Reduction In Visual Analog Scale Score Research Articles

Postoperative analgesia with ropivacaine and dexmedetomidine for ultrasound-guided fascia iliaca compartment block after arthroscopic knee surgery.

Objective:The objective of this study is to evaluate the postoperative analgesic effect of a combination of ropivacaine and dexmedetomidine for ultrasound-guided fascia iliaca compartment block (FICB) after knee arthroscopy.Materials and Methods:Forty patients scheduled for knee arthroscopy were randomized to receive either 30 ml of 0.25% ropivacaine alone (Group A, n = 20) or combined with dexmedetomidine 1 μg/kg (Group B, n = 20). Pain intensity was evaluated using the visual analogue scale (VAS), at rest and during activity at 4, 6, 8, 12, and 24 h after surgery. Level of consciousness was evaluated using the Ramsay sedation score. Time to first analgesic request after surgery, the dose of analgesic used in the first 24 h after surgery, variation of heart rate, and adverse reactions were also recorded.Results:VAS scores at 6 and 12 h after surgery were significantly lower in Group B compared to Group A (P < 0.05). No significant difference was observed in the Ramsay sedation score or time to first analgesic request after surgery (P > 0.05). The total dose of analgesic used in the first 24 h after surgery was higher in Group A than in Group B. The incidence of bradycardia was higher in Group B compared to Group A. No adverse reactions were observed in either group.Conclusion:FICB with a combination of ropivacaine and dexmedetomidine resulted in significant reduction of VAS scores with lower postoperative analgesic requirement after arthroscopic knee surgery. No adverse reactions or complications were noted except for lower heart rate in Group B patients.

Total Diz Artroplastisi Sonrası Adduktor Kanal Bloğunun Analjezik Etkisi

Objective: Total knee arthroplasty (TKA) is a severely painful procedure even with the administration of extensive multimodal analgesics. We aim to assess whether US-guided adductor canal block (ACB) would improve postoperative pain scores and consequently decrease local anesthetic consumption by means of an epidural catheter with patient-controlled anaesthesia (PCA) device after TKA. Material and Methods: This was a retrospective study. Fifty-eight patients WHO underwent TKA between June 2015 and June 2016 and were fitted with either an epidural catheter with PCA (group A, n=30) or an epidural catheter with PCA followed by ACB (group B, n=28) were included in the study. PCA consumption during the postoperative 24 h and visual analogue scale (VAS) pain scores at 0, 4 and 24 h were determined. Motor block ending time and local anaesthetic drug consumption were also determined. Results: Basal bupivacaine and total bupivacaine consumption were reduced in group B 24 h postoperatively compared to that in group A. ACB reduced VAS score at 0 and 4 h post-operatively during movement. There was no statistically significant difference between VAS scores for each group at 24 h postoperatively. Motor block duration in group B patients who underwent ACB was longer than group A. Conclusion: Adductor canal block is effective for patients undergoing TKA. US-guided ACB reduced 24 h PCA requirements and VAS scores after TKA. ACB is a promising technique in producing effective and prolonged postoperative analgesia for patients undergoing TKA.

Use of local corticosteroid injection in the treatment of plantar fasciitis

Background and Objectives: Plantar fasciitis is a common pathological condition that affects the hind foot. Management of plantar fasciitis employs use of various non-surgical and surgical treatment methods. The aim of this study was to evaluate the efficacy of steroid injection in the treatment of plantar fasciitis in adults.&#x0D; Materials and Methods: From January 2016 to June 2017, fifty patients aged &gt;18 years with plantar fasciitis symptomatic for three months or more were injected with a single dose of methylprednisolone acetate with 2% lignocaine. Assessment was done using visual analogue scale (VAS) and foot function index (pain sub-scale). Patients were followed-up for a period of 6 months.&#x0D; Results:There was significant reduction in VAS score and improvement in foot function index at 1 and 3 month follow-up (p&lt;0.001) as compared to pre-injection score but this VAS reduction or improvement in foot function index was not significant at 6 month follow-up (p=0.057 and 0.729 respectively). There were no major adverse effects of the steroid injection.&#x0D; Conclusion: A single dose of corticosteroid injection provides only a short term benefit in plantar fasciitis.

Real-life effectiveness of MP-AzeFlu in Irish patients with persistent allergic rhinitis, assessed by visual analogue scale and endoscopy.

IntroductionMost allergic rhinitis (AR) patients have moderate‐to‐severe, persistent disease. Meda Pharma's AzeFlu (MP‐AzeFlu) combines intranasal azelastine hydrochloride (AZE) and fluticasone propionate (FP) in a novel formulation in a single device to treat AR. This prospective, noninterventional study sought to assess the effectiveness of MP‐AzeFlu (one spray/nostril twice daily; 548 µg AZE/200 µg FP daily dose) in relieving AR symptom severity.MethodsA visual analogue scale (VAS) was used prior to MP‐AzeFlu treatment on days 0, 1, 3, 7, 14, 21, 28, 35, and 42 by 53 persistent AR (PER) patients seen in routine clinical practice in Ireland. An endoscopy was performed on days 0 and 28, and symptoms of edema, discharge, and redness were scored on a three‐point scale (for both nostrils).ResultsPatients using MP‐AzeFlu experienced rapid VAS score reduction from 73.4 mm (standard deviation [SD], 20.3) at Day 0 to 31.5 mm (SD, 25.0) at day 28 (P < 0.0001) to 28.1 mm (SD, 24.1) at day 42 (P < 0.0001), a 45.3‐mm reduction. On average, patients achieved a clinically relevant VAS score cutoff of 50 mm before Day 7. Total endoscopy score decreased from 7.5 mm (SD, 3.1) at baseline to 3.5 mm (SD, 2.5) at Day 28. The incidence of severe edema on endoscopy decreased from 53.1% at baseline to 3.8% at Day 28. A similar reduction in the incidence of thick/mucousy discharge (from 28.3% to 4.8%) and severe redness (from 34.9% to 0%) was also observed.ConclusionsMP‐AzeFlu provided effective, rapid control of PER as assessed by VAS in a real‐world clinical setting in Ireland. Symptom improvement was observed at Day 1, sustained for 42 days, and associated with improved mucosal appearance after 28 days. These results confirm the safety of MP‐AzeFlu and exceed the efficacy demonstrated in phase 3 clinical studies for controlling AR in PER patients.

Effects of Physical-Agent Pain Relief Modalities for Fibromyalgia Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Purpose We conducted a systematic review and meta-analysis to investigate the effects of the following physical-agent modalities for pain relief in fibromyalgia (FM) patients. Methods We identified randomized controlled studies of adults with FM in the MEDLINE, CINAHL, and PEDro databases. The primary outcome measure was pain relief measured by a visual analogue scale (VAS), and the secondary outcome measures of interest were subjective improvements in the number of tender points, Fibromyalgia Impact Questionnaire (FIQ), and quality of life (QOL) scores. Results Eleven studies were included in our review. The studies' physical-agent modalities were low-level laser therapy (LLLT), thermal therapy, electromagnetic field therapy, and transcutaneous electrical nerve stimulation (TENS). LLLT did not reduce VAS scores, but it significantly reduced both the number of tender points and FIQ score. Thermal therapy was associated with significantly reduced VAS scores, tender points, and FIQ scores. Electromagnetic field therapy was associated with significantly reduced VAS score and FIQ score. TENS significantly reduced VAS scores. Conclusion Our analyses revealed that thermal therapy and LLLT had a partial effect on pain relief in FM patients, and this beneficial effect may have a positive influence on FM patients' health status.

Efficacy of Nardostachys jatamansi DC. in the management of premenstrual syndrome: A randomized controlled study

AimsThe aim of the present study was to examine the efficacy and safety of Nardostachys jatamansi in reducing PMS symptoms in otherwise healthy women. MethodsThis single-blind, randomized, placebo-controlled study was conducted with 60 women aged between 18 and 45 years. The participants were randomly allocated to receive either a total of 4 g of N. jatamansi (2 capsules 3 times a day) or placebo for the 15 days prior to menstruation, for two consecutive menstrual cycles. Premenstrual tension syndrome observer-rating scale (PMTS-O), premenstrual tension syndrome self-rating scale (PMTS-SR) and visual analogue scale (VAS) scores were recorded at baseline and then after the first and second cycle of treatment. An additional follow-up with participants was conducted one month after cessation of treatment. ResultsAfter the two months of treatment, there was a statistically significant reduction in average PMTS-O and PMTS-SR scores in the N. jatamansi group (p < 0.001) whereas there was no significant difference in average PMTS-O and PMTS-SR scores observed in the placebo group (p = 0.197 and 0.271, respectively). A comparison between baseline and post treatment scores in the N. jatamansi group showed a significant reduction in all VAS domains other than swelling of extremities and in the placebo group there was no statistically significant reduction observed in any of the 10 VAS domains. The intergroup analysis revealed that the reduction in VAS scores was significantly greater across all symptoms except swelling of extremities in the N. jatamansi than the placebo group (p < 0.001). ConclusionN. jatamansi was shown to be both safe and effective in the management of the symptoms of premenstrual syndrome. Further clinical investigations are therefore warranted.

Ultrasound-Guided Prolotherapy for Acromial Enthesopathy and Acromioclavicular Joint Arthropathy: A Single-Arm Prospective Study.

Prolotherapy is an injection-based complementary treatment for various musculoskeletal diseases. The aim of this study was to evaluate the therapeutic efficacy of ultrasound-guided prolotherapy in the treatment of acromial enthesopathy and acromioclavicular joint arthropathy. Thirty-one patients with chronic moderate-to-severe shoulder pain were recruited from September 2015 to September 2017. Ultrasound-guided prolotherapy was performed by injecting 10 mL of a 15% dextrose solution into the acromial enthesis of the deltoid or acromioclavicular joint capsule aseptically. Prolotherapy was given in 2 sessions separated by a 1-month interval. The pretreatment-to-posttreatment change in the pain visual analog scale (VAS) score was recorded as the primary outcome. The mean follow-up duration was 61.8 days. A paired t test was used to assess the difference in pretreatment and posttreatment VAS scores. A univariate logistic regression analysis was conducted to identify the demographic variables associated with substantial pain reduction after the intervention. Substantial pain reduction was defined as a posttreatment VAS score of 3 or less. Twenty of the 31 patients reported substantial pain reduction without adverse effects after the intervention. The mean VAS score reduction ± SD was 4.3 ± 2.6 (pretreatment, 6.8 ± 1.5; posttreatment, 2.5 ± 2.1; P < .01). Ultrasound-guided prolotherapy with a 15% dextrose solution is an effective and safe therapeutic option for moderate-to-severe acromial enthesopathy and acromioclavicular joint arthropathy.

Intravenous paracetamol versus dexketoprofen in acute musculoskeletal trauma in the emergency department: A randomised clinical trial

IntroductionMusculoskeletal system traumas are among the most common presentations in the emergency departments. In the treatment of traumatic musculoskeletal pain, paracetamol and non-steroidal anti-inflammatory analgesics (NSAID) are frequently used. Our aim in this study is to compare the efficacy of intravenous dexketoprofen and paracetamol in the treatment of traumatic musculoskeletal pain. MethodsThis prospective, randomised, double blind, controlled study was conducted in a tertiary care emergency unit. The participating patients were randomised into two groups to receive either 50 mg of dexketoprofen or 1000 mg of paracetamol intravenously by rapid infusion in 150 mL of normal saline. Visual analogue scale (VAS), Numeric Rating Scala (NRS) and Verbal Rating Scale (VRS) was employed for pain measurement at baseline, after 15, after 30 and after 60 mins. Results200 patients were included in the final analysis. The median age of the paracetamol group was 34 (24–48), while that of the dexketoprofen group was 35 (23–50), and 63% (n = 126) of them consisted of men. Paracetamol and dexketoprofen administration reduced VAS pain scores over time (p = 0.0001). Median reduction in VAS score at 60 min was 55 (IQR 30–65) for the paracetamol group and 50(IQR 30.25–60) for the dexketoprofen group. There was no statistically significant difference between the paracetamol and dexketoprofen groups in terms of VAS reductions (p = 0.613). ConclusionIntravenous paracetamol and dexketoprofen seem to produce equivalent pain relief for acute musculoskeletal trauma in the emergency department.CLINICALTRIALS.GOV NO: NCT03428503

The impact of circulating 25-hydroxyvitamin and oral cholecalciferol treatment on menstrual pain in dysmenorrheic patients

This study aims to determine Vitamin-D level in patients with primary dysmenorrhea and investigate the effect of Vitamin-D replacement on symptoms. About 100 patients in the 18–30 age group followed-up with primary dysmenorrhea diagnosis were included in this observational study. The pain severity was assessed using the visual analog scale (VAS). 25-hydroxy vitamin D(25(OH)D) levels of the patients were measured and the replacement therapy was applied according to measurement results. The patients were followed for three months in total. At the end of the three-month period, the 25(OH)D level was measured and the VAS score was assessed once more after the therapy. 25(OH)D level was insufficient in 23.0%, deficient in 45.0%, and severely deficient in 32.0% of the patients. It was found that the VAS score increased as the 25(OH)D level decreased (r = −0.320; p = .002). A significant reduction was observed in VAS scores after Vitamin-D treatment in all three groups; the amount of reduction in VAS score was determined to be higher in the patients with severely deficient levels of 25(OH)D, compared to the patients with deficient or insufficient levels (p < .001). A significant and negative correlation was found between Vitamin-D and symptoms associated with dysmenorrhea in our study. The Vitamin-D replacement therapy led to a significant decrease in symptoms.

Clinical Outcomes of Posterolateral Fusion Versus Posterior Lumbar Interbody Fusion in Patients with Lumbar Spinal Stenosis and Degenerative Instability

Degenerative lumbar spine disease can lead to lumbar spine instability. Lumbar spine instability is defined as an abnormal response to applied loads characterized kinematically by abnormal movement in the motion segment beyond normal constraints. Patients with lumbar spinal stenosis (LSS) typically present with low back pain (LBP), cramping, cauda equine syndrome, and signs of nerve root compression associated by weakness, numbness and tingling in their legs that are worsened with standing and walking. This degenerative condition severely restricts function, walking ability, and quality of life (QOL). This study aims to compare clinical and radiological outcomes of posterolateral fusion (PLF) with posterior lumbar interbody fusion (PLIF) with posterior instrumentation in the treatment of LSS and degenerative instability. A randomized prospective controlled clinical study. In this prospective study, 88 patients with LSS and degenerative instability were randomly allocated to one of 2 groups: PLF (Group I) or PLIF (Group II). Primary outcomes were the control of LBP and radicular pain, evaluated with visual analog scale (VAS), the improvement of QOL assessed by the Oswestry disability index (ODI) scale, and measurement of fusion rate, Cobb angle, spinal sagittal balance, and modic changes in the 2 groups. At 24 months postoperatively, the mean reduction in VAS scores in Group I was more than in Group II (5.67 vs. 5.48, respectively) and the patients in Group I had more improvement in the ODI score than the patients in Group II (42.75 vs. 40.94, respectively). There was a statistically significant difference between the preoperative and postoperative sagittal balance in the 2 groups. The mean Cobb angle changed significantly in the 2 groups. There are few prospective studies of PLIF or PLF in patients with LSS and degenerative lumbar spine instability, and a limited number of studies which exists have examined the safety and outcome of each procedure without comparing it with other fusion techniques. Because most of the studies in the literature have been conducted in the patients with IS, we could not compare and contrast our findings with studies in patients with LSS and degenerative lumbar spine instability. In addition, although in our study the findings at a 24-month follow-up period showed that PLF was better than PLIF in these patients, there were some studies in which the authors reported that PLIF showed better clinical results than PLF at a 48-month follow-up period. So we suggest that rigorous controlled trials at longer follow-up periods should be undertaken in groups of patients with LSS and degenerative lumbar spine instability who undergo posterior decompression and instrumented fusion to help to determine the ultimate best fusion technique for these patients. PLF with posterior instrumentation provides better clinical outcomes and improvement in the LBP, radicular pain, and functional QOL, more correction of the Cobb angle, more restoration of sagittal alignment, more decrease in Modic type 1, and more increase in Modic type 0, despite the low fusion rate compared to PLIF. Lumbar spinal stenosis, degenerative instability, posterolateral fusion, posterior lumbar interbody fusion, low back pain, quality of life, cobb angle, fusion rate, modic changes, sagittal balance.

Endoscopic Pulsed Radiofrequency Ablation of Genicular Nerves for the Treatment of Chronic Knee Pain

Chronic knee pain is the second most common cause of chronic pain in the United States. Occasionally, patients become refractory to conventional treatments such as intraarticular cortisone injections and viscosupplementation. Patients who have exhausted these therapies or have a contraindication to the therapies may be candidates for diagnostic genicular nerve block and if successful, subsequent radiofrequency ablation (RFA). For patients who have undergone image-guided genicular nerve radiofrequency ablation with fluoroscopic or ultrasound guidance without success, an endoscopic approach can be used as an alternative modality with success. With direct visualization of the genicular nerves, the likelihood of success with an endoscopic approach increases as some patients can have varying anatomy of the genicular nerves for which cannot always be detected with fluoroscopy or ultrasound. The purpose of this study is to demonstrate the utilization of a direct endoscopic approach for genicular nerve RFA for patients with chronic knee pain that have failed to improve after image-guided genicular RFA with fluoroscopic or ultrasound guidance. Two patients who had underwent successful diagnostic genicular nerve blocks were assessed for pre-procedure and post-procedure visual analog scale (VAS) scores following endoscopic genicular nerve RFA after failure of the conventional image guided approach at 6 and 12 months. Both patients reported greater than 80% reduction in VAS score and improvement in function at 6 and 12 months Limitations of the current study is a limited number of patients, and lack of the use of a formal functional scale to demonstrate improvement. Ultimately, the conclusion was drawn that an endoscopically-guided genicular nerve RFA can be utilized successfully due to direct visualization of the genicular nerves when conventional approaches with Fluoroscopic/ultrasound guidance has failed to achieve analgesia and functional improvement. Key words: Genicular nerve block, endoscopic, radiofrequency ablation. knee pain, chronic osteoarthritis, genicular neuritis, genicular neuralgia, total knee arthroplasty, arthritis

Radial extracorporeal shock wave therapy for adhesive capsulitis of the shoulder: A prospective, randomized, placebo controlled, double-blind study with subjective and objective endpoints

This study tested the hypothesis that radial extracorporeal shock wave therapy (rESWT) is effective and safe in the treatment of adhesive capsulitis of the shoulder (adC-S). One hundred and six patients (mean age, 55.8 years; range, 39–77) with pain and limitations in shoulder mobility due to adC-S lasting for averaged 11.6 months (range, 9–14) were randomly allocated to either rESWT ( n = 53) (four sessions, one session per week, Swiss DolorClast [Electro Medical Systems S.A., Nyon, Switzerland], radial handpiece, 15-mm applicator, 2000 rESWT impulses per session, positive energy flux density 0.14 mJ/mm 2 , rESWT impulses applied at 8 Hz) or placebo treatment ( n = 53). Patients completed the Visual Analog Scale (VAS) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire at baseline (BL) as well as at one month (M1), six months (M6) and twelve months (M12) after baseline. Moreover, passive and active abduction of the arm (pA and aA) as well as passive external rotation of the shoulder (pER) were measured at BL, M1, M6 and M12. All patients completed the final review at M12 and were included in the study. Mean pretreatment VAS scores, DASH scores and pA, aA and pER measurements for the rESWT and control groups were 6.3 and 6.3 (VAS), 73.5 and 72.5 (DASH), 98.2 and 99.3 degrees (pA), 65.8 and 68.8 degrees (aA), and 20.3 and 22.0 degrees (pER), respectively. Compared to placebo treatment rESWT resulted in statistically significantly reduced VAS score (by averaged 3.5 points) and statistically significantly improved DASH score (53.8 points), pA (63.9 degrees), aA (79.1 degrees) and pER (43.3 degrees) at all follow-up examinations. rESWT as performed in the present study is an effective and safe treatment for adhesive capsulitis of the shoulder.

Analgesic Effects of Locally Administered Ketorolac-based Analgesics After Breast Surgery: A Meta-Analysis of Randomized Controlled Trials.

Reducing postoperative pain following breast surgery is crucial for rapid recovery and shortening hospital stay. Ketorolac, a nonsteroidal anti-inflammatory drug, has been used as a postoperative analgesic in many surgical procedures. We conducted a systemic review and meta-analysis on the efficacy of locally administered ketorolac-based analgesics in managing pain after breast surgery. We searched the PubMed, Embase, Cochrane Library, Scopus, and ClinicalTrials.gov registry for randomized control trials (RCTs) published up to September 2016. The primary outcome was pain level assessed using a visual analog scale (VAS) at 1 and 6 hours following breast surgery. We reviewed 4 RCTs with 255 patients. For meta-analysis, VAS at 1 and 6 hours of 3 similar RCTs were compared. At 1 hour, VAS scores were significantly lower in patients administered a ketorolac solution [weighted mean difference (WMD)=-2.04; 95% confidence interval (CI): -3.08 to -1.00] or ketorolac-bupivacaine solution (WMD=-2.30; 95% CI, -4.07 to -0.54) than in controls. At 6 hours, the ketorolac-bupivacaine solution reduced VAS scores significantly (WMD=-1.40; 95% CI, -2.48 to -0.32) compared with controls. However, at 1 hour, the ketorolac solution was significantly more effective than the bupivacaine solution was (WMD=-1.70; 95% CI, -2.81 to -0.59). The effects of ketorolac-based analgesics vary as per the surgery and disease type. Locally administered ketorolac-based analgesics decreased postoperative pain in breast surgery patients, and the effect of local ketorolac was better than local bupivacaine. Therefore, ketorolac-based analgesics demonstrate considerable local infiltration during pain management after breast surgery.

Vertebroplasty versus sham procedure for painful acute osteoporotic vertebral compression fractures (VERTOS IV): randomised sham controlled clinical trial

ObjectiveTo assess whether percutaneous vertebroplasty results in more pain relief than a sham procedure in patients with acute osteoporotic compression fractures of the vertebral body.DesignRandomised, double blind, sham controlled clinical...

Fluoride varnish versus glutaraldehyde for hypersensitive teeth: a randomized controlled trial, meta-analysis and trial sequential analysis

Reports indicate Gluma and Duraphat are commonly used in-office agents to treat hypersensitive teeth. Considering this, the aim of this paper is to compare Gluma and Duraphat using a randomized controlled trial, meta-analysis collating evidences from previous studies and trial sequential analysis. Thirty-eight participants were randomized. Hypersensitivity and visual analog scale (VAS) scores were recorded at baseline, 5min and 7days. Oral health-related quality of life (OHIP) questionnaire was administered at baseline and 7days. Statistical analysis was performed to identify significant differences between the variables. For the meta-analysis, electronic data bases were searched and eligible data was extracted and analysed using RevMan 5.0. Trial sequential analysis was performed using O'Brien-Fleming boundary approach for the primary outcome. Both agents caused significant reduction in hypersensitivity and VAS score at 5min and 7days in the randomized trial with no superiority. The quality of life significantly improved in patients treated with both the agents. Four studies including the present trial in meta-analysis and trial sequential analysis indicated that Gluma produced significant reduction in VAS scores at 7days. Gluma produces significant reduction in hypersensitivity at 7days post treatment compared with Duraphat. There is definite lack of evidence on the long-term effect of these agents. This paper provides strong evidence on the use of Gluma for hypersensitive teeth. This also is a way forward to future research on long-term effects, adverse effects and cost-effectiveness studies.

Comparative efficacy of corticosteroid injection and non-invasive treatments for plantar fasciitis: a systematic review and meta-analysis

The first choice of treatment for patients with plantar fasciitis is non-invasive treatment, rather than corticosteroid injection (CSI). However, no comprehensive study has compared the effectiveness of CSI with non-invasive treatments for plantar fasciitis. We conducted a meta-analysis comparing CSI and non-invasive treatment effects on plantar fasciitis. The primary outcome was pain reduction. Nine randomized controlled trials comparing CSI with 4 non-invasive treatment types were included. A trend favoring CSI over non-invasive treatments was indicated regarding reduction in the visual analogue scale (VAS) score at 1–1.5 (mean difference (MD), 1.70; 95% confidence interval (CI) = 0.39–3.01; P = 0.01) and 2–3 months (MD, 1.67; 95% CI = 0.58–2.76; P = 0.003). At 1.5-month follow-up, CSI was associated with improved VAS score compared with physical therapy (PT) (MD, 2.5; 95% CI = 0.1–4.9; P = 0.04). No significant differences in the VAS score reduction were observed between CSI and shock wave therapy within 3 months. In summary, CSI tends to be more effective for pain reduction than non-invasive treatments within 3 months. Moreover, CSI provides significant pain relief at 1.5 months after treatment compared with PT. This study provides important clinical information for selecting therapeutics.

MP-AzeFlu provides rapid and effective allergic rhinitis control: results of a non-interventional study in Romania.

Allergic Rhinitis and its Impact on Asthma (ARIA) and the European Union (EU) recommend a shift to guide allergic rhinitis (AR) treatment decisions from symptom severity to disease control, using a simple visual analogue scale (VAS). Using this VAS we assessed, in a real-life study in Romania, the effectiveness of MP-AzeFlu nasal spray. In this multi-centre, prospective, non-interventional study, 253 patients (over 11 years old) with moderate-to-severe AR were prescribed MP-AzeFlu and assessed their symptoms on a VAS (0 (not at all bothersome) to 100 mm (very bothersome)) on Days 0, 1, 3, 7 and 14. The proportion of patients who achieved a defined VAS score cut-off for well-controlled (38 mm) AR were also calculated. Patients perception of disease control was assessed on Day 3. MP-AzeFlu use was associated with a mean (standard deviation) VAS score reduction from 78.4 (15.1) mm at baseline to 14.7 (15.1) mm on the last day. Effectiveness was consistent irrespective of disease severity, phenotype or patient age. 83.4% of patients achieved the smaller than 39 mm well-controlled VAS score cut-off by last day and 95.2% considered their symptoms to be well- or partly controlled at Day 3. MP-AzeFlu provided rapid, effective and sustained AR symptom control in a real-life setting in Romania, irrespective of severity, phenotype or patient age, aligning with ARIA and EU recommendations and supporting the position of MP-AzeFlu as the drug of choice for the treatment of moderate-to-severe AR.

The Effect of Kinesio Taping in Reducing Myofascial Pain Syndrome on the Upper Trapezius Muscle: A Systematic Review and Meta-Analysis

Background: Myofascial Pain Syndrome is a condition causing pain at myofascial trigger points. Kinesio Taping has been widely used to decrease pain and improve range of motion. Objective: The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of therapeutic programs that include kinesio taping on reducing myofascial pain syndrome symptoms. Methods: Independent research was performed for legit studies using the following electronic databases: PubMed, CINAHL, MEDLINE, SPORT Discus, EM base, and Cochrane Central Register of Controlled Trials, from February 2017 to March 2017. The keywords were “keniso tape myofascial” AND “taping myofascial” AND “myofascial pain Syndrome” AND “myofascial trigger points.” The research resulted in 5,793 articles that eventually included 6 articles that had met the inclusion and exclusion criteria, and the data extracted data from the articles was about the pain severity, and was measured by Visual Analog Scale (VAS). Results: The collected data was pooled from the results of 256 subjects (199 females and 57 males). Using KT showed improvement but not significant statistically in three of the analyzed studies, and the remaining three studies showed a statistical significant reduction in VAS score. The overall P value that computed by the European Scientific Journal February 2018 edition Vol.14, No.6 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431 337 Comprehensive Meta-Analysis 2.0 software was statistically significant (P value= 0.001) between the KT group and the control group. Conclusion: This systematic review and meta-analysis was performed on six studies in regarding to the efficacy of KT on the myofascial pain in the upper trapezius muscle. The meta-analysis suggests KT with other therapeutic protocols to treat myofascial pain syndrome and increase cervical range of motion as well as the functional activities.

Distribution characteristics of bone cement used for unilateral puncture percutaneous vertebroplasty in multiple planes.

To study the distribution of bone cement in unilateral puncture percutaneous vertebroplasty (PVP). A total of 64patients with osteoporotic vertebral compression fractures (OVCF) who underwent unilateral PVP were included in this study. The vertebral body was longitudinally divided into four equal parts. The intermediate layer between each part was representative of the part and there were four layers in total. Each layer was divided into 4regions a, b, c, and d by the crossed lines at the center of the vertebral body. Region c was the first half of the puncture side and region d was the second half of the puncture side. Region awas the first half of the opposite side, and b was the second half of the opposite side. Bone cement filling areas in the four layers and the four regions of each layer were compared. There were significant differences in visual analogue scale (VAS) scores before and after surgery (P < 0.05). Variance analysis indicated that the bone cement filling ratio of the region b in each layer was significantly lower than the other three regions, and that the bone cement filling ratio of region awas equal to that of the regiond. Unilateral puncture PVP can reduce VAS scores, and plays arole in reducing pain. The bone cement showed a regular distribution.

In-office Treatments for Dentin Hypersensitivity: A Randomized Split-mouth Clinical Trial.

To assess the effectiveness of four in-office therapies used for the treatment of dentin hypersensitiviy (DH) after one single application. A randomised, controlled, split-mouth clinical trial was designed to evaluate the following treatments: 5% sodium fluoride varnish (positive control); 3% potassium oxalate; two-step self-etching adhesive; high power diode laser. Nineteen patients were selected and one tooth per quadrant was included in the study. After evaporative stimulation, pain was quantified by the Visual Analog Scale (VAS) at baseline, immediately after treatment, and after 15, 30 and 60 days. Compared to the baseline values, fluoride varnish (p = 0.00) and potassium oxalate (p = 0.00) presented an immediate desensitising effect that remained constant at 15, 30 and 60 days. The high-power diode laser presented significant reduction in VAS scores after 15 days (p = 0.00), while in the self-etching adhesive group, a significant reduction in VAS scores was observed only after 60 days (p = 0.03). The change in VAS ([VAS x days] - VAS baseline) differed among the groups immediately after treatment, being higher in the fluoride varnish and lower in the adhesive groups, but no statistically significant difference was found at time intervals of 15, 30 and 60 days. When an immediate desensitising effect is desired after one single application, fluoride varnish and potassium oxalate should be used. High-power diode laser and self-etching adhesive may not be clinically considered an appropriate desensitising therapy after one single application.