Both procedures lead to significant short-term pain relief of at least 4 weeks, however, TI displayed a significantly greater duration of benefit. Patients with effusions and milder radiographic change obtained the best response to treatment.

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Osteoarthritis (OA) is the most prevalent form of arthritis in the world. Aim of the work: To evaluate the effect of 6-monthly intra-articular injection of platelet rich plasma (PRP) on the functional status of knee joint measured by the International Knee Document Committee scale (IKDC), the visual analogue scale for pain (VAS) on the ultrasonographic findings of OA knee. Assessment of its safety as a new line of treatment was taken into consideration.Patients and methods: The study was carried out on 20 patients with mild to moderate primary knee OA. They were injected intra-articularly with 5 ml PRP for each affected joint, at 1 month intervals for 6 injections. Clinical examination, VAS, IKDC score and diagnostic Doppler ultrasonography were performed before and after PRP treatment.Results: After 6 months of PRP, there was a significant improvement in the duration of inactivity stiffness (8.3 ± 2.4 min), VAS score (3.9 ± 1.1) and IKDC score (74.3 ± 10.2) compared to baseline values (18.7 ± 6.5 min, 5.9 ± 1.3 and 40.9 ± 10.4 respectively; p < 0.001). A significant improvement in Doppler activity (p = 0.04) and synovial thickening (p < 0.001) was found after 6 months of PRP. A significant correlation was found between age of patients, body mass index and disease duration with the VAS (r = 0.55, p < 0.001 and r = 0.29, p = 0.03 and r = 0.71, Please cite this article in press as: Hassan AS et al. Effectiveness of the intra-articular injection of platelet rich plasma in the treatment of patients with primary knee osteoarthritis, The Egyptian Rheumatologist (2014), http://dx.) and a negative correlation with the IKDC score (r = À0.32, p = 0.03, r = À0.96, p < 0.001 and r = À0.79, p < 0.001 respectively). Conclusion: Intra-articular injection of PRP is an effective and safe method for treatment of knee OA. Maximal improvement is obtained in patients with young age and short disease duration.

The biochemical processes involved in depression go beyond serotonin, norepinephrine, and dopamine. The N-methyl-D-aspartate (NMDA) receptor has a major role in the neurophysiology of depression. Ketamine, one of the prototypical NMDA antagonists, works rapidly in controlling depressive symptoms, including acutely suicidal behavior, by just a single injection. Ketamine may rapidly increase the glutamate levels and lead to structural neuronal changes. Increased neuronal dendritic growth may contribute to synaptogenesis and an increase in brain-derived neurotrophic factor (BDNF). Activation of the mechanistic target of rapamycin (mTOR), as well as increased levels of BDNF, may increase long-term potentiation and result in an improvement in the symptoms of depression. The mechanisms of ketamine’s proposed effect as an off-label treatment for resistant depression are outlined in this paper.

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Background: Paints and coatings include paints, varnishes, lacquers, stains, printing inks and more. A wide variety of volatile solvents are used in paint and coating manufacturing including aliphatic and aromatic hydrocarbons, alcohols, ketones and consist of more than 30% of most of paints. At low or moderate concentrations, the organic solvents may cause transient symptoms such as euphoria, headache and dizziness. At high concentrations, anaesthesia and disturbances in respiration and circulation may occur and may lead to death. Long-term exposure may cause damage to the Central Nervous System (CNS), such as cognitive and emotional deficits. Methods: A cross sectional study was conducted among 92 male workers exposed to organic solvents on performing their job in Koratol Paint Factory in Alaama Village in Sharkia Governorate. Another group of 95 workers, not working with organic solvents were selected from the Faculty of Medicine in Zagazig University and considered as a control group. All participants in the study were subjected to a pre-designed questionnaire to collect information about personal, socio-demographic data, occupational history, use of personal protective equipments, frequently perceived health complaints which included irritation symptoms (skin, eye and nose) and Questions of the validated questionnaire for the neuropsychological symptoms (Q22). Results: The neuropsychological symptoms score (Q22) revealed that 63.04% of solvents exposed paint manufacturing workers had neuropsychological symptoms, compared to about only 2.1% in control group and the difference was statistically significant. Regarding the relation between types of job done and results of neuropsychological symptoms score (Q22) there was increased risk for neuropsychological symptoms in production group than packing group (OR = 13.94) and for the duration of work the risk increased in workers with duration over 15 years (OR = 32.84). Logistic regression analysis showed that the most important predictors of neuropsychological symptoms were the type of job performed by the workers such as production or packing and their duration of work ≥15 years. Conclusions: The paint industry workers were at increased risk of several irritant and neuropsychological symptoms which significantly related to exposure to paint and organic solvents.

Background: Organophosphates pesticides (OPs) exert their toxicity on the body through inhibition of Cholinesterase Enzyme (ChE) in the nerve and muscle tissues. Inhibition of cholinesterase itself cannot account for the wide range of disorders that have been reported following OPs exposure as oxidative stress has been implicated as one of the mechanisms for the adverse health effects of OPs exposure. Aim of the study: To study oxidative stress among agricultural workers through assessment of blood level of Butyl Choline Esterase enzyme (BuChE), as an indicator of exposure to OPs, assessment of blood level of Malondialdehyde (MDA), as an indicator of oxidative stress, and erythrocyte activity of Superoxide Dismutase (SOD), as an indicator of antioxidant activity and identification of occupational and personal risk factors that may be associated with oxidative stress among agricultural workers. Subjects and methods: A comparative cross sectional study was conducted among 48 agricultural workers exposed to OPs and 48 subjects non-exposed to OPs. Both two groups were subjected to a structured questionnaire included questions about Socio-demographic and Occupational history, followed by laboratory investigations to measure BuChE, MDA and SOD. Results: This study showed that the median level of MDA was significantly higher among exposed group compared to non-exposed group, while the median levels of BuChE and SOD were significantly lower among exposed group compared to non-exposed group. The level of BuChE, MDA and SOD were significantly correlated with each other and with work duration (years), number of worked hours/day, hours of spraying pesticides/day. Non-usage of personal protective equipment (PPE) and lack of washing facilities increased the risk of abnormal MDA and SOD. Duration of work (years) and number of worked hours / day were the significant predictors for abnormal oxidative indices. Conclusion: The study concluded that exposure to OPs can induce abnormal oxidative stress indices among agricultural workers. So, it is recommended to do regular screening of agricultural workers, design strategies that can reduce pesticide exposure, provide PPE all time and encourage workers to take antioxidants regularly.

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