Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study.

OBJECTIVE: To determine the efficacy and safety of Curcuma domestica extracts in pain reduction and functional improvement. METHODS: 367 primary knee osteoarthritis patients with a pain score of 5 or higher were randomized to receive ibuprofen 1,200 mg/day or C. domestica extracts 1,500 mg/day for 4 weeks. The main outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, WOMAC pain, WOMAC stiffness, and WOMAC function scores. Adverse events (AEs) were also recorded. RESULTS: 185 and 182 patients were randomly assigned into C. domestica extracts and ibuprofen groups, respectively. The baseline characteristics were no different between groups. The mean of all WOMAC scores at weeks 0, 2, and 4 showed significant improvement when compared with the baseline in both groups. After using the noninferiority test, the mean difference (95% confidence interval) of WOMAC total, WOMAC pain, and WOMAC function scores at week 4 adjusted by values at week 0 of C. domestica extracts were noninferior to those for the ibuprofen group (P=0.010, P=0.018, and P=0.010, respectively), except for the WOMAC stiffness subscale, which showed a trend toward significance (P=0.060). The number of patients who developed AEs was no different between groups. However, the number of events of abdominal pain/discomfort was significantly higher in the ibuprofen group than that in the C. domestica extracts group (P=0.046). Most subjects (96%-97%) were satisfied with the treatment, and two-thirds rated themselves as improved in a global assessment. CONCLUSION: C. domestica extracts are as effective as ibuprofen for the treatment of knee osteoarthritis. The side effect profile was similar but with fewer gastrointestinal AE reports in the C. domestica extracts group.

Prevalence and associated factors of musculoskeletal pain among the dental personnel in a dental school.

OBJECTIVE: To study the prevalence and associated factors of musculoskeletal (MS) pain among the dental personnel. In addition, impacts and treatment of MS pain were reported. MATERIAL AND METHOD: Random sampling of 390 participants from the name lists of dental personnel working in each department. Self-administered questionnaires were equally distributed to three groups of dental personnel namely clinical instructors, postgraduate students, and dental assistants. The present study was conducted as a survey in the Faculty of Dentistry, Mahidol University, Bangkok between December 2008 and January 2009. RESULTS: Three hundred and ninety questionnaires were delivered and 164 questionnaires were returned (response rate 42.5%). The participants with MS pain were 32 clinical instructors (20.3%), 52 postgraduate students (32.9%), and 74 dental assistants (46.8%). Their mean age was 33.0 +/- 9.1 years old. The MS pain found respectively was shoulder pain 72.2% (n = 114), neckpain 70.3% (n = 111), and low backpain 50.6% (n = 80). The participants with shoulder and neckpain were combined and defined as cervicobrachial pain. The associated factor of cervicobrachial pain was working status. Being a clinical instructor and postgraduate student were associated with cervicobrachial pain with OR being 4.7 [1.3, 7.1] and 4.6 [1.6, 13.4], respectively. The impacts of MS pain among the dental personnel included usage of pain relieving medication (34.8%), seeking medical evaluation (32.3%), reduction in working hours (27.2%), difficulty sleeping (22.8%), and work absence (10.8%), respectively. The treatments of MS pain utilized to alleviate those impacts were Thai traditional massage (51.9%), medication (28.5%), physical therapy (15.8%), acupuncture (7.6%), and alternative medicine (4.4%), respectively. CONCLUSION: Cervicobrachial pain was the most prevalent MS pain among the dental personnel and working status was associated with their MS pain problems. The impact of MS pain was predominantly usage of pain relieving medication. Thai traditional massage was the most utilized treatment.