ABSTRACT
Objective: Phenytoin is a medication primarily used to treat seizures, but it has been discovered to have the potential for wound healing due to its ability to increase collagen production, promote new blood vessel growth, reduce inflammation, fight infections, and encourage new skin growth. These effects are particularly useful for healing chronic wounds like pressure ulcers, diabetic ulcers, traumatic wounds, and venous ulcers.Methods: This is a two-year prospective study conducted between January 2020 and December 2022 at the Government General Hospital in Kurnool. A study was conducted on 60 patients with traumatic wounds, dividing them into two groups. One group received topical phenytoin dressing, while the other received normal saline dressing. The study compared wound surface area, granulation tissue percentage, pain ratings on the visual analog scale, and healing time between the groups on day 14 and day 21.Results: On day 0, cases and controls had similar wound surface areas (62.17±25.74 cm2 and 62.14±21.57 cm2, respectively) and VAS scores (8.81±1.22 and 8.88±1.52). By day 14, cases had significantly smaller wound surface areas (41±32.32 cm2), a higher percentage of granulation tissue (75.56±7.30%), and lower VAS scores (4.57±1.78) compared to controls (53.28±25.33 cm2, 58.45±7.01%, and 6.32±1.02, respectively). By day 21, cases had even smaller wound surface areas (28.3±31.75 cm2), a higher percentage of granulation tissue (93±3.46%), and lower VAS scores (2.78±0.42) compared to controls (40.34±34.23 cm2, 72.56±5.05%, and 4.82±1.27, respectively). The time for wound healing was significantly shorter for cases (22.76±7.28 d) compared to controls (32.64±9.31 d). On day 21, negative cultures were found in 80% of wounds in the study group and 50% of wounds in the control group, with a statistically significant difference (P-value<0.05).Conclusion: Topical phenytoin dressing had positive effects on wound healing by increasing the rate of granulation tissue formation, providing better pain relief, and shortening the healing time. It was found to be a safe, effective, and cost-effective option for wound healing due to its various mechanisms. The study highlights the significance of phenytoin in treating traumatic wounds, particularly in patients with limited access to expensive wound-healing medications.
ABSTRACT
Objective: Osteoarthritis is a chronic and degenerative disease that commonly affects the knee joint. The effectiveness of using PRP injections in the knee joint for managing osteoarthritis symptoms, which include pain, disability, deformity, and reduced quality of life, is being studied.Methods: This is a two-year prospective study conducted between January 2019 and December 2020 at the Government General Hospital in Kurnool. The study focused on the management of osteoarthritis knee in 60 patients who received 3 ml autologous intra-articular platelet-rich plasma injections, with their pain, joint stiffness, and joint mobility being evaluated using the WOMAC score. The majority of participants were middle-aged women with grade KL 2 and 3 osteoarthritis knee.Results: The study included 60 cases with KL grade II (28 cases) and grade III (32 cases) of knee osteoarthritis. The pretreatment WOMAC score for KL grade II was 56.11±6.36, which showed significant improvement to 50.76±7.6 (p=0.000) at 2 w, 50.76±7.6 (p=0.001) at one month, 26.97±3.47 (p=0.001) at 3 mo, and 22.11±2.99 (p=0.001) at 6-month follow-up. Similarly, for KL grade III, the pretreatment WOMAC score was 59.21±5.63, which improved significantly to55.76±7.6 (p=0.000) at 2 w, 48.79±5.42 (p=0.001) at one month, 36.46±4.36 (p=0.001) at 3 mo, and 32.12±2.66 (p=0.001) at 6-month follow-up.Conclusion: PRP injection is a safe and cost-effective alternative for treating knee osteoarthritis, leading to pain relief and an enhanced quality of life, especially in the initial stages. Not only does PRP provide immediate relief, but it also results in gradual improvements over time. Overall, PRP is a viable option for individuals seeking alternative treatments for knee osteoarthritis.