The effect of honey on post-tonsillectomy pain relief: a randomized clinical trial

Abstract Objective: The study aimed to evaluate the effects of honey on the incidence of post-operative pain in patients undergoing tonsillectomy. Methods: This study is a double-blind and randomized controlled trial design. Twenty-four adult male patients underwent tonsillectomy surgery and were randomized assigned into three groups consist of honey group, placebo group, and control group. All subjects were given standard analgesia and antibiotics, also honey for the honey group and placebo for the placebo group, and only standard post-operative regimens for the control group. This study used silk-cotton tree or kapok tree honey (Ceiba pentandra). Honey was used by gargling every six hours for ten days. Likewise, the same method was applied in the placebo group. Pain scale was assessed for ten days using the Visual Analogue Scale questionnaire, and the frequency of analgesic drugs was recorded on days 1, 2, 4, 7, and 10. Result: Honey group showed significantly higher pain reduction when compared to placebo and control groups, with a significant reduction in the pain scale on day 1, 2, 4, 7 and 10 (p = 0.034; p = 0.003; p < 0.001; p = 0.001; p = 0.001) gradually; Significant differences were also observed in analgesic use, especially on day 2, 4 and 7 (p = 0.028; p = 0.001; p = 0.003). Conclusions: Administration of Kapok tree honey (C. pentandra) after tonsillectomy might reduce post-operative pain and reduce the need for analgesia. Therefore, honey can be considered a complementary medicine and can be administered routinely as adjunctive therapy for post-operative patients.

ANALYSIS AND COMPARATIVE STUDY OF TOPICAL CONSERVATIVEMEDICATION VERSUS OPERATIVE MANAGEMENT IN PATIENTS OFANAL FISSURE

Introduction:Anal fissures or anal ulcers are considered one of the commonest causes of severe analpain. Surgical techniques like manual anal(lords) dilatation or lateral internalsphincterotomy, effectively heal most fissures within a few weeks, but mayresult in permanently impaired anal continence. This has led to the research foralternative non-surgical treatmentAIMS AND OBJECTIVES:The present study comprises the comparative study of 2% Diltiazem gel,0.2% Glyceryl Nitrate,2%lignocaine jelly application and need of surgical intervention in the treatment of chronic fissure inano.MATERIALS AND METHODS: This is a prospective study of fissure in ano during the period from September 2020 to September2021 in Sheth Lallubhai Gordhandas Municipal General Hospital, Ahmedabad. Clinical Data ofadmitted patient were collected by their detail history after stabilizing the patient, clinicalexamination with appropriate investigations.OBSERVATION AND DISCUSSION:Anal fissure is a very common problem across the world. It causes considerablemorbidity and adversely affects the quality of life. Therefore appropriate treatment ismandatory.In this study the commonest age group affected was 31-40 years agegroup (40%) and least affected were 51-60 years age groupThe incidence of fissure in males was slightly greater than females with MaleFemale ratio being 2.2: 1 in our study.CONCLUSION:Propper clinical examination and appropriate investigations helps in management of patient eitheroperative or non-operative which leads successful treatment in these patients.

Evaluating the Pilot Usability for Telenursing-based Cancer Pain Monitoring System

The purpose of this study was to evaluate the pilot usability used in a telenursing-based cancer pain monitoring system. Health care providers and advanced cancer patients who visited a hospital as outpatients (n=10/group) used and evaluated the system using a Web Usability Scale (WUS) and free description. Of the WUS seven factors, “comprehensibility” and “content reliability” received good evaluation, and “ease of operation”, “visual effects”, “responsiveness”, “usefulness”, and “acceptablity” didn’t received good evaluation. In the free description, the system was evaluated to enhance self-management of cancer pain, a request for expansion of operation, and social issues were shown. Improving patient usability is an issue, and sufficient orientation is required to verify the effects.

Tramadol versus placebo for labor analgesia in low risk women: a randomized controlled trial

Background: In low- and middle-income countries epidural analgesia is generally not available and practically no form of labor analgesia is given to the majority of the parturient. The purpose of study was to evaluate the safety and efficacy of tramadol as a labor analgesic during first stage of labor.Methods: Pregnant women admitted in the labor room satisfying the eligibility criteria were randomized to receive intramuscular injection of either 100 mg tramadol or 2 ml distilled water. Visual analogue score (VAS) was assessed at the beginning and every hour till 4 hours. Pain satisfaction, duration of second stage of labor, fetal heart rate, mode of delivery, and any maternal side effects of the study drug were recorded. Neonatal evaluation using Apgar score at 1 and 5 minutes was done. For statistical analysis Student t-test, Chi Square test and Fisher’s exact test were used.Results: Total of 86 women were included in the study. The VAS scores were significantly lower in the tramadol group at 1, 2 and 3 hours after the administration. Pain relief satisfaction was significantly higher in the tramadol group. Rate of cervical dilatation, duration of the second and the third stage, need for instrumental delivery or lower segment caesarean section, rate of fetal distress and Apgar score at one and five minutes were comparable in both the groups. Nausea was significantly higher in tramadol group.Conclusions: Tramadol is a safe and efficacious drug which is inexpensive, easily available and easy to administer with few minor side effects. It can be used as a labour analgesic as an alternative to epidural analgesia in settings where epidural analgesia is not available. Trial registration: Clinicaltrials.gov PRS registration number: NCT02999594.

Digital evaluation of finite element model for percutaneous kyphoplasty with bone cement injection / 中国组织工程研究

BACKGROUND: The treatment principle, long-term therapeutic effects, and complications of percutaneous kyphoplasty are closely related to blomechanlcs. Its blomechanlcs have attracted wide attention. OBJECTIVE: To establish a virtual digital evaluation system for biomechanical changes and bone cement leakage after percutaneous kyphoplasty and bone cement injection. METHODS: Percutaneous kyphoplasty with bone cement injection was performed based on previously established three-dimensional model of L3-L5. The model was processed using the software Abaqus2016 for finite element analysis. The effects of bone cement injection model, injection pressure, and injection volume on the stress of fractured L4 vertebral endplate were analyzed. RESULTS AND CONCLUSION: (1) After simulated percutaneous kyphoplasty with bone cement injection, the stress of L4 fractured vertebral endplate decreased significantly under the partial pressure of cement. Different injection methods had no significant effect on the stress of fractured L4 vertebral endplate (P > 0.05), but bilateral injection made the distribution of bone cement more uniform and produced the best effect. (2) Different injection pressures had no significant effect on the stress of fractured L4 vertebral endplate (P > 0.05), but with the increase of injection pressure, the distribution of bone cement was more dispersed and leakage was more likely to occur. (3) With increase in bone cement injection dose, the stress of fractured L4 vertebral endplate gradually decreased (P < 0.05). The physiological stiffness of the vertebral body could not be restored when 2 mL of bone cement was injected. The distribution of bone cement was more concentrated when 4 mL of bone cement was injected. The breakdown point was reached when 8 mL of bone cement was injected. (4) After injection of bone cement, the upper endplate of the lower vertebral body was more prone to suffer from fracture than the lower endplate of the upper vertebral body. (5) These results suggest that the stress of L4 vertebral endplate shifted obviously after simulated surgery compared with before surgery, that is, the stress of L4 upper endplate increased and that of L4 lower endplate decreased. Different injection methods had little effect on the surgical results, but the distribution of bone cement injected bilaterally was more uniform, which reduced the incidences of re-fracture and collapse. Lower injection pressure could reduce the risk of cement leakage after surgery. Injection of 4 mL bone cement can restore good stiffness and physiological curvature of the diseased vertebra, without reaching the yield point or causing refracture.

Cost of Medications, Preference and Willingness-to-Pay for Pain Relief among Adult Patients Diagnosed with Acute and Chronic Musculoskeletal Pain Conditions

Objective@#To determine the current cost, medication preferences, willingness to pay for symptom relief and reduced adverse events of adult patients with acute and chronic musculoskeletal pain. @*Methods@#This was a cross-sectional study among adult Filipinos consulted for musculoskeletal conditions at Family Medicine Clinic. Data were collected through a questionnaire and a systematic sampling of respondents. @*Results@#The study had a total of 342 participants with degenerative osteoarthritis as the most common primary diagnosis. Twenty percent (N=69/342) were acutely symptomatic while 273/342 (80%) have chronic musculoskeletal pain. Most would prefer medicines at a lower price point, effectively reduces pain, fast onset of action, longer therapeutic effects and less adverse effects. Willingness-to-pay was at an average price of Php 86.11 (SD±15.47) per pill for complete symptom relief. @*Conclusion@#Adult Filipinos with musculoskeletal pain symptoms prefer pain medicines with good symptom control, less adverse event and were willing to pay for complete symptom relief at an average of eighty-six pesos per pill.

High vs mid thoracic epidural analgesia – A comparative study on the ease of insertion and effects on pain, hemodynamics, and oxygenation in patients undergoing thoracotomies

Background: Thoracic epidural analgesia offers effective perioperative pain relief in patients undergoing thoracotomies apart from attenuating stress responses. It helps in fast tracking by facilitating early mobilization and improving respiratory function. Literature on high (T1–T2 level) thoracic segmental analgesia for thoracotomy is less. Aim: The aim of present study was to compare the ease of insertion, effect on pain relief in high (T1–T2 level) vs mid (T5–T6) approach of thoracic epidural. Setting and Design: The present study was a randomized control trial conducted at our institute. Materials and Methods: About 52 patients aged between 18–65 years scheduled for elective thoracotomies under general and thoracic epidural anesthesia were randomized into two groups. Intraoperatively ease of epidural insertion, extent of blockade, and postoperatively pain relief were assessed. Ropivacaine with fentanyl was used for epidural analgesia. Statistical Analysis: Data were presented as mean ± standard deviation and analyzed by the Student's t test, Chi-square test, and non-parametric test whereever applicable. A P value <0.05 was considered statistically significant. Results: We observed that high thoracic epidural anesthesia was easier to place (time taken 123.42 vs 303.08 s) P < 0.05, with less number of attempts (1.27 vs 1.92) P < 0.05. Extent of blockade, postoperative pain scores, rescue analgesia requirement, hemodynamics, and oxygenation were comparable. Conclusion: We conclude that high thoracic epidural is easier to insert, provides adequate pain relief, and stable hemodynamics with the advantage of patient comfort and safety.

Programmed Labour: A Comparative Study

Programmed labour is meant to provide pain relief and to hasten the labour process for better obstetric andneonatal outcome. It includes 3 components: active management of labour, use of obstetric analgesia anduse of partography. It was a prospective study for the patients admitted in ASCOMS hospital undergoingprogrammed labour for a period of 2 years from 2017 to 2019. A total of 50 patients underwent programmedlabour in this period. and an equal number of controls were enrolled. The duration of stages of labour,amount of pain relief and maternal and neonatal outcome was noted. In the present study, the duration offirst stage was 3.36 hrs as compared to 5.25 hours in control group which was significantly lower. Theduration of second stage of labour was also significantly lower in study group (27.2 mins vs 56.88 mins).Among the pain relief scores, 8 patients had no pain relief, 9 had mild pain relief, 14 had moderate painrelief while 19 patients had excellent pain relief. The incidence of normal vaginal delivery, LSCS andforceps/ventouse delivery were respectively 88%, 6% and 6% and neonatal outcome was also good.Programmed labour is a safe and effective technique to provide pain free labour to patients and shortenthe duration of labour without inadvertent side effects and excellent maternal and neonatal outcome.

Anestesia, analgesia, reumatología y alivio del dolor agudo y crónico / Anesthesia, analgesia, rheumatology and relief of acute and chronic pain

Introducción: el tratamiento eficaz del dolor postquirúrgico es hoy un reto para los anestesistas, reumatólogos, traumatólogos, cirujanos e investigadores de diversas especialidades, quienes proponen constantemente protocolos que toman como base a la evidencia científica. Objetivo: reflexionar y abrir el debate respecto al rol de la anestesia en el alivio del dolor de origen reumatológico. Desarrollo: en Reumatología, se recomienda, en todo paciente con dolor reumático crónico, calcular la intensidad del dolor, tanto para la elección primera del tratamiento analgésico como para la medición de la respuesta. Y, para ello, se han propuesto varios métodos de cuantificación. Conclusiones: el manejo diagnóstico y el tratamiento multidisciplinario presiden cuando se examina a este tipo de casos, ya que es la única manera de identificar el origen del dolor y suministrar un alivio prudente. En su generalidad, los pacientes responden al tratamiento conservador y solo un exiguo grupo va a necesitar de técnicas anestésicas invasivas(AU)

Introduction: The effective treatment of postoperative pain is today a challenge for anesthetists, rheumatologists, orthopedic surgeons, surgeons and researchers of various specialties, who constantly propose protocols based on scientific evidence. Objective: Reflect and open the debate regarding the role of anesthesia in the relief of pain of rheumatological origin. Development: In Rheumatology, it is recommended, in all patients with chronic rheumatic pain, to calculate the intensity of the pain, both for the first choice of the analgesic treatment and for the measurement of the response. And, for this, several methods of quantification have been proposed. Conclusions: Diagnostic management and multidisciplinary treatment preside when this type of case is examined, since it is the only way to identify the origin of pain and provide prudent relief. In general, patients respond to conservative treatment and only a small group will need invasive anesthetic techniques(AU)

Evaluation of pain relief and satisfaction in women using epidural analgesia in labour

Background: Pain during childbirth is the most severe pain women may experience in their lifetime. Epidural analgesia is an effective form of pain relief during labour.Methods: This retrospective study was carried out at Omega Hospital, Nagpur in 50 women in labour who demanded epidural analgesia for pain relief. It was carried out to determine extent of pain relief and overall satisfaction in women using epidural analgesia.Results: In present study, out of 50, 28 (56%) patients delivered by normal vaginal delivery, 14 (28%) patients delivered by cesarean section, 8 (16%) patients had vacuum delivery while in no patient forceps were applied. In first stage,36 (72%) patients had zero score (no pain), 13 (26%) patients had 1-3 score (mild pain) while 1 (2%) patient had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had very good effect in first stage in terms of pain scoring. In second stage, 13 (26%) patients had zero score (no pain), 31 (62%) had 1-3 score (mild pain) while 6 (12%) had 4-6 score (moderate pain) after epidural analgesia. That means epidural analgesia had good effect in second stage in terms of pain scoring. In terms of satisfaction, 11 (22%) patients said it was excellent, 27 (54%) patients said it was good, 8 (16%) patients said it was average while 4 (8%) said it was poor. Apgar score for all babies at 1 min and 5 min was very good. It was ≥7 in all 50 (100%) of newborn babies.Conclusions: Epidural labor analgesia gives significantly less pain scores and has better maternal satisfaction. It is not associated with increased rate of instrumental vaginal delivery or cesarean delivery. Patients had excellent neonatal outcome.

To Compare and Assess Quality of Analgesia and Side Effects following the use of Fentanyl, Buprenorphine Hydrochloride, Bupivacaine Hydrochloride, through the Thoracic Epidural Catheter

Introduction: Epidural anaesthesia and analgesia hasjustified use in the perioperative care of high-risk surgicalpatients, as they give better analgesia, and also improvedoutcome. Thoracic Epidural analgesia is an excellent methodof postoperative and post injury pain control in proceduresinvolving significant thoracic and abdominal injury weathertraumatically or surgically induced. Though Bupivacaine isconsidered to be the drug of choice, many other agents arebeing used for epidural anesthesia.Material and Methods: This study was carried out on 105ASA grade I and II nulliparous patients, between 20 to 70 yearsof age undergoing laparotomy, voluntary donor nephrectomyand renal surgeries. They were randomly divided in theBuprenorphine, Bupivacaine and Fentanyl Groups. Quality ofanalgesia and post-operative complications were monitored.Results: Analgesic failure was observed in all the threeGroups. But complete pain relief was better in theBuprenorphine Group. Also, complications (hypotension,bradycardia, sedation) were less in the Buprenorphine Groupthan in the Bupivacaine and Fentanyl Groups.Conclusion: Buprenorphine is safer and provides betterquality analgesia than Bupivacaine and Fentanyl.

Low Dose Ketamine in Labour Analgesia

Introduction: Ketamine is dissociative anaesthesia- acombination of profound analgesia with superficial sleep.This state is characterized by spontaneous ventilation, relativepreservation of airway reflexes and hemodynamic stability.The present study was designed to evaluate the efficacy ofprogrammed labour protocol in proving shorter, safer andrelatively pain free deliveries.Material and methods: This study was a randomised controltrial done in The Department of Obstetrics and Gynaecology,Rohailkhand Medical College and Hospital for a span of oneyear (October 2016 to September 2017).Result: In our study, the duration of labour, induction deliveryinterval was significantly reduced. Pain relief was excellent instudy group.Conclusion: Ketamine’s site of action appears to be primarilyin the thalamus and limbic systems, acting as N- methyl Daspartate receptor non- competitive antagonist. It does notsuppress respiratory drive unless high dosage are used, orsmall dosage given rapidly. Intravenous ketamine in low doseappears to be safe laternative to epidural analgesia.

Assesment of Insulin Resistence in Different Stages of Chronic Kidney Disease

Introduction: Epidural anaesthesia and analgesia hasjustified use in the perioperative care of high-risk surgicalpatients, as they give better analgesia, and also improvedoutcome. Thoracic Epidural analgesia is an excellent methodof postoperative and post injury pain control in proceduresinvolving significant thoracic and abdominal injury weathertraumatically or surgically induced. Though Bupivacaine isconsidered to be the drug of choice, many other agents arebeing used for epidural anesthesia.Material and Methods: This study was carried out on 105ASA grade I and II nulliparous patients, between 20 to 70 yearsof age undergoing laparotomy, voluntary donor nephrectomyand renal surgeries. They were randomly divided in theBuprenorphine, Bupivacaine and Fentanyl Groups. Quality ofanalgesia and post-operative complications were monitored.Results: Analgesic failure was observed in all the threeGroups. But complete pain relief was better in theBuprenorphine Group. Also, complications (hypotension,bradycardia, sedation) were less in the Buprenorphine Groupthan in the Bupivacaine and Fentanyl Groups.Conclusion: Buprenorphine is safer and provides betterquality analgesia than Bupivacaine and Fentanyl.

Clinical Observations on Combined Use of Acupuncture and Medicine for External Hemorrhoids / 上海针灸杂志

Objective To investigate the clinical efficacy of combined acupuncture and medicine for external hemorrhoids. Method Included 68 patients with external hemorrhoids were allocated, in order of visits, to acupuncture, external application and acupuncture-medicine groups. The acupuncture group received acupuncture at points Chengshan (BL57) and Dachangshu (BL25); the external application group, external application of Divine Pain-Relief Decoction; the acupuncture-medicine group, comprehensive intervention. Result The pain was markedly relieved (P<0.01) but the severity of swelling and the size of hemorrhoids were less reduced (P<0.01, P<0.05) in the acupuncture group compared with the external application group. The therapeutic effect was better in acupuncturemedicine group than in the acupuncture and external application groups with more reduced size of hemorrhoids (P<0.01, P<0.05), lower VAS score (P<0.05, P<0.01) and lower swelling severity score (P<0.01, P<0.05).Conclusion Acupuncture is more effective in relieving the pain, while external application of herbal medicine is more effective in reducing the severity of swelling and the size of hemorrhoids. The combined use of acupuncture and medicine can synergically enhance the clinical therapeutic effect.

Exploring the Factors That Influence Pain Relief and Bone-marrow Suppression When Strontium Chloride Is Administrated

Aim: The usefulness and safety of strontium chloride (89Sr), a radiopharmaceutical agent for painful bone metastasis, varies from patient to patient, but the reasons for why the usefulness and safety vary have not been elucidated. The purpose of this study is to explore the background factors of patients who experienced pain relief or bone-marrow suppression after 89Sr was administrated. Methods: In the cases of pain relief, we divided the results from a numeric rating scale (NRS) before and after 89Sr administration into effective and ineffective groups as outcomes. In the cases of bone-marrow suppression, we analyzed neutrophil cells, blood platelets, and hemoglobin levels, respectively, before and after 89Sr administration as outcomes. Then, we performed statistical analyses on both case groups. Results: The results showed that the background factors associated with pain relief were weight, the 89Sr dosage amount, NRS, eGFR, SCr, and Ca levels before 89Sr administration and the area of bone metastasis (number of sites reached). We found that background factors associated with bone-marrow suppression have a moderate significant correlation with hemoglobin, NRS, and SCr levels before 89Sr administration after investigating factors which influence neutropenia. In the case of thrombocytopenia, there was a moderate significant correlation with platelet counts before 89Sr administration. In the case of hypochromia, there was a moderate significant correlation with hemoglobin levels before 89Sr administration. Discussion: Our study could elucidate patient background factors associated with pain relief and bone-marrow suppression after 89Sr administration.

Inadequate pain relief among patients with primary knee osteoarthritis / Alívio inadequado da dor em pacientes com osteoartrite de joelho primária

ABSTRACT Background: Despite the widespread treatments for osteoarthritis (OA), data on treatment patterns, adequacy of pain relief, and quality of life are limited. The prospective multinational Survey of Osteoarthritis Real World Therapies (SORT) was designed to investigate these aspects. Objectives: To analyze the characteristics and the patient reported outcomes of the Portuguese dataset of SORT at the start of observation. Methods: Patients ≥50 years with primary knee OA who were receiving oral or topical analgesics were eligible. Patients were enrolled from seven healthcare centers in Portugal between January and December 2011. Pain and function were evaluated using the Brief Pain Inventory (BPI) and WOMAC. Quality of life was assessed using the 12-Item Short Form Health Survey (SF-12). Inadequate pain relief (IPR) was defined as a score >4/10 on item 5 of the BPI. Results: Overall, 197 patients were analyzed. The median age was 67.0 years and 78.2% were female. Mean duration of knee OA was 6.2 years. IPR was reported by 51.3% of patients. Female gender (adjusted odds ratio - OR 2.15 [95%CI 1.1, 4.5]), diabetes (OR 3.1 [95%CI 1.3, 7.7]) and depression (OR 2.24 [95%CI 1.2, 4.3]) were associated with higher risk of IPR. Patients with IPR reported worst outcomes in all dimensions of WOMAC (p < 0.001) and in all eight domains and summary components of SF-12 (p < 0.001). Conclusions: Our findings indicate that improvements are needed in the management of pain in knee OA in order to achieve better outcomes in terms of pain relief, function and quality of life.

RESUMO Antecedentes: Apesar dos tratamentos muito difundidos para a osteoartrite (OA), dados sobre os padrões de tratamento, a adequação do alívio da dor e a qualidade de vida são limitados. O estudo multinacional prospectivo Survey of Osteoarthritis Real World Therapies (SORT) foi projetado para investigar esses aspectos. Objetivos: Analisar as características e os desfechos relatados pelo paciente do conjunto de dados português do Sort no início da observação. Métodos: Consideraram-se elegíveis os pacientes com 50 anos ou mais com OA de joelho primária que recebiam analgésicos orais ou tópicos. Os pacientes foram recrutados de sete centros de saúde de Portugal entre janeiro e dezembro de 2011. A dor e a função foram avaliadas pelo Brief Pain Inventory (BPI) e pelo WOMAC. A qualidade de vida foi avaliada com o 12-item Short Form Health Survey (SF-12). O alívio inadequado da dor (AID) foi definido como uma pontuação > 4/10 no item 5 do BPI. Resultados: Foram analisados 197 pacientes. A idade média foi de 67 anos e 78,2% eram do sexo feminino. A duração média da OA de joelho foi de 6,2 anos. O AID foi relatado por 51,3% dos pacientes. O sexo feminino (odds ratio ajustado - OR 2,15 [IC 95% 1,1-4,5]), o diabetes (OR = 3,1 [IC 95% 1,3-7,7]) e a depressão (OR 2,24 [IC 95% 1,2-4,3]) estiveram associados a um maior risco de AID. Os pacientes com AID relataram piores desfechos em todas as dimensões do Womac (p < 0,001) e em todos os oito domínios e nos dois componentes sumários do SF-12 (p < 0,001). Conclusões: Os resultados do presente estudo indicam que é necessário melhorar o manejo da dor na OA de joelho a fim de alcançar melhores desfechos em termos de alívio da dor, função e qualidade de vida.

Curcumina, una alternativa térapéutica para la clínica dental. Parte: antiinflamatorio y analgésico / Curcumin, a therapeutic alternative for the dental clinic (Part I):An anti-inflammatory and analgesic

La curcumina es una sustancia derivada de una planta llamada Curcuma longa. A esta sustancia se le han atribuido diversos efectos terapéuticos. En relación con la clínica dental, se ha observado que, además de ayudaren el control del dolor, ha sido efectiva contra la periodontitis, estomatitis y mucositis pediátrica. El control del dolor e inflamación son aspectos muy importantes para la mayoría de los tratamientos en odontología; la búsqueda de nuevas alternativas analgésicas y antiinflamatorias que, en comparación con las actuales, sean más eficientes, efectivas y tengan menos efectos colaterales es uno de los grandes retos de las ciencias biomédicas. La presente revisión muestra algunas evidencias científicas de los efectos de la curcumina como un antiinflamatorio y analgésico, con el propósito de sentar las bases para futuros estudios clínicos y de ciencia básica que aporten un mayor entendimiento de los procesos celulares, bioquímicos, moleculares, fisiológicos y farmacológicos de la curcumina como una sustancia potencialmente útilen el consultorio dental.

Curcumin is a substance derived from the plant Curcuma longa andone that has been attributed a range of therapeutic eff ects. In dentalpractice, curcumin has not only been found to help with pain control, buthas also been eff ective against periodontitis, stomatitis, and pediatricmucositis. Controlling pain and infl ammation are both very importantaspects of most dental treatments. The search for more effi cient andeff ective analgesic and anti-infl ammatory alternatives with fewerside eff ects compared to those currently used is one of the greatestchallenges for biomedical science. This review presents some of thescientifi c evidence of the eff ects of curcumin, both as an analgesic andan anti-infl ammatory agent, in order to establish the foundations forfurther clinical and basic science studies that will provide a greaterunderstanding of the cellular, biochemical, molecular, physiological,and pharmacological processes of curcumin as a potentially usefulsubstance in dental practice.

EFFICACY OF SEQUENTIAL TREATMENT WITH ADDUCTOR CANAL NERVE BLOCK AND CYCLOOXYGENASE 2 SELECTIVE INHIBITOR AFTER TOTAL KNEE ARTHROPLASTY / 中国修复重建外科杂志

OBJECTIVE: To investigate the efficacy of sequential treatment with adductor canal nerve block (ACNB) and cyclooxygenase 2 (COX-2) selective inhibitor (parecoxib and celecoxib) after primary total knee arthroplasty (TKA). METHODS: Between January 2015 and December 2015, 90 osteoarthritis patients who met the inclusion criteria were treated, and randomly divided into 3 groups:ACNB+COX-2 group (group A, n=30), COX-2 group (group B, n=30), and control group (group C, n=30). There was no significant difference in gender, age, body mass index, side, and osteoarthritis duration between groups (P>0.05), and the data were comparable. ACNB was used in group A at the end of TKA. Intravenous injection of parecoxib (40 mg per 12 hours) was administrated at the first three postoperative days, and followed by oral celecoxib (200 mg per 12 hours) until 6 weeks after operation in groups A and B; while placebo was given at the same time point in group C. Oral tramadol or intravenous morphine, as remedial measures, were introduced when patients had a visual analogue scale (VAS) score more than 4. The following indicators were compared between groups:the operative time, drainage volume at 24 hours after operation, length of hospital stay, and incidence of side effect; VAS pain scores, morphine consumption, range of motion (ROM) of the knee joint, and inflammatory cytokines levels at pre-operation and at 1 day, 2 days, 3 days, 1 week, 2 weeks, 4 weeks, and 6 weeks after operation; morphine consumption within first 24 hours and at 24 hours to 6 weeks after operation; the American Hospital for Special Surgery (HSS) score at 1, 2, 4, and 6 weeks after operation; and the serum coagulation parameters at pre-operation, and at 1, 3, and 14 days after operation. RESULTS: The length of hospital stay was significantly shorter and the incidence of postoperative nausea and vomiting was significantly lower in groups A and B than group C (P0.05). CONCLUSIONS: Sequential treatment with ACNB and COX-2 selective inhibitor is a safe and effective approach for postoperative pain management after primary TKA, and it can alleviate postoperative pain, promote the joint function recovery, and reduce the risk of adverse reactions.

Effect of Ramaze Pain Relief Delivery Method Combined with Delivery Ball Care on the Outcome of Delivery / 沈阳医学院学报

Objective:To investigate the effect of Ramaze pain relief delivery method combined with delivery ball care on the outcome of delivery. Methods:A total of 90 puerpera who got antenatal examination and delivered in our hospital from Aug 2014 to Jun 2015 were selected and divided into 2 groups by random number table method. And 45 cases in the control group received conventional delivery care, while 45 cases in the observation group received Ramaze pain relief delivery method combined with delivery ball care. Their outcomes of delivery were observed. Results:Delivery process in the observation group were significantly shorter than in the control group (P<0.05) . The occurrence rate of maternal fetal abnormalities, uterine atony, fetal intrauterine distress in the observation group was 4.44%, which was significantly less than 33.33% in the control group (P<0.05) . Conclusions:Ramaze pain relief delivery method combined with delivery ball care can shorten delivery process,reduce the rate of dystocia,and reduce maternal pain. It is important in improving the prognosis of mothers and their infants,and worthy of promotion.

Implantation of radioactive (125)I seeds improves the prognosis of locally advanced pancreatic cancer patients: A retrospective study / 华中科技大学学报（医学）（英德文版）

Locally advanced pancreatic cancer is associated with a very poor prognosis. This study was performed to evaluate whether patients with locally advanced pancreatic cancer benefit from (125)I seed implantation. This retrospective study included 224 patients with locally advanced pancreatic cancer, with 137 patients (61.2%) in the implantation (IP) group and 87 (38.9%) in the non-implantation (NIP) group. The survival status, complications and objective curative effects were compared between the groups. The average operative time in the IP group was significantly longer than that in the NIP group (243±51 vs. 214±77 min). The tumor response rates were 9.5% and 0 at the 2nd month after surgery in the IP and NIP groups, respectively (P<0.05). The IP group exhibited a trend toward pain relief at the 6th month after surgery. The global health status scores of the IP group were higher than those of the NIP group at the 3rd and 6th month after surgery. The median survival time in the IP group was significantly longer than that in the NIP group. In conclusion, patients with locally advanced pancreatic cancer can benefit from (125)I seed implantation in terms of local tumor control, survival time, pain relief and quality of life.