جستجوی مقالات مرتبط با کلیدواژه « Visual Analogue Scale » در نشریات گروه « پزشکی »

 Various treatment methods are available for calcaneal spur, which can cause disability.

 To evaluate the efficacy of pulsed electromagnetic field therapy (PEMFT) added to extracorporeal shock wave therapy (ESWT) on pain and functional capacity in treating calcaneal spurs.

 Patients with calcaneal spurs who were recommended ESWT or ESWT+PEMFT and whose Foot Function Index (FFI) and visual analogue scale (VAS) values were available in their records were retrospectively analyzed. The two groups were ESWT (n=35) and ESWT+PEMFT (n=40). FFI and VAS scores were obtained from their records before treatment, after treatment, and in the third month after treatment.

 The two groups were similar regarding their pre-treatment FFI and VAS scores. In intra-group evaluation, statistically significant decreases were found in terms of the FFI pain, disability, and activity limitation and VAS scores in both groups after treatment and in the third month after treatment compared to the pre-treatment period. In the comparison between the groups, the post-treatment and post-treatment third-month FFI pain, disability, and activity limitation and VAS scores were significantly lower in the PEMFT+ESWT group than the ESWT group (P<0.001).

 A calcaneal spur is a condition that can cause pain and functional limitation in patients. Various studies have demonstrated the efficacy of ESWT in the treatment of calcaneal spurs. In our study, we observed that PEMFT added to ESWT significantly improved the pain and functionality of the patients. Further studies are needed to evaluate the efficacy of PEMFT in calcaneal spurs.

Patient satisfaction with septoturbinoplasty was measured using the subjective visual analogue scale (VAS) and Nasal Obstruction Symptom Evaluation (NOSE) scale. In addition, those factors that impacted satisfaction were confirmed.  We conducted an observational study of patients who underwent septoturbinoplasty. Age, sex, smoking habit, duration of improvement, postoperative complications, type of packing and surgeon were analysed. The results were compared using the VAS and NOSE scale. The improvement experienced with surgery corresponded to 69.80±26.97 points on the VAS 42.65±22.9 points (p <0.01) on the NOSE scale. A strong, direct correlation between the two scales (r = 0.79; p <0.01) was achieved. Surgeon, presence of complications, smoking habit and type of packing were not associated with the improvement experienced on the VAS or NOSE scale. Patients under 30 years of age and patients with permanent improvement achieved higher levels of satisfaction on both scales (p <0.01). Women showed a stronger tendency to perceive their improvement as temporary (p <0.01). Patients who underwent septoturbinoplasty experienced a subjectively measured improvement in nasal obstruction. The VAS and the NOSE scale were strongly correlated with one another. Sex, age and duration of improvement (temporary versus permanent) impacted patient perception; surgeon, smoking habit and type of packing did not.

Carpal tunnel syndrome (CTS) is a common peripheral entrapment neuropathy with squeezing of the median nerve and the patient is unable to function properly. There are different physiotherapy interventions for the management of these patients and recently, shock wave therapy and low-power laser (LPL) have been widely used, but there is no strong evidence comparing the effect of shock wave therapy and LLLT. Therefore, this trial was designed to compare the effect of extracorporeal shock wave therapy (ESWT), LPL, and routine interventions on clinical outcomes and electrophysiological parameters in patients with moderate CTS.

Fifty-four patients were randomly assigned to the control (routine interventions), ESWT, and LPL therapy groups. All participants received transcutaneous electrical nerve stimulation (TENS) therapeutic ultrasound, hot pack, mobilization, and stretching for ten sessions over two weeks. Additionally, the ESWT group received radial ESWT in four sessions, and the LPL therapy group received laser in ten sessions. The primary outcomes were pain (assessed by the visual analog scale), function (assessed using the Boston questionnaire (BQ)), hand grip, and finger pinch strength. Secondary outcomes were electrophysiological parameters (distal motor and sensory latency and nerve conduction velocity (NCV) of the median nerve. 

Time group interactions were significant for pain, the symptom severity subscale of BQ, finger pinch, and hand grip strength (p<0.001). Significant improvements were seen in clinical and sensory latency and motor NCV of the median nerve (p<0.05). The ESWT group experienced significant improvements with a large effect size in pain, function, and finger pinch strength compared to the control group (p<0.01). Additionally, the LPL therapy group showed significant changes in the function and finger pinch and hand grip strength compared to the control group. There were no significant differences between the LPL therapy and ESWT groups except for pain in favor of the ESWT group. No significant differences were found among the three groups in electrophysiological parameters (p>0.05).

Although laser therapy increased the efficacy of routine interventions, it seems adding ESWT to the routine treatment may be superior for the management of moderate CTS patients.

 In all surgical interventions including cesarean section, pain is a challenging issue.  The aim of this study was to identify the underlying causes that affect post-cesarean pain intensity.

 A total of 128 consecutive patients who underwent cesarean section at Taleghani hospital were included in the study. A questionnaire was used to gather the patients’ demographic and clinical data. The length of the incision was measured with a ruler on the first day following the cesarean section. In addition, the pain intensity was assessed using a Likert scale at scales: 1, 2, 4, 8, 12, and 24, on the day after surgery and 48 hours and one week later. Descriptive statistics were calculated for all variables. Analyses were conducted using SPSS version 22 and a p-value < 0.05 was considered statistically significant.

 The study showed that overall, patient age, BMI, level of education, type of surgical incision, duration of surgery, type of cesarean section, type of anesthesia, and breastfeeding were not predictors of postoperative pain intensity. However, the study found that “indication of the cesarean section” and the “stage of labor” in which the cesarean was performed are correlated with postoperative pain intensity. (P-value<0.05).

In this study, we were able to identify 2 parameters that were independently associated to postoperative pain scores: “underlying indication of cesarean section” and the “stage of labor” in which cesarean section is performed. This information helps clinicians to identify high-risk patients in terms of postoperative pain and take early action.

 Clinical and Radiologic Degenerative Spondylolisthesis (CARDS) classification is a relatively newer system than Meyerding’s to better categorize lumbar degenerative spondylolisthesis (LDS). The purpose of this study was to evaluate the outcome of surgery in patients with different types of LDS based on CARDS classification.

 In this retrospective study, we assessed 49 (38 female and 11 male) patients with refractory L4-L5 LDS undergoing decompression, reduction and instrumented fusion in Imam Reza Hospital of Mashhad from February 2015 to January. Patients' classification, disability, and pain were assessed based on CARDS classification, Oswestry disability index (ODI), and visual analogue scale (VAS). Finally, a statistical analysis was performed to find out any correlation between different types of the disease and their clinical improvement.

 The mean follow-up period was 40.5±6.8 months (26 -72 months). Type B had the highest prevalence, and A had the lowest. Type C had the highest body mass index. Surgery could significantly improve both pain and disability in all types of the disease; however, we could not find any significant difference between the types in response to the surgery (p-value > 0.477). Gender distribution was similar among the types, but body mass index was the highest in type C.

 Although all types of refractory L4-L5 LDS benefit from the operation, this improvement is not different among the types. It seems here, like other areas of the spine, that no significant relationship exists between the clinical and radiological characteristics.

Low-level laser is a pain-free and non-invasive treatment modality. It is used in many acute and chronic painful conditions. This study aimed to determine the correlation between pain intensity, functional disability, and range of motion using low-level laser therapy (LLLT) in patients with discogenic lumbar radiculopathy.

This cross-sectional study was conducted as a part of a randomized controlled trial of LLLT to treat patients with discogenic lumbar radiculopathy in physical therapy departments of three different hospitals in Islamabad, Pakistan, from August 2021 to September 2021. The study was conducted according to STROBE guidelines. Fifty-Five patients from the experimental group of the trial were invited to participate in this study. The outcomes of the treatment were recorded on a semi-structured questionnaire on the first day and last day of their treatment from each patient’s pain intensity, functional disability, and Lumbar range of motion (L-ROM) (flexion and extension) by using the visual analogue scale (VAS) for pain intensity, Oswestry Disability Index (ODI) for functional disability, and dual inclinometer for L-ROM. The data were analyzed through SPSS version 26.0.

The results of the correlation coefficient/Pearson’s correlation of VAS, ODI, and dual inclinometer were varied. The strength of correlation between variables was weak to moderate (r = 0.033 to 0.425) with statistically insignificant correlation coefficient (P > 0.05, 95% CI) except for lumbar flexion (P < 0.05, 95% CI).

For acute low back pain (LBP) with discogenic lumbar radiculopathy, LLLT at a wavelength of 830-nm and a dose of 3 J/point in conjunction with conventional physical therapy had no significant correlation, but rather weak to moderate values with pain intensity, functional disability, and L-ROM.

It is widely accepted that recurrent aphthous stomatitis (RAS) is the most common recurrent oral ulcer. Since none of the various symptomatic therapies recommended for painful periods can affect the etiology of the disease, the goal is only to reduce the severity of the pain, irritation, and duration of the ulcers. The purpose of this study was to compare the effects of tetracycline and Myrtus communis extract (Myrtex) on the treatment of RAS.

The patients (n=54) enrolled in the study consisted of two groups of 26 and 28 people who received tetracycline and Myrtex, respectively. The case group received Myrtex solution and the control group received 250-mg tetracycline capsules. The patients in both groups kept the drug on the ulcer for 30 seconds four times a day. They answered the visual analogue scale (VAS) on days 0, 2, and 6 and were clinically examined to check any chenges in ulcer size and healing.

According to VAS analysis, the pain and irritation levels in the Myrtex group were 34.8% less than in the tetracycline group (P<0.02). The ulcer size was 40% higher on the second day in the Myrtex group than in the tetracycline group, which was statistically significant (P<0.02), but the ulcer size changes on the sixth day of follow-up were not statistically significant (P<0.15).

According to the study, the administration of Myrtex is more effective in reducing the severity of pain and irritation and improving the quality of life. Therefore, it is recommended to prescribe Myrtex (Myrtex 5%) on the basis of the mentioned method for the treatment of minor aphthous.

Short-wave diathermy (SWD) is an electrotherapeutic modality used in the conservative treatment of knee osteoarthritis (KOA).  Electromagnetic radiation delivered in continuous (cSWD) or pulse (pSWD) mode provides a deep heating effect on tissues.  There is no consensus on outcomes of treatment with cSWD versus pSWD in KOA. The aim of this study was to compare the effects of cSWD versus pSWD on pain, functionality and walking distance in KOA.

34 female patients aged 49-65 with KOA were randomized into two groups.  A total of 27 patients completed the study. One group (n=11) was treated with cSWD, the other (n=16) with pSWD for three weeks. Patients were assessed before, after and at one month post therapy. Outcome measures included visual analogue scale (VAS) for knee pain, Western Ontario and Mcmaster University Osteoarthritis Index (WOMAC) and a six-minute walking test (6MWT).

Based on the minimal clinically important improvement (MCII), there was a reduction in VAS and WOMAC scores in both cSWD and pSWD groups post treatment (-37.3mm, 31.2mm respectively for VAS and 26%, 23% respectively for WOMAC) and at one month post treatment. There was no difference in pre and post treatment VAS for pain, WOMAC or 6MWT scores between the two groups.  There was a small post treatment effect size on between- group 6MWT scores (Cohen’s d: 0.238).

Both treatment options appear to be efficacious in reducing pain and improving functionality in KOA.  There was no between-group difference. A larger study must be conducted to consolidate these findings.

Low Back Pain (LBP) is one of the most prevalent problems associated with sport activities. The present study aimed to investigate the relationship between pain and plantar pressure variables. In addition, we compared these variables in male and female athletes with LBP.

In this study, 47 participants with the age range of 18 to 25 years were selected (22 males and 25 females). Visual Analogue Scale (VAS) was used to evaluate the LBP severity. The plantar pressure variables were recorded using a plantar pressure measurement device (model: Foot pressing FDM-S) made by Zebris Company.

Length of minor axis (pmale= 0.020, pfemale= 0.227), length of major axis (pmale= 0.041, pfemale= 0.011), area of sway (pmale= 0.0001, pfemale= 0.007), path length (pmale= 0.053, pfemale= 0.001), velocity of sway (pmale= 0.023, pfemale= 0.008), and standard deviation X (pmale= 0.048, pfemale= 0.147) of the COP variables had a positive and significant relationship with the pain. The symmetry of plantar pressure variables did not show strong correlation with the pain intensity (p>0.05). The COP variables also showed a significant difference in area of sway (p=0.042), path length (p=0.044), and standard deviation X (p=0.043) between the males and females. Females had more oscillations than males, but there was no difference in the symmetry of plantar pressure variables between the males and females (p>0.05).

LBP is a factor that can impair the postural control, resulting in increased risk of injury among the athletes with LBP, especially in females.

Using hearing aids is one of the most important management methods for patients with hearing loss and tinnitus. Many studies have been conducted to assess the effect of hearing aids on tinnitus using different tools, but there is no consensus on their usefulness and effect in relieving tinnitus. The present study aimed to investigate the effect of hearing amplification on tinnitus using the tinnitus handicap inventory (THI) and tinnitus psychoacoustic measurements. A total of 10 patients (5 male and 5 female), aged 39 to 70 years old with mild to severe sensorineural hearing loss (amplifiable hearing loss) and chronic tinnitus entered the study. The Persian version of the THI was completed for the patients and tinnitus psychoacoustic measurements, the visual analogue scale (VAS) loudness, and the annoyance VAS were performed. The patients used hearing aids for six weeks, and measurements were repeated after the intervention. Comparing the total mean score of all of the study variables before and after the intervention showed significant reductions (p<0.05). Based on tinnitus pitch matching, no significant difference was observed in mean score changes in the THI between low-pitch and high-pitch groups. Improvement was observed in tinnitus annoyance after using hearing aids for 6 weeks. Tinnitus pitch is not a good criterion for determining tinnitus treatment prognosis

Pain management following dental procedures, particularly pulpotomies and extraction, is of great importance in pediatric dentistry. The aim of this study was to investigate the efficacy of pre-treatment with ibuprofen on post-operative pain following pulpotomy of primary molars.
Methods and Materials: In a split mouth double-blinded randomized clinical trial, 49 children aging between 6-10 years old were given either ibuprofen or a placebo 45 min prior to the treatment. After pulpotomy and placement of a stainless steel crown (SSC), the pain level was evaluated using the Wong-Baker face visual analogue scale for up to 7 days post-treatment. McNemar and Wilcoxon tests were used for data analysis.
Forty-five patients were eligible to participate in this study. Pre-medication with ibuprofen significantly reduced pain during the first 24 h post-treatment (P=0.032). However, there was no significant difference in the pain levels between placebo and ibuprofen groups at 48 and 72 h post-treatment (P=0.154 and P=0.197, respectively). The number of times patients needed analgesics in ibuprofen group was significantly lower compared to that in the placebo group (P=0.008).
Pre-medication with ibuprofen resulted in less pain following pulpotomy and SSC placement in primary teeth.

Statement of the Problem: Dental injection is one of the most fearful procedures in dental setting, especially for children. Many researchers have attempted to find a painless method. As computer controlled local anesthesia delivery system devices (CCLADs) allow the speed rate and pressure of injection solution to be controlled, they may cause less pain during injection in comparison to the conventional method.
The aim of this study was to compare pain perception in dental injection by Smartject with conventional technique.
The present study was a randomized single-blind crossover clinical trial. The participants consisted of 50 healthy volunteer dental students.
They received a topical anesthetic agent plus injection in maxillary premolar buccal mucosa via conventional technique on one side (control) and a topical anesthetics agent plus injection in maxillary premolar buccal mucosa by Smartject on the other side (experimental). The first injection method was chosen based on block randomization table. A blind person recorded the subjects’ pain perception of injection based on the visual analogue scale (VAS) in the two groups. Repeated measure test, independent Student t-test and Student paired t- test were used. Statistical significance was defined at p There was statistically significant difference in VAS score between Smartject and the conventional technique. The mean of VAS scores for Smartject and the conventional technique were 14.5±7.4 and 24±12.1, respectively.
It is suggested, needle penetration is not the main reason of pain during injection. Inconsistent fluid pressure created by injected anesthetic solution on nerve fibers is more impressive in pain development. Hence, Smartject as a CCLAD can be considered as an appropriate device for dental injection.

In the current study, we sought to track the clinical course of children under control-based asthma management and focused on respiratory pathogens monitoring. We prospectively explored influencing factors for asthma control. 121 children with uncontrolled asthma between 3-14 years of age were recruited. Common respiratory pathogens were detected with pharyngeal swabs and serum aeroallergen-specific IgE was measured. Numeric asthma control scores, airway resistance and fractional concentrations of exhaled nitric oxide (FENO) were evaluated. A proper control-based asthma management plan was established by the study physician. Regular reviews were performed, with the above measurements retested at set time intervals. The proportion of patients achieving asthma control at 1 month and 3 months were 59% and 76% ; respectively (p=0.013). These patients exhibited significant improvement in numeric scores and lung function parameters. The prevalence of common respiratory pathogens did not significantly differ between reviews. The number of sensitized aeroallergens significantly increased with age (r=0.235, p=0.010). Children with a high visual analogue scale (VAS) score for asthma at baseline were less likely to achieve asthma control after 1 month, while those sensitized to more aeroallergens were more likely to achieve asthma control after 1 month (p=0.016 and 0.012). In summary, children with asthma showed significant improvements in control rates and lung function during control-based asthma management, independent of respiratory pathogens testing reults. Patients with high VAS scores and fewer sensitizations to aeroallergens had difficulty achieving short-term asthma control.

Degenerative lumbar spine disease can lead to lumbar spine instability. The patients can present with Low Back Pain (LBP), radicular pain, and motor and sensory dysfunction. Age >50, female sex and pregnancies are among prevalent risk factors. The degeneration process usually starts from the intervertebral discs progressing to involve facet joints, ligaments, and vertebral bodies leading to spinal instability and deformity. This study aims to evaluate the effect of lumbar decompression and Posterolateral Fusion (PLF) on the short- and long-term outcomes of these patients.
Methods and Materials/Patients: This prospective study assessed the effect of lumbar decompression and PLF in patients with lumbar instability referred to the Neurosurgery Clinic of Chamran hospital between March 2011 and March 2013. Forty-four patients with degenerative lumbar spine instability and stenosis were eligible for participation to undergo lumbar decompression and PLF. Its clinical effect was evaluated using Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI). The change in sagittal and coronal planes was also assessed according to pre- and post-operative findings at 2-year follow-up. The statistical method of assessment was repeated using paired t-test. P The mean preoperative VAS score decreased significantly at 2 years after the surgery (6.87±1.07 vs. 2.20±1.15; P Lumbar decompression and PLF is a safe and effective method for patients suffering from degenerative lumbar instability.

Postoperative pain is a complex process commonly caused by surgical trauma. It is one of the major concerns of patients undergoing heart surgery. Despite new techniques and modern analgesic treatments, postoperative pain is still one of the most important controversial issues.
68 patients scheduled for elective CABG with CPB were included in a prospective, double-blind clinical trial. They were randomly divided into two groups. One group received PCA pump including morphine (group P) with underlying infusion of 0.02 mg/kg/Qh, bolus dose of 1 mg, lockout time of 15 minutes, and a maximum of 4 bolus of 0.02 mg/kg for one hour and the other group received morphine bolus (group B). Three patients were excluded from the study, and 33 and 32 patients participated in the groups P and B, respectively. Variables including age, gender, pump time, aortic clamp time, duration of surgery, complications (nausea and vomiting, GI Bleeding, and hypoxia), level of pain based on VAS, opioid consumption, hemodynamic, and sedation status were measured in both groups.
There was no significant difference between the groups regarding age, gender, pump time, clamp time, duration of surgery, complication, sedation score, and hemodynamic status in most of the assessment periods. By assessing the pain severity in the groups at different periods, results showed a significant difference between the groups except at enrollment, and a lower severity of pain was noted in the group P compared to the group B. The consumed opioid was significantly higher in the group P than in the group B. However, higher doses of diclofenac and paracetamol were administered in the group B compared to the group P.
Results showed that higher morphine would be used in patients with PCA pump after extubation following heart surgery, and this increased dose of opioid was associated with better pain control and lack of complication. Therefore, PCA pump with underlying infusion could be effectively used in patients undergoing CABG that are directly assessed in intensive care unite.

Prevertebral soft tissue swelling (PSTS) following anterior cervical surgery, may proceed to airway compromise which is potentially lethal. We plan to evaluate the effect of local steroid injection to reduce PSTS after anterior cervical discectomy and fusion (ACDF).
In a randomized clinical trial 66 patients who underwent ACDF involving one to three segments due to radiculopathy or myelopathy were enrolled and randomly divided to two groups of 38 with local injection of 80 mg methylprednisolone in operation site, and control. Prevertebral soft tissue thickness to mid anteroposterior vertebral body diameter (S/V) ratio was defined to assess PSTS. In addition, dysphagia and pain at surgery site was evaluated using Bazaz dysphagia scale and Visual Analogue Scale (VAS) respectively, at 1st, 5th and 10th post-operative days.
We have observed significantly lower S/V ratio in all studied vertebrae, except C6 on second postoperative day in case group. At the end of the 6th month, there was no significant difference for S/V ratio in any level in two groups. Severity of dysphagia was significantly lower in 1st, 5th and 10th post-operative day in patients in case group. (P value The use of local methyl prednisolone in prevertebral space is a simple and effective method to reduce PSTS and severity of dysphagia and odynophagia. Furthermore, this method was not associated with any adverse effects.

Pharmacotherapy with analgesics and non-steroidal anti-inflammatory drugs has been traditionally used to relief post-operative pain of endodontic treatments. However, due to the side effects reported for these drugs, some efforts have been made to decrease the post-operative pain of the endodontic treatments through laser irradiation. The present study aimed to evaluate the effects of low level laser therapy (LLLT) on the reduction of pain after root canal retreatment.
In this clinical trial, 61 patients requiring endodontic retreatments in posterior teeth were selected. A single visit endodontic retreatment was performed. After biomechanical preparation, low level laser was irradiated to the buccal and lingual mucosa overlying the apices of the target tooth in the experimental group. In the control group patients received placebo laser to eliminate the probable psychological effects of laser. Laser irradiation was done with a single dose of 808 nm wavelength (Whitening Lase II- Laser DMC, Samsung, Korea) with 100 mW power, and dose of 70 J/cm2 for 80 seconds. Pain severity was recorded before, immediately after and 4, 8, 12, 24 and 48 hours after the treatment by visual analogue scale (VAS). The pain scores were statistically analyzed by chi-square test between 2 groups. The effects of different variables on the post-operative pain experience were also studied by means of Logistic regression.
Pain scores decreased significantly through time until 48 hours after treatment. No significant differences were observed between the 2 modalities regarding pain scores at any time. According to regression analysis, pain severity scores were lower in the laser-irradiated specimens than control groups (OR = 5.69); however, this difference was not statistically significant. Consumption of analgesics after the treatment had significant effect in decreasing post-operative pain experience (OR = 56) while factors of age, gender, laser irradiation, pre-treatment pain scores and education level did not.
Low level laser irradiation had limited effects to decrease pain associated with the endodontic retreatments in the first and second molars; however, more studies are required to assess the effects of different parameters of low level laser in this regard.