Pub Date : 2018-01-01DOI: 10.4172/2167-7921.1000267
S. Nobuta, Katsumi Sato, E. Itoi
Objective: The authors reported the long-term results of ulnohumeral arthroplasty (UHA) for symptomatic elbow osteoarthritis. UHA does not allow access to the medial ulnohumeral osteophyte and to the radiohumeral joint, and the influence of remained medial ulnohumeral osteophyte on the outcome is still unclear. The purpose of the present study was to determine the influence of remained medial osteophyte on the outcome in a much larger sample size. Methods: Fifty-eight elbows in 51 patients with elbow osteoarthritis underwent UHA and were evaluated. Before surgery, all patients complained of motion pain and loss of flexion-extension arc of the elbow. Preoperative evaluation and the outcome at follow-up were assessed using Mayo Elbow Performance Score (MEPS), and medial ulnohumeral osteophyte was assessed in anteroposterior radiograph. Results: Forty-one elbows had no pain and 17 decreased pain. The average flexion-extension arc improved from 93° preoperatively to 107°postoperatively. Total MEPS improved from 69 to 91. The result was excellent for 40 elbows (69%), good for 14 (24%), fair for four (7%) and no poor case. Patients’ satisfaction showed that fifty (86%) were satisfactory subjective result and eight (14%) were unsatisfactory result. The preoperative flexion-extension arc was factors for predicting postoperative results. Remained medial ulnohumeral osteophyte was related to decreased arc of the flexion-extension but not patients’ satisfaction and pain scale. Conclusions: Remained medial ulnohumeral osteophyte was related to decreased arc of the flexion-extension but not patients’ satisfaction and pain scale after UHA.
{"title":"Influence of Remained Medial Osteophyte on the Outcome after Ulnohumeral Arthroplasty","authors":"S. Nobuta, Katsumi Sato, E. Itoi","doi":"10.4172/2167-7921.1000267","DOIUrl":"https://doi.org/10.4172/2167-7921.1000267","url":null,"abstract":"Objective: The authors reported the long-term results of ulnohumeral arthroplasty (UHA) for symptomatic elbow osteoarthritis. UHA does not allow access to the medial ulnohumeral osteophyte and to the radiohumeral joint, and the influence of remained medial ulnohumeral osteophyte on the outcome is still unclear. The purpose of the present study was to determine the influence of remained medial osteophyte on the outcome in a much larger sample size. Methods: Fifty-eight elbows in 51 patients with elbow osteoarthritis underwent UHA and were evaluated. Before surgery, all patients complained of motion pain and loss of flexion-extension arc of the elbow. Preoperative evaluation and the outcome at follow-up were assessed using Mayo Elbow Performance Score (MEPS), and medial ulnohumeral osteophyte was assessed in anteroposterior radiograph. Results: Forty-one elbows had no pain and 17 decreased pain. The average flexion-extension arc improved from 93° preoperatively to 107°postoperatively. Total MEPS improved from 69 to 91. The result was excellent for 40 elbows (69%), good for 14 (24%), fair for four (7%) and no poor case. Patients’ satisfaction showed that fifty (86%) were satisfactory subjective result and eight (14%) were unsatisfactory result. The preoperative flexion-extension arc was factors for predicting postoperative results. Remained medial ulnohumeral osteophyte was related to decreased arc of the flexion-extension but not patients’ satisfaction and pain scale. Conclusions: Remained medial ulnohumeral osteophyte was related to decreased arc of the flexion-extension but not patients’ satisfaction and pain scale after UHA.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-7921.1000273
I. Russell
{"title":"Management of Pain in the Fibromyalgia Syndrome","authors":"I. Russell","doi":"10.4172/2167-7921.1000273","DOIUrl":"https://doi.org/10.4172/2167-7921.1000273","url":null,"abstract":"","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000273","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-7921.1000274
Shigemi Matsumoto, Kazu Matsumoto, H. Ogawa, K. Nagase, K. Tanabe, Haruhiko Akiyama, H. Iida
Background: Different techniques and medications are used to achieve pain relief and early mobilization after total knee arthroplasty (TKA). However, the relationship between subacute postoperative pain and early functional recovery remains to be fully resolved. We examined the effects of low-dose tramadol, and morphine on subacute postoperative pain management with NSAID in patients after TKA. Hypothesis: The low-dose tramadol combined with NSAIDs are effective for subacute postoperative pain in TKA. Methods: We prospectively studied 81 patients who underwent primary TKA. Before surgery, we randomly assigned participating patients into one of three treatment groups; Group NSAID, Group Tramadol, or Group Morphine. The postoperative pain intensity was measured and recorded by physical therapists with a visual analogue scale (VAS) at rest (rVAS) and during movement (mVAS) on the day before surgery, and on postoperative days (PODs) 3, 7 and 14. The lower leg functional recovery was also evaluated by the range of motion (ROM) of the knee, and the quadriceps muscle strength (% muscle strength). Results: Twenty-two patients from each group completed the study. The mean rVAS scores of the groups showed no significant differences between throughout the postoperative period. The mean mVAS scores showed no differences on PODs 7, 10, and 14. However, the mVAS scores of Group Tramadol were significantly lower than those of Group NSAID on POD 3 (p=0.0216). No significant differences were found among the groups in ROM or % muscle strength. The incidence of constipation in Group Morphine was significantly higher than that in Group NSAID (p=0.0026). Conclusion: Tramadol 100mg/day was effective for postoperative pain management, especially in the first week after TKA. Level of Evidence: Level II, low-powered prospective randomized trial.
{"title":"A Prospective, Randomized Comparison of the Postoperative Administration of Tramadol and Morphine following Primary Total Knee Arthroplasty","authors":"Shigemi Matsumoto, Kazu Matsumoto, H. Ogawa, K. Nagase, K. Tanabe, Haruhiko Akiyama, H. Iida","doi":"10.4172/2167-7921.1000274","DOIUrl":"https://doi.org/10.4172/2167-7921.1000274","url":null,"abstract":"Background: Different techniques and medications are used to achieve pain relief and early mobilization after total knee arthroplasty (TKA). However, the relationship between subacute postoperative pain and early functional recovery remains to be fully resolved. We examined the effects of low-dose tramadol, and morphine on subacute postoperative pain management with NSAID in patients after TKA. Hypothesis: The low-dose tramadol combined with NSAIDs are effective for subacute postoperative pain in TKA. Methods: We prospectively studied 81 patients who underwent primary TKA. Before surgery, we randomly assigned participating patients into one of three treatment groups; Group NSAID, Group Tramadol, or Group Morphine. The postoperative pain intensity was measured and recorded by physical therapists with a visual analogue scale (VAS) at rest (rVAS) and during movement (mVAS) on the day before surgery, and on postoperative days (PODs) 3, 7 and 14. The lower leg functional recovery was also evaluated by the range of motion (ROM) of the knee, and the quadriceps muscle strength (% muscle strength). Results: Twenty-two patients from each group completed the study. The mean rVAS scores of the groups showed no significant differences between throughout the postoperative period. The mean mVAS scores showed no differences on PODs 7, 10, and 14. However, the mVAS scores of Group Tramadol were significantly lower than those of Group NSAID on POD 3 (p=0.0216). No significant differences were found among the groups in ROM or % muscle strength. The incidence of constipation in Group Morphine was significantly higher than that in Group NSAID (p=0.0026). Conclusion: Tramadol 100mg/day was effective for postoperative pain management, especially in the first week after TKA. Level of Evidence: Level II, low-powered prospective randomized trial.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"07 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70836727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2167-7921.1000E117
P. Lee, James P. Brock, Sarah Mansoor, Bethan Whiting
Paul Y F Lee1,2*, James Brock1, Sarah Mansoor1 and Bethan Whiting1 1Lincolnshire Elective Orthopaedics Institute, Grantham and District Hospital, Manthorpe Road, Grantham, NG31 8DG, UK 2School of Sport and Exercise Science, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, UK *Corresponding author: Prof. Paul Y F Lee, Lincolnshire Elective Orthopaedics Institute, Grantham and District Hospital, Manthorpe Road, Grantham, NG31 8DG, UK, Tel: +447764614688; E-mail: plee@lincoln.ac.uk
Paul Y F Lee1,2*， James Brock1, Sarah Mansoor1和Bethan Whiting1 1 1英国格兰瑟姆郡曼索普路格兰瑟姆郡和地区医院林肯郡选任骨科研究所2英国林肯郡布莱福德普尔林肯大学体育与运动科学学院*通讯作者:Paul Y F Lee教授，英国格兰瑟姆郡曼索普路格兰瑟姆郡和地区医院，格兰瑟姆郡曼索普路格兰瑟姆郡，NG31 8DG，英国，电话:+447764614688;电子邮件:plee@lincoln.ac.uk
{"title":"Knee Braces and Anti-Inflammatory Sleeves in Osteoarthritis, Innovation for the 21st Century?","authors":"P. Lee, James P. Brock, Sarah Mansoor, Bethan Whiting","doi":"10.4172/2167-7921.1000E117","DOIUrl":"https://doi.org/10.4172/2167-7921.1000E117","url":null,"abstract":"Paul Y F Lee1,2*, James Brock1, Sarah Mansoor1 and Bethan Whiting1 1Lincolnshire Elective Orthopaedics Institute, Grantham and District Hospital, Manthorpe Road, Grantham, NG31 8DG, UK 2School of Sport and Exercise Science, University of Lincoln, Brayford Pool, Lincoln, LN6 7TS, UK *Corresponding author: Prof. Paul Y F Lee, Lincolnshire Elective Orthopaedics Institute, Grantham and District Hospital, Manthorpe Road, Grantham, NG31 8DG, UK, Tel: +447764614688; E-mail: plee@lincoln.ac.uk","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":"7 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000E117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70837314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-27DOI: 10.4172/2167-7921.1000261
Masashi Mastuzaki, N. Sekine
Transparent 3D images was used to analyze the motion of the patella in knee extension movements at the patellofemoral joint in asymptomatic persons aged 40 and over who are at increased risk of osteoarthritis of the knee.By adding transparency to 3D images constructed by extracting the femoral condyle cartilage and patella from 3D data using MRI scans at knee flexion angles of 120°, 90° and 60°, the patella movement analysis images allow the position of the patella to be accurately ascertained through the joint cartilage. This made it possible to analyze the rotation and inclination of the patella when the patella is moved by the femoral trochlear during knee extension movements.There was a correlation between patella rotation and patella inclination when the knee is extended. 3D motion analysis of the patella at the patellofemoral joint was performed by complex computer analysis according to conventional methods. Transparent 3D imaging facilitates the use of bony landmarks to analyze the motion of the patella. This method is thought to be useful in preventive medicine by enabling early prognostic prediction by performing motion analysis of the patella with respect to deformation of the patellofemoral joint.
{"title":"Motion Analysis of the Patella in Asymptomatic Patellofemoral Joints by Transparent 3D Imaging","authors":"Masashi Mastuzaki, N. Sekine","doi":"10.4172/2167-7921.1000261","DOIUrl":"https://doi.org/10.4172/2167-7921.1000261","url":null,"abstract":"Transparent 3D images was used to analyze the motion of the patella in knee extension movements at the patellofemoral joint in asymptomatic persons aged 40 and over who are at increased risk of osteoarthritis of the knee.By adding transparency to 3D images constructed by extracting the femoral condyle cartilage and patella from 3D data using MRI scans at knee flexion angles of 120°, 90° and 60°, the patella movement analysis images allow the position of the patella to be accurately ascertained through the joint cartilage. This made it possible to analyze the rotation and inclination of the patella when the patella is moved by the femoral trochlear during knee extension movements.There was a correlation between patella rotation and patella inclination when the knee is extended. 3D motion analysis of the patella at the patellofemoral joint was performed by complex computer analysis according to conventional methods. Transparent 3D imaging facilitates the use of bony landmarks to analyze the motion of the patella. This method is thought to be useful in preventive medicine by enabling early prognostic prediction by performing motion analysis of the patella with respect to deformation of the patellofemoral joint.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2017-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45782671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-25DOI: 10.4172/2167-7921.1000258
Y. ElMiedany, M. Elgaafary, N. ElAroussy, S. Youssef, S. Bahlas, M. Hegazi
Objectives: 1. To assess the validity of an electronically comorbidity assessment strategy to identify comorbid conditions among inflammatory arthritis patients in standard practice. 2. To evaluate the impact of e-comorbidity assessment on the patients’ care and adherence to therapy.Methods: A cohort of 112 RA and 111 PsA subjects diagnosed according to RA ACR/EULAR criteria and PsA CASPAR criteria were followed longitudinally for 36 months. The patients were classified into a study group (112 patients) whose electronic patient-reported comorbidities were compared to a control group of 111 patients who were managed according to standard protocols. The sensitivity, specificity, positive and negative predictive values of the electronic data entry were compared to ICD-10 medical record (reference standard) and rheumatology clinic visits outcomes.Results: The sensitivity for identifying comorbidities using the electronic approach (median, 99.2%; interquartile range [IQR]: 96%-100%) outperformed those recorded using using ICD-10 codes (median, 66%; IQR: 50%-74%); and those recorded using clinic letters (median, 38%; IQR: 32%-54%). The median PPV and NPV were 97.7% (IQR: 96-100%) and 99.6% (IQR: 99-100%) for the e-comorbidity tool Vs 61.8% (IQR: 41%-76%) and 97.4% (IQR: 91%-98%) for the ICD-10 codes, physician recorded comorbidity respectively. The patients’ adherence to antirheumatic therapy was significantly (p<0.1) higher in the studied group.Conclusions: e-comorbidity assessment offered a specific and dynamic approach tailored to the patient’s needs over the 3-years study period, which is applicable in standard practice. Patient reported e-comorbidity outperformed the standard medical recording systems and can have a role in healthcare management and research.
{"title":"E-Comorbidity: Evaluation of the Electronic Comorbidity Assessment in Identifying Comorbid Conditions among Patients with Inflammatory Arthritis","authors":"Y. ElMiedany, M. Elgaafary, N. ElAroussy, S. Youssef, S. Bahlas, M. Hegazi","doi":"10.4172/2167-7921.1000258","DOIUrl":"https://doi.org/10.4172/2167-7921.1000258","url":null,"abstract":"Objectives: 1. To assess the validity of an electronically comorbidity assessment strategy to identify comorbid conditions among inflammatory arthritis patients in standard practice. 2. To evaluate the impact of e-comorbidity assessment on the patients’ care and adherence to therapy.Methods: A cohort of 112 RA and 111 PsA subjects diagnosed according to RA ACR/EULAR criteria and PsA CASPAR criteria were followed longitudinally for 36 months. The patients were classified into a study group (112 patients) whose electronic patient-reported comorbidities were compared to a control group of 111 patients who were managed according to standard protocols. The sensitivity, specificity, positive and negative predictive values of the electronic data entry were compared to ICD-10 medical record (reference standard) and rheumatology clinic visits outcomes.Results: The sensitivity for identifying comorbidities using the electronic approach (median, 99.2%; interquartile range [IQR]: 96%-100%) outperformed those recorded using using ICD-10 codes (median, 66%; IQR: 50%-74%); and those recorded using clinic letters (median, 38%; IQR: 32%-54%). The median PPV and NPV were 97.7% (IQR: 96-100%) and 99.6% (IQR: 99-100%) for the e-comorbidity tool Vs 61.8% (IQR: 41%-76%) and 97.4% (IQR: 91%-98%) for the ICD-10 codes, physician recorded comorbidity respectively. The patients’ adherence to antirheumatic therapy was significantly (p<0.1) higher in the studied group.Conclusions: e-comorbidity assessment offered a specific and dynamic approach tailored to the patient’s needs over the 3-years study period, which is applicable in standard practice. Patient reported e-comorbidity outperformed the standard medical recording systems and can have a role in healthcare management and research.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49578842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-08DOI: 10.4172/2167-7921.1000I105
S. Dhanda, S. Quek
Foot complications in diabetes need early diagnosis to start timely therapy and prevent amputation. Diabetic foot remains a challenge for the clinicians due to confusing clinical picture and associated complications. It may present as neuroarthropathy, septic arthritis, osteomyelitis, ischemic devitalised bone or as soft tissue complications such as cellulitis, myositis, ulceration, callus formation, sinus tracts, abscess, muscle denervation, tenosynovitis etc. Awareness of the various imaging findings of a diabetic foot, their relevance to the therapeutic decisions and correct usage of various imaging modalities to answer pertinent clinical questions are very important to improve the patient management and to reduce complications and morbidity [1].
{"title":"Imaging in Diabetic Foot","authors":"S. Dhanda, S. Quek","doi":"10.4172/2167-7921.1000I105","DOIUrl":"https://doi.org/10.4172/2167-7921.1000I105","url":null,"abstract":"Foot complications in diabetes need early diagnosis to start timely therapy and prevent amputation. Diabetic foot remains a challenge for the clinicians due to confusing clinical picture and associated complications. It may present as neuroarthropathy, septic arthritis, osteomyelitis, ischemic devitalised bone or as soft tissue complications such as cellulitis, myositis, ulceration, callus formation, sinus tracts, abscess, muscle denervation, tenosynovitis etc. Awareness of the various imaging findings of a diabetic foot, their relevance to the therapeutic decisions and correct usage of various imaging modalities to answer pertinent clinical questions are very important to improve the patient management and to reduce complications and morbidity [1].","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000I105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48972648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-04DOI: 10.4172/2167-7921.1000256
Hilal Akhtar, Mohammad Rashid, M. Siddiqi, Qazi Zaid Ahmad
Gout is a potentially progressive and debilitating form of chronic inflammatory arthritis caused by the deposition of monosodium urate crystals in synovial fluid and other tissues, characterized by sudden & severe episode of pain, warmth and swelling in a joint. People suffering from recurrent attacks frequently experience pain and disability, reduced health-related quality of life and productivity and increased morbidity. NSAIDs, colchicines, glucocorticoids, uric acid lowering agent like uricostatic drugs (allopurinol, a xanthine oxidase inhibitor), Uricosuric drugs (Probenecid) are very effective but risky in patients having pre-existing renal, cardiovascular, gastrointestinal and metabolic disorders. Cupping (Al-Hijama) is a widely used therapeutic regimen of Unani system of medicine with high acceptance in Egypt and Arab countries. It is used for the treatment of various inflammatory and painful conditions like sciatica, gout, rheumatoid arthritis, pain of knee, removal of deep swelling, disease of liver and skin etc. It is a minor surgical excretory procedure related scientifically to the principles of renal glomerular filtration and abscess evacuation where a pressure-dependent excretion of causative pathological substances occurs. Cupping is thought to act mainly by increasing local blood circulation and relieving the painful muscle tension. It acts by improving microcirculation, promoting capillary endothelial cell repair, accelerating granulation, and angiogenesis in the regional tissues. It is the best deep tissue massage which normalizes the patient’s functional state and progressive muscle relaxation. In Unani system of Medicine, this is a simple and economic treatment, effectively treating diseases with different etiologies and pathogenesis.
{"title":"Role of Hijamaâ (Cupping Therapy) in the Management of Niqras (Gouty Arthritis)","authors":"Hilal Akhtar, Mohammad Rashid, M. Siddiqi, Qazi Zaid Ahmad","doi":"10.4172/2167-7921.1000256","DOIUrl":"https://doi.org/10.4172/2167-7921.1000256","url":null,"abstract":"Gout is a potentially progressive and debilitating form of chronic inflammatory arthritis caused by the deposition of monosodium urate crystals in synovial fluid and other tissues, characterized by sudden & severe episode of pain, warmth and swelling in a joint. People suffering from recurrent attacks frequently experience pain and disability, reduced health-related quality of life and productivity and increased morbidity. NSAIDs, colchicines, glucocorticoids, uric acid lowering agent like uricostatic drugs (allopurinol, a xanthine oxidase inhibitor), Uricosuric drugs (Probenecid) are very effective but risky in patients having pre-existing renal, cardiovascular, gastrointestinal and metabolic disorders. Cupping (Al-Hijama) is a widely used therapeutic regimen of Unani system of medicine with high acceptance in Egypt and Arab countries. It is used for the treatment of various inflammatory and painful conditions like sciatica, gout, rheumatoid arthritis, pain of knee, removal of deep swelling, disease of liver and skin etc. It is a minor surgical excretory procedure related scientifically to the principles of renal glomerular filtration and abscess evacuation where a pressure-dependent excretion of causative pathological substances occurs. Cupping is thought to act mainly by increasing local blood circulation and relieving the painful muscle tension. It acts by improving microcirculation, promoting capillary endothelial cell repair, accelerating granulation, and angiogenesis in the regional tissues. It is the best deep tissue massage which normalizes the patient’s functional state and progressive muscle relaxation. In Unani system of Medicine, this is a simple and economic treatment, effectively treating diseases with different etiologies and pathogenesis.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2017-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45812112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-20DOI: 10.4172/2167-7921.1000252
C. Eken, M. Serinken
Although the incidence of Lisfranc injuries is not high, they are related to long-term disability of the foot such as malalignment, functional deficits and weight bearing difficulties. Delayed treatment or missed diagnosis of Lisfranc injuries can result in significant complications. Lisfranc injuries result from both indirect and direct trauma. A 43 years old man came into the emergency with pain in his right foot after a direct trauma to the anterior part of his foot while playing soccer.Introduction Lisfranc injuries are relatively uncommon, representing approximately 0.2% of all fractures. Although the incidence of Lisfranc injuries is not high, they are related to long-term disability of the foot such as malalignment, functional deficits and weight bearing difficulties [1]. Delayed treatment or missed diagnosis of Lisfranc injuries can result in significant complications.
{"title":"Ecchymosis on the Plantar Side of the Foot","authors":"C. Eken, M. Serinken","doi":"10.4172/2167-7921.1000252","DOIUrl":"https://doi.org/10.4172/2167-7921.1000252","url":null,"abstract":"Although the incidence of Lisfranc injuries is not high, they are related to long-term disability of the foot such as malalignment, functional deficits and weight bearing difficulties. Delayed treatment or missed diagnosis of Lisfranc injuries can result in significant complications. Lisfranc injuries result from both indirect and direct trauma. A 43 years old man came into the emergency with pain in his right foot after a direct trauma to the anterior part of his foot while playing soccer.Introduction \u0000Lisfranc injuries are relatively uncommon, representing approximately 0.2% of all fractures. Although the incidence of Lisfranc injuries is not high, they are related to long-term disability of the foot such as malalignment, functional deficits and weight bearing difficulties [1]. Delayed treatment or missed diagnosis of Lisfranc injuries can result in significant complications.","PeriodicalId":91304,"journal":{"name":"Journal of arthritis","volume":" ","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2167-7921.1000252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47355544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-31DOI: 10.4172/2167-7921.1000251
Khaled M Alsubiaee, Abdulmohsan F Alotaibi, Abdulaziz Alshehri, Mohammed Alassaf
After the World War II (WWII), the industrial era began. Therefore the risk management philosophy concerns shifted from error resolving to error prevention by predicting the causes. One of the most common processes used to decrease the failures is utilizing the Failure Mode and Effects Analysis (FMEA). FMEA approximates the probability based on Risk Priority Number (RPN). RPN is known for limitations in the process of RPN scoring system measuring the severity (S), occurrence (O), and detection of the failure (D). RPN is not an accurate, in determining the relative importance of failure. R-FMEA provides a proactive more reliable method using Kruskal-Wallis test. This article discusses with examples how a new suggested statistical model (R-FMEA) is enhancing the reliability of FMEA to predict errors.
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