Reduction In Pain Levels Research Articles

Impact of early rehabilitation therapy on functional outcomes in patients post distal radius fracture surgery: a systematic review and meta-analysis

BackgroundThis meta-analysis aims to investigate the efficacy of early rehabilitation on patients who have undergone surgery for distal radius fractures (DRFs) with palmar plating, focusing on multiple outcome measures including upper limb function, wrist function, back extension mobility, pain levels, and complications.MethodsA rigorous search strategy adhering to the PRISMA guidelines was employed across four major databases, including PubMed, Embase, Web of Science, and the Cochrane Library. Studies were included based on stringent criteria, and data extraction was performed independently by two reviewers. Meta-analysis was conducted employing both fixed-effect and random-effects models as dictated by heterogeneity, assessed by the I2 statistic and chi-square tests. A total of 7 studies, encompassing diverse demographic groups and timelines, were included for the final analysis.ResultsThe meta-analysis disclosed that early rehabilitation yielded a statistically significant improvement in upper limb function (SMD -0.27; 95% CI -0.48 to -0.07; P < 0.0001) and back extension mobility (SMD 0.26; 95% CI 0.04 to 0.48; P = 0.021). A notable reduction in pain levels was observed in the early rehabilitation group (SMD -0.28; 95% CI -0.53 to -0.02; P = 0.03). However, there were no significant differences in wrist function (SMD -0.13; 95% CI -0.38 to 0.12; P = 0.36) and complications (OR 0.99; 95% CI 0.61 to 1.61; P = 0.96).ConclusionsEarly rehabilitation post-DRF surgery with palmar plating has been found to be beneficial in enhancing upper limb functionality and back extension mobility, and in reducing pain levels. Nevertheless, no significant impact was observed regarding wrist function and complications.

Ultrasound-Guided Occipital Nerve Block in the Management of Refractory Headache and Its Outcomes: A Prospective Study

Abstract Purpose Headache severely impacts health and lifestyle, causing distress and leading to accommodative changes in affected individuals. Treatment options available for refractory headache range from a conservative approach to advanced forms. The purpose of our study was to evaluate the effectiveness of ultrasound-guided occipital nerve block (ONB) in the management of refractory headaches using visual analog scale (VAS) score and Barrow Neurological Institute Pain Intensity Score (BNIPIS). Methods A study sample of 30 eligible patients with refractory headaches including occipital neuralgia, migraine, tension headache, cluster headache, and vascular headaches aged between 18 and 65 years were included in our study. VAS and BNIPIS were noted for each patient before and after the procedure. ONB was given around the target nerve under aseptic precaution. Two milliliters of 0.5% bupivacaine was used as an injection solution for all patients. Results The mean VAS score in acute pain at pre-treatment and post-treatment after 24 hours and 3 months was found as 7.53, 1.53, and 3.20, whereas in chronic pain the score was 8.13, 3.07, and 5.87, respectively. Pre-treatment pain levels in acute and chronic subjects in BNIPIS IV and V category shifted to category I and II after 24 hours (postinjection) that later were recorded II and III, respectively, after 3 months. Conclusion Standard treatment guidelines are given by the international headache association for the management of headaches. The use of ONB is well advocated and practiced for a long time. In our study, we found that the use of greater occipital nerve block reduced pain levels affecting VAS and BNIPIS, which was more effective in acute cases than in chronic cases.

Narrative Review of the Effect of Endorphin Massage and Oxytocin Massage on Pain Intensity in Maternity Women

Background: Childbirth is the effort or process of expelling a full-term baby which is often accompanied by pain caused by contractions in the uterus. From the research results, it was found that 32% of 300 women who gave birth during the active phase experienced severe pain, 57% moderate pain, and 11% mild pain. Evidence shows that fear of vaginal childbirth and anxiety experienced by many women during their pregnancy. Therefore, it then led to their decision to choose other methods of birth such as Section Caesarea (SC). The effects of anxiety during labor could potentially result in excessive levels of catecholamines causing decreased blood flow to the uterus, decreased uterine contractions, decreased blood flow to the placenta, decreased oxygen available to the fetus, and can increase the length of labor. One of alternative methods of dealing with pain during the labor process is using non-pharmacological such as endorphin massage and oxytocin massage. Purpose: The aim of this literature study was to present information about the effect of endorphin massage and oxytocin massage on the intensity of pain among mothers giving birth. Methods: This research method was a literature review study. Journal searches were carried out by applying online database such as ScienceDirect, Google scholar, Pubmed, Scopus, Portal Garuda. Articles were selected based on inclusion and exclusion criteria. Result: The study investigated the influence of endorphin and oxytocin massages on pain intensity in maternity mothers during childbirth, revealing a significant reduction in pain levels following the administration of these massages. Both endorphin and oxytocin massages were found to alleviate pain, induce relaxation, and promote feelings of comfort and calmness, thereby facilitating a smoother birth process. Conclusion: The influence of endorphin massage and oxytocin massage is useful in reducing pain in maternity mothers

Asuhan Keperawatan Pada Ibu Post Sectio Caesarea Untuk Menurunkan Intensitas Nyeri Dengan Tindakan Foot Massage

Sectio Caesarea (SC) is a delivery with specific indications that require a surgical method on the abdominal wall to remove the baby. Sectio caesarea causes pain due to the release of histamine and prostaglandins. For this reason, non-pharmacological interventions are needed to help reduce pain, including the foot massage technique. This study aims to determine the effect of foot massage techniques on reducing pain intensity. The number of samples in this study amounted to 2 respondents. This research was conducted on April 11-16, 2023. The instrument used is a numerical rating scale (NRS). The type of design of this research is descriptive with a case study report. Foot massage technique in post sectio caesarea mothers carried out 6x implementation for three days and done 2x a day. The results of this study indicate that foot massage can reduce pain levels in both respondents. The First respondent before being given the foot massage pain scale (6) after being given the foot massage pain scale becomes a pain (2), and the second respondent before being given the foot massage pain scale (6) after being given foot massage pain scale becomes (1). The conclusion obtained in this study is that the foot massage technique can reduce the pain scale and can be used as an alternative to non-pharmacological management in pain management.

Nursing Care of Acute Pain in Multiple Fractures with Spiritual Therapy Quantum Touch and Finger Holding: A Case Study

Background: Multiple Fractures or broken bones are a condition where the continuity of the bones is broken in a complex manner, this is caused by trauma caused by frequent traffic accidents. Objective: To analyze the effect of a combination of non-pharmacological therapies Quantum Spiritual Touch Therapy" (QST) and Finger Holding in multiple fraktur patients with acute pain at RSD dr. Soebandi Jember. Method: This research is an observational study with a case study design. Primary data obtained through anamnesis and physical assessment. Assessment of the effect of QST therapy and finger holding was carried out a total period of 35 minutes, 20 minutes for QST therapy and 15 minutes for finger holding therapy, based on initial, process, and final data. Results: The results showed a reduction in pain levels with a Numerical Rating Scale (NRS) was carried out for 6 meetings with the implementation of therapy once a day. Pain levels decreased in the pre-implantation measurements with an average of 5,4 to 4,7 at the time of post-implementation. Discussion: The combination of pharmacological therapy from QST therapy and finger holding aims to help the effectiveness of analgesic drugs by improving the psychological structure with implementations that contain spiritual elements.

Effectiveness of Rehabilitation for Disk Displacement of the Temporomandibular Joint—A Cross-Sectional Study

(1) Background: Dislocations of articular disk can occur as a result of parafunctions in the Temporo Mandibular Joint (TMJ), which limits the opening of the mandible and other movements. The aim of this study was to evaluate the effectiveness of rehabilitation in patients with disk displacement of the TMJ. A total of 327 subjects with Temporo Mandibular Disorders underwent stomathognatic physiotherapy. (2) Methods: Based on the results obtained by a manual functional analysis, 35 patients who were identified with articular disk locking (disk displacement without reduction) were included in the study. The study group (N = 35) was subjected to passive repositioning of the articular disk, reposition splints, and physiotherapy. The patient’s TMJs were then examined before the therapy, immediately after the therapy, and during the follow-up visit 3–6 weeks after the therapy. The Diagnostic Criteria for the Most Common Intra-articular Temporomandibular Disorders was used to evaluate the effects of rehabilitation on the patients’ range of motions and the Numeric Pain Rating Scale (NPRS). For the statistical analysis, Pearson’s r correlation coefficient test and Wilcoxon signed-rank test were used. (3) Results: The results showed a significant improvement in the range of motion of the mandible movements. The level of improvement was dependent on the time from the incident until undergoing rehabilitation. (4) Conclusions: The stomatognathic physiotherapy applied increased the range of motion of the mandible and reduced pain levels to the expected range.

Bisphosphonate therapy in the management of diffuse sclerosing osteomyelitis of the mandible: a systematic review and narrative synthesis

Background: Diffuse sclerosing osteomyelitis (DSO) affecting the mandible is an uncommon condition characterised by recurrent pain and functional disturbances. Traditional treatments involving antibiotics, steroids, and analgesics have generally yielded unsatisfactory results. Numerous articles have proposed the utilisation of bisphosphonate therapy as an alternative approach to achieve sustained symptom relief. This study aims to consolidate the available evidence on the effectiveness of bisphosphonate therapy in managing DSO. Methods: A systematic review protocol was registered with PROSPERO and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies were devised, and studies were screened based on predefined inclusion and exclusion criteria. Results: Ten articles met the eligibility criteria, encompassing a total of 135 patients diagnosed with DSO who received bisphosphonate treatment. All included studies consistently reported a reduction in pain levels and swelling, along with a decrease in the cumulative use of analgesics. The majority of patients reported long-lasting symptom improvement with bisphosphonate therapy. Notably, four studies documented improvements in maximal mouth opening, with one study reporting a mean increase of 9.6mm. Furthermore, six studies observed improvements in panoramic radiographs and cone beam computed tomography scans, with one publication describing two patients exhibiting near-normal bone architecture. Importantly, all studies reported the absence of long-term complications. Conclusions: Bisphosphonate therapy emerges as a promising treatment modality for DSO, exhibiting efficacy in symptom alleviation and radiological enhancement while conferring lasting benefits. Nevertheless, further prospective studies are warranted to refine treatment protocols and substantiate these findings.

Geriatric Pain Protocol: Impact of Multimodal Pain Care for Elderly Orthopedic Trauma Patients

ABSTRACT Hip fractures are costly, and associated complications are the leading cause of injury-related deaths in persons 65 years or older. Uncontrolled pain leads to increased hospital length of stay (LOS), delayed physical therapy, and long-term functional impairment. The Geriatric Pain Protocol (GPP) is Cedars-Sinai's multimodal pain management solution, addressing the needs of older adult inpatients who have suffered fractures. Study participants included hip fracture patients admitted between February 1, 2019, and March 5, 2021. Inclusion criteria were patients 65 years or older with a hip fracture sustained from a ground-level fall and surgical candidate. Participants were divided into 2 categories: Geriatric Fracture Program (GFP) and non-GFP, with physician participation in the GFP being the differentiating factor. End points included postoperative pain, postoperative opioid utilization, LOS, complications, and 30-day readmission rates. The GPP decreased morphine milligram equivalent (MME) daily totals on days 1 and 2 and improved pain management compared with non-GPP patients. MMEs were lower in the GPP group than in the non-GPP group for both postoperative day 1 (POD1) (P = 0.007) and POD2 (P = 0.043); the Numerical Rating Scale (NRS) pain score on POD1 was lower in the GPP group (vs non-GPP, P = 0.013). There were no group differences in NRS POD2 pain or complications (all Ps &gt; 0.1). The study sample (N = 453) had no significant difference between sex and LOS (all Ps &gt; 0.3). Although not statistically significant, the 30-day readmission rate trended lower in patients treated in accordance with the GPP. Use of the GPP reduced pain levels and MME totals.

Management Fisioterapi Pada Kasus Post Operasi Histerektomi Total Akibat Mioma Uteri: Case Study

Uterine myoma or often called fibroids is a benign tumor originating from the smooth muscle of the uterus. Tumor cells are formed due to genetic mutations, then develop due to the induction of the hormones estrogen and progesterone. The incidence of uterine myoma in Indonesia ranks second after cervical cancer, the incidence of uterine myoma in Indonesia is found to be 2.39% - 11.70% in all patients with gynecological cases hospitalized. Hysterectomy is surgical removal of the uterus (uterus) is one of the procedures performed for uterine myoma. Physiotherapy aids recovery by avoiding or minimizing complications as well as providing physical rehabilitation to support the return of physical function postoperatively hysterectomy. Based on the results of the evaluation of interventions that have been given, breathing exercises, pelvic floor muscle training, active exercises on the hip to the lower extremities as well as early transfer and ambulation exercises have been shown to reduce pain levels, strengthen pelvic floor muscles thereby reducing incontinence, and increase functional activity.

Efficacy of modified active physical therapy program on pain, muscle strength, and function in adolescent football players with osteitis pubis

BackgroundIn athletes, osteitis pubis (OP) is considered a major cause of chronic groin pain. In addition to the difficulties with diagnosis, controversy exists regarding the most appropriate treatment approach. The study aimed to evaluate the effect of a modified active physical therapy program (MAPT) on pain, hip and trunk muscle strengths, and lower extremity function in adolescent football players with OP.MethodsFifty football players aged from 12 to 18 years with OP were included and allocated into two groups: the MAPT group (n = 24) and the traditional physical therapy (TPT) group (n = 26). Each group received a different treatment protocol for 60 min applied 3 times/week for 12 weeks. A visual analog scale, digital hand-held dynamometer (HHD), and lower extremity functional scale (LEFS) were used to measure pain, hip and trunk muscle strengths, and lower limb function, respectively, at baseline and 12 weeks post-intervention.ResultsThere was a highly significant difference in the TPT group’s pain score (p < 0.001) compared with the MAPT group. Also, the strength of hip flexors, abductors, adductors, internal rotators, external rotators, and trunk flexors and extensors improved significantly (p < 0.05) than the TPT group. However, the between-group analysis revealed that the strength of hip extensors and LEFS in the MAPT group achieved a highly significant difference (p < 0.001) compared with the TPT group.ConclusionMAPT could be recommended strongly in the rehabilitation of OP in adolescent football players in which the functional abilities of OP patients improved because of reduced pain levels and increased hip and trunk muscle strength. (IRCT20210909052421N3, Iranian Registry of Clinical Trials, https://www.irct.ir/trial/68946/pdf, 9-April-2023).

Physical therapy management for muscle tightness in a surfing athlete: a case report study

Background: Muscle tightness refers to the sensation of tension or stiffness in the muscles, often resulting from factors such as excessive physical activity, inadequate warm-up before exercise, muscle injury, or underlying medical conditions. This article describes a case of a surfer patient with muscle tightness who has had ACL reconstruction meniscectomy and physical therapy management.&#x0D; Case description: The patient was a 51-year-old male surfing athlete from New Zealand diagnosed with muscle tightness. The patient had a history of ACL and meniscus injuries, followed by ACL reconstruction and meniscectomy of the right knee. The patient was on vacation in Bali, and he was surfing every day. The patient underwent physical therapy twice a week. The intervention program included modalities (transcutaneous electrical nerve stimulation and ultrasound), manual therapy (massage and patellar mobilization), and exercise therapy (range of motion exercises, strength training, and stretching).&#x0D; Conclusion: The physical therapy intervention program designed for one week can yield positive results in reducing pain levels, improving the range of motion of the right knee, increasing the circumference of the right knee segment, and enhancing the functional activities of the right knee.

Effect of strengthening exercises in individuals with patellofemoral pain syndrome: a randomised controlled trial

Background/Aims Muscle imbalance in patella stabilisers leads to patellar lateral glide and can cause patellofemoral pain syndrome. This study investigated the effect of progressive strengthening exercises of the vastus medialis oblique on pain and patellar alignment in patients with patellofemoral pain syndrome and patellar lateral glide. Methods A double-blind, randomised controlled trial was conducted with 40 individuals with patellofemoral pain syndrome with patellar lateral glide aged 20–40 years. The study group received vastus medialis oblique-specific strengthening exercises and routine physiotherapy treatment, and the control group received routine physiotherapy treatment only (stretching exercises, gluteal and quadriceps isometric exercises and conventional transcutaneous electrical nerve stimulation). Participants performed these exercises three times a week for 8 weeks. Pain intensity was measured before and after the intervention using a visual analogue scale and patellar alignment was measured using ultrasonographic parameters, including the trochlear angle, patella offset angle and distance between patellar tip and trochlear groove. Results In the between-groups comparison, there was a significant decrease in pain intensity in both the study and control groups, although the study group had a greater decrease (study group before intervention: 71.15 ± 1.54, study group after intervention: 22.21 ± 0.35, P=0.001); control group before intervention: 70.09 ± 1.22, control group after intervention: 31.82 ± 0.36 (P=0.001)) and patella offset angle (in the study group compared to the control group after 8 weeks of intervention. In within-groups comparison, a significant decrease of the patella offset angle in the study group was observed (before intervention: 16.2 ± 1.53; after intervention: 13.2 ± 1.87, P=0.001). No significant differences were found for the other parameters. Conclusions Specific strengthening of the vastus medialis oblique muscle in patients with patellofemoral pain syndrome and patellar lateral glide can lead to pain reduction and improvement of patellar alignment to correct lateralisation. This change may delay the process of patellofemoral joint degeneration. Including vastus medialis oblique-specific strengthening exercises in standard physiotherapy treatments may help to reduce pain levels in people with patellofemoral pain syndrome. Implications for practice Investigating the main cause of patellofemoral pain syndrome could have an essential role in the rehabilitation treatment of patients.

Comparing two protocols of shock wave therapy for patients with plantar fasciitis: A pilot study.

This pilot study primarily aimed to detect the adherence as well as the effect size required to estimate the actual sample size needed for a larger scale study to compare and evaluate the effectiveness of two extracorporeal shock wave therapy (ESWT) protocols along, with a physical therapy program in reducing pain and improving function among patients suffering from plantar fasciitis. The study also aimed to report the effects of the ESWT protocols used on pain and function. A total of 26 participants took part in the study, including 17 females and 9 males. The average age of the participants was 34 years with a body mass index (BMI) of 23 kg/m2. Participants were divided into three equal groups; Group A received ESWT at a frequency of 15 Hz and intensity of 3, Group B received ESWT at a frequency of 10 Hz and intensity of 4, while Group C underwent the selected physical therapy program along with sham shock wave therapy as a control. Pain levels were assessed using the Visual Analog Scale (VAS) while functional improvements were evaluated using the Foot Function Index (FFI). Data was collected prior to treatment, after three sessions and at the end of six weeks (after six sessions). The three groups were well matched, and the results revealed high adherence rates (90%, 90% and 80% respectively). Results also indicated reductions in pain levels and improvements in function for both intervention groups when compared to the control group. Group A demonstrated better outcomes compared to Group B while Group C showed relatively less improvement. The study concluded a high adherence rate for the three groups as well as a small effect size detected of 0.282 that would suggest a total of 123 participants to be required to replicate the study on a larger scale. With regards to the findings of this pilot, the combination of ESWT and a targeted physical therapy program revealed a possible effective therapeutic approach for plantar fasciitis, with a higher frequency potentially yielding more favourable results.

Comparison of pain between laparoscopic appendectomy vs open appendectomy in patients with acute appendicitis

IntroductionPain is almost the main problem after surgery, effective pain management is crucial for recovery, since poorly managed pain can have detrimental effects on a patient's physical functioning, mental health, interpersonal connections, and productivity. ObjectiveOur study compares LA and OA to evaluate post-operative pain in 42 ​h using the Visual Analouge Scale (VAS) with the goal decreasing the requirement for opioids to address postoperative pain. MethodsA retrospective analysis of patients with an appendicitis diagnosis who were admitted to the Department of General Surgery at General Hospital University of Muhammadiyah Malang between January 2018 and June 2019. 258 individuals with acute appendicitis, with 137 undergoing open appendectomy (OA) and 121 undergoing laparoscopic appendectomy (LA). ResultWe reported patients who obtained OA surgery experienced significant pain on first day, compared with patients who underwent LA operation, who reported light pain (P ​= ​0.000). On second day Thirteen patients who underwent OA surgery reported a reduction in pain levels from moderate to mild (P ​= ​0.000). Patients who underwent LA procedure, 59 participants had a significant reduction of pain level, 54 patients reduced from mild to no pain. and moderate pain to light pain reported in 5 patients, whereas the remaining 62 had no change level of pain (P ​= ​0.000). ConclusionIn terms of post-operative pain, the LA operation is a reliable surgical technique and is preferable to an OA appendectomy.

A Study to Assess Effectiveness of Play Therapy in Reducing Post-Operative Pain among Children Age 2 To 5 Year who have Undergone General Surgeries in Selected Pediatric Hospitals of Vadodara

Background: Play is a crucial part of a child's life and serves as one of the most powerful methods for relieving stress, discomfort, and pain. Aim: To evaluate the effectiveness of play therapy in reducing postoperative pain in children aged 2 to 5 years who have undergone general surgery at pediatric hospital in Vadodara. Objective • To assess the intensity of postoperative pain among children who have undergone general surgeries before, during and after administering play therapy in experimental and control groups. • To determine the effectiveness of play therapy on postoperative pain among children who have undergone general surgeries in experimental and control groups. • To find out association between pre-test postoperative pain and among children who have undergone general surgeries, regarding selected demographic variable. Methodology: A quasi-experimental study was conducted with ethical committee approval, utilizing the FLACC pain assessment scale to evaluate postoperative pain in children aged 2 to 5 who had undergone general surgeries. The study used a non-probable, convenient sampling technique and obtained written informed consent from all participants. The FLACC scale scores range from 0 to 10, with pain categorized as follows: 0-3 indicating mild pain, 4-7 moderate pain, and 8-10 severe pain. The study focused on children from selected paediatric hospitals in Vadodara, examining how play therapy influenced postoperative pain levels. Data on pain were analysed in terms of percentages based on various factors, including the child's age, education level, parental education, previous surgical history, type of anaesthesia used, administration of analgesics, and the type of surgery performed. The study also explored the association between postoperative pain, play therapy, and selected demographic variables for children aged 2 to 5 who underwent general surgeries. Result: The pretest and posttest assessments of pain levels in the experimental group of children aged 2 to 5 years who underwent general surgeries in selected pediatric hospitals of Vadodara showed significant improvements. Before the intervention, none of the children reported mild pain, 96.7% experienced moderate pain, and 3.3% experienced severe pain. After implementing play therapy, the posttest results revealed a remarkable reduction in pain levels, with 96.7% of the children experiencing mild pain, 3.3% experiencing moderate pain, and none experiencing severe pain. This substantial decrease indicates the effectiveness of play therapy in alleviating post-operative pain. Conclusion: The investigator determined that play therapy was effective for children who had undergone general surgeries, showing a strong connection between play therapy and reduced post-operative pain.

Magnitude of changes in muscle endurance in the Biering-Sorensen test and changes in balance in subjects with LBP treated with muscle energy techniques.

Purpose: Manual therapy is used as a conservative treatment for people with low back pain (LBP). The scale of the problem encourages the search for the most effective methods to assess of manual treatment. Therefore, the aim of the study was to investigate magnitude of changes in muscle endurance using the Biering-Sorensen test (BST) and to analyse balance in patients with LBP treated with ERS and FRS muscle energy techniques (MET). Methods: The study included fifteen men with LBP (mean age: 42 years) working as automotive assemblers. Endurance of the biceps femoris (BF), gluteus maximus (GM) and erector spinae (ES) muscles were analysed using sEMG during the BST. The level of experienced pain, degree of disability and postural stability were also examined. Results before and after a three-week treatment cycle using MET were compared. Results: The MET therapy resulted in a reduction in pain ( p = 0.001), an improvement in the degree of disability ( p < 0.001) and an increase in the duration of the BST ( p < 0.001). After therapy, the values of the NMFs parameter indicating the degree of fatigue increased, i.e., ES muscle endurance increased, both right ( p = 0.004) and left ( p < 0.001). There was also a statistically significant decrease in the centre of pressure (COP) movement velocity in balance tests. Conclusions: The use of MET in patients with LBP increases muscle endurance, improves postural balance, and reduces pain levels on the VAS and disability levels according to the ODI. MET appears to be a good tool for preventing LBP.

Effect of electrode attachment location for transcutaneous electrical nerve stimulation for pain relief in lumbar vertebral body fractures.

[Purpose] This study aimed to investigate the effect of the location of electrode attachment in transcutaneous electrical nerve stimulation on pain relief in patients with lumbar vertebral body fractures. [Participants and Methods] This study included 59 patients with lumbar vertebral body fractures, who were randomly assigned to receive transcutaneous electrical nerve stimulation to the lumbar region, lower limbs, or upper limbs, or no treatment, over a 4-week period. Pain, activities of daily living, and pain catastrophizing were assessed. [Results] Compared with the control group, transcutaneous electrical nerve stimulation to the lumbar region or lower limbs significantly reduced pain levels in the first 2 weeks. Although, activities of daily living and pain catastrophizing improved over time, no significant differences were observed between the groups. [Conclusion] Transcutaneous electrical nerve stimulation provides pain relief to patients during the early stages of lumbar vertebral body fractures. However, it had no effect on the activities of daily living, pain catastrophizing, or long-term pain-relief. For lumbar vertebral body fracture pain relief, transcutaneous electrical nerve stimulation electrodes should be attached to the lumbar region or lower limbs.

Treatment of Willis-Ekbom Disease (Restless Leg Syndrome); The Efficacy of Mulligan's Traction Straight Leg Raise among Paramedical Professionals.

Background: Restless Leg Syndrome (RLS) is a generalized neurological sensory-motor disorder characterized by intense restlessness and discomfort in the lower extremities, leading to an urge to move the legs at sleep time. Treatment protocols for RLS may include thermotherapy, stretching exercises, and Mulligan’s traction straight leg raise (SLR). Mulligan’s traction SLR is an effective method that influences peripheral and central neural pathways through mobilization, thereby alleviating RLS symptoms. Objective: The study aimed to compare the efficacy of stretching exercises and Mulligan traction straight leg raise in reducing RLS severity among paramedical staff. Methods: This randomized clinical trial included a sample size of 38 paramedical staff members diagnosed with RLS using standard criteria. Participants were allocated using the Convenient Sampling Technique and randomly assigned into Group 1 (Stretching Exercises) and Group 2 (Mulligan Traction SLR) through coin tossing. Each group consisted of 19 participants. The interventions were conducted three times per week for one month. Assessments were made using the RLS Severity Scale, Numeric Pain Rating Scale, Groningen Sleep Quality Scale, and Goniometer at baseline, and after the 2nd and 4th weeks of treatment. Results: The study indicated that both treatments were effective in treating RLS, showing a significant difference with p&lt;0.05. However, Mulligan's TSLR exhibited remarkable results in improving sleep quality, increasing SLR range of both legs, reducing pain intensity, and improving RLS symptoms, with p-values of 0.001, 0.000, 0.012, and 0.001, respectively. Data analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 26. Conclusion: The study concluded that both Stretching Exercises and Mulligan's TSLR are effective treatments for RLS. However, Mulligan's TSLR showed superior effectiveness in reducing pain levels, RLS symptoms, and in improving sleep quality and SLR range among paramedical staff members.

Comparing the outcomes between silver sulfadiazine (SSD) versus sustained-release silver foam in treatment of partial thickness burn patients

Objective: To compare the outcomes between silver sulfadiazine (SSD) versus sustained-release silver foam in treatment of partial thickness burn patients.&#x0D; Study design: Randomized controlled trial.&#x0D; Place and Duration: Department of Burn/Plastic surgery, Nishtar Medical University/Hospital, Multan in Six months from 27-11-2021 to 27-05-2022.&#x0D; Methodology; All patients of second degree partial thickness burns (n=164) were divided in equally in two groups through draw method, 82 patients in each, group (A) treated with silver sulfadiazine and group (B) with sustained-release silver foam dressing. Baseline data and outcome i.e., pain, wound healing and hospital stay were recorded on predesigned proforma&#x0D; Results: In Group I, there were 15.0% patients who had wound healed and 25.0% patients had wound healed in Group II. The mean VAS score at 5, 10, 15 and 20 day of Group II was less than the Group II (p&lt;0.001). whereas, the wound healing in both the groups were almost equal at 5, 10, 15 and 20 day, and the differences were statistically insignificant, (p&gt;0.050).&#x0D; Conclusion; utilization of sustained-release silver dressing exhibits notable advantages in the wound healing process, including accelerated recovery rates, reduced pain levels, and consequently, earlier hospital discharge, when compared to silver sulfadiazine (SSD) dressings in treatment of partial thickness burn patients.

Postoperative analgesia and side effects of oral or injectable metamizole (dipyrone) in dogs and cats

PICO Question In dogs and cats after surgery, does the peri-operative administration of injectable or oral metamizole (dipyrone) as opposed to no intervention result in lower postoperative pain scores or higher incidence of side effects? Clinical bottom line Category of research Treatment. Number and type of study designs reviewed Three prospective, randomised, blinded, clinical studies were critically reviewed. Strength of evidence Weak. Outcomes reported Variables assessed included: different pain assessment methods, metamizole dose required to reduce peri- and postoperative pain scores, changes in cardiovascular variables (heart rate, systolic, mean and diastolic blood pressure), changes in respiratory variables and variations in haematological and biochemical variables. Conclusion In healthy cats and dogs undergoing ovariohysterectomy, the use of metamizole in the peri- and postoperative period was associated with some reduction in pain levels (i.e., lower pain score or reduced need for rescue analgesia). In dogs, metamizole alone provided insufficient analgesia. No study evaluating metamizole after orthopaedic surgery was found. No evidence suggested that using metamizole peri-operatively resulted in higher incidence of side effects. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.