Effect of adding garlic therapy to a comprehensive rehabilitation program on control of clinical manifestations and quality of life of knee osteoarthritis

To compare the effect of comprehensive rehabilitation program versus combined garlic therapy and comprehensive rehabilitation program in controlling the clinical manifestations and quality of life in patients with knee osteoarthritis. This was a randomized clinical trial in an outpatient setting. Participants were 43 patients with knee osteoarthritis randomized to group I [comprehensive rehabilitation] [n = I5] and group II [combined garlic therapy and comprehensive rehabilitation] [n-28]. All patients had diet modification, electrotherapy, resistive and flexibility exercises for legs 3 times weekly for 8 weeks. Group II received garlic capsules 900 mg daily with breakfast for 8 weeks. Evaluation was performed using knee pain with visual analogue scale [VAS], Stanford health assessment questionnaire [HAQ], one repetition maximum [1RM] for quadriceps, body mass index [BMI], synovial fluid level of interleukinl-beta, inrerleukin-6, tumor necrosis factor- alpha and selenium level. BMI significantly decreased in both groups [P<.05] without significant difference between groups. Knee pain significantly decreased in group II mean_ standard deviation [-51.77 +/- 11.17%] more than in group I [-22.92 +/- 5.31%] [p-.00001]. 1 RM significantly increased in group II [105.10_ 65.90%] more than in group I [64.78 +/- 54.77%] [p=.01986]. Percent change of HAQ was more in group II [-36.56 +/- 12.2] than in group I [-16.42 +/- 14.10] [p=.00004]. Synovial selenium significantly increased only in group II [213.19 +/- 28.26%] [p=.00001]. Synovial inflammatory mediators significantly reduced only in group II [interleukin 1 beta [-89.67% +/- 3.73] [p=.00001], interleukin 6 [-92.98% +/- 5.02] [p=.00001], tumor necrosis factor alpha [-83.20% +/- 8.52] [p=.00001]. Garlic improves rehabilitation outcome of knee osteoarthritis

Hyperhomocysteinaemia in renal allograft recipients: could methylenetetrahydrofolate reductase gene polymorphism be a determinant risk factor for chronic allograft dysfunction?

The elevated plasma homocysteine could adversely influence long-term renal graft survival by promoting vascular sclerosis in the kidney allograft. This could be mediated through endothelial dysfunction. A polymorphism C677T in the gene coding for the enzyme methylenetetrahydrofolate reductase [MTHFR] was identified. The aim of the present work was to study the influence of the C677T MTHFR gene polymorphism on total plasma homocysteine and folate levels in renal graft recipients, and its impact on chronic graft dysfunction and the associated endothelial dysfunction. Thirty two stable renal allograft recipients were included in this study [group I] and compared with age and sex matched thirty control subjects [group II]. Plasma homocysteine level, plasma folic acid level, plasma van Willebrand factor [vWF] activity together with endothelial dependent and independent brachial artery vascular responses were done for all subjects. MTHFR genotype was determined by PCR in all renal recipients who were further classified accordingly into 3 subgroups: [group Ia] with homozygous TT type, [group Ib] with heterozygous CT type, and [group Ic] is wild CC type. Renal allograft recipients showed significant higher level of homocysteine as compared to control group [44.42 +/- 32.08 vs 11.62 +/- 2.57 respectively, p<0.001]. There was significant endothelial dysfunction in the transplant group as evidenced by the higher vWF [119.71 +/- 17.71 vs 67.60 +/- 28.65 p<0.001] and poorer endothelial dependent dilatation [EDD] of the brachial artery [7.84 +/- 1.08 vs 12.68 +/- 0.96 p<0.001] as compared to the control group. There was significant negative correlation between plasma homocysteine level and creatinine clearance [r=-0.55, p=0.001], suggesting the deleterious effect of hyperhomocysteinaemia on graft function. The homozygous subgroup [gpIa] showed significant higher level of homocysteine, vWF, lower folic acid, creatinine clearance and EDD as compared to the other two subgroups [gp Ib and Ic]. Our study identified that the presence of hyperhomocysteinemia in combination with unfavorable MTHFR genotypes contributes to an increased risk for development of chronic allograft dysfunction

Serum levels of selenium and glutathione peroxidase during asthmatic attacks in children

Asthma is a complex disorder which cannot be defined adequately in terms of a single pathophysiological mechanism. The pathogenesis of bronchial asthma is chronic airway inflammation caused by immune cells such as T-lymphocytes and eosinophils which release cytotoxic products including reactive oxygen species at the site of inflammation leading to epithelial damage. The aim of this study is to evaluate the importance of selenium and glutathione peroxidase as important antioxidants in asthmatic attacks and to highlight the possible burden of body mass index in asthmatic children. Fifty children were included in this study. Group I "asthmatic children" consisted of 25 patients [14 males and 11 females] aged 6-12 years. Group II "control group" consisted of 25 healthy children [13 males and 12 females] aged 6-12 years. All children were examined thoroughly and their FEVI % and PEFR were measured. These tests were repeated after bronchodilators only in asthmatic children. Body mass index [BMI] was calculated. Chest X-rays, urine and stool analysis for parasites, complete blood picture and sputum eosinophils were performed. Glutathione peroxidase [GPx] and selenium [Se] blood levels were assayed for both groups. The results showed that sputum eosinophils and peripheral eosinophils were significantly higher in asthmatics. Glutathione peroxidase and selenium blood levels were significantly lower in asthmatic children and can reliably assess severity of the asthmatic attack besides pulmonary function tests [FEVI % and PEFR]. BMI of our asthmatic children was significantly higher than control, with the overweight asthmatics showing slightly lower serum selenium level and pulmonary function tests and less improvement of their severity scores of the asthmatic attack and pulmonary functions by bronchodilators. It was also found that the improvement of asthmatic attacks [severity score, PEFR and FEV, %] was better in cases with higher GPx, serum Se and low BMI and the most severe cases had less GPx and Se levels and had high BMI and higher sputum eosinophils and peripheral eosinophilia

Conclusion: selenium and Glutathione peroxidase as antioxidants are deficient in asthmatic children during severe attacks; hence further studies with supplementation of antioxidants are recommended

Can sPLA2-IIA, sICAM be a predictor of atherogenic susceptibility in Egyptian rheumatoid arthritis patients: correlative study to other atherogenic parameters

Aim: The aim of the present study was to investigate the state of sPLA2-IIA and sICAM-1 in the plasma of RA patients and their possible role as risk factors for atherogenic susceptibility in those patients. Subjects and Twenty rheumatoid arthritis patients [group I] and 20 healthy controls of matched age and sex [group II] were subjected to estimation of ESR, CRP, plasma total cholesterol, triglycerides, HDL-C, LDL-C, secretory phospholipase A2 group II A [sPLA2-IIA] by ELISA method and soluble intra-cellular adhesion molecule-1 [sICAM-1] by ELISA method and plasma Lp[a] by turbidimetry method. The results revealed a significant increase of all of the bllowing in RA patients as compared to controls: 1] sPLA2-IIA [112.05 +/- 13.22 versus 14.06 +/- 2.04, P=0.000], 2] sICAM [332.05 +/- 13.64 versus 266.25 +/- 9.24, P=0.000], 3] Lp[a] [18.36 +/- 2.1 versus 11.46 +/- 0.8, P=0.0001]. A significant decrease of HDL in patients as compared to controls [47.3 +/- 4.6 versus 66.45 +/- 8.16, P=0.000] while no significant differences were found in total cholesterol, triglycerides, and LDL-C in patients when compared to controls. A correlation was found between CRP, as an inflammatory marker, and sPLA2-IIA, sICAM, Lp[a] and LDL-C in RA patients and a correlation was also found between LDL, as an atherogenic marker, and sPLA2-IIA, sICAM, and Lp[a]. Conclusions: sPLA2-IIA and sICAM may contribute to atherogenesis in RA patients. Further studies are needed in the future to settle whether they are early markers of atherogenesis or not. Further studies are also needed to detect the benefit of using anti-ICAM as a preventive measure against coronary atherosclerosis in RA patients