scholarly journals Pain Reduction in Adults with Limb Spasticity Following Treatment with IncobotulinumtoxinA: A Pooled Analysis

Toxins ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 887
Author(s):  
Jörg Wissel ◽  
Alexandre Camões-Barbosa ◽  
Georg Comes ◽  
Michael Althaus ◽  
Astrid Scheschonka ◽  
...  
Keyword(s):  
Pain Relief ◽  
Pooled Analysis ◽  
Pain Severity ◽  
Disability Assessment ◽  
Phase 2 ◽  
Multiple Injection ◽  
Chi Square ◽  
Experienced Pain ◽  
Significant Difference ◽  
Limb Spasticity

Some studies have shown that incobotulinumtoxinA reduces spasticity-associated pain, but further evidence is needed. This exploratory analysis pooled pain-relief data from six Phase 2 or 3 studies of incobotulinumtoxinA (four placebo-controlled studies) for treating upper limb spasticity in adults. Spasticity-associated pain was assessed at baseline and 4 weeks post incobotulinumtoxinA injection using the disability assessment scale (DAS) for pain. Only data for patients with pain at baseline were analysed. Overall, 544 (incobotulinumtoxinA, N = 415; placebo, N = 129) of 937 patients (58.1%) experienced pain at baseline. At Week 4, a significantly greater proportion of incobotulinumtoxinA- (52.1%) than placebo-treated patients (28.7%; Chi-square p < 0.0001) showed a response (≥1-point improvement in DAS pain score). In logistic regression analysis, incobotulinumtoxinA-treated patients were 2.6 times more likely to achieve this endpoint than placebo-treated patients. A significant difference between incobotulinumtoxinA and placebo was observed regardless of baseline pain severity. Additionally, 27.1% of incobotulinumtoxinA- versus 12.4% of placebo-treated patients reported complete pain relief at Week 4 (p = 0.0006). Pain relief increased with multiple injection cycles. To achieve patient-centred care, pain relief may be considered a treatment goal in adults with spasticity-associated pain regardless of pain severity. This study contributes to understanding the benefits of incobotulinumtoxinA in treating limb spasticity-associated pain.

scholarly journals The Efficacy of Thai Herbal Prasaplai Formula for Treatment of Primary Dysmenorrhea: A Short-Term Randomized Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Manmas Vannabhum ◽  
Sirikan Poopong ◽  
Thanyarat Wongwananuruk ◽  
Akarin Nimmannit ◽  
Ueamphon Suwannatrai ◽  
...  
Keyword(s):  
Placebo Group ◽  
Pain Relief ◽  
Controlled Trial ◽  
Primary Dysmenorrhea ◽  
Average Pain Intensity ◽  
Experienced Pain ◽  
Significant Difference ◽  
Average Pain ◽  
Experimental Group

This study aims to compare the efficacy of pain relief between a specific Thai herbal Prasaplai formula (PPF) and placebo in patients with primary dysmenorrhea. Forty women with primary dysmenorrhea symptoms were randomized into two groups. The experimental group received PPF capsules 1000 mg orally three times per day before meals for three days starting from the first day of menstruation. The placebo group received placebo as the same dose and time. Average pain intensity from the first day to the third day of cycle significantly decreased in both groups (p<0.001), but with no statistically significant difference between groups. Using a pre- and posttreatment difference in NRS of at least 2, a greater proportion of patients in PPF group experienced pain relief compared to placebo during the first and second day of period. A greater proportion of PPF group also experienced no pain compared to the placebo group on day 1 and day 3 by using multidimensional scoring. The PPF demonstrates pain relief activity when used during menstruation in primary dysmenorrhea patients, with no adverse effects. However, further studies are needed in order to assess the value of PPF as a long-term prophylaxis for primary dysmenorrhea.

scholarly journals Comparison of personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment

2014 ◽  
Vol 85 (3) ◽  
pp. 474-479 ◽  
Author(s):  
Elham S. Abu Alhaija ◽  
Mona A. Abu Nabaa ◽  
Emad F. Al Maaitah ◽  
Mahmoud K. Al-Omairi
Keyword(s):  
Personality Traits ◽  
Pain Score ◽  
Orthodontic Treatment ◽  
Pain Perception ◽  
Orthodontic Appliances ◽  
Chi Square ◽  
Experienced Pain ◽  
Fixed Orthodontic Appliances ◽  
Significant Difference ◽  
Before And After

ABSTRACT Objective:  To compare personality traits, attitude toward orthodontic treatment, and pain perception and experience before and after orthodontic treatment. Materials and Methods:  One hundred subjects (50 male and 50 female) were included in this study. The mean (SD) age was 17.5 (2.05) years at T1 and 19.15 (2.32) years at T2. The instruments for data collection were questionnaires that included assessment of patients' personality traits, attitudes toward orthodontic treatment, and pain perception/experience. Subjects completed the questionnaires at two different times: before orthodontic treatment (T1) and after fixed orthodontic treatment (T2). Subjects were treated by fixed orthodontic appliances for an average (SD) period of 18.64 (0.35) months. Paired sample t-test and chi-square test were used to detect any differences. Results:  Significant changes in personality traits were detected after orthodontic treatment irrespective of gender. Neuroticism, openness, agreeableness, and conscientiousness scores were improved (P &lt; .001). A positive attitude toward orthodontic treatment was reported at T1 (4.31 [±1.26]) and improved at T2 (3.98 [±1.16]) irrespective of gender (P &lt; .05). The average (SD) expected pain score (T1) was 4.73 (1.88) and the average (SD) experienced pain score (T2) was 4.63 (1.58). Significant difference in the expected and experienced pain scores was not detected (P  =  .11). Conclusions:  Personality traits and attitude toward orthodontic treatment improved after orthodontic treatment. Reported actual pain experience during orthodontic treatment was similar to that expected before treatment.

scholarly journals Development and Evaluation of an Intravenous Infusion Sequence Annotation System

2021 ◽  
Vol 12 (01) ◽  
pp. 065-072
Author(s):  
Ji Qiu ◽  
Tingting Deng ◽  
Zhuo Wang ◽  
Zhangwei Yang ◽  
Ting Liu ◽  
...  
Keyword(s):  
Intravenous Infusion ◽  
Phase 1 ◽  
Sequence Annotation ◽  
Manual Annotation ◽  
Phase 2 ◽  
Phase 3 ◽  
Chi Square ◽  
Annotation System ◽  
Intravenous Infusions ◽  
Significant Difference

Abstract Objectives The sequence of intravenous infusions may impact the efficacy, safety, and cost of intravenous medications. The study describes and assesses a computerized clinical decision support annotation system capable of analyzing the sequence of intravenous infusions. Methods All intravenous medications on the hospital formulary were analyzed based on factors that impact intravenous infusion sequence. Eight pharmacy infusion knowledge databases were constructed based on Hospital Infusion Standards. These databases were incorporated into the computerized sequence annotation module within the electronic health record system. The annotation process was changed from pharmacists' manual annotation (phase 1) to computer-aided pharmacist manual annotation (phase 2) to automated computer annotation (phase 3). Results Comparing phase 2 to phase 1, there were significant differences in sequence annotation with regards to the percentage of hospital wards annotated (100% vs. 4.65%, chi-square  = 180.95, p < 0.001), percentage of patients annotated (64.18% vs. 0.52%, chi-square = 90.46, p < 0.001), percentage of intravenous orders annotated (75.67% vs. 0.77%, chi-square = 118.78, p < 0.001), and the number of tubing flushes per ward per day (118.51 vs. 2,115.00, p < 0.001). Compared with phase 1, there were significant cost savings in tubing flushes in phase 2 and phase 3. Compared with phase 1, there was significant difference in the time nurses spent on tubing flushes in phase 2 and phase 3 (1,244.94 vs. 21,684.8 minutes, p < 0.001; 1,369.51 vs. 21,684.8 minutes, p < 0.001). Compared with phase 1, significantly less time was required for pharmacist annotation in phase 2 and phase 3 (90.6 vs. 4,753.57 minutes, p < 0.001; 0.05 vs. 4,753.57 minutes, p < 0.001). Conclusion A computerized infusion annotation system is efficient in sequence annotation and significant savings in tubing flushes can be achieved as a result.

scholarly journals The Effects of Transcutaneous Electrical Nerve Stimulation on Post-Episiotomy Pain Severity in Primiparous Women: A Randomized, Controlled, Placebo Clinical Trial

2019 ◽  
Vol 8 ◽  
pp. 1404
Author(s):  
Seyedeh Soma Zakariaee ◽  
Roonak Shahoei ◽  
Leila Hashemi Nosab ◽  
Ghobad Moradi ◽  
Mina Farshbaf
Keyword(s):  
Clinical Trial ◽  
Pain Relief ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Intervention Group ◽  
Pain Severity ◽  
Control Group ◽  
Electrical Nerve Stimulation ◽  
Significant Difference ◽  
The Mean ◽  
Primiparous Women

Background: Episiotomy or cutting the perineum is the most common operation in obstetrics. Perineal pain is the main complication of episiotomy that affects the quality of life and mental health of the mother. Reducing the pain and side effects of the chemical drugs prescribed for pain relief has attracted the attention of both physicians and scientists. This study was conducted to determine the effects of transcutaneous electrical nerve stimulation (TENS), as an alternative method, on post-episiotomy pain severity. Materials and Methods: This randomized clinical trial was performed on 120 primiparous women who had referred to Sanandaj Besat Hospital in 2018. The patients were divided randomly into three groups, including the intervention group (TENS-On), the placebo group (TENS-Off), and the control group. TENS electrodes were placed near the episiotomy site in genitofemoral and pudendal nerves. The pain was measured after episiotomy in lying, sitting, and activity positions. The pain severity was measured using a pain measurement instrument (numeral rating score) at four-time points, i.e., before the intervention as well as 30, 60, and 120 minutes after the TENS intervention. For data analysis, Pearson correlation, student’s t-test, Kruskal-Wallis test, ANOVA test, and Mann-Whitney U tests were used. Results: Intragroup evaluation results for placebo and control groups demonstrated no significant difference in the pain score (P>0.05). A significant difference was observed between the mean pain severity of the intervention group and that of the group with walking activities (P=0.04). In terms of the intergroup evaluation, there was a significant difference observed between the mean pain severity of the lying position and that of the control group (P=0.008). Regarding the sitting position, no significant difference was observed between its mean pain severity and that of the other two groups (P=0.04). Conclusion: TENS is an effective and safe method for post-episiotomy pain relief and a routine method used in the obstetrics and gynecology ward. [GMJ.2019;8:e1404]

scholarly journals Effect of Local Dexamethasone on Pain, Swelling, and Trismus After Extraction of Impacted Mesioangular Third Molar

2020 ◽  
Vol 12 (4) ◽  
pp. 131-135
Author(s):  
Farshad Khosraviani ◽  
Seyedeh Fatemeh Seyedjavadi Limoodi ◽  
Sara Ehsani ◽  
Mojgan Khosravi
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Pain Severity ◽  
Third Molar Surgery ◽  
Control Group ◽  
Chi Square ◽  
Significant Difference ◽  
Background Pain ◽  
Lower Pain ◽  
Ibuprofen Group

Background: Pain and inflammation are common problems after the third molar surgery. The purpose of this study was to compare the effect of ibuprofen and intra-muscular injection or the intra-socket placement of dexamethasone on pain, swelling, and trismus after the extraction of impacted third molar. Methods: In this triple-blind randomized clinical trial study, 72 eligible patients were randomly divided into four groups of 18 subjects. The groups received dexamethasone powder (4 mg) inside the alveolar socket immediately before flap suturing, injection in the masseter muscle (4 mg/1 mL) immediately after the suture, the ibuprofen tablet from an hour before the surgery (400 mg every 6 hours for 1 day), and placebo. Three parameters of pain severity, swelling, and trismus were evaluated on the second and seventh days after the surgery. Data were analyzed using SPSS 17. Qualitative and quantitative data were expressed as a percentage and mean ± standard deviation, respectively. Chi-square, one-way analysis of variance (ANOVA) and, if necessary, the least significant difference tests were used for inter-group comparison. The findings were significant at P<0.05 Results: Dexamethasone groups had significantly lower pain severity (second and seventh days), swelling (second day), and maximum mouth opening (MMO, alveolar socket: second and seventh days, masseter: second day) in comparison to the other groups (P<0.05). The ibuprofen group had significantly lower levels of pain (second and 7th days) and swelling (second day) in comparison to the control group (P<0.05). There was no significant difference between dexamethasone groups in any measurement for pain, swelling, and MMO. Conclusions: The findings of this study suggest that the intra-oral administration of dexamethasone may have a better effect on pain, swelling, and trismus compared to ibuprofen and has no placebo effect.

Randomized trial of short-course versus long-course radiotherapy for palliation of painful vertebral bone metastases: A retrospective analysis of RTOG 97–14

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9521-9521
Author(s):  
D. D. Howell ◽  
J. L. James ◽  
W. F. Hartsell ◽  
M. Suntharalingam ◽  
M. Machtay ◽  
...  
Keyword(s):  
Pain Relief ◽  
Bone Metastases ◽  
Late Toxicity ◽  
Future Research ◽  
Recurrent Pain ◽  
Chi Square ◽  
Entire Study ◽  
Vertebral Bone ◽  
Significant Difference ◽  
Chi Square Test

9521 Background: RTOG 97–14 [Hartsell et al, breast/prostate cancer patients (pts) with painful bone metastases randomized to 8 Gy/1 fraction or 30 Gy/10 fractions], revealed no difference in pain relief or narcotic use 3 months post randomization. The 8 Gy regimen resulted in fewer acute toxicities, but higher rates of retreatment for recurrent pain. Single 8 Gy fractions for painful vertebral bone mets have not been well accepted, possibly due to provider concerns about efficacy and toxicity. The present study evaluates treatment differences in the subset of pts treated specifically for painful vertebral bone mets (PVBM). Methods: PVBM were treated to the cervical, thoracic, and/or lumbar spine. Chi-square test was used to evaluate population differences between PVBM and non-PVBM. Amongst PVBM, differences in retreatment rates (cumulative incidence method, Gray's test) and in pain relief/BPI worst pain score, narcotic use, and toxicity 3 months post randomization (chi-square test) were evaluated. Results: Of 909 eligible pts, 235 (26%) were PVBM. PVBM and non-PVBM pts differed in % of males [55% vs. 47%,p=0.03] and pts with multiple painful sites [57% vs. 38%,p<0.01]. Amongst PVBM, more 30 Gy pts had multiple sites treated [65% vs. 49%, p=0.02]. T [10% vs. 20%, p=0.01] here was no statistically significant difference (8 vs. 30 Gy) in pain relief [70% vs. 62%, p=0.59] or narcotic use [27% vs. 24%, p=0.76] at 3 months. There were significant differences in acute grade 2–4 toxicityand acute grade 2–4 GI toxicity [6% vs. 14%, p=0.01] at 3 months, lower toxicity seen in 8 Gy. Late toxicity was rare, with 1 grade 3 CNS event (8 Gy) and 1 grade 4 lung event (30 Gy). 8 Gy showed significantly higher 3-year retreatment rates [15% vs. 5%, p=0.01]. Conclusions: Although a clinically different pt population, the results for PVBM are comparable to those of the entire study population. Both 8 Gy/1 fraction and 30 Gy/10 fractions resulted in comparable pain relief and narcotic use at 3 months. Both were well tolerated with few adverse effects. 8 Gy had less acute toxicity, and a higher need for retreatment than 30 Gy. This may have implications for future research comparing single fraction conventional radiation therapy with stereotactic spine radiosurgery. No significant financial relationships to disclose.

scholarly journals Effect of Nebulized Morphine vs. Intravenous Morphine in Decreased Pain in Renal Colic Patient

2020 ◽  
Author(s):  
Mehrnaz Nikouyeh ◽  
Mohammad ali Jafari nedoushan ◽  
Mahmood Vakili ◽  
Majid Hajimaghsoudi ◽  
Mehdi Bagherabadi ◽  
...  
Keyword(s):  
Pain Relief ◽  
Pain Intensity ◽  
Normal Saline ◽  
Renal Colic ◽  
Chi Square ◽  
Mean Intensity ◽  
Significant Difference ◽  
Intravenous Morphine ◽  
The Mean ◽  
The Difference

Introduction: Renal colic refers to one or more acute and painful short-term attacks due to the movement and excretion of kidney stones. The aim of this study was to determine the effect of intravenous morphine and inhaled morphine on pain relief in renal colic patients. Methods: This clinical trial study was performed on 50 patients of Shahid Sadoghi Hospital and Shahid Rahnemoon Hospital with renal colic symptoms who were randomly divided into two groups. The first group received 5 mg intravenous morphine and 5 cc normal saline (placebo) and the second group received 10 mg inhaled morphine and 5 cc normal saline. Severity of pain was assessed at the time of emergency and onset of Visual Analog Scale and then questionnaires were completed at 10, 20 and 30 minutes intervals.  The data through SPSS Inc., Chicago, IL; Version 16 and the Friedman, Mann-Whitney, and Chi-square tests were analyzed. Results: Our study showed the mean intensity of pain was 9.52±1.12 (nebulized) and 9.24±1.51 (intravenous) on admission without significant difference (p=0.46). After 10 minutes, mean pain intensity in both nebulized and intravenous groups was 7.76±1.3 and 6.68±2.03, respectively. There was a significant difference between the two groups (p=0.03). After 20 minutes, the mean pain intensity was 5.68±1.72 and 4.32±2.17, respectively, and the difference between the two groups was significant. After 30 minutes, the mean intensity of pain in two groups of nebulized and intravenous was 3.88±3.14 and 3.36±3.34, respectively. The difference between the two groups was not significant (p = 0.57).The mean pain intensity in the intravenous method was lower than the nebulized, but in the nebulized method it was showed a decreasing trend. Conclusion: Nebulized morphine relieves pain in the patients with renal colic, but pain relief is faster by intravenous morphine. Accordingly, this method is more preferred in renal colic patients.

scholarly journals Evaluation of Prescribing and Administering As-Needed Pain Medications Based on Pain Severity Scores

2021 ◽  
Vol 12 (3) ◽  
pp. 19
Author(s):  
Jenna Stearns ◽  
Christine Cortese ◽  
Jennifer Remington ◽  
Nirav Patil
Keyword(s):  
Pain Management ◽  
Management Practices ◽  
General Medicine ◽  
Pain Severity ◽  
Common Symptom ◽  
Chi Square ◽  
Pain Medications ◽  
Severity Scores ◽  
Significant Difference ◽  
Patient Reported

Pain is a common symptom reported by patients admitted to hospitals in both medical and surgical units. Due to the subjective and multidimensional nature of pain, it should be assessed regularly to ensure patient pain control. Suboptimal prescribing of opioids and other pain medications contribute to the inadequate treatment of pain. To combat the wide variability and response to pain medications, many providers prescribe as-needed range orders of pain medications to cover each pain severity. These range orders enable necessary and safe adjustments in dose based on individual responses to treatment. Currently, there are no studies analyzing the prescribing of pain medications based on pain severity, leaving a gap in literature in inpatient pain management. The purpose of this retrospective cohort study was to evaluate the appropriateness of prescribing as-needed pain medications based on the patient’s pain severity scores throughout their hospital stay at a 125-bed community hospital in Northeast Ohio on the general medicine floor. Secondarily, this study also evaluated the administration of pain medications by nursing staff based on patient-reported pain severity scores. Statistical analyses including Chi-square tests, t-tests, Fisher’s Exact tests and descriptive statistics were utilized to determine the significance of the data collected. This study found that there was a statistically significant difference between appropriately (47.4%) and inappropriately (52.6%) prescribed pain medications (P<0.001). There was also a statistically significant difference between appropriately (40.5%) and inappropriately (59.5%) administered pain medications (P<0.001). Pharmacists hope to improve pain management practices by providing education to both providers and nurses to prevent poor patient outcomes and uncontrolled pain.

Personal Audio System: Hearing Symptoms, Habits, and Sound Pressure Levels Measured in Real Ear and a Manikin

2020 ◽  
Vol 63 (6) ◽  
pp. 2016-2026
Author(s):  
Tamara R. Almeida ◽  
Clayton H. Rocha ◽  
Camila M. Rabelo ◽  
Raquel F. Gomes ◽  
Ivone F. Neves-Lobo ◽  
...  
Keyword(s):  
Sound Pressure ◽  
Daily Basis ◽  
Cross Sectional Study ◽  
Normal Hearing ◽  
Chi Square ◽  
Cross Sectional ◽  
The Real ◽  
Significant Difference ◽  
Sound Pressure Levels ◽  
Audio System

Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted ( M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435

The Influence of Age and Gender on Mandibular Indices among the Libyan Population

2019 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Negative Correlation ◽  
Bone Mineralization ◽  
Age Groups ◽  
T Test ◽  
Chi Square ◽  
Age And Gender ◽  
Significant Difference ◽  
Chi Square Test ◽  
And Gender ◽  
Libyan Population

Radiographic Mandibular Indices serve as easy and relatively cheap tools for evaluating bone mineralization. Objectives: To examine the effect of age and gender on three mandibular indices: the panoramic mandibular index (PMI), the mandibular ratio (MR) and the mandibular cortical index (MCI), among Libyan population. Methods: The three indices were measured on 317 digital (OPGs) of adult humans (155 males, 162 females). The sample was divided into six age groups (from 18-25 years through 56-65 years). The measurements were analyzed for interactions with age and sex, using SPSS (Statistical Package for Social Studies) software version no. 22. The tests employed were two way ANOVA, the unpaired T-test and chi-square test. Results: The mean PMI fluctuated between 0.37 s.d. 0.012 and 0.38 s.d. 0.012. among the sixth age groups. One-way ANOVA statistical test revealed no significant of age on PMI. On the other hand gender variation has effect on PMI, since independent sample t-test disclosed that the difference between the male and female PMI means statistically significant. ANOVA test showed that the means of MR among age groups showed a negative correlation i.e. MR mean declined from 3.01 in 18-25 age groups to 2.7 in 55-65 age groups. In contrary, the gender showed no effect on MR according two sample t-test at p> 0.05. In regards with MCI, statistical analysis showed that it affected by age that is C1 was decreasing by age while C2 and C3 were increased by age. Using chi square test the result indicated that there is a significant difference among the different age group and the two genders in MCI readings. Conclusion: PMI was influenced significantly by age but minimally by the gender. MR is not affected by gender but has a negative correlation with age. MCI is affected by both age and gender

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