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Fulltext Essential Attributes of Clear Aligner Therapy in terms of Appliance Configuration, Hygiene, and Pain Levels during the Pandemic: A Brief Review

Marya A, Venugopal A, Vaid N, Alam MK, Karobari MI

Pain Res Manag, 2020;2020:6677929.
PMID: 33488889 DOI: 10.1155/2020/6677929

Fixed orthodontic treatment has been compromised at many levels during the pandemic period, as clinics underwent a prolonged lockdown and patients could not be treated regularly. With the end of the pandemic nowhere in sight, may be it is time to put newer tools, such as clear aligner therapy, for better use. Fixed orthodontic appliances by nature are not always self-limiting, which, if left unmonitored over a long period may cause undesirable side effects, pain, and discomfort. The undesired tooth movements that may occur with arch wire-guided mechanics in addition to problems with cut wires or removed brackets may be minimized with the use of aligners. While the benefits of using aligners are for all to see, they do require extensive planning and careful evaluation of the progress. This article reviews the advantages of using aligners during the pandemic period and how it can be beneficial in helping orthodontists resume their practice.

Matched MeSH terms: Pain/etiology
Prevalence of postpartum dyspareunia: A systematic review and meta-analysis

Banaei M, Kariman N, Ozgoli G, Nasiri M, Ghasemi V, Khiabani A, et al.

Int J Gynaecol Obstet, 2021 Apr;153(1):14-24.
PMID: 33300122 DOI: 10.1002/ijgo.13523

BACKGROUND: Dyspareunia is one of the most common postpartum sexual dysfunctions.
OBJECTIVE: To estimate the prevalence of postpartum dyspareunia.
SEARCH STRATEGY: Web of Science, Scopus, PubMed, and Embase databases were searched to July 2019 using keywords including 'perineal pain,' 'dyspareunia,' and 'sexual pain'.
SELECTION CRITERIA: Observational studies on the prevalence of postpartum dyspareunia were included.
DATA COLLECTION AND ANALYSIS: Two authors independently reviewed articles and extracted data. Study heterogeneity was evaluated by I2 index; publication bias by Egger and Begg tests.
MAIN RESULTS: Twenty-two studies enrolling 11 457 women were included. Based on meta-analysis, the overall estimated prevalence of dyspareunia was 35% (95% confidence interval [CI], 29%-41%). The prevalence was 42% (95% CI, 26%-60%) at 2 months, 43% (95% CI, 36%-50%) at 2-6 months, and 22% (95% CI, 15%-29%) at 6-12 months postpartum. Begg test showed no significant bias in data related to the prevalence of postpartum dyspareunia (p = 0.466).
CONCLUSION: The prevalence of postpartum dyspareunia was 35% and decreased with increasing postpartum duration. Given the high prevalence and its impact on a woman's quality of life, special attention should be paid to this common complaint during the postpartum period.

Matched MeSH terms: Pelvic Pain/etiology
Improvement of trigeminal neuralgia after massage therapy and dry needling

Wan Adnan Wan Omar, Nur Liana Abu Bakar

Malaysian Journal of Medicine and Health Sciences, 2020;16(102):81-83.
MyJurnal

Trigeminal neuralgia is a debilitating disease that can lead to depression and even suicide. Trigeminal neuralgia is usually treated using carbamazepine; however, many patients are refractory to such medical treatment. Thus, other treatment modalities are required, such as physical treatment and dry needling. The objective of this case report is to describe the management of trigeminal neuralgia in a 35 years old Malay housewife, who had left side atypical trigeminal neuralgia involving V2 region in the last four years, which was refractory to medical treatment. The appli- cation of Malay massage, combined with dry needling executed along the distribution of trigeminal nerve showed an improvement of pain on the Visual Analog Scale (VAS) from 7–8/10 to 0-1/10 after 11 sessions. Therefore, Malay massage combined with dry needling can be used as a non-pharmaceutical approach to managing trigeminal neu- ralgia.

Matched MeSH terms: Pain; Pain Measurement
Fulltext A Comparative Clinical Study between Concentrated Growth Factor and Low-Level Laser Therapy in the Management of Dry Socket

Kamal A, Salman B, Razak NHA, Samsudin ABR

Eur J Dent, 2020 Oct;14(4):613-620.
PMID: 32777838 DOI: 10.1055/s-0040-1714765

OBJECTIVE: A dry socket is a well-recognized complication of wound healing following tooth extraction. Its etiology is poorly understood and commonly occur among healthy patients. As such, management strategies for dry socket has always been empirical rather than scientific with varying outcome. The aim of this study is to investigate the efficacy of concentrated growth factor (CGF) and low-level laser therapy (LLLT) and compared them to the conventional treatment in the management of dry socket.
MATERIALS AND METHODS: Sixty patients with one dry socket each, at University Dental Hospital Sharjah, were divided into three treatment groups based on their choice. In group I (n = 30), conventional treatment comprising of gentle socket curettage and saline irrigation was done. Group II (n = 15) dry sockets were treated with CGF and group III (n = 15) sockets were lased with LLLT. All dry socket patients were seen at day 0 for treatment and subsequently followed-up at 4, 7, 14, and 21 days. Pain score, perisocket inflammation, perisocket tenderness, and amount of granulation tissue formation were noted.
STATISTICAL ANALYSIS: Data were analyzed as mean values for each treatment group. Comparisons were made for statistical analysis within the group and among the three groups to rank the efficacy of treatment using one-way analysis of variance (ANOVA). Statistically significant difference is kept at p < 0.05.
RESULTS: Conventional treatment group I took more than 7 days to match the healing phase of group II CGF treated socket and group III LLLT irradiated socket (p = 0.001). When healing rate between CGF and LLLT are compared, LLLT group III showed a delay of 4 days compared with CGF in granulation tissue formation and pain control.
CONCLUSION: CGF treated socket was superior to LLLT in its ability to generate 75% granulation tissue and eliminate pain symptom by day 7 (p = 0.001).

Matched MeSH terms: Pain; Pain Management
Fulltext A Survey on Daily Activity Inclination and Health Complaints among Urban Youth in Malaysia

Chen AH, Rosli SA, Hovis JK

J Environ Public Health, 2020;2020:9793425.
PMID: 33376494 DOI: 10.1155/2020/9793425

Environmental influence is one of the attributing factors for health status. Chronic interaction with electronic display technology and lack of outdoor activities might lead to health issues. Given the concerns about the digital impact on lifestyle and health challenges, we aimed to investigate the daily activity inclination and health complaints among the Malaysian youth. A self-administered questionnaire covering lifestyle and health challenges was completed by 220 youths aged between 16 and 25. There were a total of 22 questions. Seven questions inspected the patterns of indoor and outdoor activities. Fifteen questions focused on the visual and musculoskeletal symptoms linked to both mental and physical health. The total time spent indoors (15.0 ± 5.4 hours/day) was significantly higher than that spent outdoors (2.5 ± 2.6 hours/day) (t = 39.01, p < 0.05). Total time engrossed in sedentary activities (13.0 ± 4.5 hours/day) was significantly higher than that in nonsedentary activities (4.5 ± 3.8 hours/day) comprised of indoor sports and any outdoor engagements (t = 27.10, p < 0.05). The total time spent on electronic related activities (9.5 ± 3.7 hours/day) was were higher than time spent on printed materials (3.4 ± 1.6 hours/day) (t = 26.01, p < 0.05). The association of sedentary activities was positive in relation to tired eyes (χ2 = 17.58, p < 0.05), sensitivity to bright light (χ2 = 12.10, p < 0.05), and neck pain (χ2 = 17.27, p < 0.05) but negative in relation to lower back pain (χ2 = 8.81, p < 0.05). Our youth spent more time in building and engaged in sedentary activities, predominantly electronic usage. The health-related symptoms, both visual and musculoskeletal symptoms, displayed a positive association with a sedentary lifestyle and a negative association with in-building time.

Matched MeSH terms: Low Back Pain; Neck Pain
The efficacy of pulsed radiofrequency intervention of the lumbar dorsal root ganglion in patients with chronic lumbar radicular pain

Marliana A, Yudianta S, Subagya DW, Setyopranoto I, Setyaningsih I, Tursina Srie C, et al.

Med J Malaysia, 2020 03;75(2):124-129.
PMID: 32281592

INTRODUCTION: In recent years, pulsed radiofrequency (PR) has been used as a minimally invasive pain intervention. However, various studies on the efficacy of PR as modalities for the treatment of radicular pain in lumbar disc herniation have had varied results.
OBJECTIVE: This study aims to determine the efficacy of PR in reducing radicular pain among lumbar disc herniation patients compared with conservative treatment.
METHODS: This study was conducted using the before-andafter quasi experimental design. There were 50 subjects that fulfilled the inclusion and exclusion criteria and they were divided into an intervention group (n=25) and control group (n=25). The intervention group was given once PR in the dorsal root ganglion. All subjects were assessed for Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) before treatment, at 1- , 2- and 4-week after treatment.
RESULTS: At1-, 2- and 4-week, the VAS reduction in the intervention group was statistically significant compared to the control group. Four weeks after the intervention, the VAS score decreased in the intervention group (mean VAS -78.5, SD 16.8) more significantly compared to the control group (p<0.001). The ODI score decreased in the intervention group (mean ODI -61.8, SD 20.1) more significantly than in the control group (p<0.001).
CONCLUSION: Finding showed that at1- , 2- and 4-weekPR was more efficacious in reducing radicular pain among lumbar disc herniation patients compared to the conservative therapy.

Matched MeSH terms: Pain; Pain Measurement
Mouth pain and cheek numbness

Chong W, Musa MSH, Sugumaran V

Emerg Med J, 2020 Jul;37(7):436-443.
PMID: 32616656 DOI: 10.1136/emermed-2019-209395
Matched MeSH terms: Pain/diagnosis*
Chylous mesenteric cyst in children -A case report in a 4-year-old boy

Kusuma FSP, Poerwadi P

Med J Malaysia, 2020 05;75(Suppl 1):48-50.
PMID: 32471968

Chylous mesenteric cyst is a very rare case, with some vague clinical findings, and it is hard to establish the diagnosis before surgery. The most common complaints post-surgery are abdominal pain and abdominal distention. We report a case of chylous mesenteric cyst in a 4-year-old boy with chief complaint of a lump in the abdomen. Preoperative abdominal ultrasound study could not identify the origin of the mass, and suspected it as a tuberculous peritonitis. A repeat ultrasound examination revealed a multicystic mass, suspected as lymphangioma. From the exploratory laparotomy, we noted a giant mesenterial cyst (20cm in diameter) containing chylous fluid within the ileal mesentery situated 30cm from the ileocaecal junction and made an effect of diminution of the bowel lumen above it, resection and end to end anastomoses was done. Histopathology examination confirmed it as a giant mesenteric cystic lymphangioma.

Matched MeSH terms: Abdominal Pain/diagnosis
Fulltext Capsaicin: current understanding in therapeutic effects, drug interaction, and bioavailability

Suk Huei Chan, Azrina Azlan, Amin Ismail, Nurul Husna Shafie

Malaysian Journal of Medicine and Health Sciences, 2020;16(106):219-227.
MyJurnal

Capsaicin (N-vanillyl-8-methyl-6-(E)-none amide) is a unique and significant compound from group component of capsaicinoids. This component can only be found in the plants from the Capsicum genus. It is the primary source of pungency or spiciness of chilli pepper. Traditionally, capsaicin has been used to alleviate pain. Recently, some studies showed significant therapeutic effects of capsaicin in many diseases such as diabetes, hypertension, cancer and obesity. Determination of the most effective dosage used and underlying working mechanism of capsaicin are still in progress. Currently, capsaicin research, especially in drug interaction and encapsulation technologies, has not been reviewed. We aim to report current experimental evidence of capsaicin research focusing on its pharmacolog- ical properties, interaction with drugs and ways to improve the bioavailability of capsaicin. It is essential to provide a general orientation for further investigation that can discover more potency of capsaicin usage as a medicinal supplement to treat various diseases.

Matched MeSH terms: Pain; Pain Management
Correlates of low back pain among Filipino caregivers of children with disability: A preliminary study

Zamora MAL, Labao HC

Enferm Clin, 2020 02;30 Suppl 1:120-123.
PMID: 32115158 DOI: 10.1016/j.enfcli.2019.09.033

The caregiver's role in rearing a child with disability requires huge physical demands which may lead to development of musculoskeletal disorders such as low back pain (LBP). This study aims to determine the factors associated with low back pain among caregivers of children with disability. A quantitative, correlational research design was used. Data were gathered among caregivers of children with disabilities enrolled in a specialized educational and pediatric rehabilitation unit in Valenzuela City. A personal information sheet was used to gather relevant demographic data while Oswestry Disability Index (ODI) was used to measure low back pain and disability. Pearson's correlation and Chi-square were used to determine the relationship and association among demographic factors and low back pain and disability. Majority of the respondents are mothers (59.09%) caring for children with autism spectrum disorder (31.82%), married (68.18%), and living in an extended family (36.36%). Chi-squared revealed a statistically significant association between caregivers' gender (p=0.003), relationship to child (p=0.000), and marital status (p=0.000) to low back pain and disability. Results imply that married mothers who are the primary caregivers to children with disability are prone to develop low back pain and disability. Preventive and restorative physical interventions, such as caring rotation, is recommended. Future studies should focus on other factors such as psychosocial, physical, and emotional aspects of low back pain and disability among caregivers of children with disability.

Matched MeSH terms: Low Back Pain*
A case report of Blastocystis infection and Steven Johnson's syndrome

Singh A, Priyadarshi K, Raj T, Banerjee T

Trop Biomed, 2019 Dec 01;36(4):987-992.
PMID: 33597468

Blastocystis species (spp.) is an emerging pathogen. There are several unsolved issues linked to this parasite ranging from its nomenclature, commensal status, standardization of laboratory diagnostic methods, genotypes and treatment. Recently, there has been an increase in reports of Blastocystis spp. from symptomatic cases which provide enough evidence of its pathogenic potential. A range of signs and symptoms, from gastro-intestinal to cutaneous manifestations have been attributed to Blastocystis infection. Few reports have established an association between intestinal infection with Blastocystis spp. and skin manifestations in form of urticaria, palmoplantar pruritus and allergy with complete resolution of cutaneous lesions with eradication of the parasite. In this report, we describe a case of Steven Johnson's syndrome (SJS) in a 6 years old girl along with infection with Blastocystis spp. marked by diarrhea and abdominal pain. Stool examination revealed the presence of all forms of the parasite with subsequent decrease in parasite burden and diarrhea over a period of time. Interestingly, the clearance of Blastocystis spp. from stool was followed by recovery from skin lesions and other symptoms. In this case, the course of SJS was clearly associated with Blastocystis infection. Though skin manifestation with Blastocystis infection has been previously reported, this is the first report of its association with SJS. This report indicates newer insights of the parasite that are less well studied.

Matched MeSH terms: Abdominal Pain/parasitology
Fulltext Case Study on the effect of Epidural Analgesia on pain management during labour

Ho, S.E., Sumathi, U., Ismail, M.S., Choy, Y.C., Ahmad Zailani, H., Liu, C.Y.

Medicine & Health, 2013;8(1):33-36.
MyJurnal

Child birth is associated with severely painful experience for the parturient, and often exceeds one’s expectations. Even though, severe pain is non life-threatening condition in healthy parturient women, it may lead to undesired neuropsychological consequences. When no analgesia was used, postnatal depression may be more common, and this labour pain leads to the development of post-traumatic stress disorder. Epidural analgesia is now considered gold standard for effective pain relief during labour. We here report a case of a 37-year-old G1 P0 patient at term gestation who successfully used epidural analgesia for labour pain management.

Matched MeSH terms: Labor Pain; Pain Management
Fulltext Randomized Clinical Trial of Periarticular Drug Injectionused in combination Patient-Controlled Analgesia versusPatient-Controlled Analgesia Alone in Total KneeArthroplasty

Sabran, M.N., Talha, A.J.M., Omar, M., Ibrahim, M.Y., Shahril, Y.

Malays Orthop J, 2008;2(2):21-26.
MyJurnal

This is a prospective randomized clinical trial to compare use of a combination of periarticular drug injection with patientcontrolled analgesia (PCA) to PCA alone in post-total knee arthroplasty (TKA). Thirty patients who were admitted for unilateral total knee arthroplasty were selected randomly into an Injection group or a Standard group. The periarticular injection contained Ropivacaine, Ketorolac and Adrenaline, given intra-operatively. The mean amount of opioid used was 22.87 mmol/L in the Injection group as compared to 39.78 mmol/L in the Standard group (p = 0.026). The Injection group had lower pain score at rest and during exercise (p=0.021, p=0.041, respectively), as well as better return to function (p=0.026) and shorter hospital stay (6.1 days, Injection; 7.5 days, Standard, p=0.027). Overall, the group receiving periarticular drugs injection had less pain, less narcotic usage, earlier return to function, similar experience of adverse effects and shorter hospital stays.

Matched MeSH terms: Pain; Pain Management
Fulltext Pain interference level and its effects on patients’ quality of life and depression: a study on breast cancer survivors in Hospital Kuala Lumpur, Malaysia

Zubaidah, J.O., Hejar, A.R., Lim, Y.W., Chin, K.T., Muhd Aizuddin, Z., Mud Hazeman, Z.

Malaysian Journal of Medicine and Health Sciences, 2013;9(1):45-54.
MyJurnal

Cancer pain is a complex experience and is one of the most common and distressing symptom of breast cancer which affects patients’ functioning in daily activities, their quality of life (QOL), and mood. Yet, there is a great lack of data on breast cancer and pain in Malaysia.
Methods: A cross-sectional study using the Breast Cancer Patient Version of Quality of Life (QOL) Instrument (translated into Malay) and Depression Anxiety and Stress Scale (DASS) were conducted on 87 female breast cancer patients to investigate the impact of pain interference level on their quality of life and depressive level.
Results: The patients were divided into 4 groups based on their rating of how pain and aches have been a problem to them (i.e not a problem [n=18 (20.7%)], mild[n=29 (33.3%)], moderate [n=18 (20.7%)] and severe [n=22(25.3%). Pain and aches ware reported to be the most severe interference problems in QOL physical domain by patients (mean=5.8, SD=2.8), followed by fatigue (mean=6.0, SD=3.1) and sleep changes (mean=6.2, SD=3.5). Patients who reported that pain and aches had severely affected them showed significantly lower score on many aspects of quality of life (Fs > 5, p < 0.005; p < 0.0001) and patients reported pain was not a problem at all demonstrated highest score on all aspects of QOL. Patients with most severe pain interference level showed highest depressive score [F (3, 84) =3, p < 0.05].
Conclusion: The study underscores the impact of pain interference on patients’ quality of life and depressive level. The pain assessment deserves significant attention and therefore a comprehensive biopsychosocial assessment of pain to rule out any related underlying issues is warranted in the management of breast cancer to ensure appropriate intervention given to the patients.

Matched MeSH terms: Pain; Pain Measurement
A Survey on Work-related Musculoskeletal Disorders (WMSDs) among construction workers

Isa Halim, Rohana Abdullah, Ahmad Rasdan Ismail

Journal of Occupational Safety and Health, 2012;9(1):15-19.
MyJurnal

Work-related Musculoskeletal Disorders (WMSDs) are common occupational injuries among workers in the construction industry. Epidemiological studies indicated that WMSDs include neck pain, lower back pain, knee pain, leg fatigue as well as ankle and feet discomfort. The objectives of this study are to identify the WMSDs experienced by the workers during construction works and discuss the causes of those WMSDs. Subjective approach associated with modified Nordic Musculoskeletal Questionnaire (NMQ) was applied to identify the symptoms of WMSDs. A case study was conducted in several construction sites situated at the southern region of Peninsular Malaysia. During the study, 37 construction workers with different age and scope of works were interviewed to determine the WMSDs that they have experienced. Based on distributed questionnaire, almost all workers experienced pain in the region of lower back, upper back and biceps. These pains were contributed by manipulation of heavy load and high force exertion. Based on discussed causations, control measures via engineering controls method and administrative controls method were proposed to alleviate the risk of WMSDs among construction workers.

Matched MeSH terms: Low Back Pain; Neck Pain
Fulltext Backcare awareness among nurses in Hospital Kota Kinabalu

Ayiesah, R., Ismail, D.

Malaysian Journal of Community Health, 2007;13(1):11-15.
MyJurnal

Low back pain (LBP) is a major medical and social problem associated with disability and work absenteeism. Since the effect on unawareness on back care among hospital staff may affect the smooth running of the services to the public and patients, it is the objective of this study to identified the awareness of back care among nurses so that preventive measures can be taken. About 80 nurses working in the outpatient clinic was survey using self addressed questionnaires which were adapted from Zutphen Physical Activity Questionnaire at Queen Elizabeth Hospital, Kota Kinabalu. Demographic analysis demonstrated that among the eighty nurses that responded, 37.5% (n=30) are Malays, 25% (n=25) Chinese and 37.5% (n=30) ( to include other Sabahan tribes). Their age group varies between 23 to 55 years of age. A total of 72 nurses, both agreed (45%,n=36) and strongly agreed (45%,n=36) that understanding good postures is important to prevent LBP. They felt strongly (55%, n=44) about the importance of correct lifting techniques, and having a well-designed workplace (50%,n=40). Regarding factors that cause LBP, 55% (n=44) of them strongly agreed that good lifting technique can prevent LBP while 56 (70%) agreed that prolong sitting doing computer work can cause LBP. About 60% (n=48) also agreed that LBP can cause stress and that 45% (n=36) of them strongly agreed that being overweight than average can worsen LBP. However, 40% (n=32) provide a neutral answer to whether height have any influence on LBP while 50% (n=40) agreed that weak back muscles can worsen the backache further. However, 45% (n=36) agreed that games that involved back movement have high risks and 55% (n=44) agreed that swimming helps to strengthen back muscle. The environmental factors addresses issues of footwear and soft mattress where 60%(n=48) agreed while 15%(n=12) strongly agreed that good footware and appropriate use of soft mattresses 60% (n=48) can prevent LBP. This study have demonstrated that the nurses that participated had a clear understanding and knowledge on back care even though a wider study need to be carried out to ensure validity of study finding.

Study site:outpatient clinic, Queen Elizabeth Hospital, Kota Kinabalu

Matched MeSH terms: Back Pain; Low Back Pain
Fulltext The Aetiology And Management Of ChronicIdiopathic Facial Pain: A Review

Abdul Rahman, Z.A.

Ann Dent, 1998;5(1):-.
MyJurnal

Chronic idiopathic facial pain is the diagnosis given to a group of orofacial pain of psychogenic origin which includes atypical facial pain, facial-arthromyalgia, atypical odontalgia and oral dysaesthesia. Despite various biochemical findings, the condition remains poorly understood, but we have begun to understand the nature of these patients. This review discusses the possible aetiology of the disease through various biochemical and clinical findings. The contribution of behavioural and psychological factors to the clinical course of the disease are described. The type of adverse life events that predispose people to the disease and their potency are briefly mentioned. The current diagnostic approach for the disease is also mentioned. Treatment includes antidepressant medication, physiotherapy, bite-guards and analgesics. The problems encountered in the long-term management and outcome studies of these patients include drop-outs, non-compliance and denial.

Matched MeSH terms: Facial Pain; Chronic Pain
Systematic review and meta-analysis of perioperative outcomes of peroral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for achalasia

Awaiz A, Yunus RM, Khan S, Memon B, Memon MA

Surg Laparosc Endosc Percutan Tech, 2017 Jun;27(3):123-131.
PMID: 28472017 DOI: 10.1097/SLE.0000000000000402

AIMS AND OBJECTIVES: Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM.

MATERIALS AND METHODS: A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed. Variables analyzed included prior endoscopic treatment, prior medical treatment, prior Heller myotomy, operative time, overall complications rate, postoperative gastroesophageal reflux disease (GERD), length of hospital stay, postoperative pain score, and long-term GERD.

RESULTS: Seven trials consisting of 483 (LHM=250, POEM=233) patients were analyzed. Preoperative variables, for example, prior endoscopic treatment [odds ratio (OR), 1.32; 95% confidence interval (CI), 0.23-4.61; P=0.96], prior medical treatment [weighted mean difference (WMD), 1.22; 95% CI, 0.52-2.88; P=0.65], and prior Heller myotomy (WMD, 0.47; 95% CI, 0.13-1.67; P=0.25) were comparable. Operative time was 26.28 minutes, nonsignificantly longer for LHM (WMD, 26.28; 95% CI, -11.20 to 63.70; P=0.17). There was a comparable overall complication rate (OR, 1.25; 95% CI, 0.56-2.77; P=0.59), postoperative GERD rate (OR, 1.27; 95% CI, 0.70-2.30; P=0.44), length of hospital stay (WMD, 0.30; 95% CI, -0.24 to 0.85; P=0.28), postoperative pain score (WMD, -0.26; 95% CI, -1.58 to 1.06; P=0.70), and long-term GERD (WMD, 1.06; 95% CI, 0.27-4.1; P=0.08) for both procedures. There was a significantly higher short-term clinical treatment failure rate for LHM (OR, 9.82; 95% CI, 2.06-46.80; P<0.01).

CONCLUSIONS: POEM compares favorably to LHM for achalasia treatment in short-term perioperative outcomes. However, there was a significantly higher clinical treatment failure rate for LHM on short-term postoperative follow-up. Presently long-term postoperative follow-up data for POEM beyond 1 year are unavailable and eagerly awaited.

Matched MeSH terms: Pain, Postoperative/etiology
Fulltext The impact of dry needling on patients with neck pain in a tertiary hospital

Ho, S.E., Loong, S., Fatin Nur Laily R., Wan Nur Aizzati M., Muhammad Firdaus I.Z., Ho, Christopher C.K., et al.

Journal of Surgical Academia, 2015;5(1):44-50.
MyJurnal

Neck pain presents as a symptom of dull pain or discomfort mainly along the trapezius muscle. Dry needling is an invasive procedure which uses acupuncture needle directed at myofascial trigger points. The aim of the study was to evaluate the effectiveness of dry needling in managing patients with neck pain. A pre-test-post-test interventional study design was used. Patient education package was provided to 32 respondents who fulfilled the inclusion criteria. A 13-item Pain Catastrophizing Scale (PCS) questionnaire was used to assess Rumination, Magnification and Helplessness. Subjective pain intensity was measured by Visual Analogue Scale (VAS). These questionnaires were given before and after the dry needling intervention. The findings reported that respondents scored high in pre-test total PCS score (27.41±13.652). Post-test result revealed a significant improvement in total PCS score (23.06±13.938) (p = 0.000). Post-test VAS score (4.78±1.237) was also significantly better than pre-test (6.47±1.414) (p = 0.000). There was no significant difference in pre-test PCS in terms of marital status (p > 0.05) whereas there was significant difference between marital status and rumination in post-test (Z = -2.303, p = 0.021). There was significant difference between pre-test magnification in terms of respondents’ occupation (p = 0.008) and race (p = 0.035) but no significant difference in post-test. Respondents’ age group showed no significant differences between pre-test and post-test PCS and VAS (p > 0.05). In conclusion, patients who received dry needling showed improvement in pain intensity and catastrophizing towards neck pain.

Matched MeSH terms: Pain Measurement; Neck Pain
Fulltext Intra-articular sodium hyaluronate for the treatment of osteoarthritis of the knee. A retrospective review of 45 patients.

Yoga R, Mukaram M, Ramachandran

Malays Orthop J, 2009;3(2):4-7.
MyJurnal

Intrarticular Hyaluronic Acid was administered to 45 patients with various grades of osteoarthritis in the knee. Following 3 fortnightly injections, these patients were reviewed at 6 weeks and 3 months with regard to their knee pain. We found the most patients (84.4%) has decreased knee pain following these injections. Patients who had severe grade osteoarthritis based on knee radiographs before the injections were less likely to have pain reduction compared to those with milder grade osteoarthritis. Only 4 (8.9%) patients showed no improvement and were subsequently considered for surgery. Many patients did not require any further treatment (24.4%) and the remaining were given analgesia (64.4%) to aid in their pain. One patient required another course of this injection. there were no complications recorded in this study. We concluded that Intrarticular Hyaluronic acid is an easy and safe method to treat osteoarthritis. The short-term outcome with regard to knee pain is good in patients with milder grades of osteoarthritis.
Study site: Private orthopaedic clinic, Johor, Malaysia

Matched MeSH terms: Pain; Pain Management

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