Pain Intensity Visual Analogue Research Articles

Comparison of Bromelain and Diclofenac in the Management of Postoperative Pain and Quality of Life Following Root Canal Therapy: A Randomized Controlled Trial.

Aim This study aimed to compare the analgesic efficacy and adverse effects of oral bromelain and diclofenac in relieving postoperative pain and improving postoperative quality of life in patients with irreversible pulpitis in mandibular first molars after root canal therapy. Materials and methods A simple randomized double-blinded clinical trial was carried out. One hundred patients with symptomatic pulpitis requiring root canal therapy of mandibular first permanent molars were randomly divided into two groups after obtaining informed consent. After access opening, preparation of the root canal and temporization, Group I (n=50) patients received oral bromelain 200 mg and Group II (n=50) received oral diclofenac sodium 50 mg, respectively. The patients were asked to rate their pain on a visual analog pain intensity scale (VAS) and rate their quality of life using the postoperative quality of life (POQoL) questionnaire after 6, 12, 24, 48, and 72 hours. Results Bromelain and diclofenac were equally effective for postoperative analgesia, but diclofenac showed immediate pain relief and improved quality of life at 6 hours. After 12 hours bromelain showed similar effects in managing pain and postoperative quality of life with less adverse effects. Conclusions When compared to diclofenac, bromelain has the same analgesic efficacy after 12 hours but a lower risk of adverse effects in patients receiving root canal therapy for postoperative pain. Diclofenac is more effective in immediate postoperative pain relief and improvement in quality of life for patients with moderate to severe pain.

Effect of virtual reality on women’s labor pain perception at Tanta University Hospital

Background Normal labor is considered one of the most memorable and painful experiences in a woman’s life. It is ranked high on the pain rating scale when compared to other painful life experiences. The aim of this study is to evaluate the effect of virtual reality on pain perception during the first stage of labor. Design A quasi-experimental design (pretest–posttest nonequivalent control group design) was adopted in this study to obtain the stated aim. Sample A purposive sample of 300 laboring women was recruited for this study and categorized into two groups: the study group consisted of 150 laboring women who received the virtual reality intervention and routine hospital care, and the control group consisted of 150 laboring women who received routine hospital care only. Setting The current study was conducted at the labor and delivery ward at Tanta University Hospital. Tools: four tools were utilized: (a) Structured Interviewing Questionnaire Schedule, (b) visual analog pain intensity scale, (c) Wong-Baker faces pain rating scale, and (4) laboring women satisfaction tool. Result The study findings showed that there was a statistically significant decrease in labor pain perception in the study group using the visual analog scale after the first application of virtual reality with a mean of 7.23±0.99 and 3.87±1.74 in control group and study group, respectively (P=0.001). Moreover, after the third application of virtual reality with a mean of 8.79±0.88 and 3.47±2.37 in control group and study group, respectively (P=0.001). While using Wong Baker face rating scale the labor pain perception statistically significantly decreased in the study group after using the first application of virtual reality with a mean of 3.35±0.56 and 2.17±0.88 in the control group and study group, respectively (P=0.001). Moreover, 86% of the study group were satisfied regarding virtual reality application. Conclusion Based on the findings of this study, virtual reality has a positive effect in decreasing pain perception during the first stage of labor. It also achieved satisfaction of laboring women with using it during labor. Recommendation Apply virtual reality technique as a non-pharmacological therapy in labor pain management.

Efficacy of Intra-articular, intra-osseous Injections of Platelet-Rich Plasma in Osteoarthritis Knee: A Randomized Clinical Trial

<h3>Research Objectives</h3> To evaluate the efficacy of intra-articular, intra-osseous Injections of platelet-rich plasma (PRP) and compare its efficacy with intra-articular injection of PRP in OA Knee. <h3>Design</h3> A parallel 2 group, prospective randomized clinical trial. <h3>Setting</h3> A tertiary care teaching hospital in India. <h3>Participants</h3> A total of 64 persons with OA knee with a Kellgren-Lawrence score of 3 were randomized into two groups. <h3>Interventions</h3> Persons in Group-I received 8ml of single intra-articular PRP injection, and persons in Group II received 18 ml of PRP (two-intra-osseous injections (5ml each in femoral-condyle and tibia plateau) and one intra-articular injection (8ml) of PRP (total 18 ml of PRP, for single joint)) the in the target knee joint under fluoroscopic guidance. All persons (n=64) were followed up at 3 and 6 months. <h3>Main Outcome Measures</h3> Clinical outcomes were evaluated using the visual analog (VAS) pain intensity scores and knee injury and osteoarthritis outcome score (KOOS) questionnaire. <h3>Results</h3> There was no disparity between the two groups in baseline demographic and clinical parameters. Both groups demonstrated statistically significant improvement in VAS pain scores and KOOS scores (pain, symptoms, ADL, sport/recreation, and quality of life) at baseline, 3- and 6 months. However, comparing the two groups revealed no significant difference in VAS scores and KOOS scores at six months. Persons in Group-II reported increased injection-associated pain following interventions. Except for injection-associated pain, no other adverse events were reported in any person. <h3>Conclusions</h3> Though both groups showed significant improvement following PRP injections, additional injections of PRP in the subchondral region did not provide additional benefits (pain-relief and KOOS scores) than intra-articular-PRP injections at 6 months. <h3>Author(s) Disclosures</h3> The institutional intramural research grant supported the study.

Prospective, Single-arm, Split-face Pain Management Evaluation of Nitrous Oxide System During Micro-Focused Ultrasound With Visualization.

Although micro-focused ultrasound with visualization (MFU-V) has great cosmetic results, patients can be hesitant or decline the treatment due to the pain experienced during the treatment. The primary objective is to assess the efficacy of pain management of the nitrous oxide system during MFU-V treatment. The secondary objectives include patient satisfaction and efficacy on reducing facial laxity and improving aesthetic appearance. A prospective, single-arm, split-face, open-label study. Ten patients were treated with MFU-V without use of a self-administered nitrous oxide system on the right side of the face, followed by use of the nitrous oxide system on the left. A patient-reported Visual Analog Pain Intensity Scale was used to assess pain on the right and left sides at 3 different treatment time points. Patient satisfaction was measured using a 5-point Likert scale and efficacy was measured using the Investigator GAIS and the Facial Laxity Score. Clinically significant differences were seen between pain ratings for the treated and untreated sides at 2 of the 3 time points. 100.0% of patients (n=9) who had completed the study were very satisfied (55.6%) or somewhat satisfied (44.4%). Five patients (55.6%) were scored as Improved on the GAIS and 4 patients (44.4%) were scored as Much Improved. 90.00% (n=9) of patients had moderate lower face and neck laxity prior to treatment, compared with 11.11% (n=1) and 22.22% (n=2) with moderate laxity at follow-up. The nitrous oxide system provides clinically significant pain reduction, increases patient satisfaction, and improves cosmetic results of MFU-V treatment. J Drugs Dermatol. 2022;21(11):1228-1234. doi:10.36849/JDD.7030.

Effect of sitting position versus walking positions during first stage of labor on pain intensity and labor outcomes among primiparous women

Background: Labor is a physiologic process and consideration of labor pain and relief that is among the major components of maternal care. Application of some labor positions can lay the fetus better in the pelvic canal direction. Aim of the study: to evaluate the pain intensity in the sitting position versus the walking position during the first stage of labor and investigate their effects on labor outcomes among primiparous women. Research design Quasi-experimental research design was utilized to fulfill the aim of this study. Setting: The study was carried out in the labor unit in the obstetric department at Mansoura University Hospital. Sample: Included 100 primiparous women in 1 st stage of labor were recruited in the study, they were divided into two equal groups; a sitting group (50) and a walking group (50) randomly selected through convenient sampling from those who were hospitalized in the previously selected setting with a gestational age of 37–42 weeks, singleton pregnancy, and with cephalic presentation. Tools: Structured Interviewing questionnaire sheet, Structured Observational Checklist including (Partograph and Apgar score), and Visual analogue pain intensity scale (VAS) were used.

69 Defining Numerical Cutoff Values for Mild, Moderate, and Severe Pain in Adult Burn Survivors

Abstract Introduction Pain is a common and often debilitating sequelae of a significant burn injury. Clinicians and researchers need clinically valid, reliable pain measures to guide treatment decisions and to provide evidence for study protocol development. Pain rating scores that represent mild, moderate, and severe pain in the burn survivor population have not been established. The aim of this study was to determine the numerical pain intensity rating scores that best represent mild, moderate, and severe pain in adult burn survivors. Methods Average pain intensity visual analog scale (VAS; 0–10) and customized PROMIS pain interference short form was administered to adult burn survivors (age ≥18) treated at a regional burn center at hospital discharge and at 6, 12, and 24-months postburn. To identify the optimal VAS scores for mild, moderate, and severe pain we computed F values and Bayesian Information Criterion (BIC) statistics associated with multiple ANOVA comparisons for mean pain interference scores by various VAS pain intensity cut points. Six possible cut points (CP) were compared: CP 3,6; CP 3,7; CP 4,6; CP 4,7; CP 2,5; and CP 3,5. For example, CP 3,6 refers to pain categorized as mild (0–3), moderate (4–6), and severe (7–10). Optimal cutoffs were those with the highest ANOVA F statistics. Models with similar F statistics were compared using changes in BIC. Results 178 participants (85% white, 65% male, mean age of 46 years) with pain intensity and interference scores at one or more timepoints comprised the study sample. The optimal classification for mild, moderate, and severe pain at baseline and 12-months was CP 2,5. Although CP 3,6 had the highest F value at 6-months, there was not strong evidence to support CP 3,6 over CP 2,5 (BIC difference: 2.9); similarly, CP 3,7 had the highest value at 24-months, but the BIC difference over CP 2,5 was minimal (2.2). Conclusions We recommend that visual analog pain intensity scores for adult burn survivors be categorized as mild (0–2), moderate (3–5), and severe (6–10). These findings advance our understanding regarding the meaning of pain intensity ratings following a burn injury and provide an objective definition for clinical management, quality improvement, and pain research.

Oral health quality of life is associated to jaw function and depression in patients with myogenous temporomandibular dysfunction

ABSTRACT Objective To determine which factors influence and better differentiate between good and poor oral health-related quality of life (OHRQoL) in patients with myogenous TMD and which cut-off could predict a good/poor OHRQoL. Methods Fifty-eight women with myogenous TMD were included. Factors of interest were collected (i.e., demographic variables, depression symptoms (Symptom Checklist-90 R (RDC/TMD)), pain intensity (Visual Analog Scale), jaw function (Mandibular Functional Limitation Questionnaire), and OHRQoL (Oral Health Impact Profile-14). A multivariable regression model, logistic regression, and receiver operating curve (ROC) analyses were conducted. Results Depression symptoms (β = 0.139) and jaw function (β = 0.478) were significantly associated with OHRQoL in the multivariable model. The best model to discriminate between good/poor OHRQoL included only jaw function (AUC = 0.90), with the best cut-off of 17 points (sensitivity: 0.93; specificity: 0.79). Conclusion Depression symptoms and jaw function were significantly associated with OHRQoL. The best model and cut-off to discriminate good/poor OHRQoL included only jaw function.

Efficacy of mebeverin in treatment of abdominal pain

An original study evaluating the effectiveness and safety of mebeverin in treatment of abdominal pain in patients with irritable bowel syndrome (IBS) are presented. Materials and methods: 40 patients diagnosed with IBS, according to the Rome Criteria IV, were monitored. Patients depending on the type of therapy were divided into two groups: 20 patients of the first group had recommendations for lifestyle modification, a hypocaloric diet and took mebeverin per os at a dose of 135 mg three times a day 20 minutes before meals for a month; 20 patients of the second group received only recommendations for lifestyle modification and a hypocaloric diet. All patients were evaluated before and after treatment using the Gastrointestinal Symptom Rating Scale (GSRS), Visual-Analog Pain Intensity Rating Scale (0–10 points), SF‑36 Quality of Life Assessment Question, adverse events assessment. Colonoscopy was performed before treatment to exclude organic pathology of the colon. Results. After treatment patients in the first group had a faster and more significant relief of complaints compared to the second group, a significant improvement in the quality of life on the scales of physical and mental functioning, as well as almost complete disappearance of pain on a visual-analog scale (7.1 out of 10 points before treatment and 0.4 points after). Conclusions. Mebeverin in a dosage of 135 mg three times a day during a month contributes to a significant improvement in well-being, optimizes the quality of life of this category of patients, is effective and safe, which allows us to recommend its use as a first-line spasmolytic drug in the complex therapy of IBS, as well as in various variants of visceral abdominal pain.

Effect of upright and ambulant positions versus lying down during the active first stage of labor on birth outcomes among nulliparous women: randomized controlled clinical trial

Abstract Objective To examine the effect of upright and ambulant positions versus lying down during the active first stage of labor on birth outcomes for nulliparous women. Methods This is a randomized controlled clinical trial conducted at the delivery department of Damanhour Educational Institute, El Behira Governorate, Egypt. The study sample involved 150 parturient women equally divided into intervention and control groups using randomization block technique. The researchers used four tools for data collection: Demographic data interview schedule, World Health Organization Partograph, Apgar's score, to evaluate neonatal outcomes, and visual analogue pain intensity scale. For the study group, the parturient women were encouraged to assume one of the upright positions or ambulating around the bed so as to maintain the pelvis in vertical plane as far as possible for 20–25 min for every 1 h. The control group received routine hospital care, which includes lying down in bed. IBM SPSS 23.0 was used to analyze the data. Results Significant differences (P &lt; 0.05) were observed between the study and control groups in relation to cervical dilation, fetal head descent, uterine contractions interval, and frequency. The duration of the first stage of labor significantly reduced (P = 0.018) in the intervention group compared with control group. No significant differences (P &gt; 0.05) were observed between both groups in term of emergency cesarean birth rates, oxytocin use, and neonatal outcomes. Conclusions This study proves that upright and ambulant positions significantly enhance uterine contractility, cervical dilatation, and fetal head descent and reduce the first stage duration.

Association Between Objectively Measured Physical Activity And Musculoskeletal Disorders, And Perceived Work Ability Among Adult, Middle-Aged And Older Women.

PurposeThe purpose of this study was to assess the relationship between objectively measured physical activity and perceived work ability and musculoskeletal disorders among adult, middle-aged, and older women.Patients and methodsThis study used a cross-sectional design with a convenience sample of 348 women divided into 3 age groups: 30–49 years (n=111), 50–65 years (n=120), 66–75 years (n=117). Weekly physical activity was monitored using tri-axial accelerometer ActiGraph Gt3X. Perceived work ability was assessed using the standardized Work Ability Index (WAI) questionnaire. Information about the occurrence and intensity of musculoskeletal disorders was collected using standardized Nordic Musculoskeletal Questionnaire (NMQ) expanded by visual analog pain intensity scale (VAS).ResultsRegardless of age, women who met physical activity recommendations achieved higher scores in each part of the WAI, and also in the total WAI scores. However, the most significant differences were found in women aged 50–64 years, and included the following items: subjective work ability, work ability in relation to demands, work impairments, sick leave in the past year. Total WAI scores were also significantly higher in women aged 30–49 and 50–64 years who met PA recommendations in comparison to women who did not meet recommendations. Also, significant relations between the frequency of occurrence of musculoskeletal problems and meeting physical activity recommendations were found in women aged 50–64 years. Those who were more physically active reported less musculoskeletal problems in shoulders (p=0.006) and ankles/feet (p=0.018) regions.ConclusionAdherence to Global Recommendations on Physical Activity for Health disseminated by WHO is related to better-perceived work ability among adult (30–49 years) and middle-aged (50–64 years) women. There is also a relationship between adherence to recommendations of physical activity and frequency and intensity of musculoskeletal pain among middle-aged women.

(325) Does Time Variation between Study Visits Relate to Differences in Pain Ratings

Experimental pain research often requires research participants to complete multiple study visits. Variability in the time difference between study visits may be a factor that should be controlled for in pain research. We aim to investigate the question of how variation in the time interval between two study visits affects pain ratings and whether anxiety or pain catastrophizing moderate this effect. During the first visit (V1), participants rated pain intensity (visual analog scale) after each noxious heat stimulus in a series (7 stimuli of 48°C, 10 seconds each). In addition, subjects completed self-reported measures for anxiety (PROMIS® Anxiety) and pain catastrophizing (Pain Catastrophizing Scale). The second visit (V2) included a repeat of the self-report measures and the same noxious heat stimuli during an MRI scan. Pain intensity ratings of the 48°C stimuli were averaged for each visit, and difference scores (V2 minus V1), as well as the percent change [(average intensity V2 minus average intensity V1)/average intensity V1], were calculated for each participant. This is a secondary analysis of 100 healthy adults (31 males, 69 females, age 28.8±6.8) from the parent study. The average difference between study visits was 20.1±20.5 days (range: 1 to 83 days). No significant correlations were identified for the time difference between study visits and pain intensity rating difference (p=0.166), and including anxiety and pain catastrophizing into the analysis did not affect the relationships (p=0.715 and p=0.262 respectively). Similar results were found using percent reduction in pain ratings. Sex and age were included in the models and did not have a significant effect on the relationships. The realities of human research make it difficult to schedule multiple study visits at exact time intervals. Despite variable time between study visits, time difference does not appear to have a significant effect on pain ratings in healthy adults.

Timing of kyphoplasty influences the outcome: a prospective study

The aim of this prospective study was to evaluate the efficiency of early versus delayed treatment of vertebral fractures by balloon kyphoplasty with regard to fracture age. A total of 106 patients (37 male and 69 female) with 128 vertebral body fractures, an average age of 67.5 years (21 to 92) and a body mass index of 26.4 (16 to 40.4) were recorded. All fractures were evaluated radiologically and clinically. Pain intensity (visual analogue scale 0-10), analgesics consumption (WHO steps 1 to 3) and the relevant surgery data (operating time, cement consumption, complications) were recorded. 37 A 1.1, 43 A 1.2, 43 A 1.3, 4 A 3.1 and 1 A 2.3 classifications were collected. Fracture age in days was less than 23 days in 75 patients; the mean time of surgery was 43 minutes. Analgesics consumption was reduced from 1.8 ± 0.8 preoperatively to 1.0 ± 0.6 postoperatively. A significant improvement was found in pain intensity, which fell significantly from 8.2 ± 0.9 preoperatively to 3.9 ± 0.8 postoperatively. In relation to fracture age and pain intensity, a significantly higher pain reduction was achieved with timing of kyphoplasty between 0 and 23 days. Here, pain intensity decreased to 2.5 ± 0.5 postoperatively, compared with 4.5 ± 0.4 for fractures treated later. Fracture age had no influence on vertebral body alignment or improvement of the kyphotic angle. In summary, it can be stated that balloon kyphoplasty is a sufficient method to treat vertebral body fractures, to improve the kyphotic angle and reduce pain significantly.

Effect of Gabapentin vs Pregabalin on Pain Intensity in Adults With Chronic Sciatica

Optimal pharmacologic treatment for chronic sciatica (CS) is currently unclear. While gabapentin (GBP) and pregabalin (PGB) are both used to treat CS, equipoise exists. Nevertheless, pharmaceutical regulation authorities typically subsidize one drug over the other. This hinders interchange wherever the favored drug is either ineffective or ill-tolerated. To assess GBP vs PGB head to head for the treatment of CS. A preplanned interim analysis of a randomized, double-blind, double-dummy crossover trial of PGB vs GBP for management of CS at half the estimated final sample size was performed in a single-center, tertiary referral public hospital. A total of 20 patients underwent randomization from March 2016 to March 2018, and 2 were excluded with 1 lost to follow-up and the other requiring urgent surgery unrelated to the study. Patients attending a specialist neurosurgery clinic with unilateral CS were considered for trial recruitment. Chronic sciatica was defined as pain lasting for at least 3 months radiating into 1 leg only to, at, or below the knee level. Imaging (magnetic resonance imaging with or without computed tomography) corroborating a root-level lesion concordant with symptoms and/or signs was determined by the trial clinician. Inclusion criteria included patients who had not used GBP and PGB and were 18 years or older. Analyses were intention to treat and began February 2018. Randomly assigned participants received GBP (400 mg to 800 mg 3 times a day) then PGB (150 mg to 300 mg twice daily) or vice versa, each taken for 8 weeks. Crossover followed a 1-week washout. The primary outcome was pain intensity (10-point visual analog scale) at baseline and 8 weeks. Secondary outcomes included disability (using the Oswestry Disability Index) and severity/frequency of adverse events. The total trial population (N = 18) consisted mostly of men (11 [61%]) with a mean (SD) age of 57 (16.5) years. A third of the cohort were smokers (5 [28%]), and more than half consumed alcohol (12 [67%]). Gabapentin was superior to PGB, with fewer and less severe adverse events. Both GBP (mean [SD], 7.54 [1.39] to 5.82 [1.72]; P < .001) and PGB (mean [SD], 7.33 [1.30] to 6.38 [1.88]; P = .002) displayed significant visual analog pain intensity scale reduction and Oswestry Disability Index reduction (mean [SD], 59.22 [16.88] to 48.54 [15.52]; P < .001 for both). Head to head, GBP showed superior visual analog pain intensity scale reduction (mean [SD], GBP: 1.72 [1.17] vs PGB: 0.94 [1.09]; P = .035) irrespective of sequence order; however, Oswestry Disability Index reduction was unchanged. Adverse events for PGB were more frequent (PGB, 31 [81%] vs GBP, 7 [19%]; P = .002) especially when PGB was taken first. Pregabalin and GBP were both significantly efficacious. However, GBP was superior with fewer and less severe adverse events. Gabapentin should be commenced before PGB to permit optimal crossover of medicines. anzctr.org.au Identifier: ACTRN12613000559718.

Using of Birthing Ball during the first Stage of Labor: Its Effect on the Progress of Labor and Outcome among Nulliparous Women

Background: It is beyond argument that women who are about to give natural birth to their babiesneed some physical exercise such as standing, walking around, sitting, or kneeling in order to provide for the “gravity effect” that would help in speeding up the dilation of the cervix. The birth ball used to be utilized in various settings of birth and is highly considered as a powerful, secureand easy method of promoting the progress of labor and relieving pain. The current study aim sat studying the using of the birthing ball during the first stage of labor and its effect on the progress of labor and outcome among nulliparous women. The design: The quasi-experimental design was utilized. A group of 120 laboring women was included by purposive sampling technique; the study subjects randomly assigned into two equal group. Setting: The study was implemented in the maternity Unit located in El-Nabawy El Mohandes Hospital (economical part), Fayoum. Five tools have been employed ingathering the needed data; 1) structure interview schedule questionnaire, 2) Partograph, 3) Visual analog pain intensity scale, 4) State Trait Anxiety Inventory and 5) Satisfaction visual analogue scale. The Findings of the present results revealsa high significant statistical difference between the two groups concerning the improvement of the dilatation of the cervix and fetus head descent that end in decreases duration of the first and second labor stages in the study sample. Also the sample of the study expressed less pain and anxiety score. Conclusion: the using of birthing ball throughout the first stage of labor is associated with positive effect on labor progress and outcome. Recommendation: Encourage women to use birth ball during the first stage of labor as one of the significant modalities to improve labor progress, manage pain, anxiety and attain more satisfactory birthing experience.

Robotic rectal resection: preliminary Russian experience

PurposeTo outline the preliminary experience of the da Vinci® robotic system used in a Moscow tertiary colorectal referral center for an unselected range of benign and malignant rectal conditions. MethodsProspective non-randomized single-center study which analyzed results of 26 robotic rectal resections performed between january 2014 and december 2016. ResultsThe cohort included 10 females and 16 males (mean total age 61.6 years). Three patients underwent surgery for benign rectal villous adenomas. The median overall ASA score was 4 (ranged from 2 to 5). Of the surgeries, there were 19 total mesorectal excisions with 6 patients undergoing a multivisceral resection. The mean operating time was 358 minutes with a mean blood loss of 203mL. All total mesorectal excision specimens were adjudged according Philip Quirke classification as mesorectal plane – Grade 3 with a mean of 18.5 lymph nodes identified (from 12 to 35). Of these there were 10 patients (38.5%) with lymph node metastases. After surgery the average pain score was 2.1 out of 10 on the “Visual-Analogue Pain Intensity Scale” and 1.5 score out of 10 on the “Brief Pain Inventory with Quality of Life”. Anal continency after rectal resection with total mesorectal excisions estimated according Wexner Scale: 10 days after surgery average score was −3.1 and a 6 month after surgery −1.6 score. The median length of hospital stay was 11 days (from 10 to 15). ConclusionOur initial experience with a totally robotic rectal resection has shown the technique to be safe and feasible, particularly in patients where conventional laparoscopic rectal resection would be anticipated to be challenging.

Upright versus recumbent position during first stage of labor among primipara women on labor outcomes

Objective: The aim of this study was to assess the effect of upright versus recumbent position during the active phase of first stage of labor among primipara women on labor outcomes in term of progress, duration of labor, method of delivery, neonatal outcome and maternal satisfaction with assumed position.Methods: Quasi experimental design was used. The study was conducted in the labor unit in obstetric department at Benha University Hospital. A purposive sample of 100 parturient women in 1st stage of labor were recruited in the study, they divided into two groups; upright group (50) and recumbent group (50). Data were collected through four main tools: Structured Interviewing questionnaire sheet, Structured Observational Checklist include (Partograph and Apgar score), Visual analogue pain intensity scale and maternal satisfaction with assumed position questionnaire.Results: It revealed that high statistical significant difference between the upright and recumbent groups in term of decreases interval and increases duration, frequency and intensity of uterine contraction, cervical dilatation and fetal head descent/fifth among the upright group. While the recumbent group showed less progress. Moreover, the recumbent group expressed more pain score, consume longer duration of 1st, 2nd, 3rd stage of labor than the upright group and statistical significant difference in Apgar score of the neonate during both first and fifth minute. In addition, the upright group had higher satisfaction scores compared to those assumed recumbent positions (p &lt; .001).Conclusions: Upright position had positive effect on progress of labor, decreased duration of the three stages of labor, better neonatal outcomes and improving parturient women's satisfaction with assumed position. The study recommended that all parturient women in low-risk labor should be informed about the benefits of assuming upright positions during first stage of labor, and be encouraged and supported to use them.

Appleby operation for carcinoma of the body and tail of the pancreas.

The aim of this study is to evaluate the therapeutic efficacy of Appleby operation for carcinoma of the body and tail of pancreas. From March 2010 to February 2015, Appleby operation was performed in 17 patients with carcinoma of the body and tail of pancreas. The values of fasting plasma blood, body weight (BW), visual analog pain intensity scale (VAS score), and the quality of life indices were evaluated before and 1 day, 1, 2, 6 weeks after surgery. Survival time, tumor recurrence time, hospitalization time, and treatment-related complications were analyzed. There was no hospital mortality. Pancreatic fistula and diarrhea were major and most frequent. The rate of morbidity in general was 47.1%. After operation, all of the patients were completely pain-free. The VAS score decreased more after surgery comparing with before (83.2 ± 8.5 vs. 1.9 ± 3.6, P < 0.05). After operation, patients gained more than their preoperative BW with a mean increment of (4.1 ± 1.3 kg) (68.1 ± 4.3 vs. 64.0 ± 6.7, P < 0.05). A significant rise of the overall quality of life index was observed after surgery (93.8 ± 9.7 vs. 68.6 ± 6.7, P < 0.05). The 1-, 2-, 3-, and 5-year recurrence rates were 22.9%, 58.9%, 72.6%, and 72.6%, respectively. The 1-, 2-, 3-, and 5-year survival rates after operation were 80.4%, 54.2%, 32.5%, and 16.3%, respectively. Appleby operation is both safe and effective with regard to pain relief and improvement of overall quality of life. Appleby operation can also achieve a high survival rate and a long overall survival time.

Effect of ice pack application on pain intensity during active phase of the first stage of labor among primiparaous

Labor pain management is one of the main goals of maternity care. Ice application or cooling has been claimed to be as an effective, safe and non-invasive adjuvant mean for providing pain relief during the first stage of labor. Aim of the study: To evaluate effect of ice pack application on pain intensity during active phase of the first stage of labor among primiparaous. Research design: None-randomized-controlled clinical trial research design was utilized. Setting: The study was conducted at labor and delivery unit of El Shatby Maternity University Hospital affiliated to Alexandria University. Subjects: Convenience sample of 80 pregnant women attending the previously mentioned setting were recruited in the study. They were equally divided into ice application &amp; control groups. Tools: Three tools were used for data collection, namely: Tool (I): Pregnant women basic data structured interview schedule, Tool II: Visual Analogue pain intensity scale (VAS) &amp; Tool III: Present Behavioral Intensity Scale (PBIS) Tool IV: Satisfaction visual analogue scale (SVAS). A high statistically significant difference was observed between the study &amp; control groups in relation to their pain intensity using VAS before and after the intervention (P ≤ .000). In addition, another high statistically significant difference was detected between the study group &amp; control groups in relation to their behavior of labor pain (P = .000) before &amp; after 30 as well as 60 min of intervention. Based on the study findings, it could be concluded that the application of ice pack application during active phase of first stage of labor appeared to have a remarkable effect on labor pain intensity. In service training programs for nurses in labor units about the utilization of non-pharmacological approaches is recommended.

"Impact of Interferential Current on Pain Relief among Patients with Orchialgia"

Background:&nbsp;Scrotal discomfort can contribute to unusual impact on body scheme and result in behavioral alterations, as well as changes in sexual function such as delay of sexual ability that may affect both man and his companion. There are many physiotherapy modalities to reduce the intratesticular pain such as pelvic floor muscle training, hydrotherapy, ultrasound and electrotherapy. Interferential current therapy is a noninvasive therapy used to reduce acute and chronic, post-operative and post-trauma acute pain. It provides a safe and effective alternative to pharmacological approaches to pain control. The purpose of the current study was to investigate the efficacy of interferential current in alleviating testicular pain.Methods:&nbsp;Randomized clinical study conducted on 50 participants. They divided into two equal groups: Group A received interferential current with two electrodes placed over the upper medial aspects of thighs and the other two electrodes were positioned over the suprapubic area. While group B received placebo interferential current. The treatment protocol was applied 3 times/ week for six successive weeks, in a total of 18 sessions. Patients were evaluated before and after the six weeks of the treatment by visual analogue scale and pain intensity while pain relief scale was measured after the treatment.Results:&nbsp;Group A showed a significant pain improvement in both inter and intra group comparison in all measured parameters (visual analogue scale and pain intensity while pain relief scale) (p &lt;0.05).Conclusion:&nbsp;The findings show that interferential current is an effective modality and can be recommended for the treatment of testicular pain.

Oral morphine for cancer pain.

Oral morphine for cancer pain.