Wound Pain Research Articles

A Prospective Randomized Study Comparing 27-Gauge Vitrectomy to 23-Gauge Vitrectomy for Epiretinal Membranes and Full-Thickness Macular Holes.

To compare the surgical and clinical outcomes of 27-gauge vitrectomy and 23-gauge vitrectomy. We conducted a single-center, prospective, randomized study. Fifty-three patients affected by vitreoretinal interface disorders (epiretinal membranes and macular holes) were randomly scheduled to undergo 27-gauge (28 patients) or 23-gauge (25 patients) pars plana vitrectomy. The presence of any potential factor of increased baseline inflammation or eye anatomy influencing the surgery was criteria for exclusion. The time of surgery, postoperative intraocular pressure (IOP), state of sclerotomy wounds, rate of complications, postoperative pain, and indicators of inflammation were studied. We also introduced a new parameter to compare intraocular inflammation after surgery, given by the change in the number of intraretinal hyperreflective foci (HRF). The 27-gauge vitrectomy was 1.28 min longer than 23-gauge vitrectomy (P < 0.05). The day after surgery, the mean IOP value was significantly higher in the 27-gauge group (16.12 mmHg versus 13.04 mmHg in the 23-gauge group,P < 0.05), but this difference disappeared in successive follow-ups and the sclerotomy wounds closed after 2 weeks in the both groups. The rate of postoperative hypotony did not significantly differ in the two groups (10.71% in the 27-gauge group and 8% in the 23-gauge group the day after the surgery,P = 0.94). Less postoperative eye redness was seen in 27-gauge eyes (value 1 on the scale) compared to 23-gauge (value 2 on the scale) (P < 0.05), but there was no significant difference in intraocular inflammation (cells, Tyndall, and number of HRF,P > 0.05 for all). The 27-gauge vitrectomy may have better outcomes in terms of IOP maintenance and cause less redness after the surgery but with a slightly prolonged surgery time and no other differences under other parameters (inflammation, rate of complications, postoperative pain, visual gain, and closure of the sclerotomy wounds).

Patients ‘acceptance’ of chronic wound-associated pain – A qualitative descriptive study

Chronic wound-associated pain negatively impacts the quality of life of individuals and their families. To date, little research exists that has explored collectively how individuals describe wound pain, strategies they use to manage pain, and the perceived effectiveness of such strategies. Therefore, qualitative, semi-structured interviews were carried out between June and August 2021 with 13 individuals to gain a deeper understand of the experience and impact of chronic wound-associated pain in this population. Data were analyzed following Braun and Clarke's approach for reflexive thematic analysis using MAXQdA®. Two themes and subthemes were identified. Theme 1 reflects participants' characterization of pain and how wound-associated pain affected their daily life and how they learned to accept it. Participants felt functionally impaired. In theme 2, participants described how they accepted to live with such a pain even though they received support to manage their chronic wound-associated pain, especially during the dressing-changes. Patients depended on their health care professionals and family support networks to cope with the pain. Coping with pain is exhausting contributing to poorer quality of life. Health care professionals should be aware of wound-associated pain during dressing changes. Patients recommended the need for further research on dressings and not drugs to manage pain.

A retrospective study comparing open and percutaneous trigger finger release in the Thai population

Background: Over the years, open surgery has been the primary treatment for trigger finger, a prevalent issue among hand illnesses. There has been some resistance to the technique's routine use, despite the fact that the percutaneous release of triggers provides a quicker recovery than surgery. As a result, the study proposed that the percutaneous release technique outperforms open surgery. The objective of this study was to compares the trigger finger surgery's open and percutaneous releases in terms of short-term results. Methods: From 2014 to 2020, 166 patients who underwent open or percutaneous release surgery for the trigger finger at Naresuan University Hospital were the subjects of this retrospective analysis. For one, three, and six weeks, the initial characteristics and post-operative hemorrhage, digital nerve and artery injury, surgical site pain, inability to flex the finger, and other outcomes were compared. The visual analog scale (VAS) score and the impairments of the arm, shoulder, and hand (DASH) score were also compared between the two groups. Results: The age, sex, and number of patients in both groups were statistically comparable. Before the procedure, there was no difference between the groups in terms of DASH and VAS scores for pain; however, at six weeks, the percutaneous release group showed a substantial difference and low VAS scores. There were no differences between the groups in terms of consequences, including wound pain, damage to digital nerves and arteries, and others. Conclusion: Based on the patients' short-term outcomes, the study found that percutaneous release of the trigger finger is just as successful as traditional open surgery.

Temperature measurements on facial skin surface as evaluated by infrared thermal cam-era and pyrometer following physiotherapeutic light treatments

Any clinical procedure in dentistry, especially one that involves a breach of tissue integrity, carries the risk of complications, which can occur in any speciality. These include: postopera-tive wound pain, tissue swelling, bleeding, redness, elevated temperature, trismus, decreased sensation as a result of nerve damage. Postoperative patient care aims to minimise the risk of complications and to treat those which have developed. To this end, we can resort to physical therapy, one of the modalities of which is light therapy, using electromagnetic wave ranges of red, infrared, yellow and ultraviolet light. Yet, it remains unclear which wavelength should be used to treat any specific disease entity and which form of therapeutic light should be used in the rehabilitation of a specific complication following dental procedures? In this study, we used the Cason CA380 infrared digital pyrometer with a laser pointer and the Fluke Ti 400 thermal imaging camera. On the basis of the tests and statistical analysis, it can be concluded that the application of light significantly increases the temperature of the irradiated facial skin surface. Irrespective of the type of light used, each was associated with an increase in temper-ature. A more pronounced increase in temperature on the facial skin surface after a given ap-plication suggests that the effect of light therapy is shallow, which is relevant to the choice of a specific light wavelength to be applied in a particular disease entity or dental complication.

Effectiveness of Aloe Vera Gel in Management of Superficial Burn in Children

Background: Aloe vera has been used traditionally for healing burn and inflammation. Though, the evidence for the effectiveness of aloe vera for healing burn is not sufficient.&#x0D; Objective: The aim of this study was to assess the effectiveness of aloe vera gel in management of superficial burn in children.&#x0D; Methods: This retrospective study was taken place in the Department of Burn and Reconstructive Surgery, Bangladesh Shishu Hospital &amp; Institute, Dhaka and other two privet clinics at Dhaka, from September, 2019 to March, 2022. Total 47 patients with superficial partial thickness burn was included in the study.&#x0D; Results: In this study, majority (48.94%) patients were belonged to the age group of £24 months. The mean age was found 38.9±26.31 months. The current study observed that almost two third (61.70%) patients were male. In our study, majority (63.83%) patients stayed hospital for 1-5 days. In the present study, mean (±SD) pain relief time was 3.56±1.24 days and mean (±SD) wound healing time was found 8.19±1.6 days. The current study observed that only 3(6.38%) patients had found wound infection. In current study showed that mean treatment cost was found 76.46±31.88 Taka.&#x0D; Conclusion: Aloe vera gel facilitated early pain alleviation, wound healing, and costeffective superficial burn treatment in children. Therefore, it can be utilized to treat superficial burns in children to get better results.&#x0D; DS (Child) H J 2021; 38(1): 39-43

Efficacy of Irsal-i-Alaq (Hirudotheraphy) in the Management of Venous Ulcer: A Case Report

Background: The most frequent and recurring type of leg ulcers seen in general practise is a venous ulcer (stasis ulcer). Its neglect has a considerable negative influence on quality of life, might result in gangrene, and may necessitate amputating the affected limb. The most serious and incapacitating complication of chronic venous insufficiency is venous ulcer. The conventional system of medicine offers limited clinical evidence for its effectiveness and usually needs amputation. Hence, it can be managed well by one of the Unani regimens, i.e., Irsal-e-Alaq (Hirudotherapy). Objective: The purpose of this case report is to provide insight into the effects of Irsal-e-Alaq (Hirudotherapy) in venous ulcer. Intervention: A 53-year-old male who has complaints of ulcer in left lower leg near lateral malleolus with swelling, pain, discharge and darkening of skin of left lower limb. Four leeches were applied once every 15 days for 45 days. Ulcer was assessed on 0th day, 15th day, 30th day and 45th day on the basis of area of the wound in a square centimetre, appearance of healthy granulation tissues, epithelization in percentage and depth of wound in centimetres, pain (VAS scoring), discharge, smell and number of wounds. Results: on the first day wound size was 4 cm long, 3 cm wide, 2 cm deep and the floor filled with dark granulation tissue with 0 % epithelization, discharge, pain and smell. On the 45th day ulcer was completely healed with 100% epithelization. Conclusion: Irsal-e-Alaq has been proven beneficial in treating venous ulcers and enhancing patients' quality of life. To determine the effectiveness of Irsal-e-Alaq in the management of venous ulcer, rigorous, controlled, randomised, blinded, and long-term follow-up studies on high sample sizes are required.&#x0D; Keywords: Hirudotherapy, Unani Medicine, Leech Therapy, Varicose Ulcers

Effects of dexmedetomidine on surgical site wound pain in patients undergoing laparoscopic cholecystectomy: A meta-analysis.

This study aimed to evaluate the effectiveness of dexmedetomidine as an adjuvant to local wound infiltration anaesthesia in reducing surgical site wound pain in patients undergoing laparoscopic cholecystectomy. The Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, and Wanfang databases were searched from the time of database creation until February 2023. We performed a randomised controlled trial on the effect of dexmedetomidine as an adjunct to local wound infiltration anaesthesia on postoperative wound pain in patients undergoing laparoscopic cholecystectomy. Two investigators independently screened the literature, extracted data, and evaluated the quality of each study. This study was performed using the Review Manager 5.4 software. Ultimately, 13 publications with 1062 patients were included. The results showed that dexmedetomidine was effective as an adjunct to local wound infiltration anaesthesia at 1 h (standardised mean difference [SMD]: -5.31, 95% confidence intervals [CIs]: -7.22 to -3.40, P < .001), 4 h (SMD: -3.40, P < .001), 12 h (SMD: -2.11, 95% CIs: -3.10 to -1.13, P < .001) and 24 h postoperatively (SMD: -1.98, 95% CIs: -2.76 to -1.21, P < .001) significantly reduced surgical site wound pain. However, there was no significant difference in the analgesic effect at 48 h postoperatively (SMD: -1.33, 95% CIs: -3.25 to -0.58, P = .17). Dexmedetomidine provided good postoperative wound analgesia at the surgical site when used for laparoscopic cholecystectomy.

Efficacy of Low-Level Laser Therapy in Wound Healing and Pain Reduction After Gingivectomy: A Systematic Review and Meta-analysis.

Introduction: Complete healing of a gingivectomy wound usually takes between one and two months. To speed up this process, different topical medications have been reported. In addition, there are different studies assessing the efficacy of low-level laser therapy (LLLT) in terms of wound healing and pain relief subsequent to gingivectomy, yielding inconsistent outcomes. In the present study, we systematically reviewed the existing evidence in the literature to resolve the given conflicts. Methods: We searched for the studies published from inception to 1 April 2023 in Embase, PubMed, and Scopus databases without language limitation by the use of appropriate keywords. We included randomized or non-randomized clinical trial studies that appraised the efficacy of LLLT in pain reduction and wound healing in adult patients who underwent gingivectomy. We pooled the continuous data concerning the pain visual analogue scale and the healing index extracted from the individual studies to provide a standardized mean difference (SMD) with a 95% confidence interval (CI), using a random-effects model. Results: Out of 188 sources initially captured from the database search, six studies were ultimately included. Regarding wound healing, the LLLT group exhibited a significantly higher mean value of the healing index compared to the control group on days 3 (SMD, 0.93; 95% CI, 0.39 to 1.47) and 7 (SMD, 1.03; 95% CI, 0.49 to 1.57) post-surgery. Also, significant differences were noted in the postoperative pain reduction between the two groups on days 3 (SMD, -2.00; 95% CI, -2.48 to -1.51) and 7 (SMD, -2.44; 95% CI, -4.66 to -0.22) post-surgery. Conclusion: According to the present systematic review, LLLT could potentially be an efficient adjunctive treatment after gingivectomy for wound healing acceleration and patient pain alleviation.

Surgical site wound infection and wound pain after video-assisted thoracoscopy in patients with lung cancer: A meta-analysis.

A meta-analysis was performed to comprehensively assess the effects of video-assisted thoracoscopy on surgical site wound infection and wound pain in patients with lung cancer. Studies on video-assisted thoracoscopy for lung cancer were collected from PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang database, from inception to January 2023. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the included studies according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software. Thirty-one articles with a total of 3608 patients were included, with 1809 in the video-assisted thoracoscopy group and 1799 in the control group. Compared with the control group, video-assisted thoracoscopy significantly reduced surgical site wound infection (odds ratio: 0.22, 95% confidence interval [CI]: 0.14-0.33, P < .001) and surgical site wound pain at postoperative day 1 (standardised mean difference [SMD]: -0.90, 95% CI: -1.17 to -0.64, P < .001) and postoperative day 3 (SMD: -1.59, 95% CI: -2.25 to -0.92, P < .001). Thus, these results showed that video-assisted thoracoscopy may have beneficial outcomes by reducing surgical site wound infection and pain. However, owing to the large variation in sample sizes and some methodological shortcomings, further validation is needed in future studies with higher quality and larger sample sizes.

Effects of Self-perineal Care Education using a Mobile Application on Knowledge and Practice of Perineal Care among Primigravida Mothers: A Quasi-Experimental Study

Background: Poor self-perineal care (SPC) by new mothers due to inadequate knowledge can result in perineal pain and poor wound healing outcome. Objectives: This study aimed to evaluate the effectiveness of self-perineal care education on knowledge and practice among primigravida mothers in Malaysia. Methods: This quasi-experimental study was conducted in two public tertiary care hospitals from September 2019 to March 2020. In total, 125 mothers were recruited using consecutive sampling procedures from two tertiary care hospitals. The intervention group consisted of 62 mothers who received SPC education supplemented by the mobile app, while the other 63 mothers in the control group received only routine hospital care. The knowledge of mothers regarding SPC was assessed at 32 to 33 weeks of gestation and then at 4 h post-delivery. The mothers of both groups reported their perineal care practices on Day 1, Day 3, Day 5, and Day 7 post-childbirth using the SPC education mobile app. Results: There was no significant difference in the SPC knowledge scores between the two groups at baseline (P=0.155). Post-analysis showed a significant increase in the SPC knowledge score in the intervention group (P&lt;0.001) but not in the control group (P=0.133). At all-time points, the mothers in the intervention group performed better SPC practice than those in the control group (P&lt;0.001). There were significant associations between changes in knowledge and practice on all four days (P&lt;0.001). Conclusion: The increased knowledge of SPC was significantly associated with improved SPC practice among the primipara mothers postnatally.

Use of local wound infiltration in open hepatectomy to reduce wound pain: A systematic review and meta-analysis.

The aim of this study was to assess the effects of local wound infiltration anaesthesia on postoperative wound pain in patients undergoing open liver resection. The Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM) and Wanfang databases were searched. The search period spanned from database creation to December 2022. All relevant studies on local wound infiltration anaesthesia for analgesia after hepatectomy were included. Two investigators independently screened the literature, extracted data and evaluated the quality of each study. Review Manager (RevMan) 5.4 software (Cochrane Collaboration) was used for the meta-analysis, in which 12 studies with 986 patients were included. The results show that local wound infiltration anaesthesia effectively reduced surgical site wound pain at 4 h (mean difference [MD]: -1.26, 95% confidence intervals [CIs]: -2.15 to -0.37, P = .005), 12 h (MD: -0.84, 95% CIs: -1.26 to -0.42, P < .001), 24 h (MD: -0.57, 95% CIs: -1.01 to -0.14, P = .009) and 48 h (MD: -0.54, 95% CIs: -0.81 to -0.26, P < .001) postoperatively; however, there was no significant difference in analgesia at 72 h postoperatively (MD: -0.10, 95% CIs: -0.80 to 0.59, P = .77). These findings suggest that local wound infiltration anaesthesia administered to patients undergoing open liver resection provides good postoperative wound analgesia at the surgical site.

Clinical value of combined serum MMP-2, MMP-9 and TIMP-1 for the prognosis of perianal fistula patients who received minimally invasive surgery.

This study aimed to investigate the clinical value of combined serum matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) for the prognosis of perianal fistula patients. Patients diagnosed and treated for perianal fistula by minimally invasive surgery (MIS) were enrolled. The concentrations of serum MMP-2, MMP-9 and TIMP-1 were measured at 24 h after surgery. Different levels of wound secretion, growth of granulation tissue and wound pain were used as criteria to evaluate surgical incision healing. The receiver operating characteristic curve was used to analyze the predicted assessment value. The concentrations of serum MMP-2 and MMP-9 were significantly higher, while the concentrations of serum TIMP-1 at 24 h after surgery were significantly lower in the poor healing group than in the good healing group. It was further found that high levels of serum MMP-2 and MMP-9 were risk factors for poor healing, while high concentrations of serum TIMP-1 at 24 h after surgery were protective factors for poor healing. High concentrations of serum MMP-2 and MMP-9 and low concentrations of serum TIMP at 24 h after surgery are risk factors for poor healing in perianal fistula patients who receive MIS, and the combined test has a higher predictive value.

Mapping of traditional healthcare providers and their healing approaches in a tribal community of district Sirohi, Rajasthan.

Traditional applications of medicinal plants in healthcare practices provide indication to new therapeutic concepts; hence, their relevance is highly recognized. The objective of the study was to map the traditional healers from the aspirational district and scientific documentation of their healing practices to treat various diseases. This was community-based study in tribal subpopulation zone of district Sirohi. The data was collected through field survey and interviews of tribal healers by using semi-structured questionnaire. We identified 1015 tribal healers (68% male and 32% female), and all belong to Bhil, Meena, and Garasia communities of district Sirohi. The mean age was 60.45 ± 16.56 years, 82.6% healers were uneducated, and 12.6% had primary education, while 1.2% were graduates. Tribal healers act as primary point of care for tribal community and practiced various treatment modalities including herbal healing (32.7%), diviners (28.9%), child birth attendant (24.7%), and bone setters (13.7%). We recorded 88 herbal healing practices from tribal communities of district Sirohi and scientifically documented. The common diseases treated by tribal healers included wound healing, skin infection, fever, arthritis, pain, diarrhea, cough, and cold. The Fabaceae family was credited with highest number (17%) of plants used by herbal healers. It was also noted that some of the plants used for medicinal purpose are endangered and overexhausted. Ethnopharmacological data is the foundation for further validation and value addition of herbal healthcare practices. The mapping of indigenous knowledge holders and scientific documentation of their knowledge might be a crucial step for providing clue regarding new therapeutic molecules.

Innovations in the Treatment of Dystrophic Epidermolysis Bullosa (DEB): Current Landscape and Prospects.

Dystrophic epidermolysis bullosa (DEB) is one of the major types of EB, a rare hereditary group of trauma-induced blistering skin disorders. DEB is caused by inherited pathogenic variants in the COL7A1 gene, which encodes type VII collagen, the major component of anchoring fibrils which maintain adhesion between the outer epidermis and underlying dermis. DEB can be subclassified into dominant (DDEB) and recessive (RDEB) forms. Generally, DDEB has a milder phenotype, while RDEB patients often have more extensive blistering, chronic inflammation, skin fibrosis, and a propensity for squamous cell carcinoma development, collectively impacting on daily activities and life expectancy. At present, best practice treatments are mostly supportive, and thus there is a considerable burden of disease with unmet therapeutic need. Over the last 20 years, considerable translational research efforts have focused on either trying to cure DEB by direct correction of the COL7A1 gene pathology, or by modifying secondary inflammation to lessen phenotypic severity and improve patient symptoms such as poor wound healing, itch, and pain. In this review, we provide an overview and update on various therapeutic innovations for DEB, including gene therapy, cell-based therapy, protein therapy, and disease-modifying and symptomatic control agents. We outline the progress and challenges for each treatment modality and identify likely prospects for future clinical impact.

Wound healing and pain sensitivity following caustic paste disbudding in dairy calves

Caustic paste disbudding is increasing in popularity on commercial dairy farms in the US, but little research has explored the pain and welfare implications beyond the acute period of this procedure. Researchers have reported it takes 7 to 9 wk, on average, for hot-iron disbudding wounds to re-epithelialize in dairy calves. Our objective was to describe wound healing and sensitivity following caustic paste disbudding. Jersey and Holstein female calves were disbudded using Dr. Naylor's caustic paste at 3 d of age (n = 18) while control calves received a sham procedure (n = 15). Before disbudding, calves received a local block and an NSAID. Calves ≥34 kg and <34 kg at birth had 0.3 or 0.25 mL of paste applied per unshaved horn bud, respectively. Following disbudding, wounds were scored 2x/wk for the presence/absence of 8 tissue categories including the final stages: new epithelium and fully healed. Control calves were removed from the experiment after 6 wk to be hot-iron disbudded and avoid more invasive procedures. Mechanical nociceptive threshold (MNT) measures were collected weekly to evaluate wound sensitivity until calves were removed from the study or wounds were healed. Wounds were slow to re-epithelialize (16.2 ± 5.7 wk, mean ± SD; range: 6.2-32.5 wk) and contract to be considered fully healed (18.8 ± 6 wk, mean ± SD; range: 8.7-34.1 wk). Compared with non-disbudded controls, paste calves exhibited lower MNT values for all 6 wk (mean ± SE, Control:1.46 ± 0.16; Paste:1.18 ± 0.12 N). These data indicate that wounds from caustic paste disbudding are more sensitive than undamaged tissue for at least 6 wk and take twice as long to heal compared with cautery methods described in the literature. In conclusion, caustic paste disbudding wounds took 18.8 wk to fully heal and were more sensitive than intact horn buds for 6 wk. Future work should examine if aspects of paste application (e.g., amount, time rubbed in, age, pain mitigation), could improve healing time and sensitivity.

Multicenter randomized trial of carpal tunnel release with ultrasound guidance versus mini-open technique

ABSTRACT Background Comparative studies of carpal tunnel release with ultrasound guidance (CTR-US) vs. mini-open CTR (mOCTR) are limited, prompting development of this randomized trial to compare efficacy and safety of these techniques. Research design and methods Patients were randomized (2:1) to CTR-US or mOCTR, treated by experienced hand surgeons (median previous cases: 12 CTR-US; 1000 mOCTR), and followed for 3 months. Results Among 149 randomized patients, 122 received CTR-US (n = 94) or mOCTR (n = 28). Mean incision length was 6 ± 2 mm in the wrist (CTR-US) vs. 22 ± 7 mm in the palm (mOCTR) (p < 0.001). Median time to return to daily activities (2 vs. 2 days; p = 0.81) and work (3 vs. 4 days; p = 0.61) were similar. Both groups reported statistically significant and clinically important improvements in Boston Carpal Tunnel Questionnaire Symptom Severity and Functional Status Scales, Numeric Pain Scale, and EuroQoL-5 Dimension 5-Level, with no statistical differences between groups. Freedom from wound sensitivity and pain favored CTR-US (61.1% vs. 17.9%; p < 0.001). Adverse event rates were low in each group (2.1% vs. 3.6%; p = 0.55). Conclusions The efficacy and safety of CTR-US were comparable to mOCTR despite less previous surgical experience with CTR-US. The choice of CTR technique should be determined by shared decision-making between patient and physician. Clinical trial registration www.clinicaltrials.gov identifier is NCT05405218.

Study of microwave ablation in patients with unresectable soft tissue sarcoma.

e23545 Background: Currently, the main treatment for soft tissue sarcoma is a combination of radiotherapy, chemotherapy and complete surgical resection. However, there is no ideal method for soft tissue sarcoma after multiple recurrences, large tumours, insensitivity to radiotherapy or failure of down grade therapy. Microwave ablation is one of the main techniques for tumour thermal therapy, but its use in soft tissue sarcoma is not yet widespread. The aim of this study was to investigate the safety and efficacy of microwave ablation in refractory soft tissue sarcoma. Methods: Fourteen eligible patients with refractory soft tissue sarcoma were treated with local anaesthesia, multi-point intra-tumour needle placement under ultrasound guidance and local radiofrequency ablation (20-40 J, 2-5 minutes). For tumours larger than 5 cm in diameter, repeat ablation can be performed after 3-4 weeks. Of the 14 patients, 8 were male and 6 were female, with a mean age of 58.91 years. There were 4 cases of myxofibrosarcoma, 3 cases of dedifferentiated liposarcoma, 2 cases of malignant nerve sheath tumour, 2 cases of clear cell sarcoma and 3 cases of other sarcomas. Tumours were located in the trunk in 7 cases, in the upper limbs in 3 cases and in the lower limbs in 4 cases. Of these, 5 patients had two operations and 9 patients had three or more operations. Four cases had received first-line therapy, five cases had received second-line therapy, and five cases had received third-line therapy or more. Postoperative pain relief and wound complications were recorded. MRI was performed regularly to assess tumour shrinkage. Results: Post-operatively, all patients experienced a significant reduction in local swelling and pain. Post-operative imaging showed partial response (PR) in 11 cases and stable disease (SD) in 3 cases. The overall response rate (ORR) was 78.57%. Progression-free survival (PFS) ranged from 2-18 months with a median of 5.82 months. Complications included tumour ulceration in 2 cases, skin burns with necrosis in 2 cases and postoperative fever in 5 cases. Conclusions: For soft tissue sarcomas that cannot be removed by surgery, where tumour growth is slow and insensitive to radio/chemotherapy, local microwave ablation can achieve tumour shrinkage and reduce patient symptoms such as local swelling and pain. It is an effective treatment option for some specific sarcoma patients.

The Influence of Finger Grip Relaxation on The Intensity of Perineal Wound Pain During Wound Treatment in Post Partum Mothers at Sundari Hospital

The delivery process often causes injuries and trauma to the uterine and vaginal areas. Especially those who do vaginal delivery. This wound can cause uncomfortable feelings and also quite severe pain when giving birth to pregnant women. And in order to reduce or overcome this pain, of course there are several ways that can be done to help pregnant women who are in labor so that pain can be overcome during labor. The purpose of this study was to find out and also obtain information and data on how the effect of holding finger relaxation can overcome and become the management of perineal wound pain in postpartum mothers for respondents or informants who control and deliver the process at the Sundari General Hospital. This study used pre and post test systems based on control of groups of respondents or informants in Sundari Public Hospital. In this study, there were 50 postpartum mothers who experienced perineal injuries. From this population the experimental group consisted of 25 people, while the control group also consisted of 25 respondents. For sampling using a purposive sampling technique where the research instrument will use an observation sheet with the NRS pain scale or Numerical Ra Scale as the data to be collected. The data collection will be analyzed using the Mann-Whitney system. And the effect of finger grip relaxation on perineal wound pain in postpartum mothers carried out at Sundari General Hospital can be an application process for mothers who are about to give birth to reduce pain.

Priesthood: A family Pastoral Care Vocation in a local Catholic Church in South Africa

The article begins by considering priesthood as a family pastoral care vocation in the local Catholic Church, South Africa. For most priests the priesthood is the superlative gift, a particular calling to participate in the mystery of Christ, a calling which confers on priests the inspiring possibility of speaking and acting in God’s holy name. Pope John Paul II stated that the church prays continuously for new priestly callings and celebrates at the increase in such vocations. Priest make promises relating to the sacrament of the priesthood and these all have great implications. What is essentially in the balance is the word priests ultimately give to Jesus Christ himself. Loyalty to the vocation builds up the holy church, and when there is an act of unfaithfulness this indeed a painful wound to the mystical body of Our Lord. This work deliberates upon the vocation of the priesthood as a career, and it briefly examines and assesses the challenges encountered in promoting the priestly vocation. This includes the manageable number of young people who decide to become priests. Various causes are linked, such as for example the departure from the spiritual life, the disappointment of the missionaries, the induction of young men, the need for participation and commitment. It’s an issue that requires important internal and external collaboration. A critical analysis of the social milieu of local South African Catholic Church serves as a methodology.

Effectiveness of Non-Pharmacological Intervention to Reduce Perineal Pain In Postpartum Women

The morbidity and mortality rates for pregnant, postpartum and postpartum women are still a big problem. One of the factors of this morbidity rate is postpartum pain caused by perineal tears. Pain management has two methods, namely pharmacological and non-pharmacological. The purpose of this study was to determine the effectiveness of non-pharmacological interventions in reducing perineal wound pain in postpartum mothers. The method used in this paper is a literature review. The preparation of the literature review was carried out by searching articles from the Google Scholar and Pubmed databases. The keywords used included non-pharmacological, perineal pain OR reducing perineal pain, and postpartum. The inclusion criteria in this literature search were articles from 2018-2023, articles in Indonesian, articles in English, free full-text articles, original articles and articles on non-pharmacological therapy to reduce perineal wound pain in postpartum mothers. The results of the study, it was obtained the results of several non-pharmacological interventions that were effective in reducing perineal wound pain, namely Papaya Leaf Decoction, Red Ginger, Cinnamon Extract, Aromatherapy (Chamomile Aromatherapy, Lavender Aromatherapy, Lemon Aromatherapy), Sitz Bath Therapy, Compress Ice Gel and Acuyoga Postpartum. Based on the findings of the literature, this non-pharmacological intervention in postpartum mothers has proven effective to be applied in practice and is recommended for health workers.