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1.
Int. arch. otorhinolaryngol. (Impr.) ; 26(2): 226-232, Apr.-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1385088

ABSTRACT

Abstract Introduction In the current era, the major indication for septoplasty is nasal obstruction due to deviated nasal septum (DNS). Even though septoplasty is a commonly performed surgery, its effectiveness in relieving nasal obstruction in DNS has not been proven. Objective The present study involved the measurement of both objective (nasal patency) and subjective (quality of life measures) outcome measures for the evaluation of the efficacy of septoplasty as compared with medical management. Methods Patients with DNS presenting with nasal obstruction were included and randomized into a septoplasty group or into a nonsurgical management group, with 70 patients in each group. The improvement in nasal obstruction was assessed subjectively by the visual analogue scale (VAS), and the sino-nasal outcome test-22 (SNOT-22) and the nasal obstruction symptom evaluation (NOSE) questionnaires and was measured objectively by assessment of nasal patency by peak nasal inspiratory flow (PNIF) at 0, 1, 3, and 6 months of treatment in both groups. Results The average VAS, SNOT-22 and NOSE scores for the septoplasty versus the nonsurgical group before treatment were 6.28 versus 6.0, 19.5 versus 15, and 14 versus 12, respectively, and at 6 months post-treatment, the scores were 2.9 versus 5.26, 10 versus 12, and 8 versus 10 (p= 0.001), respectively. The average PNIF scores at 0 and 6 months were 60/50 l/min and 70/60 l/min, respectively, in the septoplasty group (p= 0.001); the scores at 0 and 6 months in the nonsurgical management group were 60/60 l/min and 70/70 l/min, respectively (p= 0.001). Conclusion Surgical correction of DNS by septoplasty improves nasal obstruction better than nonsurgical management at 6 months postsurgery.

2.
China Pharmacy ; (12): 344-351, 2022.
Article in Chinese | WPRIM | ID: wpr-913094

ABSTRACT

OBJECTIVE To evaluate the efficacy and safety of dydrogesterone in the treatment of dysmenorrhea. METHODS The prospective ,random-controlled,open-labeland multicenter clinical study was adopted. A total of 108 women with dysmenorrhea were randomly assigned into dydrogesterone group and control group according to the ratio of 1∶1,with 54 patients in each group. Dydrogesterone group was treated with dydrogesterone 10 mg orally ,twice a day ,on the 5th-25th day of menstrual cycle ,for 3 menstrual cycles. Control group received Guizhi fuling capsule 0.93 g orally ,three times a day,since the end of menstrual bleeding to the third day of the next menstruation ,for 3 menstrual cycles. Main results were the changes of visual analogue scale (VAS)scores in 2 groups after 3 menstrual cycles ;secondary results were the changes of COX menstrual symptom scale (CMSS),quality life of 36-item short form (SF-36),levels of carbohydrate antigen 125(CA125)and interleukin 6(IL-6)after 3 menstrual cycles ;other findings included additional benefits and drug safety. RESULTS The results of intention to analysis data set and the follow-up study protocol analysis data set showed that VAS scores of 2 groups after treatment of dysmenorrhea for 1,2 and 3 menstrual cycles were lower than those before treatment ,the longer the treatment time ,the more obvious the decrease of VAS score (P<0.05),and VAS score decline of dydrogesterone group was better than that of control group(P<0.05). After 3 menstrual cycles ,both the two group showed significant reduction in the severity and duration scores of CMSS(P<0.05);and the decrease of the above scores in the dydrogesterone group was superior than in the control group (P< 0.05). After 3 menstrual cycles ,among 8 dimensions of SF- 36 scale,the scores of 7 dimensions in dydrogesterone group were significantly higher than those before treatment ,such as the scores of physiological function ,physical role ,physical pain , emotional function ,social function ,general health status and energy (P<0.05);the increase of the scores of four dimensions were higher than those in the control group ,such as physical pain ,social function ,general health status ,energy(P<0.05). There was no significant difference in the levels of CA 125 and IL- 6 between 2 groups before and after treatment (P>0.05). After 3 menstrual cycles,the menstrual cycle and menstrual period in the dydrogesterone group were shorter than those before treatment ,and the menstrual volume decreased (P<0.05);but there was no significant change in the above indexes of control group (P>0.05). After 3 menstrual cycles ,the incidence of adverse drug events and adverse reactions in dydrogesterone group was 32.69%(17/52)and 28.85%(15/52);no serious adverse drug events or adverse reactions such as thrombosis occurred in both groups. CONCLUSIONS Dydrogesterone can effectively reduce the VAS score ,also relieve dysmenorrhea-related symptoms ,and improve the quality of life. The efficacy of dydrogesterone is superior than that of Guizhi fuling capsule in treatment for dysmenorrheal ,without serious adverse reactions. It is well tolerated.

3.
Article in Japanese | WPRIM | ID: wpr-887120

ABSTRACT

Objective:The Japanese Orthopaedic Association Low Back Pain Evaluation Questionnaire (JOABPEQ) consists of 25 questions, which allows for the multifaceted evaluation of patients with low back pain. In this study, we aimed to investigate whether the JOABPEQ could be used to construct a regression model to quantify low back pain, lower limb symptoms, and hip range of motion (ROM) in patients with lumbar spinal stenosis.Methods:We evaluated 115 patients with lumbar spinal stenosis scheduled to undergo surgery at our hospital. We measured the degrees of low back pain, lower leg pain, and lower leg numbness using the visual analog scale before the surgery. In addition, we measured the ROM of the hip joint during flexion, external rotation, and internal rotation. All responses of the JOABPEQ and physical function data were subjected to a partial least-squares (PLS) regression analysis.Results:Low back pain, lower limb pain, lower limb numbness, and hip ROM during flexion could each be used for significant regression models with JOABPEQ items. However, the hip ROMs during external and internal rotation could not be used for regression models with the JOABPEQ.Conclusion:On the basis of the results of the PLS regression analysis in this study, the degree of pain symptoms in patients with lumbar spinal stenosis may be quantified with the JOABPEQ items. Furthermore, the flexion angle of the hip ROM was quantified using the JOABPEQ items. The results of this study may indicate an effective means for establishing treatment plans for physical therapy.

4.
Article in Chinese | WPRIM | ID: wpr-877543

ABSTRACT

OBJECTIVE@#To compare the clinical therapeutic effect on painful diabetic peripheral neuropathy (PDPN) between dragon-tiger fighting needling and pregabalin capsules.@*METHODS@#A total of 60 patients with PDPN were randomized into an observation group and a control group, 30 cases in each one. On the base of treatment with routine anti-hyperglycaemic measures and nutritional neurotherapy, the dragon-tiger fighting needling was exerted at Sanyinjiao (SP 6), Zusanli (ST 36), Yinlingquan (SP 9) and Xuehai (SP 10) in the observation group, once daily. Pregabalin capsules were prescribed for oral administration in the control group, 75 mg, twice a day. The treatment for 2 weeks was as one course and 2 courses of treatment were required in total. The score of visual analogue scale (VAS), the score of MOS item short form health survey (SF-36) and nerve conduction velocity before and after treatment were compared between the two groups. The clinical therapeutic effect was evaluated in the two groups.@*RESULTS@#After treatment, VAS score was reduced as compared with before treatment in the two groups (@*CONCLUSION@#The dragon-tiger fighting needling therapy relieves painful symptoms, improves the quality of life and increases nerve conduction velocity in the patients with diabetic peripheral neuropathy, and the therapeutic effect is better than oral administration of pregabalin capsules.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Animals , Diabetes Mellitus , Diabetic Neuropathies/drug therapy , Humans , Quality of Life , Tigers , Treatment Outcome
5.
Article in Chinese | WPRIM | ID: wpr-920998

ABSTRACT

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.


Subject(s)
Acupuncture Points , Acupuncture Therapy , Humans , Migraine without Aura , Tablets , Treatment Outcome , Triazoles , Tryptamines
6.
Article in Japanese | WPRIM | ID: wpr-874022

ABSTRACT

Objective:The Japanese Orthopaedic Association Low Back Pain Evaluation Questionnaire (JOABPEQ) consists of 25 questions, which allows for the multifaceted evaluation of patients with low back pain. In this study, we aimed to investigate whether the JOABPEQ could be used to construct a regression model to quantify low back pain, lower limb symptoms, and hip range of motion (ROM) in patients with lumbar spinal stenosis.Methods:We evaluated 115 patients with lumbar spinal stenosis scheduled to undergo surgery at our hospital. We measured the degrees of low back pain, lower leg pain, and lower leg numbness using the visual analog scale before the surgery. In addition, we measured the ROM of the hip joint during flexion, external rotation, and internal rotation. All responses of the JOABPEQ and physical function data were subjected to a partial least-squares (PLS) regression analysis.Results:Low back pain, lower limb pain, lower limb numbness, and hip ROM during flexion could each be used for significant regression models with JOABPEQ items. However, the hip ROMs during external and internal rotation could not be used for regression models with the JOABPEQ.Conclusion:On the basis of the results of the PLS regression analysis in this study, the degree of pain symptoms in patients with lumbar spinal stenosis may be quantified with the JOABPEQ items. Furthermore, the flexion angle of the hip ROM was quantified using the JOABPEQ items. The results of this study may indicate an effective means for establishing treatment plans for physical therapy.

7.
Rev. colomb. reumatol ; 27(4): 262-268, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1289330

ABSTRACT

RESUMEN Introducción: La percepción global de la salud (PGA) es una parte de los instrumentos compuestos utilizados para determinar la actividad de la artritis reumatoide (AR). Por lo general, se mide por medio de la escala visual análoga (EVA). En nuestra práctica clínica y en la literatura se han observado dificultades en la aplicación de la EVA. Este estudio se llevó a cabo luego de considerar la necesidad de definir el desempeño de las diferentes escalas usadas para evaluar la PGA, determinar la facilidad de su uso y proponer una nueva escala. Métodos: Se trata de un estudio basado en desenlace de pacientes con diagnóstico de AR a los que se aplicaron cuatro tipos de escalas para evaluar la PGA: escala 1 (EVA), escala 2 (escala de rostros) y una propuesta de escala visual en dos versiones: escala 3 (escala visual compuesta en orientación horizontal) y escala 4 (similar a la escala 3, pero en orientación vertical). Se analizó su correlación y la frecuencia con la que los pacientes las entendieron. Resultados: Se incluyeron 198 pacientes, 169 mujeres (85,3%) y 29 hombres (14,6%), y la edad media fue de 54,2 anos. El 59,6% de los pacientes no entendió la escala 1. La mayoría de los pacientes entendió las escalas 2, 3 y 4. Aproximadamente el 80% de los pacientes prefirió las escalas 2 (43,4%) y 3 (36,3%) (p < 0,00). Ninguna variable clínica predijo la selección de la escala. Se observó una buena correlación y una aceptable reproducibilidad de las escalas 2, 3 y 4. Conclusiones: La mayoría de los pacientes no entendió la EVA; la mayoría de nuestros pacientes entendió y prefirió las escalas propuestas, que podrían ser útiles en la práctica clínica de los pacientes con AR.


ABSTRACT Introduction: The overall perceived health (OPH) is part of the composite tools used to determine the activity of Rheumatoid Arthritis (RA). It is usually measured using a Visual Analogue Scale (VAS). Difficulties in applying the VAS have been observed in clinical practice and in the literature. This study was carried out after considering the need to define the performance of the different scales used to evaluate OPH, and determine their ease of use, as well as to propose a new scale. Methods: The study based on the outcome of patients, subjects diagnosed with RA, to whom 4 types of scales were applied to evaluate OPH: Scale 1 (VAS), Scale 2 (face scale), a proposal of a visual scale in two versions: Scale 3 (composite visual scale in horizontal orientation), and Scale 4, similar to 3 in vertical orientation. Results: Of the 198 patients included, 169 (85.3%) were women, and 29 (14.6%) were men. The mean age was 54.2 years, and 59.6% of the patients did not understand the Scale 1. The majority of the patients understood the Scales 2,3, and 4. Approximately 80% of the patients preferred the Scales 2 (43.4%) and 3 (36.3%) (P< .00), but no clinical variable predicted the selection of the scale. A good correlation and an acceptable reproducibility were observed for scales 2, 3, and 4. Conclusions: Although the majority of patients did not understand the VAS, the majority of our patients understood and preferred the proposed scales that could be useful in the clinical practice of RA patients.


Subject(s)
Humans , Perception , Arthritis, Rheumatoid , Weights and Measures , Pain Measurement , Health , Diagnosis
8.
Säo Paulo med. j ; 138(5): 414-421, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1139713

ABSTRACT

ABSTRACT BACKGROUND: Postoperative nausea and vomiting (PONV) is a common complication from general anesthesia that impacts on postoperative recovery. OBJECTIVE: To evaluate prophylactic rewarming following general anesthesia, so as to decrease the incidence of PONV among patients undergoing laparoscopic hysterectomy. DESIGN AND SETTING: Prospective randomized clinical study at a hospital in China. METHODS: Sixty-two patients were randomly assigned into two groups. The forced air warming (FAW) group received pre-warmed Ringer's solution with FAW until the end of surgery. The control group received Ringer's solution without FAW. The pre-warmed Ringer's solution was stored in a cabinet set at 40 °C. The FAW tube was placed beside the patient's shoulder with a temperature of 43 °C. RESULTS: Sixty patients completed the study. The FAW group showed significant differences versus the controls regarding temperature. At 6, 24 and 48 hours postoperatively, the incidences of PONV were 53.3%, 6.7% and 3.3% in the FAW group versus 63.3%, 30% and 3.3% in the controls. VAS scores were significantly lower in the FAW group than in the controls at 24 hours (P= 0.035). Forty-item questionnaire total scores in the FAW group were significantly higher than in the controls. The physical independence and pain scores at 24 hours and emotional support and pain scores at 48 hours in the FAW group were higher than in the controls (P < 0.05). There was no difference in hemodynamics or demographics between the two groups (P > 0.05). CONCLUSIONS: Prophylactic rewarming relieved PONV and improved the quality of postoperative recovery. CHINESE CLINICAL TRIAL REGISTER (ChiCTR): ChiCTR-IOR-17012901.


Subject(s)
Humans , Female , Laparoscopy/adverse effects , Rewarming , Postoperative Nausea and Vomiting/prevention & control , Hysterectomy/adverse effects , Hysterectomy/methods , China , Prospective Studies , Treatment Outcome
9.
Article | IMSEAR | ID: sea-215199

ABSTRACT

Application of arch bar is considered as a gold standard for intermaxillary fixation (IMF) in the management of mandibular fractures. Both the application and removal of arch bars can inflict pain for patients who require IMF. For removal of the arch bars, local anaesthesia (local infiltration or conduction block) is often indicated. The study aimed at comparing and validating the efficacy of topical lidocaine spray and benzocaine gel in patients undergoing removal of arch bars. METHODS30 subjects were included in this prospective randomized controlled trial. Maxillary arch was chosen as the test site. 10 patients (Group A) were anaesthetized in the upper gingiva with 15 % lidocaine spray and remaining 10 patients (Group B) were anaesthetized with 20 % benzocaine gel, following which removal of arch bar was done. 10 patients were included in the control group (Group C) where 2 % lignocaine infiltration was offered only on request. Visual analog scale and Wong-Baker Faces Pain Rating Scale was used to measure the pain perceived by the patient during the procedure. RESULTSThe mean and standard deviation of the pain scores of Group A was 2.5 ± 0.70, Group B was 2.7 ± 0.67 and Control group was 5.5 ± 0.85. Both the test groups had a significant pain reduction when compared with the control group. CONCLUSIONSTopical application of both 15 % lidocaine spray and 20 % benzocaine gel provided equally efficient analgesia and can be useful alternatives to conventional local anaesthetic infiltration during arch bar removal.

10.
Dental press j. orthod. (Impr.) ; 25(5): 30-37, Sept.-Oct. 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1133685

ABSTRACT

ABSTRACT Objective: This prospective study aimed at assessing the effects of anxiety and a follow-up text message on pain perception after the installation of fixed orthodontic appliances and its impact on the patients' routine. Methods: The sample of this study consisted of 103 orthodontic patients, 40 males and 63 females (mean age 20.5 years), distributed in two groups: G1 (n=51), including control patients that did not receive any post-procedure communication; and G2 (n=52), including patients that received a structured text message. In baseline phase, the patients completed a questionnaire to assess their level of anxiety prior to treatment. Pain was assessed by using 100-mm visual analog scale (VAS) in baseline and ten times prospectively in predetermined time points. VAS was also applied to assess the patient's routine alterations caused by the pain. All data were analyzed using ANOVA, Tukey, Mann-Whitney, t-test, chi-square and Spearman's correlation tests. All statistical tests were performed with significance level of 5%. Results: Low-level and high-level anxiety was observed in 42.7% and 7.8% of the patients, respectively. Statistically significant correlation was observed between anxiety and pain (p< 0.05). Maximum mean pain intensity was detected in the second treatment day (G1=36.9mm and G2=26.2mm) and was significantly higher in G1. Nearly 53% of the patients in G1 reported alterations in the routine (18.8mm), while in G2 the percentage rate reached 28.8% (9.9mm) (p=0.013). Conclusions: Anxious patients report more pain after the installation of orthodontic appliances. Text messages were effective to reduce pain levels and to decrease the negative effects on patients' daily routine.


RESUMO Objetivo: O presente estudo prospectivo teve como objetivo avaliar os efeitos da ansiedade e de mensagens de texto de acompanhamento na percepção da dor após a instalação de aparelhos ortodônticos fixos e seu impacto na rotina dos pacientes. Métodos: A amostra deste estudo foi composta por 103 pacientes ortodônticos, 40 homens e 63 mulheres (idade média de 20,5 anos), distribuídos em dois grupos: G1 (n = 51), que incluiu pacientes controle, que não receberam comunicação pós-procedimento; e G2 (n = 52), incluindo os pacientes que receberam mensagem de texto estruturada. Na fase inicial, os pacientes responderam a um questionário para avaliar seu nível de ansiedade antes do tratamento. A dor foi avaliada por meio de escala visual analógica (EVA) de 100 mm antes da instalação dos aparelhos e em 10 períodos consecutivos predeterminados. A EVA também foi aplicada para avaliar as alterações de rotina do paciente causadas pela dor. Os resultados foram analisados usando ANOVA, Tukey, Mann-Whitney, teste t, Qui-quadrado e testes de correlação de Spearman. Todos os testes estatísticos foram realizados com nível de significância de 5%. Resultados: Níveis baixos e altos de ansiedade foram observados em 42,7% e 7,8% dos pacientes, respectivamente. Foi observada correlação estatisticamente significativa entre ansiedade e dor (p< 0,05). A intensidade média máxima da dor foi detectada no segundo dia de tratamento (G1 = 36,9mm e G2 = 26,2mm) e foi significativamente maior no G1. Quase 53% dos pacientes do G1 relataram alterações na rotina (18,8mm), enquanto no G2 o percentual atingiu 28,8% (9,9mm) (p= 0,013). Conclusões: Pacientes ansiosos relatam mais dor após a instalação de aparelhos ortodônticos. As mensagens de texto foram eficazes para reduzir os níveis de dor e diminuir os efeitos negativos na rotina diária dos pacientes.


Subject(s)
Humans , Male , Female , Adult , Anxiety/etiology , Text Messaging , Pain Measurement , Prospective Studies , Pain Perception
11.
Article | IMSEAR | ID: sea-207835

ABSTRACT

Background: Chronic pelvic pain (CPP) of myofascial origin is a condition that is difficult to control and with great repercussion on the quality of life for women who suffer from it. This study objective was to compare the effectiveness of two treatments for the management of this pathology; vaginal analgesic electrostimulation (VES) versus sacral electroacupuncture (EAS).Methods: Quasi-experimental comparative study of two treatments in patients with myofascial CPP. The sample was made up of women who presented this condition during the period 2016 to 2019. The main objective was to assess the effectiveness of the treatments in comparison in terms of the decrease in the VAS score, the secondary ones were: To know the effectiveness of the VES for pain chronic pelvic myofascial (MFPP), the effectiveness of EA for the same condition, complications of therapies, main urological dysfunctions and other chronic pelvic pain associated with myofascial CPP.Results: Thirteen thousand patient files were reviewed, of which 47 were diagnosed with myofascial CCP, with 38 patients eligible for our study. The VES was more effective than the EAS in decreasing the VAS in the twelfth session from 1.36 versus 2.62 p .001. Both therapies were effective for the management of myofascial DCP as they decreased the VAS score to more than 60% of the initial VAS. Vulvodynia (34%), mixed urinary incontinence (32%), and voiding symptoms (26%) were other pelvic floor dysfunctions that presented concomitantly to the MFPP.Conclusions: In patients with myofascial CPP, vaginal VES is better than AD for the treatment of this condition.

12.
Article | IMSEAR | ID: sea-214763

ABSTRACT

Labour is an extremely painful process. Labour pain can have deleterious effects on the mother, on the foetus and on the labour outcome. Among the current methods of obstetric analgesia, regional analgesia (the most widespread technique being epidural analgesia) offers the best effectiveness/safety ratio. The increased availability of epidural analgesia and the favourable experiences of women who have had painless labour with epidural block have reshaped the expectations of pregnant women entering labour. Compared with other forms of pain relief, epidural analgesia is associated with the highest level of maternal satisfaction. Taking into consideration this aspect, a study was performed in a tertiary care center over a period of 18 months.METHODS160 patients fulfilling the inclusion criteria were divided into two groups namely Group A and Group B. Group A was administered epidural analgesia while Group B was offered other analgesic agents (inj. tramadol hydrochloride) after obtaining well informed consent. Pain compliance is marked over VAS at this point of time. Once the effect of epidural starts waning off, top up dosages are administered by anaesthesiologists. Increments or derangements in pain compliance are noted timely. Any maternal side effects such as headache, hypotension, motor paralysis etc. are noted. Duration of first and second stage of labour is noted with the help of partogram. In the end, mode of delivery, indication of instrumental delivery/caesarean section, neonatal outcome in terms of APGAR scores were noted.RESULTSProlongation of first and second stage of labour, increase in the rate of instrumental/caesarean delivery was not statistically significant between both the groups. (p>0.05). p Value calculated using unpaired t test (p= 0.5116). Maternal requests for caesarean section were significantly higher in control group compared to epidural group (p<0.05). This may be due to non/less efficacy of other analgesic drugs than epidural analgesics. The difference in VAS score between both the study groups was statistically significant (p<0.001) indicating that pain was significantly less in epidural group.CONCLUSIONSEpidural analgesia provides excellent labour analgesia compared to other agents with no significant prolongation of first and second stage of labour or mode of delivery. Study also shows that there is no significant rise in the number of instrumental or caesarean deliveries due to epidural analgesia. There are no serious maternal or foetal side effects of the epidural analgesia. Hence, it can be safely recommended in labour. The analgesic effect can be maintained as long as needed and even after delivery to relieve postoperative pain.

13.
Article | IMSEAR | ID: sea-200545

ABSTRACT

Background: Much of the pharmacological treatment modalities especially individual drugs for treating neuropathic pain have unwanted side effects, multiple day to day dosing, modest efficacy of topical treatments, and their local side effects. Combination drug regimen has the advantage of offering relatively better pain relief at lower drug doses and lesser side effects.Methods: The study was conducted in the Department of Neurology at NRI General Hospital, Guntur. The patients who met the inclusion and exclusion criteria were enrolled and assigned into 3 groups of the study drug combinations. The baseline characteristics and post interventional scores of Toronto Clinical Scoring System (TCSS), visual analogue scale (VAS), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Depression Rating Scale (HAM-D) and Medical outcome of sleep scale (MOS) and were analyzed using t test and mean difference.Results: A statistically significant reduction in neuropathic pain in all the three groups was found. The mean difference between the baseline and post interventional scores of TCSS and VAS of group I, II and III were 2.97, 2.75, and 1.97; 2.32, 1.12, and 0.95 respectively. There was a statistically significant improvement of HAM-A in all the three groups, HAM-D and MOS sleep scale were found significant only in group II.Conclusions: The study findings revealed that all the three drug combinations were effective in the management of neuropathic pain with pregabalin and oxcarbazepine combination being better with respect to efficacy and tolerability. Regarding the treatment of depression and sleep disturbances associated with NP pregabalin and duloxetine was more effective.

14.
Article | IMSEAR | ID: sea-207342

ABSTRACT

Background: The common reason for rise in elective Caesarean Section (CS) rate among primigravidas is maternal request due to labor pain fear. Many non-pharmacological pain relief strategies are available to help women cope with labor pain, providing a positive and satisfactory birth experience. The objective of this study was to evaluate effects of KT and Acu-TENS on maternal and neonatal outcomes in primigravidas.Methods: 40 full-term primigravidas with an age range of 20-40 years were enrolled into the study by convenience sampling method and divided into 2 groups. Group A received KT and Group B received Acu-TENS. Both groups received breathing exercises. Pain assessment at various cervical dilatation levels were carried out for all participants before and after treatment using Visual Analogue Scale (VAS). Duration of active phase in first stage labor, mode of delivery and neonatal well-being were measured following delivery.Results: Group A experienced VAS score reduction significantly more than Group B, p=0.004; <0.05. There was no significant change in active phase duration of first stage labor between Group A and Group B, p=0.319; >0.05. CS rate was increased in Group A [35% (7/20)] than in Group B [25% (5/20)], but neonatal outcomes were not different.Conclusions: This study proves that KT produced significantly better pain relief than Acu-TENS in first stage labor among primigravidas. Acu-TENS showed reduction in active phase duration of first stage labor than KT. Both interventions can safely be used non-invasively for labor pain relief.

15.
Article in Chinese | WPRIM | ID: wpr-848071

ABSTRACT

BACKGROUND: Steroids have strong anti-inflammatory, anti-emetic and analgesic effects and are widely used in perioperative analgesia. Studies have shown that periarticular injection of steroid-containing cocktail analgesic therapy in knee arthroplasty can relieve postoperative pain, improve knee activity, and reduce complications. However, the other studies show that steroids can increase the risk of postoperative infection, and tendon rupture. Therefore, the safety and efficacy of steroid-containing cocktail periarticular injection in knee arthroplasty is still controversial. OBJECTIVE: To evaluate the safety and efficacy of steroid-containing cocktail periarticular injection after knee arthroplasty by meta-analysis. METHODS: The published literatures were searched on the databases of PubMed/Medline, Cochrane Central Register of Controlled Trials, and EMBASE until April 2019. All randomized controlled trials of topical steroid analgesia after knee arthroplasty were collected and eligible articles were screened. Two researchers independently assessed the risk of bias and methodological quality of included studies by the Cochrane 5.0. The outcome data were extracted and a meta-analysis was conducted by Review Manager 5.2 software. RESULTS AND CONCLUSION: (1) A total of 10 randomized controlled articles involving 820 patients were included. (2) The meta-analysis showed that visual analogue scale score was lower in the steroid group than in the control group at postoperative 1 day [MD=-1.52, 95%C/(-2.94, -0.10), P=0.04]. Motion range was higher in the steroid group than in the control group at postoperative 1, 2, 3,4 and 5 days [MD=11.57, 95%C/(9.85, 13.30), P < 0.000 01; MD=9.03, 95%C/(B.67, 11.38), P < 0.000 01; MD=5.73, 95%C/(0.85, 10.60), P=0.02; MD=5.53, 95%C/(0.68, 10.38), P=0.03); MD=5.90, 95%C/(0.87, 10.93), P=0.02j. Morphine use was less in the steroid group than in the control group [MD=-7.94, 95%C/(-14.35, -1.53), P=0.02j. Hospital stay was shorter in the steroid group than in the control group [AfD=-0.98, 95%C/(-1.25, -0.71), P < 0.000 01]. Straight leg raising took less time in the steroid group than in the control group [MD=0.65, 95%C/(-0.86, 0.44), P < 0.000 01]. Postoperative C-reactive protein level was lower in the steroid group than in the control group [WMD=-4.82, 95%C/(7.41, 2.23), P=0.000 3]. Knee society score and complication rate were not significantly different between the two groups. (3) To conclude, the periarticular injection of steroid-containing cocktails after knee arthroplasty is safe and effective.

16.
Article in Chinese | WPRIM | ID: wpr-847905

ABSTRACT

BACKGROUND: Percutaneous curved vertebroplasty is a modified surgical method of percutaneous vertebroplasty; the most prominent feature of which is that it can make the bone cement distributed symmetrically and balance the strength on both sides of the vertebral body. In theory, it can ensure the distribution of bone cement in the vertebral body, and solve the problem that the uneven distribution of bone cement in the traditional percutaneous vertebroplasty and single injection leads to poor pain relief effect in the fracture area. OBJECTIVE: To compare the clinical efficacy of percutaneous curved vertebroplasty and percutaneous vertebroplasty bone cement injection in the treatment of osteoporotic vertebral compression fractures, and to discuss the value of percutaneous curved vertebroplasty in clinical application. METHODS: Seventy patients with single vertebral osteoporotic vertebral compression fractures from the Third Affiliated Hospital of AnHui Medical University between 2017 and 2018 were selected. The patients were randomly divided into two groups. Percutaneous curved vertebroplasty group (n=35) received treatment with percutaneous curved vertebroplasty. Percutaneous vertebroplasty group (n=35) received treatment with percutaneous vertebroplasty. Distribution and leakage of bone cement were observed in the two groups. Visual analogue scale score and Oswestry disability index were assessed preoperatively and 1 day postoperatively. Postoperative follow-up was conducted for 1 year to observe the recovery of the height of the anterior edge of the injured vertebra and the occurrence of adjacent vertebral fractures. The trial was approved by the Ethics Committee of the Third Affiliated Hospital of Anhui Medical University. RESULTS AND CONCLUSION: (1) Compared with the percutaneous vertebroplasty group, the distribution of bone cement was more uniform and satisfactory (P0.05). (4) There was no significant difference in the incidence of adjacent vertebral fractures between the two groups (P>0.05). (5) The results showed that compared with the treatment of percutaneous vertebroplasty, the treatment of osteoporotic vertebral body compression fractures by percutaneous curved vertebroplasty can reduce the rate of bone cement leakage and improve the quality of life of patients.

17.
Article in Chinese | WPRIM | ID: wpr-847533

ABSTRACT

BACKGROUND: Medial parapatellar approach has become the standard technique for total knee arthroplasty. However, recent studies have reported superior results in functional recovery using midvastus approach. OBJECTIVE: To evaluate the early functional outcomes of medial parapatellar and midvastus approaches. METHODS: This was a prospective, randomized, double-blind, and controlled trial. Fifty patients receiving total knee arthroplasty were randomized into two groups: medial parapatellar approach and midvastus approach. The same type of implants was used in both groups. The Visual Analogue Scale scores were recorded. The range of motion, quadriceps strength and proprioception were assessed at 3 and 6 weeks after surgery. RESULTS AND CONCLUSION: (1) The Visual Analogue Scale scores at rest and in active in the midvastus approach group were significantly lower than those in the medial parapatellar approach group. (2) The average quadriceps strength in the midvastus approach group was significantly better than that in the medial parapatellar approach group. (3) The postoperative quadriceps proprioception in the midvastus approach group was better than that in the medial parapatellar approach group. The range of motion was similar in both groups. (4) Therefore, during early rehabilitation, the midvastus approach is superior to the medial parapatellar approach, and no adverse effects associated with this method are observed.

18.
Article in Chinese | WPRIM | ID: wpr-847476

ABSTRACT

BACKGROUND: Percutaneous kyphoplasty (PKP) for the treatment of osteoporotic compression fractures has been widely recognized in clinical practice, but clinicians are still impelled to seek for new treatment regimens due to complications such as bone cement leakage and adjacent vertebral re-fracture. OBJECTIVE: To compare the therapeutic efficacy of facet joint injection (FJI) and PKP in the treatment of mild vertebral fragility fractures. METHODS: Forty-six patients with mild vertebral fragility fractures (osteoporotic fractures) were divided into FJI group and PKP group according to the treatment regimens. The two groups of patients were treated with FJI and PKP separately based on standardized anti-osteoporosis treatment. The data of each group were recorded before and 1 week, 1, 3, 6, and 12 months after treatment. The analgesic efficacy was evaluated by visual analogue scale (VAS) and Oswestry disability index (ODI). Spine stability was evaluated by anterior vertebral height, kyphotic angle and lumbar spine density and the incidence of re-fracture were compared. The study protocol was implemented in line with the ethic requirements of Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences in China. Informed consent was obtained from each patient. RESULTS AND CONCLUSION: Intragroup comparison: VAS and ODI scores of patients in both groups were significantly decreased in each period after treatment compared with the baseline (P 0.05). After treatment, the anterior vertebral body height and kyphosis angle in the PKP group were better than those in the FJI group (P 0.05). Standardized anti-osteoporosis treatment with either FJI or PKP can provide effective analgesia for patients with mild vertebral fragility fracture, and PKP has certain advantages in rapid analgesia and recovery of spinal stability.

19.
Article in Chinese | WPRIM | ID: wpr-847437

ABSTRACT

BACKGROUND: Calcaneal fracture is the most common patella fracture. Traditionally, surgical treatment via an enlarged lateral approach is the gold standard method for the treatment of calcaneal fractures. However, this method can lead to joint stiffness and peroneal tendon adhesion to different extents, resulting in postoperative foot pain. OBJECTIVE: To investigate the effect of preserving the integrity of peroneal tendon sheath on hindfoot movement during open reduction and internal fixation of calcaneus fractures. METHODS: A total of 160 patients with displaced intra-articular calcaneus fractures who were admitted to the Department of Foot and Ankle Surgery, Affiliated Hospital of Binzhou Medical University from July 2016 to September 2017 were randomly divided into a control group and an experimental group. The classical lateral “L” incision was used in both groups. In the control group, the calcaneus was exposed by traditional dynamic retraction of the fibular tendon, while the experimental group was treated by static retraction with the preservation of fibular tendon sheath. The trial protocol was approved by the Ethics Committee of the Affiliated Hospital of Binzhou Medical University on February 18, 2016 with the approval No. 2016-G026-01. RESULTS AND CONCLUSION: There were 156 patients with complete follow-up data, 78 in the control group and 78 in the experimental group. The visual analogue scale scores on the first day, Bohler angle and Gissane angle at the 3rd month, and ankle dorsiflexion and plantar flexion angle at the 6th month of internal fixation were similar in the two groups. Hind foot valgus and varus angles at the 6th month of internal fixation and the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores at the 1st year of internal fixation in the experimental group were better than those in the control group. Meanwhile, the excellent and good rate of Maryland hindfoot scoring system in the experimental group was higher than that in the control group at the last follow-up. There were four cases of incision complications in the control group (one case of infection and three cases of necrosis) and two cases of necrosis in the experimental group. These findings indicate that calcaneus fracture surgery with preserving the integrity of peroneal tendon sheath can significantly improve the mobility of the hindfoot, and improve the patient’s satisfaction, and meanwhile do not increase the incidence of incision complications.

20.
Article in Chinese | WPRIM | ID: wpr-847403

ABSTRACT

BACKGROUND: Facial scars are mainly caused by trauma or surgery, which greatly affect the appearance. Dermatologists and plastic surgeons have tried many ways to change the appearance of scars. Botulinum toxin A injection is widely used in clinical practice for prevention of scars, but the efficacy and safety are not proved. OBJECTIVE: To evaluate the effectiveness and safety of botulinum toxin A injection in the prevention of facial trauma or postoperative hypertrophic scar. METHODS: PubMed, EMbase, the Cochrane library, CNKI, CBM, WanFang, and VIP were searched for randomized controlled trials regarding botulinum toxin A injection in the prevention of facial scars. Manual retrieval was done for supplement of incomplete data. Two doctors were responsible for literature screen and evaluation. Finally, 11 randomized controlled clinical trials were included. The experimental group was injected with botulinum toxin A, and the control group was given saline or nothing. Part of the data was analyzed using Revman 5.3 software for meta-analysis, and the data that could not be analyzed using software were subjected to a descriptive analysis. RESULTS AND CONCLUSION: Eleven randomized controlled trials were included, involving 436 patients with 518 wounds. Meta-analyses showed that Vancouver scar scale score, visual analogue scale score and width of scars in the botulinum toxin A group were significantly better than those in the control group (weighted mean difference (WMD)=-1.61, 95% confidence interval (CI)=-2.06 to -0.26, P = 0.02; WMD=1.7, 95%CI=0.38 to 3.02, P = 0.01; WMD=-0.17, 95%CI=-0.22 to -0.12, P < 0.000 1). Incidence of adverse reactions of botulinum toxin A group was higher than that in the control group (χ2 =8.335, P=0.004), but they were all slight and easy to release. There were no serious adverse events in both groups. It seems that botulinum toxin A injection can reduce the width of scars, improve Vancouver scale and visual analogue scale scores. However, it is suggested to make clear communication before and after the operation and take measures to deal with various adverse reactions in advance.

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