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Article
A STUDY OF LEPTIN & LIPID PROFILE IN A SAMPLE OF IRAQIPATIENTS WITH KNEE OSTEOARTHRITIS.

Authors: Zina H. Abdul-Qahar --- Mohammed H. Alosami --- Kismat M. Turki
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 3 Pages: 372-376
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: New data suggests that joint damage in Knee Osteoarthritis (KOA) may be
caused by systemic factors like adipose tissue products; Adipokines, which may provide a
metabolic link between obesity & KOA. Recently, one of the known adipokines named
LEPTIN has been linked to KOA because it can be detected in serum & synovial fluid of
patients with KOA.
Objective: To evaluate the contribution of Leptin & serum lipids to the pathophysiology of
Osteoarthritis in Iraqi patients with Knee OA.
Subjects& Methods: The study was carried on 90 subjects divided into four groups:
Knee Osteoarthritis cases group (n=60).
Control group (n=30).
Obese subjects group (n=60).
Non-obese subjects group (n=30).
KOA cases were diagnosed clinically whereas obesity was specified by BMI ≥25kg/m2. For
all subjects studied measurements of fasting serum leptin and lipid profile have been done.
Results: Mean serum leptin level was significantly higher in KOA cases compared to control
group (P<0.001), and higher in obese than non-obese subjects (P<0.001). Serum leptin level
also showed a strong positive correlation with BMI (r=0.501, P<0.01).
Conclusions: Leptin may play an important role in the pathogenesis of KOA. In addition
abnormal lipid profile and obesity are important risk factors for KOA.


Article
The Effect of Body Weight & Smoking on the Risk of Osteoarthritis of the Knee Joint

Authors: Zina A. Rajab --- Ikhlas K. Hameed --- Zina H. Abdul-Qahar
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2011 Volume: 4 no 2 Issue: 10 Pages: 1180-1186
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Knee osteoarthritis is common in old adults. Determination of risk factors of knee osteoarthritis may help in its prevention and modification of treatment. The objective of this study is to determine the significance of some risk factors like obesity and smoking on knee osteoarthritis.Material & methods: The study included 132 outpatient attendants (102 females & 30 males) aged (53±9) years. Height and weight were measured for calculation of Body Mass Index; smoking habits were registered by questionnaire. Hemoglobin level, Erythrocyte Sedimentation Rate & C - reactive protein was measured for all participants.Results: The number of patients with knee osteoarthritis was 61(46%), of these; 39 patients (64%) were obese including 13 patients who were smokers.The mean & standard deviation of Hemoglobin & Erythrocyte Sedimentation Rate were 12±1 & 24±16 respectively, while C - reactive protein was positive in 29 (22%) of participants.Smoking habit was significantly higher in patients with knee osteoarthritis (p<0.01) and in knee osteoarthritis obese patients (p<0.01) when compared to non- knee osteoarthritis subjects and obese non- knee osteoarthritis subjects; respectively.Conclusion In accordance with the literature, this study found a strong association between Body Mass Index and knee osteoarthritis risk. In addition, the increase in the prevalence of smoking in radiographically confirmed knee osteoarthritis was observed suggesting that smoking habit may be a potentially modifiable environmental risk factor for knee osteoarthritis.


Article
Risk Factors of Knee Osteoarthritis in Women > 50 years
عامل الخطورة في التهاب مفاصل الركبة ألضموري لدى النساء في سن أكثر من خمسين سنة

Author: Dhafer B. AL-Youzbaki ظافر بشير
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2007 Volume: 20 Issue: 3 Pages: 394-396
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract: Background: Osteoarthritis is one of the most disabling disease affecting middle age population specially knee osteoarthritis in women >50 years old, high parity had not been investigated thoroughly in western researches probably because it is not frequent in western societies, and hence it is very common in our locality, this research sheds lights on this important factor in the development of osteoarthritis in our patients.Aim: To determine risk factors in the development of knee osteoarthritis in our society's women aged > 50 yearsPatients & methods: A case-control design was adopted for this study, where 110 women >50 years with osteoarthritis of knee joints were allocated as cases, and another 110 women > 50 years without osteoarthritis of knee or other joints , were allocated as controls. Study period extended from 15 October 2005 to 1st. April 2006.Questionnaire forms were including, family history, parity status, history of previous abortion , history of previous trauma to knee joints and history of presence of one or more of chronic-non communicable diseases as Hypertension, ischemic heart disease, obesity and diabetes. Examination for assessing weight in kg and height in cm to obtain body mass index, also was undertaken by the researcher.Results: Obesity measured by body mass index (≥ 25) in this study appeared to be highly associated in the development of knee osteoarthritis (OR= 7.48, 95% C.I.= 3.66-15.29 ) and also positive family history was highly correlated with the development of knee osteoarthritis (OR= 3.47, 95% C.I.= 2.01-6.00). This study also, indicated that high parity ( >4 ) is an important risk factors for over 50 years women in the development of knee osteoarthritis (OR= 6.97, 95% C.I.= 3.55-13.70) , where 90 % of women with knee osteoarthritis were in high parity status compared to 56% of women with the same character , but without knee OA. Previous history of trauma to knee joints, past history of abortion and the presence of one or more of chronic non-communicable diseases, all appeared in this study not to be associated with the development of knee osteoarthritis. Conclusion: Obesity, positive family history and high parity are established risk factors for the development of knee osteoarthritis in women more that 50 years old.

الملخص:-المقدمة:إن أتهاب المفاصل ألضموري هو احد أهم الأمراض المعطلة و المعيقة التي تصيب الأعمار المتوسطة للناس و خاصة التهاب مفصل الركبة ألضموري لدى النساء في سن أكثر من خمسين سنة. الهدف:لتعيين عوامل الخطورة في حدوث مرض التهاب مفصل الركبة ألضموري لدى النساء في سن أكثر من خمسين سنة.تصميم الدراسة:دراسة العينة و الشاهد.النتائج:السمنة في هذه الدراسة ظهرت مرتبطة في حدوث التهاب الركبة ألضموري و كذلك تاريخ العائلة الايجابي لنفس المرض. كذلك أثبتت هذه الدراسة أن الخصوبة العالية لدى النساء كانت من عوامل الخطورة ذات القيمة الإحصائية قي حدوث مرض التهاب الركبة ألضموري لدى النساء في سن أكثر من خمسين سنة.الاستنتاجات:السمنة و تاريخ العائلة الايجابي للمرض إضافة للخصوبة العالية هي من العوامل الخطرة في حدوث مرض التهاب الركبة ألضموري للنساء في سن أكثر من خمسين سنة.


Article
The role of Chloroquine phosphate on rheumatoid factor in patients with knee osteoarthritis

Authors: Mohammed H. Alosami --- Kismat M. Turki --- Eman S. Saleh
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 1 Pages: 60-61
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Osteoarthritis (OA) is disorder of diarthrodial joints characterized clinically by pain and functional limitation. Rheumatoid factor (RF) represents one of routine laboratory tests that done for all patients have joint complaints. Chloroquine phosphate (CQP) is a disease modifying antirheumatic drug (DMARD) used for patients suffer from knee osteoarthritis (KOA) in order to reduce their RF value and improves the disease status. Objective: To evaluate the effect of chloroquine phosphate on rheumatoid factor (RF) level in serum of patients with knee osteoarthritis KOA) Design: case report.Subjects and methods: RF value were assessed quantitatively by ELISA technique before and after treatmtnt for a total of fifty five patients with KOA (30 femal and 25 male) their age ranged from (50-66 years) selected randomly from out patient clinic in Baghdad Teaching Hospital , Medical City Baghdad; suffering from KOA. All patients were treated with oral dosage form of CQP for one month twice daily.Results: Mean serum RF level was significantly reduced (p<0.05) in serum of patients after treatment with CQP for one month.Conclusion:CQP is a disease modifying antirheumatic drug (DMARD) used for patients suffering from KOA in order to reduce their RF value and improves the disease status.


Article
The Role of Chloroquine Phosphate on Acute Phase Reactant Proteins in Patients with Knee Osteoarthritis#

Authors: Mohammed H.Al-Osami --- Kismet M.Turki --- Eman S. Saleh ايمان سعدي صالح
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2009 Volume: 18 Issue: 1 Pages: 56-60
Publisher: Baghdad University جامعة بغداد

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Abstract

The acute phase response is a major pathophysiologic phenomenon that accompanies inflammation whether acute or chronic. Complement (C3 and C4) and C - reactive protein (CRP) are positive acute phase proteins (+ ve APPs ). Their production takes place in hepatocyte and the blood concentration of these parameters are increased in osteoarthritis (OA). Chloroquine (CQ) is a diprotic weak base traditionally used to treat malaria. Recently the phosphate salt of CQ is used to decrease this type of (+ve APPs) . In this study, patients who suffered from knee osteoarthritis (KOA) are treated with oral dosage form of chloroquine phosphate (CQP) for one month, twice daily. Our results demonstrate that CQP improves the patient status by decreasing complement and C-reactive protein in blood.

لقد تمت دراسة دور عقار فوسفات الكلوراكوين على مستوى البروتينات التفاعلية CRP, C4, C3 لدى المرضى الذين يعانون من الفصال العظمي للركبة.أجريت تجربة عشوائية على 50 شخصا من الاصحاء (30أنثى , 20 ذكر) و 74 مريضا (45 انثى و 29 ذكر) في مستشفى مدينة الطب العيادة الاستشارية من( شهر كانون الثانى الى ايلول 2008 ) تم تشخيصهم من قبل الطبيب الاختصاصي حسب طريقة الكليه الأمريكيه لمبحث الرثيه حيث تم تحريز الأعراض بواسطة مؤشر ( كليكرين ولورنس ) للفصال العظمي ، أخذت صور شعاعيه أماميه خلفيه لمفصل الركبه وحدد مستوى البروتين التفاعلي- C مع مستوى كل من ألمتممين C3 و C4. وصف لهم حبوب فوسفات الكلوراكوين بتركيز (250 ملغم) مرتين باليوم ولمدة شهر. سحبت عينة من دم الاصحاء والمرضى اولاً ثم عينة من دم المرضى الذين استعملوا هذا العقار بعد شهر لغرض قياس نسب البروتينات التفاعلية في المصل. لوحظ انخفاض مستويات هذه العوامل بصورة واضحة ومعنوية عند استعمال العلاج حيث زيادتها تلعب دورا مهما في تسريع تآكل الغضاريف وتكوين النتوءات العظمية.


Article
Effectiveness of Short Wave Diathermy and Therapeutic Ultrasound on The Management of Patients With Knee Osteoarthritis

Author: Falah Salim Manhal
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2007 Volume: 20 Issue: 1,2 Pages: 1-12
Publisher: Baghdad University جامعة بغداد

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Abstract

AbstractObjective : The present study is aimed to evaluate the effectiveness of short wave diathermy and ultrasound therapy for the management of patients with knee osteoarthritisMethodology : all patients who referred to the Medical Rehabilitation Unit in Baghdad Teaching Hospital and Sadr A!-Qanat Center. The period of the study was from October 2004 to April 2005, total number of patients was 24 (9 male and 15 female). Age range of patients was 42-70 years. Complete clinical and radiological examinations were achieved on all patients and referred to the Medical Rehabilitation Unit for physiotherapy. Short wave diathermy and ultrasound therapy were applied on all patients.Results : Demographic distribution revealed that female gender, the ages more than 50 year, the weight with grade II obesity were the most affected. Clinical observations indicated that chronic and severe cases were the most obvious. The study revealed that deformity, muscle wasting, local inflammation, and effusion were recorded in most patients. Outcomes of treatment with short wave and ultrasound therapies were nearly equally regarding their well-effectiveness, patient's acceptance, and patient's improvement. It was concluded that the ultrasound therapy is more preferable than short wave diathermy in the management of oedema accompanying chronic knee osteoarthritis. Recommendation : Further cohort studies are required to evaluate the effects of these procedures on a large sample of patients. Key wards : Knee osteoarthritis, Physiotherapy, Short wave diathermy, Ultrasound therapy


Article
Association of C-reactive protein positivity among groups of patients with knee osteoarthritis in Erbil
رابطة إيجابية البروتين التفاعلي C بين مجموعات من المرضى الذين يعانون من التهاب المفاصل في الركبة في أربيل

Authors: Niaz k. Jawad --- Helen Ahmed Pirdawood
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2017 Volume: 21 Issue: 2 Pages: 1743-1750
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Osteoarthritis is the most common joint disease and a leading cause of disability. Increased circulating levels of C-reactive protein have been associated with prevalent knee osteoarthritis. This study aimed to assess the association between C- reactive protein positivity in patients with knee osteoarthritis in ErbilMethods: Data from100 participants in this case-control study were enrolled from May 1st to December 1st, 2015 in Rizgary Teaching Hospital in Erbil city. Data were divided into two groups. The cases included 50 patients (17 male and 33 female) with a mean age of 58.9 ±3.8 years and diagnosed with primary knee osteoarthritis of one or both knee joints. Controls included 50 persons (17 male and 33 female) with a mean age of 58.1 ±3.9 years without knee osteoarthritis and matched for age, sex, and body mass index. C-reactive protein qualitatively measured. Patients were radiologically assessed by Kellgren and Lawrence grading scale (grade 0-4).Results: C-reactive protein was positive in 41 out of 50 (82%) of knee osteoarthritis patients compared to 3 out of 50 (6%) of healthy controls (P = 0.001). C- reactive protein positivity among knee osteoarthritis patients were significantly associated with body mass index, positive family history of knee osteoarthritis, duration of diseases, and Kellgren and Lawrence grade (P <0.05). No significant association was found with sex, site of knee joint involvement, and knee pain severity (P >0.05).Conclusion: C-reactive protein positivity was significantly associated with knee osteoarthritis compared to healthy controls. Furthermore, body mass index, positive family history of knee osteoarthritis, early osteoarthritis, and Kellgren and Lawrence grade II, were significantly associated with positive C-reactive protein in knee osteoarthritis.


Article
EFFECTS OF THERAPUTIC EXERCISES PROGRAMM FOR REDUCING PAIN OF KNEE OSTEOARTHRITIS
أثر برنامج للتمارين العلاجية في تخفيف الالم الناتج عن سوفان مفصل الركبة

Author: Muneeb A. Fathi منيب عبدالله فتحي
Journal: Al-Rafidain Journal For Sport Sciences مجلة الرافدين للعلوم الرياضية ISSN: 19939345 Year: 2013 Volume: 19 Issue: 60 Pages: 412-425
Publisher: Mosul University جامعة الموصل

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Abstract

The aim of this study was preparing program of therapeutic exercises for reducing the pain of knee Osteoarthritis (OA). The study also aimed at improving the mobility of the knee joint in addition to improving the flexibility of the joint while extending and flexing movements. The sample of study included (24) patients which were reported at therapeutic department at Al-Salaam learning hospital. The sample was (7) males (17) females aged (47 to 58) years and they had early OA knee according to an orthopedic diagnostic. The study depended on the scale of (KOOS) in order to assess the symptoms and pain levels of the knee joint. In addition the study assessed the ability to perform certain daily activities, the motion range of flexibility at the injured knee joint while extending and flexing movements and the mobility to walk by 6min./meters walk test with indication of the distance achieved.After processing data statistically, the study concluded that the therapeutic exercises has effective and positive role in decreasing knee pain and related disability and improving daily activates in addition to the range of motion while extension and flexion of the knee joint. The study concluded also that the pain is the main cause of all knee symptoms and if it reduced, all things will improved. The study recommended preparing and improving a therapeutic exercises program by the physiotherapy centers. It is necessary also to explain the importance of physiotherapy since it includes exercises which are in turn more effective and safety than drugs which have side effects.

هدفت الدراسة الى إعداد برنامج للتمارين العلاجية لتخفيف الم مفصل الركبة لدى المصابين بسوفان المفصل، وتحسين القابلية الحركية في المفصل وتطوير المدى الحركي لمرونة المفصل في حركتي المد والثني. شملت عينة الدراسة المصابين والمصابات المراجعين لقسم العلاج الطبيعي في مستشفى السلام العام في الموصل وعددهم ( 24 ) مصاب، من الذكور ( 7 ) والاناث ( 17 ) تراوحت أعمارهم بين ( 47 – 58 ) سنة، وباستخدام استمارة استبيان (كووز) لمعاينة مفصل الركبة ومعرفة مستوى الالم وكذلك مستوى القدرة في انجاز الفعاليات الحياتية اليومية، وايضا قياس المدى الحركي لمرونة مفصل الركبة المصابة في حركتي الثني والمد، وقياس القابلية الحركية على المشي من خلال اختبار أفضل مشي لمدة (6) دقائق / متر. ومن خلال المعالجات الاحصائية لنتائج الاختبارات القبلية والبعدية استنتجت الدراسة أن التمارين العلاجية لها دور فعال وايجابي في تقليل مستوى الالم لدى المصابين بسوفان مفصل الركبة، كما استنتجت الدراسة بأن التركيز على تخفيف الالم ومعالجته إن كان من اولويات البرنامج العلاجي سيحسن القابلية الحركية والوظيفية لدى المصابين ويزيد من تحسين النشاطات اليومية الحياتية لديهم ويطور المدى الحركي في المفصل، وقد أوصت الدراسة إعتماد برنامج التمارين العلاجية المعد من قبل الباحث في مراكز العلاج الطبيعي والتأهيلي وتطويره، وتوحيد جهود المسوؤلين عن معالجة المصابين في توضيح فوائد العلاج الفيزيائي ولاسيما التمارين كونها آمنة وفعالة مقارنة بالأدوية التي لا تخلو من مضاعفات جانبية.


Article
Role of Chloroquine phosphate on Acute phase reactant in patients with knee osteoarthritis

Author: Kismat M. Turki* , Ph.D قسمة محمد تركي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 3 Pages: 400-402
Publisher: Baghdad University جامعة بغداد

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Article
Fibromyalgia Syndrome among Iraqi Patients with Knee Osteoarthritis
متلازمة الالم الليفي العضلي في المرضى العراقيين المصابين بسوفان الركبة

Authors: Ziad S. Al-Rawi زياد الراوي --- Faiq I. Gorial فائق ايشوكوريال --- Wafi H. Ali وافي هادي علي
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2014 Volume: 56 Issue: 1 Pages: 45-48
Publisher: Baghdad University جامعة بغداد

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Abstract

Back ground: Fibromyalgia syndrome (FMS) is a common chronic musculo-skeletal disorder resulting in chronic widespread pain impacting on quality life.Objectives: To assess the relationship between FMS and knee osteoarthritis (KOA) and to evaluate the predictors of this relationship if present.Patients and Methods: One hundred Iraqi KOA patients and 100 healthy controls were included in this cross-sectional study. Full history was taken and complete clinical examination was done for all patients. Baseline characteristics [age, sex, duration, body mass index (BMI), waist circumference, family history (Hx) of KOA, smoking history, and drug history.] were also documented. Laboratory analysis included complete blood count, erythrocyte sedimentation rate (ESR), thyroid stimulation hormone, serum calcium, serum alkaline phosphatase, serum phosphate, and anti-nuclear antibody were done for all patients. X-rays of both Knees was taken for patients and was graded according Kellgren and Lawrence scale. The American College of Rheumatology (ACR) criteria for classification and reporting osteoarthritis of the knees were applied on both groups. Individuals in both groups were assessed for FMS and the American College of Rheumatology 1990 Criteria for fibromyalgia were applied for both groups. Comparative statistics were done using Chi square test for categorical variables and students' independent 2 samples (t) test for continuous variables.Results: FMS was present in 26 of 100(26%) KOA patients compared to 7(75%) of 100 of controls [odd ratio (OR)=4.6(95% CI(1.92-11.35),p=0.001]. Frequencies of associated features (headache, sleep disturbances, fatigue, depression, anxiety, and parasthesia) were significantly more in patients than that of controls (P<0.05). Longer duration of KOA, higher waist circumference, and positive family Hx of FMS were significant associates with FMS in the patient group (P<0.05). However no significant association was found with age, sex, BMI, grade of KOA, drugs taken marital status, and increased ESR. Conclusions: FMS was significantly increased in Iraqi patients with KOA compared to controls. Longer disease duration of KOA, large waist circumference and family history of FMS were significant predictors. Keywords: Knee osteoarthritis, fibromyalgia, Kellgren and Lawrence scale,osteoarthritis

الخلفية: متلازمة الالم الليفي العضلي هو اضطراب هيكلي عضلي مزمن شائع ينتج الما منتشرا مزمنا مؤثرا على نوعية الحياة.الاهداف: تقييم العلاقة بين متلازمة الالم الليفي و الفصال العظمي وتحديد العوامل المنبئة ان وجدت.المرضى والطرائق: اشتملت الدراسة المقطعية على 100مريض عراقي مصاب بالفصال العظي و100 شخص سوي كمجموعة ضبط.تم اخذ التاريخ المرضي واجراء الفحص السريري الكامل لكل المرضى ووثقت الميزات الاساسية للمرضى(العمر، الجنس، مدة المرض،معيار كتلة الجسم، محيط الخصر، التاريخ العائلي للفصال العظمي، تاريخ التدخين، والتاريخ الدوائي).ثم اجريت الفحوصات المختبرية كفجص صورة الدم، مقدار ترسب الخلايا الحمر، هورمون تحفيز الدرقية، مصل الكالسيوم، مصل الفوسفيت ، مصل انزيم الفوسفاتيز القاعدي،و وفحص الاجسام الضدية( اي ان اي) لكل المرضى. تم اخذ الرقائق الشعاعية للمرضى وتديجها حسب معيار كلكرن-لورانس. وطبقت معايير الكلية الامريكية 1990 لتصنيف مرض الفصال العظمي للركبة ومعايير الكلية الامريكية 1990 لتصنيف متلازمة الالم الليفي العضلي على المجموعتين.اجريت المقارنة الاحصائية باستعمال فحص الكاي سكوير للمتغيرات الصنفية وفحص تي للمتغيرات المستمرة. النتائج: وجدت متلازمة الالم الليفي العضلي في 26 من 100 مريض (26%) مصاب بالفصال العظمي مقارنة ب7 من 100 (7%) من من مجموعة الضبط) القيمة الاحتمالية =0.001). وجد ان مقدار تكرار العلامات المترافقة ( الصداع، اضطرابات النوم،التعب،الاكتئاب ، القلق،والخدر)اكثر في المرضى عما هو في مجموعة الضبط وذو علاقة احصائية ذات جدوى((القيمة الاحتمالية>0.05). كانت مدة مرض فصال الركبة الاطول، محيط الخصر الاعلى، والتاريخ العائلي الموجب لمتلازمة الليفي العضلي مترافقات ذات علاقة احصائية ذي جدوى مع متلازمة الالم الليفي العضلي لمجموعة المرضى (القيمة الاحتمالية>0.05).ولكن لم نجد علاقة احصائية ذات جدوى مع العمر، الجنس، معيار كتلة الجسم، وشدة فصال الركبة.الاستنتاج: كانت متلازمة الالم الليفي العضلي اكثر في مجموعة المرضى مقارنة بمجموعة الضبط.كما ان مرضى فصال الركبة الاطول مدة، محيط الخاصرة الاكبر، والتاريخ العائلي الموجب لمتلازمة الالم الليفي العضلي هي متنبئات لمتلازمة الالم الليفي العضلي.الكلمات المفتاحية:الفصال العظمي للركبة، متلازمة الالم الليفي العضلي

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