Differences In Visual Analog Scale Scores Research Articles

Subtalar arthroereisis for simultaneous treatment of flexible pes planus during surgical correction of hallux valgus

BackgroundScarf osteotomy is a well-established procedure for hallux valgus, yet recurrence rates range from 3.6% to 10%. Pes planus, which often coexisting with hallux valgus, is a risk factor for recurrence. This study aimed to evaluate the effectiveness of simultaneous correction of hallux valgus and flexible pes planus.MethodsA total of 85 feet with hallux valgus associated with adult flexible pes planus were retrospectively reviewed. All patients were treated with scarf osteotomy (SO). Subtalar arthroereisis using a HyProCure implant (SOH) was performed to correct hindfoot valgus based on shared decision-making. We collected and compared pre- and at least 2 year postoperative clinical outcomes (American Orthopaedic Foot & Ankle Society (AOFAS) forefoot, hindfoot score, Visual Analog Scale (VAS) pain intensity) and radiographic outcomes (hallux valgus angle (HVA), intermetatarsal angle (IMA), Meary’s angle, talonavicular coverage angle (TNCA), and calcaneal pitch (CP) angle in both groups.ResultsOf the cases reviewed, 51 feet were allocated to SO group, and 34 feet were in SOH group. Recurrence frequency was 5 feet (9.8%) in the SO group, while no recurrences were reported in the SOH group. There was no significant difference in AOFAS forefoot and VAS scores between the groups, However, the SOH group demonstrated significant improvement in AOFAS hindfoot scores and CP angle, as well as a greater reduction in Meary’s angle and TNCA, compared to the SO group. Changes in HVA and IMA did not differ significantly between the groups. Three feet in the SOH group experienced sinus tarsi pain, which resolved after removal of the HyProCure implant.ConclusionsSubtalar arthroereisis with a HyProCure implant is an effective treatment option for adult flexible pes planus associated with scarf osteotomy for hallux valgus, leading to a steady improvement in the patients forefoot deformity and increased patient satisfaction at least 2 years postoperatively.

Comparative study of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting for the treatment of osteochondral lesions of the talus

BackgroundSurgical management methods for Hepple IV-V osteochondral lesions of the talus (OLT) are diverse. This study aimed to compare the clinical efficacy of arthroscopic autologous cancellous bone grafting and medial malleolar osteotomy combined with autologous periosteal iliac bone grafting in the treatment of medial Hepple IV-V OLT.MethodsA retrospective analysis of clinical data from patients who underwent surgical treatment for Hepple IV-V OLT (2020–2023) was conducted. A total of 37 patients were included, with 17 receiving arthroscopic autologous cancellous bone grafting (Group A) and 20 receiving medial malleolar osteotomy combined with autologous periosteal iliac bone grafting (Group B). Compared the surgical time of the two groups; the visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society (AOFAS) scores, and ankle joint mobility were used preoperatively, and at 3 months and 1 year postoperatively to assess clinical efficacy; the magnetic resonance observation of cartilage repair tissue (MOCART) 2.0 ankle scores were evaluated at early postoperatively and 1 year postoperatively to assess cartilage repair.ResultsThe surgical time for Group A was significantly shorter than Group B (P < 0.05). At 3 months and 1 year postoperatively, both groups showed a significant improvements in VAS scores, AOFAS scores, and ankle joint mobility compared to preoperative levels (P < 0.05). At 3 months postoperatively, Group A had significantly higher AOFAS scores and ankle joint mobility than Group B (P < 0.05), while there was no statistically significant difference in VAS scores between the two groups (P > 0.05). At 1 year postoperatively, no significant differences in any of the assessed parameters were found between the two groups (P > 0.05). The MOCART 2.0 ankle scores at 1 year postoperatively were significantly higher than early postoperatively for both groups (P < 0.05), with no significant differences between the two groups (P > 0.05).ConclusionArthroscopic autologous cancellous bone grafting showed superior early functional recovery at the 3-month follow-up compared to medial malleolar osteotomy combined with autologous periosteal iliac bone grafting, with shorter surgical time and avoiding osteotomy. Both surgical methods were able to relieve patients’ pain, restore function, and improve cartilage repair.Level of evidenceIII, retrospective comparative study.

COMPARE THE ANALGESIC EFFICACY OF 0.25% BUPIVACAINE AND 0.25% BUPIVACAINE WITH 0.9 μG/KG DEXMEDETOMIDINE IN TAP BLOCK

Objectives: The transversus abdominis plane (TAP) block is a relatively new regional anesthesia technique that provides analgesia to the parietal peritoneum as well as the skin and muscles of the anterior abdominal wall. Despite a relatively low risk of complications and a high success rate using modern techniques, TAP blocks remain overwhelmingly underutilized. The objective is to compare the analgesic efficacy of 0.25% bupivacaine and 0.25% bupivacaine with 0.9 μg/kg dexmedetomidine in TAP block as a part of a multimodal analgesia regimen for post-cesarean delivery pain management. Methods: Patients more than 18 years old posted for elective/emergency caesarean section in ABVGMC, Vidisha, Madhya Pradesh. After approval from the institutional ethical committee and written informed patients consent, 20 each pregnant women were included in the both study group. Group A: TAP block with 0.25% bupivacaine 20 mL each side Group B: TAP block with 0.25% bupivacaine with 0.9 μg/kg dexmedetomidine 20 mL each side. We studied TAP block in patients posted for elective caesarean section. Results: The women received 0.25% bupivacaine or 0.25% bupivacaine with 0.9 μg/kg dexmedetomidine. The median visual analogue scale (VAS) for pain was significantly higher in the bupivacaine Group A at 12 h with compare to Group B. Overall, there was no difference in VAS score at 0.5, 2, 4, 6, and 24 h demands between the two groups. The mean time to first rescue analgesia in Group A was 14.6±5.5 h and in Group B was 16.8±4.2 h. Conclusion: We conclude that the using dexmedetomidine as an additive to bupivacaine in ultrasound-guided TAP block for elective/emergency caesarean section provides prolonged duration of post-operative analgesia, and lowered VAS pain scores. The addition of dexmedetomidine to bupivacaine also reduced the total dose of opioid requirement in the first 24 h after caesarean section.

Effect of smoking on hip arthroscopy outcomes: a systematic review and meta-analysis

Hip arthroscopy is an increasingly utilized procedure for treating various hip pathologies. However, patient-related factors, such as smoking, may significantly impact postoperative outcomes. Smoking is known to impair tissue healing and increase the risk of complications, potentially leading to poorer surgical results. This meta-analysis aims to evaluate the effect of smoking on outcomes following hip arthroscopy, focusing on functional scores, pain levels, and patient satisfaction. A comprehensive search was conducted in PubMed, Web of Science, Scopus, Medline, the Cochrane Library, and Google Scholar to identify studies assessing hip arthroscopy outcomes in smokers and nonsmokers. After removing duplicates, screening titles and abstracts, and assessing full-text eligibility, five studies were included in the quantitative synthesis. Outcomes were pooled using a fixed-effect model to calculate mean differences and 95% confidence intervals (CIs). The meta-analysis included data from five studies with a total of 618 patients (234 smokers and 384 nonsmokers). The hip outcome score–sports specific (HOS-SS) was significantly lower in smokers, with a mean difference of -8.63 (95% CI: -12.71, -4.54), indicating worse sports-specific function. The modified Harris hip score (mHHS) was also significantly lower in smokers (mean difference: -4.47, 95% CI: -7.50, -1.44). Pain levels measured by the visual analog scale (VAS) were higher in smokers (mean difference: 0.62, 95% CI: 0.17, 1.06). However, there was no significant difference in satisfaction VAS scores between smokers and nonsmokers (mean difference: -0.13, 95% CI: -0.61, 0.34). In conclusion, smoking is associated with significantly worse functional outcomes and higher pain levels following hip arthroscopy. These findings highlight the importance of smoking cessation programs for patients undergoing hip arthroscopy to improve surgical outcomes. Despite the worse functional and pain outcomes, patient satisfaction did not differ significantly, which may indicate a disparity between objective outcomes and subjective satisfaction in smokers.

Hypertonic dextrose compare with other substances for knee osteoarthritis: a meta-analysis of randomized control trial

Background: Globally, osteoarthritis (OA) highly prevalent in the elderly more than 80% of those over 55 years old. At least 151 million people worldwide are afflicted. The knees, hips and spine are the joint areas that are most frequently affected. For the treatment of knee OA, intra-articular injection like stem cells, platelet rich plasma (PRP), and hypertonic dextrose (HD) the most used prolotherapy fluid is HD. It is widely accessible, reasonably inexpensive priced and reportedly safe. The aim of this meta-analysis is to thoroughly assess and compare the results of intra articular dextrose prolotherapy with hyaluronic acid and normal saline, with a focus on visual analog scale (VAS) and WOMAC score. Methods: A comprehensive search was conducted across major electronic databases for relevant studies published from 2014 to 2024. Studies that compare intra articular dextrose prolotherapy with hyaluronic acid and normal saline for knee OA were included. We recorded the first author, year, study design, sample number, age, sex, Kellgren Lawrence grade, VAS and WOMAC score were extracted and analyzed using appropriate statistical methods. Results: The initial search yielded a total of 2371 studies, of which 7 studies met the inclusion criteria, consisting of a total of 372 patients of intra articular dextrose prolotherapy with hyaluronic acid and normal saline for knee OA. It shows that there is no significant difference in VAS score between two groups (MD=-0.72, 95% CI:-1.74 to 0.31, p=0.17). There was no difference in WOMAC score between two groups. Conclusions: Our results show that both methods provide similar outcome in pain scale and WOMAC score. More over to enhance the efficacy of prolotherapy in comparison to alternative treatments like HA or saline injections, it is suggested that a multicenter clinical trial with a larger number of participants be carried out.

Comparative study on effectiveness of injecting platelet-rich plasma with different concentrations of leukocytes under ultrasound in treatment of supraspinatus tendon injury

To compare effectiveness of injecting platelet-rich plasma (PRP) with different concentrations of leukocytes under ultrasound in treatment of supraspinatus tendon injury. A clinical data of 30 patients with supraspinatus tendon injury, who met the selection criteria and were admitted between December 2022 and December 2023, was retrospectively analyzed. Thirty patients were treated with 4 injections of leukocyte-poor PRP (LP-PRP, n=10), leukocyte-rich PRP (LR-PRP, n=11), and triamcinolone ( n=9), with an interval of 7-10 days between each injection. There was no significant difference between groups ( P>0.05) in the age, gender, disease duration, affected shoulder side, Ellman classification, preoperative visual analogue scale (VAS) score, Constant score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and American Shoulder and Elbow Surgeons (ASES) score. At 1, 3, and 6 months after injection, the shoulder pain and function were evaluated by using the VAS score, Constant score, DASH score, and ASES score. MRI was conducted to observe supraspinatus tendon healing. No severe adverse reactions was observed in all groups. All patients were followed up 6-7 months, with an average of 6.5 months. After injection, the ASES score and Constant score gradually increased in the LR-PRP group and LP-PRP group, while the VAS score and DASH score decreased, with significant differences compared to before injection ( P<0.05). Except for no significant difference between 3 and 6 months after injection in LR-PRP group ( P>0.05), the above scores showed significant differences between different time points ( P<0.05). At 1 month after injection, the Constant score in triamcinolone group significantly increased compared to before injection, while the VAS score significantly decreased ( P<0.05). There was no significant difference in all scores between other time points in the triamcinolone group ( P>0.05). Except for 1 month after injection, there was no significant difference in Constant score and VAS score between groups ( P>0.05). At all other time points, the LR-PRP group and LP-PRP group had better scores than the triamcinolone group ( P<0.05). There was no significant difference between the LR-PRP group and the LP-PRP group ( P>0.05). MRI showed that only 4 patients in the LP-PRP group had signs of repair at the supraspinatus tendon injury site at 6 months after injection, while no significant tendon repair sign was observed in the other patients. Compared with triamcinolone treatment, multiple injections of LP-PRP and LR-PRP under ultrasound can promote the recovery of shoulder joint function and significantly relieve pain in patients with supraspinatus tendon injury, and imaging improvement can be seen after LP-PRP treatment.

Immediate effects of Kinesio taping on pain, proprioception, and posture in round shoulder individuals with subacromial impingement syndrome: A randomized, double-blinded controlled trial.

Round shoulder posture (RSP), characterized by forward shoulder positioning from weakened and tense muscles, disrupts normal biomechanics and can cause Subacromial impingement syndrome (SIS), resulting in pain during specific movements or positions. This study examines the immediate effects of Kinesio taping (KT) on pain, proprioception, and posture in individuals in round shoulder individuals with SIS. The study involved 114 patients diagnosed with RSP and SIS. Pain intensity was assessed using a Visual Analog Scale (VAS), proprioception was measured with an inclinometer, and posture was evaluated using The New York Posture Rating Chart (NYPRC). Participants were randomly assigned to experimental group (EG) (n = 57), which received KT application, or to sham group (SG) (n = 57), which underwent a sham procedure. KT was applied to the affected shoulder and scapular regions. Assessments were conducted both before and after the application of Kinesio tape. According to the study results, the differences in VAS scores (P = .002), proprioception abduction (P = .023) and NYPRC scores (P = .04), were statistically significant in the EG compared to the SG (P < .05). However, there was no significant difference in proprioception flexion between the groups (P > .05). KT demonstrates immediate benefits in reducing pain and improving scapular alignment in individuals with RSP and chronic shoulder pain. These findings underscore its potential effectiveness as a therapeutic intervention for managing symptoms associated with RSP and impingement syndrome, particularly in terms of pain relief and posture enhancement.

Impact on Quality of Life of Full-time and Night-time Braces in Adolescent Idiopathic Scoliosis: A Randomized Clinical Trial.

Randomized clinical trial. To compare the effect on quality of life of night-time (NT) and full-time (FT) brace treatment for adolescent idiopathic scoliosis (AIS). Conservative treatment of AIS with FT braces has proven to prevent the risk of progression and the need for surgery, with an inversely proportional relationship to the number of hours worn. However, therapeutic adherence and its effect on quality of life continue to pose a clinical challenge. Open-label clinical trial including AIS patients with curves between 25 and 45° randomized to either NT or FT brace group. Follow-up occurred over 2 years, assessing treatment efficacy through radiographs and quality of life using SRS-22 and visual analog scale (VAS) questionnaire scores at baseline, 6 months, and 12 months. Compliance was monitored with thermal sensors every 3 months. Statistical analyses were conducted, with significance set at P < 0.05. Seventy-eight AIS patients, predominantly females (85.9%), were recruited, including 35 (44.87%) in the FT group and 43 (55.13%) in the NT. Initial Cobb angles were comparable between groups. Nine patients were excluded, and eight required surgery (NT 12.82%, FT 10%). After 2 years, both braces showed similar effectiveness in preventing curve progression. No differences in SRS-22 nor VAS scores were found before treatment. At 6-month follow-up, the NT group reported significantly better outcomes in "self-image" compared with FT ( P =0.047). After 1 year, NT patients reported less pain compared with baseline ( P =0.048). According to our results, both braces are equally effective in avoiding the progression of the deformity and need for surgery. However, FT brace has a higher impact on self-image and pain compared with NT brace.

Early effectiveness of unilateral biportal endoscopy technique for migrated lumbar intervertebral disc herniation

To explore early effectiveness of unilateral biportal endoscopy (UBE) technique in the treatment of migrated lumbar intervertebral disc herniation. A retrospective analysis was conducted on 87 patients with migrated lumbar intervertebral disc herniation, who were treated with UBE technique between May 2021 and December 2022 and met the selection criteria. There were 55 males and 32 females, with an average age of 48.8 years (range, 29-74 years). The disease duration ranged from 2 to 23 months, with an average of 9.1 months. The surgical segments included 17 cases of L 3, 4, 32 cases of L 4, 5, and 38 cases of L 5, S 1. According to Lee's classification criteria, there were 12 cases of type 1, 17 cases of type 2, 37 cases of type 3, and 21 cases of type 4. The operation time, length of hospital stay, and complications were recorded. The visual analogue scale (VAS) score was used to assess the degree of low back and leg pain before operaion and at 3 days, 3 months, 6 months, and 12 months after operation. The Oswestry disability index (ODI) was used to evaluate the lumbar spine function. At last follow-up, the modified MacNab criteria was used to evaluate the effectiveness. According to the preoperative migrated intervertebral disc classification, the patients were allocated into groups Ⅰ to Ⅳ. The differences in VAS score and ODI were compared. All 87 patients successfully completed the operations. There was no nerve root injury, dural sac injury, or dural tear during operation. The operation time was (58.6±14.6) minutes and the length of hospital stay was (4.0±0.8) days. All incisions healed by first intention after operation. No symptomatic epidural hematoma occurred. All patients were followed up for 12 months. There were significant differences in VAS scores and ODI at each time point after operation when compared with those before operation ( P<0.05). There were significant differences in VAS score at 3 days after operation when compared with that at 3, 6, and 12 months after operation ( P<0.05). For ODI, except that there was no significant difference between 6 and 12 months after operation ( P>0.05), there were significant differences between other time points after operation ( P<0.05). At last follow-up, the effectiveness was rated as excellent in 66 cases, good in 13 cases, and fair in 8 cases according to the modified MacNab criteria, and the excellent and good rate was 90.8%. There was no intervertebral disc herniation recurred during follow-up period. There was no significant difference in VAS score and ODI among groups Ⅰ -Ⅳ before operation and at each time point after operation ( P>0.05). The UBE technique is safe and effective in the treatment of migrated lumbar intervertebral disc herniation, with a low complication rate and satisfactory early effectiveness.

Comparative Effects of Spinal Anesthesia and Combined Spinal with Peripheral Nerve Blocks on Postoperative Outcomes in Anterior Cruciate Ligament Repair.

Objectives: This study aimed to compare the effectiveness of spinal anesthesia (SA) alone versus combined spinal anesthesia with adductor canal block (ACB) and sciatic nerve block (SNB) (SA + ACB + SNB) in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. We hypothesized that SA + ACB + SNB would provide better analgesia, greater patient satisfaction, and shorter postanesthesia recovery times than SA alone. Methods: A prospective randomized controlled trial was conducted with 60 patients aged 15-49 years scheduled for elective arthroscopic ACL reconstruction. Participants were randomly assigned to receive either SA or SA + ACB + SNB. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 4, 12, and 24 h post-operation. General health was evaluated using the 12-item Short Form Survey (SF-12) at 1 month postoperatively. Range of motion and analgesic consumption were also recorded. Results: The median VAS score at 4 h post-operation was significantly lower in the SA + ACB + SNB group compared to the SA group (0 [IQR: 0-1] vs. 2 [IQR: 1-3], p = 0.0137). No significant differences in VAS scores were found at 12 h (p = 0.9282) and 24 h (p = 0.5809). PCS-12 and MCS-12 scores did not differ significantly between groups. The SA group had a lower postoperative range of motion (ROM) compared to the SA + ACB + SNB group, with a mean active ROM of 40.67 degrees (±23.52) versus 72.17 degrees (±24.69), respectively (p < 0.0001). Analgesic consumption was similar, with 53.33% of participants in each group using postoperative analgesics (p = 1.0). The mean surgery duration was 74.6 min. The gender distribution was 83% male and 17% female, with an average age of 27.7 years. Conclusions: Adding ACB and SNB to spinal anesthesia improved immediate postoperative pain relief and preserved range of motion in patients undergoing ACL reconstruction, suggesting potential clinical benefits in pain management and functional recovery.

Comparison of robot-assisted versus fluoroscopically guided treatment of atlantoaxial dislocation in combination with high-riding vertebral artery: a preliminary study

BackgroundRobotic-assisted surgery has emerged as an innovative approach widely adopted in the field of orthopedics. However, its application specifically for managing atlantoaxial dislocation with a high-riding vertebral artery (AAD-HVA) remains underreported in the existing literature.ObjectiveTo compare the perioperative outcomes of robotic-assisted (RA) and fluoroscopic-guided free-hand (FH) techniques for atlantoaxial dislocation in combination with a high-riding vertebral artery (AAD-HVA).Study designThis was a retrospective study.SettingThis research was performed at a single department of spine surgery.MethodsData from patients who underwent atlantoaxial internal fixation between July 2018 and January 2022 at our hospital were retrospectively analyzed. Among the cases, 14 were performed using free-hand (FH) techniques and 11 utilized robotic-assisted (RA) techniques. Data collected included case notes, imaging records, and follow-up data. The reliability of screw placement was evaluated based on the Gertzbein and Robbins scores, while treatment outcomes were assessed using the Japanese Orthopaedic Association (JOA) score, visual analog scale (VAS), neck disability index (NDI), and postoperative complication rate.ResultsBaseline patient characteristics were comparable between the FH and RA groups. The mean blood loss was markedly lower in the RA group (157.3 ± 49.7 ml) compared to the FH group (290.0 ± 110.3 ml) (p = 0.03). Although the average operative time was slightly higher in FH group than in RA group, this disparity did not achieve statistical significance (p = 0.7588). Moreover, the radiation exposure dose was remarkably higher in FH group (32.7 ± 4.4 mGy) than in RA group (23.0 ± 3.2 mGy) (p < 0.0001). The percentage of clinically acceptable screw placement was slightly lower in FH group (87.5%) than in RA group (97.8%), but the observed variance was not statistically meaningful (p = 0.3669). Furthermore, the differences in JOA, VAS, and NDI scores between the FH and RA groups were not statistically significant. Additionally, no obvious differences were found in clinical outcomes or complications related to screw implantation between the two groups.LimitationsThis study has inherent limitations as it was retrospective in nature and conducted at a single center.ConclusionRobotic-assisted surgery for AAD-HVA patients offers a minimally invasive approach, reduced bleeding and lower radiation exposure compared with traditional free-hand surgery.

Traditional Chinese herbal compound as complementary treatment for nonspecific low back pain: A randomized controlled trial.

This prospective randomized controlled trial was designed to evaluate the clinical efficacy and safety of Bu Shen Tong Luo herbal compound as a complementary treatment for nonspecific low back pain (NSLBP). A total of 76 patients with NSLBP included from January 2022 to June 2023 according to the criteria were randomly divided into Bushen Tongluo formula (BSTL) group (n = 38) and celecoxib group (n = 38). According to Traditional Chinese Medicine principles, patients of 2 groups were divided into 5 syndrome types. Celecoxib or BSTL herbal compound were used to treat NSLBP of each group for 3 weeks, every week the Visual Analog Scale (VAS), Oswestry Disability Index, and Japanese Orthopaedic Association scores of each patient was record and compared to evaluate the clinical efficacy, and adverse reaction was reported to evaluate the safety of 2 interventions. A total of 71 patients finished the follow-up, including 36 patients in BSTL group and 35 patients in celecoxib group. The result showed that within 3 weeks, both BSTL and celecoxib interventions were able to treat NSLBP, with improvements in VAS scores and waist function index. However, there were no significant differences in clinical outcomes between these 2 interventions. Then we divided the patients into 5 syndromes on the basis of traditional Chinese medicine principles and observed their clinical outcomes. We found that celecoxib had similar improvements in VAS score and waist function index for each syndrome type and most of the syndromes in the BSTL group, except for the SRBZ syndrome. In the treatment of SRBZ syndrome, BSTL prescription showed no statistically significant clinical improvement. Meanwhile, in the treatment of HSBZ syndrome of NSLBP, BSTL prescription showed better clinical results than celecoxib, although there was no difference in VAS scores between the 2 groups, patients in BSXL group had better waist function than those in celecoxib group. Both BSTL herbal compound and celecoxib are effective and safe in the clinical treatment of NSLBP, and BSTL herbal compound had unique advantages in the treatment of HSBZ syndrome type of NSLBP especially in waist function improvement.

Two types of vidian neurectomy show efficacy in treating allergic rhinitis and vasomotor rhinitis

This study aimed to evaluate the efficacies of endoscopic vidian neurectomy (VN) and highly selective vidian neurectomy (HSVN) for the treatment of allergic rhinitis (AR) and vasomotor rhinitis (VMR). All AR and VMR patients were divided into two groups, Group VN and Group HSVN. The efficacy evaluation methods were visual analog scale (VAS), rhinoconjunctivitis quality of life questionnaire (RQLQ), and medication score. The efficacy evaluations were used to assess patient rhinitis symptoms, quality of life and drug usage. The time points of follow-up period were preoperative, 3 months, 6 months, 1 year, 2 years, and 3 years post operation. By analyzing pre- and postoperative VAS, medication score and RQLQ score, the results showed that rhinitis symptoms and quality of life in both VN and HSVN groups were significantly improved at 3 years, and the rate of improvement decreased gradually with time. Post operation, there were no significant differences in VAS and medication scores between the VN and HSVN groups. With respect to RQLQ, postoperative 2 years and 3 years improvements in sleep disorders, non-nasal symptoms and eye symptoms were significantly greater in the HSVN group than in the VN group. Improvements in rhinitis symptoms and quality of life in AR and VMR were sustained by VN and HSVN until 3 years post operation, with greater quality of life improvements in the HSVN group.

Examination of oral health quality of life and patient satisfaction in removable denture wearers with OHIP-14 scale and visual analog scale: a cross-sectional study

BackgroundOral Health-Related Quality of Life (OHRQoL) is a term that encompasses conditions such as oral health status, living conditions, and function. OHQoL can change with the varying health conditions of the same individual. Many patients cannot afford implants or have anatomical limitations and therefore use traditional removable dentures. There are comparatively few studies investigating OHRQoL and denture satisfaction that include the patients’ sociodemographic data, denture satisfaction and related questions.AimThis study aimed to investigate OHRQoL and patients’ satisfaction with three types of dentures: upper and lower complete dentures, upper and lower partial dentures, and upper complete lower partial dentures.MethodsThe study was conducted between January 2022 and June 2023, with 150 patients using removable dentures. Patients’ age, gender, education level, place of residence, smoking status, reasons for tooth loss and visiting the clinic, type of denture and the duration of denture use were recorded. Oral Health Impact Profile (OHIP-14) and patient satisfaction with dentures as measured on a Visual Analog Scale (VAS) were used to assess patients’ satisfactions with OHRQoL and dentures respectively. Descriptive statistics, the Shapiro-Wilk normality test, the Mann-Whitney non‐parametric test and the Kruskal-Wallis test were used.ResultsStatistically significant differences were found between gender, prosthetic type, usage duration and OHIP and VAS scores (p < 0.05). Women’s OHIP scores were higher than men’s, patients using complete dentures had higher scores than those using partial dentures in both jaws, those using dentures for less than 1 year had higher scores than those that had used them for more than 1 year. The analysis revealed no statistically significant differences in OHIP and VAS scores based on age, education level, and place of residence (p > 0.05).ConclusionsPatients may find it easier to adapt to removable partial dentures compared to complete dentures. Therefore, in prosthetic planning, dentists should prioritize preserving existing teeth. Regardless of the type of prosthesis, patients adapt to their prostheses over time, leading to increased satisfaction with prolonged use. Since individuals do not have a habit of visiting the dentist when there is no known problem, dentists should encourage patients to attend regular dental check-ups.

The positive significance of staged physical mental combined pain reduction nursing based on pain scoring for cancer pain patient

AbstractTo observe the positive of stage‐based physical mental combined pain reduction nursing based on pain scoring for cancer pain patients. A total of 120 cancer pain patients admitted to our hospital from December 2022 to December 2023 were selected. They were randomly divided into a control group and an observation group, with 60 cases in each group. The control group received medication intervention nursing, whereas the observation group received phased physical mental combined pain reduction nursing. The visual analogue scale (VAS) pain scores, Psychological Hope Level (HHI) score and Psychological Health Mood State Questionnaire (POMS) score of the two groups of patients were observed before nursing and at 1, 6, and 12 months after nursing. There was no difference in VAS scores between two groups at 1 month after nursing care (p &gt; 0.05), but the observation group had lower VAS scores at 1, 6, and 12 months after nursing; In the HHI score of the observation group patients after nursing, there was no difference between the pre‐nursing and 1 month post nursing scores and the control group (p &gt; 0.05), but scores were lower than the control group at 6 and 12 months after nursing; The POMS score of the observation group patients after nursing was better than the control group. All the difference was statistically significant (p &lt; 0.05). Our findings suggest that staged physical mental combined pain reducing care has a positive impact on patients with cancer pain.

A Single Preoperative Low Dose of Dexamethasone is Efficacious in Improving Early Postoperative Pain, Function, Nausea, and Vomiting After Primary Total Knee Arthroplasty: A randomized, Double-Blind, Placebo-Controlled Trial

PurposeThe primary objective was to evaluate a single preoperative low-dose (8 mg) dexamethasone (DXM) efficacy in relieving postoperative pain in patients undergoing total knee arthroplasty (TKA). The secondary objectives were to assess its effect on postoperative nausea and vomiting (PONV), C-reactive protein (CRP) levels, and early wound complications incidence. MethodsThis was a single-center, double-blind, randomized controlled trial. We included 86 unilateral primary TKA divided equally into two groups (Placebo (Group A) and DXM (Group B), as a single intravenous (I.V.) dose given after anesthesia). Postoperative pain was assessed as the primary outcome at rest and while walking using a Visual Analogue Scale (VAS). Secondary outcomes included PONV evaluated using VAS for postoperative nausea. The following variables were evaluated: the Time Up and Go (TUG) test, serum CRP, quadriceps muscle power, and wound complications. All outcomes were reported in the first three days and at 14 days follow-up visit. ResultsBoth groups’ baseline data were comparable. Group B reported significantly less pain at rest and walking throughout all time points (P < 0.001). Group B had fewer vomiting episodes on postoperative days one and two (P = 0.195 and 0.747, respectively) and no difference in PONV VAS score. Group B had significantly lower TUG test scores for postoperative days one and two (P = 0.029 and 0.016, respectively) and significantly better quadriceps muscle power on postoperative days two and three (P = 0.042 and 0.019, respectively). The Serum CRP levels were significantly less in Group B throughout all follow-up time points (P < 0.001) except on day three (P = 0.302). No wound complications were reported in any patient. ConclusionPreoperative single low dose (eight mg) DXM I.V. in patients undergoing unilateral TKA is safe (early postoperatively) and effective for reducing postoperative pain scores, improving early mobility, and reducing inflammatory markers. However, the effect on PONV was less evident.

Efficacy of topical Raphanus sativus seed powder mixed with honey versus hydroquinone 4 % cream in the treatment of melasma – A randomized controlled trial

BackgroundMelasma is a prevalent skin disorder affecting a wide range of populations. In Unani system of medicine, a traditional healing system with a rich historical background, there exists a repository of therapeutic modalities for melasma, elucidated by esteemed scholars and practitioners. Despite its extensive utilization, the scientific substantiation supporting these interventions remains limited. ObjectiveThis study aims to scientifically evaluate and compare the safety and efficacy of topically applied Raphanus sativus seed powder and honey mixture versus hydroquinone (4 % w/w) cream for melasma treatment. MethodsIn this 8-week open-label, randomized controlled trial, 40 participants (20 per group), aged 18–65 years and diagnosed with melasma, successfully completed the study. The test group applied finely powdered Raphanus sativus seeds mixed with honey twice daily, while the control group used hydroquinone (4 % w/w) cream twice daily. Primary outcome measure was change in modified Melasma Area and Severity Index (mMASI) at each follow-up. Secondary measures examined subjective nuances using a 100 mm visual analogue scale (VAS) and recorded the dermatology life quality index (DLQI) at baseline and the conclusion of the study. Safety was ensured through comprehensive clinical reviews, with documentation of adverse events during bi-weekly follow-ups. ResultsFollowing the conclusion of the study, the mean difference in the mMASI score between the test and control groups was –0.22 (95 % CI: –0.75 to 0.30, d = 0.27, p = 0.394). Additionally, post-trial mean differences in VAS and DLQI scores between the test and control groups were determined as –5.25 (95 % CI: –10.65 to –0.15, d = 0.62, p = 0.056) and –0.10 (95 % CI: –1.53 to 1.33, d = 0.04, p = 0.888), respectively. ConclusionBased on the investigative findings, the test intervention involving Raphanus sativus and honey demonstrated therapeutic efficacy statistically comparable to conventional hydroquinone treatment for managing melasma, with no reported adverse reactions. Moreover, both groups exhibited statistically comparable improvements in the dermatology life quality index.

Endoscopic Radiofrequency Ablation for Sacroiliac Joint Pain: A Systematic Review and Meta-analysis

Objective: The aim of this study was to investigate the efficacy of endoscopically visualized radiofrequency for treating sacroiliac joint pain.Methods: The study protocol was preregistered on INPLASY (INPLASY202450011). A systematic search was carried out across multiple databases, including PubMed, Embase, Cochrane CENTRAL, and Web of Science, from their inception until May 6, 2024. Peer-reviewed studies on human participants with low back pain diagnosed with sacroiliac joint pain and treated with endoscopically visualized radiofrequency ablation (RFA) were included. The study focused on evaluating changes in the visual analogue scale (VAS) and Oswestry Disability Index (ODI) from before the commencement of endoscopically visualized radiofrequency to postoperation. The quantitative syntheses employed a random-effects model, with effect sizes reported using the mean difference. Subgroup analyses were conducted based on 6-month and 12-month postoperative time points.Results: Four studies were ultimately included in this meta-analysis. Three of the studies were case series, while one was a retrospective cohort study. The mean difference of VAS scores between the preoperative and 6-month and 12-month postoperative assessments was -5.60 and -5.96, respectively. The mean difference of the ODI between preoperative and 6-month and 12-month postoperative assessments was -21.03 and -23.67, respectively. A subgroup analysis of both outcome measurement indices at the 2 follow-up time points did not reveal any statistically significant differences.Conclusion: Endoscopically visualized RFA demonstrates potential as a treatment modality for sacroiliac joint pain; however, there is currently insufficient evidence to substantiate its long-term efficacy.

Anesthetic Effects of Dexmedetomidine Combined with Nalbuphine in Patients Undergoing Laparoscopic Cholecystectomy and its Impact on Nutritional Status.

Laparoscopic cholecystectomy (LC) is a common surgical procedure for the removal of the gallbladder. Effective anesthesia is crucial for ensuring patient comfort and safety during LC. Dexmedetomidine, a selective α2-adrenergic agonist, is widely used as an adjunct to anesthesia due to its sedative and analgesic properties. Nalbuphine, a synthetic opioid analgesic, is also employed for pain management during various surgical procedures. This study aimed to determine the anesthesia effects of dexmedetomidine combined with nalbuphine on patients undergoing LC and its impact on their nutritional status. The clinical records of 100 patients who underwent LC at Wuhan No.1 Hospital between January 2021 and January 2022 were analyzed retrospectively. Forty-six patients who received intravenous dexmedetomidine (0.4 µg/kg) were assigned to the control group, while fifty-four patients who received intravenous nalbuphine (0.2 mg/kg) and dexmedetomidine (0.4 µg/kg) were assigned to the study group. The outcomes compared between the two groups included heart rate (HR), mean arterial pressure (MAP), Riker sedation-agitation scale (RSAS) scores, visual analogue scale (VAS) scores, duration of operation, awakening time from anesthesia, extubation time, adverse reactions, and nutrition-related indicators before and after surgery. There were no significant differences in MAP between the groups at the same time point (p > 0.05). However, at T1 and T3, the study group had significantly lower HR compared to the control group (p < 0.05), with no significant differences in HR at other time points (p > 0.05). The study group exhibited significantly lower RSAS scores compared to the control group (p < 0.01). No significant differences were observed between the groups in terms of duration of operation, awakening time from anesthesia, and extubation time (p > 0.05). At 6 hours post-operation, there were no significant differences in VAS scores between the groups (p > 0.05), but at 12, 24, and 48 hours post-operation, the study group had significantly lower VAS scores compared to the control group (p < 0.0001). No significant inter-group difference was observed in the total incidence of adverse reactions (p = 0.180). Additionally, one week after surgery, the study group exhibited significantly higher levels of albumin, prealbumin, transferrin, and total protein compared to the control group (p < 0.0001). Dexmedetomidine combined with nalbuphine provides a superior anesthetic effect compared to dexmedetomidine alone in patients undergoing LC. This combination effectively controls hemodynamic fluctuations during the recovery period and reduces agitation without affecting the awakening time from anesthesia. These findings suggest that this combination is beneficial and worth promoting.

Effects of Different Ultrasound-Guided Nerve Block Modalities on Inflammatory Stress Response in Elderly Patients after Total Hip Arthroplasty.

This study aimed to evaluate the impact of different ultrasound-guided nerve blocks on the postoperative inflammatory and stress response in elderly patients undergoing total hip arthroplasty (THA), providing a theoretical foundation for clinical application. Elderly patients with THA who received ultrasound-guided nerve block combined with general anesthesia from June 2021 to June 2022 in the hospital were selected as a retrospective cohort study. Patients were divided into two groups based on the type of nerve block used. The observation group (n = 60) received ultrasound-guided pericapsular nerve group (PENG) block combined with femoral nerve block (FNB), while the control group (n = 60) received ultrasound-guided PENG block. The cortisol (Cor), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), visual analogue scale (VAS) scores, and pain medication consumption in both groups were compared. The observation group demonstrated significantly lower serum levels of Cor, TNF-α, and IL-6 at postoperative 1 day, 3 days and 7 days, as well as lower soluble protein-100β (S100β) levels at postoperative 1 day compared to the control group (p < 0.001). The VAS score in the observation group was significantly lower than that in the control group at postoperative 1 day, 3 days and 7 days (p < 0.001), with no significant difference in preoperative VAS score between the two groups (p > 0.05). Additionally, opioid consumption in the observation group was significantly lower than that in the control group at postoperative 48 h (p < 0.001). The combination of ultrasound-guided PENG block and FNB effectively reduces postoperative pain and the inflammatory response in elderly patients undergoing THA, facilitating early recovery.