scholarly journals Outcome of Scapulothoracic Arthroscopy for Painful Snapping Scapula

2017 ◽  
Vol 11 (1) ◽  
pp. 785-793
Author(s):  
Saif Ul Islam ◽  
Muhammad Naghman Choudhry ◽  
Sobia Akbar ◽  
Mohammad Waseem
Keyword(s):  
Pain Relief ◽  
Visual Analogue Score ◽  
Arthroscopic Treatment ◽  
Treatment Modalities ◽  
Functional Improvement ◽  
P Value ◽  
Snapping Scapula ◽  
Oxford Shoulder Score ◽  
Good Pain Relief ◽  
Shoulder Score

Introduction: Patients with scapulothoracic syndrome present with pain in the scapulothoracic area aggravated by overhead and repetitive shoulder movements. The aim of our study was to assess the outcome of scapulothoracic arthroscopic treatment in patients with painful snapping scapula in our institution. Methods: Fourteen patients underwent scapulothoracic arthroscopic treatment for painful snapping scapula. Pre-operatively, all these patients had a trial of conservative treatment modalities for at least 6 months. Two portals along the medial border of scapula were used for arthroscopy and instrumentation. In three cases a superior portal was also used. The arm was placed in the “chicken wing” position so that the scapula lifted up from the chest wall. Outcome was assessed using pre and postoperative pain visual analogue score and Oxford Shoulder Score. Results: Of the fourteen patients included in our study, ten were female and four were male patients. Mean age at the time of surgery was 27.6 years. Mean follow up was 35.7 months. Pain visual analogue score improved significantly from a mean of 8.8 preoperatively to 2.5 postoperatively (P value 0.00002). There was also a significant improvement in Oxford Shoulder Score from a mean of 10.8 to 40.9 (P= 0.00001). Mean crepitus score significantly decreased from 2.6 to 0.21 (p < 0.00001). Crepitus completely resolved in eleven patients. In three there was residual palpable crepitus but they had good pain relief. Conclusion: Arthroscopic scapulothoracic treatment provides significant pain relief and functional improvement for painful snapping scapula symptoms not responding to non-surgical treatment modalities.

scholarly journals Arthroscopic capsular release for idiopathic frozen shoulder with intra-articular injection and a controlled manipulation

2014 ◽  
Vol 96 (1) ◽  
pp. 55-60 ◽  
Author(s):  
CD Smith ◽  
P Hamer ◽  
TD Bunker
Keyword(s):  
Pain Relief ◽  
Range Of Motion ◽  
Frozen Shoulder ◽  
Stage Ii ◽  
Capsular Release ◽  
Oxford Shoulder Score ◽  
Arthroscopic Capsular Release ◽  
Good Pain Relief ◽  
The Mean ◽  
Shoulder Score

INTRODUCTION The aim of this prospective study was to assess the immediate and long-term effectiveness of arthroscopic capsular release in a large cohort of patients with a precise and isolated diagnosis of stage II idiopathic frozen shoulder. METHODS All patients underwent a preoperative evaluation. Patients with secondary frozen shoulder and those with concurrent pathology at arthroscopy were excluded. This left 136 patients with a stage II arthroscopically confirmed idiopathic frozen shoulder. At each postoperative attendance, a record was made of pain, function and range of motion. At 12 months, the Oxford shoulder score was calculated, and pain and range of motion were assessed. RESULTS Fifty per cent achieved good pain relief within a week and eighty per cent within six weeks of arthroscopic capsular release. The mean preoperative visual analogue scale pain score was 6.6 and the mean postoperative score was 1.0. The mean time to achieving good pain relief was 16 days following surgery. No patient could sleep through the night prior to surgery while 90% reported having a complete night’s sleep at a mean of 12 days after surgery. The mean postoperative Oxford shoulder score was 38/48 and the mean improvement was 19.2. CONCLUSIONS This large series demonstrates that arthroscopic capsular release is a safe procedure, with rapid improvement in pain and a marked improvement in range of motion.

CLINICAL OUTCOME OF BLIND VERSUS SONOGRAPHIC GUIDED INFILTRATION OF CORTICO STEROID FOR PAINFUL SHOULDER CONDITIONS IN ADULTS – A COMPARATIVE STUDY

2021 ◽  
pp. 57-59
Author(s):  
Paramjit Singh ◽  
Rajesh Kapila ◽  
Sarika Kapila ◽  
Kamal Arora ◽  
Sheenam Bansal ◽  
...  
Keyword(s):  
Pain Relief ◽  
Shoulder Pain ◽  
Constant Score ◽  
Corticosteroid Injection ◽  
Visual Analogue Score ◽  
Functional Improvement ◽  
P Value ◽  
Painful Shoulder ◽  
Image Guided ◽  
Corticosteroid Injections

Background: Painful shoulder is one of the commonest ailmaent encountered in the outpatient department of orthopedica now a days. One of the ways to get relief from the pain is to instill intraarticular corticosteroids. Corticosteroid injections can be performed blind or with image guidance. The objective of this study was to compare the accuracy and efcacy of image guided intraarticular corticosteroid injections in shoulder pain versus blind, with specic reference to pain relief as per VAS and functional improvement as per constant score. Objective : To compare the efcacy of image guided intra-articular corticosteroid injection in shoulder pain versus blind method of inltration, with specic reference to 1. pain relief as per visual analogue score. 2. To compare post inltration functional improvement of as per constant score with these two methods. Methods: The present Study included 50 adults with a history of pain around the shoulder of three or more than three months duration and were divided into two groups of 25 patients each by simple computer based allocation. Results: Both groups showed improvement as per CONSTANT SCORE, (26.64 to 72.00, an improvement of 45.36 in USG group and 27.48 to 58.60, an improvement of 31.12 in blind group with significant p value of 0.001). Conclusion: USG inltration of corticosteroids in shoulder pain is a superior method compared to blind inltration as clearly established by signicant improvement in pain and range of motion (ROM) of shoulder joint (more in ultrasonic group compared to blind group) probably due to accurate needle placement and proper dosage of drug is delivered at the required site.

scholarly journals Surgical Outcome of Microvascular Decompression for Trigerminal Neuralgia in Terms of Pain Control Using Visual Analogue Scale

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
RIAZ-UR- REHMAN ◽  
MUHAMMAD NAWAZ KHAN ◽  
ATTIYA NASIR SIDDIQUE ◽  
AKBAR JAMAL
Keyword(s):  
Pain Relief ◽  
Visual Analogue Scale ◽  
Trigeminal Neuralgia ◽  
Pain Control ◽  
Analogue Scale ◽  
Visual Analogue Score ◽  
Definitive Treatment ◽  
Inclusion Criteria ◽  
Good Pain Relief ◽  
Vascular Decompression

Objective:  The aim of conducting this study was to evaluate the outcome of a Micro vascular Decompression procedure for the definitive treatment of Trigeminal Neuralgia in our setup. Material and Methods:  This observational prospective study was carried out in Neurosurgery unit Hayatabad Medical Complex, Peshawar. A total of 50 patients operated for micro vascular decompression surgeries were enrolled in the study, both genders and any age were in inclusion criteria. Patients previously operated for trigeminal neuralgia were excluded from the study. Post operatively all patients were followed for 1year to calculate the outcome in terms of pain control using visual analogue score (VAS). Immediate pain relief during the first post-operative week and trigeminal neuralgia pain at 1 year post op were recorded and  graded into three categories based on Visual Analogue Scale (VAS) such as Excellent: 0-2 , Good: 3-6, Fail/Poor: 7 – 10. Results:  50 patients fulfilled the inclusion criteria. 22 were male & 28 were female with an age range from 42-78 years. Average duration of disease was 5 years. In 30 patients, clinically v2-v3 were predominantly involved, in remaining 14 patient v1-v2 were involved & only in 6 patients all three branches were involved. Among all operated 50 patients 18(36%) had excellent pain relief, 26 (52%) had good pain relief & 6 (12%) had fail/poor pain relief. Conclusion:  From this data it was concluded that micro vascular decompression is an effective surgical procedure in relieving pain of trigeminal neuralgia in patients who are refractive to medical treatment.

scholarly journals Effectiveness of Ultrasonography and Fluoroscopy as a Therapeutic Imaging Modality in the Management of Lumbar Facet Arthropathy: A Prospective Interventional Study

2020 ◽  
Author(s):  
Rachit Gulati ◽  
Ushnish Mukherjee ◽  
Sandeep Kumar Gupt ◽  
Pankaj Kumar Mandal
Keyword(s):  
Facet Joint ◽  
Imaging Modality ◽  
Visual Analogue Score ◽  
Functional Improvement ◽  
P Value ◽  
Interventional Study ◽  
Facet Joint Injection ◽  
Common Causes ◽  
Facet Arthropathy ◽  
Lumbar Facet

Introduction: Lumbar zygopophyseal joint arthropathy is one of the most common causes of low back pain in adults. Historically, C-arm/Fluoroscopy has served as an image guidance tool in intra-articular facet joint injections, however, now ultrasound guidance is also a viable option. Aim: To compare ultrasonography (USG) and fluoroscopy as therapeutic imaging modalities on the basis of time taken for intervention, Visual Analogue Score (VAS) for pain and Oswestry Disability Index (ODI) at 2, 4 and 12 weeks. Materials and Methods: It was a prospective interventional study done with 62 patients who satisfied the inclusion and exclusion criteria and randomly allocated into two groups. Groups were compared on the basis of time taken for intervention, VAS for pain and ODI at 2, 4 and 12 weeks. Independent sample student t-test/Mann-Whitney U test was applied. Confidence Interval (CI) was taken as 95% and p-value <0.05 was considered as statistically significant. Results: Ultrasound group had mean age of 37.75 years (range, 23-55 years) while that of Fluoroscopy group was 40.05 years (range, 20-54 years). Ultrasonography group was quicker by about 135 seconds (2 minutes and 15 seconds) which was statistically significant but there was statistically no difference between the two groups in terms of VAS and ODI at 2 weeks (p=0.107 and 0.893, respectively), 4 weeks (p=0.383 and 0.408, respectively) and 12 weeks (p=0.343 and 0.777, respectively) at 95% CI. Conclusion: Both groups showed significant improvement in pain and disability after 2, 4 and 12 weeks however there were no significant differences in pain and functional improvement between USG guided transverse view and fluoroscopy guided intra-articular lumbar facet joint injection. Therefore, USG guided transverse approach is quicker, feasible and minimises exposure of radiation to patient as well as interventionist

scholarly journals The Efficacy of Boswellia carterii Oleogel in Pain Relief and Functional Improvement Among Patients with Carpal Tunnel Syndrome: A Triple-Blind Randomized, Controlled Trial

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mehrdad Karimi ◽  
Setareh Rohani ◽  
Masood Ghahvechi Akbari ◽  
Elham Kargozar ◽  
Arman Zargaran ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Carpal Tunnel Syndrome ◽  
Pain Relief ◽  
Controlled Trial ◽  
Symptom Relief ◽  
Functional Improvement ◽  
P Value ◽  
Randomized Controlled ◽  
Tunnel Syndrome ◽  
Boswellia Carterii

Objectives: The current study aimed at investigating the effectiveness of a topical herbal extract, Boswellia carterii (BC), on pain relief and functional improvement in patients with carpal tunnel syndrome (CTS) versus placebo in a randomized, controlled trial (RCT). Methods: The current study was conducted on 36 patients with mild or moderate levels of bilateral CTS (both hands were involved in all the subjects). Subjects were randomly assigned into two groups receiving either topical oleogel of BC or placebo for six weeks. All the patients were instructed to use wrist splinting; 29 subjects completed the study. The efficacy of topical BC in symptom relief and functional improvement of CTS was evaluated two and six weeks after the intervention using the Visual Analogue scale (VAS) for pain, pain-free grip strength (PFGS), Nerve Conduction study (NCS), and Boston CTS questionnaire (BQ). Results: The subjects in both groups had similar demographics and baseline clinical features. The topical use of BC oleogel led to a significant improvement in VAS scores, symptoms severity score (SSS), functional status scale (FSS), and PFGS in comparison with the baseline level. The baseline VAS score of the intervention group was 5.7 ± 2.9, which decreased to 3.4 ± 1.5 two weeks and 2.7 ± 2.1 six weeks after the intervention (P-value = 0.001). SSS decreased from 29.53 ± 9.4 to 20.93 ± 6.4 and 18.80 ± 6.8 in the same follow-up time points, respectively (P-value = 0.001). The corresponding figures related to FSS were 18.35 ± 6.1, 15.07 ± 7.0, and 12.93 ± 3.79, respectively (P-value = 0.007). PFGS was 6.9 ± 2.6 at pre-intervention, which increased to 7.29 ± 1.7 and 7.65 ± 1.8 two and six weeks after treatment, respectively (P-value = 0.01). Except for grip-strength, the improvement was significantly superior to that of the placebo group. Both VAS and SSS indicated that the topical oleogel of BC achieved a better symptom relief than placebo. On the other hand, no remarkable preference was observed between the two groups in terms of improvement in electrodiagnostic parameters (P ⟩ 0.05). Conclusions: According to the current study findings, the topical application of BC oleogel among patients with CTS improved pain and functional status, remarkably more than placebo. However, no significant changes were observed in electrodiagnostic parameters.

Dorsal root entry zone lesions for the treatment of post-herpetic neuralgia

1984 ◽  
Vol 60 (6) ◽  
pp. 1258-1262 ◽  
Author(s):  
Allan H. Friedman ◽  
Blaine S. Nashold ◽  
Janice Ovelmen-Levitt
Keyword(s):  
Pain Relief ◽  
Dorsal Root ◽  
Post Herpetic Neuralgia ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Content Type ◽  
Root Entry Zone ◽  
Adequate Pain Relief ◽  
Good Pain Relief ◽  
Transcutaneous Nerve Stimulation

✓ Post-herpetic pain was treated in 12 patients using dorsal root entry zone (DREZ) lesions. All patients had failed to receive adequate pain relief from conservative therapy consisting of transcutaneous nerve stimulation, carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to include the involved dermatomes plus one-half of the dermatomes above and below the painful areas. Eight patients reported good pain relief with follow-up periods ranging from 6 to 21 months. A ninth patient obtained satisfactory pain relief, but the superior 1 cm of the original painful area was not included in the distribution of the DREZ lesions. Patients whose lesions were performed using a thermally controlled lesion probe suffered no significant postoperative neurological deficit. Dorsal root entry zone lesions appeared to be a satisfactory treatment for post-herpetic neuralgia in patients who have failed to respond to more conservative modes of therapy.

Comparison between Low Level Diode Laser Therapy and Acyclovir Cream 5% in Treatment of Herpes Labialis

2021 ◽  
Author(s):  
Parisa Hajian ◽  
Amir Mansour Shirani ◽  
Maryam Khosravi
Keyword(s):  
Pain Relief ◽  
Laser Therapy ◽  
Median Time ◽  
Repeated Measures ◽  
Statistical Tests ◽  
Healing Time ◽  
P Value ◽  
Herpes Labialis ◽  
Low Level ◽  
Acyclovir Cream

Introduction: Recurrent Herpes Labialis (RHL) is a common infection and occurs in 20 to 40% of the general population. Risk for transmission exists in dental treatments. There are several different treatments for it. The purpose of this study is a comparison between low-level Laser therapy (LLLT) and acyclovir cream for the treatment of it. Materials & Methods: This performed study was a semi-blind clinical trial in the Oral Medicine Department, Dental School, Islamic Azad University Isfahan Branch (Khorasgan) in the year 2015- 2016. 30 patients got divided into 2 similar groups. Patients in LLLT group, treated in 3 sessions every other day, received 660 nm laser irradiation,100mW,4 J/cm2, continuous, located at a distance of 1 mm from the lesion for 40 seconds. Patients in the medication group treated with 5% acyclovir cream five times a day. In both groups severity of pain and lesion size during treatment and healing time recorded. The collected data were analyzed using statistical tests including independent T-test and Repeated Measures ANOVA ( p value < 0.05). Results: The laser group had better statistically findings for the median time for pain relief (p value < 0.001), and the median time for healing (p value < 0.001), the median lesions size two days after treatment (p value = 0.03), and four days after treatment (p value = 0.003). Conclusion: According to data analysis, laser 660 nm is more effective in pain relief and lesions size reduction and healing time than topical acyclovir in patients with herpes labialis.

ROLE OF COMPUTED TOMOGRAPHY SCAN IN POST-COVID SINO-NASAL MUCORMYCOSIS WITH CLINICO-EPIDEMIOLOGICAL CORELATION

2021 ◽  
pp. 49-52
Author(s):  
Srijit Saha ◽  
Aarti Anand ◽  
Debraj Saha
Keyword(s):  
Broad Spectrum ◽  
Health Care Professionals ◽  
Epidemiological Data ◽  
Treatment Modalities ◽  
Intracranial Extension ◽  
P Value ◽  
Comorbid Condition ◽  
Invasive Ventilation ◽  
Broad Spectrum Antibiotics

Ÿ OBJECTIVE: Ÿ To evaluate the spectrum of radiological ndings in post-COVID sinonasal mucormycosis cases Ÿ To evaluate the demography, comorbidities and treatment modalities used in these patients which may be attributable to development of sinonasal mucormycosis after recovery from COVID-19 disease. Ÿ MATERIALS AND METHODS: In this retrospective study, 80 out of 793 patients who came for follow-up after recovering from COVID pneumonia, had symptoms related to paranasal sinus and orbit. CECT PNS and orbit was performed in them and 69 patients had positive CT ndings. Clinico-epidemiological data was recorded. The correlation between CT ndings and clinical history was performed by Chi2 test. P value <0.05 was considered as statistically signicant. Ÿ RESULTS: Majority - 48 (69.5%) belonged to age group between 40-60 years. Diabetes mellitus was the most common comorbid condition seen in 58 (84%) patients. The treatment history during COVID-19 disease revealed administration of intravenous or oral steroids in 54 (78.2%) patients, Injection Remdesivir in 48 (69.5%), broad-spectrum antibiotics in 36 (52.2%). 15 (21.7%) were given non-invasive ventilation and 7 (10.1%) needed invasive ventilation. Ethmoidal sinus- 68 cases (98.5%) and maxillary sinus- 65 cases (94.2%) were most frequently affected sinus. Intraorbital extension of the soft tissue was seen in 37 (53.6%) and intracranial extension was seen in 11 (15.9%) cases. On follow-up, fungal hyphae were detected in 39 (56.5%) cases via KOH mount or biopsy. Ÿ CONCLUSION: The widespread use of steroids/monoclonal antibodies/broad-spectrum antibiotics/oxygen therapy for treating COVID-19 may lead to the development/exacerbation of pre-existing fungal diseases. Health care professionals should act promptly when there is a suspicion of mucormycosis

Digitalization and Tele-Health Care Concept of Complementary of Traditional Medical practices by Using BIOCERAMIC Technique

2021 ◽  
Author(s):  
Ting Kai Leung ◽  
Ming Tse Lin ◽  
Shu-Chen Lin
Keyword(s):  
Health Care ◽  
Pain Relief ◽  
Health Care Providers ◽  
Mixed Model ◽  
Close Contact ◽  
Health Care Service ◽  
Trigger Points ◽  
Functional Improvement ◽  
Care Providers ◽  
Myofascial Trigger Points

Objective: Tele-health care service of alternative practice for chronic pain disease is worthwhile of developing, especially in the period of COVID-19 pandemic. Targeting on myofascial trigger points, this study was performed to assess the possible short-term pain relief and functional improvement in patients by applying the device of BIOCERAMIC material enhanced by frequencies of tempo sound and visible light spectrum (BioS&L).<br><br>Methods: Fourteen patients who participated in the procedure for the selection of trigger points for the BioS&L treatment, assessment of pain levels using a visual analog scale (VAS) analysis, and detection of abnormal resonance of 12 harmonic frequencies using a quantum resonance spectrometer (QRS).<br><br>Results: Comparing the pre-and post-treatment of BioS&L on pain score of 12 HFs(V1-V12) as measured by VAS estimated by mixed model showed 91.7% (11/12) improvement with statistically significant results. The distribution of differences in the QRS score estimated by the mixed model among participants with pre-test QRS level ≥ 2 showed 83.3% (15/16) of HFs with statistically significant results.<br><br>Conclusion: Treatment of BioS&L at trigger points providing pain relief is explained by the hypothesis of microvascular physiology and physics of wave propagation. This study provides a workshop with a concept of digitalization of complementarity and traditional medical service and tele-health care, which fulfils distant data connection and remote practice. In the period of epidemic spread, it helps to decrease close contact on both health care providers and patients.

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