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Purpose: Many elderly are concerned about falling transfer to assisted living facilities (ALF). Previous literatures studied the medication use and falls in the community, hospitals, or nursing homes, with scanty data about ALF. Therefore, the aim of the current case-control study was to assess the relation between medication use and falls among elderly in ALF. Methods:A matched case-control study was conducted. The study was conducted in ALF in Cairo, Egypt. The study participants were 188 individuals; they were subdivided into two groups: fallers and nonfallers; timed up and go test (TUGT) was performed by all subjects. Medication data were collected according to the fall riskincreasing drugs list and the list of drugs that cause or worsen orthostatism. Other fall risk factors, as suggested by American Geriatric Society, were assessed.Results: The use of vasodilators, diuretics, alpha blockers, opioids, antipsychotics, and sedative hypnotics were more common in fallers than in nonfallers (P < 0.001, P = 0.03, P < 0.001, P = 0.013, P < 0.001, and P < 0.001, respectively). Vasodilators, alpha blockers, and antipsychotics were significant predictors of falls even after adjustment for the possible confounding factors. Vasodilators, alpha blockers, opioids, sedative hypnotics, and recent dose changes in oral hypoglycemics were significant predictors of higher TUGT after adjustment for the possible confounding factors. Conclusion:The current study supported the risk of psychotropic and cardiovascular medications, with especial emphasis on vasodilators, alpha blockers, and antipsychotics, with raising concern about opioids, sedative hypnotics, and recent dose change in oral hypoglycemics.

Background: Obesity and osteoporosis are two conditions that are associated with morbidity and mortality; there is contradictory evidence regarding this association. Purpose: The aim of the current study was to explore further the association between obesity and calcaneus stiffness index (CSI), as a measure of bone density, in a communitybased cross-sectional study in an Egyptian population. Methods: A cross-sectional study was conducted among active subjects, aged ≥20 years old, over one year. CSI was measured by Quantitative ultrasound (QUS), in addition; QUS T-score and Z-score of the non-dominant heel scan were recorded. Results: Two hundred and eighty participants were recruited; 7 subjects were excluded because of Z score more than −2, mean age was 61 (± 11.9) years, and mean BMI was 29.7 (±5.6). Female participants were 77.7%, with mean of age 60.3 (± 11.6); and age range 20-82 years. Male participants were 22.3%, with mean of age 63.6 (± 12.7); and age range 30-80 years. Older subjects (>55 years) had significantly lower CSI and worse T-score than the younger subjects (P < 0.001 for both). In the younger age group, BMI was not significantly associated with CSI, even after adjustment for gender (P= 0.52). However, in the older age group, BMI was significantly associated with stiffness index (P= 0.049, O.R.= 1.73), even after adjustment for gender (P= 0.041, O.R.= 1.7). Conclusion: Compared to young subjects, older subjects (≥55 years) had significantly lower bone strength as measured by CSI, and their BMI was significantly positively associated with bone density. In younger people (<55 years), BMI was not associated with bone strength.

Diabetic patients have a higher risk of infections which is the leading trigger of diabetic ketoacidosis. The second most common infection in diabetics is urinary tract infection (UTI). Elevation of glucose level induces an inflammatory process within numerous tissues in the body leading to disturbance in cytokines level and oxidative stress. This study is divided into two parts, firstly it was to investigate the prevalence of asymptomatic bacteriuria (ASB) and urinary tract infections in 84 Type 1 diabetes patients, 63 Type 2 diabetes patients and 57 ketoacidotic patients, and to determine the uropathogens responsible for ASB and UTIs as well as their antimicrobial susceptibility pattern. The second part is to determine the level of IL-1β, IL-6 and superoxide dismutase (SOD) in blood samples of diabetic and ketoacidotic patients. Escherichia coli was the most common isolated bacterial uropathogen followed by Enterococcus faecalis, Staphylococcus saprophyticus and Pseudomonas aeruginosa. These isolates showed 100% sensitivity to cephalothin, imipenem, linezolid, teicoplanin, ceftobiprole and piperacillin-tazobactam. Upon examining cytokines level in diabetic patients, results showed higher levels of IL-1β and IL-6 than control samples, indicating inflammation and disturbance in the regulation of metabolic, regenerative, and neural processes, while SOD examination showed lower levels than control samples, indicating both micro-and macrovascular diabetic complications.

Background: The ongoing scientific debate regarding the association between physical function and cognitive impairment has focused mainly on global cognitive performance rather than specific cognitive functions tests and the importance of recognition of its associations and any factors that could play a role later in the prevention of such decline. Objective: This study examined the association between physical function, using handgrip strength (HGS) and Timed Up-and-Go test (TUGT), and executive function (EF), using Clock Drawing Test (CDT), among community-dwelling Egyptian elderly. Methods: A cross-sectional study was conducted in 5 social clubs in Cairo, Egypt and included a sample of 136 elderly males and females aged≥55 years old. All participants had their physical function assessed using TUGT, and measurement of HGS using a pneumatic hand-held dynamometer. Assessment of EF using CDT was also done. Results: Higher CDT scores were significantly associated with both better HGS, and lower TUGT (OR = 3.77, and 0.65 respectively). This persisted even after adjustment for age and gender (OR = 2.56, and 0.71 respectively) and after further adjustment for weight, systolic blood pressure, education, smoking, hyperlipidemia, hypothyroidism, and physical activity (O.R. = 4.79, and 0.76 respectively). Adjustment for both male and female genders showed an association between physical (HGS and TUGT) and EF was stronger among men. Conclusion: A strong association between CDT score and both of HGS and TUGT was found among the studied sample. Higher HGS and lower TUGT was significantly associated with better performance in the CDT. This association is stronger in males than in females for both HGS and TUGT.

Background: Multiple sclerosis (MS) is a multi-component disease characterized by inflammation, neurodegeneration and failure of central nervous system (CNS) repair mechanisms. Autoimmune thyroid disease is a frequently studied disorder in MS, most studies have focused primarily on the increased prevalence of thyroid dysfunction and anti-thyroid antibodies (ATAs) in MS patients compared with a control population. Objectives: To investigate the effect of treatment with interferon beta on thyroid functions and autoimmune thyroid markers in patients with multiple sclerosis. Subjects and Methods: This prospective study was conducted on 100 subjects recruited from the inpatient and outpatient clinic of