Background Our study compare the short and long-term efficacy of the intra articular injections (IAIs) of hyaluronic acid (HA), platelet-rich plasma (PRP), plasma rich in growth factors (PRGF), and ozone in patients with knee osteoarthritis (OA). Methods In this randomized clinical trial, 238 patients with mild to moderate knee OA were randomized into 4 groups of IAIs: HA (3 doses weekly), PRP (2 doses with 3 weeks interval), PRGF (2 doses with 3 weeks interval), and Ozone (3 doses weekly). Our outcome measures were the mean changes from baseline (immediately from the first injections) until 2,6, and 12 months post intervention in scores of visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne index. Results A total of 200 patients enrolled in the final analysis. The mean age of patients was 56.9 ± 6.3 years, and 69.5% were women. In 2 months follow up, significant improvement of pain, stiffness, and function were seen in all groups compared to the baseline, but the ozone group had the best results (P < 0.05). In 6 month follow up HA, PRP, and PRGF groups demonstrated better therapeutic effects in all scores in comparison with ozone (P < 0.05). At the end of the 12th month, only PRGF and PRP groups had better results versus HA and ozone groups in all scores (P < 0.05). Despite the fact that ozone showed better early results, its effects begin to wear off earlier than other products and ultimately disappear in 12 months. Conclusions Ozone injection had rapid effects and better short-term results after 2 months, but its therapeutic effects did not persist after 6 months and at the 6-month follow up, PRP,PRGF and HA were superior to ozone. Only patients in PRP and PRGF groups improved symptoms persisted for 12 months. Therefore, these products could be the preferable choices for long-term management. Trial registration Registered in the Iranian Center of Clinical Trials (www.irct.ir) in 11/11/2017 with the following code: IRCT2017082013442N17.

Background: Epilepsy is a group of disorders characterized by recurrent unprovoked seizures. It is recognized as one of the most common neurological diseases affecting different age groups. Objectives: This study aimed to determine the causes of secondary epilepsy in patients with epilepsy at Mashhad hospitals in 2011 -2012. Patients and Methods:In this cross-sectional, descriptive study, 300 participants were selected via available sampling from patients with epilepsy referred to hospitals affiliated to Islamic Azad University of Mashhad. Diagnosis of epilepsy was based on the criteria of the International League Against Epilepsy. Patients' demographic and medical profile questionnaires were completed, using clinical examinations, electroencephalography (EEG) and brain imaging. Results: In this study, 54% and 46% of participants were male and female, respectively (mean age = 31.5 ± 15.3 years). Head trauma was the most common cause of secondary epilepsy, observed in 26% of patients. Brain tumor (9.7%), stroke (9.3%), brain infection (8.3%), metabolic disease (3.3%) and birth trauma or congenital anomalies (2.3%) were other causes. Findings of the last performed EEG were normal and abnormal in 49% and 51% of participants, respectively. Moreover, results of brain imaging were normal in 85.3% and abnormal in 14.7% of subjects. Conclusions: This study evaluated the causes of secondary epilepsy. Our findings showed that 45.3% of the subjects had secondary epilepsy. Some patients presented with multiple conditions and there was more than one cause of secondary epilepsy in these cases. This study showed that the average age of patients with previous history of stroke was higher than that of other participants. However, previous history of stroke and head trauma mostly observed in males.