Pain Assessment Scale Research Articles

The Effect of Swing on Stress and Comfort in Premature Newborns: A Randomised Controlled Trial.

The study was conducted to investigate the effect of swing on stress and comfort in premature newborns who could not be reunited with their mothers. The study was conducted in a randomised controlled experimental design. The intervention group included newborns who received swing intervention (n = 64) and the control group included newborns who did not receive swing intervention (n = 64). Research data were collected using Newborn Information Form, Premature Infant Comfort Scale and ALPS neo newborn pain and stress assessment scale. The research data were collected two times, before and after the intervention was completed. Experimental and control groups were similar regarding descriptive characteristics. There was no difference between the groups after the swing intervention (p > 0.05). It was determined that there was no significant difference between the groups in terms of comfort levels before and after the swing intervention (p > 0.05). When the intra-group mean scores were compared, it was determined that the comfort level increased in the intervention group before and after the swing intervention, and there was a significant difference between the mean scores (p = 0.028). It was determined that swing intervention did not affect the stress and comfort level of the newborn.

Reducing children’s anxiety and pain in dental environment using an eye massage device combined with natural sounds—a randomized controlled trial

This study evaluated the efficacy of an eye massage device that uses acupressure points combined with natural sounds to reduce anxiety and pain in children receiving dental anesthesia for the first time. A total of 105 children aged between 8 and 10 years whose dental treatment required inferior alveolar nerve block (IANB) injection participated in this randomized controlled clinical trial. The participants were randomly divided into three groups: Group A: eye massage with natural sounds; Group B: eye massage only; and Group C (control group): traditional behavior management techniques. Anxiety and pain were assessed before, during, and after anesthesia using the Children’s Fear Scale (CFS), Wong-Baker pain rating scale (WBS), the Face-Legs-Activity-Cry-Consolability (FLACC) observational pain assessment scale, and pulse rate as a physiological scale. Anxiety and pain significantly decreased in groups A and B compared with those in the control group (p < 0.05), with group A showing a greater decrease in pulse rate and objective pain assessed during injection via the FLACC scale than group B (p < 0.05); however, no significant difference was noted between groups A and B regarding the data recorded after anesthesia using the WBS and CFS (p > 0.05). Changes in pulse rate and anxiety levels (CFS) measured before and after the procedure in each group revealed a significant decrease in fear and pulse rate in group A and no significant change in group B, whereas group C showed a significant increase in pulse rate and fear at the end of the procedure. Eye massage with natural sounds can effectively alleviate children’s anxiety in the dental setting and reduce pain related to anesthesia, and the combination of these two interventions has the best relaxation effect on children.

Does a Prolonged Sham Theta Burst Stimulation Intervention Regimen Outperform Standard Care in Terms of Functional Recovery and Pain Relief After an Upper Limb Fracture?

In a recent sham-controlled 13-session prolonged continuous theta burst stimulation intervention protocol, recovery from upper limb fracture at both 1 and 3 months was better than anticipated in patients assigned to the sham intervention group. To determine whether potential placebo effect and close patient monitoring affected recovery, the current study aimed to compare clinical outcomes between sham-treated participants who also received standard care with similarly injured patients who only received standard care. Twenty participants with isolated upper limb fractures from the sham group were seen 13 times post-fracture (1 baseline session, 10 treatments, and 2 follow-ups [1 and 3 months]) over 3 months. They completed the self-reported Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire and the Numerical Rating Scale for pain assessment at 1 and 3 months post-fracture. Two control groups were recruited: 43 participants at 1 month post-fracture and another 40 participants at 3 months post-fracture. These control groups completed the same questionnaires online, without any lab visits. At 1 month, patients from the sham group reported significantly less functional impairments on the DASH (p = .010). At 3 months, significantly more patients from the control group reported functional limitations (72.5% versus sham's 40%, p = .015). Although preliminary, these findings suggest clinically significant beneficial effects of the sham intervention over the standard care groups. This positive sham intervention effect may be attributed to a placebo response that includes the placebo effect associated with sham rTMS, but also the impact of various factors such as the close monitoring of the injury.

Validation of the Korean version of Defense and Veterans Pain Rating Scale for assessment of postoperative pain: a prospective observational cohort study.

The Defense and Veterans Pain Rating Scale (DVPRS) is a pain assessment tool combining a numerical rating scale (NRS) with descriptive words, colors, and facial expressions. This study aimed to validate the Korean version of the DVPRS (K-DVPRS) for postoperative pain assessment. This study included patients who underwent elective laparoscopic or robotic abdominal surgery. The original DVPRS was translated into Korean using a forward-backward method. Pain intensities at rest and during coughing were assessed at 24 and 48 hours postoperatively using the NRS and K-DVPRS, respectively. The EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire was also used. The validity, reliability, and responsiveness of the K-DVPRS were evaluated. Of the 174 patients screened, 150 were enrolled, and 148 completed the study. The K-DVPRS had strong convergent validity with the NRS at 24 and 48 hours postoperatively (ρ: 0.75 to 0.78, all P < 0.001). Construct validity was confirmed by significant differences in pain scores based on surgical extent and duration. The internal consistency was acceptable (Cronbach's alpha: 0.77 and 0.85 at 24 and 48 hours, respectively), and test-retest reliability at 24 hours was excellent (intraclass correlation coefficient: 0.90 at rest and 0.95 during coughing). Responsiveness, measured by Cliff's effect size, was high from preoperative to 24 hours postoperatively and moderate from 24 to 48 hours. At 48 hours, the K-DVPRS had stronger correlations with the EQ-5D-5L index and EQVAS than with the NRS. The K-DVPRS is a valid, reliable, and responsive tool for assessing postoperative pain in Korean patients.

CLINICAL EFFICACY OF ERAND SNEHA IN MANAGEMENT OF ACUTE NE-CROTISING PANCREATITIS: A CASE REPORT

Acute pancreatitis with local and systemic complications should be managed through a multi- disciplinary approach. Delays in assessment or mismanagement may lead to serious consequences. The existing treatment of this disease is mollifying and expensive. Cost-effective management of acute necrotizing pancreatitis with Ayurveda medicines within time constraintsand without any complications is encouraging. CASE PRESENTATION: In this case study, a 45-year-old male patient’s diagnosis of pancreatitis was established on the basis of the revised Atlanta classification. As per morphological classification, the patient was of necrotizingpancreatitis and severity grade was moderate as there were local complications. MANAGEMENT AND OUTCOME: The patient was hospitalized and prescribed Murchit Erand Sneha 100ml at 10 pm daily. The result was assessed by applying a numerical pain assessment scale to subjective and objective findings. On the 25th day patient was found free from signs and symptoms. DISCUSSION: In pancreatitis, Srotorodha is an important phenomenon, and Erand Sneha causes Sampraptivighatana by its Srotoshodhana effect. CONCLUSION: Management of acute necrotizing pancreatitis by using Erand Sneha within time constraints and without any complications is encouraging that needs to be further evaluated on a large number of subjects to bring some concrete conclusions and better treatment modality.

Efficacy of Wet Cupping in the Management of Sciatica: A Case Report

Sciatica, a prevalent and debilitating condition, is characterized by radiating pain along the sciatic nerve, often resulting from lumbar disc herniation, spinal stenosis, or degenerative disc disease. In Unani medicine, the condition is referred to as Irq-un-Nasa, considered a subtype of Waja-ul-Mafasil (joint pain). Unani texts attribute the cause of Irq-un-Nasa to the accumulation of morbid humors (khilt) like Khilt-e-Balgham or Khilt-e-Dam, causing inflammation and obstruction in the affected nerves and joints.This study evaluates the effectiveness of Hijama (wet cupping therapy) in treating sciatica through two case reports. Case 1 involves a 38-year-old female with L5-S1 disc herniation and left-sided sciatica, while Case 2 concerns a 42-year-old male with right-sided sciatica due to lumbar spondylosis. Both patients underwent four sessions of Hijama over 28 days. Results were measured using the Visual Analogue Scale (VAS) for pain assessment. These findings indicate that Hijama effectively alleviated sciatica pain in both cases. The therapeutic effect of Hijama is believed to involve neural, haematological, and immune mechanisms, promoting pain relief, blood circulation, and immune modulation. The results suggest Hijama as an effective, low-cost alternative for managing sciatica. Keywords: Irq-un-Nasa, lumbar disc herniation, Low Back Pain, Unani medicine, Hijama, wet cupping therapy.

Paediatric Pain Assessment and Perioperative Pain Management: A Survey of Practice in Teaching Hospitals in the Two Provinces of Pakistan.

To map the practice of paediatric perioperative pain assessment and management among consultant anaesthetists working in teaching institutions in the two provinces of Pakistan. A cross-sectional survey. Place and Duration of the Study: Department of Anaesthesiology, Teaching institutions of Sindh and Khyber Pakhtunkhwa (KPK), Pakistan, from January to October 2022. A questionnaire was designed to determine the participants' practices about perioperative pain assessment and management. It consisted of 26 questions that included participants' demographic data and questions about their paediatric practice. A total of 152 responses were received (response rate 76%). Most participants (n = 84, 55.3%) had a two-year diploma in anaesthesiology, while 38.2% had a four-year diploma. Additionally, 66.4% worked at public sector hospitals and 28.3% at private hospitals. Only 66% of respondents used paediatric pain scales for pain assessment in the recovery rooms. Most participants, 72.2%, had no Paediatric Pain Management Guidelines available at their institution. Only 5% had access to 5 analgaesic medications, while 32% had access to only 2 medications for intraoperative pain management. The practice of anaesthesiologists in these two provinces of Pakistan is highly varied since there is a lack of national guidelines. Paediatric anaesthesia, Acute pain, Pain management, Pain measurement, Paediatric pain assessment, Anaesthesia and analgaesia, Survey and questionnaires.

Local Lidocaine-Prilocaine for Immunisation in Infants.

Introduction: Lidocaine-prilocaine cream effectively reduces vaccination pain, improving vaccination adherence and advocating for its routine use in healthcare settings. Methods: This review used PRISMA guidelines and the PICOT format to structure the analysis. The focus was on paediatric patients aged 0-12 months requiring intramuscular vaccinations, comparing the application of lidocaine-prilocaine cream to other interventions or no treatment. Data sources included MEDLINE, PUBMED, EMBASE, BMC, Research GATE, and Cochrane Library. Studies were selected based on predefined inclusion and exclusion criteria, with data extracted regarding participant demographics, pain assessment scales, and study conclusions. The Cochrane Risk of Bias Tool assessed study quality, while statistical analyses evaluated the effectiveness of the intervention. Results: Fifty studies were identified, with nine ultimately included in the analysis, involving 704 participants. The primary outcome was the effectiveness of lidocaine-prilocaine cream in reducing pain after vaccinations. Results showed a significant mean difference of -1.719 in pain scores for infants treated with lidocaine-prilocaine compared to those receiving other interventions. Behavioural indicators, such as crying duration and latency to the first cry, favoured the lidocaine-prilocaine group. Conclusions: Lidocaine-prilocaine cream effectively reduces vaccination pain, supporting its routine use in healthcare settings. Engaging parents can enhance vaccination adherence. Training healthcare professionals on lidocaine-prilocaine cream application and pain scales is vital for improving patient satisfaction. Further research is needed to evaluate the long-term effects of lidocaine-prilocaine cream on vaccination experiences and infant behavioural health.

Efficacy of topical anesthetics of lidocaine, benzocaine, and EMLA in reducing pain during inferior alveolar nerve block in schoolchildren: a randomized controlled trial

ObjectivesThis study aimed to evaluate the efficacy of 5% EMLA cream and 8% lidocaine gel in reducing pain during inferior alveolar nerve block (IANB) compared with 20% Benzocaine in children aged 6–10 years.Materials and methodsThis was a triple‐blinded, randomized, parallel‐group, active-controlled trial with three arms. 45 children were randomly assigned into 3 groups. Group 1: control group, 20% benzocaine gel (n = 15). Group 2: 8% lidocaine gel (n = 15). Group 3: 5% EMLA cream (n = 15). Each topical anesthetic was applied in an amount of 0.3 mL using a cotton swab for 2 min, followed by IANB administration. The following primary outcome measures were considered: pulse rate, the face, legs, activity, cry, consolability (FLACC) behavioral pain assessment scale, and the Wong-Baker FACES pain rating scale.ResultsThe mean score of the FLACC behavioral pain assessment scale in group 2 (2.20 ± 1.86) was slightly higher, but this result was not statistically significant p = (0.806). Regarding the Wong-Baker FACES pain rating scale scores, no statistically significant difference was noted between the study groups p = (0.593). After IANB administration, the mean pulse rate was higher in group 3 (102.40 ± 14.28). However, this difference was not statistically significant p = (0.351). In addition, the mean change of the pulse rate from the baseline to this time point was not statistically significant p = (0.638), indicating a smaller physiologic response to the painful stimulus.Conclusion8% lidocaine gel was not superior to 20% benzocaine nor 5% EMLA in reducing pain during IANB administration.

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

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. 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). 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. 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.

Original Research: Improving Pain Assessment After Inpatient Orthopedic Surgery: A Comparison of Two Scales.

In pain assessment, the commonly used Numeric Rating Scale (NRS) offers an incremental 0-to-10 range of response options. But this broad range often leads to discordant evaluations between nurses and their patients. This study aimed to compare the NRS to the three-category Interventional Pain Assessment (IPA) scale, validate the IPA scale in an inpatient setting, and determine RN and patient scale preferences. This prospective study enrolled 122 postoperative orthopedic patients and their designated 104 RNs at a level 1 trauma center in the midwestern United States. Patients were asked to verbally rate their pain from 0 to 10 using the NRS and from 0 to 2 on the IPA scale. Patients were also asked which scale best conveyed their pain. The RNs were asked which scale best informed them of their patient's pain situation and which scale they preferred. To establish a correlation between the two scales, we considered NRS values of 0 to 7 (signifying no pain to moderate pain) to correspond to IPA scale values of 0 to 1 (signifying no pain to tolerable pain). NRS values of 8 to 10 (signifying severe pain) were considered to correspond to IPA scale values of 2 (signifying intolerable pain). Responses in which patients reported IPA scores indicating no pain to tolerable pain but NRS scores above 7 or IPA scale scores indicating intolerable pain but NRS scores of 7 or below were defined as discordant answers. Data analysis revealed a strong significant correlation between the NRS and IPA scale (τ = 0.597), with an 82.7% concordance rate. Once an NRS score rose above 7, more discordance between the two scales became increasingly prevalent, as evidenced by the 45% of patients who also reported tolerable pain on the IPA scale. Significantly more patients (89.3%) preferred the IPA scale to communicate their pain level than the NRS (10.7%). Significantly more RNs (76%) felt the IPA scale best informed them of their patient's pain and was a better guide for treatment than felt the NRS did so (24%). The IPA scale asks about pain tolerability and thus has a direct role in the management of pain medications. Both patients and nurses felt they were better able to convey and understand pain when using the IPA scale than when using the NRS. There was consensus regarding pain scale preference among patients and their RNs, with both groups preferring the IPA scale due to its simplicity and, among the RNs, its usefulness in guiding treatment. The IPA scale may be a much better tool for accurately assessing a patient's pain experience and needs, with the potential to change practice and improve pain management.

The Effect of the Parent's Presence during the Dressing Process on the Severity of the Child's Pain

This research was carried out to determine the effect of the parent's presence near the child during the dressing process on the severity of pain caused by the dressing. The sample of the descriptive comparative study consisted of 60 children. Ethics committee and study permission were obtained from the relevant institutions. Data were collected by observation and face-to-face interviews using the “Individual Characteristics Form” and the YBATT (facial expression, legs, activity, crying, and being able to be consoled) pain assessment scale. In the examination of the way parents supported their children during the painful procedure, it was observed that 13 (43.4%) of them used remote monitoring approach. The mean dressing time of the children showed a significant difference according to the parent variable; it was determined that the dressing time of the children with a parent present (7.5 min) was higher than the dressing time of the children without a parent present (6.3 min). In this study, it was seen that the presence of the parent with the child during the dressing did not affect the severity of the pain, the presence of the parent extended the dressing time, and the parents were in the approach of remote monitoring as a way of supporting the child during the procedure.

THE EFFECT OF THE FIRST INTRADETRUSOR BOTULINUM TOXIN INJECTION ON FUNCTIONAL INDEPENDENCE, QUALITY OF LIFE, PAIN AND SPASMS IN INDIVIDUALS WITH SPINAL CORD INJURY

After a spinal cord injury (SCI) practically all patients experience neurogenic bladder dysfunction. The botulinum toxin type A is a procedure for treating urological complications in these patients. The objective this study was to analyze whether individuals with traumatic SCI have improved functionality, quality of life (QoL), pain, and spasms after the first application of intradetrusor botulinum toxin type A. A prospective longitudinal observational study was developed with twenty patients with traumatic SCI followed up in a rehabilitation center. The patients were evaluated before, one and four months after the first application of intradetrusor botulinum toxin type A. The instruments used were: Spinal Cord Independence Measure III (SCIM III) and Qualiveen-SF, to assess functionality and QoL, respectively; Numeric Rating Scale for pain assessment and the Penn Scale to assess the spasms. Descriptive and inferential (p &lt;0.05) statistics were perfomed. Of the patients evaluated, 90% were men, and 80% had paraplegia. In the first month after applying botulinum toxin type A, there was improvement in the domain related to sphincter control of SCIM III (p=0.02). There was no statistically significant difference in the QoL, pain intensity, frequency and severity of spasms before application of botulinum toxin and after 1 and 4 months (p&gt;0.05). The first application of intradetrusor botulinum toxin type A interfered positively functional independence related to sphincter control in the first month after application, but did not influence the pain, spasm and QoL.

Physical Activity Level and Time of Participation in a Water Aerobics Project for the Elderly: Analysis of the Association with Quality of life, Musculoskeletal and Osteoarticular Disorders, Chronic Pain and Body Mass Index

The objective was to analyze the association between the physical activity level (PAL) and time of participation in the practice of water aerobics with the variables successful aging (SA), quality of life (QOL), musculoskeletal and osteoarticular disorders (MOD), chronic pain (CP) and body mass index (BMI). The method has a quantitative, descriptive and cross-sectional design. The non-probabilistic sample, for convenience, comprised 101 elderly people over 60 years of age, of both genders, who regularly participate in water aerobics activities in the city of Dois Irmãos, in the state of Rio Grande do Sul. The following instruments were used: Multidimensional Pain Assessment Scale, EUROHIS-QOL, IPAQ, SOC and Body Mass Index. Descriptive analyses of frequency, comparison, correlation and multiple linear regression were used. The results showed that the irregularly active group has adequate perception of QOL and longer participation in water aerobics activities associated with lower intensity of pain perception. Likewise, better QOL and control attitudes are associated with lower prevalence of MOD.

Assessing pain management in total joint arthroplasty using the Detroit interventional pain assessment scale—A prospective cohort study

BackgroundTotal joint arthroplasty (TJA) is an effective treatment for end-stage osteoarthritis, but postoperative pain has been poorly managed. The purpose of this study was to (1) assess how much narcotic medication was prescribed after TJA; (2) assess if patients were satisfied with their pain management; (3) compare these same data between total hip arthroplasty (THA)/total knee arthroplasty (TKA); (4) compare these same data between preoperative opioid users/opioid-naïve patients.MethodsAn IRB-approved prospective study was conducted at a US academic joint replacement practice. Patients were evaluated by an independent observer at three weeks, three months, and six months postoperatively using the Detroit Interventional Pain Assessment (DIPA) scale. Patients verbally rated their pain with their current medication regimen as 0 (no pain), 1 (tolerable pain), or 2 (intolerable pain) on the DIPA scale. Narcotic usage was verified by the Michigan Automated Prescription System (MAPS). Patients were divided into THA, TKA, previously on opioids, and opioid-naïve groups. Provider efficiency scores reflected pain management satisfaction and were calculated as the percentage of patients reporting no pain or tolerable pain.ResultsOut of 200 patients, the percentage of patients using narcotics and their daily usage (MMEs) significantly decreased from 75.5% (27.5 MMEs) at three weeks to 42.9% (5.3 MMEs) at six months (P < 0.001). In 80% of patients, narcotics taken at six months were prescribed by outside providers. Significantly fewer patients used narcotics at six months for THA (15.4%) compared to TKA (52.7%) (P < 0.021). There was a significant difference in daily narcotic usage between patients who took narcotics preoperatively (22.9 MMEs) and opioid-naïve ones (13.4 MMEs) (P < 0.001). Provider efficiency scores were best at three weeks (76.6%) and three months (70%) but declined at six months (57.2%).ConclusionsNarcotic tapering practices were observed as postoperative daily narcotic intake decreased across six months. However, outside providers prescribed 80% of narcotics at six months, necessitating a better-coordinated practice with surgeons. Patients taking preoperative narcotics experienced higher daily MME requirements than their opioid-naïve counterparts. In terms of the percentage of patients on narcotics, THA is a better procedure for tapering patients off narcotics by six months.

Muscle energy technique versus Maitland’s mobilization on shoulder pain and disability after neck dissection surgeries

Background. A substantial number of patients who undergo various neck dissection procedures experience shoulder dysfunction and pain, which can significantly complicate or disrupt daily routines, social engagements, and overall Quality of Life (QOL). Muscle Energy Techniques (MET) and mobilization have been demonstrated to effectively reduce shoulder pain and disability. Objective. The objective of this study was to examine the therapeutic benefits of MET and mobilization in improving shoulder pain and disability following neck dissection surgeries and compare these two techniques’ efficacies. Design. The present study employed a randomized, single-blind, controlled trial Methods. Thirty patients between the ages of 25 and 70 (13 men and 17 women) with shoulder dysfunction following six months’ post-neck dissection surgeries were enrolled in the study. Patients were equally randomized into two groups of 15per each: Group A received the Muscle Energy Technique (MET), and Group B underwent Maitland’s Mobilization. Both groups participated in identical conventional physiotherapy regimens. Both interventions were administered at a frequency of three sessions per week over four weeks. Visual Analogue Scale (VAS) for pain assessment, Shoulder Pain, and Disability Index (SPADI), in addition to shoulder range of motion (flexion, abduction, and lateral rotation), were measured before and after four weeks of intervention. Results. Following four weeks of intervention, both groups exhibited significant improvements in VAS, SPADI, and shoulder flexion, abduction, and lateral rotation, with p values ≤ 0.001. A comparison between the groups showed a statistically significant difference in all measured outcomes, favoring Group A, with p-values &lt; 0.001. Conclusion. The Muscle Energy Technique (MET) and Maitland’s Mobilization were effective therapeutic strategies for alleviating shoulder pain and disability following neck dissection surgeries. However, the results showed that MET outperformed Maitland’s Mobilization strategies.

Development of the calf grimace scale for pain and stress assessment in castrated Angus beef calves

Grimace scales have been used to assess pain in various animal species. This study aimed to develop the calf grimace scale (CGS), evaluate its responsiveness and the effect of external factors (change of environment and dam separation, and restraint) on CGS. Sixty-nine Angus calves, 6–8 weeks old, were randomly allocated into castrated (n = 34) and sham castrated (n = 35) groups. Images were extracted from videos pre- (M1-M4), during- (M5), and post-castration/sham castration (M6, M7). Six facial action units (FAUs) were identified: ear position, orbital tightening, tension above the eye, nostril dilation, straining of chewing muscle, and mouth opening. Final CGS median scores increased after castration (P < 0.001) for both non-restrained (M7 versus M2) and restrained (M6 versus M3) calves, indicating scale responsiveness. Final CGS median scores increased (P < 0.001) when calves were subjected to external factors before castration (M1 [baseline] versus M2 and M3). However, there was no difference (P > 0.05) in CGS median scores before and after sham castration, regardless of restraint (M3 versus M6, and M2 versus M7), indicating that the external factors may have reached a maximum effect. The CGS is composed of six FAUs, responsive to acute pain and can identify stress unrelated to pain.

Non-steroid anti-inflammatory drugs: recommendations and precautions for safe use in a multidisciplinary surgical department

Aim of the study. Conducting a safety analysis of the use of non-steroidal anti-inflammatory drugs in order to develop informed recommendations and precautions for medical practice.Materials and methods. A retrospective analysis of inpatient medical records of 250 patients in the multidisciplinary surgery department was conducted for the period from December 2023 to February 2024.Results and discussion. Based on the results of the analysis of inpatient medical records, such criteria as the presence of indications for the prescription of non-steroidal anti-inflammatory drugs (according to the diagnosis, clinical pain syndrome and according to pain assessment scales), compliance of the choice of non-steroidal anti-inflammatory drugs with national protocols/international recommendations, compliance with age, the patient's physiological/ pathological condition and allergy history for the prescription of non-steroidal anti-inflammatory drugs were 100%. The indicator for compliance of a single therapeutic dose, route of administration, frequency, duration and an appropriate diluent of non-steroidal anti-inflammatory drugs with instructions for use was 86%, where medication errors were mainly made in the frequency of use of drugs. The percentage of polypharmacy was 20%. The criterion for assessing drug-drug interactions between drugs taken by patients showed that interactions of high clinical significance (major) were 8%, while those of moderate clinical significance (moderate) were 40%.Conclusions. Nonsteroidal anti-inflammatory drugs are convenient and affordable drugs that are widely used in the treatment of diseases of various organs and systems. Therefore, to ensure the rational and safe use of drugs in this group, it is necessary to introduce effective recommendations and precautions:1. Timely completion of pain assessment scales and diary records in the Damumed medical information system;2. Development in the Damumed medical information system of divisions of appointments into planned and pro re nata (as necessary), introduction into the system of accurately recording the time of execution of doctors’ prescriptions by nursing staff for strict compliance with the intervals between doses of non-steroidal anti-inflammatory drugs allowed by the instructions.3. Introduction into the practice of doctors the use of tools to combat polypharmacy in patients ≥65 years old: Beers criteria;4. Conducting educational activities, covering both medical personnel and patients, in order to increase the level of registration of unwanted adverse reactions.

A Comparative Study on the Effectiveness of Rhythmic Stabilization Technique (PNF) and Conventional Physiotherapy in the Treatment of Knee Osteoarthritis

Osteoarthritis (OA) of the knee presents with pain, joint difficulty, reduced range of motion (ROM), and impaired proprioceptive accuracy, impacting the quality of life for affected individuals. Proprioceptive Neuromuscular Facilitation (PNF) stretching techniques have emerged as interventions to address muscle flexibility, pain, and ROM in OA. Recent research has highlighted impaired proprioceptive accuracy as a contributing factor in the onset and progression of knee OA. Rhythmic stabilization, a component of PNF, targets mechanoreceptor stimulation, offering promise in alleviating OA symptoms. This study aimed to compare the effectiveness of rhythmic stabilization PNF with conventional physiotherapy in managing knee OA. Thirty-six participants aged 40-60 were randomly assigned to two groups: Group A received rhythmic stabilization PNF, while Group B received conventional physiotherapy. Outcome measures included the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and visual analog scale (VAS) for pain assessment. Results indicated significant pain reduction, increased flexibility, and improved functional mobility in both groups post-treatment. However, the rhythmic stabilization PNF group demonstrated superior outcomes compared to conventional physiotherapy alone. This suggests that rhythmic stabilization PNF is more effective in reducing pain, enhancing flexibility, and promoting functional independence in Grade 2-3 knee OA. These findings underscore the potential of incorporating rhythmic stabilization PNF into OA management protocols to optimize patient outcomes

Clinical Efficacy of 830 nm LED Photobiomodulation Therapy on Postoperative Blepharoplasty Complications.

Blepharoplasty is the most prevalent cosmetic surgery procedure in Asia. There are three main types of blepharoplasty procedures: incision, threading, and spotting, with incision being the most common procedure. However, after incisional surgery, patients experience prolonged periorbital swelling, bruising, and scarring. In order to help patient reduce periorbital swelling and erythema and ease the discomfort. In this research, the authors introduce a photobiomodulation therapy and to investigate the efficacy and safety of 830 nm light-emitting diode (LED) phototherapy in improving complications after incisional blepharoplasty. Participants were randomly assigned 830 nm LED phototherapy (novel care model) or traditional care model for postoperative care. The efficacy of different care measures on postoperative complications after incisional blepharoplasty was assessed using swelling score, pain score (VAS), wound healing grading, and anxiety scale (SAS). A total of 145 patients were included, including 73 in the novel care model group and 72 in the traditional care model group. The new care model based on 830 nm LED phototherapy could significantly improve the swelling, pain, wound healing, and anxiety self-assessment scale assessment of the patients compared with the traditional care model, and the difference was statistically significant (P<0.05). Photobiomodulation using 830 nm LED can markedly reduce postoperative swelling and pain, promote effective wound healing, lessen postoperative patient anxiety, and have no negative side effects. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .