Reduction In Pain Levels Research Articles

The Benefits of Low-Carbohydrate, High-Fat (LCHF) Diet on Body Composition, Leg Volume, and Pain in Women with Lipedema.

This study aimed to assess the potential benefits of a low-carbohydrate, high-fat (LCHF) diet on body composition, leg volume, and pain reduction in women with lipedema compared to overweight or women with obesity. The study included 113 female participants, 56 with lipedema and 57 with overweight/obesity (BMI >25 kg/m2) without lipedema. All subjects were prescribed a low-carbohydrate, high-fat (LCHF) diet with anti-inflammatory properties to adhere to for a duration of 7 months. Measurements of anthropometry, body weight, composition, and pain (VAS) were conducted at the study's commencement and conclusion. 52 participants completed the study. Both groups experienced a similar weight reduction, amounting to 12.9% compared to the baseline (-10.8 kg vs. -11.9 kg; p = 0.14, for lipedema and women with overweight/obesity, respectively). The most reduction was in body fat mass. Improvements in various parameters were observed, except for ankle circumferences, which decreased more in the lipedema group. Lipedema participants showed significantly reduced pain levels following the LCHF diet (4.6 ± 2.6 vs 3.0 ± 2.3; p < 0.001). The LCHF diet holds promise for weight loss, body fat reduction, leg volume management, and pain alleviation in women with lipedema. These findings provide valuable insights into potential therapeutic strategies for lipedema management.

Nile tilapia skin in the treatment of second-degree burns: a systematic review with meta-analysis

Objective: Systematically review the effects of using Nile tilapia skin (NTFS) for management/treatment in patients with second-degree skin burns, when compared with two treatments containing silver, hydrofiber dressing or sulfadiazine cream (AgSD). Methodology: Systematic review with meta-analysis performed in january 2023, using PubMed, Web of Science, CINAHL, Scopus, Cochrane and Gale databases, to identify relevant randomized clinical trials. Results: In total, five randomized trials were identified comparing the use of NTFS with two types of silver-based treatment of second-degree skin burns. Occlusive dressings with NTFS significantly reduced pain levels, measured using the Visual Analogue Scale - VAS (p=0.0008), time (measured in days) for complete wound healing, corresponding to re-epithelialization of 95% or more of the initial burn (p=0.002), and the number of dressings needed until complete healing of the burn (p=0.0004). Conclusion: The results confirm the positive effects of using the NTFS dressing on patients with second-degree burns and can benefit public health systems, especially in developing and resource-poor countries.

Efektifitas Terapi Murottal Al-Qur’an terhadap Intensitas Nyeri pada Pasien Pascaoperasi Ortopedi

This study aims to determine the effectiveness of mutual Al-Qur'an therapy on pain intensity in post-orthopedic surgery patients. This research method is Quasi experiment pre-post non-equivalent with a control group. The sample of this study were long bone ORIF postoperative patients totaling 37 in the control group and 37 in the experimental group. Data collection was carried out twice pre and post murottal intervention with the Brief Pain Inventory (BPI) instrument. Data analysis used Mann-Whitney statistical test analysis. The results showed that the p-value was 0.000 (α &lt;0.05) which indicated that Ha was accepted or murottal Al-Qur'an therapy was effective in reducing pain intensity in post-orthopedic surgery patients at dr. Fauziah Bireuen. In conclusion, Al-Qur'an murotal therapy can be applied as an intervention in providing nursing care to post-ORIF patients to reduce pain levels.&#x0D; &#x0D; Keywords: Al-Qur'an Murottal Therapy, Pain Intensity, Postoperative Orthopedic.

Comparison Between Eracs and Non Eracs Methods on The Level of Pain and Mobilization in Post-Caesarean Section Patients

Enhanced Recovery After Caesarean Section (ERACS) is a post-cesarean recovery method that can provide faster functional recovery results and can minimize the occurrence of complications, and reduce hospitalization time. ERACS is considered to be able to reduce pain levels and accelerate early mobilization of patients after delivery better than the non-ERACS method. This study aims to compare ERACS and non-ERACS methods on the level of pain and mobilization in post-cesarean section patients. The method used in this study was observational analytic with a cross-sectional design carried out on 66 respondents at Abby Lhokseumawe Mother Children's Hospital. The results showed that there were differences between the ERACS and non-ERACS methods in terms of pain levels with a p-value of 0.010 (&lt;0.005) and early mobilization with a p-value of 0.000 (&lt;0.005) in post-cesarean section patients which can be concluded that delivery with the ERACS method is better in reducing the degree of pain and accelerating early mobilization compared to non-ERACS methods

Effect of Kinesio taping versus mechanical cervical traction combined with physiotherapy program on chronic neck pain in young female university students.

Mechanical neck pain is common among young female university students and can lead to disability and reduced physical activity. The aim of this study was to compare the effect of Kinesio taping (KT) to mechanical cervical traction (MCT) on young female university students with chronic neck pain. Sixty young female university students with mechanical neck pain participated in this study; their ages ranged from 19 years to 23 years. They were assigned to three equal groups: the control group (A) received infrared, massage, stretching, and strengthening exercises three days per week for 6 weeks. Experimental group B received cervical traction in addition to the same program as the control, and experimental group C received KT in addition to the same program as the control group. Absolute pain intensity by the visual analogue scale (VAS) and neck disability index (NDI) were measured pre-and post-treatment intervention. Data were gathered at baseline, and after 6 weeks of intervention for three groups. The MANOVA test showed a significant reduction in NDI and pain level after 6 weeks between pre-and post-treatment intervention in group B ( and , respectively). There was a significant reduction in pain after 6 weeks in group C. There was also a significant reduction in NDI and pain level after 6 weeks in group B versus control group ( and , respectively). In addition, a significant reduction in pain level and NDI after 6 weeks was detected in group B compared to group C (, , respectively) while a significant reduction in pain level only between the control group (A) and group C was detected (). In young female university students with mechanical neck pain, cervical traction combined with physiotherapy program was found to be more effective than KT with physiotherapy program or physiotherapy program alone in reducing pain and enhancing functional abilities after 6 weeks. This will help physiotherapists make more informed decisions concerning the clinical effects of MCT.

Parameters predicting postoperative pain and quality of life after hemorrhoidectomy: follow-up results from a prospective multicenter randomized trial

PurposePain and reduced quality of life (QoL) are major subjects of interest after surgery for hemorrhoids. The aim of this study was to find predictive parameters for postoperative pain and QoL after hemorrhoidectomy.MethodsThis is a follow-up analysis of data derived from a multicenter randomized controlled trial including 770 patients, which examines the usefulness of tamponade after hemorrhoidectomy. Different pre-, intra-, and postoperative parameters were correlated with pain level assessed by NRS and QoL by the EuroQuol.ResultsAt univariate analysis, relevant (NRS > 5/10 pts.) early pain within 48 h after surgery was associated with young age (≤ 40 years, p = 0.0072), use of a tamponade (p < 0.0001), relevant preoperative pain (p = 0.0017), pudendal block (p < 0.0001), and duration of surgery (p = 0.0149). At multivariate analysis, not using a pudendal block (OR 2.64), younger age (OR 1.55), use of a tamponade (OR 1.70), and relevant preoperative pain (OR 1.56) were significantly associated with relevant early postoperative pain. Relevant pain on day 7 was significantly associated only with relevant early pain (OR 3.13, p < 0.001). QoL overall remained at the same level. However, n = 229 (33%) patients presented an improvement of QoL and n = 245 (36%) an aggravation. Improvement was associated with a reduction of pain levels after surgery (p < 0.0001) and analgesia with opioids (p < 0.0001).ConclusionEarly relevant pain affects younger patients but can be prevented by avoiding tamponades and using a pudendal block. Relevant pain after 1 week is associated only with early pain. Relief in preexisting pain and opioids improve QoL.Trial registrationDRKS00011590 12 April 2017.

Acupressure for Pain of Osteoarthritis : A Systematic Review

Background: Osteoarthritis can be defined as a disorder of movable joints characterized by deterioration of articular cartilage; osteophyte formation and bone remodeling; changes in periarticular tissues; and a low-grade, nonpurulent inflammation of variable degree. Acupressure is a traditional non-pharmacological intervention that promotes blood circulation and muscle activity. Purpose: This review aimed to investigate the efficacy of acupressure as a complementary therapy method for the pain of osteoarthritis. Methods: Four electronic databases were searched from PubMed, ProQuest, Scopus, and The Cochrane Library use PICO strategy. In studies comparing acupressure with sham acupuncture, no intervention, or conventional intervention was eligible for inclusion. Article study is published on 2012-2022, using English and design RCT and Quasi-experiment. Prisma analysis was used in selection process. The risk of bias in the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Tools for Quasi-Experimental Studies and Randomized Controlled Trials. Results: There were 12 reports selected for review with the homogeny of knee Osteoarthritis. Outcomes were either objectively- or subjectively assessed improvements in specific pain parameters and safety for clinical use. Results showed more clinical trials with proper methodology are needed to confirm the effectiveness of acupressure for the pain of Osteoarthritis. The results of the review showed a positive effect in reducing pain level with acupressure intervention as either the main or complementary therapy. Conclusion: This systematic review shows that acupressure as a single or complementary intervention provides significant benefits in the management of Osteoarthritis. Further trials with a more rigorous design are needed to further validate and address the limitations of the current evidence.

Ulcere ischemiche del piede diabetico: terapia cellulare autologa come possibile trattamento adiuvante. Risultati di uno studio prospettico non controllato sul trattamento cellulare con cellule mononucleate da sangue periferico in pazienti affetti da piede diabetico ulcerato e malattia dei piccoli vasi: efficacia, sicurezza e valutazione economica

Background/aim: this editorial is aimed at providing some insights on cell therapy in patients with diabetic foot ulcers and no-option critical limb-threatening ischemia (CLTI). Methods and results: the present paper revised the available evidence on cell therapy in patients affected by diabetes and peripheral artery disease and reported the main results of a recently published uncontrolled study on the effects of peripheral blood mononuclear cells (PBMNC) therapy in patients with diabetic foot ulcers, no-option CLTI, and small artery disease. All patients included in that study were allocated in a surgery waiting-list for major amputations. Patients treated with autologous PBMNC experienced a significant reduction of pain levels, an increase of oxygen tissue levels, a high rate of healing without the need of a major amputation. Conclusions: the present paper illustrates the possible favorable effects of PBMNC cell therapy in patients with diabetes and peripheral artery disease even in presence of microangiopathy.

Comparison of Peripheral Nerve Conventional and Pulse Radiofrequency Applications in Patients with Primary Trigeminal Neuralgia: A Retrospective Analysis

Aim: This study aims to retrospectively investigate the results of continuous radiofrequency (CRF) and pulsed radiofrequency (PRF) applications to the peripheral branches of the trigeminal nerve in patients with trigeminal neuralgia (TN).&#x0D; Material and Methods: Patients who experienced a significant reduction in pain symptoms after local anesthetic application to the peripheral branches of the trigeminal nerve were divided into two groups. The first group received PRF treatment and the second group received CRF treatment. Pain intensity scores of both groups at 1 and 3 months were compared. The results were analyzed retrospectively.&#x0D; Results: Among the participants, 10 received PRF treatment and another 10 received CRF treatment. At the 1st month follow-up, both groups demonstrated considerable reductions in pain levels. By the 3rd month, no substantial disparities were noted between the two groups in terms of pain-related disability and pain intensity.&#x0D; Conclusion: Both PRF and CRF interventions emerge as effective and secure techniques applicable to the peripheral branches of the trigeminal nerve. They should be contemplated as valuable options in cases where conventional medical treatments fall short in delivering adequate pain control.

Comparison of the Effects of Extracorporeal Shock Wave Therapy and Dry Needing on Spasticity in Poststroke Patients: A Randomized Controlled Trial

Introduction: The effective treatment of spasticity following a stroke is a critical and pressing concern. Various therapeutic approaches, such as physiotherapy (7, 8) and medication (9, 10), have been employed. In recent years, external corporeal shockwave therapy (ESWT) and dry needling (DN) have gained popularity for managing spasticity and post-stroke pain. This study aims to conduct a comparative analysis of the effectiveness of ESWT and DN in addressing spasticity, pain, as well as upper limb function and sensation in individuals with hemiplegia. Methods: In this study, individuals with hemiplegia were randomly assigned in a 1:1 ratio to either the External Corporeal Shockwave Therapy (ESWT) group (n = 10) or the Dry Needling (DN) group (n = 10). We assessed Upper Extremity Functions, Sensation, Spasticity, and Pain. All measurement indicators were evaluated before treatment and immediately after a single treatment session. To determine the presence of a group *time interaction effect on the treatment's impact for each outcome variable, we used mixed-model repeated-measures ANOVAs. The between-subjects variable was the group, and time served as the within-subjects variable. Results: Both Dry Needling (DN) and External Corporeal Shockwave Therapy (ESWT) demonstrated significant reductions in spasticity within the biceps brachii muscle, along with notable improvements in upper extremity function tests. Moreover, both DN and ESWT led to significant enhancements in the forearm, arm, and finger; however, the same level of improvement was not observed for the hand. Tactile sensitivity, pain sensation, and light touch did not show significant improvements in either treatment group. Nonetheless, both groups experienced a significant reduction in pain levels. When we conducted a comparative analysis between these two treatment groups across all measures, no significant differences were observed (p &gt; 0.05). Conclusion: In individuals with hemiplegia, both External Corporeal Shockwave Therapy (ESWT) and Dry Needling (DN) have demonstrated the ability to effectively reduce pain and spasticity while enhancing upper extremity function. As a result, these treatments may be regarded as viable alternative methods for addressing the needs of individuals with hemiplegia.

Electrospun skin dressings for diabetic wound treatment: a systematic review.

Diabetes mellitus is a metabolic disease characterized by persistent hyperglycemia associated with a lack of insulin production or insulin resistance. In diabetic patients, the capacity for healing is generally decreased, leading to chronic wounds. One of the most common treatments for chronic wounds is skin dressings, which serve as protection from infection, reduce pain levels, and stimulate tissue healing. Furthermore, electrospinning is one of the most effective techniques used for manufacturing skin dressings. The purpose of this study was to perform a systematic review of the literature to examine the effects of electrospun skin dressings from different sources in the process of healing skin wounds using in vivo experiments in diabetic rats. The search was carried out according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and the Medical Subject Headings (MeSH) descriptors were defined as "wound dressing," "diabetes," "in vivo," and "electrospun." A total of 14 articles were retrieved from PubMed and Scopus databases. The results were based mainly on histological analysis and macroscopic evaluation, demonstrating moderate evidence synthesis for all experimental studies, showing a positive effect of electrospun skin dressings for diabetic wound treatment. This review confirms the significant benefits of using electrospun skin dressings for skin repair and regeneration. All the inks used were demonstrated to be suitable for dressing manufacturing. Moreover, in vivo findings showed full wound closure in most of the studies, with well-organized dermal and epidermal layers.

Development and efficacy evaluation of a personalised self-care programme for reducing work-related musculoskeletal disorders among rubber farmers in Thailand

IntroductionWork-related musculoskeletal disorders (WMSDs), the most common causes of work-related pain, suffering, absenteeism, and disability, are a major health concern for rubber farmers. WMSDs are persistent and frequently recur, resulting in increased health burdens for workers. Fortunately, appropriate intervention may relieve discomfort. Specified interventions have been recommended to reduce incidences of WMSD. ObjectiveThis study aimed to develop and evaluate the efficacy of a personalised self-care programme (PSCP) for relieving pain caused by WMSDs among rubber farmers. MethodsDemographic data and details concerning the prevalence of pain regions were collected using a questionnaire adapted from the Nordic Musculoskeletal Questionnaire (IOC 1.00). The evidence gained from modified questionnaires and special tests was used to develop the PSCP. The PSCP was verified by three experts (IOC 1.00). Based on the questionnaires, only participants with a pain score of 3 or higher were recruited for the study. The PSCP's efficacy was evaluated by comparing the results before application and after 28 days. A numerical rating scale was employed to estimate the degree of pain. The pathogeneses of WMSDs were confirmed with a special test performed by a physical therapist. Additionally, the levels of interleukin (IL)-6 and IL-10 were measured to determine the PSCP's effect on inflammatory molecules. The efficacy of the PSCP was analysed using a paired t-test. ResultsThe results showed that farmers experienced the greatest discomfort in the lower back, followed by the shoulders, legs, and neck. Therefore, this PSCP was designed to alleviate work-related musculoskeletal pain in these body regions. A reduction in pain by two degrees was observed after 28 days of the PSCP (x‾before = 5.26, SD = 1.96, x‾after = 2.40, SD = 1.64, p < 0.001). Special tests confirmed that the number of pain regions were also decreased (x‾before = 0.089, SD = 0.067, x‾after = 0.016, SD = 0.030, p < 0.001). In addition, IL-10 levels increased (p ≤ 0.001) following the PSCP, whereas IL-6 levels remained unaltered. ConclusionsAfter 28 days of use, the PSCP was effective at reducing pain levels, decreasing pain regions, and promoting the production of anti-inflammatory molecules. This finding demonstrates that the PSCP could help alleviate work-related musculoskeletal pain among rubber farmers. The PSCP may be an appropriate intervention for alleviating pain.

THE EFFECT OF HYPNOSIS THERAPY ON THE PAIN SCALE OF POST OPERATIVE PATIENTS: LITERATURE REVIEW

Background: Acute pain is a sensory or emotional experience associated with actual or functional tissue damage, with a sudden or slow onset and of mild to severe intensity lasting less than 3 months. Surgical procedures can cause acute pain. The main outcome of nursing interventions related to acute pain is a decrease in the level of pain. One of the non-pharmacologic nursing therapeutic interventions that can reduce pain levels and increase comfort is hypnosis therapy. Purpose: To determine the effect of hypnotherapy on pain scale in postoperative patients. Methods: Scientific articles in English and full texts published in 2002-2020 were identified and then analyzed by PI(E)O (problem; intervention; exposure; comparison; outcome). A total of 3404 articles from the PubMed, Wiley, Science Direct, and Google Scholar databases were identified using the keywords "hypnotherapy" OR "pain". Results: The results of the study found articles that discussed the effect of hypnotherapy on the pain scale. Conclusion: Patients who are given hypnosis will feel relaxed and make their subconscious active so that they can easily accept suggestions and can ignore other stimuli, including pain stimuli. Further research should also be carried out in patients who experience chronic pain.

COMPARISON OF ENDOSCOPIC AND MINIMALLY INVASIVE SURGICAL INTERVENTIONS FOR INTERVERTEBRAL DISC HERNIATIONS IN THE LUMBAR SPINE

Introduction. Intervertebral disc herniations are a common condition that is often associated with painful sensations and restricted spinal mobility. Since this condition can significantly deteriorate a patient's quality of life, it is essential to seek effective and safe methods for its treatment. Therefore, evaluating the effectiveness and safety of treating patients with pain caused by intervertebral disc herniation, which includes performing surgical interventions for hernia removal using endoscopic and minimally invasive techniques, is a relevant task today. In this context, comparing endoscopic and minimally invasive surgical interventions becomes a pertinent topic for research, as it can help determine the optimal treatment method for each patient.&#x0D; The aim of the study is to compare endoscopic and minimally invasive surgical procedures for intervertebral disc herniations in the lumbar spine.&#x0D; Materials and Methods. The study involved 100 patients diagnosed with lumbar intervertebral disc herniation. Of these, 50 patients underwent endoscopic surgery, while the remaining 50 underwent minimally invasive surgery. The effectiveness and safety of both methods were compared using several criteria, including the duration of surgery, blood loss, length of hospital stay, pain level, overall health status, the incidence of complications, and patient satisfaction with the procedure.&#x0D; Results. Compared to minimally invasive surgery, endoscopic surgery resulted in lower blood loss, shorter treatment duration, reduced pain levels, and fewer complications. All patients in both groups returned to normal activity according to their health status.&#x0D; Conclusions. Endoscopic surgery is more effective and safer compared to minimally invasive surgery in the treatment of herniated intervertebral discs in the lumbar spine. The endoscopic technique allows for better visualization and more precise manipulation in hernia removal, which positively affects treatment outcomes, reduces the risk of complications, shortens hospitalization, and leads to faster patient recovery. The results of this study can be valuable for physicians and patients when choosing the method of treatment for herniated intervertebral discs in the lumbar spine.

Hemiarthroplasty for proximal humerus fractures: clinical and radiographic outcomes after an average of 19 years

BackgroundThe main objective of this retrospective analysis was to report on the long-term clinical and radiographic outcomes (>10 years) in a series of patients who have previously undergone hemiarthroplasty for proximal humerus fracture. Materials and methodsThe charts of 11 patients (12 shoulders) who underwent hemiarthroplasty for proximal humerus fractures were retrospectively analyzed and stratified based on tuberosity healed (TH) or tuberosity resorption (TR). The primary end points included range of motion measurements and patient-reported outcome scores. We obtained forward elevation, exterx nal rotation, internal rotation, Simple Shoulder Test, American Shoulder and Elbow Surgeons scores, and Visual Analog Scale (VAS) scores. Tuberosity healing or resorption, acromiohumeral interval, subluxation, and humeral radiolucency were analyzed separately by 2 fellowship-trained orthopedic surgeons. ResultsThe mean age at surgery for TH patients was 60.0 ± 9.8 years and for TR patients was 57.7 ± 4.3 years. There were 7 cases in tuberosity healing cohort and 5 cases in the tuberosity resorption cohort. Implant survivorship at final follow-up was 100% (7/7) for TH and 60% (3/5) for TR; 2 patients who failed hemiarthroplasty were converted to reverse total shoulder arthroplasty. Mean postoperative forward elevation (TH: 155°, TR: 36°; P value < .01), external rotation (TH: 59°, TR: 28°; P value < .01), and internal rotation (TH:T12, TR:L3; P value = .08) were higher in the TH cohort. American Shoulder and Elbow Surgeons scores (TH: 90, TR: 40; P value < .01) and Simple Shoulder Test scores (TH: 9, TR: 2; P value < .01) were statistically significant between the 2 cohorts while VAS scores approached significance (mean VAS [TH: 1, TR: 4; P value = .08]). DiscussionTo our knowledge, this study provides the longest follow-up to date for outcomes following hemiarthroplasty with fracture. Significant improvements in shoulder function and reduction in pain levels are sustainable even after 19 years in patients whose tuberosity heals. Hemiarthroplasty remains a viable option for younger candidates whose tuberosity will heal postoperatively.

Mid-term outcomes following reverse total shoulder arthroplasty.

The utilization of reverse total shoulder arthroplasty now exceeds the incidence of anatomic shoulder arthroplasty. Previous mid-to-long-term studies on rTSA have reported a decrease in shoulder function as follow-up increased. The purpose of this study was to provide data on mid-term outcomes and implant survival in a series focusing on reverse total shoulder arthroplasty. Demographic information such as age at surgery, revision surgery status, BMI, and smoking status were recorded. The clinical endpoints measured in this study were range of motion scores (forward elevation, external rotation, internal rotation) and patient reported outcomes (VAS, ASES, SST). Radiographic variables captured included preoperative glenoid morphology, humeral lucency, and glenoid loosening. Fifty-six shoulders were included in this study. The overall mean age at surgery was 72.5 ± 7.2years with an average follow-up time of 6.8 ± 3.5years. The mean BMI was 28.1 ± 5.5. All measurements of range of motion saw significant and sustained improvements. Overall, forward elevation improved from 82° preoperatively to 133° postoperatively (p < 0.01). External rotation improved from 23° preoperatively to 36° (p < 0.01), while internal rotation improved from L3 to L1 (p = 0.05). ASES scores improved from 31 preoperatively to 70 postoperatively (p < 0.01). SST scores improved from 2 preoperatively to 7 (p < 0.01). VAS pain index scores improved from 6 to 2 following surgery (p < 0.01). Postoperative scapular notching was seen in 18 patients at final follow-up. Glenoid loosening was seen in 3 shoulders. Humeral loosening was seen in 18 shoulders. Tuberosity resorption was seen in 8 shoulders. The 5year survival estimate was 98%, and the 10year survival estimate was 83%. In this series, we found that rTSA provides mid-term improvements in range of motion in patients while reducing pain levels. When considered together, this demonstrates that most patients undergoing rTSA can have excellent use of their shoulder from age at surgery to end-of-life.

The Effectiveness of the Enhanced Recovery after Cesarean Surgery (ERACS) method on patients’ pain levels and satisfaction in hospitals: a quasi-experimental posttest design

Enhanced Recovery after Cesarean Surgery (ERACS) is an evidence-based, interdisciplinary method used before, during, and after surgery. The purpose of this study is to determine the effectiveness of ERACS on patients’ pain levels and satisfaction during their hospital stay. This research is expected to be a consideration for the development of hospital midwifery services in the future. This study adopted quantitative research methodology with a quasi-experimental posttest design only approach. The sampling technique used was purposive sampling. There were two types of subject criteria: the intervention group with ERACS and control groups of mothers who had conventional Cesarean sections (C-sections). A total of 140 respondents were divided into the control and experimental groups, with 70 respondents each. Pain levels were measured using the visual analog scale (VAS). Patient satisfaction data were collected using a pretested questionnaire and analyzed using IBM-SPSS version 22 statistics. There was a significant difference between pain levels at rest 24 h after C-section (p &lt; 0.001) and at movement 24 h post-C-section (p &lt; 0.001) in the control group compared to the experimental group. The ERACS method has been shown to be effective in reducing pain levels at rest and at movement in patients 24 h after C-section (p &lt; 0.001). There was no significant difference between ERACS and non-ERACS patient satisfaction, but the customer satisfaction index (CSI) indicated that the patients were very satisfied. The ERACS method has been shown to be effective in reducing pain levels in C-section patients. This study also proved that the ERACS patients were very satisfied, based on the CSI results. Therefore, the ERACS method must be used and improved to enhance hospital midwifery services.

The Effects of Calcium Silicate- and Calcium Hydroxide–based Root Canal Sealers on Postoperative Pain: A Randomized Clinical Trial

IntroductionThis study aimed to compare the postoperative pain level changes resulting from using calcium silicate- (EndoSeal MTA) and calcium hydroxide–based (Sealapex) root canal sealers in mandibular first and second molar teeth with symptomatic apical periodontitis. MethodsA total of 60 patients with symptomatic apical periodontitis in their lower molar teeth were randomly allocated into 2 groups according to sealer type (n = 30). Demographic data, including gender, age, and smoking habit, and preoperative pain measures were recorded. Root canal treatments were performed in a single visit. Postoperative pain measurements and analgesic intake were measured at 6, 12, 24, and 48 hours and after 3, 5, and 7 days using the visual analog scale. The data were statistically analyzed using a chi-squared test (to compare gender, age, smoking habit, analgesic intake, and sealer extrusion), the Mann-Whitney U test (to compare pain levels), Friedman tests (for the evaluations of the reduction in pain levels over time), and Spearman's correlation test (to analyze the relationships of age, gender, smoking habit factors with postoperative pain) (P = .05). ResultsThe statistical analysis showed no significant differences between the groups in postoperative pain and analgesic intake at any of the time intervals evaluated (P > .05). ConclusionsPatients treated with calcium silicate– and calcium hydroxide–based root canal sealers experienced similar postoperative pain and no statistically significant differences were observed in analgesic intake.

Complementary Therapy: Foot and Hand Massage on Reducing Post Laparotomy Pain Levels with Adenomyosis (Case Study)

Adenomyosis is a disorder of the reproductive system characterized by tissue that lines the uterus growing into the muscular wall of the uterus. At the time after the postoperative patient complained of pain postoperative laparotomy cystectomy. The application of the intervention that will be given to treat pain is the application of foot and hand massage to reduce post-laparotomy pain. The aim of the study was to apply foot and hand massage to reduce post-laparotomy pain levels with adenomyosis. The research method is in the form of evidence based practice. The intervention was carried out for 3 days, with 2 sessions each morning and evening, with pain scale measurements using the NRS and WBFPRS. Intervention is carried out before the administration of medical therapy. Intervention is only done with one sample. The results of the study described a decrease in pain levels after massage. The results obtained by the patient seemed relaxed and able to do activities independently. It can be concluded that foot and hand massage can reduce pain levels in post-laparotomy patients, with a pain scale of NRS 2 and WBFPRS 2.

The Lower-Back Painkiller Challenge: Efficacy of Tramadol Versus Tapentadol

Introduction: To reduce pain levels in people with lower back pain, the study looked at the comparative efficacy and tolerability of Tramadol and Tapentadol taken by oral route. Materials &amp; Methods: This comparative study consisted of a total of 126 patients divided into 2 groups, the Tapentadol and Tramadol groups for managing low back pain. Participants aged 18-60 with moderate or higher pain intensity were included. Data on pain intensity, adverse events, and patient-reported outcomes were collected at baseline, day 7, and day 14. Participants were randomly assigned to Tapentadol or Tramadol groups, receiving respective medications for 14 days. Data analysis involved t t-test to compare groups. Means and SD were also calculated. Results: The mean age of the patients in the Tramadol group was 33.1 ± 19.1 and in the Tapentadol group was 37.6 ± 19.9, respectively. Sixty of the total participants were men and sixty-five were women. Participants were split equally between groups A and B, with 30 men and 33 women in group A and 30 men and 32 women in group B. The findings demonstrated that both medications considerably lessened moderate to severe chronic lower back pain (CLBP) patients' pain levels. At 28 days after the baseline, the mean VAS scores for groups A and B were 34.57 and 37.55, respectively. Conclusion: According to the study's findings, these two medications effectively reduce pain in those with chronic lower back pain. Tapentadol is observed to be tolerated well and more effective than Tramadol.