Visual Analog Scale Scoring System Research Articles

Chairside digital design and manufacturing method for children's band and loop space maintainers.

This study proposes a chairside digital design and manufacturing method for band and loop space maintainers and preliminarily validates its clinical feasibility. Clinical cases of 10 children requiring space maintenance caused by premature loss of primary teeth were collected. Intraoral scan data of the affected children were also collected to establish digital models of the missing teeth. Using a pediatric band and loop space maintainer design software developed by our research team, a rapid personalized design of band and loop structures was achieved, and a digital model of an integrated band and loop space maintainer was ultimately generated. A chairside space maintainer was manufactured through metal computer numerical control machining for the experimental group, whereas metal 3D printing in the dental laboratory was used for the control group. A model fitting assessment was conducted for the space maintainers of both groups, and senior pediatric dental experts were invited to evaluate the clinical feasibility of the space maintainers with regard to fit and stability using the visual analogue scale scoring system. Statistical analysis was also performed. The time spent in designing and manufacturing the 10 space maintainers of the experimental group was all less than 1 h. Statistical analysis of expert ratings showed that the experimental group outperformed the control group with regard to fit and stability. Both types of space maintainers met clinical requirements. The chairside digital design and manufacturing method for pediatric band and loop space maintainers proposed in this study can achieve same-day fitting of space maintainers at the first appointment, demonstrating good clinical feasibility and significant potential for clinical application.

Haematoma Block for Distal Radius Fracture Pain Management

Introduction: HB (Hematoma Block) is a commonly utilized technique all over the world to relieve discomfort during the management of DRF (Distal Radius Fractures). In this approach, 10ml to 15ml of 2 percent lignocaine, a topical anesthetic is utilized to reduce discomfort during the fracture reduction process. Materials & Methods: In this study, we recruited fifty individuals between January and December of 2023. Every patient had a distal radius extra-articular fracture that required percutaneous pinning or plaster casting. HB using 12 to 15 ml of 2% lignocaine was administered to the patients for hematomas at the fracture site. Using the Visual Analogue Scale method, the patient's pain distribution and severity were measured before, during, and after the decrease. Findings: Before the HB, the average VAS (Visual Analogue Scale) score was 9.5. Less than two hours after the surgery and during reduction, the average VAS score dropped to 2.5 (range between 0.5 to 3.5). A scale of 0 to 10 cm is used to define the VAS scoring system. Conclusion: We found that HB is a safe and efficient technique of anesthetic in DRF where manipulation or reduction is necessary for pinning or casting.

A comparative study between functional and radiological outcome of short and long segment transpedicular fixation for unstable thoracolumbar vertebral fractures

: Management of unstable thoracolumbar fracture remains controversial between short segment and long segment pedicle screw fixation. Surgical stabilization is indicated to adequately decompress the spinal canal, maximizing neurological recovery and creating spinal stability. : A comparative study in unstable thoracolumbar fractures fixed with short and long segment transpedicular screw fixation was done and followed up for 6 months. For functional assessment Modified MACNAB criteria, Oswestry disability index and Visual analogue scale scoring system used. Neurological status, radiological kyphotic angle correction were analyzed.: A total of 30 cases were included in the study of which 23 were male and 7 females. The mean age was 36.77 years. Younger individuals were more susceptible to road traffic accident. L1 was the most common vertebral level involved. Cases with a higher ASIA grade had a better improvement post operatively compared to one with a lesser ASIA grade preoperatively (P Value 0.003). Cases with lesser number of transfers had a better outcome at final followup. (P value 0.018). At all months of followup both short and long segment fixation groups have statistically significant kyphotic deformity correction, but long segment have better correction with 19.86 degrees pre-operative to 8.8 degrees at the end of 6 month of followup. : Short segment transpedicular fixation gives better functional outcome than long segment transpedicular fixation, but long segment transpedicular stabilization gives better radiological results in the form of kyphotic deformity correction.

Does "no-touch" technique hysteroscopy increase the risk of infection?

Objective:Today, thanks to its many advantages, hysteroscopy with a vaginoscopic approach (no-touch) is increasingly being used more in outpatient diagnoses and treatments. However, there are concerns that the “no-touch” technique increases ascending genital tract infections since a speculum is not inserted, and disinfection of the cervix cannot achieve.Materials and Methods:Between 2011 and 2017, 302 patients who underwent office hysteroscopy with the vaginoscopic approach (group 1) and 254 patients who underwent hysteroscopy with the standard method under anesthesia in the operating room (group 2) were compared in terms of early complications (within two weeks postoperatively). The primary outcome was early postoperative infection, and the secondary outcome was other early complications, such as bleeding and rupture.Results:In this study, the success rate of hysteroscopy with the vaginoscopic approach was 96.4%. According to the visual analog scale scoring system, 88.7% of the patients described mild-to-moderate pain. When group 1 and 2 were compared in terms of postoperative infection (3% and 2.4%, respectively) and other early complication rates (0% and 0.8%, respectively), no statistically significant difference was found (p>0.05).Conclusion:Hysteroscopy with a vaginoscopic approach continues to be the gold standard method that is safe and well-tolerated by patients.

A series of transforaminal epidural steroid injections in acute lumbar disc herniation with unilateral radiculopathy

Objective: To evaluate functional outcomes of patients suffering from unilateral lower limb radiculopathy due to lumbar disc herniation conservatively treated with transforaminal epidural steroid injection (TFESI). Materials and Methods: It is a prospective study of 100 patients. We correlated clinical findings with magnetic resonance imaging. The patients are treated with dexamethasone injection through transforaminal epidural space under C-ARM guidance using Kambin's triangle approach with follow-up at 3 weeks, 6 weeks, 9 weeks, 12 weeks, and 24 weeks. Assessment of functional outcomes is done by visual analog scale (VAS) and modified Oswestry disability index (ODI). Results: Eighty-eight percent of patients significantly improved their radicular pain, according to the VAS scoring system and modified ODI. The mean modified ODI score of preinjection was found to be 64.18; it was reduced to 33.9 at 3 weeks, 30.82 at 6 weeks, 24.04 at 9 weeks, 22.04 at 12 weeks, and 19.38 at 6 months. The t = 18.49 and the P < 0.00001. Preinjection mean VAS was 8, 3.98 at 3 weeks, 3.28 at 6 weeks, 3.04 at 9 weeks, 2.72 at 12 weeks, and reduced to 2.14 at 24 weeks. The t = 19.83 and the P < 0.00001. There were no complications seen during our study. Conclusion: Our study justifies that unilateral lower limb radiculopathy due to lumbar disc herniation can be well managed by TFESI without any complication. It is very less invasive technique, safe, and effective for pain relief.

Clinical Outcome of Fenestration as Minimally Invasive Surgery for Lumbar Disc Herniation: Successes and Obstacles

Objective: To assess the clinical outcome of fenestration as minimally invasive surgery among patients with lumbar disc herniation undergoing microdiscectomy.Methods: This retrospective observational study was conducted at the Neurosurgery Department of JinnahPostgraduate Medical Centre (JPMC), Karachi from June 2015 to December 2019. Patients with single-level unilateral side lumbar disc herniation underwent microdiscectomy, age more than 18 years of either gender were consecutively included. The patients were observed for pre and post-surgical pain improvement using a rd visual analogue scale (VAS). The follow-up was conducted at 3 months of treatment.Results: A total of 247 cases were enrolled. The mean age was 47.57 ±8.22 years. There were 152 (61.5%) males and 95 (38.5%) females. Back pain and radiating leg pain, i.e. 182 (73.7%) and 139 (56.3%) respectively were the most common complaints. Complications were reported in 19 (7.69%) cases. Of these 19 cases, 8 (42.10%) had discitis, 6 (31.57%) had superficial infection, and 5 (26.31%) had dual tear. The VAS score was markedly improved when compared among pre and post-operative cases (7.56 ±1.01 vs. 2.46 ±0.84, p-value <0.001, 95% CI 4.94-5.25).Conclusion: Our study shows that a microdiscectomy is an effective approach with removal for the unilateral disc with a small incision, early mobilization, low rate to morbidity and success rate based on VAS scoring system was 86.6% ranged from good to excellent.

Reliability of Self-Reporting by Parents using Visual Analog Scale Scoring System in Non-Plastic Surgical Hospital Based Setting An Analysis of Outcome in Cleft Lip andor Palate Patients

Reliability of Self-Reporting by Parents using Visual Analog Scale Scoring System in Non-Plastic Surgical Hospital Based Setting An Analysis of Outcome in Cleft Lip andor Palate Patients

Arthroscopic 360 degrees capsular release for treatment of adhesive capsulitis– A study of 40 cases

Introduction: Adhesive capsulitis, better known as frozen shoulder is a common disabling musculoskeletal disease, characterized classically by pain and restriction in range of motion. Management of this condition is controversial, ranging from non-operative to operative interventions, all intending to decrease pain and restore joint function. Arthroscopic capsular release has emerged as an effective surgical procedure for treating adhesive capsulitis. The aim of this study was to evaluate the results of arthroscopic capsular release for adhesive capsulitis Methods: Between February 2013 and May 2015, 40 patients underwent arthroscopic capsular release non responsive to conservative management. Patients having rotator cuff disease, osteoarthritis, history of fracture upper end humerus and bilateral adhesive capsulitis were excluded from the study. Patients were followed up for a minimum period of 11 months. Results were evaluated using Constant score, UCLA (University of California Los Angeles) and VAS (Visual Analog Scale) scoring system. Results: The mean age of the patients was 57.1 years, with 13 male (32.5%) and 27 female (67.5.5%) patients. The right and left shoulder were affected in 31 patients (77.5%) and 9 patients (22.5%) respectively. 21 patients were diabetic (52.5%), 6 patients had a history of trauma (15%) whereas 13 patients had primary idiopathic adhesive capsulitis (42.5%). Post-operatively, the mean time to achieve maximum pain relief was 1.7 months, whereas the mean time to achieve maximum gain in range of motion was 2 months. Mean preoperative range of motion (Anterior Elevation/ Abduction/ External Rotation/ Internal Rotation) was 98.20/36.30/21.10/13.80 whereas post-operatively it increased to 178.50/166.80/55.70/48.10. The average VAS, Constant and UCLA score was 8.7, 27.5 & 12.8, which improved to 2.3, 88.8 & 31.3 respectively.Conclusion: The results of arthroscopic capsular release for adhesive capsulitis are encouraging and provide an effective treatment modality to provide pain relief restore joint function in cases resistant to conservative management

Establishing the prevalence of dyspraxia in individuals with visual impairment using Bruininks Oseretsky test of motor proficiency, second edition

evaluated before treatment and at 3-months follow-up using a visual analog scale scoring system (VAS). Results: Average VAS scores before treatment and at the 3-month follow-up were 3.8 and 1.4 in the unilateral-pain group, and 4.9 and 2.9 in the center-pain group, respectively. Both groups reported a significant reduction in pain. At the 3-month follow-up, the mean improvement rate of VAS was 77% in the unilateral-pain group and 33.5% in the center-pain group. The improvement rate of VAS in the unilateral-pain group was significantly decreased compared with the centerpain group (p< 0.05). Conclusion(s): This study showed that, overall, physical therapy reduced pain in patients with CLBP. In addition, the unilateral-pain CLBP patients showed significantly more improvement in pain reduction than center-pain patients. Therefore, the results of this study suggest that CLBPpatients with unilateral low back painmay benefit more from physical therapy than those with center low back pain. In conclusion, this study reveals that the response to physical therapy for CLBP varies according to pain location. Future clinical trials using differential physical therapy should be performed to investigate the effect of physical therapy on CLBP patients with centered and unilateral pain. Implications: A better understanding of the differential effects of physical therapy on CLBP patients based on pain locationmight lead to better treatments of this common problem.

Reduction of Acute Shoulder Dislocations in a Remote Environment: A Prospective Multicenter Observational Study

Acute dislocations of the glenohumeral joint are common in wilderness activities. Emergent reduction should take place at the site of trauma to reduce the patient's pain and the risk of vascular and neurological complications. A limited number of reduction methods are applicable in remote areas. The aim of this study is to present our method of reduction of anterior shoulder luxation that is easily applicable in remote areas without medication, adjuncts, and assistants and is well tolerated by patients. A prospective observational study was conducted during a 5-year period. The patients included underwent closed manual reduction with our technique. After each reduction, the physician who performed the reduction completed a standardized detailed history, and reexamined the patient (for acute complications). The patients were contacted 6 months after the trauma to investigate long-term postreduction complications. Reduction was achieved with our method in 39 (100.0%) of 39 patients. The mean pain felt during our reduction procedure was rated 1.7 ± 1.4 (on a scale of 10) using the visual analog scale scoring system. No complications were noted before or after the reduction attempts. We did not find any long-term complications. The reduction method presented in the present study is an effective method for the reduction of acute shoulder luxations in remote places. Our data suggest that this method could be applied for safe and effective reduction of shoulder dislocation.

Evaluation of Nonspecific Low Back Pain Using a New Detailed Visual Analogue Scale for Patients in Motion, Standing, and Sitting: Characterizing Nonspecific Low Back Pain in Elderly Patients

Because we have a clinical impression that elderly patients have low back pain while in motion and standing, but less pain when sitting, we investigate characteristics of nonspecific low back pain (NSLBP), using a new detailed visual analog scale (VAS) scoring system. One hundred eighty-nine patients with NSLBP were divided into an elderly group (≥65 years old, n = 56) and a young group (<65 years old, n = 133). Low back pain was evaluated by a traditional VAS scoring system, the Oswestry Disability Index (ODI), and a new detailed VAS scoring system in which pain is independently evaluated in three different postural situations (in motion, standing, and sitting). No significant differences were observed in traditional VAS and ODI scores between the two groups. The results of the detailed VAS showed no significant differences between the two groups while in motion and standing. However, the elderly group showed significantly lower VAS score while sitting compared to the young group. In this study of the first use of a new detailed VAS scoring system, differences in characteristics of NSLBP between elderly and young patients were successfully detected. This minor modification of the traditional VAS may be useful for characterizing and evaluating low back pain.

Comparison of morphine and butorphanol as pre-anaesthetic agents in combination with romifidine for field castration in ponies

Objective The aim of this study was to compare two different α2 agonist–opioid combinations in ponies undergoing field castration.Study design Prospective double-blind randomized clinical trial.Animal population Fifty-four ponies undergoing field castration.Materials and methods The ponies were randomly allocated to receive one of three different pre-anaesthetic medications [intravenous (IV) romifidine 100 μg kg−1 and butorphanol 50 μg kg−1; romifidine 100 μg kg−1 and morphine 0.1 mg kg−1 IV, or romifidine 100 μg kg−1 and saline IV] before induction of anaesthesia with ketamine 2.2 mg kg−1 IV. Further doses of romifidine (25 μg kg−1) and ketamine (0.5 mg kg−1) were given when required to maintain anaesthesia. Quality of sedation, induction of anaesthesia, maintenance of anaesthesia, recovery, and surgical condition were assessed using a visual analogue scale scoring system and compared. The effects of the different drug combinations on heart and respiratory rate were evaluated and the recovery time was recorded.Results Anaesthesia was considered adequate for surgery in all ponies. No anaesthetic complications were observed. Quality of sedation was significantly better in the butorphanol group compared with the control group (p = 0.0428). Overall quality of anaesthesia was better in the butorphanol group compared with morphine (p = 0.0157) and control (p < 0.05) groups. Quality of induction of anaesthesia and recovery were not significantly different between groups, nor were the surgical conditions, recovery time and the number of repeated anaesthetic doses required during the procedure. Muscle twitches were observed in both the control and morphine groups. Maintenance of anaesthesia was judged to be smoother in the butorphanol group compared with the morphine and control groups (p = 0.006). Heart rate decreased significantly (p < 0.01) in all groups after administration of sedatives but did not differ significantly between groups at any time point.Conclusion The combination of butorphanol and romifidine was found to provide better sedation compared with the other drug combinations.Clinical relevance The combination of butorphanol and romifidine provided better sedation, but morphine was found to be a suitable alternative to butorphanol. Use of morphine and butorphanol in combination with α2 agonists should be further investigated to assess their analgesic effects.

Cumulative UV radiation dose and outcome in clinical practice: effectiveness of trioxsalen bath PUVA with minimal UVA exposure.

The cumulative artificial ultraviolet (UV) exposure dose of dermatological patients was prospectively monitored in clinical conditions for a total of 2 years (August 1997 - July 1999). We focused on whole body UV treatments, i.e. the trioxsalen (TMP) bath PUVA, the broad-band UVB, and the UVA plus UVB phototherapy. Irradiance of the UV devices was calibrated with a spectroradiometer. The cumulative UV doses received by the patients were recorded. A visual analog scale scoring system (VAS) was employed to assess the improvement of various skin conditions at the end of the treatment course. The analysis included 265 patients (141 females and 124 males) and a total of 311 UV treatment courses. Treatments consisted of 86 courses of TMP bath PUVA for psoriasis with a mean cumulative UVA dose of 3.54 J/cm2 and an improvement rate of 89%. For other conditions, 30 courses were needed, with a cumulative UVA dose of 1.47 J/cm2 and an improvement rate of 76%. Altogether, 47 UVB courses were undertaken for psoriasis, and the mean cumulative unweighted UV dose was 2.20 J/cm2, equivalent to 85 standard erythema doses (SED), and an improvement rate of 85%. A total of 25 UVB courses was used for other skin conditions with a mean UV dose of 1.05 J/ cm2, equivalent to 40 SED, and an improvement rate of 71%. A total of 123 courses of UVA plus UVB phototherapy were completed, resulting in a mean cumulative dose of 73.01 J/cm2 for UVA and 0.75 J/cm2 for the unweighted UVB, equivalent to 29 SED. The VAS improvement rate was 85%. The exceptionally low mean cumulative UVA dose in the TMP bath PUVA, taken together with the previous report showing no increase in the risk of squamous cell carcinoma or cutaneous malignant melanoma after TMP bath PUVA, suggests that TMP bath PUVA is an effective and safe therapeutic option.