Search results for: post-stroke pain

Authors: Bheeshma B., Mathivanan N., Manoj Deepak M., Prabhu Thangaraju, K. Venkatachalam

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This study involves the effect of autologous blood injection for patients who had degeneration of the origin of extensor carpi radialis brevis which was confirmed radio logically and by ultrasound examination and failed cortisone injections to the lateral epicondylitis. In this prospective longitudinal series involves pre-injection assessment of grip strength, pain, and function, using the patient-rated tennis elbow evaluation. In this study, blood from the contralateral limb is taken and injected into the affected limb with the help of ultrasound guidance and then the patient wore a customized wrist support for five days, after which they were commenced with stretching, strengthening, and massage programme with an occupational therapist. In these patients assessment was done after six months and then finally at 12 months after injection, using the patient-rated tennis elbow evaluation. 50 patients completed the study, showing significant improvement in pain; the worst pain decreased by two to five points out of a 10-point visual analogue for pain. Self-perceived function improved by 11–25 points out of 100. Women showed significant increase in grip, but men did not. Our study thus concludes that autologous blood injection show significant improvement in pain and function in patients with chronic lateral epicondylitis, who did not have relief with cortisone injection.

Keywords: lateral epicondylitis, autologous blood injection, conservative treatment, plasma-rich proteins (PRPs)

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Authors: Ali Saleh Al-Rafedah, Ahmed Mohammed Al-Quthami, Tariq Jalal Al-Ashawi, Talal Nasser Motar Al-Enez

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Introduction: Barodontalgia is essentially dental pain provoked by changes in atmospheric pressure which usually disappear when the affected person reaches normal pressure zone. Barodontalgia has been recognized as a potential cause of aircrew-member vertigo and sudden incapacitation, which could jeopardize the safety of flight. Objective: The current study aimed to investigate the incidence of this phenomena among aircrews in Kingdom of Saudi Arabia. It also aimed to assess the knowledge of dental interns toward this phenomena. Material and Method: A 120 questionnaire consists of 17 questions were distributed to different of Aircrews working in commercial and governmental centers in different areas of KSA. Another questionnaire also distributed to 240 interns in different institutes in KSA. Results: Out of 120 questionnaire distributed to aircrews, 48 has been returned back (40%) and the participants were mainly pilots. The results showed that about 33% of the participants had this pain at least once during flying and the incidence of this pain was not associated with any age group. Most of the pain experience were during descending and at altitude between 10.000-20.000 feet (63%). The pain completely relieved after landing in most of the cases. Regarding pain scores, the majority of the participants reported moderate scores of severity (%65) and about 85% of them had visited the physician or dentist to investigate the existing oral problem. Among dental interns in KSA, our finding indicated lack of knowledge regarding this phenomena since only 23 % of the participants have an idea about this phenomena. Conclusion and recommendation: The incidence of Barodontalgia among aircrews in Saudi Arabia is considerably high and further studies should be carried out for better understanding of this phenomena. Significant lack of knowledge among dental interns about the Barodontalgia has been highlighted and inclusion of it in the teaching of clinical and preclinical curriculum is recommended.

Keywords: Barodontalgia/dental, atmospheric pressure, incapacitation, Saudi Arabia

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Authors: Ahmed R. Z. Baghdadi,  Mona H. Gamal Eldein

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Background: With the perceived pain and poor function experienced following knee arthroplasty, patients usually feel unsatisfied. Yet, a controversy still persists on the appropriate operative technique that doesn’t affect proprioception much. Purpose: This study compared the effects of Cruciate Retaining (CR) and Posterior Stabilized (PS) total knee arthroplasty (TKA on dynamic balance, pain and functional performance following rehabilitation. Methods: Thirty patients with CRTKA (group I), thirty with PSTKA (group II) and fifteen indicated for arthroplasty but weren’t operated on yet (group III) participated in the study. The mean age was 54.53±3.44, 55.13±3.48 and 55.33±2.32 years and BMI 35.7±3.03, 35.7±1.99 and 35.73±1.03 kg/m2 for group I, II, and III respectively. The Berg Balance Scale (BBS), WOMAC pain subscale and Timed-Up-and-Go (TUG) and Stair-Climbing (SC) tests were used for assessment. Assessments were conducted four weeks pre- and post-operatively, three, six and twelve months post-operatively with the control group being assessed at the same time intervals. The post-operative rehabilitation involved hospitalization (1st week), home-based (2nd-4th weeks), and outpatient clinic (5th-12th weeks) programs, follow-up to all groups for twelve months. Results: The Mixed design MANOVA revealed that group I had significantly lower pain scores and SC time compared with group II three, six and twelve months post-operatively. Moreover, the BBS scores increased significantly and the pain scores and TUG and SC time decreased significantly six months post-operatively compared with four weeks pre- and post-operatively and three months post-operatively in group I and II with the opposite being true four weeks post-operatively. But no significant differences in BBS scores, pain scores and TUG and SC time between six and twelve months post-operatively in group I and II. Interpretation/Conclusion: CRTKA is preferable to PSTKA, possibly due to the preserved human proprioceptors in the un-excised PCL.

Keywords: dynamic balance, functional performance, knee arthroplasty, long-term

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Authors: Martonovich Noa, Maman David, Alfandari Liad, Behrbalk Eyal.

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Introduction: The human body is designed for upright standing and walking, with the lower extremities and axial skeleton supporting weight-bearing. Constant weight-bearing on joints not meant for this action can lead to various pathologies, as seen in wheelchair users. Handstand practitioners use their wrists as weight-bearing joints during activities, but little is known about wrist injuries in this population. This study aims to investigate the epidemiology of wrist pain among handstand practitioners, as no such data currently exist. Methods: The study is a cross-sectional online survey conducted among athletes who regularly practice handstands. Participants were asked to complete a three-part questionnaire regarding their workout regimen, training habits, and history of wrist pain. The inclusion criteria were athletes over 18 years old who practice handstands more than twice a month for at least 4 months. All data were collected using Google Forms, organized and anonymized using Microsoft Excel, and analyzed using IBM SPSS 26.0. Descriptive statistics were calculated, and potential risk factors were tested using asymptotic t-tests and Fisher's tests. Differences were considered significant when p < 0.05. Results: This study surveyed 402 athletes who regularly practice handstands to investigate the prevalence of chronic wrist pain and potential risk factors. The participants had a mean age of 31.3 years, with most being male and having an average of 5 years of training experience. 56% of participants reported chronic wrist pain, and 14.4% reported a history of distal radial fracture. Yoga was the most practiced form, followed by Capoeira. No significant differences were found in demographic data between participants with and without chronic wrist pain, and no significant associations were found between chronic wrist pain prevalence and warm-up routines or protective aids. Conclusion: The lower half of the body is meant to handle weight-bearing and impact, while transferring the load to upper extremities can lead to various pathologies. Athletes who perform handstands are particularly prone to chronic wrist pain, which affects over half of them. Warm-up sessions and protective instruments like wrist braces do not seem to prevent chronic wrist pain, and there are no significant differences in age or training volume between athletes with and without the condition. Further research is needed to understand the causes of chronic wrist pain in athletes, given the growing popularity of sports and activities that can cause this type of injury.

Keywords: handstand, handbalance, wrist pain, hand and wrist surgery, yoga, calisthenics, circus, capoeira, movement.

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Authors: Merav Ben Natan, Yaniv Steinfeld, Sara Badash, Galina Shmilov, Milena Abramov, Danny Epstein, Yaniv Yonai, Eyal Berbalek, Yaron Berkovich

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Introduction: Postoperative pain management is crucial for effective rehabilitation, with the Visual Analog Scale (VAS) being a common tool for assessing pain intensity due to its sensitivity and accuracy. However, challenges such as misunderstanding of instructions and discrepancies in pain reporting can affect its reliability. Additionally, the mandatory use of face masks during the COVID-19 pandemic may impair nonverbal and verbal communication, potentially impacting pain assessment and overall care quality. Aims: This study examines the association between the type of mask worn by health care professionals and the assessment of pain intensity in patients after orthopedic surgery using the visual analog scale (VAS). Design: A nonrandomized controlled trial was conducted among 176 patients hospitalized in an orthopedic department of a hospital located in northern-central Israel from January to March 2021. Methods: In the intervention group (n = 83), pain assessment using the VAS was performed by a healthcare professional wearing a transparent face mask, while in the control group (n = 93), pain assessment was performed by a healthcare professional wearing a standard nontransparent face mask. The initial assessment was performed by a nurse, and 15 minutes later, an additional assessment was performed by a physician. Results: Healthcare professionals wearing a standard non-transparent mask obtained higher VAS scores than healthcare professionals wearing a transparent mask. In addition, nurses obtained lower VAS scores than physicians. The discrepancy in VAS scores between nurses and physicians was found in 50% of cases. This discrepancy was more prevalent among female patients, patients after knee replacement or spinal surgery, and when health care professionals were wearing a standard nontransparent mask. Conclusions: This study supports the use of transparent face masks by healthcare professionals in an orthopedic department, particularly by nurses. In addition, this study supports the assumption of problems involving the reliability of VAS.

Keywords: postoperative pain management, visual analog scale, face masks, orthopedic surgery

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Authors: Nuo Xu, Sijing Chen

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Background: Childbirth is considered a critical traumatic event throughout our lives, positively or negatively impacting the mother's physiology, psychology, and even the whole family. Adverse birth experiences, such as labor pain, anxiety, and fear can negatively impact the mother. Studies had shown that the immersive nature of VR can distract attention from pain and increase focus on interventions for pain relief. However, the existing studies that applied VR to maternal delivery were still in their infancy and showed disparate results, and the small sample size is not representative, so this review analyzed the effects of VR in labor, such as on maternal pain and anxiety, with a view to providing a basis for future applications. Search strategy: We searched Pubmed, Embase, Web of Science, the Cochrane Library, CINAHL, China National Knowledge Infrastructure, Wan-Fang database from the building to November 17, 2021. Selection Criteria: Randomized controlled trials (RCTs) that intervened the pregnant women aged 18-35 years with gestational >34 weeks and without complications with VR technology were contained within this review. Data Collection and Analysis: Two researchers completed the study selection, data extraction, and assessment of study quality. For quantitative data we used MD or SMD, and RR (risk ratio) for qualitative data. Random-effects model and 95% confidence interval (95% CI) were used. Main Results: 12 studies were included. Using VR could relieve pain during labor (MD=-1.81, 95% CI (-2.04, -1.57), P< 0.00001) and active period (SMD=-0.41, 95% CI (-0.68, -0.14), P= 0.003), reduce anxiety (SMD=-1.39, 95% CI (-1.99, -0.78), P< 0.00001) and improve satisfaction (RR = 1.32; 95% CI (1.10, 1.59); P = 0.003), but the effect on the duration of first (SMD=-1.12, 95% CI (-2.38, 0.13), P=0.08) and second (SMD=-0.22, 95% CI (-0.67, 0.24), P=0.35) stage of labor was not statistically significant. Conclusions: Compared with conventional care, VR technology can relieve labor pain and anxiety and improve satisfaction. However, extensive experimental validation is still needed.

Keywords: virtual reality, delivery, labor pain, anxiety, meta-analysis, systematic review

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Authors: Tayyibah Shah Alam, Joe Thomas, Nayantara Shenoy

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Presenting a case that we would like to share, the answer is straight forward but the path taken to get to the diagnosis is where it gets interesting. A 31-year-old lady presented to the Rheumatology Outpatient department with left-sided chest pain associated with left-sided elbow joint pain intensifying over the last 2 days. She had been having a prolonged history of chest pain with minimal intensity since 2016. The pain is intermittent in nature. Aggravated while exerting, lifting heavy weights and lying down. Relieved while sitting. Her physical examination and laboratory tests were within normal limits. An electrocardiogram (ECG) showed normal sinus rhythm and a chest X-ray with no significant abnormality was noted. The primary suspicion was recurrent costochondritis. Cardiac blood inflammatory markers and Echo were normal, ruling out ACS. CT chest and MRI Thorax contrast showed small ill-defined STIR hyperintensity with thin peripheral enhancement in the anterior mediastinum in the left side posterior to the 5th costal cartilage and anterior to the pericardium suggestive of changes in the fat-focal panniculitis. Confirming the diagnosis as Epicardial fat necrosis. She was started on Colchicine and Nonsteroidal anti-inflammatory drugs for 2-3 weeks, following which a repeat CT showed resolution of the lesion and improvement in her. It is often under-recognized or misdiagnosed. CT scan was collectively used to establish the diagnosis. Making the correct diagnosis prospectively alleviates unnecessary testing in favor of conservative management.

Keywords: EFN, panniculitis, unknown etiology, recurrent chest pain

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Authors: Selvia Arokiya Mary

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Introduction: Worldwide, breast cancer comprises 10.4% of all cancer incidence among women. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). Many women who undergo breast surgery suffer from ill-defined pain syndromes. STATEMENT OF THE PROBLEM: A study to assess the effectiveness of twin therapeutic approaches on certain bio-physiological parameters in breast cancer patients after breast surgery at selected hospital, Chennai. Objectives: This study is to 1. assess the level of certain biophysiological parameters in women after mastectomy. 2. assess the effectiveness of twin therapeutic approaches on certain biophysiological parameters in women after mastectomy. 3. correlate the practice of twin therapeutic approaches with certain biophysiological parameters. 4. associate the selected demographic variables with certain biophysiological parameters in women after mastectomy Research Design and Method: Pre experimental research design was used. Fifty women were selected by using convenient sampling technique at government general hospital, Chennai. Results: The Level of pain shows, in the study group 49(98%) of them had moderate in the pre test and after the intervention all of them had mild pain in the post test. In relation to level of shoulder function before the intervention shows that in the study group 49(98%) of them had movement towards gravity and after intervention 24 (48%) of them had movement against gravity maximum resistance. There was a significant reduction in pain and shoulder stiffness level at a ‘P’ level of < 0.001. There was a negative correlation between the pranayama practice and the level of pain, there was a positive correlation between the arm exercise practice and the level of shoulder function. There was no significant association between demographic and clinical variables with the level of pain and shoulder function in the study. Hypothesis: There is a significant difference in level of pain and shoulder function among women following breast surgery who receive pranayama & arm exercise programme. The pranayama had effect in terms of reduction of pain, arm exercise programme had effect in prevention of arm stiffness among post operative women following breast surgery. Thus the stated hypothesis was accepted. Conclusion: On the basis of the findings of the present study there was Advancing age related to increasing risk of breast cancer, level of pain also the type of surgery was associated with level of pain and shoulder function, There fore it is to be concluded that the study participants may get benefited by practice of pranayama and arm exercise program.

Keywords: biophysiological parameters breast surgery, lumpectomy , mastectomy, radical mastectomy, twin therapeutic approach, pranayama, arm exercise

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Authors: M. A. Akulov, V. O. Zaharov, A. A. Tomskij

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Introduction: Scapulohumeral periarthrosis, resulting as a reaction to mechanical injury of shoulder tendons and muscles, is associated with high incidence of temporal and permanent disability. There is a strong need for investigation of treatment of that patient group. Severe pain leads to limitation of movements range, which result in secondary alterations of joint capsule and ligamentous apparatus. Muscle tension and edema, swelling of fascial and fibrous structures result in nerve and vascular compression in intramuscular and osseo-muscular-fibrous spaces. Botulinum toxin injection leads to decrease of muscle tone, increase of movements range and associated pain alleviation. Study aim: Optimization of rehabilitation process in scapolohumeral periarthrosis using Xeomin. Patients and methods: 40 patients aged 37-56 years with scapulohumeral periarthrosis were evaluated. Patients were divided into two groups according to treatment regimen. The first (main) group included 21 patients, receiving intramuscular Xeomin 150-200 U in the area of brachio-scapular joint and trigger points (inducing motion range limitation and pain). Treatment procedures were combined with physical therapy and osteopathic procedures. The second (control) group included 19 patients, receiving conventional physical therapy and osteopathic procedures. The evaluation and efficacy comparison was carried out using McGill pain questionnaire, Clinical Global Impression scale (CGI), and patient-reported increase of brachio-scapular joint movement range and pain decrease at 1, 3 and 6 months of treatment. Results. The study demonstrated a significant improvement in the main group after one month of treatment, which persisted during months of treatment. At baseline, rank pain index on McGill pain questionnaire was 18,4±4,9 and 17,8±5,1 in the main and control group, respectively (p > 0,05). At 1 month of treatment we observed a significant decrease of pain syndrome (no pain or modest pain) and increase of movement range in angular degrees in the main group (р < 0,05). In the control group significant improvements were observed only on the 3 month of treatment (р < 0,05), but at 6 months of treatment the improvement in pain syndrome and motion range in brachio-scapular joint was significantly smaller, than in the main group. Rank pain index on McGill pain scale was 5,2±1,8 in the main group compared to 12,0±2,6 in the control group (р < 0,05). At 6 months of treatment patients in the first group reported a significant/highly significant improvement of general health on CGI, whereas in the second group most patients reported a minimal improvement. We observed a sustained and persistent improvement of motion range in brachio-scapular joint in the main group. Conclusion: Xeomin injections as a part of rehabilitation process in scapulohumeral periarthrosis lead to reduced time and increased quality of rehabilitation.

Keywords: botulinum toxin, rehabilitation, scapulohumeral periarthrosis

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Authors: Josiah Damisa, Michelle Louise Richardson, Morenike Adewuyi

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Lower back pain is a significant cause of disability worldwide and associated with great implications in terms of the well-being of affected individuals and society as a whole due to its undeniable socio-economic impact. With its prevalence on the increase as a result of an aging global population, the need for novel forms of pain management is ever paramount. This review aims to provide further insight into current research regarding a role for the endocannabinoid signaling pathway as a target in the treatment of chronic pain, with particular emphasis on its potential use as part of the treatment of lower back pain. Potential advantages and limitations of cannabis-based medicines over other forms of analgesia currently licensed for medical use are discussed in addition to areas that require ongoing consideration and research. To evaluate the efficacy of cannabis-based medicines in chronic pain, studies pertaining to the role of medical cannabis in chronic disease were reviewed. Standard searches of PubMed, Google Scholar and Web of Science databases were undertaken with peer-reviewed journal articles reviewed based on the indication for pain management, cannabis treatment modality used and study outcomes. Multiple studies suggest an emerging role for cannabis-based medicines as therapeutic agents in the treatment of chronic back pain. A potential synergistic effect has also been purported if these medicines are co-administered with opiate analgesia due to the similarity of the opiate and endocannabinoid signaling pathways. However, whilst recent changes to legislation in the United Kingdom mean that cannabis is now licensed for medicinal use on NHS prescription for a number of chronic health conditions, concerns remain as to the efficacy and safety of cannabis-based medicines. Research is lacking into both their side effect profiles and the long-term effects of cannabis use. Legal and ethical considerations to the use of these products in standardized medical practice also persist due to the notoriety of cannabis as a drug of abuse. Despite this, cannabis is beginning to gain traction as an alternative or even complementary drug to opiates, with some preclinical studies showing opiate-sparing effects. Whilst there is a paucity of clinical trials in this field, there is scope for cannabinoids to be successful anti-nociceptive agents in managing chronic back pain. The ultimate aim would be to utilize cannabis-based medicines as alternative or complementary therapies, thereby reducing opiate over-reliance and providing hope to individuals who have exhausted all other forms of standard treatment.

Keywords: endocannabinoids, cannabis-based medicines, chronic pain, lower back pain

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Authors: Arben Murtezani, Shefqet Mrasori, Vančo Spirov, Bukurije Rama, Oliver Dimitrovski, Visar Bunjaku

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Overview: Temporomandibular disorders (TMDs) are chronic musculoskeletal pain conditions. Clinical indicators of discomfort are related to the use of the joint stiffness during first motions after extended rest and restricted joint range of motion can cause substantial pain and disability. There is little evidence that physical therapy methods of management cause long-lasting reduction in signs and symptoms. Exercise programs premeditated to improve physical fitness have beneficial effects on chronic pain and disability of the musculoskeletal system. Objective: The aim of this study was to assess the effectiveness of physical therapy interventions in the management of temporomandibular disorders. Materials and Methods: A prospective comparative study with a 2-month follow-up period was conducted between April 2016 and June 2016 at the Physical Medicine and Rehabilitation Clinic in Prishtina. Forty six patients with TMDs, (more than three months duration of symptoms) were randomized into two groups: the TENS therapy group (n=24) and combination of active exercise and manual therapy group (n=22). The TENS therapy group patients were treated with twelve sessions of TENS. The treatment period of both groups was 3 weeks at an outpatient clinic. Following main outcome measures were evaluated: (1) pain at rest (2) pain at stress (3) impairment (4) mouth opening at base-line, before and after treatment and at 3 month follow-up. Results: Significant reduction in pain was observed in both treatment groups. In the TENS group 73% (16/22) achieved at least 80% improvement from baseline in TMJ pain at 2 months compared with 54% (13/24) in the exercise group (difference of 19%; 95% confidence interval 220 to 30%). Active and passive maximum mouth opening has been greater in the TENS group (p < 0.05). Conclusion: Exercise therapy in combination with TENS seems to be useful in the treatment of temporomandibular disorders.

Keywords: temporomandibular joint disorders, TENS, manual therapy, exercise

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Authors: Ghada M. R. Koura, Mohamed N. Mohamed, Ahmed M. F. El Shiwi

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Chronic mechanical Low back dysfunction (CMLBD) is the most common problem of the working-age population in modern industrial sociaty; it causes a substantial economic burden due to the wide use of medical services and absence from work. Aim of work: the aim of this study was to investigate the effect of positional release technique on patients with chronic mechanical low back pain. Materials and Methods: Thirty two patients from both sexes were diagnosed with CMLBP, aged 20 to 45 years and were divided randomly into two equal groups; sixteen patients each; group A (control group) received therapeutic exercises that include (Stretch and Strength exercises for back and abdominal muscles). Group B (experimental group) received therapeutic exercises with positional release technique; treatment was applied 3 days/week for 4 weeks. Pain was measured by Visual Analogue Scale, Lumbar range of motion was measured by Inclinometer and Functional disability was measured by Oswestry disability scale. Measurements were taken at two intervals pre-treatment and post-treatment. Results: Data obtained was analyzed via paired and unpaired t-Test. There were statistical differences between the 2 groups, where the experimental group showed greater improvement than control group. Conclusion: Positional release technique is considered as an effective treatment for reducing pain, functional disability and increasing lumbar range of motion in individuals with chronic mechanical low back pain.

Keywords: chronic mechanical low back pain, traditional physical therapy program, positional release technique, randomized controlled trial

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Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

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Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

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Authors: Anju Rani, Geeta, Sudha Rani, Choudhary, Puhal

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Method- A total of 300 patients were studied, with 100 patients in each group. Patients aged 16-60 years, ASA grade I and II undergoing elective general surgical, urology and orthopedic procedures were included in the study. The patients were randomly allocated to any of the three groups by Using Sealed envelopes. 1. Group A: EMLA (eutectic mixture of 2.5% lidocaine with 2.5% prilocaine) - Patients receiving eutectic Lidocaine/ Prilocaine cream (2gm/10cm2) of Prilox cream), for 60- 70 min under occlusive dressing. 2. Group B - Patients receiving topical diclofenac 4 % spray gel for 60- 70 min, covering an absorption area of 50 cm2 3. Group C: control – Direct cannulation was done without any intervention. Results - Group B showed significantly least number of patients complaining pain on IV cannulation in comparison to group A and group C. The Mean VAS scores were found to be maximum in GROUP C: control-8.76 ± 4.14, then in GROUP A: EMLA- 2.54 ± 4.21.and least in GROUP B: Diclofenac 4% spray-1.13 ± 3.05. Erythema, induration and edema were significantly reported to be higher for the control group. Also group A patients reported adverse skin reactions more than patients in group B. Conclusion - It can be concluded that diclofenac spray 4 % and EMLA cream are effective in reducing the incidence and severity of venous cannulation pain as compared to the control group. However, a higher incidence of skin blanching, erythema, and oedema associated with EMLA cream and a lower incidence of these adverse effects favours the use of diclofenac spray 4%. They are promising agents for the treatment of venous cannulation pain.

Keywords: diclofenac spray, EMLA, intravenous, pain

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Authors: Mohammad Javaherian, Siamak Bashardoust Tajali, Monavvar Hadizadeh

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Objective: This systematic review study was conducted to evaluate the effects of Pulsed Electromagnetic (PEMF) and Static Magnetic Fields (SMG) on pain relief and functional improvement in patients with musculoskeletal Low Back Pain (LBP). Methods: Seven electronic databases were searched by two researchers independently to identify the published Randomized Controlled Trials (RCTs) on the efficacy of pulsed electromagnetic, static magnetic, and therapeutic nuclear magnetic fields. The identified databases for systematic search were Ovid Medline®, Ovid Cochrane RCTs and Reviews, PubMed, Web of Science, Cochrane Library, CINAHL, and EMBASE from 1968 to February 2016. The relevant keywords were selected by Mesh. After initial search and finding relevant manuscripts, all references in selected studies were searched to identify second hand possible manuscripts. The published RCTs in English would be included to the study if they reported changes on pain and/or functional disability following application of magnetic fields on chronic musculoskeletal low back pain. All studies with surgical patients, patients with pelvic pain, and combination of other treatment techniques such as acupuncture or diathermy were excluded. The identified studies were critically appraised and the data were extracted independently by two raters (M.J and S.B.T). Probable disagreements were resolved through discussion between raters. Results: In total, 1505 abstracts were found following the initial electronic search. The abstracts were reviewed to identify potentially relevant manuscripts. Seventeen possibly appropriate studies were retrieved in full-text of which 48 were excluded after reviewing their full-texts. Ten selected articles were categorized into three subgroups: PEMF (6 articles), SMF (3 articles), and therapeutic nuclear magnetic fields (tNMF) (1 article). Since one study evaluated tNMF, we had to exclude it. In the PEMF group, one study of acute LBP did not show significant positive results and the majority of the other five studies on Chronic Low Back Pain (CLBP) indicated its efficacy on pain relief and functional improvement, but one study with the lowest sessions (6 sessions during 2 weeks) did not report a significant difference between treatment and control groups. In the SMF subgroup, two articles reported near significant pain reduction without any functional improvement although more studies are needed. Conclusion: The PEMFs with a strength of 5 to 150 G or 0.1 to 0.3 G and a frequency of 5 to 64 Hz or sweep 7 to 7KHz can be considered as an effective modality in pain relief and functional improvement in patients with chronic low back pain, but there is not enough evidence to confirm their effectiveness in acute low back pain. To achieve the appropriate effectiveness, it is suggested to perform this treatment modality 20 minutes per day for at least 9 sessions. SMFs have not been reported to be substantially effective in decreasing pain or improving the function in chronic low back pain. More studies are necessary to achieve more reliable results.

Keywords: pulsed electromagnetic field, static magnetic field, magnetotherapy, low back pain

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Authors: Jonathan de Rothewelle

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Heeled shoes are notoriously bad for physical health. The vast majority of Americans have suffered lower extremity pain at some point in their lives; women have been in pain for centuries. More recently, however, with an increase in number due to cultural shifts in acceptability, more men wear heeled shoes. Men who wear heels (MWWH) also suffer lower limb pain. In my hypothesis, their pathologies should be treated as unique due to males’ difference in body mass, center of gravity, posture, gait, and foot anatomy when compared with their female counterparts. These differences alone warrant a closer examination of the pathologies associated with the wearing of heeled shoes among male populations. This research performs a broad literature review on the differences between male and female anatomy and discusses implications on heel wearing. This research discusses the need for further inquiry and makes recommendations for future study.

Keywords: heeled shoes, gait, pathologies, biological sex

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Authors: Prataksitorn Chonlakan, Tiparat Wongsilarat

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The traditional clinical practice guideline used at the emergency room at Songkhla Hospital in caring for patients who come in contact with jellyfish venom took a long time for the pain to reduce to the level that patients can cope with. To investigate the effectiveness of clinical practice guidelines by comparing the effectiveness of a newly developed clinical practice guideline with the traditional clinical practice guideline in the following aspects: 1) pain reduction, 2) length of pain, 3) the rate of patient’s re-visit, 4) the rate of severe complications such as anaphylactic shock, and cardiac arrest, and death, and 5) patient satisfaction. This study employed a quasi-experimental research design. Thirty subjects were selected with purposive sampling from jellyfish-sting patients who came for treatment at the Emergency Room of Songkhla Hospital. The subjects were divided using random assignment into two groups of 15 each: an experimental group, and the control group. The control group was treated using the traditional clinical practice guideline consisting of rinsing the affected area with 0.9% normal saline, using a cloth soaked with vinegar to press against the affected area, and controlling pain using tramadol or diclofenac intramuscular injection. The data were analyzed using descriptive statistics and paired t-test at the significance level p < 0.05. The results of the study revealed the following. The pain level in the experimental group was significantly lower than that of the control group (the average pain score of the experimental group was 3.46 while that of the control group was 6.33) (p < 0.05).The length of pain in the experimental group was significantly lower than that of the control group (the average length of pain in the experimental group was 48.67 minutes while that of the control group was 105.35 minutes) (p < 0.05). The rate of re-visit within 12 hours in the experimental group was significantly lower than that of the control group (the rate of re-visit within 12 hours of the experimental group was 0.07 while that of the control group was 0.00) (p < 0.05).No severe complications such as anaphylactic shock, and cardiac arrest were found in the two groups of subjects.The rate of satisfaction among the subjects in the experimental group was significantly higher than that of the control group (the rate of satisfaction among the subjects of the experimental group was 90.00 percent while that among the control group was 66.33 percent) (p < 0.05). The newly develop clinical practice guideline could reduce pain and increase satisfaction among jellyfish-sting patients better than the traditional clinical practice guideline.

Keywords: effectiveness, clinical practice guideline, jellyfish-sting patients, cardiac arrest

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Authors: Mengestie Mulugeta Belay, Serebe Abay Gebrie, Biruk Lambbiso Wamisho, Amare Worku

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Background: Low back pain (LBP) related to nursing profession, is a very common public health problem throughout the world. Various risk factors have been implicated in the etiology and LBP is assumed to be of multi-factorial origin as individual, work-related and psychosocial factors can contribute to its development. Objectives: To determine the prevalence and to identify risk factors of LBP among nurses working in Addis Ababa City Public Hospitals, Ethiopia, in the year 2015. Settings: Addis Ababa University, Black-Lion (‘Tikur Anbessa’) Hospital-BLH, is the country’s highest tertiary level referral and teaching Hospital. The three departments in connection with this study: Radiology, Pathology and Orthopedics, run undergraduate and residency programs and receive referred patients from all over the country. Methods: A cross-sectional study with internal comparison was conducted throughout the period October-December, 2015. Sample was chosen by simple random sampling technique by taken the lists of nurses from human resource departments as a sampling frame. A well-structured, pre-tested and self-administered questionnaire was used to collect quantifiable information. The questionnaire included socio-demographic, back pain features, consequences of back pain, work-related and psychosocial factors. The collected data was entered into EpiInfo version 3.5.4 and was analyzed by SPSS. A probability level of 0.05 or less and 95% confidence level was used to indicate statistical significance. Ethical clearance was obtained from all respected administrative bodies, Hospitals and study participants. Results: The study included 395 nurses and gave a response rate of 91.9%. The mean age was 30.6 (±8.4) years. Majority of the respondents were female (285, 72.2%). Nearly half of the participants (n=181, 45.8% (95% CI (40.8%- 50.6%))) were complained low back pain. There was statistical significant association between low back pain and working shift, physical activities at work; sleep disturbance and felt little pleasure by doing things. Conclusion: A high prevalence of low back pain was found among nurses working in Addis Ababa Public Hospitals. Recognition and preventive measures like providing resting periods should be taken to reduce the risk of low back pain in nurses working in Public hospitals.

Keywords: low back pain, risk factors, nurses, public hospitals

Procedia PDF Downloads 311

Authors: Pei-Ru Yang, Yu-Chen Lin, Jia-Min Wu

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Background: A 58-year-old man with a history of osteoporosis and diabetes presented with chronic pain in his left knee due to severe knee joint degeneration. The knee replacement surgery was recommended by the doctor. But the patient suffered from low pain tolerance and wondered if virtual reality could relieve acute postoperative wound pain. Methods: We used the PICO (patient, intervention, comparison, and outcome) approach to generate indexed keywords and searched systematic review articles from 2017 to 2021 on the Cochran Library, PubMed, and Clinical Key databases. Results: The initial literature results included 38 articles, including 12 Cochrane library articles and 26 PubMed articles. One article was selected for further analysis after removing duplicates and off-topic articles. The eight trials included in this article were published between 2013 and 2019 and recruited a total of 723 participants. The studies, conducted in India, Lebanon, Iran, South Korea, Spain, and China, included adults who underwent hemorrhoidectomy, dental surgery, craniotomy or spine surgery, episiotomy repair, and knee surgery, with a mean age (24.1 ± 4.1 to 73.3 ± 6.5). Virtual reality is an emerging non-drug postoperative analgesia method. The findings showed that pain control was reduced by a mean of 1.48 points (95% CI: -2.02 to -0.95, p-value < 0.0001) in minor surgery and 0.32 points in major surgery (95% CI: -0.53 to -0.11, p-value < 0.03), and the overall postoperative satisfaction has improved. Discussion: Postoperative pain is a common clinical problem in surgical patients. Research has confirmed that virtual reality can create an immersive interactive environment, communicate with patients, and effectively relieve postoperative pain. However, virtual reality requires the purchase of hardware and software and other related computer equipment, and its high cost is a disadvantage. We selected the best literature based on clinical questions to answer the patient's question and used share decision making (SDM) to help the patient make decisions based on the clinical situation after knee replacement surgery to improve the quality of patient-centered care.

Keywords: knee replacement surgery, postoperative pain, share decision making, virtual reality

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Authors: Manikandan S. P., Sharmila N.

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Pain in the neck, intermediate and anterior, and even low back may occur in one or more locations. Numerous factors can lead to back discomfort, which can manifest into sensations in the other parts of your body. Up to 80% of people will have low back problems at a certain stage of their lives, making spine-related pain a highly prevalent ailment. Roughly twice as commonly as neck pain, low back discomfort also happens about as often as knee pain. According to current studies, using digital devices for extended periods of time and poor sitting posture are the main causes of neck and low back pain. There are numerous monitoring techniques provided to enhance the sitting posture for the aforementioned problems. A sophisticated technique to monitor the extended sitting position is suggested in this research based on this problem. The system is made up of an inertial measurement unit, a T-shirt, an Arduino board, a buzzer, and a mobile app with cloud services. Based on the anatomical position of the spinal cord, the inertial measurement unit was positioned on the inner back side of the T-shirt. The IMU (inertial measurement unit) sensor will evaluate the hip position, imbalanced shoulder, and bending angle. Based on the output provided by the IMU, the data will be analyzed by Arduino, supplied through the cloud, and shared with a mobile app for continuous monitoring. The buzzer will sound if the measured data is mismatched with the human body's natural position. The implementation and data prediction with design to identify balanced and unbalanced posture using a posture monitoring t-shirt will be further discussed in this research article.

Keywords: IMU, posture, IOT, textile

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Authors: Desjardin, Michaels, Martinez, Ulmann

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Copper IUD is one of the most efficient and cost-effective contraception. However, pain at insertion hampers the use of this method. This is especially unfortunate in nulliparous women, often younger, who are excellent candidates for this contraception, including Emergency Contraception. Standard insertion procedure of a copper IUD usually involves measurement of uterine cavity with an hysterometer and the use of a tenaculum in order to facilitate device insertion. Both procedures lead to patient pain which often constitutes a limitation of the method. To overcome these issues, we have developed a modified insertor combined with a copper IUD. The singular design of the inserter includes a flexible inflatable membrane technology allowing an easy access to the uterine cavity even in case of abnormal uterine positions or narrow cervical canal. Moreover, this inserter makes possible a direct IUD insertion with no hysterometry and no need for tenaculum. To assess device effectiveness and patient-reported pain, a study was conducted at two clinics in Fance with 31 individuals who wanted to use a copper IUD as contraceptive method. IUD insertions have been performed by four healthcare providers. Operators completed questionnaire and evaluated effectiveness of the procedure (including IUD correct fundal placement and other usability questions) as their satisfaction. Patient also completed questionnaire and pain during procedure was measured on a 10-cm Visual Analogue Scale (VAS). Analysis of the questionnaires indicates that correct IUD placement took place in more than 93% of women, which is a standard efficacy rate. It also demonstrates that IUD insertion resulted in no, light or moderate pain predominantly in nulliparous women. No insertion resulted in severe pain (none above 6cm on a 10-cm VAS). This translated by a high level of satisfaction from both patients and practitioners. In addition, this modified inserter allowed a simplification of the insertion procedure: correct fundal placement was ensured with no need for hysterometry (100%) prior to insertion nor for cervical tenaculum to pull on the cervix (90%). Avoidance of both procedures contributed to the decrease in pain during insertion. Taken together, the results of the study demonstrate that this device constitutes a significant advance in the use of copper IUDs for any woman. It allows a simplification of the insertion procedure: there is no need for pre-insertion hysterometry and no need for traction on the cervix with tenaculum. Increased comfort during insertion should allow a wider use of the method for nulliparous women and for emergency contraception. In addition, pain is often underestimated by practitioners, but fear of pain is obviously one of the blocking factors as indicated by the analysis of the questionnaire. This evaluation brings interesting information on the use of this modified inserter for standard copper IUD and promising perspectives to set up a changement in the standard of IUD insertion procedure.

Keywords: contraceptio, IUD, innovation, pain

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Authors: S. M. C. Kelly, M. Goulden

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Introduction: Chronic Pancreatitis is an increasing problem worldwide. Pain is the main symptom and the main reason for hospital readmission following diagnosis, despite the use of strong analgesics including opioids. Ketamine infusions reduce pain in complex regional pain syndrome and other neuropathic pain conditions. Our centre has trialed the use of ketamine infusions in patients with chronic pancreatitis. We have evaluated this service to assess whether ketamine reduces emergency department admissions and analgesia requirements. Methods: This study collected retrospective data from 2010 in all patients who received a ketamine infusion for chronic pain secondary to a diagnosis of chronic pancreatitis. The day-case ketamine infusions were initiated in theatre by an anaesthetist, with standard monitoring and the assistance of an anaesthetic practitioner. A bolus dose of 0.5milligrams/kilogram was given in theatre. The infusion of 0.5 milligrams/kilogram per hour was then administered over a 6 hour period in the theatre recovery area. A study proforma detailed the medical history, analgesic use and admissions to hospital. Patients received a telephone follow up consultation. Results: Over the last eight years, a total of 30 patients have received intravenous ketamine infusions, with a total of 92 ketamine infusions being administered. 53% of the patients were male with the average age of 47. A total of 27 patients participated with the telephone consultation. A third of patients reported a reduction in hospital admissions with pain following the ketamine infusion. Analgesia requirements were reduced by an average of 48.3% (range 0-100%) for an average duration of 69.6 days (range 0-180 days.) Discussion: This service evaluation illustrates that ketamine infusions can reduce analgesic requirements and the number of hospital admissions in patients with chronic pancreatitis. In the light of increasing pressures on Emergency departments and the increasing evidence of the dangers of long-term opioid use, this is clearly a useful finding. We are now performing a prospective study to assess the long-term effectiveness of ketamine infusions in reducing analgesia requirements and improving patient’s quality of life.

Keywords: acute-on-chronic pain, intravenous analgesia infusion, ketamine, pancreatitis

Procedia PDF Downloads 136

Authors: Faezeh Jahanpour, Shahin Dezhdar, Saeedeh Firouz Bakht, Afshin Ostovar

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Objective: The hospitalized premature babies often undergo various painful procedures such as venous sampling. The Kangaroo mother care (KMC) method is one of the pain reduction methods, but as mother’s presence is not always possible, this research was done to compare the effect of swaddling and KMC method on venous sampling pain on premature neonates. Methods: In this randomized clinical trial 90 premature infants selected and randomly alocated into three groups; Group A (swaddling), Group B (the kangaroo care), and group C (the control). From 10 minutes before blood sampling to 2 minutes after that in group A, the infant was wrapped in a thin sheet, and in group B, the infant was under Kangaroo care. In all three groups, the heart rate and arterial oxygen saturation in time intervals of 30 seconds before, during, 30-60-90, and 120 seconds after sampling were measured and recorded. The infant’s face was video recorded since sampling till 2 minutes and the videos were checked by a researcher who was unaware of the kind of intervention and the pain assessment tools for infants (PIPP) for time intervals of 30 seconds were completed. Data analyzed by t-test, Q square, Repeated Measure ANOVA, Kruskal-Wallis, Post-hoc and Bonferroni test. Results: Findings revealed that the pain was reduced to a great extent in swaddling and kangaroo method compared to that in control group. But there was not a significant difference between kangaroo and swaddling care method (P ≥ 0.05). In addition, the findings showed that the heart rate and arterial oxygen saturation was low and stable in swaddling and Kangaroo care method and returned to base status faster, whereas, the changes were severe in control group and did not return to base status even after 120 seconds. Discussion: The results of this study showed that there was not a meaningful difference between swaddling and kangaroo care method on physiological indexes and pain in infants. Therefore, swaddling method can be a good substitute for kangaroo care method in this regard.

Keywords: Kangaroo mother care, neonate, pain, premature, swaddling, venipuncture,

Procedia PDF Downloads 215

Authors: Mohd Fadzly Yahya, Matthew Teo Yong Chang

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Globally, the increasing life expectancy of human beings has brought more issues with non-communicable diseases, especially work-related musculoskeletal disorders (WMDs). WMSD also is one of the leading causes of health-related absence from work restricted work time in Malaysia. WMDs are cumulative disorders, resulting from repeated exposure to high or low-intensity loads over a long period. Evidence from a previous study showed that office workers in government and private sectors were showing high WRMDs prevalence in Malaysia. The objectives of this study were to determine the prevalence of MSDs among Malaysian office workers in Klang Valley and to identify the association between MSDs pain and working experience among office workers. This is a cross-sectional study focusing on officer workers in the Klang Valley area. The questionnaires consisted of the subject’s demographics, Nordic Musculoskeletal Questionnaire, and The Numeric Pain Rating Scale were distributed online via google forms to all consenting participants. The data were analyzed for descriptive analysis, parametric test, and student T-test using IBM SPSS Statistics Version 27. From a total of 244 participants, 95 (38.9%) were male and 149 (61.1%) were female. 57.8% of the total samples were government staff while private-sector workers were 42.2%. The highest MSDs prevalence was neck pain during the last 12 months which contributed to 69.3% (n=169) of total participants, which is male 38.5% (n=65) and female 61.5% (n=104). Our study revealed that female office workers have a higher prevalence of WMDs and there is a significant difference in elbow pain, wrist, and hands pain, and lower back pain across four different working experience groups. Office workers in this study were highly exposed to MSDs due to poor ergonomics implementation at the workplace. It is crucial to advocate preventative measures to employers such as workplace ergonomics and changes to work practices to reduce the incidence of MSDs cases in office settings.

Keywords: musculoskeletal disorders, pain, prevalence rate, office workers, risks

Procedia PDF Downloads 134

Authors: Maria Do Carmo Baracho De Alencar

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Back pain is considered a worldwide public health problem and has led to numerous work-related absence from work and public spending on rehabilitation, as well as difficulties in the process of professional rehabilitation and return to work. Also, the rehabilitation of workers is one of the great challenges today and for the field of Workers' Health in Brazil. Aim: To investigate the procedures related to the professional rehabilitation of insured workers affected by chronic low back pain, based on the perceptions of professional counselors. Methods: A list of related professional counselors was obtained from the Professional Rehabilitation Coordination of the Baixada Santista (SP) region, and from the Social Security National Institute of Brazil, and in which cities they worked. Semistructured and individual interview was scheduled, based on a pre-elaborated script, containing questions about procedures, experiences at work and feelings. The interviews were recorded and transcribed in full for content analysis. Results: Ten (10) professional counselors of both genders and from nine (9) cities from the Baixada Santista region participated in the study. Aged between 31 and 64 years, and time in service between 4 and 38 years. Only one of the professionals was graduaded in Psychology. Among the testimonies emerged the high demand of work, the lack of interest of companies, medical authority, the social helplessness after rehabilitation process, difficulty in assessing invisible pain, and suffering, anguish, and frustration at work, between others. Conclusion: The study contributes to reflections about the importance of interdisciplinary actions and the Psychology in the processes of professional rehabilitation and readaptation in the process of return to work.

Keywords: low back pain, rehabilitation, work, occupational health

Procedia PDF Downloads 133

Authors: Sergei Kosarev

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Wrong treatment tactics for hand and wrist sport-related injuries can lead to the inability to play sports in the future. It is especially important for professional athletes. The members of the Russian Olympic Team are treated in our hospital -Federal Clinical Research Center (Moscow). For their treatment, we use minimally invasive methods such as wrist arthroscopy and also orthobiologics procedures. In 2022 we had cases with scaphoid fracture and TFCC injuries. In all the cases, we were using the arthroscopy technic for treatment. The scaphoid fracture was fixed by K-wires with free bone grafting. For TFCC injures we used transossal sutures. Rehabilitation started the next day after surgery. Rehabilitation included hand therapy and physiotherapy. All athletes returned to the sport after 8-12 weeks after surgery. One of them had pain in the wrist after 12 weeks after surgery, not more than 4 point VAS. Pain syndrome was blocked after 2 PRP injections in the ulnar side of the wrist.

Keywords: sport trauma, wrist arthroscopy, wrist pain, scaphoid fracture

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Authors: Mrinal Kanti Bhowmik, Shawli Bardhan Jr., Debotosh Bhattacharjee

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Human skin containing temperature value more than absolute zero, discharges infrared radiation related to the frequency of the body temperature. The difference in infrared radiation from the skin surface reflects the abnormality present in human body. Considering the difference, detection and forecasting the temperature variation of the skin surface is the main objective of using Medical Infrared Thermography(MIT) as a diagnostic tool for pain detection. Medical Infrared Thermography(MIT) is a non-invasive imaging technique that records and monitors the temperature flow in the body by receiving the infrared radiated from the skin and represent it through thermogram. The intensity of the thermogram measures the inflammation from the skin surface related to pain in human body. Analysis of thermograms provides automated anomaly detection associated with suspicious pain regions by following several image processing steps. The paper represents a rigorous study based survey related to the processing and analysis of thermograms based on the previous works published in the area of infrared thermal imaging for detecting inflammatory pain diseases like arthritis, spondylosis, shoulder impingement, etc. The study also explores the performance analysis of thermogram processing accompanied by thermogram acquisition protocols, thermography camera specification and the types of pain detected by thermography in summarized tabular format. The tabular format provides a clear structural vision of the past works. The major contribution of the paper introduces a new thermogram acquisition standard associated with inflammatory pain detection in human body to enhance the performance rate. The FLIR T650sc infrared camera with high sensitivity and resolution is adopted to increase the accuracy of thermogram acquisition and analysis. The survey of previous research work highlights that intensity distribution based comparison of comparable and symmetric region of interest and their statistical analysis assigns adequate result in case of identifying and detecting physiological disorder related to inflammatory diseases.

Keywords: acquisition protocol, inflammatory pain detection, medical infrared thermography (MIT), statistical analysis

Procedia PDF Downloads 342

Authors: Fedili Benamar, Beloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

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 Background and aims: Peripheral regional anesthesia has been integrated into most analgesia protocols for total knee arthroplasty which considered among the most painful surgeries with a huge potential for chronicization. The adductor canal block (ACB) has gained popularity. Similarly, the IPACK block has been described to provide analgesia of the posterior knee capsule. This study aimed to evaluate the analgesic efficacy of this block in patients undergoing primary PTG. Methods: 90 patients were randomized to receive either an IPACK, an anterior sciatic block, or a sham block (30 patients in each group + multimodal analgesia and a catheter in the KCA adductor canal). GROUP 1 KCA GROUP 2 KCA+BSA GROUP 3 KCA+IPACK The analgesic blocks were done under echo-guidance preoperatively respecting the safety rules, the dose administered was 20 cc of ropivacaine 0.25% was used. We were to assess posterior knee pain 6 hours after surgery. Other endpoints included quality of recovery after surgery, pain scores, opioid requirements (PCA morphine)(EPI info 7.2 analysis). Results: -groups were matched -A predominance of women (4F/1H). -average age: 68 +/-7 years -the average BMI =31.75 kg/m2 +/- 4. -70% of patients ASA2 ,20% ASA3. -The average duration of the intervention: 89 +/- 19 minutes. -Morphine consumption (PCA) significantly higher in group 1 (16mg) & group 2 (8mg) group 3 (4mg) - The groups were matched . -There was a correlation between the use of the ipack block and postoperative pain Conclusions :In a multimodal analgesic protocol, the addition of IPACK block decreased pain scores and morphine consumption ,

Keywords: regional anesthesia, analgesia, total knee arthroplasty, the adductor canal block (acb), the ipack block, pain

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Authors: R. Domínguez, A. Castro, N. Fernandez, F. Hidalgo, F. Ortiz

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Aims: Study musculoskeletal disorders produced by excess physical exertion in marines Introduction: Musculoskeletal injuries during military training are an important medical problem faced by military organizations throughout the world. Military occupations are physically demanding, which represents a high risk of injury "and subsequent disability, these injuries represent important risk factors for hospitalization, disability, and discharge Methodology: This is a causal correlational study in which data were collected in order to find a cause-effect relationship between the physical effort in marines during their career in the Chilean Navy and the musculoskeletal disorders that occur in some from them. Results:100% had experienced musculoskeletal pain in some part of the body and 73.52% of the respondents had experienced limitations in the ability to work, as a consequence forced to change jobs due to musculoskeletal pain. The neck, shoulders and the lumbar dorsal region were the regions with the highest prevalence of pain, as well as pain that limit the ability to work. Conclusion: Musculoskeletal injuries and illnesses related to injuries are common in marines, both in those who operate in campus Charles, as in another operational unit due to the nature of the work. Many of these injuries occur during physical training and sports and various studies have dealt with the descriptive epidemiology of musculoskeletal injuries in military personnel.

Keywords: physical effort, marines, musculoskeletal disorders produced (MSD), training

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Authors: Kaili Wang, Botao Zhang, Enming Zhang

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Background: Low back pain (LBP) is a common problem affecting athletes' training and competition. Although the association between a limited hip range of motion and prevalence of low back pain has been studied extensively, it has not been studied in table tennis. Aim: The main purposes of this study in table tennis players were (1) to investigate if there is a difference in hip internal rotation (HIR) and external rotation (HER) range of motion (ROM) between players with LBP and players without LBP and (2) to analyze the association between HIR and HER ROM and LBP. Methods: Forty-six table tennis players from the Chinese table tennis team were evaluated for passive maximum HIR and HER ROM. LBP was retrospectively recorded for the last 12 months before the date of ROM assessment by a physical therapist. The data were analyzed the difference in HIR and HER ROM between players with LBP and players without LBP by Mann-Whitney U test, and the association between the difference in HIR and HER ROM and LBP was analyzed via a binary logistic regression. Results: The 54% of players had developed LBP during the retrospective study period. Significant difference between LBP group and the asymptomatic group for HIR ROM (z=4.007, p<0.001) was observed. Difference between LBP group and asymptomatic group for HER ROM (z=1.117, p=0.264) was not significant. Players who had HIR ROM deficit had an increased risk of LBP compared with players without HIR ROM deficit (OR=5.344, 95%CI: 1.006-28.395, P=0.049). Conclusion: HIR ROM of a table tennis player with LBP was less than a table tennis player without LBP. Compared with player whose HIR ROM was normal, player who had HIR ROM deficit appeared to have a higher risk for LBP.

Keywords: assessment, injury prevention, low back pain, table tennis players

Procedia PDF Downloads 111