Effect of Platelet Rich Plasma Injection Effect on Knee Osteoarthritis in Elderly: Single Dose versus Double Dose Randomized Clinical Trial

Objective: This study aims to evaluate the effect of platelet rich plasma (PRP) and compare between single and double dose regimens among patients diagnosed with osteoarthritis admitted to the orthopedic department of Al Qassimi Hospital Sharjah, United Arab Emirates. Methods: 200 patients were allocated into two groups in this randomized clinical trial. Patients were chosen to participate in this study after an informed consent. The trial took place at the Al Qassimi Hospital Sharjah, United Arab Emirates from July 2019 to July 2020. All patients had knee osteoarthritis, half of them received single dose PRP (group A) and the other half received double dose PRP (group B). All patients were adults and older than 18 years of age. Patients were followed up using Western Ontario and McMaster Universities Arthritis Index (WOMAC). The follow up was done prior to the administration of PRP, at 1 month, 3 month and 6 months after administration. Data was analyzed using SPSS program. Ethical approval was gained from the hospital as well as from patients. Results: The mean age of the patients was 48.5 ± 8.3 years. The study included 200 participants, among them, 60 were females and 140 were males. There was improvements in all parameters of WOMAC at 3 and 4 weeks following administration of PRP. The effect of PRP continued until 6 months of follow up with no differences between the two groups. Group A baseline WOMAC parameters (pain, stiffness, physical function and total score) mean score were 15.8, 6.24, 43.01 and 65.22 respectively. At the follow up, the mean scores were 4.73, 1.78, 13.88 and 19.56 respectively. This shows significant improvement. On the other hand, group B baseline mean scores were 16.31, 6.81, 40.89 and 64.77 respectively. At the final follow up of group B, the parameters mean scores were 4.40, 1.11, 13.64 and 20.27 respectively. Both groups were compared to each other and no benefit for the double dose over the single dose (P value, 0.66). Conclusion: Previous results suggests improvement in functionality in both groups of the trial. There was pain and stiffness relief among all patients. It is concluded that double dose has no additional effect to the single dose regimen.

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COMPARATIVE EVALUATION OF THE EFFICACY OF 4% MANGOSTEEN GEL AND 1% CHLORHEXIDINE DIGLUCONATE GEL IN MANAGEMENT OF PATIENTS WITH CHRONIC GINGIVITIS: A RANDOMIZED CLINICAL TRIAL

International Journal of Research in Ayurveda and Pharmacy ◽

10.7897/2277-4343.1206161 ◽

2022 ◽

Vol 12 (6) ◽

pp. 6-11

Author(s):

Vinayaka A.M. ◽

Gayathri G.V. ◽

Triveni M.G.

Keyword(s):

Clinical Trial ◽

Plaque Index ◽

Age Group ◽

Chlorhexidine Digluconate ◽

Gingival Index ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B

To clinically evaluate & compare the efficacy of 4% Mangosteen Gel and 1% chlorhexidine digluconate gel in managing patients with chronic gingivitis. Materials and Methods: A total of 50 patients with an age group of 20-45 years diagnosed with generalized plaque-induced gingivitis were selected for this clinical trial once attaining their informed consent. A thorough case history was chronicled comprising plaque index (P.I.), gingival index (G.I.) and Sulcus bleeding index (SBI) at baseline; then full-mouth scaling and polishing (SAP) was performed by a solitary attuned examiner. Patients were then randomly assigned into two groups using a computer-generated random numbering sequence system. Patients in group A received 4% Mangosteen Gel, and group B received 1% chlorhexidine digluconate gel for home application. The post-treatment follow-up examination for P.I., G.I. and SBI changes were assessed after 14 days and 21 days and compared with baseline data. Results: In both the groups, the mean plaque index, gingival index and sulcus bleeding index scores were significantly decreased after the 14th and 21st day compared to baseline scores. There was no significant difference between the groups, but only in group B, there was a substantial difference in SBI scores observed on day 21. Conclusion: 4% Mangosteen Gel and 1% chlorhexidine digluconate gel were clinically effective when used as an adjunct to SAP in managing patients with gingivitis. Hence, 4% Mangosteen Gel can be considered an alternative to 1% chlorhexidine digluconate gel without any side effects in managing generalized plaque-induced gingivitis.

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Single Dose or Divided Dose of Polyethylene Glycol in Treatment of Pediatric Functional Constipation: A Randomized Clinical Trial

10.21203/rs.3.rs-977795/v1 ◽

2021 ◽

Author(s):

Heidar Safarpour ◽

Mohammad Hadi Imanieh ◽

naser honar ◽

sajad hekmati ◽

Naeimehossadat Asmarian

Keyword(s):

Clinical Trial ◽

Single Dose ◽

Polyethylene Glycol ◽

Randomized Clinical Trial ◽

Divided Dose ◽

Functional Constipation ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B

Abstract BackgroundThis study aimed to compare different regimens of Polyethylene Glycol (PEG, single dose vs. divided dose) in the treatment of functional constipation among children aged 4-15 years.Materials and MethodsThis double-blind randomized clinical trial was conducted on the children (4-15 years old) with functional constipation who were visited in an outpatient pediatric clinic affiliated to Shiraz University of Medical Sciences between February and July 2021. Among the120 eligible patients, 80 ones who met the inclusion criteria were recruited. The patients were divided into two parallel groups; the children who received single-dose PEG (group A) and those who received PEG in divided doses (group B). The study was performed during 12 weeks and follow-up visits were scheduled at 1, 3, 6, and 12 weeks after enrollment. The outcomes were measured using the Bristol Stool Form Scale (BSFS).ResultsThe study was performed on 78 cases including 45 boys (57.7%) and 33 girls (42.3%) with the mean age of 5.52±1.79 years. After 12 weeks, a significant difference was observed between groups A and B regarding the mean of BSFS (4.94±0.52 vs. 4.50±0.88, p=0.008). However, no significant difference was observed between the two groups regarding the number of defecation times during the study. The detected complications included mild abdominal pain in eight children in group A (5.3%), fecal incontinency in six children in group B (3.8%), and painful defecation in six children in group B (3.8%).ConclusionThis study confirmed that the administration of the single dose (0.4 g/kg) of PEG early in the morning was more effective, well tolerated, and accompanied by fewer complications compared to the divided dose.

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Long-Term Prosthetic Aftercare of Two- vs. Four-Ball Attachment Implant-Supported Mandibular Overdentures

Applied Sciences ◽

10.3390/app11198974 ◽

2021 ◽

Vol 11 (19) ◽

pp. 8974

Author(s):

Ofir Rosner ◽

Eran Zenziper ◽

Hadas Heller ◽

Joseph Nissan ◽

Guy Melamed ◽

...

Keyword(s):

Pressure Sore ◽

The Other ◽

Mechanical Wear ◽

Group A ◽

The Mean ◽

Number Of Visits ◽

Edentulous Patients ◽

Group B

Little is reported about the prosthetic aftercare of implant-supported mandibular overdentures regarding the number of implants placed. The purpose of this study was to evaluate the prosthetic aftercare among edentulous patients restored with two vs. four mandibular implant-retained overdentures (MISOD). Forty-six consecutive edentulous patients treated by a new MISOD were retrospectively studied. Twenty-five patients had two-ball attachment MISOD (Group A), and 21 had four-ball attachment MISOD (Group B). The total amount of aftercare visits was recorded, as well as the type of treatments required (pressure sore spots relief, attachment liner replacement due to loss of retention, and metal ball attachment replacement due to wear). The mean follow-up duration was 93 ± 57 months (range 9–246 months). None of the implants was lost. There were significantly more visits for pressure sore spots relief in Group A vs. Group B (6.2 ± 2 in group A and 4.09 ± 1.54 in group B, p < 0.0001). Differences in the other two tested parameters (number of visits for liner replacement (2.3 ± 1.84 in group A and 2.4 ± 1.63 in group B) and attachment replacement (2.36 ± 1.85 in group A vs. 2.48 ± 1.63 in group B) yielded a non-significant outcome (p = 0.814 for liner replacement and p = 1.000 for attachment replacement). The use of four-ball attachments in MISOD was more beneficial than two-ball attachments with regards to the aftercare of pressure sore spots. The number of implants did not influence the mechanical wear.

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Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial

Cartilage ◽

10.1177/1947603518805230 ◽

2018 ◽

Vol 12 (1) ◽

pp. 51-61 ◽

Cited By ~ 4

Author(s):

Michael-Alexander Malahias ◽

Leonidas Roumeliotis ◽

Vasileios S. Nikolaou ◽

Efstathios Chronopoulos ◽

Ioannis Sourlas ◽

...

Keyword(s):

Clinical Trial ◽

Platelet Rich Plasma ◽

Symptomatic Relief ◽

Controlled Clinical Trial ◽

Dash Score ◽

Ultrasound Guided ◽

Radiographic Osteoarthritis ◽

Group A ◽

Group B

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.

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A Single Blind Randomised Clinical Study Of Outcome Of Local Injection Of Platelet Rich Plasma Vs Methyl Prednisolone Acetate In Management Of Lateral Epicondylitis

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2799 ◽

2020 ◽

Vol 11 (3) ◽

pp. 4949-4955

Author(s):

Kumar Shubham ◽

Kulkarni P N ◽

Kshirsagar A Y

Keyword(s):

Diabetes Mellitus ◽

Tennis Elbow ◽

Platelet Rich Plasma ◽

Lateral Epicondylitis ◽

Prednisolone Acetate ◽

Methyl Prednisolone ◽

Group A ◽

The Mean ◽

Group B

The most well-known abuse condition is identified with inordinate wrist expansion and generally alluded to as tennis elbow, however it is in reality increasingly regular in non-tennis players. METHODS- A prospective, comparative study was conducted with 50 patients after Ethical approval. Quantitative data is presented with Mean and Standard deviation. Examination among the investigation bunches is finished with the assistance of unpaired t test according to consequences of ordinariness test. Majority of the patients (80%) in Group A and (76%) in Group B were from the age group of 31-40 years. The mean age in Group A was 36.4±5.44 years and in Group B were 36.8±5.87 years. Majority of the patients in both groups were female. There was dominance of right side (68% and 72%) as compared to left side (32% and 28%) in both groups. The mean duration of symptom in Group A was 2.24±0.72 months as compared to 1.92±0.81 months in Group B. 20% and 12% patients in Group A had Diabetes Mellitus and Hypertension respectively whereas 16% and 24% patients in Group B had Diabetes Mellitus and Hypertension respectively. The mean baseline VAS score in Group A was 7.6±0.51 and Group B was 7.7±0.38 which decreased to 5.1±0.81. The mean baseline MGS score in Group A was 74.6±10.32 which increased to 91.6±4.08 in 2 weeks. And in Group B was 74.5±10.31 which increased to 99.8±2.646 in 2 weeks. The MGS score improved more in Group B after 2 weeks (p=0.005), 4 weeks (p=0.002) and 6 weeks (p=0.022). However, toward the finish of 3 months, a half year and a year, improvement in MGS Score was fundamentally better in Group A as compared to Group B.Along these lines, we presumed that PRP as an unrivaled treatment choice in instances of tennis elbow. In any case, keeping in see the constrained time of follow up in the current examination we prescribe longer follow up studies to additionally unite our discoveries and set up the long haul viability of PRP in instances of sidelong epicondylitis.

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Modified Percutaneous Achilles Tendon Lengthening by Triple Hemisection for Achilles Tendon Contracture

BioMed Research International ◽

10.1155/2019/1491796 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Yangjing Lin ◽

Jin Cao ◽

Changgui Zhang ◽

Liu Yang ◽

Xiaojun Duan

Keyword(s):

Achilles Tendon ◽

Recurrence Rate ◽

Operative Time ◽

Achilles Tendon Rupture ◽

Tendon Lengthening ◽

Group A ◽

Achilles Tendon Lengthening ◽

The Mean ◽

Group B

Background. Both percutaneous Achilles tendon lengthening by triple hemisection and the traditional open Z-lengthening are effective methods for Achilles tendon contracture. This study aims to evaluate the efficacy and safety of this new therapeutic method, which is based on the percutaneous sliding technique with three hemi-cuts in the tendon, as compared with the traditional open Z-lengthening. Methods. Retrospective analysis of the Achilles tendon contracture cases in our hospital between January 2010 and September 2016 was conducted. Twenty-five cases received percutaneous Achilles tendon lengthening (group A), and 30 patients who underwent open Z-lengthening during the same period were in the control group (group B). Operative time and hospital stay were statistically analyzed. Incision complication, equinus recurrence rate and Achilles tendon rupture morbidity were recorded. The function was assessed by American Orthopaedic Foot & Ankle Society (AOFAS) score. All cases in group A received Magnetic Resonance Imaging (MRI) of ankle preoperatively and in the follow-ups. Results. The mean follow-up period was 42.04 months in group A and 61.7 months in group B. The entire operative time and the mean hospitalization days were lower in group A than in group B. No incision and infection complication occurred in group A. The infection rate in group B was 3.3%. Equinus recurrence rate was 4% in group A and the equinus recurrence rate in group B was 21.4%. In group A, the mean AOFAS score increased from 64 ± 10.16 points preoperatively to 96.08 ± 3.17 at final follow-up, while the score in group B increased from 63.48 ± 6.2 points to 85.4 ± 10.3. MRI showed continuity of the Achilles tendon and homogeneous signal in group A. Conclusion. Modified surgery can significantly reduce the risk of Achilles tendon rupture, provide better balance in soft tissue strength between ankle dorsiflexion and ankle plantarflexion, helping to avoid recurrence of the deformity.

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Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000231 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0002

Author(s):

Hwa Jun Kang ◽

Hong-Geun Jung ◽

Jong-Soo Lee ◽

Sungwook Kim ◽

Mao Yuan Sun

Keyword(s):

Hallux Valgus ◽

Screw Fixation ◽

Fixation Method ◽

Kirschner Wires ◽

Significant Difference ◽

Group A ◽

The Mean ◽

Group B ◽

Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

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Influence of Ulnar Bow Sign on Surgical Treatment of Missed Bado Type I Monteggia Fracture in Children

10.21203/rs.3.rs-101496/v1 ◽

2020 ◽

Author(s):

Shijie Liao ◽

Tiantian Wang ◽

Qian Huang ◽

Yun Liu ◽

Rongbin Lu ◽

...

Keyword(s):

Surgical Treatment ◽

Radial Head ◽

Monteggia Fracture ◽

Type I ◽

Ulnar Osteotomy ◽

Group A ◽

The Mean ◽

Group B ◽

Stable Reduction

Abstract PurposeThe present study aimed to explore the influence of ulnar bow on the surgical treatment of Bado type I missed Monteggia fracture in children.MethodsThis study is a retrospective review of 24 patients between November 2010 and March 2019. All patients were treated with open reduction of the radial head and ulnar opening wedge osteotomy without annular ligament reconstruction. The mean interval between injury onset and surgery was five months (range: 2–12 months). The average age of participants at the time of surgery was 6.4 years (range: 3–10 years). We evaluated the maximum ulnar bow (MUB) and MUB position (P-MUB) via radiography. The patients were divided into middle group (group A: 14 cases, MUB located at 40% to 60% of the distal ulna) and distal group (group B: 10 cases, MUB located at 20% to 40% from the distal end of the ulna) based on P-MUB. The mean period of follow-up was 37 months (range: 6–102 months).ResultsAt the last follow-up, all the children showed stable reduction of the radial head, and the flexion function of elbow joint improved after operation (P<0.05). Group A presented a larger the ratio of maximum ulnar bow(R-MUB) and angle of ulnar osteotomy(OA) than group B (P<0.05). There was statistically significant difference between group A and Group B in the P-MUB (P < 0.05). The osteotomy angle was positively correlated with the R-MUB (R2 =0.497,P=0.013), The osteotomy angle was positively correlated with the P-MUB (R2=0.731,P=0.000), The R-MUB is proportional to the P-MUB (R2 =0.597,P=0.002). The regression equation of P-MUB and osteotomy angle: Angle=7.064+33.227* P-MUB (R2=0.459, P =0.000).ConclusionWhen the ulnar bow is positioned at the middle ulna, a stable reduction of radial head need to be achieved through a larger angle in the ulnar osteotomy. If the position of maximum ulnar bow (P-MUB) is closer to the middle of the ulna or the ratio of maximum ulnar bow (R-MUB) is larger, the osteotomy angle is larger.

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Banded Sleeve Gastrectomy Improves Weight Loss Compared to Nonbanded Sleeve: Midterm Results from a Prospective Randomized Study

Journal of Obesity ◽

10.1155/2020/9792518 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Paolo Gentileschi ◽

Emanuela Bianciardi ◽

Leandro Siragusa ◽

Valeria Tognoni ◽

Domenico Benavoli ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Weight Regain ◽

Randomized Study ◽

Banded Sleeve Gastrectomy ◽

Group A ◽

The Mean ◽

Group B ◽

To Receive

Background. Weight regain after laparoscopic sleeve gastrectomy (LSG) is nowadays a growing concern. Sleeve dilatation and loss of food restriction is considered the main mechanism. The placement of a silicon ring around the gastric tube seems to give benefits in the short term. We report the results of a randomized study comparing LSG and laparoscopic banded sleeve gastrectomy (LBSG) over a 4-year follow-up. Objectives. To evaluate the efficacy of banded sleeve gastrectomy compared to standard sleeve in the midterm. Methods. Between 01/2014 and 01/2015, we randomly assigned 50 patients to receive one of the two procedures. Patients’ management was exactly the same, apart from the band placement. We analyzed differences in weight loss, operative time, complication rate, and mortality, with a median follow-up of 4 years. Results. Twenty five patients were assigned to receive LSG (Group A) and 25 LBSG (Group B). The mean preoperative BMI (body mass index) was 47.3 ± 6.58 kg/m2 and 45.95 ± 5.85 kg/m2, respectively. There was no significant difference in the operative time. No intraoperative or postoperative complications occurred. At 12-month follow-up, the mean BMI was 29.72 ± 4.40 kg/m2 in Group A and 27.42 ± 4.47 kg/m2 in Group B (p=0.186). After a median follow-up of 4 years, the mean BMI in Group B was significantly lower than Group A (24.10 ± 4.52 kg/m2 vs 28.80 ± 4.62 kg/m2; p=0.00199). Conclusions. LBSG is a safe procedure, with no impact on postoperative complications. The banded sleeve showed a significant greater weight loss in the midterm follow-up. Considering the issue of weight regain observed after LSG, the placement of a perigastric ring during the first procedure may be a strategy to improve the results. This trial is registered with NCT04228185.

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Which Surgical Method is More Effective in the Fifth Metatarsal Base Fracture?

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000242 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0002

Author(s):

Jun-Beom Kim ◽

Chi Ahn ◽

Byeong-Seop Park

Keyword(s):

Clinical Results ◽

Plate Group ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B ◽

Clinical And Radiological Results ◽

Mean Time ◽

Screw Group

Category: Trauma Introduction/Purpose: The aim of this study was to evaluate and compare the clinical and radiological results of internal fixation with headless cannulated screw and locking compression distal ulna hook plate for the fracture at the base of fifth metatarsal bone, Zone 1. Methods: From April 2012 to April 2015, thirty cases (29 patients) were evaluated retrospectively. The mean follow up periods was 13 months. There were divided two groups based on use of the screw (group A, n=15) or the plate (group B, n=15).We measured the displacement to diastasis of the fracture on the foot oblique radiographs taken pre- and post-operatively in each group, checked the time to bone union and the difference of the reduction distance in each group. Clinical results were evaluated using American Orthopedic Foot and Ankle Society (AOFAS) midfoot score at 12 months postoperative. Results: In group A, the mean time to union was 54.2±9.3 days, the mean displacement to diastasis improved to 0.3±0.4 mm postoperatively (p<0.001), and the mean reduction distance was 2.9±1.0 mm. In group B, the mean time to union was 41.5±7.0 days, the mean displacement to diastasis improved to 0.06±0.2 mm postoperatively (p<0.001), and the mean reduction distance was 4.1±1.6 mm. AOFAS score was verified 97.7±3.4 in group A and 98.2±3.2 in group B. The time to union was significantly different between groups A and B (p=0.01).There were no complications. Conclusion: We suggest that the plate is more effective method for the shorter union time in surgical treatment of fifth metatarsal base fractures.

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