scholarly journals Pain and Functional Outcome with Single dose 25% Dextrose Intra-Articular Injection in Patients with Primary Osteoarthritis of the Knee

2021 ◽  
Vol 29 (2) ◽  
pp. 138-144
Author(s):  
Ziaur Rahman Chowdhury ◽  
Abul Khair Mohammad Salek ◽  
Moshiur Rahman Khasru ◽  
Farzana Khan Shoma ◽  
SM Mazharul Islam ◽  
...  
Keyword(s):  
Single Dose ◽  
Physical Function ◽  
Statistical Difference ◽  
Functional Improvement ◽  
P Value ◽  
Function Score ◽  
Significant Statistical Difference ◽  
Vas Score ◽  
Initial Stage ◽  
Physical Function Score

Introduction: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide and is associated with significant pain and disability. The introduction of 25% Dextrose injection has been viewed as an advance in the management of OA knee. Methods: A prospective, randomized clinical trial was conducted with 84 cases in the Physical Medicine and Rehabilitation (PMR) department of BSMMU. Group A, 42 patients received single dose 25% Dextrose injection intra articular 8ml, exercise and ADL; Group B, 42 patients received exercise and ADL. Outcomes were measured by OA specific translated and validated Bengali instrument- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and visual analogue scale (VAS 0-10). They were followed up for 6 months. Result: At the initial stage and in week 4, there was no statistical difference between two groups regarding VAS score (as p value was >0.05). But in week 12 and 24, there was highly significant statistical difference regarding VAS score between two groups as the p value was <0.001. Again at the initial stage and week 4, there was no statistical difference between two groups regarding stiffness and physical function score. But in week 12 and 24, there was significant statistical difference regarding stiffness and physical function score between two groups as the p value was less than 0.05. Conclusion: Intra-articular injection of 25% dextrose administered to patients with OA knee has significant effects in pain reduction and functional improvement. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 138-144

scholarly journals Patient Outcomes Differences Following Ankle Fracture Fixation with or without Ankle Arthroscopy

2020 ◽  
Vol 5 (2) ◽  
pp. 2473011420S0001
Author(s):  
Kenneth S. Smith ◽  
Katherine D. Drexelius ◽  
Shanthan C. Challa ◽  
Daniel K. Moon ◽  
Joshua A. Metzl ◽  
...  
Keyword(s):  
Physical Function ◽  
Ankle Fracture ◽  
Patient Reported Outcomes ◽  
Chart Review ◽  
Ankle Arthroscopy ◽  
P Value ◽  
Function Score ◽  
Patient Reported ◽  
Physical Function Score

Category: Arthroscopy; Ankle; Trauma Introduction/Purpose: Ankle fractures are one of the most common types of fractures, yet there is currently no consensus about how best to treat these patients. The treatment approach typically includes open reduction-internal fixation (ORIF), but not all patients have a good clinical outcome. Intra-articular injuries have been suggested as one potential cause of these sub-optimal outcomes. Use of arthroscopy at the time of surgery is useful in identifying intra-articular lesions in acute ankle fractures, however, there is no evidence that arthroscopic intervention changes the patient’s outcome. Ankle arthroscopy increases the duration and potential complications of anesthesia administration and also increases cost. Our study assesses the clinical impact of arthroscopy accompanying an ankle fracture ORIF, which is essential to promote positive outcomes, while decreasing unnecessary complications and costs. Methods: This is a retrospective chart review. We queried all patients that underwent operative fixation of a bimalleolar or trimalleolar ankle fracture at our institution from January 1, 2014 through November 1, 2018. From this list, we excluded patients less than 18 years old and patients that had concomitant injuries to other body parts that required surgery. In addition, we only included Weber B and Weber C fibula fracture to homogenize the data. We then performed a chart review to extract all demographic data, fracture pattern, surgical procedures performed, tourniquet times, any revision surgeries, arthroscopic findings and any interventions performed due to the arthroscopic portion of the procedure. We then conducted a phone and email survey utilizing the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Short Form and the two question Patient Acceptable Symptom State (PASS). Results: Our study included 213 total patients (142 traditional ORIF, 71 ORIF plus arthroscopy) with an average age of 40 (standard deviation 14.2). The average follow up was 32.4 (13.1) months with a survey follow up rate of 50.7%. The demographic information between the two cohorts was statistically similar. The average tourniquet time for the arthroscopy cohort is 10 minutes longer (89 minutes versus 79 minutes). During the arthroscopy, there was a 28.2% rate of full thickness osteochondral lesions, 33.8% rate of loose bodies, and a 49.2% rate of small cartilage injury not requiring intervention. The mean PROMIS physical function score amongst Weber B fibula fractures was 45.8 and 42.3 in the arthroscopy and non-arthroscopy groups respectively (P value 0.012). In addition, the patient satisfaction rate in Weber B fibula fractures was higher in those patients that underwent arthroscopy as compared to ORIF alone (93.1% versus 75.5%, P value of 0.05). Patients that suffered a tibiotalar joint dislocation at the time of the ankle fracture had a significantly higher PROMIS physical function score (46.6 versus 40.2, P value 0.005) when their surgery included arthroscopy. Conclusion: Ankle arthroscopy at the time of ORIF led to higher mean patient reported outcomes for every tested metric but this reached statistical significance only when looking at the Weber B fibula fractures and ankle dislocations. There was no increase in complication rate and the arthroscopy took only 10 minutes longer on average. [Table: see text]

PROMIS Physical Function Score Strongly Correlates With Legacy Outcome Measures in Minimally Invasive Lumbar Microdiscectomy

Spine ◽  
2019 ◽  
Vol 44 (6) ◽  
pp. 442-446 ◽  
Author(s):  
Benjamin Khechen ◽  
Brittany E. Haws ◽  
Dil V. Patel ◽  
Mundeep S. Bawa ◽  
Islam M. Elboghdady ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Physical Function ◽  
Outcome Measures ◽  
Function Score ◽  
Lumbar Microdiscectomy ◽  
Physical Function Score

scholarly journals How to predict return to work after lumbar discectomy: answers from the NeuroPoint-SD registry

2016 ◽  
Vol 25 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Khoi D. Than ◽  
Jill N. Curran ◽  
Daniel K. Resnick ◽  
Christopher I. Shaffrey ◽  
Zoher Ghogawala ◽  
...  
Keyword(s):  
Return To Work ◽  
Physical Function ◽  
Smoking Status ◽  
Lumbar Discectomy ◽  
Work Status ◽  
Function Score ◽  
Younger Age ◽  
Sf 36 ◽  
Physical Function Score ◽  
Working Status

OBJECTIVE To date, the factors that predict whether a patient returns to work after lumbar discectomy are poorly understood. Information on postoperative work status is important in analyzing the cost-effectiveness of the procedure. METHODS An observational prospective cohort study was completed at 13 academic and community sites (NeuroPoint–Spinal Disorders [NeuroPoint-SD] registry). Patients undergoing single-level lumbar discectomy were included. Variables assessed included age, sex, body mass index (BMI), SF-36 physical function score, Oswestry Disability Index (ODI) score, presence of diabetes, smoking status, systemic illness, workers' compensation status, and preoperative work status. The primary outcome was working status within 3 months after surgery. Stepwise logistic regression analysis was performed to determine which factors were predictive of return to work at 3 months following discectomy. RESULTS There were 127 patients (of 148 total) with data collected 3 months postoperatively. The patients' average age at the time of surgery was 46 ± 1 years, and 66.9% of patients were working 3 months postoperatively. Statistical analyses demonstrated that the patients more likely to return to work were those of younger age (44.5 years vs 50.5 years, p = 0.008), males (55.3% vs 28.6%, p = 0.005), those with higher preoperative SF-36 physical function scores (44.0 vs 30.3, p = 0.002), those with lower preoperative ODI scores (43.8 vs 52.6, p = 0.01), nonsmokers (83.5% vs 66.7%, p = 0.03), and those who were working preoperatively (91.8% vs 26.2%, p < 0.0001). When controlling for patients who were working preoperatively (105 patients), only age was a statistically significant predictor of postoperative return to work (44.1 years vs 51.1 years, p = 0.049). CONCLUSIONS In this cohort of lumbar discectomy patients, preoperative working status was the strongest predictor of postoperative working status 3 months after surgery. Younger age was also a predictor. Factors not influencing return to work in the logistic regression analysis included sex, BMI, SF-36 physical function score, ODI score, presence of diabetes, smoking status, and systemic illness. Clinical trial registration no.: 01220921 (clinicaltrials.gov)

scholarly journals Determinants of Function After Total Knee Arthroplasty

2003 ◽  
Vol 83 (8) ◽  
pp. 696-706 ◽  
Author(s):  
C Allyson Jones ◽  
Donald C Voaklander ◽  
Maria E Suarez-Almazor
Keyword(s):  
Functional Status ◽  
Physical Function ◽  
Short Form ◽  
Study Data ◽  
Walking Distance ◽  
Comorbid Conditions ◽  
Function Score ◽  
Sf 36 ◽  
Physical Function Score ◽  
Total Knee

Abstract Background and Purpose. Decreasing hospital stays for patients with total knee arthroplasties (TKAs) have a direct effect on rehabilitation. The identification of modifiable determinants of postsurgical functional status would help physical therapists plan for discharge from hospitals. The purpose of this study was to identify preoperative determinants of functional status after a TKA. Participants. Using a community-based, prospective cohort study, data were collected from 276 patients who received a primary TKA in a Canadian health care region. Data were collected in the month before surgery and 6 months after surgery. Methods. Function was measured using the function subscale of a disease-specific measure—the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index—and a generic health status measure—the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Independent variables examined included demographic variables (eg, age, sex), medical variables (eg, diagnosis, number of comorbid conditions, ambulatory status), surgical variables (eg, type of implant, number of complications), and knee range of motion. Results. At 6 months after surgery, the average WOMAC physical function score was 70.5 (SD=18.2) and the average SF-36 physical function score was 44.8 (SD=25.3). Using multiple regression analyses, baseline function, walking device, walking distance, and comorbid conditions predicted 6-month function (WOMAC: R2=.20; SF-36 physical function: R2=.27). Discussion and Conclusion. Patients who have lower preoperative function may require more intensive physical therapy intervention because they are less likely to achieve functional outcomes similar to those of patients who have less preoperative dysfunction.

scholarly journals A prospective observational study involving three fixed infusion regimens of phenylephrine for hemodynamic support during spinal anaesthesia for caesarian delivery

2019 ◽  
Vol 8 (6) ◽  
pp. 2293
Author(s):  
Aymen Masood ◽  
Ajaiz Rasool ◽  
Aabid Hussain Mir ◽  
Waqurl Neesa ◽  
Ayaz Farooqi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Placebo Group ◽  
Side Effects ◽  
Spinal Anaesthesia ◽  
Statistical Difference ◽  
P Value ◽  
Significant Statistical Difference ◽  
Umbilical Blood ◽  
Phenylephrine Infusion

Background: Spinal anaesthesia used in caesarian section is associated with hypotension which can have maternal and fetal side effects. To determine the efficacy and ideal dosing of Phenylephrine in attenuating the hypotensive episodes during caesarean section under spinal anaesthesia.Methods: 100 patients were allocated to four groups, placebo group (PE 0) and 3 fixed phenylephrine infusion regimens, phenylephrine 25 μg/min-1 (PE 25), phenylephrine 50 μg/min-1 (PE 50), and phenylephrine 75 μg/min-1 (PE 75). Blood pressure, heart rate were noted among primary variables and fetal parameters like umbilical blood pH and lactate were recorded as secondary parameters.Results: There was a significant reduction in heart rate with increasing the infusion dosage of phenylephrine, with a mean of 86.8 beats/min at the end of procedure in placebo group and 69.4 beats/min in 75 μg group (p value <0.001). There was significant statistical difference among systolic blood pressure in the four groups after 7 min of the procedure and p-value of <0.05 with better attenuation of hypotension in infusion groups as compared to placebo. Similarly there was significant statistical difference in diastolic blood pressure among the four groups after 8 min of the procedure with p values <0.05.Conclusions: Prophylactic phenylephrine infusions reduced the incidence and severity of maternal pre-delivery hypotension. Among the fixed rate phenylephrine infusion regimens investigated, infusion rates of 50 μg/min-1 were associated with greater maternal hemodynamic stability compared with 25 and 75 μg/min-1, with minimal side effects and intervention.

Galectin-1 Is Overexpressed in Myeloid Cells and There Is a Significant Different Overexpression in Cells Carrying the BCR-ABL Chimeric Gene.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4383-4383
Author(s):  
Enrica Lerma
Keyword(s):  
Gene Expression ◽  
T Cell ◽  
Cancer Progression ◽  
Time Course ◽  
Statistical Difference ◽  
Myeloid Cells ◽  
T Test ◽  
Chimeric Gene ◽  
P Value ◽  
Significant Statistical Difference

Abstract The galectins are a family of lectins, beta-galactoside sugar chain binding proteins, that have been identified as mediator of cell adhesion, cell growth regulators, and as triggers or inhibitors of apoptosis. Their expression pattern is deregulated during inflammation and in breast, colon, prostate, and thyroid cancers and their overexpression correlates to metastatic potential. Galectin-1 is a pleiotropic dimeric protein participating in cancer progression. The gene encoding galectin-1 is located in an 11-kb region on chromosome 22q13.1. Induction of apoptosis in activated T lymphocytes is a well-known function of this galectin. The association of accumulation of galectin-1 in the stroma of malignant tissue and aggressiveness of the tumor suggested a role for this lectin in the acquisition of the invasive phenotype and may act as an immunological shield by inducing activated T-cell apoptosis. To be susceptible to galectin-1 induced apoptosis, the T cell must express specific glycoprotein receptors, such as CD7, that bear the specific oligosaccharides recognized by galectin-1. The sensitivity to galectin-1 is associated with repression of the endogenous galectin-1 gene whereas non-sensitive cells express high levels of galectin-1. The current analysis has been performed in myeloid cells negative or positive for BCR-ABL, a chimeric gene derived by the t(9;22), that is present in chronic myeloid leukemia patients. The BCR-ABL gene, the expression of which was governed by the tetracycline inducible promoter, has been introduced by transfection in a myeloid cell line. Total RNA for microarray analysis, in presence or absence of BCR-ABL gene expression, has been isolated. The comparison involved ~5300 transcripts. A comprehensive galectin fingerprinting in these cells by microarray gene expression analysis to define the pattern in BCR-ABL positive and negative cells has been done. The results showed in the table clearly demonstrated that myeloid cells express more mRNA species for galectin-1 than for galectin-9 while none of the other lectins belonging to this family are expressed in either BCR-ABL positive or negative cells. A significant statistical difference has been found between the levels of expression of galectin-1 compared to galectin-9. A higher significant statistical difference has been found in the levels of galectin-1 overexpression in BCR-ABL positive cells. To better understand the preliminary data, a time course after the addition of tetracycline to the 32Dtetp210Bcr-Abl cells has been carried out. This last experiment demonstrated that galectin expression levels decrease over 18 hours and the expression of galectin-9 is already absent after 6 hours from the addition of tetracycline to the culture medium while the expression of galectin-1 is still present after 12 hours but at a level comparable to normal cells. These results might suggest a role for the modulation of galectin-1 activity as a new strategy for molecular treatment of BCR-ABL positive leukemia. Galectins gene expression profile in myeloid cells BCR-ABL negative BCR-ABL positive raw t-test p-value flags raw t-test p-value flags Gal9 776 0,238 P 520,2 0,347 P Gal7 15,8 0,874 A 13,2 0,849 A Gal6 39,6 0,928 A 61,9 0,962 A Gal8 71,2 1 A 51,2 0,937 A Gal3 6 0,853 A 4,6 0,83 A Gal1 5.652,80 0,0315 P 12.087,30 0,0142 P

scholarly journals Comparative Study between Modified Transverse and Hayman Suture Regarding the Efficacy and Purperium Complications in Thi-Qar

2021 ◽  
pp. 22-33
Author(s):  
Aseel Mosa Jabber
Keyword(s):  
Statistical Difference ◽  
Post Partum ◽  
High Rate ◽  
P Value ◽  
Post Partum Hemorrhage ◽  
Significant Statistical Difference ◽  
Surgeon Experience ◽  
Compression Suture ◽  
Uncontrolled Hemorrhage

Background: Main causes of death post-partum is the uncontrolled hemorrhage, that managed by different modalities, whereuterine compression suture had different efficacies as a main interventional tools of sever postpartum hemorrhage. Aim: comparing different sutures types (modified transverse and Hayman suture) regarding their efficacy through its impact and in determining the final outcome and complications of post-partum hemorrhage. Materials and methods: A prospective comparative analytical study including 122 females , who underwent delivery between march 2017and December 2019, all of them followed for , 1 week, 6,weeks 6 months. Were the samples collected from Bent-Al-Huda teaching hospital and Al-Rehman private hospital-Thi-Qar, 2 groups of study; 1st one (52) underwent modified B-lynch suturing (Hyman suturing) while the 2nd group(70) underwent transverse sutures of modified Ouahba suture, written consent had taken from all patients, SPSS version 24 used for analysis. Results: Among 122 delivered women suffer from primary post-partum hemorrhage, 52 (42.63%) were sutured by Hayman suture, and 70 (57.37%)were sutured by transverse suturing,There was significant statistical difference between the types of intervention and blood loss P value <0.05. There was significant statistical difference between the types of intervention and complication development (p value=0.0001). There was no significant independent predictors or determinant for the complication development except the type of intervention. Only follow-up period and complication were truly to be correlated with type of intervention, the other variable were confounders Conclusion: Even though the hemostasis had been achieved in both maneuver with excellent success rate, the transvers suture carrying high rate of persistent pain but the Hayman suture carry higher rate of serious complication such hysterectomy and intestinal obstruction. several factors determine the choosing of the suture type such as site, severity and cause of bleeding and the surgeon experience.

scholarly journals ASSESSMENT OF FLOW MEDIATED DILATATION OF BRACHIAL ARTERY BY ANGIODEFENDER DEVICE AS COMPARED TO BRACHIAL ARTERY ULTRASOUND IMAGING.

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Mukesh Kumar Sharma ◽  
Chandra Bhanu Chandan ◽  
Abhishek Shukla ◽  
Deepak Ameta ◽  
Pradeep Kurmi
Keyword(s):  
Correlation Coefficient ◽  
Ultrasound Imaging ◽  
Brachial Artery ◽  
Statistical Difference ◽  
P Value ◽  
Positive Correlation ◽  
Significant Statistical Difference ◽  
Flow Mediated Dilatation ◽  
The Mean ◽  
Flow Mediated Vasodilation

Aims & Objectives: To demonstrate, Angiodefender device, is comparable to “Brachial artery ultrasound imaging” (BAUI) in their abilities to quantify percentage flow mediated vasodilation (FMD) of the brachial artery. Methods: Study was conducted on 100 patients, flow mediated vasodilation was measured by BAUI as well as by the Angiodefender device and the results were compared. Results: The mean %FMD measured by the BAUI was found to be 7.46 ±  4.21 whereas mean %FMD measured by the Angiodefender was 8.24 ±  2.46, (p value 0.113). Positive correlation was found between both the tests with correlation coefficient of 0.65, p value < 0.0001 which is highly significant. Conclusion: Results obtained by both the methods were comparable there was no significant statistical difference. Positive correlation was highly significant between both the tests with correlation coefficient of 0.65. Keywords: Brachial artery ultrasound imaging, Angiodefender, Flow mediated vasodilation

scholarly journals Outcomes Following Ankle Fracture Fixation With or Without Ankle Arthroscopy

2020 ◽  
Vol 5 (1) ◽  
pp. 247301142090404
Author(s):  
Kenneth S. Smith ◽  
Katherine Drexelius ◽  
Shanthan Challa ◽  
Daniel K. Moon ◽  
Joshua A. Metzl ◽  
...  
Keyword(s):  
Physical Function ◽  
Ankle Fracture ◽  
Ankle Arthroscopy ◽  
Complication Rates ◽  
Function Score ◽  
Anatomic Reduction ◽  
Patient Reported ◽  
Physical Function Score ◽  
Operative Fixation

Background: Ankle fractures are one of the most common orthopedic injuries, and although most patients have a satisfactory outcome following operative fixation, there are patients that have persistent pain despite anatomic reduction. Intra-articular injuries have been suggested as one potential cause of these suboptimal outcomes. Our study assesses the clinical impact of performing an ankle arthroscopy during ankle fracture open reduction and internal fixation (ORIF). Methods: This was a retrospective chart review of all patients who underwent operative fixation of a bimalleolar or trimalleolar ankle fracture at our institution from 2014 through 2018. We extracted all demographic data, fracture pattern, operative procedures performed, tourniquet times, arthroscopic findings and any arthroscopic interventions. We then conducted a phone and e-mail survey. Our study included 213 total patients (142 traditional ORIF, 71 ORIF plus arthroscopy) with an average age of 40 years. The average follow-up was 32.4 months with a survey follow-up rate of 50.7% (110/213). Results: The average tourniquet time for the arthroscopy cohort was 10 minutes longer (89 minutes vs 79 minutes). During the arthroscopy, there was a 28% (20/71) rate of full-thickness osteochondral lesions, 33% (24/71) rate of loose bodies, and a 49% (35/71) rate of partial-thickness cartilage injury. The mean Patient Reported Outcome Information System (PROMIS) physical function score among Weber B fibula fractures was 45.8 and 42.3 in the arthroscopy and nonarthroscopy groups, respectively ( P = .012). In addition, the patient satisfaction rate in Weber B fibula fractures was higher in those patients who underwent arthroscopy compared with ORIF alone (93% vs 75%, P = .05). Patients who had a tibiotalar joint dislocation at the time of the ankle fracture had a significantly higher PROMIS physical function score (46.6 vs 40.2, P = .005) when their surgery included arthroscopy. Conclusion: Ankle arthroscopy at the time of ORIF led to statistically significant improvements in patient-reported outcomes for Weber B fibula fractures and ankle dislocations. There was no increase in complication rates and the arthroscopy took 10 minutes longer on average. Level of Evidence: Level III, retrospective cohort study.

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