Isometric thumb extension exercise as part of a multimodal intervention for de Quervain's syndrome: A randomised feasibility trial

Introduction: de Quervain's syndrome is a painful condition commonly presented to hand therapists. Exercise is utilised as an intervention, but isometric exercise has not been investigated. We aimed to assess the feasibility and safety of isometric thumb extension exercise for de Quervain's syndrome and to explore differences between high-load and low-load isometric exercise. Method(s): This parallel-group randomised clinical feasibility trial included individuals with de Quervain's syndrome. All participants underwent a 2 week washout period where they received an orthosis, education, and range of motion exercises. Eligible participants were then randomised to receive high or low-load isometric thumb extension exercises, performed daily for 4 weeks. Feasibility and safety were assessed by recruitment and drop-out rates, adherence, adverse events, and participant feedback via semi-structured interviews. Secondary outcomes included patient-reported outcomes for pain and function, and blinded assessment of range of motion and strength. Result(s): Twenty-eight participants were randomised. There were no drop-outs after randomisation, and no serious adverse events. Adherence to exercise was 86.7%, with 84% of participants stating they would choose to participate again. There were clinically and statistically significant improvements in pain and function over time (p < 0.001) but not in range of motion or strength. There were no statistically significant between-group differences. Conclusion(s): Isometric thumb extension exercise within a multimodal approach appears a safe and feasible intervention for people with de Quervain's syndrome. A large multi-centre trial would be required to compare high- and low-load isometric exercises. Further research investigating exercise and multimodal interventions in this population is warranted.Copyright © The Author(s) 2023.

Dissociation Among Women with Chronic Pelvic Pain: Relation to Surgical Treatment, Pelvic Pain Severity, and Health-Related Quality of Life.

Chronic pelvic pain (CPP) is associated with a history of trauma and symptoms of somatoform dissociation. We aimed to describe how somatoform dissociation impacts CPP symptoms, surgical treatment, and health-related quality of life (HRQOL). Patients (N = 133) diagnosed with CPP presenting for an appointment at a women's health clinic between November, 2019 - July, 2021 were recruited to participate in a cross-sectional study and complete a survey assessing symptoms of somatoform dissociation, post-traumatic stress disorder (PTSD), pelvic pain severity, history of CPP-related surgeries, and mental and physical HRQOL. We also conducted a post-hoc analysis assessing correlations of individual symptom items on the Somatoform Dissociation Questionnaire (SDQ-20) with HRQOL outcomes. We did not find a relationship between somatoform dissociation and pelvic pain severity or surgical history. Physical HRQOL outcomes were related to somatoform dissociation, PTSD symptoms, and pelvic pain severity, while mental HRQOL outcomes were connected to somatoform dissociation and PTSD symptoms. Our study reveals preliminary evidence suggesting that among CPP patients, HRQOL outcomes are affected by unique profiles of positive and negative symptoms of somatoform dissociation, including sensory disturbances, localized genital pain, and generalized numbness and bodily analgesia. Addressing specific symptoms of somatoform dissociation may enhance HRQOL among trauma-exposed women with CPP. Replication studies are needed to validate our findings. Integrating trauma-informed approaches, including standardized evaluations of trauma exposure and symptoms of somatoform dissociation into routine care for women with CPP is encouraged.

Outcomes of coblation tonsillectomy versus bipolar electrocautery tonsillectomy in pediatric population

Background: Bipolar electrocautery tonsillectomy has been the preferred technique for many otolaryngologists, yet coblation tonsillectomy is gaining popularity in the current practice. This study aims at comparing both techniques in terms of pain, bleeding, and healing. Result(s): A total of 120 patients were randomly divided into two equal groups. Overall mean pain score associated with coblation tonsillectomy was statistically less than that caused by bipolar electrocautery throughout the follow-up period (p < 0.001). The difference in pain duration was statistically longer for the bipolar group. The incidence of postoperative hemorrhage-both reactionary and secondary-was statistically higher in the bipolar group. Coblation tonsillectomy showed statistically shorter duration of healing (p < 0.001). Conclusion(s): Coblation tonsillectomy is associated with less pain severity and shorter pain duration, fewer bleeding incidents, and more prompt healing.Copyright © 2022, The Author(s).

RESULTS OF A 12-WEEK OPEN-LABEL, NON-INTERVENTIONAL STUDY OF THE EFFICACY AND SAFETY OF OLOKIZUMAB THERAPY IN PATIENTS WITH RHEUMATOID ARTHRITIS AFTER SWITCHING FROM ANTI-B-CELL THERAPY DURING THE SARS-COV-2 PANDEMIC.

The COVID-19 pandemic has significantly changed the understanding of the safety profile of therapies for immunoinflammatory rheumatic diseases (IRDs). This is primarily due to the negative impact of a number of basic anti-inflammatory drugs (DMARDs) and biological DMARDs on the course and outcomes of a new coronavirus infection. A number of studies have shown that anti-B-cell therapy (rituximab) gave a statistically significant increase in the risk of severe COVID-19 and an increase in mortality. At the same time, the analysis of real clinical practice data dictated the need to establish a number of restrictions on the use of certain classes of biological DMARDs and to search for alternative therapy programs to maintain control over disease activity. Purpose of the study - to evaluate the efficacy and safety of the drug Artlegia (olokizumab), solution for subcutaneous injection, 160 mg/ml - 0.4 ml, manufactured by R-Pharm JSC, Russia) for the treatment of patients with rheumatoid arthritis in real clinical practice after switching with rituximab during the COVID-19 pandemic. Materials and methods. The study included 14 patients with a confirmed diagnosis of rheumatoid arthritis (RA), who were previously on rituximab therapy at a dose of 1000-500 mg twice with an interval of 2 weeks, who received at least one course of therapy with this drug. As RA worsened, patients were switched to olokizumab against the background of standard DMARDs. At 4, 8, 12 weeks after the switch, the severity of pain was assessed on the VAS scale, the number of painful and swollen joints (TJC28 and TSC28), the level of acute phase markers of inflammation, the DAS28 disease activity index calculated using ESR and CRP, and the CDAI (clinical activity index), functional state index HAQ, as well as assessment of the safety profile of therapy. Results. Data analysis was performed using median values (Me) were used for data analysis. A significant decrease of TJC28 was after the injection of olokizumab (Artlegia) in 8 and 12 weeks (Me baseline = 10;Me 8 weeks = 4;Me 12 weeks = 4;p<0.05) and a decrease of TSC28 in 4, 8 and 12 weeks (Me baseline = 9;Me 4 weeks = 3.5;Me 8 weeks = 2.5;Me 12 weeks = 2.0;p<0.05). Laboratory markers of inflammation showed a decrease in CRP and ESR levels after 4 weeks of treatment (CRP: Me baseline = 21, Me 4 weeks = 1 (p<0.05);ESR: Me baseline = 31, Me 4 weeks = 7 (p<0.05)). Positive dynamics persisted at 8 and 12 weeks (CRP: Me 8 weeks = 1, Me 12 weeks = 0;ESR: Me 8 weeks = 4, Me 12 weeks = 5). The level of CRP by the fourth week 4 became within the normal range, regardless of the initial values. All activity indices improved from the fourth week in each evaluation period compared to baseline: DAS28-ESR: Me baseline = 5.52, Me 4 weeks = 3.59, Me 8 weeks = 3.33, Me 12 weeks = 3.22 (p<0.05);DAS28-CRP: Me baseline = 5.39, Me 4 weeks = 3.71, Me 8 weeks = 3.35, Me 12 weeks = 3.45 (p<0.05);CDAI: Me baseline = 28.5, Me 4 weeks = 18.0, Me 8 weeks = 16.5, Me 12 weeks = 16.0 (p<0.05). All patients showed a reduction in pain (VAS scale) by week 8. The functional status of patients, according to the HAQ index, showed a significant decrease only by the 12th week of the study: Me baseline = 1.62, Me 12 weeks = 1.31 (p<0.05). Conclusion. The study found that switching from rituximab to olokizumab was effective and safe during the COVID-19 pandemic.Copyright © 2023 Ima-Press Publishing House. All rights reserved.

Impact of Different Exercise Techniques on Menstrual Pain Severity in Postacute Covid-19 Women

Background: The purpose of this investigation was to determine the impact of different exercise techniques on menstrual pain severity in post-acute covid-19 women. Method(s): Thirty post-acute COVID-19 women suffering from primary menstrual pain. Their body mass index ranged from 25 to 35 kg/m2, and their age was between 18 and 25 years old. They were split up into two groups randomly. The control group (n=15) were instructed to avoid regular physical exercise during the study period, and the exercise group (n=15) were requested to perform set of home-based exercise protocol, from the fourth day of the menstrual cycle till the onset of the second menstrual cycle. Both groups were examined for pain intensity Pre-treatment and post-treatment using visual analogue scale (VAS). Result(s): Menstrual pain intensity was significantly reduced in the exercise group (p=0.000) but not statistically different in the control group (p=0.089). Conclusion(s): Different exercise techniques has a positive impact on menstrual pain severity in post-acute covid-19 women. Therefore, it can be recommended for menstrual pain relief in post-acute covid-19 women to promote their daily activities, independent living and quality of life.Copyright © 2021 Muslim OT et al.

Recurrent intussusception with ileal perforation as a complication of Blue Rubber Bleb Nevus Syndrome in a pediatric patient

Blue rubber bleb nevus syndrome (BRBNS) is a rare congenital condition, characterized by multiple venous malformations that may involve any organ system, most commonly the skin or the gastrointestinal tract. These lesions are often responsible for chronic blood loss and secondary anemia, and in rare situations may cause severe complications such as intussusception, volvulus, and intestinal infarction. Intussusception as a complication of BRBNS, although a known complication of the disease, has rarely been reported, especially in the Philippines. In the Philippine Society for Orphan Disorders, only 2 cases of BRBNS are currently included in the organization, including the patient presented in the case report. The treatment of BRBNS that involves the gastrointestinal tract depends on the extent of intestinal involvement and severity of the disease. The treatment aims to preserve the GI tract as much as possible due to the high recurrence in the disease. In this case report, we present a 13 year-old male with BRBNS with previous history of intussusception, successfully managed conservatively;however, upon recurrence, underwent exploratory laparotomy wherein a subcentimeter perforation in the antimesenteric border of the proximal ileum was noted, together with a gangrenous intussuscipiens, and multiple mulberry-like formations on the antimesenteric border of the small bowels. Histopathological findings of the resected bowels showed multiple cavernous hemangiomas consistent with BRBNS. The postoperative course of the patient was unremarkable.Copyright © 2023 The Authors

Relationship between Pain, Physical Activity, and Quality of Life in Patients with Haemophilia a and Haemophilia B

Introduction: The extended half-life (EHL) registry was established in 2016 to ascertain the long-term outcomes in patients with HaemophiliaA(HA) and B(HB) receiving replacement therapy. The aim was to quantify disease burden and quality of life at baseline and after switching to EHLs. Method(s): The study is a prospective, observational cohort study that enrolled patients switching EHLs or on standard replacement therapy after informed consent following local ethics approval and was registered at www.clinicaltrials.gov (NCT02938156). The study was paused during the COVID pandemic. Here the baseline results are presented for pain, activity and quality of life and their correlations. Pain evaluation was assessed through the brief pain inventory (BPI) 7-day recall, quality of life by EuroQol-5 Dimension (EQ5D5L) and physical activity through the international physical activity questionnaire (IPAQ). The BPI assess severity of pain and the interference with activities. IPAQ assess physical activity undertaken across a comprehensive set of domains. Three levels of physical activity are used to classify the populations: 'low', 'moderate', and ' high'. Result(s): A total of 231 HA and 97 HB were included in the analysis, of whom 231 had switched to EHL products and 96 were on standard replacement therapy. The levels of Physical Activity were similar between Haemophilia types, with approximately 46%, 32% and 22% of patients reporting high, moderate, and low physical activity, respectively. BPI mean (+/-SD) severity score in HA was 2.86 (+/-2.1), HB 3.24 (+/-2.0);interference score HA 3.22 (+/-2.8), HB 3.09 (+/-2.5), mean EQ5D5L visual analogue scale (VAS) for HA 72.92 (+/-15.5) and HB 71.10 (+/-18.2). Within instruments, IPAQ sub-scores and BPI average scores were highly correlated. Between instruments, the strongest linear correlations were seen between theVAS and the BPI scores (R=-0.59, p< 0.0001, n=206 for the average interference score, R=-0.57, p< 0.0001, n=208 for the average pain severity, v.s. the VAS). Correlations between the IPAQ total score and either VAS or BPI scores were weaker, even when limiting to patients with moderate or high activity and using a log scale given the skewed distribution of the IPAQ summary measure. Discussion/Conclusion: The study demonstrates for the first time a strong correlation between pain and quality of life, and weaker correlation between physical activity and quality of life.

Effects of basic body awareness therapy on pain, sleep, quality of life during COVID-19 pandemic -a randomized controlled study

Aim: In this study, we aimed to investigate the effects of the telerehabilitation-based BBAT (Basic Body Awareness Therapy) approach on body awareness, musculoskeletal pain, sleep, and quality of life (QoL) in university students during the COVID-19 social isolation and home quarantine period. Material(s) and Method(s): The study was designed as a randomized controlled trial. A total of 40 university students participated in the study. Patients were divided into two groups: the treatment group who received the BBAT (n=20) and the control group who refused to receive treatment (n=20). BBAT was applied to the treatment group on an online platform for three days a week (60 minutes per session) for six weeks. Pre-and post-treatment self-reported questionnaire data were used. Pain severity was assessed using the McGill Pain Questionnaire (MPQ), sleep quality using the Pittsburg Sleep Quality Index (PSQI), body awareness using the Body Awareness Questionnaire (BAQ), and QoL using the World Health Organization Quality of Life (WHOQoL) questionnaire. Result(s): In the treatment group, there was a statistically significant difference between the participants' pre-treatment and post-treatment scores in MPQ, PSQI and BAQ, as well as in the psychological health, social relationships and environment domains and general health facet of the WHOQoL questionnaire (p<0.05). In the control group, no statistically significant difference was observed between the participants' pre-treatment and post-treatment scores in MPQ, PSQI, BAQ and the psychological health, social relationships and environment domains of the WHOQoL questionnaire (p>0.05). Discussion(s): The telerehabilitation-based BBAT approach is effective for university students' body awareness, musculoskeletal pain, sleep, and quality of life during the ongoing COVID-19 pandemic period.Copyright © 2023, Derman Medical Publishing. All rights reserved.

Evaluation of the pain in COVID-19 patients with musculoskeletal pain: A cross-sectional study

Aim: There is no study that have assessed face-to-face using the multidimensional pain scale in COVID-19 patients with musculoskeletal pain. This study aimed to reveal the pain region, character and severity in COVID-19 patients with musculoskeletal pain. Material(s) and Method(s): This cross-sectional study was carried out in 214 patients who had a positive result of the polymerase chain reaction test within the last five days and at least one musculoskeletal pain symptom, such as fatigue, myalgia, and arthralgia/polyarthralgia. The cases were divided into groups as clinically severe and non-severe. Evaluations were made on the first day of admission. Myalgia symptoms were classified as diffuse and local. The McGill Pain Questionnaire was used for pain regions and caharacters while the Visual Analog Scale (VAS) was for pain intensity. Result(s): The frequency of involvement was myalgia (96.3%), fatigue (77.6%) and polyarthralgia (62.6%), respectively. The diffuse myalgia was (53.3%) in all patients. The mean myalgia VAS score in the non-severe group was 5.88+/-1.83 and 6.25+/-1.24 in the severe group (p=0.192). The most common pain areas were the back, feet, and knees respectively, and throbbing (40.7%), aching (30.8%), and pricking (26.1%) were the most common characteristics. The suffocating character of the pain was significantly higher in the severe group (p<0.05). Discussion(s): Defining disease-specific pain regions, character and severity in COVID-19 patients with musculoskeletal pain is important in managing possible chronic pain.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Pediatric ovarian torsion: A diagnostic challenge in covid-19 times

Ovarian torsion is a rare gynecological emergency in children and an early surgical intervention is needed to salvage the ovary. Herein, we present a case of eight year old girl who presented with complaints of lower abdominal pain during ongoing COVID-19 pandemic. She was diagnosed as a case of ovarian torsion on right side. She underwent exploratory laparotomy and ovarian cystectomy was performed. Delay in diagnosis and treatment of ovarian torsion may have grave consequences, resulting in functional loss of the ovary. Copyright © 2020, Kathmandu University. All rights reserved.

Interdisciplinary chronic pain rehabilitation program modifications for COVID-19: Preliminary evidence regarding dosage and telemedicine

Patients with chronic pain may be disproportionately impacted by the COVID-19 pandemic due, in part, to shared risk factors for both chronic pain and COVID-19 infection. At the same time, the pandemic has increased barriers to participating in interdisciplinary chronic pain rehabilitation programs (ICPRPs). The present study provides preliminary evidence regarding the effects of two ICPRP modifications-reduced program dosage and delivery via telemedicine-designed to increase access during the initial COVID-19 surge but with implications beyond the pandemic. Design(s): Retrospective cohort comparison evaluating pain severity, pain interference, and beliefs relating pain and disability for groups completing 4-week (110-hour) versus 3-week (73-hour) and in-person versus telemedicine ICPRP formats. Subjects: 103 patients who completed an ICPRP at an academic medical center between April 2019 and July 2021. Result(s): The 4-week, in person;3-week, in-person;and 3-week, telemedicine programs were all effective in decreasing pain severity, pain interference, and beliefs relating pain and disability. Compared to the 4-week, in-person version, however, the 3-week, in-person program proved less effective in reducing pain interference and beliefs equating pain with impairment. The 3-week, telemedicine format, in turn, was less effective than the 3-week, in-person version in decreasing beliefs associating pain and disability. Conclusion(s): Decreasing program dosage and offering participation via telemedicine may be viable strategies for increasing access to ICPRPs, but may result in reduced program effectiveness in certain domains. The study's uncontrolled design and small telemedicine group underscore the need for randomized, controlled trials comparing different ICPRP dosages and modalities. Copyright © 2022 Nova Science Publishers, Inc.

INVESTIGATION of the EFFECT of the HISTORY of COVID-19 on COGNITIVE LEVEL, PAIN CATASTROPHIZATION, and PHYSICAL ACTIVITY LEVEL in INDIVIDUALS with CHRONIC LOW BACK and NECK PAIN

Background: Low back and neck pain is one of the most common health problems in society and one of the top reasons for admission to the hospital (1). Studies show that the level of physical activity decreases in individuals with chronic pain, and the cognitive level and quality of life are negatively affected (2). There are studies examining the effects of the Covid-19 pandemic process on the level of physical activity and cognitive level in various groups. However, the number of studies on how the history of Covid-19 affects individuals with low back and neck pain is limited. Objectives: The aim of this study is to examine the effect of Covid-19 history on cognitive level, pain catastrophe and physical activity level in individuals with chronic low back and neck pain in individuals. Methods: A total of 25 individuals with chronic pain, including 16 with low back pain and 9 with neck pain, were included in the study. Demographic data such as age, gender and body mass index (BMI) were obtained from all individuals. The education levels of the individuals were recorded. Cognitive level was assessed by the Montreal Cognitive Assessment (MoCA)[3], pain severity was assessed by the Visual Analog Scale (VAS), pain catastrophization was assessed by the Pain Catastrophizing Scale (PCS)[4], and physical activity level was assessed by the International Physical Activity Questionnaire-Short Form (IPAQ-SF)[5]. Results: Table 1. Demographic data, VAS, MoCA, PCS, and IPAQ-SF scores are given in Table 1. 7 of the participants had history of Covid-19, 18 did not. The MoCA scores and education levels of individuals with Covid-19 were higher than individuals without history of Covid-19 (p<0.05). There was no difference in physical activity, pain and pain catastrophization levels between the 2 groups (p> 0.05). Conclusion: Surprisingly, individuals who had a history of Covid-19 had higher cognitive levels than individuals without a history of Covid-19. In addition, there was no difference between physical activity and pain catastrophization levels. This may be due to the higher education level of individuals with a history of Covid-19. There is a need for further studies in which education levels are similar, and hospitalization and the Covid-19 positivity process are examined in more detail.

MAINTAINING PHYSICAL ACTIVITY DURING COVID-19: THE INFLUENCE OF PSYCHOSOCIAL VARIABLES IN INDIVIDUALS WITH BACK PAIN

Purpose Stressor events, such as COVID-19, may trigger adaptive or maladaptive pain management strategies among individuals with persistent low back pain (LBP). Emerging research shows individuals with lower fear avoidance, depression and anxiety, and greater positive affect and quality of life can better maintain positive pain management strategies during stressor events. For individuals with persistent LBP, physical activity (PA) has been shown to be a beneficial pain management strategy. This study investigated psychosocial variables of individuals with LBP who demonstrated adaptive pain management strategies during COVID-19, indicated by the maintenance of physical activity. Methods Twenty-five individuals with persistent LBP (age 22.4 (3.4) years, 7m, 18f) from an existing longitudinal cohort participated. Participants completed a baseline survey prior to COVID-19. This survey quantified demographics, pain severity, frequency, and duration. Other baseline measures were the Physical Activity Scale, the WHOQOL-Bref physical, psychological, social, and environmental quality of life subscales, Fear Avoidance Beliefs Questionnaire, Hospital Anxiety and Depression Scale, and Trait Affect scale. Participants then completed follow-up surveys for 18 months. During COVID-19 lockdown, the impact of lockdown on PA was assessed. The cohort was dichotomized into individuals reporting the same or more PA (MPA) and those reporting less PA (LPA) and baseline characteristics were compared between groups. Results The LPA group contained 17 individuals and the MPA group contained 8 individuals. There was no significant demographic difference between groups. The MPA group had greater duration of LBP symptoms (p=0.015, d =1.16). The MPA group trended towards higher physical quality of life (p=0.101, d=0.79) and higher environmental quality of life (p=0.057, d=0.96) at baseline. Individuals in the MPA group had lower negative affect (fatigue domain) scores than the LPA group (p=0.038, d=0.86). Depression scores were lower in the MPA group (p=0.006, d=1.12). Conclusions Individuals with persistent LBP who had greater duration of symptoms, better physical and environmental quality of life, lower negative affect, and less depression were more likely to maintain or increase physical activity during COVID-19. These characteristics may facilitate positive adaptation to a stressor event.

VIDEO-TELECARE COLLABORATIVE PAIN MANAGEMENT DURING COVID-19

BACKGROUND: COVID-19 presents a barrier to high-quality treatment for patients with chronic pain receiving long-term opioid therapy (LTOT) as guideline-recommended approaches may be challenging to deliver. We implemented a novel virtual care model, Video-Telecare Collaborative Pain Management (VCPM) harnessing innovative clinical approaches: opioid reassessment and tapering, buprenorphine switch and maintenance, and behavioral pain self-management. The primary aim of this study was to assess the feasibility and acceptability of VCPM. METHODS: VCPM is a multi-component intervention led by clinical pharmacy practitioners (CPPs) supported by a collaborating physician and approved as a quality improvement project by the two participating VA IRBs. Participants were VA patients on LTOT for chronic pain at ≥50 mg morphine equivalent daily dose identified using a VA dashboard. We mailed eligible patients letters describing the program, then called to invite them to schedule a virtual appointment with a CPP. Following a standardized intake, an individualized plan was presented to patients. Interested patients continued virtual follow-up for up to 90 days via video or phone, based on patient preference. We assessed feasibility and acceptability based on 1) enrollment rate, defined as completion of baseline visit;2) retention rate, as indicated by engagement in longitudinal care;3) willingness to trial buprenorphine when recommended;and 4) treatment satisfaction measured at three months post intake. We assessed pain and other measures at 3-month follow up. RESULTS: Of 133 patients contacted, 44 completed an initial CPP visit (33%) and 19 engaged in longitudinal care with VCPM (14%). Of those who engaged in VPCM, 11 trialed buprenorphine (58%), 7 reduced their opioid dose (37%), and 1 was lost to follow up. 32/44 patients (73%) completed the 3-month survey. Patients endorsed high satisfaction with both video (M = 4.3/5) and phone visits (M = 4.0/5). Patients who engaged viewed VCPM as successful (M = 7.0/10) and would recommend (M = 7.6/10). Patients who attended multiple VCPM visits (n = 16), compared to one visit, generally reported lower pain intensity (6.1/10 vs. 7.1), pain interference with enjoyment of life (6.0/10 vs 8.3) and general activities (5.9/10 vs 7.3), reported higher quality of patient-provider interaction (70.2/75 vs 64.1), and were more likely to report that their pain severity had improved compared to 3 months ago (44% vs 19%). CONCLUSIONS: Results partially supported feasibility and acceptability of VCPM. Enrollment rates were low, perhaps due to recruitment strategies;we are exploring peer outreach. Enrolled patients were satisfied and showed potential improvements in pain-related functioning. Refining recruitment approaches and larger effectiveness trials are underway.

EFFECT of COVID-19 PANDEMIC on PATIENTS with TEMPOROMANDIBULAR DISORDERS over TWO-YEAR PERIOD

Introduction: The impact of Covid-19 on musculoskeletal problems is still under investigation. The effect of stress caused by lockdown and pandemic may exacerbate existing symptoms of temporomandibular disorders (TMD), painful masticatory system disorders. This study's aim was to investigate the somatic and psychological effects a two-year pandemic might have on individuals diagnosed with TMD. Materials and methods: A total of 186 TMD patients were contacted through email to take part in an online survey. The survey, created using Google forms, comprised of 20 questions on the long-term impact of the pandemic on present and/or new TMD-related symptoms, oral behavioral habits, other bodily pains, anxiety, depression and temporomandibular pain severity. Statistics included chi-square test and Spearman's correlation. Results: The response rate was 63.98%;57.98% of individuals were infected with COVID-19, and 73.94% said they had been vaccinated at least once. In a two-year period, 40.33% participants developed new TMD-related symptoms or their symptoms deteriorated. New symptoms (headache, difficulty while opening, other bodily pains, depressive symptoms) correlated with temporomandibular joint discomfort, while new symptoms (headaches, grinding, insomnia) correlated with masticatory muscle discomfort (p<0.05). There was no difference in the number of patients who developed new symptoms or developed deterioration of existing symptoms between those who had been infected with COVD-19 or had been vaccinated and those who hadn't been infected with COVID-19 or hadn't been vaccinated. (p>0.05). Patients experiencing anxiety more often reported other bodily pains (p=0.005) and headaches (p=0.002). Other bodily pains were more common in those experiencing depressive symptoms (p<0.001). Conclusion: Majority of somatic difficulties that emerged throughout pandemic, such as orofacial pain, might be attributed to a psychological response to stress rather than to COVID-19 infection or vaccination.

PREVALENCE AND BURDEN OF ILLNESS OF ROME IV IRRITABLE BOWEL SYNDROME IN THE U.S

Introduction: Rome IV irritable bowel syndrome (IBS) is characterized by abdominal pain and altered bowel habits, and meta-analysis reveals a global prevalence of 3.8%. Using data from the “National GI Survey II”—a nationwide audit of gastrointestinal (GI) symptoms in nearly 90,000 adult Americans—we aimed to determine the prevalence, burden of illness, and healthcare seeking behavior of those who met Rome IV IBS criteria. Methods: We conducted the National GI Survey II from 5/3-6/24/20, a period coinciding with the peak of the initial COVID-19 wave in the U.S. A representative adult sample based on U.S. Census age, sex, and region data was recruited. The self-administered survey guided participants through the Rome IV IBS questionnaire, NIH GI PROMIS symptom scales, and questions on comorbidities and demographics. A primary outcome was prevalence of IBS based on Rome IV criteria;we also determined the presence and severity of non-cardinal IBS symptoms and healthcare seeking for abdominal pain, constipation, or diarrhea in those with IBS. We used multivariable logistic regression to adjust for confounding variables. Results: Of the 88,969 individuals who completed the survey, 6,543 (7.4%) met Rome IV IBS criteria: mixed IBS (IBS-M), 34.0%;IBS with constipation (IBS-C), 32.1%;IBS with diarrhea (IBS-D), 29.6%;unsubtyped IBS, 4.4%. Females, non-Hispanic Whites, and those 30-49yo and with comorbidities (e.g., prior gastroenteritis, fibromyalgia, inflammatory bowel disease) had statistically higher odds for meeting Rome IV IBS criteria (all p<.001). Differences in pain severity, as measured by PROMIS, were not evident among the subtypes (p>.05). Table 1 presents the presence and severity of symptoms beyond the cardinal IBS symptoms;those with IBS-D or IBS-M were more likely to report excess gas, heartburn, regurgitation, nausea/vomiting, pelvic pain, or bowel incontinence vs. those with IBS-C, but symptom severity scores were largely similar among groups. Those with IBS reported the following healthcare seeking behaviors for their cardinal IBS symptoms: ever sought care, 73.8%;ever sought care via telehealth, 19.4%;sought care in past 12 months, 59.7%. Table 2 presents the healthcare seeking data stratified by subtype;those with IBS-D and IBS-M were less likely to have sought care vs. those with IBS-C. Discussion: In this nationwide U.S. survey, we found that Rome IV-positive IBS is more prevalent (7.4%) vs. prior estimates. Additional research is needed to understand if this higher prevalence is in part due to the COVID-19 pandemic, as social distancing may have levied a psychological toll on many individuals, leading to alterations in the gut-brain axis and a propensity to develop IBS or gain greater awareness of symptoms. We also noted that people with IBS commonly experience other symptoms on top of their cardinal IBS symptoms.(Table presented) (Table presented)