Via Visual Analogue Scale Research Articles

EFFECTS OF CHEWING TIME OF HIGH PROTEIN MEAL ON SATIETY AND GLP-1 HORMONE

Background: Chewing or mastication process affects satiety as well as satiety regulating hormone Glucagon-like Peptide-1 (GLP-1). Proteins have the highest satiating effects among the macronutrients. This study explored the association of chewing with satiety and GLP-1 in participants consuming high-protein meal. Methods: Fifteen healthy volunteers, aged 25-35 years were enrolled through random sampling. Effects of chewing on postprandial satiety and plasma GLP-1 was examined through quasi-experimental study conducted in Khyber Medical University, Peshawar, from Jan to Mar 2023. Three visits were designed with one week wash-out period. Satiety and GLP-1 were compared among normal, fast, and slow chewing conditions, while providing high protein meal. Subjective satiety was assessed via visual analogue scale (VAS) and labelled magnitude scale (LMS), while serum GLP-1 levels were analysed through ELISA at baseline, 30, 120 and 240 min in each visit. Results: The participants had a mean chewing time of 793.66±311 second at normal rate. Mean chewing time was decreased to 496.60±135.82 second during fast chewing, while significantly increased to 1459.66±400.83 second during slow chewing. A comparison of satiety at different chewing rates revealed that slow chewing significantly reduced hunger and enhanced fullness (p<0.05), relative to normal and fast chewing, at 240 minutes (p<0.05). However, no significant difference was observed in plasma GLP-1 levels at any time intervals (p>0.05). Conclusion: Satiety is significantly influenced by chewing and number of chews per bite of a high protein meal, whereas postprandial plasma GLP-1 levels show no significant differences across different chewing rates. Pak J Physiol 2024;20(2):31-35

Efficacy of a Novel Melatonin-Loaded Gelatin Sponge in Palatal Wound Healing

ObjectivesThe aim of this research was to assess both clinically and histologically the effect of a topically applied melatonin-loaded gelatin sponge on palatal wound healing after graft harvesting. MethodsTwenty-six patients for whom free palatal graft procurement was indicated were divided equally into 2 groups. In the test group, the donor site was covered by a melatonin-loaded gelatin sponge, and in the control group the site was covered by a placebo-loaded gelatin sponge. Wound healing was evaluated on the day of surgery and at 7 and 14 days postsurgery using photo-digital planimetry. Histologic specimens were taken to verify healing type and rate. Pain was assessed via Visual Analogue Scale (VAS) for 7 days from the day of the surgery. ResultsAt the 7-day interval, photo-digital planimetry showed a significant decrease in the traced raw area (P = .04) in the test group compared with the control group and a significant increase in the mean area of immature epithelia (P = .04). At the 14-day interval, there was no statistically significant difference in any area of interest. Histologically, the application of melatonin was associated with accelerated healing and superior maturation at all follow-up time points. No significant differences were noted in VAS scores between the 2 groups. ConclusionsMelatonin-treated tissue showed marked clinical improvement in the first week postsurgery, indicating an increased rate of healing. Similarly, histologic analysis revealed significant maturation at both time intervals. A melatonin-loaded gelatin sponge is a novel palatal wound dressing that can be used to improve wound healing outcomes and reduce patient morbidity.

EFFECTIVENESS OF MULLIGAN TAPING VERSUS KINESIO TAPING WITH COMMON USE OF ULTRASOUND THERAPY IN TENNIS ELBOW OF CRICKET PLAYERS: A RANDOMIZED CLINICAL STUDY

BACKGROUND: The purpose of this study was to compare the effectiveness of Mulligan taping versus kinesio taping with common use of ultrasound therapy in managing tennis elbow. METHODS: Thirty cricketers aged between 25 to 35 years, presenting with tennis elbow with symptom duration within one month, were randomized into two groups. The Group-A received Mulligan taping with ultrasound therapy and Group-B received kinesio taping with ultrasound therapy. Treatment duration was 3 times a weekly four weeks. OUTCOME MEASURES: Data was obtained on pain intensity levels via Visual Analog Scale (VAS) grip strength via measuring Pain Free Grip Strength (PFGS) and functional status measured by the Patient-Rated Tennis Elbow Evaluation (PRTEE). RESULTS: Result shows that significant improvement in VAS (p=.04), PFGS (p=.02) and PRTEE (p=.01). CONCLUSION: The results of this study demonstrate that kinesio taping with ultrasound therapy is a superior treatment approach compared to Mulligan taping with ultrasound therapy in managing tennis elbow.

Gut peptides before and following Roux-En-Y gastric bypass: A systematic review and meta-analysis.

A systematic search was conducted in Medline Ovid, Embase, Scopus, and Cochrane Central Register of Controlled Trials up until March 2021 following PRISMA guidelines. Studies included evaluated ghrelin, GLP-1, PYY or appetite sensation via visual analogue scales (VASs) before and after Roux-en-Y gastric bypass (RYGB) in adults. A multilevel model with random effects for study and follow-up time points nested in study was fit to the data. The model included kcal consumption as a covariate and time points as moderators. Among the 2559 articles identified, k = 47 were included, among which k = 19 evaluated ghrelin, k = 40 GLP-1, k = 22 PYY, and k = 8 appetite sensation. Our results indicate that fasting ghrelin levels are decreased 2weeks post-RYGB (p = 0.005) but do not differ from baseline from 6weeks to 1-year post-RYGB. Postprandial ghrelin and fasting GLP-1 levels were not different from pre-surgical values. Postprandial levels of GLP-1 increased significantly from 1week (p < 0.001) to 2years post-RYGB (p < 0.01) compared with pre-RYGB. Fasting PYY increased at 6months (p = 0.034) and 1year (p = 0.029) post-surgery; also, postprandial levels increased up to 1year (p < 0.01). Insufficient data on appetite sensation were available to be meta-analyzed.

Systemic inflammation and its relationship with pruritus in early-stage mycosis fungoides.

The underlying mechanisms mycosis fungoides (MF)-related pruritus remain unclear, and the link between pruritus and systemic inflammation in MF is unexplored. We aimed to investigate systemic inflammation in MF patients and its potential connection to pruritus. In this retrospective study, demographic characteristics, MF stage, clinical and laboratory findings, and neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and pan-immune inflammation value (PIV) were assessed for all participants. Additionally, mSWAT scores, Dermatology Life Quality Index (DLQI), and pruritus presence and intensity via Visual Analogue Scale (VAS) scoring were recorded for MF patients. A total of 81 patients with early-stage MF and 50 controls were enrolled. Itching was present in 41 patients (50.6%). NLR, PLR, SII, SIRI and CRP values in the MF group were significantly higher. CRP, NLR, mSWAT and DLQI score were significantly higher in MF patients with pruritus than those without. Pruritus was positively correlated with DLQI, mSWAT, CRP, NLR, MLR and SIRI. VAS score was positively correlated with eosinophil count and DLQI. In the multivariate logistic regression model, only NLR was an independent and significant associate of pruritus in patients with MF. This study provides evidence of enhanced systemic inflammation in early-stage MF patients. Additionally, the correlation between pruritus with mSWAT scores and systemic inflammation parameters suggests a potential link between pruritus and the inflammatory milieu in MF.

Low-intensity focused ultrasound targeting the nucleus accumbens as a potential treatment for substance use disorder: safety and feasibility clinical trial.

While current treatments for substance use disorder (SUD) are beneficial, success rates remain low and treatment outcomes are complicated by co-occurring SUDs, many of which are without available medication treatments. Research involving neuromodulation for SUD has recently gained momentum. This study evaluated two doses (60 and 90 W) of Low Intensity Focused Ultrasound (LIFU), targeting the bilateral nucleus accumbens (NAc), in individuals with SUD. Four participants (three male), who were receiving comprehensive outpatient treatment for opioid use disorder at the time of enrollment and who also had a history of excessive non-opioid substance use, completed this pilot study. After confirming eligibility, these participants received 10 min sham LIFU followed by 20 min active LIFU (10 min to left then right NAc). Outcomes were the safety, tolerability, and feasibility during the LIFU procedure and throughout the 90-day follow-up. Outcomes also included the impact of LIFU on cue-induced substance craving, assessed via Visual Analog Scale (VAS), both acutely (pre-, during and post-procedure) and during the 90-day follow-up. Daily craving ratings (without cues) were also obtained for one-week prior to and one-week following LIFU. Both LIFU doses were safe and well-tolerated based on reported adverse events and MRI scans revealed no structural changes (0 min, 24 h, and 1-week post-procedure). For the two participants receiving "enhanced" (90 W) LIFU, VAS craving ratings revealed active LIFU attenuated craving for participants' primary substances of choice relative to sham sonication. For these participants, reductions were also noted in daily VAS craving ratings (0 = no craving; 10 = most craving ever) across the week following LIFU relative to pre-LIFU; Participant #3 pre- vs. post-LIFU: opioids (3.6 ± 0.6 vs. 1.9 ± 0.4), heroin (4.2 ± 0.8 vs. 1.9 ± 0.4), methamphetamine (3.2 ± 0.4 vs. 0.0 ± 0.0), cocaine (2.4 ± 0.6 vs. 0.0 ± 0.0), benzodiazepines (2.8 ± 0.5 vs. 0.0 ± 0.0), alcohol (6.0 ± 0.7 vs. 2.7 ± 0.8), and nicotine (5.6 ± 1.5 vs. 3.1 ± 0.7); Participant #4: alcohol (3.5 ± 1.3 vs. 0.0 ± 0.0) and nicotine (5.0 ± 1.8 vs. 1.2 ± 0.8) (all p's < 0.05). Furthermore, relative to screening, longitudinal reductions in cue-induced craving for several substances persisted during the 90-day post-LIFU follow-up evaluation for all participants. In conclusion, LIFU targeting the NAc was safe and acutely reduced substance craving during the LIFU procedure, and potentially had longer-term impact on craving reductions. While early observations are promising, NAc LIFU requires further investigation in a controlled trial to assess the impact on substance craving and ultimately substance use and relapse.

Use of Temporary Percutaneous Peripheral Nerve Stimulation in an Oncologic Population: A Retrospective Review

ObjectivesPatients with an underlying cancer diagnosis may experience pain from many sources. Temporary, percutaneous peripheral nerve stimulation (PNS) is a minimally invasive procedure that can control pain in those who have failed conservative management. The purpose of this retrospective review is to show the use of PNS in managing pain in the oncologic setting. Materials and methodsTemporary, percutaneous PNS was placed under fluoroscopic or ultrasound guidance for 15 patients at a cancer pain facility. Cases were grouped by subtypes of cancer pain (ie, tumor-related, treatment-related, cancer-associated conditions, and cancer-independent). Before PNS, patients were refractory to medical management or previous interventional treatments. Patients were observed with routine clinic visits to monitor pain levels via visual analog scale (VAS) and quality-of-life measures. PNS was removed after the indicated 60-day treatment period. ResultsThis retrospective review presents ten successful cases of oncologic-related pain treated with PNS. Patients with subtypes of pain that were tumor related, from cancer-associated conditions, and cancer independent all experienced a similar degree of pain relief. However, patients with cancer-treatment–related pain experienced the least analgesia from PNS. We also present six cases in which PNS did not provide adequate pain relief. ConclusionPNS is an emerging technology in neuromodulation that may be useful in managing pain, especially in the oncologic population. Patients with cancer-related and non–cancer-related pain localized to a specific nerve distribution should be considered appropriate candidates for PNS. Further research is needed to optimize patient selection and indications for PNS in the population with cancer.

Minimally invasive transforaminal lumbar interbody fusion by a novel two-medium compatible bichannel endoscopy system, technique note and preliminary clinical results.

Our team designed a novel two-medium compatible bichannel endoscopy system for spinal surgery, V-shape bichannel endoscopy (VBE) system. Hereby, this study will introduce minimally invasive transforaminal lumbar interbody fusion (TLIF) with VBE system and report its preliminary clinical results. Fifty-two participants, who accepted VBE-assisted TLIF surgery (VBE-TLIF) in our hospital were included in this study. The duration of operation, off-bed time, and days of hospitalization were recorded. Besides, the patient's preoperative and postoperative pain were evaluated via visual analog scale (VAS), the functional status was evaluated via Oswestry dysfunction index (ODI) and modified MacNab criteria. Patients were asked to follow-up in the outpatient department at the 3rd, 6th, 12th, and 24th month after surgery. X-ray or CT was examined to evaluate the internal fixation position and interbody fusion result. All patients received unilateral decompression with an average operation duration of 178.49 ± 27.49min. After the surgery, their VAS score of leg pain and back pain reduced significantly. At the last follow-up, the VAS score of leg pain and back pain was 0.80 ± 0.69 and 0.86 ± 0.75 separately. The difference shows statistically significant with p < 0.05. At the last follow-up, the ODI was 15.20 ± 5.75. According to modified MacNab criteria, 39 patients rated their function as excellent, and 10 patients were good. The overall satisfaction rate reached 94%. The VBE system reported in the current study can complete TLIF surgery safely and effectively.

Effect of high-intensity laser on upper trapezius myofascial pain syndrome

Aim of the study: As high intensity laser therapy (HILT) is capable of reaching and stimulating deeper and larger tissues than traditional physiotherapy modalities, so we studied its influence on cervical myofascial pain. Subject and methods: 50 patients with chronic upper trapezius muscle myofascial trigger points (MTrPs) within age range of 20 to 40 years old were assigned into group A that received traditional treatment only (transcutaneous electrical nerve stimulation (TENS), ultrasound massage (US), stretch and exercise), while group B received HILT with traditional treatment. Outcome measures included pain severity via visual analogue scale (VAS), pressure pain threshold (PPT) by pressure algometer, neck functional activities by neck disability index (NDI) and cervical range of motion by CROM apparatus. Results: both groups showed significant improvement in the posttreatment outcome measures, but the HILT group (group B) showed a more significant improvement than the control group (group A) with p-value &gt;0.001. Conclusion: HILT is a supportive physical therapy modality that may provide preferable results for a cervical MTrP patient.

The Effect Of Sex And Exercise Intensity On Hunger Ratings In Adults: A Pilot Study

Acute exercise transiently suppresses appetite, oftentimes in an intensity dependent manner. However, the majority of prior work only included young adult males, and did not explore the effects of sex on exercise-induced appetite measures. PURPOSE: To determine the effect of exercise intensity and sex on appetite responses in middle-age adult males and females. METHODS: Untrained males (n = 5; age: 46.8 ± 5.8 y; BMI; 22.5 ± 0.84 kg/m2 VO2peak: 34.7 ± 6.7 mL/kg/min) and females (n = 4; age: 43.8 ± 5.4 y; BMI 22.2 ± 0.94 kg/m2;VO2peak: 28.15 ± 2.3 mL/kg/min) completed 3 conditions in a randomized, crossover design: control (C), moderate intensity exercise (at the lactate threshold (LT); MOD), or high intensity (75% of the difference between LT and VO2 peak; HI) exercise. Exercise intensity was determined from a maximal incremental cycle ergometer test. Venous blood was sampled at the end of each 3-min stage and analyzed for lactate. Visits occurred in the morning after an overnight fast. All exercise sessions were calorically matched within subjects. Subjective appetite parameters were assessed via visual analogue scales (VAS) during each condition at: 0 minutes, 60 minutes, 90 minutes, 120 minutes. Area-under-the curve values were calculated using the trapezoidal method for each VAS component. RESULTS: Preliminary inspection of data suggest perception of hunger (units = mm*120 min-1; males: C: 491.1 ± 291.7 MOD: 355.8 ± 107.8, HI: 351.6 ± 129.2;females: C: 539.6 ± 69.5, MOD: 419.6 ± 106.9, HI: 409.5 ± 67.5) satisfaction (males: C: 420.6 ± 174.9, MOD: 293.7 ± 187.65, HI: 395.3 ± 197.05; females: C: 279.0 ± 239.7 MOD: 342.4 ± 159.6, HI: 382.0 ± 146.4), fullness (males: C: 393.6 ± 154.3, MOD: 266.1 ± 163.8, HI: 398.6 ± 176.5; females: C: 247.5 ± 241.2, MOD: 264.4 ± 215.5, HI: 411.5 ± 159.9), and how much you think you can eat (males: C: 653.7 ± 225.9, M: 573.9 ± 239.2, HI: 460.2 ± 248.9; females: CON: 684.4 ± 192.1, MOD: 545.6 ± 107.4, HIGH: 731.0 ± 150.2), are affected in an intensity dependent manner with differing responses between middle aged males and females. CONCLUSIONS: Both exercise intensity and sex may impact subjective ratings of appetite. Supported by The University of Virginia School of Education and Human Development, and National Institute of Diabetes and Digestive and Kidney Diseases (1R01DK12950-01)

Prosthetic temporomandibular joint replacement (TJR): Stock or custom? A single institution pilot comparison

The aim of this study was to compare stock (Biomet-Lorenz Stock, Parsippany, NJ) and custom (TMJ Concepts, Inc., Ventura, CA) total temporomandibular joint (TMJ) replacement prosthetics. This was a retrospective cohort study of 17 consecutive patients operated by the same surgeon from 2015 to 2020 comparing stock and custom options for total joint replacement (TJR). The inclusion criteria were patients who documented 1 year of follow-up post-TJR without previous TMJ replacement surgery. The predictor variable was the TMJ prosthetic replacement. The primary clinical outcome variables was pain via Visual Analog Scale (VAS) measured at 1, 3, and 6 months postoperatively and maximum incisal opening measured pre and post-surgery. The other variables were grouped into the following categories: surgery time, length of stay, and unilateral vs bilateral replacements. Our review showed no statistically significant difference in maximum incisal opening, subjective pain score, hospital stay, surgical time, or complication rate between Biomet-Lorenz stock and TMJ Concepts, Inc. custom total joint replacement. Bilateral TJR, irrespective of prosthesis type, did have greater improvement in maximal incisal opening (MIO) compared with unilateral that was statistically significant (P < .05). There was no statistically significant difference in the pain VAS or MIO using either stock or custom TJR. Both should be considered good surgical options for improvements in patient function and long-term jaw stability.

Urological Chronic Pelvic Pain Syndrome improves when underlying neuromuscular dysfunction is addressed in an outpatient, multimodal treatment protocol

Background: Urological chronic pelvic pain syndrome (UCPPS) combines two of the most widespread chronic urological pain disorders: interstitial cystitis (IC)/bladder pain syndrome (BPS) and chronic prostatitis (CP)/chronic pelvic pain syndrome (CPPS). This manuscript aims to assess the effectiveness of an outpatient, multimodal treatment protocol for men with UCPPS. Methods: A retrospective study of 58 male patients was done on an institutional review board approved protocol consisting of pelvic floor physical therapy (PFPT) in concomitance with the pelvic floor muscles receiving ultrasound guided trigger point injections and peripheral nerve blocks weekly for six weeks. Patients rated their levels of pelvic pain, performance, and quality of life via Visual Analogue Scale (VAS), Functional Pelvic Pain Scale (FPPS), and NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) at their new patient consult and 3-month follow up. Results: Initial average VAS was 6.24 ± 2.26 and average VAS after treatment reduced to 4.25 ± 2.8. Initial average FPPS score was 9.21 ± 5.24. Final average FPPS reduced to 7.28 ± 5.03. Initial average total NIH-CPSI score was 24.55 ± 6.43 and after treatment reduced to 18.36 ± 7.62. Initial average NIH-CPSI pain, urinary symptoms, and quality of life sub scores were 11.28 ± 3.46, 3.41 ± 3.31, and 9.86 ± 2.05, respectively. After treatment, they decreased to 8.34 ± 4.14, 2.47 ± 2.45, and 7.55 ± 2.74. Differences in pre and post treatment outcomes were statistically significant. Conclusions: This shows the protocol was successful at improving pain and performance in male UCPPS patients. This supports the validity of a multimodal treatment protocol given patients failed to improve after a full course of PFPT by itself. However, they improved once PFPT was combined with other treatment modalities, alleviating the underlying neuropathic and myofascial pain seen in UCPPS.

Effects of Esketamine on Acute and Chronic Pain After Thoracoscopy Pulmonary Surgery Under General Anesthesia: A Multicenter-Prospective, Randomized, Double-Blind, and Controlled Trial.

Background: Post-operative pain management for patients undergoing thoracoscopy surgery is challenging for clinicians which increase both health and economic burden. The non-selective NMDA receptor antagonist esketamine possesses an analgesic effect twice that of ketamine. The application of esketamine might be beneficial in alleviating acute and chronic pain after thoracic surgery. The current study describes the protocol aiming to evaluate the analgesic effect of esketamine after pulmonary surgery via visual analog scale (VAS) score for acute and chronic pain.Methods: A multi-center, prospective, randomized, controlled, double-blind study is designed to explore the analgesic effect of esketamine in randomized patients undergoing video-assisted thoracoscopic surgery (VATS) with general anesthesia. Patients will be randomly assigned to Esketamine Group (Group K) and Control Group (Group C) in a ratio of 1:1. Group K patients will receive esketamine with a bolus of 0.1 mg/kg after anesthesia induction, 0.1 mg/kg/h throughout the operation and 0.015 mg/kg/h in PCIA after surgery while Group C patients will receive the same volume of normal saline. The primary outcome is to measure the pain intensity through the VAS score at 3 months after the operation. The secondary outcome includes VAS score at 1, 4, 8, 24, and 48 h and on the 7th day and 1 month after the operation, complications, ketamine-related neurological side effects, recovery time of bowel function, and total amount of supplemental analgesics.Discussion: The results of the current study might illustrate the analgesic effect of esketamine for patients undergoing thoracoscopy pulmonary surgery and provide evidence and insight for perioperative pain management.Study Registration: The trial was registered with Chinese Clinical Trial Registry (CHICTR) on Nov 18th, 2020 (ChiCTR2000040012).

Evaluation of Post-operative Pain by using Calcium Hydroxide Based Root Canal Sealer: A Clinical Study

Objective: To assess the post-operative pain by using calcium hydroxide Ca(OH)2 based root canal sealer, a clinical study at tertiary care Hospital&#x0D; Materials and Methods: This cross-sectional study was performed at operative dentistry department of Liaquat University of Medical and health Sciences Jamshoro Pakistan. Study duration was 6 months from March 2020 August 2020. Total 60 patients, those having permanent anterior teeth with irreversible pulpitis, teeth restoration after root canal treatment and either of gender were included. Multiple visits of endodontic treatment were performed by obturating the canals using calcium hydroxide Ca(OH)2 (sealapex, Sybron endo). Patients were recalled next day, after 3rd day and after one week of obturation to assess the severity of post-operative pain (POP) via visual analogue scale (VAS). All the information was recorded via study proforma. Data analysis was done by using SPSS version 20.&#x0D; Results: Mean age of the study participants was 26.77+8.72 years. males were in majority 36(60.0%). On the next day as per severity of pain, mostly patients were presented with severe pain as mean visual analogue scale was 8.7+0.3. On third day pain was markedly decrease among almost all of the cases as average of visual analogue scale was found 2.6+0.2. However after one all the patients were seen without pain as average of visual analogue scale was 0.65+0.7. Pain was statistically insignificant according to gender.&#x0D; Conclusion: Calcium hydroxide based root canal sealer found to be feasible and effective for endodontic treatment in terms of lower postoperative pain.

Postoperative ethmoid sinus mucoceles: Late complication of endoscopic ethmoidectomy and MWA management in outpatient

ObjectiveThe aim of this study was to investigate the feasibility of intranasal endoscopic microwave ablation (MWA) on the management of postoperative ethmoid sinus mucoceles. Methods and materialsThe patients with postoperative ethmoid sinus mucoceles were ablated through intranasal endoscopic MWA. Postoperative pain intensity was measured via visual analogue scale (VAS), post-operative complications were recorded. ResultsOf the 26 patients with unilateral postoperative ethmoid sinus mucoceles, the mucoceles were diagnosed 3 to 11 years with average time of time of 6.9 ± 2.7 years after endoscopic ethmoidectomy. The ipsilateral middle turbinate was present and intact in 24 patients and partially resected during the original surgery in the remaining 2. There were adhesions in the middle meatus in one case. All 26 patients were successfully treated with the intranasal endoscopic ablation technique in outpatient. The ablation time was 6 to 11 min, with an average duration of 6.84 ± 1.27 min. The mean VAS pain score was 2.41 ± 1.22. There were no perioperative complications reported in this series. No evidence of recurrence was observed in any patients during follow-up periods. ConclusionsThe present study demonstrates the safety and efficacy of intranasal endoscopic MWA in the office. The procedure is well tolerated by patients with low complication rates. Thus, it is alternative to conventional endonasal endoscopic marsupialization for treatment of postsurgical ethmoid sinus mucoceles.

Using pharmacopuncture for chronic tension-type headache treatment

Objective: assessing pharmacopuncture effect on pain syndrome and level of anxiety-depressive disorders in patients with chronic tension-type headache (CTTH). Materials and methods. An open-label controlled trial was conducted on 95 CTTH patients split among two groups by means of adaptive randomization. The comparison group subjects were receiving 35-70 mg/day of amitriptyline and 450 mg/day of tolperisone, while patients of the treatment group were assigned 2-4 courses of pharmacopuncture by the original method. The results were evaluated on the basis of the scores obtained via Visual Analogue Scale (VAS), McGill Pain Questionnaire, Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) sensu Ch. Spielberger and Yu. Khanin. Results. Patients in both clinical groups were inclined to a positive evaluation of received treatment. Based on the results of McGill Pain Questionnaire, we determined both affective and sensory pain descriptors, with a predominance of the latter. Both groups exhibited moderate depressive symptoms according to BDI of the psychological status. Prevalence of trait anxiety over reactive anxiety was determined by STAI. According to VAS, pain intensity after the treatment declined from 5.26±0.87 to 1.7±0.78 points (p&lt;0.05) and from 5.17±0.78 to 1.65±0.79 (p&lt;0.05) in the comparison group versus the treatment group. An improvement of anxiety and depression indicators was detected. Conclusion. Our results have demonstrated that pharmacopuncture is very promising in treating CTTH patients

Clinical performance of implant crowns with customized zirconia abutments: A prospective cohort study with a 4.5- to 8.8-year follow-up.

To assess the clinical and esthetic outcomes and patient satisfaction of screw-retained one-piece implant crowns fabricated with zirconia abutments after a 4.5- to 8.8-year follow-up. Thirty-two patients (12 women and 20 men), who received 40 implant single crowns in anterior and premolar sites, were included in this prospective study. All restorations were based on ceramic hand-veneered customized CAD/CAM zirconia abutments. The follow-up consisted of clinical and radiological examinations. The pink esthetic score-white esthetic score (PES-WES) was used to evaluate the esthetic outcome. Patients' satisfaction was assessed via visual analog scale (VAS). Implant and prosthetic survival rates were 100% and 97.5%, respectively. Mean marginal bone loss was -0.17mm (SD 1.16mm). Probing depth was ≤4mm in 98.7% and 5mm in 1.3% of the sites; 8.3% of them were bleeding on probing positive. No technical or biological complications were observed except for one abutment fracture. The mean PES-WES scores were 7.0 and 7.1, respectively. VAS scores (10-point) of 9.41 for function and 9.26 for esthetics showed high patient satisfaction. After a mean observation period of 6years and 7months, screw-retained implant crowns based on veneered customized CAD/CAM zirconia abutments with conical connection showed very good clinical performance and may be recommended for the replacement of missing anterior and premolar teeth. (ClinicalTrials.gov # NCT04370314).

The impact of living with transfeminine vocal gender dysphoria: Health utility outcomes assessment

Background: The voice signals a tremendous amount of gender cues. Transfeminine individuals report debilitating quality-of-life deficits as a result of their vocal gender dysphoria.Aims: We aimed to quantify the potential impact of this dysphoria experienced with quality-adjusted life years (QALYs), as well as associated treatments, through validated health utility measures. Methods: Peri-operative phonometric audio recordings of a consented transfeminine patient volunteer with a history of vocal gender dysphoria aided in the description of two transfeminine health states, pre- and post-vocal feminization gender dysphoria; monocular and binocular blindness were health state controls. Survey responses from general population adults rate these four health states via visual analogue scale (VAS), standard gamble (SG), and time tradeoff (TTO). Results: Survey respondents totaled 206 with a mean age of 35.8 years. Through VAS measures, these general adult respondents on average perceived a year of life with transfeminine vocal gender dysphoria as approximately three-quarters of a life-year of perfect health. Respondents also on average would have risked a 15%–20% chance of death on SG analysis and would have sacrificed 10 years of their remaining life on TTO measures to cure the condition. The QALY scores for the post-gender affirming treatments for vocal gender dysphoria (+0.09 VAS, p < 0.01) were significantly higher compared to the pretreatment state. There were no differences in the severity of these QALY scores by survey respondent’s political affiliation or gender identity. Conclusions: To our knowledge, this study is the first to quantify how the general population perceives the health burden of vocal gender dysphoria experienced by transfeminine patients. Feminization treatments including voice therapy with feminization laryngoplasty appear to significantly increase health utility scores.

Analgesia for the Change of Dressing in Burn Victims: A Comparison Between Oral Ketamine and Oral Dexmedetomidine

Objective: To compare the efficacy of oral ketamine with oral dexmedetomidine for providing adequate analgesia for change of dressing in burn patients in burn dressing room. Methods: This randomized controlled trial was carried out in Jinnah Burn and Reconstructive Surgery Center, Lahore, from April 2019 to September 2019 after getting the approval from the Ethical Committee of Jinnah Hospital / Allama Iqbal Medical College, Lahore. 80 patients between 20 to 50 years, with 1st and 2nd degree burns and 20 to 40% of total body surface area involved were allocated in two groups A and B. The patients in group A received oral ketamine at a dose of 5mg/kg in 15 ml of water 30 mins while those in group B received dexmedetomidine, 4 ug/kg orally, in 15 ml of water 30 mins before the start of dressing change. The change of dressing was carried out with continuous vital monitoring. Pain was assessed via visual analogue scale (VAS) and sedation via Ramsay sedation score. All the observations were recorded on the predesigned proforma. SPSS version 21 was used for data analysis. Result: The baseline mean VAS score of patients in group A was 7.67 + 0.55 and in group B was 7.70 + 0.57 (p value = 0.799). Significant decrease in pain score in both groups was noted after 30 mins of drugs administration (p=0.000). Also a significant difference in pain scores was seen between the two groups (p&lt; 0.05), with the patients in group A having lower pain scores as compared to patients in group B. Conclusion: both ketamine and dexmedetomidine provide adequate analgesia for the change of burn dressing when administered orally with ketamine providing better analgesic state as compared to dexmedetomidine. Key Words: Burn, ketamine, dexmedetomidine, analgesia. How to cite: Sohail F., Bangash R.L., Azim W., Arshad F, Anwar A., Niazi K.A. Analgesia for the Change of Dressing in Burn Victims: A Comparison between Oral Ketamine and Oral Dexmedetomidine. Esulapio 2021;17(01):39-44

Traumatic compression fractures in thoracic-lumbar junction: vertebroplasty vs conservative management in a prospective controlled trial

BackgroundBoth surgery and conservative management are well established treatments for compression fractures of the thoraco-lumbar spine without neurological compromise. This article aims to compare the outcomes of conservative management to...