Mean Values Of Visual Analogue Scale Research Articles

Impact of Spencer Technique on Pain, Range of Motion, and Functional Disability in Patients With Frozen Shoulder: A Pilot Study.

Background and objective The shoulder is the most flexible ball- and socket-type joint in the human body. The pathological condition that can commonly affect this joint is the frozen shoulder. This condition is marked by pain and stiffness in the area surrounding the shoulder complex. This leads to difficulty in doing the daily activities of living. Exercise and physical therapy are mostly recommended to decrease pain and improve and maintain the range of motion (ROM). Mainly traditional techniques such as Mulligans, Maitland, and Kaltenborn are used, along with electrotherapy and exercises, for the treatment of this condition. The effect of the Spencer technique is seen in baseball players' shoulder function. Thus, the purpose of this study is to determine how the Spencer approach affects patients with frozen shoulders in terms of pain, ROM, and functional impairment. Methodology This study included 20 patients aged between 40 and 60 years with stage 2 and 3 diagnosed frozen shoulder. This is a single-group pilot study that received the Spencer technique along with a moist heat pack and Codman's exercises on the affected shoulder for three weeks. Outcome measures used for assessment before and after treatment were the visual analogscale (VAS), shoulder ROM, and shoulder pain and disability index (SPADI). After the second, third, and sixth months, a follow-up was conducted.Two patients were lost to follow-up; consequently, statistical analysis was performed on the data from 18 patients. Results The current study's results suggested that there was an improvement in the mean values of VAS, ROM, and SPADI at post-three weeks, anda sustained effect was observed at the second, third, and sixth months. A statistically significant difference (P< 0.05) was found. Conclusions The study's conclusions demonstrated improved pain, ROM, and SPADI scores post-intervention. Treatment effects persisted, as seen by follow-up at the two, three, and six-month marks. As a result, the Spencer technique utilized in this pilot study on frozen shoulder patients proved effective. Also, the outcome effects were sustained, which suggests its utility in frozen shoulder rehabilitation.

Effects of the Addition of Hands-on Procedures to McKenzie Exercises on Pain, Functional Disability and Back Mobility in Patients with Low Back Pain: A Randomised Clinical Trial.

Low back pain (LBP) is a common musculoskeletal disorder that affects people of all ages. This study investigates the effects of the addition of hands-on procedures to McKenzie exercises on patients with LBP and derangement syndrome. Forty-eight female patients were randomly assigned to either the experimental group or control group. All the patients in both groups underwent McKenzie exercises, transcutaneous electrical nerve stimulation (TENS) and education for 35 min/session-45 min/ session, with three sessions/week for 2 weeks. Hands-on procedures were added to the McKenzie extension exercises only for the patients in the experimental group. A visual analogue scale (VAS), the Oswestry disability index (ODI), back range of motion (BROM) and body diagrams were used to measure pain, functional disability, BROM and the centralisation of symptoms, respectively. The mean values of VAS, ODI and BROM significantly improved after the interventions in both groups (P < 0.05), whereas the results of repeated measures ANOVA and Mann-Whitney U tests showed statistically non-significant differences between the two groups (P > 0.05). The addition of hands-on procedures to McKenzie exercises, TENS and education significantly alleviated back pain and functional disability and improved the back mobility and centralisation of symptoms in patients with LBP and derangement syndrome; however, these measures did not result in any significant additional benefits for such patients.

The efficacy of oral pain relief cocktail during pan-retinal photocoagulation for diabetic retinopathy: a randomized clinical trial

Purposeto evaluate the pain-relieving effect of analgesic combinations during pan-retinal photocoagulation (PRP) in patients with non-proliferative diabetic retinopathy (NPDR).MethodsThis study was a randomized, double-blind, placebo-controlled trial. Patients with severe NPDR without previous history of PRP were included in the study. Both eyes of the patients were treated with a pan-retinal photocoagulation procedure. The retina was divided into four quadrants and the treatment plan for patients submitted to PRP was divided into four sessions. Different oral medications were given to patients 1 hour before the procedure. Capsules containing a combination of analgesic drugs (including 325 mg acetaminophen, 200 mg ibuprofen, and 40 mg caffeine, referred to as N), pregabalin capsules (75 mg, referred to as P), a combination of N capsules and P capsules (referred to as NP), and the placebo were used in each session. Each patient scored the pain sensation immediately after the procedure using a visual analog scale (VAS).Result60 eyes of 30 patients were studied. The mean value of VAS in patients receiving the placebo was 3.3 ± 1.822 units, while this scale was 3.067 ± 1.507, 3.5 ± 1.479, and 3.5 ± 1.77 in the N, P, and NP consumed patients, respectively. There was no significant difference in VAS levels and the patient’s vital signs between different sessions (P = 0.512).ConclusionNo evidence of the pain-relieving effect of N, P or NP was found during PRP.Trial registration: IRCT20200915048724N1. Registered 20 October 2020, https://www.irct.ir/trial/51345

Twelve-Month Follow-Up of Different Dentinal Hypersensitivity Treatments by Photobiomodulation Therapy, Nd:YAG and Nd:YAP Lasers.

In this retrospective study, data for three different laser-assisted approaches for the management of dentinal hypersensitivity (DH) was collected (n = 920 teeth). In total, 387 teeth were treated with photobiomodulation (PBM) therapy with 660 nm red light laser (PBM group), 327 were treated with the Nd:YAG laser (1064 nm) and 206 were treated with the Nd:YAP laser (1340 nm). To assess the effectiveness of each treatment, a visual analogue scale (VAS) was used, where zero represented no pain at all and ten represented the greatest pain. VAS was used before (T0), immediately after (T1), one week after (T2), four weeks after (T3), six months after (T4) and one year after treatment (T5). Means and standard deviations of VAS at different follow-up times were calculated. Values were compared within and between groups. Statistical significance was considered to be achieved when p-value was less than 0.05. Confidence level was proposed to be 99% with a P value lower than 0.001. Within groups, a statistically significant reduction was obtained when the mean value of VAS at T0 was compared with T5. At T5, the PBM group had the highest reduction of VAS (with mean value of 0), while the Nd:YAG and Nd:YAP groups had scores of 1.065 ± 0.674 and 4.665 ± 0.674, respectively. Conclusion: this retrospective study showed that PBM therapy and irradiation with Nd:YAG and Nd:YAP lasers are effective in managing DH pain. However, PBM therapy was the only procedure that showed complete pain relief at six and twelve months after treatment.

Comparing the effect of cup placement between true and false acetabula in total hip arthroplasty in patients with Crowe type 3 dysplastic hip: A randomized clinical trial.

Hip dysplasia is one of the most widespread hip disorders. Total hip arthroplasty (THA) is the preferred treatment in patients with cup placement choices in true or false acetabulum. The objective of this research was to compare the effectiveness of the two mentioned procedures. This study was a randomized, open-label, parallel-group clinical trial, in which 46 patients/51 hips with Crowe type 3 dysplastic hip having THA were assigned to two groups: Group 1 - patients who had cup placement in the true acetabulum and Group 2 - patients who underwent cup placement in the false acetabulum. The variables that were evaluated and analyzed included severity of pain using the visual analog scale (VAS), range of motion (ROM), gait ability, the need for repeated joint replacement, and the Harris Hip Score (HHS). Forty-six patients/51 hips were included in the present study. The patients who were evaluated included 30 (65.2%) males and 16 (34.8%) females. The mean age in the population under study was 71.0 ± 10.22, and the mean body mass index of participants was 26.34 ± 2.22 kg/m2. The basic parameters in the two research groups were similar (P > 0.05). There were no significant differences between the two groups in terms of the mean values of VAS and ROM (P > 0.05); however, the mean HHS was significantly higher in the true acetabulum group, 57.90 ± 18.47 versus 48.29 ± 13.80 (P = 0.04). The effectiveness of cup placements both in the true and false acetabula was similar in all of the evaluated variables in terms of clinical outcomes except for HHS which was higher in the true acetabulum group. To further support the results of this research, it is recommended that more research be done on a greater population.

Olfactory Dysfunction in Patients Infected with 2019 Novel Coronavirus.

Introduction:The current study aimed at investigating the occurrence and features of olfactory dysfunction in patients with confirmed coronavirus disease 2019 (COVID-19) infection.Materials and Methods:Patients with laboratory and clinically confirmed COVID-19 infection were enrolled in this longitudinal study. They were managed in either the inpatient or outpatient setting. The demographic, clinical, and outcome data were retrieved from patients’ medical records. Olfactory dysfunction features, including the onset pattern, duration, and recovery time were investigated. The visual analog scale (VAS) was utilized as a self-rating subjective measurement of olfactory function.Results:According to the results, the mean age of the patients (n=502) was obtained at 46.8±18.5 years; moreover, 52.4% and 47.6% of cases were female and male, respectively. It was also revealed that 35.4% and 64.5% of the subjects were outpatients and hospitalized, respectively. Based on the findings, 178 (38.4%) subjects had olfactory dysfunction. The mean values of VAS in hyposmic patients were estimated at 2.5±2.5, 8.3 ±2.1, and 9.4±1.6 at the first evaluation, in 2 weeks, and after 1 month of follow-up (P<0.001). The onset of olfactory dysfunction was more suddenly (58.7%). The majority of cases experienced olfactory dysfunction at the same time as other symptoms 72(51.1%). Based on the results, 0.4% of subjects infected with COVID-19 had olfactory dysfunction as an isolated symptom. The olfactory dysfunction was recovered after 2 weeks in 18 (25.3%) anosmic and 37(46.8%) hyposmic patients.Conclusion:Olfactory dysfunction seemed to be an important symptom of COVID-19 infection. The occurrence of this disturbance as a transient self-limited condition was significantly higher among female subjects.

Calcific tendinitis of the shoulder in the Korean population: demographics and its relation with coexisting rotator cuff tear.

BackgroundTo evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear.MethodsBetween October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images.ResultsThere were 402 female patients (79%) with mean age of 55 years (range, 31–87 years). Mean duration of symptoms was 16 months. Mean size of calcific materials was 11.4 mm (range, 0–35 mm). Mean value of VAS and ASES scores were 6.5 (range, 1–10) and 47 (range, 8–95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all p<0.05).ConclusionsThis study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.

Effect of reassurance and lifestyle modifications in treating Mastalgia :- Evidence from a Tertiary Care Centre of Northern India

INTRODUCTION: Mastalgia is a frequent complaint among women of reproductive age group. Majority of the females have the fear of breast cancer which further elevates their pain and anxiety. OBJECTIVE: To assess the effect of reassurance and lifestyle modifications among patients of mastalgia and determine its associated socio-demographic correlates. MATERIAL AND METHODS: A retrospective study using a quantitative tool, was conducted among females with mastalgia attending the Breast clinic OPD of a tertiary care centre of north India from 1st November 2020-31st January 2021. Medical records of these patients were reviewed for baseline and follow up information. A routine non-pharmacological treatment in form of verbal reassurance and counselling for lifestyle modifications with emphasis on wearing proper breast support is done for patients with mastalgia who have no abnormality detected upon screening. The degree of breast pain was assessed by using VAS (visual analogue scale) at all the visits of the patient in the clinic. RESULTS: The mean age of the study participants was 34.5±4.03 years. The mean VAS of at baseline was 5.79 ±0.90 and 2.81±0.84 in 1st follow up. The was a significant difference in the mean value of VAS at baseline and 1st follow up (p=0.0001). Majority of the patients (69.2%) had more reduction in pain on VAS after reassurance and lifestyle modification. Females of 25-35 years age and those belonging to upper socioeconomic status showed more reduction in pain. CONCLUSION: A significant reduction in pain is seen among majority of the females with mastalgia after reassurance and lifestyle modification especially wearing a proper bra. Proper breast support is crucial in the management and prevention of mastalgia.

The Relationship between Vitamin D Concentrations and Knee Pain in Patients of Osteoarthritis

Objectives. In older people Osteoarthritis (OA) and vitamin D deficiency are common health conditions. It controversial Whether vitamin D concentration is associated with knee OA or not. In this study, we aimed to determine the association between serum concentrations of vitamin D and osteoarthritic knee pain. Subjects and Methods. Vitamin D concentrations were measured with the 25 hydroxy vitamin D test in patients presenting with clinical symptoms of primary knee osteoarthritis. Osteoarthritis was graded on the Kellgren-Lawrence grading scale from anteroposterior and lateral radiographs. Height, weight, and body mass index (BMI) were recorded. Patients completed a 10-cm visual analogue scale (VAS) for indicating pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC).Vitamin D concentration was defined as severely deficient (&lt;10 ng/mL), insufficient(10 to 19 ng/mL), or normal (20 to 50 ng/mL). Results. Of 149 patients (133 women), the mean age was 62.7 years. Mean vitamin D concentration was 10.93 ng/mL, and 89% patients were vitamin D deficient. Mean WOMAC score was 56.9, and VAS pain score was 7.5. Kellgren-Lawrence grade was 3 for 11 patients, grade 2 for 60, and grade 4 for 88. Mean BMI was 33.4. Mean values of VAS, WOMAC, and BMI did not differ by vitamin D status. Conclusion. Serum vitamin D concentration is not associated with knee pain in patients with osteoarthritis.

The Efficacy of Adding Electromagnetic Therapy or Laser Therapy to Medications in Patients With Diabetic Peripheral Neuropathy.

Introduction: Diabetes mellitus (DM) is a common disease with a highly significant burden among the Saudi population. This study aimed to investigate the effects of adding either magnetic or laser therapy to medications in patients with diabetic peripheral neuropathy (DPN). Methods: Seventy-one medically controlled diabetic patients were randomly assigned to 1) Magnetic group: 26 patients were exposed to magnetic therapy for 20 minutes/session, 2 sessions/week, for 3 months 2) Laser group: 25 patients were exposed to laser therapy with intensity 5.7 J/cm2 for 30 minutes/session, 2 times/week, for 3 months. 3) Drug group: 20 patients received only the regular medications for diabetic control and pain analgesia. Pain and neuropathy were assessed by the visual analog scale (VAS) and the Toronto Clinical Neuropath Scoring System (TRCNSS). Conduction velocities and amplitudes of peroneal and sural nerves were measured by electromyography. Results: The results showed significant increases in conduction velocities and amplitudes in both magnetic and laser groups in parallel with significant reductions in TRCNSS. Non-significant changes were obtained only after using only medications (P >0.05). The mean values of VAS reduced significantly in the three groups. The least significant differences showed significant changes among the three groups, whereas non-significant differences were obtained between both magnetic and laser groups. Conclusion: There were non-significant differences between both magnetic and laser therapy groups. Addition of either magnetic or laser therapy to medications could bring extra positive benefits to patients with DPN. Both magnetic and laser therapy can be applied with medications for the treatment of patients with DPN.

Evaluation of the Effect of Jambira Pinda Sweda in Cervical Spondylosis w.r.t. Clinical Symptomatology

Introduction: Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies, intervertebral discs of the neck, and the contents of the spinal canal. Spondylosis progresses with age and often develops at multiple interspaces. Though many conventional treatments are available but in view of their side effects and dependency, it is important to search for safe and effective Ayurvedic treatment. Objective: To evaluate the effect of Jambira Pinda Sweda in cervical spondylosis w.r.t. clinical symptomatology. Materials and methods: A single-arm, open, prospective interventional clinical study was conducted at two peripheral institutes of Central Council for Research in Ayurvedic Sciences. Total 60 patients of either sex aged between 30 years and 65 years, with clinical and radiological evidence of cervical spondylosis, were selected for the study. The treatment procedure Jambira Pinda Sweda was done daily for the period of 14 days. The patients were assessed at baseline, 7th day, 14th day, and 21st day (after 1 week without intervention) on the basis of relief in sign and symptoms of cervical spondylosis by reduction in the visual analog scale (VAS) score, Northwick Park Neck Pain Questionnaire, and SF-36 Health Survey Score for Quality of life. Results: Mean value of VAS on baseline was 6.90, on 7th day it was 3.37, and decreased up to 2.57 on 14th day and 2.08 on 21st day showing statistically significant improvement (p &lt; 0.001). The mean value of Northwick Park Neck Pain Questionnaire on baseline was 45.79, on 7th day it was 23.57, which further decreased to 17.32 on 14th day showing statistically significant decrease (p &lt; 0.001). The significant improvement was revealed in all the parameters of the SF-36 health survey (p &lt; 0.001). Conclusion: Jambira Pinda Sweda have been shown to be an effective local Ayurvedic treatment for cervical spondylosis. During the study, no adverse effect was noticed; hence, it proved to be a safe treatment.

Erector Spinae Plane Block in Laparoscopic Cholecystectomy, Is There a Difference? A Randomized Controlled Trial.

Background:The ultrasound (US)-guided erector spinae plane (ESP) block and oblique subcostal transversus abdominis plane (OSTAP) block are used to decrease postoperative pain and subsequently opioids consumption.Aim:The aim was to test the hypothesis that US-guided ESP blocks can produce more reduction in opioid usage during the first 24 h after laparoscopic cholecystectomy when compared to OSTAP block.Settings and Design:Seventy adult patients (20–60 years old) who were planned to undergo elective laparoscopic cholecystectomy were allocated in three groups in randomized controlled trial.Materials and Methods:The three groups received either port site infiltration, US-guided bilateral ESP block (ESP group), or OSTAP (OSTAP group) with bupivacaine hydrochloride 0.25%.Statistical Analysis:Postoperative 24 h Morphine consumption, visual analogue scale (VAS), the intraoperative fentanyl (μg) and equivalent morphine dose in the recovery unit were recorded and analyzed using one-way analysis of variance.Results:The mean 24-h morphine consumption was statistically significant between groups (P < 0.001), but it was insignificant between ESP and OSTAP (P = 0.173). Median (range) and interquartile range of intraoperatively consumed fentanyl showed significance between the three groups (P < 0.001). There was insignificance between ESP block Group II and OSTAP block Group III (P = 0.95) by post hoc analysis. The mean values of VAS at both rest and movement of the control group were significantly higher than the ESP block group at 6 and 12 h postoperative.Conclusion:Bilateral US-guided ESP block was found to be as effective as bilateral US OSTAP block. There was more decrease in intraoperative rescue fentanyl, PACU morphine analgesia, 24-h morphine, and pain assessment score in both groups than the control port-site infiltration group.Clinical trial registration number: NCT03398564.

Clinical evaluation of the effect of reducing tooth sensitivity caused by in office bleaching using dentifrices

Objective To evaluate tooth sensitivity and the efficacy of in-office bleaching when using different desensitizing dentifrices. Methods In total, 150 eligible individuals were recruited and randomized by computer-generated block randomization into three groups: potassium nitrate group (n=50), stannous fluoride group (n=50), and placebo group (n=50). Participants were asked to use a desensitizing dentifrice and toothbrush 15 days prior to and after the in-office bleaching. Each patient received a one-session in-office bleaching with 35% hydrogen peroxide whitening gel. The in-office bleaching included three 15 min operations, totally 45 min. Tooth sensitivity was evaluated by 100 mm visual analog scale (VAS) scores immediately 0 d and 1 d, 2 d, 7 d, 14 d, and 30 d after in-office bleaching. In total, 48 (96%), 45 (90%), and 46 (92%) individuals in the potassium nitrate, stannous fluoride, and placebo groups, respectively, completed the follow-up observations. Results Data were analyzed using analysis of covariance (ANOVA). For tooth sensitivity produced by in-office bleaching, the mean VAS values of the three groups were analyzed. At 0 d immediately after surgery, the mean VAS of the potassium nitrate group was 39.22±15.08, which was lower than that of the stannous fluoride group (47.18±12.59) and the placebo group (52.53±14.05), and the difference was statistically significant (P 0.05). On 1 day postoperatively, the mean VAS of the potassium nitrate group was 38.27±16.52, which was lower than that of the stannous fluoride group (44.69±14.92) and the placebo group (44.45±13.54), P 0.05). The mean values of VAS were similar 2 d, 7 d, 14 d and 30 d after operation, and the difference was not statistically significant (P>0.05). Conclusion Compared with the stannous fluoride group and the placebo group, the use of potassium nitrate desensitizing toothpaste 15 days before surgery can effectively alleviate the tooth sensitivity during and after in-office bleaching.

Effect and reliability of Transcranial Magnetic Stimulation on neuropathic pain, depressive symptoms in stroke patients: Preliminary Study

Objective: In this paper, we aimed to evaluate the effect of repetitive Transcranial Magnetic Stimulation (rTMS) on central pain in patients with stroke. Material and Methods: Ten patients who had a stroke history were included in this preliminary study. Patients with middle cerebral artery lesion, first-time stroke, subacute or chronic lesion and no other neurological involvement were included. Patients were examined before and after the first month of treatment with repetitive Transcranial Magnetic Stimulation (rTMS). Visual Analog Scale (VAS) was used for pain scale measurement; Leeds Assessment of Neuropathic Symptoms and Signs Scale (LANSS) and Douleur Neuropathique en 4 Questions (DN4) were used for neuropathic pain level and Beck Depression Inventory (BDI) for depressive mood. All patients received the current treatments and appropriate neurorehabilitation as recommended for the treatment of ischemic stroke Results: This prospective study included a total of 10 post-stroke patients (mean age 58.2 ± 16.1 years; range 29 to 75, 8 male; 2 female) with neuropathic pain. The mean values of VAS, LANSS, DN4 and BDI scales were significantly decreased after rTMS treatment in all patients. Conclusion: We discussed the preliminary results of the efficacy and safety of rTMS in the treatment of uncontrolled neuropathic pain. We consider that, rTMS may have significant effect on relief of chronic pain. These clinical parameters can be utilized for the further study of rTMS application in pain control.

Efficacy of Endoscopic Surgery in Management of Patients with Lumbar Canal Stenosis

Background Data: The treatment of lumbar stenosis has originally included extensive resections of posterior neural arch components. Moreover, wide muscular dissection and retraction is generally used to accomplish sufficient visualization. With the advancing noninvasive neuro-imaging modalities; the major component of neurological pressure typically occurs at the level of the interlaminar window. Microendoscopic decompressive laminotomies (MEDL) have now increased popularity among spine specialists for the treatment of lumbar canal stenosis. It has been developed from the unilateral hemilaminotomy technique.Purpose: To evaluate the efficacy of lumbar endoscopic decompression in patients of segmental lumbar canal stenosis from a unilateral skin incision.Study Design: A prospective clinical case study.Patients and Methods: A total of 30 patients 10 males and 20 females were operated in Alexandria Main University Hospital, during the period from January 2013 to June 2015. The degree of pain and disability were assessed pre-operatively using the Visual Analogue Scale (VAS), both for radicular pain and back pain (if present), and the Oswestry Disability Index (ODI). The length of the incision, the duration of surgery, the operative blood loss, and duration of hospital stay were calculated. Mean follow up period for patients was 38.5±18.2 months (Range, 36-48).Results: The mean age was 62.7±6.9 years. All patients had claudicating sciatica; 57% had bilateral sciatica, while 43 % had unilateral sciatica. 60% had low back pain. Only 3 patients (10%) had motor weakness preoperatively. 24 patients (80%) had single level affection, while 6 patients (20%) had double level affection. We operated totally on 36 segmental levels. There was a statistically significant reduction for the mean values of VAS both for radicular pain and back pain in the follow up period (P<0.001). Also, there was a statistically significant reduction for the ODI mean value in the follow up period (P<0.001). Operative blood loss was 109.5±63.2 ML. Mean operative time was 103.8±32.7 minutes. Mean duration of hospital stay was 1.5±0.6 days (Range, 1-3 days). We had two patients of intraoperative dural tears (7%) with no postoperative CSF leak occurred, two patients (7%) had superficial wound infection, no patients had deep wound infection or discitis, and no patients encountered of postoperative instability in the follow up period. Conclusion: Endoscopic surgery for bilateral decompression through a unilateral approach is a useful and effective procedure for treating patients with lumbar canal stenosis with encouraging results. (2018ESJ161)

Association between vitamin D concentrations and knee pain in patients with osteoarthritis.

ObjectivesOsteoarthritis (OA) and vitamin D deficiency are common health conditions in older people. Whether vitamin D concentration is associated with knee OA is controversial. In this study, we aimed to determine the association between serum concentrations of vitamin D and osteoarthritic knee pain.Subjects and MethodsVitamin D concentrations were measured with the 25 hydroxyvitamin D test in patients presenting with clinical symptoms of primary knee osteoarthritis. Osteoarthritis was graded on the Kellgren-Lawrence grading scale from anteroposterior and lateral radiographs. Height, weight, and body mass index (BMI) were recorded. Patients completed a 10-cm visual analogue scale (VAS) for indicating pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Vitamin D concentration was defined as severely deficient (<10 ng/mL), insufficient (10 to 19 ng/mL), or normal (20 to 50 ng/mL).ResultsOf 149 patients (133 women), the mean age was 63.6 years. Mean vitamin D concentration was 11.53 ng/mL, and 90% patients were vitamin D deficient. Mean WOMAC score was 57.2, and VAS pain score was 7.5. Kellgren-Lawrence grade was 2 for 10 patients, grade 3 for 61, and grade 4 for 88. Mean BMI was 33.4. Mean values of VAS, WOMAC, and BMI did not differ by vitamin D status.ConclusionSerum vitamin D concentration is not associated with knee pain in patients with osteoarthritis.

Association between Vitamin D Concentrations and Knee Pain in Patients with Osteoarthritis

Objectives:Osteoarthritis (OA) and vitamin D deficiency are common health conditions in older people. Whether vitamin D concentration is associated with knee OA is controversial. In this study, we aimed to determine the association between serum concentrations of vitamin D and osteoarthritic knee pain.Subjects and Methods:Vitamin D concentrations were measured with the 25 hydroxyvitamin D test in patients presenting with clinical symptoms of primary knee osteoarthritis. Osteoarthritis was graded on the Kellgren-Lawrence grading scale from anteroposterior and lateral radiographs. Height, weight, and body mass index (BMI) were recorded. Patients completed a 10-cm visual analogue scale (VAS) for indicating pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Vitamin D concentration was defined as severely deficient (<10 ng/mL), insufficient (10 to 19 ng/mL), or normal (20 to 50ng/mL).Results:Of 149 patients (133 women) the mean age was 63.6 years. Mean vitamin D concentration was 11.53 ng/mL, and 90% patients were Vitamin D deficient. Mean WOMAC score was 57.2, and VAS pain score was 7.5. Kellgren-Lawrence grade was 2 for 10 patients grade 3 for 61, and grade 4 for 88. Mean BMI was 33.4. Mean values of VAS, WOMAC, and BMI did not differ by vitamin D status.Conclusion:Serum vitamin D concentration is not associated with knee pain in patients with osteoarthritis.

Efficacy of knee joint aspiration in patients with acute ACL injury in the emergency department

PurposeTo evaluate the influence of joint aspiration on the sensitivity of physical examination for diagnosing acute anterior cruciate ligament (ACL) lesion in the second outpatient-department (OPD) follow-up referred from emergency department (ED). MethodsThis retrospective study included sixty patients underwent ACL reconstruction with initial visit at ED. They were divided into two groups based on the presence or absence of joint aspiration at ED. All participants were referred to second OPD follow-up within 7–14days after the injury. Clinical manifestation (including visual analogue scale (VAS) for pain, range of motion (ROM), and severity of knee effusion) and physical examination (Lachman test and pivot shift test) were checked in ED and the second OPD follow-up. ResultsThe group of patients with joint aspiration (G1) showed substantial decreases in mean values of VAS for pain (p=0.005), ROM (p=0.001), and effusion level (p<0.001), even higher VAS and effusion level and lower ROM at the initial visit of ED than the other group (G2). The sensitivity of positive Lachman and pivot shift test was significantly (p<0.05) increased following knee joint aspiration. Positive Lachman test was recorded at 76.5% in the second follow-up in G1, which was significantly (p=0.047) higher than that (47.6%) in G2. The percentage of positive pivot shift test was recorded at 76.5% in the second follow-up in G1, which as significantly (p<0.001) higher than that (31.0%) in G2. ConclusionsKnee joint aspiration in acute ACL injury with suspected hemarthrosis could be considered as a diagnostic procedure. Joint aspiration in early medical attendance might be able to lower pain scores or raise the sensitivity of physical examination for diagnosing acute ACL injury at follow up visit in orthopedic outpatient department. Level of evidenceRetrospective cohort study III.

The effects of aquatic, isometric strength-stretching and aerobic exercise on physical and psychological parameters of female patients with fibromyalgia syndrome.

[Purpose] There are various treatment modalities for fibromyalgia syndrome (FMS), which is characterized by widespread pain and fatigue. The aim of this study was to investigate the effects of aquatic, aerobic and isometric strength-stretching exercises on the physical and psychological parameters of patients with FMS. [Subjects and Methods] Seventy five female patients with FMS were randomly selected and divided into three groups. Patients (18–50 years) were treated for 3 months using one of three methods: a home-based isometric strength and stretching exercise program (ISSEP), a gym-based aerobic exercise program (AEP), and a pool-based aquatic aerobic exercise program (AAEP). Items evaluated were: the number of tender points, Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), the Six-Minute Walk Test (6MWT), SF-36 physical and mental health scores, and the Beck Depression Inventory (BDI). [Results] The results revealed that AAEP was the most effective treatment of the three. All of the groups showed significant improvements in all variables between pre-and post-test, except the mean values of VAS and BDI in ISSEP. [Conclusion] The results suggest that aquatic aerobic exercise program is more effective than AEP and ISSEP in the treatment of FMS.

Alexithymia, mood states and pain experience in systemic lupus erythematosus and rheumatoid arthritis

This prospective study aims to examine alexithymia, mood states and pain experience in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients. We enrolled 49 patients with SLE or RA. All patients were evaluated through a set of questionnaires: (1) the Toronto Alexithymia Scale-20 (TAS), (2) the Profile of Mood States (POMS) and (3) visual analogue scale (VAS) and Questionario Italiano sul Dolore, self-report measures to assess pain intensity. Alexithymia was more prevalent in RA (44 %) than in SLE (37.5 %). The mean values of VAS were significantly higher in RA than in SLE population (p < 0.05). A linear relation between TAS and VAS values has been found in SLE (R = 0.714, p < 0.0001). The mean values of POMS regarding all negative dimensions of mood were higher in SLE than in RA. There was a linear relationship between TAS and POMS values in SLE patients (R = 0.7, p < 0.001). We found a high prevalence of alexithymia in SLE and RA. The chronic pain is influenced by emotional status as documented by a linear relation between TAS and VAS values in SLE patients. The difficulty in reporting emotional responses in these patients seems to be mediated by negative mood states.