Pain Categories Research Articles

Incidence of Postoperative Sore Throat and Associated Factors Among Pediatric Patients Undergoing Surgery Under General Anesthesia at Hawassa University Comprehensive Specialized Hospital, a Prospective Cohort Study.

Postoperative sore throat is one of the common postoperative complications following general anesthesia. Postoperative sore throat causes decreased patient satisfaction, and it affects patients' well-being after surgery, thus identifying its incidence and predictors helps to distinguish the preventable causes of postoperative sore throat. This study aimed to assess the incidence and associated factors of postoperative sore throat among pediatric patients undergoing surgery under general anesthesia at Hawassa university comprehensive specialized hospital. A prospective cohort study was conducted among children in the age range 6-16 years old who underwent emergency and elective surgical procedures under general anesthesia. Data were entered and analyzed using SPSS version 26 software packages. Univariate and multivariate analyses were performed to investigate the independent predictors. The presence and severity of postoperative sore throat were assessed by using a four-point categorical pain scale at the 2nd, 6th, 12th, and 24th-hour postoperative time. A total of 102 children were recruited in this study, from which 27 children (26.5%) complained of sore throat postoperatively. This study found that endotracheal intubation (P value: 0.030; AOR: 3.155; 95% CI [1.114-8.933]) and several attempts greater than one (P value: 0.027 and AOR: 4.890; 95% CI: [1.203-19.883]) had statistically significant association with a postoperative sore throat. The overall incidence of postoperative sore throat was 26.5%. Endotracheal intubation and the number of attempts greater than one were independent factors that were significantly associated with the occurrence of postoperative sore throat in this study.

Atlas of the receptive anal sex experience among people with prostates.

Receptive anal intercourse (RAI) is commonly practiced among individuals of all sexual orientations. However, negative stigmatization by society and health care professionals leads to the underreporting or this practice. We sought to assess and describe the subjective role of the prostate as a pleasure center in participants with diverse RAI experiences. The secondary aim was to describe nonprostatic areas within the anorectal region that produce erotic sensation and/or pain. The exploratory sequential multimethod study design included focus groups and semistructured interviews with 30 individuals with prostates who had engaged in RAI. We used graphic elicitation of natal male anatomy to enhance visualization and assess participant perspectives. The main outcome of interest was the identification of anatomic locations of erogenous sensation and pain during RAI. Among the participants (median age 38, range 24-77 years), most participants (90%) identified as cisgender male. Three major themes emerged within the motivations for RAI, including (1) deriving intrinsic pleasure, (2) providing both pleasure for a partner and a way to improve intimacy/connection, and (3) an inability to be the insertive partner due to physical or mental challenges. The data suggest that the anorectal region produces a variety of erogenous sensations which participants find pleasurable. Overall, 2 major areas of erogenous sensation occur along the anterior rectal wall and within the anus. Within the context of RAI, 2 distinct categories of pain emerged, including pain with insertion and pain at other times. Understanding where erogenous sensation originates for each individual may predict sexual functioning after various surgical interventions. Timing and location of pain may aid in further characterizing anodyspareunia. Our study utilized a sequential design (from focus groups to interviews) with diverse RAI experiences, especially regarding age, geographic location, and prostate pathology. We included individuals of diverse gender identities, but too few to evaluate these groups independently from cisgender men. People with prostates experience pleasure in multiple areas during RAI. Contrary to some lay literature, the prostate region is not the subjective pleasure center for all individuals. Timing and location of pain during RAI may inform areas for intervention. Providing a language for pleasure and pain during RAI may improve communication between not only sexual partners but also clinicians and patients.

The Relationship between Husband's Assistance and Pain During Birth at BPM Zahriah Stabat District in 2022

Labor pain is very important to pay attention to because pain in labor can weaken uterine contractions and result in prolonged labor and even death. Efforts that can be made to reduce pain are by providing the closest person, namely assistance from the husband, because the effect of feeling pain in every mother in labor can be minimized by making the husband as a delivery companion. This study aims to find out about the relationship between husband's mentoring and pain during childbirth at BPM Zahriah, Stabat District in 2022. The results of the study showed that the husband's assistance at BPM Zahriah, Stabat sub-district was in the good category (79.17%), the category of pain during labor at BPM Zahriah, Stabat sub-district was (50.0%). The results of the analysis with a value of p = 0.005 so that the conclusion is that there is an effect of the relationship between husband's assistance and pain during childbirth in post partum mothers at BPM Zahriah, Stabat District in 2022.Data was collected using a questionnaire and for pain measurement using a checklist. The conclusion in this study is that there is a relationship between husband's assistance and pain in childbirth at BPM Zahriah, Stabat District in 2022. Suggestions in this study are expected for BPM Zahriah to continue to encourage and support Husband Assistance for mothers in labor to reduce pain during childbirth.

Work Facility Design of the Ergonomic Tempeh Plastic Wraps Punching Tool Reduces Musculoskeletal Complaints and Working Time (A Case Study at MSME HM Tempe Murni, Ngoto, Yogyakarta)

Abstract. Tempe Murni small unit is a tempeh processing business located in Ngoto, Bangunharjo, Sewon, Bantul, Yogyakarta. There was a work process which caused muscle fatigue on the process of making holes on the tempeh wraps using manual tool because it had not met the ergonomic standard. The work posture of the workers in doing the work was sitting on the floor, the left leg was folded inward and the right leg was stretched forward a little bit, thus, it might cause musculoskeletal complaints. Therefore, it required an ergonomic tempeh plastic wrap punching tool which could reduce the musculoskeletal complaints and the working time of the workers.The research object was the workers in the process of making holes on the tempeh plastic wraps. This research used ergonomic and anthropometric approaches to determine the dimensions of the workers’ bodies. The Nordic Body Map (NBM) and the Visual Analogue Scale were used to determine the musculoskeletal complaints of workers.The results showed that the ergonomic design of the punching tool could reduce musculoskeletal complaints of pain sensation on the upper neck from the initial Visual Analog Scala (VAS) score of 65 into mild pain category with the scale score of 25. The initial back pain complaint with a moderate category with the scale score of 70 was reduced into mild pain category with the scale score of 16. The initial moderate pain on waist with the scale score of 70 was reduced into mild pain with the scale score of 18. The initial moderate pain on buttocks with the scale score of 70 was reduced into mild pain with the scale score of 26. The initial moderate pain on the lower part of the buttocks with a scale score of 69 was reduced into mild pain with a scale score of 29. The working time was reduced from 1.03 hours/unit into 0.52 hour/unit.

Pengaruh Fisioterapi terhadap Penurunan Nyeri pada Pasien Rheumatoid Artritis di Klinik Fisioterapi Kota Jambi

Rheumatoid Arthritis sufferers nationally in Indonesia are dominated by someone who has entered the age of Pre-elderly to the elderly in the age range between 55-64 years (15.5%), 67-74 years (18.6%), and ages above 75 years is at the number (18.9%), when totaled between the pre-elderly age up to 53% suffering from Rheumatoid Arthritis (Riskesdas 2018). Rheumatoid arthritis is a joint disease that occurs due to an autoimmune disorder that causes inflammation of the joints that causes pain, heat, stiffness, weakness. The solution offered to prevent this from happening is to provide physiotherapy to the aching joints. The goal is to reduce pain levels in patients undergoing physiotherapy at a physiotherapy clinic. The research method used in this study is quantitative, with a sample of 60 people, the method used is Pre Experimental Design with Pre Test and Post Test One Group design with intervention given to patients measured at each stage of physiotherapy. Research Results: Most of them are male (53.33%). Most of them are adults and elderly (35%) The description of the patient's pain level before physiotherapy is done, all patients experience pain, most of which are on a moderate to severe scale. After doing physiotherapy on T1 severe pain became 0%, and mild pain was 21.67%, on T2 mild pain was 6.67% and no pain was no pain 13.33%, while T3 was mostly in the no pain category (68.33%). The results of the statistical test obtained a p-value of 0.000. It can be concluded that physiotherapy is very effective in reducing pain levels in patients with pain rheumatoid artritis.

Assessing the impact of binaural and non-binaural auditory beat intervention to pain and compression in mammography

IntroductionPain and discomfort has a negative impact on a patient's overall experience and may impact on subsequent re-attendance to mammography. Pain during mammography remains a significant issue. Assessment of interventions to reduce levels of pain associated with mammography are essential to increase attendance to breast services and improve user experience. MethodsParticipants (n = 60) were invited to take part in the study at one hospital Trust within the UK. Postal invitations were sent 2 weeks prior to appointment to patients older than 40 years with previous mammography attendance at the same Trust to allow for comparison of previous and current pain scores/compression values. Patients were randomised into 3 groups: Binaural music (BM), non-binaural music (NBM) and standard care (C). A numerical rating scale (NRS) was used to rate pain. ResultsPatient tolerance is increased by the application of both the non-binaural and binaural music. Binaural music was most effective in improving patient tolerance (p = 0.02). When applied compression increased some patients recorded less pain, which may have implications to image quality and radiation dose for patients. Binaural music reduces the perception of mammographic pain within this data set. Conclusion5 min exposure to binaural music improves patient experience and tolerance for mammography which could be utilised to improve attendance rates in screening and symptomatic services. Implications for practiceThere is an indication for further research looking at application prior and during interventional biopsies. Music intervention can be offered to patients in the severe pain category who refuse mammography. It is acknowledged from these findings that the introduction of BM and NBM prior to mammography would be a low risk, cost effective intervention within the hospital setting.

THE EFFECT OF ACUPRESSUR TECHNIQUES ON PAIN INTENSITY Menstruation in Class VII MADRASAH TSANAWIYAH GUPPI BANJIT WAY KANAN DISTRICT IN 2022

AbstractDysmenorrhea or menstrual pain is problem often experienced dolescents during menstruation. Dysmenorrhea not disease, but symptom arises due abnormalities pelvic cavity and interferes with activities, impact on school-age dolescents, causing disruption learning activities in class. Safe treatment prevention dysmenorrhea is treatment acupressure techniques. Acupressure is traditional Chinese therapy by using massage techniques on meridian points of certain body parts. This study wants prove whether there is influence of acupressure technique on intensity of menstrual pain in VII grade students of Madrasah Tsanawiyah Guppi Banjit, Way Kanan Regency 2022. This research experimental study using one-shot case study approach. The population 82 students and number samples 16 students selected by purposive sampling technique. Variable measured cupressure technique independent variable, while dependent variable intensity menstrual pain. The results obtained from this study were 87.5% were in the no pain category. The statistical test used in this study was a non-parametric statistical test (Zcount = -3.571b) and a 95% confidence level (α = 0.05). After being compared with the table (Ztable = 0.00) it was found that the calculated Z value was smaller than the Z table value. It is proven that there are differences in the effectiveness of the influence of acupressure techniques on the intensity of menstrual pain in Class VII students of Madrasah Tsanawiyah Guppi Banjit, Way KananRegency.

The Effect Of Massage Effleurage Therapy Towards Reduction Of Mental Pain In Adolescent Women At Sma Negeri 09 Medan In 2022

Massage effleurage is a movement using the entire surface of the hand attached to the abdomen which is rubbed lightly and soothingly. The massage of the abdominal effleurage massage stimulates the fibers in the skin to make it comfortable during uterine contractions so as to facilitate blood circulation to the uterus and block pain impulses to reduce. The purpose of this study was to determine the effect of massage effleurage therapy on the reduction of menstrual pain in adolescent girls at SMA Negeri 09 Medan in 2022. Methods: Using a pre-experimental research design with a one group pretest-posttest approach. The population in the study amounted to 52 female students who experienced mild menstrual pain and moderate menstrual pain in class XII SMA Negeri 09 Medan using purposive sampling obtained a sample of 10 people. Data analysis used univariate and bivariate analysis with Wilcoxon test. Results: From 10 respondents, before the effleurage massage was performed the highest category of moderate pain was 9 respondents (90.0%), the pain scale after the effleurage massage was the highest in the category of mild pain 8 respondents (80.0%). The average pain scale for effleurage massage got a mean of 2.1000 with a standard deviation of 0.31623. the pain scale after massage got a mean of 3.2000 with a standard deviation of 0.42164, indicating a decrease in pain scale in adolescent girls after effleurage massage. Conclusion: There is an effect of effleurage massage therapy on reducing menstrual pain in adolescent girls at SMA Negeri 09 Medan in 2022. It is recommended to respondents to increase their insight and knowledge about the benefits and how to do effleurage massage therapy, so that they can carry out effleurage massage therapy as a solution in handling pain during menstruation.

Are changes in pain associated with changes in heart rate variability in patients treated for recurrent or persistent neck pain?

BackgroundPersistent or recurrent neck pain is associated with perturbations in the autonomic nervous system balance, and nociceptive stimulation has been seen to influence this balance. However, very few prospective studies have addressed the extent to which changes in pain associate with changes in autonomic cardiac regulation. Therefore, we investigated if changes in pain vary with changes in heart rate variability in a cohort of patients treated for persistent or recurrent neck pain.MethodThis analysis is based on data from a randomized controlled trial in which participants were given home stretching exercises with or without spinal manipulative therapy for two weeks. As the effectiveness of the intervention (home stretching exercises and spinal manipulative therapy) was found to be equal to the control (home stretching exercises alone), all 127 participants were studied as one cohort in this analysis. During the intervention, pain levels were recorded using daily text messages, and heart rate variability was measured in the clinics three times over two weeks. Two approaches were used to classify patients based on changes in pain intensity: 1) Clinically important changes in pain were categorized as either "improved" or "not improved" and, 2) Pain development was measured using pain trajectories, constructed in a data driven approach. The association of pain categories and trajectories with changes in heart rate variability indices over time were then analysed using linear mixed models.ResultsHeart rate variability did not differ significantly between improved and not-improved patients, nor were there any associations with the different pain trajectories.ConclusionsIn conclusion, changes in pain after home stretching exercises with or without spinal manipulative therapy over two weeks were not significantly associated with changes in heart rate variability for patients with persistent or recurrent neck pain. Future studies should rely on more frequent measurements of HRV during longer treatment periods.Trial registrationThe trial was registered at ClinicalTrials.gov, registration number: NCT03576846.

Novel Therapies for Centralized Pain: a Brief Review.

Centralized pain presents a complex pathology that many classic pharmacological agents for pain have not been able to sufficiently treat. To date, there are no clear guidelines for preferred treatment methods or comprehensive protocol that addresses confounding factors in this population. We sought to summarize the current field of knowledge around centrally mediated pain and to understand promising novel therapies. Many treatments currently used address not only the centralized pain phenotypem but the impact of central sensitization and the common comorbidities that reside within this population. Some novel therapies with promising evidence include the following: low-dose naltrexone, IV ketamine, acupuncture, aerobic activity, and laser therapy. Non-interventional treatment options include aerobic exercise, cognitive-behavioral therapy, mind-body therapies, virtual reality, and patient education on disease expectations. Much of the literature further emphasizes the importance of patient-level predictors, including factors like pain catastrophizing and social history, on treatment compliance and reported pain relief. We found that there are many potential treatment options for patients with centralized pain, particularly those that can be used as adjunct or combination therapies. The introduction of new approaches should occur in a carefully controlled, titrated manner to avoid exacerbation of pain symptoms. This is successfully conducted through patient-physician communication as this is a highly complex and personalized pain category. Our examination shows that while physicians have many options with proven success, there is a need for studies with longitudinal and larger patient populations to better articulate treatment guidelines.

Primary headache and myofascial pain: a data based study

Aim: This study aimed to evaluate the relationship between the presence of primary headaches and myofascial pain in orofacial patients. Materials and methods: Six hundred and ninety-nine records of patients seeking treatment in a specialized orofacial pain clinic were assessed. The primary diagnostic categories of headache and myofascial pain were recorded. Data analyses were carried out by Pearson Chi-square and Logistic Regression, with a p-value of 0.05. Results: Average age of patients was 34.6 years. Females constituted 82.8% of the sample. A relationship between the presence of tension-type headache and myofascial pain was found (p=0.00); however, this relationship was not found for the presence of migraine and myofascial pain (p>0.05). Discussion: Tension-type headaches may be triggered or perpetuated by trigger points in orofacial structures. Conclusion: It can be concluded that trigger points in myofascial pain patients can play an important role in the genesis of tension-type headache.

Fast pain relief in exercise-induced acute musculoskeletal pain by turmeric-boswellia formulation: A randomized placebo-controlled double-blinded multicentre study.

Background:Plant extracts with analgesic properties are seldom considered for treatment of acute musculoskeletal pain due to delay in onset of analgesia. Turmeric (Curcuma longa) and boswellia (Boswellia serrata) extracts are well-studied anti-inflammatory compounds gaining in popularity and used as an alternative to conventional treatments for musculoskeletal pain. This study analyzed the analgesic effect of a formulation of turmeric and boswellia extracts in sesame oil (Rhuleave-K, TBF) in reducing exercise-induced acute musculoskeletal pain in healthy participants.Methods:In this randomized double-blinded placebo-controlled, single-dose, single-day, multicentre study, a total of 232 participants (TBF n = 116; placebo n = 116) having moderate-to-severe exercise-induced acute musculoskeletal pain were randomized in an allocation concealed 1:1 ratio to receive a single dose of 1000 mg of TBF or placebo. The outcome measures were numerical rating scale (NRS), categorical pain relief scale (PRS), onset of analgesia, and short form of McGill questionnaire (SF-MPQ). NRS and PRS were measured from predose to every 30 minutes interval of postdose up to 6 hours at rest, with movement and applying pressure on the affected part. The onset of analgesia was measured from the time of dosage and censored at 6 hours of postdose. The sum of pain intensity difference (SPID6) and total pain relief (TOTPAR6) at 6 hours was, respectively, analyzed from NRS and PRS scores.Results:TBF showed a significant reduction in pain intensity (SPID6rest) with 97.85% improvement in cumulative responder analysis compared with 2.46% in placebo. The onset of pain relief was fast and highly significant in the TBF group with 99% of participants having a mean perceptible pain relief at 68.5 minutes (95% confidence interval, 59.5–77.4) and 96% of participants having a mean meaningful pain relief at 191.6 minutes (95% confidence interval, 176.7–206.4) compared to the placebo group. Highly significant and continuous improvement in pain relief was observed in the TBF group with 93% of participants having ≥ 50% of maximum TOTPAR6 with a number needed to treat of 1.1 at rest.Conclusion:Exercise-induced acute musculoskeletal pain can be effectively relieved by TBF (Rhuleave-K) in about 3 hours signifying its strong analgesic activity.

THE EFFECT OF YOGA ON THE REDUCTION OF BACK PAIN IN PREGNANT WOMENS TRIMESTER II AND III

Background : Back pain is a common discomfort in pregnancy. Back pain in pregnant women if not handled properly can lead to poor quality of life for pregnant women. So it is necessary to make efforts to overcome one of them with non-pharmacological therapy, namely pregnant yoga practice. Research Objectives: To determine the effect of pregnant yoga on reducing back pain in pregnant women in the second and third trimesters in the Kasreman Health Center Work Area, Ngawi Regency, East Java. Research Methods: This type of research is Quasi Experiment with (Pretest and post test without control group design). The population in this study was pregnant women in the second and third trimesters in the Kasreman Health Center Work Area, Ngawi Regency, East Java. A sample of 30 people was taken by purposive sampling technique. The dependent variable is pregnant yoga and the independent variable is the decrease in back pain for pregnant women in the second and third trimesters. The research instrument used NRS (Numerical Rating Scale). Data processing using editing, coding, tabulating with Wilcoxon test data analysis. Research Results: The results showed that back pain before doing yoga during pregnancy, most of the respondents experienced back pain with a minimum distribution scale of 1 (mild pain) category of pain scale as many as 5 respondents and a maximum distribution of scale with a pain scale category of 8 (severe pain) as many as 1 respondent, while After being given yoga, most of the pregnant women became the minimum distribution scale with a pain scale category of 0 (Mother Doesn't Feel Pain) as many as 9 respondents and a distribution scale that was maximum with a pain scale category of 5 (Medium Pain) as many as 2 respondents. The Wilcoxon statistic test showed that p value= 0.000 < (0.05) so that H1 is accepted. Conclusion: There is an effect of yoga on reducing back pain in pregnant women in the second and third trimesters in the Kasreman Health Center Work Area, Ngawi Regency, East Java. Key Word : Pregnancy Yoga, Back Pain in Second and Third Trimester

Design of Work Facilities to Reduce Complaints of Musculoskeletal Disorders (MSDS) with an Ergonomic Approach to Coffee Farmers

Complaints on the musculoskeletal system are complaints that are felt by a person in the muscles and skeleton with different levels of complaints, complaints to this damage are usually referred to as musculoskeletal disorders. The purpose of this study was to improve work facilities in the process of picking coffee cherries in Arul Item Village, Central Aceh. This measurement was carried out using the REBA (Rapid Entire Body Assessment) method and using the NBM (Nordic Body Map) questionnaire as the research instrument. The study was conducted using an analytical survey method which aims to see the relationship between work attitudes and musculoskeletal complaints with an ergonomic approach. From the results of the NBM questionnaire on 56 workers, it shows that the musculoskeletal complaints experienced by coffee berry pickers are in the category of pain, most of which are in the upper neck and left wrist as many as 39 (70%). In the very category of pain, the most pain was in the left shoulder 50 (89%) and the right wrist as much as 33 (59). Based on measurements using the REBA method, it is stated that there is an actual REBA score of 4-7 where the risk is at moderate risk for musculoskeletal disorders and on the proposed REBA score there is a score of 2 where the score is in a low risk area, so as to improve work attitudes and work posture which resulted in the emergence of musculoskeletal complaints, a modified work tool design, namely a bag, was proposed to reduce the high number of musculoskeletal complaints in coffee fruit pickers

Opioid prescription patterns among adults with cerebral palsy and spina bifida

BackgroundPain is the most common symptom of cerebral palsy and spina bifida (CP/SB). The objective of this study was to compare the opioid prescription patterns for differing pain types and overlapping pain among adults living with and without CP/SB. MethodsPrivately-insured beneficiaries were included if they had CP/SB (n = 22,647). Adults without CP/SB were also included as controls (n = 931,528). Oral morphine equivalents (OMEs) were calculated. A multivariable logistic regression was used to analyze the association between CP/SB and OMEs, across the three pain categories: (1) no pain, (2) isolated pain, and (3) pain multimorbidity. ResultsAdults living with CP/SB had a higher OME prescription pattern per year than adults without CP or SB (8,981.0 ± 5,183.0 vs. 4,549.1 ± 2,988.0), and for no pain (4,010.8 ± 828.1 vs. 1,623.53 ± 47.5), isolated pain (7,179.9 ± 378.8 vs. 3,531.0 ± 131.0), and pain multimorbidity (15,752.4 ± 1,395.5 vs. 8,492.9 ± 398.0) (all p < 0.001), and differences were to a clinically meaningful extent. Adjusted odds ratios (OR) for prescribed OMEs were higher for adults with CP/SB vs. control and (1) no pain (OR: 1.51; 95%CI: 1.46, 1.56), (2) isolated pain (OR: 1.48; 95%CI: 1.44, 1.52), and (3) pain multimorbidity (OR: 1.79; 95%CI: 1.72, 1.86). ConclusionsAdults with CP/SB obtain significantly higher prescription of OMEs than adults without CP/SB.

Poster 244: Pain Catastrophizing in Patellar Instability Patients Undergoing MPFL Reconstruction

Objectives:Pain catastrophizing was established as a way to measure patient perception and response to pain, as represented by three subscores: rumination, magnification, and helplessness. Prior clinical studies have demonstrated the close relationship between pain catastrophizing and persistent postoperative pain after total knee arthroplasty. Among patellofemoral instability patients, pain catastrophizing has also been investigated. However, specific patient factors that contribute to greater degrees of pain catastrophizing in patellofemoral instability are not yet understood. Additionally, investigations of the association between preoperative catastrophizing and postoperative pain are limited. Therefore, the purpose of this study is to investigate risk factors for higher preoperative pain catastrophizing and its correlation with pain scores following medial patellofemoral ligament reconstruction (MPFLR).Methods:This study retrospectively evaluated patients who underwent MPFLR between 2015 and 2020 with preoperative pain catastrophizing scores (PCS). Patient demographics were collected to evaluate risk factors for worse PCS scores. Four overlapping questions from the KOOS JR and full KOOS questionnaires were utilized at the preoperative and 6 months postoperative time points to assess pain on a scale from 0 (least) to 4 (most), including pain with: 1.) Knee Twisting, 2.) Knee Straightening, 3.) Stair Climbing, and 4.) Standing Upright.Results:Thirty-four patients were included for analysis. Higher age at the time of surgery was significantly associated with worse Helplessness (R2=0.11, p=.035), Rumination (R2=0.18, p=.020), and Total PCS scores (R2=0.08, p=.039). Patients with >5 instability events reported significantly worse Rumination (2.29±2.87 vs 4.60±3.31, p=.049). At 6 months post-operatively, 32.35% of patients (11/34) continued to report moderate pain in at least one pain category. These patients reported significantly greater Rumination at baseline (2.91 ± 3.37 vs 6.64 ± 5.22, p = .017). Lastly, higher baseline Helplessness significantly correlated with greater improvement in pain with stairs (p = .049), higher Magnification significantly correlated with greater improvement in pain with standing (p = .012), and higher baseline Total PCS correlated with more improvement in pain with stairs (p = .035) and standing (p = .037). Multivariate analysis demonstrated that history of prior surgery and age remained independently predictive of postoperative pain scores (Table 1).Conclusions:Older age and >5 instability events at presentation were patient risk factors associated with increased pain catastrophizing. Pain catastrophizing had different correlations with postoperative pain depending on subscore, with higher Rumination associated with persistent moderate pain while higher Magnification or Helplessness correlated with greater improvement in pain. However, on multivariate analyses the only significant independent predictors of persistent moderate to severe post-operative pain at 6 months were age and history of prior surgery. Further investigation is needed to determine whether pain catastrophizing is an innate patient factor with post-operative implications or merely an effect of prolonged symptoms in patellar instability patients.Table 1.Multivarite Linear regression model evaluating indepentant predictors of worse postoperative pain scores

Faktor yang Berhubungan dengan Upaya Penanganan Keluhan Dismenore pada Siswi SMK Negeri 17 Samarinda

Dysmenorrhea are still quite high but there are still few young women who seek information about dysmenorrhea and the impact it causes. This triggers young women to pay less attention to the handling efforts made when experiencing complaints of menstrual pain. This study aims to find out the relationship between knowledge, the degree of pain and exposure to information with efforts to handle dysmenorrhea complaints. This type of research is quantitative with a cross sectional approach. The study population was 425 with a sample of 197 people using purposive sampling techniques. The data was taken using questionnaires. Analysis of the data used using the Spearman Rank Test with a 95% confidence level. The results showed that respondents' handling efforts were in the good category (39.6%), respondents' knowledge levels were in the good category (58.4%), respondents' pain levels were in the category of mild pain (58.9%) and the respondent information exposure category was in the exposure category (61.9%). The study's conclusions showed there was a relationship between knowledge (p-value 0.000), degree of pain (p-value 0.035) and exposure to information (p-value 0.049) with efforts to handle dismenore complaints. It is recommended to be able to increase socialization evenly to all students so that each student gets the same information in addition to it is recommended that students can improve handling such as exercising, doing knee chest positions and doing examinations to the doctor and maximizing parental support as an accurate source of information

A novel artificial neural network for the diagnosis of orofacial pain and temporomandibular disorders.

Temporomandibular disorders (TMD) and orofacial pain are highly prevalent. This prevalence can be compared to that of leading non-communicable diseases (NCDs). However, it is surprising to still find a high degree of controversy regarding its diagnosis and management. Patients usually experience treatment delays, missed diagnoses, and receive unnecessary therapies. New artificial intelligence algorithms have helped diagnose numerous diseases. Nevertheless, no studies have focused on the use of artificial intelligence to diagnose these conditions. This study aimed to develop and test the performance of a novel neural network (multilayer perceptron) with diagnostic capabilities in orofacial pain and TMD, including some types of referred pain. A multilayer perceptron (MLP) was developed with one input layer, five hidden layers, and one output layer. It was trained using backpropagation algorithms. Several categories of orofacial pain and TMD clinical cases were presented to 12 general dental clinicians, and their diagnoses were contrasted to those provided by the artificial intelligence neural network. Overall, the diagnostic accuracy of the artificial intelligence was superior to that of the general dental clinicians (p=.0072). This was more evident in the clinical cases involving non-dental and referred orofacial pains (e.g. neuropathic pain, referred cardiac pain, neurovascular pain). This study showed, for the first time, that an artificial neural network can help medical and general dental clinicians diagnose several types of orofacial pain and dysfunction, including TMD, neuropathic, neurovascular, and referred cardiac pain. In some cases, the MLP appears to have a life-saving role.

External Concurrent Occipital and Trigeminal Neurostimulation Relieves Migraine Headache: A Prospective, Randomized, Double-Blind, Sham-Controlled Trial.

IntroductionCurrent external peripheral nerve stimulation devices stimulate only one nerve. This prospective, randomized, double-blind, sham-controlled trial assessed efficacy, safety, and tolerability of a novel external combined occipital and trigeminal neurostimulation (eCOT-NS) device as a self-administered home treatment for migraine (Relivion®MG, Neurolief Ltd; Netanya, Israel).MethodsEpisodic and chronic migraine subjects (N = 55) were randomized to receive active (n = 27) or sham (n = 28) treatment. Subjects received eCOT-NS devices and performed 60 ± 20-min home treatments within 45 min of migraine episode onset. The primary endpoint was relative (percent) change in mean baseline VAS pain scores 1 h after treatment initiation. Treatment outcomes assessed at 1-, 2-, and 24-h post-treatment initiation were pain reduction and proportion of pain-free subjects and treatment responders, defined as ≥ 50% pain reduction. Categorical pain ratings (none, mild, moderate, and severe pain) were also analyzed.ResultsActive stimulation was significantly more effective than sham stimulation for decreasing pain intensity at 1 h (53% vs. 10%), 2 h (52% vs. 17%), and 24 h (71% vs. 34%). Pain-free ratings were greater for the active treatment arm at 1 h (29.2% vs. 16%), 2 h (41.7% vs. 20%), and 24 h (65.2% vs. 40%). The number of subjects with baseline moderate or severe migraine pain who were pain-free at 2 h was significantly greater among active treatment subjects (43% vs. 10.5%). The responder rate was significantly higher among the active treatment group at 1 h (67% vs. 20%), 2 h (66.7% vs. 32%,), and 24 h (78.3% vs. 48%). Overall headache relief was significantly higher in the active treatment group at 1 h (67% vs. 26%) and 2 h (76% vs. 31.6%). Mild adverse events, reported by a minority of subjects, resolved spontaneously.ConclusionseCOT-NS provides superior clinically meaningful relief and freedom from migraine pain, offering an effective and safe therapy for acute treatment of migraine.Trial registrationClinicalTrials.gov Identifier NCT03398668.

Diagnosis and Treatment of Five Pain-Related Conditions in Urban China: A Population-Based Cross-Sectional National Health and Wellness Survey.

BackgroundWhile there is an extensive body of research regarding pain and its treatment in developed countries, little research on this topic has been performed in developing countries. This study aimed to investigate the diagnosis, treatment, and treatment satisfaction in individuals with pain in urban China using real-world data.MethodsAll respondents from the 2013, 2015, and 2017 China National Health and Wellness Survey were included in the analysis and were classified into diagnosed and undiagnosed groups according to their self-reported physician diagnosis or experience in the past month. The following five categories of pain were analysed: headache, cancer-associated pain, musculoskeletal pain, neuropathic pain, and fibromyalgia. Rates for diagnosis, treatment, and satisfaction with medication were calculated overall and for each pain type.ResultsA total of 3802 respondents reported experience of at least one type of pain in the past month. Among those, 61.2% were diagnosed with a pain-related condition, the majority of which (84.0%) were receiving treatment. For diagnosed respondents taking over-the-counter and/or prescription medication, 70.3% were satisfied with their treatment. Comparing between pain types, the diagnosis rates for cancer-associated pain (32.7%) and fibromyalgia (22.8%) were relatively low, whereas respondents with musculoskeletal pain has the highest diagnosis rate (61.1%). Respondents with cancer-associated pain had the lowest satisfaction (30.0%) with over-the-counter and prescription medication, while respondents with headache (76.2%) had the highest satisfaction rate with such medications.ConclusionOur study highlights the importance of raising awareness for pain management as well as education and training for healthcare providers and patients.