Baratloo, Alireza;Mirbaha, Sahar;Kasmaei, Hossein Delavar;Payandemehr, Pooya;Elmaraezy, Ahmed;Negida, Ahmed
The Korean Journal of Pain
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v.30
no.3
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pp.176-182
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2017
Background: Current evidence suggests that intravenous magnesium sulfate might be effective for reducing migraine pain. In a recent pilot study, we showed that intravenous caffeine citrate could reduce the severity of migraine headache. The objective of this study is to investigate the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache. Methods: We conducted a prospective quasi-experimental study from January until May 2016 in two educational medical centers of Shahid Beheshti University of Medical Sciences (Shoahadaye Tajrish Hospital and Imam Hossein Hospital), Tehran, Iran. The study included patients who were referred to the emergency department and met the migraine diagnosis criteria of the International Headache Society. Patients were allocated into 2 groups receiving either 60 mg intravenous caffeine or 2 g intravenous magnesium sulfate. The pain scores, based on the visual analog scale, were recorded on admission, as well as one and two hours after receiving the drug. A Chi-Square test and student t-test were used for analysis of baseline characteristics. A Mann-Whitney U test and Wilcoxon singed rank test were used to analyze differences in the visual analogue scale (VAS) score between and within the groups respectively. Results: In total, 70 patients (35 patients in each group) with the mean age of $33.1{\pm}11.3years$ were included (64.3% female). For the Caffeine citrate group, the median pain score decreased from 9.0 (2.0) to 5.0 (4.0) after one hour and to 3.0 (4.0) after two hours. For the magnesium sulfate group, the pain score decreased from 8.0 (2.0) to 2.0 (2.0) after one hour and to 0.0 (1.0) after two hours. Both intravenous caffeine citrate and intravenous magnesium sulfate reduced pain scores significantly but the magnesium sulfate group showed more improvement than the Caffeine citrate group after one hour (P < 0.001) and after two hours (P < 0.001). Conclusions: It is likely that both intravenous caffeine and intravenous magnesium sulfate can reduce the severity of migraine headache. Moreover, intravenous magnesium sulfate at a dose of 2 g might be superior to intravenous caffeine citrate 60 mg for the short term management of migraine headache in emergency departments.
Objective : The aim of this study is to investigate the effectiveness of Bee-venom therapy for Cervical radiculopathy patients. Methods : To evaluate the effectiveness of Bee-venom therapy, 14 patients were treated by Bee-venom therapy. To estimate the efficacy of treatment, we used Quardruple Visual Analog Scale (QVAS), JOA score and Odom's degree. Results & Conclusions : 1. As a objectivity treatment record, they test treatment record excellent(7 case) 50%, good(4 case) 28.57%, fair(,3 case) 21.43%. 2. After Bee-venom therapy, pain rate changed from 8.82 to 3.25.(p=0.000) 3. After Bee-venom therapy, JOA score changed from 11.00 to 12.79.(p=0.000) 4. By the results which puts out the statistics in sex, age, existence of finger numbness and disc type, the pain rate is not significantly difference as a therapy. (p<0.05) 5. By the results which puts out the statistics in sex, age and disc type, the JOA score is not significantly difference as a therapy.(p<0.05) But by the results which puts out the statistics in existence of finger numbness the JOA score is significantly difference as a therapy.(p=.025) There was reports about Bee-venom therapy of the Patient with Cervical radiculopathy. It is very effective to reduce the pain and increase the JOA score.
Kim, Kyung-Tae;Lee, Song;Ko, Dong-Oh;Yang, Seung-Jin;Chun, Tae-Hwan;Yang, Jong-Hwa
Journal of the Korean Arthroscopy Society
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v.13
no.3
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pp.249-253
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2009
Purpose: We evaluated the clinical and radiographic results of arthroscopic ankle arthrodesis using 3 cannulated screws for the treatment of arthritis of ankle. Materials and Methods: From May 2006 to February 2009, 17 cases of arthritis of ankle were treated by ankle arthrodesis using 3 cannulated screws under arthroscopy. There were 8 male and 7 female and the average age was 62.2 years. We evaluated them clinically using AOFAS ankle-hindfoot functional scale, VAS pain score and patient’s satisfaction. For the radiographic evaluation, we checked them by simple AP, lateral and mortise view. The average follow-up period was 24.2 months. Results: The ankle-hindfoot functional scale was improved from an average of 47.4 points preoperatively to an average of 82.5 points at the last follow-up. The visual analogue scale pain score was decreased from an average of 8.6 to 2.4. Patient's satisfaction had favorable results with excellent in 7 cases(41.2%), good in 8 cases(47.0%), fair in 1 case(5.9%) and poor in1 case(5.9%). All ankles were successfully fused and the mean period of fusion was 9.1 weeks. Conclusion: Arthroscopic ankle arthrodesis using 3 cannulated screws was good modality of ankle arthrodesis with good clinical results and high union rate in the case of advanced ankle arthritis.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.9
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pp.347-355
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2017
The purpose of this study was to investigate the effects of pelvic adjustment on low back pain and spino-pelvic parameters in middle-aged women. Thirty-eight middle-aged women with chronic low back pain were randomly assigned to the pelvic adjustment (n = 20) oruntreated control (n = 18) group. Pelvic adjustment interventionswereperformed four times a week for 8 weeksin the former group. At baseline and after 8 weeks, the back pain and back function were evaluated using the visual analogue scale (VAS), Oswestry disability index (ODI), and back flexibility. Additionally, the spino-pelvic radiographic parameters and serum C-reactive protein (CRP) levels were assessed. After 8 weeks, the VAS, ODI, and back flexibility significantly improved in the pelvic adjustment group compared with the control group. It was found that the changes from baseline in the lumbar lordotic angle, sacral slope, pelvic crest unleveling, and femoral head height inequality were significantly greater in the pelvic adjustment group than in the control group. There were no significant changes in the pelvic incidence or serum CRP levels in either group. In conclusion, pelvic adjustment has beneficial effects on chronic low back pain and back function, suggesting that the effects of pelvic adjustment on back pain may at least in part result from changes in the spino-pelvic alignment.
Objective : The aim of this study is to investigate the curative effect of Bee Venom Acupuncture Therapy for pain and limited R.O.M (range of motion) of shoulder in stroke patients. Methods : The subjects of this study were 6 patients with shoulder pain in stroke sequelae. Routine Oriental Medical programs (Acupunture, moxibustion, herbal medicine and physical therapy) were maintained for each subject throughout this study. Single subject ABABAB design was adopted. Each period was 4 days as a rule. Only during the treatment period, Bee Venom Acupuncture Therapy was provided as intervention at the acupoints of LI15(Gyeonu), TE14(Gyeollyo), GB21(Gyeonjeong), LI14(Bino). The change of pain was measured with a Visual Analogue Scale(VAS). The pain threshold was measured using pressure algometer at the same acupoints where Bee Venom Acupuncture Therapy was provided. And the R.O.M of shoulder joint (flexion, extension, abduction, adduction, external rotation, internal rotation) was measured as well. Analysis was performed by Bayesian analysis using WinBUGS for the comparison of treatment(Bee Venom Acupuncture Therapy) and non-treatment. Results : The median overall improvement for difference in VAS was -2.219(-3.213, -1.175), for difference in external rotation of shoulder R.O.M was 9.992(-2.298, 18.49), for difference in tenderness score of LI14(Bino) by pressure algometer was 5.05(0.6283, 7.762). 95% credibility intervals being shown in brackets. However, the median overall improvement for difference in the other measurements was not significant. Conclusion : This study suggests that Bee Venom Therapy may be applicable to decrease pain and improve R.O.M of shoulder in hemiplegia patients with stroke. Further elaborated single subject designs need to be accumulated to confirm the effects of Bee Venom Acupunture Therapy on shoulder pain in patients with stroke sequelae.
Objective : This retrospective study was performed to evaluate the clinical and radiological results of anterior lumbar interbody fusion (ALIF) using two different stand-alone cages in the treatment of lumbar intervertebral foraminal stenosis (IFS). Methods : A total of 28 patients who underwent ALIF at L5-S1 using stand-alone cage were studied [Stabilis$^{(R)}$ (Stryker, Kalamazoo, MI, USA); 13, SynFix-LR$^{(R)}$ (Synthes Bettlach, Switzerland); 15]. Mean follow-up period was 27.3 ${\pm}$ 4.9 months. Visual analogue pain scale (VAS) and Oswestry disability index (ODI) were assessed. Radiologically, the change of disc height, intervertebral foraminal (IVF) height and width at the operated segment were measured, and fusion status was defined. Results : Final mean VAS (back and leg) and ODI scores were significantly decreased from preoperative values (5.6 ${\pm}$ 2.3 ${\rightarrow}$ 2.3 ${\pm}$ 2.2, 6.3 ${\pm}$ 3.2 ${\rightarrow}$1.6 ${\pm}$ 1.6, and 53.7 ${\pm}$ 18.6 ${\rightarrow}$ 28.3 ${\pm}$ 13.1, respectively), which were not different between the two devices groups. In Stabilis$^{(R)}$ group, postoperative immediately increased disc and IVF heights (10.09 ${\pm}$ 4.15 mm ${\rightarrow}$ 14.99 ${\pm}$ 1.73 mm, 13.00 ${\pm}$ 2.44 mm ${\rightarrow}$ 16.28 ${\pm}$ 2.23 mm, respectively) were gradually decreased, and finally returned to preoperative value (11.29 ${\pm}$ 1.67 mm, 13.59 ${\pm}$ 2.01 mm, respectively). In SynFix-LR$^{(R)}$ group, immediately increased disc and IVF heights (9.60 ${\pm}$ 2.82 mm ${\rightarrow}$ 15.61 ${\pm}$ 0.62 mm, 14.01 ${\pm}$ 2.53 mm ${\rightarrow}$ 21.27 ${\pm}$ 1.93 mm, respectively) were maintained until the last follow up (13.72 ${\pm}$ 1.21 mm, 17.87 ${\pm}$ 2.02 mm, respectively). The changes of IVF width of each group was minimal pre- and postoperatively. Solid arthrodesis was observed in 11 patients in Stabilis group (11/13, 84.6%) and 13 in SynFix-LR$^{(R)}$ group (13/15, 86.7%). Conclusion : ALIF using stand-alone cage could assure good clinical results in the treatment of symptomatic lumbar IFS in the mid-term follow up. A degree of subsidence at the operated segment was different depending on the device type, which was higher in Stabilis$^{(R)}$ group.
Park, Ji-Kang;Kim, Yong-Min;Kim, Dong-Soo;Park, Kyoung-Jin;Cho, Byung-Ki;Jeong, Ho-Seung
Journal of Korean Foot and Ankle Society
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v.17
no.3
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pp.225-233
/
2013
Purpose: This study was performed to evaluate the impact of the lesser toe operation on the overall clinical outcomes, and to analyze the clinical results of concomitant surgery for hallux valgus and lesser toe deformities. Materials and Methods: Forty-six cases underwent surgery for hallux valgus with concomitant lesser toe deformities were followed up for at least 1 year. Lesser toe deformities consisted of 9 crossover toes, 10 claw toes, 12 hammer toes and 15 bunionettes. Clinical evaluation was performed according to AOFAS (American Orthopaedic Foot and Ankle Society) score, patient's satisfaction score, and pain VAS (visual analogue scale) score. Hallux valgus angle (HVA), intermetatarsal angle (IMA), and period to union were measured. Preoperative expectation about lesser toe deformities, postoperative satisfaction, complication rate, hospitalization period, medical expenses, and frequency of outpatient follow-up were analyzed. Results: AOFAS score, VAS score, HAV and IMA had improved significantly. On preoperative expectation of patients, correction of lesser toe deformities was ranked third, following the improvement of big toe(bunion) pain and the correction of hallux valgus. Patient's satisfaction score was average 92.8 points, and the importance of lesser toe operation was 30.2%. When compared to hallux valgus operation only, there were average 2.5 days of additional hospitalization, 2.4 times of additional outpatient follow-up, 386000 won of additional medical expenses. Conclusion: Combined operation for hallux valgus and concomitant lesser toe deformities showed good clinical results. When compared to hallux valgus operation only, there were longer hospitalization, more frequent follow-up, more medical expenses, more complications. However, lesser toe deformity correction in patients underwent hallux valgus operation is considerable, because of high preoperative expectation and postoperative satisfaction.
Purpose: This study was done to evaluate the effectiveness of EMLA cream on pain related to venipuncture among children. Methods: In this study, 48 children were evaluated using a sequential measurement for level of pain by Skin Conductance Level (SCL) based on Galvanic Skin Response (GSR), heart rate, and the Visual Analogue Scale (VAS) at four times. Results: The maximum and mean of the SCL were each significantly different between the experimental and control groups and furthermore, the two were also significantly different among observed times. In addition there was a significant interaction between group and time. The children's perceived pain using VAS was not significantly different between the experimental and control groups. There was no significant difference in the heart rate between the experimental and control groups; however, the interaction between group and time was significant. Conclusion: In conclusion, applying topical anesthetic cream to the venipuncture site to reduce pain was effective among the children and therefore it is highly recommended that topical anesthetic cream be applied at the venipuncture site as a nursing intervention to reduce pain when a child has to undergo a venipuncture.
The purpose of this study was to elucidate the effects of inhalation method using essential oils on the preoperative anxiety of hystrectomy patients, and to provide effective and holistic nursing care to them. The research design was a nonequivalent control group non synchronized design. The data were collected from February 1 to March 31, 2002 at D Medical Center in Busan. The subjects were forty one patients that were operated on under general anesthesia for hystrectomy. They were assigned to two groups, twenty one subjects in the experimental group and twenty subjects in the control group. The tool of the Visual Analogue Scale(VAS) was used to anxiety on all patients the day before surgery and the preoperative period. Then systolic and diastolic blood pressure, pulse rate levels were measured the day before surgery and the preoperative period. The experimental group received two treatments of inhalation method using essential oils of with lavender, ylang ylang, and bergamot oil. The data were analyzed by the $X^2$ test and the independent t-test. The results of this study were summarized as follows: 1. Hypothesis 1: It has been supported that the experimental group received inhalation method using essential oils might cause lower level of the preoperative VAS anxiety than that of the control group(t=-2.93, p=.006). 2. Hypothesis 2: It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative systolic blood pressure than the control group(t=-.120, p=.905). It has been rejected that the experimental group received inhalation method using essential oils might cause lower level in the preoperative diastolic blood pressure than the control group.(t=1.766, p=.085). 3. Hypothesis 3: It has been supported that the experimental group received inhalation method using essential oils might cause lower level in preoperative pulse rate than the control group(t=5.853, p=.000). According to these results, inhalation method using essential oils can be considered an effective nursing intervention that relieves the preoperative anxiety of hysterectomy patients and stabilizes vital sign partially.
Park, Jong-Ho;Moon, Jeong-Seok;Lee, Woo-Chun;Bae, Woo-Han;Seo, Jeong-Gook
Journal of Korean Foot and Ankle Society
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v.13
no.2
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pp.113-117
/
2009
Purpose: To evaluate the short-term results of medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot deformity. Materials and Methods: Twenty four patients (25 feet) who had undergone medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot between July 2004 and May 2007 were included. The mean age was 43.6 years (16~78 years). The mean follow-up was 26 months (14~50 months). Clinical outcomes were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Six radiographic parameters were measured from weightbearing radiographs to assess the difference between preoperative and postoperative radiographs. Results: The mean AOFAS score improved from 57.9 points preoperatively to 89.2 points at latest follow-up (p=0.000). The mean VAS improved from 62 points preoperatively to 23 points at latest follow-up (p=0.000). The mean talonavicular coverage angle on anteroposterior (AP) view changed from 20.2 degrees to 16.0 degrees (p=0.002). The mean calcaneal pitch angle on lateral view changed from 12.6 degrees preoperatively to 14.5 degrees at latest follow-up (p=0.001). Regarding these radiographic parameters, the difference between interobserver measurements was larger than that between pre- and post-operative measurements. The calcaneus was transferred medially by average 11.8 mm (p=0.003), which was 27.9% of the width of calcaneal tuberosity (p=0.000). The mean talo-first metatarsal angle on AP and lateral views, and navicular height on lateral view were not significantly changed. Conclusion: Medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot could lead to improve the clinical outcomes, although the restoration of medial longitudinal arch was not clinically significant.
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