Reduction In Visual Analog Scale Score Research Articles

Impact of Adlay-Based Formula on Pain and Discomfort in Women with Dysmenorrhea: A Randomized Controlled Trial

Background: Primary dysmenorrhea, a highly prevalent condition that significantly impacts women’s daily activities and quality of life, occurs without underlying pelvic pathological changes. Conventional treatments, such as warm water therapy, provide temporary relief; however, more effective interventions are needed. This study aimed to evaluate the effectiveness of an Adlay-based formula in reducing dysmenorrhea symptoms through randomized controlled trials. Methods: A total of 69 participants were randomly assigned to either the Adlay-based formula group (n = 35) or the placebo group (n = 34). Baseline characteristics, including age, age of menarche, dysmenorrhea onset, menstrual duration, BMI, blood pressure, and heart rate, were comparable between groups. The primary outcomes were measured using the Visual Analogue Scale (VAS) for dysmenorrhea, pain assessment scales, the Menstrual Distress Questionnaire (MDQ), and serum levels of inflammatory biomarkers (PGE2, PGF2α, IL-6, Hs-CRP). Results: The intervention group showed a significant reduction in VAS scores at both the first treatment and at the end of the study compared to baseline and the placebo group. Pain assessments indicated improvements in persistent pain, dull pain, exhaustion, nausea/vomiting, lower abdominal swelling, back pain, diarrhea, and cold sweats. Additionally, biomarker analysis revealed significant reductions in PGE2, PGF2α, and Hs-CRP levels in the intervention group, with no significant change in IL-6 levels. Conclusions: The Adlay-based formula effectively alleviated dysmenorrhea symptoms, improved pain and discomfort, and reduced inflammatory biomarkers compared to placebo. These findings suggested that the formula could serve as a promising alternative for managing primary dysmenorrhea.

Outcomes associated with functional mobility and pain amelioration in 49 patients after sacroplasty: a single-center study

This study aimed to determine the predictive factors for analgesic reduction and amelioration of mobility following percutaneous sacroplasty in patients with insufficiency fractures or metastatic lesions. A single-center retrospective analysis of 49 patients who underwent percutaneous sacroplasty for insufficiency fractures and sacral pathological lesions was conducted. Visual analog scale (VAS), Functional Mobility Scale (FMS), and Oswestry Disability Index (ODI) were assessed. All data were accessed immediately before and 1 month after the procedure. Thirty-one patients (63.3%) experienced a significant reduction in VAS score, 36 (73.5%) experienced amelioration of FMS, and 20 (40.8%) fell within the ODI at 1 month. The mean VAS score was 7.8 (median [min-max] = 8 [3-10]) pre-procedure and 3.4 (median [min-max] = 3 [0-8]) post-procedure. The mean ODI was 0.5 (median [min-max] = 0.5 [0.3-0.8] pre-procedure and 0.3 (median [min-max] = 0.3 [0-0.7]) post-procedure. The mean FMS was 2.6 (median [min-max] = 3 [1-5]) pre-procedure and 1.2 (median [min-max] = 1 [0-4]) post-procedure. There was a statistically significant increase in VAS amelioration in patients without concomitant vertebroplasty (OR = 4.16, IR [1.09; 15.79], p < 0.05). Major complications were not observed. In terms of long-term satisfaction, only two patients reported that they would not undergo the same procedure again. Percutaneous sacroplasty was effective for pain relief, functional outcomes, and short-term satisfaction. The absence of concomitant vertebroplasty was significantly associated with VAS improvements.

Short-Term Efficacy of Repetitive Peripheral Magnetic Stimulation for Chronic Low Back Pain: A Double-Blinded Randomized Control Trial

Objective: To evaluate the efficacy of repetitive peripheral magnetic stimulation (rPMS) in alleviating pain and enhancing functional recovery in patients with chronic low back pain. Materials and Methods: The present study was a double-blinded randomized controlled trial conducted in 30 patients aged 18 to 60 years with chronic low back pain at the outpatient clinic of Department of Rehabilitation Medicine. Patients were randomly assigned to the rPMS group or the sham treatment group, receiving one session per week for three weeks. Visual analog scale (VAS) scores were assessed before treatment, after each session, and one-week post-treatment. The Roland-Morris Disability Questionnaire (RMDQ) and Oswestry Disability Index (ODI) were evaluated before and one week after treatment. Results: Baseline characteristics and scores for VAS, RMDQ, and ODI, were comparable between groups. VAS scores improved significantly in both groups at one-week post-treatment, with the rPMS group showing better outcomes. The mean VAS score decreased in the rPMS group after the second and third sessions was 2.5 (SD 1.6) and 2.5 (SD 1.4), respectively. A linear mixed-effects model indicated a significant reduction in VAS scores by the third session. The median improvement in RMDQ was 3.0 (IQR 3.0) for the rPMS group versus 2.0 (IQR 2.0) for the sham group (p=0.030). ODI scores improved by 5.6 (SD 3.5) in the rPMS group compared to 2.4 (SD 1.8) in the sham group (p=0.048). Conclusion: rPMS, combined with exercise and behavioral modifications, reduces pain and disability in chronic low back pain patients. However, the change in VAS scores did not exceed the minimal clinically important difference (MCID), suggesting limited clinical impact.

Effectiveness of electroacupuncture and acupuncture in alleviating cold hypersensitivity in the hands and feet: A randomized controlled trial.

Cold hypersensitivity in the hands and feet(CHHF) is a common condition that reduces the quality of life and causes daily discomfort. The current treatments are primarily pharmacological. This study aimed to expand treatment options by comparing the efficacy of electroacupuncture (EA) and acupuncture (AC) with that of no treatment (control). A three-group randomized controlled trial was conducted with 72 women diagnosed with cold hypersensitivity in the hands and feet, as confirmed by subjective symptoms and objective temperature differences. Participants were randomly assigned to the EA, AC, or control groups. Outcome measures included hand and feet visual analog scale (VAS) scores, temperature changes measured using a non-contact thermometer, and World Health Organization Quality of Life-BREF (WHOQOL-BREF) scores assessed at pretreatment (T0), posttreatment (T1), and follow-up (T2). Repeated measures ANOVA and 2-way mixed-model ANOVA were used to evaluate group, time, and interaction effects. Both the EA and AC groups showed significant improvements in hand and feet VAS and WHOQOL-BREF scores compared with those of the control group posttreatment (T1). Notably, the EA group demonstrated sustained benefits at follow-up (T2), with significant reductions in feet VAS scores and positive changes in several WHOQOL-BREF domains. Interaction effects between group and time were observed, indicating that the changes in the EA and AC groups were meaningfully different form those in the control group. The control group also exhibited a statistically significant reduction in the VAS scores at follow-up (T2), likely due to the natural variability of cold extremity symptoms and psychological factors. This study demonstrated that EA and AC are effective in alleviating the symptoms of CHHF and enhancing the quality of life compared to no treatment. EA showed long-lasting effects than those of AC, suggesting its potential to regulate the autonomic nervous system. These findings provide a foundation for expanding non-pharmacological treatment options for CHHF and offer clinical guidance on the use of EA and AC.

COMPARISON OF THE EFFICACY OF ARTHROCENTESIS WITH AND WITHOUT CONCENTRATED GROWTH FACTOR INJECTIONS IN REDUCING CLINICAL SYMPTOMS IN PATIENTS WITH TEMPOROMANDIBULAR JOINT OSTEOARTHRITIS

There is a significant prevalence of temporomandibular joint (TMJ) disorders, estimated at 34% according to various sources. Given that this condition often leads to a reduced quality of life and disability, there is a pressing need to develop and implement effective treatment methods. Arthrocentesis, along with the injection of pharmacological agents—particularly platelet-rich plasma—into the joint cavity, is a recognized treatment for TMJ osteoarthritis. Recently, a third generation of platelet concentrates has been developed, which is an evolutionary advancement of the platelet-rich plasma technique. This study involved 60 patients, equally divided into control and experimental groups. The control group was treated with arthrocentesis for TMJ osteoarthritis, while the experimental group received arthrocentesis combined with intra-articular injections of concentrated growth factor. The effectiveness of the treatments was evaluated using the visual analogue scale (VAS) for pain and measuring maximum mouth opening. The study results showed a 74.22% reduction in VAS scores in the control group and a 79.87% reduction in the experimental group (p &lt; 0.001). Maximum mouth opening increased by 17.84% in the control group and by 20.53% in the experimental group (p &lt; 0.001). Both treatment methods demonstrated significant clinical efficacy (p &lt; 0.001). In our opinion, the use of arthrocentesis with concentrated growth factor injections for the treatment of TMJ osteoarthritis is clinically justified and more effective than arthrocentesis alone.

Tuina versus physiotherapy or a combination of both for the management of chronic nonspecific low back pain: A randomized controlled trial

ObjectiveTo rigorously evaluate the short-term and long-term effectiveness of Tuina (TN), alone and in combination with physiotherapy (PT), for Chronic nonspecific low back pain (CNLBP) through a comprehensive, high-quality clinical trial. MethodsThis randomized, single-blind trial was conducted from September 2020 to July 2023, involving 204 CNLBP patients from the First Affiliated Hospital of Jinan University. Participants underwent a baseline assessment, 6 treatment sessions over 8 weeks, a post-treatment evaluation in the 9th week, and a 20-week follow-up. Participants were randomly assigned to TN, PT, or a combination of TN and PT (TP) groups. Each treatment involved 6 sessions with a minimum 7-day interval, each lasting 30 minutes. Primary outcome was the change in Visual Analog Scale (VAS) for pain. Secondary outcomes included the Oswestry Disability Index (ODI), 36-Item Short Form Health Survey (SF-36), Range of Motion (ROM) of the spine, Traditional Chinese Medicine Syndrome Scale (TCMSS), and adverse events (AE). ResultsAmong the 204 participants, 67.16 % were female, and 88.73 % completed the 20-week follow-up. All groups showed significant reductions in VAS scores post-treatment and at follow-up. Secondary outcomes improved significantly, with notable decreases in ODI and TCMSS scores. Pairwise comparisons within groups indicated statistical significance, particularly in ODI scores, with clinical relevance. No significant differences were found between the groups. ROM and SF-36 showed statistical but not clinical significance. Only one AE (0.49 %) was reported, with no severe incidents. ConclusionAll treatment groups, including TN, TP, and PT, demonstrated significant reductions in VAS scores for CNLBP patients, with effects lasting up to 20 weeks. While TN and TP showed substantial improvements in secondary outcomes, particularly in ODI scores, no significant differences were found between the groups. These findings suggest that all treatments can be effective for managing CNLBP, supporting clinical practitioners in selecting appropriate interventions for patients, especially for those unable to engage in active exercises, utilizing passive movements like TN to enhance health outcomes.

Comprehensive assessment of heavy slow resistance training and high-dose therapeutic ultrasound in managing patellar tendinopathy, a randomized single-blind controlled trial

BackgroundPatellar tendinopathy (PT) is a common sport injury prone to recurrence. Heavy Slow Resistance Training (HSR) and High-Dose Therapeutic Ultrasound (TUS) are frequently used interventions for PT. However, the combined effectiveness of these therapies remains unclear. This study investigated the impact of combination therapy on functional outcomes in patients with PT.MethodsFifty-one college students aged 18–25, diagnosed with PT via musculoskeletal ultrasound, were randomly assigned to one of three groups (n = 17 per group): combined HSR and high-dose TUS, HSR training alone, or high-dose TUS alone. The eight-week intervention included assessments using the Victorian Institute of Sport Assessment-Patella (VISA-P), Visual Analogue Scale (VAS), Y-balance Test (YBT), Modified Thomas Test (MTT), Horizontal Jumping Distance, Maximum Isometric Muscle Strength Test, and musculoskeletal ultrasound for patellar tendon thickness and blood flow. Assessments were conducted at baseline and post-intervention, with a follow-up VISA-P assessment at week 16. This randomized, single-blind controlled trial was registered on ISRCTN11447397 (www.ISRCTN.com) on February 17, 2024 (retrospectively registered).ResultsAll groups demonstrated significant improvements in VISA-P scores at the end of the intervention compared to baseline (p < 0.01), with the combined group showing the greatest improvement (21 points). Follow-up at week 16 revealed continued improvement in VISA-P scores for the combined and HSR groups, while the TUS group showed a slight decrease (from 74 to 70). All groups displayed significantly reduced VAS scores post-intervention (p < 0.01) compared to baseline, indicating decreased pain. While no significant between-group differences were observed in pre-intervention VAS scores, post-intervention results revealed significant differences between the combined and HSR groups (p < 0.05), as well as between the combined and TUS groups (p < 0.01).ConclusionBoth exercise intervention and high-dose TUS appear effective in reducing pain and improving motor function in individuals with PT. However, the therapeutic effect of high-dose TUS alone seems limited compared to exercise intervention. The combined application of both methods yielded the most significant improvements in pain relief and motor function enhancement.

Efficacy of Extranasal Neurostimulation for Patients With Neuropathic Corneal Pain: A Pilot Study

Purpose: Neuropathic corneal pain (NCP) has been recognized as a distinct disease, yet treatment options remain limited. The aim of this pilot study was to explore the effectiveness of extranasal neurostimulation (EXNS) as a potential pain relief strategy for individuals with the peripheral component of NCP. Methods: A retrospective study was performed to identify patients who were diagnosed with refractory peripheral or mixed NCP and subsequently underwent a single session of EXNS. Visual analog scale (VAS) was used to evaluate pain intensities in the office before and after 60 seconds of EXNS. Demographic information, changes in pain scores, and comorbidities were recorded, and their correlations with pain score changes were analyzed. Results: Twenty-two patients with a mean age of 48.91 ± 3.32 years were included. The average VAS score before EXNS was 5.59 ± 0.41, which was reduced to 2.59 ± 0.43 after EXNS, indicating a 54.88% reduction (P &lt; 0.001). EXNS reduced VAS scores from 4.90 ± 0.72 to 1.60 ± 0.42 (68.40%) for 10 patients with peripheral NCP and from 6.17 ± 0.42 to 3.42 ± 0.62 (43.61%) for 12 patients with mixed (peripheral and central) NCP (P = 0.005 for both groups). Fourteen patients (63.63%) experienced an improvement of at least 50% in their pain scores, 2 patients (9.09%) showed an improvement between 30% and 49.9%, while 6 patients (27.27%) experienced an improvement of less than 30%. No correlations between the change in pain scores and patient demographics, as well as comorbidities were detected. Conclusions: EXNS may be used as an adjuvant therapy to ameliorate pain among patients with NCP with the peripheral pain component.

Comparative Efficacy of Spinal Cord Stimulation in the Management of Acute Pain and Chronic Pain Related to Failed Back Surgery Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Spinal cord stimulation (SCS) is a well-established treatment for chronic pain. However, its potential in acute pain management requires further investigation. The goal of this review is to assess and compare the effectiveness of SCS for managing acute postoperative pain against chronic pain associated with failed back surgery syndrome (FBSS). A comprehensive search of databases identified randomized controlled trials (RCTs) that examined SCS for both acute and chronic pain associated with FBSS. Pain relief was measured using the Visual Analog Scale (VAS) and Numeric Rating Scale (NRS). Study quality was evaluated using the Jadad score and Cochrane risk of bias tool. Evidence suggests that SCS significantly reduces acutepain, achieving over a 50% reduction in VAS scores. For chronic pain associated with FBSS, SCS demonstrated substantial efficacy, with a mean reduction of -2.45 on pain scales compared to baseline. When compared to optimal medical management (OMM), SCS was more effective, showing a mean reduction of -1.17 in pain scores for FBSS.Overall, SCS offers significant benefits in managing chronic pain, particularly in FBSS, by reducing pain intensity and opioid use. While the initial findings for acute pain relief are promising, further high-quality RCTs are needed to better understand SCS's role in preventing the transition from acute to chronic pain. Continued research into optimizing patient selection and stimulation parameters will be essential to improve therapeutic outcomes in both acute and chronic pain management.

Effects of 3′-Sialyllactose on Symptom Improvement in Patients with Knee Osteoarthritis: A Randomized Pilot Study

Background/Objectives: 3′-Sialyllactose (3′-SL), a human milk oligosaccharide, has anti-inflammatory effects and is demonstrated to have protective effects against osteoarthritis (OA) in vitro and in vivo. However, this hypothesis remains to be investigated in a clinical setting. Herein, we investigated the effects of 3′-SL on pain and physical function in patients with knee OA. Methods: Sixty patients with knee OA with Kellgren and Lawrence grades (KL-grades) 1–4 and Korean Western Ontario and McMaster Universities Osteoarthritis Index (KWOMAC) scores ≥30 were randomly assigned to the placebo (n = 20), 3′-SL 200 mg (n = 20), and 3′-SL 600 mg (n = 20) groups. For 12 weeks, 3′-SL or placebo was administered to patients once a day. Clinical efficacy was evaluated using a visual analog scale (VAS) for pain and KWOMAC for physical function at baseline and at 6 and 12 weeks. Adverse effects were assessed for 12 weeks. Results: Significant reductions in VAS and KWOMAC scores were observed at 12 weeks compared with the baseline in the 3′-SL group. No severe adverse effects were observed over 12 weeks. Conclusions: 3′-SL reduced pain in patients with knee OA, improved daily life movements, and was safe, suggesting that 3′-SL might be an effective treatment for knee OA without severe side effects.

Spa Therapy Efficacy in Mental Health and Sleep Quality Disorders in Patients with a History of COVID-19: A Comparative Study.

The COVID-19 pandemic has left behind mental health issues like anxiety, depression, and sleep disorders among survivors. This study assessed the efficacy of spa therapy in enhancing psychological well-being and sleep quality in individuals with chronic arthro-rheumatic, respiratory, and otorhinolaryngological diseases, including COVID-19 recoverees. Our prospective observational study included 144 Caucasian subjects from three Italian spas who underwent a 2-week spa therapy cycle, involving balneotherapy and/or inhalation treatments. Symptoms were assessed with the Visual Analogue Scale (VAS), psychological well-being with Depression Anxiety Stress Scales-21 items (DASS-21), and sleep quality with the Insomnia Severity Index (ISI). Significant reductions in VAS scores for arthro-rheumatic, respiratory, and otorhinolaryngological symptoms were observed after spa therapy, as well as for DASS-21 and ISI scores for sleep quality, transitioning to less severe insomnia categories. Females had more pronounced improvements in DASS-21 scores and sleep quality. Subjects with and without prior SARS-CoV-2 infection experienced significant reductions in anxiety, depression, and stress, with more pronounced improvements in those without prior infection. COVID-19 survivors also showed significant ISI score improvements. Spa therapy is a promising complementary treatment for improving mental health and sleep quality in chronic disease patients, including COVID-19 survivors.

Comparison of Ultrasound-Guided Genicular Pulse Radiofrequency and Fluoroscopy-Guided Intra-Articular Pulse Radiofrequency for Knee Osteoarthritis-Related Pain.

To compare two different algological intervention technique outcomes with ultrasound-guided genicular pulse radiofrequency (PRF) and fluoroscopy-guided intra-articular pulse radiofrequency for knee osteoarthritis-related pain. Observational study. Place and Duration of the Study: Izmir Bakircay University, Cigli Training and Research Hospital and Health Science University Tepecik, Training and Research Hospital, Izmir, Turkiye, between March 2022 and May 2023. Patients aged 60 years and above with stage 3 and 4 knee osteoarthritis, experiencing knee pain for more than six months, and non-responsive to conservative treatments were included. Patients with recent knee surgery or intra-articular injections and those ineligible for radiofrequency application were excluded. Ultrasound-guided genicular nerve PRF and fluoroscopy-guided intra-articular PRF were administered to the included patients. Pain and quality of life were evaluated using the visual analogue scale (VAS) and Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) scores before and after the procedures. The study included 64 patients. Both ultrasound-guided genicular PRF and fluoroscopy-guided intra-articular PRF resulted in significant reductions in VAS and WOMAC scores at 1 and 3 months after the procedures. There was no significant difference in efficacy between the two techniques. Ultrasound-guided genicular PRF and fluoroscopy-guided intra-articular PRF are effective and safe options for managing knee osteoarthritis-related pain. Osteoarthritis, Pulse radiofrequency, Ultrasound, Fluoroscopy, Pain.

Effect of Flaxseed on Pain Relief and Quality of Life in Patients With Mastalgia: A Single Arm Interventional Study.

Mastalgia, a common complaint among women, denotes breast discomfort that can manifest as cyclical or non-cyclical. Reassurance, mechanical support and various non-pharmacological treatments, like flaxseeds, have been seen to have a good effect in treating mastalgia. Thus, the aim of this study was to investigates the efficacy of flaxseed in alleviating pain associated with mastalgia and its impact on the overall health-related quality of life among female patients. Conducted at a tertiary care center in Northern India over 18 months, it employed a single-arm interventional design. The participants included females aged 18 years and older presenting with breast pain at the Department of General Surgery. The intervention involved daily consumption of 30 g of milled flaxseed for each participant, administered over a period of six months. Pain severity was assessed using the visual analogue scale (VAS) before supplementation and at follow-up intervals up to six months. Concurrently, the Short Form-12 (SF-12) items Health Survey measured health-related quality of life, encompassing both physical and mental health domains. Statistical analysis employed parametric (paired t-test) and non-parametric tests (chi-square, McNemar) where appropriate, with statistical significance set at p<0.05. Two hundred women with mastalgia were included with a significant reduction in mean VAS scores from 6.03±0.83 at baseline to 2.19±0.66 at six months post-intervention (p = 0.0001). This reduction in pain intensity demonstrated a positive correlation with duration of flaxseed supplementation, notably declining after the initial three months. The mean difference in physical and mental SF-12 score at first visit and at 6 months after intervention was significant (p = 0.0001). This study underscores the potential of flaxseed as a therapeutic option for managing mastalgia and enhancing health-related quality of life among affected individuals.

Comparison of Intercostal Nerve Block and Serratus Anterior Plane Block for Perioperative Pain Management and Impact on Chronic Pain in Thoracoscopic Surgery: A Randomized Controlled Trial.

The intent of this study was to compare the analgesic efficacy of intercostal nerve block (ICNB) under direct thoracoscopic visualization and serratus anterior plane block (SAPB) with ultrasound guidance during thoracoscopic surgery's perioperative period. Furthermore, it examined their impact on chronic pain and identifies potential risk factors associated with its development. In this prospective randomized controlled study, 74 thoracoscopic surgery patients were randomly assigned to ICNB or SAPB groups. Attending surgeons administered ICNB, while anesthesiologists performed SAPB, both using 20mL of 0.5% ropivacaine. Primary outcomes included Visual Analog Scale (VAS) scores for resting and coughing pain at 6, 12, 24, and 48 hours postoperatively, perioperative opioid and NSAID consumption, and chronic pain incidence at 3 months postoperatively. Secondary outcomes aimed to identify independent risk factors for chronic pain. The primary results reveal that the SAPB group exhibited significantly lower VAS scores than the ICNB group for postoperative coughing at 24 hours ( P <0.001, 95% CI=0.5, 1) and for resting pain at 48 hours ( P =0.001, 95% CI=0.2, 1). Conversely, the ICNB group demonstrated a reduced VAS score for resting pain at 6 hours compared with the SAPB group ( P =0.014, 95% CI=-0.5, 0.5). SAPB group required significantly less intraoperative sulfentanil ( P <0.001, 95% CI=2.5, 5), remifentanil ( P =0.005, 95% CI=-0.4, -0.1), and flurbiprofen ester ( P =0.003, 95% CI=0, 50) than ICNB group. Chronic pain incidence was similar ( P =0.572, 95% CI=0.412, 1.279), with mild pain in both ICNB and SAPB groups. Secondary findings indicate that resting VAS score at 12 hours (OR=7.59, P =0.048, 95% CI=1.02, 56.46), chest tube duration (OR=3.35, P =0.029, 95% CI=1.13, 9.97), and surgical duration (OR=1.02, P =0.049, 95% CI=1.00, 1.03) were significant predictors of chronic pain occurrence. ICNB and SAPB demonstrated comparable analgesic effects, with similar rates of chronic pain occurrence. Chronic pain independent risk factors included resting VAS score at 12 hours, chest tube duration, and surgical duration.

Comparison of treatment results between microvascular decompression and gamma knife radiosurgery in primary trigeminal neuralgia.

This study aims to analyze and evaluate the comparative clinical outcomes associated with microvascular decompression (MVD) and gamma knife radiosurgery (GKRS), focusing on pain relief, pain recurrence, and complications encountered in the treatment of trigeminal neuralgia (TN). Among 155 surgical procedures performed for TN (90 GKRS, and 65 MVD) between March 1997 and December 2020, the exclusion criteria encompassed prior surgical interventions, the presence of other pathological conditions such as tumors, vascular diseases, and multiple sclerosis, as well as patients who were lost to follow-up. Ultimately, 101 patients received their initial treatment for primary TN (47 GKRS, and 54 MVD) and were followed up for more than 1 year. The MVD procedures utilized the suboccipital retrosigmoid sinus approach, whereas GKRS was conducted with MR imaging guidance, employing a single 4mm isocenter, with median GKRS doses of 80 Gy. We retrospectively analyzed patient characteristics, including sites of divisions, distributions of pain, and clinical outcomes. The assessment of outcomes was performed utilizing the Barrow Neurological Institute Pain Intensity Score and the Visual Analog Scale (VAS), with evaluations taking place preoperatively and after 1, 3, 6 and 12 months. Postoperative VAS scores for patients undergoing either MVD or GKRS demonstrated a significant improvement when compared with their preoperative counterparts. The reduction in postoperative VAS scores within the MVD group was significantly more substantial than that observed in patients who underwent GKRS at the initial postoperative evaluations (P = .037). The maintenance of pain relief after MVD proved significantly superior to that following GKRS (P < .01). Both MVD and GKRS present as safe and efficacious therapeutic options for individuals diagnosed with primary TN, though MVD displayed superior initial outcomes in terms of pain relief and its maintenance. However, for older patients or those with medical contraindications to invasive procedures, GKRS emerges as a viable and less invasive alternative for initial treatment in cases of primary TN.

Comparison of two methods of greater occipital nerve block in patients with chronic migraine: ultrasound-guided and landmark-based techniques

BackgroundMigraine is a primary headache defined as moderate-to-severe pain lasting 4 to 72 h, ranking 2nd among the disabling conditions for both genders regardless of the age and the greater occipital nerve (GON) block has been reported as an efficient treatment method for migraine. The present study aims to evaluate and compare the efficiency of the two methods of GON block, i.e., the ultrasound (US)-guided technique and the landmark-based technique.MethodHaving a prospective and randomized design, the study assigned the patients with chronic migraine into two groups after which a neurologist performed landmark-based GON block in the first group while an algologist performed US-guided GON block in the second group. During the 3-month follow-up period, the number of days with pain, the duration of pain, the number of analgesic drugs taken in a month, and Visual Analogue Scale (VAS) scores were compared with the values ​​before treatment and at the 1st week, 1st month, and 3rd month after treatment.ResultsUS-guided GON block group included 34 patients while there were 32 patients in the landmark-based GON block group. US-guided GON block group showed significantly reduced VAS scores and frequency of attacks compared to the landmark-based GON block group at Month 1 after the procedure. After a 3-month follow-up period of the two groups, the frequency of attacks, analgesic intake and the duration of attacks were lower in both groups compared to the baseline. At 3-month follow-up, the mean of VAS scores decreased from 9,47 ± 2,69 to 4,67 ± 1,9 in US-guided GON block group and from 9,46 ± 0,98 to 7 ± 2,5 in the landmark-based GON block group.ConclusionIt was determined that both US-guided and landmark-based GON block were efficient techniques in patients with chronic migraine. US-guided GON block technique resulted in lower VAS scores, shorter durations of pain, lower frequencies of attack, and lower intake of analgesics compared to the landmark-based GON block technique.

A New Nonpharmacological Tool for Coping With Labor Pain: Focusing on Birth-Specific Stereogram Cards (BSSC)

BACKGROUND/AIMS:Minimizing labor pain perception is crucial to mitigate its adverse effects and enhance women’s birth satisfaction. Two-dimensional images (stereograms) can effectively reduce labor pain perception by inducing a three-dimensional mental perception. This study was conducted to determine the effect of focusing on birth-specific stereogram cards (BSSC) on the perception of labor pain.METHODS:This prospective randomized controlled clinical trial involved 60 eligible pregnant women in an Istanbul state hospital’s delivery room. Data collection tools included a pregnancy data form, the State Anxiety Scale, BSSC, visual analog scale (VAS), and a postpartum data form. The researchers developed the BSSC for birth, and SPSS software version 20 was used for data analysis.RESULTS:The study noted reduced VAS scores, lower anxiety scores, decreased postpartum fatigue levels, and a shortened active phase in the BSSC group, along with high satisfaction with the intervention.CONCLUSIONS:The BSSC focus method effectively reduces labor pain perception, anxiety, and postpartum fatigue, making it a promising approach to improving birth experience.

Clinical outcomes for minimally invasive sacroiliac joint fusion with allograft using a posterior approach.

Sacroiliac joint (SIJ) dysfunction can occur as a result of injury, degeneration, or inflammation. This dysfunction presents symptoms of pain at various locations, including the low back, hips, buttocks, and legs. The diagnosis of SIJ dysfunction is challenging and cannot be achieved solely with imaging studies such as X-rays, MRI, or CT. The current gold standard diagnostic modality is intra-articular SIJ blocks using two differing local anesthetics. Current treatments for SIJ dysfunction may be beneficial for short-term relief but lack long-term efficacy. The purpose of our study was to examine the outcomes of patients who underwent minimally invasive, posterior SIJ fusion using allograft at a single center. This was a retrospective study which received exemption from the WCG IRB. Data regarding preoperative and postoperative pain levels, surgical time, complications, and medication usage were obtained retrospectively from patient electronic medical records and prescription drug monitoring program reports. No mapping was completed prior to the procedure. Pain was assessed with the 11-point (0-10) Visual Analogue Scale (VAS) and medication usage was assessed using Morphine Milligram Equivalents (MME). Patients were included if they had been diagnosed with SIJ dysfunction using two intra-articular diagnostic blocks that resulted in at least an 80% decrease in pain and had failed conservative management. Patients with sacral insufficiency fractures were excluded. VAS scores reduced from 8.26 (SD = 1.09) at baseline to 2.59 (SD = 2.57), 2.55 (SD = 2.56), 2.71 (SD = 2.88), and 2.71 (SD = 2.88) at 3, 6, 9, and 12 months, respectively. MME reduced from 78.21 mg (SD = 51.33) to 58.95 mg (SD = 48.64), 57.61 mg (SD = 47.92), 61.71 mg (SD = 45.64), and 66.29 mg (SD = 51.65) at 3, 6, 9, and 12 months, respectively. All reductions in VAS scores and MME were statistically significant. No adverse events occurred, and the average operating room time was 40.16 min (SD = 6.27). Minimally invasive, posterior SIJ fusion using allograft is a safe and efficacious method for managing SIJ dysfunction.

Efficacy and safety of Kegan Liyan oral liquid for patients with acute pharyngitis: A randomized, double-blinded, placebo-controlled, multi-center trial

BackgroundAlleviating the sore throat caused by acute pharyngitis is a primary patient concern. However, antibiotics are not commonly recommended drugs, and abuse can lead to serious consequences such as drug resistance. Therefore, seeking alternative treatments is necessary. PurposeTo investigate the efficacy and safety of Kegan Liyan (KGLY) oral liquid for patients with acute pharyngitis. Study designRandomized, double-blinded, placebo-controlled, multi-center study. MethodsParticipants from 17 hospitals were randomly assigned 1:1 to receive KGLY oral liquid or placebo for five days. Assessments occurred at baseline, day 3, and day 6. The primary outcome was the recovery rate. Secondary outcomes included sore throat and cough visual analogue scale (VAS), the area under the curve (AUC) of sore throat VAS, time to sore throat relief and recovery, proportion of participants with sore throat relief and recovery, traditional Chinese medicine (TCM) syndrome score, single TCM manifestation score and use of acetaminophen. ResultsInvolving 239 participants (120 in KGLY and 119 in placebo group), the study found a significantly higher recovery rate on day 6 in the KGLY group (between-group difference, 27.20 % [15.00 % to 39.40 %], p < 0.001). On day 3 and 6, the KGLY group showed significantly larger reductions in sore throat (–3.02 vs –2.37, p = 0.001; –4.66 vs –3.64, p < 0.001) and cough VAS scores (–1.55 vs –1.05, p = 0.004; –2.28 vs –1.56, p < 0.001) from baseline. KGLY oral liquid lowered the AUC of sore throat VAS score (–2.33 [–4.10 to –0.56], p = 0.011), shortened time to sore throat recovery (hazard ratio, 0.42 [0.30 to 0.59], p < 0.001), increased sore throat recovery rate at day 6 (75.00 % vs 42.86 %, p < 0.001), decreased the TCM syndrome score (–2.03 [–2.69 to –1.37], p < 0.001), and improved individual TCM symptoms compared to placebo. No significant differences between the groups in acetaminophen usage. KGLY oral liquid was safe and tolerated. ConclusionKGLY oral liquid may be a beneficial and safe alternative treatment for acute pharyngitis, which can alleviate symptoms such as sore throat, swollen throat, cough, and phlegm production.

Clinical and Functional Outcomes of Platelet-Rich Plasma Injection and Corticosteroid Injection in Patients With De Quervain's Tenosynovitis: A Comparative Retrospective Study.

Background and aim De Quervain's tenosynovitis (DQST) is a prevalent condition involving tendon inflammation in the wrist. This study compares the clinical and functional outcomes between patients receiving platelet-rich plasma (PRP) injections and those receiving corticosteroid injections for DQST. Methods A retrospective study conducted at Sri Devaraj Urs Academy of Higher Education and Research, Kolar, India, included 58 patients with DQST, divided into Group A (PRP injection) and Group B (corticosteroid injection). Assessments were conducted using the Visual Analogue Scale (VAS), the Disabilities of the Arm, Shoulder, and Hand (DASH) score, and the Modified Mayo Wrist Score (MMWS) at baseline, one month, three months, and six months. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, NY, USA), with significance set at p < 0.05. Results Both treatment groups demonstrated a reduction in VAS scores over time. Significant improvements were observed at one month (p = 0.007) and six months (p = 0.004) post-injection. Baseline (p = 0.336) and three-month (p = 0.829) VAS scores showed no significant differences. Similarly, DASH scores were not significantly different at any measured time points: baseline (p = 0.331), one month (p = 0.592), three months (p = 0.707), and six months (p = 0.314). MMWS scores also showed no significant differences at baseline (p = 0.123), one month (p = 0.101), three months (p = 0.422), and six months (p = 0.956). Independent sample t-tests highlighted significant VAS score improvements at one month (t = 2.813, p = 0.007) and six months (t = -3.009, p = 0.004), but DASH and MMWS scores showed no significant differences at any time points. Chi-square tests indicated no significant associations between the groups at one-month, three-month, and six-month follow-ups. Conclusion Both PRP and corticosteroid injections effectively alleviate pain in DQST patients, as evidenced by significant VAS score improvements. However, functional outcomes measured by DASH and MMWS scores did not significantly differ between the treatments. These results suggest that while both treatments are effective for pain management, their short-term impact on functional improvement may be similar. To investigate long-term functional results, more research with bigger sample sizes and longer follow-up periods is required.