scholarly journals KERION CELSI YANG DISEBABKAN OLEH TRICOPHYTON VERRUCOSUM PADA PASIEN IMUNOKOMPROMAIS

2019 ◽  
Vol 46 (1) ◽  
Author(s):  
Alfonsus Rendy Laksditalia N ◽  
Santosa Basuki
Keyword(s):  
Diabetes Mellitus ◽  
Trichophyton Verrucosum ◽  
Rating Score ◽  
Kerion Celsi ◽  
Numerical Rating ◽  
Terbinafine Hcl

Kerion celsi merupakan manifestasi inflamasi pada infeksi dermatofita zoofilik diskalp. Salah satu penyebabnya adalah Trichophyton verrucosum. Imunitas seluler pada pasien imunokompromais terganggu sehingga rentan terinfeksi dermatofita.Pria, 73 tahun mengeluh benjolan bernanah di kepala yang nyeri dan gatal sejak 3 bulan sebelum konsultasi. Pada pemeriksaan dermatologis parietal skalp didapatkan alopesia berbatas tegas dengan boggy eritematosa 5 cm dan pustul folikular. Pemeriksaan dengan lampu Wood tidak menunjukkan fluoresensi. Pemeriksaan mikroskopik dengan KOH 20% didapatkan hifa dan artrokonidia ektotriks. Numerical rating score (NRS) nyeri 8, dan gatal 4. Identifikasi kultur kerokan kulit kepala dan rambut menunjukkan Trichophyton verrucosum. Pasien didiagnosis kerion celsi ,diterapi dengan griseofulvin microsized 20 mg/kg berat badan/hari selama 8 minggu, dan prednison 0,5 mg/kg berat badan/hari selama 10 hari yang kemudian diturunkan perlahan. Ditambahkan krim terbinafine HCL 1 % didahului kompres basah dua kali sehari. Setelah 8 minggu, perbaikan NRS mencapai nol, tanpa efek samping.Kerion celsi seringkali terjadi pada anak, jarang pada dewasa. Pada kasus ini terjadi pada pasien neoplasma berusia lanjut dalam kemoterapi. Usia lanjut, kanker paru, kemoterapi geftinib, diabetes mellitus dan kontak langsung dengan hewan peliharaan merupakan faktor risiko kondisi imunokompromais dan inokulasi patogen sehingga mempermudah dermatofita menginvasi rambut.Kata kunci: kerion celsi, Tricophyton verrucosum, imunokompromais, griseofulvin

scholarly journals Predictors of hospital-based multidisciplinary rehabilitation effects in persons with multiple sclerosis: a large-scale, single-centre study

2019 ◽  
Vol 5 (2) ◽  
pp. 205521731984367 ◽  
Author(s):  
Elisabetta Groppo ◽  
Alessio Signori ◽  
Maria Pia Sormani ◽  
Cristina Grosso ◽  
Loredana La Mantia ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Barthel Index ◽  
Large Scale ◽  
Disease Duration ◽  
Female Gender ◽  
Baseline Score ◽  
Rating Score ◽  
Multidisciplinary Rehabilitation ◽  
Relapsing Remitting ◽  
Numerical Rating

Background Persons with multiple sclerosis may benefit from hospital-based multidisciplinary rehabilitation. Objectives To investigate the effects of hospital-based multidisciplinary rehabilitation and to identify their potential predictors in a large sample of persons with multiple sclerosis. Methods From the charts of 655 persons with multiple sclerosis consecutively admitted to our unit, disease profiles, modified Barthel index, Expanded Disability Status Scale (EDSS), pain numerical rating score and type of interventions were retrospectively collected. We defined an improvement at discharge as follows: modified Barthel index increase of at least 5 points, EDSS decrease of 1.0 if baseline score was 5.5 or less and of 0.5 if baseline score was greater than 5.5; any numerical rating score decrease. Results After a median admission period of 36 days, at discharge 65%, 22% and 89% of persons with multiple sclerosis improved for modified Barthel index, EDSS and numerical rating score, respectively. The modified Barthel index improvement was associated with shorter disease duration, lower EDSS at baseline and with access to psychological counselling. EDSS improvement was associated with shorter disease duration, relapsing–remitting course, female gender and longer duration of the admission period. Conclusions Inpatient multidisciplinary rehabilitation was associated with improved autonomy in activities of daily living in a relevant proportion of persons with multiple sclerosis. The effect seems to be more evident in individuals with shorter multiple sclerosis duration and relapsing–remitting disease course.

scholarly journals Associations of Healthcare Utilization and Costs with Increasing Pain and Treatment Intensity Levels in Osteoarthritis Patients: an 18-Year Retrospective Study

2021 ◽  
Author(s):  
Jove Graham ◽  
Tonia Novosat ◽  
Haiyan Sun ◽  
Brian J. Piper ◽  
Joseph A. Boscarino ◽  
...  
Keyword(s):  
Healthcare Utilization ◽  
Complex Disease ◽  
Emergency Department Visits ◽  
Treatment Intensity ◽  
Linear Regression Models ◽  
Rating Score ◽  
Pain Scores ◽  
Outpatient Visits ◽  
Numerical Rating ◽  
Ed Visits

Abstract BackgroundOsteoarthritis (OA) is a complex disease, and prior studies have documented the health and economic burdens of patients with OA compared to those without OA. Our goal was to use two strategies to further stratify OA patients based on both pain and treatment intensity to examine healthcare utilization and costs using electronic records from 2001-2018 at a large integrated health system. Methods Adult patients with ≥1 pain numerical rating score (NRS) and diagnosis of OA were included. Pain episodes of ≥90 days were defined as mild (0-3), moderate (4-6) or severe (7-10) based on initial NRS. Patients were initially classified as mild and moved to moderate-severe OA if any of eight treatment-based criteria were met. Outpatient visits (OP), emergency department visits (ED), inpatient days, and healthcare costs (both all-cause and OA-specific) were compared among pain levels and OA severity levels as frequencies and per-member-per-year rates, using generalized linear regression models adjusting for age, sex and body mass index, with contrasts of p<0.05 considered significant. ResultsWe identified 127,656 patients, 92,576 with pain scores. Moderate and severe pain were associated with significantly higher rates of OA-related utilization and costs, and all-cause ED visits and pharmacy costs. Moderate-severe OA patients had significantly higher OA-related utilization and costs, and all-cause OP, ED and pharmacy costs. ConclusionsPain and treatment intensity were both strongly associated with OA-related resource utilization but not consistently with all-cause utilization. With better understanding of how OA patients intensify services, thus increasing costs, we can deploy targeted preventative strategies aimed at halting progression into more costly phases of the disease.

scholarly journals Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

2019 ◽  
Author(s):  
Sasikaan Nimmaanrat ◽  
Manasanun Jongjidpranitarn ◽  
Sumidtra Prathep ◽  
Maliwan Oofuvong
Keyword(s):  
Placebo Group ◽  
Intravenous Injection ◽  
Controlled Trial ◽  
Injection Pain ◽  
Rating Score ◽  
Double Blind ◽  
Randomized Controlled ◽  
Numerical Rating ◽  
Injection Methods ◽  
Different Doses

Abstract Background: To compare the effect of premedication with 2 different doses of oral paracetamol to prevent pain at propofol intravenous injection. Methods: We conducted a double-blind randomized controlled trial in which patients scheduled for induction of general anesthesia with intravenous propofol received either a placebo, 500 mg or 1000 mg of oral paracetamol (P500 and P1000, respectively) 1 hr prior to induction. Two mg/kg of propofol was injected at a rate of 600 ml/hr. After 1/4 of the full dose had been injected, the syringe pump was paused, and patients were asked to rate pain at the injection site using a verbal numerical rating score (VNRS) from 0-10. Results: Three hundred and twenty-four patients were included. Pain intensity was lower in both P500 and P1000 groups (median VNRS [interquartile range] = 2 [0-3] and 4 [2-5], respectively) than in the placebo group (8 [7-10]; P<0.001)*. The rate of pain was lower in the P1000 group (70.4%) than in both the P500 and the placebo group (86.1% and 99.1%, respectively; P<0.001)*. The respective rates of mild (VNRS 1-3), moderate (VNRS 4-6) and severe pain (VNRS 7-10) were 47.2, 23.2 and 0% in the P1000 group, 28.7, 50 and 7.4% in the P500 group, and 0, 22.2 and 76.9% in the placebo group (P<0.001* for between group comparisons). Tolerance was similar in the 3 groups. Conclusions: A premedication with oral paracetamol can dose-dependently reduce pain at propofol intravenous injection. To avoid this common uncomfortable concern for the patients, this well-tolerated, available and cheap treatment appears as an option to be implemented in the current practice.

scholarly journals Musculoskeletal complications of diabetes post COVID-19

2021 ◽  
Vol 9 (1) ◽  
pp. 263
Author(s):  
Vijay Krishna Kumar A. K. ◽  
Ashwini Ganesan ◽  
Suruthi Raju
Keyword(s):  
Diabetes Mellitus ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Severe Disease ◽  
Multiple Organ ◽  
Organ System ◽  
Disease Course ◽  
Analog Scale ◽  
Patients With Diabetes ◽  
Numerical Rating

Background: COVID-19 is an emerging disease caused by the severe respiratory syndrome. This affects the respiratory system but directly or indirectly affects the multiple organ system, including the musculoskeletal system. The patients with diabetes who get COVID are at risk of a severe disease course and mortality.Methods: The study design is Observational study. The study will be conducted on 30patients who have recovered from covid-19 with diabetes mellitus. The samples of the study are selected randomly. The data will be collected in a non-homogenous way, especially regarding lifestyle habits, and severity of the illness. Myalgia was calculated by numerical rating scale, Arthralgia was calculated by visual analog scale, and fatigue was calculated by Chalder fatigue scale to assess the severity of fatigue.Results: The severity of the complication was decreased in patients with second month COVID-19 recovery than in the first month.Conclusions: Background: COVID-19 is an emerging disease caused by the severe respiratory syndrome. This affects the respiratory system but directly or indirectly affects the multiple organ system, including the musculoskeletal system. The patients with diabetes who get COVID are at risk of a severe disease course and mortality.Methods: The study design is Observational study. The study will be conducted on 30patients who have recovered from covid-19 with diabetes mellitus. The samples of the study are selected randomly. The data will be collected in a non-homogenous way, especially regarding lifestyle habits, and severity of the illness. Myalgia was calculated by numerical rating scale, Arthralgia was calculated by visual analog scale, and fatigue was calculated by Chalder fatigue scale to assess the severity of fatigue.Results: The severity of the complication was decreased in patients with second month COVID-19 recovery than in the first month.Conclusions: This study concluded that there is decrease in the severity of musculoskeletal complications in diabetic patients from 1st month to 2nd month COVID-19 recoveries. 

scholarly journals Peripheral administration of selective GlyT2 inhibitor, oleoyl-D-lysine, is analgesic in neuropathic but not acute or inflammatory pain models in mice

2021 ◽  
Author(s):  
Bruce Wilson ◽  
Julian Peiser-Oliver ◽  
Alexander Gillis ◽  
Sally Evans ◽  
Claudia Alamein ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Side Effects ◽  
Respiratory Depression ◽  
Side Effect ◽  
Inflammatory Pain ◽  
Rating Scale ◽  
Lethal Dose ◽  
Whole Body ◽  
Rating Score ◽  
Numerical Rating

Background and Purpose: Changes to spinal glycinergic signalling are a feature of pain chronification. Normalising those changes by inhibiting glycine transporter-2 (GlyT2) is a promising treatment strategy. However, existing GlyT2 inhibitors e.g. ORG25543 are limited by narrow therapeutic windows and severe dose-limiting side effects such as convulsions, and are therefore poor candidates for clinical development. Experimental Approach: Analgesic and side-effect properties of intraperitoneally administered oleoyl-D-lysine, a lipid-based GlyT2 inhibitor, were characterised in mice. Analgesia was assessed in models of chronic neuropathic and inflammatory pain via the von Frey test, and acute nociception via hotplate. Side effects were scored via numerical rating scale, convulsions score, the Rotarod test and whole-body plethysmography for respiratory depression. Key Results: Oleoyl-D-lysine produced significant analgesia/anti-allodynia in the model for chronic neuropathic pain but not for chronic inflammatory or acute pain. No side effects were seen at the peak analgesic dose, 30 mg kg-1. Mild side effects were observed at the highest dose, 100 mg kg-1, in the numerical rating score, but no convulsions. These results contrasted markedly with ORG25543, which produced significant analgesia only at the lethal or near-lethal dose of 50 mg kg-1. At this dose, ORG25543 caused severe side effects on the numerical rating score, severe convulsions, and Rotarod impairment. Oleoyl-D-lysine (30 mg kg-1) did not cause any respiratory depression, a problematic side effect of opiates. Conclusions and Implications: Oleoyl-D-lysine safely and effectively reverses neuropathic pain in mice. GlyT2 inhibitors may be better suited to treating pain of neuropathic origin over other pain aetiologies.

scholarly journals Premedication with Oral Paracetamol for Reduction of Propofol Injection Pain: A Randomized Placebo-Controlled Trial

2019 ◽  
Author(s):  
Sasikaan Nimmaanrat ◽  
Manasanun Jongjidpranitarn ◽  
Sumidtra Prathep ◽  
Maliwan Oofuvong
Keyword(s):  
Placebo Group ◽  
Intravenous Injection ◽  
Controlled Trial ◽  
Injection Pain ◽  
Rating Score ◽  
Double Blind ◽  
Randomized Controlled ◽  
Numerical Rating ◽  
Injection Methods ◽  
Different Doses

Abstract Background: To compare the effect of premedication with 2 different doses of oral paracetamol to prevent pain at propofol intravenous injection. Methods: We conducted a double-blind randomized controlled trial in which patients scheduled for induction of general anesthesia with intravenous propofol received either a placebo, 500 mg or 1000 mg of oral paracetamol (P500 and P1000, respectively) 1 hr prior to induction. Two mg/kg of propofol was injected at a rate of 600 ml/hr. After 1/4 of the full dose had been injected, the syringe pump was paused, and patients were asked to rate pain at the injection site using a verbal numerical rating score (VNRS) from 0-10. Results: Three hundred and twenty-four patients were included. Pain intensity was lower in both P500 and P1000 groups (median VNRS [interquartile range] = 2 [0-3] and 4 [2-5], respectively) than in the placebo group (8 [7-10]; P<0.001)*. The rate of pain was lower in the P1000 group (70.4%) than in both the P500 and the placebo group (86.1% and 99.1%, respectively; P<0.001)*. The respective rates of mild (VNRS 1-3), moderate (VNRS 4-6) and severe pain (VNRS 7-10) were 47.2, 23.2 and 0% in the P1000 group, 28.7, 50 and 7.4% in the P500 group, and 0, 22.2 and 76.9% in the placebo group (P<0.001* for between group comparisons). Tolerance was similar in the 3 groups. Conclusions: A premedication with oral paracetamol can dose-dependently reduce pain at propofol intravenous injection. To avoid this common uncomfortable concern for the patients, this well-tolerated, available and cheap treatment appears as an option to be implemented in the current practice.

scholarly journals Imagined Examples of Painful Experiences Provided by Chronic Low Back Pain Patients and Attributed a Pain Numerical Rating Score

2020 ◽  
Vol 13 ◽  
Author(s):  
Robert S. Griffin ◽  
Maria Antoniak ◽  
Phuong Dinh Mac ◽  
Vladimir Kramskiy ◽  
Seth Waldman ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Rating Score ◽  
Numerical Rating ◽  
Pain Patients

scholarly journals Marital Relationship and Quality of Life in Couples Following Hip Replacement Surgery

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 401
Author(s):  
Michael Tanzer ◽  
Christopher Pedneault ◽  
Esther Yakobov ◽  
Adam Hart ◽  
Michael Sullivan
Keyword(s):  
Quality Of Life ◽  
Hip Replacement ◽  
Marital Relationship ◽  
Rating Score ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Before And After ◽  
Numerical Rating ◽  
Patient’S Perception

For the majority of patients with osteoarthritis, total hip (THA) arthroplasty results in a significant reduction in pain, emotional distress, and disability and a significant improvement in their quality of life. Little is known about how these recovery-related changes impact the spouse or the marital relationship. Methods: Twenty-nine couples whose spouse underwent a THA (29 THA) participated in a semi-structured retrospective interview designed for this study. They were each asked to recall the level of pain before and after surgery and to provide a numerical rating score for questions pertaining to the level of disability in seven different activities of daily living. Couples were also asked to list in order of importance the five ways in which the surgery affected their overall quality of life. Results: The spouses estimated their partner’s pain, both pre- and postoperatively, to be significantly higher level than the patient’s perception. The spouses perceived a greater improvement in family/home responsibilities, recreation and social activities, and in their occupation than that noted by the partner. After the arthroplasty, the spouses indicated that their lives had improved with respect to doing more activities/leisure (72%), because their partner had less suffering (59%), they had more independence/less caregiving (55%), it improved their marital relationship (52%), they had a better social/family life (28%), and they were able to travel (28%). Conclusions: This study indicates that THA result in a significant improvement in quality of life not only for the patients, but also for their spouses.

scholarly journals Premedication with parecoxib sodium for reduction of propofol injection pain: a randomized placebo-controlled trial

2020 ◽  
Author(s):  
xiaoxia gu ◽  
Weiming Huang ◽  
Jingjing Wang ◽  
Yue Lu ◽  
Jinxian Chen ◽  
...  
Keyword(s):  
Placebo Group ◽  
Intravenous Injection ◽  
Controlled Trial ◽  
Injection Pain ◽  
Rating Score ◽  
Double Blind ◽  
Randomized Controlled ◽  
Numerical Rating ◽  
Injection Methods ◽  
Different Doses

Abstract Background To compare the effect of premedication with two different doses of parecoxib sodium to prevent pain at propofol intravenous injection. Methods We conducted a double-blind randomized controlled trial in which patients scheduled for induction of general anesthesia with intravenous propofol received either a placebo, 20 mg or 40 mg of parecoxib sodium (P20 and P40, respectively) 30min prior to induction. 2mg/kg of propofol was injected at a rate of 600 ml/hr. After 1/4 of the full dose had been injected, the syringe pump was paused, and patients were asked to rate pain at the injection site using a verbal numerical rating score (VNRS) from 0 to 10. Results Three hundred and twenty-four patients were included. Pain intensity was lower in both P20 and P40 groups (median VNRS [interquartile range] = 2 [0–3] and 4 [3–6], respectively) than in the placebo group (8 [7–10]; P < 0.001)*. The rate of pain was lower in the P40 group (62.9%) than in both the P20 and the placebo group (87.0 and 98.2%, respectively; P < 0.001)*. The respective rates of mild (VNRS 1–3), moderate (VNRS 4–6) and severe pain (VNRS 7–10) were 46.1, 22.3 and 0% in the P40 group, 29.7, 55.4 and 8.5% in the P20 group, and 0, 24.2 and 77.8% in the placebo group (P < 0.001* for between group comparisons). Tolerance was similar in the 3 groups. Conclusions A premedication with parecoxib sodium can dose-dependently reduce pain at propofol intravenous injection. To avoid this common uncomfortable concern for the patients, this well-tolerated, available and cheap treatment appears as an option to be implemented in the current practice.

scholarly journals COMPARISON OF PAIN RELIEF EFFICACY OF PLATELET-RICH PLASMA VERSUS CORTICOSTEROIDS IN KNEE OSTEOARTHRITIS

2021 ◽  
Vol 71 (5) ◽  
pp. 1764-68
Author(s):  
Amir Sohail ◽  
Ameer Yasser Zaid ◽  
Shizan Hamid Feroz ◽  
Mohammed Saeed ◽  
Syed Khurram Naseer ◽  
...  
Keyword(s):  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Platelet Rich Plasma ◽  
Corticosteroid Injection ◽  
Numeric Rating Scale ◽  
Rating Score ◽  
Numerical Rating ◽  
Group A ◽  
Group B

Objective: To compare the pain relief efficacy of platelet rich plasma injection with corticosteroid injection in knee osteoarthritis using numeric rating scale. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia and Pain Management, Combined Military Hospital Peshawar, from Jan 2018 to Dec 2019. Methodology: Total of 310 patients who underwent knee injection for osteoarthritis were included in this study. Patients were divided into two groups; group A and group B comprising of 155 patients each. Patients in group ‘A’ received intra articular corticosteroid injection while patients in group ‘B’ received intra articular platelet rich plasma injection for knee osteoarthritis. Pain assessment via numerical rating score was done at the start of the treatment and at 6 months. Results: In group A female to male ratio was 2.69:1 while in group B the female to male ratio was 2.78:1. Mean age of ‘group A’ was 58.52 ± 11.87 years and that of ‘group B’ was 58.79 ± 11.15 years. Numerical rating score pre-treatment in ‘group A’ vs ‘group B’ was 8.35 ± 1.17 vs 8.42 ± 1.14. While numeric rating scale post treatment in ‘group A’ vs ‘group B’ was 5.74 ± 1.37 vs 4.06 ± 1.19, respectively with p-value of 0.001, which is statistically significant. Conclusion: Patients who received intra-articular platelet rich plasma had significantly more pain relief as compared to patients who received intra-articular steroid on numerical rating score.

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