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Article
Histological and histomorphometric studies of the effects of hyaluronic acid on osseointegration of titanium implant in rabbits

Authors: Mohammad Hasan Mohammad محمد حسن محمد --- Nada M. H. Al-Ghaban ندى الغبان
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2018 Volume: 30 Issue: 2 Pages: 10-16
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: One of the unique prosthesis for tooth or teeth replacement is the dental implant. Our attempt is using a biomaterial system that is easily obtained and applicable and has the ability to provoke osteoinductive growth factor to enhance bone formation at the site of application. One of these natural polymers is hyaluronic acid. Material and methods: Sixty machined surface implants from commercially pure titanium rod inserted in thirty NewZealand rabbits. Two implants placed in both tibia of each rabbit. The animals scarified at 1, 2 and 4 weeks after implantation (10 rabbits for each interval). For all of animals the right tibia’s implant was control (uncoated) and the left one was experimental (coated with 0.1ml Hyaluronic acid gel). All sections have been stained with Haematoxylin and Eosin then they were histologically examined and assessed for histomorphometric analysis for counting of bone cells (osteoblast, osteocyte and osteoclast), cortical bone thickness, trabecular width, thread width and marrow space star volume (V*).Results: Histological findings for hyaluronic acid- coated titanium implant revealed an earlier bone formation, mineralization and maturation than that in control groups. Histomorphometric analysis for all bone parameters that examined in this study, showed highly significant difference between control and experimental groups in all healing intervals.Conclusion: Commercially pure titanium endosseous implants coated with hyaluronic acid may be osteocoductive thus accelerating healing process and enhancing osseointegration


Article
Safety and efficiency intra articular hyaluronate injections of treatment knee Osteoarthritis

Author: Ali Hasanain Alhamadan
Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2017 Volume: 4 Issue: 1 Pages: 53-59
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

Osteoarthritis is a chronic disease characterized by degradation joint that may cause cartilage loss and morphological deterioration to another joint tissue, more delicate biochemical changes occur in the early stages of Osteoarthritis progress. healthy cartilage content water that make balanced by compressive force driving water out while hydrostatic and osmotic pressure drawing water in. Collagen fiber make the pressure force and cartilage proteoglycan create osmotic pressure which draw water in, Without the protective effect of the proteoglycan the fiber and collagen of the cartilage can become susceptible to degradation and degeneration. Hyaluronic acid is major component of synovial fluid and articular cartilage, and is responsible for viscosity and elasticity of synovial fluid. The quantity and molecular weight of Hyaluronic acid in the synovial flu-id is decrease in the osteoarthritis patient. The purpose of injecting intra-articular HA is to replace HA so that the natural viscosity of synovial fluid is maintained, so relieve pain and improve function of knee Osteoarthritis. HA injections have been used in treating knee osteoarthritis for over two decades in most developed countries, but in Iraq begin used late and slow due to lack of patient education about the injection, study diagnosed two group of knee Osteoarthritis for both gender and observed benefit and effectiveness to pre-and post of HA injection, the results were various significant during one month under study.


Article
THE VALUES OF HYALURONIC ACID AND AS A MARKER OF CIRRHOSIS IN CHILDREN WITH CHRONIC LIVER DISEASES

Authors: Nadia N Hassan نادية نوري حسن --- Firyal H Al-Obaidi فريال حسن العبيدي --- Hala S Arif هاله سامح عارف
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2013 Volume: 11 Issue: 1 Pages: 72-77
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Hyaluronic acid (HA) is removed by the liver via sinusoidal cell adhesion molecules. This is impeded in fibrosis, leading to a rise in serum HA. As a noninvasive marker of fibrosis, HA may obviate the need for liver biopsy.Objective:To evaluate HA as a marker of hepatic fibrosis in unselected children undergoing liver biopsy or ultrasound.Methods:Fifty children aged 2-156 months diagnosed to have different types of chronic liver diseases (CLDs) and thirty healthy children aged 2-156 months were studied as controls were evaluated at the Teaching Hospital and Gastroenterology and Hepatology Center, Medical City, Baghdad, Iraq. The degree of severity of liver infection was assessed by liver biopsy or ultrasound. HA levels were measured using an ELISA.Results:The mean of HA level was 0.61± 0.32 ng/ml in the control group, 3.05± 1.11 ng/ml in patients with significant fibrosis and 1.18±0.86 ng/ml in patients with chronic liver diseases without significant fibrosis. Significant fibrosis was found in 31 out of 50 children with chronic liver disease, 20 of them were classified (METAVIR score) as cirrhotic liver. Seven out of 18 biopsies value of stage 4. Thirteen out of 32 ultrasounds described as having a coarsely textured liver. The sensitivity and specificity of estimated HA values in the diagnosis of liver cirrhosis were 87.1% and 94.74%, respectively.Conclusion:HA is a valid noninvasive predictor of histological fibrosis in children with CLD. It complements the thorough investigations of a child with CLD; however, it cannot at present replace histological examination to identify liver fibrosis. Further evaluation of HA is needed to ascertain the use of serial measurements in the targeted patient groups.Key word:Hyaluronic acid, chronic liver disease, liver fibrosis.


Article
Evaluation the effect of hyaluronic acid on bone healing process in rabbits (Immunohistochemical study for TGF-β)

Authors: Ibtihal H. Radhi --- Nada M. Al-Ghaban
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2015 Volume: 27 Issue: 1 Pages: 111-116
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Bone augmentation techniques are commonly employed in medical fields. This biomaterial system mustbe readily available, easily applicable by minimally-invasive technique and able to release an osteoinductivegrowth factor. Such a system will be able to engineer new bone formation locally at the site of injection. Hyaluronicacid has osteogenic potential that can be exploited not only for repairing bone defects but also for providingtransplantable bone for the reconstruction of a variety of bone defects. The aims of this study were to evaluate theeffects of Hyaluronic acid gel on bone healing by immunohistochemical estimation of transforming growth factor -beta 3 in experimental and control groups.Materials and methods: Thirty two New Zealand male rabbits were used in this study .Two Intra bony holes were madefor each rabbits on the right and left buccal side of the upper diastema. The right hole was filled with Hyaluronic acidgel (experimental one), while the left hole was left for normal healing (control one). The rabbits were randomlydivided and sacrificed at 1, 2, 3 and 6 weeks post operatively. Immunohistochemical test for the expression of TGF-β3were performed on bone specimens of both control and experimental groups at all healing interval.Results: Immunohistochemical examination of this study revealed that the hyaluronic acid treatment increased thepositive expression of TGF-β3by osteoblasts, osteocytes and bone marrow stromal cells especially in 1 and 2 weeksintervals than that observed in control one.Conclusions: The present study illustrated that the Hyaluronic acid was osteoconductive material that enhanceosteogenesis and accelerated the bone healing process


Article
Efficacy of arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibular joint

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Abstract

Background: Temporomandibular joint disorders refer to a group of heterogeneous pain and dysfunction conditionsinvolving the masticatory system, reducing life quality of the sufferers. Arthrocentesis is simple and less invasivesurgical procedure for the treatment of internal derangement than arthroscopy and better than other conservativeprocedures such as drugs, occlusal appliances and physiotherapy. The aim of the study was to evaluate the effectof arthrocentesis with injection of hyaluronic acid in the treatment of internal derangement of temporomandibularjoint for the restoration of its function, reducing pain and preventing further deterioration of the temporomandibularjoint dysfunction.Materials and methods: This study was performed in Al-Sheed Ghazi Al-Hariri Hospital, Department of Oral andMaxillofacial Surgery, from November 2012 to October 2013, included 60 patients, aged 18 to 45 years withsymptoms of temporomandibular joint pain, clicking during function and limited mouth opening.Temporomandibular joint internal derangement was assessed with clinical examination and confirmed withcomputed tomography scan. Arthrocentesis was done with insertion of two 18 gauge needles in the upper jointcompartment, lavaged with ringer’s lactate solution and at the end of the procedure 1ml of hyaluronic acid wasinjected. Intensity of temporomandibular joint pain was assessed using visual analog scale, maximum mouth openingwas assessed with ruler scale and joint clicking was assessed clinically by stethoscope and manual palpation. All theparameters were measured before the procedure then 1 and 3 months later.Results: During 4 months follow-up, clinical examination and comparison of the results showed reduction in pain withsuccess rate 95%, improvement in mouth opening with success rate 100% and clicking disappeared in 95% ofpatients.Conclusion: The technique of arthrocentesis using Sodium Hyaluronate injection, used in patients who presented withinternal derangement, showed therapeutic benefits, simplicity, safety, patients acceptance of the technique andlack of significant side effects and complications.


Article
Efficacy Of Hyaluronic Acid And Corticosteroid Intra-Articular Injection In Knee Joint With Primary Osteoarthritis

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Abstract

Background: Osteoarthritis OA is the most common joint disorder in the world. Injection of high molecular weight hyaluronic acid intra-articular with steroid is a one of the used therapeutic option for patients with (OA)knee. Objectives: Objective of this study was the evaluation the efficacy, safety, pluse duration of action of viscosupplementation of the HMWHA( high molecular weight hyluranic acid ).Type of the study: Cross-sectional study.Methods: From 81 patients with sever knee pain due to OA (grades 3–4) were recruited from Al-Yarmouk teaching hospital & a private clinic during the period from January 2014 till July 2016. The patients were (24 males - 57 females) with mean age 57.14 years( range from 45y -64 y). Visual Analog Scale (VAS) questionnaire for pain, morning stiffness calculated by minuets and physical function were used to assess treatment efficacy after intra-articular HMWHA injection.Results: The study included 81 patients who gave the examination data and complete the vital baseline and follow-up data necessary to check for the safety and efficacy .Major improvement was seen after 6 months from injection, as pain, stiffness and physical activity data decreased to 20.32, 1.42 and 4.44 respectively. Such achievement continue for 9 months after injection, as the pain marks was 28.3, the stiffness marks was 3.15,while the physical activity marks was 5.Conclusions: injection of HMWHA with steroid intr articular is effective, safe for the period of 9 months for those patients who complain from moderate and severe OA knee joint.

فعالية حقنتي حمض الهيالورونيك والستيروئيد في الفصام العظمي الاولي لمفصل الركبة.الخلفية: التهاب المفاصل من الامراض المزمنه الذي توثر على الغضروف وتحطمهالهدف: فعالية استخدام حامض الهيالوروناتطرائق العمل: دراسة مستقبلية اجريت على واحد و ثمانون مريضاً بالغين يعانون من مرض الفصال العظمي تم علاجهم بواسطة حقن حمض الهيالورونيك والستيروئيد ,, يتوزعون الى ( 24 ) حالات ذكور و ( 57 ) حالات اناث تتراوح اعمارهم من ( 45 ) سنة الى (69 ) سنة بمعدل ( 57 ) سنة. تمت الدراسة في مستشفى اليرموك التعليمي والعيادة الخاصة للفترة من تاريخ كانون الثاني لسنة 2014 الى تموز لسنة 2016. كل هذه الحالات تعاني من مرض الفصام العظمي المتوسط والشديد تم فحصها وتسجيل معدلات الالم والتصلب والصعوبة في اداء الفعاليات الوظيفية.تحت ظروف التعقيم تم سحب سائل مفصل الركبة في معظم الحالات من الجهة الجانبية الخارجية.ثم تم علاج جميع الحالات بحقن مفصل الركبة بمادة المخدر الموضعي الليدوكائين وحقنة مادة المثيل بريدنيزيلون ثم بمادة حمض الهيالورونيك عالية الوزن الجزيئي ومتابعتها لمدة تسعة اشهر جرى خلالها تسجيل النتائج ومعدلات الاختلاف عند الشهر الاول والثالث والسادس والتاسع. النتائج: كانت نتائج دراستنا كالاتي: وجود انخفاض ملحوظ في معدل قراءات الالم على مدى اشهر المتابعة لتصل الى معدل28.3 عند قراءة الشهر التاسع مقارنة بما كان عليه قبل العلاج وهو 58.42 بلغ الانخفاض في معدل قراءات التصلب من معدل 10.43 دقائق الى 3.15 دقائق. بلغ التحسن في صعوبة اداء الفعاليات الوظيفية من معدل 12.48 الى معدل 5فيما نتج عن الدراسة كأعراض جانبية تضمنت 35 حالة توزعت بين الشعور بالالم والتورم والاحمرار وتحدد الحركة وجميعها تم علاجها خلال ثلاثة ايام فقط اما بالباراسيتامول او مضادات الالتهابات غير الستيروئيدية.الاستنتاجات: ان استخدام حمض الهيالورونات هو فعال وآمن في حالات المرضى الذين يعانون من مرض الفصال العظمي ذو الدرجة المتوسطة والشديدة في مفصل الركبة


Article
The Effect of Hyaluronic Acid and Platelet - Rich Plasma on Soft Tissue Wound Healing: An Experimental Studyon Rabbits

Author: Wafaa K Fathi
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2012 Volume: 12 Issue: 23 Pages: 115-125
Publisher: Mosul University جامعة الموصل

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Abstract

Aims: This study aimed to evaluate the benefits of using platelet– rich plasma and hyaluronic acid when used alone or in combination with each other on wound healing. Materials and methods: The study performed on 15 adult male rabbits divided into three group according to healing periods (3,7,14 days), each group containing 5 animals. Four longitudinal incisions were made on the back of each rabbit, 2 in the right and 2 in the left. A distance of about 1.5 cm was left between one incision and another. The defects were filled with platelet–rich plasma, hyaluronic acid, or mixture of both, and the last incision served as control. Animals were sacrificed at 3rd, 7th, and 14th day after intervention, and biopsy were taken. Histopathological analyses were performed to evaluate the effect of these materials on acceleration of wound healing of skin. Statistical analyses was performed with Analysis of Variance and Duncan's Multiple Range Analysis Test, using a significant level of p ≤ 0.01. Results: Histopatho-logical analysis revealed significant improvement of wound healing when treated with PRP, and with mixed application of PRP and HA compared with control and HA groups in 3rd and 7th day postope-ratively, while there was no significant differences in wound healing between all groups at the end of the second week. Conclusions: The use of PRP alone or in combination with HA will accelerate wound healing , while the use of low concentration of HA alone presents no improvement of wound healing in comparison with normal one.


Article
Clinical Improvement of osteoarthritic knee pain by adding intra-articular steroid Injection to viscosupplementation

Author: Ahmed Latteef Al-Shamari
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2015 Volume: 14 Issue: 1 Pages: 51-57
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Intra-articular injections have been used for many years to treat painful joint disorders, especially by means of injecting crystalline suspensions of long-duration corticosteroids. Viscosupplementation, which is a relatively new intervention, consists of injection of exogenous hyaluronic acid into joints in order to treat osteoarthritis of knee joint. Patients and Methods: A prospective cohort study was conducted in a private orthopedic clinic in Baghdad from March 2013 to the end of September 2014, where it enrolled a total of fifty six (56) patients of middle ages, ranging from 39 to 64 years, classified as either grade II or III according to Kellgren and Lawrence radiographic criteria. Intra-articular injection of two drugs (a long acting steroid drug, then hyaluronic acid) were given locally in one or both knee joints with one week apart. To evaluate the effect of therapy, current study group patients were assessed by Visual Analogue Scale (VAS) after 1 week, and after 4-8 weeks from the beginning of the therapeutic trial. Results: more than two-third of cases were women (a ratio of 2.1:1), with age group of 50- 59 years old. No statistical correlation was found between Visual analogue scale (VAS) and radiographic grading (i.e. Kellgren and Lawrence radiographic criteria). Significant statistical difference (P<0.05) was shown in patients receiving intra-articular corticosteroids after week "1" of therapy, and a slightly better effect after adding hyaluronic acid on week "4" regarding the VAS scale of pain for radiographic grade II patients. Radiographic grade III patients showed a significant statistical correlation in VAS after week (4) of therapy for both moderate and severe classes. Conclusion: Intra-articular injections of both corticosteroids and hyaluronic acid with one week apart appear to give clinical improvement better than using Intra-articular injection of hyaluronic acid alone.


Article
Molecular Identification of Hyaluronic Acid Genes of Streptococcus pyogenes

Authors: Kawkab Abdulla Al-Saadi1 --- Ali Hmood Al-Saadi --- Hassan Fadhil Naji
Journal: Journal of University of Babylon مجلة جامعة بابل ISSN: 19920652 23128135 Year: 2017 Volume: 25 Issue: 2 Pages: 420-415
Publisher: Babylon University جامعة بابل

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Abstract

The genes responsible for hyaluronic acid (HA) production (has A,has B and has C genes) of eight local S. pyogenes isolates were identified using polymerase chain reaction(PCR). It was found that all isolates possessed has A and has B genes whereas has C gene was found in three isolates of S. pyogenes . This study supports the opinion that has A and has B genes are required for direct HA biosynthesis, while has C gene is not required for HA production

شخصت الجينات المسؤولة عن انتاج حامض الهاليرونك (جينات has A وhas B و has C) لثمانية عزلات محلية للمسبحيات القيحية باستخدام تفاعل البلمرة المتسلسل (PCR) . وجد ان كل العزلات تمتلك جينات has A وhas B بينما جين has C وجد في ثلاثة عزلات من المسحيات القيحية . تدعم هذه الدراسة فكرة ان has A و has B ضرورية للتصنيع المباشر لحامض الهاليرونك بينما الجين has C غير ضروري لانتاج حامض الهاليرونك.

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