Visual Analogue Scale Questionnaire Research Articles

Efficacy and safety of a lipid-containing artificial tear compared with a non-lipid containing tear: a randomized clinical trial.

Dry eye disease (DED) is a prevalent condition affecting over 16 million patients in the USA. DED and the symptoms of ocular discomfort are debilitating and a significant burden on patients. If left untreated, DED can progress to cause severe pathology. Treatment is often initiated by patients without consulting a healthcare professional. This study investigated the safety and efficacy of a novel lipid-containing eye drop (BTC), which might better mimic the components of natural tears. This was a multicenter, randomized, double-masked, active control, two arm, parallel group study of eye drops in adult subjects with self-reported DED. Subjects were randomly assigned to BTC or control (commercially available non-lipid eye drops; NLED) arm and were followed for 30 days. Assessments using visual analog scale and patient-reported outcomes (PRO) questionnaires, non-invasive tear break up time, slit-lamp examination, and subject-reported ocular symptoms were conducted at baseline and at days 7 and 30. The primary endpoint was change in overall ocular comfort score from baseline to day 30. 158 subjects were randomized, of whom 130 completed the study per protocol (PP). Mean (SD) age was 47.8 (14.14) years. The mean (95% CI) change in overall comfort scores at the 30-day follow-up in the PP population was 21.4 (15.1, 27.7) for the test drop and 10.0 (3.9, 16.1) for the comparator. The mean (95% CI) treatment difference was 11.3 (2.6, 20.1); this met the pre-defined requirements for non-inferiority. There was no significant difference in the proportion of eyes with reported ocular symptoms between the groups. At day 7, the OR (95% CI) was 0.967 (0.528, 1.770) and at day 30 was 1.160 (0.610, 2.203). There were no Grade 3 or higher corneal edema, corneal neovascularization, corneal staining, conjunctival injection, tarsal abnormalities or any other biomicroscopy findings, and no corneal infiltrates observed during the study. The investigational lipid eye drop BTC was noninferior to the commercially available non-lipid comparator in all parameters measured and has the potential to provide an effective therapy for subjects with symptoms of dry eye who would benefit from a lipid-based artificial tear. NCT03995355 ( http://www. gov ), registered June 24, 2019.

Possible Role of Platelet-Rich Plasma in the Treatment of Patients with Postherpetic Neuralgia: A Prospective, Single-Arm, Open-Label Clinical Study

Abstract Background: Currently, no treatment can fully and finally treat postherpetic neuralgia (PHN). Objectives: This study aimed to evaluate the possible efficacy of autologous intralesional platelet-rich plasma (PRP) injection in treating patients with PHN. Materials and Methods: A prospective, single-arm, open-label clinical study was conducted on 45 patients with PHN attending the Dermatology Outpatient Clinics of Sohag University Hospital, Egypt, between November 2019 and November 2021. Patients were subjected to full clinical general and dermatologic examinations. Patient’s assessment included; severity of pain through visual analogue scale (VAS), numerical rating scale (NRS), and verbal rating scale (VRS), in addition to Medical Outcomes Study 36 Item Short-Form (SF-36). Patients were treated by autologous PRP injection every 2 weeks for 2 months (4 sessions). Patients were evaluated before every session and 3- months after the last session. Results: There was a significantly decreased VAS, NRS, VRS, and SF-36 questionnaire values in the last session and three months after the last session. There was a highly significant moderate correlation between both scales (VAS and VRS) and patient’s age in years and who have aggravating factors. Likewise, there was a significant moderate positive correlation between scales (VAS and VRS) and the disease duration, medical co-morbidities, and associated myalgia. Limitations: These findings require further confirmations on more inclusive large-sized multicenter, randomized, placebo-controlled, clinical trials with longer follow-up. Conclusion: This clinical pilot study concluded that autologous intralesional PRP injection was an effective therapeutic option for patients with PHN.

Decoding pain: prediction under different emotional contexts through physiological signals

AbstractPain recognition is a challenging yet crucial problem. Common methods used to measure pain are based on self-reported tools; however, not every person can communicate it. Therefore, automatic pain detection methods have emerged. Since pain is related to the emotional state of an individual, this variable must be considered. Thus, this work proposes pain prediction under different emotional contexts. For this purpose, data were collected during a protocol designed for pain induction with previous emotional elicitation. Emotions were elicited through videos composed of excerpts of documentaries, horror and comedy films, while the pain was induced through a Cold Pressor Test. Physiological signals, such as electrocardiogram, electrodermal activity and surface electromyogram, were collected during the protocol. Furthermore, several questionnaires were answered and pain reports were also registered. Two problems were addressed: pain classification and estimation of the Pain Tolerance score. The algorithm with the best performance for each problem was found using only data from the neutral session and nested cross-validation strategy. Using only physiological data from the neutral session, a F1-score of 99.32% was obtained for pain recognition and a mean absolute error (MAE) of 0.29 was obtained for Pain Tolerance estimation. When considering all the emotional sessions, the physiological data were merged with scores of the Visual Analogue Scale questionnaire, achieving a F1-score of 98.60% and a MAE of 0.41, for the first and second problems, respectively. These results are promising and stress out the key role that the emotional context of the individuals plays in pain prediction.

Bisphosphonates and Antibiotics Combination Therapy for Chronic Low Back Pain Associated with Modic Change: A Quasi-Experimental Study

Background: Although effective treatments are still lacking for chronic low back pain (CLBP) associated with Modic changes (MC), in recent years, the efficacy of bisphosphonate and antibiotic treatment has been tested separately with variable success. This study aimed to compare the effectiveness of combined therapy of bisphosphonate and antibiotics versus single-drug therapy in CLBP patients with MC.Methods: This quasi-experimental study was carried out from October 2019 to September 2020 according to 1964 Helsinki declaration among 60 adult CLBP patients with MC (confirmed by magnetic resonant imaging) and randomly allocated in Group-A (n=20): Zoledronic acid (ZA) only, Group-B (n=20): amoxicillin-clavulanate only, and Group-C (n=20): both ZA and amoxicillin-clavulanate. The primary outcomes were measured by the visual analog scale (VAS) and Roland Morris disability questionnaire (RMDQ) at follow-ups after 1 month, 100 days, and 6 months. Per-protocol analysis was performed using SPSS 24.Results: Out of the 60 patients, 43 patients (72%) completed all three follow-ups. The VAS score gradually decreased in all groups after treatment, wherein Group-C patients had the significantly lowest score at the 2nd and 3rd follow-ups (2.87±0.80 and 1.68±0.70, respectively) compared to Group-A (3.40±0.63 and 2.20±0.67, respectively) and Group-B (3.50±0.52 and 2.41±0.66,respectively). In addition, RMDQ also decreased significantly after 1 month compared to pretreatment (p<0.05) in all 3 groups, and this gradual decrement was continued until 6 months of treatment. However, it was reduced more in Group-C (6.26±0.70) than in group-A (6.69±1.40) and Group-B (7.75±1.21) at the end of the 3rd follow-up. Moreover, Group-C patients had the highest satisfaction level and lowest number of days with absence from work score compared to A and B (p<0.05). However, adverse effects were relatively higher in Group-C than A and B (p>0.05).Conclusion: Bisphosphonates and antibiotics combination therapy is more effective than single-drug therapy for CLBP associated with MC.

Association of Diabetes with Musculoskeletal Pain of the Upper Quadrant in Housewives of Lahore

Background: Musculoskeletal (MSK) pain is a common yet under-recognized complication of Type 2 Diabetes Mellitus (T2DM). Diabetic patients, particularly housewives, are prone to upper quadrant musculoskeletal discomfort due to physical strain and poor glycemic control.Objective: To determine the association between diabetes and musculoskeletal pain in the upper quadrant among housewives in Lahore.Methods: A cross-sectional study was conducted on 162 diabetic housewives aged 30-60 years. Participants were recruited using non-probability convenient sampling from four hospitals in Lahore. Data were collected through the Visual Analogue Scale (VAS) and Nordic Musculoskeletal Questionnaire. SPSS version 27 was used for data analysis, with Chi-square tests applied to assess associations. Statistical significance was set at p < 0.05.Results: The mean age of participants was 47.26 ± 7.57 years. Shoulder pain was reported at 39.5%, neck pain at 23.5%, and upper back pain by 13.6%. 61.1% experienced moderate pain, while 17.9% had severe pain. A significant association was found between diabetes and musculoskeletal pain (p < 0.001).Conclusion: There is a strong association between T2DM and upper quadrant musculoskeletal pain, particularly in the shoulder. Early detection and management are essential to prevent chronic MSK conditions.

Internal Nasal Valve Collapse Treatment by Endonasal Hyaluronic Acid Injection.

Internal nasal valve collapse (IVC) is a common functional complication of rhinoplasty and injecting hyaluronic acid is one of the treatment options available, but its effectiveness has never been evaluated. The objective of this study was to assess the evolution of IVC after injection of hyaluronic acid using objective and subjective measures of nasal obstruction. A prospective interventional study was conducted. Adult patients consulting for nasal obstruction after (septo)rhinoplasty and diagnosed with IVC were included. Patients underwent 4-phase rhinomanometry, completed nasal obstruction symptoms evaluation (NOSE) and visual analog scale (VAS) questionnaires and received hyaluronic acid injections. Measurements were repeated immediately, one month and one year later. The primary outcome measure was the proportion of patients below the rhinomanometric diagnostic threshold for IVC at one month. Among the 22 patients included, 20 (91%) had rhinomanometry measurements below the diagnostic threshold for IVC one month after injection. It decreased to 53% (8/15 patients) at one year post injection. The mean NOSE score decreased from 74.5 (± 18.0) before injection to 35.2 (± 23.3) after injection (p < 0.0001). The mean VAS score decreased from 7.0 (± 1.4) before injection to 3.4 (± 1.9) after injection (p < 0.0001). In these patients with post-(septo)rhinoplasty IVC, hyaluronic acid injection into the internal nasal valve substantially improved subjective and objective measures of nasal obstruction. These results suggest hyaluronic acid injection (performed as described) is an effective treatment for IVC and is an excellent alternative to surgical treatment. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .

The impact of protein delivery on short-term and long-term clinical outcomes in critically ill patients: Protocol for a multicenter, prospective, observational study (The ACTION study)

Background and aimsNutrition therapy is a vital part of the management of critically ill patients. Efforts have been made to optimize nutrition therapy in the ICU setting, and it is argued that protein might be the most important substrate to deliver during critical illness. However, the impact of protein delivery on patient-centered outcomes, including short-term and long-term outcomes, is controversial. Moreover, previous studies showed that compliance with the guidelines is poor in practice, and the amounts of protein intake vary significantly among different hospitals. The objective of this study is to describe the current practice of protein delivery for critically ill patients and to investigate the association between different protein delivery amounts and approaches during ICU admission and multiple patient-centered outcomes (short-term and long-term). MethodsThis is a multicenter, prospective, observational study conducted in 70 hospitals, aiming to recruit more than 1800 newly admitted critically ill patients who are expected to stay in ICU for at least 48 hours. Data, including the baseline characteristics, illness severity scores, requirements of organ support therapy, and daily nutritional therapy, will be recorded until day 28 after enrollment unless discharge from the ICU or death occurs first. The key long-term clinical outcomes, like readmission post the index discharge and health-related quality of life, will be collected via telephone contact on Day 90 and Day 180 after recruitment. Quality of life will be assessed by the EuroQol five dimensions five-level questionnaire (EQ5D5L) visual analogue scale score. Apart from descriptive data, multivariate analyses adjusted for potential confounders will be applied to assess the association between protein intake during ICU stay and short-term and long-term clinical outcomes. Ethics and trial registrationThis study was reviewed and approved by the ethics committee of Jinling Hospital (2021NZKY-027-01) and the participating sites. The study was registered at the Chinese Clinical Trials Registry (ChiCTR2200067016) before enrollment.

Effect of ear cleaning on treatment outcome for canine otitis externa.

Ear cleaning is often recommended for management of canine otitis externa (OE). Few invivo studies evaluate how ear cleaning affects treatment outcome. To determine the effect of ear cleaning on canine OE by comparing treatment outcome in cleaned versus noncleaned ears. Twenty-three client-owned dogs with ceruminous or purulent OE. Forty ears were randomised to one of two groups: 20 ears were wiped with dry or saline-moistened gauze (grp1), and 20 external ear canals received manual cleaning (grp2) with a commercial product. One millilitre of a commercial otic suspension containing hydrocortisone aceponate, miconazole nitrate and gentamicin sulfate was applied to affected ears every 24 h for five days. Cytological scores, modified otitis index score (OTIS3), pruritus Visual Analog Scale (PVAS), modified PVAS and client questionnaire were compared on Day (D)0 and D7. There were no statistical differences between cytological scores, modified OTIS3, PVAS, modified PVAS or client assessments between groups at D7. Both groups had significant reduction in all treatment parameters from D0 to D7 with the exception of cytological rod scores that were only significantly decreased in cleaned ears. There was a significant difference in OTIS3 before and after cleaning on D0. Both groups achieved successful outcome regardless of cleaning. Ear cleaning may be more important when rod-shaped bacteria are present.

Kombinasi Pemberian Sereh dan Kunyit terhadap Penurunan Intensitas Nyeri Menstruasi pada Remaja Putri Kelas VII di SMP N 2 Kuta

Intoduction: Adolescence is a transition period marked by physical, emotional and psychological changes.Menstrual discomfort is one of the most frequent illnesses associated with menstruation. Non-pharmacological therapy is used to alleviate menstrual discomfort, specifically a combination of lemongrass and turmeric. The purpose of this study was to assess whether administering lemongrass and turmeric reduced the menstrual pain intensity felt by adolescent girls. Method: This study employed a quasi-experimental research design using a Non-Equivalent Control Group Design and purposive sampling, involving 64 grade VII adolescent girls separated into two groups: the intervention and the control group. Pain intensty was assessed using a VAS (Visual Analog Scale) questionnaire.. Result: The results of This study’s findings obtained that the pretest p-value for the treatment group was 0.000&lt;0.05, indicating a difference in menstrual pain after the intervention. However, the post-test p-value for the control group was 1,000&gt;0.05, indicating no difference in menstrual pain in the control group. Mann Whiteny analysis yielded a p value of 0.00 (&lt;0.05), indicating that the combination of lemongrass and turmeric reduced menstruation pain felt by adolescent girls. Sugestion: It is intended that the combination of lemongrass and turmeric will be considered when delivering complete midwifery care to adolescent girls in order to minimize the menstrual pain intensity.

Effectiveness of topical gabapentin cream in treating pruritus in dialysis patients: A randomized controlled trial.

Gabapentin is an antiepileptic drug that alleviates neuropathic pain. Its oral use reduces the intensity of pruritus in patients receiving chronic dialysis therapy. However, it could lead to toxicity because of the patients' renal deficiency. In this study, we assessed the use of gabapentin topical in treating pruritus in dialysis patients. This randomized, triple-blinded trial was performed on 80 patients divided into two groups randomly (40 in each group). In intervention group, 92.5% of the patients were on hemodialysis. Patients in intervention and control groups were provided with 5% gabapentin and placebo topical creams every 2 weeks for a month. Both Visual Analog Scale and 12-item Pruritus Severity Score questionnaire were used to evaluate itching intensity and score before treatment, a month, and 2 months after starting treatment in both groups. In addition, the effect of itching on quality of life was investigated with the same questionnaire. Eighty patients (40 in each group) participated in our study. No complication was found in our intervention group. Itching score significantly decreased after a month and 2 months of follow-up in intervention group (p < 0.001). Our results showed that 5% gabapentin topical cream can be effective in reducing itching in different areas of the body. None of our patients reported complications.

Effect of immediate all-digital restoration of single posterior implants: The SafetyCrown concept on patient-reported outcome measures, accuracy, and treatment time-A randomized clinical trial.

The SafetyCrown workflow facilitates the immediate restoration of posterior single sites with the one-abutment/one-time concept. This randomized clinical trial aimed to assess the direct effect of immediate restoration on dental patient-reported outcomes (dPROs), feasibility, implant accuracy, and time. Participants with a single posterior edentulous site for late implant placement underwent optical impressions, shade selection, and cone beam computed tomography. After virtual treatment planning, they were randomized into the test group and the control group. For the test group, individual definitive hybrid abutments were prefabricated. The next step was a fully guided surgery with printed guides. After the implant was placed using guided surgery, the abutment was inserted. A chairside CAD/CAM workflow was used to provide the patient with a provisional restoration. Implants in the control group were left submerged to heal. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-G14, and dPRO was measured using a 10-item visual analog scale (VAS) questionnaire. Additional measurements of implant accuracy and time were performed. Follow-up was performed 7 to 10 days after implant placement. Thirty-nine participants with 45 restorations were included (test group: 23, control: 22). Immediate restoration was successful in 21 out of 23 implants (91.3%) in the test group. Both groups exhibited decreased OHRQoL without significant intergroup differences, while patient satisfaction was high overall. Test group participants perceived higher benefits and satisfaction with immediate loading than participants in the control group. Implant accuracy averaged 0.60 mm at the shoulder and 0.95 mm at the apex. Operative time was longer in the immediate loading group (61.9 min) than in the control group (32.1 min) (p < 0.001). Considering the limitations, the immediate restoration of late placed posterior implants using the described workflow proved feasible in 21 out of 23 cases. Both groups achieved high patient satisfaction with no differences in OHRQoL during the first week. Patients who received immediate loading rated the benefits very highly and were satisfied with the provisional restoration during the healing period.

Evaluation of the efficiency of rehabilitation interventions in patients after unilateral biportal endoscopic discectomy

Background. Unilateral bi-portal endoscopic discectomy (UBED), as other surgical methods of treatment, may require the use of additional rehabilitation interventions in the recovery process of patients. Unfortunately, studies on the effectiveness of nonpharmacological methods in the postoperative period for these patients are insufficient. The study purposed to evaluate the effectiveness of a rehabilitation intervention program in the patients who have undergone UBED. Materials and methods. The study was conducted at the Department of Neurosurgery of the Spine and Spinal Cord of the Ivano-Frankivsk Regional Clinical Hospital in 2022–2023. The sample consisted of the main group (MG, n = 74) — patients who underwent removal of the hernia of the intervertebral disc used UBED and complex rehabilitation and control group (CG, n = 68) — UBED was performed without a rehabilitation course. Study methods: we used visual-analogue scale (VAS) and Oswestry questionnaire before surgery and after it (in 1 day and 1, 6 and 12 months). Results. In the preoperative period, the back pain index was 5.3 ± 1.4 and 5.6 ± 1.1 cm in MG and CG, respectively. In the postoperative period the back pain index according to the VAS decreased to 1.5 ± 0.4 cm in one day after surgery in the MG with its positive dynamics during the year of observation. In CG this index also decreased to 1.4 ± 0.9 cm with a gradual improvement to 0.3 ± 0.1 cm in 12 months. At the 12 months after the surgery the Oswestry index demonstrated that quality of life was better in the subjects of MG compared to the CG (5.4 ± 3.2 and 17.4 ± 3.3 %, respectively). Conclusions. The use of physical ­exercises in combination with massage and hardware physiotherapy in patients who have UBED improved the quality of life of the patients in the long-term observation period, but did not affect the reduction of pain after the surgery in both short-term and long-term observation

Application of Multi-Rod Constructs for the Revision of Thoracolumbar Fractures.

The revision procedure for failure of internal fixation after thoracolumbar fracture is controversial. Combined anterior and posterior surgery is associated with higher risk more intraoperative bleeding and tissue damage. The success rate of simple anterior surgery needs further confirmation, and posterior surgery lacks stability of internal fixation. This study evaluates the feasibility and surgical effect of multi-rod constructs in the revision of thoracolumbar fractures. Eleven patients with thoracolumbar fractures who underwent previous construct failure and were treated with revision and internal fixation with the multi-rod technique from March 2017 to September 2018 were analyzed. The original internal fixation was removed and replaced in the medial insertion of satellite rods and bone graft. The average follow-up time was 15.97 months. The intraoperation blood loss, the time of the operation, activation and discharge and the rate of rod fracture were calculated. The sagittal Cobb angle before revision, after revision and at the last follow-up were compared. The clinical effect was evaluated by visual analogue scale (VAS) and Oswestry Disability Index questionnaire (ODI). The average operation time was 107 min, the intraoperative blood loss was 131.81 mL, the active time was 1.59 days, and the discharge time was 10.89 days. No rod fractured again during the follow-up period. The paired t-test was used to compare the Cobb angle, VAS score, and ODI before and after surgery. There was significant difference in the sagittal Cobb angle between the pre-revision and the posterior sagittal position (p = 0.000), and no significant difference was found between post-revision and last follow-up (p = 0.551). VAS and ODI were greatly improved at the last follow-up. The literature on revision of thoracolumbar fractures is insufficient and comprises varying opinions. This paper proposes a new treatment option. The application of the multi-rod constructs in the revision of thoracolumbar fractures is safe, simple, and effective and might provide guidance for future clinical work.

Effect of 8 weeks of cognitive behavioral therapy versus 8 weeks core stabilization training in the management of subjects with non-specific low back pain: a randomized controlled trial

BackgroundPatients with chronic pain usually regard pain as a stressful situation. The literature revealed that chronic pain is associated with social and cognitive dysfunction. Recently, the literature started to support using cognitive behavioral therapy to reduce the effect of chronic nonspecific low back pain.ObjectivesThe study aimed to assess the effect of cognitive behavioral therapy versus core stabilization training in the treatment of subjects with non-specific chronic low back pain.MethodsNinety subjects were enrolled in the current study, with mean age (32.30 ± 4.38) and mean weight (72.27 ± 10.88). They were equally randomized into three equal groups A, B, and C using opaque envelopes and computer-generalized numbers. Group A received cognitive behavioral therapy plus traditional treatment, group B received a core stabilization training program plus traditional treatment, and group C received only traditional treatment. Visual Analog Scale, Fear Avoidance and Belief Questionnaire, and Oswestry Disability Index were used pre- and post-treatment to measure the outcomes in response to the treatment plans.ResultsStatistical analysis revealed that there was a significant decrease in the Visual Analog Scale, Fear Avoidance and Belief Questionnaire, and Oswestry Disability Index post-treatment compared with pre-treatment in group A (P < 0.001), group B (P < 0.001), and group C (P < 0.001). Also, the results revealed that there was a significant decrease in the Visual Analog Scale, Fear Avoidance and Belief Questionnaire work/lifestyle, and Oswestry Disability Index of group A compared with group B (P < 0.05) and group C (P < 0.001) and a significant decrease in outcome measures in group B compared with group C (P < 0.05).ConclusionThe results of the current study support the involvement of cognitive therapy in the management of chronic pain as it guides the patient to be aware of the underlying mechanism of chronic pain and the management maneuvers to overcome such pain. Also, the results provide credit to cognitive behavioral therapy in terms of long-term relief of chronic pain.

Postprandial appetite responses to a pecan enriched meal: A randomized crossover trial

Longer-term pecan consumption has shown appetite-regulating effects as a part of a free-living diet, yet the physiologic appetite responses to a single pecan-containing meal are unclear. The purpose of this study was to compare the acute physiologic, subjective, and direct appetite responses of a pecan-containing meal to an energy- and macronutrient-matched control meal. This was an acute meal challenge study utilizing a double-blinded randomized crossover design with two periods. Participants were young, healthy adults (BMI: 22.9 ± 3.3 kg/m2, age: 22 ± 3 y) who consumed a meal containing either 68 g of pecans (PEC; 795 kcal) or an energy- and macronutrient-matched control meal (CON; 794 kcal) on separate testing days. At both testing visits, five postprandial blood draws, and visual analog scale (VAS) questionnaires (in-lab) were used to determine differences in peptide YY (PYY), ghrelin, and subjective appetite over a 4-h postprandial period. Participants also completed VAS questionnaires (at-home) and food records for the rest of the day after leaving the testing visits. Thirty-one out of thirty-two randomized participants completed the study. There was a greater overall postprandial PYY response (p < 0.001), and a greater suppression of postprandial ghrelin after time point 120 min (p < 0.001), with the PEC vs. CON meal. Further, there was a greater increase in subjective fullness (p = 0.001), and suppression of at-home overall appetite (p = 0.02), from time 240–780 min post-meal with PEC vs. CON meals. There were no differences in self-reported EI between meals or any other VAS measure. In conclusion, a pecan-containing breakfast shake produced more favorable physiologic and subjective improvements in appetite compared to an energy- and macronutrient-matched control meal. This trial is registered at clinicaltrials.gov (NCT05230212).

Comparative study of efficacy and safety of pregabalin and gabapentin for treatment of neuropathic pain in oral cavity cancer patients: a comparative, randomized and prospective study

Background: Pain in patients with oral cancers can limit the normal functioning and quality of life. Neuropathic pain raises the anxiety and depression levels, increases the morbidity and decreases the efficiency to work. Neuropathic pain is frequently diagnosed as a complication of cancer pain due to direct invasion of nerves, plexus or compression, and side effect of chemotherapy, radiation injury or surgery. Methods: A total of 60 patients were divided randomly into two groups based on treatment: group P (pregabalin) and group G (gabapentin). The intensity of pain was measured using visual analog scale (VAS) and DN4 questionnaire (Douleur Neuropathique 4) was used to evaluate neuropathic component. Changes in pain score and neuropathic component was assessed at 2nd and 4th week of follow up. Data was collected and analysed using SPSS 20.0 software at level of significance being p&lt;0.05. Results: At baseline, the mean±SD of VAS score in group P was 7.20±0.79; in group G was 7.13±0.66. At 2nd week, the mean±SD of VAS score in group P was 4.5±0.91; in group G was 4.46±0.88. At 4th week, the mean±SD of VAS score in group P was 3.66±0.69; in group G was 3.83±0.85. At baseline, the mean±SD of DN4 score in group P was 7.13±0.80; in group G was 6.93±0.85. At 2nd week, the mean±SD of DN4 score in group P was 4.73±0.92; in group G was 4.46±0.82. At 4th week, the mean±SD of DN4 score in group P was 3.73±0.42; in group G was 3.93±0.62. Conclusions: Pregabalin was found to be more effective with lesser side effects than gabapentin.

A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled 14-Week Study of Mirogabalin in Chinese Patients with Diabetic Peripheral Neuropathic Pain.

There is no approved effective drug for diabetic peripheral neuropathic pain (DPNP) in China. Gabapentinoids including mirogabalin have shown promise, although data in Chinese patients are scarce. This phase 3, multicenter, randomized, double-blind, placebo-controlled trial investigated the efficacy and safety of mirogabalin for treating DPNP in China. Mirogabalin was administered at 5mg twice daily for the first week and uptitrated to 15mg twice daily for a total duration of 14weeks. The primary efficacy endpoint was the change from baseline in weekly average daily pain score (ADPS) at week 14; secondary endpoints included the ADPS responder rate, Short-Form McGill Pain Questionnaire visual analogue scale score, patient global impression of change (PGIC), average daily sleep interference score (ADSIS), EuroQol 5-dimensions 5-levels (EQ-5D-5L), and incidence of treatment-emergent adverse events (TEAEs). Of 393 patients (mirogabalin, n = 196; placebo n = 197), the mean age was 58.2years (mirogabalin, 58.7years; placebo, 57.7years) and 54.2% were male (mirogabalin, 56.1%; placebo, 52.3%). Mirogabalin elicited a greater change from baseline in the weekly ADPS vs. placebo at week 14: least-squares mean difference (95% confidence interval) vs. placebo - 0.39 (- 0.74, - 0.04), p = 0.0301. PGIC, ADSIS, and EQ-5D-5L data reflected significantly better improvements for patients receiving mirogabalin vs. placebo. The incidence of TEAEs was 75.0% and 75.1% in the mirogabalin and placebo groups, respectively. Most TEAEs were mild or moderate, and the incidence of TEAEs leading to treatment discontinuation was 2.6% in the mirogabalin group and 1.5% in the placebo group. Although the effect size of mirogabalin was reduced due to the placebo effect, mirogabalin is a safe and effective treatment option for Chinese patients with DPNP. ClinicalTrials.gov identifier, NCT04094662.

Comparison of the clinical effectiveness of Class IV Laser therapy and therapeutic ultrasound in patients with chronic neck pain: a randomized controlled trial

INTRODUCTION: Chronic neck pain (CNP) is a common musculoskeletal problem that affects a large proportion of the population and lasts longer than three months. It has a high cost in terms of life, disability, and healthcare. Several modalities have effectively provided immediate and long-term relief for CNP; however, the comparative clinical effectiveness of these modalities is limited. OBJECTIVES: The study aimed to determine the clinical effectiveness of Class IV Laser therapy and Therapeutic Ultrasound (TUS) in patients with CNP. METHODS AND MATERIALS: Forty-four patients with CNP of both genders were recruited from an age range of 20–45 years from the Department of Musculoskeletal Physiotherapy of Maharishi Markandeshwar Institute of Physiotherapy, MM(DU), Ambala, India. They were divided into two groups at random: the LASER group A (n = 22) and the TUS group B (n = 22). The intervention duration was 2 weeks with 6 treatment sessions. Pre- and post-treatment outcome measures were assessed with the Visual Analog Scale (VAS), Algometer, Goniometer, and Neck Disability Index (NDI) questionnaires at baseline and after 2 weeks of intervention. The LASER group received a target dose of 10 joules per cm2 at a power of 10 watts, with a continuous dosage frequency. The TUS group underwent a continuous mode ultrasound (3 MHz, 1 W/cm2) for 6 minutes. The Shapiro-Wilk test was used to assess the normality of the data. For parametric and non-parametric data analysis within the group, the paired t-test and Wilcoxon signed rank were used. The independent t-test and Mann-U Whitney test were used for the group comparison of parametric and non-parametric data, respectively. RESULTS: In both groups, there was a significant improvement in all the outcome measures (p&lt;0.001). There was a statistically significant difference between the two interventions in VAS, Pain Pressure Threshold (PPT), and NDI (p&lt;0.05). CONCLUSION: Class IV Laser therapy is clinically more effective than therapeutic ultrasound in treating patients with chronic neck pain.

Assessing the effectiveness of high frequency repetitive transcranial magnetic stimulation for post-mastectomy pain in breast cancer patients: A randomized controlled trial.

Post-mastectomy pain Syndrome (PMPS), characterized by chronic neuropathic pain stemming from intercostobrachial nerve lesions, presents a formidable clinical challenge. With the incidence of breast cancer surging, effective interventions for PMPS are urgently needed. To address this, we conducted this double-blind, placebo-controlled, randomized clinical trial to study the efficacy of repetitive Transcranial Magnetic Stimulation (rTMS) therapy over the motor cortex on pain, quality of life and thermal sensitivity in PMPS patients. We delivered 15 rTMS sessions over three weeks in a cohort of 34 PMPS patients. These patients were allocated randomly to either rTMS therapy or sham therapy groups. Pain assessments, utilizing the Visual Analogue Scale (VAS) and Short Form McGill Pain Questionnaire (SF-MPQ), alongside quality-of-life evaluations through the Functional Assessment of Cancer Therapy-Breast (FACT-B), were recorded before and after the 15 sessions. Additionally, we assessed thermal sensitivity using Quantitative Sensory Testing (QST). Our findings demonstrate the superior efficacy of rTMS therapy (over sham therapy) in reducing VAS and SF-MPQ scores (p < 0.0001), improving physical (p = 0.037), emotional (p = 0.033), and functional well-being (p = 0.020) components of quality of life, as quantified by FACT-B. Our investigation also unveiled marked enhancements in thermal sensitivity within the rTMS therapy group, with statistically significant improvements in cold detection threshold (p = 0.0001), warm detection threshold (p = 0.0033), cold pain threshold (p = 0.0078), and hot pain tolerance threshold (p = 0.0078). The study underscores the profound positive impact of rTMS therapy on pain, quality of life, and thermal sensitivity in patients havingPMPS, opening new avenues for pain management strategies.

Effects of suboccipital inhibition versus soft tissue manipulation on pain intensity and disability in tension-type headache among undergraduate physiotherapy students

BackgroundTension-type headache (TTH) is prevalent among collegiate students due to academic stress. Manual therapies like suboccipital inhibition and soft tissue manipulation have shown efficacy in TTH management. However, comparative studies between these interventions in collegiate populations are scarce. Understanding their relative effectiveness can enhance treatment strategies and improve outcomes, shedding light on optimal manual therapy approaches for TTH among collegiate students. This study aimed to investigate the effects of suboccipital inhibition and soft tissue manipulation on pain intensity and disability in tension-type headache (TTH) among undergraduate physiotherapy students.MethodsForty undergraduate physiotherapy students diagnosed with TTH were randomly assigned to the suboccipital inhibition group (group A, n = 20) and the soft tissue manipulation group (group B, n = 20). The suboccipital inhibition group received manual therapy targeting the suboccipital muscles, while the soft tissue manipulation group received manipulation techniques focusing on the cervical and shoulder girdle muscles. Pain intensity and disability were assessed using Visual Analogue Scale (VAS) and Headache Disability Index (HDI) Questionnaire at baseline and after 6 weeks of intervention. The data were collected and analysed using independent t test.ResultsBoth interventions demonstrated significant reductions in pain intensity and disability after 6 weeks, with the t value − 4.3150 and − 3.3106 at p < 0.05 for VAS and HDI respectively.ConclusionSuboccipital inhibition and soft tissue manipulation are effective interventions for reducing pain intensity and disability among undergraduate physiotherapy students with TTH. However, the suboccipital inhibition group showed improvement in pain intensity and disability and it has been statistically significant when compared to the soft tissue manipulation group.