Objective: To evaluate clinical efficacy and safety of ginger with naproxen, in treating knee osteoarthritis. Study design and setting: Randomized clinical trial conducted in medicine department OPD of National Medical Center, Karachi from 21st September 2018 till 31st March 2019. Methodology: This study was conducted on 60 patients of knee osteoarthritis. After written informed consent, the patients were randomized to two groups. Group A received tablet naproxen 500mg and capsule ginger 550mg, twice daily and group B was given tablet naproxen 500mg twice daily. Total 53 patients finished the study (group A: n=27 and group B: n=26). Baseline pain (Visual Analogue Scale) and Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores were noted at the beginning of study and reassessed after 6 weeks of the intervention. Safety profile of the drugs was assessed by observing adverse effects. Independent t-test was applied to check difference between the two groups. Statistical analysis was performed using SPSS version 23.0. P-value < 0.05 was considered as statistically significant. Results: Before the intervention no significant difference was observed in two groups. However significant difference was observed between the groups in pain (p=0.019) and WOMAC (p=0.020) scores after 6 weeks of intervention. Moreover there was no significant difference (p=0.914) in occurrence of adverse effects between the two groups at the end of 6 weeks of study. Conclusion: Ginger with naproxen can effectively treat pain and stiffness in knee osteoarthritis without added adverse effects when compared with naproxen alone.
Osteoarthritis, an inflammatory, degenerative disease of joints mostly affects weight bearing joints in old age. Treatment modalities are categorized into non-pharmacological, pharmacological and surgical. Among pharmacological options, oral formulations are mostly used. Acetaminophen is considered as first line though, NSAIDs are well established choice for the management of osteoarthritis and mostly employed for the same. However NSAIDs are associated with gastric adverse effects. Symptomatic slow acting osteoarthritis drugs like glucosamine, chondroitin sulfate, diacerein and avocado soybean saponifiables are considered as maintenance therapy as they have shown to reserve joint space width. Topical formulations are good for patients with co-morbidities. For patient not responding to other modalities, opioids and duloxetine are employed but with caution. Intra-articular injections like corticosteroids, hyaluronic acid and Platelet rich plasma are ranked highest in efficacy. Newer agents like Nerve growth factor- inhibitors, Interleukin-1 antagonists and certain neutraceutical preparations are under investigation for osteoarthritis management
Objective: To compare clinical efficacy of diacerein-ginger with diacerein alone in treating knee osteoarthritis. Duration and place of study: It was a randomized clinical trial conducted from 21st September 2018 to 31stMarch 2019, in medical OPD of a private hospital in Karachi. Methodology: 60 diagnosed patients of knee osteoarthritis were included in this study. Male and female patients 50 years of age, fulfilling the inclusion criteria and after written informed consent experienced a wash-out period of 72 hours. These patients were systematically randomized into 2 groups each having 30 members. Group A received capsule Diacerein 50mg + capsule Ginger 550 mg twice daily and group B received capsule Diacerein 50mg twice daily, for 12 weeks. Parameters checked at 0, 6 and 12 weeks were: Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, pain at rest and movement (Visual Analogue Scale). Comparison of the two groups was done by independent t-test. Results: Among 60 patients; 20 (33.33 %) were males and 40 (66.66%) were females. 4 patients in group A and 4 in B, dropped out during the study. Comparison of group A with group B in WOMAC and pain (at rest and movement) scores showed insignificant difference at day 0 before prescription of the drugs. However comparison showed highly significant difference (P-value < 0.001) between the two groups in WOMAC, pain at rest and movement scores at the end of 6th and 12th weeks of intervention. Conclusion: Diacerein-Ginger is clinically more efficacious for management of knee OA than Diacerein alone
Diabetic osteopathy is a complication of diabetes that elevates the risk of bone fractures and influences bone remodeling. Osteocalcin is a bone protein produced by osteoblasts that plays a role in the regulation of glucose and energy metabolism. Objectives: To explore the relationship between the level of glycosylated hemoglobin (HbA1c) and osteocalcin in diabetic patients. Methods: This cross-sectional analytical study was carried out at Hayatabad Medical Complex, Peshawar from January 2017 to February 2018. A total of 100 patients suffering from Type 2 Diabetes Mellitus (T2DM) were recruited. HbA1c and osteocalcin levels were measured by the enzymatic method and electrochemiluminescence immunoassay, respectively. SPSS was utilized for data entry and analysis; Pearson’s correlation was performed to assess the relationship between variables while statistical significance was accepted at p < 0.05. Results: The mean (SD) age of participants was 50 (9.2), while 58% of the study population was female. The mean (SD) HbA1c and osteocalcin levels were 11.3 (8.8) and 13.1 (6.8), respectively. The results of the correlation analysis yielded a negative relationship between HbA1c and osteocalcin levels (r =-0.099), but the results were statistically non-significant (p-value =0.328). Conclusion: Our study suggested that osteocalcin level has a negative correlation with HbA1c level in Type 2 Diabetes Mellitus patients
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