ObjectiveKnee osteoarthritis (KOA) is one of the growing health problems with a considerable burden. With recent research on the possible effectiveness of antioxidants in the remission of KOA symptoms, a systematic review and meta-analysis was required to confirm this hypothesis.DesignLiterature studies were searched on the most comprehensive databases such as PubMed, International Scientific Indexing, and Scopus, with no language and time restrictions. On 17 July 2021, a search strategy was developed based on the roots of “osteoarthritis (OA)” and “antioxidants,” with no time or language limitations. As the primary outcome, pain was evaluated based on all indicators for evaluating pain [e.g., Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores, the visual analog scale (VAS), and the numerical rating scale (NRS)]. The symptoms and functions of KOA and quality of life (QOL) were also considered as secondary outcomes, each of which was measured and reported by the corresponding instrument in the studies. To measure the changes in pain, symptoms, and functions of participants, we included randomized controlled trials with a placebo control or other medical therapeutic interventions. Publication bias was assessed using Begg's funnel plot and Egger's regression test, which was deemed to be statistically significant at 0.1, and the results were checked by the trim-and-fill test.ResultsAfter refinement, data were extracted from 31 documents from 7,698 primary searched papers. Using the VAS as a reliable psychometric measuring instrument, the present study revealed that a significant difference in the characteristics of disease-related symptoms of patients with KOA was reached after antioxidant therapy (standardized mean difference (SMD): 0.467, 95% confidence interval (CI): 0.303–0.632, p < 0.0001). The results reported by WOMAC confirmed no significant difference in the combined score, difficulty score, pain score, and stiffness score.ConclusionAs the first comprehensive systematic review of the association between antioxidant supplementation and KOA, this study showed that antioxidants can decrease disease-related symptoms in patients with KOA. The results can be useful for health policy decisions and future related studies.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022351060, identifier: CRD42022351060.
Background Severe acute respiratory syndrome coronavirus 2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis; however, the exact underlying pathogenesis of severe acute respiratory syndrome coronavirus 2-induced myositis is still unclear. Case Presentation Herein, we report a rare case of necrotizing autoimmune myositis in a 67-year-old middle eastern male following coronavirus disease 2019 infection, who presented with muscle weakness. The patient had positive anti-NXP2. The diagnosis of necrotizing autoimmune myositis was made according to muscle weakness, increased liver enzymes, electromyography and nerve conduction velocity results, and muscle biopsy. The patient underwent a full malignancy evaluation, which was unremarkable, and was discharged in relatively well condition with a daily dose of 1 mg/kg prednisolone and azathioprine 150 mg (2 mg/kg). Conclusion Our report highlights the already known possible protracted sequence of coronavirus disease 2019 infection and the potential for delayed-onset necrotizing myositis.
AimAvascular necrosis (AVN) or osteonecrosis is characterized by death of bone tissue due to endothelial damage and vascular abnormality. Coronavirus can induce endothelial damage and abnormal blood clotting, so that COVID‐19 is known as a vascular disease. We aim to evaluate the relationship between AVN and COVID‐19.CaseHere we present a 39‐year old man with severe COVID‐19 and corticosteroid consumption who developed late onset AVN of both hips 20 month after COVID‐19.ConclusionAn awareness of the possible osteonecrosis for all physicians dealing with patients with musculoskeletal problems following COVID‐19 is necessary.
A 55‐year‐old lady with a nine‐year history of controlled sarcoidosis developed vasculitis after Sinopharm COVID‐19 vaccine (BBIBP‐ CorV). She was ultimately diagnosed with mononeuritis multiplex based on EMG‐NCV findings and administered methylprednisolone and cyclophosphamide pulse therapy for 5 days, and then continue with prednisolone and a monthly pulse of cyclophosphamide.
Muscle involvement represents a well-recognized but rare manifestation of amyloidosis. Here, we report a 40-year-old female who presented with muscle weakness, musculoskeletal pain, and proteinuria, which was eventually diagnosed as myopathic amyloidosis based on muscle biopsy results. A multidisciplinary approach appears to be the cornerstone of the diagnostic work up for recognizing the unusual amyloid myopathy.
Introduction: The use of mobile applications (apps) become widespread and Provide many benefits especially in healthcare. According to the World Health Organization, osteoporosis is one of the most common diseases of elderly in the world. Like other chronic conditions, disease self-management can prove fruitful. Using a mobile application for Osteoporosis can improve patient care and self-management by encouraging patients to take a more active role in their health.Material and Methods: This study presents a systematic review of mHealth applications, available on Google Play Store, Bazaar market (as a local market) and also Apple App Store, for both the English and Persian speakers. The assessment criteria, including content, visual aids, reminders, health warnings, social and design of selected apps, were tested during July 2019.Results: Reviewing the 19 included applications showed that the most and least focus of apps content was on exercise with 84% repetition and the osteoporosis fracture that no program addressed this issue separately. Findings on reminders, health warnings, and visual aids were not very encouraging (available in 11% apps). Reminders were more common in English-speaking apps than Persian-speaking ones, and Visual aids, one of the benefits of mobile apps over paper logbooks, were provided only in2 apps. The opportunity to share data in social networks was available in 26% of apps, and in the design section, most of the apps have no significant flaws, but 74% of cases did not provide any clear instructions required for the elderly.Conclusion:The review shows that there are rather few products on offer and the ones that are available display low quality, poor performance, and evidence-based information is also insufficiently used. Further efforts are required to collect data that will support the design of validated evidence-based educational functions for mHealth apps.
Background: Behçet’s disease is an autoimmune, rare, multi-system vasculitis characterized by recurrent oral and genital ulcers, uveitis, skin lesions, and arthritis. Azathioprine has been well established as an effective therapy among other immunosuppressive drugs; however, concerns remain about the safety of azathioprine. This study is conducted to determine various types and prevalence of adverse effects of azathioprine in patients with ocular Behçet’s. Methods: We carried out a cross-sectional study on 165 patients with confirmed diagnosis of Behçet’s who suffered from ocular involvement. Data concerning the different episodes of the disease, including severity, recurrence, relapse, recovery and flare up of Behçet’s disease, were collected retrospectively, as well as the azathioprine dosage and duration of consumption. Results: Of 165 enrolled patients, 103 patients (62.43%) were male and 62 patients (37.57%) were female. Adverse events of treatment with azathioprine occurred in 11 patients (6.67%). Side effects occurred in 11 patients (6.67%) taking azathioprine. These side effects included elevation of liver enzyme in 4 patients (2.43%), hypersensitivity reaction in 2 patients (1.21%), leukopenia in 2 patients (1.21%), nausea in 1 patient (0.61%), skin tumor in 1 patient (0.61%) and concomitant pancreatitis and hepatitis in 1 patient (0.61%). Six of these cases discontinued and five of them tapered the dose. In addition, we observed severe leukopenia in two patients. Conclusion: Administration of azathioprine, with due attention to the signs, symptoms, and severity of the disease, results in a reduced rate of adverse effects, and resolving of the ocular involvement in Behçet’s disease patients.
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