Efficacy of Guanqiao Zhengqi holistic therapy for chronic rhinosinusitis / 中国基层医药

Objective:To investigate the efficacy of Guanqiao Zhengqi holistic therapy in the treatment of chronic rhinosinusitis. Methods:A total of 200 patients with chronic rhinosinusitis who received treatment in the Department of Otolaryngology, Shanxi Provincial Integrated Traditional Chinese Medicine and Western Medicine Hospital ( n = 72) and Shanxi Yishengtang Traditional Chinese Medicine Center ( n = 128) from January 2021 to January 2022 were included in this study. These patients were randomly assigned to undergo treatment either with mometasone furoate nasal spray and levocetirizine hydrochloride tablets (control group, n = 100) or Guanqiao Zhengqi holistic therapy combined with mometasone furoate nasal spray and levocetirizine hydrochloride tablets (observation group). All patients were treated for 4 weeks and followed up for 3 months. Clinical efficacy, modified Visual Analogue Scale score, Lund-Kennedy endoscopy scoring system score, and duration of glucocorticoid and anti-leukotriene use were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group [92.00% (92/100) vs. 73.00% (73/100), χ2 = 18.45, P < 0.001). There was no significant difference in the modified Visual Analogue Scale score between the two groups before treatment ( Z = 1.37, P = 0.170). There was a significant difference in the modified Visual Analogue Scale score between the two groups after treatment ( Z = -5.27, P < 0.001). Before treatment, there was no significant difference in the Lund-Kennedy endoscopy scoring system score between the two groups ( Z = -1.65, P = 0.098) and the Lund-Kennedy endoscopy scoring system score differed significantly between the two groups after treatment ( Z = -6.03, P < 0.001). The duration of glucocorticoid and anti-leukotriene use in the observation group was significantly shorter than that in the control group [10.00 (10.00, 14.00) days vs. 42.00 (28.00, 70.00) days, 7.00 (7.00, 7.00) days vs. 21.00 (14.00, 26.25) days, Z = -11.27, P < 0.001, Z = -12.31, P < 0.001). Conclusion:Based on the conventional treatment with western medicine, Guanqiao Zhengqi holistic therapy for the treatment of chronic rhinosinusitis can effectively reduce clinical symptoms, reduce the dose of hormones and anti-leukotriene used, shorten the use cycle, and improve the therapeutic efficacy.

Different operation sequences between acupuncture and cupping therapy for lumbar muscle strain with cold and dampness: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy on lumbar muscle strain with cold and dampness between the different operation sequences of acupuncture and cupping therapy.@*METHODS@#Seventy-six patients with lumbar muscle strain with cold and dampness were randomly divided into an acupuncture + cupping group (A + C group, 38 cases) and a cupping + acupuncture group (C + A group, 38 cases, 1 case dropped off). In the A + C group, cupping therapy was delivered 10 min after the end of treatment with acupuncture, while in the C + A group, acupuncture therapy was exerted 10 min after the end of treatment with cupping. Acupuncture was applied to Mingmen (GV 4), Yaoyangguan (GV 3), ashi point and bilateral Shenshu (BL 23), Dachangshu (BL 25), Weizhong (BL 40) and Yanglingquan (GB 34), and the needles were retained for 30 min in each intervention. Flash cupping was operated along the bilateral sides of the lumbar spine for 3 min, and the cups were retained for 10 min at bilateral Shenshu (BL 23), Dachangshu (BL 25) and ashi points. The intervention was delivered once every two days, 3 times weekly, for 3 weeks totally in each group. The scores of visual analogue scale (VAS) and Oswestry disability index (ODI), TCM syndrome score and the mean temperature of the lumbar region before and after treatment were compared between the two groups. The safety and the clinical efficacy were assessed for the interventions of the two groups.@*RESULTS@#Compared with the values before treatment, except for the sleep score of ODI, the VAS scores, ODI scores and TCM syndrome scores were decreased after treatment (P<0.01, P<0.05); while the mean temperature of the lumbar region was increased (P<0.01) in both groups. After treatment, the VAS score and the pain score of ODI in the C + A group were lower than those in the A + C group (P<0.05). The incidence rate of adverse reactions of the C + A group was lower than that of the A + C group (P<0.01). The effective rate in the A+C group was 92.1% (35/38), that in the C+A group was 94.6%(35/37), there was no statistical difference between the two groups (P>0.05).@*CONCLUSION@#Different operation sequences between acupuncture and cupping therapy obtain the similar efficacy on lumbar muscle strain with cold and dampness, but cupping therapy delivered prior to acupuncture has certain advantages in relieving pain and improving safety.

Transcutaneous electrical acupoint stimulation combined with electroacupuncture for rapid recovery after abdominal surgery: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with electroacupuncture (EA) on rehabilitation after abdominal surgery.@*METHODS@#A total of 320 patients undergoing abdominal surgery were randomly divided into a combination group (80 cases), a TEAS group (80 cases, 1 case discontinued), an EA group (80 cases, 1 case discontinued) and a control group (80 cases, 1 case discontinued). The patients in the control group received enhance recovery after surgery (ERAS) standardized perioperative management. On the basis of the treatment in the control group, the TEAS group was treated with TEAS at Liangmen (ST 21) and Daheng (SP 15); the EA group was treated with EA at Neiguan (PC 6), Hegu (LI 4), Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39); the combination group was treated with TEAS combined with EA, with continuous wave, 2-5 Hz in frequency, and the intensity was tolerable to the patients, 30 min each time, once a day, from the first day after surgery, until the anus resumed spontaneous defecation and the oral intake of solid food was tolerated. The gastrointestinal-2 (GI-2) time, first exhaust time, first defecation time, first tolerance of oral intake of solid food time, time of first get out of bed and hospital stay were observed in all the groups; the pain visual analogue scale (VAS) score and incidence rates of nausea and vomiting 1, 2, 3 days after surgery were compared in all the groups; after treatment, the acceptability of each treatment was evaluated by patients in each group.@*RESULTS@#Compared with the control group, the GI-2 time, first exhaust time, first defecation time, first tolerance of oral intake of solid food time were shortened (P<0.05), the VAS scores 2, 3 days after surgery were decreased (P<0.05) in the combination group, the TEAS group and the EA group; those in the combination group were shorter and lower than the TEAS group and the EA group (P<0.05). Compared with the control group, the time of hospital stay in the combination group, the TEAS group and the EA group were shortened (P<0.05), and that in the combination group was shorter than the TEAS group (P<0.05).@*CONCLUSION@#TEAS combined with EA can accelerate the recovery of gastrointestinal function in patients after abdominal surgery, relieve postoperative pain, and shorten hospital stay.

The Effect of Intravenous Ketamine After Spinal Anesthesia on the Duration of Postoperative Analgesia and Analgesic Requirement

Objective: To evaluate the impact of ketamine following spinal anesthesia on the duration of postoperative analgesia and the need for analgesics. Methods: This was a prospective, randomized, double-blinded placebo-controlled study done over a period of two years. A total of 60 participants undergoing elective surgeries under spinal anesthesia were randomized into two groups. After 10 min of spinal anesthesia and achieving the required level of sensory and motor blockade, both groups were given Inj. Midazolam 1 mg intravenously, followed by Inj. Ketamine 0.25 mg/kg, volume made up to 10 mL with normal saline, given intravenously for Group K and Inj. Normal Saline 10 mL was given intravenously for Group N. Hemodynamic monitoring was done intraoperatively, and the postoperative visual analog score (VAS), sedation score, the mean time for the first rescue analgesia, and the total dose of postoperative analgesic required in 24 h were tabulated. Results: There was no statistical difference between the two groups in terms of age, weight, ASA grade, and duration of surgery. In Group K, the VAS scores were significantly lower and patients were comfortable when compared to Group N (P value <.01). The mean time to first rescue analgesia was longer in Group K (6.4 ± 1.69 h) when compared to Group N (2.9 ± 1.01 h), and the total dose of postoperative analgesia (Tramadol) required in 24 h was also significantly less in Group K (143.33 ± 56.83 mg) when compared to Group N (236 ± 49.01 mg). Changes in hemodynamic parameters (heart rate and mean arterial pressure (MAP)) were statistically and clinically not significant in both the intraoperative and postoperative periods between the groups. Conclusion: Patients in Group K were more comfortable, had a longer duration of postoperative analgesia, and required less dose of rescue analgesia in the postoperative period. Ketamine is a safe drug that is readily available, and it decreases the use of opioids and opioid-related side effects. Therefore, ketamine can serve effectively as an adjunctive analgesic drug.

Clinical observation on horizontal penetration needling combined with rizatriptan monobenzoate tablets for migraine without aura in acute stage / 中国针灸

OBJECTIVE@#To observe the therapeutic effect of horizontal penetration needling combined with rizatriptan monobenzoate tablets, simple horizontal penetration needling and simple rizatriptan monobenzoate tablets for migraine without aura in acute stage.@*METHODS@#A total of 99 patients with migraine without aura in acute stage were randomized into an acupuncture plus medication group, an acupuncture group and a western medication group, 33 cases in each one. In the acupuncture group, horizontal penetration needling was applied once at Hanyan (GB 4) to Xuanli(GB 6), Shenting (GV 24) to Yintang (GV 29), Baihui (GV 20) to Qianding (GV 21), etc. for 2 h. In the western medication group, oral rizatriptan monobenzoate tablets for 10 mg were given once. In the acupuncture plus medication group, treatment of acupuncture combined with rizatriptan monobenzoate tablets were given, the application was the same as the acupuncture group and the western medication group. Before treatment and 0.5, 2, 24 h after treatment, the visual analogue scale (VAS) score was observed, the remission rate and the disappearance rate of migraine of 2, 24 h after treatment were compared in the 3 groups.@*RESULTS@#Compared before treatment, the VAS scores of each time point after treatment were decreased in the 3 groups (@*CONCLUSION@#Horizontal penetration needling combined with rizatriptan monobenzoate tablets have significant therapeutic effect on rapid analgesia and continuous analgesia for migraine without aura in acute stage, its effect is superior to simple horizontal penetration needling and simple rizatriptan monobenzoate tablets.

Transpedicular Percutaneous Vertebroplasty in Management of Osteoporotic Vertebral Compression Fractures Assessment of Clinical Outcome: A Study of 21 Procedures

Introduction: Osteoporotic vertebral fractures that produce increased morbidity, persistent back pain, risk of collapse with time, and increased fracture risk. Subsequently, these vertebral fractures produce kyphotic deformity and effect on lung capacity. In our study purpose is to assess the clinical outcome, safety, and efficacy of transpedicular percutaneous vertebroplasty in osteoporotic vertebral compression fractures (VCFs). Methodology: The study done between December 2017 and December 2019 at our institute. Atotal of 10 patients with 21 vertebral body collapse in that 13 dorsal vertebra and 8 lumbar vertebral body included in the study in neurologically intact individuals. Patients are considered for treatment, those with chronic pain refractory to medical therapy and bracing and those with severe disabling pain caused by fractures. Severe cardiopulmonary disease, coagulopathy, and cord compression are contraindications to vertebroplasty. Severe vertebral compression may also be a contraindication to treatment, because the vertebra may be compressed to such a degree that needle placement and cement injection become impossible. After treatment, they selected one of three possible responses for each: Significantly improved, worse, or approximately the same. As an overall assessment analgesic requirement, visual analog scale, grading of subjective satisfaction score, sleep, and ambulation improvement assessed. To ensure uniformity despite the variable follow-up period, patients were instructed to indicate their status at 2 weeks after the procedure, 6 months, and 1-year follow-up. Results: Both pain and functional outcome improved significantly in immediate post-procedure at 2 weeks, 6 months, and 1 year. The majority (70%) of the patients were treated for 2 levels while 2 patients were treated for 3 levels and 1 patient was treated for 1 level. Visual analog scale (VAS) in the pre-procedure period is 8.3 which decrease in the post-procedure period at 2 weeks and 6 months is 2.6 and 3.6 subsequently and at 1-year average VAS score is 4. Mobility and sleep pattern is significantly improved in 8 patients (80%) at 1-year follow-up whereas remain same in 2 patients. Conclusion: Significant relief in pain in the post-procedure period with minimum risk noticed for VCFs.

Comparative Study Regarding Functional and Radiological Outcomes of Different Modes of Fixation for Distal Femur Fracture.

Treatment of distal femur fractures has recently evolved towards indirect reduction and minimally invasive techniques. The goal is to strike a balance between the mechanical stability of the fragments and the biological viability. Advent of MIPO technique has reduced the amount of soft tissue injury, delayed healing, tissue necrosis and infections. The objective was to compare the functional and radiological outcome of fracture distal femur treated by open reduction with LCP by minimally invasive plate osteosynthesis (MIPO). We wanted to compare the clinical and radiological differences between open and MIPO techniques for distal femoral fracture fixation.METHODSThis was a prospective interventional study. 41 subjects with closed supracondylar femur fracture treated surgically from March 2013 to December 2017, were evaluated prospectively for functional and radiological outcome results after fixation with distal femoral locking compression plate in open or minimally invasive way, with minimum follow up of 1 year. IBM SPSS Ver. 25 software was used to perform statistical analysis.RESULTSThe mean age of 41 treated patients was 53.8 ± 13.7 years and ranged from 23 to 84 years. 19 patients were females and 22 were males. Mean time to surgery was 5.7 ± 2.9 days with minimum 2 and maximum of 18 days from injury. Initially 20 patients underwent open surgery and 21 patients were operated by minimally invasive plating technique. In all cases, a 316L stainless steel alloy distal femoral locking plate was used.CONCLUSIONSKnee ROM could be started at a mean of 1.4 weeks earlier in the MIPO group and this was statistically significant. The two groups did not differ significantly in start of full weight bearing. Knee flexion at 6 weeks was also comparable in the two groups. However, knee flexion was average 21.9° higher in MIPO group at 1 year which was significantly different than ORIF group. The proportion of patients with >90° and >110° knee flexion also varied significantly between the groups. VAS score in MIPO group was significantly less at 6 weeks but difference was non-significant at 1 year. There were 2 cases with non-union and implant failure in the ORIF group, but the proportion was not significant. There was 10° FFD in 1 patient of ORIF group, while varus deformity occurred in 3 patients of MIPO group. The proportion of deformity was not significantly different between the two groups.

Combination of a pulmonary recruitment maneuver and intraperitoneal bupivacaine for the reduction of postoperative shoulder pain in gynecologic laparoscopy: a randomized, controlled trial

OBJECTIVE: To compare the efficacy of a pulmonary recruitment maneuver using lower airway pressure (30 cm H2O) and intraperitoneal bupivacaine, alone or in combination, for reducing shoulder pain after gynecologic laparoscopy.METHODS: A prospective controlled study was performed in a teaching hospital with patients who underwent elective gynecologic laparoscopic surgery. Two hundred eighty-seven patients were randomized into 1 of 4 groups: group A, placebo; group B, intraperitoneal instillation of bupivacaine; group C, CO2 removal by a pulmonary recruitment maneuver; group D, combination of intraperitoneal bupivacaine and pulmonary recruitment maneuver. The interventions were performed at the end of surgery. Shoulder pain was recorded on a visual analog scale (VAS) at 1, 6, 12, and 24 hours postoperatively.RESULTS: The overall incidence of shoulder pain was 49.8% and the incidence tended to gradually decrease from group A to group D (59.0% in group A, 54.8% in group B, 44.4% in group C, and 41.5% in group D; P=0.026). In addition, the VAS scores gradually decreased from group A to D, although a statistically significant difference was only found at 6 hours postoperatively (P=0.03). There were no complications related to the interventions.CONCLUSION: The combination of a pulmonary recruitment maneuver with intraperitoneal bupivacaine significantly reduced shoulder pain after gynecologic laparoscopy.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01039441

Therapeutic effect of Yaotongning Capsules and thunder-fire moxibustion in treatment of 40 cases of lumbar disc herniation with cold and blood-stasis syndrome / 中草药

Objective: To explore the clinical efficacy effect of Yaotongning Capsules combined with thunder-fire moxibustion on lumbar disc herniation (LDH). Methods: A total of 80 LDH patients who met the inclusion criteria were randomly divided into observation group and control group, with 40 cases in each group. The observation group was treated with Yaotongning Capsules combined with thunder-fire moxibustion, and the control group was treated with ibuprofen sustained release capsule combined with thunder-fire moxibustion. VAS score, JOA score, ODI score and clinical efficacy were compared. Results: VAS scores and ODI scores of the two groups after treatment were lower than those before treatment (P < 0.05), and the JOA score was higher than that before treatment (P < 0.05); After treatment, the VAS score and ODI score in the observation group were lower than those in the control group (P < 0.05); After treatment, the JOA score was higher than that in the control group (P < 0.05). The clinical efficacy of the observation group was better than that of the control group (P < 0.05). Conclusion: The clinical treatment of Yaotongning Capsules combined with thunder-fire moxibustion treating LDH can obviously alleviate the pain symptoms and improve the daily function of the patients, which is worthy of further clinical application.

A study of comparison of efficacy and side effects of intravenous paracetamol and intravenous diclofenac as a postoperative analgesic

BBackground: A postoperative patient suffers from pain the best relief of which is a clinician’s duty. Till date very few studies have been conducted for comparison of paracetamol and diclofenac as analgesics. As a result a comparative study between Paracetamol and Diclofenac was carried out. The aim of the study was to compare the efficacy and side effects of intravenous Paracetamol and intravenous Diclofenac in patients undergoing major abdominal open surgeries in obstetrics and gynaecology. The study was conducted to assess the postoperative visual analogue pain scores (VAS) and total analgesic requirement in the first 24 hours and also to study the total requirement of additional analgesics despite administration of either Paracetamol or Diclofenac in postoperative period.Methods: 100 patients satisfying the inclusion/exclusion criteria were recruited for the study. They were divided into two groups of 50 each. Group A was given IV Paracetamol 6 hourly for 48 hours starting 2 hours after surgery. Group B was given IV Diclofenac 8 hourly for 48 hours starting 2 hours after surgery. Patients were assessed for pain relief by visual analogue scale (VAS) of zero to ten after 6 hours, 12 hours, 24 hours and 48 hours of surgery by asking the patient to point the position on the 100 mm scale.Results: The results revealed that when we compared the VAS scores between the 2 Groups at different time intervals, it showed that at 24 hours and 48 hours VAS score in the Diclofenac Group was significantly less than the Paracetamol Group. The main side effects were nausea and vomiting in both the groups. There was more nausea and vomiting in Diclofenac group compared to Paracetamol group.Conclusions: It was concluded that at 24 hour and 48 hour pain reduction was more in the Diclofenac group as compared to Paracetamol group, but the side effects were more in the Diclofenac group compared to Paracetamol group.

Comparative Study of Levobupivacaine with Fentanyl Versus Ropivacaine with Fentanyl for Labor Analgesia

Effective pain relief is one of the important components of management of normal labor. Adequate pain relief is associated with reduction in maternal sympathetic activity and considerably decreased maternal anxiety level. Epidural analgesia is being increasingly used for this purpose. Many local anesthetic drugs are being used for providing epidural analgesia. We conducted this study to compare Ropivacaine and Levobupivacaine in terms of onset and duration of analgesia, motor involvement, hemodynamic effects and neonatal outcome. Methods: This was a prospective comparative study in which 100 patients presenting in spontaneous labour were included in this study on the basis of a predefined inclusion and exclusion criteria. Patients were divided into 2 groups on the basis of drug used. Group A patients received Ropivacaine along with fentanyl whereas group B patients received Levobupivacaine along with fentanyl. VAS score, Sensory and motor block and vital parameters were recorded before giving epidural and 5,15, 30 and 60 minutes and thereafter every hourly till delivery took place. Sensory block was assessed by pin prick sensation whereas motor block was assessed by modified bromage scale. Statistical analysis was done using SSPS 21 software and p value less than 0.05 was taken as statistically significant. Results: Parameters such as height, weight, body mass index, ASA grades, gravidity and duration of labor were found to be comparable in both the groups with no statistically significant difference in between 2 groups (P>0.05). Mode of delivery and conversion to LSCS was also similar in both the groups. Mean time for onset of analgesia was comparable in both the groups. The mean VAS scores in group A were found to be less as compared to group B during initial 1 hour after the bolus dose and the difference was found to be statistically significant (P<0.0001). After 1 hour the VAS scores were found to be comparable in both the groups with no statistically significant difference in the mean VAS scores of patients in both the groups (P>0.05). The need for top-up analgesia was found to be statistically significantly higher in group B as compared to group A (P=0.0277). The motor sparing was better in group A as compared to group B and the difference was found to be statistically significant (P=0.0026). Hemodynamics and neonatal outcome were found to be comparable in both the groups (P>0.05). Conclusion: Ropivacaine is a better local anesthetic drug as compared to Bupivacaine for labor analgesia. Its use is associated with better analgesic effect, superior motor sparing and less need for top up analgesic doses.

A comparative evaluation of diclofenac and tramadol as post-operative analgesics along with causality and severity assessment of ADRs

Background: Diclofenac and Tramadol are well established analgesics for post-operative pain management, yet some adverse effects are associated with their use which govern their tolerability. The objective of the study was to evaluate the comparative efficacy of the two drugs and to assess the causality and severity of documented Adverse Drug Reactions (ADRs).Methods: An open labelled, prospective, interventional, simple randomized clinical study to compare efficacy and safety of diclofenac and tramadol was conducted by the Department of Pharmacology in collaboration with the Department of Surgery. Post-operative pain intensity was measured on Visual Analogue Scale (VAS). Causality and severity assessment of the recorded ADRs was done using WHO-UMC scale and modified Hartwig and Seigel Scale respectively.Results: A total of 211 patients underwent different surgeries. The most common surgery performed was mesh hernioplasty 78 (36.96%). VAS score was used as data to determine the analgesic efficacy of two drugs. Wilcoxon Signed Rank test showed significant reduction in pain on all days for each group individually while Mann Whitney U test compared both the groups and revealed that both the drugs i.e. diclofenac and tramadol were equally efficacious in reducing post-operative pain. Causality assessment showed that all the documented ADRs fall in POSSIBLE category while severity assessment revealed that all the ADRs were MILD in nature.Conclusions: Diclofenac and tramadol proved to be equi-effective in reducing post-operative pain . The study also emphasized that active surveillance of ADRs can lead to timely intervention and provide maximum benefit to the patient.

Role of Mifepristone in treatment of uterine fibroid: an experience from tertiary care centre in South India

Background: Uterine fibroid are the most common benign tumour of the uterus and is seen in 20% of women in their reproductive age group. The aim of the study was to evaluate effect of Mifepristone on uterine fibroid with reference to reduction in size of fibroid and change in symptomatic profile.Methods: It is a hospital based interventional study conducted at KIMS Hubli hospital. 98 patients with symptomatic fibroid uterus were given 50mg of Mifepristone on alternate day for 3 months.Results: Mifepristone treatment significantly reduced mean PBAC score from baseline score of 212.61 to 20.39 at the end of 3rd month of therapy. Mean fibroid volume also reduced significantly from baseline value of 237.95cm3 to 30.45cm3 after 3 months of treatment. At the end of therapy hemoglobin was raised from 9.57g/dl at baseline to 10.42g/dl after 3 months of treatment. No major side effects were observed, and 7% patients had hysterectomy.Conclusions: Mifepristone is very useful option in perimenopausal women with symptomatic fibroid. It reduces fibroid size and its symptoms without any major side effects. However, future long term RCTs are needed to assess the safety and efficacy of Mifepristone.

Observational study to assess the effectiveness of post-operative pain management of patients undergoing major abdominal surgeries in a tertiary care hospital

Background: Patients undergoing major surgical operations continue to experience pain with an overall reported incidence of 29.7% for moderate-to-severe pain and 10.9% for severe pain. Even in developed countries, 86% of patients experience postsurgical pain and 75% of those who reported pain described its severity as moderate-to-severe during the immediate postoperative period Major abdominal surgical operations ideally require the Acute Pain Management Service (APMS) for regular pain assessment and timely management of breakthrough pains and complications in the postoperative period. Aim of the study: To determine the effectiveness of Postoperative Analgesia used for Major Abdominal surgery and its efficacy and safety. Materials and methods: 38 Patients under General Anesthesia and 13 Patients under Regional + General Anesthesia who underwent major Laparotomy procedures were included in the study. Data regarding the type of postoperative Analgesia, Co–Analgesic used (NSAIDS, Paracetamol in oral/suppository form) during both intra and postoperative period were noted. All patients were followed on the first and second postoperative day at 4 PM. Pain severity with VAS score, side effects of Analgesia and Patient satisfaction with Pain management were recorded. Sindhu, Naheed Azhar, Nalini. Observational study to assess the effectiveness of post-operative pain management of patients undergoing major abdominal surgeries in a tertiary care hospital. IAIM, 2019; 6(5): 98-103. Page 99 Results: Use of Epidural Analgesia and Multimodal approach for Postoperative Pain relief greatly improves the patient satisfaction and early recovery of patients undergoing Major Abdominal surgeries. Conclusions: Although there is limited drug availability, regular assessments and appropriate dose adjustments and Use of Epidural and multimodal analgesic practice led to a high level of patient satisfaction

Effect of Acupuncture and Moxibustion plus Zushima on Serum VEGF and bF GF in Patients with Knee Osteoarthritis / 上海针灸杂志

Objective To investigate the effect of acupuncture and moxibustion plus Zushima on serum vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b FGF) in patients with knee osteoarthritis.Method Two hundred and thirty-six patients with knee osteoarthritis were allocated, using a random number table, to two groups, 118 cases each. The control group was treated with Celecoxib and the observation group, with acupuncture and moxibustion plus Zushima. The therapeutic effects, and pre-treatment and post-treatment VAS scores and WOMAC scores and serum VEGF and bFGF levels were compared between the two groups of patients. The adverse reaction incidences were compared between the two groups of patients. Result The total efficacy rate was 87.3％ in the control group and 94.9％ in the observation group and was significantly higher in the observation group than in the control group (P<0.05). There were no statistically significant pre-treatment differences in the VAS score and WOMAC score between the two groups (P>0.05). The VAS score and WOMAC score decreased significantly in both groups after treatment (P<0.05). After treatment, there was no statistically significant difference in the VAS score between the two groups (P>0.05) but the WOMAC score was significantly lower in the observation group than in the control group (P<0.05). There were no statistically significant pre-treatment differences in VEGF and bFGF between the two groups (P>0.05). After treatment, VEGF and bFGF decreased significantly in both groups (P<0.05) and were significantly lower in the observation group than in the control group (P<0.05). The adverse reaction incidence was3.4％ in the control group and 1.7％ in the observation group with no statistically significant difference between the two groups (P> 0.05). Conclusion Acupuncture and moxibustion plus Zushima can reduce inflammatory reactions, inhibit synovial angiogenesis, and effectively relive the pain, and improve articular functions in the treatment of knee osteoarthritis.

Anesthetic potential of lidocaine/prilocaine cream versus placebo before venepuncture

Background: Pain associated with venepuncture has long been accepted as an unavoidable consequence. Many studies show reducing pain during venepuncture after application of prilocaine/lignocaine, but there are few studies that has depicted, the depth of anesthesia produced by prilocaine/lignocaine tends to be too superficial for the reducing the pain during venepuncture. These two scenarios were debatable. Therefore, authors planned a study to assess anesthetic potential of lidocaine /prilocaine cream versus placebo before venepuncture with help of VAS in an adult patient who were drawn blood sample for investigation purposes.Methods: Prospective interventional study. All adult patient for blood sampling from surgery OPD to central laboratory were included in study. Site of venepuncture selected in both control and study group was left cubital fossa. 30 patients selected in study group received lignocaine/prilocaine locally, 30min prior to venepuncture which was later covered with occlusive tape, whereas 30 control group patient received normal saline locally as placebo. The extent of pain was assessed by patient on 10cm visual analogue scale (VAS) with end points of 0 cm rated as no pain and the points of 10cm as intolerable pain.Results: A total of 60 patient were randomly selected who were referred from surgery OPD for blood sampling. Other 30 patient were applied normal saline as placebo and 30 patient with lignocaine and prilocaine cream. In the control group there were 30 patients (5 female and 25 male). In the study group there were 30 patients (8 females and 22 males). The level of pain among study group is as follows: mild 22, moderate 7, worst 1 and in control group: no pain 0, mild 5, moderate 14 and worst pain 1. Statistical analysis between outcome of two groups done by calculating chi-square test. Chi- square test was 20.0263. P value is 0.000168. Hence the result is significant at p <0.05.Conclusions: The present study shows that prilocaine-lidocaine cream reduces the pain of needle puncture in adults and facilitates the procedure of venous blood sampling.

Local Injection of Autologous Platelet Rich Plasma and Corticosteroid in Treatment of Plantar Fasciitis in Female Patients

Background: Chronic plantar fasciitis is the commonest cause of foot complaints in India. The incidence of plantar fasciitis peaks in people between the ages of 40 to 60 years with no bias towards either sex. Numerous methods have been advocated for treating plantar fasciitis, including rest, non-steroidal anti-inflammatory medication, night splints, foot orthosis, stretching protocols and extracorporeal shock wave therapy. The aim of this study to compared the functional outcome of Local Steroid and PRP in Plantar Fasciitis. Methods: A prospective randomized control trial done on 63 patients with complaint of plantar fasciitis coming to SMS Medical College & Hospitals, Jaipur, who were attain the inclusion criteria in the study. Patient coming to OPD were randomly allocated C.R. number. Patients with Odd C.R. number were given PRP and those with even number were given Steroids.  Patients were followed at 12 weeks and 24 weeks after the injection to look for the effect of PRP and corticosteroid. Then the results were obtained on mean VAS score and AOFAS score in both the groups. Results: The present study showed that the mean age was 40 years in group I and 39 years in group II. Maximum females were housewife (41.26%) in both groups. The difference of mean in between groups, VAS score & AOFAS was insignificant in first visit (P=0.8642 & P=0.3400) and statistical significant after 12 weeks (P<0.0001*** each) and 24 weeks (P<0.0001***each). Conclusions: We believe that PRP injection is safe and can be an excellent alternative to corticosteroid injection in plantar fasciitis, not responsive to conservative means. The findings of this preliminary study can be very relevant in clinical practice.

Multicenter clinical trial of Tiaojing Huoxue Capsules for primary dysmenorrhoea / 中草药

Objective To assess the efficacy of Tiaojing Huoxue CapsuleS for the primary dysmenorrhoea (PD). Methods A total of 300 women with PD were enrolled and randomly divided into the control and treatment group, which were administrated with placebo and Tiaojing Huoxue Capsules for three menstrual cycles, respectively. The efficacy of Tiaojing Huoxue Capsule was evaluated by visual analogue scale (VAS) and traditional Chinese medicine (TCM) syndrome scores. Results The effective rate of VAS was 62.43% in the experiment group with statistical significance when compared with the control group (P < 0.01). Similarly, the total effective rate in the treatment group was 76.30% while that in the control group was 36.67% after treatment of three menstrual cycles. Conclusion Tiaojing Huoxue Capsules can relieve the alleviating pain for women with PD.

Clinical observation of percutaneous vertebroplasty in treatment of 83 breast cancer patients with verte-bral metastases / 实用医学杂志

Objective To assess the clinical efficacy and safety of percutaneous vertebroplasty(PVP)in the treatment of breast cancer patients with vertebral metastases. Methods Retrospective analysis of 83 breast cancer patients with spinal metastases underwent PVP was conducted. The scores of visual analogue,Karnofsky performance status and mobility were evaluated 24 h before and 24 h,1 month,3 and 6 months after PVP. Re-sults All patients were successfully completed the operation with no serious complications. After PVP,all the scores were improved,with a statistically significant difference between 24 h before PVP and 24 h,1 month,3 and 6 months after PVP(P < 0.05). Conclusions PVP can significantly relieve pain and improve the quality of life for breast cancer patients with vertebral metastases.

Influence of Scaler Tip Design on Intensity of Pain and Discomfort During Scaling

@#To evaluate patient’s subjective preferences to scaling with narrow probe-shaped EMS Perio Slim PS tips compared to conventional tip based on pain perception using the Visual Analogue Scale (VAS). Ten patients were treated using a piezoelectric ultrasonic device (EMS) and two different scaler tips representing a conventional scaler tip and a Perio Slim PS scaler tip in a split-mouth design. Pain was evaluated after 2 minutes scaling using Visual Analogue Scale (VAS). Data obtained was analysed by SPSS version 19.0 using Wilcoxon test. Pain assessment after treatment confirmed by the Visual Analogue Scale (VAS) showed that the Perio Slim PS scaler tip (maximum pain score: 4, minimum: 2) caused less pain than the conventional scaler tip (maximum: 8, minimum: 3) (p-value = 0.007). Using Perio Slim PS scaler tip caused less pain and discomfort during scaling treatment when compared with conventional scaler tip. Acrylic resin is commonly used to fabricate removable prostheses due to its adequate physical, mechanical properties and cost effectiveness. There has been continuous development of the materials to improve their properties and to widen its application in different clinical setting. To study the history development of the acrylic resin and elaborate on the properties of different types and the processing methods of acrylic resins used to fabricate denture base which are commercially available in the market. This would help the dental clinician in choosing the best material of choice. The authors have summarized the history, development and classification of different type of acrylic resins used in fabricating denture and processing methods based on all the published research available on this topic using published materials available in the Dental Library, University of Malaya and the database (Science Direct, PubMed). Every type of acrylic denture base material has its pros and cons. Therefore, careful selection of material and the processing method is crucial to ensure the best outcome for prosthodontic treatment. Hence, upholding the patients’ best interest and improving their quality of life.