Hyaluronic Acid Group Research Articles

Internal fixation or hip replacement for undisplaced femoral neck fractures? Pre-fracture health differences reflect survival and functional outcome.

Background and purposeInternal fixation (IF) has been the standard procedure for undisplaced femoral neck fractures (FNFs). However, there is a changing trend towards hip replacement (HR). Yet there is a knowledge gap regarding the benefits of this surgical method. We investigated functional outcomes in patients ≥ 70 years following HR compared to IF for undisplaced FNFs.Patients and methodsPatients ≥ 70 years with undisplaced FNF registered in the Swedish National Hip Fracture Registry (SHR) who underwent either IF or HR (hemiarthroplasty [HA)] or total hip arthroplasty [THA]) were investigated in terms of 1-year survival and proportion of reoperation. In a subsample with 4-month follow-up data (n = 3,623), pain, changes in living status, and physical function were additionally analyzed.Results7,758 patients were included with a mean age of 85 years. 93% of the patients were operated on with IF, 5% with HA, and 2% with THA. Patients with THA more often lived independently and were able to walk outdoors, both before and after the hip fracture. The IF and HA groups were similar in baseline characteristics, and in functional and survival outcomes. The THA group had a 54% lower adjusted risk of 1-year mortality. The proportion of reoperations within 1 year was 9.5% for IF, 5.3% for HA, and 7% for THA.InterpretationThe pre-fracture difference in health and function between patients operated on with IF, HA, and THA maked it difficult to compare outcomes of the 2 methods. Decision on surgical method must be taken on an individual level, considering patients’ well-being and allocation of resources.

Rheological properties and preclinical data of novel hyaluronic acid filler containing epidermal growth factor.

Recently, a novel hyaluronic acid (HA) filler containing the epidermal growth factor (EGF) was developed. The objective of this study was to evaluate the rheological properties, preclinical efficacy and biocompatibility of the EGF-containing HA filler (HA-EGF filler) using a photoaged mouse model. The rheological properties of the new HA-EGF filler were assessed. Twenty-four female hairless mice (SKH1) underwent photoaging induction with 8 weeks of ultraviolet-B irradiation. The mice were randomly divided into four groups and intradermally injected 100 μl of phosphate-buffered saline, HA-EGF filler, HA filler or polynucleotide (PN) into the dorsal region. We examined the effect of fillers on photoaged skin by dermoscopic examination. Furthermore, histological evaluation with immunohistochemical staining was performed to determine the biocompatibility and collagen formation at the 10th week. A real-time quantitative polymerase chain reaction analysis and western blot test assessed the expression of collagen I/III, matrix metalloproteinases (MMPs) and transforming growth factor. The viscosity and elasticity of the HA-EGF filler were lower than those of the HA filler. Histological evaluation revealed no significant differences in the collagen synthesis between the HA-EGF, HA and PN filler groups. No inflammation was observed during the experimental period. The HA-EGF filler induced type I/III collagen production and downregulated the expression of MMP-1, 3 and 9. Our results suggest that the novel HA-EGF filler may be an additional therapeutic option for photoaged skin, which works by inducing collagen synthesis. Based on these preclinical results, further well-controlled clinical studies are required.

Fracture Resistance of Custom Lithium Disilicate Implant Restorations with Two Fabrication Techniques and Two Designs.

To compare the fracture resistance of a press-on ceramic custom implant restoration with pressed and cemented restorations. Thirty-two (32) lithium disilicate (IPS e.max Press) custom hybrid abutment restorations were fabricated. The restorations were divided into two groups (n = 16) according to the construction technique: the commercial control group (C) and the press-on group (P). For the control group, lithium disilicate restorations were pressed and cemented on titanium bases. For the press-on group, lithium disilicate pressable ceramic (IPS e.max Press) was pressed on the titanium bases with injection molding. Each group was further divided according to the restoration design, either screw- or cement-retained, into two subgroups of eight specimens each. Specimens of C group were divided into screw-retained (cemented hybrid abutment crown, CHAC) or cement-retained (cemented hybrid abutment, CHA). Specimens of the P group were also divided into screw-retained (pressed hybrid abutment crown, PHAC) and cement-retained (pressed hybrid abutment, PHA). The specimens were subjected to static loading until failure with a universal testing machine. Two-way analysis of variance (ANOVA) was used to assess the effect of different techniques and designs on the fracture resistance of the samples (P < .05), followed by one-way ANOVA and Tukey honest significant difference (HSD) test (α = .05). C group showed higher mean fracture resistance (812.443 ± 129.14 N) than P group (596.71 ± 108.83 N), and the difference was statistically significant (P < .05). Regarding restoration design, HA groups showed higher mean fracture resistance (742.621 ± 153.82 N) than HAC (666.53 ± 163.07 N) groups with no statistically significant difference. CHA showed the highest mean fracture resistance (817.65 ± 161.76 N), while PHAC showed the lowest mean fracture resistance values (525.83 ± 47.29 N). The commercial cemented lithium disilicate restorations showed higher fracture resistance than the press-on restorations, although both showed a maximum load capacity that was greater than physiologic incisal force in the anterior region, and both hybrid abutments and hybrid abutment crowns were equally efficient in withstanding occlusal loading forces.

The Benefits of Radical Treatments with Synchronous Splenectomy for Patients with Hepatocellular Carcinoma and Portal Hypertension.

Simple SummaryRadical treatment combined with synchronous splenectomy has recently emerged as an effective therapy for patients with hepatocellular carcinoma (HCC), in the setting of portal hypertension secondary to liver cirrhosis, but its survival benefits remain to be elucidated. We retrospectively analyzed a longitudinal cohort of 96 patients receiving HCC radical treatment combined with splenectomy and a control group comprising 42 patients receiving radical treatment alone, comparing the oncological outcomes of the synchronous splenectomy for the two subgroups. Our analysis highlighted better recurrence-free survival (RFS), particularly in stage T1 patients. Cox multivariate analysis showed that preoperative irregular anti-viral therapy, Child-Pugh grade B liver function, vascular invasion, and microvascular invasion (MVI) were independent risk factors for early postoperative RFS (within 2 years), and preoperative irregular anti-viral therapy and vascular invasion were independent risk factors for 5-year overall survival (OS).Background: The survival benefits of radical treatment (resection or radiofrequency ablation) combined with splenectomy for primary hepatocellular carcinoma (HCC) in patients with liver-cirrhosis-associated portal hypertension (PH) remain to be clarified. Methods: 96 patients undertaking HCC radical treatment combined with splenectomy (HS group) were retrospectively analyzed, 48 of whom belonged to HCC stage T1 (HSS group). Another 42 patients at stage T1 with PH who received hepatectomy (or radiofrequency ablation) alone (HA group) during the same period served as the control group. Recurrence-free survival (RFS) and overall survival (OS) were compared at each time point between the HSS and HA group. The risk factors affecting early RFS and OS were confirmed through COX multivariate analysis. Results: The median RFS was 22.3 months and the mean median OS was 46 months in the HS group. As such, 1-year, 2-year, 3-year, and 5-year RFS rates in the HSS and HA group were 95% and 81% (p = 0.041), 81% and 67% (p = 0.05), 64% and 62% (p = 1.00), and 29% and 45% (p = 0.10), respectively. Further, 1-year, 3-year, and 5-year OS rates in the HSS and HA group were 98% and 98% (p = 1.00), 79% and 88% (p = 0.50), and 60% and 64% (p = 0.61), respectively. Cox multivariate analysis showed that preoperative irregular anti-viral therapy, Child-Pugh grade B liver function, vascular invasion, and microvascular invasion (MVI) were independent risk factors for early postoperative RFS (within 2 years), and preoperative irregular anti-viral therapy and vascular invasion were independent risk factors for 5-year OS. Conclusions: Radical treatment of HCC combined with synchronous splenectomy, especially applicable to patients with Child-Pugh grade A liver function, can significantly improve early postoperative RFS in patients with stage T1 HCC and liver-cirrhosis-associated portal hypertension, but fail to improve OS.

Hyaluronan-colistin conjugates: Synthesis, characterization, and prospects for medical applications

The development of nanotechnology-based antibiotic delivery systems (nanoantibiotics) is an important challenge in the effort to combat microbial multidrug resistance. These systems have improved biopharmaceutical characteristics by increasing local bioavailability and reducing systemic toxicity and the number and frequency of drug side effects. Conjugation of low -molecular -weight antibacterial agents with natural polysaccharides is an effective strategy for developing optimal targeted delivery systems with programmed release and reduced cytotoxicity. This study describes the synthesis of conjugates of colistin (CT) and hyaluronic acid (HA) using carbodiimide chemistry to conjugate the amino groups of CT with the carboxyl groups of HA. The obtained polysaccharide carriers had a degree of substitution (DS) with CT molecules of 3–10 %, and the CT content was 129–377 μg/mg. The size of the fabricated particles was 300–600 nm; in addition, there were conjugates in the form of single macromolecules (30–50 nm). The ζ-potential of developed systems was about −20 mV. In vitro release studies at pH 7.4 and pH 5.2 showed slow hydrolysis of amide bonds, with a CT release of 1–5 % after 24 h. The conjugates retained antimicrobial activity depending on the DS: at DS 8 %, the minimum inhibitory concentration (MIC) of the conjugate corresponded to the MIC of free CT. The resulting systems also reduced CT nephrotoxicity by 20–50 %. These new conjugates of CT with HA are promising for the development of nanodrugs for safe and effective antimicrobial therapy.

Long-Term Outcomes (2 Years) After Hyaluronic Acid Therapy for Peyronie’s Disease

BackgroundHyaluronic acid (HA) has demonstrated clinical benefits for the treatment of Peyronie’s disease (PD); however, there are no reports that documented long-term outcomes. The aim of the current study is to illustrate the clinical outcomes after 2 years of follow-up in patients who received HA for PD.MethodsFrom January 2015 to December 2018, we enrolled 244 patients affected by PD in this multicenter non-randomized clinical study, as previously reported. Patients received intralesional HA (Group A) or verapamil (Group B). Follow-up was undertaken after 3 months, 1 year, and 2 years. International Index of Erectile Function (IIEF-5), PC, and visual analogue scale (VAS) were collected.ResultsAmong the whole cohort, 125 patients were included in Group A and 119 in Group B. As PC, the median curvature was 25.0° at 3 months [interquartile range (IQR), 15.0–30.0] (p=0.45) and was maintained at 1 (p=0.87) and 2 years of follow-up (p=0.90) (Group A), while it was 30.0° (IQR, 20.0–35.0) (p=0.67) at 3 months and was stable at 1 (p=0.77) and 2 years of follow-up (p=0.80) (Group B). For VAS score, the median change in Group A was −4.0 (IQR, −4.0, −5.0, p&amp;lt;0.01) after 3 months, −4.0 (IQR, −4.0, −5.0, p&amp;lt;0.01) at 1 year, and −4.0 (IQR, −4.0, −5.0, p&amp;lt;0.01) at 2 years of follow-up, while in Group B, it was −1.0 (IQR, −2.0, −0.5, p=0.25) after 3 months, −3.5 (IQR, −3.5, −2.0, p&amp;lt;0.01) at 1 year, and −4.0 (IQR, −4.0, −5.0, p&amp;lt;0.01) at 2 years of follow-up. Adjusted p-value for between-group comparisons was &amp;lt;0.01 at 3 months and not significant at 1 (p=0.53) and 2 years (p=0.80).ConclusionsWe reported clinical efficacy of intralesional HA in patients with PD after 2 years of follow-up by slightly improving penile curvature (PC) and bother of the disease. These results should be considered during the counseling of the patients especially regarding the lack of worsening over time.

Altitude-adaption of gut microbiota in Tibetan chicken

Low oxygen levels and extremely cold weather in high-altitude environments requires more energy intake to maintain body temperature in animals. However, little is known about the characteristics of cecal and ileac microbiota in Tibetan chicken and how the high and low altitude environments affect the gut microbiota communities in Tibetan chicken. In the present study, In the present study, Tibetan chickens (Group HA, 3572 m, 578.5 Pa) and their introduced flatland counterparts (Group LA, 580 m, 894.6 Pa) in the cecum and ileum to identify the possible bacterial species that are helpful for their host in environmental adaption. High-throughput sequencing was used to sequence the V3 to V4 hypervariable regions of the bacterial 16S rRNA gene. By comparing the gut microbial diversity of HA chicken with that of LA, the results indicated that the microbial diversity of the cecum and ileum in group HA was significantly lower (P < 0.05) than those in group LA. The cecum microbiome maintained higher population diversity and richness than the ileum (P < 0.05). Four phyla Firmicutes, Bacterioidetes, Actinobacteria, and Proteobacteria were dominant in two groups. Interestingly, there were significant differences in abundance ratio among the four groups (P < 0.05). The predominant bacteria in HA and LA ileum belong to Proteobacteria and Firmicutes, whereas in cecum, Bacterioidetes and Actinobacteria were predominant in both groups (P < 0.05). Correlation analysis showed that Sporosarcina, Enterococcus, and Lactococcus were strongly related to air pressure, and Peptoclostridium and Ruminococcaceae_UCG-014 are related to altitude and gut microbiota of LA group was influenced by altitude, while HA group affected by air pressure. Meanwhile, the Ruminococcus-torques-group was negatively correlated with the relative abundance of Paenibacillus, and positive correlated with those of other microorganisms. Furthermore, HA has higher abundance of microbiota involved in energy and glycan biosynthesis metabolism pathway, while LA has higher abundance of microbiota involved in membrane transport, signal transduction, and xenobiotics biodegradation and metabolism. Generally, our results suggested that the composition and diversity of gut microbes changed after Tibetan chickens were introduced to the plain. Tibetan chicken may adapt to new environment via reshaping the gut microbiota. Gut microbes may contribute to the host adaption to high altitude environments by increasing host energy and glycan biosynthesis.

Histological Evaluation of Restylane Lyft Used as a Scaffold for Dental Pulp Regeneration in Non-Infected Immature Teeth in Dogs.

Commercially available hyaluronic acid dermal fillers used as a scaffold in regenerative endodontic procedures (REPs) have demonstrated attractive potentials. This study aimed to histologically evaluate the outcome of REPs using Restylane Lyft (HA) as a scaffold. REPs were performed on pulpless, immature roots in dogs (n = 69). The roots were divided into four groups: blood clot (BC), Restylane Lyft (BC + HA), negative control, and positive control. At 13 weeks postoperatively, hard tissue formation, vascularization, the presence of vascularized soft connective tissue and collagen fibers, the degree of inflammation within pulp spaces and/or periapical tissues, and apical closure were evaluated histologically. The vascularization and formation of loosely arranged collagen fibers within the regenerated soft connective tissues were observed significantly more in the BC+HA group (85% and 40%, respectively; p < 0.05) compared to the BC group (54.6% and 9.1%, respectively; p < 0.05). The degree of inflammation was significantly higher in the HA group than in the BC group; moderate to severe inflammatory cell infiltration was seen in 45% and 13.6% of the cases, respectively. The results of the present study suggest that Restylane Lyft combined with a blood clot used as a scaffold may improve the outcomes of REPs in non-infected, pulpless, immature teeth in dogs.

Intra-Articular Injections of Allogeneic Mesenchymal Stromal Cells vs. High Molecular Weight Hyaluronic Acid in Dogs With Osteoarthritis: Exploratory Data From a Double-Blind, Randomized, Prospective Clinical Trial.

This double-blind, randomized, prospective clinical trial was conducted to obtain exploratory data comparing the efficacy of intra-articular allogeneic mesenchymal stem/stromal cells (MSC) to high molecular weight hyaluronic acid (HA) for the treatment of pain associated with canine osteoarthritis (OA). Objective gait analysis (%Body Weight Distribution, %BWD), accelerometry, clinical metrology instruments and veterinary exams were used as outcome measures during various time points throughout the 48-week study period. Fourteen dogs with elbow or coxofemoral OA were enrolled and assigned in a 2:1 ratio to the treatment groups. Each patient received a set of two injections 4 weeks apart. Self-limiting joint flare was observed in seven patients, with six of these in the MSC group. Ten patients completed all follow-up appointments. Both treatment groups showed evidence of mild improvement following the treatment, but the results were inconsistent among the various outcome measures assessed. Overall, dogs enrolled in the HA group showed greater improvement compared to the MSC group. The primary outcome measure, %BWD, showed evidence of improvement, when compared to baseline values, at 36 weeks after injection for the HA group only (p = 0.048, estimated difference: 4.7). Similarly, when treatment groups were compared, evidence of a difference between treatment groups (with the HA-group showing greater improvement) were identified for weeks 24 and 36 (p = 0.02 and 0.01, respectively). The small sample size of this exploratory study does not allow firm conclusions. However, until studies with larger sample sizes are available, the current literature combined with our data do not support the clinical use of intra-articular MSC therapy over high molecular weight HA for the treatment of canine OA at this time.

Disc-condyle relationship alterations following stabilization splint therapy or arthrocentesis plus hyaluronic acid injection in patients with anterior disc displacement: a retrospective cohort study.

The objective of this study was to quantitatively evaluate the efficacy of stabilization splint (SS) therapy or arthrocentesis plus hyaluronic acid (HA) injection in the treatment of anterior disc displacement (ADD) through magnetic resonance imaging (MRI). 99 subjects were collected in this study. 46 subjects received SS treatment (SS group), 53 subjects received arthrocentesis plus HA injection (HA group). Joints with anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) were compared separately. MRI before the beginning of the treatment and after a set of treatment were used for measurement. Disc-condyle relationship and positions of condyles and discs were determined by disc-condyle angles and X-Y coordinates. The disc-condyle angles decreased significantly in the SS group (P < .0001). Whereas no significant change was found in the HA group. Substantial anteroinferior condyle movement was detected in the SS group, slight anterior movement of condyles was discovered in the HA group. Anterior shift of discs position was observed in HA group and joints with ADDwoR in the SS group. SS was effective in improving the disc-condyle relationship in ADD subjects, while significant improvement of disc-condyle relationship cannot be achieved through arthrocentesis plus HA injection.

Comparison of single platelet-rich plasma injection with hyaluronic acid injection for partial-thickness rotator cuff tears.

Partial-thickness rotator cuff tears (PTRCTs) is not uncommon, and various nonsurgical injection therapy for PTRCTs emerged. Platelet-rich plasma (PRP) and hyaluronic acid (HA) injection were proposed for treating PTRCTs; however, the relation of dose among injectates was still lacking. This was a prospective, nonrandomized, comparative study. The aim of the study was to compare the effects of ultrasound-guided single PRP injection with three doses of HA injection, combination of postinjection rehabilitation, for treating PTRCTs. Subjects received either ultrasound-guided PRP injection and rehabilitation exercise, or ultrasound-guided subacromial HA injection and rehabilitation exercise. Shoulder Pain and Disability Index (SPADI), range of motion (ROM), pain visual analog scale (VAS), and Constant-Murley Shoulder Score (CMSS) were recorded before injection, and at 1 and 3 months after injection. Forty-eight patients were enrolled. They received either ultrasound-guided single PRP (n = 24) intralesional and peritendinous injection or three doses of HA (n = 24) subacromial injection plus rehabilitation exercise. In the PRP group, SPADI scores, VAS scores, CMSS significantly improved at 1-month and 3-month follow up; flexion and abduction ROM significantly increased at 3-month follow up. In the HA group, SPADI scores, VAS during overhead activities, VAS night pain, and CMSS significantly improved in the first and third months; flexion and active abduction ROM significantly increased in the third month. The PRP group revealed significantly better passive abduction ROM and CMSS at third month than HA group. Ultrasound-guided single PRP injection exhibited comparable benefit to three doses of HA injection in patients with PTRCTs short-termly, with an extended effect regarding passive shoulder abduction ROM and CMSS.

Different intra-articular injection substances following temporomandibular joint arthroscopy and their effect on early postoperative period: A randomized clinical trial

ABSTRACT Objective To compare the effect of plasma rich in growth factors (PRGF), hyaluronic acid (HA), and saline intra-articular injections following temporomandibular joint arthroscopy on decreasing pain and increasing maximal mouth opening. Methods Included patients were randomized into three groups: PRGF group, hyaluronic acid group, and control group. Intra-articular injections were done at the end of the arthroscopy. Pain was measured using the VAS scale preoperatively, 7 days, 1 month, and 6 months postoperatively. Maximal mouth opening was measured preoperatively and 7 days postoperatively. Results There was a statistically significant decrease in pain in all groups, although, the decrease was significantly greater in the HA group following surgery. Conclusion A hyaluronic acid injection following temporomandibular joint arthroscopy can decrease pain better than saline and platelet-rich plasma during the first postoperative week. However, the results do not differ in later postoperative periods.

A radiolabeled nanoparticle probe coated with hyaluronic acid via electrostatic interaction to diagnose CD44-positive tumors

CD44 is overexpressed in many tumors and is associated with tumor malignancy, including metastasis. Hyaluronic acid (HA) is a biocompatible polymer that specifically targets CD44-positive tumors. In this study, a ternary complex (charge ratio of carboxyl groups of indium-111 (111In)-labeled polyamidoamine dendrimer, amino groups of polyethyleneimine, and carboxyl groups of HA of 1:8:32) was successfully prepared using electrostatic interactions to develop a nuclear medical imaging probe for CD44-positive tumors. The particle size and zeta potential of the probe were 38.6 ± 1.3 nm and −31.6 ± 0.7 mV, respectively. The ternary HA complex was taken up by CD44-positive tumor cells via HA-specific pathway in vitro. Partial CD44-specific tumor uptake of the 111In-labeled HA complex occurred in tumor-bearing mice. The radiolabeled HA complex established by electrostatic interaction may be a nuclear medical imaging probe targeting CD44-positive tumors.

Evaluation of the Hyaluronic Acid Versus the Injectable Platelet-Rich Fibrin in the Management of the Thin Gingival Phenotype: A Split-Mouth Randomized Controlled Clinical Trial.

BackgroundSeveral procedures have been used to enhance thin gingival phenotype and the majority of these procedures have been surgical. A new minimally invasive approach that involved multiple injections of platelet-rich fibrin (i-PRF) to enhance the thin gingival phenotype has been proposed. As the hyaluronic acid (HA) and the i-PRF share similar properties in terms of promoting periodontal regeneration, the present trial aimed to evaluate the effectiveness of multiple injections of the i-PRF in patients with thin gingival phenotypes in comparison with those of the HA in increasing the gingival thickness (GT) and the keratinized tissue width (KTW).Materials and methodsEighty-four sites from 14 systematically healthy patients who had thin gingival phenotypes (GT ≤1 mm) were included in this split-mouth randomized controlled trial. For each patient, each side of the anterior mandible was randomly allocated to one of the two materials (HA or i-PRF). In the HA group, the selected sites of the gingiva were injected with cross-linked HA using a 30-gauge microneedle. In the i-PRF group, the i-PRF was injected in the same manner. This procedure was repeated in both groups three times with intervals of 7 days. The GT, KTW, and periodontal indices: gingival index (GI), bleeding on probing (BOP), and probing depth (PD) were measured at baseline, 1 month, and 3 months following the initial injection.ResultsThe GT increased significantly in both groups at the three assessment times (p<0.001). The KTW also showed a statistically significant increase in the intragroup comparisons in both groups (p<0.05). No statistically significant difference was observed between the two groups at the three assessment times for the GT and the KTW (p>0.05).The GI significantly decreased after 1 month and 3 months compared to the baseline values in both groups (p<0.05). The intergroup comparisons for the GI revealed no statistically significant differences at the three assessment times (p>0.05). As for the BOP and the PD, no statistically significant differences were found between the three assessment times (p>0.05) and between the two groups at each assessment time (p>0.05).ConclusionMultiple injections of the i-PRF and the HA in the thin gingival phenotype resulted in an increased GT and increased KTW, with no statistically significant differences between the two methods. Both minimally invasive techniques were more effective in improving the GT rather than the KTW.

Intra-articular Injection of Hyaluronic Acid (HA) and Plateletrich Plasma (PRP) in the Treatment of Mild and Moderate Osteoarthritis of Knee

Background: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide and is associated with significant pain and disability. Introduction of platelet-rich plasma (PRP) injection has been viewed as an advance in the management of OA knee. Objective: To compare the effectiveness of PRP and Hyaluronic Acid (HA) in the treatment of mild and moderate OA knee Methods: The present randomized clinical trial had been conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 2018 to 2019. A total of 154 patients with mild and moderate OA knee were randomly allocated into two groups: group A (received PRP injection) and group B (received HA injection) where 133 patients completed the follow-up schedule. Outcomes were measured by OA specific translated and validated Bengali instrument- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and visual analogue scale (VAS 0-10). They were followed-up for 6 months. Results: There was no significant statistical difference at the baseline between the groups regarding age, sex, grading of OA knee, side involvement, mean duration of the disease, VAS scores and WOMAC scores. After one month, VAS score significantly decreased in PRP group compared to HA group (p&lt;0.001). However, there was no statistical difference regarding total WOMAC scores between two groups (p=0.063). In third and sixth month, VAS score significantly decreased in PRP group compared to HA group (p&lt;0.001). Though the stiffness and physical activity scores of WOMAC did not reduce significantly, the pain score reduced significantly in PRP group compared to HA group. In both groups, significant reduction of VAS and WOMAC total scores was observed after six months follow-up compared to baseline values (p&lt;0.001). Conclusion: Intra-articular platelet-rich plasma improves pain and function of the knee in patients with osteoarthritis. Though intra-articular hyaluronic acid also improves pain and function in the foot, PRP is more effective than hyaluronic acid. Multi-centered clinical trial with long term follow-up should be conducted to see the effects of PRP and HA. Bangladesh Med Res Counc Bull 2021; 47(1): 62-69

Characteristic and Chondrogenic Differentiation Analysis of Hybrid Hydrogels Comprised of Hyaluronic Acid Methacryloyl (HAMA), Gelatin Methacryloyl (GelMA), and the Acrylate-Functionalized Nano-Silica Crosslinker

Developing a biomaterial suitable for adipose-derived stem cell (ADSCs)-laden scaffolds that can directly bond to cartilage tissue surfaces in tissue engineering has still been a significant challenge. The bioinspired hybrid hydrogel approaches based on hyaluronic acid methacryloyl (HAMA) and gelatin methacryloyl (GelMA) appear to have more promise. Herein, we report the cartilage tissue engineering application of a novel photocured hybrid hydrogel system comprising HAMA, GelMA, and 0~1.0% (w/v) acrylate-functionalized nano-silica (AFnSi) crosslinker, in addition to describing the preparation of related HAMA, GelMA, and AFnSi materials and confirming their related chemical evidence. The study also examines the physicochemical characteristics of these hybrid hydrogels, including swelling behavior, morphological conformation, mechanical properties, and biodegradation. To further investigate cell viability and chondrogenic differentiation, the hADSCs were loaded with a two-to-one ratio of the HAMA-GelMA (HG) hybrid hydrogel with 0~1.0% (w/v) AFnSi crosslinker to examine the process of optimal chondrogenic development. Results showed that the morphological microstructure, mechanical properties, and longer degradation time of the HG+0.5% (w/v) AFnSi hydrogel demonstrated the acellular novel matrix was optimal to support hADSCs differentiation. In other words, the in vitro experimental results showed that hADSCs laden in the photocured hybrid hydrogel of HG+0.5% (w/v) AFnSi not only significantly increased chondrogenic marker gene expressions such as SOX-9, aggrecan, and type II collagen expression compared to the HA and HG groups, but also enhanced the expression of sulfated glycosaminoglycan (sGAG) and type II collagen formation. We have concluded that the photocured hybrid hydrogel of HG+0.5% (w/v) AFnSi will provide a suitable environment for articular cartilage tissue engineering applications.

Efficacy and safety of hyaluronic acid filler injection as compared to polylactic acid filler for temporary penile augmentation: A multi-center, patient/evaluator-blinded, randomized control trial with a safety extension

ABSTRACT Introduction Soft tissue augmentation using hyaluronic acid (HA) filler has grown rapidly in recent years, while clinical studies, especially randomized control trial, in penile augmentation (PA) using HA filler rarely conducted. Objective This study aimed to investigate the efficacy and safety of HA filler injection for temporary PA as compared to polylactic acid (PLA) filler. Methods The present prospective, patient/evaluator-blinded, multi-center study randomized 74 patients with small penis syndrome, which defined as the anxiety felt when one's penis is being observed because of concern that the penis is small, to HA filler injection or PLA filler injection for PA. Penile girth and satisfaction, were assessed at baseline and at 4, 12, and 24 weeks after injection. Safety profile evaluation was extended for 48 weeks for HA filler injection group. Results Grossly, both filler materials were evenly distributed, and led to a significant volume expansion for up to 24 weeks post-injection (Figure 1) In both group, mean penile girths significantly increased at 4 weeks post-injection (2.7±1.0 and 2.3±1.1 cm mean increases in the HA and PLA groups, respectively; each p&amp;lt;0.001). Although, both filler gradually decreased, penile girth increases adequately lasted for 24 weeks (2.3±1.3 and 2.0±0.9 cm mean increases from baseline in the HA and PLA groups, respectively; each p&amp;lt;0.001). (Figure 2) Satisfactions for penile appearance and sexual life were significantly increased at 24 week in both group. Adverse event related to filler injection were reported in 2 (5.56%) and 3 (7.89%) patients in HA and PLA groups, respectively during 24 weeks. And 1 case was recorded after extensions for 48weeks for HA group. Conclusion HA filler was similarly effective with PLA filler for temporary PA in men with small-penis syndrome and can be used safely for a long time until 48 weeks.

Safety and Effectiveness of Platelet Rich Plasma versus Hyaluronic Acid Injection in Pain Management of Hip Osteoarthritis

Background: Platelet rich plasma therapy is a simple, low cost and minimally invasive method that provides a natural concentrate of autologous blood growth factors that can be used to enhance tissue regeneration (1). Recent evidences have shown that Platelet Rich Plasma Therapy can be helpful as an osteoarthritis (OA) therapeutic tool by intra-articular injection (2). Hyaluronic acid (HA) is widely used therapy for relief of OA pain and stiffness by intra-articular injection. In addition, there is a sufficient evidence for being significant disease modifying effects. Objectives: The aim of the study was to compare the clinical efficacy of Platelet Rich Plasma with that of hyaluronic acid viscous supplementation. Methods: This study included forty patients with hip osteoarthritis. These patients were selected from the Out Patient Department (OPD) of Dhaka Pain Management Center (DPMC) and Ava Pain &amp; Intervention Center (APIC), Dhaka, Bangladesh during the period from January 2020 to December 2020. Patients were randomly divided into two groups. The first group consisted of 20 patients treated by using intra-articular injection of 2 ml autologous Platelet Rich Plasma Therapy. The second group consisted of 20 patients they were treated by using intra-articular injections of low molecular weight (hyaluronic acid [HA]) (32mg/2mL) of HA (HA group). All patients received 3 injections with one week interval (3) For Follow up: The subjective clinical outcome were measured at baseline, 1, 3, 6 and 12 months after the last treatment dose using the Visual Analog Scale (VAS) (5). Results: The Platelet rich plasma and Hyaluronic Acid groups showed an improvement, with significant difference between the two groups. However after 6 months follow up there was significant improvement in Platelet Rich Plasma Therapy group than HA group (P&lt;0.005). The follow up after 12 months reveled subsided improvement than that was at 6 months. Nevertheless, this subsidence was less in Platelet ...

Effects of Replacing Alfalfa Hay With Native Grass Hay in Pelleted Total Mixed Ration on Physicochemical Parameters, Fatty Acid Profile, and Rumen Microbiota in Lamb.

This study aimed to investigate the effects of replacing alfalfa with native grass on growth performance, meat quality, and rumen microbiota of lambs. Forty-five 6-month-old Ujimqin lambs with live body weight (BW) of 29.50 ± 0.26 kg were used for the experiment, and the lambs were assigned to three diet treatments (three pens per treatment and five lambs per pen) with 30 square meters per pen in semi-open housing based on similar BW. The lambs have received 30% alfalfa (HA, high alfalfa percentage group), 20% alfalfa (MA, moderate alfalfa percentage group), and 10% alfalfa (LA, low alfalfa percentage group) diets, respectively (dry matter basis). The diet treatments had a significant (P < 0.05) influence on the dry matter intake of lambs and the dry matter intake increased with the increasing percentages of native grass hay, while the significantly (P < 0.05) lower final BW and average daily gain were observed in the MA and LA groups compared with that in the HA group. The diet had a significant (P < 0.05) difference in meat pH value, water loss rate, cooked meat rate, moisture, and intramuscular fat, while no significant (P > 0.05) difference was found in protein. As native grass hay percentages increased in the diet, the contents of palmitic (C16:0) and palmitoleic (C16:1 cis-9) in the HA and MA groups were significantly (P < 0.05) lower than that in the LA groups, and compared with the HA group, the contents of elaidic (C18:1 trans-9), oleic (C18:1 cis-9), and linoleic (C18:2 cis-9–cis-12) were significantly (P < 0.05) increased in the MA and LA groups. The content of α-linolenic (C18:3n3) was significantly (P < 0.05) higher in the LA group than that in the HA and MA groups. The principal coordinate analysis profile displayed that the composition of the bacterial community of these groups was distinctly separated from each other. No significant (P > 0.05) difference was observed in the dominant rumen bacteria at the phyla and genus levels. In conclusion, the meat quality and fatty acid profile analysis revealed that replacing alfalfa hay with native grass hay is more beneficial for Mongolian lambs, and the meat from LA diet treatment is better than the others. In addition, correlation analysis of the association of rumen microbiome with growth performance, meat quality, and fatty acid profile provides us with a comprehensive understanding of the composition and function of rumen microbiota. These findings could provide knowledge of how the diet affects the animal performance, meat quality of lambs, and microbiota of the rumen, laying a theoretical basis for replacing alfalfa with native grass.

Evaluation of macular and choroidal thickness in healthy residents living at high altitude.

Purpose:Assessment of long-term effects of high altitude on choroidal thickness.Methods:This prospective cross-sectional study included 88 and 79 age- and sex-matched healthy individuals who were living at sea-level (SL group) and high-altitude (HA group), respectively. Participants were required to have resided in the same place for at least 10 years. Spectral-domain optical coherence tomography (SD-OCT) scans were conducted in two different and were performed within the same time (08:00 am to 10:00 am). Central macular thickness (CMT) and choroidal thickness were measured at five different points (i.e., at the central fovea and 1 mm and 2 mm temporal and nasal of the fovea). Blood hemoglobin (Hb), red blood cell (RBC), hematocrit (Htc) levels, blood oxygen saturation, heart rate, and body mass index (BMI) were compared between groups statistically.Results:The HA group had a mean age of 47.5 ± 13.3 years, whereas the SL group was 48.7 ± 13.4 years (P = 0.57). There was no significant difference between the groups in terms of CMT. Subfoveal choroidal thickness (SCFT) was 282.73 ± 87.82 mm in the HA group and 310.49 ± 74.73 in the SL group (P = 0.02). The choroid was found to be thinner at all the measured locations in the HA group except the 2 mm nasal point of the fovea. However, only the difference at an SFCT was statistically significant. Furthermore compared with the SL group statistically significant higher Hb, RBC, Htc levels were determined in the HA group. In the multiple linear regression model analysis, age was found an only effective confounder factor for SCFT (P = 0.001, 95% CI 4.132–2.476).Conclusion:The systemic adaptive changes due to chronic high altitude exposure may cause structural changes in the choroidal vascular network. The current study results revealed significant thinning only at SFCT. Large-scale longitudinal studies are needed to obtain more definitive data on this subject.