Comparing the results of pes anserinus bursitis treatment with local triamcinolone acetonide injection with conservative therapy

Pes anserinus is the attachment of the sartorius, gracillis and semitendinosus tendons to the proximal anteromedial aspect of tibia. Clinicians commonly refer to the pain in this area as pes anserinus bursitis. The signs and symptoms include: localized pain, tenderness and swelling. The common risk factors are obesity, osteoarthritis and abnomial walking. The treatment of pes anserinus bursitis includes injecting a long acting corticosteroid into this area or conservative treatments like the use of NSAIDS, friction massage and physiotherapeutic methods. The objective was to compare the results of the treatment of pes anserinus bursitis with local injection of triamcinolone acetonide and those of the conservative treatments. Fifty eight patients suffering from pes anserinus bursitis who were visited in the orthopedic clinic of Aria hospital, Babman 22nd hospital and private offices participated in this study. The patients were divided into two groups: One group was treated by local injection of triamcinolone acetonide and the other group underwent conservative treatments. The results of the treatment were assessed after 3 weeks, using VAS and WOMAC scales. According to the findings measured by VAS scale, there was a significant difference between the average intensity of the left knee pain before and after the treatment [p =0.0113], but there was no such difference in two treatment groups [p=0.338]. Based on WOMAC measurements, there was a significant difference in the intensity of the left knee pain before and after the treatment [p=0.0108] while such difference was not found in the two treatment groups. [p=0.151]. As for the right knee, according to the results obtained from VAS scale there was a significant difference in the average of intensity of the right knee pain before and after the treatment [p=0.0195]. However, the results showed no difference in the intensity of pain between the two treatment groups [p=0.968]. WOMAC scale, too, revealed that there was a significant difference in the intensity of the right knee pain before and after the treatment. [p=0.3 002] Again, there was no such difference between the two treatment groups. [p=0.825]. Treatments of Pes Anserinus bursitis with both local injection of triamcinolone acetonide and conservative therapy are equally effective

Evaluation of ejection fraction changes during the course of treatment of mitoxantrone in patients with secondary progressive form of multiple sclerosis

Multiple sclerosis [MS] is one of the most common neurological disorders in young adults. Mitoxantrone, as an immunosuppressant and cytotoxic drug has shown a slight beneficial erect on the progressive form of the disease. However, it has been experienced that in cancer treatment this drug has caused cardiologic side effects such as congestive heart failure and decrease in ejection fraction. The aim of this study is to investigate the left ventricular ejection fraction changes induced by Mitoxantrone as administered in patients with secondary progressive form of multiple sclerosis. During the years of 2005-2007, the patients with secondary progressive MS who referred to the Neurological Clinic of Aria General Hospital in Mashhad were included in our cross-sectional study. These patients had no history of hematological, cardiac or hepatic disorders. Neither they had ever used immunosuppressant drugs. They were prescribed to intravenously take 12 mg/m2 of Mitoxantrone every 3 months for at least 2 years. Before each infusion of Mitoxantrone, the left ventricular ejection fraction [EF] was measured by echocardiography. After the treatment [8 infusions], the results of echocardiography were compared and analyzed through statistical methods using SPSS and Excel soft wares. Forty four patients with secondary progressive-MS were included in our study [24 females and 20 males]. Five of the subjects were younger than 30 year old, 27 patients were between 30 and 40, and 12 patients were above 40. The data was analyzed using the method of repeated measures. The results demonstrate that Mitoxantrone had no significant effect on the left ventricular ejection fraction. Also, the trend mean of EF during 8 months showed no significant drop. The mean of EF between sexes was not significant, either. As a whole, ten percent of the subjects treated with Mitoxanterone showed a decrease of EF which returned to its normal stage once the treatment was stopped. The benefit from using Mitoxanterone in multiple sclerosis was more than the complication caused by its usage. Multiple sclerosis, Mitoxantrone, Heart failure, echocardiography, Ejection fraction