Effects of Omega-3 Fatty Acid Supplementation on Serum Biomarkers, Inflammatory Agents, and Quality of Life of Patients on Hemodialysis.

INTRODUCTION: Patients on long-term hemodialysis are at a higher risk of cardiovascular disease and premature mortality. It is generally believed that omega-3 supplementation can prevent cardiovascular events due to its anti-inflammatory and anti-atherosclerotic effects. MATERIALS AND METHODS: Fifty-two hemodialysis patients were divided into 2 groups to receive omega-3 and placebo for 6 six months. Serum biomarkers and inflammatory agents were measured in both groups before and after the intervention. Quality of life was also assessed before and after the trial using the Kidney Disease Quality of Life-Short Form questionnaire. RESULTS: Patients who received omega-3 showed an increase in serum calcium level (P = .005), a decrease in vascular cell adhesion molecule (P = .04), and an increase in the high-density lipoprotein cholesterol level (P < .001), while such changes were not documented in the control group. However, omega-3 administration did not have a significant effect on serum levels of albumin, low-density lipoprotein cholesterol, or triglyceride. Quality of life scores were improved after treatment with omega-3 in both scopes of general and kidney-specific assessment (P = .37 and P = .20, respectively), while no similar changes were seen in the control group. CONCLUSIONS: Our data showed beneficial effects of omega-3 supplementation during chronic hemodialysis on inflammatory processes and also quality of life. We suggest administration of omega-3 in the hemodialysis community in a preventive manner for improvement of cardiovascular events and quality of life.

Extracorporeal shock wave therapy of gastroc-soleus trigger points in patients with plantar fasciitis: A randomized, placebo-controlled trial.

BACKGROUND: Plantar fasciitis is the most common cause of heel pain. Extracorporeal shock wave therapy (ESWT) is an alternative treatment for refractory cases of plantar fasciitis. Studies also demonstrated that ESWT may be an appropriate treatment for myofascial trigger points. This study was designed to evaluate its effectiveness by comparing the ESWT of Gastrocnemius/Soleus (gastroc-soleus) trigger points and heel region with the ESWT of the heel region alone. MATERIALS AND METHODS: The study was carried out among 40 patients with a clinical diagnosis of plantar fasciitis, divided randomly to case (n = 20) and control (n = 20) groups. The case group received ESWT for the heel region and for the gastroc-soleus trigger points. The control group received ESWT just for the heel region. The protocol was the same in both groups and they were treated for three sessions every week. The pain score (100 mm visual analog score [VAS]) and the modified Roles and Maudsley score was evaluated before the first session and eight weeks after the last session. RESULTS: Eight weeks after the last session, although the mean VAS had decreased significantly in both groups, this decrement was more significant in the case group. (P = 0.04). According to the modified Roles and Maudsley score, there was a significant improvement in both the case (P < 0.001) and control (P = 0.01) groups, eight weeks after treatment, but there were significantly better results in the case group. CONCLUSION: The combination of ESWT for both plantar fasciitis and gastroc-soleus trigger points in treating patients with plantar fasciitis is more effective than utilizing it solely for plantar fasciitis.

Effect of subacromial sodium hyaluronate injection on rotator cuff disease: A double-blind placebo-controlled clinical trial.

BACKGROUND: Rotator cuff disease is a common cause of shoulder pain. There are studies about the effectiveness of sodium hyaluronate injection on shoulder and knee pain, but few studies demonstrating the efficacy of sodium hyaluronate ultrasonography guided injection for rotator cuff disease. This study evaluates effectiveness of ultrasonography guided subacromial sodium hyaluronate injection in patients with impingment syndrome without rotator cuff complete tear. MATERIALS AND METHODS: This prospective, double-blind, placebo controlled clinical trial study was performed among 40 patients with subacromial impingement syndrome without complete tear of rotator cuff. Patients randomly injected ultrasonography guided in 2 groups: Case group by 20 mg of sodium hyaluronate (Fermathron™) and control group by 0.9% normal saline. Both groups received 3 weekly injections. The pain score (100 mm visual analogue score [VAS]) was evaluated before first injection and one week after each injection. The constant score was evaluated before first and 12 week after last injection. Data was analyzed statistically by Independent t-test. RESULTS: In both groups mean VAS has decreased, but more significantly in case group (P < 0.001). Mean constant score was significantly higher in case group 12 weeks after last injection (P < 0.001). The constant score improved 12 weeks after the last injection in both groups with a significantly better result in case group (P < 0.001). CONCLUSION: Subacromial injections of sodium hyaluronate are effective in treating rotator cuff disease without complete tears.

Acupuncture in treatment of carpal tunnel syndrome: A randomized controlled trial study.

BACKGROUND: Carpal tunnel syndrome (CTS) is the most preva lent form of peripheral neuropathy. The efficacy of acupuncture in management of mild to moderate CTS has been investigated in limited studies with controversial results. The aim of this study was to assess the short-term effects of acupuncture in treatment of mild to moderate carpal tunnel syndrome. METHODS: In a randomized controlled trial study, participants were randomly assigned to either control group which night splinting, vitamin B1, B6 and sham acupuncture for four weeks were administered, or intervention group that underwent acupuncture in 8 sessions over 4 weeks and night splinting. The clinical symptoms using global symptom score (GSS) and electrophysiological parameters were assessed at baseline and four weeks after the intervention. RESULTS: Of 72 patients met the inclusion criteria, 64 patients actually completed the 4 week intervention and were evaluated for the outcome. There was a statistically significant difference in GSS between two arms of treatment after the intervention (p < 0.001) Using repeated measure ANOVA, the GSS in acupuncture group was significantly different after 4 weeks (p <0.001). Among electrophysiological parameters, nerve conduction velocity (NCV) was significantly different between two groups after 4 weeks (p = 0.02). Other parameters showed no statistically significant difference after intervention (p > 0.05). CONCLUSIONS: Our findings indicated that the acupuncture can improve the overall subjective symptoms of carpal tunnel syndrome and could be adopted in comprehensive care programs of these patients.

Changes in electrophysiological parameters after open carpal tunnel release.

BACKGROUND: Carpal tunnel syndrome (CTS) is the most frequent compressive mononeuropathy, affecting mostly females. Few studies have been performed to assess the electrophysiological parameters before and after carpal tunnel release. The purpose of our study was to evaluate these changes postoperatively and in the course of a 9-month period after operation in comparison with the preoperative values. MATERIALS AND METHODS: A case-series study was carried out and included 17 cases of moderate or severe electrophysiologically confirmed CTS, who underwent open carpal tunnel release (CTR) from December 2010 to May 2011. Severity grade was assigned following American Association of the Electrodiagnostic Medicine criteria of CTS. Distal motor and sensory latencies and sensory nerve conduction velocity of the median nerve across the carpal tunnel were evaluated and compared before, at 6, and 9 months after surgery. RESULTS: From the 17 evaluated hand with moderate, moderate to severe and severe CTS, severity improvement was reported in 82.3% 6 months and in 88.2% 9 months after surgery, but only 47% had satisfied or completely satisfied opinion about the results. Others, though still complaining of serious symptoms, had improved or normal NCS. DISCUSSION: Electrophysiological investigations outlined severity improvement after CTR. In the current study, the electrophysiological studies were not meaningful in determining outcome.