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DR.WAGDY ELTAIAR
DR.WAGDY ELTAIAR
OZONE THERAPY
ByDr.Med.WAGDY EL Taiar
Ozone Therapy Expert
Member of international Ozone association
Manager for Almahmoud medical center
DR.WAGDY ELTAIAR
What is Ozone?
• Oxygen with 3 atoms O3
• Created by• O2 + Ultraviolet Rays• O2 + High Voltage (lightning)• O2 + Sea Waves
DR.WAGDY ELTAIAR
What is Ozone?
*Upper atmosphere… Ozone Layer
*Lower atmosphere … Reduce Hydrocarbons
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History of Medical Ozone
• C. Lender 1870 (ozone purify the blood)• In Holland 1893 Water treatment with ozone
(now more than 3000 in the world)• War I 1914-1918 ozone used to treat
wounds, foot gangrene and effect of poisonous chlorine gas
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History of Medical Ozone
• Dr.Otto Warburg awarded Noble Prize in Medicine in 1931 and in 1944 for his discovery of the basic cause of cancer in damaged cell respiration.
• In 1983 first International Medical Ozone Association conference was held in Washington
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Approval of use of Ozone in Medicine
• After 130 years of usage it is approved in 22 countries: Germany, France, Italy, Russia, Romania, Poland, Bulgaria, Hungary, Czech Republic, Japan, Singapore, Cuba, Mexico, Britain and 25US states.
• In December 1999 approved in Egypt as an Adjuvant Therapy
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Mode of Action of Ozone
• Inactivation of bacteria, viruses, fungi and protozoa:
– Disrupts the integrity of bacterial cell envelope through oxidation of the phospholipids and lipoproteins.
– Damages viral capsid and upsets reproductive cycle by disrupting virus-to-cell contact with peroxidation.
– Inhibits cell growth at certain stages in fungi
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Mode of Action of Ozone
• Enhancement of Circulation:– Reduce clumping of red cells and restore its
flexibility and oxygen carrying ability.
– Arterial oxygen partial pressure increases and viscosity decreases leading to better tissue oxygenation
– Oxidizes plaque in arteries allowing removal of the breakdown products.
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Mode of Action of Ozone
• Stimulation of oxygen metabolism:– Increases red blood cell glycolysis rate
stimulation of 2,3-diphosphoglycerate (2,3-DPG) increase of oxygen released to tissues.
– Activates Krebs cycle by enhancing oxidative carboxylation of pyruvate stimulating production of ATP.
DR.WAGDY ELTAIAR
Mode of Action of Ozone
• Stimulation of the production of the enzymes which act as a free radical scavengers and cell wall protectors:Glutathione Peroxidase, Catalase, and Superoxide Dismutase
• Production of Prostacycline vasodilatation.
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Mode of Action of Ozone
• Dissolution of malignant tumors:– Ozone inhibits tumor metabolism, oxidizes the
outer lipid layer of malignant cells and destroys them through cell lysis
• Ozone increases the ability of phagocytes to kill tumor cells (by stimulation of conversion of arginine to citrulline, nitrite and nitrate by phagocytes)
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Mode of Action of Ozone
• Activation of the immune system: stimulates production of
– Interferon
– Tumor necrosis factor (TNF)
– Interleukin 2
Reactive Oxygen Species (ROS)Medical ozone Peroxides
(at physiological pH < 8)easily penetrates cell membrane.e.g.: Hydrogen peroxide (H2O2).e.g.: Lipid peroxides.
in plasma “lipoproteins” in cell membrane[Polyunsaturated fatty acids]
HydroperoxidesDR.WAGDY ELTAIAR
Erythrocytes: ATP 2,3 DPG facilitates transfer of O2 to tissues
clumping - enhances blood flow. Mononuclear cells (monocytes - lymphocytes). Physiological release of cytokines. O3 modulates immune system.
Neutrophils. Platelets. Endothelial cells. Activates body’s own antioxidant and radical scavengers.
O3 Action: Activates cellular metabolism:
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DR.WAGDY ELTAIAR
Conditions treated by Ozone
As ozone works on the cellular level so it can be used in many conditions and in different specialties
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Conditions treated by Ozone
• Viral diseases e.g. Hepatitis, AIDS, Herpes Zoster
• Bacterial diseases e.g. infected wounds, diabetic foot, infected burns, chronic sinusitis
• Degenerative diseases and Disturbances of the immune system e.g. Rheumatic diseases and Rheumatoid disorders
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Conditions treated by Ozone
• Exhaustion, nervous tension , pain in general• Vascular diseases e.g. atherosclerosis,
disturbances in peripheral blood circulation• Malignancy in combination with chemotherapy
and/or radiotherapy• Obesity and hyper-chlesterolaemia
And many other conditions (around 190 disease or medical problem)
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DR.WAGDY ELTAIAR
OZONE
does Not Rule Out Classic Medicine
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But OZONEHas Remarkable Results
# In Combination with Classic Medicine
# If Classic Medicine Can Not be used due to Ineffectiveness Or
Side-effects
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Ozone side effects
In comparison to many other therapeutic modalities it has far less side effects
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CONTRA-INDICATIONS
• Thyrotoxicosis
• Favism
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CONTRA-APPLICATIONS
• Inhalational
• Direct Intravenous
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OZONE THERAPY OZONE THERAPY in in
BACK PAINBACK PAIN
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Conditions Treated
• Myalgia
• Muscle Spasm
• Disc Prolapse
• Fatigue and overexertion of Back muscles
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Methods of Treatment
• Chemical Acupuncture in Pravertebral Muscle
• Intra-Discal injection
• Epidural injection
• Ozone Sauna
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DR.WAGDY ELTAIAR
DR.WAGDY ELTAIAR
Chemical Acupuncture
• The iliac crests are palpated and transiliac line is determined to identify the L4 spinous process.
• The inter-spinous spaces are identified by selecting the space corresponding to the herniated disc.
• Roughly 2 cm are calculated bilaterally to the spinous process.
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Chemical Acupuncture
• Once the needle is inserted through the fasciae, material is aspirated while holding the needle still and a 20 /ml of an oxygen-ozone mixture is injected very slowly up to a maximum of 10 ml per infiltration. Aspiration is repeated during infiltration (Tabaracci, 2001)
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How does Ozone Injected Intra-muscularly Work?
• It infiltrates the muscle and in 24 hours some ozone moves towards the vertebral canal (as seen radiologically).
• Ozone dissolves into the interstitial water of the muscle and will generate H2O2, that will inhibit amyelinic fibers (C-nociceptors) and activates the anti-nociceptive system.
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How does Ozone Injected Intra-muscularly Work?
• As occurs during acupuncture (Ceccherelli et al, 1995), the introduction of the needle, re-enforced by the pressure of O2-O3 induces strong inhibition of nociceptors, and prolonged due to H2O2
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How does Ozone Injected Intra-muscularly Work?
• It is known that an algic stimulation of the skin and muscles can reduce pain through the mechanism of diffuse noxious inhibitory control (DNIC), that is why: the needle+H2O2+oxygen pressure can be translated into chemical acupuncture (Bocci, 1998)
DR.WAGDY ELTAIAR
Comparative Studies on Back Pain due to Disc Prolapse
• Paravertebral injection of O2-O3 – 75% satisfactory response
• Epidural injection with dexamethazone– 55% satisfactory response
• Paraverteral injection of bupivacaine 0.25%– 70% satisfactory response
(Gionovich et al. 2001)
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Intra-Discal Injection
• Direct intradiscal injection of 3-10 ml of O2-O3 with conc. Of 20 g/ml.
• Several thousands of patients have been treated with a success rate of 54-86% (Alexandre et al. 1998,Jucopilla et al. 2000, Bonetti 2001 et al.,Fabris 2001 et al., Leonardi et al. 2001, Petralia et al. 2001)
DR.WAGDY ELTAIAR
How Intra-Discal Injection Works?
• Ozone dissolves in the interstitial water and reacts immediately generating a cascade of ROS, among which H2O2 and possibly hydroxyl radical OH, which is most reactive.
• The hydroxyl radical reacts with carbohydrates and amino-acids composing proteoglycans and collagen type I and type II, major components of the degenerate nucleus pulposus leading to its breakdown (McCord 1974,Curran et al. 1984,Hawkins et al. 1996,Bocci et al. 2001,Leanardi et al. 2001)
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How Intra-Discal Injection Works?
• Consequently re-absorption of hydrolytic products and water may lead to progressive shrinkage and disappearance of of the herniated material
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there is an MD Research on this topic been carried on, in Neurology Department in the Faculty of Medicine, Ain Shams University with promising results
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Mechanisms
• Release of endorphins blocks transmission of the noxious signal to the thalamus and cortex
• Hypo-stimulation (elevation of the activation threshold) linked to the oxidative degeneration of C-nociceptors. H2O2 may act like capsaicin.
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Mechanisms
• Activation of the descending nociceptive system.
• Simultaneous psychogenic stimulation of the central analgesic system induced by the gas injection (elicitation of a placebo effect).
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Mechanisms
• The localized oxygenation and analgesia permit muscle relaxation and vasodilatation, and thus a reactivation of muscle metabolism, by favoring oxidation of lactate, neutralization of acidosis. Increased synthesis of ATP,Calcium reuptake and reabsorption of oedema.
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Conclusion
• Results are remarkable
• Safe and less invasive
• Used widely in Italy with wonderful results in thousands of patients
• BUT
– Some of the mechanisms are postulations
– Not enough combined researches with rheumatology or orthopedic doctors
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Conclusion
• The field is open for intensive researches to make use and settle down the benefit of OZONE in BACK PAIN, a safe, easy, effective, non-invasive, simple method.
DR.WAGDY ELTAIAR
Thank YouThank You