Hasil Pencarian  ::  Simpan CSV :: Kembali

"When hero policeman Grant Cliveden dies from a poisoning in the Old Bailey, it threatens to shake the country to its core. The evidence points to one man. Jimmy Knight has been convicted of multiple offences before and defending him will be no easy task. Not least because this is trainee barrister Adam Green's first case. But it will quickly become clear that Jimmy Knight is not the only person in Cliveden's past with an axe to grind. The only thing that's certain is that this is a trial which will push Adam - and the justice system itself "

"Background: Glucosamine, chondroitinsulfate are frequently used to prevent further joint degeneration in osteoarthritis (OA). Methylsulfonylmethane (MSM) is a supplement containing organic sulphur and also reported to slow anatomical joint progressivity in the knee OA. The MSM is often combined with glucosamine and chondroitin sulfate. However, there are controversies whether glucosamine chondroitin sulfate or their combination with methylsulfonylmethane could effectively reduce pain in OA. This study is aimed to compare clinical outcome of glucosamine chondroitin sulfate (GC), glucosamine chondroitin sulfate methylsulfonylmethane (GCM), and placeboin patients with knee osteoarthritis (OA) Kellgren Lawrence grade I II. Methods: a double blind, randomized controlled clinical trial was conducted on 147 patients with knee OA Kellgren Lawrence grade I II. Patients were allocated by permuted block randomization into three groups: GC (n=49), GCM (n=50), or placebo (n=48) groups. GC group received 1500 mg of glucosamine + 1200 mg of chondroitin sulfate + 500 mg of saccharumlactis; GCM group received 1500 mg of glucosamine + 1200 mg of chondroitin sulfate + 500 mg of MSM; while placebo group received three matching capsules of saccharumlactis. The drugs were administered once daily for 3 consecutive months VAS and WOMAC scores were measured before treatment, then at 4th, 8th and 12th week after treatment. Results: on statistical analysis it was found that at the 12th week, there are significant difference between three treatment groups on the WOMAC score (p=0.03) and on the VAS score (p=0.004). When analyzed between weeks, GCM treatment group was found statistically significant on WOMAC score (p=0.01) and VAS score (p<0.001). Comparing the score difference between weeks, WOMAC score analysis showed significant difference between GC, GCM, and placebo in week 4 (p=0.049) and week 12 (p=0.01). In addition, VAS score also showed significant difference between groups in week 8 (p=0.006) and week 12 (p<0.001). Conclusion: combination of glucosamine chondroitinsulfate methylsulfonylmethane showed clinical benefit for patients with knee OAK ellgren Lawrence grade I II compared with GC and placebo. GC did not make clinical improvement in overall groups of patients with knee OA Kellgren Lawrence grade I II.

---

Latar belakang: glukosamin-kondroitin sulfate sering digunakan untuk mencegah degenerasi lutut lebih lanjut pada osteoartritis (OA). Metilsulfonilmetan (MSM) adalah suplemen yang mengandung belerang organik dan juga dilaporkan memperlambat progresifitas kerusakan anatomis pada OA lutut. MSM sering dikombinasikan dengan glukosamin dan kondroitin sulfat. Namun, masih terdapat kontroversi apakah glucosamin-kondroitin sulfat atau kombinasinya dengan methylsulfonylmethane secara efektif dapat mengurangi rasa sakit pada OA. Penelitian ini bertujuan membandingkan perbaikan klinis glukosamin-kondroitin sulfat (GK), glukosamin-kondroitin sulfat-metilsulfonilmetan (MSM) (GKM) dan plasebo pada pasien osteoartritis derajat Kellgren-Lawrence I dan II.

Metode: suatu uji klinis acak tersamar ganda dilakukan pada 147 pasien dengan OA lutut derajat Kellgren-Lawrence I atau II. Subyek dibagi menjadi 3 kelompok, dengan metode randomisasi blok permutasi, yaitu kelompok GK (n=49), GKM (n=50) dan plasebo (n=48). Kelompok GK mendapat 1500 mg glukosamin + 1200 mg kondroitin sulfat + 500 mg sakarumlaktis; kelompok GKM mendapat 1500 mg glukosamin + 1200 mg kondroitin sulfat + 500 mg MSM; kelompok plasebo menerima 3 kapsul yang serupa berisi sakarum laktis. Obat-obatan ini diberikan sekali sehari selama 3 bulan berturut-turut. Skor VAS dan WOMAC dinilai sebelum pemberian terapi, kemudian pada minggu ke 4, 8 dan 12.

Hasil: pada analisa statistik ditemukan perbedaan signifikan pada minggu ke 12, dimana kelompok GK pada skor WOMAC berbeda signifikan dibandingkan dengan GKM dan plasebo (p=0,005), sedangkan GKM pada skor VAS berbeda signifikan dibandingkan dengan GK dan plasebo (p=0,001). Pada analisis lebih lanjut ditemukan bahwa terdapat perbedaan signifikan pada kelompok GKM dan GM pada skor VAS. Efektivitas pemberian per 4 minggunya ditemukan berbeda bermakna pada kelompok GKM dan plasebo (p<0,005).

Kesimpulan: kombinasi glukosamin-kondroitin sulfat-metilsulonilmetan menunjukkan manfaat klinis yang lebih baik untuk pasien OA sendi lutut Kellgren-Lawrence derajat I dan II dibandingkan dengan GK dan plasebo. Sedangkan suplemen GK secara umum tidak menunjukkan manfaat klinis yang lebih baik pada pasien OA sendi lutut derajat Kellgren Lawrence I-II."