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"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.

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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."

"Conn's Current Therapy 2014 is an easy-to-use, in-depth guide to the latest advances in therapeutics for common complaints, acute disease and chronic illness. Family medicine experts, Drs. Edward T. Bope and Rick D. Kellerman present the expertise and knowledge of hundreds of skilled international leaders on evidence-based clinical management options. With key diagnostic points and treatment recommendation tables, you'll have access to the information you need to make accurate clinical decisions. Apply the proven treatment strategies of hundreds of top experts in family and internal medicine.Get quick access to critical information with "Current Diagnosis" and "Current Therapy" boxes at the beginning of each chapter as well as standardized diagnostic points and clinical recommendation tables."

"ABSTRAKGlukosamin hidroklorida dan kondroitin sulfat merupakan senyawa glikosaminoglikan (GAGs) yang merupakan komponen struktural utama dari tulang yang akan membentuk proteoglikan. Kedua senyawa ini dapat merawat kesehatan tulang dengan menstimulasi sintesis cairan sinovial dan menghambat degradasi kartilage persendian, sehingga dapat digunakan untuk terapi osteoartritis. Penelitian ini bertujuan untuk memperoleh metode analisis yang selektif untuk penetapan kadar glukosamin hidroklorida dan kondroitin sulfat dalam sediaan tablet dan krim. Setelah diderivatisasi menggunakan pereaksi ortoftalaldehida dan 2-merkaptoetanol (OPA/2-ME), sampel dianalisis menggunakan kromatografi cair kinerja tinggi (KCKT) dengan detektor fluoresensi pada panjang gelombang eksitasi 335 nm dan panjang gelombang emisi 445 nm. Glukosamin mempunyai gugus amin primer sehingga dapat diderivatisasi dengan OPA/2-ME, sedangkan kondroitin mempunyai gugus asetil pada gugus amin, sehingga perlu dilakukan deasetilasi menggunakan natrium hidroksida untuk memutus gugus asetil. Fase gerak yang digunakan tetrahidrofuran 0,25% dalam air-asetonitril (87:13) dengan laju alir 1,5 mL/menit. Kondisi analisis yang telah dioptimasi kemudian divalidasi mencakup akurasi, presisi, linieritas, selektivitas, batas deteksi, dan batas kuantitasi. Hasil menunjukkan kadar rata-rata glukosamin hidroklorida dan kondroitin sulfat pada sediaan tablet dan krim adalah 92,76%; 96,11% dan 101,15%; 100,33% memenuhi syarat keberterimaan.

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ABSTRAKGlucosamine hydrochloride and chondroitin sulphate are glycosaminoglycans (GAGs) compound which is a major structural component of bone that form proteoglycans. Both of these compounds can take care of bone health by stimulating the synthesis of synovial fluid and inhibit the degradation of joint cartilage, so it can be used for the treatment of osteoarthritis. The aimed of this study were obtain selective analytical method for the determination of glucosamine hydrochloride and chondroitin sulphate levels in tablet and cream dosage forms. After derivatization using orthophtalaldehyde and 2-mercaptoethanol (OPA/2-ME), samples were analyzed using high performance liquid chromatography (HPLC) with fluorescence detector at excitation wavelength of 335 nm and emission wavelength of 445 nm.. Glucosamine has a primary amine group that can be derivatized with OPA/2-ME, while chondroitin having an acetyl group at the amine group, so we needed deacetylation using natrium hydroxide to break the acetyl group. The mobile phase used tetrahydrofuran 0.25% in water-acetonitrile (87:13) with a flow rate 1.5 mL/min. Analysis conditions have been optimized, validated in terms of accuracy, precision, linearity, selectivity, limit of detection, and limit of quantitation. The results showed average levels of glucosamine hydrochloride and chondroitin sulphate in tablet and cream dosage forms were 92.76%; 96.11% and 101.15%; 100.33% and fulfilled the acceptance criteria."

"Occupational therapy is an allied health profession, which is concerned with the use of interventions and assessments to recover, maintain, and develop meaningful activities for individuals, groups or communities. It has developed owing to the philosophical ideals of humanism, pragmatism and romanticism. It primarily works with people who suffer from injuries, disabilities, health problems or impairments. Support for adults experiencing physical and cognitive impairment, injury rehabilitation and assistance to children with disabilities are under the scope of this field. Some common models which form the framework of practice of this field include person environment occupation performance model, cognitive-behavioral frame of reference, model of human occupation, the recovery model, etc. The objective of this book is to give a general view of the different areas and practices of occupational therapy. It elucidates the modern trends and techniques of this healthcare profession. Those in search of information to further their knowledge will be greatly assisted by this text."

"Lupus nephritis (LN) is involvement of the kidney in patient with systemic lupus erythematosus (SLE) and one of the most common target organ in SLE. The diagnosis of LN will significantly impact the clinical outcome and therapy of the patient. Therapy regiment of LN is divided into two stages, induction and maintenance treatment. The main objective of the induction therapy is to achieve complete or partial remission as soon as possible since it is correlated with better prognosis and fewer relapse incidence. In the maintenance stage, the main aim of the therapy is to maintain the remission status and avoid future relapse. It is also important to evaluate the effectiveness of the therapy as it will affect the duration and the regiment therapy being used. Corticosteroid, cyclophosphamide, mycophenolate mofetil, azathrioprine, cyclosporine and tacrolimus are example of drugs used in LN therapy. Currently, studies are being conducted to evaluate and develop targeted drug therapy to further add treatment options for LN.

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Nefritis lupus (NL) adalah keterlibatan organ ginjal pada pasien lupus eritematosus sistemik (LES) dan merupakan salah satu keterlibatan organ yang paling sering ditemukan. Ditemukannya NL pada pasien LES akan berdampak besar baik secara prognosis dari pasien maupun dalam pengobatan itu sendiri. Pengobatan NL dibagi menjadi dua tahap, induksi dan rumatan. Target dari pengobatan tahap induksi adalah untuk secepatnya mencapai remisi, baik parsial ataupun komplit, karena akan memberikan prognosis yang lebih baik dan kejadian relapse yang lebih rendah. Pada tahap rumatan, target yang ingin dicapai adalah untuk mempertahankan status remisi dan mencegah terjadinya relapse. Evaluasi keberhasilan dari masing-masing tahap juga sangat penting karena akan berpengaruh pada kelanjutan pengobatan. Kortikosteroid, siklofosfamid, mikofenolat mofetil, azatioprin, siklosporin dan takrolimus adalah obat-obat yang biasa dipakai dalam pengobatan NL. Berbagai target pengobatan baru juga terus berkembang guna memberikan pilihan yang lebih luas dalam menangani kejadian NL."