scholarly journals Evaluation of Efficacy of Customized Lidocaine Bioadhesive Anaesthetic Patch for Extraction of Primary Tooth - An Invitro Study

2021 ◽  
Vol 10 (24) ◽  
pp. 1830-1834
Author(s):  
Amith Adyanthaya ◽  
Risana K ◽  
Aparna Sivaraman ◽  
Gopika Gopan A ◽  
Nazreen Ayub K. ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Anaesthetic Agent ◽  
Age Groups ◽  
Negative Influence ◽  
Paediatric Dentistry ◽  
Primary Tooth ◽  
P Value ◽  
Pain Response ◽  
Chi Square

BACKGROUND We wanted to clinically evaluate the efficacy of lidocaine bioadhesive patches for extraction in paediatric dentistry and assess the comfort and pain response by sound eye motor (SEM) scale and intensity of pain using the visual analogue scale (VAS). METHODS A total of thirty-five co-operative children of age group 8 - 12 years without systemic diseases who needed dental extraction participated in the study. Extraction was carried out using customized lidocaine bioadhesive patches as anaesthetic agent. Evaluation of comfort and pain response was done by sound eye motor scale and intensity of pain using the visual analogue scale. Statistical analysis was done with SPSS version 2.0. Comparison of SEM scale and VAS scores between different subgroups was done using a chi-square test. P value less than 0.001 was considered statistically significant. RESULTS Children of higher age groups belonging to both the genders demonstrated less perception to pain during extractions using lidocaine patch. During extraction of firm teeth and teeth with Grade I mobility, perception of pain was more in girls. Maxillary arch extraction in children with various grades of mobility perceived less pain. Irrespective of age, gender and arches,teeth with Grade II and Grade III mobility were extracted with minimal VAS and SEM score. CONCLUSIONS Bioadhesive patches serve as a potential non-invasive alternative to traditional modes of local anaesthetic delivery with the advantage of eliminating needle phobia and possible negative influence on the behaviour. KEY WORDS Bioadhesive Patches, Lidocaine, Extraction, Paediatric Dentistry

scholarly journals Comparative Evaluation of Effectiveness of Intravenous Paracetamol and Intravenous Diclofenac as Post-operative Analgesia in Laparoscopic Cholecystectomy

2018 ◽  
Vol 6 (2) ◽  
pp. 6
Author(s):  
Kalpana Kharbuja ◽  
Mahesh Sharma ◽  
Nil Raj Sharma
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
P Value ◽  
Anesthesia Induction ◽  
Chi Square ◽  
Rescue Analgesia ◽  
Post Operative Period ◽  
Post Operative Pain ◽  
Intravenous Paracetamol

Introduction: Though the development of minimally invasive surgery  has revolutionized the field of surgery,  post-operative pain is still a significant issue. Unlike in the past, concerns about adverse effects have limited the role of opioids in post-operative pain management. This study aims to compare the effectiveness of intravenous paracetamol and  diclofenac as postoperative analgesia in laparoscopic cholecystectomy. Methods:One hundred and twenty eight patients of American Society of Anesthesiologists (ASA) categories I and II  included in this study  were divided into two groups. Anesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) intravenous paracetamol and the second group received 2mg/kg (maximum 75mg) intravenous diclofenac 30 minutes prior to ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. Mann Whitney U test was used to analyze quantitative data and Chi-square test for categorical data. P value <0.05 was considered statistically significant. Results:  Profiles of hemodynamic changes were almost similar in both groups with respect to heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We observed statistically significant differences  in visual analogue scale between the two groups. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in  paracetamol group.   Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect  with low mean pain score and less requirement for rescue analgesia compared to diclofenac.

scholarly journals Impact of pharmacist directed counseling on knowledge, attitude, practices and medication adherence among hypothyroidism patients: a quasi-experimental design

2019 ◽  
Vol 10 (3) ◽  
pp. 1891-1899
Author(s):  
Narayana Goruntla ◽  
Vijayajyothi Mallela ◽  
Devanna Nayakanti
Keyword(s):  
Medication Adherence ◽  
Experimental Design ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Pill Count ◽  
P Value ◽  
Chi Square ◽  
Validated Questionnaire ◽  
Quasi Experimental ◽  
Chi Square Test

The pharmacist plays an important role in providing counseling services to patients suffering with various chronic disorders and to improve health outcomes. The study aims to evaluate the effect of pharmacist mediated counseling on Knowledge, Attitude, and Practice (KAP) and medication adherence (MA) among hypothyroidism patients attending outpatient department of a secondary care referral hospital. This is a Quasi-Experimental design without control. A total of 403 patients were enrolled and subjected for KAP assessment by pre-validated questionnaire, and medication adherence levels by pill count and visual analogue scale methods. All patients were counselled by the pharmacist regarding hypothyroidism and its management. After three months, post-KAP and medication adherence levels were measured. Chi-square test was used to compare the adequacy of KAP levels. The paired t-test was used to compare mean medication adherence and mean KAP percentage levels. The mean KAP percentage levels were significantly improved after counselling (80.5±16.4; 86.2±15.7; 67.5±13.8) compared to before (34.1±21.7; 33.8±22.9; 24.5±20.9) with a P value less than <0.0001. There was a significant improvement in mean medication adherence levels measured by visual analogue scale method and pill count method after counselling (92.4±4.8, 97.4±3.2) compared to before counselling (76.8±6.8, 80.3±6.4). The study illustrates how pharmacist plays an integral part in improving medication adherence and KAP towards hypothyroidism management. Improving KAP and medication adherence levels will promote positive clinical outcomes and prevents complications associated with hypothyroidism.

scholarly journals Clinical Spectrum of Angiomatous Granuloma and Inflammatory Fibrous Hyperplasia- A Retrospective Study

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 159-162
Author(s):  
Rithanya P ◽  
Archana Santhanam ◽  
Subhashree R
Keyword(s):  
Age Groups ◽  
Hospital Setting ◽  
Clinical Spectrum ◽  
Complete Analysis ◽  
P Value ◽  
Chi Square ◽  
Female Population ◽  
Gingival Enlargement ◽  
Gingival Diseases ◽  
Chi Square Test

Angiomatous granuloma is a reactive tumour-like lesion commonly seen in the oral cavity. It generally occurs due to proliferation of capillary blood vessels. Whereas, inflammatory fibrous hyperplasia (IFH) refers to gingival enlargement, which is the current terminology for an increase in the size of the gingiva and is a common feature of gingival diseases. Therefore, the aim of the current study is to analyse the clinical spectrum of angiomatous granuloma/ IFH in a private dental hospital. This study was carried out in a hospital setting (single centred study). The data of the study subjects was collected after a complete analysis of data of 86000 patients between June 2019 and March 2020. The data of the patients, including age, gender clinical diagnosis and histopathological reports, were collected and analysed using the Chi-square test to find the association between the clinical and histopathological reports in the study. In the present study, angiomatous granuloma(55%) had a higher prevalence compared to IFH (40%) with higher gender predilection among the female population (61.5%) and generally in the age group ranging from 20 to 40 years. (57.5%) [p value= 0.329] statistically not significant. Similarly, IFH was also found to be higher in the female population of about (38.4%), in the age groups between 20 to 50 years (41.3%). The knowledge of various clinical presentations and histopathological characteristics the lesion is necessary for proper identification and treatment planning.

scholarly journals Evaluation of cosmetic appearance of herniotomy wound scars in African children: Comparison of tissue glue and subcuticular suturing

2009 ◽  
Vol 42 (02) ◽  
pp. 199-203
Author(s):  
A. O. Ademuyiwa ◽  
O. A. Sowande ◽  
O. Adejuyigbe ◽  
U. E. Usang ◽  
T. I. B. Bakare ◽  
...  
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Wound Closure ◽  
Plastic Surgeon ◽  
Cosmetic Outcome ◽  
Chi Square ◽  
Tissue Glue ◽  
Cosmetic Appearance ◽  
Significant Difference ◽  
Suturing Technique

ABSTRACT Aim: To evaluate the cosmetic appearance of herniotomy wound scars closed using either the tissue glue or subcuticular suturing technique. Materials and Methods: Prospective randomised control study; randomisation into tissue glue and suturing groups. Ethical clearance obtained. Cosmetic outcome were based on visual analogue scale by parents and Hollander wound evaluation scale by a Plastic Surgeon blinded to the wound closure method. Results: Fifty one wounds were evaluated, 26 in the tissue glue group and 25 in the suturing group. Parents’ evaluation using Visual Analogue scale (VAS) showed that in the suturing group, 17 parents (68%) gave a VAS of 8cm while six parents (24%) gave a score of 7cm. Two parents (8%) gave a score of 9cm. In the tissue glue group, 22 parents (84.6%) scored the scar of their children as 8 or 9cm on the VAS while four parents (15.4%) gave a score of 7cm. The median VAS was 8cm for both groups with a range of 7 to 9cm. The Chi- square test showed that the parents preferred tissue glue compared with subcuticular suturing (X2 = 7.90, P < 0.05). The Hollander Wound Evaluation Scale (HWES) used by Plastic Surgeon showed 21 herniotomy wounds (84%) had a score of 6 in the suturing group while four wounds (16%) had a score of 5. In the tissue glue group, 19 wounds (73%) had a score of 6, six wounds (23.1%) had a score of 5 and a patient (3.8%) had a score of 4. The median score is 6 for both groups. There was no statistically significant difference between both groups (X2 = 1.481, P = 0.393). Conclusion: This study has shown that the cosmetic outcome of wound closure using the tissue glue technique and subcuticular suturing technique are similar.

scholarly journals Prevalence of De-Quervain’s Tenosynovitis and Its Association with Text Messaging in Collegiate Girl Students of Amritsar

2021 ◽  
Vol SP (1) ◽  
Author(s):  
Vandana ◽  
Shyamal Koley
Keyword(s):  
Visual Analogue Scale ◽  
Text Messaging ◽  
Analogue Scale ◽  
Smart Phones ◽  
Chi Square ◽  
De Quervain’S Tenosynovitis ◽  
Chi Square Test ◽  
Girl Students

Purpose: The purpose of the present study was to search the prevalence of De-Quervain’s tenosynovitis in collegiate girl students of Amritsar and its association with mobile size and text messaging per day by the students. Materials and methods: To fulfill the purpose, randomly selected 201 girl students those who used their smart phones of different sizes and for texting varied number of SMS every day, aged 18-26 years, were selected from Guru Nanak Dev University, Amritsar. The Visual Analogue Scale (VAS) was used to measure the pain in wrist. The Finkelstein test was conducted on the subjects to ascertain their De-Quervain’s tenosynovitis status. Chi-square test was applied to search any association of De-Quervain’s tenosynovitis and mobile size and SMS messaging by the students. Results: It was observed that, out of 201 girl students, 20.89% were reported Finkelstein test positive. Statistically, highly significant (p<0.001) association was found between positive Finkelstein status and the mobile size and SMS messaging per day by the collegiate girl students. Conclusion: It might be concluded that 20.89% of the girl students had De-Quervain’s tenosynovitis. Statistically highly significant association was found between positive Finkelstein status and the mobile size and SMS messaging per day by the collegiate girl students.

scholarly journals Prevalence of internet gaming disorder in India: a technological hazard among adolescents

2020 ◽  
Vol 7 (2) ◽  
pp. 688
Author(s):  
Vamsi Krishna Undavalli ◽  
Gobburi Sudha Rani ◽  
Jonnalagadda Ravi Kumar
Keyword(s):  
Internet Gaming Disorder ◽  
Age Groups ◽  
Smart Phone ◽  
Cross Sectional Study ◽  
P Value ◽  
Gaming Disorder ◽  
Chi Square ◽  
Cross Sectional ◽  
Adolescent Students ◽  
Internet Gaming

Background: Internet gaming disorder (IGD) refers to the problematic use of on-line or off-line video games.  Presently the prevalence of IGD among the adolescent group was between 1.3%  to 19.9% and males reported more prevalence than females. Aims of this study was to know the prevalence and the various factors associated with the development IGD among adolescents.Methods: Settings and Design was to a cross sectional study was conducted among students of High schools for a period of 3 months from July 2018 - September 2018. Four hundred adolescent students were included in the study. English version of the DSM–5 short (9-item) dichotomous scale with cut-off point of five or more criteria was used for diagnosing the IGD.Statistical analysis used descriptive statistics were represented with frequencies and percentages. Chi-square and Fisher Exact tests were applied to find significance difference. P<0.05 was considered as statistically significant.Results: An overall prevalence estimate of IGD was 3.50% among the school children and it is higher among male students (8.8%) than female students (0.8%) and it was found statistically significant with a p value of <0.001.Conclusions: The prevalence differences between Age groups, gender, class of the student and availability of smart phone with internet facility act as an important risk factors for the occurrence of IGD among adolescents.

scholarly journals Oral hygiene practices and knowledge among children of age 10-13 years in a private school in Chennai, South India

2020 ◽  
Vol 7 (10) ◽  
pp. 4093
Author(s):  
Aravind Sunderavel Kumaravel Kanagavelu ◽  
Arun Chandran ◽  
Jaya Brinda
Keyword(s):  
Oral Health ◽  
Private School ◽  
Age Groups ◽  
Cross Sectional Study ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Dental Floss ◽  
Hygiene Practices ◽  
Chi Square Test

Background: Oral health is an important and proven determinant of overall health and quality of life. It is well established that oral health and non-communicable diseases share common risk factors. Our study was designed to assess the practice and knowledge of oral health among 10-13 years old because at this age, lifelong beliefs and essential skills are developed.Methods: A cross-sectional study was done by randomly selecting students from V to VIII standards in a private school. Data was collected using a pre-designed questionnaire. The results were analysed using ‘Jamovi’ software with 'Pearson Chi-square test’ and a p-value of less than 0.05 was considered statistically significant.Results: Out of the 210 students, only around 1/3rd of the students used both brush with toothpaste, and dental floss to clean their teeth. 123 (58.6%) students brushed twice a day. The association between the frequency of brushing and the age groups was statistically significant. Gender played a role in the duration of brushing.Conclusions: It can be noted from our study that the oral practices and knowledge was better in 10-11 years olds than the 12-13-year olds and better in girls than in boys. Thus, oral education must be tailor made based on the calibre of a particular group instead of ‘one for all’ method.

scholarly journals Management of obstetric hemorrhage; an observational study highlighting the efficacy of uterine artery ligation

2020 ◽  
Vol 8 (6) ◽  
pp. 2238
Author(s):  
Ambreen Ghouri ◽  
Bushra Mushtaq ◽  
Azra Ahmed ◽  
Najma Dalwani ◽  
Padma Bai ◽  
...  
Keyword(s):  
Uterine Artery ◽  
Post Partum ◽  
Age Groups ◽  
Sampling Technique ◽  
P Value ◽  
Obstetric Hemorrhage ◽  
Chi Square ◽  
Artery Ligation ◽  
Cross Sectional ◽  
Uterine Artery Ligation

Background: Obstetrical hemorrhage is leading cause of maternal mortality. UAE is termed safe and effective method for resolving hemorrhage. objective of this study was to determine efficacy of uterine artery ligation in management of obstetrical hemorrhage.Methods: This cross sectional observational using non-probability convenient sampling technique was carried out for six months. After ethical approval, females between 18 to 35 years diagnosed with obstetrical hemorrhage, uterine atony refractory to medical treatment, having active bleeding from placental side or having normal coagulation profile were while females with post-partum hemorrhage because of retained products of conception, due to genital tract trauma or with disseminated intravascular coagulation were excluded. Analysis of data was done using SPSS version 23.0. Quantitative variables were reported as mean and standard deviation and for qualitative variables, frequency and percentages. Chi-square test was applied keeping p-value of <0.05 as statistically significant.Results: From 109 females with mean age 47±5.25 years. In comparison of parity distribution, 62 (56.88%) were multiparous and 47 (43.12%) were primiparous. Type of bleeding observed was antepartum 36(33.03%), peripartum 39 (35.78%) and postpartum in 34 (31.19%). Efficacy of uterine artery ligation in management of obstetric hemorrhage was observed to be 35 (32.11%). The efficacy of uterine artery ligation in management of obstetric hemorrhage in three categories of age groups reported significant association (p=0.0005) and type of bleeding (p=0.025).Conclusions: Efficacy of UAE in different types of obstetrical hemorrhage reported in our study was lower than expected in about one-third of females.

scholarly journals Μελέτη των παραγόντων που επηρεάζουν την εμφάνιση εξέλκωσης σε διαβητικό πόδι και σχεδιασμός εξατομικευμένου υποδήματος

2020 ◽  
Author(s):  
Αριστομένης Κοσσιώρης
Keyword(s):  
Visual Analogue Scale ◽  
Receiver Operating Characteristic ◽  
Scale Score ◽  
Visual Analogue Scale Score ◽  
Roc Curve ◽  
Analogue Scale ◽  
Operating Characteristic ◽  
Curve Analysis ◽  
Roc Curve Analysis ◽  
Chi Square

Εισαγωγή: Αν και οι ακρωτηριασμοί και οι παραμορφώσεις στα πόδια, αποτελούν παραμέτρους που έχουν μελετηθεί ως παράγοντες κινδύνου για διαβητική εξέλκωση [10,127,128], η συμπερίληψη των ποδικών ακρωτηριασμών και παραμορφώσεων σε μία ευρεία, ενιαία μεταβλητή παραμορφώσεων με αναφορά στη βαρύτητα αυτών, μπορεί να χαρακτηρίζει καλύτερα τα άτομα σε κίνδυνο για διαβητική εξέλκωση. Η διαβητική εξέλκωση μπορεί να προληφθεί εφαρμόζοντας κατάλληλες παρεμβάσεις, όπως η χρήση ειδικών υποδημάτων αποφόρτισης για ≥60% του χρόνου κατά τον οποίο βαδίζουν ή βρίσκονται σε όρθια στάση ή εκτός του κρεβατιού (≥9.6/16 ώρες) [72,76,79]. Ωστόσο, από απλούς υπολογισμούς, μόνο οι μισοί σχεδόν ασθενείς (49.5% -ενδοτεταρτομοριακό εύρος 39.0-49.5%-) των ασθενών έχουν προμηθευτεί υποδήματα πρόληψης διαβητικής εξέλκωσης μετά από σχετική σύσταση του ιατρού [74,129], όπως επίσης οι μισοί σχεδόν ασθενείς (55.7% -τυπική απόκλιση 16.9%-), από αυτούς που έχουν προμηθευτεί ειδικά υποδήματα αποφόρτισης, τα φορούν για τον ενδεδειγμένο χρόνο [72-76]. Υλικό και Μέθοδος: Σκοπός της παρούσας μελέτης ήταν η διερεύνηση της βαρύτητας των ακρωτηριαστικών και μη ακρωτηριαστικών ποδικών παραμορφώσεων ως παράγοντα κινδύνου για διαβητική εξέλκωση σε σχέση με τους άλλους καθιερωμένους στη βιβλιογραφία παράγοντες κινδύνου και η σύνδεση των ευρημάτων της διερεύνησης αυτής με τη θεωρητική υπόθεση ότι η χρήση κατάλληλων υποδημάτων από τους ασθενείς με διαβήτη τουλάχιστον για το 60% του χρόνου κατά τον οποίο βρίσκονται εκτός του κρεβατιού μπορεί να προλάβει την ανάπτυξη διαβητικών ελκών, σε δύο μελέτες στο ίδιο δείγμα ασθενών με διαβήτη με ή χωρίς ενεργά ποδικά έλκη (μελέτες 1 και 2, N=134 και 134 αντίστοιχα). Στην πρώτη μελέτη, διερευνήθηκε η βαρύτητα των ακρωτηριαστικών και μη ακρωτηριαστικών ποδικών παραμορφώσεων ως παράγοντα κινδύνου για διαβητική εξέλκωση σε σχέση με τους άλλους, καθιερωμένους στη βιβλιογραφία παράγοντες κινδύνου. Διενεργήθηκε συγχρονική και ασθενών-μαρτύρων έρευνα από τον Οκτώβριο του 2005 μέχρι τον Νοέμβριο του 2016. Για τη συλλογή των δεδομένων, χρησιμοποιήθηκε δομημένος ποσοτικός οδηγός συνέντευξης. Πραγματοποιήθηκε μονομεταβλητή λογιστική παλινδρομική ανάλυση για τους καθιερωμένους στη βιβλιογραφία παράγοντες κινδύνου, όπως επίσης για δύο εκδοχές της μεταβλητής «βαρύτητα των ακρωτηριαστικών και μη ακρωτηριαστικών ποδικών παραμορφώσεων» (με δύο και τρεις κατηγορίες βαρύτητας ποδικών παραμορφώσεων). Ακολούθως, πραγματοποιήθηκε πολυμεταβλητή λογιστική παλινδρομική ανάλυση για τρία προβλεπτικά μοντέλα και ανάλυση καμπύλης λειτουργικού χαρακτηριστικού δέκτη (receiver operating characteristic -ROC- curve analysis) για τη σύγκριση αυτών. Στη δεύτερη μελέτη, εξετάστηκαν η αρχική και συνεχιζόμενη συμμόρφωση των ασθενών με διαβητική ποδοπάθεια στη χρήση κατάλληλων υποδημάτων. Για τη συλλογή των δεδομένων, χρησιμοποιήθηκε επίσης δομημένος ποσοτικός οδηγός συνέντευξης. Για την επαγωγική στατιστική ανάλυση των δεδομένων, εφαρμόστηκαν τα τεστ Chi-square και Mann-Whitney U, όπως επίσης μονομεταβλητή λογιστική παλινδρομική ανάλυση. Αποτελέσματα: Όσον αφορά στη μελέτη 1, η μονομεταβλητή λογιστική παλινδρομική ανάλυση, αναφορικά με τις μεταβλητές που περιλαμβάνονταν στα τρία μοντέλα («1», «2» και «3») ήταν σημαντική (P≤.05) για τη διαβητική περιφερική νευροπάθεια (OR 3.80, 95% CI 1.66-8.70, P=.002), την περιφερική αρτηριοπάθεια (OR 4.14, 95% CI 1.84-9.32, P=.001), τις ακρωτηριαστικές ποδικές παραμορφώσεις (OR 2.78, 95% CI 1.04-7.45, P=.042), το ιστορικό προηγούμενης ποδικής εξέλκωσης (OR 3.79, 95% CI 1.64-8.77, P=.002) και τις μέτριες/σοβαρές ποδικές παραμορφώσεις από τη μεταβλητή «βαρύτητα των ακρωτηριαστικών και μη ακρωτηριαστικών ποδικών παραμορφώσεων» με τις δύο κατηγορίες βαρύτητας (κατηγορία αναφοράς: «καμία/ήπιες») (OR 2.78, 95% CI 1.13-6.86, P=.026). Σχετικά με την πολυμεταβλητή λογιστική παλινδρομική ανάλυση του μοντέλου 1, δεν παρήχθη καμία στατιστικά σημαντική μεταβλητή. Αναφορικά με την πολυμεταβλητή λογιστική παλινδρομική ανάλυση των μοντέλων 2 και 3, μόνο η περιφερική αρτηριοπάθεια ήταν στατιστικά σημαντική (OR 3.56, 95% CI 1.17-10.82, P=.025 και OR 3.33, 95% CI 1.10-10.08, P=.033 αντίστοιχα). Όσον αφορά στην ανάλυση καμπύλης λειτουργικού χαρακτηριστικού δέκτη, και τα δύο μοντέλα 2 και 3 είχαν μεγαλύτερες περιοχές κάτω από την ROC καμπύλη από την περιοχή του μοντέλου 1 (0.763, P<.001 και 0.754, P<.001 αντίστοιχα). Σχετικά με τη μελέτη 2, υπήρξε μια σημαντική συσχέτιση μεταξύ της παρουσίας ή απουσίας ενεργής ποδικής εξέλκωσης και του αν ή όχι οι συμμετέχοντες φορούσαν σωστά υποδήματα τη στιγμή της έρευνας (χ2(1)=4.36, P=.037). Οι ασθενείς με ενεργά ποδικά έλκη φορούσαν κατάλληλα υποδήματα σε μικρότερο ποσοστό (44.4% έναντι 78.6%) από εκείνους που δεν είχαν έλκη (τους ασθενείς σε κίνδυνο για διαβητική εξέλκωση). Η αρχικά συμμορφούμενη ομάδα είχε σημαντικά χαμηλότερο Visual Analogue Scale score αναφορικά με την ικανοποίηση από την τιμή των υποδημάτων (διάμεσος=5.0) από την ομάδα που δεν ήταν αρχικά συμμορφούμενη (διάμεσος=8.0, U=97.0, z=-2.36, P=.019, r=-0.38). Η μονομεταβλητή λογιστική παλινδρομική ανάλυση σε σχέση με την έκβαση της αρχικής συμμόρφωσης, ήταν σημαντική (P=.045) μόνο για την παράμετρο της «παρουσίας ή απουσίας ενεργής ποδικής εξέλκωσης» (OR 4.58, 95% CI 1.04-20.24) καταδεικνύοντας γραμμική σχέση μεταξύ της κατηγορικής ανεξάρτητης μεταβλητής και των λογαριθμικών λόγων των πιθανοτήτων της εξαρτημένης. Η απουσία ενεργών ποδικών εξελκώσεων είχε θετική επίδραση στη αρχική συμμόρφωση (B=1.52, SE=0.76) και ο δείκτης Nagelkerke’s R2, ο οποίος ήταν ίσος με 0.14, φανέρωσε μια σχετικά αδύναμη συσχέτιση μεταξύ της προβλεπτικής και της εξαρτημένης μεταβλητής. Το μέγεθος της υποομάδας των ασθενών σε κίνδυνο για ποδική εξέλκωση ήταν αρκετά μικρό (n=11) και συνεπώς ανεπαρκές για επαγωγική ανάλυση αναφορικά με τη συνεχιζόμενη συμμόρφωση. Συμπεράσματα: Μια ενιαία μεταβλητή για τους ακρωτηριασμούς των κάτω άκρων και τις άλλες ποδικές παραμορφώσεις με αναφορά στη βαρύτητα αυτών και ≥2 κατηγορίες κινδύνου, θα μπορούσε να είναι πιο βοηθητική στους κλινικούς για τον εντοπισμό και την ταξινόμηση των ασθενών με διαβήτη σε κίνδυνο για διαβητική εξέλκωση. Για την επαύξηση της αρχικής συμμόρφωσης και κατ’ επέκταση της συνεχιζόμενης συμμόρφωσης στη χρήση κατάλληλων υποδημάτων από τους ασθενείς με διαβήτη με ποδικά έλκη ή σε κίνδυνο για ποδική εξέλκωση, οι επαγγελματίες υγείες θα μπορούσαν αν δίνουν μεγαλύτερη έμφαση στην εκπαίδευση των ασθενών με ενεργά ποδικά έλκη, εφαρμόζοντας εντατικές εκπαιδευτικές παρεμβάσεις [70,71]. Επιπρόσθετα, θα μπορούσαν να παρέχουν στους ασθενείς πολλαπλές επιλογές κόστους αναφορικά με τα υποδήματά τους (π.χ. προτείνοντας αποτελεσματικά και οικονομικά προϊόντα) ή θα μπορούσαν να συμμετέχουν, υπό τον όρο της κατάλληλης εφαρμογής της σχετικής τεχνολογίας στα νοσοκομεία, στην διαδικασία σχεδιασμού/κατασκευής ιατροτεχνολογικών προϊόντων, όπως τα θεραπευτικά/προληπτικά υποδήματα, μειώνοντας έτσι το τελικό κόστος [109,149].

scholarly journals COMPARISON OF STEROIDS TO NSAIDS, AND OTHER FORMS OF ANALGESIA IN THE MANAGEMENT OF POST-CHIKUNGUNYA ARTHRITIS

2021 ◽  
Vol 71 (2) ◽  
pp. 619-24
Author(s):  
Hamza Alam ◽  
Tahira Perveen Umer ◽  
Iffat Khanum ◽  
Lubna Nazir ◽  
Uzma Erum ◽  
...  
Keyword(s):  
Single Dose ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Treatment Options ◽  
Complete Response ◽  
Cross Sectional Study ◽  
Response To Treatment ◽  
P Value ◽  
Cross Sectional ◽  
Treatment Naïve

Objective: To compare steroids with other treatment options like NSAIDS and other analgesics for management of postchikungunya arthritis based on visual analogue scale (VAS). Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Rheumatology, Liaquat National Hospital, Karachi, from Jan to Jul 2018. Methodology: A total of 112 patients were included in this study, of both genders. Patients with history of fever >38.5°C and polyarthralgia who had positive chikungunya IgM serology or PCR were included in this study. Patients fulfilling inclusion criteria and who were treatment naïve were given NSAIDs or other analgesics if contraindication to NSAIDs was present. Those who had received 2 weeks of NSAIDs were given a single dose of intramuscular steroids. Response to treatment was characterized by clinical examination according to visual analogue scale (VAS) taken at baseline, 2 weeks and 4 weeks. All analyses will be conducted by using SPSS-20. Results: Overall, 66 (58.9%) received steroids, 37 (33%) patients were given NSAIDs, and other forms of analgesics were prescribed to 9 (8%) patients. In nearly half of the patients, i.e. 57 (50.89%) partial response was seen, 13 (11.6%) showed complete response, while 42 (37.5%) had persistent arthralgia, which was statistically significant p-value <0.001. Conclusion: This study shows that improvement in symptoms is seen with a single dose of intra-muscular steroid and it helped bring down the VAS score.

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