Enteral diclofenac controls pain and reduces intravenous injection during extracorporeal shock wave lithotripsy

Urinary system stones are the third most common disease of urinary system following urinary infection and prostate pathology. Extracorporeal shockwave lithotripsy (ESWL) is one of the methods used to treat Urolithiasis where shockwaves are transmitted through skin and body organs and crush the stones into small pieces. This is a painful procedure which usually requires analgesics. Each analgesic drug has its own advantages and disadvantages. The present research seeks to study the effectiveness of using diclofenac suppository in order to control pain and reduce need for venous drugs during ESWL procedure. This is a double blind clinical trial. 158 patients resorting to Shahid Hasheminezhad Specialized Center for ESWL were randomly selected to take part in this projects with due consideration of inclusion criteria. The patients were equally divided into the S (diclofenac suppository) and A (placebo) groups. 2 diclofenac suppositories were used in the S group 20 minutes prior to beginning ESWL. Then, ESWL was carried out in supine position using fluoroscopic conduction with standard method. The present research has studied pain scale of patients, operator’s and patient’s satisfaction during the operation and patient’s hemodynamic parameters in three phases prior to, during, and after ESWL. SPSS v.17 was used to study the data and Chi-Square Tests and Repeated Measure ANOVA were used to analyze the results. The level of significance in the present research was set to P-value<0.05.A review of pain scales across both groups showed that using diclofenac suppository has a significant influence in reducing the pain scale and, hence, need for venous drugs (P-value<0.05). No significant difference was observed between the two groups in terms of heart beat and blood pressure changes in various times (P-value>0.05). The results also report different satisfaction levels for patients and operators across the two groups (diclofenac suppository and placebo) (P-value<0.05). Higher satisfaction levels were observed among both patients and operators in the group receiving diclofenac suppository. A general look at the data yields the conclusion that receiving pain killers (diclofenac suppository) before starting ESWL plays a more efficient role in reducing pain scales of patients and enhancing operators’ satisfaction.

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Effectiveness of Distraction Therapy on Pain Relief among Children Undergoing Vein-Puncture in a Selected Hospital, Bhubaneswar

Journal of Advanced Research in Medicine ◽

10.24321/2349.7181.202008 ◽

2020 ◽

Vol 07 (02) ◽

pp. 15-21

Author(s):

Soumika Debnath ◽

Keyword(s):

Intervention Group ◽

Sampling Technique ◽

Pain Scale ◽

Control Group ◽

P Value ◽

Double Blind ◽

Significant Difference ◽

Post Test ◽

And Control ◽

Experimental Group

Aim: The present study is aimed to assess the effect of distraction therapy during venipuncture in reducing pain among 6-12 years children in the selected hospital at Bhubaneswar. Methods: The study was a double blind; Randomized control trial design was used and the formal consent was obtained from Pradyumna Bal Memorial Hospital and the investigator selected 182 samples using consecutive sampling technique and then randomized into experimental and control groups. The intervention group and the control were having 91 samples each. Measurement of pain experienced by the school going children was assessed with the help of Wong-Baker Faces Pain Scale. Descriptive and inferential statistics were used to analyze the data. Result: The mean pain score of children in experimental group was 2.571 and the standard deviation was 2.006. The p value in comparing the pain level of children in control and experimental group was <0.01, which was statistically significant at p<0.05 (confidence interval 95%) level indicating that there was significant difference in the post test level of pain between the experimental and control group. Conclusion: Hence the distraction therapy was responsive in reducing the vein-puncture pain among school going children.

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Clinical Efficacy in Relieving Dentin Hypersensitivity of Nanohydroxyapatite-containing Cream: A Randomized Controlled Trial

The Open Dentistry Journal ◽

10.2174/1874210601812010572 ◽

2018 ◽

Vol 12 (1) ◽

pp. 572-585 ◽

Cited By ~ 4

Author(s):

Bennett T. Amaechi ◽

Kelly C. Lemke ◽

Shyamali Saha ◽

Jonathan Gelfond

Keyword(s):

Controlled Trial ◽

Pain Scale ◽

Positive Control ◽

Dentin Hypersensitivity ◽

Double Blind ◽

Pure Silica ◽

Parallel Group ◽

Pain Scales ◽

Significant Difference ◽

Time Point

Objective:The study aimed to investigate the effectiveness of Apadent Pro (Sangi) Nanohydroxyapatite (nHAP) dental cream to relieve Dentin Hypersensitivity (DHS), compared with a positive control cream containing 20% pure silica (Silica).Methods:In this double-blind, randomized, parallel-group clinical trial, patients diagnosed with DHS and qualified to participate were randomized into two groups, nHAP (n=25) and Silica (n=26). Subjects’ baseline and posttreatment sensitivity were assessed using two pain scales, a four-point Dental Pain Scale (DPS) followed by a linear Visual Analog Scale (VAS), after the application of ice-cold and air stimuli. Subjects used custom-fabricated trays to apply their respective cream for 5 minutes once daily following brushing with standard fluoride toothpaste. Posttreatment sensitivity (efficacy) was assessed every 2 weeks for 8 weeks. Mean treatment outcomes (percentage change from baseline) at each time point were compared using the Tukey HSD test for multiplicity (P<0.05).Results:With either air or cold stimulus, VAS and DPS indicated a significant (P<0.001) reduction in DHS at each time point with either nHAP or Silica. Comparing pain scales, VAS showed no significant difference in DHS reduction between the products with either air or cold. However, with DPS, DHS reduction was significantly (P<0.05) better with Silica than with nHAP at all time points with cold, and at 2, 4, and 8 weeks with air.Conclusion:Both Apadent Pro nHAP and Silica dental creams are effective at promoting the relief of DHS symptoms. When comparing the efficacy of the two compounds to relieve DHS, results of the two pain scales were conflicting.

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Topical Diltiazem Versus Topical Glyceryl Trinitrate In The Management Of Chronic Anal Fissure

JMS SKIMS ◽

10.33883/jms.v17i2.241 ◽

2014 ◽

Vol 17 (2) ◽

pp. 55-58

Author(s):

Shams Ul Bari ◽

Ajaz Ahmad Malik ◽

Khurshid Alam Wani ◽

Ajaz A Rather

Keyword(s):

Side Effects ◽

Anal Fissure ◽

Chronic Anal Fissure ◽

P Value ◽

Double Blind ◽

Surgical Methods ◽

Significant Difference ◽

Topical Glyceryl Trinitrate ◽

One Year

Background: Chemical sphincterotomy is a novel way for treating patients of chronic anal fissure which avoids the risk of fecal incontinence associated with traditional surgical methods. Aims and objectives: The aim of this study was to compare the results of topical Diltiazem with topical Glyceril trinitrate in the management of chronic anal fissure. Methods: 71 patients in the age group of 15 - 61 years with chronic anal fissure were included in this prospective, randomized, double-blind trial over a period of two years with further follow up for one year. The patients were randomly allocated to either Diltiazem gel 2% (37 patients) or Glyceril trinitrate ointment 0.2% (34 patients) and were asked to use the treatment twice daily for 8 weeks. Each patient was reviewed every two weeks. Symptoms, healing, side effects and recurrence were compared using SPSS version 10 employing X2 test. A p-value below 0.05 was considered statistically significant. Results: Patients who received topical diltiazem (DTZ) showed statistically significant difference than those who were prescribed topical glyceril trinitrate in terms of symptoms, wound healing, side effects ( headaches) and recurrence (p=0.03 and 0.003 respectively). Healing occurred in 34 of 37 (92%) patients treated with Diltiazem after 6 weeks and 27 of 34 (80%) patients treated with Glyceril trinitrate after 8 weeks, which shows a significant difference in favour of Diltiazem (P < 0.001). The rest of the patients did not heal and underwent sphincterotomy (SILS). Headache occurred in all of the patients treated with Glyceril trinitrate but none of the patients treated with Diltiazem. Conclusion: Diltiazem gel was found to be better than Glyceril trinitrate ointment due to significantly higher healing rate and fewer side-effects. JMS 2014;17(2):55-58

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The Effect of Extract Supplements of Moringa Oleifera Leaves Plus Royal Jelly on Hemoglobin (Hb) Levels of Anemia Pregnant Mother in Takalar Regency

International Journal Papier Advance and Scientific Review ◽

10.47667/ijpasr.v1i2.31 ◽

2020 ◽

Vol 1 (2) ◽

pp. 22-29

Author(s):

Yulni Yulni ◽

Veni Hadju ◽

Burhanuddin Bahar ◽

Citrakesumasari Citrakesumasari ◽

Rahayu Indriasari ◽

...

Keyword(s):

Pregnant Women ◽

Leaf Extract ◽

Moringa Oleifera ◽

Royal Jelly ◽

P Value ◽

Double Blind ◽

Significant Difference ◽

Before And After ◽

The Difference ◽

Double Blind Design

The aim of this study was to determine the effect of Moringa oleifera leaf extract supplements, Moringa oleifera leaf extract plus royal jelly and placebo on hemoglobin levels in anemic pregnant women. This research is a randomized controlled double blind design study which was conducted in Polombangkeng Utara District, Takalar Regency for 2 months. The subjects of this study were pregnant women with anemia, the majority of which were 20-35 years old, primigravida parity, income less than UMR, unemployment, higher education, pregnancy distance of more than 2 years with p value> 0.05. Then divided into three groups, namely Moringa capsules plus royal jelly (KRJ) (n = 24), Moringa capsules (KTR) (n = 24) and placeco (PLC) (n = 21). Before and after the intervention, measurements of hemoglobin levels were carried out using the Hemocue tool and interviewing the characteristics of the respondents. The results showed that the average Hb level increased from each group (mean SD): KRJ 10.06 ± 0.75 to 11.42 ± 1.23, P = 0.001, KTR 10.40 ± 0.46 to 11.15 ± 0 , 90 P = 0.001 and PLC 10.43 ± 0.42 becomes 11.14 ± 0.88 P = 0.002. but there was no significant difference from the difference in the average increase in Hb levels in the three groups, but there was a tendency that KRJ was superior to the KTR and PLC groups with an increase of 1.36 gr / dl, KTR 0.75 gr / dl and PLC 0.71 gr / dl. So it can be concluded that KRJ is better than KTR and PLC in increasing Hb levels in anemic pregnant women in Takalar Regency.

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A double-blind randomized placebo-controlled study of low dose mirtazapine once daily in patients of major depressive disorders on escitalopram

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191602 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1067

Author(s):

Mallikarjuna Rao I. ◽

Usha Kiran Prayaga ◽

Dharma Rao Uppada ◽

Ramachandra Rao E. ◽

B. L. Kudagi

Keyword(s):

Depressive Disorders ◽

Low Dose ◽

Rating Scale ◽

Controlled Study ◽

P Value ◽

Chi Square ◽

Double Blind ◽

Increased Risk ◽

Significant Difference ◽

Chi Square Test

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression.

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Double-Blind Trial Comparing Epidural Lignocaine with Epidural Fentanyl for Anaesthesia during Extracorporeal Shock Wave Lithotripsy

Anaesthesia and Intensive Care ◽

10.1177/0310057x8901700104 ◽

1989 ◽

Vol 17 (1) ◽

pp. 9-15 ◽

Cited By ~ 3

Author(s):

B. S. Silbert ◽

R. Kluger ◽

A. C. Meads ◽

K. Stasytis

Keyword(s):

Shock Wave ◽

Extracorporeal Shock Wave Lithotripsy ◽

Shock Wave Lithotripsy ◽

Epidural Fentanyl ◽

Double Blind Trial ◽

Double Blind ◽

Blind Trial ◽

Extracorporeal Shock Wave ◽

Significant Difference ◽

Fentanyl Group

A randomised double-blind trial was undertaken to compare epidural lignocaine 1.5% with adrenaline to epidural fentanyl (100μg in saline 10 ml) in forty unpremedicated patients undergoing extracorporeal shock wave lithotripsy without ancillary procedures. Midazolam only was used for sedation. There was no significant difference in intraoperative pain scores with several patients in each group complaining of pain. Decreases in blood pressure occurred in both groups but were more pronounced in the lignocaine groups (36% vs 25 % maximum decrease from control, P = 0.004). Heart rate was increased in the lignocaine group compared with control and to the fentanyl group, but there was no difference in respiratory rates within or between groups. Pruritis was more common in the fentanyl group and leg heaviness in the lignocaine group, but neither was troublesome. There was no difference in urological outcome at one month. Both techniques were satisfactory for the majority of patients, but the fentanyl group had a shorter preparation time and less cardiovascular changes.

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A Multicenter, Prospective, Randomized, Placebo-Controlled, Double-Blind Study of a Novel Pain Management Device, AT-02, in Patients with Fibromyalgia

Pain Medicine ◽

10.1093/pm/pnz064 ◽

2019 ◽

Vol 21 (2) ◽

pp. 326-332 ◽

Cited By ~ 1

Author(s):

Hiroshi Oka ◽

Kenji Miki ◽

Iwao Kishita ◽

David F Kong ◽

Takahiro Uchida

Keyword(s):

Rating Scale ◽

Numerical Rating Scale ◽

Repeated Measure ◽

Controlled Clinical Trial ◽

Double Blind Study ◽

Double Blind ◽

Point Change ◽

Entire Treatment Period ◽

Magnetic Field Therapy ◽

Significant Difference

Abstract Objectives Existing treatments for fibromyalgia have limited efficacy, and only a minority of individuals clinically respond to any single intervention. This study was a prospective, multicenter, randomized, double-blind, controlled clinical trial to evaluate the feasibility of alternating magnetic field therapy in fibromyalgia patients by comparing the Angel Touch device (AT-02) with a sham control (S-01). Methods Two sites enrolled 44 subjects with diagnosed fibromyalgia. After informed consent, subjects taking prohibited concomitant drugs underwent a washout period of two or more weeks. All subjects then began a one-week run-in period. Numerical rating scale (NRS) pain scores were collected without device intervention for one day, followed by S-01 application to four or more painful sites for 10 minutes at each site, twice daily for six days. Subjects were then randomized to AT-02 or S-01, applied to four or more painful sites for 10 minutes at each site, twice daily for eight weeks. NRS scores were obtained twice daily during the entire treatment period. Results The primary end point (change in NRS ± SD at week 8 vs baseline) was –0.94 ± 1.33 in the AT-02 group and –0.22 ± 1.38 in the S-01 group. A trend toward a between-group difference in eight-week NRS scores favored the AT-02 group (–0.73, 95% confidence interval = –1.56 to 0.11, P = 0.086). An adjusted repeated measure analysis detected a significant difference in NRS scores (P = 0.039). Conclusions The reduction in NRS scores for AT-02 relative to sham was comparable to reductions observed in meta-analyses of fibromyalgia drug therapy. The unadjusted results and the persistence of the pain score reductions remain encouraging.

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Effect of Chinese Propolis as an Intracanal Medicament on Post-Operative Endodontic Pain: A Double-Blind Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17020445 ◽

2020 ◽

Vol 17 (2) ◽

pp. 445 ◽

Cited By ~ 3

Author(s):

Juzer Shabbir ◽

Fazal Qazi ◽

Waqas Farooqui ◽

Shahbaz Ahmed ◽

Tazeen Zehra ◽

...

Keyword(s):

Calcium Hydroxide ◽

Controlled Trial ◽

Repeated Measure ◽

P Value ◽

Time Intervals ◽

Pain Scores ◽

Significant Difference ◽

Bonferroni Test ◽

The Impact ◽

Chinese Propolis

Propolis is a potent anti-microbial and natural anti-inflammatory by-product obtained from the beehive. Studies have demonstrated the superior biocompatibility and anti-microbial properties of propolis as compared to calcium hydroxide. However, its effect on postoperative endodontic pain is unknown. Therefore, this study aimed to investigate the impact of Chinese propolis paste as an intracanal medicament on postoperative endodontic pain intensities compared with calcium hydroxide (control) at different time intervals in necrotic teeth with periapical radiolucency. Eighty patients with single-rooted necrotic teeth with visible periapical radiolucency were recruited and randomly allocated to either the calcium hydroxide or propolis groups. After chemo-mechanical preparation and intracanal medicament insertion, patients were given the VAS (visual analogue scale) to record pain scores. Inter-group data were compared and analyzed using two-way repeated measure ANOVA (Bonferroni test). A p-value of < 0.025 was considered significant. In total, >78% of the patients experienced no or only mild post-operative pain in both the groups at all time intervals, without any significant difference in pain scores between the two groups (p > 0.025). An overall flare-up rate of 14.8% was found. The results suggest that either of these medicaments can be used as an inter-appointment medication for the prevention of postoperative pain in necrotic cases.

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The Effect of Methylphenidate on Reed Scaling in Benzodiazepine Poisoning: A Prospective Trial

Current Clinical Pharmacology ◽

10.2174/1574884714666190112153157 ◽

2020 ◽

Vol 15 (1) ◽

pp. 81-88

Author(s):

Masoud Latifi-Pour ◽

Hossein Hassanian-Moghaddam ◽

Helya-Sadat Mortazavi ◽

Shahin Shadnia ◽

Nasim Zamani ◽

...

Keyword(s):

Controlled Trial ◽

Prospective Trial ◽

Laboratory Data ◽

Age Groups ◽

Acute Poisoning ◽

P Value ◽

Poison Center ◽

Double Blind ◽

Laboratory Confirmation ◽

Significant Difference

Background: Benzodiazepine is one of the most important causes of substance abuse and intoxication throughout the world and Iran. Objective: The aim of our study is to determine the role of stimulants in reversing CNS level in acute Benzodiazepine poisoning patients who were hospitalized at referral poison center. Methods: This was a randomized double-blind placebo-controlled trial study on 32 cases with pure acute Benzodiazepine poisoning from March 2016 to February 2017. Diagnosis of pure acute poisoning was based on history, and laboratory confirmation. We gathered the demographics, clinical data, laboratory data, hospitalization and outcome. Participants were randomized into two groups: Methylphenidate Group (MPH) and Placebo Group (PBO). Results: The randomized sample consisted of 32 participants who were predominately female (83%). The majority of the PBO group and the MPH group reported improvement in their consciousness with a significant difference between the two groups (p = .005). Paired sample t-test analyses on Reed Scale data revealed an increase in the probability of improvement during the trial for the MPH group compared to the PBO group. Furthermore, the HCo3 (bicarbonate) level has a significant p-value with respect to age groups (p = .02). None of our cases required either the ICU facility or intubation. Conclusion: Our study provided the MPH superiority over PBO in reversing CNS symptoms in loss of consciousness in acute BZD poisoned patients. Thus, this trial provides concrete evidence that improvement in consciousness levels (Reed Scale rated) among those patients receiving MPH was associated with a methylphenidate use.

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Effects of Bupropion on Cognitive Function in Schizophrenia: A Double Blind Randomized Controlled Trial

Global Journal of Health Science ◽

10.5539/gjhs.v9n5p67 ◽

2016 ◽

Vol 9 (5) ◽

pp. 67

Author(s):

Mansoureh Mirzadeh ◽

Najmeh Shahini ◽

Masoud Kashani Lotf Abadi ◽

Maryam Tavakoli ◽

Arash Javanbakht ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Cognitive Function ◽

Rating Scale ◽

Controlled Trial ◽

Control Group ◽

P Value ◽

Double Blind ◽

Randomized Controlled ◽

Significant Difference ◽

Schizophrenic Patients

Smoking habits are common in schizophrenic patients. Nicotine can suppress negative symptoms and cognitive impairments. The aim of this study was to determine the efficacy of bupropion on cognitive function in schizophrenic patients. This study is a double blind randomized controlled trial in a large referral psychiatric university hospital in Iran. Ninety smoker schizophrenic patients were randomly allocated (based on DSM -IV TR criteria) in two groups (46 patients for case group and 44 patients in control group). They get risperidone up to 6 mg/d and bupropion up to 400 mg/d .clinical assessment (Positive and Negative Syndrome Scale (PANSS), Brief psychiatric rating scale (BPRS) were taken in beginning of study, 14th and 28th days of study. Cognitive assessment (Stroop, Digit Span, and Wechsler, Wisconsin) were taken in begging of study, the days 2nd, 7th, 14th, 28th. All data were analyzed by SPSS Ver. 17 with analytic and descriptive tests. Mean age of patients was 37.66±1.01. Mean duration of disorder was 11.63±.98 years. The scores were significantly lower at the day 28th compared to the beginning of the study in both groups in Wechsler, Stroop color word , Stroop word , Stroop color , BPRS, PANSS p value ≤0.05 .The difference between the two treatments was not significant as indicated by the effect of group, the between-subjects factor p value ≥0.05. In this study, the side effects were examined and there was no significant difference between the two groups p value ≥0.05. Augmentation of bupropion to routine treatment improves cognitive symptoms of schizophrenia in abstinence of tobacco.

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