Usefulness of Kaloderm® in Finger Tip Necrosis : A Case Report

We experienced a case of crush injury of the hand for which we performed a flap surgery and treated the necrotic parts placement using cultured allogeneic keratinocytes (Kaloderm^® ) with good results. The patient was a 31-year-old woman whose left middle finger was caught in a door, causing a crush injury. Although primary repair was performed, a 2 × 2.5-cm-sized necrosis developed, and a V-Y advancement flap was performed after the removal of dead tissues. However, a 1 × 2-cm-sized partial necrosis occurred and was treated using Kaloderm ^® . After the use of Kaloderm^® , the patient’s wound was healed, and no complications, except for mild pain, were observed for 1 year after the surgery. If a necrotic site appears after flap placement of fingertip, its treatment is difficult. If used well, Kaloderm^® may be a good option for necrosis of the fingertips and other areas that are difficult to cure.

Systemic toxicity in a child after topical cyclopentolate eye drops application

An 8-year-old girl was seen in our ophthalmology OPD who had come with complaints of mild pain in both eyes for 1 month. Her unaided vision in both eyes was 6/6. Her weight was 20 kg. Cyclopentolate 1% eye drops was administered twice to the child at 5 min interval in both eyes. The child became restless after 30 min of installation of eye drops installation. She started behaving abnormally and was not allowing to do retinoscopic examination. She had altered behavior, visual hallucination, and difficulty in walking. She was disoriented with slurred speech. She had ataxia and frequent tightening of limbs with jerky movements and was plucking her hair. Her pulse rate was 90/min and blood pressure was 120/90 mm of Hg. Her oxygen saturation was 94% in room air. The child was shifted to nearby hospital where a paediatrician and anesthesiologist were available and was kept under observation. Child’s pulse, blood pressure, and oxygen saturation were monitored for the next 5 hours. The child recovered completely over the next 8 hours.

A Study to Evaluate the Effectiveness of Aloe Vera Gel on Pain Perception among Patients with Osteoarthritis at Selected Communities in Kanyakumari District

Aim: to evaluate the effectiveness of Aloe Vera gel on pain perception among patients with osteoarthritis in selected communities at Kanyakumari district. Objectives: (i) To assess and compare the pre-test and post-test level of pain perception among patients with osteoarthritis in experimental and control group. (ii) To evaluate the effectiveness of Aloe Vera gel on level of pain perception among patients with osteoarthritis in experimental group. (iii) To find out the association between the post-test level of pain perception among patients with osteoarthritis in experimental group and control group with the selected demographic variables. A Quasi experimental, non-equivalent, pre test and post test control group design was adopted. The convenience sampling technique was used to select 30 samples for experimental group and 30 samples for control group. OARSI (osteoarthritis research society international) questionnaire was used to assess the osteoarthritic pain. Aloe Vera gel was applied locally on painful areas for 28 consequent days and post test was conducted on 28th day by using OARSI questionnaire. The data were gathered and analyzed by descriptive and inferential statistical method. The findings revealed that during pre test 20(67%) of them had moderate pain, 10(33%) of them had mild pain. During post test 19(63%) of them were in mild pain, 11(37%) of them were in moderate pain. The mean score on level of pain perception among patients with osteoarthritis was 33.3 in pre test and 22 in post test. The estimated t’ value was 8.99* which is significant at p < 0.05. It shows that local application of Aloe Vera gel was effective in reducing the level of pain perception among osteoarthritis pain. Hence the research hypothesis H1 is retained. This study statistically proved the pain reducing effect of Aloe Vera gel on Osteoarthritic patients at 5% significant level. The researcher concluded that Aloe Vera gel application is a non pharmacological, cost effective and very practicable measure to reduce the level of pain perception among patients with osteoarthritis. Keywords: Aloe Vera gel, Pain perception, Osteoarthritis.

MASSAGE EFFLURAGE USING RED GINGER EFFECTIVELY RELIEVES GOUT ARTHRITIS PAIN IN ELDERS

ABSTRACT BACKGROUND: Most elders with gout arthritis pain choose analgesic to deal with their pain. Massage efflurage using red ginger is a therapy to reduce gout arthritis pain. The objective of research was to find out the effectiveness of message efflurage using red ginger in relieving gout arthritis pain in elders. METHOD: The research design employed in this study was pre-experimental one group pre-posttest design. Independent variable was massage efflurage using red ginger and dependent variable was gout arthritis pain in elders. The population of research was all elders in Kedungbendo Village of Mojokerto Regency, consisted of 36 elders. The sample of research consisted of 33 elders taken using probability simple random sampling technique used. Pretest-posttest data were collected using numerical pain scale observation sheet. RESULT: The result of pretest-posttest obtained from 8 respondents with severe pain showed that their pain change into mild (5 respondents) and moderate pains (3). Out of 21 respondents, 9 respondents showed that their pain changed from moderate into no pain, 10 respondents into mild pain and 2 stable. Out of 4 respondents with mild pain, all of them showed that their pain changed into no pain. CONCLUSION: The result of Wilcoxon test showed 0.000 ≤ α= 0.05, meaning that there is an effective effect of massage efflurage using red ginger on the relief of gout arthritis pain in elders. This result indicated that massage efflurage using red ginger affected the gout arthritis pain scale in elders. Respondents are expected to reduce the consumption of analgesics and to switch to a safe alternative therapy to reduce negative effect related to aging process experienced by elders. Keywords: Gout Arthritis, Massage Efflurage, Red Ginger

A Functional and Radiological Outcome Analysis of Hip Forage Procedure, done for Early Stages(Ficat and Arlet Grade 1 and 2A) of Avascular Necrosis of Head of Femur

Background: Avascular necrosis of the femoral head is a severe disease and causes osteoarthritis of the hip joint in young adults. Early diagnosis leads to better prognosis and therapeutic success. Aim: To study pain, radiological outcome & functional outcome post hip forage procedure in patients of avascular necrosis of head of femur (Ficat and Arlet grade 1 and grade 2A). Study Design: This was a prospective observational study. Place and Duration of Study: Conducted in the Department of Orthopaedics, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Nerul, Navi Mumbai over a period of 2 years from 2015 to 2017 Methodology: We included 50 patients (39 males, 11 females) with Avascular necrosis of unilateral or bilateral head of femur (Grade 1 and Grade 2A), clinical, radiological and functional(with the help of Harris hip score) examination was done at 6 months and 12 months follow up post operatively. Results: Out of the 50 patients, pre-peratively, 60% reported moderate pain, 20% mild pain and 20% severe pain. At follow-up, 36% patients reported slight pain, 26% mild pain, 26% moderate pain, 8% marked pain, and no pain was reported by 4% patients. Pre-operatively, no limp was seen in 34% patients, while 66% patient had a limp. At follow-up, 70% patient had a limp and no limp in 30% patients. Before surgery, support (cane use) was required by 6% patients, while at follow-up, support was noted by 12% patients. Preoperative mean Harris Hip Score was 63.6, while that at follow-up it was 74.74. Radiological worsening of the disease occurred only in 38% of the patients which suggests that disease progression was delayed in most patients(62%). 2% patients had a complication of foot drop. Conclusion: Avascular necrosis of femoral head is more common in young males. Core decompression by multiple drilling and/or core decompression with fibular strut grafting are equally effective in pre collapse stages (stage 1 and stage 2A) with better functional and radiological outcomes and hence these procedures can play a vital role in delaying the disease progression.

The Effect of Murottal Al-Quran Therapy on Pain in Post Cesarean Surgery Patients at Abby Mother and Child Hospital, Lhokseumawe City

Pain is an unpleasant sensory and emotional experience resulting from actual or potential tissue damage or described in terms of the damage. Murottal is a recording of the voice of the Qur'an sung by a qori (reader of the Qur'an). In this study, the degree of pain before murottal therapy was obtained based on the NRS (numeric rating scale) pain measuring instrument by the respondents, it was found that 8 patients (18.6%) had normal pain levels, 23 people (53.5%) experienced mild pain. ), and 12 people (27.9%) experienced moderate pain. Meanwhile, after murottal therapy based on the NRS pain measuring instrument (Numeric Rating Scale) by the respondents, it was found that patients with normal pain levels increased to 28 people (65.1%), and those who experienced mild pain became 15 people (34.9%). There is an effect of murottal Al-Qur'an therapy in lowering the pain intensity in post-cesarean patients at RSIA Abby, Lhokseumawe City

Body Mass Index and Other Factors Related to Mastalgia: A Cross Sectional Study

BACKGROUND: Mastalgia is a common complaint in females aged 30–50 years. Mastalgia varies in degrees of severity. The quality of life of women may be adversely affected by severe mastalgia. It was associated with disturbance in sexual, social, and physical activities and behaviors. AIM: The main objective of this study is to investigate factors affecting mastalgia. METHODS: This is an analytical cross-sectional study. Conducted on 148 females attending the Family Medicine outpatient clinic. Mastalgia was assessed by new breast pain score. RESULTS: The mean age of patients was 32.6 and their mean body mass index (BMI) was 24.8. The majority of the cases were highly educated 48% and working 58.1%. There was a highly statistically significant difference between females with mild pain and those of moderate to severe pain regarding to BMI as the mean of BMI in patient with mild pain was 22.7 ± 2.5 while it was 27.6 ± 3.1., there was highly statistically significant difference between both groups as regards to the type of the contraception used that means females who used hormonal contraception had more pain. After logistic regression the only remaining significant factor was BMI 0.001. CONCLUSION: There are many factors affecting mastalgia as BMI, type of contraception, menstrual regularity, menstrual duration, breast pain duration, and premenstrual symptoms. But BMI is the most important factor affecting mastalgia.

Frequency of plantar fasciitis due to improper shoes among different universities students

Back ground: study was conducted to determine the frequency of plantar fasciitis among three different universities students due to improper shoes. It was cross-sectional study. Plantar fasciitis is the inflammation of plantar fascia; plantar fascia is a thick connective tissue that forms the medial arch of foot. Improper shoes cause constant pressure and irritation on plantar fascia that leads to inflammation. When someone wears improper shoes, pronation activity of the foot decreased and it can lead to plantar fasciitis. Objective: The objective of study was to determine the frequency of plantar fasciitis due to improper shoes among three different universities students. Material and Methods: Study was cross-sectional and the data was collected from university students. Data was collected by using questionnaire and by applying statistical procedures results were concluded. Results: There were the following results in this study as, 35.5% participants without pain, 45% with mild pain, 16% with moderate pain and 3.6% with severe pain. There were 84% participants with single etiology, 13% participants with multiple etiology and 3% participants with nerve entrapment. There were 31 participants with no pain, 49 participants with mild pain, 11 participants with moderate pain and 2 participants with severe pain between ages 20-25 years. And between ages 26-30 there were 29 participants with no pain, 27 with mild pain, 16 with moderate pain and 4 participants with severe pain. Conclusion: Study concluded that 55.6% participants were between ages of 20-25 years. 54.4% participants were females, 59.2% participants were with no pain, 84% participants were with single etiology that is plantar fasciopathy. There were mostly participants suffered with mild pain and only 3.6% participants showed response with severe pain. There were mostly participants suffered with single etiology and the number of affected participants with plantar fasciitis slightly increased with age.

Oral or nasal breathing; preferred breathing pattern for endodontics

Objective: The objective of study was to explore the relationship of breathing and pain during endodontic therapy. Materials and methods: 500 patients who presented in the department of operative dentistry were included in the study. Numeric pain scale was used to document the pain perceived during endodontic therapy. Results were analysed using SPSS version 23. Results: Among the 500 cases, 250 cases presented with mild pain, 158 presented with moderate pain while 92 presented with severe pain. 55.4% cases were of nasal breathers while 44.6% cases were of oral breathers. Conclusion: Patients presenting with nasal breathing pattern reported with mild pain perception during endodontic therapy when compared to patients who were oral breathers. Considering life style modifications like breathing patterns, body hydration and sleep impact the patient’s life and pain management during endodontic therapy. Educating patients on proper breathing and its benefits will have positive outcome on endodontic therapy. Keywords: Oral breathing, nasal breathing, pain perception, endodontics.

Topical Anaesthesia Versus Peribulbar Anaesthesia in Small Incision Cataract Surgery – A Comparative Study from Hyderabad Karnataka Region

BACKGROUND Anaesthesia is an integral part of any successful surgery. Advances in cataract surgery have led to changes in delivery of anaesthesia as well. Patient and surgeons’ comfort during anaesthesia and surgery is the single most important factor. In developing countries, small incision cataract is preferred sometimes over phacoemulsification in high volume centers. This study was done to compare patient and surgeon satisfaction following topical anaesthesia (TA) versus peribulbar anaesthesia (PA) for small incision cataract surgery (SICS) with intraocular lens implantation (IOL). METHODS This comparative observational study was done at M.R. Medical College, Kalaburagi over a period of 15 months from November 2018 to April 2020. 400 patients undergoing manual small incision cataract surgery (MSICS) after obtaining consent were included in the study, out of which 200 patients were administered TA while 200 were given PA randomly. Patients were prospectively evaluated for pain during administration, during surgery and 4-hours postoperatively through a questionnaire. RESULTS In our study TA group complained no pain whereas 85 % had mild pain and 13 % had moderate pain in PA group during administration of anaesthesia (P < 0.05). During surgery, none of the patients in both the groups experienced severe pain. 17 % patients in TA group had mild pain at 4 hours while only 4 % patients in PA group had pain (P < 0.05). There was no statistically significant difference in surgeon’s satisfaction between 2 groups. CONCLUSIONS Although the administration of PA is painful compared to TA, the patient satisfaction was more post-operatively in PA group. Topical anaesthesia has gained popularity due to minimal discomfort, speed of onset and lack of PA related complications. It is a safe and effective alternative to PA in MSICS with proper selection and education of patient. KEYWORDS Small Incision Cataract Surgery, Topical Anaesthesia, Peribulbar Anaesthesia