scholarly journals Effect of intraarticular steroid injection in addition to physical modalities in osteoarthritis knee

2015 ◽  
Vol 23 (1) ◽  
pp. 48-54
Author(s):  
Md Jahidul Islam ◽  
MM Jalal Uddin ◽  
Md Shahadat Hossain ◽  
Md Ruhul Amin ◽  
Md Moshiur Rahman ◽  
...  

Context: Osteoarthritis (OA) is the most common form of arthritis accounting for about 30% of general physician visits. Intrarticular (IA) corticosteroid injections have been used for decades in clinical practice for pain relief and control of local inflammation in OA. In the present study a combined therapy of long acting intra-articular injection in addition to physical modalities of OA knee was given to find out the functional improvement and clinical outcome of the patient. Methods: It was a prospective interventional non-randomized clinical study conducted in the Department of Physical Medicine & Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from October, 2011 to March, 2012. Fifty four patients between 35 and 75 years without consideration of gender with a history of not less than three months knee pain with radiographic confirmation of primary osteoarthritis were selected purposefully. Then they were divided randomly in group A and B, having 27 patients in each group. Group A received NSAID (non steroidal anti-inflammatory drugs) i.e. aceclofenac 100mg twice daily for 10 days + omeprazol 20mg twice daily for 10 days + MWD (micro wave diathermy 20 minutes for 14 days. + therapeutic exercise + ADL (activities of daily living), while Group B received 80mg intraarticular triamcinolon acetonide injection once followed by NSAID i.e. aceclofenac 100mg twice daily for 10 days + omeprazol 20mg twice daily for 10 days + MWD 20 minutes for 14 days. + therapeutic exercise + ADL. In both groups the patients were observed for six weeks. Results: The mean of age of patients in group A and B were 52.33±9.62 years and 52.29±9.67 years respectively. In group A, 9 (33.3%) were male and 18 (66.7%) were female. In group B, 10 (37.0%) were male and 18 (63.0%) were female. Mean visual analogue scale (VAS) during pre treatment in group A and group B were 6.22±1.60 and 7.15±1.56 respectively. Mean range of motion (ROM) during pre treatment in group A and group B were 117.33±13.05 and 112.37±19.01 respectively. Mean time taken to walk 50 feet during pre treatment in group A and group B were 18.22±2.39 and 18.81±2.13 minutes respectively. Mean Western Ontario and Mc Master Universities (WOMAC) index in group A and group B were 60.85±15.86 and 67.33±16.33 minutes respectively. After treatment in both groups visual analogue scale (VAS), range of motion (ROM), time taken to walk 50 feet and Western Ontario and Mc Master Universities (WOMAC) index gradually decreased and range of motion (ROM) gradually increased, which were statistically significant. However, the study conducted with small sample size in a single centre in Dhaka city, which may not be representative for the whole country. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22694 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 48-54

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 750-757
Author(s):  
Md Firoze Hasan ◽  
Muhammad Alamgir Mandal ◽  
Md Afzalur Rahman ◽  
Mohammad Moniruzzaman ◽  
Md Jahidul Islam ◽  
...  

Background: Osteoarthritis (OA) is the most common form of arthritis accounting for about 30% of general physician visits. Objectives: To detect the effects of ultrasound therapy on patients with osteoarthritis of the knee joint.Methodology: It was a prospective non randomized clinical study, conducted in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka during the periods of 1st March, 2012 to 31st August, 2012. Fifty four patients between 35-75 years of age without consideration of gender with a history of not less than three months knee pain with radiographic confirmation of primary osteoarthritis were selected purposefully. Then they were divided randomly in group A & group B. Group A received g NSAID [Aceclofenac 100mg B.D.-10 days]+Omeprazol (20mg B.D.-10days) + Therapeutic exercise + ADL and Group B received gUST+NSAID [Aceclofenac 100mg B.D.-10 days]+ Omeprazol (20mg B.D.-10days) + Therapeutic exercise + ADL. In both groups the patients were observed for six weeks. Outcome measured by VAS, ROM, 50 feet walking time and WOMAC index.Results: Mean ± SD of age in group A and group B were 52.33 ± 9.62 years and 52.29 ± 9.67 years respectively. Among the 27 patients in group A 9 (33.3%) were male and 18 (66.7%) were female. Among the 27 patients in group B 10 (37.0%) were male and 18 (63.0%) were female. Mean ± SD of VAS during pre treatment in group A and group B were 6.22 ± 1.60 and 7.15 ± 1.56 respectively. Mean ± SD of ROM during pre treatment in group A and group B were 117.33 ± 13.05 and 112.37 ± 19.01 respectively. Mean ± SD of time taken to walk 50 feet during pre treatment in group A and group B were 18.22 ± 2.39 and 18.81 ± 2.13 minutes respectively. Mean ± SD of WOMAC index in group A and group B were 60.85 ± 15.86 and 67.33 ± 16.33 minutes respectively. After treatment in both groups VAS, time taken to walk 50 feet and WOMAC index gradually decreased and ROM gradually increased.Conclusion: Although the study conducted with small sample size in a single centre in Dhaka city which may not be representative for the whole country it was found that there was statistically significant difference found in VAS, ROM, and time taken to walk 50 feet and WOMAC index between the groups.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 750-757


2018 ◽  
Vol 63 (No. 6) ◽  
pp. 279-286
Author(s):  
SY Heo ◽  
SJ Kim ◽  
NS Kim

The purpose of this prospective double blind clinical study was to evaluate the analgesic efficacy of meloxicam with/without a buprenorphine patch for pain management after ovariohysterectomy in cats. Cats were randomly divided into two groups: ten cats were treated with meloxicam s.c. after ovariohysterectomy (Group A), and eight cats were treated with s.c. meloxicam and a 20 µg/h buprenorphine transdermal patch (Group B). For patch treatment, the cat’s hair was clipped on the left side in the thoracic area. Pain scores were assessed at 0.5, 1, 2, 4, 6, 8, 24 and 30 h post-ovariohysterectomy extubation. To evaluate postoperative pain, 4A-VET pain scale and visual analogue scale pain scores were used. In addition, blood was collected from all cats to determine the cortisol levels at –2 h and at 0.5, 4, 6 and 24 h after extubation. The 4A-VET scores for Group B were significantly lower at 1, 4, 6, 8, 24 and 30 h than the scores for Group A. The visual analogue scale pain scores for Group B were significantly lower at 4, 6, 24 and 30 h than the scores for Group A. Serum cortisol concentrations were not significantly different between Groups A and B at any of the measured intervals. There was a significant positive correlation between postoperative visual analogue scale and 4A-VET pain scores in both groups. Our results should be subject to careful interpretation as the study was limited by its small sample size and by observer subjectivity.


2019 ◽  
Vol 70 (4) ◽  
pp. 1500-1506
Author(s):  
Romina Marina Sima ◽  
Dragos Albu ◽  
Antoniu Cringu Ionescu ◽  
Mihai Dimitriu ◽  
Mihai Popescu ◽  
...  

Visual analogue scale (VAS) is a psychometric scale applied to measure subjective characteristics. The purpose of our study was to evaluate the efficiency of Ulipristal acetate (UPA) compared with Dienogest for endometriomas related pain using VAS. We performed a randomized study on women with symptomatic endometriomas. The study was realized between January 2016�December 2018. The patients were randomized in two groups: Group A- that received UPA in doses of 5 mg daily for 12�13 weeks and Group B that received 2 mg Dienogest for 12�13 weeks. Each group received de VAS (Visual Analogue Scale) questionnaire before and after treatment. 70 women wereincluded in the study with 35 patients for each group. The age the mean age was 30.20 years. For Numeric Rating Scale before treatment in the group with UPA the median value was 6 (CI= 5.26, 6.51) and for group B the median was 5 (CI= 5.13, 5.66). After treatment for group A the median value was 4 (CI= 3.58, 4.29) and for group B the median value 4 (CI= 4.23, 4.6). For FRS before treatment in the group with UPA median value was 6 (CI= 5.87, 6.58) and for the group B median was 6 (CI= 6.16, 6.57). After treatment for group A the median value was 4 (CI= 4.12, 4.73) and for group B the median value 5 (CI= 4.9, 5.06). The pain significantly improved for group A. (p[ 0.05) VAS represent a good method to evaluate the quality of pain for patients with endometriomas. The UPA and Dienogest treatment improve the VAS parameters with better results for UPA in the present study.


Author(s):  
Dr. Sara Sultana ◽  
Dr. Braj Nandan Kumar Sah

Objectives: This present study was done to compare the tolerability and efficacy of tramadol versus aceclofenac in terms of WOMAC Osteoarthritis Index and Visual Analogue Scale of patients with osteoarthritis of knee joint. Methods: A detail history, clinical examinations and relevant investigations were performed to all cases of osteoarthritis of knee joint. Group A patients were advised to receive tramadol 75 mg twice daily for 8 weeks, and group B patients were advised to receive aceclofenac 100 mg twice daily for 8 weeks. And we had evaluated the WOMAC Osteoarthritis Index and VAS score of first day and last day visit of patients with osteoarthritis of knee joint. Results: Data was analyzed by using SPSS (version 26) software. Paired sample statistical methods were used. Mean and standard deviation was observed and mean differences were compared. P value was taken less than or equal to 0.05 (p≤0.05) for significant differences. Conclusions: This present study concluded that the WOMAC Osteoarthritis Index score and VAS score of patients who had received aceclofenac medication had statistically significant differences as well as greater mean differences than patients who received tramadol. Hence, aceclofenac is effective drugs than tramadol in terms of efficacy and tolerability of patients with osteoarthritis of knee joint. Key words: Osteoarthritis of knee, WOMAC osteoarthritis index, Visual Analogue Scale.


2018 ◽  
Vol 09 (01) ◽  
pp. 53-56
Author(s):  
Jamshed Ahmed ◽  
Syed Abrar Ali ◽  
Rizwan Jouhar ◽  
Haroon Shah

Objective: To compare the mean reduction in pain scores between Bonding agent (GLUMA® Comfort® Bond+ Desensitizer, and Fluoride varnish. Methodology: The study was conducted at Operative Dentistry, Department at Altamash Institute of Dental Medicine, Karachi from July 2015 to August 2016. Total 152 patients were selected. Patients were randomly allocated into two groups A and B. Gluma comfort bond plus desensitizer® was applied to the patients in group A and Duraphet® was applied to the patients in group B. Initial assessment was done after the application of the above products and thermal test was performed. The outcomes were based on a Visual Analogue Scale (VAS). Re-Evaluation was done again after 30 days of treatment in terms of mean reduction in pain from baseline by applying thermal test on visual analogue scale. Results: The average age of the patients was 37.4 ±8.38 years. After 30 days, mean Visual Analog Scale was significantly low in Group A i.e. 2.95±0.0.86 as compared to Group B i.e. 4.01±0.79(p=0.0005). Significant more reduction in mean pain score was observed in Bonding agent (Gluma desensitizer) as compared to Fluoride varnish Duraphat. Conclusion: In our study we found that bonding agent ( Gluma Desensitizer) is more effective in treating Dentine Hypersensitivity compared to fluoride varnish (Duraphat desensitizer group).


2018 ◽  
Vol 4 (1) ◽  
pp. 82-88
Author(s):  
Kiran Shakya ◽  
Sangita Shakya ◽  
Ram Prasad Pokhrel ◽  
Om Krishna Malla

Background Phacoemulsication under topical anesthesia makes a quickest visual recovery and reduces surgical time. Topical anesthesia with supplementary intracameral lidocaine may reduce some pain during iris manipulation or iris diaphragm movement.Objective To study the anesthetic efficacy of topical 0.5% proparacaine hydrochloride versus combined topical - intracameral 1% lidocaine injection during phacoemulsification surgery.Method Total 80 patients divided into A and B, each group having 40 patients was enrolled in this study. Phacoemulsification was performed on group A under topical anesthesia with proparacaine hydrochloride 0.5% and on group B under combined topical - intracameral injection of 0.5cc 1% lidocaine. Preoperatively, all patients received counseling about the potential intraoperative visual fear. Each patient was shown visual analogue scale 10 minutes after completion of surgery and was recorded their pain score. Unco-operative patients and previous history of ocular trauma were excluded.Results According to visual analogue scale, on group A, 30% felt no pain, 50% felt mild pain and 20% felt tolerable moderate pain (level 4) and on group B, 80% felt no pain and 20% felt mild pain. The group A perceived pain higher than group B (P <0.001). Mean operation time was 10 minutes. Most of the patients in A and B groups had no eye movement (Group A: 88% and Group B: 95%).Conclusions The combined topical proparacaine - intracameral injection of lidocaine anesthesia is better than topical proparacaine during phacoemulsification ensuring patients and surgeons comfort. Preoperative counseling helps the patients to focus on operating microscope light during surgery.


2004 ◽  
Vol 29 (1) ◽  
pp. 32-34 ◽  
Author(s):  
C. K. YIANNAKOPOULOS

This study investigated the effects of alkalinization and warming of lidocaine 1% on injection pain in patients undergoing carpal tunnel decompression. Sixty-four adult patients were randomly allocated into one of three groups: Group A ( n=20) received plain lidocaine 1%, Group B ( n = 22) alkalinized lidocaine and Group C ( n = 22) warmed and alkalinized lidocaine. Pain on needle insertion and on infiltration was assessed using a 100 mm Visual Analogue Scale (VAS). There was no significant difference regarding pain on needle insertion whereas significant differences were noted in reference to infiltration pain. In Groups B and C (alkalinized lidocaine) the VAS scores on skin infiltration were significantly lower than in Group A, while the pain score in Group C (alkalinized and warmed lidocaine) was significantly lower than in Group B.


2014 ◽  
Vol 13 (4) ◽  
pp. 269-274 ◽  
Author(s):  
Diana Gregoletto ◽  
Cruz Miguel Cendán Martínez

Objective: To analyse changes in the range of motion (ROM) and pain after spinal manipulation of the cervical spine and thoracic spine in subjects with mechanical neck pain. Methods : Spinal manipulations were performed in the cervical and thoracic spine with the Gonstead and Diversified DTV techniques. To assess cervical ROM an inclinometer was used. Cervical pain was assessed by Visual Analogue Scale (VAS). The participation of 73 patients was obtained. Ages ranged from 18 to 63 years, with an average of 42.27 years. The subjects of this study were characterized by having mechanical neck pain and restricted cervical ROM. Results: We observed a reduction in the intensity of pain perceived by patients and increased cervical ROM. There were significant differences between pre-treatment values (first visit) and the fifth and tenth visits (p&lt;0.01), and between the fifth and tenth visits (p&lt;0.01) in all parameters except in the cervical extension of 70&#186;. Conclusions: The results of this study suggest that spinal manipulation of the cervical and thoracic regions with the Gonstead and Diversified DTV techniques could subjectively reduce pain and produce considerable increase in cervical ROM in adults with mechanical neck pain.


2021 ◽  
Vol 6 (2) ◽  
pp. 289-298
Author(s):  
Nawal M Mulla ◽  
Parag Kulkarni ◽  
Ajay Kumar

Background: The most common form of neck pain is non-specific which is deep, dull aching & poorly localized. Non-specific pain is associated with upper trapezius tenderness. For people who work at desks and computers, or who spend many hours driving, have poor ergonomics which causes the upper trapezius to become sore and painful. The soreness can lead to the development of tender points which can be the major reason for developing neck pain and muscle spasm. Physiotherapy techniques like muscle energy technique and Strain counterstrain has been proposed to treat tenderness in trapezius. Objective: To compare the immediate effect of Strain Counterstrain Technique & Muscle Energy Technique on pain, pain pressure sensitivity & mobility on non-specific neck pain with upper trapezius tenderness using Visual analogue scale, Pressure Algometer & Universal Goniometer respectively. Method: 60 subjects were selected as per inclusion and exclusion criteria& were randomly assigned to Group A (n=30) & Group B (n=30); Strain Counterstrain and Muscle Energy Technique respectively. Visual Analogue Scale, Pain Pressure Sensitivity & Cervical Rotation & Lateral Flexion Motion bilaterally was noted before & after application of both techniques and the data was statistically analysed. Result: Both groups showed statistical significance (p< 0.05) differences in all outcome measures between pre test and post test values of Group A and Group B but there is no statistical significant (p> 0.05) difference in the outcome measures between groups. Conclusion: The study concludes that both techniques are equally effective in treating pain, increasing lateral flexion and rotation range of motion, and improving pain pressure sensitivity. Keywords: Strain Counterstrain, muscle energy technique, upper trapezius tenderness,visual analog scale, non-specific neck pain,pain pressures sensitivity.


Author(s):  
Rubab Jawed ◽  
Muhammad Fareed Nasir ◽  
Nabeel Naeem Baig ◽  
Maryam Younus ◽  
Ayesha Arshad ◽  
...  

Abstract Objective: To compare the effects of physiotherapy with and without manual therapy in the management of postural neck pain. Method: The randomised controlled trial was conducted at the Physiotherapy Department of South City Hospital, Karachi, from September 2017 to July 2018, and comprised subjects with >6 months of neck pain with no related medical dysfunction. The patients were enrolled by non-probability consecutive sampling technique and   randomly divided into Group A and Group B using computer-generated numbers. Group A received physiotherapy along with manual therapy, while Group B only had physiotherapy. Group A was also taught a home exercise programme. A printed exercise sheet was provided with frequency and repetition details. Visual analogue scale for pain intensity level and neck disability index were used to measure outcome at 3rd and 12th week. Data was analysed using SPSS 22. Results: Of the 60 subjects, there were 30(50%) in each of the two groups. The mean age in Group A was 32.77±7.44 years and it was 32.53±7.9 years in Group B. Overall, there were 21(35%) males and 39(65%) females. Significant reduction in pain intensity and neck disability levels at 3 and 12 weeks was noted compared to baseline (p<0.05). Inter-group comparison at final follow-up showed better Group A results compared to Group B (p<0.05). Conclusion: Physiotherapy with manual therapy was found to be better compared to physiotherapy alone. Key Words: Neck pain, Visual analogue scale, Neck disability index, Manual therapy, Exercise. Continuous...


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