scholarly journals FRI0396 HOW DOES OSTEOARTHRITIS PAIN IMPACT FUNCTION, MOBILITY AND REQUIREMENT FOR HELP IN DAILY ACTIVITIES IN EUROPEAN PATIENTS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 796.2-796
Author(s):  
P. G. Conaghan ◽  
L. Abraham ◽  
P. Graham-Clarke ◽  
L. Viktrup ◽  
J. C. Cappelleri ◽  
...  
Keyword(s):  
Physical Function ◽  
Functional Impairment ◽  
Severe Pain ◽  
Functional Limitations ◽  
Pain Severity ◽  
Daily Activities ◽  
Pharmacologic Therapy ◽  
Moderate Pain ◽  
Mild Pain ◽  
Impact Function

Background:Symptomatic osteoarthritis (OA) leads to functional limitations and loss of independence. OA management focuses on pain relief and preserving physical function using non-pharmacologic and pharmacologic therapy. Additionally, patients commonly manage OA pain by avoiding activities that exacerbate their pain. Informal care, i.e. assistance from an unpaid caregiver, plays a major role in the total care provided to patients with chronic diseases like OA.Objectives:To evaluate how OA pain severity affects physical functioning and the subsequent need for assistance with mobility and daily activities in 5 EU countries: France, Germany, Italy, Spain and UK.Methods:Data were drawn from the Adelphi OA Disease Specific Programme (2017-18), a point-in-time study of physicians and their OA patients. Patients rated their average pain intensity over the last week on a 0-10 scale (0 = no pain; 10 = worst possible pain) and were then categorised into mild (0-3), moderate (4-6) and severe (7-10) pain groups. Patients also provided an assessment of their physical function (0-10 WOMAC scale where higher scores indicated greater functional impairment), impact on mobility, whether caregiver assistance was required, daily activities requiring caregiver assistance and home modifications made due to their OA. Physicians also rated patients’ functioning on a 0 to 10 scale (0 = fully functional; 10 = completely impaired). Comparisons among pain severity groups were made using chi-squared tests and analysis of variance.Results:The analysis included 1750 OA patients: 24% mild pain (n=413); 47% moderate pain (n=822); 29% severe pain (n=515). The patients were predominantly women (58%) and had a mean (SD) age of 65.6 (11.5).Increased pain severity was associated with greater functional impairment scores as reported by patients (WOMAC scores: mild pain=2.1; moderate pain=4.1; severe pain=5.9) and physician-rated functional impairment (mild pain=3.5; moderate pain=4.3; severe pain=5.6). Mobility was impacted for 78% of patients with severe pain (vs. 41% mild; 63% moderate) and the need for a walking aid such as a walking stick or walking frame increased with worsening severity; wheelchair assistance was needed for 7% of severe patients (compared with <1% of mild or moderate patients). Furthermore, 31% of patients with severe pain reported having to modify their home due to their OA (vs. 11% mild; 18% moderate [p<0.001]), typically adapting their bathroom (23%) or fitting a stairlift (6%).The need for assistance from a caregiver to help with daily activities was associated with an increase in patients’ pain (9% mild; 20% moderate; 42% severe [p<0.001]). For most patients this was an immediate family member, however, the proportion of patients paying for professional care also increased with severity (1% mild; 2% moderate; 7% severe). Taking the patient to work or doctor’s appointments; help with shopping; preparing/cooking meals and help with travelling out of the home were most frequently reported activities needing caregiver assistance.Conclusion:In this study of European patients, increased pain severity was associated with greater functional impairment and impact on mobility as expected; however, this study highlights the substantial need for assistance with daily activities as well as modifications to the home. The unseen costs to the patient with moderate to severe OA pain are significant.Disclosure of Interests:Philip G Conaghan Consultant of: AbbVie, BMS, Eli Lilly, EMD Serono, Flexion Therapeutics, Galapagos, GSK, Novartis, Pfizer, Speakers bureau: AbbVie, Eli Lilly, Novartis, Pfizer, Lucy Abraham Shareholder of: Pfizer, Employee of: Pfizer, Peita Graham-Clarke Shareholder of: Eli Lilly and Co, Employee of: Eli Lilly and Co, Lars Viktrup Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, Joseph C Cappelleri Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Craig Beck Shareholder of: Pfizer, Employee of: Pfizer, Andrew G Bushmakin Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Niall Hatchell: None declared, Emily Clayton: None declared, James Jackson: None declared

Frequency and nature of pain in patients undergoing neurorehabilitation

2020 ◽  
pp. 026921552095678
Author(s):  
Alicja Timm ◽  
Stefan Knecht ◽  
Matthias Florian ◽  
Heidrun Pickenbrock ◽  
Bettina Studer ◽  
...  
Keyword(s):  
Treatment Period ◽  
Daily Living ◽  
Severe Pain ◽  
Pain Medication ◽  
Daily Activities ◽  
Inpatient Stay ◽  
Moderate Pain ◽  
Group Level ◽  
Analog Scale ◽  
Pain Scores

Objective: This prospective study investigated the extent to which patients undergoing neurorehabilitation reported pain, how this pain developed during inpatient stay and whether patients were treated accordingly (using pain medication). Methods: The extent of pain, performance in daily activities, with a focus on possible impairment from pain, and pain medication were assessed at the beginning and the end of neurorehabilitation treatment. Overall 584 patients, with various neurological diagnoses, such as stroke, intracerebral hemorrhage, polyneuropathy, etc. were classified into four groups based on whether they reported having “no pain,” “mild pain,” “moderate pain,” or “severe pain.” All patients received conventional neurorehabilitation therapy in the Mauritius Hospital, Germany. Results: A total of 149 patients had clinically relevant pain at the beginning of their inpatient stay, at a group level this did not change significantly during the treatment period. At the end of inpatient stay, a slight increase was noted in patients reporting pain. Overall 164 patients suffered from moderate or severe pain, operationalized of pain scores >3 on the visual analog scale. A total of 145 patients who had pain at the end of inpatient stay, did not receive pain medication. There was a weak negative association between pain at baseline and activities of daily living at the end of the treatment period, such that, patients with higher pain levels tended to showed lower Barthel Index scores at the end. Conclusion: In our study, about one-third of patients suffered from clinically relevant pain during neurorehabilitation treatment and most of them did not receive any pain medication.

Pain and Health-Related Quality of Life (HRQoL) in Patients with Relapsed and Plateau-Phase (PP) Multiple Myeloma (MM) Treated with Denosumab

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2388-2388 ◽  
Author(s):  
Karen C Chung ◽  
Arie Barlev ◽  
Yi Qian ◽  
Susie Jun
Keyword(s):  
Severe Pain ◽  
Short Form ◽  
Human Monoclonal Antibody ◽  
Moderate Pain ◽  
Mild Pain ◽  
Osteoclast Activity ◽  
The Past ◽  
Hrqol Data ◽  
The Impact

Abstract BACKGROUND: MM is the second most common hematalogical malignancy in the U.S. The expansion of myeloma cells in bone, which is characteristic of MM, results in increased osteoclast activity that cause osteolytic lesions, which can lead to spinal cord compression, pathologic fracture, surgery or radiation therapy to bone, and bone pain. Denosumab is a fully human monoclonal antibody that can inhibit bone resorption by reducing the number and activity of osteoclasts by inhibiting RANK ligand, a key mediator of osteoclast activity. The objective of this analysis was to evaluate the pain and HRQoL in patients with MM being treated with denosumab. METHODS: 96 patients with either ≥2 prior treatment regimens and relapsed following a response to any conventional MM therapy (relapsed) or response to the most recent MM therapy and stable M-protein for ≥3 months (PP) were enrolled in a phase 2, multicenter, open-label, single-arm study of denosumab. Patients received 120mg denosumab SC on days 1, 8, 15, and 29 then every 28 days thereafter until disease progression or discontinuation. The Brief Pain Inventory-Short Form (BPI) and Functional Assessment of Cancer Therapy-General (FACT) were assessed at baseline (BL) and prior to treatment on day 1 of each 28-day cycle. BPI “pain at worst in the past 24 hours” scores were categorized as no pain (BPI 0), mild pain (BPI 1–4), moderate pain (BPI 5–6) or severe pain (BPI 7–10). BL and month 3 (relapsed) and month 5 (PP) pain and HRQoL data were analyzed. Longitudinal data regarding pain and HRQoL data were reported at BL and the latest assessment timepoint where &lt;30% of patients had dropped out. RESULTS: 45 patients with relapsed MM (Table 1) and 37 patients with PP MM (Table 2) had BL and ≥1 post-BL assessment. 30% or more patients dropped out after month 3 of treatment in relapsed patients and after month 5 in PP patients. In relapsed patients, 12 (27%), 21 (47%), 8 (18%), and 4 (9%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. In PP patients, 15 (41%), 13 (35%), 5 (14%), and 4 (11%) patients reported no pain, mild pain, moderate pain and severe pain at BL, respectively. 68% and 89% of relapsed and PP patients, respectively, demonstrated improvement or no categorical change in pain. At BL, mean (sd) FACT total scores (0–108, higher score indicating better HRQoL) for relapsed and PP patients were 77.4 (15.3) and 82.5 (11.2), respectively. FACT total scores remained relatively constant in relapsed and PP patients, 77.9 (19.4) and 83.6 (13.3), respectively. In addition, mean change from baseline in FACT domain scores varied between 1.2 to 0.2 in relapsed patients and between 0.3 to 1.1 in PP patients. CONCLUSION: The majority of patients with relapsed and PP MM demonstrated maintenance or improvement in pain and maintenance of HRQoL during treatment with denosumab. These results suggest denosumab may be associated with stabilization of pain and maintenance of HRQoL in patients with MM. Randomized trials are needed to further understand the impact of denosumab on pain and HRQoL in patients with MM. Table 1. “Pain at Worst in the past 24 hours” Category Shift between BL and month 3 in relapsed patients (n=45). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 7 2 2 1 12 Mild 4 10 4 3 21 Moderate 2 3 1 2 8 Severe 0 0 2 2 4 TOTAL 13 15 9 8 45 Table 2. “Pain at Worst in the past 24 hours” Category Shift between BL and month 5 in PP patients (n=37). Follow-up Pain Category No Pain Mild Moderate Severe TOTAL BL Pain Category No Pain 13 2 0 0 15 Mild 4 7 1 1 13 Moderate 1 2 1 1 5 Severe 0 0 2 2 4 TOTAL 18 11 4 4 37

Impact of Pain on Incident Risk of Disability in Elderly Japanese

2017 ◽  
Vol 126 (4) ◽  
pp. 688-696 ◽  
Author(s):  
Yu Kaiho ◽  
Yumi Sugawara ◽  
Kemmyo Sugiyama ◽  
Yasutake Tomata ◽  
Yasuhiro Endo ◽  
...  
Keyword(s):  
Severe Pain ◽  
Functional Disability ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Pain Severity ◽  
Joint Disease ◽  
Moderate Pain ◽  
Term Care ◽  
Elderly Japanese ◽  
Multivariate Hazard Ratio

Abstract Background Although several cross-sectional studies have reported that pain is associated with functional disability in the elderly, data regarding a longitudinal association between pain and disability are inconsistent. This study aimed to investigate the association of pain severity with subsequent functional disability due to all causes as well as stroke, dementia, and joint disease/fracture. Methods The authors conducted a prospective cohort study of 13,702 Japanese individuals aged 65 yr or older. Information regarding pain severity during the previous 4 weeks and other lifestyle factors was collected via questionnaire in 2006. Data on the incidence of functional disability were retrieved from the Long-term Care Insurance database. Cox proportional hazards regression analysis was used to estimate the multivariate-adjusted hazard ratios for incident functional disability. Results The authors documented 2,686 (19.6%) cases of incident functional disability. The multivariate hazard ratio of functional disability was 1.15 (95% CI, 1.02 to 1.31) among respondents with moderate pain and 1.31 (95% CI, 1.12 to 1.54) among respondents with severe pain in comparison with those without pain (P trend &lt; 0.001). These positive associations were particularly remarkable for disability due to joint disease/fracture: the multivariate hazard ratio was 1.88 (95% CI, 1.37 to 2.58) for moderate pain and 2.76 (95% CI, 1.93 to 3.95) for severe pain (P trend &lt; 0.001). There was a negative association between pain severity and disability due to dementia (P trend = 0.041) and no significant association between pain severity and disability due to stroke. Conclusions Among elderly Japanese individuals, the authors found a significant positive association between pain severity and future incident functional disability.

scholarly journals Effectiveness of Mobilizations along With Hot Therapy versus Mobilizations for Management of Chronic Neck Pain Due to Over Usage of Smart Phones among Young at LUMHS Jamshoro

2021 ◽  
pp. 57-62
Author(s):  
Jeetendar Valecha ◽  
Syed Mukhtar Ahmed ◽  
Tasghir Nabi ◽  
Mahesh Kumar Mugria ◽  
Siknader Ali Sangrasi ◽  
...  
Keyword(s):  
Neck Pain ◽  
Severe Pain ◽  
Chronic Neck Pain ◽  
Smart Phones ◽  
Moderate Pain ◽  
Mild Pain ◽  
Group A ◽  
Group B ◽  
Rehabilitation Sciences ◽  
Therapy Treatment

Objective: To determine the effectiveness of mobilizations along with hot therapy versus mobilizations for the management of chronic neck pain due to over usage of smart phones among young. Materials and Methods: This interventional clinical trial was conducted at OPD, Institute of Physiotherapy & Rehabilitation Sciences (IPRS) in Liaquat University Medical and Health Sciences Jamshoro (LUMHS). All the individuals from LUMHS Jamshoro including students, age 18-35 years and either of gender were included. All the individuals were divided in two groups (group A and group B). Cases of group A were underwent management of mobilization with hot therapy and cases of group B underwent only mobilization management. Outcome was observed in the terms of decrease the pain during work, reading and sleeping. All the data was recorded via study proforma. Results: Total 64 individuals were studied. Mean age was 26.2+4.2 years in group A and 28.6+5.3years. Males were in majority in both groups. According to the pain assessment on movement, mild pain was in 18.8%, moderate pain was 50.0%, severe pain was in 12.5% and very severe pain was in 18.85 of the patients of group A. However in group B most of the patients 93.8% had mild pain and 6.2% patients had severe pain, while no any patients with moderate pain and very severe pain was found in group B. After treatment pain was more decreased in patients of group A as pain during work, reading and sleeping was significantly higher in only mobilizations treatment group as compared to those underwent mobilizations with hot therapy treatment, p-values were quite significant. Conclusion: It was concluded that the treatment of mobilization with Hot pack was more effective than treatment only mobilization.

scholarly journals Frequency of plantar fasciitis due to improper shoes among different universities students

2021 ◽  
Vol 12 (1) ◽  
pp. 454-464
Author(s):  
Abdul wahid ◽  
Muhammad Arsalan Ali Sajid ◽  
Ambreen Muzaffar ◽  
Muhammad Zohaib Hussain
Keyword(s):  
Plantar Fasciitis ◽  
Severe Pain ◽  
Plantar Fascia ◽  
Cross Sectional Study ◽  
Moderate Pain ◽  
Cross Sectional ◽  
Mild Pain ◽  
Plantar Fasciopathy ◽  
Back Ground ◽  
Multiple Etiology

Back ground: study was conducted to determine the frequency of plantar fasciitis among three different universities students due to improper shoes. It was cross-sectional study. Plantar fasciitis is the inflammation of plantar fascia; plantar fascia is a thick connective tissue that forms the medial arch of foot. Improper shoes cause constant pressure and irritation on plantar fascia that leads to inflammation. When someone wears improper shoes, pronation activity of the foot decreased and it can lead to plantar fasciitis. Objective: The objective of study was to determine the frequency of plantar fasciitis due to improper shoes among three different universities students. Material and Methods: Study was cross-sectional and the data was collected from university students. Data was collected by using questionnaire and by applying statistical procedures results were concluded. Results: There were the following results in this study as, 35.5% participants without pain, 45% with mild pain, 16% with moderate pain and 3.6% with severe pain. There were 84% participants with single etiology, 13% participants with multiple etiology and 3% participants with nerve entrapment. There were 31 participants with no pain, 49 participants with mild pain, 11 participants with moderate pain and 2 participants with severe pain between ages 20-25 years. And between ages 26-30 there were 29 participants with no pain, 27 with mild pain, 16 with moderate pain and 4 participants with severe pain. Conclusion: Study concluded that 55.6% participants were between ages of 20-25 years. 54.4% participants were females, 59.2% participants were with no pain, 84% participants were with single etiology that is plantar fasciopathy. There were mostly participants suffered with mild pain and only 3.6% participants showed response with severe pain. There were mostly participants suffered with single etiology and the number of affected participants with plantar fasciitis slightly increased with age.

scholarly journals Pain and Its Interference with Daily Activities in Medical Oncology Outpatients

2013 ◽  
Vol 4;16 (4;7) ◽  
pp. 379-389
Author(s):  
Nienke te Boveldt
Keyword(s):  
Pain Management ◽  
Pain Intensity ◽  
Severe Pain ◽  
Medical Oncology ◽  
Brief Pain Inventory ◽  
Daily Activities ◽  
Analgesic Treatment ◽  
Mild Pain ◽  
Pain Management Index ◽  
Pain Prevalence

Background: Pain prevalence at various stages of cancer ranges from 27% to 60% for outpatients. Yet, how pain is managed in this patient group is poorly understood. Objectives: The primary objective was to assess pain prevalence and intensity, and its interference with daily activities, in medical oncology outpatients. The secondary objectives were the adequacy of analgesic pain treatment and to identify independent predictors for moderate to severe pain. Study design: A cross-sectional study. Setting: Oncology outpatient clinics of 7 Dutch regional hospitals. Methods: Four hundred twenty-eight medical oncology outpatients were assigned to the study. Pain prevalence and interference of pain with daily activities were assessed using the Brief Pain Inventory. Adequacy of analgesic treatment was determined by calculating the Pain Management Index (PMI). Descriptive statistics, non-parametric tests, and logistic regression analysis were conducted. Results: More than one third of all participants reported pain (39%). Eighty-three patients (20%) had moderate to severe pain (NRS 5-10). Analgesic treatment was inadequate in more than half of the patients with pain (62%). Interference of pain with daily activities increased with increased intensity, yet even 10%-33% of patients suffering mild pain reported high interference with daily activities. High current pain intensity and high interference with general daily activities predicted moderate to severe pain. Limitations: No characteristics of nonparticipants were available. Conclusion: Pain remains a significant problem in medical oncology outpatients, and often pain is insufficiently managed. Patients with a high pain intensity were more at risk to experience pain related interference with daily activities, but even some patients suffering mild pain experienced this. As adequate pain relief for up to 86% of the patients with cancer should be feasible, pain in medical oncology outpatients is still undertreated. Taking into account the interference of pain with daily activities and predictors of pain will facilitate cancer pain management. The study has been approved by the Medical Ethics Committee (CMO) in all 7 hospitals (METC protocol number 2011/020) and has been registered by the Dutch Trial register (NTR): NTR2739. Key words: Pain, prevalence, cancer, interference with daily activities, pain management, Brief Pain Inventory, Pain Management Index, neuropathic pain

scholarly journals ARTHROSCOPIC TREATMENT FOR LATERAL EPICONDYLITIS: OUTCOMES IN 104 CASES OF A SINGLE INSTITUTION

2019 ◽  
Vol 27 (3) ◽  
pp. 156-159
Author(s):  
Alexandre Tadeu do Nascimento ◽  
Gustavo Kogake Claudio ◽  
Pedro Bellei Rocha ◽  
Juan Pablo Zumárraga ◽  
Olavo Pires de Camargo
Keyword(s):  
Severe Pain ◽  
Short Form ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Lateral Epicondylitis ◽  
Dash Score ◽  
Moderate Pain ◽  
Duration Of Symptoms ◽  
Mild Pain ◽  
Sf 36

ABSTRACT Objective: To evaluate the outcomes of patients that underwent arthroscopic surgery for lateral epicondylitis (LE), after failed conservative treatment. Methods: One hundred four patients with LE treated with arthroscopic debridement of the extensor carpi radialis brevis (ECRB) tendon were enrolled in this retrospective study. They were evaluated using Disabilities of the Arm, Shoulder and Hand (DASH) score, Visual Analogue Scale (VAS) and Short Form Health Survey (SF-36) scale. Mean age at surgery was 46.9 years. Duration of symptoms was 2.1 years (range: 6 m to 10 yrs.). Mean follow-up was 34.4 months (range: 6 to 68 m). Results: Mean postoperative scores were: 20.67 points on the DASH; 1.8 points on the VAS at rest, with 48 cases (46%) without pain, 40 (38%) with mild pain, 13 (13%) with moderate pain and 4 (4%) with severe pain; 4.7 points on the VAS in activity, with 21 (20%) without pain, 21 (20%) with mild pain, 35 (34%) with moderate pain and 27 (26%) with severe pain; and SF-36 was 66.8 points. Of the 23 patients who practiced sports regularly or with higher physical demand from the upper limbs, 17 (74%) were able to return to the same activity at the same level. No significant complications were observed postoperatively, except for 3 (2.8%) cases of postoperative superficial infection. Conclusion: Surgical treatment with arthroscopy for recalcitrant LE is effective and safe, presenting positive outcomes in the studied patients. Level of evidence IV, Case Series.

Pain assessment behavioral scale in agonic cancer patients: Experience in total care—An end-of-life care home service.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19636-e19636
Author(s):  
Maricarmen Alfaro ◽  
Raquel Baldeos ◽  
Beatriz Rosales ◽  
Maria Berenguel ◽  
Alfredo Aguilar
Keyword(s):  
Pain Score ◽  
Cancer Patients ◽  
Pain Assessment ◽  
Severe Pain ◽  
Care Home ◽  
Self Report ◽  
Moderate Pain ◽  
Primary Tumors ◽  
Mild Pain ◽  
Behavioral Scale

e19636 Background: Assessing pain in nonverbal, especially agonic cancer patients is a great challenge. In the absence of self-report, measurement of pain could be difficult and patient`s behavior could be useful. The aim of this work was to evaluate the Pain Assessment Behavioral Scale (PABS) in cancer agonic patients. Methods: PABS scale was used to evaluate 118 cancer patients enter in agony. Pain levels was categorized according to PABS score in Mild Pain (score 1-3), Moderate Pain (score 4-5), Severe Pain (score>6). We correlated levels of pain with age, sex, cancer metastatic site or active tumor localization with the ANOVA, Chi square or Fisher tests when were appropriated. A P<0.05 was considered significant. Results: Fifty two patients (44.1%) were male and 66 female (55.9%). The median age was 74 (Standar Deviation [SD]:13.1; Range: 30-94). Most frequent primary tumors were colorectal (16%), lung (11%), Pancreas (9.3%), Breast (8.5%), lymphomas (6.8%), prostate (6.8%) and gastric (5.6%) cancer. Involvement of primary active tumor or active metastases was present in lung (22%), Central Nervous System (CNS) (13.6%), liver (22%), and bone (7.6%). The median of PABS score was 5 (SD=1.25; range: 2 – 8). Seven cases had mild pain (5.9%), 105 moderate pain (89%) and 6 severe pain (5.1%). There was no correlation of pain levels with age (P=0.420), sex (P=0.098), active tumor or metastatic involvement of lung (P=0.321), CNS (P=0.972), Liver (P=0.575) or bone (P=0.529). Conclusions: In our experience, PABS scale is a useful tool to evaluate pain in agony cancer patients. We found no correlation between active tumor or metastatic localization with the intensity of pain.

scholarly journals Efficacy of 10% Ichthammol Glycerine Pack and Steroid-antibiotic Pack for Relieving Pain in Acute Otitis Externa. A Comparative Study.

2019 ◽  
Vol 4 (1) ◽  
pp. 634-638
Author(s):  
Karuna Shrestha ◽  
Rajeev Shah ◽  
Srijana Sapkota
Keyword(s):  
Severe Pain ◽  
Otitis Externa ◽  
Combined Therapy ◽  
Treatment Modalities ◽  
Moderate Pain ◽  
Painful Condition ◽  
Female Ratio ◽  
Mild Pain ◽  
Number Of Patients ◽  
Antibiotic Ointment

Introduction: Otitis externa is a common painful condition presents with generalized infection of external auditory canal, typically reveals erythema and edema of the skin. Aural packing plays an important role in relieving the pain and edema. For packing, either we impregnated with 10% Ichthammol glycerine or steroid-antibiotic ointment. Objective: To compare the efficacy of 10% Ichthammol Glycerine pack with steroid-antibiotic ointment pack for relieving the pain in acute otitis externa. Methodology: A prospective, non-randomized clinical trial was carried out in 94 patients at Birat Medical College and Teaching Hospital, Biratnagar, Nepal from February 2018 to July 2018. Patients diagnosed with acute otitis externa were included in this study, where 47 patients were treated with 10% IG pack and remaining 47 patients treated with a combination steroid antibiotic ointment pack. Before aural packing was carried out, pain was assessed using visual analogue scale (VAS). Both groups of patients were evaluated after 48 hours for assessment of pain. Results: The total number of patients included in this study was 94. Among them 41 (43.6%) were male and 53(56.4%) were female where male and female ratio was 1:1.29. Majority of the patients were below 40 years (83%). Treatment with steroid-antibiotic ointment pack had significant reduction in pain after 48 hours post treatment, none of them had severe pain, 4(8.5%) had moderate pain remaining and 43(91.4%) had only mild pain. Whereas in patients treated with 10% IG pack 1(2.1%) had severe pain, 14(29.7%) had moderate pain and 32(68%) had mild pain. There was statistically significant decrease in pain with steroid-antibiotic pack. Conclusions: Both treatment modalities are effective but this study showed steroid-antibiotic ointment pack, the combined therapy is more effective than 10% IG pack for relieving the pain in acute otitis externa.

scholarly journals AB0864-HPR INFLUENCE OF THE TYPE OF PAIN SYNDROME ON THE SEVERITY OF ANXIETY-DEPRESSIVE DISORDERS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1455.2-1456
Author(s):  
E. Egorova ◽  
N. Nikitina ◽  
A. Rebrov
Keyword(s):  
Rheumatoid Arthritis ◽  
Severe Pain ◽  
Depressive Disorders ◽  
Functional Limitations ◽  
Joint Damage ◽  
Statistical Processing ◽  
Pain Syndrome ◽  
Anxiety And Depression ◽  
Moderate Pain ◽  
The Relationship

Background:Rheumatoid arthritis (RA) is a chronic autoimmune disease that leads to joint damage and deformation. Pain syndrome, along with functional limitations, causes the emergence of anxiety-depressive disorders. The patient’s psycho-emotional characteristics affect the patient’s quality of life and the effectiveness of the therapy. The aim: to assess the severity of anxiety and depression in women with rheumatoid arthritis, depending on the type of the pain syndrome.Objectives:The study included 163 women with RA according to the EULAR / ACR 2010 criteria (age 53,9 ± 10,15 years, RA duration - 10 [4; 14] years, DAS28 – 5,03 [4,35; 5,8]).Methods:We used the Hospital Depression and Anxiety Scale (HADS) questionnaire: 0-7 points were assessed as the absence of significant symptoms of anxiety and depression, 8-10 points - subclinically expressed anxiety and depression, more than 11 points - clinically expressed anxiety and depression. The severity of pain was determined by the VAS: no pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), severe pain (75-100 mm). Assessment of the type of pain (identification of the neuropathic component of pain) was carried out using the DN4 questionnaire: a sum of 4 or more points indicated the presence of a neuropathic component of pain (NCP). Statistical processing was performed using the STATISTICA 10,0 program.Results:The frequency of occurrence of anxiety-depressive disorders in RA patients was determined: clinically pronounced anxiety was detected in 35 (21,4%) patients, depression - in 34 (20,9%); subclinically expressed anxiety - in 42 (25,8%), depression - in 44 (27%) patients; absence of reliably pronounced symptoms of anxiety - in 86 (52,8%) patients, depression - in 85 (52,1%) patients.Severe pain according to VAS was noted in 57 (35%) patients, moderate pain - in 75 (46%), in 31 (19%) patients the pain syndrome was mild. In 81 (49,7%) patients a neuropathic component of pain was revealed.The relationship was established between the presence of NCP and the severity of anxiety (r = 0,27, p < 0,05), depression (r = 0,31, p <0,05). The relationship was revealed between the presence of NCP and the severity of pain according to the VAS (r = 0.32, p <0.05).To explain the relationship between the presence of NCP and anxiety-depressive disorders, the patients were divided into two groups depending on the presence of NCP, comparable in age, the main clinical characteristics of RA, and basic therapy. The level of anxiety in women with NCP (9,5 [7; 13]) was significantly higher than in patients without NCP (6.1 [4; 9]) (p = 0.01). The severity of depression in women with NCP was 8,55 [6; 11], in patients without NCP – 5,15 [3; 6] (p = 0.005).Conclusion:Thus, every fifth patient with RA had clinically significance anxiety and depression, subclinical anxiety and depression were found in 26% of RA patients. Most of the patients (81%) had moderate or severe pain, half of the patients had signs of neuropathic pain. The relationship between the severity of anxiety and depression with the intensity of pain and the presence of a neuropathic component was revealed.Disclosure of Interests:None declared

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