validity of current animal studies, high quality experimental studies and efforts for effective translation from preclinical studies to clinical trials are still required. The present study also demonstrates that moderate confidence could be placed in safety of MSCs therapy for knee OA but with low confidence in efficacy outcomes due to limitations of the current evidence. Further high-quality studies with high internal and external validity are still required.
Introduction: Mesenchymal stem cell (MSC) therapy appeared promising in knee osteoarthritis (OA). We examined if a single intra-articular (IA) autologous total stromal cells (TSC) and platelet-rich plasma (PRP) injection improved knee pain, physical function, and articular cartilage thickness in knee OA.Methods: The study was performed in the physical medicine and rehabilitation department of Bangabandhu
A 37-year-old Bangladeshi woman presented with low back and several joints pain and swelling for months together; there was significant morning stiffness for more than two hours. Repeated abortions, dry eye, hair fall, photosensitivity, and oral ulcer were the additional complaints. Clinical examination unveiled asymmetrical peripheral and both sacroiliac joint tenderness, positive modified Schober’s test, and limited chest expansion. Schirmer’s test was positive. The history of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) among 1st-degree relatives was also significant. Biochemical analysis revealed pancytopenia, raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and mild microscopic proteinuria. The patient was seropositive for rheumatoid factor (RF), antibodies against cyclic citrullinated peptides (anti-CCP), antinuclear antibody (ANA), anti-Sm antibody, anti-Sjögren’s-syndrome-related antigen A and B (anti-SSA/SSB), antiphospholipid (aPL-IgG/IgM), and HLA B27; however, serum complement (C3 and C4) levels were normal. Basal cortisol level measured elevated. Besides, X-ray and MRI of lumbosacral spines demonstrated sacroiliitis. There was radiological cardiomegaly, echocardiography unveiled atrial regurgitation, and ascending aorta aneurysm. Based on the abovementioned information, RA, AS, and systemic lupus erythematosus (SLE) have been diagnosed. Moreover, the patient developed Sjogren’s syndrome (SS), antiphospholipid lipid syndrome (APS), Cushing syndrome, ascending aorta aneurysm, and atrial regurgitation. Her disease activity score for RA (DAS28), DAS for AS (ASDAS), SLE disease activity index (SLEDAI), and Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) scores were 3.46, 2.36, 23, and 5, respectively. The patient received hydroxychloroquine (200 mg daily), pulsed cyclophosphamide, prednisolone (20 mg in the morning), and naproxen 500 mg (twice daily). To our best knowledge, this is the first report documenting RA, AS, and SLE with secondary SS and APS.
In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) caused by SARS coronavirus 2 (SARS-CoV-2) began at Wuhan, China and was declared a threatening global pandemic by the World Health Organization on 11 March 2020 [1]. As of 10 April 2021, more than 134 million people have been affected by this SARS-CoV-2 infection, and more than 2.9 million people have died due to . The mortality of this pandemic disease ranges between 0.4% and 7%, mostly from respiratory failure, sepsis, and coagulopathy [3]. However, the complete course of the disease is not yet understood [4]. According to Yang et al., SARS-CoV-2 is transmitted from human to human at an estimated rate of transmission of 3.77 [5]. The incubation period of COVID-19 generally ranges between 1 to 14 days (median 5.1 days) [6]. Individuals with COVID-19 may present with a wide range of symptoms such as fever, cough, nausea, vomiting, dyspnea, myalgia, fatigue, arthralgia, headache, Review Article Open AccessCoronavirus disease (COVID-19) started its journey around the world from Wuhan, China and gradually became a pandemic. COVID-19 often affects the respiratory system, but symptoms may include fatigue, myalgia, arthralgia, arthritis, and spine and bone pain as presenting complaints. In the present systematic search and review, we aim to highlight the musculoskeletal manifestations during COVID-19. PubMed Central and Google Scholar search engines were searched for the key words "muscle pain", "joint pain", "b ody ache", and "fatigue", in Covid-19 patients. After screening, a total of 76 articles dated between January 1 and July 1, 2020 met the inclusion criteria and were included in the study. All articles were published in English comprising 36,558 COVID-19 cases. In cross-sectional studies, fatigue was found in 55%, myalgia in 26%, and arthralgia in 20% of cases, respectively. In cohort studies, fatigue was found in 35%, myal gia in 15%, and arthralgia in 5%, respectively. Sporadic case reports also mention back pain, bone pain, myositis, and arthritis as presenting symptoms of COVID-19. Fatigue was the most frequent musculoskeletal (MSK) manifestation of COVID-19 followed by myalgia and joint pain. The frequency of the different MSK manifestations in COVID-19 may vary widely among different geographic regions. MSK like fatigue, myalgia and arthralgia are frequent symptoms in COVID-19 patients and may vary in different countries.
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