Effect of dry cupping versus soft and prolonged massage in the management of knee osteoarthritis – a randomized controlled clinical trial

Author(s):  
Mearaj ul Islam ◽  
Mohd Nayab ◽  
Abdul Nasir Ansari

Abstract Objectives Osteoarthritis is one of the most common musculoskeletal diseases which leads to functional decline and loss of quality of life. Knee osteoarthritis is considered as highly burdensome disease as well as highest contributor to global disability. Ḥijāmah (Cupping Therapy) and Dalk (Massage) are claimed effective in the treatment of Wajaʹul Mafāṣil (osteoarthritis). Present study was framed to compare the efficacy of Ḥijāmah bilā Sharṭ (Dry Cupping) and Dalk-i-Layyin Kathīr (soft and prolonged massage) with Roghan-i-Bābūna (chamomile oil) in the management of Wajaʹ ur Rukbah (knee osteoarthritis). Methods In present randomised controlled clinical trial, a total of 48 diagnosed patients of knee osteoarthritis were allocated randomly into group A (n=24) and group B (n=24). Group A was treated with soft and prolonged massage with Roghan-i-Bābūna while group B was managed with dry cupping on alternate day for 15 min. Visual Analog Scale (VAS) and Knee osteoarthritis outcome score (KOOS) were used for the assessment of efficacy. A total of 40 patients, group A (n=20) and group B (n=20), were completed the allocated duration of protocol therapy and were restricted to statistical analysis. Results Statistically highly significant improvement was observed in objective parameters using both paired and unpaired t-tests. VAS and all KOOS subscales were found to be strongly significant at 20th day when compared with baseline (p<0.001). In intergroup comparison significant change (p>0.05) was not observed. Safety parameters were in their normal range after treatment. Conclusions Dalk-i-Layyin Kathīr with Roghan-i-Bābūna and Ḥijāmah bilā Sharṭ both were found safe and effective in the management of Wajaʹur Rukbah. Hence, it may be concluded that both regimenal therapies are safe, effective and almost equal in their efficacy in the management of Knee Osteoarthritis.

2019 ◽  
Vol 13 (01) ◽  
pp. 029-035 ◽  
Author(s):  
Debopriya Chatterjee ◽  
Anjali Kapoor ◽  
Sharmistha Vijay ◽  
Geetika Sobti ◽  
Dheeraj Kara ◽  
...  

Abstract Objective Periodontitis initiation and progression are a result of host immune inflammatory response to oral pathogens. Several pharmacological agents are being delivered locally, to improve periodontal health. Hence, the present randomized placebo controlled clinical trial is designed to check the clinical and antimicrobial efficacy of locally delivered 1.2% rosuvastatin (RSV) in intrabony defects (IBD) in periodontitis patients. Materials and Methods One-hundred patients were randomly allotted into two treatment groups: group A received 1. 2% RSV gel, scaling and root debridement and group B received placebo gel, scaling and root debridement. Clinical parameters, including modified sulcus bleeding index (mSBI), probing depth (PD), clinical attachment level (CAL), and plaque index (PI), were recorded at baseline before phase 1 and after 6 months. Radiographic assessment of IBD was done by cone beam computed tomography at baseline and after 6 months. Anaerobic colony count was done at baseline and after 180 days. Results On intragroup comparison, there is a significant improvement in periodontal parameters in both the groups. On intergroup comparison, there is significant gain in CAL in group A than group B (p = 0.04). There is significant decrease in PD in group A, compared to group B. There is significant bone fill in group A (p = 0.034), compared to group B. With respect to mSBI, PI, and anaerobic colony count, there is no significant difference between the two groups after 6 months. No adverse effect was noticed in any subjects. Conclusion The author concludes that 1.2% RSV gel when delivered locally into IBD improved periodontal clinical parameters such as PD and CAL and showed significant bone fill.


2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Yutaka Nagata ◽  
Hirozo Goto ◽  
Hiroaki Hikiami ◽  
Tatsuya Nogami ◽  
Makoto Fujimoto ◽  
...  

We evaluated the effect of keishibukuryogan (KBG; Guizhi-Fuling-Wan), a traditional Japanese (Kampo) formula, on endothelial function assessed by reactive hyperemia peripheral arterial tonometry (Endo-PAT2000) in patients with metabolic syndrome-related factors by controlled clinical trial with crossover design. Ninety-two patients were assigned to group A (first KBG-treatment period, then control period; each lasting 4 weeks, with about one-year interval) or group B (first control, then KBG-treatment). In forty-nine (27, group A; 22, group B) patients completing all tests, the mean value of the natural logarithmic-scaled reactive hyperemia index (L_RHI) increased and those of serum nonesterified fatty acid (NEFA), malondialdehyde, and soluble vascular cell adhesion molecule 1 decreased significantly during the KBG-treatment period, but not during the control period, and 4-week changes of L_RHI, NEFA, and malondialdehyde between the 2 periods showed significance. These results suggest that KBG has beneficial effect on endothelial function in patients with metabolic syndrome-related factors.


Author(s):  
Shakun Singh ◽  
Rachna Chaudhary ◽  
Vandana Dhama ◽  
Anu Singh ◽  
Urmila Karya

Background: To study the impact of Vitamin A supplementation in anaemia during Pregnancy and thus improving maternal and fetal outcome a Randomized double blind controlled clinical trial was conducted in Department of Obstetrics and Gynaecology, L.L.R.M. Medical college Meerut involving 250 pregnant women in late pregnancy 18-28 weeks with haemoglobin levels <11 g% (7-11 g%)..Methods: The study subjects were divided into two groups: Group A (n=125): Received daily supplement containing Iron (60 mg elemental iron) + Folate (500 mcg) + Vitamin A 20,000 IU weekly for a minimum of 12 weeks. Group B (n=125): Received daily supplement containing iron (60 mg elemental iron) + Folate (500 mcg) for a minimum of 12 weeks.Results: Maximum patients were uneducated belonging to low socioeconomic status. The mean haemoglobin values in Group A and Group B increased from 9.674±1.05 and 9.53±1.04 to 12.2±0.89 and 10.82±1.06 respectively after supplementation. Similarily Serum Ferritin levels increased from 15.96±2.94 and 15.70±2.83 to 78.40±17.82 and 58.64±11.93. Mean corpuscular volume, packed cell volume and red blood cell counts also increased significantly. Maximum haemoglobin levels were achieved with both vitamin A and iron supplementation. The proportion of women who became non anaemic was 97.17% in Group A vs 68.69% in Group B.Conclusions: Vitamin A supplementation improves anaemia and also dramatically improves iron stores in anaemic pregnant women.


2018 ◽  
Vol 50 (05) ◽  
pp. 348-352 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Maria-Kyriaki Kaseta ◽  
Sotirios-Tsambikos Kazas ◽  
Panayiotis D Megaloikonomos ◽  
Andreas F Mavrogenis ◽  
...  

Abstract Background There have been several studies published comparing the ultrasound-guided with the “blind” infiltrations in the shoulder’s area. On the contrary, there is only very limited data regarding the necessity of ultrasound guidance in lateral epicondylitis. Materials and Methods A prospective, randomized, blinded at initial and follow-up evaluation, comparative clinical trial was conducted, involving 44 patients with a history of chronic persistent epicondylopathy. The patients were randomly divided into 2 groups of 22 people each. Group A patients underwent three ultrasound-guided betamethazone injections, while group B included those who underwent three “blind” injections, centered at the palpable point of maximum pain. The evaluation was done before and after (4 and 12 weeks) the injections using the Visual Analogue Scale for pain (VAS, 0–10) and the Roles & Maudsley score. Results There was not any significant statistical difference between the two groups as for mean VAS at 4 weeks (p = 0.150, t-test) and mean VAS at 12 weeks (p = 0.286, t-test). Furthermore, the final success rate, as measured by the Roles & Maudsley score, was slightly superior in group B (67 % of the patients with excellent or good results) when compared with group A (46 % of the patients), but without any statistical difference (p = 0.161, chi-square). Conclusion Our trial proved that an ultrasound-guided injection is not superior than a palpation-guided injection of corticosteroids in the treatment of lateral epicondylopathy.


1970 ◽  
Vol 33 (2) ◽  
pp. 55-59 ◽  
Author(s):  
M. A. Shakoor ◽  
Md. Abu Taslim ◽  
Md. Shahadat Hossain

A prospective randomized clinical trial was conducted on 162 patients of osteoarthritis of knee were included in the study. The patients were divided into two groups- Group A and Group B. The Group A was treated with shortwave diathermy, exercise, naproxen and activity modification and the Group B was treated with shortwave diathermy, exercise and naproxen. Improvement was found more in Group A than Group B after 4th week (95 % CI was -2.59 to 6.56). Then it was found that the improvement was gradually increased in Group A than Group B and finally, it was found that there was highly significant improvement in Group A than Group B after 6th week (95 % CI was -3.45 to -0.70). This study suggests that activity modification play an important role for the treatment of the patients with osteoarthritis of knee.     Keywords: Knee; Osteoarthritis DOI: 10.3329/bmrcb.v33i2.1205Bangladesh Med Res Counc Bull 2007; 33: 55-59


2016 ◽  
Vol 22 (3) ◽  
pp. 468-472 ◽  
Author(s):  
Pratibha Mamgain ◽  
Abhishek Kandwal ◽  
Ravindra K. Mamgain

Present study evaluates efficacy of Trifala and Ela as plaque controlling agent and compares it with chlorhexidine. Aim. To evaluate Antigingivitis, Antiplaque and Antihalitosis effect of Triphala and Ela decoction. A randomized sample of 60 patients with plaque induced gingivitis was enrolled and equally divided into two groups group A and group B. Group A was given Trifala and Ela decoction and Group B Chlorehexidine mouthwash for 21 days twice daily. Gingival inflammation index, plaque index and Organoleptic scoring scale was recorded at baseline, 14th day and 21st day. Comparing the plaque index for Group A with group B the reduction in from baseline to 14 day was 42.59 % and 38.62% respectively while from baseline to 21 day was 56.20% and 68.57% respectively. On comparing Gingival index for group A with group B the reduction from baseline to 14 day was 31.95% and 38.62 % respectively while from baseline to 21 day was 69.95 % and 68.57% respectively. Halitosis Percentage reduction at 14th day from base line was 33.33% and 38.18%; at 21 day from baseline 66.66% and 72.72% respectively for group A and group B. No statistical significant difference for intergroup comparison was found using paired t test. Intra group analysis using unpaired t test was significant for all the indices at different time intervals. Triphala and Ela decoction is organic, easy to prepare economical and equally effective as compared to chlorhexidine mouthwash.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Hamid Reza Farpour ◽  
Najme Rajabi ◽  
Bahareh Ebrahimi

Purpose. The high prevalence of knee osteoarthritis (KOA) is a major cause of disability among elders. NSAIDs are recommended to reduce KOA patients’ symptoms, but their adverse side effects limit their consumption. In this study, we evaluated the effectiveness of Harpagophytum procumbens compared to a routine NSAID (meloxicam) on pain reduction and functional improvement of KOA patients. Patients and Methods. Sixty patients aged 40–60 years, with painful knee osteoarthritis (grades 1-2 of Kellgren–Lawrence scale) for at least one month, were randomized into two groups with different routine medication periods. Group A consisted of daily administration of two Harpagophytum procumbens (Teltonal) tablets (2 ∗ 480 mg) for one month, and group B consisted of daily administration of meloxicam (15 mg) for ten days. The visual analogue scale (VAS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), Oxford Knee Scale (OKS), and patient satisfaction were evaluated at the baseline and after 2, 4, and 8 weeks. Results. There were no statistically significant differences between demographic characteristics, pain intensity, and function scores before the treatment. VAS, OKS, and WOMAC scores improved in both groups p < 0.001 over time, but no significant superiority was shown; after 8 weeks: VAS (Teltonal (4.80 ± 1.80) vs. meloxicam (5.06 ± 1.43)), OKS (34.06 ± 4.38, 34.00 ± 7.87, Teltonal vs. meloxicam, respectively), and WOMAC scores (25.73 ± 10.11 Teltonal vs. 26.20 ± 13.94, meloxicam). Conclusion. Teltonal is an effective and safe treatment in patients with mild KOA in the short term. However, no significant superiority was shown in using Teltonal or meloxicam, in people who cannot take NSAIDs, it can be a good alternative, although difference in medication periods should be considered.


Cartilage ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Leonidas Roumeliotis ◽  
Vasileios S. Nikolaou ◽  
Efstathios Chronopoulos ◽  
Ioannis Sourlas ◽  
...  

Various systematic reviews have recently shown that intra-articular platelet-rich plasma (IA-PRP) can lead to symptomatic relief of knee osteoarthritis for up to 12 months. There exist limited data on its use in small joints, such as the trapeziometacarpal joint (TMJ) or carpometacarpal joint (CMCJ) of the thumb. A prospective, randomized, blind, controlled, clinical trial of 33 patients with clinical and radiographic osteoarthritis of the TMJ (grades: I-III according to the Eaton and Littler classification) was conducted. Group A patients (16 patients) received 2 ultrasound-guided IA-PRP injections, while group B patients (17 patients) received 2 ultrasound-guided intra-articular methylprednisolone and lidocaine injections at a 2-week interval. Patients were evaluated prior to and at 3 and 12 months after the second injection using the visual analogue scale (VAS) 100/100, shortened Disabilities of the Arm, Shoulder, and Hand Questionnaire (Q-DASH), and patient’s subjective satisfaction. No significant differences between the baseline clinical and demographic characteristics of the 2 groups were identified. After 12 months’ follow-up, the IA-PRP treatment has yielded significantly better results in comparison with the corticosteroids, in terms of VAS score ( P = 0.015), Q-DASH score ( P = 0.025), and patients’ satisfaction ( P = 0.002). Corticosteroids offer short-term relief of symptoms, but IA-PRP might achieve a lasting effect of up to 12 months in the treatment of early to moderate symptomatic TMJ arthritis.


2016 ◽  
Vol 6 (2) ◽  
pp. 90
Author(s):  
Samaresh Chandra Hazra ◽  
Agha Masood Choudhury ◽  
Lubna Khondker ◽  
Md. Shirajul Islam Khan ◽  
Muhammad Munir Rashid

<p><strong>Background:</strong> For better management of lichen planus a clinical trial of oral methotrexate is necessary in ow· country. Objective: The objective of this study is to evaluate efficacy and safety ofmethotrexate therapy in the treatment of lichen planus.</p><p><strong>Methods:</strong> It was a prospective randomized controlled clinical trial conducted in the department of Dermatology and Venereology, BSMMU, Dhaka, from January 2009 to December 2010. Forty four patients of lichen planus were included in the study. Cases (group-A, n=23) were treated with methotrexate (10 mg) single morning dose and control (group-B, n=21) were treated with mini pulse betamethasone (5mg) single morning dose on 2 consecutive days during the period of 12 weeks. <strong></strong></p><p><strong>Results:</strong> Clinical parameters were measured by follow up clinical examination. Morphological lesion of lichen planus improved 95. 7% in group-A and only 28.6% improved in group-B. At the end of study 82.6% bad no complaints of itching in group-A and 100% had no complaints of itching in group-B. 16(69.6%) patients in group-A were completely cured clinically but 10(47.6%) in group-B. Anemia 3(14.2%) and edema 12(57.1 %) developed in group-B but none in group-A. In group-B, dyspepsia 15(71.4%), acne 10(47.6%),mooning face 8(38.1%), striae 8(38.1%) and hyper­trichosis 4(19.0%) developed but none in group-A lntermittenr diarrhoea, headache, nausea and fatigue complained in both groups of patients but the percentage of complaints was higher amog group-8 compared to group-A. Menstrual abnormality developed in group-B 5(71.4%) but none in group-A.</p><p><strong>Conclusion:</strong> The overall adverse effects were less in group-A than group-B. Therefore, methotrexate can be used as an alternative safer option for the treatment of lichen planus.</p>


2019 ◽  
Vol 8 (3) ◽  
pp. 181-189
Author(s):  
Mitra Mahdavian ◽  
Khadijeh Mirzaii Najmabadi ◽  
Hossein Hosseinzadeh ◽  
Sara Mirzaeian ◽  
Shapour Badiee. Aval ◽  
...  

Introduction:. Menopause is the transition from the reproductive phase of a woman to the non-reproductive. It may impair quality of life. The study aims to determine the effectiveness of mixed herbal medicines on menopause symptoms Methods: A randomized, triple-blind, clinical trial and placebo-controlled study on 120 peri-menopausal women aged 45-65 years for 12 weeks. All participants took herbal extracts drops orally daily and randomly allocated into four groups: placebo (C), A (250 mg chamomile, 30 mg fennel, 15 mg saffron), B (1000 mg, 120 mg, 60 mg), and D (500 mg, 60 mg, 30 mg). Primary outcome was the mean change in scores of the menopause rating scale that evaluates 11 symptoms. Results: The median (IQR) physical score significantly reduced from 8.5(4) to 2(3), in psych score reduced from 12(4) to 2 (2) and in urogenital score reduced from 6.5(3) to 3(2) in group B. In group D physical score decreased from 12(6) to 8(4), in psychological score reduced from12 (3) to 8(4) and urogenital score reduced from 7.5 (3) to 8(3) at week 12. No significant differences in group A and C. With comparison the scores of physical, psych and urogenital domain of MRS questionnaire in 1th ,6th and 12th, no significant difference within group A and C were seen, but statistically significant difference was within group B (p&lt;0.001) and D (p&lt;0.001) in all weeks. The effect size was 0.92. Conclusion: A 12 weeks extracts treatment, there were significant improvement in physical, psychological and urogenital domains in group B.


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