Bahram Naderi Nabi; Abbas Sedighinejad; Mohsen Mardani-Kivi; Mohammad Haghighi; Zahra Atrkar Roushan; Samaneh Ghazanfar Tehran; Gelareh Biazar
Volume 20, Issue 3 , 2018, Pages 1-9
Abstract
Background: Knee osteoarthritis is one of the most prevalent and disabling diseases worldwide, which decreases patients’ qual- ity of life (QoL). However, pharmacological and non-pharmacological treatments, apart from complications, could not desirably control the disease. Objectives: The current ...
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Background: Knee osteoarthritis is one of the most prevalent and disabling diseases worldwide, which decreases patients’ qual- ity of life (QoL). However, pharmacological and non-pharmacological treatments, apart from complications, could not desirably control the disease. Objectives: The current study aimed at evaluating the effect of two methods of intra-articular injection of Platelet-Rich Plasma (PRP) and corticosteroid on pain control of knee osteoarthritis. Methods: A randomized clinical trial was performed on 67- patients with grades II-III of knee osteoarthritis (OA) referring to painclinic of a referral, university-affiliated hospital, Rasht, Iran, from April 2016 to June 2017. Patients were randomly divided into two groups: Triamcinolone (T) (n=34) and PRP (P) (n=33) by quadruple block. In the group T, 40 mg Triamcinolone and in the group P, PRP was injected intra-articularly, under ultrasound- guidance, once a month, for three consecutive months. Patients’ pain intensity was evaluated based on the Visual Analog Scale (VAS), and their outcome was determined based on the Knee injury and Osteoarthritis Outcome Score (KOOS) monthly for three consecutive months, as well as six months after the treatment. Results: There were no significant differences between the groups regarding demographic characteristics. VAS assessments indi- cated lower pain scores in the group P than group T; the difference between the groups was statistically significant two, three, and six months after the injections. In the group P, the mean initial VAS was 7.36 ± 0.92 compared with 7.12 ± 1.29 in the group T (P = 0.385). After six months, the scores dropped to 3.45 ± 0.86 and 4.81 ± 1.4, respectively (P = 0.0001). Examination of the KOOS param- eters showed a significant association between treatment outcomes in the group P than the group T. Therefore, the test showed asignificant difference between the groups regarding relief of pain, improvement of symptoms and activities of daily living (ADL) two, three, and six months after treatment. There was also a significant difference between the groups in terms of the quality of life (QoL) and doing sport activities three and six months after the treatment (P < 0.05). Based on the repeated measures analysis, a significant inter- and intra-group differences in the mean score of KOOS parameters was observed between the intervals (P = 0.0001). Conclusions: The current study results showed that three intra-articular injections of Triamcinolone and PRP could reduce pain and improve articular function in patients with grades II-III knee osteoarthritis. However, pain relief and improvement in the outcomes were more effective and more prolonged secondary to PRP injections than corticosteroids.
Abbas Sedighinejad; Vali Imantalab; Ali Mirmansouri; Ali Mohammadzadeh Jouryabi; Nassir Nassiri Sheikhani; Bahram Naderi Nabi; Mohammad Haghighi; Gelareh Biazar; Zahra Atrkarroushan
Volume 19, Issue 4 , April 2017, , Pages 1-10
Abstract
Background: In patients with coronary artery stenosis, coronary artery bypass graft surgery (CABG) is the most effective strategy to limit infarct size and improving outcomes. However, the rapid restoring of blood flow to the tissue can paradoxically induce cardiac damage. This phenomenon termed as myocardial ...
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Background: In patients with coronary artery stenosis, coronary artery bypass graft surgery (CABG) is the most effective strategy to limit infarct size and improving outcomes. However, the rapid restoring of blood flow to the tissue can paradoxically induce cardiac damage. This phenomenon termed as myocardial ischemic/reperfusion (I/R) injury which is exacerbated under cardiopulmonary bypass (CPB) and is the cause of poor clinical outcomes. Therefore, it is essential to search for novel strategies with further cardio protective effects.Objectives: In the current study, we investigated the effects of selenium (Se) administration on I/R injury in CABG patients.Methods: This randomized double-blind clinical trial was conducted in the department of cardiac surgery of a university hospital in North of Iran from May 2015 to September 2015. One hundred and ten patients undergoing an elective isolated CABG surgery were divided into two groups using randomized fixed quadripartite blocks. They received either intravenous Se before induction of anesthesia, or normal saline as placebo. Cardiac troponin I (CTnI) and creatine kinase-MB (CKMB) were measured as biomarkers at four measurement point times, before the intervention (T0), at 6, 12, 24 and 48 hours after the surgery (T1-T4).Results: Finally, data from 104 patients were analyzed, the Se (n = 53) and control (n = 51) groups. There was no significant difference between the two groups regarding the baseline characteristics. In both groups CPB caused a markedly increase in CKMB and CTnI plasma concentrations compared to the baseline (P = 0.0001). Based on CKMB, there was no significant difference between the two groups at any point times, T0 (P = 0.357), T1 (P = 0.751), T2 (P = 0.46), T3 (P = 0.16) and T4 (P = 0.053). According to CTnI, there was just a significant difference between the two groups at T1 (P = 0.011) but not at T2 (P = 0.116), T3 (P = 0.09) and T4 (P = 0.634). No adverse effect was recorded linked to our intervention.Conclusions: Selenium can alleviate I/R injury in short time. Further well-planned trials are needed to find the optimized administration method to achieve the most beneficial effects to the patients.
