Search

Objectives: Wounds may occur in the mouth during orthodontic treatment. Orthodontists use a variety of substances to eliminate the irritation. This randomized clinical trial aimed to examine the effect of orthodontic wax and ora-aid material on wound healing, the duration of staying in the mouth, and the effect on pain and to evaluate the effect on the patient’s quality of life. Materials and methods: The study included two hundred forty patients aged 11–14 years. At the end of 1 week, patients with no wound were determined as the control group G1(n:65), patients using Ormco orthodontic wax as G2(n:86), and patients using Ora-aid as G3(n:89). The patients were asked to fill out the questionnaire given to them five times in total, as T0 when the wound occurred, T1 after 24 h, T2 after 48 h, T3 after 96 h, and T4 after 168 h. Results: The study’s results demonstrated no significant differences in the level of pain between males and females. For all post-baseline time points, the Ora aid group had a lower VAS for pain when compared with the Ormco orthodontic wax group (P < 0.01). Conclusions: This study demonstrated that ora-aid effectively reduces the mucosal discomfort associated with orthodontic appliances, and this product may be a suitable alternative to traditional orthodontic wax material for dealing with oral mucosal injuries during orthodontic treatment. Clinical Relevance: This product may be a suitable alternative to traditional orthodontic wax material for dealing with oral mucosal injuries during orthodontic treatment. [ABSTRACT FROM AUTHOR]

Objectives: Platelet concentrates are biomaterials with significant potential in tissue regeneration, functioning as scaffolds with greater leukocyte inclusion and a flexible fibrin mesh. However these concentrates have different preparation methods and biological properties. The objective of this clinical investigation was to evaluate the effects of utilizing platelet-rich fibrin (PRF) materials (L-PRF and A-PRF) as a palatal bandage following free gingival graft (FGG) on patients' morbidity and oral health-related quality of life. Materials and methods: Thirty-nine participants received FGG to promote keratinized tissue and treat gingival recession. Participants were randomly assigned to L-PRF, A-PRF, and control groups, with 13 participants in each. They used a visual analog scale (VAS) to rate their pain, analgesic medication use, dietary changes, discomfort, and bleeding at 1–7 days, 14 days and 1 month during the healing process. Patients' quality of life was assessed using the Oral Health Impact Profile (OHIP-14) at baseline, 1–7 days, 14 days, 1 month, and 6 months. Results: There was no difference in anxiety levels between the all groups. (p > 0.05). The control group had higher OHIP-14 total scores than the other groups, but the differences were not statistically significant, especially in the first seven days (p > 0.05). In addition, the PRF groups showed an improvement in quality of life after 14 days, 1 month, and 6 months (p < 0.05). Patients' pain and suffering decreased with healing. The control group took more postoperative analgesics than PRF groups. In addition, there was a significant decrease in patient complaints about medicine intake, bleeding, pain, perceived sensitivity, and dietary modifications in all groups during follow-up. Conclusions: PRF palatal bandages may improve patient's quality of life, donor site healing, postoperative pain and morbidity. Clinical relevance: This study found that preserving the palate in FGG and employing PRF materials that speed palate healing reduce discomfort and morbidity. [ABSTRACT FROM AUTHOR]

Patients with locally advanced breast cancer post-mastectomy complain of shoulder pain and restricted shoulder movement. The role of suprascapular nerve block (SSNB) in such patients needs to be explained as it may help in improving their quality of life along with pain relief. This study aims to evaluate the effect of ultrasound-guided suprascapular nerve block (SSNB) in improving shoulder motion and pain following surgery and compare its effect with exercise group. This study is a randomized controlled trial. Forty-eight patients were enrolled in the study who were referred from the endocrine surgery department, and they were randomized into two groups. Group A underwent ultrasound-guided (USG-guided) SSNB and Group B underwent an exercise program only. Each group had 24 patients who complained of pain and restricted shoulder range of motion (ROM). The outcome measures were assessed using the Mann–Whitney test for visual analog score and unpaired t-test for shoulder ROM and Quick Disabilities of Arm, Shoulder, and Hand (Q-DASH) questionnaire score. All patients (n = 48) had modified radical mastectomy. The mean age was 44 ± 9.44 years and all were female gender. The improvement was noted in both the groups, but in intergroup comparison, Group A patients had significant improvement in VAS, Q-DASH score, shoulder flexion, and abduction immediately and at the 4th week follow-up (p = 0.001). No adverse effect was reported. A small sample size and no blinding reduce the strength of the study. USG-guided SSNB in post-mastectomy patients is proven to be an effective, safe, and economically accepted treatment for low-resource countries like India. [ABSTRACT FROM AUTHOR]

Background: Tourniquets are used during total knee arthroplasty for better surgical fields and improved cementation. The functional benefits of tourniquet application for limited periods compared with total duration applications during total knee joint arthroplasty (TKA) surgery have not been well explored.Aim of the study: To evaluate and compare the outcomes of limited use of a tourniquet (LT) for a shorter duration (just before cement application) with total use of a tourniquet (TT) for a longer duration (from skin incision to the completion of surgery).Patients and method: A sum of 100 patients who undertook primary total knee arthroplasty were involved in this study, they were allocated randomly into two groups according to whether a limited or total tourniquet was used during the surgery. Both groups underwent the same surgical procedures with a digital tourniquet applied to all patients using the same technique. Intraoperative and postoperative assessment of blood loss, knee functional society score (KSS), visual analogue score (VAS) for thigh pain and knee pain evaluation, surgical complications like deep vein thrombosis (DVT), wound infections and nerve injuries are the main factors evaluated in the study.Results: Patients with LT required more intraoperative blood transfusion compared with those with TT who required more blood transfusion postoperatively. There were no significant differences in KSS, VAS for thigh pain and knee pain evaluation, and surgical complications like DVT, wound infections and nerve injuries.Conclusion: Limited tourniquet application from starting of cementing is associated with a higher need for intraoperative blood transfusion, but the use of a TT throughout surgery is associated with a higher need for postoperative blood transfusion. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the efficacy and safety of mepolizumab in the treatment of severe uncontrolled CRSwNP with or without comorbid asthma in a real-life setting over the first six months of therapy. Methods: A total of 45 patients with nasal polyps with or without comorbid asthma were treated with mepolizumab (100 mg q4w) for 6 months. The following outcomes were assessed before therapy (V0), and after 6 months (V1): endoscopic nasal polyp score (NPS), nasal congestion score (NCS), sinonasal outcome test (SNOT-22), visual analog scale (VAS), nasal flow rate (PNIF), olfactory test (SS-I), and asthma control test (ACT). Blood eosinophil count, oral steroid intake, and rescue surgery were also measured. Results: We found a statistically significant improvement in NPS, NCS, SNOT-22, overall VAS, PNIF, SS-I, and ACT. In addition, we observed a decrease in blood eosinophils count. Mepolizumab was well tolerated, and no patients interrupted the treatment during the follow up. Conclusions: Our real-life study confirmed the efficacy and tolerance of mepolizumab prescribed for CRSwNP with or without asthma. The safety profile of mepolizumab was consistent with previous reports. [ABSTRACT FROM AUTHOR]

Previous research has identified a specific subtype known as failure of pelvic compensation (FPC) in patients with adult spinal deformity (ASD). However, the criteria for assessing FPC remain inconsistent, and its impacts on spinal sagittal alignment and health-related quality-of-life (HRQoL) scores remain unclear. To propose a novel criterion for identifying FPC based on variations in spinopelvic alignment during the transition from the supine to upright position and to evaluate the effects of FPC on patients' spinal sagittal alignment and HRQoL scores. Retrospective cross-sectional study. Patients with ASD from a monocenter database. Radiographic measures, including thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic tilt, pelvic incidence (PI), and sagittal vertical axis (SVA), were measured on lateral whole-spine radiographs. LL and SS were also measured on reconstructed lumbar computed tomography images in the sagittal view taken in the supine position. The relative functional cross-sectional area (rFCSA) of paraspinal muscles was evaluated via lumbar magnetic resonance imaging. HRQoL measures, encompassing visual analog scale for back pain (VAS-BP), Oswestry Disability Index (ODI), and Scoliosis Research Society-22R (SRS-22R), were collected. A total of 154 patients were enrolled. Based on the calculated minimum detectable change of SS, FPC was defined as the change in SS of less than 3.4° between supine and upright positions. Patients were divided into 3 groups: sagittal balance with pelvic compensation (SI-PC), sagittal imbalance with pelvic compensation (SI-PC), and sagittal imbalance with failure of pelvic compensation (SI-FPC). Radiographic parameters and HRQoL scores were compared among the groups. Thirty-six patients were categorized into the SB-PC group, 87 into the SI-PC group, and 31 into the SI-FPC group. Patients with low PI and small paraspinal muscles rFCSA were more prone to experiencing FPC accompanied by severe sagittal imbalance. The SI-FPC group exhibited less TK and a larger SS than the SI-PC group exhibited and had a similar SVA as that of the SI-PC group. Additionally, they displayed worse VAS-BP, ODI, SRS-function, and SRS-22 total scores than the SB-PC group displayed. In patients with ASD, an inherently low pelvic compensatory reserve and a high fatty infiltration in paraspinal muscles are pivotal factors contributing to FPC. Compared with SI-PC patients, SI-FPC patients demonstrate a thoracic-dominant compensatory pattern for sagittal malalignment. In addition, these patients experienced more severe pain and functional decline than the SB-PC patients experienced. [ABSTRACT FROM AUTHOR]

Background: Oral lichen planus (OLP) is a chronic inflammatory disease associated with the formation of symptomatic lesions in the mouth. P63 is essential for epidermal development and regeneration. Weak expression of this protein has been shown in OLP lesions. Photobiomodulation (PBM) therapy has been reported to reduce OLP symptoms, but its ability to correct the molecular perturbations of the disease has not been studied. This study aimed to evaluate the efficacy of PBM in OLP treatment by evaluating changes in p63 expression and their association with clinical response. Methods: Twenty OLP patients underwent PBM with a diode laser (810 nm), (0.50 W, 30 s, 1.2 J/cm2), 3 times weekly for a month. The treatment efficacy index (EI) was calculated based on pain-level values and clinical scores of lesions before and after therapy. Biopsies were taken before and after therapy, analyzed immunohistochemically for p63 expression, and compared with 10 healthy controls. Results: P63 levels in OLP lesions were significantly lower than those in normal oral mucosa. After treatment, the pain level and clinical scores of the lesions decreased significantly. The calculated EI showed PBM effectiveness in 90% of cases. Increased p63 positivity and staining intensity were observed after therapy. Conclusions: The established p63 deficiency in OLP lesions is likely an important molecular mechanism in the pathogenesis of the disease. Laser irradiation at 810 nm increased p63 expression to a level close to that found in the healthy epithelium and significantly improved the symptoms and clinical signs of OLP. All of this determines the effectiveness of PBM therapy in the management of OLP. [ABSTRACT FROM AUTHOR]

The temporal bisection task has long been used to study time perception as well as measure individual differences in time perception ability. The task involves training participants on short and long reference durations before presenting intermediate durations and asking participants to classify them as ‘short’ or ‘long’. However, there is little information about how well the bisection task measures individual differences in timing ability. To bridge this gap, we assessed the psychometric properties of measures obtained from a classic temporal bisection task: Weber ratio and percent correct. Because measures with binary responses tend to require many trials to reach adequate reliability, we also assessed the psychometric properties of a modified bisection task which used a continuous response format. In this task, participants represented intermediate durations on a visual analogue scale. Estimation error was used as the outcome measure. Participants (n = 46) completed the classic and modified bisection tasks twice across two sessions approximately one week apart. The modified bisection task had excellent internal consistency and test–retest reliability, while the classic task had fair to good internal consistency and good test–retest reliability. Overall, estimation error had the highest reliability, followed by percent correct, and then Weber ratio. In terms of validity, there was excellent convergent validity between the classic and modified bisection tasks. As an exploratory analysis, we assessed how the number of trials affected the reliability of each outcome measure across the two tasks. Based on this, we make recommendations on how to optimize reliability for both tasks in future research. [ABSTRACT FROM AUTHOR]

Background: Pain remains a significant challenge for cancer patients. Upper abdominal cancer patients often experience severe visceral pain, profoundly impacting their quality of life. In such cases, minimally invasive pain interventions like celiac plexus neurolysis may be necessary to alleviate the debilitating pain and improve overall wellbeing. Objective: Our study aimed to evaluate the effectiveness of various volumes of 70% alcohol (40 ml, 30 ml, 20 ml) for neurolytic celiac plexus block in alleviating pain associated with upper abdominal tumors. Patients and Methods: at the Anesthesia, ICU and Pain Management Department of Al Menoufia University Hospital, and the Pain Therapy Unit at Tanta Cancer Center, spanning one year. Ninety patients of both sexes who were suffering from non-resectable upper abdominal tumors were enrolled in the study. Results: Visual Analog Scale (VAS) scores exhibited a significant decrease for 12 months in all groups with the degree of relief being directly proportional to the volume of the neurolytic agent. Additionally, there was a noteworthy reduction in tramadol requirements observed up to 12 months in both Group I and group II, and up to 5 months only for Group III. Furthermore, Quality of Life Questionnaire-Core 30 (QLQ-C30) scores were markedly decreased in Group III compared to other two groups, but it was better in group I than in group II from 4th month onward. Conclusion: Administration of 40 ml and 30 ml of 70% alcohol yielded significant outcomes compared to the use of 20 ml of 70% alcohol. Furthermore, the use of 40 ml of 70% alcohol demonstrated superior results when compared to 30 ml in terms of the duration of pain relief, opioid consumption, and overall QOL improvement. [ABSTRACT FROM AUTHOR]

Background: Knee osteoarthritis (OA) affects approximately 260 million people worldwide and is a common cause of disability. Effective and safe medical treatments are needed. Currently, no approved disease-modifying drugs exist, and non-operative therapies are associated with only small to moderate benefits and may have serious adverse effects. Platelet-rich plasma (PRP) is a safe autologous blood product containing high levels of growth factors and cytokines with potential to alter biological processes implicated in OA pathogenesis and symptoms. Objective: The aim of this study is to determine the clinical efficacy of Intraarticular PRP injection in early osteoarthritis of knee joint. Materials and Methods: A prospective, single blinded, randomized control trial in 100 Patients of Karnataka Medical College & Research Institute, Hubballi with early (Grade 1 and 2 Kellgren-Lawrence classification) osteoarthritis of knee joint in patients between 40 - 65 years of age treated with platelet rich plasma injection. Demographic data, history, Clinical examination and details of investigations will be recorded in the study proforma. Results: Intraarticular PRP was injected into 100 patients. The most common age group involved in study is 56-60 years (28%) with 54 (54%) patients were male and M:F ratio of 1.17. There is a statistically significant difference between the mean values of VAS, KOOS, WOMAC and OK Scores at 6 months compared to baseline scores without any serious adverse effect. Conclusion: The outcomes of this study showed that the use of PRP injections for treating OA (Grade 1 and 2 Kellgren-Lawrence classification) were shown to be successful in terms of improving functional results and diminishing pain intensity. PRP holds a promising, effective, better solution in the management in OA knee. [ABSTRACT FROM AUTHOR]

Our study examined whether bupivacaine and steroid injections followed by Radiofrequency Thermocoagulation (RFT) improved symptoms among coccydynia patients. The Ganglion Impar Block (GIB) treatment of eight patients with coccydynia in our neurosurgery clinic was reviewed. A retrospective analysis of demographics, pain causes, X-ray results, types of invasive procedures, and Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores was performed. VAS and ODI scores were recorded before the procedure, the first day after the procedure, and three months after the procedure. The study included five females (62.5%) and three males (27.5%). The mean age of the patients was 4 0.5 ± 10.6 years, and the mean BMI was 26.21 ± 4.2 kg/m². Two patients had idiopathic neuralgia, two had trauma -related neuralgia, two had post-herpetic neuralgia, and one patient had persistent pain following previous anorectal surgery and S2 perineural c ystrelated pain. There was a significant improvement in both VAS [2.5 (range: 1 -4)] and ODI scores [4 (range: 0-34)] on the first day after the procedure (p<0.001). These low scores were maintained at the third month [VAS: 1.5 (range: 1 -10) and ODI: 1 (range: 0-78)]. In only one patient, excision of the coccyx was planned due to inadequate pain relief. In patients with coccydynia, bupivacaine and steroid injections followed by RFT provide satisfactory long -term analgesia, as evidenced by decreased VAS and ODI scores. [ABSTRACT FROM AUTHOR]

To determine the association of adenoid hypertrophy with allergic rhinitis in pediatric patients based on Simplified Visual Analog Scale and serum IgE levels. The present study was conducted in our tertiary care centre on 130 patients planned for adenoidectomy from May 2022 to June 2023. Children were divided into two groups based on IgE levels and Allergic history- Group I: who had raised immunoglobulin E levels with allergic rhinitis (according to ARIA guidelines) before adenoidectomy (n = 69) and Group II: who had normal immunoglobulin E levels pre-operatively (n = 72). VAS scoring was done in both groups and compared pre and post operatively. In our study it was found that the adenoid volume was more in patients with allergic history and increased IgE levels as compared to those with normal IgE levels (p < 0.05) pre-operatively. Also, the difference between pre-operative VAS score among Group I and Group II was statistically significant (p = 0.046). Also, the difference between postoperative VAS score among Group I and group II was also statistically significant (p = 0.043). There was statistically significant higher change in VAS score in Group II post-operatively (p = 0.027). sOur study demonstrates that children with allergic rhinitis tend to present earlier with symptoms of adenoid hypertrophy. In addition, children without allergic history show better post-operative VAS scores as the allergic component still prevails in children with allergic history. [ABSTRACT FROM AUTHOR]

Background: Dorsal ramus medial branch radiofrequency ablation is reported to be effective for refractory lumbar facet joint syndrome. However, as nerve fibers can regenerate, the therapeutic effect was reported to be short and last only 6 to 12 months. Previously, we reported a novel endoscopic joint capsule and articular process excision procedure. In that case, a satisfying effect was achieved by removing the culprit hyperplastic articular synovial entrapped in the joint space endoscopically. We presume this treatment is an etiologic treatment and can exert longer-term efficacy. Aim: This retrospective clinical trial aimed to elucidate the longer-term efficacy as well as the safety profile of the procedure. Methods: This was a retrospective descriptive study. The participants underwent endoscopic joint capsule and articular process excision procedures. The Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) before the operation, and at 3 months, 6 months, 1 year, and 2 years post-operation were recorded by reviewing medical charts and conducting telephone interviews. Results: A total of 234 participants were evaluated in the trial. After participant screening, 13 participants were included in the final analysis. The VAS score was reduced from (median (P25, P75)) 6 (4.5, 6) at pre-operation to 2 (0, 4) at 1-year post-operation and 0 (0, 1) at 2-year pre-operation. The ODI score was reduced from 37.78 (27.09, 59.95) at pre-operation to 8.89 (2.22, 24.34) at 1-year post-operation and 6 (0.02, 11.11) at 2-year post-operation. The difference was statistically significant. Further subgroup analysis demonstrated that a narrowed intervertebral space was a possible relevant factor for poor outcomes. No procedure-related complications were reported. Conclusion: Endoscopic joint capsule and articular process excision is an effective and safe procedure for refractory lumbar facet joint syndrome. The effectiveness duration can last up to 1 to 2 years. [ABSTRACT FROM AUTHOR]

Recently, as mask-wearing has become a common practice and interest in oral care has increased, more and more people have become concerned about their own halitosis. The causative agents of halitosis are volatile sulfur compounds (hydrogen sulfide, methyl mercaptan, and dimethyl sulfide), which are produced mainly by the metabolism of oral waste by anaerobic bacteria in the oral cavity. Many of their production sites are the accumulated tongue coating. Persimmon tannins are polyphenol compounds with a chemical structure consisting of four types of catechin molecules (epicatechin, epigallocatechin, epicatechin gallate, and epigallocatechin gallate) contained in persimmon (Diospyros kaki Thumb.) fruit and have been reported to have a variety of functions. It has been previously shown that a 1% aqueous solution of PANCIL® PS-M, which is mainly composed of persimmon tannin, significantly reduces these volatile sulfur compounds (VSCs) in the exhaled breath 10 minutes after swallowing. In this study, chewable tablets containing PANCIL® PS-M were prepared, and a blinded evaluation of the amount of tongue coating, concentration of volatile sulfide compounds, number of oral bacteria, and subjective indices using a visual analog scale (VAS) was performed in participants after 4 and 8 weeks of chewable tablet intake. The aim of demonstrate the effectiveness of this product in controlling halitosis. The results showed that ingestion of PANCIL® PS-M-contaiiiing chewable tablets suppressed VSC production in the exhaled breath continuously after 8 weeks, and effectively reduced the amount of tongue coating, with the effect being felt by the participants. This indicates that PANCIL® PS-M-containing chewable tablets are effective in controlling halitosis. [ABSTRACT FROM AUTHOR]

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Agri: Journal of the Turkish Society of Algology / Türk Algoloji (Ağrı) Derneği'nin Yayın Organıdır is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate short-term clinical efficacy of autologous leukocyte-poor platelet-rich plasma(LP-PRP) treatment of knee osteoarthritis(KOA). Methods 85 cases of patients with Keligren Lawrence grade Ⅰ-Ⅲ knee osteoarthritis in Peking University First Hospital Taiyuan Hospital (Taiyuan Central Hospital) from 2022 to 2023 were collected for autologous LP-PRP collection and quality assessment using a blood component separator, and all patients were treated with autologous LP-PRP. The degree and function of knee pain were assessed by visual analog scale(VAS) and knee arthritis index scale(WOMAC) at 1, 3 and 6 months after injection. Knee MRI was performed after 6 months of treatment, and the MRI imaging changes before and after treatment were compared. Different influencing factors in the treatment results were grouped and analyzed, mainly including platelet concentration in LP-PRP and K-L grading of knee joint. According to the platelet concentration in LP-PRP, it was divided into three grades, which are low concentration[(1 000)×109/L]; According to the K-L grade of the knee joint, the severity of knee osteoarthritis was divided into three grades: Ⅰ、Ⅱ、Ⅲ. Results The VAS and WOMAC scores at 1, 3 and 6 months after LP-PRP treatment were significantly lower than those before treatment, and the difference was statistically significant (P

Abstract Objective This study aimed to compare the impact of case-based learning (CBL) versus lecture-based learning (LBL) on dental students' clinical decision-making regarding DF severity using Visual Analog Scale (VAS) scoring. Methods Eighty first-year graduate dental students were randomly assigned to either the CBL (n = 38) or LBL (n = 42) groups. Both groups received instruction on DF diagnosis, with CBL involving small group sessions analyzing real cases and LBL involving traditional lectures. Effectiveness was assessed by presenting 32 dental fluorosis cases with Thylstrup-Fejerskov Index (TSIF) scores ranging from 0 to 7 through slide presentations to both groups for VAS assessment. Five evaluators of each group randomly selected were asked to repeat the rating 2 weeks later. Statistical analysis included two-way ANOVA for group and gender differences, intra-class correlation coefficient (ICC) for reliability, and Spearman correlation coefficients for validity. Results Variations in VAS scores were observed between CBL and LBL groups, with no significant gender impact. Excellent inter- and intra-evaluator agreement was found for VAS scoring in both groups, indicating its reliability. Validation against established indices (such as DI and TSIF) demonstrated strong correlations, with CBL students exhibiting higher correlations. Conclusions CBL enhances students' clinical decision-making and proficiency in DF diagnosis, as evidenced by more consistent and accurate VAS scoring compared to LBL. These findings highlight the importance of innovative educational strategies in dental curricula, with implications for improving training quality and clinical outcomes. Trial registration: The study was registered at the Clinical Research Center, Hospital of Stomatology, Wuhan University (Registration code: HGGC-036).

Objective: To assess the treatment efficacy of dienogest specifically in the Taiwanese population with endometriosis. Materials and Methods: Eighty-eight patients diagnosed with endometriosis receiving at least 3 months of dienogest 2 mg once daily, from January 2018 to June 2022, were enrolled. They were divided into two groups: surgery group and non-surgery group. The assessment of pain improvement was based on visual analog scale (VAS) scores (0–100 mm) recorded at 0, 3, 6, and 12 months following the initiation of dienogest. Serum CA-125 value and ovarian endometrioma size were analyzed at 0 and 6 months. Results: A total of 65 patients with endometriosis presented painful symptoms. In the surgery group (N = 28), the initial VAS score was 47.5 mm, which significantly declined to 9.6 mm at 3 months (p

The plantar heel pain is very common complaint that causes significant discomfort. Plantar fasciitis is due to degenerative change of the plantar fascia at attachment site. Corticosteroids and autologous PRP injections are effective in the treatment of plantar fasciitis. We compared the local corticosteroid (methyl prednisolone acetate) injection and platelet-richplasma in terms of patient outcome in chronic plantar fasciitis. Materials and methods: The study was conducted at Pain clinic and in Department of Orthopaedics, Government District hospital Chitradurga, Karnataka from November 2022 to October 2023. Forty patients were enrolled in this study. The patients were selected randomly and were divided in two groups of 20 patients each (PRP and Steroid groups). Follow up done at 2 weeks, 6 weeks, 3 months and 6 months. Results: Significant pain relief after 6 weeks of platelet rich plasma therapy and after at 3 months and 6 months follow up. Significant improvement in both groups with respect to AOFAS score and VAS scores. This improvement was significantly more in PRP group. Conclusion: PRP injection is more effective in resulting pain relief and function as compared to corticosteroid injection in the treatment of plantar fasciitis. [ABSTRACT FROM AUTHOR]

• Dienogest led to a significant reduction in visual analogue scale score compared with the levonorgestrel intrauterine system (LNG-IUS). • Dienogest reduced uterine volume significantly compared with LNG-IUS. • The occurrence of side effects was comparable in the dienogest and LNG-IUS groups. Adenomyosis is a gynaecological lesion that impairs female fertility and contributes to reduced quality of life. There are several surgical and medical options for the management of this lesion; however, women who wish to conceive opt for medical therapies such as the levonorgestrel intrauterine device (LNG-IUS) and dienogest, which have various outcomes. To date, there is no consensus regarding which is more effective. To compare the effectiveness of LNG-IUS and dienogest for the management of adenomyosis, and explore the risk of occurrence of known side effects for both treatments. Design: Systematic review and meta -analysis exploring the effectiveness of LNG-IUS and dienogest for the management of adenomyosis. A literature search was conducted using PICO guidelines and EMBASE, PubMed/MEDLINE, Scopus and Web of Science databases. Only clinical trials were collected and analysed. Of the 792 studies that were initially identified, six were eligible for inclusion in this study. The studies included a total of 707 women; of these, 270 were treated with LNG-IUS, 354 were treated with dienogest, and 83 were controls. All the studies were from Asia (Bangladesh n = 1, China n = 2, India n = 1, Japan n = 1, South Korea n = 1). Dienogest was found to reduce pelvic pain significantly, evidenced by a lower visual analogue scale score, compared with LNG-IUS. Also, dienogest led to a significant reduction in uterine volume compared with LNG-IUS. However, subjects in the LNG-IUS group had significantly higher levels of haemoglobin than those in the dienogest group. Nonetheless, the occurrence of side effects such as weight gain, breast tenderness/distension, headache, insomnia/sleep disorder, depression/mood disorder, skin disorder/acne, and coital discomfort/reduced libido were comparable in both treatment groups. Dienogest may be more effective than LNG-IUS for the management of adenomyosis, as it shows a superior effect in the reduction of pelvic pain and uterine volume. As only six studies were included in the present meta-analysis due to the paucity of data in the literature, it is recommended that well-designed randomized controlled trials comparing the effectiveness of dienogest with LNG-IUS should be conducted. [ABSTRACT FROM AUTHOR]

Objective: To estimate the level of urinary C-terminal telopeptide of type II collagen (uCTX-II) as a biomarker of cartilage turnover and to determine its correlation with radiological grading, pain, and functions of patients with knee osteoarthritis (OA). Methods: A descriptive cross-sectional study was conducted between September 2017 and August 2019 on 102 patients suffering from knee OA. Detailed demographic data were collected. uCTX-II level was measured for each patient. Radiological grading, pain and functional assessments were performed using Kellgren-Lawrence (K-L) grading, visual analogue scale (VAS), and Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC). Results: The mean age of 62.3 (6.4) years and most patients (n = 56, 54.9%) were 61–70 years old. Females constituted 80.4% (n = 82). Among the occupations, housewives were more affected (55.9%, n = 57). Out of 102 patients, 32 (31.4%) had VAS pain 4, 25 (24.5%) had 5 and 45 (44.1%) had 6; 9 (8.8%) had K-L score 1, 51 (50%) had 2, 41 (40.2%) had 3 and 1 (1%) had 4; 35(34.3%) had WOMAC score <30, 59 (57.8%) had 30–40, and 8 (7.8%) had >40; 55 (53.9%) had uCTX-II level <50 ng/mmole, 25 (24.5%) had between 50 and 200 ng/mmole and 22 (21.6%) had >200 ng/mmole. There was a positive correlation between uCTX-II and WOMAC (P =.006) and VAS (P =.042). Conclusion: The present study findings highlighted that higher levels of uCTX-II were associated with higher levels of pain and greater difficulty with daily activities (measured by WOMAC disability score). This suggests that uCTX-II could be a useful biomarker for monitoring cartilage turnover in patients with knee OA and its relationship with pain and functional abilities. [ABSTRACT FROM AUTHOR]

Aim: Study of the effectiveness of complex physiotherapeutic treatment of cervicalgia in the MM of the AFU. Materials and Methods: 45 male MM of the AFU aged 27-62 years, average age 42.3 ± 5.8 years, with pain in the cervical spine were examined. The effectiveness of drug and combined drug and complex physiotherapeutic treatment of cervical pain was evaluated according to the indicators of the NPAD scales, NDI and VAS. Results: Cervicocranial pain (37.8%) and cervicobrachial pain (33.3%) prevailed in the structure of the pain syndrome in the MM of the AFU. Against the background of the treatment, a significant decrease in the severity of the pain syndrome and complaints was observed in a significant majority of patients. There was a statistically significant decrease in the intensity of the pain syndrome according to the VAS (from 6.8±0.8 points to 5.2±0.5 points in group 1, and from 6.2±0.4 points to 4.8±0, 6 points in group 2. There was also a trend towards normalization of indicators on the NPAD scales (from 61.8 ± 3.6 points to 57.3 ± 4.1 points in group 1 and from 62.2 ± 4.1 points to 50, 2±3.8 points in group 2) and NDI (from 36.7±3.2 points to 29.1±4.3 points in group 1 and from 37.5±3.8 points to 25.3±3.2 points in the 2nd group). Conclusions: 1. Cervical pain syndrome of the spine in MM of the AFU most often manifests itself in the form of cervicocranialgia and cervicobrachialgia. 2. Drug treatment of cervicalgia demonstrates an effective reduction in pain intensity according to VAS, especially when combined with physiotherapeutic treatment. 3. Complex physiotherapeutic treatment in combination with drug therapy in MM of the AFU leads to regression of pain syndrome and improvement of quality of life and reduction of disability according to the diagnostic scales of NPAD and NDI. [ABSTRACT FROM AUTHOR]

AbstractThe goal of the present study was to evaluate the efficacy of topical tramadol in the management of knee osteoarthritis pain. Sixty patients with moderate to severe pain of knee osteoarthritis were enrolled. Patients were randomized to receive tramadol 5% or placebo along with oral diclofenac 100 mg/day. They were instructed to apply the ointment every 12 h on the knee for three weeks. To control breakthrough pain, the patients were allowed to take acetaminophen up to 650 mg per day. The measured variables were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Visual Analog Scale (VAS). Sixty patients completed the study. At the end of follow-up period, VAS decreased by 21% (from 7.2 ± 2.1 to 5.7 ± 2.4, p-value < 0.05) and WOMAC score decreased by 23% (from 49.6 ± 17.4 to 38.4 ± 18.1, p-value < 0.05) in intervention group. Topical tramadol was significantly effective in reducing the intensity of pain and osteoarthritis symptoms in comparison to placebo considering VAS (5.7 ± 2.4 vs. 8.0 ± 2.9, p-value = 0.001) and WOMAC score (38.4 ± 18.1 vs. 46.0 ± 18.6, p-value = 0.007). Topical tramadol 5% appears to be effective in moderate to severe knee osteoarthritis pain. [ABSTRACT FROM AUTHOR]

Tennis elbow or lateral epicondylitis is a painful condition of the elbow. It is commonly seen in carpenters, musicians, gardeners and computer programmers. Steroid injections in periarticular or soft tissue structure relieve pain, inflammation and improve mobility. Aim of study is to evaluate the usefulness of intra-lesional steroid injections in tennis elbow. Materials and Methods: This was a prospective study of 42 patients conducted at teaching hospital from January 2023 to December 2023. Results were assessed with visual analog scale [VAS] and Patient Rated Tennis Elbow Evaluation (PRTEE) questionnaire. Patients were injected with local injection of 1ml (40mg) of methylprednisolone acetate (corticosteroid) combined with 1 ml of 2% lignocaine at the maximal point tenderness at lateral epicondyle. Patients were followed-up at 2, 6, 12 weeks. Results: 26were males and 16 were females. All belong to the age group of 26-50 years, with the average age of 38.5 years. We observed significant decrease in pain level at 2 weeks, 6 weeks and 12 weeks follow up as compared to baseline with help of VAS and PRTEE scores. Conclusion: corticosteroid injection in tennis elbow patients showed significant pain reduction and functional improvement. [ABSTRACT FROM AUTHOR]

Background: This randomized clinical and haematological study evaluated the effect of Hijama-BilShart (Wet Cupping) on musculoskeletal pain and inflammatory markers in venous and cupped blood. Materials and Methods: 110 patients with musculoskeletal pain were screened, with 90 diagnosed and included. After 30 subjects were lost to follow-up, 60 completed the study. Participants received 4 weekly sessions of wet cupping therapy over 4 weeks. Pain intensity was measured using VAS and KOOS scores, and inflammatory markers (Serum uric acid & CRP) were assessed in venous and cupped blood. Results: Pain relief, measured by VAS, showed significant improvement across various musculoskeletal conditions: cervical spondylosis, frozen shoulder, low backache, sciatic pain, knee osteoarthritis, gout, and rheumatoid arthritis. KOOS scores for knee osteoarthritis improved significantly. Serum uric acid levels in venous blood were suggestively insignificant, while CRP levels decreased gradually but were not statistically significant. No adverse effects were reported. Conclusion: Hijama-Bil-Shart (wet cupping) therapy is effective in relieving musculoskeletal pain and improving quality of life. It shows long-term benefits with sustained pain relief and gradual reduction in CRP levels. However, it is not effective in significantly reducing raised serum uric acid levels. [ABSTRACT FROM AUTHOR]

Background: Quality-of-life (QOL) is important for cancer patients with poor prognosis. However, conducting a QOL survey with patients is difficult. Therefore, we conducted a QOL survey with physicians. Specifically, this study aimed to clarify how physicians assess QOL in patients with pancreatic cancer by conducting a survey and comparing the results between physicians and the general public. Methods: A survey was conducted by interviewing physicians administering chemotherapy to patients for recurrent/metastatic pancreatic cancer. This method is similar to that of the QOL survey conducted among the general public. Responses were evaluated using the composite time trade-off (cTTO) and the visual analog scale (VAS) for 11 pancreatic cancer status scenarios (survey scenarios). These scenarios consisted of patients’ health states as well as the types and grades of adverse events (AEs). Health status was classified into two categories: Stable disease (SD) and Progressive disease (PD). In addition, we conducted a survey using the EuroQol 5 Dimensions 5-Level (EQ-5D-5l) as reference values. Results: Twenty physicians responded to the survey. SD had the highest mean QOL value for both assessment methods (Physicians: 0.78, General public: 0.63), whereas PD had the lowest mean QOL value (Physicians: 0.15, General public: −0.12). The physicians assigned higher QOL values on both the VAS and cTTO than the general public did in all survey scenarios. Conclusions: The QOL values obtained from physicians were consistent with the degree of status in any assessment scenarios. Based on the differences in the QOL survey results between physicians and the general public, physicians tended to assign higher QOL values than the general public in cTTO and VAS assessments. [ABSTRACT FROM AUTHOR]

The immunological pathogenesis of atopic dermatitis (AD) and chronic spontaneous urticaria (CSU) has not been fully elucidated yet. The aim of our research was to assess the serum concentration of interleukin-5 receptor (IL-5R) in relation to the disease activity and pruritus intensity in adult patients with AD and CSU. This pilot study included 45 participants (15 patients with AD, 15 patients with CSU, and 15 healthy controls). Blood samples were taken to examine the serum levels of IL-5R using the enzyme-linked immunosorbent assay (ELISA) test. The Scoring Atopic Dermatitis (SCORAD) index, the Urticaria Activity Score (UAS7), and the Visual Analogue Scale (VAS) were used to assess the disease activity and the pruritus intensity, respectively. Obtained results revealed that the IL-5R concentration was significantly higher in patients with CSU than in patients with AD and in the controls (p = 0.038). There was a positive correlation between the IL-5R level and the SCORAD index in patients with AD (r = −0.9, p = 0.047), which was not found for the CSU activity by UAS7 and with the pruritus severity by VAS in both examined groups of patients. Our findings underscore higher serum levels of IL-5R among CSU and AD patients, which may highlight its functional role in the pathogenesis of these diseases. In contrast, IL-5R might not be fully useful in reflecting the severity of symptoms. Although our results are promising, this study should be conducted on a larger cohort of patients. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the impact of case-based learning (CBL) versus lecture-based learning (LBL) on dental students' clinical decision-making regarding DF severity using Visual Analog Scale (VAS) scoring. Methods: Eighty first-year graduate dental students were randomly assigned to either the CBL (n = 38) or LBL (n = 42) groups. Both groups received instruction on DF diagnosis, with CBL involving small group sessions analyzing real cases and LBL involving traditional lectures. Effectiveness was assessed by presenting 32 dental fluorosis cases with Thylstrup-Fejerskov Index (TSIF) scores ranging from 0 to 7 through slide presentations to both groups for VAS assessment. Five evaluators of each group randomly selected were asked to repeat the rating 2 weeks later. Statistical analysis included two-way ANOVA for group and gender differences, intra-class correlation coefficient (ICC) for reliability, and Spearman correlation coefficients for validity. Results: Variations in VAS scores were observed between CBL and LBL groups, with no significant gender impact. Excellent inter- and intra-evaluator agreement was found for VAS scoring in both groups, indicating its reliability. Validation against established indices (such as DI and TSIF) demonstrated strong correlations, with CBL students exhibiting higher correlations. Conclusions: CBL enhances students' clinical decision-making and proficiency in DF diagnosis, as evidenced by more consistent and accurate VAS scoring compared to LBL. These findings highlight the importance of innovative educational strategies in dental curricula, with implications for improving training quality and clinical outcomes. Trial registration: The study was registered at the Clinical Research Center, Hospital of Stomatology, Wuhan University (Registration code: HGGC-036). [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare the efficacy of intra-articular prolotherapy (IG) combined with peri-articular perineural injection (PG) in the management of knee osteoarthritis (KOA). Methods: A total of 60 patients with the diagnosis of KOA were included in this double-blinded randomized controlled clinical trials. The inclusion criteria were as follow: (1) 48–80 years old; (2) the diagnose of KOA; (3) the grade 2 and 3 of the Kellgern–Lawrence grading scale; (4) the pain, crepitation, and knee joint stiffness continuing for 3 months at least. The main exclusion criteria were as follow: (1) any infection involving the knee skin; (2) history of any Influencing factors of disease. All patients were divided into three groups and received either IG, PG and I + PG under the ultrasound guidance and the 2, 4 and 8 weeks follow-up data of patients were available. (IG n = 20 or PG n = 20, I + PG n = 20). Visual Analogue Scale (VAS), The Western Ontario McMaster University Osteoarthritis Index (WOMAC) and the pressure pain threshold (PPT) were used as outcome measures at baseline, 2, 4 and 8 weeks. Results: There were no statistically significant differences in terms of age, sex, BMI, duration of current condition and baseline assessments of pain intensity, WOMAC scores and PPT. After treatment, the improvement of VAS activity, WOMAC and PPT values was showed compared with pre-treatment in all groups (p < 0.05). At 4 and 8 weeks after treatment, the VAS and WOMAC scores of the I + PG were significantly lower than those of the PG or IG, and the difference was statistically significant (p < 0.05). The PPT values of PG and I + PG were significantly improved compared to IG at 2, 4, and 8 weeks after treatment. Conclusion: The ultrasound guided I + PG of 5% glucose seem to be more effective to alleviate pain and improve knee joint function than single therapy in short term. Clinical rehabilitators could clinically try this combination of I + PG to improve clinical symptoms in patients with KOA. [ABSTRACT FROM AUTHOR]

Introduction: Frozen shoulder which is a common condition which is characterized by painful limitation of active and passive range of motion. 2%-5% of general population are affected with this condition. Usually incidence is higher in females than males with age between 40 and 65 years. Main stay of treatment is symptomatic pain relief and followed by regaining normal range of movements. Aim: The purpose of the study is to evaluate effect of manipulation under anaesthesia of Frozen shoulder, objectives are to improve range of motion and pain and early return of individual to perform his daily activities of living. Material and methods: This is a prospective study, for a period of 15 months, carried out in 42 patients posted for manipulation under anaesthesia for Frozen shoulder. For evaluation of outcome we used VAS (Visual analog scale) for pain scoring, American Shoulder and Elbow surgeons Score (ASES) for evaluation of improvement in activities of daily living, Range of movements. Results: In the 42 patients analyzed, females were dominantly affected with 71.42% compared to males 28.57%. Of all 42 shoulders, dominant hand was more involved with 57.14%. Overall 40 patients achieved significant reduction of pain immediately after procedure and ASES score was improved from preoperatively 24.32 ± 9.36 to 88.52 ± 7.92 at 6 months after the procedure. There was significant improvement in range of movements. Conclusion: Frozen Shoulder treated with manipulation under anaesthesia followed by physiotherapy, results in good pain relief and also leading to good functional recovery, helps the patient for their early return to daily activities of living. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis (OA), a degenerative disorder, becomes more prominent with advancing age. Various treatment modalities available, two noninvasive modalities to halt its progression are PRP and oral glucosamine. PRP therapy utilizes growth factors for tissue healing and cartilage regeneration, alleviating symptoms. Glucosamine, a natural compound, supports cartilage health by acting through cell mediators, retarding degradation, enhancing joint function. Materials and methods: Involving 30 patients per group, the study focused on elderly individuals diagnosed with symptomatic knee osteoarthritis (OA) grades 1, 2, or 3, who were randomly assigned to receive either intra-articular injection of autologous PRP or oral glucosamine. Clinical outcomes, VAS scores, and WOMAC scores were assessed and compared over a 4-month period. Data were collected and statistically analyzed to determine treatment efficacy .Results: In a comparison between Platelet-Rich Plasma (PRP) injection (group A) and oral glucosamine (group B) for knee osteoarthritis, significant WOMAC score reductions were observed in both groups over four months: Group A from 58.90 to 25.20 (p=0.001) and Group B from 59.43 to 42.90 (p=0.001). Regarding VAS scores, Group A demonstrated larger mean decreases (3.50±0.814, 3.17±0.980, 2.47±0.928) compared to Group B (0.36±0.973, 0.83±1.037, 1.53±1.208) (p=0.001). Conclusion: Our study highlights the effectiveness of intra-articular PRP and oral glucosamine for managing OA knee symptoms. Both treatments significantly reduced pain and improved function, with PRP showing superior efficacy, particularly in mild-to-moderate cases. PRP and glucosamine offer valuable options for symptom management and disease progression. [ABSTRACT FROM AUTHOR]

Background: People who had a mastectomy may feel pain that comes from the breast that was cut off. These are called phantom breast sensations (PB sensations) and phantom breast pain. Some of the problems that breast cancer patients have after treatment are a limited range of motion in the shoulder, arm swelling, loss of shoulder strength and PB feeling. Purpose: To investigate efficacy of low-level laser therapy on shoulder mobility and phantom breast pain postmastectomy. Patients and methods: 44 patients with postmastectomy phantom pain, their ages ranged from 20 to 50 years. They were randomly divided into two groups; Group (A) (study group): received low level laser therapy combined with routine physical therapy exercises, 3 sessions per week for 4 weeks, Group (B) (control group): received only routine physical therapy exercises, 3 sessions per week for 4 weeks. Visual analogue scale (VAS) was used to measure shoulder pain, goniometer was used to measure shoulder range of motion. Quality of life questionnaire was used to assess functional state and symptoms. Results: There was a significant decrease in VAS post treatment compared with that of pretreatment in study group when compared with control group. Statistical analysis showed significant improvement in shoulder flexion, abduction and external rotation post treatment compared with that of pretreatment in both groups. Statistical analysis showed significant improvement in quality-of-life questionnaire post treatment compared with that of pretreatment in both groups. Conclusion: Low level laser therapy can improve shoulder ROM, quality of life scale and decrease phantom pain postmastectomy. [ABSTRACT FROM AUTHOR]

Background: Myofascial plane block has recently replaced central neuraxial analgesia as the preferred method of effective, opioid-sparing pain treatment. The use of external oblique intercostal (EOI) nerve blocks to treat postoperative pain has increased recently because they can relieve pain in the upper midline and upper lateral abdominal wall. Objectives: To evaluate the effect of external oblique intercostal plane block (EOIPB) on the postoperative pain that was evaluated by visual analogue pain scale (VAS) as a primary objective. Time to first rescue analgesia, 24 hours' postoperative consumption of analgesia, perioperative hemodynamics, postoperative anesthetic care unit (PACU) stay, patient satisfaction, and postoperative complications were the secondary objectives. Patients and Methods: This prospective and randomized controlled study was conducted on fifty patients with ASA I and II, aged ≥ 20 to ≤ 70 years, scheduled for upper abdominal surgeries. Patients were divided equally into two groups, group (A) Patients received US-guided EOIB with 20 ml of 0.25% bupivacaine on each side after induction, and group (B) Patients received postoperative morphine on patient request. Results: The EOIPB group showed a significantly lower VAS score than the control group at 0 time, 1h, 2h, 4h, 8h and 12h postoperatively (p<0.001), but there was no significant difference at postoperative 24h between the two groups (p>0.05). Postoperative 24-hour morphine consumption was significantly lower in the EOIPB group than in the control group (9.8±2.4 (6-15) mg vs. 19.4±2.7 (15-25) mg respectively, P<0.001). Similarly, the time until the first required analgesia was significantly longer in EOIPB group (8.1 ±0.8(7-9) vs. 4.1 ±0.8(3-5) in hours, respectively, P<0.001). Conclusion: We concluded that EOIPB resulted in decreased postoperative pain, morphine, and fentanyl usage while increasing patient satisfaction. [ABSTRACT FROM AUTHOR]

Objective: Opiorphin is a pentapeptide secreted in saliva and has a strong analgesic effect. Salivary opiorphin has been shown to increase in orofacial pain and may act as a pain reliever in pain caused by denture‐related ulcers. The current study aimed to evaluate the salivary opiorphin levels in traumatic ulcers caused by ill‐fitting dentures and demonstrate whether there is any correlation between trauma‐related pain levels and salivary opiorphin levels. Materials and Methods: Twenty‐two individuals with new full dentures and a complaint of pain due to ill‐fitting were included in this study. Patients were asked to rate their level of pain on a visual analog scale (VAS). Then, saliva specimens were collected at the first visit with the complaint of pain and 7 days following the denture adjustment. Results: The average saliva opiorphin level before and after denture adjustment were 19.29 ± 5.44 and 15.78 ± 3.95 ng/mL, respectively. A dependent (paired) t‐test determined that the mean salivary opiorphin level differed statistically significantly before and after the adjustment of the dentures. Conclusions: The findings show that salivary opiorphin levels increase in pain associated with denture‐related traumatic ulcers. Adjusting the dentures resulted in pain relief and a statistically significant reduction in opiorphin levels. [ABSTRACT FROM AUTHOR]

No reports have been published verifying the effects of manual interventions such as humeral head stabilization on improving function and reducing pain when applying aggressive manual passive stretching in patients with painful stiff shoulders. The purpose of this study was to compare clinical outcomes, such as range of motion, pain, and disability scores, in patients with painful stiff shoulders with and without humeral head stabilization intervention while applying aggressive manual passive stretching. Fifty-six patients with painful stiff shoulders were recruited (31 with humeral head stabilization intervention and 25 without such intervention). Clinical outcomes such as active range of motion (A-ROM), pain, and disability scores were evaluated using a goniometer; measurement of activity visual analog scale (A-VAS); and Disabilities of the Arm, Shoulder and Hand (DASH) and Shoulder Pain and Disability Index (SPADI), respectively. All the parameters, A-ROM, A-VAS, and disability scores (DASH and SPADI) were not significantly different between the 2 groups (P >.05) before the intervention. However, after the intervention, the mean difference in A-ROM for flexion, abduction, and external and internal rotation was 18 (95% confidence interval [CI], 14.1-21.7), 31 (95% CI, 24.9-37.4), 17 (95% CI, 13.4-21.4), and 16 (95% CI, 11.6-20.9), respectively. The mean difference in A-VAS and disability scores for DASH and SPADI was −1 (95% CI, −1.5 to −0.8), −27 (95% CI, 32.3 to −22.6), and −23 (95% CI, −27.8 to −18.3), respectively. All of these measurements favored humeral head stabilization. During aggressive manual passive stretching in patients with painful stiff shoulders, humeral head stabilization intervention may be more beneficial in improving clinical outcomes such as A-ROM, A-VAS pain levels, and disability scores. [ABSTRACT FROM AUTHOR]

To evaluate the effect of the Mulligan mobilization technique on pain intensity and range of motion in individuals with neck pain. Forty individuals with mechanical neck pain were enrolled in the study. The patients were randomly divided into 2 groups and a total of 10 sessions of treatment were administered to all 2 groups for 2 weeks, 5 days a week. Mulligan mobilization technique, electrophysical agents, active range of motion, and stretching exercises were carried out in the Mulligan group. In contrast, only electrophysical agents and exercises were applied to the conventional physiotherapy group. Range of motion (ROM) of the neck, Visual Analog Scale (VAS), Neck Pain and Disability Scale (NPDS), and Short-Form 36 Health Survey (SF-36) were used for evaluation. Statistical analyses were done to compare the amounts at the baseline and immediately after treatment. Statistically significant improvements were found in the post-treatment ROM, VAS, NPDS values in both groups (p < 0.05). When the differences were compared, the results of the Mulligan group were significantly better than the conventional physiotherapy group (p < 0.05). There was no significant difference between the groups in terms of SF-36 parameters (p > 0.05). This study showed that the Mulligan mobilization technique plus conventional physiotherapy is more effective than conventional physiotherapy in increasing joint range of motion, reducing pain, and reducing neck disability. ClinicalTrials.gov (NCT05074576). • Mulligan mobilization provided benefit in terms of relieving pain and increasing the range of motion of the joint without pain. • Mulligan mobilization technique plus conventional physiotherapy is more effective than conventional physiotherapy in decreasing disability. • In daily clinical practice, Mulligan mobilization might be considered as a non-invasive treatment method for mechanical neck pain. [ABSTRACT FROM AUTHOR]

Aim: To assess the clinical implications of cervical foraminal stenosis severity and evaluate the impact of surgical intervention on postoperative outcomes. Methods: A retrospective analysis was conducted on 557 patients who underwent anterior cervical discectomy and fusion (ACDF) surgery for cervical disc herniation between 2020 and 2023. Cervical foraminal stenosis severity was graded using a classification system based on axial T2-weighted magnetic resonance imaging (MRI) images. Preoperative and postoperative visual analog scale (VAS) and Neck Disability Index (NDI) scores were recorded to evaluate pain and disability levels. Results: The majority of patients (79.5%) exhibited severe stenosis (grade 2), with significant improvements in VAS and NDI scores observed postoperatively. Patients with grade 2 stenosis demonstrated the most pronounced reduction in VAS scores, indicating greater pain relief following surgery. However, patients with grade 0 and grade 1 stenosis also experienced improvements in pain and disability scores postoperatively. Conclusions: Cervical foraminal stenosis severity significantly influences postoperative outcomes, with surgical intervention leading to substantial improvements in pain and disability levels, particularly in cases of severe stenosis. These findings underscore the importance of accurately grading stenosis severity and considering surgical intervention as an effective treatment option for symptomatic patients. [ABSTRACT FROM AUTHOR]

Aims: To comparatively evaluate the effect of normal saline gel and ozonated saline-ozonated gel (ozone therapy) on pain, inflammation, soft tissue, and crestal bone loss in dental implant surgery. Methods and Material: Forty adult patients scheduled to undergo implant were randomized into two groups: Twenty patients (n = 20) received ozone therapy and controls (n = 20) received normal saline and gel during implant placement. Inflammation and pain were noted at days 1 and 7 and 3 month intervals by estimating C-reactive protein (CRP) levels and assessing visual analogue scale (VAS) scores. At 3 months, soft tissue outcomes were noted in terms of plaque index, gingival index, and pocket depth, while crestal bone loss was noted via a radiograph. Results: Mean CRP levels were significantly higher in the control group as compared to that in the case group on day 1 and day 7 follow-ups (P < 0.05). Mean VAS scores for pain were also lower in the case group as compared to the control group at all follow-ups, but the difference was significant statistically only at day 1 (P = 0.061). The plaque index was significantly lower in the case group as compared to the control group (P = 0.011) at final follow-up. No significant difference between two groups was observed for crestal bone loss. Conclusions: Ozone therapy during implant placement was effective in reduction of pain, systemic inflammation, and plaque deposition in dental implant patients.

Abstract Objectives This randomized controlled trial compared the efficacy and tolerability of danzhixiaoyao pills in the accurate treatment of patients with burning mouth syndrome (BMS). Method Collect a total of 78 patients (75 female patients and 3 male patients) from the oral mucosa department who were considered eligible fromOctober 2020 to October 2022.The patients were randomized and divided into trial group and control group.The trail group received danzhixiaoyao pills and mecobalamine tablets while the control group was given mecobalamine tablets.The Visual Analogue Scale (VAS), Beck Anxiety Inventory(BAI), Beck Depression Inventory (BDI), Oral Health Impact Profile (OHIP-14), Traditional Chinese medicine(TCM) syndrome integral and adverse reactions were performed at baseline and after 2, 4, and 6 weeks of treatment. Descriptive statistics, including the Wilcoxon rank-sum test and the Chi-square test for median comparisons between different times, were used. Result 1.After treatment, the VAS, BDI,OHIP-14, and TCM syndrome integral in the trial group had a significant decrease than the control group(P< 0.05).However, there was no statistical difference in the BAI scores between the two groups (P> 0.05). 2.According to the efficacy determination criteria , the total effective rate of the test group was 73.68% , the control group was 52.94% and the recurrence rate was 0. There was a significant difference between the two groups (Z=-2.688, P < 0.05). The results showed that the curative effect of test group was better than that of control group.3. No adverse effects occurred in patients in either group. Conclusion Danzhixiaoyao pills has demonstrated to have a positive effect in relieving BMS symptoms and in improving a patient's overall quality of life with no AEs compared with the control group. The efficacy evaluation systems that can be verified and complementary in this study provide a perfect, effective and referential evaluation system for the use of Chinese patent medicine in the treatment of oral mucosal diseases. Trial Registration Registry name: Chinese Clinical trail Registry Registration number: ChiCTR2000038189 Date of Registration: 2020-09-13 Please visit ( https://www.chictr.org.cn/showproj.html?proj=61462 ) to the protocol.

Abstract Background This study aimed to compare the efficacy of intra-articular prolotherapy (IG) combined with peri-articular perineural injection (PG) in the management of knee osteoarthritis (KOA). Methods A total of 60 patients with the diagnosis of KOA were included in this double-blinded randomized controlled clinical trials. The inclusion criteria were as follow: (1) 48–80 years old; (2) the diagnose of KOA; (3) the grade 2 and 3 of the Kellgern–Lawrence grading scale; (4) the pain, crepitation, and knee joint stiffness continuing for 3 months at least. The main exclusion criteria were as follow: (1) any infection involving the knee skin; (2) history of any Influencing factors of disease. All patients were divided into three groups and received either IG, PG and I + PG under the ultrasound guidance and the 2, 4 and 8 weeks follow-up data of patients were available. (IG n = 20 or PG n = 20, I + PG n = 20). Visual Analogue Scale (VAS), The Western Ontario McMaster University Osteoarthritis Index (WOMAC) and the pressure pain threshold (PPT) were used as outcome measures at baseline, 2, 4 and 8 weeks. Results There were no statistically significant differences in terms of age, sex, BMI, duration of current condition and baseline assessments of pain intensity, WOMAC scores and PPT. After treatment, the improvement of VAS activity, WOMAC and PPT values was showed compared with pre-treatment in all groups (p

Hypertension is a silent killer disease that can affect the patient's quality of life. There is a need for rational treatment to achieve the success of therapy and the desired quality of life. This study aims to determine the relationship between the rationality of prescribing and the quality of life of hypertensive patients. The study design was an observational cohort. Data were obtained from hypertensive patients at the Puskesmas Siantan Tengah Pontianak who met the inclusion criteria in June-July 2021 using a prospective purposive sampling and collected from medical records, EQ5D5L and VAS questionnaires. The results of the study on 101 samples were obtained; the rationality of prescribing antihypertensive drugs was rational, with the percentage of rationality being the appropriate indication 87,12%; appropriate drug 87.12%; appropriate patient 88.11%; and appropriate dose 88.11%. In addition, 28 patients (27.72%) did not have a problem with the five dimensions with the highest EQ5D5L index of 1,000, while the quality of life, as measured by VAS, had a median value of 60. The results of the Pearson chi-square test showed that there was a relationship between the rationality of prescription and quality of life for hypertensive patients with a significance value ≥ 0.05 using the EQ5D5L (p = 0.688) and VAS (p = 0.583) questionnaires. Conclusion: there is no significant relationship between the rationality of prescribing and the quality of life of hypertensive patients, both using the EQ5D5L and VAS questionnaires.

Abstract Background An increasing number of individuals undergo total knee arthroplasty (TKA), which can result in pain, limited motor function and adverse complications such as infection, nausea and vomiting. Glucocorticoids have been shown anti-inflammatory and antiemetic effects, but can also elevate blood glucose levels and increase the risk of wound infection. Thus, it is essential to investigate the efficacy and safety of glucocorticoid usage in TKA. Method A comprehensive systematic search of PubMed, Medline, EMBASE, Cochrane databases, to identify relevant randomized controlled trials (RCTs) of glucocorticoid application in TKA. The primary outcomes assessed were the postoperative pain assessment. Secondary outcomes included the range of motion in knee joint, levels of inflammatory cytokines, adverse complications, and the length of hospital stay. Results Thirty-six randomized controlled trials were included in the final analysis. The glucocorticoid group exhibited significant reduction in the resting VAS scores on postoperative days 1, 2 (POD1, 2)and postoperative 3 months (POM3), as well as decreased morphine consumption on POD1 and increased range of motion (ROM) in knee joint on POD1, 3. Additionally, the glucocorticoid group exhibited decreased levels of postoperative inflammatory cytokines and the incidence of PONV along with a shorter length of hospital stay. The blood glucose concentration was significantly increased in the glucocorticoid group on POD1 compared with the control group. While the blood glucose on POD2 and occurrence of postoperative adverse complications were similar between two groups including wound infection and venous thrombosis. The periarticular injection analgesia (PIA) group demonstrated lower VAS scores on POD2 comparing to the systemic administration (SA) group according to two studies. However, there was no significant difference of the resting VAS on POD1 and POD2 between PIA and SA group across all studies. Conclusion Perioperative glucocorticoids treatment in TKA significantly reduced short-term pain score and opioid-use which was probably not patient relevant. The application of glucocorticoids in TKA implied a beneficial trend in analgesic, anti-inflammatory, and antiemetic effects, as well as improved range of motion and shortened hospital stay. While it will not increase the risk of continued high glucose, postoperative wound infection and venous thrombosis.

Abstract Background The aim of this study was to evaluate the psychological distress pre-operatively, at 3, 6, and 12 months in patients who underwent lumbar spine fusion surgery. Methods A total of 440 patients received instrumented lumbar spine fusion were enrolled. Psychological distress was evaluated using the Modified Somatic Perception Questionnaire (MSPQ) and the Modified Zung Depressive Index (ZDI). The results of lumbar fusion surgery were evaluated using the Oswestry Disability Index (ODI), the Japanese Orthopedic Association (JOA-29), and the visual analog scale (VAS). Results Psychological distress was reported among 23% of patients and 7, 5.5, and 4.0% of the patients preoperatively, at 3, 6, and 12 months after lumbar surgery, respectively. The mean MSPQ score decreased from 8.78 (before surgery) to 4.30, 3.52, and 3.43 at 3, 6 and 12 months in after surgery, respectively, in patients with psychological distress patients (p

Background: Osteoarthritis (OA), is a leading causes of disability. Herbal medications are often used as an alternative to allopathic drugs to manage symptoms of osteoarthritis. Objectives: This study was conducted to evaluate the efficacy of curcumin longa & fenugreek extracts in patients of KOA (knee osteoarthritis). Methods: Patients were randomized into four groups. Group 1 received placebo (glucose 500mg), Group 2 curcumin longa (CL 500mg), Group 3 Fenugreek (FE 500mg) and Group 4 combination (CL 500 mg + FE 500 mg). Also, aceclofenac 100 mg twice daily was given to all patients. Groups were compared using VAS & WOMAC scores, as well as, by changes seen in serum level of IL-1β and SOD at 0, 60 and 120 days. Results: VAS and WOMAC scores, IL - 1 β level significantly reduced, while SOD level significantly increased in CL, FE, and (CL+FE) groups as compared to placebo at 60 and 120 days. Though the effect in FE group is not significant in 60 days, significant improvement was seen at 120 days. Conclusion: Curcumin longa and Fenugreek may be effective in reducing progression and pain of OA, and can be combined with NSAIDs. They are not known to produce any side effects and have better tolerability.

Regardless of the underlying cause for speech impairment in speakers with cleft palate, a universal consequence of cleft palate is reduced speech intelligibility. Still, there is no standardised approach for measuring intelligibility for speakers with cleft speech. The current study aimed to determine the relationship between orthographic transcription (OT)-based measures, interval-scale ratings, and visual analog scale (VAS) ratings for perceptual judgements of intelligibility in speakers with cleft palate as judged by speech-language pathologists (SLPs). The speaker participants were six speakers with velopharyngeal insufficiency secondary to cleft palate. Four sets of sentences from the Hearing in Noise Test were recorded from each speaker. A total of 14 SLPs provided their intelligibility judgement on these speaker's recordings by word-by-word orthographic transcriptions, a visual analog scale (0–100), and a 5-point interval rating scale. A Spearman rank correlation test indicated a negative, strong correlation between OT-based measurements and VAS scores (r = −.94; p = 0.01) and between OT-based measurements and interval rating scores (r = −.77, p = 0.01). A strong, positive correlation was found between scores obtained from VAS and interval rating scales (r =.83, p = 0.05). The strong relationship between the objective measure of intelligibility (i.e. OT-based measure) and a subjective measure of intelligibility (i.e. VAS and interval scale) supports using a less time-consuming VAS as a substitute for orthographic transcription in measuring intelligibility in cleft palate speech. [ABSTRACT FROM AUTHOR]

Introduction: Allergic rhinoconjunctivitis (AR) is an IgE-mediated inflammation of nasal and ocular mucosa after environmental allergen exposure, mainly by house dust mites (HDM). AR affects more than one third of the population worldwide and it is associated with loss of quality of life (QoL). Aim: To analyse the improvement in the QoL in 50 patients with moderate-persistent AR due to house HDM before and after receiving 1 year of subcutaneous specific aeroallergen immunotherapy treatment (SAIT). Material and methods: A prospective observational study was performed based on clinical practice in 50 patients with moderate-severe persistent AR due to HDM and candidates to SAIT. Forty-one patients completed the study. Patients were evaluated with the ESPRINT short-version QoL questionnaire, a score of medication use and visual analogue scale (VAS) symptom score, prior to and 12 months after SAIT. Results: Forty-one patients (25 women, mean age 26.9 years). Mean ESPRINT values prior to the start SAIT was 3.06 (moderate-severe) and 1 year after starting subcutaneous SAIT the mean value dropped in all patients to 0.88 (mild). The VAS score symptom dropped from 8.26 to 3.68. 97.56% of patients used 3 or more drugs (oral antihistamine, ophthalmic/intranasal antihistamine, intranasal corticosteroid and/or oral antileukotrienes) prior to starting SAIT, and 1 year after it, 58.53% used one on-demand medication to control symptoms, oral antihistamine or nasal spray, and not daily use. Conclusions: Subcutaneous SAIT seems to be a valid treatment in our patients with moderate-persistent AR due to HDM, since it reduces the ESPRINT score, VAS score and the use of medication. An improvement in the quality of life and satisfaction was observed by the patients themselves. [ABSTRACT FROM AUTHOR]