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Mousaei Ghasroldasht M, Moayednia A, Shahrezaee M. Effectiveness of Platelet-ich Plasma Based on Gene Expression in Knee Osteoarthritis. Arch Bone Jt Surg 2019; 7:435-440. [PMID: 31742220 PMCID: PMC6802546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 04/29/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Intra-articular injection of Platelet-rich plasma (PRP) is an effective method for the treatment of patients with knee osteoarthritis (OA). This study aimed to assess the effects of PRP injection on OA, based on gene expression analysis. METHODS A sample of 30 subjects with knee OA was asked to complete the Persian versions of the Intermittent and Constant Osteoarthritis Pain (ICOAP) and Knee and Osteoarthritis Outcome Score (KOOS). Thereafter, the expression of IGF-1, HIF-1, cartilage oligometric matrix protein (COMP), and bone morphogenetic proteins (BMP2) were compared in the patient before and 1 month after PRP injection using real-time polymerase chain reaction (PCR). RESULTS According to the results of the study, the expression of IGF-1, HIF-1, COMP and BMP2 were reported to be higher in subjects with PRP injection; however, only the up-regulation of IGF-1 was statistically significant (P<007). Moreover, the significant change in the KOOS and ICOAP scores was attributed to PRP injection (P<0.01). CONCLUSION Intra-articular injections of PRP were reported to ease the pain, decrease the stiffness, and improve quality of life in patients with knee OA through the promotion of IGF-1 expression.
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Affiliation(s)
- Mohammad Mousaei Ghasroldasht
- Department of Biology, Ashrafi Esfahani University, Esfahan, Iran
- Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
- Shahid sadooghi Hospital, isfahan, iran
- Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
- Research performed at Research Center, Iranian Biovision, Isfahan, Iran
| | - Amir Moayednia
- Department of Biology, Ashrafi Esfahani University, Esfahan, Iran
- Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
- Shahid sadooghi Hospital, isfahan, iran
- Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
- Research performed at Research Center, Iranian Biovision, Isfahan, Iran
| | - Mostafa Shahrezaee
- Department of Biology, Ashrafi Esfahani University, Esfahan, Iran
- Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
- Shahid sadooghi Hospital, isfahan, iran
- Department of Orthopedic Surgery, AJA University of Medical Sciences, Tehran, Iran
- Research performed at Research Center, Iranian Biovision, Isfahan, Iran
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Abrishamkar S, Kouchakzadeh M, Mirhosseini A, Tabesh H, Rezvani M, Moayednia A, Ganjeifar B, Mahabadi A, Yousefi E, Kooshki AM. Comparison of open surgical discectomy versus plasma-laser nucleoplasty in patients with single lumbar disc herniation. J Res Med Sci 2016; 20:1133-7. [PMID: 26958046 PMCID: PMC4766818 DOI: 10.4103/1735-1995.172979] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Intervertebral disc herniation is a major cause of low back pain. Several treatment methods are available for lumbar disc herniation including Chemonucleolysis, open surgery, nucleoplasty, laser disc decompression, and intradiscal electrothermal therapy. The high prevalence of lumbar disc herniation necessitates a minimally invasive yet effective treatment method. In this study, we compared the outcomes of open surgery and nucleoplasty method in patients with single lumbar disc herniation. Materials and Methods: This study was a noninferiority randomized clinical trial conducted in one of the University Hospitals of Isfahan Medical University; The Alzahra Hospital. About 200 patients with the diagnosis of lumbar disc herniation were recruited and were assigned to either the treatment or control groups using block randomization. One group received open surgery and the other group received nucleoplasty as the method of treatment. Patients were revisited at 14 days, 1, 2, 3 months, and 1-year after surgery and were assessed for the following variables: Lower back pain, lower limb pain, common complications of surgery (e.g., discitis, infection and hematoma) and recurrence of herniation. Results: The mean (standard deviation) severity of low back pain was reduced from 6.92 (2.5) to 3.43 (2.3) in the nucleoplasty group (P = 0.04) and from 7.5 (2.2) to 3.04 (1.61) in the discectomy group (P = 0.73). Between group difference was not statistically significant (P = 0.44), however, time and treatment interaction was significant (P = 0.001). The level of radicular pain evaluated 1 year after treatment was reduced from 8.1 (1.2) to 2.9 (1.2) (P = 0.004) and from 7.89 (2.1) to 3.6 (2.5) (P =0.04) in the discectomy and the nucleoplasty groups respectively, significant interaction between time and treatment options was observed (P < 0.001) while there was no significant difference between two treatment groups (P = 0.82). Conclusion: Our results show that while nucleoplasty is as effective as open discectomy in the treatment of lumbar disc herniation, it is also less invasive with higher patient compliance. Taking factor such as decreased cost and duration of the surgery, as well as faster recovery in patients into account; we suggest considering nucleoplasty as an effective method of treatment in patients with single-level disc herniation.
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Affiliation(s)
- Saeid Abrishamkar
- Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masih Kouchakzadeh
- Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Mirhosseini
- Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Homayoun Tabesh
- Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Rezvani
- Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Moayednia
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Babak Ganjeifar
- Department of Neurosurgery, Mashhad University of Medical School, Emam Reza Hospital, Mashhad, Iran
| | - Amir Mahabadi
- Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Yousefi
- Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Mehrabi Kooshki
- Departmentt of Epidemiology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Tahririan MA, Momeni A, Moayednia A, Yousefi E. Designing a prognostic scoring system for predicting the outcomes of proximal fifth metatarsal fractures at 20 weeks. Iran J Med Sci 2015; 40:104-9. [PMID: 25821289 PMCID: PMC4359929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 08/28/2013] [Accepted: 09/15/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Fractures of the proximal fifth metatarsal bone are among the most common fractures observed in the foot and their classification and management has been subject to much discussion and disagreement. In this study, we aim to identify and quantify the effect of possible predictors of the outcome of the treatment of proximal fifth metatarsal fractures. METHODS Patients with established proximal fifth metatarsal fractures were enrolled in this prospective cohort and the outcome of their treatment was assessed using the AOFAS mid foot scale at 6 and 20 weeks. RESULTS 143 patients were included in the study. Our study showed that displacement, weight and type III fractures were significant independent predictors of poor outcome at 6 weeks while at 20 weeks in addition to these factors, gender and diabetes mellitus were also shown to be significant independent predictors of poor outcome. A scoring system was designed by assigning weight to these factors and it was shown to be a strong predictor of outcome at 20 weeks. CONCLUSION We recommend that our scoring system would help surgeons to decide whether patients' prognostic factors are significant enough for him/her to opt for a surgical approach to treatment rather than a conservative approach.
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Affiliation(s)
- Mohammad Ali Tahririan
- Department of Orthopaedic Surgery, Kashani University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran;
| | - Amir Momeni
- Department of Orthopaedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran;
| | - Amir Moayednia
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Yousefi
- Department of Orthopaedic Surgery, Isfahan University of Medical Sciences, Isfahan, Iran;
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Tahririan MA, Moayednia A, Momeni A, Yousefi A, Vahdatpour B. A randomized clinical trial on comparison of corticosteroid injection with or without splinting versus saline injection with or without splinting in patients with lateral epicondylitis. J Res Med Sci 2014; 19:813-8. [PMID: 25535493 PMCID: PMC4268187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 01/11/2014] [Accepted: 02/20/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lateral epicondylitis is a common problem affecting 1-3% of the population. There has been much debate about the best treatment modality for this condition. There is, however, no conclusive evidence in support of any of the proposed treatment modalities. In this trial, we have studied the effect of corticosteroid injection (with or without splinting) with normal saline injection (with or without splinting). MATERIALS AND METHODS In this double-blind, randomized clinical trial, individuals were randomly assigned to either of four treatment groups and received either 40 mg depomedrol injection alone, 40 mg depomedrol injection with splinting, normal saline injection alone, or normal saline injection with splinting. They were evaluated using the visual analog scale (VAS) at weeks 2, 4 and 24 and with the Oxford elbow scale (OES) at 24 weeks. RESULTS A total of 79 patients were participated in the study. The corticosteroid injection groups had better pain relief as measured by VAS at 2 and 4 weeks compared with the two saline injection groups. Mean VAS difference at week 0 versus week 2 was 4.5 ± 0.9 and 2.8 ± 0.6 in corticosteroid injection groups and saline injection groups respectively (P < 0.01) but at 24 weeks, there was only moderate benefit reported for the group which received steroid injection and splinting (P < 0.01) compared to the saline injection groups. The saline injection groups reported better improvement in OES scores (20.1 ± 3.7) at the end of the trial compared corticosteroid injection groups (16.1 ± 2.9) (P < 0.05). CONCLUSION Our results indicate that despite the clear pain reduction benefit associated with steroid injection in short term, this benefit in comparison with normal saline injection fades by the 24(th) week of follow-up.
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Affiliation(s)
- Mohammad Ali Tahririan
- Department of Orthopedics, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Mohammad Ali Tahririan, Department of Orthopedics, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Amir Moayednia
- Department of Physical Medicine and Rehabilitation, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Momeni
- Department of Physical Medicine and Rehabilitation, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Yousefi
- Department of Physical Medicine and Rehabilitation, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Babak Vahdatpour
- Department of Physical Medicine and Rehabilitation, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Moayednia A, Haghdani S, Khosrawi S, Yousefi E, Vahdatpour B. Long-term effect of extracorporeal shock wave therapy on the treatment of chronic pelvic pain syndrome due to non bacterial prostatitis. J Res Med Sci 2014; 19:293-6. [PMID: 25097599 PMCID: PMC4115342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 01/22/2014] [Accepted: 03/12/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is limited evidence about the chronic pelvic pain syndrome (CPPS) treatment by shockwave therapy, and the aim of this study was to evaluate the effect of extracorporeal shockwave therapy on CPPS due to non bacterial prostatitis in a long-term period. MATERIALS AND METHODS In a follow-up survey, 40 patients with CPPS (that were randomly distributed into the treatment or sham groups were evaluated at 16, 20, and 24 weeks. In the treatment group, patients were treated by extracorporeal shock wave therapy (ESWT) once a week for 4 weeks by a protocol of 3000 impulses, 0.25 mJ/m(2) and 3 Hz of frequency. 0.05 mJ/m(2) were added in each week. In the sham group, the same protocol was applied, but with the probe being turned off. The follow-up assessments were done by visual analog scale for pain and National Institutes of Health-developed Chronic Prostatitis Symptom Index (NIH-CPSI). Data were compared using independent t-test or analysis of variences. RESULTS Three patients did not complete the study protocol, 37 patients were evlauated (19 patients in treatment and 18 patients in the sham group). At week 24, the mean of pain score, urinary score, quality-of-life and NIH-CPSI score between two groups were not statistically different. CONCLUSION Although, ESWT therapy as a safe and effective therapy in CPPS in short-term follow-up has been established, its long-term efficacy was not supported by this study.
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Affiliation(s)
- Amir Moayednia
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeid Haghdani
- Department of Urology, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Khosrawi
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Yousefi
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Babak Vahdatpour
- Department of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Babak Vahdatpour, Al-Zahra Hospital, Sofeh Street, Isfahan, Iran. E-mail:
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Boroujeni AM, Yousefi E, Moayednia A, Tahririan MA. Effects of 8 weeks of military training on lower extremity and lower back clinical findings of young Iranian male recruits: A prospective case series. Adv Biomed Res 2014; 3:20. [PMID: 24600600 PMCID: PMC3929018 DOI: 10.4103/2277-9175.124655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 08/06/2013] [Indexed: 11/25/2022] Open
Abstract
Background: In this prospective case series we have assessed the clinical effects of 8 weeks military training on the lower extremity of the recruits. Materials and Methods: Military recruits who met the eligibility criteria and gave informed consent were entered into the study. They were asked to fill out a self-reporting pain and functionality questionnaire before and after their training. They were also examined by a physician before and after their military training. The questionnaire and examination were concentrated on three blocs: lower back, knee, and foot. Results: Three-hundred and seventy-three study subjects were evaluated. The study showed that there is a significant difference in reporting lower back pain after the training compared to the rate of complaints prior to the training (P < 0.001), knee pain, and foot pain also increased significantly (P < 0.1 and P < 0.0001, respectively) The difference was most prominent in foot complaints. Physical examination also showed significant increase in lower extremity findings following the training (P < 0.05). Conclusion: Our study shows that there is a need for a new approach to military training of male recruits in Iran in order to minimize the adverse health effects.
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Affiliation(s)
- Amir Momeni Boroujeni
- Faculty of Medicine, Isfahan University of Medical Sciences, Postgraduate, Isfahan, Iran
| | - Elham Yousefi
- Faculty of Medicine, Isfahan University of Medical Sciences, Postgraduate, Isfahan, Iran
| | - Amir Moayednia
- Resident of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Tahririan
- Department of Orthopedics, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Zargham M, Alizadeh F, Moayednia A, Haghdani S, Nouri-Mahdavi K. The role of pelvic organs prolapse in the etiology of urinary incontinence in women. Adv Biomed Res 2013; 2:22. [PMID: 23977650 PMCID: PMC3748635 DOI: 10.4103/2277-9175.108010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 08/20/2012] [Indexed: 11/09/2022] Open
Abstract
Background: Urinary incontinence is relatively common in women and is usually associated with pelvic organs prolapse. Our aim was to determine the relationship between type and intensity of urinary incontinence and different grades and types of pelvic organ prolapse among women. Materials and Methods: One-hundred female patients with the chief complaint of incontinence, who were diagnosed with pelvic organ prolapse participated in this study. Intensity of prolapse, stress and urge incontinence were evaluated using POP-Q (Pelvic Organ Prolapse Questionnaire), SEAPI (Stress related, Emptying ability, Anatomy, Protection, Inhibition) and Freeman criteria, respectively. Results: Patients’ mean age was 51.95 ± 12.82 years. The most common type of incontinence was stress incontinence (53%) and the most common prolapse type was cystocele (76%). Cystocele and rectocele had a significant relationship with stress (P value = 0.012) and urge incontinence (P value = 0.035), respectively; however, no relationship was observed between different grades of cystocele, rectocele and enterocele with different types of urinary incontinence (P value > 0.05). In patients with urge and mixed incontinence, prolapse grade significantly increased with age, but no such relationship was found in patients with stress incontinence. The number of vaginal deliveries had a significant relationship only with cystocele and rectocele grade; however, the relationship between other variables such as intensity of different types of urinary incontinence and enterocele grade with the number of deliveries was not significant. Conclusion: Pelvic organ prolapse had a significant relationship with urinary incontinence regardless of intensity and POP should be examined in all of these patients.
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Affiliation(s)
- Mahtab Zargham
- Department of Urology, Isfahan Urology and Kidney Transplantation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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