Purpose. The high prevalence of knee osteoarthritis (KOA) is a major cause of disability among elders. NSAIDs are recommended to reduce KOA patients’ symptoms, but their adverse side effects limit their consumption. In this study, we evaluated the effectiveness of Harpagophytum procumbens compared to a routine NSAID (meloxicam) on pain reduction and functional improvement of KOA patients. Patients and Methods. Sixty patients aged 40–60 years, with painful knee osteoarthritis (grades 1-2 of Kellgren–Lawrence scale) for at least one month, were randomized into two groups with different routine medication periods. Group A consisted of daily administration of two Harpagophytum procumbens (Teltonal) tablets (2 ∗ 480 mg) for one month, and group B consisted of daily administration of meloxicam (15 mg) for ten days. The visual analogue scale (VAS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), Oxford Knee Scale (OKS), and patient satisfaction were evaluated at the baseline and after 2, 4, and 8 weeks. Results. There were no statistically significant differences between demographic characteristics, pain intensity, and function scores before the treatment. VAS, OKS, and WOMAC scores improved in both groups p < 0.001 over time, but no significant superiority was shown; after 8 weeks: VAS (Teltonal (4.80 ± 1.80) vs. meloxicam (5.06 ± 1.43)), OKS (34.06 ± 4.38, 34.00 ± 7.87, Teltonal vs. meloxicam, respectively), and WOMAC scores (25.73 ± 10.11 Teltonal vs. 26.20 ± 13.94, meloxicam). Conclusion. Teltonal is an effective and safe treatment in patients with mild KOA in the short term. However, no significant superiority was shown in using Teltonal or meloxicam, in people who cannot take NSAIDs, it can be a good alternative, although difference in medication periods should be considered.
Background: Childbirth is an event in the life of a woman that, if it is associated with a negative memory in mind, it leads to negative psychological reactions and disturbs the mother’s mental health during the postpartum period. Aim: The aim of the present study was to assess the relationship between experiences of antepartum intervention with post-traumatic stress symptoms following childbirth. Methods: The sample comprised 176 Iranian women, with assessments at 8 weeks after postpartum. Current PTSD was assessed by the Impact of Events Scale – Revised (IES-R). Data were collected on obstetric variables. Data were analyzed with SPSS version 19.0. The adjusted odds ratios were estimated by binary logistic regression. Results: 38.3% (N=62) of the women appeared at risk for PTSD symptoms. The mean score of PTSD symptoms was 22.51±12.04 (0-65). The results showed that women in PTSD group underwent more obstetrical interventions than women without PTSD during childbirth (p=0.002) and experienced childbirth pain (p=0.048). Insertion of sublingual or vaginal prostaglandin tab, experience of episiotomy incision, perineal/labial/vaginal sutures and artificial rupture of amniotic membranes correlated significantly with PTSD symptoms (P<0.05). The results of binary logistic regression analysis confirmed that the rate of obstetrical interventions was the significant predictor of PTSD after childbirth (Odd ratio=1.284; p=0.008). Conclusion: The findings indicated that by enhancing health provider's understanding of obstetric intervention consequences, opportunities are provided to prevent PTSD through providing physiological delivery and supportive care in labor.
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