pain of >6 months duration involving the lower extremities were randomly assigned to receive active PENS (needles with electrical stimulation at an alternating frequency of 15 and 30 Hz) and sham (needles only) treatments for 3 weeks. Each series of treatments was administered for 30 min three times a week according to a standardized protocol. After a 1-week washout period, all patients were subsequently switched to the other modality. A 10-cm visual analog scale (VAS) was used to assess pain, physical activity, and quality of sleep before each session. The changes in VAS scores and daily requirements for oral analgesic medication were determined during each 3-week treatment period. Patients completed the MOS 36-Item Short-Form Health Survey (SF-36), the Beck Depression Inventory (BDI), and the Profile of Mood States (POMS) before and after completion of each treatment modality. At the end of the crossover study, a patient preference questionnaire was used to compare the effectiveness of the two modalities. RESULTS: Compared with the pain VAS scores before active (6.2 +/- 1.0) and sham (6.4 +/- 0.9) treatments, pain scores after treatment were reduced to 2.5 +/- 0.8 and 6.3 +/- 1.1, respectively. With active PENS treatment, the VAS activity and sleep scores were significantly improved from 5.2 +/- 1.0 and 5.8 +/- 1.3 to 7.9 +/- 1.0 and 8.3 +/- 0.7, respectively. The VAS scores for pain, activity, and sleep were unchanged from baseline values after the sham treatments. Patients' daily oral nonopioid analgesic requirements decreased by 49 and 14% after active and sham PENS treatments, respectively. The post-treatment physical and mental components of the SF-36, the BDI, and the POMS all showed a significantly greater improvement with active versus sham treatments. Active PENS treatment improved the neuropathic pain symptoms in all patients. CONCLUSIONS: PENS is a useful nonpharmacological therapeutic modality for treating diabetic neuropathic pain. In addition to decreasing extremity pain, PENS therapy improved physical activity, sense of well-being, and quality of sleep while reducing the need for oral nonopioid analgesic medication.
CONTEXT: Low back pain (LBP) contributes to considerable disability and lost wages in the United States. Commonly used opioid and nonopioid analgesic drugs produce adverse effects and are of limited long-term benefit in the management of this patient population. OBJECTIVE: To compare the effectiveness of a novel nonpharmacologic pain therapy, percutaneous electrical nerve stimulation (PENS), with transcutaneous electrical nerve stimulation (TENS) and flexion-extension exercise therapies in patients with long-term LBP. DESIGN: A randomized, single-blinded, sham-controlled, crossover study from March 1997 to December 1997. SETTING: An ambulatory pain management center at a university medical center. PATIENTS: Twenty-nine men and 31 women with LBP secondary to degenerative disk disease. INTERVENTIONS: Four therapeutic modalities (sham-PENS, PENS, TENS, and exercise therapies) were each administered for a period of 30 minutes 3 times a week for 3 weeks. MAIN OUTCOME MEASURES: Pretreatment and posttreatment visual analog scale (VAS) scores for pain, physical activity, and quality of sleep; daily analgesic medication usage; a global patient assessment questionnaire; and Health Status Survey Short Form (SF-36). RESULTS: PENS was significantly more effective in decreasing VAS pain scores after each treatment than sham-PENS, TENS, and exercise therapies (after-treatment mean +/- SD VAS for pain, 3.4+/-1.4 cm, 5.5+/-1.9 cm, 5.6+/-1.9 cm, and 6.4+/-1.9 cm, respectively). The average +/- SD daily oral intake of nonopioid analgesics (2.6+/-1.4 pills per day) was decreased to 1.3+/-1.0 pills per day with PENS (P<.008) compared with 2.5+/-1.1, 2.2+/-1.0, and 2.6+/-1.2 pills per day with sham-PENS, TENS, and exercise, respectively. Compared with the other 3 modalities, 91 % of the patients reported that PENS was the most effective in decreasing their LBP. The PENS therapy was also significantly more effective in improving physical activity, quality of sleep, and sense of well-being (P<.05 for each). The SF-36 survey confirmed that PENS improved posttreatment function more than sham-PENS, TENS, and exercise. CONCLUSIONS: In this sham-controlled study, PENS was more effective than TENS or exercise therapy in providing short-term pain relief and improved physical function in patients with long-term LBP.
Sciatica is a common pain problem and current pharmacologic therapies have proven inadequate for many patients. The objective of this sham-controlled investigation was to compare a novel non-pharmacologic technique, percutaneous electrical nerve stimulation (PENS), to transcutaneous electrical nerve stimulation (TENS) in the management of the radicular pain associated with sciatica. Sixty-four consenting patients with sciatica due to lumbar disc herniation were treated with PENS, TENS and sham-PENS according to a randomized, single-blinded, cross-over study. All patients had been maintained on a stable oral non-opioid analgesic regimen for at least 6 weeks prior to entering the study. Each treatment modality was administered for a period of 30 min three times per week for 3 weeks, with 1 week 'off' between each modality. Both PENS and TENS treatments were administered using a stimulation frequency of 4 Hz. The pre-treatment assessment included the health status survey short form (SF-36), as well as visual analog scales (VAS) for radicular pain, physical activity and quality of sleep. The pain VAS was also repeated after each treatment session. At the end of each 3-week treatment block, the SF-36 was repeated. After receiving all three treatment modalities, a global assessment questionnaire was completed. Both PENS (42%) and TENS (23%) were significantly more effective than the sham (8%) treatments in decreasing VAS pain scores. The daily oral analgesic requirements were also significantly reduced compared to the pre-treatment values with PENS (P<0.01) and TENS (P<0.05). However, PENS was significantly more effective than TENS (and sham-PENS) in improving physical activity and quality of sleep. The SF-36 evaluation confirmed the superiority of PENS (versus TENS and sham-PENS) with respect to post-treatment functionality. In the overall assessment, 73% of the patients reported that PENS was the most desirable modality (versus 21% for TENS and 6% for sham-PENS). Finally, 71% of the patients stated that they would be willing to pay extra to receive PENS therapy compared to 22% and 3% for TENS and sham-PENS, respectively. In this sham-controlled study, we concluded that PENS was more effective than TENS when administered at a stimulation frequency of 4 Hz in providing short-term pain relief and improved functionality in patients with sciatica.
UNLABELLED: Low back pain (LBP) is one of the most common medical problems in our society. Increasingly, patients are turning to nonpharmacologic analgesic therapies such as percutaneous electrical nerve stimulation (PENS). We designed this sham-controlled study to compare the effect of three different frequencies of electrical stimulation on the analgesic response to PENS therapy. Sixty-eight consenting patients with LBP secondary to degenerative lumbar disc disease were treated with PENS therapy at 4 Hz, alternating 15 Hz and 30 Hz (15/30 Hz), and 100 Hz, as well as sham-PENS (0 Hz), according to a randomized, cross-over study design. Each treatment was administered for a period of 30 min three times per week for 2 wk. The pre- and posttreatment assessments included the health status survey short form and visual analog scales for pain, physical activity, and quality of sleep. After receiving all four treatments, patients completed a global assessment questionnaire. The sham-PENS treatments failed to produce changes in the degree of pain, physical activity, sleep quality, or daily intake of oral analgesic medications. In contrast, 4-Hz, 15/30-Hz, and 100-Hz stimulation all produced significant decreases in the severity of pain, increases in physical activity, improvements in the quality of sleep, and decreases in oral analgesic requirements (P < 0.01). Of the three frequencies, 15/30 Hz was the most effective in decreasing pain, increasing physical activity, and improving the quality of sleep (P < 0.05). In the global assessment, 40% of the patients reported that 15/30 Hz was the most desirable therapy, and it was also more effective in improving the patient's sense of well-being. We conclude that the frequency of electrical stimulation is an important determinant of the analgesic response to PENS therapy. Alternating stimulation at 15-Hz and 30-Hz frequencies was more effective than either 4 Hz or 100 Hz in improving outcome measures in patients with LBP. IMPLICATIONS: The frequency of electrical stimulation seems to be an important determinant of the analgesic efficacy of percutaneous electrical nerve stimulation. Mixed low- and high-frequency stimulation was more effective than either low or high frequencies alone in the treatment of patients with low back pain.
BACKGROUND: Transcutaneous electrical nerve stimulation (TENS) at either an acupoint or dermatome corresponding to the surgical incision produces comparable decreases in postoperative opioid requirements and opioid-related side effects. However, the effect of the frequency of the electrical stimulus on the postoperative analgesic response to TENS therapy has not been studied. METHODS: One hundred women undergoing major gynecological procedures with a standardized general anesthetic technique were enrolled in the study. Patients were randomly assigned to four groups: group I, patient-controlled analgesia (PCA) plus sham TENS (no stimulation); group II, PCA plus low-frequency (2-Hz) TENS; group m, PCA plus high-frequency (100-Hz) TENS; group IV, PCA plus mixed-frequency (2- and 100-Hz) TENS. The PCA device was programmed to deliver 2-3 mg intravenous boluses of morphine with a lockout interval of 10 min. The TENS device was used every 2 h during the day. Standard 100-mm visual analog scales were used to assess pain, sedation, fatigue, and nausea at specific intervals after surgery. RESULTS: Mixed frequency (2 and 100 Hz) of stimulation decreased morphine requirements by 53% compared with the sham group; low (2-Hz) and high (100-Hz) frequencies produced 32% and 35% decreases, respectively. All three "active" TENS groups reduced the duration of PCA therapy, as well as the incidence of nausea, dizziness, and itching. CONCLUSIONS: TENS decreased postoperative opioid analgesic requirements and opioid-related side effects when utilized as an adjunct to PCA after lower abdominal surgery. Use of TENS at mixed (2- and 100-Hz) frequencies of stimulation produced a slightly greater opioid-sparing effect than either low (2-Hz) or high (100 Hz) frequencies alone.
BACKGROUND: Electrical stimulation of peripheral nerves produces acute analgesic effects. This randomized, sham-controlled, crossover study was designed to evaluate the effect of differing durations of electrical stimulation on the analgesic response to percutaneous electrical nerve stimulation in 75 consenting patients with low back pain. METHODS: All patients received electrical stimulation for four different time intervals (0, 15, 30, and 45 min) in a random sequence over the course of an 11-week study period. All active percutaneous electrical nerve stimulation treatments were administered using alternating frequencies of 15 and 30 Hz three times per week for 2 consecutive weeks. The prestudy assessments included the health status survey short form questionnaire and 10-cm visual analog scale scores for pain, physical activity, and quality of sleep, with 0 being the best and 10 being the worst. The pain scoring was repeated 5-10 min after each 60-min study session and 24 h after the last treatment session with each of the four methods. The daily oral analgesic requirements were assessed during each of the four treatment blocks. At the end of each 2-week treatment block, the questionnaire was repeated. RESULTS: Electrical stimulation using percutaneously placed needles produced short-term improvements in the visual analog scale pain, physical activity, and quality of sleep scores, and a reduction in the oral analgesic requirements. The 30-min and 45-min durations of electrical stimulation produced similar hypoalgesic effects (48+/-21% and 46+/-19%, respectively) and were significantly more effective than either 15 min (21+/-17%) or 0 min (10+/-11%). The 30- and 45-min treatments were also more effective in improving physical activity and sleep scores over the course of the 2-week treatment period. In contrast to the sham treatment (0 min), the health status survey short form revealed that electrical stimulation for 15 to 45 min three times per week for 2 weeks improved patient function. CONCLUSION: The recommended duration of electrical stimulation with percutaneous electrical nerve stimulation therapy is 30 min.
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The relation between cervical cancer and schistosomal infection is controversial. A case of well differentiated adenocarcinoma associated with schistosomiasis of the cervix is presented. A 45-year-old female complaining of intermenstrual bleeding had a polypoid ulcerated cervical mass. Biopsy revealed well differentiated adenocarcinoma and bilharzial ova with terminal spine embedded in the tumor tissue. The relation between cancer cervix and schistosomiasis is discussed.
The solubility of sweetpotato nitrogen increased outside the pH range 3-6 for the pulp, and 2-5 for the peel of the two varieties namely, "Abees" and "Giza 69". The minimum nitrogen extractability occurred between the pH range 3-4, and 4-5 for the peel and pulp, respectively. The sweetpotato protein isolates were prepared separately from both peel and pulp of the two varieties. The former had the highest values of carbohydrates and ash while the latter had the highest values of protein and fat. The in-vitro digestibility of sweetpotato proteins and casein by pepsin-pancreatin was studied. Casein was more easily digested than the proteins of sweetpotatoes, whose digestibilities were higher in the pulp than in the peel of the two varieties. No trypsin inhibitor activity was detected in peel and pulp of both varieties under test. The effect of the variety of sweetpotatoes on the protein patterns was studied using the polyacrylamide gel electrophoresis and varietal specific patterns were obtained.
Fourteen Egyptian cottonseed varieties were analysed to study some properties of their lipids and proteins. Lipid contents of the kernels ranged from 29.0 to 35.1%. The mean value of the iodine number was 110.9. The tested varieties showed little or no differences regarding to their fatty acid content. A slight higher proportion of linoleic acid was recorded for the triglycerides whereas the polar lipids components contained a lower amount of this fatty acids compared to that found in the total lipids. Protein contents in the examined varieties ranged from 32.3 to 37.9%. The amount of water-soluble protein ranged from 12.8 to 23.0% of the total protein. An almost complete recovery (94.5-100%) of the total protein was yielded when the extraction was performed with 0.02 N NaOH instead of water. The electrophoretic patterns of the water-soluble proteins gave only two bands, having a molecular weight between 14,000 and 25,000 dalton. A clear differentiation between the varieties was noticed when the alkaline soluble protein extracts were subjected to electrophoresis. Accordingly, the examined varieties were classified into five groups each of them having a similar spectrum.
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