Comparison Between Propolis and Celecoxib as Anti-inflammatory Agent in Rat with Knee Synovitis

Introduction. Synovitis is an inflammation occurs in a joint marked by an increase in macrophage numbers in synovium resulting in cartilago and bone destruction by production of fibroblasts. Administration of non-steroid anti inflammation drug (NSAID) in management of arthritis and synovitis has its own complications, including gastrointestinal and bleeding disorder. Propolis, a natural bee product, is recognized as one of traditional pain killers at knee joint pain containing flavonoid and caffeic acid phenolic esters (CAPE). Several studies show its anti-inflammation effect, but its effect compared to other NSAID is still unknown. Therefore the aim of the study is to compare Propolis and celecoxib anti-inflammation effect in rat with knee joint synovitis. Materials and Methods. In this experimental study, Wistar strain rats were used. They were divided into three groups. Each group were given peptidoglycan only, peptidoglycan followed by Propolis, and peptidoglycan followed by celecoxib. Scoring based on number of macrophages and synovitis degree were evaluated by immunohistochemistry CD 68 and HE staining. It was evaluated in day 1, 3, and 14. Those scores were collected and analyzed using ANOVA. Results. Increasing number of macrophages and synovitis degree for all groups occur on day 3 and continuously decreasing until day 14. There is a significant difference in number of macrophages between grup 1 and the other two groups on day 3 (p<0.05). It shows that there is an anti-inflammation effect of both propolis and celecoxib. On day 3 and 14, the number of macrophages in grup 2 were five times lower than grup 3. (p<0.05) Conclusions. Propolis anti-inflammation effect shows 4-5 folds stronger than celecoxib in knee joint synovitis

Pelvic Ring Injury: Should We Notice Acid-Base Imbalance as Mortality Predictor?

Introduction. Young-Burgess classification system for pelvic ring fracture is popular because it is theoretically a mechanistic classification that is able to predict mortality. The inherent usefulness has led to its widespread use by both orthopaedic and general surgeon in guiding treatment. It can also predict associated injuries and the severity of hemorrhagic shock. Severe hemorrhagic shock will cause hypoperfusion of tissues which may lead to metabolic acidosis, one among the triad of death. Materials and methods. Medical records of pelvic ring injury patients in Department of Orthopaedic and Traumatology Hasan Sadikin Hospital, Bandung during 2010 were retrospectively reviewed. Data about age, gender, mechanism of injury, Young-Burgess classification, base excess, lactate concentration, pH, and outcome in 24 hours were extracted. Non-parametric Kendall-Tau analysis was used to analyze the correlation among Young-Burgess classification and hemorrhagic shock class, base excess, lactate concentration, pH, and outcome in 24 hours. Kruskal-Walis test was used to determine the difference among Young-Burgess classification and hemorrhagic shock class, base excess, lactate concentration, pH, and outcome in 24 hours Results. There were significant correlation between Young-Burgess classification and severity of hemorrhagic shock (p<0.01), haemoglobin (p<0.01), pH (p<0.01), and mortality (p<0.01). There were significant correlation between stability of fracture and hemorrhagic shock class (p<0.05), haemoglobin (p<0.05), pH (p<0.05), and mortality (p<0.01). Conclusions. stability of fracture, severity of hemorrhagic shock, and acid-base imbalance will lead to higher mortality

Efficacy of Povidone Iodine and Honey Mixture in Laceration Recovery

Introduction. Patients with lacerations to feet are usually involved in motor vehicle accidents. Based on trauma mechanism, the wound may be classified as a dirty contaminated wound. Patients are taken to operating theater for debridement then followed by wound care at ward. Clinical conditions of such wounds frequently are not optimal for healing process and may require further treatment to decrease the risk for postoperative infection. Honey has been long used as a material for dressing of burn wounds and infected wounds because of its antimicrobial, angiogenetic, and anti-inflammatory properties. Thus the aim of the study is determine efficacy of povidone iodine mixed with honey in laceration recovery. Materials and methods.This clinical study had twenty samples which were randomly assigned into two groups. One group have the wound treated using a mixture of 5% povidone iodine solution and pure honey, while the other group is treated using 5% povidone iodine only. The wound healing process was observed by evaluating granulation tissue, amount of exudates during the eight days of care, and the number of colony forming units (CFUs) from samples taken on admission in the ER and another taken at the eighth day of care. Statistical analysis is performed using the Wilcoxon Sign Rank Test and Mann Whitney Test. Results. The analysis revealed a significant difference between the group I and group II in the amount of granulation and exudate production, while there is no significant difference in number of CFUs in both groups. Conclusion. The mixture of 5% povidone iodine and pure honey are more effective compared to 5% povidone iodine only for the healing process of lacerations of the dorsal aspect of the right foot

Effectivity of Handmade Tubular Lyophilized Amnion Membrane as a Nerve Conduit in Repair of Peripheral Nerve Injury with 5 Mm Gap in Rats

Introduction.Peripheral nerve injury with 5–30 mm gap which is caused by direct injury cases (87%) or iatrogenic(12%) become a special concern because it may cause a serious disability in the future. Therefore, we need manykind of nerve repair methods without adding morbidity to the patient. One of the methods is entubulation method, byusing natural or synthetic material.Materials & Methods.This is an animal experimental research by using post-test only control group design inPharmacology Laboratory Faculty of Medicine Universitas Padjadjaran Bandung in May 2012. In this study, weused 14 Wistar rats divided into 2 groups. After creating gap on sciatic nerve, nerve conduit is installed on treatmentgroup by using handmade tubular lyophilized amnion membrane. Nerve conduit is not installed on control group.After 21 observation days, conduction test and histopathology examination were done. Data was analyzed using nonparametricstatistical analysis Sign test.Results.Result showed significant difference between two groups; the conduction test=0.016 (p<0.05), nerve growthto distal gap=0.063 (p<0.05), no radial direction of nerve growth=0.031 (p<0.05). Reaction of inflammation wasminimal and there was no difference between two groups.Conclusions. Handmade tubular lyophilized amnion membrane is effective as nerve conduit in repair of peripheralnerve injury with 5 mm gap

The Comparison of Ibuprofen and Celecoxib Effect on Tibial Fracture Healing in Wistar Mice: a Biomechanical Analysis

Introduction. Operated fracture patients are always given analgesic to overcome postoperative pain. Analgesic being given is non-steroidal anti-inflammatory drugs which also give anti-inflammatory effect. However, anti-inflammatory effect is believed to inhibit inflammation which is needed in fracture healing. The differences between selective and non-selective NSAID in inhibiting fracture healing need to be evaluated in the planning of fracture management. Materials and methods. We conducted an experimental research involving 90 Wistar mice aged below 6 months. They were randomly allocated into 3 groups to receive either non-selective NSAID (ibuprofen), selective NSAID (celecoxib) or aquades. At the beginning of the study, tibia of the mouse was fracturized and immobilized. After 30 days, mice were sacrificed and their tibiae were mechanically tested to examine the quality of the callus. The results were statistically analyzed using multivariate analysis. Results. There were significant differences in lateral bending and torsion force among groups (p<0.05). Univariate analysis revealed they were due to the difference between ibuprofen and celecoxib. Comparison of torsion force between ibuprofen and control was insignificant (p>0.05). Conclusions. Ibuprofen provides less suppresion effect on fracture healing biomechanicaly than celecoxib with significant difference in the bending and torsion test

Concepts for increasing gentamicin release from handmade bone cement beads

Background and purpose Commercial gentamicin-loaded bone cement beads (Septopal) constitute an effective delivery system for local antibiotic therapy. These beads are not available in all parts of the world, and are too expensive for frequent use in others. Thus, orthopedic surgeons worldwide make antibiotic-loaded beads themselves. However, these beads are usually not as effective as the commercial beads because of inadequate release kinetics. Our purpose was to develop a simple, cheap, and effective formulation to prepare gentamicin-loaded beads with release properties and antibacterial efficacy similar to the commercially ones. Methods Acrylic beads were prepared with variable monomer content: 100% (500 μL/g polymer), 75%, and 50% to increase gentamicin release through creation of a less dense polymer matrix. Using the optimal monomer content, different gel-forming polymeric fillers were added to enhance the permeation of fluids into the beads. Polyvinylpyrrolidone (PVP) 17 was selected as a suitable filler; its concentration was varied and the antibiotic release and antibacterial efficacy of these beads were compared with the corresponding properties of the commercial ones. Results Gentamicin release rate and the extent of release from beads prepared with 50% monomer increased when the PVP17 content was increased. Beads with 15 w/w% PVP17 released 87% of their antibiotic content. This is substantially more than the gentamicin release from Septopal beads (59%). Acrylic beads with 15 w/w% PVP17 reduced bacterial growth by up to 93%, which is similar to the antibacterial properties of the commercial ones. Interpretation A simple, cheap, and effective formulation and preparation process has been described for hand-made gentamicin-releasing acrylic beads, with better release kinetics and with antibacterial efficacy similar to that of the commercial ones