Benefits Of Medicine Research Articles

Severe Acute Respiratory Syndrome Coronavirus 2 Virus-Like Particle and Its Application in Chinese Medical Research

Background: The global outbreak of coronavirus disease 2019 (COVID-19) has brought disastrous consequences to public health and medical systems, whereas no approved medications are currently available. Benefits of traditional Chinese medicine (TCM) against COVID -19 have been observed, however, the underlying mechanistic actions remain unclarified. Due to high pathogenicity and infectivity of the new coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]), the lack of access to SARS-CoV-2 and biosafety level 3 (P3) facilities has impeded scientific investigations of TCM against COVID-19. Though low-pathogenic coronavirus and pseudoviral systems have been applied to substitute SARS-CoV-2 in fundamental studies, both models cannot imitate virological and clinical features associated with SARS-CoV-2. The virus -like particle (VLP) is a virological model that is safe and could be performed without biosafety protections. Aims and Objectives: To construct VLP of SARS-CoV-2 containing structural proteins of authentic viruses and resembling the morphology, partial life cycle, and immunoreactions of natural virions, and to introduce VLP into Chinese medical research. Materials and Methods: Using mammalian expression system, we have currently constructed SARS-CoV-2 VLP containing four essential structural proteins. Results: Based on this model, we propose six aspects of research that could be carried out for TCM formulas in the fight against COVID-19. Conclusion: Application of the VLP model provides a safe methodology to strengthen the response systems of Chinese medicine in preventing and controlling newly identified infectious diseases and offers collaborative opportunities for interdisciplinary deciphering of molecular and biological basis of anti-viral TCM formulas.

Adapting discrete goods supply chains to support mass customisation of pharmaceutical products

Emerging research within the field of personalised medicines has aimed to enhance patient treatment through the use of pharmaceutical products that are customised to the individual needs and preferences of the patient. The currently dominant production platforms of pharmaceutical products, however, regard a mass production paradigm and are thus unfeasible for the production and provision of personalised medicines. The production platforms are not designed or are intended for a customisation context. Operating such a context with the current supply chain entails challenges such as increasing costs, time to patient and efforts in quality assurance activities. To address these challenges, this paper presents four reconfigured pharmaceutical supply chain designs. A qualitative operational performance assessment elicits the strengths and weaknesses of the respective supply chain design operating in a customisation context. The results suggest that a later point of variegation, that is, the point in the supply chain where the final customisation is achieved, can relieve the operational effort of the stakeholders in the supply chain while providing the benefits of personalised medicines, that is, an enhanced treatment outcome of the patient. A trade-off remains, however, between the supply chain’s decreased operational effort and degree of necessary reconfigurations, such as introducing new functions to stakeholder operation, reallocating activities to other stakeholders or educating stakeholders.

PEMBERDAYAAN IBU PKK MELALUI PEMBUATAN JAMU HERBAL UNTUK MENINGKATKAN SISTEM IMUN TUBUH DI DESA ALUE SENTANG KABUPATEN ACEH TAMIANG

Covid 19 is a disease caused by SARS-CoV-2 or known as a virus that can cause pneumonia, multi-organ failure, and death. Therefore, alternative efforts are needed to increase the body's immune system so that it can prevent viral infections in the body. One effort that can be done is to empower the people of Alue Sentang Village to make and consume herbal herbs which have the potential to increase endurance. Besides, it also increases the role and function of universities, Covid 19 volunteers, and village officials in accelerating and expanding the adoption of innovations in making herbal medicine to support the government in breaking the chain of the spread of Covid 19. The methods used in this activity are the direct approach method, lectures, and practice. The approach method was carried out by listing the problems faced by the people of Alue Sentang Village regarding the Covid 19 attack. The lecture method was carried out by providing information to the community, Covid 19 volunteers, and village officials about the advantages and benefits of herbal medicine in improving the immune system so that it could prevent and overcome Covid infection. 19. The practical method is carried out by providing training in making herbal herbwhich plays a role in increasing the immune system. The results achieved were the increased understanding and skills of PKK Alue Sentang Village women about making Herbal herbs to improve the immune system to control and prevent Covid-19.

Aqueous extract of Moringa oleifera Lam. induced mitodepression and chromosomal aberration in Allium cepa, and reproductive genotoxicity in male mice

Moringa oleifera is a multipurpose plant with nutritional and medicinal value. Despite its widely acclaimed therapeutic benefits in traditional medicine, there are reports on its toxicity in living cells. Information is however, limited on toxic effect of the plant on the genetic component and male reproductive cells. We evaluated genotoxicity of aqueous extract of the leaves of M. oleifera using the Allium cepa chromosome aberration (CA) and mouse sperm morphology assays. Roots of onion bulbs were exposed to 0.5–20% of the extract for analysis of root growth inhibition, mitotic index (MI) and CA. Swiss male mice orally exposed to the aqueous extract (50–800 mg/kg) for 35 consecutive days were analysed for body and testes weight, testicular histology and sperm morphology. There was a significant (p < 0.05) root growth inhibition, decrease in MI and induction of CA compared to the negative control bulbs. The extract did not cause adverse effect on body and testes weight, but maturation arrest, atrophy and germ cell sloughing and degeneration were observed in testicular sections of exposed mice. A significant increase in sperm morphology was observed in exposed mice relative to the control group. Aqueous extract of M. oleifera was cytotoxic, mitodepressive and genotoxic in A. cepa. It induced DNA damage in the sperm head and interfered with spermatogenesis. This suggests potentials of M. oleifera to modulate somatic cell cycle and impact male fertility.

ASTOUNDING POSITIVE BENEFITS IN SHWITRA (VITILIGO) TREATED FOR NECROZOOSPERMIA (SHUKRA DOSHA): A CASE REPORT

In the present era, there is a heightened awareness about the safety of drugs rather than the efficacy, which is largely due to the side effects as well as their consequences. This case study highlights the benefits of Ayurvedic medicine, which has yielded positive results by reducing hypo-pigmented patches of vitiligo, though the treatment was intended to treat Necrozoospermia. Vitiligo is an autoimmune cutaneous disorder of pigmentation which is correlated with Shwitra in Ayurveda. Main line of treatment for Shwitra in Ayurveda is Snehana (medicated fats) Shodhana (Purificatory therapies) followed by anointing body and exposure to sunlight. However, in this present case astounding effects were seen when the patient was treated only with internal medication for Necrozoospermia without considering Shwitra. Fifty-six years old man approached with chief complaint of secondary infertility and was diagnosed as Necrozoospermia (Shukra Dosha). There were hypo-pigmented patches of Vitiligo on his forehead. The patient was given Koshtha shuddhi (purgation) with Eranda Taila (medicated castor oil) to treat shukra dosha followed by medicines like Arogyavardhini Vati, Chandraprabha Vati, Shilapravanga and Phala Ghrita (medicated ghee). At the end of 3½ month of treatment, marked improvement in sperm count and increase in the sperm motility was observed, along with that vitiligo patches on the forehead were reduced remarkably without any external application. The present case study shows the effective management of vitiligo with Ayurvedic formulations without use of external applications highlighting the basic Dhatu Siddhanta (theory of tissue formation) of Ayurveda.

Plant microRNAs from Moringa oleifera Regulate Immune Response and HIV Infection.

Traditional medicine is often chosen due to its affordability, its familiarity with patient’s cultural practices, and its wider access to the local community. Plants play an important role in providing indispensable nutrients, while specific small RNAs can regulate human gene expression in a cross-kingdom manner. The aim of the study was to evaluate the effects of plant-enriched purified extract microRNAs from Moringa oleifera seeds (MO) on the immune response and on HIV infection. Bioinformatic analysis shows that plant microRNAs (p-miRs) from MO belonging to 18 conserved families, including p-miR160h, p-miR166, p-miR482b, p-miR159c, p-miR395d, p-miR2118a, p-miR393a, p-miR167f-3p, and p-miR858b are predicted to target with high affinity BCL2, IL2RA, TNF, and VAV1, all these being involved in the cell cycle, apoptosis, immune response and also in the regulation of HIV pathogenesis. The effects of MO p-miRs transfected into HIV+ PBMCs were analyzed and revealed a decrease in viability associated with an increase of apoptosis; an increase of T helper cells expressing Fas and a decrease of intracellular Bcl2 protein expression. Meanwhile no effects were detected in PBMCs from healthy donors. In CD4+ T cells, transfection significantly reduced cell activation and modified the T cell differentiation, thereby decreasing both central and effector memory cells while increasing terminal effector memory cells. Interestingly, the p-miRs transfection induces a reduction of intracellular HIV p24 protein and a reduction of viral DNA integration. Finally, we evaluated the effect of synthetic (mimic) p-miR858b whose sequence is present in the MO p-miR pool and predicted to target VAV1, a protein involved in HIV-Nef binding. This protein plays a pivotal role in T cell antigen receptor (TCR) signaling, so triggering the activation of various pathways. The transfection of HIV+ PBMCs with the synthetic p-miR858b showed a reduced expression of VAV1 and HIV p24 proteins. Overall, our evidence defines putative mechanisms underlying a supplementary benefit of traditional medicine, alongside current antiretroviral therapy, in managing HIV infection in resource-limited settings where MO remains widely available.

The Proportion of Complementary and Alternative Medicine Utilization Among Saudi Population for Eye Care: Cross-Sectional Study.

PurposeTo estimate the prevalence, determinants and perceived benefit of complementary and alternative medicine (CAM) use for ophthalmic purposes among the Saudi population.MethodsA cross-sectional study was carried out in 2019 targeting visitors of King Khaled Eye Specialist Hospital (KKESH), Riyadh, Saudi Arabia. The survey had 18 questions in Arabic regarding the use of CAM for eye ailments. The magnitude was associated to the demographic and eye-related factors.ResultsWe interviewed 999 participants. The prevalence of CAM usage was 21.9% (95% confidence interval 19.3; 24.5). Castor oil (49.3%), antimony (khohl alethmed) (40.6%), chamomile (19.6%), and green tea leaves (11.4%) were the most common medications used. Other traditional eye treatments included eye vitamins, faith healing (prayer, reciting Quran, Zamzam water), cautery, cupping, and acupuncture.ConclusionsOne in five Saudi eye patients used CAM. The factors governing this health behavior should be studied to change this practice pattern.

On the complexity of haplotyping a microbial community.

MotivationPopulation-level genetic variation enables competitiveness and niche specialization in microbial communities. Despite the difficulty in culturing many microbes from an environment, we can still study these communities by isolating and sequencing DNA directly from an environment (metagenomics). Recovering the genomic sequences of all isoforms of a given gene across all organisms in a metagenomic sample would aid evolutionary and ecological insights into microbial ecosystems with potential benefits for medicine and biotechnology. A significant obstacle to this goal arises from the lack of a computationally tractable solution that can recover these sequences from sequenced read fragments. This poses a problem analogous to reconstructing the two sequences that make up the genome of a diploid organism (i.e. haplotypes) but for an unknown number of individuals and haplotypes.ResultsThe problem of single individual haplotyping was first formalized by Lancia et al. in 2001. Now, nearly two decades later, we discuss the complexity of ‘haplotyping’ metagenomic samples, with a new formalization of Lancia et al.’s data structure that allows us to effectively extend the single individual haplotype problem to microbial communities. This work describes and formalizes the problem of recovering genes (and other genomic subsequences) from all individuals within a complex community sample, which we term the metagenomic individual haplotyping problem. We also provide software implementations for a pairwise single nucleotide variant (SNV) co-occurrence matrix and greedy graph traversal algorithm.Availability and implementationOur reference implementation of the described pairwise SNV matrix (Hansel) and greedy haplotype path traversal algorithm (Gretel) is open source, MIT licensed and freely available online at github.com/samstudio8/hansel and github.com/samstudio8/gretel, respectively.

Regulatory and clinical perspective on patient access to antidiabetic medicines in Slovenia

Introduction/Objective. Three novel classes of antidiabetic medicines have been introduced into the market in the last decade, namely dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose co-transporter 2 inhibitors. Many factors influence patient access to these medicines and their utilization in clinical practice: these need to be explored. The aim of the study was to gain an insight into patient access to antidiabetic medicines in Slovenia from a regulatory and clinical point of view. Methods. A focus group with five Slovenian experts (representatives of regulatory bodies and prescribers of antidiabetic medicines) was performed in January 2019. The discussion was audiotaped upon obtaining written consent from the experts and transformed into a verbatim transcript. Two researchers independently analyzed the content of the discussion, using NVivo 11 to identify main themes and subthemes. Results. Slovenia provides satisfactory patient access to antidiabetic medicines; however, prescribing restrictions and unequal access to diabetologists in the Slovenian regions may limit patient access to novel antidiabetic medicines. Prescribing restrictions should be aligned with the new evidence on cardiovascular benefit of some antidiabetic medicines. A national registry of patients with diabetes should be established in order to obtain reliable data on patient outcomes and improve the quality of patient care. Conclusion. Patient access to antidiabetic medicines could be significantly improved not only in Slovenia but also in other countries by changing prescribing restrictions, establishing national registries of patients with diabetes, and involving multidisciplinary teams in diabetes care.

Recommendations of National symposium on “Integrative Medicines and Health: From Basic to Translational Research”

Translational Biomedical Research Society (TBRS), India founded in the year 2019, strives to promote communication and integration of traditional and standard healthcare systems through bridging the gap between Ancient Science and Modern Medicine. Continuing in this direction, TBRS took the lead to organize a national symposium entitled “Integrative Medicines and Health: From Basic to Translational Research” during December 4-6, 2020 as TBRS-2020. The symposium was jointly organized by Centre of Biomedical Research (CBMR), Lucknow and Faculty of Biosciences Institute of Biosciences and Technology, Shri Ramswaroop Memorial University (SRMU), Barabanki, UP in online mode. This meeting was a successful endeavor promoting integration of Natural Healthcare systems and Modern medical care systems for the benefit of human society. The theme of the symposium revolved around integrative health care so that to bring conventional and complementary approaches together with mainstream medical care systems. The use of integrative approaches to healthcare management is growing rapidly, especially, within critical care settings and researchers are currently exploring the potential benefits of integrative medicines in a variety of situations, including relief of symptoms in cancer patients and survivors, and programs to promote healthy life style and healthy behaviors.

Alternative Medicine: New Ways to Treat Diseases and Therapies

Alternative medicine is the most widely used remedy systems, in the treatment of various diseases. Alternative medicine is used widely because there are a large health care alternatives to be more congruent within the own values and beliefs towards health. Alternative medicine is more compatible with patients, offers more personal autonomy and control over the health care decisions. It is accepted worldwide because of its compatibility and acceptability in increasing the beliefs regarding the nature and meaning of health and illness. This review deals with various alternative therapies used such as Ayurveda, homeopathy, acupuncture, naturopathy, yoga, herbal medicine, massage therapy; effectiveness of the alternative medicine; assessment of the effectiveness of alternative medicine; sources of information about the alternative medicine; alternative medicine therapies in treatment of various diseases; perceived benefits of alternative medicine and thereby concluding with the increased level of acceptance of alternative medicine, its widespread use in various diseases and their treatment with various alternative therapies.

Estimating the entire length of the fragmentary tibia with proximal and distal dimensions

Forensic anthropology is an important scientific discipline that determines the ethnicity, sex, height and body type characteristics from human skeletal remains for the benefit of forensic medicine. One of the important tasks of forensic anthropology is to determine the stature of individual from their skeletal remains. Lower extremities are mostly preferred in estimating stature. The current study aims to develop regression formulas to estimate the entire length of the tibia in case a fragmentary tibia is found. The study was conducted on 148 tibiae excavated from the ancient city of Nicaea and are housed in the Department Anatomy, Faculty of Medicine, Bursa Uludağ University. In total, eighteen parameters were examined on the tibiae. SPSS 22.0 was used for the statistical analyses. The descriptive statistics of the tibiae were evaluated. Taking the correlations between proximal and distal morphometric traits of the tibia and the entire tibial length into consideration, regression formulas were developed to determine the entire length of the tibia. In this study, we evaluated that the morphometric characteristics of ethnic groups are different from each other and therefore the use of formulas determined for one group can increase the margin of error for other groups. In addition, we developed formulas that estimate the length of the entire tibia. We believe that the results of this study will be of great importance for both anthropology and forensic medicine.

Ad-Dressing Stem Cells: Hydrogels for Encapsulation

Regenerative medicine is a novel scientific field that employs the use of stem cells as cell-based therapy for the regeneration and functional restoration of damaged tissues and organs. Stem cells bear characteristics such as the capacity for self-renewal and differentiation towards specific lineages and, therefore, serve as a backup reservoir in case of tissue injuries. Therapeutically, they can be autologously or allogeneically transplanted for tissue regeneration; however, allogeneic stem cell transplantation can provoke host immune responses leading to a host-versus-transplant reaction. A probable solution to this problem is stem cell encapsulation, a technique that utilizes various biomaterials for the creation of a semi-permeable membrane that encases the stem cells. Stem cell encapsulation can be accomplished by employing a great variety of natural and/or synthetic hydrogels and offers many benefits in regenerative medicine, including protection from the host’s immune system and mechanical stress, improved cell viability, proliferation and differentiation, cryopreservation and controlled and continuous delivery of the stem-cell-secreted therapeutic agents. Here, in this review, we report and discuss almost all natural and synthetic hydrogels used in stem cell encapsulation, along with the benefits that these materials, alone or in combination, could offer to cell therapy through functional cell encapsulation.

The value and benefit of narrative medicine for psychiatric practice.

This article describes how applying techniques from literary studies and considering patient histories as texts helps me understand and formulate systemic issues in psychiatric assessments. Psychiatrists are not generally taught to pay close attention to aspects of language, including metaphor and syntax, but I argue that paying attention to the form, as well as to the content, of the stories patients bring us, can make us better attuned to the contexts of their needs and distress, and therefore better placed to help.

THE DYNAMICS OF JAMA (JAMU MADURA-MADURESE TRADITIONAL HERBAL MEDICINE) IN THE VIEWPOINT OF PUBLIC WOMAN

Currently the development of modern medicine is happening, the people in Sumenep persist in using and consuming Jamu (Indonesian traditional herbal medicine) to prevent and to cure diseases, in the process of pregnancy, childbirth and the postpartum period. This habit was inherited from their ancestors. This study aimed to describe views and opinions of postpartum mothers on the puerperal herbal medicine that they consumed during the postpartum period. This study design was qualitative study with a phenomenological approach with total participants were 20 postpartum mothers and their families and 2 postpartum herbal medicine makers. Data were collected by direct observation through in-depth interviews. The results showed 5 themes describing the dynamics of the Madurese traditional herbal medicine in the viewpoint of post-partum mothers, namely their reasons for consuming postpartum traditional herbal medicine, the form of the herbal traditional medicine consumed, their knowledge of postpartum herbal medicine, the benefits of postpartum traditional herbal medicine, and the mother's desire to consume the puerperal herbal medicine in the future. It can be concluded that there was different viewpoint that described by postpartum women about consuming postpartum herbal medicine. In general, they found that postpartum herbal medicine had benefits directly in the recovery process of the postpartum period and increasing breast milk production

Towards a better use of scientific advice for developers of advanced therapies.

Scientific advice (SA) is an important tool offered by regulators to help developers generate robust evidence on a medicine's benefits and risks. Drawing on accumulated experience and looking at the SA provided by the European Medicines Agency in 2018 to advanced therapy medicinal products originally developed by public bodies, we discuss most commonly raised issues and the complexity and timings of the questions posed. Earlier and more frequent SA could help advanced therapy medicinal product developers to pre‐empt delays at the marketing authorisation stage. Carefully addressing quality and nonclinical issues before entering the pivotal phase of development will clear the path for a smooth clinical development and successful marketing authorisation.

The Relevance of Complementary and Integrative Medicine in the COVID-19 Pandemic: A Qualitative Review of the Literature.

Background: During the COVID-19 pandemic people are facing risks of adverse health effects due to the restrictions implemented such as quarantine measures, reduced social contact, and self-isolation. In this qualitative review, we collected data on potential preventive and therapeutic health benefits of Complementary and Integrative Medicine (CIM) that might be useful during the COVID-19 pandemic. We have reviewed the scientific literature to summarize CIM practices that could be beneficial for improving physical and mental health and well-being of the population under the current pandemic circumstances. It must be noted that this review is not SARS-CoV-2 specific and we explicitly do not intend to make any SARS-CoV-2 specific health claims in this article.Methods and Findings: A qualitative, non-systematic literature review was conducted in Medline to identify literature describing preventive and therapeutic CIM approaches for strengthening mental and physical health. For a variety of CIM approaches clinical evidence was identified, indicating beneficial effects. CIM approaches include specific dietary measures and selected micronutrients, physical activity, techniques from Mind-Body Medicine, single botanicals or botanical compounds, and spending time in nature among others. The effects of CIM measures on conditions like obesity and hypertension are of special relevance here, as these conditions are considered as risk factors for a severe course of COVID-19. Moreover, a possibly direct effect of CIM approaches on immune functions and clinical parameters in respiratory tract infections, such as influenza, were identified. The findings of this review could be helpful for clinicians, patients, and the general population during the current pandemic when discussing and/or considering CIM options.Conclusions: CIM offers a variety of preventive and therapeutic options for strengthening physical and mental resilience, which could also be useful in the current COVID-19 pandemic. The evidence of CIM approaches with a potential benefit in the COVID-19 pandemic in different areas is worth to be analyzed. While this qualitative review has several obvious limitations, it might serve as useful starting point for further research on this topic.

Effects of Sub-acute Oral Administration of Ethanolic Leaf Extract of Byrsocarpus coccineus on Haematology and Serum Biochemical Parameters of Wistar Albino Rats.

Byrsocarpus coccineus is an indigenous herb widely dispersed in tropical Africa and commonly known as Crimson thyme. The leaf and root of the plant is noted to possess medicinal benefits in traditional medicine of the Western part of Nigeria. The plant has been reported to possess analgesic, antiplasmodial, inflammatory, antidiarrhic and antipyretic activities. The present study was therefore aimed at determining the sub-acute toxicity of ethanolic leaf extract of Byrsocarpus coccineus. The ethanolic leaf extract of the plant was administered orally at 250, 500, and 1000 mg/kg to three groups A, B and C of Wistar rats respectively for 14 days while the control group D was administered orally with 3ml/kg of distilled water. Blood samples were then obtained from the anaesthetized rats for haematology and serum biochemistry. The result obtained from serum analyses showed a significant increase (p&lt;0.05) in the levels of blood urea nitrogen and creatinine levels while the increase in alkaline phosphatase is not significant for the treated groups B and C compared with the control. It was therefore concluded that high doses of the extract may have untoward effects on the kidney and therefore, the use of the plant extract in high doses should be discouraged.

DNA sequencing of anatomy lab cadavers to provide hands-on precision medicine introduction to medical students

BackgroundMedical treatment informed by Precision Medicine is becoming a standard practice for many diseases, and patients are curious about the consequences of genomic variants in their genome. However, most medical students’ understanding of Precision Medicine derives from classroom lectures. This format does little to foster an understanding for the potential and limitations of Precision Medicine. To close this gap, we implemented a hands-on Precision Medicine training program utilizing exome sequencing to prepare a clinical genetic report of cadavers studied in the anatomy lab. The program reinforces Precision Medicine related learning objectives for the Genetics curriculum.MethodsPre-embalmed blood samples and embalmed tissue were obtained from cadavers (donors) used in the anatomy lab. DNA was isolated and sequenced and illustrative genetic reports provided to the students. The reports were used to facilitate discussion with students on the implications of pathogenic genomic variants and the potential correlation of these variants in each “donor” with any anatomical anomalies identified during cadaver dissection.ResultsIn 75% of cases, analysis of whole exome sequencing data identified a variant associated with increased risk for a disease/abnormal condition noted in the donor’s cause of death or in the students’ anatomical findings. This provided students with real-world examples of the potential relationship between genomic variants and disease risk. Our students also noted that diseases associated with 92% of the pathogenic variants identified were not related to the anatomical findings, demonstrating the limitations of Precision Medicine.ConclusionWith this study, we have established protocols and classroom procedures incorporating hands-on Precision Medicine training in the medical student curriculum and a template for other medical educators interested in enhancing their Precision Medicine training program. The program engaged students in discovering variants that were associated with the pathophysiology of the cadaver they were studying, which led to more exposure and understanding of the potential risks and benefits of genomic medicine.

Laser Needling® and Natural origin, Highly Purifi ed Polynucleotides (PN-HPT™) in Knee Osteoarthrosis: Benefi ts in Physiatry and Sports Medicine

Background and Objectives: The purpose of the paper is to illustrate the real life clinical outcomes of a retrospective cohort of knee Osteoarthritis (OA) patients treated with a novel laser disease management program; at the same time, to defi ne the most effective operative procedure. The new laser technique mimics the in-vitro benefi ts of Low-Level Laser Therapies (LLLT). The study compared the 3month effi cacy and 6-month persistence of clinical and functional benefi ts after application of laser energy either externally with a standard High Power Laser Therapy (HPLT) laser device (AG1 device, FP3 version), or intra-articularly with the patented, low-energy AG8 intra articular fi ber device (ultrasound-guided, same wavelengths, no handpiece). This innovative laser device reduces to one hundredth the applied energy density. The pain suppressing effi cacy of the LLLT-like laser FP3 procedure is intended to act synergically with the strong biorestructuring and pain suppressing effi cacy of natural origin polynucleotides (PN-HPT™ or Highly Purifi ed Technology™) injected before the laser session. PN-HPT™ are widely used in knee OA management for their persistent viscosupplementation properties overlapping those of high molecular weight hyaluronic acid. Trial design: retrospective comparison of:  Short term 3 month effi cacy outcomes on pain and disability  6-month persistence of clinical improvements in two cohorts of patients with severe knee osteoarthritis. The active cohort knee OA patients (105 agonistic or recreative practitioners with persistent knee pain and disability resistant to conventional medical or physical therapies) were treated with an innovative intra articular low-energy AG8 physical therapy protocol (ambulatory “AG8 Protocol 3” combined with a preliminary PN-HPT™ knee injection); the control-cohort patients (109 patients with knee disease of similar severity) were treated with a standard, multi frequency HPLT ambulatory treatment protocol (FP3 device). Outcome parameters: Western Ontario and McMaster Universities (WOMAC) assessments at baseline (T0) and after 2 weeks (T2) and 3 months (T3). Secondary parameters: Nociceptive and neuropathic pain; assessment: standard 10 cm Visual Analogue Scale (VAS) immediately before and at the end of each treatment session. Results: Treatment with the AG8 protocol 3 / PN-HPT™ intra articular combination was associated with strongly signifi cant short term (2 weeks) and medium-term (3 months) benefi ts vs. controls treated with a conventional FP3 extra-articular treatment protocol both for the WOMAC Total Score and WOMAC Pain and Function subscores. Benefi ts for the WOMAC Stiffness subscore were borderline non-signifi cant. The subgroup analysis showed that the 2A (Grade-2 KL primary OA) and 2B (Grade-2 KL secondary (post-surgical) OA) mainly contributed to overall benefi ts. Conclusion: The study showed the intra-articular Laser Needling® technique (ultrasound-guided AG8 laser device, Protocol 3 plus infi ltration of a facilitating agent such as intra-articular PN-HPT™ gel) to be more effective on knee OA pain than the traditional extra-articular FP3 laser technique, with special reference to pain associated with primary OA.