Effectiveness and cost-effectiveness of telephone-based support versus usual care for treatment of pressure ulcers in people with spinal cord injury in low-income and middle-income countries: study protocol for a 12-week randomised controlled trial

Arora, Mohit; Harvey, L A; Hayes, Alison; Chhabra, Harvinder Singh; Glinsky, Joanne; Cameron, Ian D.; Lavrencic, L; Arumugam, Narkeesh; Hossain, Mohammad Sohrab; Bedi, Parneet Kaur

doi:10.1136/bmjopen-2015-008369

Cited by 23 publications

(18 citation statements)

References 23 publications

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“…Acute spinal cord injury (SCI) is a serious nervous system injury, which often results in partial or complete loss of feeling and motor function below the injury surface. According to a previous report, the annual incidence of SCI is 15-40/1,000,000 worldwide (1). SCI can be caused by traffic accidents, falls or sports injuries.…”

Section: Introductionmentioning

confidence: 99%

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Thymoquinone reduces spinal cord injury by inhibiting inflammatory response, oxidative stress and apoptosis via PPAR‑γ and PI3K/Akt pathways

2018

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The present study used a mild contusion injury in rat spinal cord to determine that thymoquinone reduces inflammatory response, oxidative stress and apoptosis in a spinal cord injury (SCI) rat model and to demonstrate its possible molecular mechanisms. The rats in the thymoquinone group received 30 mg/kg thymoquinone once daily by intragastric administration from 3 weeks after surgery. Hematoxylin and eosin staining, Basso, Beattie and Bresnahan (BBB) scale and tissue water content detection were used in the present study to analyze the effect of thymoquinone on SCI. The activity of inflammatory response mediators, oxidative stress factors and caspase-3/9 was measured using ELISA kits. Furthermore, western blotting was performed to analyzed the protein expression levels of prostaglandin E2, suppressed cyclooxygenase-2 (COX-2) and activated peroxisome proliferator-activated receptor γ (PPAR-γ), PI3K and Akt. The results from the study demonstrated that thymoquinone increased Basso, Beattie and Bresnahan score and decreased water content in spinal cord tissue. Treatment with thymoquinone decreased inflammatory response [measured by levels of tumor necrosis factor α, interleukin (IL)-1β, IL-6 and IL-18], oxidative stress (measured by levels of superoxide dismutase, catalase, glutathione and malondialdehyde) and cell apoptosis (measured by levels of caspase-3 and caspase-9) in SCI rats. Thymoquinone treatment inhibited prostaglandin E2 activity, suppressed COX-2 protein expression and activated PPAR-γ, PI3K and p-Akt protein expression in SCI rats. These data revealed that thymoquinone reduces inflammatory response, oxidative stress and apoptosis via PPAR-γ and PI3K/Akt pathways in an SCI rat model.

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Section: Introductionmentioning

confidence: 99%

“…SCI can be caused by traffic accidents, falls or sports injuries. Of these, traffic accidents are the main cause (44.5%) of SCI in the USA, followed by falls (16.6%) and sports injuries (12.7%) (1). The injured people are commonly of working age (range, 18-80 years old).…”

Section: Introductionmentioning

confidence: 99%

Thymoquinone reduces spinal cord injury by inhibiting inflammatory response, oxidative stress and apoptosis via PPAR‑γ and PI3K/Akt pathways

2018

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“…Spinal cord injury whether traumatic or form other cause and Bangladesh a poor developing country with a literacy rate of about 61.0% among the age of 15 years and above [12,13] spinal cord injury and its health related complications are a major issue as it causes a great deal of morbidity and mortality as well as economic problems [14]. The researcher aimed to looking into the trend in demographic distribution of spinal cord injury, diagnosis, as well as complications in patients with spinal cord injury which will help to identify the specific population group at risk and take preventive measure to prevent the associated complications [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Demography, Diagnosis and Complications of Spinal Cord Injury Patients in a Rehabilitation Center of Bangladesh

Quadir¹,

Sen²,

Sultana³

et al. 2017

Int J Neurorehabilitation Eng

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IntroductionSpinal cord injury, is certainly a debilitating and devastating condition in terms of its effect on a person`s physical, mental, familial as well as social life [1]. Due to its profound impact on a person`s overall quality of life and increasingly high incidence, injury to spinal cord due to any pathology is now considered as a morbid condition as well as a threat to both personal and national economy [2,3]. Spinal cord injury itself is a crippling condition, at the same time may lead to a variety of complications which can affect the life of the patient as it increases the treatment cost significantly and accelerate the disease process which link to early mortality [1,3,4]. The incidence of Spinal cord injury is increasing throughout the world with an annual incidence rate of 15 to 40 per million with a male predominance, more prevalence in low socio-economic society and the causes ranges from traumatic in most of the case like motor vehicle accident to gunshot injury and physical violence, however non traumatic causes like Tuberculosis (TB) of the spine is also responsible for this [3][4][5][6]. A great variety of complications usually follow injury to spinal cord such as pressure sore, urinary complications, most of which are preventable nonetheless these associated complications are the most common cause of re-hospitalization following spinal cord injury and eventually lead to a great deal of disability, morbidity, degree of dependence and mortality [1][2][3][4].Spinal cord injury is a severe condition of the musculoskeletal system, more often leading to permanent disability and on the top of that brings about drastic changes the functioning ability of the patient and eventually encompassing each and every aspect of life [5][6][7][8]. Complications may associate virtually all systems of the body namely cardio-respiratory system, genitourinary system, local disorders like pressure sore or full blown biochemical disorders. Such domino effect following the injury to spinal cord significantly decreases the quality of life of the individual and happens on the early or acute stage when initial rehabilitation process are being initiated [6]. Spinal cord injury whether traumatic or form other cause and AbstractBackground: Spinal cord injury and its health related complications pose a major impact on the overall morbidity and mortality as well as cause economic constrains. It was aimed at looking into the demographic distribution, diagnosis, as well as complications in patients with spinal cord injury.

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“…The trial protocol (including full details of the trial rationale, design and statistical analysis) has been published and is available online. 17 The trial was conducted through the Indian Spinal Injuries Centre (New Delhi, India), Punjabi University (Punjab, India) and The Centre for Rehabilitation of the Paralysed (Dhaka, Bangladesh). Initially, the trial was planned for just one site.…”

Section: Methods Designmentioning

confidence: 99%

Telephone-based management of pressure ulcers in people with spinal cord injury in low- and middle-income countries: a randomised controlled trial

et al. 2016

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The results of our primary outcome (that is, size of pressure ulcer) do not provide conclusive evidence that people with SCI can be supported at home to manage their pressure ulcers through regular telephone-based advice. However, the results from the secondary outcomes are sufficiently positive to provide hope that this simple intervention may provide some relief from this insidious problem in the future.

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Effectiveness and cost-effectiveness of telephone-based support versus usual care for treatment of pressure ulcers in people with spinal cord injury in low-income and middle-income countries: study protocol for a 12-week randomised controlled trial

Cited by 23 publications

References 23 publications

Thymoquinone reduces spinal cord injury by inhibiting inflammatory response, oxidative stress and apoptosis via PPAR‑γ and PI3K/Akt pathways

Thymoquinone reduces spinal cord injury by inhibiting inflammatory response, oxidative stress and apoptosis via PPAR‑γ and PI3K/Akt pathways

Demography, Diagnosis and Complications of Spinal Cord Injury Patients in a Rehabilitation Center of Bangladesh

Telephone-based management of pressure ulcers in people with spinal cord injury in low- and middle-income countries: a randomised controlled trial

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