Laser Surgery for Treating Retarded Teeth Eruption in Children

Objective: To analyze the efficacy of laser surgery in treating retarded eruption in children.Method: Sixty-three children (age：7-13 ，30 boys and 33 girls)were selected and according to the random number table divided into three groups: Laser surgery group (group A), electrosurgery group (group B), and routine surgery group (group C).The total operative time, the duration of pain after gingival excision, and VAS pain intensity scores, gingival healing time, and intraoperative coordination were all recorded . Pain intensity was assessed using a Visual Analogue Scale (VAS) score (0 to 100mm). At six months during the follow-up, this physician checked and recorded the periodontal indicators of permanent teeth, including gum index (GI), plaque index (PLI), and probing depth (PD).Results: All teeth erupted normally in three groups after treatment, showing normal pulp and periodontal tissue. There was no significant difference in operative time, pain duration, pain intensity, healing time between group A and group B. There was a significant difference in total operative time, pain duration, pain intensity, and healing time between electrosurgery group (group B) and routine surgery group (group C) (P<0.05).There was a significant difference in total operative time, pain duration, pain intensity, and healing time between laser surgery group (group A) and routine surgery group (group C) (P<0.05).Periodontal indexes, including gingival indexes, plaque indexes, were examined in three groups at six months after treatment by the same periodontist. Then, the efficacy of the three methods was compared.Conclusion: Laser surgery and high-frequency electrosurgery has favorable efficacy, less pain, and higher operability. However, in the use of the electric knife, the paste flavor may discomfort the children, make them less cooperative, and prolong the procedures.

COMPARATIVE CLINICAL STUDY OF KUMARIKA VATI AND MEFENAMIC ACID IN UDAVARTINI YONIVYAPAD (SPASMODIC DYSMENORRHEA)

Menstruation is a normal physiological process when it is accompanied by pain is called Dysmenorrhea. It is one of the commonest gynaecological complaints. Dysmenorrhea is painful menstruation, which is the pratyatma lax- ana of Udavartini yoni vyapad i.e., spasmodic dysmenorrhea. It is a common cause of distress in women. Here the main reason for pain is the vitiation of vata dosha (apana vata), viloma/pratiloma gati leading to vedna yukta artava munchan and to manage this pratiloma vata, one needs to use drugs that have anulomana properties and vedna samak. Kumarika vati is used as vedana shamaka aushadha to give symptomatic relief. Hence the topic was selected for the study. Objectives: To compare the effect of Kumarika Vati with Mefenamic Acid in the man- agement of Udavartini Yonivyapad (Spasmodic Dysmenorrhea). Materials & Methods: 20 patients of Group A were treated with Kumarika Vati, a dose of 250mg BD 5 days before menstruation & 5 days during menstruation. 20 patients of Group B were treated with a Mefenamic Acid dose of 250mg BD for 3 days during menstruation. Result: The data of both groups were collected according to the objective and subjective parameters and analyzed using the most appropriate statistical test (repeated measures of ANOVA test and Mann –Whitney U test). The efficacy is statically significant within the group at P<0.001 and statistically insignificant between the group at P>0.05 among all the parameters. Interpretation and Conclusion: On comparison of Kumarika Vati with Mefenamic acid both have equal effectiveness in relieving the pain intensity, pain duration, site of pain, nature of pain and associated complaints. Keywords: Udavartini Yoni Vyapad, Dysmenorrhea, Kumarika Vati, Mefenamic Acid.

The Effect of Sleep Quality on Pain in Chilean Individuals with Musculoskeletal Disorders

Poor sleep quality (SQ) negatively affects pain associated with musculoskeletal disorders (MSD). As the level of economic development of a country determines its sanitary conditions, these can influence the sleep–pain relationship; therefore, it is relevant to generate evidence in the population with MSD in developing countries. This cross-sectional study sought to determine the effect of poor SQ on pain in Chilean individuals with MSD, controlling for sex and duration of pain (in months). Method: A total of 228 individuals were included. SQ was measured with the Pittsburg Sleep Quality Index (PSQI), pain (intensity, interference and distress relative to pain) was measured with visual analog scales. Structural equation modeling (SEM) was performed to analyze the effect of SQ on pain. Results: A high frequency of poor SQ was present in the studied group, and was more prevalent in women. The SEM model evidenced that poor SQ predicts greater pain. Sex influences sleep quality and pain, but not pain duration. Conclusions: These findings indicate that poor SQ predicts higher pain in MSD and that women exhibit worse SQ and more significant pain than men. Our findings support that SQ should be considered in the comprehensive approach to pain in individuals with MSD.

Prediction and Management of Strangulated Bowel Obstruction: A Multiomics Model Analysis

BackgroundDistinguishing strangulated bowel obstruction (StBO) from simple bowel obstruction (SiBO) still poses a challenge for emergency surgeons. We aimed to construct a predictive model that could distinctly discriminate StBO from SiBO based on the degree of bowel ischemia.MethodsA total of 281 patients diagnosed with intestinal obstruction were enrolled. According to pathological confirmation, patients were divided into a simple bowel obstruction (SiBO, n=236) group and a strangulated bowel obstruction (StBO, n=45) group. The clinical characteristics, laboratory tests and radiomics were compared between the groups via univariate analysis. Binary logistic regression was applied to identify independent risk factors, and then predictive models based on radiomics and multiomics models were constructed. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were calculated to assess the accuracy of the predicted models. Finally, via stratification analysis, we validated the multiomics model in the prediction of transmural necrosis. ResultsOf the 281 patients with SBO, 45 (16.0%) were found to have StBO, while 236(84.0%) with SiBO. Via univariate analysis, clinical characteristics including pain duration (p=0.036), abdominal pain(p=0.018), tenderness (p=0.020), rebound tenderness (p<0.001), bowel sounds (p=0.014), and laboratory parameters like white blood cell (WBC) (p=0.029), neutrophil (NE)% (p=0.007), low levels of sodium (p=0.009), abnormal potassium (p=0.003), high levels of blood urea nitrogen (BUN) (p<0.001) and glucose (p=0.002), as well as the radiomics consisting of mesenteric fluid (p=0.018), ascites (p=0.002), bowel spiral signs (p<0.001) and edema of bowel wall (p=0.037) were closely related to bowel ischemia. The ascites (OR=4.067) and bowel spiral signs (OR=5.506) were identified as independent risk factors of StBO in the radiomics model, the AUC for which was 0.706 (95%CI, 0.617–0.795). In the multivariate analysis, seven risk factors including pain duration≤3days (OR=3.775), rebound tenderness (OR=5.201), low-to-absent bowel sounds (OR=5.006), low levels of potassium (OR=3.696) and sodium (OR=3.753), high levels of BUN (OR=4.349), high radiomics score (OR=11.264) were identified. The area under the receiver operating characteristics (ROC) curve of the model was 0.857(95%CI, 0.793-0.920). The score of the mutiomics model can be calculated as following formula (1.328*Pd+1.649*Rt+1.611*Bs+1.307*K+1.323*Na+1.470*BUN+2.422*Rad-6.009). In the stratification of risk scores, the proportion of patients with transmural necrosis was significantly greater in the high-risk group (24%) than in the medium-risk group (3%). No transmural necrosis was found in the low-risk group.ConclusionThe novel multiomics model consisting of risk factors for pain duration, rebound tenderness, bowel sounds, potassium, sodium, and BUN levels and radiomics offers a useful tool for predicting StBO. Clinical management can be performed according to the multiomics score; for patients with low risk (scores≤ -3.91), conservative treatment is recommended. For the high-risk group (risk scores> -1.472), there was a strong suggestion for detection with laparotomy. For the remaining patients (-3.091< risk scores ≤ -1.472), dynamic observation is suggested.

Dietary Interventions with or without Omega-3 Supplementation for the Management of Rheumatoid Arthritis: A Systematic Review

Rheumatoid Arthritis (RA) is a chronic autoimmune condition characterized by symptoms of inflammation and pain in the joints. RA is estimated to have a worldwide prevalence of 0.5–1%, with a predominance in females. Diet may play an important role in the symptoms of RA; however, little is known about the effects of various diets. The aim of this systematic review is to explore the effect of dietary interventions, with or without omega-3 supplementation for the management of RA. The electronic databases MEDLINE, EMBASE, CINAHL, and the Cochrane Library were systematically searched for clinical trials investigating dietary interventions, with or without omega-3 supplementation to retrieve papers from inception to April 2021. Randomized and non-randomized controlled trials of dietary interventions in adults with RA were eligible for inclusion. Twenty studies with a total of 1063 participants were included. The most frequently reported outcomes were pain, duration of morning stiffness, joint tenderness, grip strength and inflammatory markers. Dietary interventions with an anti-inflammatory basis may be an effective way for adults with RA seeking complementary treatments, potentially leading to improvements in certain parameters. However, there is a need for longer duration studies that are well-designed and sufficiently powered to investigate the influence of diet on RA.

Effect of High-quality Nursing Intervention on Bad Mood, Postoperative Pain and Quality of Life of Patients Undergoing Gallstone Surgery

To demonstrate the influence of high-quality nursing intervention on bad mood, postoperative pain and quality of life (QOL) of patients undergoing gallstone surgery. One hundred and thirty-three patients with gallstone surgery in our hospital were selected as the research participants, of which 76 cases received high-quality nursing during hospitalization and were regarded as the research group (RG), and the remaining 57 cases received routine nursing care alone and were included in the control group (CG). The two series were compared regarding pain status, postoperative recovery, pain scores, pain duration and frequency pre- and post-intervention, incidence of complications, psychological state scores pre-and post-intervention, as well as nursing satisfaction and postoperative QOL.The number of patients with pain in RG was notably less than that in CG (P < 0.001). RG presented shorter anal exhaust time, ambulation time and hospitalization timethan CG (P < 0.05). Also, in comparison with CG, RG displayed lower pain scores post intervention (P < 0.05), with shorter pain duration and pain frequency (P < 0.05). RG had fewer complications than CG (P < 0.009). The scores of depression and anxiety were notably lower in RG than in CG (P < 0.05). RG showed higher satisfaction and recognition than CG (P < 0.001). The QOL of patients was also superior in RG (P < 0.05).High-quality nursing intervention can validly mitigate postoperative bad mood, reduce postoperative pain and meliorate postoperative QOL of patients with gallstone surgery.

Enhanced sensory conduction in primary fibromyalgia: a case–control pilot study

Background This study aimed to test the changes in the conduction properties of peripheral nerves in patients with primary fibromyalgia (FM). Thirty patients with FM and sixteen healthy controls participated in this study. Visual analogue scale (VAS) for pain severity, pain duration, Widespread Pain Index (WPI), Symptom Severity (SS) scale, Hamilton depression rating scale, Taylor’s manifest anxiety scale, and Fibromyalgia Impact Questionnaire (FIQR) were used for measurement of psychiatric comorbidities and quality of life for each patient. Routine motor and sensory nerve conduction studies of both median, ulnar, common peroneal, posterior tibial, and sural nerves were measured for all study participants. Results We found statistically significant increase in Sensory Conduction Velocity (SCV), Sensory Nerve Action Potential (SNAP) amplitude, and decrease in Sensory Latency (SL) in patients with FM compared to controls. There were no significant changes in motor nerve conduction between patients and controls. Regression analysis showed a significant relation between WPI and both SCV and SL especially in nerves of upper limbs. However, no significant relation between SCV and SL and other presumed predictors including VAS for pain severity, pain duration, SS scale, FIQR, and psychiatric comorbidities. Patients with FM suffered more depression and anxiety than controls. Conclusions We found enhanced conductivity of the sensory rather than the motor nerves in patients with FM. To our knowledge, this is the first study to describe these sensory changes which may add further evidence of peripheral sensitization in patients with FM.

Potential Nociceptive Role of the Thoracolumbar Fascia: A Scope Review Involving In Vivo and Ex Vivo Studies

Nociceptive innervation of the thoracolumbar fascia (TLF) has been investigated over the past few decades; however, these studies have not been compiled or collectively appraised. The purpose of this scoping review was to assess current knowledge regarding nociceptive innervation of the TLF to better inform future mechanistic and clinical TLF research targeting lower back pain (LBP) treatment. PubMed, ScienceDirect, Cochrane, and Embase databases were searched in January 2021 using relevant descriptors encompassing fascia and pain. Eligible studies satisfied the following: (a) published in English; (b) preclinical and clinical (in vivo and ex vivo) studies; (c) original data; (d) included quantification of at least one TLF nociceptive component. Two-phase screening procedures were conducted by a pair of independent reviewers, after which data were extracted and summarized from eligible studies. The search resulted in 257 articles of which 10 met the inclusion criteria. Studies showed histological evidence of nociceptive nerve fibers terminating in lower back fascia, suggesting a TLF contribution to LBP. Noxious chemical injection or electrical stimulation into fascia resulted in longer pain duration and higher pain intensities than injections into subcutaneous tissue or muscle. Pre-clinical and clinical research provides histological and functional evidence of nociceptive innervation of TLF. Additional knowledge of fascial neurological components could impact LBP treatment.

Covid-19 and headache characteristics

Background & Objective: Studies have shown that the most common neurologic symptom in patients with COVID-19 is headache, which may even be the first and only symptom. This study aimed to determine headache characteristics such as frequency, duration and localization, as well as the relationship of systemic inflammation with headaches in patients with COVID-19. Methods: A total of 202 patients hospitalized for COVID-19, consisting of 101 patients with headaches and 101 patients with no headache, were included in the study. Demographic characteristics, symptoms, clinical findings, and laboratory results were evaluated. In the group with headaches, visual analog scale (VAS) scores, duration, severity, and localization of pain were recorded. Results: One hundred nineteen (58.9%) of the patients had no headache in their previous medical history, whereas 21.3% (43/202) had a migraine history. Most of the patients with headache experienced short-term attacks of moderate-severity headaches (47.1%) that were pressing in nature (59%), and generalized (32.4%). We divided our patients into two groups according to pain severity: one of patients with mild-to-moderate headache and one of those with severe headache.. Pain characteristics were compared between the groups, and it was observed that the pain duration was longer in the group with severe pain (p<0.001). When the groups with and without headaches were compared, no significant differences were found between the groups regarding inflammatory markers such as lymphocyte count, lactate dehydrogenase, C-reactive protein, ferritin, and D-dimer levels. Conclusion: The headache in our patients with COVID-19 was mostly new-onset, of moderate severity, compressive in nature, and generalized. Inflammatory markers were unrelated to the presence and severity of the headaches.

Pain and health-related quality of life in adolescents and the mediating role of self-esteem and self-efficacy: a cross-sectional study including adolescents and parents

Background To promote health-related quality of life (HRQOL) in adolescents with pain, it is important to study factors associated with pain. This study aimed to describe selected factors and pain in 14–15-year-old adolescents and their parents, to assess how these factors are associated with adolescent pain groups, and to explore whether the relationship between pain intensity and HRQOL in adolescents with persistent pain is mediated by self-esteem and self-efficacy. Methods A cross-sectional study was performed among 508 dyads of adolescents (14–15 years) and parents in a school-based setting. Among these, 148 adolescents had persistent pain. We explored the following variables: HRQOL, pain, self-efficacy, self-esteem, sleep, loneliness, stress and sociodemographic variables. All variables were assessed with well-validated instruments. HRQOL was measured with KIDSCREEN-27. Analyses included Chi-square, ANOVA, Mann–Whitney U tests, Kruskal–Wallis and the PROCESS macro method for mediation analyses. Results Adolescents with pain reported significantly higher levels of stress, loneliness and lack of sleep and lower levels of self-efficacy, self-esteem and HRQOL compared to adolescents without pain. More girls than boys reported pain. Adolescents with persistent pain scored significantly worse on self-esteem, stress, loneliness, lack of sleep, school absence, pain and HRQOL compared to adolescents with shorter pain duration. Adolescent pain groups did not differ significantly considering parental factors. However, more adolescents with persistent pain reported that someone in their family had pain. The associations between pain intensity and the HRQOL subscales in adolescents with persistent pain were completely mediated by self-esteem, but not by self-efficacy. The highest degree of mediation was estimated for the HRQOL subscale school environment (indirect effect = 73.5%). Conclusions Our findings highlight the complexity within adolescent pain, demonstrating that adolescents with pain differ from adolescents without pain when it comes to gender, school absence, factors within-person and between-persons. Longer pain duration makes adolescents more vulnerable. We confirm the importance of resilience factors for HRQOL but indicate that self-esteem is more important than self-efficacy. To promote HRQOL in adolescents with persistent pain, a strengthening of both their self-esteem and self-efficacy is recommended. We highlight the need for an individual, holistic approach to adolescent pain.