Biomedical Research and Therapy

Comparison of the pain-killing effects of leech therapy versus physiotherapy in patients with knee osteoarthritis: A double-blind randomized clinical trial

2022-07-01T13:51:11+00:00

Background: Knee osteoarthritis is a debilitating disease that affects a large proportion of the elderly population. Treatments for this disease are mostly based on symptomatic management. The primary treatments are physiotherapy, which is associated with high costs, and nonsteroidal antiinflammatory drugs (NSAIDs), which have serious side effects, including gastrointestinal bleeding, renal failure, and cardiovascular complications. This study aimed to assess the effects of leech therapy versus physiotherapy as a noninvasive method in the treatment of knee osteoarthritis.

Methods: This double-blind randomized clinical trial was performed on 98 patients with osteoarthritis of the knee. The patients were randomly divided into two groups: leech therapy or physiotherapy. The analgesic effects and recovery of the patients were assessed using the KOOS questionnaire 90 days after the beginning of the study. Student's t-test, the Wilcoxon test, and the Mann–Whitney U test were used for comparisons between the two groups.

Results: The mean age of the patients was 61.03 +/- 10.99 years. The KOOS ADL and KOOS sport/recreational activities decreased significantly in the leech therapy group (P < 0.05). Additionally, the mean KOOS QOL after treatment was significantly lower than it was before treatment (P < 0.001). In the physiotherapy group, the KOOS pain score increased significantly after treatment (25.86 +/- 18.77 vs. 31.60 +/- 11.71; P = 0.008). The KOOS ADL score also showed a significant increase (24.59 +/- 18.55 vs. 35.74 +/- 15.83; P < 0.001). In addition, the median KOOS sport/recreational activities and KOOS QOL increased significantly in the physiotherapy group (P < 0.05). All of the factors in the physiotherapy group had significantly better prognoses than those in the leech salivary therapy group (P < 0.05).

Conclusion: This study failed to identify any therapeutic or remedial effects of leech therapy on pain and symptoms in the symptomatic treatment of knee osteoarthritis. Future studies using more leeches and examining the therapeutic effects over a shorter period of time are recommended to more fully evaluate the effectiveness of leech therapy.

Onion Peel Quercetin Attenuates Ethanol-Induced Liver Injury in Mice by Preventing Oxidative Stress and Steatosis

2022-07-01T21:47:44+00:00

Introduction: Alcoholic liver disease (ALD) is a histological abnormality of the liver that ranges from steatosis to fibrosis/cirrhosis. This study examines the role of onion peel quercetin (OPQ) on oxidative stress, liver function and steatosis in ethanol-treated mice over two phases, protective and therapeutic.

Methods: In each phase, 25 mice were divided equally among five groups (n = 5). In both phases, groups 1 and 2 received vehicle and ethanol, respectively, for 8 days. In the protective phase, groups 3 - 5 received 50 mg/kg OPQ, 100 mg/kg OPQ and 100 mg/kg silymarin, followed by ethanol for 8 days. Mice in these groups were euthanized on day 9. In the therapeutic phase, groups 3 - 5 received ethanol for 8 days and were then treated with 50 mg/kg OPQ, 100 mg/kg OPQ and 100 mg/kg silymarin for an additional 8 days before being euthanized on day 17.

Results: Significant decreases in ALT, AST, and ALP serum levels were observed in mice that received OPQ and silymarin compared to mice that received ethanol (P < 0.05). The catalase activity of mice treated with 50 mg/kg OPQ was significantly higher than in controls (P < 0.05). OPQ treatment significantly improved MDA levels relative to controls (P < 0.05). Hepatocyte degeneration, steatosis, and increased lipid peroxidation were observed in ethanol-treated mice. OPQ significantly decreased ALP, ALT, and AST serum levels compared with ethanol treatment (P < 0.05).

Conclusion: Therefore, OPQ can be used as an antioxidant to delay the onset and progression of liver disease by preventing lipid peroxidation, regulating liver function, and promoting albumin synthesis.

Urinary Mycobacterium tuberculosis Antigens Cocktail as a Potential Marker for Differentiating Active and Latent Tuberculosis Patients

2022-07-02T10:51:02+00:00

Background: Early secretory antigenic target protein 6-kDa (ESAT-6), culture filtrate 10-kDa (CFP- 10), and Mycobacterium tuberculosis (Mtb) 64 (MPT-64) antigens are secreted by actively growing Mtb in active tuberculosis (TB) patients. Increased levels of ESAT-6, CFP-10, and MPT-64 at the site of infection facilitate the entry of antigens into the systemic circulation. These low molecular weight proteins (< 67 kDa) can be excreted into the urine via the kidneys. Therefore, this study evaluated the urinary Mtb antigen cocktail (ESAT-6, CFP-10, and MPT-64) levels in active [pulmonary (P) and extrapulmonary (EP)] TB and latent tuberculosis infections (LTBI) individuals.

Methods: This study was conducted in Dr. Hasan Sadikin General Hospital Bandung from June 2016 to June 2017, using 474 participants. The specimens for TB diagnosis were taken and investigated for acid-fast bacilli (AFB) using the Ziehl Neelsen (ZN) technique. The remaining sputum was cultured on Lowenstein- Jensen (LJ) medium, and TB Ag MPT-64 rapid tests were performed to identify Mtb. In addition, LTBI individuals were screened in a TB outpatient clinic who had close contact with patients with active TB and underwent an interferon g release assay (IGRA). Urine samples were collected for urinary Mtb antigen cocktail (ESAT-6, CFP-10, and MPT-64) testing using the quantitative immunochromatographic method.

Results: The 99 patients were divided into three groups, PTB (n = 52), EPTB (n = 22) and LTBI (n = 25). There were significant differences in urinary Mtb antigen cocktail levels between PTB and EPTB (33.8 vs 13.6 ng/ml; p < 0.001), between PTB and LTBI (33.8 vs 0 ng/ml; p < 0.001), and between EPTB and LTBI (13.6 vs 0 ng/ml; p = 0.015).

Conclusion: Urinary Mtb antigen cocktail levels were increased in patients with active TB and undetected in those with LTBI. This result was obtained using the urinary Mtb antigen cocktail as a potential marker for differentiating active TB and LTBI.

Oral lesions during dermatomyositis treatment: A case report

2022-07-01T08:51:40+00:00

Dermatomyositis is an inflammatory autoimmune disease that causes significant muscle damage. The diagnosis and treatment of this disease commonly requires both therapeutic and dental care. This article describes a clinical case of dermatomyositis where the patient has been receiving therapy since 2018. Stable disease remission was achieved with therapy, with dual-energy X-ray absorptiometry (DXA) indicating an improvement in bone tissue parameters. However, despite this remission, the patient experienced progressive dental manifestations (characteristic complaints, presence of oral mucosal lesions, destruction of jawbone structures). The primary cause of these dental manifestations was not found to be local oral cavity factors, suggesting they were the consequence of both disease pathology and steroid treatment that targeted the oral cavity tissues. The collaboration between an internist and dentist contributed to the early diagnosis and prevention of possible complications associated with this disease.

Extranodal primary CD20-negative diffuse large B-cell lymphoma with cytoplasmic p16 expression

2022-07-01T09:38:55+00:00

Extranodal primary CD20-negative diffuse large B-cell lymphoma (DLBCL) is a rare tumor. It often presents a diagnostic challenge for pathologists as the morphological features of neoplastic cells are similar to those of undifferentiated carcinoma or sarcoma cells. While several B-cell markers are commonly tested, expanding the panel of B-cell markers is necessary to ascertain definitive DLBCL diagnoses and would assist in decisions regarding treatment and prognoses. Several additional markers have been proposed, including several mutated genes commonly expressed in cancer cells, such as c-Myc, Bcl6/c-Myc, Bcl6, Bcl2 (double/triple expressors), as well as cytoplasmic p16.