Upper limb paresis is a common problem in patients with stroke. To determine the effect of core stability exercises on upper limb function and trunk balance in hemiparetic patients. Thirty patients with hemiparesis, with age between 45 and 60 years, and with illness duration of more than 6 months. They were assigned into two equal groups, the control group, Group A: with 15 patients who received only conventional physical therapy program; the study group, Group B: with 15 patients who received conventional physical therapy program and additional core muscle training. Patients received 18 sessions for 6 weeks, three sessions/week. The upper limb function was assessed using Wolf motor function test with subscales (function ability scale, time, and grip strength), the range of motion of shoulder flexion and abduction was measured by using goniometer, trunk balance was assessed using the trunk impairment scale with subscales (static sitting balance, dynamic sitting balance, and coordination). All measurement outcomes were assessed before and after applying the treatment program. There was no statistical significant difference between two groups in pretreatment assessment using wolf motor function test, trunk impairment scale, and shoulder range of motion. In post treatment assessment, there was no statistical significant difference between group A and group B in all the outcome measures, except for trunk impairment subscale (dynamic sitting balance); the statistical significant difference was in favor of group B. Core muscle training is similar to conventional physical therapy program in improving upper limb function in hemiparetic patients, and has beneficial effect on improving trunk balance.

Mechanical low back pain (MLBP) is a major cause of illness and disability, especially in people of working age. People with chronic low back pain often experience anger, fear, anxiety, decrease in physical ability, and inadequacy of role fulfillment. This study aimed to compare the efficacy of extension exercise program versus muscle energy technique in treating patients with chronic mechanical low back pain. Forty patients complaining of chronic mechanical low back pain participated in the study. Patients were randomly allocated into two equal groups: group A which received spinal extension exercise program and group B which received muscle energy technique. Treatment sessions were given three times per week for four successive weeks. Patients were assessed before and after treatment using visual analogue scale (VAS), Oswestry Disability Index (ODI), and digital goniometer to assess pain intensity, functional disability, and range of motion (ROM) of lumbar spine respectively. There was significant decrease in the scores of pain and functional disability in both groups post-treatment especially in group B. There was significant increase in lumbar range of motion in both groups post-treatment, especially in group A. Extension exercise program had better effect on improving lumbar range of motion, whereas muscle energy technique was better in decreasing pain and functional disability in patients with chronic mechanical low back pain.

A growing body of evidence indicated that vitamin D has a potential protective role against neurovascular injury. Low serum vitamin D has been associated with increased risk for incident stroke and stroke fatality. This study aimed to investigate vitamin D status among acute ischemic stroke patients and examine its relation to initial severity and short-term outcome. Forty-eight acute ischemic stroke patients and 48 matched healthy control subjects participated in the study. Subjects were divided according to vitamin D level into deficient, insufficient, and sufficient groups. National Institute of Health Stroke Scale (NIHSS) on admission and after 72 h and modified Rankin Scale (mRS) on discharge and after 3 months were performed for all patients. Stroke patients had significantly lower serum vitamin D levels compared to healthy subjects. Vitamin D deficiency and insufficiency were significantly prevalent among patients compared to healthy controls. Significant negative correlation was detected between serum vitamin D and NIHSS scores on admission and after 72 h. Significant negative correlation was also detected between serum vitamin D and mRS scores on discharge and after 3 months. An increased risk of stroke of 2.88 times was found in patients with insufficient vitamin D in comparison to sufficient subgroup, and this likelihood increases to be 13.78 times in the deficient compared to sufficient subgroups. Vitamin D deficiency increases the risk of acute ischemic stroke and is associated with increased initial stroke severity and worse short-term outcome.

An association between antiepileptic drugs, low bone mineral density (BMD), fractures, and abnormalities in bone metabolism has been suggested for a longer period, although conclusive evidence has not been reported. Thirty epileptic patients and 30 matched healthy subjects participated in the study. Measurements of serum levels of calcium, phosphorus, vitamin D, parathormone, and alkaline phosphatase were done for included subjects. Dual-energy X-ray absorptiometry (DEXA) scan was also performed. Serum calcium, phosphorus, and vitamin D were significantly lower, whereas serum parathormone and alkaline phosphatase were significantly higher in epileptic patients compared to control subjects. Bone mineral density (BMD) abnormalities were detected in 22 patients (73.4%). A statistically significant difference in DEXA scan measurements at different regions was detected between epileptic patients and control subjects. Epileptic patients receiving enzyme inducer antiepileptic drugs (AEDs) had significantly lower serum (calcium, phosphorous, and vitamin D) and lower BMD values compared to those receiving enzyme inhibitors. Results of BMD were positively correlated with serum calcium, phosphorous, and vitamin D, while negatively correlated with serum alkaline phosphatase and duration of therapy. Abnormal bone health is common in epileptic patients. These abnormalities may be attributed to prolonged intake of AEDs especially enzyme inducers.

Selective involvement of certain muscles is an indicator for muscle diseases and helps to direct the diagnosis, but in some cases, it cannot be detected clinically; hence, the roles of muscle MRI and ultrasound are to detect this selectivity and facilitate the diagnosis. The possibility of using muscle ultrasound as a screening tool when muscle diseases are suspected and as an alternative to MRI. This cross-sectional descriptive study included 38 patients presented with clinical manifestations suggestive of muscle diseases. The patients were selected over a period of 1 year. All patients were subjected to thorough clinical assessment and muscle ultrasound of the thigh and leg for all patients, while 15 were subjected to MRI. Clinical and radiological assessments were performed separately, followed by both clinical and radiological findings to assess the power of combining the clinical and radiological assessments for the diagnosis of muscle diseases. The clinical assessment reached a main provisional probable diagnosis in 53% cases, and radiological assessment blind to clinical data suggested diagnosis in 18 of the total cases, while the combination of both ultrasound and MRI could suggest diagnosis in 87% of the cases. The concordance ratio of ultrasound to MRI ranged between 78 and 100%. The combination of clinical and radiological assessments of muscle diseases can suggest a main provisional probable diagnosis, especially when genetic diagnosis is not accessible, or to direct the genetic testing when it is available. Ultrasound can be used as a routine tool in screening and follow-up of muscle diseases.