Platelet-Rich plasma injections treatment in patients having early osteoarthritis of knee joint.

Objective: To find out the outcome following intra-articular platelet-rich plasma (PRP) injection in patients having early OA of knee. Study Design: Prospective Study. Setting: Tahira Jamshed Medical Complex, Bahawalpur. Period: January 2019 to February 2020. Material & Methods: A total of 112 cases of both gender, aged 40 to 60 years, Grade I and Grade II OA, having symptoms of OA for a minimum duration of 1 year, were enrolled. All participants were assessed for physical activity and pain linked with arthritis as per “Western Ontario and McMaster University Arthritis Index (WOMAC) score”. Results: Out of a total 98 cases who completed the study, majority 58 (59.2%) were female, 67 (68.4%) had Kellgren-Lawrence Grade-I OA and 81 (82.7%) were experiencing OA symptoms with a duration of less than 2 years. The difference between mean WOMAC score before the treatment (80.38+6.3) and after PRP treatment (42.93+6.9) turned out to be statistically significant (p value < 0.001). After the treatment, cases having duration of symptoms of OA as less than 2 years had significantly less WOMAC score (p value = 0.0418). Conclusion: PRP treatment in patients having early OA seemed to be quite efficacious. The effects of PRP injections were more favorable in cases having clinical symptoms of OA for less than 2 years of duration.

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Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome

European Journal of Translational Myology ◽

10.4081/ejtm.2018.7327 ◽

2018 ◽

Vol 28 (1) ◽

Cited By ~ 2

Author(s):

Mojgan Forootan ◽

Masood Shekarchizadeh ◽

Hamedreza Farmanara ◽

Ahmad Reza Shekarchizadeh Esfahani ◽

Mansooreh Shekarchizadeh Esfahani

Keyword(s):

Clinical Symptoms ◽

Response To Treatment ◽

Rectal Ulcer ◽

Solitary Rectal Ulcer ◽

Solitary Rectal Ulcer Syndrome ◽

Duration Of Symptoms ◽

Dyssynergic Defecation ◽

Incomplete Evacuation ◽

Anorectal Pain ◽

The Difference

Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9±45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50±0.71 versus 1.33±-0.71 before and 1.30 ± 0.95 versus 0.67±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

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HYPONATREMIA;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.11.670 ◽

2017 ◽

Vol 24 (11) ◽

pp. 1647-1651

Author(s):

Riaz Ahmed Javid ◽

Ayesha Ghafoor ◽

Ifrah Ahmed

Keyword(s):

Hepatic Encephalopathy ◽

Cross Sectional Study ◽

P Value ◽

Age Group ◽

Sectional Study ◽

Cross Sectional ◽

Male And Female ◽

Male Patients ◽

The Difference ◽

Study Setting

Objectives: To find out the frequency of hyponatremia in cases of hepaticencephalopathy. Study Design: Cross-sectional study. Setting: Department of Medicine DGKhan Hospital, DG Khan. Period: July 2016 to December 2016. Material and Methods: Total80 patients with hepatic encephalopathy either male or female were selected for this study.Hyponatremia was assessed in these selected patients. Results: Mean age of the patientswas 38.34 ± 11.140 years. Hyponatremia was found in 31 (39%) patients. Hyponatremia wasnoted in 13 (41.94%) patients of age group 18-36 years and 18 (36.73%) patients of age group37-55 years. Statistically insignificant association of hyponatremia with age was seen with pvalue 0.6467. Hyponatremia was found in 21 (40.38%) male patients and 10 (35.71%) femalepatients. But the difference of frequency of hyponatremia between male and female patients wasstatistically insignificant with p value 0.8109. Conclusion: Results of this study showed a higherpercentage of hyponatremia in patients with HE. Male were more victim of HE as compared tofemale but insignificant association of hyponatremia with gender is noted. Findings of presentstudy showed that there is insignificant association of hyponatremia with grade of HE, socioeconomicstatus, area of residence and age.

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A prospective study of intra-articular injections of platelet rich plasma in early osteoarthritis knee joint

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20175661 ◽

2017 ◽

Vol 4 (1) ◽

pp. 133

Author(s):

Rentala Vamshi ◽

Vivekananda Bheemisetty ◽

Raju Bollabathini ◽

Vishwanath Mahadevuni

Keyword(s):

Knee Joint ◽

Prospective Study ◽

Platelet Rich Plasma ◽

Autologous Blood ◽

Womac Score ◽

Knee Joints ◽

Osteoarthritis Knee ◽

Grade Ii ◽

Autologous Platelet Rich Plasma ◽

A Prospective Study

Background: Platelet-rich plasma (PRP) is a natural concentrate of autologous blood growth factors experimented in different fields of medicine in order to test its potential to enhance tissue regeneration. The aim of our study is to study the effects of intra articular injections of autologous “Platelet Rich Plasma“ in the osteoarthritis of knee joint and to assess the functional outcome after injecting platelet rich plasma in osteoarthritic knee joints and compare the results with standard studies and draw conclusions.Methods: This is a prospective study done on 161 Kellgren-Lawrence radiological grade I and grade II knee joints, between August 2013 and March 2016 which, were treated with PRP intra-articular injections. The procedure consisted of injection of 8 ml platelet concentrate into the knee joint with an 18- gauge needle without local anaesthetic. Patients were assessed with WOMAC (Western Ontario McMaster Universities Arthritis Index) scoring pre injection of PRP and post injection period of 1 month and 6 months. A reduction in WOMAC score is suggestive of improvement in the patient’s condition.Results: There is a significant improvement in WOMAC score of all the patients and the results sustained for more than 6 months. Though there is clinically better results are seen in grade I knee joints than grade II knee joints, these results are statistically not significant.Conclusions: Osteoarthritis (Grade I and Grade II) of Kellgren Lawrence radiological grading does give relief from pain, stiffness and improves functionality without any major side effects and can be recommended as a viable modality of treatment.

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LATERAL EPICONDYLITIS

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.01.1411 ◽

2015 ◽

Vol 22 (01) ◽

pp. 049-053

Author(s):

Sardar Sohail Afsar ◽

Mohammad Gulzar ◽

Mohammad Idrees ◽

Iqtidar Ullah Babar

Keyword(s):

Corticosteroid Injection ◽

Autologous Blood ◽

Lateral Epicondylitis ◽

P Value ◽

Dash Score ◽

Inclusion Criteria ◽

Duration Of Symptoms ◽

Blood Injection ◽

The Difference

Objective: With aging, chemical hormonal and vascular factors have their partto play in lateral epicondylitis. The objective is to compare results of autologous blood injectionand corticosteroid injection in treatment of lateral epicondylitis. Place and Location: Out PatientDepartment of Peshawar Institute of Medical Sciences, Peshawar from March 2013 to February2014. Material and Methods: A prospective randomized control trail conducted on 58 patientsfulfilling inclusion criteria. DASH score and VAS score used as outcome measures and bothwere recorded before injections and at each follow up made at 2 weeks, 6 weeks, 12 weeksand 24 weeks interval. P-value was calculated where applicable. Results: Out of 79 patients 65met the inclusion criteria. Mean age was 41.43 years ±13.43. 36 were females and 29 males.Dominant elbow involved in 39 patients. Mean duration of symptoms was 7.1±2.9 months. 7patients lost in follow up. DASH score improved in both groups (P value <0.0001) but whencompared there was no significance difference between the two groups ( P value 0.33 at 12weeks and 0.09 at 24 week follow up). Similarly Mean VAS improved at 12 and 24 week followup (P value <0.0001) in both groups but when compared the difference was non-significant(P value .071 at 12 weeks and 0.12 at 24 weeks follow up. Conclusions: Both steroid andautologous blood injection has shown improvement in pain and physical activity and provideacceptable results although none superior to other significantly.

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Comparison of NSAIDS Versus NSAIDS Plus Duloxetine in Knee Osteoarthritis Patients

10.53350/pjmhs2115102865 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2865-2868

Author(s):

Muhammad Muddasser Khan Panezai ◽

Shahzad Gul ◽

Zia Ehsan Kakar ◽

Uzma Rasheed ◽

Shazia Zammurad ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Knee Pain ◽

Womac Score ◽

P Value ◽

Reduction Of Pain ◽

Group A ◽

Keywords Chronic Pain ◽

The Mean ◽

Group B ◽

Study Setting

Objective: To compare the efficacy of Duloxetine with NSAIDS versus NSAIDS alone for the treatment of knee pain secondary to osteoarthritis. Study Design: Randomized clinical trial study. Setting and Duration: Department of Rheumatology, PIMS Hospital, Islamabad, from April to August 2021. Methodology: One hundred and twenty eight patients with knee osteoarthritis were included in the study and were divided in two equal groups; one group was subjected to Duloxetine plus NSAIDs and other to just NSAIDs. The response was assessed at end of 3 months. Reduction in pain more than or equal to 50% from the baseline was considered as efficacy. Results: The mean VAS score was 3.56±1.15 in group A (Duloexetine plus NSAIDS) A while in group B (NSAID alone), 4.45±1.22 and significantly (p-value > 0.05). Similarly, the comparison of WOMAC score for pain showed that the mean WOMAC score was significantly (P-value > 0.05) less 5.68±1.56 in group A in contrast to 6.39 ± 1.69 in group B. Comparison of efficacy between two groups showed that the rate of efficacy was significantly (P-value >0.05) higher in group A 48.4% as compared to 31.3% in group B. Conclusion: Addition of Duloxetine to NSAIDs resulted in more reduction of pain in terms of VAS and WOMAC score with acceptable adverse effects. Keywords: Chronic pain, Duloxetine, Knee pain, NSAIDs, Osteoarthritis

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The Influence Of Using Extract Neem Leaf (Azadirachta indica A.juss) Soap In The Scabies lesions grade II Healing

Journal of Agromedicine and Medical Sciences ◽

10.19184/ams.v4i3.8563 ◽

2018 ◽

Vol 4 (3) ◽

pp. 140

Author(s):

Anis Murniati ◽

Indah Rohmawati

Keyword(s):

Azadirachta Indica ◽

Leaf Extract ◽

Assessment Tool ◽

Clinical Symptoms ◽

Good Effect ◽

Control Group ◽

P Value ◽

Control Group Design ◽

Neem Leaves ◽

Grade Ii

Scabies is an infectious skin disease caused by infection with Sarcoptes scabiei mites. Clinical symptoms of itching in the lesions. There are herbal plants, namely the neem plant with the content of mimba leaf extract, giving a very good effect in providing resistance to mites in vitro. Mimba leaf processing can be done to make various products, including soap products. So the researchers wanted to develop the concept and knowledge of the effects of soap made from mimba leaf extract in curing lesions in scabies grade II patients in the female dormitory of Ponpes Pandanaran Ngunut Tulungagung. This study uses the Quasy Experiment design with an experimental design of Non equivalent control group design. The treatment group was divided into two treatment groups, namely the treatment using neem leaf extract soap (Azadirachta indica A. juss) and using antibacterial soap. The sample was determined using purposive sampling according to the inclusion criteria, as many as 70 respondents. The assessment used observation sheets of lesion wounds according to the modified Bates-jensen wound assessment tool. The results of the analysis of 70 respondents obtained the results of independent t-test statistics obtained a significance value of p (value) = 0,000. The use of solid soap mimba leaf extract (Azadirachta indica A. juss) in dealing with scabies with Azadirachtinya content which is able to provide resistance to mites by inhibiting the life cycle (metamorphosis). Keywords: Scabies, neem leaves, lesions, healing

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Comparative evaluation of efficacy of autogenous platelet rich plasma versus visco supplementation in treatment of early osteoarthritis of knee

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20195584 ◽

2019 ◽

Vol 6 (1) ◽

pp. 19

Author(s):

Kumar Shantanu ◽

Shailendra Singh ◽

Mahesh Kumar Navadaya ◽

Brijmohan Patel

Keyword(s):

Platelet Rich Plasma ◽

Knee Joints ◽

Long Term Results ◽

Early Osteoarthritis ◽

Group I ◽

Significant Difference ◽

Grade Ii ◽

Group Ii ◽

Grade Iii

Background: Osteoarthritis is a very common chronic degenerative disease most commonly affecting the knee joints. In present study we compared the efficacy of autogenous platelet rich plasma (PRP) versus visco supplementation in treatment of early osteoarthritis of knees.Methods: 30 patients (56 knees) were registered and divided into two groups. Out of which PRP in 28 knees and visco supplementation in 28 knees injected during. Visual analogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores were measured. These scores were measured at first visit, 6 weeks, 12 weeks and at 24 weeks.Results: All registered patients were randomized in two groups. Group I (total 16 patients and 28 knees) for intraarticular PRP injection and group II (total 14 patients and 28 knees) for intraarticular viscosupplement injection. Out of 28 knees of group I; 12 (42.85%) knees belonged to grade II and 16 (57.15%) of grade III. Out of 28 knees of group II; 15 (53.57%) knees of grade II and 13 (46.45%) of grade III. None of the knees belonged to grade I and grade 0. There was significant difference in outcome of two treatment groups (p<0.05) at 24 weeks.Conclusions: Treatment with PRP showed a significantly better clinical outcome compared with viscosupplemention at 24 weeks follow up. Although patients achieved lower WOMAC and VAS scores in PRP group at 6 and 12 weeks follow up that was statistically insignificant. We conclude that long term results of PRP are better than viscosupplementation.

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The role of platelet rich plasma injection in the management of early osteoarthritis of the knee

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20175660 ◽

2017 ◽

Vol 4 (1) ◽

pp. 128

Author(s):

Yeshwanth Subash ◽

Kamalakumar K. ◽

Lydia M.

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Platelet Rich Plasma ◽

Cost Effective ◽

Functional Results ◽

Womac Score ◽

Osteoarthritis Of The Knee ◽

Early Osteoarthritis

Background: Osteoarthritis of the knee is a degenerative disorder associated with significant morbidity in the form of pain, knee stiffness and decrease in the functional capacity of the affected limb leading to a decrease in the quality of life for the patient. Various modalities of treatment are available for the management of this condition. The aim of this study was to evaluate the role of platelet rich plasma (PRP) injection in the management of early osteoarthritis of the knee and to compare the functional outcome with the studies of various authors as available in literature.Methods: 60 patients with Kellgrenn and Lawrence grade 1 and 2 osteoarthritis of the knee were studied from January 2014 to January 2015 and were followed up for a period of 1 year.Results: There were 39 males and 21 female patients in our study with the right side being more commonly affected. There was a significant decrease in the VAS score and the WOMAC score at 1, 3, 6 and 12 months follow up as compared to the pre-injection baseline scores. All patients were satisfied with the procedure in terms of functional outcome. Conclusions: PRP injection is a cost effective, safe and efficient procedure with easily reproducible results and gives good functional results in terms of pain relief, improvement of range of movements and mobility, and improves the quality of life in patients with early osteoarthritis of the knee.

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Enhancement of ADP-induced Platelet Aggregation by Adrenaline in Vivo and Its Prevention

Thrombosis and Haemostasis ◽

10.1055/s-0038-1647788 ◽

1973 ◽

Vol 29 (02) ◽

pp. 490-498 ◽

Cited By ~ 6

Author(s):

Hiroh Yamazaki ◽

Itsuro Kobayashi ◽

Tadahiro Sano ◽

Takio Shimamoto

Keyword(s):

Platelet Count ◽

Platelet Aggregation ◽

Platelet Rich Plasma ◽

The Other ◽

Endothelial Surface ◽

Important Interaction ◽

Blood Coagulability ◽

The Difference

SummaryThe authors previously reported a transient decrease in adhesive platelet count and an enhancement of blood coagulability after administration of a small amount of adrenaline (0.1-1 µg per Kg, i. v.) in man and rabbit. In such circumstances, the sensitivity of platelets to aggregation induced by ADP was studied by an optical density method. Five minutes after i. v. injection of 1 µg per Kg of adrenaline in 10 rabbits, intensity of platelet aggregation increased to 115.1 ± 4.9% (mean ± S. E.) by 10∼5 molar, 121.8 ± 7.8% by 3 × 10-6 molar and 129.4 ± 12.8% of the value before the injection by 10”6 molar ADP. The difference was statistically significant (P<0.01-0.05). The above change was not observed in each group of rabbits injected with saline, 1 µg per Kg of 1-noradrenaline or 0.1 and 10 µg per Kg of adrenaline. Also, it was prevented by oral administration of 10 mg per Kg of phenoxybenzamine or propranolol or aspirin or pyridinolcarbamate 3 hours before the challenge. On the other hand, the enhancement of ADP-induced platelet aggregation was not observed in vitro, when 10-5 or 3 × 10-6 molar and 129.4 ± 12.8% of the value before 10∼6 molar ADP was added to citrated platelet rich plasma (CPRP) of rabbit after incubation at 37°C for 30 second with 0.01, 0.1, 1, 10 or 100 µg per ml of adrenaline or noradrenaline. These results suggest an important interaction between endothelial surface and platelets in connection with the enhancement of ADP-induced platelet aggregation by adrenaline in vivo.

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Motivasi dan kepuasan kerja pegawai puskesmas BLUD dan non-BLUD Kabupaten Semarang

Health Sciences and Pharmacy Journal ◽

10.32504/hspj.v2i3.45 ◽

2018 ◽

Vol 2 (3) ◽

pp. 111

Author(s):

Aswindar Adhi Gumilang ◽

Tri Pitara Mahanggoro ◽

Qurrotul Aini

Keyword(s):

Public Health ◽

Job Satisfaction ◽

Financial Management ◽

Work Motivation ◽

P Value ◽

The Public ◽

The Status ◽

The Difference ◽

Demand For Health ◽

Public Demand

The public demand for health service professionalism and transparent financial management made some Puskesmas in Semarang regency changed the status of public health center to BLUD. The implementation of Puskesmas BLUD and non-BLUD requires resources that it can work well in order to meet the expectations of the community. The aim of this study is to know the difference of work motivation and job satisfaction of employees in Puskesmas BLUD and non-BLUD. Method of this research is a comparative descriptive with a quantitative approach. The object of this research are work motivation and job satisfaction of employees in Puskesmas BLUD and non-BLUD Semarang regency. This Research showed that Sig value. (P-value) work motivation variable was 0.019 smaller than α value (0.05). It showed that there was a difference of work motivation of employees in Puskemas BLUD and non-BLUD. Sig value (P-value) variable of job satisfaction was 0.020 smaller than α value (0.05). It showed that there was a difference of job satisfaction of BLUD and non-BLUD. The average of non-BLUD employees motivation were 76.59 smaller than the average of BLUD employees were 78.25. The average of job satisfaction of BLUD employees were 129.20 bigger than the average of non-BLUD employee were 124.26. Job satisfaction of employees in Puskesmas BLUD was higher than non-BLUD employees.

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