RESUMO
Background: Osteoarthritis (OA) is the most common type of rheumatic disease and a leading cause of disability. Current treatments aim at alleviating these symptoms by several different methods: non-pharmacological and pharmacological treatments and invasive interventions. Among the regenerative methods, hyaluronic acid (HA) is popular now-a-days where differences exist in concentration, molecular weight, dosage, expected duration of effects and added formulations. Based on HA molecular weight, these products are classified in two groups (high and low). Due to cost effectiveness, low molecular weight HA is commonly used. To find out the outcome of single intra-articular injection of high-molecular- weight HA in patients with knee osteoarthritis.Material & Methods:This was a randomized clinical trial conducted among purposively selected 55 patients suffering from Knee OA attending at the Physical Medicine and Rehabilitation outpatient department, DMCH during July 2020 to June 2021. Patients were randomly allocated into two groups; group A received single dose of high molecular weight HA and designed exercise program and group B received same exercise program only. Pre-treatment and 3 weekly post treatment assessment were done up to 12 weeks in each group. In each follow up visit, pain, and functional status were measured in Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) respectively and compared between group A and group B where was considered as significant (p value <0.050.Results:The mean age of the participants in group A and group B were 56.8 (±9.8) and 53.3 (±7.4) years respectively where majority of the patients in both groups were female patients with overweight. In group A, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with high-molecular-weight HA (P<0.001). In group B, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with conservative management (P<0.001). After 6 weeks of intervention, the mean VAS scores of the patients became 4.9 ±1.1 and 6.0±1.0 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the VAS score was significantly decreased in group A (2.8±1.3) than group B (4.9±1.7) (P<0.001). After 3 weeks of intervention, the mean WOMAC scores of the patients became 71.2±6.6 and 75.0 ±4.9 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the WOMAC score was significantly decreased in group A (61.9±6.6) than group B (68.1±4.6) (P<0.001). Conclusion:Single intra-articular injection of high-molecular-weight Hyaluronic Acid is effective in patients with knee osteoarthritis in reducing pain and improving functional impairment. Long term and large scale research studies are needed to establish the effectiveness and safety of this procedure in patients with knee osteoarthritis.
RESUMO
Aims: Qualitative assessment of rice bran supplemented bread with local breads. Study Design: The study was designed to identify good quality bread between rice bran supplemented bread and local breads. Place and Duration of Study: Sample: Five different varieties of rice brans (BR-5, BR-10, BRRI-28, BRRI-39, and Kalijira) were collected from Noor-Habib Grain Industries Ltd. Sopura, Rajshahi, Janata Auto Rice and Flour Mills Ltd.Bogura, North Bengal Auto Rice Mills, Naogan, Biswas Rice Mills, Natore, and Chaudhuri Auto Rice Mills Dinajpur respectively. The research was carried out at Natural Products Research Division, Bangladesh Council of Scientific and Industrial Research (BCSIR) Laboratories, Rajshahi, Bangladesh. Methodology: A comparative analysis of prepared rice bran supplemented bread and locally available bread has been done for the parameters such as moisture, ash, Fiber, Fat, protein, carbohydrate, total sugar, saponification value, FFAs and iodine value. Results: The prepared rice bran bread contained wheat flour and five different varieties of rice bran named BR-5, BR-10, BRRI-28, BRRI-39 and kalijira. The physicochemical characteristics of prepared rice bran supplemented bread such as moisture, ash, Fiber, Fat, protein, carbohydrate, total sugar, saponification value, FFA and iodine value were varied from 26.0-28.4 %, 2.17-2.83%, 1.54-1.96%, 6.95-8.04%, 6.64-7.25%, 43.2-46.3%, 5.60-6.80%, 150-169 mg KOH/g fat,1.16-1.51 mg KOH/g fat,92.1-100 g I2/100 g fat respectively. On the other hand, physicochemical characteristics of locally available bread like moisture, ash, Fiber, Fat, protein, carbohydrate, total sugar, saponification value, FFA and iodine value were found to be ranged from 31.1-32.9%, 2.70-2.93%, 2.04-2.61%, 7.91-8.12%, 5.49-6.21%, 39.9-41.4%, 7.13-8.61%, 138-149 mg KOH/g fat, 1.63-1.86 mg KOH/g fat, 57.4-71.0 g I2/100 g fat respectively. Conclusion: It may be concluded that prepared rice bran supplemented bread might be considered superior quality than the locally available bread.