الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 179 |  |  |
| | | from | 179 | | |
Abstract
Arthritis is a term covered more than 100 types of diseases at any age group. arthritis leads to negative impact in form of work limitations for nearly one in three among all people. Furthermore it is a more frequent cause that leads to limitation of activities than heart disease, cancer or diabetes. Curcuma is a perennial herb belonging to the Zingiberaceae. It mainly contains four ingredients that make it work so well. Curcuma the main constituent of curcuma are a super antioxidant, and helps to fight inflammation. Curcuma has various important properties like anti-inflammatory, antibacterial, and antioxidant. It has a detoxifying action that stimulates the immune system and lowering level for bad cholesterol.
So the aim of this study was to determine the effect of life style modifications and Curcuma therapy on clinical outcomes among female patients with osteoarthritis of the knee joint.
Materials and Method:
Research design: The study followed a quasi experimental research design
Settings: The study was conducted at the outpatient clinic of El Hadara Orthopedic and Traumatology University Hospital, Alexandria.
Subjects: Sixty adult female patients with Osteoarthritis of the knee joint was randomly assigned and fulfilling the study criteria (newly diagnosed with osteoarthritis in the mild or moderate stage, Free from any other comorbid conditions as heart diseases, uncontrolled hypertension, diabetes or liver and kidney disorders, or trauma to musculoskeletal system in either lower or upper limb, able to communicate effectively and willing to participate in the study
Those subjects were divided alternatively into three equal groups:
Study group (I) followed life style modifications only plus routine hospital care.
Study group (II) followed life style modifications, plus the intake of curcuma in a capsulated dose of 400 mg oral daily for 2 months plus routine hospital treatment.
Control group (III) received routine hospital treatment only.
Tools
In order to collect the necessary data, four tools will be used.
Tool I: Osteoarthritis female patients profile structured interview schedule: This tool was developed by the researcher. It will include the following four parts:
Part I: Sociodemographic data of the study subject.
Part II: Patient medical history: past and present history, clinical manifestation and medication used.
Part III: Laboratory Findings: kidney and liver functions result will be compared against normal values.
Part IV: Knee plain X ray: To assess degenerative changes in the affected knee joint. Result will be compared against normal findings.
Tool II Knee disability and Osteoarthritis Outcome
This tool was developed by Nicholas Bellamy (1996). It was used for the assessment of symptoms associated with Osteoarthritis.
Tool III: ”The World Health Organization Quality of Life Scale.
The World Health Organization Quality of Life (2008). It was used to assess quality of life of osteoarthritis patients.
Tool IV - Nutritional Assessment check list:-
It was developed by the researcher to assess patient’s nutritional health status. It included dietary recall, curcuma intake and anthropometric measurements.
Method
An official letter was sent to the Hadara Orthopedic and Traumatology University authorities and head of departments to take the approval for data collection. Tool one and four was developed by the researcher, while tool two was developed by Nicholas Bellamy (1996). And tool three was developed by WHO (2008). All tools were submitted to five experts in the field of orthopedics, and medical surgical nursing for content validity and the necessary modification was carried out, accordingly. The reliability of all tools was tested using appropriate statistical test. A pilot study was conducted on 6 patients to test clarity, applicability and feasibility of the tools and necessary modifications was done. Data obtained was excluded from the actual study. A sample of 60 adult patients with osteoarthritis of the knee joint was assigned randomly and divided alternatively into three equal groups 20 patients in each; group (I) was follow life style modification only and plus routine hospital treatment, group (II) was follow life style modification, plus a curcuma in a dose of (400 mg oral daily) plus routine hospital treatment and group (III) was receive routine hospital treatment.
The main results obtained are as follows:
- Concerning age, patients in group 1 and 2 their age was ranged from 40 to less than 50years, while in group 3 the age group was ranged from 40 to less than 50 years. There was no statistically significant difference between the three groups; the majority of patients in the three groups were aged between 40 to less than 55 years (50%, 65% and 55% respectively).
- Regarding marital status, the majority of the total sample were married (80%, 75%, 75%), followed by widowed (10%, 15% and 25% respectively). There was no statistical significant difference between the three groups.
- In relation to Education, secondary and university education was prevailing among the study subjects and control group (60%,70% and 55% respectively). Only one patient 5% in group 1 and group 2 were illiterate, 5%. While 10%in both groups 2, 3 also had primary education. There were no statistically significant between three groups.
- As regards the occupation, the table illustrate that the study subjects and control groups (55%, 65%and 50%) are employed followed by without work (30%, 25% and 35% respectively). There was no statistical significant between three groups.
- As for the monthly income, the table shows that more than 95% of the three groups reported that their income is enough for them. No statistical significant difference was found between the three groups in relation to monthly income. All the three groups are from urban residence.
- As regards the medical diagnosis, 30%of the patients in group 1 have diabetes mellitus compared to 15% of the patients in group 2 and 20% in group 3. More than 30% have Hypertension in group 3 compared to 10% in group 1 and25% in group 2. Gout represents about 10% in 1, 3and 15% in group 2. Other health problems only 10% in group 2 and 25% in group 3 did not report any health problems in group 1.
- Regarding medications taken by the three groups, the majority of the studied sample (more than 95%) were on anti-inflammatory and analgesic. more than 80% of the studied sample among the 3 groups were using topical ointment, less than one quarter of the total sample in the 3 groups were on anti-rheumatics.
- The majority of the three group’s uses an assistive device (96%, 90% and 96%) in the three groups were using canes (5%, 10% and 5%) Regarding measures taken to overcome pain. It can be observed that the majority of the study subjects and control group used analgesics and anti-inflammatory (100%, 95% and 100%) in all three groups respectively. Weight reduction and use of herbal therapy such as garlic capsules and green tea were reported by nearly the same percentage in the three groups. 45%, 40% and 35% respectively for weight reduction while 20% was reported in both group 1,2 and only 10% in group 3.
- Regarding improvement of pain with the methods previously used, the table shows that the majority of the three groups agreed about the previous methods (95%, 80% and 85%).
- More than 95% of the studied sample (groups 1,2and 3) were non-smokers (95%, 100% and100%) respectively, only 5% of group 1 was ex-smokers.
- Concerning anxiety regarding recurrence of pain, the table illustrates that 85% in group 1 and75% in group 2 reported that they are anxious about recurrence of pain after finishing the intervention period compared to 85% of group 3. The rest of the study subjects reported that they are felt anxious sometimes 15%, 20 % and 15% for the three groups respectively.
- Regarding the type of physical exercise practiced, it was evident that walking was the most commonly reported 35% for both group 2,3 respectively compared to 45% in group 1, while only 5%of the total sample in group 1 reported that they were using a motor and run exercise.
- the duration of the disease ranged from less than one year up to 4 years with a MCPc 0.430 less than half of the studied sample in all groups(35%,45%and50%)respectively reported that they were suffering from stiffness from one year to less than 5 years. there is no statistical significance.