جستجوی مقالات مرتبط با کلیدواژه "pain" در نشریات گروه "پزشکی"

Carpal Tunnel Syndrome (CTS) is the most common peripheral nerve entrapment condition, impairing median nerve function at the carpal tunnel level. Previous studies indicate a strong patient preference for non-surgical treatment. While some evidence suggests electroacupuncture may promote nerve regeneration and improve functional outcomes, findings remain inconclusive. This study aims to assess the impact of electroacupuncture on symptom severity, functional status, pain, and grip strength in patients with mild to moderate CTS. This is a protocol for a randomized, sham-controlled trial. Thirty-eight patients diagnosed with CTS will be randomly assigned to either a treatment group receiving electroacupuncture or a control group receiving sham electroacupuncture. Both groups will undergo ten sessions over five weeks (twice weekly) and receive neurodynamic techniques as standard care. Outcome measures—symptom severity, functional status, pain, and grip strength—will be evaluated at baseline, after the fifth session, 48 hours after the tenth session, and two months post-treatment. This trial is registered at https://www.irct.ir/ (IRCT20191208045652N5) as of 7/12/2022. Ultimately, the results of this study will provide evidence regarding the efficacy of Electroacupuncture combined with NDT techniques on Symptom Severity, Functional Status, Pain, and Grip strength in patients with Carpal Tunnel Syndrome. This study will provide insights into the efficacy of electroacupuncture as a treatment for CTS.

Rutin is a bioflavonoid compound renowned for its anti-oxidative, anti-inflammatory, and antinociceptive properties. The present study aims to assess its therapeutic efficacy on complete Freund’s adjuvant (CFA)‑induced inflammatory pain. 

Arthritis was induced in Wistar rats via subcutaneous administration of CFA into the right hind paw. Rutin (15 and 30 mg/kg) and indomethacin (5 mg/kg, orally) were given once daily for three weeks. Parameters observed included alterations in paw swelling perimeter, arthritis scores, and body weight. Additionally, antinociceptive activity was measured through thermal hyperalgesia and cold allodynia responses. The Tumor necrosis factor-alpha (TNF-α) level in the serum was measured. Malondialdehyde (MDA), thiol levels, catalase, and superoxide dismutase (SOD) activities were also evaluated as serum oxidative stress markers. 

Rutin and indomethacin significantly suppressed alterations in paw edema, pain responses, and arthritis scores and reduced the loss of body weight in contrast to disease-control rats. Furthermore, in contrast to disease control rats, rutin and indomethacin treatment exhibited an anti-inflammatory effect through a marked reduction in TNF-α levels in the serum. Rutin and indomethacin demonstrated a significant increase in catalase and SOD activities, a total thiol level, and a decrease in MDA level compared to the disease-control rats.

These results suggest that rutin’s antiarthritic effect is mediated by its antinociceptive, anti-oxidant, and anti-inflammatory properties.

Aims :

Pain and altered motor control are consequences of chronic low back pain (LBP). The present study aimed to assess the effects of a six-week Swiss ball core stabilization program on pain levels and lumbopelvic motor control in patients suffering from nonspecific LBP.

Materials & Methods :

This randomized clinical pilot study involved 24 participants (12 females and 12 males) who were diagnosed with nonspecific chronic LBP (mean age=42.08±7.05 years). Participants were randomly assigned to two groups: experimental (n=12) and control (n=12). The experimental group underwent a six-week intervention of core stability exercises, while the control group received routine physical therapy. The primary outcome measured was pain intensity using a visual analog scale ranging from 0-10. Secondary outcomes included lumbopelvic motor control, which was assessed using various tests, such as the knee lift abdominal test, bent knee fall-out test, Waiter's Bow test, sitting knee extension test, and transversus abdominis test. Evaluations were conducted at three time points: baseline, the end of a six-week intervention, and after one month of follow-up.

Findings :

The core intervention resulted in a significant increase in motor control during the post-test (P<.001; Cohen's d=6.04), although this effect did not persist in the follow-up assessment. Moreover, a significant decrease in pain intensity was observed both during the post-test (P<.001; Cohen's d=3.31) and follow-up (P<.001; Cohen's d=2.98) periods. Furthermore, significant differences were identified between the two groups in all outcome measures following the intervention (P<.05).

Compared to routine physical therapy, the six-week core stability exercises on the Swiss ball resulted in marked improvements in pain intensity and lumbopelvic motor control in patients with nonspecific chronic LBP.

Diabetic Peripheral Neuropathy (DPN) is a common yet challenging complication of diabetes, particularly in managing neuropathic pain. Palmitoylethanolamide (PEA), a naturally occurring nutraceutical from the ALIAmides group, has demonstrated potential for pain modulation, inflammation reduction, and improving quality of life.

 A 9-month prospective observational study at PSG Hospital evaluated the impact of adding oral capsule PEA (708 mg in two divided doses) to standard therapy for DPN patients unresponsive to maximum tolerated dosages of Gabapentin, Pregabalin, amitriptyline, or duloxetine. The outcomes were the pain severity and quality of life. Pain was assessed using the Visual Analog Scale (VAS), sensitivity was evaluated via monofilament testing, and quality of life was measured using the American Chronic Pain Association (ACPA) Quality of Life Scale (QOLS).

 Sixty patients with DPN were treated with adjunctive PEA and monitored for 8 weeks. Pain scores decreased significantly (6.05±1.096 to 4.15±1.233 at 4 weeks and 3.57±1.155 at 8 weeks, p˂0.05). Sensitivity improved via monofilament testing (7.12±1.58 to 9.43±0.78). Quality of life scores rose from 7.67 to 9.41 at 4 weeks and 9.68 at 8 weeks, indicating notable benefits.

 PEA proved effective as a supplemental treatment for nonresponsive DPN patients, yielding significant reductions in pain, enhanced sensitivity, and better quality of life. Importantly, no side effects were reported, affirming its tolerability and safety.

Angina pectoris is characterized by chest pain due to reduced blood flow to the heart, often caused by narrowed coronary arteries. This review examines medicinal plants traditionally used in Iran to alleviate angina symptoms, exploring both historical and modern applications. The goal is to enhance understanding of potential natural remedies for this condition.

This systematic review aimed to identify literature on the use of medicinal plants for angina pectoris. Searches were conducted across major scientific databases like Web of Science, PubMed, and Scopus, using keywords related to chest pain and herbal treatments. Articles included in the review were required to be in Farsi or English, focus on the effects of medicinal plants on angina, and be original research, reviews, or clinical trials, while excluding those with insufficient data or irrelevant content.

Traditional Iranian medicine incorporates a rich array of herbal remedies for various ailments, including angina pectoris. Among the most commonly employed medicinal plants in Iran are garlic (Allium sativum), coriander (Coriandrum sativum), asafoetida (Ferula assa-foetida), cumin (Cuminum cyminum), ajwain (Carum copticum), parsley (Petroselinum crispum), pomegranate (Punica granatum), ginger (Zingiber officinale), green pumpkin (Cucurbita pepo), orange (Citrus sinensis), banana (Musa spp.), guava (Psidium guajava), apple (Malus domestica), turmeric (Curcuma longa), borage (Borago officinalis), lavender (Lavandula angustifolia), aloe vera (Aloe vera), almond (Prunus dulcis), basil (Ocimum basilicum), and alfalfa (Medicago sativa). These plants have been historically utilized as potential remedies for chest pain in Iranian traditional medicine.

The findings of this study suggest that traditional Iranian medicine offers a diverse array of medicinal plants with potential therapeutic benefits for angina pectoris. The identified plants exhibit a range of pharmacological properties, including anti-inflammatory, antioxidant, sedative, and antispasmodic effects. Additionally, these plants may contribute to improved blood circulation, potentially alleviating the symptoms of chest pain associated with angina.

Pain experienced by intubated patients is caused by several extrinsic sources, including nursing care procedures such as endotracheal suctioning. Several nonpharmacological therapies, including listening to Quran recitation, have never been tested for their pain relief effects among intubated patients, despite these therapies being cost‑effective, easy to implement, and free of adverse effects. This study aimed to examine the pain‑relieving effect of listening to Quran recitation during pain‑inducing procedures in patients receiving mechanical ventilation support.

This pilot study used an experimental design with 32 intubated patients at King Abdullah University Hospital in Irbid, Jordan. The Behavioral Pain Scale and Ramsay Sedation Scale were used to assess pain levels and sedation, and physiologic parameters were monitored before and during endotracheal suctioning.

The findings showed significant differences in Behavioral Pain Scale (BPS) scores and heart rate measures between the intervention and control groups after controlling for the level of sedation. The patients in the intervention group scored lower pain and HR measures than those in the control group (F5,26 = 11.47, p < 0.001).

The findings showed significant improvement in the levels of pain and heart rate measures among intubated patients who are exposed to Quran recitation. Complementary medicine is essential to the healthcare plans of critically ill patients and their families. Holy Quran recitation has been reported to be a useful nonpharmacological intervention for critically ill Muslim patients.

Effective pain assessment in neonatal care is crucial for ensuring the well‑being of newborns. However, barriers to its successful implementation persist. This study aims to identify the obstacles that hinder effective neonatal pain assessment by neonatal intensive care units (NICUs) nurses.

This qualitative study was conducted using the method of conventional content analysis. Purposive sampling was employed from February to September 2023, selecting 14 female nurses working in NICUs of hospitals in Tehran and Karaj as participants. Indepth, semistructured interviews were conducted to collect the data. The software “MAXQDA” version 2016 was utilized for managing qualitative data.

Four main themes and eleven subthemes were identified: “Overtasked,” “Discordant atmosphere,” “Soulless care,” and “Lack of awareness.” Each of these main themes is further elaborated through the subsequent subthemes.

This study found that the lack of knowledge and understanding of neonatal pain assessment tools, the busyness of nurses, lack of time, excessive documentation, and the inadequacy of staff relative to the number of newborns were the most significant obstacles to the assessment of newborn pain. Addressing these challenges is critical for optimal neonatal pain assessment and management, promoting the well‑being of newborns.

Virtual reality (VR) is effective in several healthcare domains. As of date, there
have been no systematic reviews investigating the efficacy of VR technology in episiotomy repair
in women. This systematic review and meta-analysis examined the effects of using VR on pain,
anxiety and satisfaction in women under episiotomy repair.

For the original articles, six databases were searched using relevant keywords without
restriction on time or languages until June 6, 2024. The Cochrane risk-of-bias tool for randomized
trials (RoB) and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) were
both used to assess the risk of bias in randomized and non-randomized studies, and the Grading
of Recommendations Assessment, Development, and Evaluation (GRADE) also determined the
quality of our evidence. All analyses employed Comprehensive Meta-Analysis (CMA) V.2.

Five randomized clinical trial and two quasi-experimental studies with poor-to highquality met the inclusion criteria. The VR significantly decreased perineal pain during [MD
(95% CI)=-1.622 (-2.598, -0.645), P=0.001], immediately after [MD (95% CI)=-1.931 (-2.785,
-1.076), P<0.001], and one hour after [MD (95% CI)=-1.596 (-2.436, -0.765), P<0.001]. It also
significantly decreased anxiety [SMD (95% CI)=-1.48 (-2.451, -0.509), P=0.003] after repair.
VR group participants were significantly more satisfied than the control group. The quality of
was moderate for perineal pain intensity one hour after episiotomy repair and anxiety after
episiotomy repair.

Given the efficacy of VR on pain, anxiety, and satisfaction, it is suggested that it be
utilized as a novel modality to enhance the quality of maternity hospital care.

This study aims to compare the effects of high-intensity laser therapy (HILT) and quadriceps muscle strengthening exercises using biofeedback on pain and function in patients with knee osteoarthritis (KOA).

This randomized, two-group clinical trial included patients with KOA (grades II - III of the Lawrence Kellgren classification) who met the inclusion criteria. Written informed consent was obtained from participants before they were randomly allocated into one of two groups: HILT + therapeutic exercise (group A) or quadriceps muscle strengthening exercises using biofeedback + therapeutic exercise (group B). Both groups followed the same therapeutic exercise regimen during the study.Knee pain severity was evaluated using the Visual Analogue Scale (VAS), and functional disability was assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire before the intervention.For group A, HILT was performed using a BTL-6000 HIL device (wavelength 1064 nm, maximum power 12 W) following the manufacturer-recommended protocol. A pain relief program (10 W, 120 J/cm²) was administered for 120 seconds per session over ten sessions. Treatment protocol, laser positioning, and session duration were standardized. Two follow-up assessments (immediately and one-month post-intervention) were conducted to evaluate outcomes based on the VAS and WOMAC scores.

The study included 40 participants with KOA, divided evenly between the two groups (20 in each). The average age of the participants was 59.34 ± 6.92 years. High-intensity laser therapy group (group A): Visual analogue scale pain scores decreased significantly immediately after and one month post-intervention compared to baseline (P < 0.01). However, the VAS score one month after the intervention showed no significant difference compared to the immediate post-intervention score (P = 0.59). Biofeedback group (group B): VAS pain scores also decreased significantly both immediately after and one month post-intervention compared to baseline (P < 0.05). The difference in VAS pain reduction between the two groups was significant, with the HILT group showing greater improvement immediately after the intervention and one month later (P = 0.007).

The study findings suggest that both quadriceps muscle strengthening exercises using biofeedback and HILT effectively reduce pain in KOA patients. However, HILT demonstrated superior efficacy compared to biofeedback exercises. These results support the use of HILT as a noninvasive therapeutic modality for KOA, particularly for patients with a higher risk of surgery due to preexisting comorbidities.

Infant immunisation by intramuscular injection is a painfull procedure for infants. The goal of this study was determine effectiveness of oral sucrose on pain severity in term newborns undergoing   vaccination.

In this randomized controlled trial 90 term newborns undergoing hepatitis B vaccine injection which performed in Shahid Mustafa Hospital in Ilam, were selected and randomly assigned into three groups: intervention, control and placebo. Then 2 minutes before vaccine injection 2ML 25% sucrose or water for injection was instilled into mouth of infants in intervention or placebo groups, respectively. The newborns of control group didn't take anything and pain intensity measured by Neonatal Infant Pain Scale (NIPS) during 1-2 min. The collected data were analysed by SPSS18 Software.

According to the results, there was no significant difference between groups in term of Apgar score, delivery type, sex, head circumstance, weight and height. Comparison of pain severity in two groups, mean and Standard deviation of pain, group that received Sucrose solution had low intensity than sterile water group (3 ± 1.66 vs. 4.05 ± 1.23), but this difference was not significant statistically (p=0.78). Comparison of pain intensity in control and intervention groups showed that the pain intensity in control group is higher than intervention and placebo groups (p<0.001).

Sweet solution of sucrose can be used as a simple and safe non pharmacological method to reduce the pain following immunization in newborn.

The use of opioids for pain relief after cesarean section (C/S) can result in adverse maternal and neonatal outcomes. Therefore, it is important to consider non-opioid analgesics as an alternative. This study examined the effect of intravenous ketamine on analgesic requirement after spinal anesthesia in C/S.

This double-blind randomized clinical trial 80 pregnant women under spinal anesthesia during a planned C/S were recruited from trainig hospitals of Mashhad, Iran between February and August 2022. The participants were selected using convenience sampling and assigned to two intervention (40) and control (40) groups through random allocation. The intervention group received intravenous ketamine (0.5 mg/kg) and midazolam (0.02 mg/kg) immediately after umbilical cord clamping, while the control group received midazolam alone (0.02 mg/kg). Pain scores were recorded at the 0th, 6th, 12th, and 24th hours after elective C/S using the Visual Analog Score (VAS), along with the amount of requiremen to analgesics. Data analysis was performed by SPSS software (version 16) using Chi-square, T-test and repeated measure ANOVA test.

A significant difference in pain scores between the two groups at different hours and over time (P=0.009). The intervention group reported significantly lower levels of pain than the control group (P=0.002) and a significantly lower need for painkillers during the first hour (P=0.04).

Administration of intravenous ketamine in elective C/S with spinal anesthesia in the first hour has a significant effect on reducing pain. Therefore, it can be considered the drug of choice for alleviating pain.

This study aimed to investigate the effect of exercise intervention on non-specific neck pain and head and neck angles among adult smartphone users. This interventional study was conducted among 84 adults divided into experimental and control groups. Data were collected using a demographic questionnaire and the Visual Analogue Scale (VAS). Craniovertebral angle (CVA), head flexion angle (HFA), gaze angle (GA), and forward head position (FHP) were determined from photographs analyzed with Kinovea software. The corrective exercises included 10 exercises targeting the neck muscles, including flexors, deep flexors, scapulothoracic muscles, and stretching of both left and right neck muscles. The experimental group performed these exercises for 12 weeks, with five weekly sessions lasting 15 minutes each. Research variables were re-measured immediately after the intervention. 45.3% of the experimental group reported moderate neck pain severity before the intervention. Following the intervention, 33.3% of the experimental group reported no neck pain. The severity of neck pain significantly improved in the experimental group after the intervention (t=8.08, P=0.004). The greatest angle improvement was observed in GA, with a mean increase of 20.44° in the experimental group after three months (t=12.49, P=0.003). HFA (t=6.52, P=0.009) and FHP (t=12.74, P=0.007) significantly decreased in the experimental group postintervention. Additionally, CVA showed a statistically significant increase in the experimental group (t=-11.75, P=0.004). Over half of the experimental group reported reduced neck pain severity after the exercise intervention. Three months of corrective exercises significantly decreased HFA and GA while increasing CVA in the experimental group by more than 10 degrees.

Bennett's fracture, the most common intra-articular fracture occurring at the base of the thumb, accounts for less than 1% of all hand fractures. It typically results from specific traumatic mechanisms, deforming forces, and ligamentous injuries. To compare the functional outcomes and sequelae in patients with Bennett's fracture treated surgically using: Open reduction and internal screw fixation, closed reduction and percutaneous fixation, arthroscopy-assisted reduction and screw fixation.

A systematic literature review was conducted to identify studies on Bennett's fracture dislocations in patients over 18 years of age without additional injuries. Searches were performed in PubMed, Scopus, Cochrane Central, Web of Science, Scielo, Lilacs, Oneme, and Epistemonikos databases, with language restrictions in English, French, Spanish, Portuguese, Italian, and German, and no date restrictions. Primary outcome variables included measures of functionality and secondary outcomes such as pain, stiffness, and osteoarthritis.

A total of 18 studies met the selection criteria, with most being retrospective (94.45%). Pain measures were reported in 77.78% of the studies, predominantly using the VAS (min=0 and max=2). All techniques seemed to achieve similar functional outcomes. The main difference was the pain registered at follow-up, mainly by patients treated with open reduction. Osteoarthritis appeared as a common consequence of these fractures, regardless of the treatment type -excluding arthroscopy-assisted reduction as there was not enough data.

The three techniques had similar functional outcomes. Closed reduction and percutaneous fixation appear to result in less pain; however, both closed reduction with percutaneous fixation and open reduction with internal screw fixation have similar rates of osteoarthritis at follow-up. Unfortunately, there is insufficient data to evaluate arthroscopy-assisted reduction with screw fixation, suggesting the need for rigorous follow-up in patients undergoing this surgical intervention. Level of evidence: III

 Platelet-rich fibrin (PRF) enhances tissue healing by releasing essential growth factors. Surgical extraction of deeply impacted mandibular third molars poses a common challenge, often leading to significant defects at the distal root of the second molar. This study explored the role of PRF in soft and hard tissue healing after surgical extraction.

This triple-blind, split-mouth, randomized controlled trial involved patients with bilateral impacted mandibular third molars. Single-stage surgical extraction was performed, and PRF was applied at one site while the other served as the control. Plaque index (PI), sulcus bleeding index (SBI), clinical attachment levels (CALs), postoperative pain, edema, tenderness, sensitivity, and bone level were assessed on day 1, day 3, first week, and first, third, and sixth months.

  Sixty-four (34 males and 30 females) patients were found eligible for assessment. The test group exhibited a significant decrease in mean pain scores compared to controls (P<0.001), notably resolving by one month. Edema scores were significantly lower in the test group at all intervals up to one month (P=0.045). Tenderness showed a significant difference at one week (P=0.001), resolving by three months. No significant hard tissue changes were noted (P=0.825).

  Significant benefits over postoperative pain, bleeding, tenderness, and initial sensitivity underscored the importance of PRF in soft tissue healing following impacted mandibular third molar extraction. However, no improvement in bone height outlined its limited potential in hard tissue regeneration over exposed root surfaces of the mandibular second molar.