scholarly journals AB0599 EFFICACY AND SAFETY OF COMBINATION THERAPY WITH NSAIDS AND ANTICONVULSANT, COMPARED WITH NSAID MONOTHERAPY FOR CHRONIC PAIN IN PATIENTS WITH OSTEOARTHRITIS OF THE KNEE JOINTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1336.1-1336
Author(s):  
E. Filatova ◽  
L. Alekseeva ◽  
E. Taskina ◽  
N. Kashevarova ◽  
A. Lila ◽  
...  

Background:In 20-44% of patients with osteoarthritis of the knee joints neuroplastic changes occur due to central sensitization (1,2), which is the rationale for complex therapy, including centrally acting drugs, for more effective pain control.Objectives:To evaluate the efficacy and safety of combination therapy with NSAID and anticonvulsant in comparison with NSAID monotherapy in patients with osteoarthritis of the knee joints and signs of central sensitization or nocyplastic painMethods:The study included 60 women with osteoarthritis of the knee joints (OAK) with signs of nocyplastic pain. Nocyplastic pain were revealed by neuropathic scales (DN4 questionnaire > 4 points), subject to the absence of patients lesions of the somatosensory nervous system. All patients were randomized into two age- and sex-matched groups: group I (n=30) received combination therapy with aceclofenac and pregabalin, group II (n=30) - monotherapy with aceclofenac. The observation period was 42 days and included three visits. All patients underwent a clinical and neurological examination, we assessed the overall WOMAC index, pain intensity at rest with the visual analogue scale (VAS), nocyplastic pain (DN4 and Pain DETECT questionnaires), anxiety and depression (HADS questionnaire) and the quality of life (EQ-5D questionnaire).Results:The intensity of pain at rest according to VAS in patients of group I significantly decreased after 14 days (visit 2) and even further after 42 days (visit 3) (64.0 [50.0; 72.0] vs 49.0 [33.0; 55.0] vs 33.5 [22.0; 49.0] p = 0.006). In group II the intensity of pain at rest also decreased after 14 days (visit 2) (63.0 [41.0; 72.0] vs 48.0 [35.0; 58.0] p <0.001), however, did not change significantly from visit 2 to 3 (48.0 [35.0; 58.0] vs 44.0 [35.0; 60.0]) (p = 0.57).The dynamics of neuropathic pain indicators according to the DN4 and Pain DETECT questionnaires was as follows: group I (visit 1-3) DN4 (6.0 [5.0; 7.0] vs 3.0[1.0; 4.0], p=0.001) and Pain DETECT (17.0 [16.0;20.0] vs 8.0 [5.0; 14.0], p=0.001). Group II DN4 (6.0[5.0;6.0] vs 5,0 [3,0; 6,0],p=0,05), Pain DETECT (17,0 [15,0; 19,0] vs 16.0 [14,0; 19,0],p=0,53).The overall WOMAC index decreased significantly in both groups.Significant positive dynamics in terms of the level of anxiety (9.0 [7.0;14.0] vs 7.0 [4.0;10.0], p=0.001), depression (8.0 [5.0;10.0] vs 6.5 [4.0;9.0], p= 0.03) and quality of life (0.52 [-0.02;0.52] vs 0.52 [0.52;0.59], p=0.01) was observed compared to baseline in group I but not in group II. Before the start of therapy, the groups were comparable in the studied parameters, however, after 42 days, anxiety (7.0 [4.0;10.0]vs 9.0 [7.0;12.0], p=0.02) and depression levels (6.5 [4.0;9.0] vs 8.0 [6.0;9.0], p=0.05) were statistically different. Moreover, the median anxiety and depression levels still exceeded 7 points in group II, indicating the presence of anxiety and depression.Conclusion:Combination therapy of chronic pain with signs of nocyplastic pain with pregabalin and aceclofenac in patients with knee osteoarthritis has been shown to be effective in terms of pain intensity, the presence of neuropathic descriptors and the severity of anxiety compared with aceclofenac alone.References:[1]Hochman JR, French MR, Bermingham SL, Hawker GA. The nerve of osteoarthritis pain. Arthritis Care Res (Hoboken). 2010;62:1019–23.[2]Hochman JR, Gagliese L, Davis AM, Hawker GA. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthr Cartil. 2011;19:647–54.Disclosure of Interests:None declared.

TRAUMA ◽  
2021 ◽  
Vol 22 (2) ◽  
pp. 28-33
Author(s):  
A.V. Makogonchuk ◽  
Yu.O. Bezsmertnyi ◽  
L.Ye. Atamanchuk

The article presents the literature data and the results of our own investigation on the efficacy and safety of Muscomed cream in the treatment of patients with osteoarthritis of the knee joint. The study included 20 women (mean age 62 years). The study design included clinical and radiological examination of patients and survey using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the visual analogue scale at the beginning of treatment, on days 7 and 14 of using Muscomed cream. Muscomed cream was applied topically as a component of physiotherapeutic procedures as a part of a comprehensive conservative treatment. Two weeks after completing the course of treatment, there was a significant decrease in the intensity of pain syndrome and a decrease in the total WOMAC index in patients who used Muscomed cream locally. There was also a more pronounced decrease in the need for non-steroidal anti-inflammatory drugs in patients of the main group. The safety and efficacy of the Muscomed cream in the treatment of osteoarthritis of the knee joints were demonstrated, which resulted in a decrease in the severity of pain syndrome and an improvement in the functional activity and quality of life of such patients.


2021 ◽  
pp. 345-351
Author(s):  
Iryna SHMAKOVA ◽  
Svitlana PANINA ◽  
Volodymyr MYKHAYLENKO

Introduction. Comorbidity is an independent risk factor for mortality and significantly influences the prognosis and quality of life. Purpose: to evaluate the impact of high-tone HiTOP 4 touch therapy on cognitive disorders and quality of life in the complex treatment of patients with comorbid pathology. Methods: complex treatment of 2 groups of patients with inclusion in the basic treatment regimen of high-tone therapy was carried out - a total of 80 patients (men - 34, women - 46) aged 41 to 79 years old, group I - patients with hypertension and chronic cerebral ischemia (CСI) - 38 patients and group II - patients with hypertension, CСI and concomitant diabetes mellitus (DM) type 2 - 42 patients. The average age in group I was 61.5, in group II - 65.5. Group I received lisinopril and amlodipine in one tablet, group II received metformin in addition to the above therapy. Both groups received a course of 10 sessions of high-tone therapy using the device HiTOP 4 touch (Germany) according to the general method: 2 electrodes on the feet, 2 on the forearms and one on the neck-collar area. All the patients were assessed for their cognitive condition, degree of anxiety and depression, and estimated for quality of life before and after a course of high-tone therapy. In order to do this, we used valid assessment tests, such as the Montreal Cognitive Assessment Scale (MoCA), the Hospital Anxiety and Depression Scale (HADS), and the SF-36 Quality of Life Questionnaire. Results: the course of high-tone therapy for patients with hypertension and CCI led to improved quality of life, on all indicators of the SF-36 scale, except for pain intensity, increased cognitive functions by 3.52 points on the MoCA scale, reduced anxiety by 2.06 points and depression by 1.92 points on the HADS scale. The course of high-tone therapy for patients with CCI, hypertension and type 2 DM resulted in a significant improvement of 5 out of 8 quality of life indicators on the SF-36 scale, cognitive functions by 2.27 points on the MoCA scale and reduced anxiety by 4.3 points, and depression by 0.53 points on the HADS scale. Conclusion: the inclusion of high-tone therapy in the complex treatment of patients with comorbid pathology improves cognitive functions, reduces anxiety and depression, improves quality of life. Keywords: comorbid pathology, high-tone therapy, cognitive functions, anxiety, depression, quality of life,


Kardiologiia ◽  
2019 ◽  
Vol 59 (12) ◽  
pp. 11-19 ◽  
Author(s):  
N. V. Pogosova ◽  
A. O. Salbieva ◽  
O. Y. Sokolova ◽  
A. K. Ausheva ◽  
A. V. Karpova ◽  
...  

Background: Quality of life, which is determined both by the physical symptoms and by psychosocial risk factors, is among the primary treatment goals in coronary heart disease (CHD). Therefore, it is reasonable to assess the impact of any therapeutic interventions in CHD on these measures. Aim: To assess the changes of psychological status and quality of life in patients with CHD and abdominal obesity (AO) over time during 2 secondary prevention programs using two different modalities of remote support. Methods: An open-label randomized study with 3 parallel groups enrolling hospitalized patients with stable CHD and AO (most hospitalizations were due to elective revascularization procedures). The patients were randomized into 2 intervention groups (Group I and Group II) and into Group III (control). Both intervention groups received secondary prevention programs including one in-hospital preventive counselling session with focus on healthy eating habits and subsequent remote support for 6 months (Month 1 to 3: once a week; Month 4 to 6: once a month). Group I received this subsequent counselling via phone calls and Group II received text messages via different platforms according to patient preferences. Group III received standard advice at discharge only. During 1 year of follow-up motivation for lifestyle changes and continued participation in secondary prevention programs, anxiety and depression symptoms (HADS), stress levels (10-point VAS) and quality of life (HeartQol) were assessed. Results: A total of 120 patients were enrolled (mean age±SD, 57.75±6.25 years; men, 83.4%) who had a high baseline motivation to participate in preventive programs. At 1 year of follow-up there was a substantial improvement in anxiety and depression symptoms in Groups I and II which was absent in Group III. As a result, the proportion of patients with HADS-A score ≥8 dropped from 45.0% to 10.0% in Group I and from 40.0% to 7.5% in Group II (both р values <0.01 vs control), and the proportion of participants with HADS-D ≥8 decreased from 30.0% to 10.0% (р<0.01 vs control) and from  12.5% to 0% (р<0.05 vs control), respectively. Stress level decreased in Groups I and II by 3.95±0.38 and 3.56±0.39 баллов, respectively (both р values <0.01 vs control). The HeartQol global score increased by 1.07±0.08 points in Group I and by 0.98±0.13 points in Group (both р values <0.01 vs control). Conclusion: Both secondary prevention programs with long-term remote support targeting obese CHD patients resulted in improvement of pivotal measures of their psychological status i.e. into a decline of anxiety and depression symptomatology, stress reduction and into a better quality of life.


Health of Man ◽  
2021 ◽  
pp. 71-78
Author(s):  
Volodymyr Trishch ◽  
Andrii Mysak

Sexual health is an integral part of everyone’s quality of life. Sexual harmony depends on a man’s sexual desire and erectile function. The most common disorder of male sexual health is erectile dysfunction. Improving the treatment of patients with this pathology helps to improve both physical and mental health and thus improve the quality of life. The objective: the aim of the study was to evaluate the efficacy and safety of combination course therapy and monotherapy in patients with erectile dysfunction. Materials and methods. The observation included 89 men with erectile dysfunction of mixed genesis aged 25 to 50 years with mild to moderate severity. All patients were divided into three groups. The I group of 32 patients with moderate ED, received during the month in the morning Bodrex 1 sachet 60 minutes before meals and in the evening Strondex one spray into the oral cavity (12,5 mg sildenafil), regardless of the presence or absence of sexual activity in this day and an additional 30 minutes before sexual intercourse from 12,5 to 25 mg, followed by a comparative assessment of clinical results immediately after treatment in relation to a group of patients (II group – 32), also with moderate ED who received sildenafil in tablet form dose of 25 mg 1 hour before sexual intercourse, but not more often than once a day. The third group (III group – 25) of patients consisted of men with mild ED, who received during the month only Bodrex in the morning 1 sachet 60 minutes before meals, with comparing clinical data before and after treatment. Bodrex and Strondex preparations are presented on the market by the pharmaceutical company Geolik Pharm Marketing Group. Results. The use of course combination therapy (Strondex + Bodrex) in the treatment of patients with moderate ED was found to be significantly more effective than sildenafil monotherapy at a dose of 50 mg on demand before sexual intercourse, as evidenced by subjective assessment of patients and objective data. Namely, the integrative indicator «erectile function» in this group of patients improved almost twice, while in the second group of patients this indicator improved by 62,9% (p<0,05). Accordingly «оverall satisfaction" in group I patients improved 2,3 times, and in group II patients 1,8 times. Dopplerosonography of the penis in patients with moderate ED showed a probable decrease in hemodynamics in the corpora cavernosa, which indicated the presence of vascular factor with impaired vascular endothelial function (p<0,05). After treatment, a more pronounced increase in cavernous blood flow occurred in group I, namely an increase in peak systolic velocity by 69,5%, while in group II by 38,5% (p1<0,05). It was noted that the concentration of ET-1 in the serum of patients with moderate ED was 3 times higher than the average in the group of almost healthy men, which may indicate severe endothelial dysfunction (p<0,05). Accordingly, after treatment, the level of ET-1 in the blood of patients decreased in group I, who received combination therapy, by 44,2%, while in group II by 28,3% (p1<0,05). Before treatment, the majority of patients with moderate ED, namely 78,1%, could not have sexual intercourse due to insufficient erection. After treatment in 53,1% of group I patients receiving combination therapy (Strondex + Bodrex), erection was completely restored, while in group II erection was completely restored in 28,1% of patients. Also, according to the obtained data, it should be noted a significant positive dynamics of all integrative indicators of IIEF on the background of taking Bodrex in patients with mild ED (p<0,05). An increase in the baseline «erectile function» by 1,4 times, contributed to an increase in sexual satisfaction and sexual satisfaction in general by 2,3 times. The mean peak systolic rate of cavernous blood flow before treatment in this group of patients was lower compared with the control group by 21,2% (p<0,05). This indicator improved after treatment by 21,7%, and became not significantly different from this indicator in the control group of almost healthy men (p1<0,05; p2>0,05), which indicated the normalization of hemodynamics in penis. In patients with mild ED, the concentration of ET-1 in the serum was 1,7 times higher than in the control group (p<0,05). After treatment, this index decreased by 1.5 times, approaching the rate in the group of almost healthy men (p2>0,05). Before treatment in this group, no patient had a complete erection, and less than half of the patients (45,5%) had a pratial erection. After a course of treatment with Bodrex, complete erection was restored in 68,2% of patients, and a total of 86,4% of patients were able to have sexual intercourse. Conclusions. The use of combination course therapy (Strondex + Bodrex) in patients with moderate ED and course monotherapy (Bodrex) in patients with mild ED contributes to a more stable clinical effect, as evidenced by the dynamics of the data.


Pharmateca ◽  
2020 ◽  
Vol 13_2020 ◽  
pp. 101-107
Author(s):  
E.S. Filatova Filatova ◽  
L.I. Alekseeva Alekseeva ◽  
E.A. Taskina Taskina ◽  
N.G. Kashevarova Kashevarova ◽  
E.P. Sharapova Sharapova ◽  
...  

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Um-e-Kalsoom ◽  
Sabiha Khan ◽  
Israr Ahmad

Abstract Background Hemodialysis may have serious psychological impact upon patients suffering from chronic kidney diseases. The aim of the present study is to investigate the impact of hemodialysis on the wellbeing of individuals with chronic kidney diseases (CKD). Result A sample consists of (N = 100) CKD patients referred from neurology ward of Leady Reading Hospital Peshawar. Data was collected from both male (50%) and female (50%) in 2017. Participants were divided into two groups on the basis of pre-set criteria. In group I, individuals with 4–5 stage of CKD referred first time for dialysis treatment were recruited. Group II comprised of CKD patients with 1–3 stage. Demographic data sheet, Pakistan Anxiety and Depression, WHO Quality of Life scale, and Perceived Social support scale (PSS) were used to test the hypotheses. Paired sample t test was use to see the difference between pre- and post-analysis of depression, anxiety, QOL, and PSS in group I (experimental group). Results suggests significant difference on depression (p > .001), anxiety (p > .001), and QOL (p > .001), while no significant difference was reported on perceived social support (p <.673). Findings also indicate no significant difference between group I and group II on QOL depression, anxiety, and PSS. Conclusion The findings concluded that patients under hemodialysis treatment suffered from depression, anxiety, and poor quality of life.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Lucas Bozzetti Pigozzi ◽  
Duziene Denardini Pereira ◽  
Marcos Pascoal Pattussi ◽  
Carmen Moret-Tatay ◽  
Tatiana Quarti Irigaray ◽  
...  

Abstract Aims To compare the difference in the quality of life between temporomandibular disorders (TMD) patients and non-TMD subjects diagnosed with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) or the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Methods Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE) and Latin American and Caribbean Health Sciences Literature (LILACS) databases were searched in studies published in English and Portuguese. The search was performed by two independent reviewers in duplicate. A manual search and the gray literature were also included. The inclusion criteria were clinical studies that used the RDC/TMD axis I and quality of life with standard questionnaires in young and middle-aged adult population (18–55 years). The data were analyzed quantitatively by combining the results in a meta-analysis using forest plots. The measure of effect used was the standardized mean difference (SMD) in depression levels. The Newcastle–Ottawa Scale (NOS) was used to evaluate the quality of the studies. The publication bias was assessed by funnel plots. The initial search included 806 articles without duplications. Results Twenty-four articles were included in the final systematic review. Of these, 9 were included in the meta-analysis, where it was shown a statistically significant in all axis I groups: (a) global TMD—groups I, II and III combined, N = 3829, SMD (95% CI) = 1.06 (0.65–1.51), p = 0.000; (b) group I—muscle disorders, N = 3,056, SMD (95% CI) = 0.82 (0.45–1.18), p = 0.000; (c) group II—disc displacements, N = 3,184, SMD (95% CI) = 0.59 (0.26–0.91), p = 0.000; and (d) group III—arthralgia/arthritis/arthrosis, N = 2781, SMD (95% CI) = 0.98 (0.59–1.36), p = 0.000. When compared to controls. Conclusions Quality of life is affected in all axis I TMD patients, especially in groups I and III with higher pain intensity and disability as compared to group II.


2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.


2020 ◽  
Vol 87 (7-8) ◽  
pp. 33-37
Author(s):  
V. І. Liakhovskyi ◽  
R. М. Riabushko ◽  
А. V. Sydorenko

Objective. To study the patients’ quality of life after operative interventions, performed for venous trophic ulcers of the lower extremities. Маterials and methods. Analysis of data from 82 hospital cards of stationary patients was conducted. The patients were treated during 2010 - 2017 yrs in the Department of Vascular Surgery of Poltava Regional Clinical Hospital named after М. V. Sklifosovskyi for venous trophic ulcers of the lower extremities (Class С5 in accordance to Clinical-Etiological-Anatomical-Pathophysiological classification - СЕАР). The cause of trophic ulcers occurrence in all the patients was confirmed, using ultrasound duplex scanning of pelvic and the lower extremities arteries and veins. After conduction of certain conservative therapy the operative intervention, directed on elimination of the occurrence cause of trophic ulcers, was done. In all the patients the conduction of endovenous thermal ablations was not indicated, taking into account the anatomic peculiarities presented. Depending on the methods of operative interventions performed, the patients were distributed into two groups: Group I - 48 (58.5%) patients, surgical treatment of whom consisted of typical conventional open operative interventions, using a standard set of instruments, while Group II - 34 (41.5%) patients, to whom operative interventions were done, using elaborated own gadgets for the wounds edges opening, dissection and ligation of perforant and large subcutaneous veins, nontraumatic suturing of postoperative wounds. All operative interventions in the Group II patients were performed, using ultrasonographic support. In patients of both Groups a subjective estimation of quality of life was conducted, using questionnaire CIVIQ (Chronic Insufficiency Venous International Questions) for interviewing preoperatively and in 1, 3 and 6 mo postoperatively. Results. In accordance to data obtained, in patients of Group II the score in points of quality of life was higher, because in them the ulcers have healed faster, the pain sensation reduced, resulting in the psycho-emotional state improvement. Besides this, 29 (85.3%) patients of Group II have noted, that even while some symptoms persisted, their subjective signs reduced, leading to the well-being improvement. The conduction of treatment in accordance to own procedures proposed have promoted the raising of the quality of life score in patients, suffering trophic ulcers of the lower extremities. Conclusion. Application of gadgets of own elaboration during operative intervention on venous system of the lower extremities accelerates its performance and reduces traumaticity. This leads to reduction of the pain sensitivity intensity, raising of subjective estimation of quality of life in remote postoperative period.


Author(s):  
Nachiket Madhukarrao Palaskar ◽  
Nitin Dinkar Chaudhari ◽  
Garima Laxminarayan Balpande ◽  
Swapna Subhash Khatu

<p class="abstract"><strong>Background:</strong> Female pattern hair loss (FPHL) is a common form of nonscarring hair loss. We compared the usefulness and safety of topical minoxidil alone with combination of oral spironolactone and topical minoxidil in the treatment of FPHL.</p><p class="abstract"><strong>Methods:</strong> This prospective, single-centre, randomised open label study over 100 patients attending tertiary care hospital in Mumbai during period December 2011 to June 2012. The data were entered into SPSS version 21 for analysis. Data collected were coded and described as frequency and percentage for qualitative data and means and standard deviation for quantitative data. Statistical analysis was done using chi-square and student t test. Statistical significance was considered if p value was less than 0.05.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 48 patients in Group I and 46 patients in Group II. At 6 months, significantly higher mean Sinclair grade was observed among Group I patients as compared to Group II patients (2.85±0.68 vs 2.56±0.50, p=0.02). We observed a significant improvement in women’s androgenetic alopecia quality of life questionnaire in Group I patients at 12 months after treatment (26.93±2.25 vs 23.47±2.95, p&lt;0.001). Minoxidil and spironolactone were tolerated well by the patients.</p><p class="abstract"><strong>Conclusions:</strong> Combination therapy of topical minoxidil and oral spironolactone has an additive effect. However, plateau of effectiveness of the combination therapy in normoandrogenic patients at 6 months of therapy was observed. We recommend the combination for 6 months and continuation of therapy with minoxidil only.</p>


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