Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, which results from median nerve compression. A lot of nonsurgical modalities are available for the management of mild to moderate situations. Local Hyalase hydrodissection (HD) of the entrapped median nerve could offer a desirable sustained symptom alleviation. Objectives: To evaluate the clinical efficacy of Hyalase/saline solution carpal tunnel HD on pain, functional status, and nerve conduction in patients with CTS. Study Design: A randomized, double-blinded trial. Setting: Anesthesia, pain, and rheumatology clinics in a university hospital. Methods: Patients: 60 patients with CTS (> 6 months’ duration). Intervention: patients were allocated equally into either group 1 (HD with Hyalase + 10 mL saline solution injection), or group 2 (HD with 10 mL saline solution only). Measurements: assessment of pain using Visual Analog Scale (VAS), functional disability (FD) score, and nerve conduction studies before injection, and over 6 months after injection. Nerve conduction parameters before injection and postinjection by the end of 3 and 6 months were evaluated as well. Results: Statistically significant lower postinjection values of VAS (1 ± 1.8, 2 ± 1.1, 2 ± 1.2, 2 ± 1.1) in group 1 versus (2 ± 1.2, 3 ± 1.7, 4 ± 1.5, 5 ± 2.6) in group 2 by the end of the first week, and the first, third, and sixth months, and significantly lower FD scores (15.3 ± 1.2, 13 ± 1.3, 10.2 ± 1.3, 10.2 ± 1.3) in group 1 versus (17.5 ± 1.8, 16.6 ± 2.8, 19.4 ± 3.2, 21.2 ± 2.5) in group 2 during the same time intervals. Nerve conduction study parameters have shown significantly higher velocity and lower latency in the Hyalase group than in the saline solution group by the 3 and 6 month follow-up. Limitation: We suggest a longer period could be reasonable. Conclusions: Carpal tunnel HD with Hyalase with saline solution is considered as an efficient technique offering a rapid onset of pain relief and functional improvements, and better median nerve conduction in patients with CTS over 6 months follow-up duration. Key words: Carpal tunnel syndrome, Hyalase, median nerve hydrodissection

Limestone is one of the most frequent building stones used in monuments in Egypt from ancient Egyptian times and salt weathering is one of the main threats to these monuments. During this work, cylindrical limestone samples (2 cm diameter and approx. 4 cm length) from Mokattam group, one of the most frequent materials in historic Cairo, were subjected, in a purpose-made simulation chamber, to laboratory salt weathering tests with a 10% weight NaCl solution at different temperatures (20, 30, 40 °C). During each test, temperature was kept constant and salt solutions flowed continuously imbibing samples by capillary rise resembling the way they get into building stone in many real cases. Air temperature, relative humidity inside the simulation chamber and also samples weight were digitally monitored and recorded. Results show the influence of temperature and the ratio between imbibitions and evaporation on the dynamics of salt crystallization in the samples. RESUMEN: La influencia de la temperatura en un ensayo simulado de deterioro por sales mediante absorción capilar en la caliza de mokattam.Los monumentos egipcios se construyeron frecuentemente con caliza desde la antigüedad y uno de sus principales agentes de deterioro son las sales. Por ejemplo, en la zona histórica de El Cairo son frecuentes las calizas del grupo Mokattam. Cilindros (2 cm de diámetro y aproximadamente 4 cm de altura) de esta caliza se sometieron a ensayos de deterioro por sales en una cámara experimental específicamente diseñada. Se utilizó una solución salina (10% en peso de NaCl) a diferentes temperaturas (20 °C, 30 °C, 40 °C) que se mantuvieron constantes en cada ensayo. La solución fluía constantemente embebiendo las muestras por capilaridad, simulando lo que ocurre en casos reales. La temperatura del aire, humedad relativa en la cámara y peso de las muestras se monitorizaron con sensores digitales. Los resultados muestran la influencia de la temperatura y del balance entre imbibición y evaporación en la dinámica de la cristalización de sales en las muestras.

AimTo determine whether early clinical, laboratory and musculoskeletal ultrasound (MSUS) characteristics can be used as early detectors of juvenile idiopathic arthritis.Patients and methodsForty (40) patients with juvenile idiopathic arthritis (JIA) diagnosed according to the ILAR criteria [1] and 20 healthy control children. All patients were subjected to the following assessment at base line and at follow up after 6 months: Clinical evaluation, MSUS examination and laboratory evaluation.ResultsOf the 40 patients, 6 patients (15%) had systemic onset subtype, 8 (20%) oligoarticular extended, 9 (22.5%) oligoarticular persistent, 5 (12.5%) polyarticular rheumatoid factor (RF) +ve, 6 (15%) polyarticular RF −ve, 5 (12.5%) enthesitis related subtype and only one patient (2.5%) had psoriatic JIA. MSUS detected more synovitis than clinical examination (subclinical synovitis) both at base line and at follow up. MSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination. Significant decrease in the mean cartilage thickness of the patients measured at follow up as compared to measures at base line.ConclusionMSUS is highly sensitive for early detection of joint involvement in JIA when compared to physical examination

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