Reduction In Pain Intensity Research Articles

Influence of audiovisual distraction on the feeling of stress, analgesic sedation and patient satisfaction during electrophysiological ablation procedures on the heart

Abstract Background Distraction using audiovisual stimuli has mostly been researched in a paediatric population with the results showing an inhibiting effect on stress and anxiety as well as the subjective perception of pain. Purpose We designed a study to test if audiovisual distraction may reduce the level of sedatives and analgesics by reducing anxiety and stress during electrophysiological intervention (EP). Methods We conducted a clinical intervention pilot study that was carried out in a randomized controlled manner. Consecutive 70 patients undergoing EP with subsequent ablation were randomized 1:1 to control (CTL) or intervention group (AVD). In addition to standardized sedation, all patients in AVD group received audiovisual glasses. Feeling of fear and stress was assessed through blood pressure changes. The patient satisfaction was assessed with Client Satisfaction Questionnaire, ZUF-8. Numeric scale (NRS) was used to quantify the perceived pain during the procedure. The difference between the subjective estimated duration of the procedure and the actual duration of the procedure was compared. Results The study included predominantly male patients (58.6%) with a mean age of 56 years. Technical aptitude was well balanced between both groups with the majority of patients in both groups owning a smartphone or a tablet (86.1% vs 85.7% for CTL and AVD respectively, p=0.92), and majority of patients in both groups using a computer, laptop or tablet on a weekly basis (58% vs 57.1% for CTL and AVD group respectively, p=0.97). The baseline feelings of anxiety were well balanced within both groups (Figure 1). Our analysis revealed no significant difference between the mean blood pressure values of the CTL and AVD groups (systolic: 135 vs. 141 mmHg; p = 0.32; diastolic: 74 vs. 72 mmHg; p = 0.45). Patient satisfaction score was comparable in both groups (26.5 vs. 26.8 points, p = 0.36). Average response for perceived pain using NRS scale as well as perceived procedure duration was similar between the groups (Figure 2). AVD group required a lower dose of Midazolam than CTL group (0.005 mg/kg/h vs 0.007 mg/kg/h, p = 0.07). Majority of patients (31.4%) in AVD group stated: "The audiovisual glasses made me feel distracted at times." 10% of the AVD patients stated: "The audiovisual glasses made me feel completely distracted and more relaxed." Conclusion The use of audiovisual glasses has no influence on the patients’ feelings of anxiety and stress during EP. The use of audiovisual glasses can temporarily induce distraction during EP, while they do not seem to be sufficient in reducing pain intensity during ablation therapy. Patients undergoing EP do not seem to be the target patient group for AVD use.

Efficacy of non-pharmacological interventions for primary dysmenorrhoea: a systematic review and Bayesian network meta-analysis

ObjectivesTo assess the relative benefits of various non-pharmacological interventions on treating primary dysmenorrhoea within a network meta-analysis.Study designSystematic review and Bayesian network meta-analysis.Inclusion criteriaRandomised controlled trial involving patient with primary...

Effectiveness of Photobiomodulation in Reducing Pain and Disability in Patients With Knee Osteoarthritis: A Systematic Review With Meta-Analysis.

Photobiomodulation (PBM) is not implemented in routine clinical management for knee osteoarthritis. This study aims to systematically investigate the effects of PBM in patients with knee osteoarthritis, comparing with placebo to understand its true clinical effects. PubMed, EMBASE, Web of Science, and Cochrane databases were searched up to October 2023. Randomized placebo-controlled trials applying PBM versus placebo were included. Study characteristics, intervention parameters, and patient-reported and physical examination outcome measures were collected. The risk of bias was judged using the Cochrane risk-of-bias tool for randomized trials (version 2) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to interpret the certainty of results. Ten studies were included comprising 542 participants. All studies were judged with unclear to a high risk of bias. Meta-analysis for pain at rest (6 studies) showed that PBM significantly reduced pain at rest as compared to placebo (-0.7 [95% CI = -1.1 to -0.2]), moderate effect, very low certainty of evidence, whereas for the Timed "Up & Go" Test (three studies), no significant effect was detected. Statistically significantly within-group (PBM) mean improvement was detected for pain, Lequesne Index, and gait performance outcomes, but not always clinically relevant or significant when compared to placebo. PBM reduces pain intensity in patients with knee osteoarthritis and may improve disability. However, the very low certainty of evidence does not allow to recommend its isolated use but may be used to complement other widely recommended therapies. More rigorous clinical trials and the revision of the recommended dosage guidelines are warranted to increase the strength of evidence. The findings indicate that photobiomodulation can reduce pain and improve disability in patients with knee osteoarthritis. However, researchers should continue to investigate isolated photobiomodulation intervention versus placebo and extend the dosage guidelines to other types of light emitters.

Synergistic neuromodulation therapy for persistent spinal pain: a proof-of-concept trial on the use of spinal cord and dorsal root ganglion stimulation.

Persistent Spinal Pain Syndrome type 2 (PSPS-T2) poses a significant clinical challenge, demanding innovative therapeutic interventions. The integration of Spinal Cord Stimulation (SCS) and Dorsal Root Ganglion Stimulation (DRG-S) is emerging as a potent synergistic strategy for comprehensive pain management. This single patient-blind proof of concept (POC) trial explores the efficacy and synergistic potential of combined SCS and DRG-S in a patient with refractory PSPS-T2. A 45-year-old male with intractable PSPS-T2 underwent a unique, methodically structured study, involving three treatment phases: Phase A with SCS alone, Phase B with DRG-S alone, and Phase C The patient, blinded to the treatment modalities, provided pain assessments using the Visual Analogue Scale (VAS) and Douleur Neuropathique 4 Questions (DN4) conducted by clinical investigators at each phase. Baseline pain scores were ten and nine, respectively. Distinct responses were noted across the phases. Phase A demonstrated moderate pain relief, while Phase B offered further pain intensity reduction. However, Phase C, combining both strategies, yielded the most significant improvement, remarkably enhancing the patient's quality of life and functional capacity. This POC trial underscores the synergistic potential of SCS and DRG-S in managing complex cases of PSPS-T2, suggesting a paradigm shift towards integrated neuromodulation strategies for enhanced pain control. The development of dual intent implantable pulse generators (IPGs) capable of offering combination therapy simultaneously might be effective for pain management in select cases. The significant pain reduction and functional improvement observed advocate for further research in dual neuromodulation therapies. IRB 20190536.

Myofascial release for adults with chronic neck pain and depression

BackgroundDepression affects a significant portion of the global adult population, with chronic pain patients being particularly susceptible to severe depression. Pain and mental illness contribute to an imbalance in the autonomic nervous system, affecting heart function. Myofascial release promises to improve mental and physical health by addressing fascial dysfunctions. ObjectiveThis study aims to investigate the influence of myofascial release on emotional states and autonomic nervous system functioning in individuals with chronic neck pain and depression. Additionally, it seeks to evaluate the myofascial release effect on fascial properties, pain intensity and sensitivity, and cervical spine range of motion. MethodExperimental Study. ResultThe study revealed significant enhancements in the myofascial release group, such as a substantial reduction in pain perception and stiffness, increased range of motion of the cervical spine, heart rate variability, positive affect, and pressure pain threshold. The effect sizes of these improvements ranged from small to large. No significant differences were observed in elasticity and tone. ConclusionThe findings suggest that myofascial release has a positive impact on individuals with chronic neck pain and depression, particularly in reducing pain intensity. Integrating myofascial release into treatment approaches may be beneficial. However, further research is needed to confirm and expand upon these findings, explore long-term effects, and better understand the clinical significance of certain outcomes. Trial registrationhttp://www.osf.io, doi.org/10.17605/OSF.IO/6F5RS

Network Meta-analysis and Economic Evaluation of Neurostimulation Interventions for Chronic Nonsurgical Refractory Back Pain.

Different types of spinal cord stimulation (SCS) have been evaluated for the management of chronic nonsurgical refractory back pain (NSRBP). A direct comparison between the different types of SCS or between closed-loop SCS with conventional medical management (CMM) for patients with NSRBP has not been previously conducted, and therefore, their relative effectiveness and cost-effectiveness remain unknown. The aim of this study was to perform a systematic review, network meta-analysis (NMA) and economic evaluation of closed-loop SCS compared with fixed-output SCS and CMM for patients with NSRBP. Databases were searched to September 8, 2023. Randomized controlled trials of SCS for NSRBP were included. The results of the studies were combined using fixed-effect NMA models. A cost-utility analysis was performed from the perspective of the UK National Health Service with results reported as incremental cost per quality-adjusted life-year (QALY). Closed-loop SCS resulted in statistically and clinically significant reductions in pain intensity (mean difference [MD] 32.72 [95% CrI 15.69-49.78]) and improvements in secondary outcomes (Oswestry Disability Index [ODI] and health-related quality of life [HRQoL]) compared with fixed-output SCS at 6-month follow-up. Compared with CMM, both closed-loop and fixed-output SCS resulted in statistically and clinically significant reductions in pain intensity (closed-loop SCS vs. CMM MD 101.58 [95% CrI 83.73-119.48]; fixed-output SCS versus CMM MD 68.86 [95% CrI 63.43-74.31]) and improvements in secondary outcomes (ODI and HRQoL). Cost-utility analysis showed that closed-loop SCS dominates fixed-output SCS and CMM, and fixed-output SCS also dominates CMM. Current evidence showed that closed-loop and fixed-output SCS provide more benefits and cost-savings compared with CMM for patients with NSRBP.

Effects of an eight-week physical exercise program on low back pain and function in fruit workers: A randomized controlled trial.

Low back pain is prevalent in workers' health and functional performance. To evaluate the effects of a physical exercise program on low back pain and disability in fruit workers. This randomized controlled trial assigned 44workers (37 ± 9years) to two groups. The experimental group consisted of 10men and 12women with an average age of 38 (± 9) years, and the control group consisted of 8men and 14women with an average age of 36 (± 10) years. The experimental group (EG) performed a program of strength and flexibility exercises for eight weeks, twice a week. The control group (CG) received minimal care, with a booklet with guidelines for performing exercises. The primary outcomes included changes in perceived disability and the intensity of pain evaluated by the Rolland-Morris questionnaire and the Numerical Pain Scale, respectively. All outcomes were measured at baseline and after eight weeks of intervention. A significant difference was observed in the within-group analysis, with a mean reduction in pain intensity in the EG and CG of -4.55 (95%CI -7.01 to -2.09) and -3.81 (95%CI 1.72-5.90), respectively. For disability, a reduction of -4.45 (95% CI -8.89 to -0.02) was observed in the EG and of -4.43 (-7.38 to -1.48) in the CG. There were no significant differences in the between-groups analysis. The exercise program was not superior to using the educational booklet. However, both interventions showed substantial decreases in pain and disability levels.

Effect of acupuncture for temporomandibular disorders: a randomized clinical trial.

Temporomandibular disorders (TMD) is the leading cause of pain and disability among frequently occurring facial pain and the second leading cause of musculoskeletal conditions. We examined whether acupuncture could alleviate pain intensity in patients with temporomandibular disorders (TMD). Sixty participants with TMD were randomly assigned (ratio 1:1) to receive three acupuncture or sham acupuncture sessions weekly for 4 weeks. The primary outcome was the change in the mean weekly pain intensity from baseline to week 4. Secondary and exploratory outcomes included proportion of participants with ≥30% or ≥ 50% reduction in pain intensity, change in jaw opening and movement, graded chronic pain scale, jaw functional limitations scale-20-item, Depression, Anxiety and Stress Scales-21, Pittsburgh sleep quality index at week 4 and 8, and the pressure pain threshold and surface electromyography at week 4. The acupuncture group showed significantly reduced pain intensity compared to the sham group at week 4 (-1.49, 95% confidence interval [CI]: -2.32 to -0.65; P < 0.001) and week 8 (-1.23, 95% CI: -2.11 to -0.54; P = 0.001). Acupuncture's effectiveness surpassed sham's at 4 weeks and lasted 8 weeks. Participants in the acupuncture group experienced significantly greater improvements in the 30% and 50% response rate, jaw opening and movement, GCPS, JFLS-20, DASS-21 and PSQI than those in the sham acupuncture group. There were no significant between-group differences in PPT and sEMG. In summary, acupuncture provided marked pain relief and improvement in physical and emotional function for patients with TMD compared with sham acupuncture.

PENGARUH TEKNIK RELAKSASI FINGER HOLD TERHADAP INTENSITAS NYERI PADA PASIEN POST OPERASI SECTIO CAESAREA DI RUANG BERSALIN RSU LATERSIA BINJAI

Sectio Caesarea is a way of giving birth to a fetus by making an incision in the uterine wall through the front wall of the abdomen. WHO in 2016 set the average standard for sectio caesarea in a country to be 5-15% per 1000 births in the world. Latin America and the Caribbean region contributed the highest caesarean method rates, namely 40.5%, followed by Europe 25%, Great Britain 20%, Asia 19.2%, Africa 7.3%, Indonesia 15.3% above the standard issued by WHO. At Latersia Hospital, the number of sectio caesarea deliveries in 2022 was 1058 cases. The purpose of this study was to identify the effect of the finger hold relaxation technique on pain intensity in postoperative sectio caesarea patients in the delivery room of RSU Latersiain 2023.This research is a quantitative research with a quasi-experimental research design with a one group pretest- posttest design without a control group. The sampling technique uses probability sampling which is taken by purposive sampling with a total sample of 46 respondents.The results of the wilcoxon showed that there was an effect of the finger hold relaxation technique on reducing pain intensity in postoperative sectio caesarea patients (p value = 0.000 &lt;0.05). Most of the respondents had a moderate pain scale before the finger hold relaxation technique was carried out, and most had a mild pain scale after the finger hold relaxation technique was carried out, so it can be concluded that the finger hold relaxation technique is effective for reducing pain in postoperative sectio caesarea patients in the delivery room of RSU Latersia2023.

Effects of Virtual Reality on Analgesia in Wound Care and Physical Therapy for Burn Patients: A Systematic Review and Meta-analysis

ObjectivesThis systematic review and meta-analysis aimed to determine the effectiveness of virtual reality (VR) in alleviating pain and improving the experience of burn patients during wound care and physical therapy. DesignA systematic review and meta-analysis. Data SourcesPubMed, Embase, the Cochrane Database, and the Web of Science. Review/Analysis MethodsWe searched four electronic databases for randomized controlled trials (RCTs) published from the earliest available date up to March 1, 2022. The primary outcome was worst pain intensity, while secondary outcomes encompassed pain unpleasantness intensity, time spent thinking about pain, and fun experience intensity. Risk of bias was evaluated using the Cochrane Collaboration's tool. ResultsThis study included 21 trials. The combined data revealed that the VR group experienced a significant reduction in worst pain intensity, pain unpleasantness intensity, and time spent thinking about pain compared to the control group. Moreover, VR treatment was associated with a significant increase in the fun experience intensity. Implications for nursingVirtual reality has the potential value of auxiliary analgesia in burn care, and exploring a more perfect scheme of VR-assisted analgesia is worthwhile. ConclusionsThe results of this meta-analysis indicate that VR can effectively reduce worst pain intensity, pain unpleasantness intensity, and time spent thinking about pain during wound care and physical therapy for burn patients. Additionally, it enhances fun experience intensity of the treatment period. Therefore, VR shows promise as a valuable complementary pain management intervention for burn patients.

EFFICACY, FEASIBILITY AND OPTIMAL TRAINING PARAMETERS FOR RUNNING IN ADULTS WITH CHRONIC LOW BACK PAIN: THE ASTEROID RANDOMISED CONTROLLED TRIAL

INTRODUCTION &amp; AIMS Running is common and one of the most accessible forms of exercise training, yet the suitability for adults with chronic low back pain is unknown. This study assessed the efficacy and feasibility of running in adults with chronic low back pain (LBP) and explored the relationship between training parameters and pain intensity. METHODS This two-arm parallel (1:1) individually randomised controlled trial allocated 40 participants (mean [SD] age: 33 [6] years, female: 50%) with non-specific chronic LBP to a 12-week intervention or waitlist control. The intervention was a progressive run-walk interval program comprising three 30-minute sessions per week, that were digitally delivered and remotely supported by an exercise physiologist. Efficacy outcomes were self-reported average and current pain intensity (100-point visual analogue scale) and disability (100-point Oswestry Disability Index). Training parameters examined were fortnightly adherence, pace and distance. RESULTS At 12-week follow-up, the intervention decreased average pain intensity (mean net difference [95%CI]: -15.30 [-25.33, -5.27] points, P=0.003), current pain intensity (-19.35 [32.01, -6.69] points, P=0.003) and disability (-5.20 [-10.12, -0.24] points, P=0.038), compared to control. There was no attrition and mean (SD) training adherence was 70% (20%; i.e. 2.1 of 3 sessions per week). Nine non-serious adverse events deemed potentially study-related were reported (lower limb injury/pain: n=7, cardiac syncope associated with an underlying condition: n=1, LBP: n=1). Greater fortnightly adherence (-0.04 [-0.33, 0.25] points), pace (0.23 [-0.48, 0.02] points) and distance (-0.03 [-0.13, 0.06] points) tended to be associated with greater reductions in pain intensity, yet did not reach statistical significance. CONCLUSION Running was feasible and improved pain intensity and disability in individuals aged 18-45 years with non-specific chronic LBP when compared to control. An individualised and conservative run-walk program should be considered a suitable form of physical activity for adults with chronic LBP.

EXERCISE PHYSIOLOGIST-LED PAIN SCIENCE COACHING VIA TELEHEALTH IMPROVED PAIN AND FUNCTION IN LIFE INSURANCE CLAIMANTS: A PRAGMATIC COHORT STUDY

INTRODUCTION &amp; AIMS Personal injury and illness compensation claimants are more likely to experience persistent pain and poorer clinical/vocational outcomes than non-compensated clients. Evidence supports the effectiveness of pain science coaching to help people understand and re-train their pain system. This consequently reduces pain intensity, improves function and quality of life. However, the effectiveness of telehealth-delivered, exercise physiologist-led pain science coaching is yet to be evaluated. This study aimed to determine the effectiveness of an accredited exercise physiologist-led pain science coaching intervention via telehealth in Australian life insurance claimants. METHODS This pragmatic cohort study included 1,275 claimants receiving a pain science coaching intervention supported by life insurance compensation. Ethics was approved via Deakin University Human Research Ethics Committee (2023-347). Outcome measures were pain intensity (11 item numerical pain rating scale, range: 0-10 points) and function (two 11-item patient-specific functional scale, range: 0-20 points). Linear mixed models determined within-group change over time. RESULTS Clients (female: 75%, male: 25%) had a mean (SD) age of 50 (10) years (range: 20-69 years) and claim duration of 2 (2) years (range: 0-20 years). Mean (SD) intervention duration was 10 (6) weeks (range: 3-41 weeks), financial cost was A$1,149 (A$202; range: A$510-A$2,040) and included 5 (1) hours (range: 2-11 hours) of pain science coaching. Following the intervention, pain intensity decreased 25% (estimated marginal mean change [95%CI]: -1.49 [-1.59, -1.40] points, P&amp;lt;0.001) and function increased 76% (4.41 [4.21, 4.62] points, P&amp;lt;0.001). Changes surpassed established clinically meaningful effect thresholds for pain intensity (1.17 points) and function (2.6 points). Client Net Promotor Score was +60 (Australian Healthcare Index benchmark ≥ +30) and 91% were satisfied with the intervention. CONCLUSION An exercise physiologist-led pain science coaching intervention resulted in clinically meaningful improvements in pain intensity and function in compensation claimants. Clients reported high satisfaction rates.

THE EFFECT OF DEEP BREATHING AND MASSAGE RELAXATION TECHNIQUES ON REDUCING THE SCALE OF PAIN IN HERNIOTOMY PATIENTS

Herniotomyis a surgery performed to free the hernia sac up to the neck, so that adhesions do not occur and then it is repositioned. The hernia sac is stitched, tied as high as possible and then cut. The patient will always experience pain after surgery on day 1. Deep breathing and massage relaxation techniques are one of the non-pharmacological pain management methods to reduce pain. this research aims todetermine the effect of deep breathing relaxation techniques and massage on reducing the pain scale in herniotomy patients. This research uses a literature review by searching articles on the Google Scholar electronic database. Several articles were found in the Google Scholar search database, but only 8 articles met all the inclusion criteria and were reviewed. Results: pain in post-operative patients often occurs, there are many non-pharmacological techniques to treat pain, one of which is the deep breathing technique. Conclusion: The conclusion of the 8 journals studied is that deep breathing relaxation therapy is very influential in reducing pain intensity in postoperative patients if done correctly and continuously.

ECAP-controlled closed-loop versus open-loop SCS for the treatment of chronic pain: 36-month results of the EVOKE blinded randomized clinical trial

IntroductionThe evidence for spinal cord stimulation (SCS) has been criticized for the absence of blinded, parallel randomized controlled trials (RCTs) and limited evaluations of the long-term effects of SCS in...

CAN AN INTERVAL-BASED RUNNING EXERCISE INTERVENTION IMPROVE LUMBAR INTERVERTEBRAL DISC HEALTH? THE ASTEROID RANDOMISED CONTROL TRIAL

BACKGROUND AND AIMS Low back pain is the leading cause of global disability, with lumbar disc pathologies estimated to contribute to up to 40% of cases. Exercise training is an established treatment to reduce pain intensity and disability in individuals with low back pain; however, the effect of exercise training on intervertebral discs is unknown. Cross-sectional studies have shown that endurance running (&amp;gt;50km per week) is associated with healthier intervertebral discs, as evidenced by greater T2-relaxation (hydration) and intervertebral disc height. However, no studies have explored the relationship between running and disc health prospectively. This study aims to examine the impact of a 12-week progressive run-walk exercise intervention on intervertebral disc health in individuals with chronic low back pain. METHODS Forty individuals with non-specific low back pain were enrolled in a 12-week parallel randomised control trial and allocated to either a digitally-delivered progressive run-walk interval exercise intervention (supervised by an accredited exercise physiologist) or waitlist control. All participants underwent magnetic resonance imaging at baseline, 6 and 12 weeks to examine intervertebral disc health (e.g. T2-relaxation, intervertebral disc height, Pfirrmann grade). RESULTS Thirty-nine participants (20 intervention and 19 waitlist control; mean [SD] age: 33 [6] years, female: 50%) underwent MRI at baseline, 6 and 12 weeks. At baseline, intervertebral disc outcomes were no different in either group (T2-relaxation[ms] mean[SD]:81.07[6.61] and 85.11[9.33]; p=0.939, height[mm] mean[SD]: 8.77[0.87] and 9.03[0.90]; p=0.819, respectively). Six and 12-week outcomes are currently being analysed and results will be available for presentation at the conference. CONCLUSION This randomised control trial will provide world-first evidence on the effects of a progressive run-walk exercise intervention on lumbar intervertebral disc health in adults with non-specific chronic low back pain. Should this intervention prove effective, findings will have marked implications for current guidelines and clinical management of this debilitating chronic condition.

The Effect Of Quadricepts Strengthening Exercise On Increasing Muscle Strength And Decreasing Pain Intensity In Genu Osteoarthritis Patients At Bhayangkara Kediri Hospital

Osteoarthritis is a joint deformity, often found in progressive degeneration of the articular cartilage, resulting in loss of joint space. Genu osteoarthritis patients complain of pain, limited movement, and a decrease in their functional activities. Patients with severe complaints use mobility aids for walking activities. This research uses a quasiexperimental design with one group pre and post test design approach. The sample for this research was 30 respondents. The sampling technique for this research is purposive sampling, which is a sample selection technique by selecting samples among a number of populations that are in accordance with what the researcher desires. There is an effect of quadriceps strengthening exercise on increasing muscle strength and reducing pain intensity in osteoarthritis genu patients at Bhayangkara Kediri Hospital in 2023. The average muscle strength of genu osteoarthritis patients before quadriceps strengthening exercise was 3.533 and the average pain intensity of genu osteoarthritis patients before quadriceps strengthening exercise was 4.8. The average muscle strength of genu osteoarthritis patients after quadriceps strengthening exercise was 4.6 and the average pain intensity of genu osteoarthritis patients after quadriceps strengthening exercise was 3.05. There is an effect of quadriceps strengthening exercise on increasing muscle strength with P-value 0,000&lt;0,05 and effect of quadriceps strengthening exercise on reducing pain intensity in osteoarthritis genu patients signification p value 0,000&lt;0,05.

The Effect of Foot Massage on Comfort and Pain Intensity After Vaginal Delivery

Childbirth is a mother's subjective experience that is very memorable in her life. It is important to maintain maternal comfort so that the process of adapting to motherhood can run well. Pain during postpartum is one of the factors that prevents mothers from having difficulty adapting during the postpartum period, especially in primapara mothers. A pharmacological method that can be given to increase comfort and reduce the intensity of pain is foot massage. The aim of this study was to determine the effect of foot massage on the comfort and intensity of maternal pain after vaginal delivery during the postpartum period. This type of quasi-experimental research sample consisted of 38 respondents and the sampling technique used simple random sampling. This research was conducted at the Independent Early Midwife Practice in Lubuk Pakam. Respondents consisted of 2 groups, namely the intervention group and the control group. The instruments used were questionnaires, Visual Analog Scale (VAS), Post Partum Comfort Scale (PCS). Data analysis used chi-square/Fisher's exact test, independent-samples t test and one-way analysis of variance (ANOVA). The mean maternal comfort score in the intervention group was higher than the control group (143.45 ± 8.96, 119.00 ± 14.65, respectively) with a value of p = 0.000. The mean pain score in the intervention group was lower than the control group (1.36 ± 1.22, 4.95 ± 2.27) and the p value = 0.000. Foot massage is effective in increasing comfort and reducing the intensity of pain after vaginal delivery. The increase in maternal comfort after intervention was 18.34% and the reduction in pain intensity after vaginal delivery was 73%. In this way, midwives can apply foot massage to every mother after vaginal delivery.

EXPLORING AYURVEDIC APPROACHES TO LOW BACK PAIN: A COMPREHENSIVE REVIEW

Introduction:Low back pain (LBP) is a common musculoskeletal disorder affecting individuals worldwide, causing significant disability and healthcare burden. While conventional treatments focus on symptomatic relief, Ayurveda, the ancient Indian system of medicine, offers a holistic approach that addresses the root cause of LBP. This comprehensive review aims to explore Ayurvedic perspectives, diagnostic methods, therapeutic interventions, and herbal formulations for managing LBP. Ayurvedic Perspective:Ayurveda views LBP as a manifestation of imbalances in the Tridosha (Vata, Pitta, and Kapha) and the Saptadhatus (seven body tissues). Vata dosha vitiation is predominantly implicated in LBP, leading to symptoms such as stiffness, spasms, and radiating pain. Pitta and Kapha imbalances may exacerbate inflammation and structural degeneration, respectively. Ayurvedic diagnosis of LBP involves assessing the individuals Prakriti (constitutional type), Vikriti (current imbalance), Agni (digestive fire), and Srotas (channels of circulation). Diagnostic Methods:Ayurvedic physicians employ a combination of clinical examination, palpation, and pulse diagnosis (Nadi Pariksha) to assess the underlying doshic imbalances and identify the specific etiology of LBP. Various factors such as lifestyle habits, occupation, dietary patterns, and psychological stressors are taken into account during the assessment. Therapeutic Interventions:Ayurvedic management of LBP is multifaceted, aiming to alleviate pain, reduce inflammation, restore musculoskeletal integrity, and prevent recurrence. Therapeutic interventions include: Panchakarma: Detoxification therapies such as Basti (medicated enema), Abhyanga (oil massage), and Swedana (herbal steam therapy) are utilized to eliminate ama (toxins) and pacify aggravated doshas. Ayurvedic Medications: Herbal formulations containing anti-inflammatory, analgesic, and muscle-relaxant herbs like Ashwagandha (Withania somnifera), Guggulu (Commiphora wightii), and Shallaki (Boswellia serrata) are prescribed to manage pain and inflammation. Yoga and Pranayama: Specific yoga asanas (postures) and pranayama (breathing exercises) are recommended to improve flexibility, strengthen the back muscles, and enhance prana (vital energy) flow to the affected area. Dietary Modifications: Dietary recommendations include consuming warm, light, and easily digestible foods, emphasizing anti-inflammatory spices like turmeric, ginger, and cinnamon, and avoiding cold, heavy, and processed foods that may aggravate Vata dosha. Lifestyle Management: Adopting a balanced daily routine (Dinacharya), practicing stress-reduction techniques such as meditation and mindfulness, and maintaining proper posture and ergonomics are crucial for long-term management of LBP. Clinical Evidence:Several clinical studies have investigated the efficacy of Ayurvedic interventions in LBP management. A randomized controlled trial comparing Ayurvedic treatment with conventional therapy demonstrated significant improvements in pain relief, functional disability, and quality of life among participants receiving Ayurvedic intervention. Furthermore, observational studies have reported favorable outcomes with Panchakarma therapies and herbal formulations in reducing pain intensity and enhancing mobility in patients with chronic LBP. Safety and Considerations:While Ayurvedic interventions are generally considered safe when administered under the guidance of a qualified practitioner, certain precautions should be observed. Individualized treatment plans based on the patients constitution, doshic imbalance, and overall health status are essential to optimize therapeutic outcomes and minimize potential adverse effects. Additionally, close monitoring and periodic reassessment are necessary to track progress and adjust treatment as needed. Conclusion:Ayurveda offers a holistic and individualized approach to managing low back pain, addressing not only the symptoms but also the underlying imbalances contributing to the condition. By incorporating Panchakarma therapies, herbal formulations, dietary modifications, and lifestyle interventions, Ayurvedic treatment aims to restore harmony within the body, promote self-healing, and prevent recurrence of LBP. Further research and collaboration between Ayurvedic and conventional healthcare systems are warranted to validate the efficacy and safety of Ayurvedic interventions and enhance their integration into mainstream healthcare for comprehensive LBP management.

The impact of laparoscopic surgery on postoperative pain: A prospective study

Introduction: The reduction of postoperative pain intensity is recognized as one of the major advantages of laparoscopic surgery. However, even though this pain is of low intensity, it is not completely abolished after laparoscopic surgery, and may even be multifactorial in origin. The objective of our study is to evaluate pain after laparoscopic surgery and to highlight the various causes of pain. Materials and Methods: This is a descriptive and prospective study involving 337 patients undergoing laparoscopic surgery for non-traumatic acute abdominal emergencies between February 2018 and October 2021. Pain was assessed using the visual analog scale (VAS). Results: Postoperative pain was present in 335 patients (99.4%) on postoperative day 0 and in 283 patients (83.98%) on postoperative day 1. This pain was of low intensity in the majority of cases (73%, n=246 patients) on postoperative day 0 and (68.5%, n=231 patients) on postoperative day 1. Surgical site pain was present in 134 cases (39.77%), pain related to delayed intestinal transit in 52 cases (15.43%), shoulder pain related to CO2 in 40 cases (11.87%), and a combination of different types of pain was found in 16.7% of patients. Conclusion: Post-laparoscopic surgery pain is multifactorial, of low intensity, and easily managed with first-tier analgesics.

A Pilot Study of the Clinical Effectiveness of a Single Intra-Articular Injection of Stanozolol in Canines with Knee Degenerative Joint Disease and Its Correlation with Serum Interleukin-1β Levels.

Stanozolol shows promise as an anabolic and anti-catabolic agent for treating degenerative joint disease (DJD). This study assessed the clinical efficacy of a single intra-articular stanozolol injection in canine knees with DJD and its correlation with serum IL-1β levels. Thirty dogs (n = 30) were divided into a control group (CG, n = 10) and a study group (SG, n = 20) with DJD. Pain levels were assessed using the Brown query, and radiographs were taken at T0 and T3. IL-1β levels were quantified via ELISA. Apart from 2 patients, all showed reduced pain intensity, with 15 patients showing improvement at T1 and 3 patients at T2. A positive correlation (r = 0.84; p < 0.01) was found between pain level and IL-1β in 15 patients. No systemic effects were observed. Most patients (18/20) experienced reduced pain. This pilot study suggests stanozolol's potential in managing DJD in dogs. Further research is warranted to validate these findings and understand stanozolol's mechanism in DJD treatment.