Significant Difference In Pain Research Articles

Intermittent vibrational stimulation enhances mobility during stair navigation in patients with knee pain

BackgroundReduced quadriceps function and proprioception can cause decreased mobility during stair navigation in patients with knee pain. Patients can benefit from interventions to mitigate pain and restore quadriceps function. Activating the somatosensory system via intermittent vibrational stimulation has the potential to improve stair navigation mobility in patients with knee pain by moderating quadriceps inhibition and enhancing proprioception. Research questionWhat are the effects of intermittent vibrational stimulus synchronized to stair ambulation on muscle activity, kinematics, kinetics, and pain using a randomized controlled clinical trial design. MethodsThirty-eight patients with knee pain were enrolled into a blinded cross-over study, and twenty-nine patients completed all assessments and analyses. Subjects were randomly assigned sequentially to both an active Treatment A (active) and passive Treatment B (passive) worn at the knee during ambulation for 4 weeks with a 2-week washout period between treatments. ResultsKnee pain during stair navigation was significantly reduced only with Treatment A (P = 0.007). During ascent, Treatment A (active) significantly increased vastus lateralis activation (P = 0.01), increased knee flexion moment (P = 0.04) and decreased trunk flexion angles (P = 0.015) between baseline and 4-week follow-up. After using passive Treatment B, there were no significant differences in pain (P = 0.19), knee flexion moment (P = 0.09), and trunk flexion angles (P = 0.23). Changes in muscle function correlated significantly with changes in knee flexion moment and trunk flexion with Treatment A (P < 0.015).Descending differed from ascending in response to Treatment A with significantly decreased knee flexion moment(P = 0.04), hip(P = 0.02) and ankle(P = 0.04) flexion angles. Treatment B significantly reduced hip flexion angles (P = 0.005) but not knee flexion moment (P = 0.85). SignificanceThe results of this study suggest that intermittent vibration can improve joint motion and loading during stair navigation by enhancing quadriceps function during stair ascent and improving movement control during stair descent by modifying an adaptive flexed movement pattern in the lower limb.

A surgeon’s dilemma: Evidence based selection of suturing technique to minimize post-operative complications following lower third molar surgical extraction

Background&#x0D; Lower third molar extraction is usually associated with multiple stigmae that deters the patients in most cases to postpone or not seek appropriate surgical care. It is also one of the most feared procedure amongst dentists and dental students. However, evidence has been reported suggesting that the choice of suturing technique can have a profound effect on post-operation complications and thereby can improve the overall outlook and comfort of the patient. In the past, multiple techniques like Mattress, Continuous etc have been compared with tissue glues, staples however, a comparative clinical study amongst the simplest and most commonly used suturing techniques have not been reported.&#x0D; Material and Methods&#x0D; Sixty patients with impacted mandibular third molars fulfilled the inclusion criteria and were randomly divided into three groups of 20 each. All patients underwent third molar extraction and sutures were placed using different techniques – Simple Interrupted (Group A), Continuous (Group B) and Figure of eight (Group C). Patients were evaluated pre-operatively as well post-operatively (at different time points) for five parameters - Pain, Swelling, Trismus, Periodontal health of second molar and Wound infection. Kruskal-Wallis (non-parametric ANOVA) with post-hoc and effect size was used for statistical analysis with P &lt; 0.05 as statistically significant.&#x0D; Results&#x0D; Statistically significant differences were obtained in terms of pain and trismus between Groups A and C post-operatively (P &lt; 0.05). There were also significant differences in pain between Groups B and C post-surgery (P &lt; 0.05). No significant differences were found between groups for swelling, periodontal health of second molar and wound infection.&#x0D; Conclusions&#x0D; Figure of eight suturing presents with better patient outlook and is associated with lower pain, swelling and trismus. Continuous and simple interrupted suturing can be preferred as second-in-line techniques. Final choice of technique shall be made based on wound anatomy, patient history and surgeon’s expertise.

Superior Capsular Reconstruction of the Shoulder Using the Long Head of the Biceps Tendon: A Systematic Review of Surgical Techniques and Clinical Outcomes.

Background and Objectives: Superior capsular reconstruction (SCR) with the use of a fascia lata autograft or a dermal allograft is an established treatment in treating irreparable rotator cuff (RC) tears. The long head of the biceps tendon (LHBT) has been recently proposed as an alternative graft for SCR. The purpose of this study was to present the surgical techniques and clinical studies utilizing the LHBT for SCR. Material and Methods: Medline, Scopus, and the Cochrane library were searched for relevant studies up to December 2020. The primary outcomes were pain intensity improvement and the incidence of RC and LHBT graft retears. Secondary outcomes were functional scores and acromiohumeral distance (AHD) improvements. Results: Nine studies described surgical techniques of SCR using the LHBT, and four clinical studies reported the outcomes of the technique. The mean pain intensity improved from 4.9 ± 2.3 to 1.6 ± 1.5 in terms of the visual analog scale, exceeding the minimum clinically important difference for adequate pain relief. Significant improvements were also noted in functional scores and AHD. When compared with other repair techniques for massive RC tears, i.e., the double-row repair, the transosseous-equivalent technique with absorbable patch reinforcement, and the traditional SCR with a fascia lata autograft, there were no significant differences in pain and function improvements. Conclusion: SCR using the LHBT is a useful treatment option for massive RC tears; it is equally effective with the traditional SCR and other established techniques. It presents numerous advantages being a safe, easy, time-saving, and cost-effective method. The only precondition for the technique is the presence of an intact LHBT. Additional clinical trials are necessary to determine which treatment is superior for treating massive RC tears, as well as to evaluate the long-term results of the technique.

Support for osteopathic manipulative treatment inclusion in chronic pain management guidelines: a narrative review.

Osteopathic manipulative treatment (OMT) is used to treat chronic pain conditions. However, few guidelines focusing on chronic pain management include recommendations for OMT. To evaluate previous literature on the use of OMT for improving chronic pain. A literature search was conducted on MEDLINE/PubMed and ScienceDirect on August 26-27, 2019, using theterms "osteopathic," "chronic," and "pain," yielding a total of 312 MEDLINE/PubMed articles and 515 ScienceDirect articles. Eligibility criteria required that studies investigate pain, functional status, or medication usage through an experimental design, focusing on human subjects with chronic pain who had various forms of OMTadministered by osteopathically trained individuals in which the comparator group received no intervention, asham or placebo, or conventional care. Three authors independently performed literature searches and methodically settled disagreements over article selection. In the 22 articles included in our study that examined OMT use in chronic pain conditions, we evaluated primary outcomes of pain (22; 100%) and functional status (20; 90.9%), and the secondary outcome of medication usage (3; 13.6%). The majority of articles showed that OMTresulted in a significant decrease in pain levels as compared to baseline pain levels or the control group (20;90.9%) and that OMT resulted in an improvement in functional status (17; 77.3%). In articles that did not find a significant difference in pain (2; 9.1%) or functional status (3;13.6%), there were overall outcomes improvements noted. All articles that investigated medication usage (3;13.6%) showed that OMT was effective in decreasing patients' medication usage. Our study was limited by its small sample size and multimodal comparator group exclusion. OMT provides an evidence-based management option to reduce pain levels, improve functional status, and decrease medication usage in chronic pain conditions, especially low back pain (LBP). Pain management guidelines should include OMT as a resource to alleviate chronic pain.

Cyanoacrylate Glue Versus Absorbable Tacks in Mesh Fixation for Laparoscopic Extraperitoneal Inguinal Hernia Repair: A Randomized Controlled Trial.

Cyanoacrylate glue (Glubran 2) is a synthetic adhesive mesh fixation material. Its utility is being evaluated in laparoscopic total extraperitoneal (TEP) inguinal hernia repair (IHR). A multicentre randomized controlled trial was performed comparing Glubran 2 to standard of care absorbable tacks, particularly assessing chronic postoperative inguinal pain and its effects. Patients undergoing elective TEP IHR at 2 centers from 2017 to 2019 were randomly assigned to Glubran 2 or absorbable tack mesh fixation, and followed for 6 months. All other aspects of surgery and aftercare remained the same. Surgeons documented operative and fixation time, and the placement of fixation on standardized diagrams. Via a questionnaire, aspects of inguinal pain were evaluated before surgery, and at various time-points postoperatively over 6 months. Postoperative clinical factors were also collected. A total of 106 operative sides were randomized to either glue (51) or tack (55) mesh fixation over a 14-month period. Similar median operative times between tack (83.0 min) and glue fixation (75.0 min) were observed. There were no significant surgical complications or observed hernia recurrences in either group. There was no significant difference in pain scores between the 2 groups at all time-points after analysis through mixed effects modeling. Temporal pain profiles over time were also similar. Totally, 55% of patients in the glue group had returned to work within 2 weeks of surgery. There was no increase in complications or pain scores despite regular lateral fixation of glue in these patients. Adding to known data, we observed no significant difference in postoperative pain, demonstrating that cyanoacrylate glue is a viable and safe alternative fixation method to absorbable tacks in laparoscopic TEP IHR. As secondary outcomes, cyanoacrylate glue permits some patients to return to work early, and we observed regular lateral mesh glue fixation without increased pain or complications.

A prospective double-blind randomized trial on ultrasound-guided versus blind intra-articular corticosteroid injections for primary frozen shoulder.

Ultrasound (US)-guided injections are widely used in patients with conditions of the shoulder in order to improve their accuracy. However, the clinical efficacy of US-guided injections compared with blind injections remains controversial. The aim of this study was to compare the accuracy and efficacy of US-guided compared with blind corticosteroid injections into the glenohumeral joint in patients with primary frozen shoulder (FS). Intra-articular corticosteroid injections were administered to 90 patients primary FS, who were randomly assigned to either an US-guided (n = 45) or a blind technique (n = 45), by a shoulder specialist. Immediately after injection, fluoroscopic images were obtained to assess the accuracy of the injection. The outcome was assessed using a visual analogue scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) score, the subjective shoulder value (SSV) and range of movement (ROM) for all patients at the time of presentation and at three, six, and 12 weeks after injection. The accuracy of injection in the US and blind groups was 100% (45/45) and 71.1% (32/45), respectively; this difference was significant (p < 0.001). Both groups had significant improvements in VAS pain score, ASES score, SSV, forward flexion, abduction, external rotation, and internal rotation throughout follow-up until 12 weeks after injection (all p < 0.001). There were no significant differences between the VAS pain scores, the ASES score, the SSV and all ROMs between the two groups at the time points assessed (all p > 0.05). No injection-related adverse effects were noted in either group. We found no significant differences in pain and functional outcomes between the two groups, although an US-guided injection was associated with greater accuracy. Considering that it is both costly and time-consuming, an US-guided intra-articular injection of corticosteroid seems not always to be necessary in the treatment of FS as it gives similar outcomes as a blind injection. Cite this article: Bone Joint J 2021;103-B(2):353-359.

Cold Therapy and Respiratory Relaxation Exercise on Pain and Anxiety Related to Chest Tube Removal: A Clinical Trial.

Background:Current strategies to control pain and anxiety of chest tube removal are not efficacious. The aim of this study is to determine the effects of cold therapy and respiratory relaxation exercise on pain and anxiety of chest tube removal.Materials and Methods:A parallel single-blind clinical trial study was conducted in Imam Khomeini Hospital, Iran, on 120 patients. Participants were randomized into 4 groups of 30. Numeric Rating Scale was used to assess pain and anxiety. One-way ANOVA test and Fisher's exact test were used to analyze demographic data. The Kruskal–Wallis test was used to compare the severity of pain and anxiety between groups; the Friedman and Mann–Whitney test were used to compare the severity of pain and anxiety within groups with a significance level of 0.05.Results:Pain intensity was weak before chest tube removal and there was no significant difference in basal pain. Pain immediately after chest tube removal was significantly higher than other times in each group (χ2 = 57.16, χ2 = 63.70, χ2 = 46.49, χ2 = 59.04, df = 3, p < 0.001). There was no significant difference in pain score immediately (p = 0.052) and 15 min (p = 0.329) after Echest tube removal in experimental groups compared to the control group. No significant difference was found between control and experimental groups in anxiety score immediately (p = 0.995) and 15 min (p = 0.976) before chest tube removal.Conclusions:Mentioned methods were not effective in reducing pain and anxiety. It is suggested to investigate effects of different methods of removing chest tubes and applying cold with a larger sample size.

Should all superficial peripheral triangular fibrocartilage complex tears be arthroscopically repaired?

Background Superficial peripheral triangular fibrocartilage complex (TFCC) tears are commonly encountered during diagnostic wrist arthroscopy done for other causes of wrist pain. The authors hypothesized that debridement of these tears in symptomatic post-traumatic superficial tears may be a sufficient alternative to arthroscopic repair. Patients and methods The authors conducted a prospective study including 29 patients with superficial peripheral TFCC tears (with no distal radioulnar joint instability) treated arthroscopically between 2011 and 2014. There were 26 males (89.7%) and three females (10.3%), with a mean age of 32.90 years (range: 21–59 years). The dominant hand was affected in 19 patients (65.5%) and the nondominant in 10 patients (34.5%). Patients were divided into two groups. The first group included 14 patients to whom arthroscopic shaving and debridement (debridement group) were done. The second group included 15 patients for whom arthroscopic repair (repair group) was done using the outside-in technique. Patients were evaluated with the visual analog scale (VAS) for pain, the quick score disability arm shoulder hand (DASH) score, and Mayo modified wrist score. Results There were no statistically significant differences in pain, disability, and functional scoring between both groups in the short-term follow-up. In the first group, the mean follow-up period was 21.87 months. The mean VAS improved from 3.53 to 1.07, the mean quick DASH score improved from 36.33 to 21.60, and the mean Mayo modified wrist score improved from 71.33 to 85.33. In the second group, the mean follow-up period was 19.71 months. The mean VAS improved from 3.86 to 1, the mean quick DASH score improved from 34.43 to 19.79, and the mean Mayo modified wrist score improved from 77.14 to 90. Conclusion Arthroscopic debridement gives comparable short-term results to repair in symptomatic superficial tear of the TFCC presenting with pain and no instability. Debridement group showed less complication and reoperation rate.

Enhancing Patient Experience in Office-Based Laryngology Procedures With Passive Virtual Reality.

ObjectivesVirtual reality (VR) has been used as nonpharmacologic anxiolysis benefiting patients undergoing office-based procedures. There is little research on VR use in laryngology. This study aims to determine the efficacy of VR as anxiolysis for patients undergoing in-office laryngotracheal procedures.Study DesignRandomized controlled trial.SettingTertiary care center.MethodsAdult patients undergoing office-based larynx and trachea injections, biopsy, or laser ablation were recruited and randomized to receive standard care with local anesthesia only or local anesthesia with adjunctive VR. Primary end point was procedural anxiety measured by the Subjective Units of Distress Scale (SUDS). Subjective pain, measured using a visual analog scale, satisfaction scores, and procedure time, and baseline anxiety, measured using the Hospital Anxiety and Depression Scale (HADS), were also collected.ResultsEight patients were randomized to the control group and 8 to the VR group. SUDS scores were lower in the VR group than in the control group with mean values of 26.25 and 53.13, respectively (P = .037). Baseline HADS scores did not differ between groups. There were no statistically significant differences in pain, satisfaction, or procedure time. Average satisfaction scores in VR and control groups were 6.44 and 6.25, respectively (P = .770). Average pain scores were 3.53 and 2.64, respectively (P = .434).ConclusionThis pilot study suggests that VR distraction may be used as an adjunctive measure to decrease patient anxiety during office-based laryngology procedures. Procedures performed using standard local anesthesia resulted in low pain scores and high satisfaction scores even without adjunctive VR analgesia.Level of Evidence1

Several interventions to alleviate pain in male patients undergoing office-based flexible cystoscopy: a systematic review and meta-analysis

Background: The purpose of this study was to explore the ability of nonpharmacologic adjuvant interventions to alleviate pain in male patients during flexible cystoscopy (FC) under local anesthesia. Methods: Electronic databases including PubMed, the Cochrane Library, and Embase were searched to identify eligible clinical trials from inception to 31 December 2020, with no language restrictions. Two independent reviewers used Cochrane Collaboration tools to assess the selection criteria, methodological rigor and risk of bias. Statistical analyses were performed using STATA 14.2. Results: In total, 717 studies were initially identified, and fourteen randomized controlled trials were ultimately included. We observed that patients who underwent FC with higher irrigation pressures had significantly lower pain scores on the visual analog scale than their counterparts with lower irrigation pressure during FC (weight mean difference (WMD): −1.43; 95% confidence interval (CI): −1.72 to −1.14) with no between-study heterogeneity (p = 0.661). There were no significant differences in pain between immediate or delayed FC groups under the same local anesthetic (standard mean difference (SMD): −0.19; 95% CI: −0.39 to 0.01). A pooled analysis of three studies including 340 male patients showed that men who observed the cystoscopy on the monitor had significantly lower pain ratings compared to those who did not view the operation on the monitor (SMD: −0.64; 95% CI: −1.14 to −0.15). Two studies, including a total of 272 patients, assessed the influence of listening to music on pain and anxiety in male patients during FC. Our meta-analysis found that music significantly improved patient pain (WMD: −0.92; 95% CI: −1.29 to −0.54). Hand-holding and urination during FC also relieved pain and anxiety in male patients undergoing FC. Conclusions: We observed that elevated irrigation pressure, real-time cystoscopy visualization, and music therapy alleviated pain in male patients undergoing FC. Well-designed trials are needed to confirm our findings.

Can buccal infiltration of articaine replace traditional inferior alveolar nerve block for the treatment of mandibular molars in pediatric patients?: A systematic review and meta-analysis.

Background It is unclear if buccal articaine infiltration can be used as an alternative to standard inferior alveolar nerve block (IANB) for treating mandibular molars in pediatric patients. Therefore, this study aimed to pool evidence to compare the efficacy of buccal infiltration of articaine vs IANB with lignocaine for pediatric dental procedures.Material and Methods We searched the PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases for randomized controlled trials (RCTs) comparing the two techniques in pediatric patients and reporting the success of anesthesia and/or pain during treatment. PRISMA guidelines were followed.Results Seven RCTs were included. Pooled analysis of five studies indicated no statistically significant difference in the success rates of the two anesthetic techniques (OR: 1.02; 95% CI: 0.13, 7.96; I2=69%, p=0.98). Meta-analysis of data from the four studies demonstrated no statistically significant difference in pain during the procedure with buccal infiltration of articaine or IANB with lignocaine (SMD: 0.62; 95% CI: -1.37, 0.12; I2=88%, p=0.10).Conclusions Evidence suggests that buccal infiltration of articaine is a viable alternative to IANB with lignocaine in pediatric patients for treating mandibular molars. Based on the confidence intervals, there may be a tendency of higher success rates with buccal infiltration of articaine. Key words:Lignocaine, articaine, primary dentition, children, molars.

Prolotherapy for the patients with chronic musculoskeletal pain: systematic review and meta-analysis.

BackgroundProlotherapy, which stimulates the healing of loosened ligaments and tendons, is a cost-effective and safe treatment modality for chronic musculoskeletal pain. Its benefits may be affected by injection protocols, comparative regimens, and evaluation scales. The aim of this study was to determine the effectiveness of dextrose prolotherapy as a long-term treatment for chronic musculoskeletal pain.MethodsMedline, Embase, Cochrane Central, KoreaMed, and KMbase databases were searched for studies published up to March 2019. We included randomized controlled trials which compared the effect of dextrose prolotherapy with that of other therapies such as exercise, saline, platelet-rich plasma, and steroid injection. The primary outcome was pain score change during daily life.ResultsTen studies involving 750 participants were included in the final analysis. Pain scores from 6 months to 1 year after dextrose prolotherapy were significantly reduced compared to saline injection (standardized mean difference [SMD] –0.44; 95% confidence interval [CI] –0.76 to –0.11, P = 0.008) and exercise (SMD –0.42; 95% CI –0.77 to –0.07, P = 0.02). Prolotherapy yielded results similar to platelet-rich plasma or steroid injection, that it showed no significant difference in pain score.ConclusionsDextrose prolotherapy is more effective in the treatment of chronic pain compared to saline injection or exercise. Its effect was comparable to that of platelet-rich plasma or steroid injection. Adequately powered, homogeneous, and longer-term trials are needed to better elucidate the efficacy of prolotherapy.

Clinical comparison of a xenogeneic collagen matrix versus subepithelial autogenous connective tissue graft for augmentation of soft tissue around implants

Dental implant placement is a predictable therapy for replacing teeth. Nevertheless, mechanical, biological, and aesthetic complications frequently occur. The aim of this study was to compare the clinical outcomes of a xenogeneic collagen matrix (XCM) used at the time of implant placement as an alternative to a subepithelial connective tissue graft (SCTG), for soft tissue augmentation. This was a prospective clinical trial with 12 months of follow-up. In the control group, soft tissue augmentation at the time of implant placement was performed with a SCTG, while in the test group, a XCM was employed. At 12 months postoperative, all xenografts showed no postoperative complications. In both groups, a significantly greater thickness was observed on the buccal and occlusal sides from preoperative to 3 months postoperative (P<0.05). No statistically significant difference in pink aesthetic score (P=0.379, 6 months postoperative) or marginal bone loss (P=0.449 at 3 months postoperative, P=0.778 at 6 months postoperative) was observed between the groups. Statistically significant differences in pain perceived by the patients (P<0.0001) and the time to complete the surgical procedure (P=0.0008) were detected. At 12 months after surgery, XCM provided similar clinical results in terms of soft tissue augmentation on the buccal and occlusal sides as compared with the SCTG.

Safety and tolerability of ultrasound-guided synovial needle biopsy in Japanese arthritis patients

Objectives We sought to clarify the safety and tolerability of ultrasound (US)-guided synovial needle biopsy in hand and knee joints in Japanese arthritis patients. Methods A total of nine consecutive arthritis patients were recruited and scheduled for US-guided synovial needle biopsies. Patients completed a safety questionnaire and patient-reported outcomes (PRO) data of joint pain, stiffness, and swelling pre- and postbiopsy. We also recorded patients’ characteristics and willingness to undergo a second biopsy by the same technique. All synovial needle biopsy samples were assessed with pathological and microbial examination to verify whether clinical evaluation was possible. Results Five and 4 patients underwent US-guided biopsy from hand and knee joints, respectively. PRO data showed no significant differences in pain, swelling, or stiffness levels before and after biopsy, with a mean 11.8 samples collected per procedure. No significant complications, including joint infection, bleeding, or vasovagal signs, were reported. Histologically adequate synovial tissue was identified in 83 (78%) samples. We were able to submit the biopsy samples to pathological and bacterial analysis to exclude septic arthritis. Conclusion We demonstrated that a minimally invasive US-guided needle biopsy is a safe and well-tolerated procedure and the synovial tissue collected was of adequate quality for pathological analysis.

A STUDY TO ASSESS THE EFFECTIVENESS OF ACUPRESSURE IN REDUCING DYSMENORRHOEA AMONG NURSING STUDENTS OF A SELECTED COLLEGE OF NURSING AT MANGALURU.

Background Acupressure is an ancient healing art that uses fingers to press key points on the surface of the skin to stimulate body’s natural self-curative abilities. When these points are pressed, they release muscular tension and promote the circulation of blood and body’s life force to aid healing. It has been reported that dysmenorrhoea can be successfully relieved by acupressure at Qihai (CV6), Guanyuan (CV4), Taichong (LIV3), Xuehai(SP10), Sanyinjiao (SP6). The sanyinjio acupoint is commonly used to induce labour and relieve pain during dysmenorrhoea. Dysmenorrhoea is a common problem among girls and acupressure is an effective non-invasive procedure to relieve pain. Acupoint Sanyinjiao (SP6) was selected for the study because it is the acupoint of choice in gynaecology and easy for girls to locate and apply pressure to without medical assistance. The aim of the study was to assess the effectiveness of acupressure in reducing dysmenorrhoea among nursing students. Materials and Method A quasi experimental time series non-equivalent control group time series design was used for the present study. Forty nursing students who met the inclusion criteria was selected by using purposive sampling technique. Baseline proforma and numeric pain scale was used to assess the level of pain. Data analysis was done by using descriptive and inferential statistics such as frequency, range, mean, median, standard deviation, uppaired “t” tet and ANOVA for repeated measures. Result There was significant difference in pain between the two group soon after, after 30 minutes and after 1 hour. The mean score of dysmenorrhoea among students before acupressure (7.95) was higher than immediately after the intervention (6.35). After 30 minutes the mean score was 4.25 and after 1 hour the mean score was (1.25). The computed value of ANOVA (F= 344.881) was found to be significant (p&lt;0.05) in reducing dysmenorrhoea. Unpaired‘t’ test was done comparing the experimental and control group at different time series was higher than the table value (t38 = 1.69) at p&lt; 0.05 level of significant, hence research hypothesis was accepted i.e. acupressure was effective in reducing dysmenorrhoea.

The Effect of Zikr Meditation on Post Operative Pain Among Women Post Cesarean Section

Pain is the most common adverse effects in the early postoperative period. Routine pharmacologic Methods may impair the recovery of patients for their sedative and emetic effects. Therefore, patients’ relaxation is necessary for a successful post-operative pain managements and it is among the interventions addressed to improve physiologic response. The aim of this study was to examine the effects of zikr meditation on post-operative pain among post cesarean section women. This is a quasy experimental research with control group pre-test post-test. A total of 30 muslim post cesarean section women were included in the study. Medical information form, Numeric Rating Scale, and Interument Guideline are used to collect the data. The results show that there is a significant difference of pain between experiment and control group (p= .012), there is a significant difference of pain before and after intervention in the experiment group (p= .00).

A QUASI EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF ISOMETRIC EXERCISES ON QUALITY OF LIFE AMONG THE INMATES OF ELDERLY PERSONS WITH JOINT PAIN AT SELECTED HOSPITAL, DEHRADUN, UTTARAKHAND

A QUASI EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF ISOMETRIC EXERCISES ON QUALITY OF LIFE AMONG THE INMATES OF ELDERLY PERSONS WITH JOINT PAIN AT SELECTED HOSPITAL, DEHRADUN, UTTARAKHAND

Effectiveness of pain coping skills training on pain, physical function, and psychological outcomes in patients with osteoarthritis: A systemic review and meta-analysis

Objective: To investigate the effectiveness of pain coping skills training in pain, function, and psychological outcomes for patients with osteoarthritis, compared to the control group; and to compare the effectiveness of pain coping skills training between the intervention involving and without involving exercise. Data sources: PubMed, Embase, the Cochrane Library, PEDro, Clinical Trials, and the WHO Clinical Trials Registry Platform (to 30 September 2020). Review methods: To calculate the results, we used standardized mean difference, and mean difference for the outcomes of continuous variables, risk difference for the risk of adverse events. Heterogeneity was identified with I2 test, and publication bias was identified with Egger’s test. Results: A total of 1195 patients with osteoarthritis underwent ten trials were included. The intervention group had significant differences in pain (SMD = −0.18; 95% CI −0.29 to −0.06), function (SMD = −0.19; −0.30 to −0.07), coping attempts (SMD = 0.37; 0.24 to 0.49), pain catastrophizing (SMD = −0.16; −0.29 to −0.02), and self-efficacy (SMD = 0.27; 0.07 to 0.46) than the control group. Between-group differences measured by the McMaster Universities Osteoarthritis Index subscales of pain (MD = −0.62; −1.48 to 0.24) or function (MD = −3.01; −6.26 to 0.24) were not statistically significant and did not reach the minimal clinically important differences that have been established. Subgroup analyses revealed no significant subgroup differences. Besides, no specific intervention-related adverse events were identified. Conclusion: Our results supported the effectiveness and safety of pain coping skills training for managing osteoarthritis in pain, function, and psychological aspects. Besides, exercise could not add benefits when combined with pain coping skills training.

Role of vitamin B12 in treating recurrent aphthous stomatitis: A review.

Vitamin B12, a water-soluble vitamin, plays a vital role in the formation of hematopoietic stem cells and has been associated with oral mucosal diseases, mainly recurrent aphthous stomatitis (RAS). The latter is a debilitating condition, and B12 was proposed as a potential treatment given its role in regenerating oral mucosal tissue. There is conflicting evidence that B12 deficiency causes RAS. Five of the seven randomized controlled trials reviewed used the inactive form of B12 (cyanocobalamin) as intervention, while the other two used the active form (methylcobalamin). Of the latter two, buccal discs (500μg B12) showed significant improvement and reduced perceived pain in 77% of the subjects, and submucosal injections showed a significant difference in pain, starting from the second day. Moreover, three studies administered vitamin B12 sublingually with different dosages, which revealed that the higher dose (1000μg) achieved a significant reduction in outbreaks, number, and duration of ulcers, especially after six months. Multivitamins showed no difference in new RAS episodes and duration. Injectable B12 was compared with the oral form, and nearly 50% of the injection group reported a desired response by the eighth week. An ointment form (500μg) showed a significant reduction in pain levels after two days of treatment. Based on the available literature, we suggest that a daily dose of 1000μg of vitamin B12 sublingually for six months can be used to treat RAS. Nevertheless, this conclusion should be considered tentative due to the lack of high quality, large scale studies.

Effectiveness of Oral Care Using Normal Saline and Baking Soda Towards Pain and Comfort in Mucositis Patients Undergoing Chemotherapy

Objects: to identify the effectiveness of oral care using normal saline and baking soda towards pain andcomfort in mucositis patients undergoing chemotherapy.Methods: this is a quai-experiment pre-posttest with a control group design. The sampling technique wasused for consecutive sampling. The sample was 40 divided into two groups.Results: the results of this study used the Paired t-test in the intervention group before and after treatmentshowed a significant difference in pain intensity (t=14,257, p=0,000) and comfort (t=-11,103, p=0,000). Inthe control group there were also significant differences in pain intensity (t = 10,341, p=0,000) and comfort(t=-6,842, p=0,000). Based on the Independent t-test, there was a significant difference in pain (t=-3.287,p=0.002) and comfort (t=4.001, p=0.000) after gargling using normal saline and baking soda.Conclusion: the results of this study indicate that gargling using a solution of normal saline and bakingsoda sodium bicarbonate is effective in reducing mucositis pain and improving the comfort of patientsundergoing chemotherapy