Physical Therapy Following Saucerisation of Discoid Meniscus – a Case Study

Introduction: Discoid meniscus is a structure with altered shape, which causes it to frequently undergo injuries and lesions. Pain, limping, limited range of motion of the knee joint and swelling are characteristic signs of this pathology. Therapeutic possibilities include meniscectomy and saucerisation. Research objective: The study aim was assessment of the therapeutic effectiveness in a patient after saucerisation of discoid meniscus. Material and methods: A 12-year-old female patient after saucerisation of lower left limb lateral discoid meniscus (type I) was subjected to 32-week physical therapy treatment. Testing included determining the range of knee joint flexion and extension movements, as well as measuring the circumference of the lower extremities 15 cm above the patella. The Kujala Score (Anterior Knee Pain Scale) and Ikeuchi grading system were employed during the 1st, 3rd, 8th, 21st and 32nd weeks postoperatively. Results: In the final stage of physical therapy, complete range of knee joint motion was achieved, the Kujala Scale score totalled 98 points and the thigh circumference of the operated limb increased by 4 cm. The circumferences of the lower extremities differed by 2 cm in the final phase of physical therapy. Conclusions: The employed postoperative protocol effectively influenced the functional state of the patient.

Evaluation of C-reactive protein and magnesium level in migraine patients on pre and post prophylactic treatment

Migraine affects the day to day life of the sufferers with the symptoms of photophobia and phonophobia with pulsatile or non-pulsatile headache lasting from 1 to 4 hours. Prophylactic treatment or anti-migraine drugs were given to migraineurs to overcome the complications. C-reactive protein (CRP) and Magnesium level of symptomatic migraineurs, which act as biomarkers for the inflammatory cerebrovascular diseases before and after the treatment with Sodium Divalproex, Flunarizine and Propranolol. The evaluation of C-reactive protein and magnesium levels are noted along with symptoms when they first walk into the clinic. Treatment provided with Sodium Divalproex, Flunarizine and Propranolol for one month. After 1 month, the same tests are being performed. During the test at first instance, the values of pain scale were 31%, CRP value for negative were 20% and positive were 80% and pre-test of Serum magnesium level was 8.8% and at the second visit the pain scale reduced to 10.25%; CRP level was negative 25% and positive was 75%; Serum Magnesium was 9.35%. So, the significant values are being measured by the statistics, which we applied and found P=0.05. The patients who visited first didn’t come for the second visit. So, the results might vary and the patients who visited for the second time after one-month treatment, some got effective results while others remained ineffective. The reason for being ineffective is that they might have adapted to their current regimen.

A comparative study of clinical outcome following topical versus peribulbar anesthesia in phacoemulsification surgery

The objective of our study was to evaluate and compare clinical outcomes, patients and surgeon’s satisfaction following topical versus peribulbar anesthesia in phacoemulsification surgery. A hospital based Randomized Prospective interventional Comparative Study done between November 2017 to May 2019. A total of 200 patients included in the study, ocular examination, biometry were done. Patients were randomly distributed into group1 TA (topical anesthesia) and group 2 PA (Peribulbar anesthesia), they underwent phacoemulsification with intraocular lens implantation, postoperative visual outcome and inflammation on day1 and after 1 week, VAS (Visual Analogue scale) pain scale used to analyse patients comfort and pain postoperatively. The Statistical analysis was performed by STATA 11.2 (College Station TX USA). In our study 200 participated, it was found in PA group, 60.47 ± 11.86 yrs and in TA group 59.01 ± 11.29yrs as mean age, majority were male. PA group had few complications during anesthesia and in both groups majority had no intraoperative complications. Log Mar visual acuity postoperative day 1, PA group was 0.65±0.40 and in TA was 0.49±0.32, post operative visual recovery was better in TA group patients and had less pain and more comfortable than PA. Surgeon had difficulty more with TA group patients. It was found, postoperative visual recovery was faster and better in patients with topical group with less postoperative inflammation and complications. Topical anesthesia being a non invasive procedure can be considered better than peribulbar when compared in terms of patients comfort and postoperative recovery.

Virtual Reality Reduces Pediatric Anxiety During Food Allergy Clinical Trials: A Pilot Randomized, Pragmatic Study

Phlebotomy procedures required in food allergy (FA) diagnosis and clinical trials often induce fear and anxiety for pediatric patients. The primary aim of this study was to determine whether virtual reality (VR) applications were effective in reducing anxiety for pediatric FA patients undergoing phlebotomy during FA clinical trials. Secondary aims assessed fear, pain, procedural compliance, and adverse events. Participants undergoing phlebotomy were enrolled and randomized to a VR group or standard of care (SOC) group for this prospective pilot randomized, pragmatic study. Participants in the VR group played interactive applications on a customized Samsung Gear VR headset and those in the SOC group received the standard of care. Participants' anxiety, fear, and pain were assessed with the Children's Anxiety Meter, Children's Fear Scale, and FACES pain scale pre, during, and post phlebotomy procedure. Compliance was assessed using the modified Induction Compliance Checklist during the procedure and compared between two groups. Forty-nine participants were randomized to VR (n = 26) and SOC (n = 23) groups. Although both the VR and SOC groups experienced a decrease in anxiety and fear from pre- to post-procedure, those in the VR group experienced less anxiety and fear during the procedure than SOC participants. Similarly, both groups experienced an increase in pain from pre- to post-procedure; however, the VR group reported less pain during the procedure than SOC. Fewer symptoms of procedural non-compliance were reported in the VR group. Interactive VR applications may be an effective tool for reducing fear, anxiety, and pain during phlebotomy for FA clinical trials.

The Effect of Relaxation Techniques and Distraction Techniques on Reducing Pain Scale in Postoperative Patients at UKI Hospital East Jakarta in 2020

The purpose of this study was to determine the effect of relaxation techniques and distraction techniques on reducing pain scale in postoperative patients at UKI Hospital in 2020. This study used a cross sectional study approach which aims to determine the effect of relaxation and distraction techniques on postoperative patients at UKI Hospital. Cross sectional is a method for approaching respondents (point time approach) which is carried out at one time. the independent variable is relaxation technique and the dependent variable distraction is the decrease in pain scale in postoperative patients. The results of the study concluded that there were differences in the results of the pain scale between the pre-test and post-test with the Relaxation technique in postoperative patients. Most of the respondents had moderate pain scale results as many as 77% of postoperative patients, the group after intervention with Relaxation showed that most respondents had mild pain scale results as many as 86% of postoperative patients. There is a difference in the results of the pain scale between the pre-test and post-test with the Distraction technique in postoperative patients. Most of the respondents had controlled severe pain scale results as many as 88% of patients, the group after the distraction intervention showed that most of the respondents had moderate pain scale results as many as 79% of patients.

Performance of the EQ-5D-Y Interviewer Administered Version in Young Children

(1) Background: An estimated 78% of South African children aged 9–10 years have not mastered basic reading, therefore potentially excluding them from self-reporting on health-related outcome measures. Thus, the aim of this study was to compare the performance of the EQ-5D-Y-3L self-complete to the newly developed interviewer-administered version in children 8–10 years. (2) Methods: Children (n = 207) with chronic respiratory illnesses, functional disabilities, orthopaedic conditions and from the general population completed the EQ-5D-Y-3L self-complete and interviewer-administered versions, Moods and Feelings Questionnaire (MFQ) and Faces Pain Scale-Revised (FPS-R). A functional independence measure (WeeFIM) was completed by the researcher. (3) Results: The 8-year-olds had significantly higher missing responses (x2 = 14.23, p < 0.001) on the self-complete version. Known-group and concurrent validity were comparable across dimensions, utility and VAS scores for the two versions. The dimensions showed low to moderate convergent validity with similar items on the MFQ, FPS-R and WeeFIM with significantly higher correlations between the interviewer-administered dimensions of Mobility and WeeFIM mobility total (z = 1.91, p = 0.028) and Looking After Myself and WeeFIM self-care total (z = 3.24, p = 0.001). Children preferred the interviewer-administered version (60%) (x2 = 21.87, p < 0.001) with 22% of the reasons attributed to literacy level. (4) Conclusions: The EQ-5D-Y-3L interviewer-administered version is valid and reliable in children aged 8–10 years. The results were comparable to the self-complete version indicating that versions can be used interchangeably.

Effectiveness of a long-term Tecar Therapy treatment on Knee Pain: building T.T.E.S.S.K., an evaluating scale A systematic review and meta-analysis

Background T.E.C.a.R (Transfer of Energy Capacitive and Resistive) Therapy (TT) is a form of endogenous thermotherapy based on radio waves 1 . It is a non-invasive procedure, that makes use of a machine able to stimulate heat inside the body to repair the inflammatory processes. Although being well known in the physiotherapy and massage therapy ambient for its benefic effects, which are still not very explored especially physiological and biochemical ones; TT is commonly used by therapists for musculoskeletal diseases. Anyhow, TT is often used as a palliative remedy for musculoskeletal disease, or linked with an ibuprofen or antidolorific medical therapy, and not as a main cure. Current literature still lacks objective ways to evaluate TT treatment. This study aims to create an evaluating Scale for the knee joint lesions treated with TT, for athletes or sports enthusiasts. Methods PubMed, Embase, and Cochrane Library databases were screened to perform an extensive review. PRISMA guidelines were applied, and the risk of bias was assessed, as was the methodological quality of the included studies. 25 articles were reviewed. 178 patients (total amount of clinic cases in PubMed, Embase and Cochrane Library articles combined) have decreased their pain after a long-term TT treatment (> 3 or 5 sessions). Results Knee joint is often affected by non-sportive or sportive musculoskeletal lesions. ((At this point, not only the TT articles were reviewed, but also all the articles (122) that included these key aspects)). Six items were selected to evaluate the efficacy of TT on the impaired joint: Range of Motion (ROM), %MVIC of quadriceps, biceps femoris and gastrocnemius, Cincinnati Rating Scale System (CRSS), NRS Pain Scale, Muscle Fiber Orientation (MFO) and %Trigger Points. Conclusions Our study allows to build a new treatment methodology with TT. It guarantees the therapist to structure a long-lasting follow-up, which is not limited to the simple use of the machine. Applying this methodology, the patient receives a treatment that is not limited, but built on his own needs thanks to the distribution of the summing scores, strictly dependent on the type of clinical case that the therapist finds. Thanks to the six items we inserted in T.T.E.S.S.K. (“Tecar Therapy Evaluation Score System of the Knee”), every aspect of a musculotendinous pathology is recognized, and might be treated with TT by therapists.

Impact of ageing on female metabolic flexibility: a cross-sectional pilot study in over-60 active women

Background Ageing influences the metabolic flexibility, albeit the physical status could determine this relationship. This cross-sectional study aims to describe and analyse the metabolic flexibility/inflexibility in a group of active older women, together with the impact of ageing and physical status on their oxidation rates and maximal fat oxidation (MFO). Methods Fifteen volunteers (69.00±6.97 years) from 24 women, completed an incremental cycling test until the second ventilatory threshold. Intensity increased 10W each 3min–15sec, starting at 30W. Gas exchange, heart rate, rate of perceived effort, pain scale and muscle power were registered, together with lactate. VO2 and VCO2 were considered for Fat and CHO oxidation (FATox & CHOox; Frayn’s equation) at the intensities 60%, 80% and 100% from the peak of power in the test (P100). Psychophysiological parameters were compared at MFO/FATmax and P100, together with the main correlation analyses, with and without P100 and VO2 as covariates. Results FATox was low at MFO (0.13; 95%CI [0.09-0.17] g·min−1·kg; 5.61 [3.59-7.63] g·min−1·kg FFM), with a shifting down and leftward of a short oxidation-rate curves. CHOox and FATox were both low for a reduced power with age (77.14±18.58 W & 39.29±9.17 W at P100 and MFO respectively), pointing to metabolic inflexibility in older women despite being active. Notwithstanding, the negative correlation between age and MFO (r=-0.54, p=0.04; R2=0.29) disappeared when normalized with P100 (r=-0.17, p=0.53), which was in turn strongly and negatively associated to age (r=-0.85, p<0.005; R2=0.72). P100 was also positive and moderately associated to MFO (r=0.71, p=0.01; R2=0.50). Conclusions Despite the inflexibility with age, physical status (i.e., larger muscular power) suggest a key role in the preservation of the metabolic health with aging in active women.

PAIIN (Precise Analgesic Instructions Improve Narcotic Usage): A Randomized Trial

Background Given the ongoing battle with opioid abuse and over-use in the United States new strategies are consistently being implemented in an attempt to reduce opioid use and over prescribing. Objectives The purpose of this study was to determine if a more regulated explicit pain management instruction plan could reduce the number of opioids taken. Methods Blinded randomized prospective study comparing a total of 110 (Group A=55, Group B=55) women undergoing elective outpatient bilateral breast reduction surgery by two different plastic surgeons. Patients were randomly divided into either Group A (control) that received general pain management instructions or Group B (experimental) that received explicit pain management instructions from the surgeons and nurses. Participants were asked to record the number of times they treated their pain with each separate modality. They were also asked to record their average daily pain scale for the days that they were treating their pain. Results Patients in group B took on average 1.5 oxycodone while patients in group A took on average 5.7 oxycodone (p&lt;0.01). Thirty-four patients in group B took no oxycodone. Patients in group B also had statistically significant lower subjective pain scores. Conclusions Based on these results it appears that standardizing how patients are instructed to treat their pain post-operatively may reduce the number of narcotics needed, thus reducing the number of narcotics prescribed without compromising pain control.

Efektivitas Aromaterapi Lavender dan Peppermint Terhadap Skala Nyeri Haid Pada Remaja Putri

Adolescent girls will experience changes in the reproductive system marked by menstruation. Menstruation experienced in adolescents is often accompanied by complaints of menstrual pain. Menstrual pain can interfere with daily activities, so it requires treatment to reduce menstrual pain. One way of handling that can be done is with aromatherapy. Lavender and peppermint aromatherapy is a treatment that uses lavender and peppermint essential oils which contain linalool and linalyl acetate which are useful for reducing menstrual pain. The purpose of this study was to determine the effectiveness of lavender aromatherapy with peppermint on the menstrual pain scale in adolescent girls. The research design used was quantitative, quasi-experimental method with a two-group pre-test and post-test design with a sample of 14 respondents, 7 respondents in the lavender aromatherapy group and 7 respondents in the peppermint aromatherapy group. The sampling technique used consecutive sampling. The instrument used is a numerical rating scale (NRS). Data were processed by Wilcoxon test and Mann Whitney test. The results of this study indicate that lavender aromatherapy and lemon aromatherapy are effective in reducing menstrual pain scale with p value 0.001 (p < 0.05). Levender aromatherapy and peppermint aromatherapy were effective in reducing menstrual pain scale, but there was no significant difference in reducing pain scale in both lavender and peppermint therapy groups.