Pain Categories Research Articles

Pengaruh Pemberian Jamu Temulawak (Curcuma Zanthorrhiza L) Terhadap Penurunan Nyeri Menstruasi Pada Remaja Putri di SMAN 1 Porehu Kabupaten Kolaka Utara

Temulawak herbal medicine is an alternative intervention in reducing the level of menstrual pain. Temulawak contains chemical compounds that have physiological activity. The curcumin content is also known as an anti-tumor, antioxidant, and pain reducer. The research aims to determine the effect of administering ginger herbal medicine (Curcuma zanthorrhiza L) on reducing menstrual pain in adolescent girls at SMAN 1 Porehu, North Kolaka Regency. The type of research used was quasi-experimental using a one group pretest-posttest research design. The sample in this study was all 27 young women who experienced pain during menstruation. The research results showed that the scale of menstrual pain before administering ginger herbal medicine (Curcuma zanthorrhiza L) reduced menstrual pain in young women at SMAN 1 Porehu, North Kolaka district in the mild pain category was 1 (3.7%), the moderate pain category was 13 (48%). .1%) and the severe pain scale category was 13 (48.1%). However, after administering ginger herbal medicine (Curcuma zanthorrhiza L) the reduction in menstrual pain in adolescent girls at SMAN 1 Porehu, North Kolaka district experienced changes where menstrual pain in the painless category was 15 (55.5%), and in the mild pain category was 12 ( 44.4%),. The conclusion is that there is an effect of giving ginger herbal medicine (Curcuma zanthorrhiza L) on reducing menstrual pain in adolescent girls at SMAN 1 Porehu, North Kolaka Regency (p value of 0.000 < α 0.05).

Occurrence of Coccydynia in Healthcare Professionals of Karachi; Pain and Straight Leg Raise Test Perspective

Coccydynia is a condition in which pain is experienced around the tailbone or coccyx region. The sitting position triggers the pain in the coccyx region especially when while patient comes from sitting to a standing position. The prevalence of coccydynia is unknown in the general population but it is more common in females than males. Objective: To determine the occurrence of coccydynia in healthcare professionals of Karachi. Methods: A cross-sectional study was conducted among healthcare professionals in Karachi from August 2023 to Feb 2024. The sample size of the study was 543 healthcare professionals. The sampling techniques which was used in this study were convenient. For the collection of data, a self-administered questionnaire was used while for the evaluation of data, two tests Visual Analog Score (VAS) and Straight Leg Raise( SLR) were used. The data were analyzed through the SPSS version 23.0 software in which we calculated the frequencies and percentages. Results: The study was done on 543 healthcare professionals between the ages of 20 to more than 59 years old who were recruited from different hospitals in Karachi. Pain intensity which was evaluated by the visual analog scale observed 223 (41.06 %) of participants found to lie in the moderate pain category while confirmation of coccydynia was done by the application of SLR and was found to be positive in 426 (78.85%) of healthcare professional's. Conclusions: The occurrence of coccydynia was found in the majority of the healthcare professionals of Karachi while the complaints of pain were found in the moderate category.

Pain types and risk factors in post-COVID-19.

This study aims to accurately evaluate pain lasting longer than three months and falls under the category of chronic pain and to determine the risk factors to follow up and treat properly and to develop appropriate diagnostic and treatment algorithms. Between March 2021 and December 2021, a total of 437 patients (162 males, 275 females; mean age: 44±14.6 years; range, 12 to 82 years) who were referred to the participating centers due to pain complaints and were diagnosed with post-COVID-19 condition according to the criteria defined by the World Health Organization (WHO) were included in the study. The patients were divided into three groups as nociceptive pain, neuropathic pain, and central sensitization, based on the physician's clinical evaluation and the Self-Report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) and Central Sensitization Inventory scores. The most common diagnosis was nociceptive pain followed by central sensitization. Patients with nociceptive pain had less pain. It was found that not exercising regularly, having a chronic disease and being a woman were risk factors for central sensitization, having thyroid disease before COVID-19, and defining the current pain as very severe were risk factors for neuropathic pain. In the evaluation of post-COVID-19 pain, neuropathic pain and central sensitization should be also considered in addition to nociceptive pain and the severity of pain, systemic diseases and physical activity should be questioned.

Cost – effectiveness analysis of hyaluronic acid injection relative to oral medication for knee osteoarthritis treatment at Nguyen Trai hospital in the period of 2022 – 2023

Objective Pharmacological treatments, primarily oral NSAIDs, constituted 73.9% usage for knee osteoarthritis. Despite the known adverse effects of NSAIDs, they are recommended for KOA management. Hyaluronic acid injections, an emerging alternative, lack consensus and evidence of cost-effectiveness in Vietnam. This study aimed to analyze the cost-effectiveness of hyaluronic acid injections relative to oral medication treatment in patients with KOA from health insurance payer’s perspective. Methods: A retrospective study was conducted using electronic medical records of KOA patients from March 1, 2022, to May 31, 2023, at Nguyen Trai Hospital to analyze costs. A cross-sectional descriptive study of two groups receiving hyaluronic acid injections (HA) or oral medication treatment (PO) was conducted using the WOMAC scale converted to EQ-5D-5L to measure treatment effectiveness in QALYs. Seemingly unrelated regression equation was utilized to estimate the Incremental Cost-effectiveness Ratio (ICER) of HA relative to PO while simutaneously adjusting for other confounding factors. Results: The PO group exhibited a higher total WOMAC score than the HA group (PO group: 45.12; HA group: 44.29), indicating greater severity in the WOMAC Pain, Function, and Stiffness categories. The QALYs of HA group was higher than those of the PO group, with QALYs values of 0,719 and 0,661, respectively. The total medical direct costs increased by 6.232.445 VND, and QALYs increased by 0,041 when using HA compared to PO. The ICER reached a 151.184.110 VND/QALY gained. With WTP of 1GDP and 3GDP, the probability of achieving cost-effectiveness of HA compared to using PO was respectively 20.06% and 100%. Conclusions: The study demonstrated that ICER based on QALYs of hyaluronic acid injections is cost-effective compared to the standard oral medication approach. Keywords: Cost analysis; WOMAC; Cost-effectiveness analysis; Hyaluronic acid injections; Knee osteoarthritis;

Stress and primary headaches – Mindfulness-Based Stress Reduction (MBSR) as a novel avenue for treatment

Introduction: In today's fast-paced life, an increasing number of people are experiencing chronic stress, which negatively impacts our mental and physical health, leading to troublesome conditions such as primary headaches. Faced with this challenge, more individuals are turning their attention to mindfulness techniques as an effective tool for stress management. In light of this, mindfulness, focusing on the awareness of the present moment, emerges as a promising method for preventing and alleviating stress-induced headaches and the resulting aftermath. 
 Purpose: Offer a comprehensive overview of the current understanding of the efficacy of mindfulness training, particularly Mindfulness-Based Stress Reduction (MBSR), in the prevention and relief of primary headaches and their associated consequences. 
 Description of the state of knowledge: MBSR demonstrates the potential for effectively coping with stress-induced headaches and their subsequent effects, including disability related to headaches. This category of pain includes conditions like migraine and tension-type headaches. In the clinical trials conducted thus far participants in the MBSR program show noticeable improvement in headache-related disability, self-efficacy, quality of life, catastrophic pain, and depression scores. 
 Summary: Studies suggest that integrating mindfulness training could present a promising strategy for preventing and reducing the severity of primary headaches and their consequences, by mitigating stress, a crucial factor influencing the onset of these headaches. To validate these promising findings, further randomized, large-scale, placebo-controlled studies are required.

Associations of long-term clinical recovery and improved quality of life across ICD-11 chronic pain categories in a real-world registry study.

There is little knowledge of what factors are needed for successful chronic pain management. We aim to identify psychosocial and treatment predictors of clinical recovery and improved quality of life (QOL) at 12-month follow-up across three chronic pain groups, based on the International Classification of Diseases-11: neuropathic pain, secondary non-neuropathic pain, and primary pain. Furthermore, we investigate baseline differences across diagnostic groups. The sample included baseline and 12-month follow-up data from 1056 chronic pain patients from the Oslo University Hospital's Pain Registry. Logistic regression models investigated longitudinal associations between psychosocial and treatment characteristics, and the outcome measures clinical recovery and improved QOL. Characteristics were compared across the diagnostic groups. Increased odds of clinical recovery and improved QOL were seen in patients receiving invasive treatment (OR = 8.04, 95% CI = 3.50-19.40; OR = 5.47, 95% CI = 2.42-12.86), while decreased odds of clinical recovery were seen for secondary non-neuropathic pain patients with pain-related disability (0.05, 95% CI = 0.01-0.29). In comparing baseline characteristics, neuropathic pain patients had lower QOL, and more severe insomnia compared to the other groups. Invasive treatment modalities were strongly associated with clinical recovery and improved QOL. Although this could be due to patient selection, it does warrant further examination as an intervention alternative for chronic pain. Intervention efficacy, risk factors and predictors of clinical recovery across diagnostic groups should be further investigated through longitudinal RCTs. This observational study indicates a potential advantage in sustained recovery for pre-selected individuals with chronic pain who undergo invasive treatments. The relationship between sustained recovery and psychosocial factors differs across neuropathic, secondary non-neuropathic, and primary pain patients. This suggests that employing ICD-11 for classifying patients into mechanistically distinct pain groups could inform the evaluation and management of chronic pain. Furthermore, factors previously identified as negative indicators for long-term outcomes in chronic pain cohorts were not clinically significant in this study.

Can illness representations be used to understand pain experienced in breast cancer survivorship-a cross-sectional study.

Chronic pain is a recognised long-term consequence associated with breast cancer and its treatment; however, it is often underdiagnosed and undertreated. This study aims to explore the associations between illness representations, chronic cancer pain, and HRQoL in women who have survived breast cancer. A cross-sectional online survey design was used. Data from 182 women who participated in the survey were analysed. Chronic cancer pain was reported by 66% of respondents. Using the BPI-SF (score 0-10), participants were categorised into one of four pain categories: no chronic pain (BPI score 0; 34.1%), mild pain (BPI score 1-3; 35.7%), moderate pain (BPI score 4-6; 25.3%), and severe pain (BPI score 7 + ; 4.9%). The main findings were that having a strong illness identity (IPQ-R subscale which assesses the number of symptoms an individual attributes to their illness) was found to be a significant predictor of pain severity (OR 1.21 (95% CI 1.07-1.37), p = 0.003). Furthermore, HRQoL was significantly associated and predictive of pain severity (OR 0.97 (95% CI 0.95-0.99), p < 0.001). An additional finding was that not being in paid work was strongly associated with being in a higher pain category (OR 5.92 (95% CI 1.84-19.05), p = 0.003). The findings of this study highlight the high prevalence of chronic cancer pain experienced by this population. Results show that dimensions of illness representations are associated with chronic cancer pain experienced by breast cancer survivors. Furthermore, having a strong illness identity and HRQoL were found to be independent, significant predictors of pain severity. These findings demonstrate that chronic pain is an unmet clinical need experienced by breast cancer survivors, which is associated with reduced overall HRQoL. Therefore, consideration is needed regarding the assessment and management of chronic pain experienced by this population.

Is nociplastic pain, a new pain category, associated with biochemical, hematological, and inflammatory parameters?

Objective The aim of the study was to evaluate the relationship between biochemical, hematological, and inflammatory parameters and pain in patients with nociplastic pain. Methods In this cross-sectional study, a total of 8632 patients, aged between 20 and 65, were evaluated according to the nociplastic pain diagnosis criteria determined by IASP. Excluding individuals who did not meet the criteria for nociplastic pain, the study included a total of 660 participants. The biochemical, hematological, and inflammatory parameters of all individuals were examined. The pain levels of the patients were assessed using the Visual Analogue Scale (VAS). The patients were categorized based on nociplastic pain types and pain regions for evaluation. Results In this study, the female gender was more prevalent both in all nociplastic pain categories and in all pain region groups (p < 0.05). In the nociplastic pain categories, it was observed that vitamin D levels were lower in patients with chronic widespread pain, while ferritin and C-reactive protein levels were higher in patients with chronic primary musculoskeletal pain. Among patients with chronic widespread pain with low hemoglobin and/or ferritin levels, the Visual Analog Scale activity score was higher. For patients with chronic widespread pain and low vitamin D levels and/or high erythrocyte sedimentation rate levels, the Visual Analog Scale rest score was higher. In patients with fibromyalgia and high parathyroid hormone levels, the Visual Analog Scale activity score was higher. For patients with fibromyalgia and high Neutrophil/Lymphocyte ratio levels, the Visual Analog Scale rest score was higher. In patients with chronic primary musculoskeletal pain and high erythrocyte sedimentation rate and/or C-reactive protein levels, the Visual Analog Scale activity score was higher. While vitamin B12 levels were found to be lower in patients with widespread pain, no significant relationship was identified between electrolytes, other blood count results, and nociplastic pain. Conclusion In our study, it was observed that levels of vitamin D in individuals with nociplastic pain were low, while erythrocyte sedimentation rate, C-reactive protein, and Neutrophil/Lymphocyte ratio were high, and hemoglobin and ferritin levels were elevated. Furthermore, these findings were found to be associated with both the presence of pain and the severity of pain assessed using the visual analog scale.

Patient Expectations of Pain Versus Experienced Expectations of Pain Following Shoulder Injection

PurposeCorticosteroids, platelet-rich plasma, and hyaluronic acid injections to either the subacromial space (SAS) or the glenohumeral joint (GHJ) of the shoulder are commonly used for diagnostic and therapeutic purposes in outpatient settings. The first aim of this study was to determine whether the anticipated pain level differed significantly from the actual pain level experienced by patients who underwent shoulder injections. The second aim was to determine whether there was a significant difference in these pain levels between SAS and GHJ injections. The secondary goal was to investigate the correlation between patients’ demographic data, anxiety characteristics, and pain scores. DesignProspective clinical study. MethodsThis study involved patients who completed a three-part questionnaire prior as well as following an injections to the GHJ\\SAS. FindingsSixty-three patients (28 males; 35 females), mean age of 54.28 years (standard deviation 13.95, range 25 to 84) met the inclusion criteria. There was a significant difference between the anticipated and the experienced pain (visual analog score 6.03 vs 3.17, P < .001). Experienced pain of the GHJ injections (n = 34) was rated as being greater than that of the SAS injections (n = 29) with borderline significance (visual analog scale 3.79 vs 2.36; P = .05). Forty-five patients (71.42%) reported a decrease in at least one pain category between anticipated and experienced pain compared to an increase reported by two patients (3.17%). ConclusionsInjections to the GHJ and SAS were shown to be significantly less painful than anticipated by the patients. GHJ injections were perceived as more painful than SAS injections. Communicating this evidence-based reassuring information with patients prior to an injection may alleviate fear of the procedure, reduce the perception of pain, and ultimately improve compliance with the procedure.

Transcranial Direct Current Stimulation for Orthopedic Pain: A Systematic Review with Meta-Analysis.

(1) Background: Transcranial direct current stimulation (tDCS) appears to alleviate chronic pain via a brain-down mechanism. Although several review studies have examined the effects of tDCS on patients with chronic pain, no systematic review or meta-analysis has comprehensively analyzed the effects of tDCS on chronic orthopedic joint pain in one study. We aim to evaluate the effectiveness of tDCS for pain reduction in chronic orthopedic patients; (2) Methods: A comprehensive search of five electronic databases (Medline, Embase, Web of Science, CINAHL, and Cochrane) was performed. Only randomized controlled trials that compared tDCS with a control intervention were included. Eighteen studies met our inclusion criteria. We identified four categories of chronic orthopedic pain: knee (k = 8), lower back (k = 7), shoulder (k = 2), and orofacial pain (k = 1). Random effect models were utilized, and a sensitivity analysis was conducted in the presence of significant heterogeneity. Studies within each pain condition were further classified according to the number of treatment sessions: 1-5 sessions, 6-10 sessions, and >10 sessions.; (3) Results: Significant reductions in chronic orthopedic joint pain were observed following tDCS compared to controls for knee (g = 0.59, p = 0.005), lower back (g = 1.14, p = 0.005), and shoulder (g = 1.17, p = 0.020). Subgroup analyses showed pain reductions after 6-10 tDCS sessions for knee pain and after 1-5 and >10 sessions for lower back pain; (4) Conclusions: tDCS could be considered a potential stand-alone or supplemental therapy for chronic knee and lower back pain. The effectiveness of tDCS treatment varies depending on the number of treatment sessions. Our findings suggest the importance of implementing individualized treatment plans when considering tDCS for chronic pain conditions.

The effects of hamstring stretching exercises on pain intensity and function in low back pain patients: A systematic review with meta-analysis of randomized controlled trials.

This meta-analysis aims to synthesize the available data on the effectiveness of hamstring stretching exercises in relieving pain intensity and improving function for patients with low back pain. Google Scholars, PubMed, Embase, Cochrane, MEDLINE, CNKI, Wanfang, and VIP were searched from inception to August 2023. We included randomized controlled trials that investigated the effectiveness of hamstring stretching exercises in patients with low back pain. The primary outcomes assessed were pain intensity, hamstring muscle flexibility, and function. Study selection, data extraction, and assessment of risk of bias were performed independently by two reviewers. Our searches retrieved 344 trials, of which 14 met the inclusion criteria for this review (n = 735 participants). The combined meta-analysis showed hamstring stretching resulted in lower pain scores (standardized mean difference = -0.72, 95% confidence interval: -1.35 to -0.09; I 2 = 89%, p = 0.03) in different categories of low back pain. Subgroup analysis showed that hamstring stretching led to a larger range of motion for cases of back pain with radiating pain (standardized mean difference = 2.39, 95% confidence interval: 1.76 to 3.02; I 2 = 0%, p < 0.001). The combined meta-analysis revealed that hamstring stretching resulted in lower Oswestry Disability Index scores in comparison to regular treatment, particularly in individuals suffering from low back pain across all subtypes (mean difference = -6.97, 95% confidence interval: -13.34 to -0.60; I 2 = 95%, p = 0.03). This meta-analysis demonstrates the effectiveness of hamstring stretching exercises in reducing pain intensity in various categories of low back pain and improving the straight leg raise in patients experiencing back pain with radiating pain. Additionally, it highlights the improvement in function for patients with back pain across all subtypes.

Long-Term Follow-Up of Ultrasound-Guided Glossopharyngeal Nerve Block Treatment for Glossopharyngeal Neuralgia: A Retrospective Clinical Study of 43 Cases.

Glossopharyngeal neuralgia (GPN) is a rare chronic neuropathic pain disorder that significantly impacts quality of life. Ultrasound-guided glossopharyngeal nerve blocks (UGPNB) have gained popularity due to their various advantages. However, there have been no studies reporting the long-term outcomes of UGPNB in a larger cohort of GPN patients. This study aims to evaluate the efficacy and safety of UGPNB in patients with GPN. We reviewed the electronic medical records of patients with GPN who received UGPNB at the Department of Pain Medicine of the First Medical Center, PLA General Hospital between June 1, 2011, and June 1, 2022. The effect of UGPNB was evaluated using the Barrow Neurological Institute (BNI) scale. Improvement was defined as a reduction in pain category by comparing pain categories before and after therapy. Recovery was defined as achieving BNI I after treatment. Patients who responded to treatment but then regressed to the category before therapy were considered to have experienced pain relapse. A total of 43 patients with GPN who received UGPNB were included in the analysis. At discharge, 35 (81.4%) patients experienced pain improvement after treatment, and among them, 13 (30.2%) patients achieved recovery. After discharge, 13 patients (37.1%) out of the 35 effective patients experienced pain relapse at different time intervals: 0.5, 0.7, 1, 1, 3, 3, 4, 12, 15, 36, 45, 63, and 96 months. The cumulative recurrence-free survival rates were 88.85% at month 1, 82.83% at month 3, 77.04% at month 12, 70.31% at month 36, and 54.66% at month 120. Among the 13 patients who experienced relapse, four patients received a second UGPNB treatment, and pain improved in two patients (50%). No severe adverse reactions were documented. UGPNB is an effective, repeatable, safe, and minimally invasive treatment for patients with GPN. It may be preferable to consider UGPNB before undergoing invasive intracranial surgery or neurodestructive methods.

Precuneal hyperperfusion in patients with attention-deficit/hyperactivity disorder-comorbid nociplastic pain.

Nociplastic pain (NP), a third category of chronic pain, offers a framework for elucidating its pathophysiology and treatment strategies. One of the characteristics of NP is comorbidity of symptoms other than pain, such as psychological and cognitive problems; therefore, these can be clues to understanding NP. Recently, we reported several cases with comorbid symptoms of attention-deficit/hyperactivity disorder (ADHD). Notably, ADHD medications, including methylphenidate (MP) and atomoxetine, improved chronic pain as well as the symptoms of ADHD. However, in clinical settings, identifying comorbid ADHD in patients with chronic pain is challenging, and underlying mechanisms have not been elucidated. To explore the common characteristics of brain function in patients with ADHD-comorbid NP, we identified brain regions where cerebral blood flow (CBF) distributions changed between pre- and post-treatment using single-photon emission computed tomography (SPECT). Additionally, we examined brain regions where CBF values correlated with clinical scores. We retrospectively studied 65 patients (mean age 53 ± 14years; 30 males and 35 females) with ADHD-comorbid NP who underwent CBF-SPECT before and after ADHD medication initiation. Clinical scores included the clinical global impression severity (CGI-S), pain numerical rating scale, hospital anxiety and depression scale, pain catastrophizing scale, and Conners' adult ADHD rating scale-self report scores. Voxel-based statistical methods were used to compare pre- and post-treatment CBF-SPECT images to identify significant differences and investigate brain regions correlated with clinical scores. The CBF was higher in the precuneus, insular gyrus, and thalamus before treatment than after treatment (paired t-test, cluster-definition p < 0.001, cluster-extent threshold p < 0.05, with family-wise error [FWE] correction). The hyperperfusion in the precuneus was positively correlated with the CGI-S score and significantly reduced after treatment with MP (paired t-test, cluster-definition p < 0.005, cluster-extent threshold p < 0.05, with FWE correction). The finding of precuneal hyperperfusion may provide insight into the mechanisms of NP and help identify patients who would benefit most from ADHD medications.

The new chronic pain MG30 category and diagnostic specificity in quality registries-problems and suggested solutions with special reference to Swedish Quality Registry for Pain rehabilitation (SQRP).

The Swedish Quality Registry for Pain rehabilitation (SQRP) is a well-established clinical registry for adult patients with complex chronic pain conditions. SQRP registers patient-reported outcome measures from a majority of specialist chronic pain units/departments in Sweden. Up to four International Classification of Diseases version 10 (ICD-10) diagnoses can be registered in SQRP. The aim of the paper is to describe how we envision the new chronic pain category MG30 in ICD-11 can be used in SQRP. We envision that the first diagnosis in SQRP shall always be a MG30 diagnosis, which will ensure broad implementation of ICD-11 in Swedish pain care. However, at first glance, there seems to be specificity problems with ICD-11 codes that might impair their useability in SQRP or other registries. But ICD-11 offers more than meets the eye. First, the entries at the level of the so-called foundational layer have unique resource identifiers (URI) that can be used to enhance specificity. Second, ICD-11 contains numerous extension codes that can be combined with the MG30 codes - for instance, concerning the anatomical location of pain. Third, to enrich the description of the clinical concept at hand, it is possible to create clusters of stem codes. These three options are briefly discussed. We conclude that the full potential of the MG30 category can be better exploited in registries such as SQRP if foundational codes, extension codes, and/or clustering of stem codes are used to enhance diagnostic specificity.

Prevalence of Achilles Tendinopathy among Physical Therapists of Pakistan

It is a degenerative disease that affects the tendon of Achilles, which attaches the gastrocnemius muscle to the heel bone. The rate of prevalence in the general population is about 6 percent, in athletes about 24 percent, 36 percent in short-distance runners, and in middle and long-distance runners about 52 percent. Objective: To determine the frequency of Achilles tendinopathy in Physical therapists of Pakistan. Methods: The cross-sectional study was done through an online survey among the Physical Therapists of Pakistan. The estimated sample size calculated from the Raosoft.com software was 449 participants. The sampling technique used in this study was convenient. The data was collected through a validated questionnaire named a Victorian Institute of Sports Assessment- Achilles( VISA-A) measurement tool, ranging from 0 to 100 in which higher scores showed least symptoms while lower scores showed severe symptoms. Statistical analysis was done through SPSS version 23.0. Results: Out of 449 research participants between the ages of 22 to 50 years were evaluated through a validated questionnaire and the result shows 298 (66.36%) of participants participated in sports activities and the level of pain was evaluated as 95(21.15%) of participants fell in healthy, 238(53%) in mild, 97(21.60%) in moderate however 19(4.23%) participants fall in severe category of pain. Conclusions: Our study concluded that the occurance of Achilles tendinopathy is uncommon among the physical therapists population of Pakistan.

PAIN TREATMENT SERVICE AND BASIC MANAGEMENT PAIN TRAINING FOR COMMONS AND MEDICAL PERSONNEL IN SURABAYA

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. The lack of up-to-date basic knowledge of pain management, especially among healthcare professionals in Primary Health Care Facilities in Surabaya, often leads to the perception that pain is trivial and consequently inadequately addressed. The objective of this social service activity in pain treatment and basic pain management training is to provide appropriate treatment for the community's pain scale and impart current knowledge on pain management that can be applied in daily practice by healthcare professionals and the general public in Surabaya. This initiative involves two methods: treating pain in non-medical community members and providing basic pain management training for healthcare professionals. Examination and anamnesis are conducted for each patient according to the examination questionnaire, which includes the Pain Questionnaire for Laypersons, the Physical Examination Form for Pain Management Social Service, and the Quality of Life Scoring. The initial examination and anamnesis results will determine whether the patient falls into the acute or chronic pain category, allowing for tailored interventions based on patient grouping. As for the basic pain management training, it is conducted by a pain management consultant, comprising the Socialization of the Pain Management Center, a General Lecture on the New Paradigm of Pain Management in the Community, and a Hands-On Pain Management Workshop for patients in pain.

Intervensi Family Triple Support (FTS) Berpengaruh terhadap Respon Bayi pada saat Imunisasi DPT

This study aims to determine whether the FTS intervention affects the baby's pain response when DPT immunization is given at the Community Health Center. This type of research is pre-experimental with a one-group pretest-posttest design. The results of the study showed that the frequency of responses to pain in babies before treatment was the highest, namely seven babies with a pain scale of 3, a percentage of 46.7% in the moderate pain category, the frequency of responses to pain in babies after treatment was the highest, six babies with a pain scale of 2, percentage 40% with the mild category. At the same time, the results of the bivariate analysis show that the p-value is 0.000 &lt; 0. In conclusion, family triple support intervention has a significant effect on the baby's pain response when DPT immunization is given at the Community Health Center.&#x0D; &#x0D; Keywords: Family Triple Support, DPT Immunization, Baby Response

A Medium-Term Comparison of Quality of Life and Pain After Robotic or Laparoscopic Cholecystectomy

IntroductionWe sought to compare medium-term outcomes between robotic-assisted cholecystectomy (RC) and laparoscopic cholecystectomy (LC) using validated quality of life (QoL) and pain assessments. Materials and MethodsPatients who underwent RC or LC between 2012 and 2017 at a single academic institution were examined. Cases converted to open were excluded. Patients were contacted by telephone in 2019 and completed two standardized surveys to rate their QoL and pain. ResultsOf those screened, 122 (35.8%) completed both surveys. Ninety three (76.2%) underwent RC and 29 (23.8%) underwent LC. The groups (RC versus LC) were similar based on mean age (47.9 versus 45.5 y, P = 0.48), gender (66.7% versus 72.4% female, P = 0.56), race (86.0% White/5.4% Black versus 72.4% White/13.8% Black, P = 0.2), insurance status (98.9% versus 100.0% insured, P = 0.58), median body mass index (31.8 versus 31.3, P = 0.43), and median Charlson Comorbidity Index (1 versus 0, P = 0.14). Fewer RC patients had a history of steroid use compared to LC (16.1% versus 34.5%, P = 0.03). No overall significant difference in QoL was demonstrated. LC group had higher severity of “tiring-exhausting pain” (P = 0.04), “electric-shock pain” (P = 0.003), and “shooting pain” (P = 0.05). The “overall intensity” of pain in the “gallbladder region” between the groups was similar at the time of follow-up (P = 0.31). ConclusionsQoL over 2-7 y following time of surgery is comparable for robotic-assisted versus conventional laparoscopic cholecystectomies. The laparoscopic approach may be associated with a higher severity of subset categories of pain, but overall pain between the two approaches is comparable.

Comparison of the Odontoid and Orbital-Coronal Vertical Axis Lines in Evaluating Coronal Alignment and Outcomes in Adult Spinal Deformity Surgery.

Asymptomatic Multi-Ethnic Alignment Normative Study (MEANS) cohort: cross-sectional, multicenter. Symptomatic cohort: retrospective, multisurgeon, single-center. To assess the association of odontoid-coronal vertical axis (OD-CVA) and orbital-coronal vertical axis (ORB-CVA) with radiographic parameters, patient-reported outcomes, and clinical outcomes. Previous literature studied the OD-CVA in an asymptomatic cohort and ORB-CVA in a symptomatic cohort, demonstrating their correlations with radiographic parameters and ORB-CVA with outcomes. A total of 468 asymptomatic adult participants were prospectively enrolled in the MEANS cohort. 174 symptomatic patients with adult spinal deformity with ≥6 fused levels and 2-year follow-ups were retrospectively enrolled in the symptomatic cohort. The association between OD-CVA and ORB-CVA, and radiographic parameters, perioperative variables, PROs, and outcomes were analyzed. Pearson correlation was used to assess correlation and logistic regression odds of outcomes. In the MEANS cohort, the ORB-CVA correlated with C7-CVA ( r = 0.58) and OD-CVA ( r = 0.74). In the symptomatic cohort, preoperative ORB-CVA correlated better with leg length discrepancy; r = 0.17, P = 0.029), whereas preoperative OD-CVA correlated better with C7-CVA ( r = 0.90, P < 0.001). Postoperative ORB-CVA correlated with postoperative C7-CVA ( r = 0.66, P < 0.001), and postoperative OD-CVA correlated strongly with postoperative C7-CVA ( r = 0.81, P < 0.001). Both preoperative OD-CVA ( r = 0.199) and ORB-CVA ( r = 0.208) correlated with the preoperative Oswestry Disability Index. ORB-CVA correlated better than OD-CVA in the preoperative Scoliosis Research Society-22r pain category but worse in total and other subcategories. Preoperative ORB-CVA was associated with increased odds of intraoperative complication (odds ratio = 1.28, 1.01-1.22), like OD-CVA (odds ratio = 1.30, 1.12-1.53). Neither preoperative ORB-CVA nor OD-CVA was associated with reoperations and readmissions after multivariate analysis. Preoperative OD-ORB mismatch >1.5 cm was not associated with increased odds of intraoperative and postoperative complications, reoperations, or readmissions. ORB-CVA and OD-CVA correlated with radiographic parameters, patient-reported outcomes, and intraoperative complications. ORB-CVA and OD-CVA can be used interchangeably as cranial coronal parameters in adult spinal deformity surgery.

Pengaruh Pemberian Kompres Hangat Terhadap Nyeri Persalinan Pada Inpartu Kala I Fase Aktif Di RSI Fatimah Banyuwangi Tahun 2022

Labor is the process by which the fetus and amniotic fluid are pushed out through the birth canal. During the birth process the mother will experience pain. Pain that is uncontrolled or excerssive and does not get proper treatment can cause problems with difficulty in childbirth. A non-pharmocological method that is quite safe was to determine the effect of giving warm compresses to labor pain in the active phase of the first stage of labor at Fatimah Banyuwangi Hospital in 2022. The research method used a pre-exsperimental one group pretest posttest on 30 respondents who met the inclusion criteria, namely pregnant women in the first active phase, singleton pregnancies, head presentations, term pregnancies, normal delivery plants, fetal interpretation between 2500-4000 grams, accompanied by their husbands or family. Data collection was carried out using the VAS observation sheet and warm compress SOP. Then the data is processed through the process of editing, coding,scring, tabulating and statistical analysis of the Wilcoxon test. The result showed that the level of labor pain before the intervention was mostly in the severe pain category by 53% and after the warm compress intervention there was a decrease in the pain level, namely in the moderate pain category by 70%. Wilcoxon test reslts Asymp. Sig. (2-tailed) 0,00 &lt; 0,05 means that there is a significant effect of giving warm compresses to labor pain in the active phase I parturition at RSI Fatimah Banyuwangi in 2022. Proper application of warm compresses according to the procedure gives a feeling of warmth and causes vasoconstriction so that labor pain in the first stage can be reduced. This method is safe and can be an alternative choice for midwives in the management of pain care during labor.