Search results for: painful

Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Degenerative disc disease is a process of premature and accelerated deterioration of the intervertebral disc; it is of multifactorial origin and is responsible for chronic low back pain. Objectives: Determine an epidemiological profile of patients with painful lumbar degenerative disc disease. Patients and methods: We performed a prospective study of 104 patients operated on for degenerative painful lumbar disc disease over a period of 25 months. The parameters analyzed were: age, sex, Body Mass Index (BMI), comorbidities, family history of low back pain, and difficulty with professional activity. Results: The average age was 43.3 years, with a clear predominance of men: 72 men for 32 women, the average BMI was 26.80Kg / m2, and 63.5% of the patients were overweight. The occurrence of disc degeneration in pathological conditions was noted in 14.4% of cases. The notion of familial low back pain was found in 49% of cases. The majority of patients perform more or less arduous work (51%) in the cases. Conclusion: In our series, degenerative painful lumbar disc disease predominates in the male subject, active obese who performs more or less painful work, in whom we find a family history of low back pain.

Keywords: degenerative disc disease, low back pain, body mass index, disque intervertebrale

Procedia PDF Downloads 70

Authors: Ghoul Rachid Brahim

Abstract:

Introduction: Back pain is a real public health problem with a significant socio-economic impact. It is the consequence of a degeneration of the lumbar intervertebral disc (IVD). This often asymptomatic pathology is compatible with an active life. As soon as it becomes symptomatic, conservative treatment is recommended in the majority of cases. The physical or functional disability is resistant to well-monitored conservative treatment, which justifies a surgical alternative which imposes a well-studied reflection on the objectives to be achieved. Objective: Evaluate the indication and short and medium term contribution of surgery in the management of painful degenerative lumbar disc disease. To prove the effectiveness of surgical treatment in the management of painful lumbar degenerative disc disease. Materials and methods: This is a prospective descriptive mono-centric study without comparison group, comprising a series of 104 patients suffering from lumbar painful degenerative disc disease treated surgically. Retrospective analysis of data collected prospectively. Comparison between pre and postoperative clinical status, by pain self-assessment scores and on the impact on pre and postoperative quality of life (3, 6 to 12 months). Results: This study showed that patients who received surgical treatment had great improvements in symptoms, function and several health-related quality of life in the first year after surgery. Conclusions: The surgery had a significantly positive impact on patients' pain, disability and quality of life. Overall, 97% of the patients were satisfied.

Keywords: degenerative disc disease, intervertebral disc, several health-related quality, lumbar painful

Procedia PDF Downloads 78

Authors: Abeer F. Almarzouki, Christopher A. Brown, Richard J. Brown, Anthony K. P. Jones

Abstract:

Although relief is commonly assumed to be a direct reflection of pain reduction, it seems to be driven by complex emotional interactions in which pain reduction is only one component. For example, termination of a painful/aversive event may be relieving and rewarding. Accordingly, in this study, whether terminating an aversive negative prediction of pain would be reflected in a greater relief experience was investigated, with a view to separating apart the effects of the manipulation on pain and relief. We use aversive conditioning paradigm to investigate the perception of relief in an aversive (threat) vs. positive context. Participants received positive predictors of a non-painful outcome which were presented within either a congruent positive (non-painful) context or an incongruent threat (painful) context that had been previously conditioned; trials followed by identical laser stimuli on both conditions. Participants were asked to rate the perceived intensity of pain as well as their perception of relief in response to the cue predicting the outcome. Results demonstrated that participants reported more pain in the aversive context compared to the positive context. Conversely, participants reported more relief in the aversive context compares to the neutral context. The rating of relief in the threat context was not correlated with pain reports. The results suggest that relief is not dependant on pain intensity. Consistent with this, relief in the threat context was greater than that in the positive expectancy condition, while the opposite pattern was obtained for the pain ratings. The value of relief in this study is better appreciated in the context of an impending negative threat, which is apparent in the higher pain ratings in the prior negative expectancy compared to the positive expectancy condition. Moreover, the more threatening the context (as manifested by higher unpleasantness/higher state anxiety scores), the more the relief is appreciated. The importance of the study highlights the importance of exploring relief and pain intensity in monitoring separately or evaluating pain-related suffering. The results also illustrate that the perception of painful input may largely be shaped by the context and not necessarily stimulus-related.

Keywords: aversive context, pain, predictions, relief

Procedia PDF Downloads 96

Authors: Rasha F. Sharaf

Abstract:

Administration of local anesthesia for a child is considered a painful procedure, which affects his vital signs, physiological parameters, and his further attitude in the dental clinic. During the extraction of mandibular molars, the nerve block technique is the most commonly used for the administration of local anesthesia; however, this technique requires deep penetration of the needle, which causes pain and discomfort for the child. Therefore, the inferior alveolar nerve block technique can be substituted with an infiltration technique which is not painful if a potent anesthetic solutions will be used. In the current study, the effect of Articaine 4% will be compared to Mepivacaine 2%, and their influence on the vital signs of the child, as well as their ability to control pain during extraction, will be assessed.

Keywords: anesthesia, articaine, pain control, extraction

Procedia PDF Downloads 87

Authors: Sumit Kanwar, Manisha Chand, Gregory Gilot

Abstract:

Background: Septic arthritis of the shoulder has infrequently been discussed. Focus on infection of the untouched shoulder has not heretofore been described. We present four patients with glenohumeral septic arthritis. Methods: Case 1: A 59 year old male with left shoulder pain in the anterior, posterior and superior aspects. Case 2: A 60 year old male with fever, chills, and generalized muscle aches. Case 3: A 70 year old male with right shoulder pain about the anterior and posterior aspects. Case 4: A 55 year old male with global right shoulder pain, swelling, and limited ROM. Results: In case 1, the left shoulder was affected. Physical examination, swelling was notable, there was global tenderness with a painful range of motion (ROM). The lab values indicated an erythrocyte sedimentation rate (ESR) of 96, and a C-reactive protein (CRP) of 304.30. Imaging studies were performed and MRI indicated a high suspicion for an abscess with osteomyelitis of the humeral head. Our second case’s left arm was affected. He had swelling, global tenderness and painful ROM. His ESR was 38, CRP was 14.9. X-ray showed severe arthritis. Case 3 differed with the right arm being affected. Again, global tenderness and painful ROM was observed. His ESR was 94, and CRP was 10.6. X-ray displayed an eroded glenoid space. Our fourth case’s right shoulder was affected. He had global tenderness and painful, limited ROM. ESR was 108 and CRP was 2.4. X-ray was non-significant. Discussion: Monoarticular septic arthritis of the virgin glenohumeral joint is seldom diagnosed in clinical practice. Common denominators include elevated ESR, painful, limited ROM, and involvement of the dominant arm. The male population is more frequently affected with an average age of 57. Septic arthritis is managed with incision and drainage or needle aspiration of synovial fluid supplemented with 3-6 weeks of intravenous antibiotics. Due to better irrigation and joint visualization, arthroscopy is preferred. Open surgical drainage may be indicated if the above methods fail. Conclusion: If a middle-aged male presents with vague anterior or posterior shoulder pain, elevated inflammatory markers and a low grade fever, an x-ray should be performed. If this displays degenerative joint disease, the complete further workup with advanced imaging, such as an MRI, CT scan, or an ultrasound. If these imaging modalities display anterior space joint effusion with soft tissue involvement, we can suspect septic arthritis of the untouched glenohumeral joint and surgery is indicated.

Keywords: glenohumeral joint, identification, infection, septic arthritis, shoulder

Procedia PDF Downloads 395

Authors: A. Estaji

Abstract:

The first part of the present paper studies the role of language in expressing pain. Pain is usually described as a personal and mental experience, so language has an important role in describing, expressing and measuring pain and sometimes it is believed that language is the only device for accessing this personal experience. The second part of this paper studies gender differences in expressing pain. Considering the biological, psychological and social differences between men and women, we raise this question whether men and women express their pain in the same way or differently. To answer this question, we asked 44 Farsi speaking participants to write about the most painful experience they had in the past. Qualitative analysis of the data shows that women, have expressed their pain more severely, have expressed their feelings about pain instead of describing the pain itself, have made their pain more personal and have given more details about the circumstances in which they experienced pain, while men have given a more neutral description of their pain and have given a description of their pain by distancing themselves from the painful event. Knowing these gender differences in expressing pain can help medical practitioners in assessing the pain level.

Keywords: discourse analysis, expressing pain, measuring pain, gender

Procedia PDF Downloads 367

Authors: Intan Maisarah Abd Rahim, Herlina Abdul Rahim, Rashidah Ghazali

Abstract:

Diabetes is a medical condition that can lead to various diseases such as stroke, heart disease, blindness and obesity. In clinical practice, the concern of the diabetic patients towards the blood glucose examination is rather alarming as some of the individual describing it as something painful with pinprick and pinch. As for some patient with high level of glucose level, pricking the fingers multiple times a day with the conventional glucose meter for close monitoring can be tiresome, time consuming and painful. With these concerns, several non-invasive techniques were used by researchers in measuring the glucose level in blood, including ultrasonic sensor implementation, multisensory systems, absorbance of transmittance, bio-impedance, voltage intensity, and thermography. This paper is discussing the application of the near-infrared (NIR) spectroscopy as a non-invasive method in measuring the glucose level and the implementation of the linear system identification model in predicting the output data for the NIR measurement. In this study, the wavelengths considered are at the 1450 nm and 1950 nm. Both of these wavelengths showed the most reliable information on the glucose presence in blood. Then, the linear Autoregressive Moving Average Exogenous model (ARMAX) model with both un-regularized and regularized methods was implemented in predicting the output result for the NIR measurement in order to investigate the practicality of the linear system in this study. However, the result showed only 50.11% accuracy obtained from the system which is far from the satisfying results that should be obtained.

Keywords: diabetes, glucose level, linear, near-infrared, non-invasive, prediction system

Procedia PDF Downloads 128

Authors: Rasha F. Sharaf

Abstract:

Treatment of dental caries in young children is considered a great challenge for all dentists, especially with uncooperative children. Recently non-invasive techniques have been highlighted as they alleviate the need for local anesthesia and other painful procedures during management of carious teeth and, at the same time, increase the success rate of the treatment done. Silver Diamine Fluoride (SDF) is one of the most effective cariostatic materials that arrest the progression of carious lesions and aid in remineralizing the demineralized tooth structure. Both fluoride and silver ions proved to have an antibacterial action and aid in the precipitation of an insoluble layer that prevents further decay. At the same time, Moringa proved to have an effective antibacterial action against different types of bacteria, therefore, it can be used as a non-invasive technique for the management of caries in children. One of the important theories for the control of caries is by depriving the cariogenic bacteria from nutrients causing their starvation and death, which can be achieved by applying stainless steel crown on primary molars with carious lesions which are not involving the pulp, and this technique is known as Hall technique. The success rate of the Hall technique can be increased by arresting the carious lesion using either SDF or Moringa and gaining the benefit of their antibacterial action. Multiple clinical cases with 1 year follow up will be presented, comparing different treatment options, and using various materials and techniques for non-invasive and non-painful management of carious primary teeth.

Keywords: SDF, hall technique, carious primary teeth, moringa extract

Procedia PDF Downloads 72

Authors: Fatemeh Rasooli, Behzad Simiari, Pooya Payandemehr, Amir Nejati, Maryam Bahreini, Atefeh Abdollahi

Abstract:

Introduction: Pain is a complex physiological reaction to tissue injury. In the course of painful procedures such as nerve block, ice has been shown to be a feasible and inexpensive material to control pain. It delays nerve conduction, actives other senses and reduces inflammatory and painful responses. This study assessed the effect of ice in reducing pain caused by needling and infiltration during digital block. Patient satisfaction recorded as a secondary outcome. Methods: This study was designed as a non-blinded randomized clinical trial approved by Tehran University of Medical Sciences Ethical Committee. Informed consent was taken from all the participants who were then randomly divided into two groups. Digital block performed by standard approach in selected patients. Tubes of ice were prepared in gloves and were fragmented at a time of application for circling around the finger. Tubes were applied for 6 minutes before digital nerve block in the site of needling in the case group. Patients in the control group underwent digital nerve block with the conventional method without ice administration. Numeric Rating Scale (NRS) used for grading pain. 0 used for no pain and 10 for the worst pain that patient had experienced until now. Scores were analyzed by Wilcoxon Rank Sum test and compared in case and control groups. Results: 100 patients aged 16-50 years were enrolled. Mean NRS scores with and without ice were 1.5 mm (S.D ± 1.44) and 6.8 mm (S.D ± 1.40) for needling pain and for infiltration pain were 2.7mm ( S.D ±1.65) and 8.5mm ( S.D ± 1.47), respectively (p<0.001). Besides, patients’ satisfactions were significantly higher in the ice group (p<0.001). Conclusion: Application of ice for 6 minutes significantly reduced pain of needling and infiltration in digital nerve block; thus, it seems to be a feasible and inexpensive material which acts effectively to decrease pain and stress before the procedure.

Keywords: digital block, ice, needle, pain

Procedia PDF Downloads 205

Authors: Hossam Mohammed Abdelfattah

Abstract:

In ancient Egypt, poverty, recognized as the foremost challenge, was extensively addressed in teachings, wisdom, and literary texts. These sources vividly depicted the suffering of a class deprived of life's pleasures. The ancient Egyptian language evolved to introduce terms reflecting poverty and hunger, underscoring the society's commitment to acknowledging and cautioning against this prevalent issue. Among the notable expressions, iwty.f emerged during the Middle Kingdom, symbolizing "the one without property" and signifying the destitute poor. iwty n.f traced back to the Pyramid Texts era, referred to "the one who has nothing" or simply, the poor. Another term, , iwty-sw emphasized the state of possessing nothing. rA-awy originating in the Middle Kingdom Period, initially meant "poverty and poor," expanding to signify poverty in various texts with the addition of the preposition "in," conveying strength given to the poor. During the First Intermediate Period, sny - mnt denoted going through a crisis or suffering, possibly referencing a widespread disease or plague. It encompassed meanings of sickness, pain, and anguish. The term .” sq-sn introduced in Middle Kingdom texts, conveyed the notion of becoming miserable. sp-Xsy . represented a temporal expression reflecting a period of misery or poverty, with Xsy ,indicating distress or misery. The term qsnt appearing in Middle Kingdom texts, held meanings of painful, difficult, harsh, miserable, emaciated, and in bad condition. Its feminine form, qsn denoted anxiety and turmoil. Finally, tp-qsn encapsulated the essence of misery and unhappiness. In essence, these expressions provide linguistic insights into the multifaceted experience of poverty in ancient Egypt, illustrating the society's keen awareness and efforts to address this pervasive challenge.

Keywords: poverty, poor, suffering, misery, painful, ancient Egypt

Procedia PDF Downloads 15

Authors: Mrinal Kanti Bhowmik, Debanjana Debnath Jr., Debotosh Bhattacharjee

Abstract:

A facial expression is undeniably the human manners. It is a significant channel for human communication and can be applied to extract emotional features accurately. People in pain often show variations in facial expressions that are readily observable to others. A core of actions is likely to occur or to increase in intensity when people are in pain. To illustrate the changes in the facial appearance, a system known as Facial Action Coding System (FACS) is pioneered by Ekman and Friesen for human observers. According to Prkachin and Solomon, a set of such actions carries the bulk of information about pain. Thus, the Prkachin and Solomon pain intensity (PSPI) metric is defined. So, it is very important to notice that facial expressions, being a behavioral source in communication media, provide an important opening into the issues of non-verbal communication in pain. People express their pain in many ways, and this pain behavior is the basis on which most inferences about pain are drawn in clinical and research settings. Hence, to understand the roles of different pain behaviors, it is essential to study the properties. For the past several years, the studies are concentrated on the properties of one specific form of pain behavior i.e. facial expression. This paper represents a comprehensive study on pain assessment that can model and estimate the intensity of pain that the patient is suffering. It also reviews the historical background of different pain assessment techniques in the context of painful expressions. Different approaches incorporate FACS from psychological views and a pain intensity score using the PSPI metric in pain estimation. This paper investigates in depth analysis of different approaches used in pain estimation and presents different observations found from each technique. It also offers a brief study on different distinguishing features of real and fake pain. Therefore, the necessity of the study lies in the emerging fields of painful face assessment in clinical settings.

Keywords: facial action coding system (FACS), pain, pain behavior, Prkachin and Solomon pain intensity (PSPI)

Procedia PDF Downloads 302

Authors: Naum Simanovsky, Vladimir Goldman, Michael Zaidman

Abstract:

Background: The optimal algorithm for the management of symptomatic tarsal coalition is still under discussion in pediatric literature. It's debatable what surgical steps are essential to achieve the best outcome. Method: The investigators retrospectively reviewed the records of twelve patients with symptomatic tarsal coalition that were treated operatively between 2017 and 2019. Only painful flat feet were operated. Two patients were excluded from the study due to lack of sufficient follow-up. Ten of eleven feet were treated with the combination of calcaneal lengthening osteotomy (CLO) and resection of coalition (RC). Only one foot was operated with CLO alone. In half of our patients, Achilles lengthening was performed. For two children, medial plication was added. Short leg cast was applied to all children for 6-8 weeks, and soft shoe insoles for medial arch support were prescribed after. Demographic, clinical, and radiographic records were reviewed. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results: There were seven boys and three girls. The mean age at the time of surgery was 13.9 (range 12 to 17) years, and the mean follow-up was 18 (range 8 to 34) months. The early complications included one superficial wound infection and dehiscence. Late complication includes two children with residual forefoot supination. None of our patients required additional operations during the follow-up period. All feet achieved complete deformity correction or dramatic improvement. In the last follow-up, seven feet were painless, and four children had some mild pain after intensive activities. All feet achieved excellent and good scoring on AOFAS. Conclusions: Many patients with talocalcaneal coalition also have rigid or stiff, painful, flat feet. For these patients, the resection of coalition with concomitant CLO can be safely recommended.

Keywords: Tarsal coalition, calcaneal lengthening osteotomy., flat foot, coalition resection

Procedia PDF Downloads 32

Authors: Malvina Hoxha, Valerie Capra, Carola Buccellati, Angelo Sala, Clara Cena, Roberta Fruttero, Massimo Bertinaria, G. Enrico Rovati

Abstract:

Today COXIBs are used in the treatment of arthritis and many other painful conditions in selected patients with high gastrointestinal risk and low CV risk. Previously we found a new mechanism of action of a traditional NSAID (diclofenac) and a COXIB (lumiracoxib) that possess weak competitive antagonism at the TP receptor. We hypothesize that modifying the structure of a known specific inhibitor of cyclooxygenase-2 (COXIB), so that it becomes also a more potent thromboxane antagonist will preserve the anti-inflammatory and gastrointestinal safety typical of COXIBs and prevent the cardiovascular risk associated with long term therapy.

Keywords: cyclooxygenase, inflammation, lumiracoxib, thromboxane A2

Procedia PDF Downloads 275

Authors: Subhankar Karmakar, Madhan Kumar Vasudevan, Manivannan Muniyandi

Abstract:

Thermal Grill Illusion (TGI) elicits a strong and often painful sensation of burn when interlacing warm and cold stimuli that are individually non-painful, excites thermoreceptors beneath the skin. Among several theories of TGI, the “disinhibition” theory is the most widely accepted in the literature. According to this theory, TGI is the result of the disinhibition or unmasking of the pain-sensitive HPC (Heat-Pinch-Cold) nerve fibers due to the inhibition of cold-sensitive nerve fibers that are responsible for masking HPC nerve fibers. Although researchers focused on understanding TGI throughexperiments and models, none of them investigated the prediction of TGI pain intensity through a computational model. Furthermore, the comparison of psychophysically perceived TGI intensity with neurophysiological models has not yet been studied. The prediction of pain intensity through a computational model of TGI can help inoptimizing thermal displays and understanding pathological conditions related to temperature perception. The current studyfocuses on developing a computational model to predict the intensity of TGI pain and experimentally observe the perceived TGI pain. The computational model is developed based on the disinhibition theory and by utilizing the existing popular models of warm and cold receptors in the skin. The model aims to predict the neuronal activity of the HPC nerve fibers. With a temperature-controlled thermal grill setup, fifteen participants (ten males and five females) were presented with five temperature differences between warm and cold grills (each repeated three times). All the participants rated the perceived TGI pain sensation on a scale of one to ten. For the range of temperature differences, the experimentally observed perceived intensity of TGI is compared with the neuronal activity of pain-sensitive HPC nerve fibers. The simulation results show a monotonically increasing relationship between the temperature differences and the neuronal activity of the HPC nerve fibers. Moreover, a similar monotonically increasing relationship is experimentally observed between temperature differences and the perceived TGI intensity. This shows the potential comparison of TGI pain intensity observed through the experimental study with the neuronal activity predicted through the model. The proposed model intends to bridge the theoretical understanding of the TGI and the experimental results obtained through psychophysics. Further studies in pain perception are needed to develop a more accurate version of the current model.

Keywords: thermal grill Illusion, computational modelling, simulation, psychophysics, haptics

Procedia PDF Downloads 137

Authors: Nanditha Rajamani, Anirudhaa R. Rao, Divya Sriram

Abstract:

One of the greatest difficulties in treating patients with pain is the highly subjective nature of pain sensation. The measurement of pain intensity is primarily dependent on the patient’s report, often with little physical evidence to provide objective corroboration. This is also complicated by the fact that there are only few and expensive existing technologies (Functional Magnetic Resonance Imaging-fMRI). The need is thus clear and urgent for a reliable, non-invasive, non-painful, objective, readily adoptable, and coefficient diagnostic platform that provides additional diagnostic information to supplement its current regime with more information to assist doctors in diagnosing these patients. Thus, our idea of developing a pain detector was conceived to take a step further the detection and diagnosis of chronic and acute pain.

Keywords: pain sensor, microwave radiometery, pain sensation, fMRI

Procedia PDF Downloads 421

Authors: Roya Yumul, Ofelia Loani Elvir-Lazo, Sevan Komshian, Ruby Wang, Jun Tang

Abstract:

BACKGROUND: An objective means for monitoring the anti-nociceptive effects of perioperative medications has long been desired as a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively. To this end, electroencephalogram (EEG) based tools including BIS and qCON were designed to provide information about the depth of sedation while qNOX was produced to inform on the degree of antinociception. The goal of this study was to compare the reliability of qCON/qNOX to BIS as specific indicators of response to nociceptive stimulation. METHODS: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board (IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to the endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed on all patients prior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. RESULTS: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from 74 ±13 mm Hg at baseline to 84 ± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76 ± 12 BPM at baseline to 80 ± 13 BPM during noxious stimuli [p=0.078] respectively). CONCLUSION: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices

Keywords: antinociception, BIS, general anesthesia, LMA, qCON/qNOX

Procedia PDF Downloads 107

Authors: Corbel Camille, Le Cerf Flora, Capriz Françoise, Vaillant-Ciszewicz Anne-Julie, Breaud Jean, Guerin Olivier, Corveleyn Xavier

Abstract:

Background: The medical environment can generate stressful and anxiety-provoking situations for patients, particularly during painful care procedures for the older population. These stressful environments have deleterious effects on the quality of care and can even put the patient at risk and set the care team up for failure. The search for a solution is, therefore, imperative. The development of new technologies, such as virtual reality (VR), seems to be an answer to this problem. Objectives: The objective of this study is to compare the effects of virtual reality on pain and anxiety when caring for older hospitalized people with the effects of usual care. More precisely, different individual factors (age, cognitive level, individual preferences, etc.) and different virtual reality universes (personalized or non-personalized) are studied to understand the role of these factors in reducing pain and anxiety during care procedures. The aim of this study is to improve the quality of life of patients and caregivers in their work environment. Method: This mono-centered, randomized, controlled study was conducted from September 2023 to September 2024 on 120 participants recruited from the geriatric departments of the Cimiez Hospital, Nice, France. Participants are randomized into three groups: a control group, a personalized VR group and a non-personalized VR group. Each participant is followed during a painful care session. Data are collected before, during and after the care, using measures of pain (Algoplus and numerical scale) and anxiety (Hospital anxiety scale and numerical scale). Physiological assessments with an oximeter are also performed to collect both heart and respiratory rate measurements. The implementation of the care will be assessed among healthcare providers to evaluate its effects on the difficulty and fatigue associated with the care. Additionally, a questionnaire (System Usability Scale) will be administered at the conclusion of the study to determine the willingness of healthcare providers to integrate VR into their daily care practices. Result: The preliminary results indicate significant effects on anxiety (p=.001) and pain (p=<.001) following the VR intervention during care, as compared to the control group. Conclusion: The preliminary results suggest that VRI appears to be a suitable and effective method for reducing anxiety and pain among older hospitalized individuals compared with standard care. Finally, the experiences of healthcare professionals involved will also be considered to assess the impact of these interventions on working conditions and patient support.

Keywords: anxiety, care, pain, older adults, virtual reality

Procedia PDF Downloads 24

Authors: S. Selman, T. Gout

Abstract:

Microbial keratitis is a serious complication of contact lens wear that can be vision and eye-threatening. Diverse presentations relating to contact lens wear include dry corneal surface, corneal infiltrate, ulceration, scarring, and complete corneal melt leading to perforation. Contact lens wear is a major risk factor and, as such, is an important consideration in any patient presenting with a red eye in the primary care setting. This paper aims to provide an overview of the risk factors, common organisms, and spectrum of contact lens-associated keratitis (CLAK) complications. It will highlight some of the salient points relevant to the assessment and workup of patients suspected of CLAK in the emergency department based on the recent literature and therapeutic guidelines. An overview of the management principles will also be provided.

Keywords: microbial keratitis, corneal pathology, contact lens-associated complications, painful vision loss

Procedia PDF Downloads 70

Authors: Jeremy Berry, Shannon Rodrigue, Caroline Norris

Abstract:

This study explores the impact of tattoos and/or brands on the recovery of sex trafficking survivors. Many victims of sex trafficking are forced or coerced to take markings of ownership while in the sex trafficking trade in the form of painful tattoos or brands. As a result, victims who are rescued and in recovery often must live with permanent reminders of their traumatic experiences or are left to resort to expensive cosmetic or cover-up jobs, which for many are out of reach. As is often true of domestic violence victims who are left with scars from their abusers, the impact of these permanent markers can delay the healing process and contribute to post-traumatic stress. This study tells the story from the perspectives of the survivors of sex trafficking, how these specific permanent reminders impacted their healing. The study employs a thematic analysis of interviews with sex trafficking victims via focus group interviews.

Keywords: sex trafficking, tattoos, trauma, healing

Procedia PDF Downloads 154

Authors: Karina Zaccari, Ernesto Cordeiro Marujo

Abstract:

This paper presents a Machine Learning (ML) approach to support Meningitis diagnosis in patients at a children’s hospital in Sao Paulo, Brazil. The aim is to use ML techniques to reduce the use of invasive procedures, such as cerebrospinal fluid (CSF) collection, as much as possible. In this study, we focus on predicting the probability of Meningitis given the results of a blood and urine laboratory tests, together with the analysis of pain or other complaints from the patient. We tested a number of different ML algorithms, including: Adaptative Boosting (AdaBoost), Decision Tree, Gradient Boosting, K-Nearest Neighbors (KNN), Logistic Regression, Random Forest and Support Vector Machines (SVM). Decision Tree algorithm performed best, with 94.56% and 96.18% accuracy for training and testing data, respectively. These results represent a significant aid to doctors in diagnosing Meningitis as early as possible and in preventing expensive and painful procedures on some children.

Keywords: machine learning, medical diagnosis, meningitis detection, pediatric research

Procedia PDF Downloads 120

Authors: Jug Maya Chaudhary

Abstract:

The principal objective of this paper has been to assess the level of psychological well-being (PWB) of freed Kamhalari girls sheltered in a governmental rehabilitation center in the Dang district. All the girls (N=100) have been selected for a quantitative study, including 15 cases of in-depth interviews for qualitative study in 2013. The study results suggest that the level of psychological well-being of freed Kamhalaris has not been found to be high; rather they are moderate, with small incidences of a lower level of psychological well-being. Regarding the qualitative study, a total of six themes was identified: physical pain and fatigue then and now, the lasting experience of anxiety, unfair treatment, low self-esteem, depressed mood, and frustration due to current state and confusion. These themes reflected the unrelenting intrusive nature of painful experiences of those affected. This research will provide empathic insight into their past experience. It will add to the body of research on Psychological Well-being of Freed Kamhalari Girls and may generate ideas for intervention research.

Keywords: Kamhalari, Experiences, Tharu, Psychological Wellbeing

Procedia PDF Downloads 34

Authors: Ofelia Loani Elvir Lazo, Roya Yumul, Sevan Komshian, Ruby Wang, Jun Tang

Abstract:

Background: Monitoring the anti-nociceptive drug effect is useful because a sudden and strong nociceptive stimulus may result in untoward autonomic responses and muscular reflex movements. Monitoring the anti-nociceptive effects of perioperative medications has long been desiredas a way to provide anesthesiologists information regarding a patient’s level of antinociception and preclude any untoward autonomic responses and reflexive muscular movements from painful stimuli intraoperatively.To this end, electroencephalogram (EEG) based tools includingBIS and qCON were designed to provide information about the depth of sedation whileqNOXwas produced to informon the degree of antinociception.The goal of this study was to compare the reliability of qCON/qNOX to BIS asspecific indicators of response to nociceptive stimulation. Methods: Sixty-two patients undergoing general anesthesia with LMA were included in this study. Institutional Review Board(IRB) approval was obtained, and informed consent was acquired prior to patient enrollment. Inclusion criteria included American Society of Anesthesiologists (ASA) class I-III, 18 to 80 years of age, and either gender. Exclusion criteria included the inability to consent. Withdrawal criteria included conversion to endotracheal tube and EEG malfunction. BIS and qCON/qNOX electrodes were simultaneously placed o62n all patientsprior to induction of anesthesia and were monitored throughout the case, along with other perioperative data, including patient response to noxious stimuli. All intraoperative decisions were made by the primary anesthesiologist without influence from qCON/qNOX. Student’s t-distribution, prediction probability (PK), and ANOVA were used to statistically compare the relative ability to detect nociceptive stimuli for each index. Twenty patients were included for the preliminary analysis. Results: A comparison of overall intraoperative BIS, qCON and qNOX indices demonstrated no significant difference between the three measures (N=62, p> 0.05). Meanwhile, index values for qNOX (62±18) were significantly higher than those for BIS (46±14) and qCON (54±19) immediately preceding patient responses to nociceptive stimulation in a preliminary analysis (N=20, * p= 0.0408). Notably, certain hemodynamic measurements demonstrated a significant increase in response to painful stimuli (MAP increased from74±13 mm Hg at baseline to 84± 18 mm Hg during noxious stimuli [p= 0.032] and HR from 76±12 BPM at baseline to 80±13BPM during noxious stimuli[p=0.078] respectively). Conclusion: In this observational study, BIS and qCON/qNOX provided comparable information on patients’ level of sedation throughout the course of an anesthetic. Meanwhile, increases in qNOX values demonstrated a superior correlation to an imminent response to stimulation relative to all other indices.

Keywords: antinociception, bispectral index (BIS), general anesthesia, laryngeal mask airway, qCON/qNOX

Procedia PDF Downloads 69

Authors: Kais Siala, Mohamed Kharrat, Mohamed Abid

Abstract:

Exposure therapies encourage patients to gradually begin facing their painful memories of the trauma in order to reduce fear and anxiety. In this context, virtual reality techniques are widely used for treatment of different kinds of phobia. The particular case of fear of death phobia (thanataphobia) is addressed in this paper. For this purpose, we propose to make a simulation of Near Death Experience (NDE) using augmented reality techniques. We propose in particular to simulate the Out-of-Body experience (OBE) which is the first step of a Near-Death-Experience (NDE). In this paper, we present technical aspects of this simulation as well as short-term impact in terms of physiological measures. The non-linear Poincéré plot is used to describe the difference in Heart Rate Variability between In-Body and Out-Of-Body conditions.

Keywords: Out-of-Body simulation, physiological measure, augmented reality, phobia psychotherapy, HRV, Poincaré plot

Procedia PDF Downloads 274

Authors: Christine Li, Amanda Robertson

Abstract:

Epidermal inclusion cysts occur when epidermal cells are implanted in the dermis following trauma, or surgery. They are a rare cause of an umbilical mass, with very few cases previously reported following abdominal surgery. These lesions can present with a range of symptoms, including palpable mass, pain, redness, or discharge. This paper reports a case of an umbilical epidermal inclusion cyst in a 52-year-old female presenting with a six-week history of a painful, red umbilical lump on a background of two previous diagnostic laparoscopies. Abdominal computed tomography (CT) scans revealed non-specific soft tissue thickening in the umbilical region. This was successfully treated with complete excision of the lesion. Umbilical lumps are a common presentation but can represent a diagnostic challenge. The differential diagnosis should include an epidermal inclusion cyst, particularly in a patient who has had previous abdominal surgery, including laparoscopic surgery.

Keywords: epidermal inclusion cyst, laparoscopy, umbilical mass, umbilicus

Procedia PDF Downloads 54

Authors: Tong-Chien Wu, Ching-Liang Hsieh, Yi-Wen Lin

Abstract:

There are accumulating evidences surrounding the therapeutic effect of electroacupuncture (EA). Local EA can reliably attenuate inflammatory pain in mouse with unclear mechanisms. However, the effect of EA on distal and contralateral acupoint for pain control has been rarely studied and the result was controversial. Here in our study, we found that inflammatory hindpaw pain in mouth, which was induced by injecting the complete Freund’s adjuvant (CFA) 2 days ago can be alleviated immediately after 2Hz 15mins EA treatment at contralateral forefoot acupoint LI4 through both mechanic and thermal behavior test, while sham acupoint group is not. The efficacy was observed to be more obvious after the second round of EA treatment on the following day. This analgesic effect is produced by applying EA to a site remote from the painful area. The present study provides a powerful experimental animal model that can be used for investigating the unique physiological mechanisms involved in acupuncture analgesia.

Keywords: remote electroacupuncture, distal EA, pain control, anti-inflammation

Procedia PDF Downloads 160

Authors: Faruk Emir, Simel Ayyıldız, Cem Şahin

Abstract:

Behçet’s disease or Behçet’s syndrome is a chronic and multi-systemic inflammatory disease of unknown cause. This syndrome often presents with mucous membrane ulceration and ocular problems. As a systemic disease Behcet includes triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis. Nearly all patients present with some form of painful oral mucocutaneous ulcerations in the form of aphthous ulcers. The aim of the treatment plan for Behçet’s Disease patients is to eliminate oral problems and increase the patient comfort.This clinical report represents the prosthodontic rehabilitation of Behcet’s disease patients mandibular total edentulism with the use of implant supported prosthesis that planned on custom abutments and bar retainers via CAD/CAM technology and patient satisfaction has been achieved in function and aesthetics.

Keywords: Behçet’s disease, CAD/CAM, custom-made manufacturing, titanium milled bar retainer

Procedia PDF Downloads 291

Authors: Vishal Bhatnagar

Abstract:

The objective of this study is to compare the efficacy of epidural analgesia of two amide local anesthetics, ropivacaine and levobupivacaine, with fentanyl for postoperative analgesia in major abdominal surgery CRS+HIPEC. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS+HIPEC) are done for primary peritoneal malignancies or peritoneal spread of malignant neoplasm. CRS and HIPEC are considered one of the most painful surgery among all major abdominal surgeries. Poorly managed postoperative pain elevates stress, increases anxiety, causes prolonged Hospital stay, increases opioid requirement and side effects, increases the cost of treatment and psychological effects on patient and family. It affects the quality of life of patients. The epidural technique provides better postoperative analgesia, earlier recovery of bowel function, fewer side effects, higher patient satisfaction, and an improvement in life quality in the postoperative days after abdominal surgery than other analgesic techniques.

Keywords: HIPEC, postoperative analgesia, cytoreductive surgery, VAS score, rescue analgesia

Procedia PDF Downloads 9

Authors: Sonia Sharma

Abstract:

In a multicultural country like Canada, Colonialism is still maintained in the form of Violence and Oppression. The Aboriginals are persistently facing Oppression and Marginalization in their own land owing to Colonial presence. Women in particular are getting most affected. They are facing double burden of patriarchy and their being Native. Tomson Highway, the Cree Canadian playwright has deftly exposed the theme of women violence and empowerment. In his plays (The Rez Sisters and Rose) taken from his Rez Septology, he has depicted Aboriginal women’s predicaments and sufferings. But simultaneously also talks about their empowerment and aggression refuting and fighting back to patriarchy and oppression. The Rez Sisters portrays women with shattering images and as a victim of both the male dominating society and the system. It represents the painful odyssey of the seven women facing several hardships. Rose represents women in entirely different light. They are shown more assertive and empowered raising their voice against the Violence and Discrimination meted out to them. The Aboriginal women in Canada are facing dual burden of Colonialism and Patriarchy which indeed is a Colonial construct. This paper is an attempt to explore the above facets Tomson Highway’s The Rez Sisters and Rose.

Keywords: violence, racism, discrimination, postcolonialism feminism

Procedia PDF Downloads 578

Authors: Ail Akbar Emamverdian, Neriman Özada, Atabak Rahimzadeh Ilkhchi, Zahra Emamverdian

Abstract:

The reverse shoulder prosthesis is an innovative procedure design to treat of (GH) joint problems with severe rotator cuff deficiency. The original reverse shoulder prosthesis was invented by France surgery in1985 and has been in clinical use in the United States in 2004. These prostheses consist of baseplate that attached to the glenoid, in order to hold a spherical component, and humeral part consist of polyethylene insert which is flat. This prosthesis is the ‘reverse’ configuration. The indications for the reverse prosthesis are: (1) treating failed hemi arthroplasty with irrecoverable rotator cuff tears, (2) relief of painful arthritis associated with cuff tear arthropathy, (3) instauration after tumor resection, (4) pseudo paralysis because of irrecoverable rotator cuff tears (5) some fractures of the shoulder which reverse shoulder prostheses is only the option for treatment. This prosthesis resulting in relief of pain and decreasing the range of motion in above indications. However, this prosthesis and its applications such as notching of the scapula, dislocation of the prosthesis parts and acromial stress fractures. In this article the reverse shoulder prostheses, indication has been reviewed. This study can make clear aspect of reverse shoulder prosthesis that can help to find some solution in future.

Keywords: prostheses, complications, reverse shoulder prosthesis, indications

Procedia PDF Downloads 248

Authors: Mona Hamdy, Iman Shaheen, Hadeel Seif Eldin, Basma Ali, Omnia Abdeldayem

Abstract:

Summary: Bone involvement of sickle cell disease (SCD) patients varies from acute clinical manifestations of painful vaso-occlusive crises or osteomyelitis to more chronic affection of bone mineral density (BMD) and debilitating osteonecrosis and osteoporosis. Secreted klotho protein is involved in calcium (Ca) reabsorption in the kidney. This study aimed to measure serum klotho levels in children with SCD to determine the possibility of using it as a marker of low BMD in children with SCD in correlation with a dual-energy radiograph absorptiometry scan. This study included 60 sickle disease patients and 30 age-matched and sex-matched control participants without SCD. A highly statistically significant difference was found between patients with normal BMD and those with low BMD, with serum Ca and klotho levels being lower in the latter group. Klotho serum level correlated positively with both serum Ca and BMD. Serum klotho level showed 94.9% sensitivity and 95.2% specificity in the detection of low BMD. Both serum Ca and klotho serum levels may be useful markers for detection of low BMD related to SCD with high sensitivity and specificity; however, klotho may be a better indicator as it is less affected by the nutritional and endocrinal status of patients or by intake of Ca supplements.

Keywords: sickle cell disease, BMD, osteoporosis, DEXA, klotho

Procedia PDF Downloads 75