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Effects of saffron (Crocus sativus L.) supplementation on inflammatory biomarkers: A systematic review and meta-analysis

Asbaghi O, Sadeghian M, Sadeghi O, Rigi S, Tan SC, Shokri A, et al.

Phytother Res, 2021 Jan;35(1):20-32.
PMID: 32525606 DOI: 10.1002/ptr.6748

The effect of saffron supplementation on subclinical inflammation remains inconclusive. We performed a systematic review and meta-analysis to summarize available findings on the effect of saffron supplementation on inflammatory biomarkers (C-reactive protein [CRP], tumor necrosis factor-α [TNF-α], and interleukin-6 [IL-6]) in adults. We searched PubMed/Medline, Scopus, Web of Science, and Google Scholar databases up to November 2019 using relevant keywords to identify eligible trials. All randomized controlled trials (RCTs) that examined the effect of oral saffron supplementation on plasma concentrations of CRP, TNF-α, and IL-6 were included. For each outcome, mean differences and SDs were pooled using a random-effects model. Overall, eight RCTs were included in this meta-analysis. The pooled results showed that saffron supplementation did not result in significant changes in serum CRP (weighted mean difference [WMD]: -0.43 mg/L; 95% confidence interval [CI]: -1.04 to 0.17; p = .16), serum TNF-α (WMD: -1.29 pg/mL; 95% CI: -4.13 to 1.55; p = .37), and IL-6 concentrations (WMD: 0.11 pg/mL; 95% CI: -0.79 to 1.00; p = .81). Subgroup analysis indicated a significant reduction in serum CRP levels in studies with baseline CRP of ≥3 mg/L, saffron dosage of ≤30 mg/day, and intervention duration of <12 weeks, as well as trials that used crocin. Similarly, saffron was found to decrease TNF-α in studies that recruited non-diabetic subjects, subjects with baseline levels of ≥15 pg/mL, and participants with <50 years old, as well as trials that administered saffron at the dosage of ≤30 mg/day. We also found a significant non-linear effect of saffron dosage on serum CRP concentrations (pnon-linearity = .03). The overall results indicated that saffron supplementation did not affect inflammatory cytokines. Further high-quality studies are needed to firmly establish the clinical efficacy of supplemental saffron on inflammatory biomarkers.
The effects of Momordica charantia (bitter melon) supplementation in patients with primary knee osteoarthritis: A single-blinded, randomized controlled trial

Soo May L, Sanip Z, Ahmed Shokri A, Abdul Kadir A, Md Lazin MR

Complement Ther Clin Pract, 2018 Aug;32:181-186.
PMID: 30057048 DOI: 10.1016/j.ctcp.2018.06.012

BACKGROUND: Osteoarthritis is a common problem affecting the joints in the elderly, caused disability and consequently decrease the quality of life. The conservative treatment includes the usage of analgesia, but the use of herbal medicine is growing. Momordica charantia or bitter melon has been widely described to have anti-diabetic and anti-inflammatory effects. However, its effect on reducing pain in primary knee osteoarthritis is not well studied. We aim to determine the effects of Momordica charantia in reducing pain among primary knee osteoarthritis patients.
MATERIALS AND METHODS: Thirty-eight and thirty-seven primary knee osteoarthritis patients underwent 3 months of Momordica charantia and placebo supplementation respectively. Three 500 mg per capsule of Momordica charantia were taken thrice daily. Rescue analgesia was allowed as needed. Pain and symptoms throughout the Momordica charantia supplementation period were assessed using Knee Injury and Osteoarthritis Outcome Score and EQ-5D-3L Health questionnaire, while rescue analgesia intake throughout the period of supplementation was measured using analgesic score.
RESULTS: After 3 months supplementation period, body weight, body mass index, and fasting blood glucose reduced significantly in the Momordica charantia group. There were also significant improvements in Knee Injury and Osteoarthritis Outcome Score subscales and EQ-5D-3L dimension score, and reduction in analgesic score. The placebo group had also shown significant improvements in certain Knee Injury and Osteoarthritis Outcome Score subscales and EQ-5D-3L dimension score, but with increased of the analgesic score.
CONCLUSION: Momordica charantia supplementation offers a safe alternative to reducing pain and improving symptoms among the primary knee osteoarthritis patients while reducing the need for analgesia consumption. These beneficial effects can be seen as early as 3 months of supplementation.
Study site: Orthopaedic clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
Fulltext Intraoperative Patella Dimension Measurement in Asian Female Patients and Its Relevance in Patellar Resurfacing in TKA

Ab Rahman S, Ahmed Shokri A, Ahmad MR, Ismail AF, Termizi NS

Adv Orthop, 2020;2020:4539792.
PMID: 32411483 DOI: 10.1155/2020/4539792

Background: Implants used for total knee arthroplasty (TKA) in Asian patients are mostly produced based on anthropometry of the Western population, thus causing problem with patella sizing, especially in Asian females where the patellae are regarded to be smaller. This study is to define intraoperative patella dimensions in our female populations and compare them with current prosthetic systems available at our institution.
Methods: This is a cross-sectional study involving 156 TKA female patients with normal patellae. The patella height, width, thickness, medial and lateral articular facets' width and thickness, and the dome position were measured. The smallest implant size from 3 manufacturers was compared to the data obtained. Analysis using descriptive statistics was used to get the mean and median of anatomical patella dimensions, whereas the independent T test and one-way ANOVA test were used to compare the Malaysian female's patella dimensions with various implant sizes.
Results: The articular surface of the patella was found to have an oval shape with a width-height ratio of 1.31. The mean (SD) patella thickness, width, and height were 20.7 (1.85) mm, 40.7 (3.79) mm, and 31.3 (2.81) mm, respectively. Only 17.9% fit for smallest implant size from all 3 manufacturers. The oval-shape implant was suitable in 53.8% patients based on their width-height ratio. The dome position is 2.2 mm medial to centre.
Conclusion: These female patients have thinner and smaller patella, which are generally unable to accommodate patellar components based on the Caucasian database. Therefore, orthopaedic implant manufacturers should consider optimizing the thicknesses as well as widths of their patellar prostheses.
Fulltext The Needs of Orthopaedic Patients in Discharge Planning

Muhamad H, Yusoff M, Shokri AA, Sulaiman Z, Bakar RS, Zain NM

Malays Orthop J, 2022 Nov;16(3):36-43.
PMID: 36589375 DOI: 10.5704/MOJ.2211.007

INTRODUCTION: Patients' transition from hospital to home could be challenging for patients and caregivers. This is of utmost importance for patients requiring special or long-term care such as post-orthopaedic surgery. Effective discharge planning is required to ensure that patients are prepared to and get continuous care after returning home to prevent complications. Patients' need assessment is essential to develop effective discharge planning to meet the patient's needs.
MATERIALS AND METHODS: This mixed-method study aimed to determine the patient's needs to develop a discharge planning for total knee replacement surgery. The needs for 96 total knee replacement patients were assessed using the Needs Evaluation Questionnaire (NEQ). The in-depth interview primary focus was to explore the lived experience of the post-total knee replacement patients receiving care in the hospital.
RESULTS: A total of 96 participants (100%) completed the NEQ questionnaire. Most of the needs concerned by the participants were expressed by at least 70% of them except the financial need (59.4%). The semi-structured interview found two elements which were a support group and patients' needs in terms of emotional, physical and spiritual preparation in developing effective discharge planning.
CONCLUSION: This study clarified that the patient needs assessment in the patient care plan.
Fulltext Goals, challenges and strategies for wound and bleeding management in total knee arthroplasty: A modified Delphi method

Lyons M, Nunley RM, Ahmed Shokri A, Doneley T, Han HS, Harato K, et al.

J Orthop Surg (Hong Kong), 2022;30(3):10225536221138985.
PMID: 36374258 DOI: 10.1177/10225536221138985

BACKGROUND: Surgical techniques related to soft tissue management play critical roles in optimizing surgical outcomes and patient satisfaction in total knee arthroplasty (TKA). Despite the importance of wound closure and bleeding management approaches, no published guidelines/consensus are available.
METHODS: Twelve orthopedic surgeons participated in a modified Delphi panel consisting of 2 parts (each part comprising two rounds) from September-October 2018. Questionnaires were developed based on published evidence and guidelines on surgical techniques/materials. Questionnaires were administered via email (Round 1) or at a face-to-face meeting (subsequent rounds). Panelists ranked their agreement with each statement on a five-point Likert scale. Consensus was achieved if ≥70% of panelists selected 4/5, or 1/2. Statements not reaching consensus in Round 1 were discussed and repeated or modified in Round 2. Statements not reaching consensus in Round 2 were excluded from the final consensus framework.
RESULTS: Consensus was reached on 13 goals of wound management. Panelists agreed on 38 challenges and 71 strategies addressing surgical techniques or wound closure materials for each tissue layer, and management strategies for blood loss reduction or deep vein thrombosis prophylaxis in TKA. Statements on closure of capsular and skin layers, wound irrigation, dressings and drains required repeat voting or modification to reach consensus.
CONCLUSION: Consensus from Asia-Pacific TKA experts highlights the importance of wound management in optimizing TKA outcomes. The consensus framework provides a basis for future research, guidance to reduce variability in patient outcomes, and can help inform recommendations for wound management in TKA.
Fulltext Bioactivity and Pharmacological Potential of Date Palm (Phoenix dactylifera L.) Against Pandemic COVID-19: a Comprehensive Review

Ahmad Mohd Zain MR, Abdul Kari Z, Dawood MAO, Nik Ahmad Ariff NS, Salmuna ZN, Ismail N, et al.

Appl Biochem Biotechnol, 2022 Oct;194(10):4587-4624.
PMID: 35579740 DOI: 10.1007/s12010-022-03952-2

A novel coronavirus disease (COVID-19) or severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), transmitted from person to person, has quickly emerged as the pandemic responsible for the current global health crisis. This infection has been declared a global pandemic, resulting in a concerning number of deaths as well as complications post-infection, primarily among vulnerable groups particularly older people and those with multiple comorbidities. In this article, we review the most recent research on the role of date palm (Phoenix dactylifera L.) fruits (DPFs) to prevent or treat COVID-19 infection. The mechanisms underlying this preventive or therapeutic effect are also discussed in terms of bioactivity potentials in date palm, e.g., antimicrobial, antioxidant, anticancer, anti-diabetic, anti-inflammatory, neuroprotective, and hemolytic potential, as well as prospect against COVID-19 disease and the potential product development. Therefore, it can be concluded that regular consumption of DPFs may be associated with a lower risk of some chronic diseases. Indeed, DPFs have been widely used in folk medicine since ancient times to treat a variety of health conditions, demonstrating the importance of DPFs as a nutraceutical and source of functional nourishment. This comprehensive review aims to summarize the majority of the research on DPFs in terms of nutrient content and biologically active components such as phenolic compounds, with an emphasis on their roles in improving overall health as well as the potential product development to ensure consumers' satisfaction in a current pandemic situation. In conclusion, DPFs can be given to COVID-19 patients as a safe and effective add-on medication or supplement in addition to routine treatments.