Effect of effleurage massage therapy on sleep disturbance, fatigue, pain, and anxiety in patients with multiple sclerosis: A quasi-experimental study.

BACKGROUND: Fatigue, pain, sleep disturbance, and anxiety are prevalent symptoms of multiple sclerosis (MS) and frequent complaints in MS patients, which reduce their quality of life. Many studies have shown that massage therapy improves MS patients' symptoms. However, the effect of effleurage massage on sleep disturbance, fatigue, pain, and anxiety in patients with MS is not studied in Egypt. AIM: To examine the effect of Effleurage massage therapy on sleep disturbance, fatigue, pain, and anxiety in patients with multiple sclerosis (MS). METHODS: This research study has a quasi-experimental design, with control and intervention groups, and pre and post-tests conducted at the multiple sclerosis in-patient clinic at one Egyptian hospital between May 2019 and January 2020. Sixty adult female patients with MS were recruited, with 30 patients in the control group and 30 in the intervention group. The intervention group received Effleurage massage therapy intervention three times a week for two weeks, and each session lasted about 20 min. Patients in the control group received routine hospital care. Data were collected using the patient's demographic and medical data sheet, Insomnia Severity Index, Modified Fatigue Impact Scale, Numeric Pain Rating Scale, and Beck Anxiety Inventory before and after the intervention. RESULTS: Significant improvement was observed in pain, sleep, fatigue, and anxiety in the massage group (P < 0.001). CONCLUSION: Based on the current study, Effleurage massage intervention for MS patients could have possible clinical value for improving sleep disturbance, palliating pain, fatigue, and reducing anxiety. Egyptian nurses can integrate massage therapy into the routine nursing care of patients with MS. Effleurage massage could be an adjunct treatment modality for MS patients; however, more significant studies are needed.

Comparison of three embolic materials at partial splenic artery embolization for hypersplenism: clinical, laboratory, and radiological outcomes.

PURPOSE: To compare effectiveness of three widely used embolic agents in partial splenic embolization (PSE) by analyzing their clinical, laboratory, and radiological outcomes within one year of follow-up. MATERIALS AND METHODS: This retrospective study examined 179 patients who underwent PSE to manage hypersplenism secondary to cirrhosis. Patients were divided into 3 groups according to embolic agent used. Group 1 (gelatin sponge) included 65 patients, group 2 (embospheres) included 58 patients, and group 3 (PVA) included 56 patients. Clinical, laboratory, and radiological outcomes were compared between groups. RESULTS: The technical success rate was 100% in all groups. Pain as a major complication was lower in the gelatin sponge group (20%) compared to the embosphere group (31%) and PVA group (32.3%). Major complications other than pain were found in 20.1%; 24.6% in gelatin sponge group, 15.5% in embosphere group and 19.6% in PVA group (p = 0.045). WBCs and platelet counts showed a significant increase after PSE in all groups. Entire splenic volume as measured by computed tomography after PSE showed no significant difference among the 3 groups; however, the volume of infarcted spleen was significantly lower in the gelatin sponge group compared to other two groups (p = 0.001). The splenic span was significantly reduced one-year post-procedure in three groups (p = 0.006), and it was significantly less in embosphere and PVA groups compared to gelatin sponge group (p < 0.05). Recurrent bleeding was higher in gelatin sponge group (p < 0.05). CONCLUSIONS: Permanent embolic materials achieved better laboratory and radiological outcomes than gelatin sponge particles in PSE of cirrhotic hypersplenism patients. However, permanent particles were associated with greater abdominal pain.

The effect of cryotherapy application before versus after subcutaneous anticoagulant injection on pain intensity and hematoma formation: A quasi-experimental design.

OBJECTIVE: To investigate the effect of cryotherapy application before versus after subcutaneous anticoagulant injection (SCAI) on pain intensity and hematoma formation. METHODS: A quasi-experimental design was utilized. A convenient sample of 105 adult patients, who were admitted to one of the biggest teaching hospitals in Cairo and receiving SCAI, were recruited over a period of six months. Patients were randomly allocated into three groups: A Control group who received the routine hospital care (G1,n = 35) and two intervention group who received cryotherapy for 5-min (G2: cryotherapy applied before SCAI, n = 35; G3: cryotherapy applied after SCAI, n = 35). Demographic and medical history data sheet, Pain Numeric Rating Scale and Hematoma Formation and Size Assessment Scale were used to collect the data. RESULTS: The pain intensity among the patients in the two intervention groups (G2: Median = 1.0; G3: Median = 0) was significantly lower than in the control group (G1, Median = 3.0). No significant difference was found between G2 and G3(P = 0.728). Applying cryotherapy after SCAI (G3) decreased the frequency of hematoma formation (48hrs = 31.4% & 72hrs = 28.5%) compared to applying it before injection (G2, 100%) or not applying it (G1, 100%). The size of hematoma in G3 was smaller than that in G2 (P < 0.01). CONCLUSION: Applying cryotherapy significantly decreased pain intensity and hematoma occurrence/size. Applying cryotherapy after injection was more effective in preventing hematoma formation and decreasing its size than applying it before injection.