Mean Visual Analog Scale Score Research Articles

Anxiety and depression among patients with chronic sciatica

IntroductionSpinal radicular syndromes are currently a significant healthcare concern in society. A common manifestation of these syndromes is sciatic pain, characterized by severe pain radiating along the course of the sciatic nerve. In many patients, chronic pain can lead to psychological problems.ObjectivesThe aim of this study was to assess the frequency of anxiety and depression disorders in patients with sciatica and their impact on functional capacity.MethodsWe conducted a cross-sectional study, including patients suffering from documented common sciatic pain evolving for more than 3 months. The study was conducted in a rheumatology department over a period of 3 years. We used the Hospital Anxiety and Depression Scale (HADS) questionnaire, supplemented with information about the study group, pain location, and patients’ occupations. Additionally, the Oswestry Disability Index (ODI) and the Visual Analog Scale (VAS) were applied.Results The study included 104 patients (71 women and 33 men, with a male-to-female sex ratio of 0.46). The mean age of our patients ranged from 23 to 74 years. The most frequent etiology of sciatic pain was a herniated disc, followed by lumbar spinal stenosis and spondylolisthesis. The root path was L5 in 74 cases and S1 in 30 cases. The average duration of sciatic pain was 6.4 months. The mean Oswestry score was 25 (ranging from 15 to 38). The mean VAS score was 7.4 (ranging from 4 to 9). The mean Work Ability Index (WAI) was 25.2 (ranging from 15 to 38). Depression was noted in 53 patients (50.9%) with a mean HADS depression score of 10.8 (ranging from 4 to 16). Anxiety was noted in 8 patients (7.6%) with a mean HADS anxiety score of 6.40 (ranging from 3 to 16). In univariate analysis, anxiety was associated with the low educational level of patients and with the duration of sciatic pain (p < 0.05). There was a significant association between depression and anxiety (p = 0.000). However, there was no relationship between these psychiatric disorders and functional status (p > 0.05).Conclusions Among patients with sciatic pain, there is a high prevalence of psychiatric disorders, including anxiety and depression. Regular screening for these disorders should be conducted by healthcare providers.Disclosure of InterestNone Declared

Impact of Midfoot Charcot Arthropathy (Brodsky Type 1) on Patient Reported Outcome Scores

Introduction/Purpose: Charcot arthropathy is a debilitating and challenging clinical problem for patients and providers. Patient reported outcome measures (PROMs) are an effective tool for gauging a patient’s quality of life and daily functioning, but they have not been reported in the setting of Charcot arthropathy. Our goal is to assess PROMs severity in midfoot Charcot arthropathy (Brodsky Type 1), alongside linked demographics and comorbidities. We will compare these values with PROMs from conditions like ESRD, knee and hip arthritis, highlighting Charcot arthropathy's comparable debilitation. Methods: A retrospective chart review identified 67 patients with Brodsky Type 1 Charcot arthropathy by one of two fellowship- trained foot and ankle surgeons at a single academic medical center between years 2015 and 2023. ICD-10 CM codes E11.610, M14.671, and M14.672 were used to identify diagnosis of Charcot arthropathy and radiological interpretation determined Brodsky type. Data collected from patient charts included demographics, medical history, presence of ulcers, and preoperative Visual Analog Scale (VAS), 12-Item Short Form Health Survey (SF-12), Pain Catastrophizing Scale (PCS), Pain Disability Index (PDI), SSS- 8, Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM) scores and postoperative FAOS and FAAM scores. A One-Way ANOVA was performed to evaluate statistical significance. Averages of preoperative PROM scores were compared to literature values for other diseases. Results: Our cohort was mostly male (58.2%), with mean age 61.73 years, BMI 32.9, and A1C 6.9. Initial presentation revealed 50.7% had ulcers. Brodsky type 1 (midfoot) had notably the lowest pre-op PROM scores when compared to other Brodsky types: PDI Recreation (p=.033), FAOS Symptoms and Stiffness (p=.044), and FAOS Recreation (p=.027). Ulcer presence yielded significantly lower FAAM-ADL scores (p=.038), while other PROMs showed no statistical difference. Our mean VAS score was 53.34 which was higher than hip arthritis VAS (43.0) but lower than ESRD VAS (60.0) and knee arthritis VAS (64.2). Our SF-12 PCS scores (29.4) exceeded prior reports (hip 28.5, knee 28.6), while SF-12 MCS scores were higher in earlier studies (hip 49.6, knee 51.5) than our 43.8. Conclusion: Patients with Charcot arthropathy struggle in daily tasks, reflected in lowered FAOS ADL scores. Brodsky type 1 patients also face challenges in higher-level activities, evident in reduced PDI recreation and FAOS recreation scores. Those with ulcers similarly encounter issues in daily tasks, seen in lower FAAM ADL scores. Brodsky type 1 patients also experience debilitating pain as noted by higher VAS scores when compared to known debilitating conditions such as hip and knee arthritis. Comparatively minor differences in knee and hip arthritis SF-12 PCS scores indicate significant physical limitations for these patients.

EQ-5D-5L Population Norms for China Derived From a National Health Survey

ObjectivesTo develop the EQ-5D-5L (5L) population norms for China and to assess the relationship between various factors and 5L data. MethodsThis study used data derived from the Psychology and Behavior Investigation of Chinese Residents, a national sample survey of 21 909 representative participants aged 12 years and above. Participants’ health-related quality of life (HRQoL) was measured by the 5L. Their socioeconomic characteristics, behavioral factors, and health conditions were also obtained from the survey. Norm scores were generated and compared for different socioeconomic variables. Multiple linear and logistic regressions were used to assess the relationships of the 3 kinds of variables with the 5L utility, visual analog scale (VAS) scores and 5L health problems. ResultsThe mean (SD) age of participants was 39.4 (18.9) years, and 50.0% of them were female. The mean (SD) utility and VAS scores were 0.940 (0.138) and 73.4 (21.6), respectively. Participants reported considerably more problems in anxiety/depression (26.2%) and pain/discomfort (22.2%) dimensions. The gender difference in HRQoL is attenuated. The participants older than 75 years suffered from a sharp decline in HRQoL; the participants in Shanghai and Tibet provinces reported lower utility and VAS scores and more health problems. Those who were younger, with better socioeconomic status and healthier lifestyles, and without diseases tended to report higher utility and VAS scores and fewer health problems. ConclusionsThis study derived the 5L population norms for China based on a representative population sample.

Robot-assisted Percutaneous Radiofrequency Ablation for the Treatment of Osteoid Osteomas.

Percutaneous CT-guided radiofrequency ablation (CT-RFA) is a widely accepted procedure for treatment of osteoid osteomas. However, the application of CT-RFA was restricted as a result of some drawbacks, such as radiation exposure, and inconvenience in general anesthesia. The primary aim of this study is to evaluate the safety and efficacy of intra-operative TiRobot-assisted percutaneous RFA of osteoid osteomas. We retrospectively reviewed 21 medical files of patients who were treated with percutaneous RFA of osteoid osteomas guided by the TiRobot system in our institution between March 2021 and April 2022. The three-dimensional images obtained by a 3D C-arm intra-operatively were sent to the TiRobot system. The puncture point and trajectory were designed. Then the guide pin was positioned to the lesion with the assistance of TiRobot and the biopsy sheath was inserted into the lesion through the guide pin. The tumor was biopsied for pathological examination. Then the RFA needle was inserted into the nidus through the biopsy sheath for thermal ablation. Data were extracted on the associated complications, the reduction in pain at 1 month and 1 year postoperatively assessed by the visual analogue scale (VAS). A paired t-test was used to compare the pre-operative and post-operative VAS scores. The patients included 17 males and four females with a mean age of 19.5 ± 10.4 years (range 3-45 years). Lesions were located on the femur in nine cases, on the tibia in nine cases, on the humerus in one case, on the calcaneus in one case, and on the acetabulum in one case. TiRobot-assisted percutaneous RFA was successfully performed on all 21 patients. There was no intra-operative or post-operative complications observed. Pathological diagnosis of osteoid osteoma was obtained in 11 patients, but the other 10 cases were not pathologically diagnosed. The mean follow-up time was 18.8 months (range: 12-26 months).Post-operative VAS scores were reduced significantly in all cases. The mean VAS score decreased from 6.5 pre-operatively to 0.5 at 1 month post-operatively and to 0.1 at 1 year post-operatively. As a reliable technique for localizing and resection of nidus, TiRobot-assisted percutaneous RFA is a safe and effective option for the treatment of osteoid osteomas.

Factors associated with pain sensation in patients with ultrasound-guided prostate biopsy.

TRUS-guided prostate biopsy is a current method used to obtain the histopathological material necessary to make a definitive diagnosis of prostate cancer. To investigate patient-related variables affecting the level of pain felt during prostate biopsy to determine what can be done to minimize pain. The study included 241 patients scheduled for prostate biopsy. Four patients who did not meet the criteria were excluded. Local anesthesia was administered intrarectally 10 minutes before the biopsy to 237 patients, and a conventional 12-core biopsy was performed. The level of pain felt by all patients during the biopsy was measured using the Visual Analog Scale (VAS) score. Pain scores were compared by forming groups according to the selected parameters. The mean age of the 237 included patients was 66.0±7.8 years, the mean serum PSA level was 33.7±197.5 ng/dL, and the mean prostate volume was 33.7±197.5 ml. The mean VAS score was 4.3±1.9. The pain score was higher in patients with positive digital rectal examination findings and lower in patients using 5-alpha reductase inhibitors(5-ARİ). At the same time, no significant difference was found in patients with positive tumor pathology, perineural invasion, alpha-blockers, or combination therapy. Some patient parameters may affect the level of pain felt during TRUS-guided prostate biopsy.

A Retrospective Study of 91 Patients Treated with Percutaneous Kyphoplasty for Mild Osteoporotic Vertebral Compression Fractures and a New Evaluation Scale of Shape and Filling Effect of Cement

BackgroundPercutaneous kyphoplasty (PKP) is commonly used to treat severe osteoporotic vertebral compression fractures (OVCFs) by restoring vertebral height. However, its application in mild cases is not frequently discussed. MethodsThe study retrospectively included 100 treated vertebral bodies of the 91 patients mentioned before, and efficacy was evaluated using visual analog scale (VAS) and Oswestry Disability Index (ODI) scores preoperatively, 2 days postoperatively, and at 1 and 6 months after treatment, as well as mean variation in vertebral body height. The study also examined complications such as pain recurrence, delayed vertebral fracture, and loss of vertebral height, and developed a scale to assess the shape and filling effect of cement (SFEC) and its impact on complications. ResultsThe results showed significant reductions in mean VAS and ODI scores from pre- to post-surgery and an increase in vertebral body height. However, complications occurred in 10 patients who received treatment for 11 vertebral bodies, including pain recurrence, fractures, and loss of vertebral height. Among the 10 patients with complications, 7(63.6%) vertebral bodies had dissatisfied SFEC scores, compared to 22(24.7%) vertebral bodies with dissatisfied SFEC scores in 81 patients without complications (89 vertebral bodies). ConclusionsPKP is a safe and effective method for treating mild OVCFs, but attention should be paid to the shape and filling effects of cement during surgery to prevent later complications. The developed SFEC scale provides a specific and quantitative standards for evaluating the recovery status after PKP, which need further validations.

Genicular artery embolization for the treatment of knee pain secondary to mild to severe knee osteoarthritis: One year clinical outcomes

ObjectiveTo evaluate the safety and efficacy of genicular artery embolization (GAE) in patients with mild-to-severe knee osteoarthritis up to 12 months after GAE. Materials & methodsThis prospective single-center study included patients who had knee osteoarthritis for >1 year with moderate-to-severe pain after failed conservative treatment for >6 months. Baseline imaging features were evaluated to determine Kellgren-Lawrence (KL) grade and magnetic resonance imaging (MOAKS) scores. GAE was performed using 150–350 μm embolic polyvinyl alcohol particles. The visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were used to evaluate knee pain, stiffness, and function at baseline and follow-up. The primary endpoints were changes in VAS and WOMAC scores at 12 months. ResultsThirty-three patients (n = 37 knees) aged 66.6 ± 8.7 years were enrolled. The patients were categorized into two groups: mild-to-moderate osteoarthritis (n = 28, KL grades 2–3) and severe osteoarthritis (n = 9, KL grade 4). GAE was successfully performed in all patients, with no major adverse events. Three to six branches of the genicular artery were embolized. The mean VAS and WOMAC scores in the mild-to-moderate group significantly decreased (6.6 at baseline vs. 3.0 at 12 months and 49.4 vs. 27.4, respectively, all P < 0.001). The mean VAS and WOMAC scores in the severe group significantly decreased at 12 months (7.3 vs. 4.4 and 58.1 vs. 40.6, respectively, all P < 0.001). ConclusionGAE is a well-tolerated and effective treatment that significantly improves pain symptoms and function in patients with mild-to-severe knee osteoarthritis.

Botulinum Toxin Injection Technique for Reducing the Masseter Size and Enhancing the Jawline.

The injection of botulinum toxin into the masseter muscle is an important method for improving hypertrophy. However, some patients may experience adverse reactions, such as sagging of the lower jaw. Therefore, we proposed a method of injecting botulinum toxin into the masseter and platysma muscles that would reduce masseter size and enhance the jawline. The aim of this study was to reduce the masseter size while enhancing the jawline. Twenty patients received botulinum toxin injections into the masseter and platysma muscles. Pain levels were evaluated with the visual analog scale. All patients were photographed before and 6 months after treatment. Evaluations were performed based on standardized criteria. The lift index, reduction index, and symmetry index were performed to assess the degree of jawline elevation, masseter size reduction, and jawline symmetry before and after treatment. The mean visual analog scale score of the 20 patients was 2.80 (±1.24). The mean lift index score decreased from 4.93 (±0.34) to 4.53 (±0.37), P < .05. The mean reduction index score decreased from 3.13 (±0.27) to 2.74 (±0.27), P < .05. The mean symmetry index score changed from 0.0393 (±0.0296) to 0.0257 (±0.0246), P < .05. Botulinum toxin injections into the masseter and platysma muscles through nerve block reduced the masseter size, elevated the jawline, and improved symmetry.

The Safety and Efficacy of Dorsal Root Entry Zone Lesioning for Pain Management in Patients With Brachial Plexus Avulsion: A Systematic Review and Meta-Analysis.

Persistent neuropathic pain after brachial plexus avulsion (BPA) is common and generally nonresponsive to medical management. Dorsal root entry zone (DREZ) lesioning is the last resort for pain management in patients with BPA. This study aims to investigate and compare the outcomes and complications of DREZ procedures. A systematic literature search was conducted to identify all related studies. Comparisons were based on the number of patients with preoperative pain vs postoperative pain, with the effect size calculated using the risk ratio. Mean visual analog scale (VAS) scores were extracted and analyzed between interventions. A meta-regression analysis was performed to identify risk factors for final outcomes. The rates of complications were also assessed and analyzed between interventions. A total of 30 studies with 917 patients (90.0% male and 10.0% female, mean age: 42.9 ± 16.6) were included in this systematic review. Of the 917 patients who underwent surgery, 655 (71.4%) patients had significant pain reduction at the last follow-up ( P < .05). The weighted mean preoperative VAS score was 8.3 ± 1.3, compared with postoperative VAS scores (1.9 ± 2.2); a significant improvement was observed ( P < .05). The subgroup analysis showed that microsurgical DREZotomy (MDT) is associated with better outcomes in terms of VAS score improvements compared with radiofrequency (RF)-assisted DREZ lesioning ( P < .05). Meta-analysis showed that the relative risk of motor deficits was significantly lower in the MDT group, compared with the RF-assisted group ( P < .05). Meta-regression showed that older age is correlated with an elevated risk of postoperative motor deficits compared with the incidence of sensory loss. DREZ lesioning is effective for intractable pain alleviation after BPA. Compared with RF-assisted DREZ lesioning, MDT is associated with better VAS score improvements and a lower rate of postoperative motor weakness.

Efficacy and Complication Rates of Percutaneous Vertebroplasty and Kyphoplasty in the Treatment of Vertebral Compression Fractures: A Retrospective Analysis of 280 Patients.

Background: Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) are established methods in the treatment of vertebral compression fractures (VCFs). In our manuscript, the target was to evaluate the efficacy of PVPs/PKPs and to determine the implications of potential periprocedural complications. Methods: 280 patients, specifically 194 women (69.3%) and 86 men (30.7%), were enrolled. We used the AO spine fractures classification and the Yeom classification to determine the subtype of cement leakage. Only single-level VCFs of the thoracic or lumbar spine were included. Visual analogue scale (VAS) was assessed preoperatively and regularly after the surgery. Vertebral compression ratio (VBCR) was used to determine postoperative vertebral body collapse. Results: We recorded 54 cases (19.3%) of cement leakage. There was a significant decrease in mean VAS scores (6.82-0.76 in PVPs, 7.15-0.81 in PKPs). The decrease in VBCR was greater in the VP group (4.39%; 84.21-79.82) compared to the KP group (1.95%; 74.36-72.41). Conclusions: No significant difference in the risk of cement leakage when comparing KPs and VPs was found. VPs and KPs provide rapid and significant pain relief in patients with VCFs. Clinically relevant complications of VPs and KPs are rare. Kyphoplasties prevent further vertebral body collapse more effectively compared to vertebroplasties.

Determining the predictors associated with the difficulty of adaptation to ageing of hospitalized older adults. Difficulty of older adult to aging.

To determine the predictors associated with the difficulty of adaptation to ageing of hospitalized older adults. This descriptive cross-sectional study was carried out in a university hospital between October 2019 and March 2020. The sample consisted of 247 older adults. Research data were collected using a Visual Analogue Scale (VAS), the Falls Efficacy Scale (FES) International, Hospital Anxiety and Depression Scale, and Assessment Scale of Adaptation Difficulty for the Elderly (ASADE). The average age of the patients was 73.90 ± 7.38 years, 22.3% of the patients had a fall history in the last year, and 74.5% had a high fear of falling. The mean FES score of the older adult patients was 35.60 ± 11.09, and the mean VAS score was 1.40 ± 1.36. The mean scores for anxiety was 9.30 ± 2.32 and depression was 10.08 ± 1.96. The mean ASADE total score was 16.56 ± 10.7, role and the self-actualization mode score was 9.05 ± 4.66, interdependence mode score was 2.02 ± 1.02, physiological mode score was 3.00 ± 2.03 and self-concept score was 2.47 ± 2.07. The findings revealed that using walking aids, being single, pain, fear of falling, and anxiety affect adaptation difficulties to aging. Anxiety was found to have an effect on all sub-dimensions of adaptation difficulty to aging. There is a need for further studies to determine the correlation between anxiety and the adaptation difficulties experienced by older adults.

Suprapatellar tibial nailing: intraoperative arthroscopic evaluation and results at a minimum of 12 months follow-up.

To arthroscopically evaluate the intra-articular structures before and after placement of an intramedullary tibial nail using the suprapatellar approach and to assess the 1-year results. All patients with a tibial fracture that underwent intramedullary tibial nailing using the suprapatellar approach with a minimal follow-up of 12 months were included. Diagnostic intraoperative knee arthroscopy was performed before and immediately after insertion of the IMN. A radiological and clinical evaluation and VAS score of the patients was collected postoperatively. In total, 36 patients were included. The mean follow-up period was 14.9 ± 4.9 months. The mean age of the patients was 45.5 ± 18.8 years. The mean visual analog scale (VAS) score at 12 months was 1.0 ± 1.5. The complication rate was 19.4% and the reoperation rate was 16.7%. Union of the fractures was achieved in 33 patients (91.6%) after primary surgery after a mean of 6.1 ± 1.8 months. A change in the patellofemoral cartilage after insertion of the nail was seen in 1 patient. The suprapatellar procedure for tibia fractures resulted in excellent VAS scores and union rates at 1-year follow up, with a complication of articular damage to the PF joint in 2.8%.

Ultrasound-Guided Occipital Nerve Block in the Management of Refractory Headache and Its Outcomes: A Prospective Study

Abstract Purpose Headache severely impacts health and lifestyle, causing distress and leading to accommodative changes in affected individuals. Treatment options available for refractory headache range from a conservative approach to advanced forms. The purpose of our study was to evaluate the effectiveness of ultrasound-guided occipital nerve block (ONB) in the management of refractory headaches using visual analog scale (VAS) score and Barrow Neurological Institute Pain Intensity Score (BNIPIS). Methods A study sample of 30 eligible patients with refractory headaches including occipital neuralgia, migraine, tension headache, cluster headache, and vascular headaches aged between 18 and 65 years were included in our study. VAS and BNIPIS were noted for each patient before and after the procedure. ONB was given around the target nerve under aseptic precaution. Two milliliters of 0.5% bupivacaine was used as an injection solution for all patients. Results The mean VAS score in acute pain at pre-treatment and post-treatment after 24 hours and 3 months was found as 7.53, 1.53, and 3.20, whereas in chronic pain the score was 8.13, 3.07, and 5.87, respectively. Pre-treatment pain levels in acute and chronic subjects in BNIPIS IV and V category shifted to category I and II after 24 hours (postinjection) that later were recorded II and III, respectively, after 3 months. Conclusion Standard treatment guidelines are given by the international headache association for the management of headaches. The use of ONB is well advocated and practiced for a long time. In our study, we found that the use of greater occipital nerve block reduced pain levels affecting VAS and BNIPIS, which was more effective in acute cases than in chronic cases.

Comparison of supracondylar radial nerve block and procedural sedation analgesia in the reduction of radius fractures

Background and Aim: Distal radius fractures are the most frequent upper extremity fractures in the whole population. The incidence of distal radius fractures is 195.2/100,000, and the rate is increasing. It can occur with low-energy trauma in the elderly associated with osteoporosis. The purpose of this study is to compare the two different treatment groups (1. Sedation analgesia, 2. Supracondylar radial nerve block) in terms of reduction in Visual Analogue Scale (VAS) score, the length of hospital stay, complications, side effects, patient-physician satisfaction, and the ease of application. Materials and Methods: Patients diagnosed with distal radius fracture were enrolled prospectively, to whom the study’s exclusion criteria do not apply. The patients included in the study were randomly separated into two groups. Ketofol was administered to the sedation and analgesia group’s patients at a dose of 0.5 mg/kg (ketamine 0.5 mg/kg, propofol 0.5 mg/kg) intravenously, and supracondylar radial nerve block was performed on the other group’s patients under ultrasound guidance. Results: There were 20 patients (6 male, 14 female) in the sedation and analgesia group and 21 patients (11 male, 10 female) in the supracondylar radial nerve block group. There was no significant difference between the groups regarding patient-physician satisfaction and complications. The length of hospital stay was significantly shorter in the supracondylar radial nerve block group (49.25 ± 4.05) compared with the sedation and analgesia group (125 ± 5.85) (p &lt; 0.01). The mean reduction VAS score in the block group was observed to be lower than the admission VAS score (p &lt; 0.01). Conclusion: Consequently, ultrasound-guided supracondylar radial nerve block would be a valuable alternative to procedural sedation analgesia and could become routine clinical practice in treating distal radius fractures.

Recovery of Smell and Taste in Patients With Persistent COVID-19-Related Hyposmia and Dysgeusia by Targeting Inflammation and Endothelial Dysfunction.

Purpose New-onset loss of olfaction and/or taste is now recognized among the hallmark symptoms of COVID-19. In most patients, these symptoms resolve completely and spontaneously within days. However, some patients experience persistent olfactory and gustatory dysfunction after COVID-19 resolution. We evaluated the efficacy of a treatment combining several therapeutic agents to target inflammation and endothelial dysfunction in patients with persistent hyposmia and dysgeusia. Methods This 12-month observational pilot study involved patients presenting with symptoms of hyposmia and dysgeusia 30 days after COVID-19 had subsided. The main objective was to evaluate the efficacy of a combination of systemic corticosteroids, a glycosaminoglycan (GAG)-based antithrombotic (mesoglycan), a diuretic, and a vitamin complex. The perceived extent of olfaction and taste impairment was assessed using an 11-point visual analog scale (VAS), where 0 = complete loss of olfaction/taste and 10 = complete recovery of olfaction/taste. Results Eighty-seven patients with post-COVID-19 hyposmia and dysgeusia were enrolled. At treatment start (T0), the mean VAS scores were 2.0 and 3.2 for olfactory and gustatory functions, respectively. Both functions appeared to improve progressively and significantly from T0 to 12 months. A shorter time between viral infection and the start of treatment was associated with a more pronounced recovery of both senses. Conclusions Combined systemic corticosteroid, GAG-based antithrombotic agent (mesoglycan), and diuretic may constitute an option for treating persistent hyposmia and dysgeusia associated with COVID-19. To ensure optimal recovery, early treatment start is recommended. The described treatment protocol deserves to be further evaluated.

Assessment of clinical, functional and radiological outcomes in patients with fracture of distal end radius managed with close reduction and internal fixation with multiple percutaneous K wires: a prospective, single centre study

Background: Distal end radius fractures are one of the commonest fractures, occurring in all the age groups. Different treatment modalities have been described in the literature ranging from conservative to operative including close/open reduction to external fixation. Our prospective study aimed at evaluating the outcomes and complications in these fractures managed by close means with multiple percutaneous K wires. Methods: All the patients with distal end radius fracture were treated with close reduction and internal fixation with multiple percutaneous K wires. They were then evaluated clinically with visual analogue scale (VAS) score, functionally with Mayo wrist score and radiologically with Sarmiento’s modification of Lindstrom’s criteria on the follow ups. Results: The study included a total of 152 patients (88 females and 64 males) with mean age being 49.5±10.4 years, with fall on outstretched hand being the most common mode of injury, and dorsal displacement (73.7%) being the most common X-ray finding. Maximum patients in the study had A2.2 fracture (80 patients) followed by C1.2 fracture type (36 patients). There was clinically and statistically significant improvement in the mean VAS scores on follow ups. Excellent functional and radiological outcomes were seen in 124 patients and 108 patients respectively. Conclusions: Close reduction and internal fixation with multiple percutaneous K wires is a cost effective and easy method to treat all distal end radius fractures, provided good anatomical reduction is achieved before the wires are put.

Percutaneous Continuous Radiofrequency Versus Pulsed Radiofrequency Thermorhizotomy for the Treatment of Neuralgia of the Trigeminal Nerve: A Retrospective Observational Study.

Trigeminal neuralgia (TN) represents one of the most powerful manifestations of neuropathic pain. The diagnostic criteria, as well as its therapeutic modalities, stand firmly established. The percutaneous radiofrequency thermorhizotomy of the gasserian ganglion and posterior root of the trigeminal nerve stands as a widely employed procedure in this context. In this retrospective observational investigation, we undertake a comparative analysis of patients subjected to treatment employing continuous radiofrequency (C-rF) versus pulsed radiofrequency (P-rF). A cohort of 128 patients afflicted with essential neuralgia of the trigeminal nerve, all under the care of the distinguished author (JCA), underwent percutaneous radiofrequency thermorhizotomy between the years 2005 and 2022. They were stratified into two cohorts: Group 1 encompassed 76 patients treated with C-rF, while Group 2 comprised 52 patients subjected to P-rF intervention.All participants met the stringent inclusion and exclusion criteria for TN, with a notable concentration in the V2 and V3 territoriesaccounting for 60% and 45%, respectively. The post-procedural follow-up period exhibited uniformity, spanning from six months to 16 years. Preceding the intervention, all patients uniformly reported a visual analog scale (VAS) score surpassing 6/10. Additionally, everyone had been undergoing pharmacological management, involving a combination of antineuropathic agents and low-potency opioids. The evaluation of clinical improvement was conducted across three temporal domains: the immediate short-term (less than 30 days), the intermediate-term (less than one year), and the prolonged-term (exceeding one year). In the short term, a noteworthy alleviation of pain, surpassing the 50% threshold, was evident in most patients (94%), a similarity observed in both cohorts (98% in Group 1 and 90% in Group 2). The VASrevealed an average rating of 3/10 for Group 1 and 2/10 for Group 2. Moving to the intermediate term, more than 50% improvement in pain was registered in 89% of patients (92% in Group 1 and 86% in Group 2). The mean VAS score stood at 3.5/10, marginally higher in Group 2 at 4/10 compared to 3/10 in Group 1. In the final assessment, a 50% or greater reduction in pain was reported by 75% of patients, with no discernible disparity between the two cohorts. Among the cohort, 18 individuals necessitated a subsequent percutaneous intervention (10 in Group 1 and eight in Group 2), while microvascular decompression was performed on six patients (equitably distributed between the two groups), and radiosurgery was administered to three patients in Group 1. Percutaneous radiofrequency thermorhizotomy emerges as an efficacious modality for addressing essential TN. The employment of continuous radiofrequency yields superior long-term outcomes, albeit accompanied by sensitive manifestations that may prove discomforting. Pulsed radiofrequency demonstrates commendable clinical efficacy with a diminished incidence of complications, rendering it a viable option even for other manifestations of facial pain.

Photobiomodulation alleviates Burning Mouth Syndrome pain: Immediate and weekly outcomes explored.

To assess immediate and weekly effects of photobiomodulation (PBM) on BMS patients. Thirty BMS patients were treated intra-orally with photobiomodulation 940(±10) nm (InGaAsP) 3 W, semi-conductor diode, weekly, for up to 10 weeks. Pain intensity, measured using the Visual Analogue Scale (VAS), and characteristics were recorded immidiately after each treatment, along with a weekly average VAS. Immediate mean VAS score decreased from a starting score of 7.80 ± 1.83 to 2.07 ± 2.55 (p < 0.001). The mean weekly VAS score for the week after the final treatment session was higher (5.73 ± 2.80, p < 0.001) than the immediate response, but still significantly lower than the starting score (p = 0.017). We observed a trend of pain improvement with more treatments, but this was only statistically significant up to the third treatment. Male gender and unilateral pain correlated with better PBM efficacy (p = 0.017, 0.022, respectively). PBM provides significant immediate pain relief for BMS patients after each treatment; however, the efficacy decreases notably over the following week. A trend of increasing pain relief across treatments was observed, statistically significant up to the third treatment.

Pulsed Radiofrequency Neuromodulation for Post-Stroke Shoulder Pain in Patients with Hemorrhagic Stroke.

Post-stroke shoulder pain (PSSP) is a common complication that limits the range of motion (ROM) of the shoulder, the patient's rehabilitation and in turn, affects the patients' quality of life (QoL). Several treatment modalities such as sling, positioning, strapping, functional electrical stimulation, and nerve block have been suggested in literatures, however none of the treatments had long-term effects for PSSP. In this study, the authors evaluated clinical efficacy of pulsed radiofrequency (PRF) neuromodulation on the suprascapular nerve for PSSP, and suggested it as a potential treatment with long-term effect. This retrospective case series was conducted at a single center, a private practice institution. From 2013 to 2021, 13 patients with PSSP underwent PRF neuromodulation of the suprascapular nerve. The primary outcome measure was the Visual analog scale (VAS) score. The secondary outcome measurements included the shoulder ROM, Disability assessment scale (DAS), modified Ashworth scale, modified Rankin scale (mRS), and EuroQol-5 dimension-3L questionnaire (EQ-5D-3L) scores. These parameters were evaluated before PRF modulation, immediately after PRF modulation, and every 3 months until the final follow-up visit. Six men and seven women were enrolled, and all patients were followed-up for a minimum of 12 months. The mean VAS score was 7.07 points before PRF neuromodulation and 2.38 points immediately post-procedure. Shoulder ROM for abduction and flexion, DAS for pain, mRS, and EQ-5D-3L demonstrated marked improvement. No complications were reported. PRF neuromodulation of the suprascapular nerve is an effective modality in patients with PSSP, and has long-term effect of pain relief, improvement of QoL.

An Observational Study to Determine the Real-Life Effectiveness of MP-AzeFlu® in Austrian Patients with Persistent Allergic Rhinitis.

Many patients with allergic rhinitis (AR) have moderate-to-severe persistent AR. Meda Pharma's AzeFlu (MP-AzeFlu®) is an intranasal AR treatment comprising a novel formulation of azelastine hydrochloride and fluticasone propionate in a single device. This prospective observational study of 214 adults and adolescents in Austria with moderate-to-severe persistent AR assessed the effectiveness of MP-AzeFlu (one spray/nostril twice daily; daily doses: azelastine hydrochloride 548μg; and fluticasone propionate 200μg) for AR control in clinical practice using the visual analog scale. Symptom severity was reported on days 0, 1, 3, 7, 14, 21, 28, 35, and 42. Patient demographics, AR phenotype, allergen sensitization, symptomatology, AR treatments in the previous year, and the reason for the MP-AzeFlu prescription were recorded. MP-AzeFlu treatment was associated with a rapid and statistically significant reduction in the visual analog scale score from baseline to each timepoint measured, including day 1 (all p < 0.0001). Mean (standard deviation) visual analog scale score was 53.5mm (26.3) at baseline, 25.3mm (21.0) on day 28, and 19.6mm (17.4) on day 42, a mean overall reduction from baseline of 41.4 (23.9) mm for completers. Results were consistent irrespective of patient age, gender, severity, or traditional AR phenotype. Prior to MP-AzeFlu prescription, congestion was considered the most bothersome symptom. The majority of patients reported using at least two AR therapies in the past year, including oral antihistamines, intranasal corticosteroids, and intranasal antihistamines. Many patients in Austria live with uncontrolled persistent AR despite treatment. MP-AzeFlu provides effective and rapid control of persistent AR in a real-world Austrian setting.