Online ISSN: 2515-8260

Keywords : VAS


Dr. Sumit Pal Singh, Dr. Manmeet Singh , Dr. Shubham Pandoh, Dr. Anil Gupta, Dr. Nitish Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 2382-2386

Background: Osteoarthritis (OA) is a chronic, non-inflammatory rheumatologic disease which affects the synovial joints. The present study was conducted to assess the role of PRP in management of osteoarthritis of the knee.
Materials & Methods: 65 patients of osteoarthritis of the knee of both genders were enrolled.
Cartilage thicknesses were measured radiologically by ultrasound before and at third and sixth months after treatment. The severity of pain was evaluated by using VAS.
Results: Out of 65 patients, males were 30 and females were 35. Right side was involved in 34 cases and left in 31 cases. The mean VAS before treatment was 5.4, after 3 months it was 2.3 and after 6 months it was 0.8. The difference was significant (P< 0.05). The mean cartilage thickness before treatment was 0.5 mm, after 3 months was 0.7 mm and after 6 months it was 0.8 mm. The difference was significant (P< 0.05).
Conclusion: PRP is found to be effective in management of cases of osteoarthritis of the knee.

A Comparative Analysis of different Treatment Modalities of Oral Lichen Planus

Sonali Roy, Archana Kumari, Praveen Chandra

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1287-1291

Background:Lichen planus (LP) is a common, chronic inflammatory mucocutaneous
disease of unknown etiology and putative autoimmune pathogenesis. The present study
compared different treatment modalities of oral lichen planus.
Materials & Methods: 78 clinically and histopathological diagnosed cases of oral lichen
planus were divided into 2 groups of 39 each. Group I patients were given 0.1% tacrolimus
cream and group II patients were given 0.05% topical application of clobetasol propionate.
Parameters such as pain on VAS and size of the lesion was recorded at baseline, after 3
weeks and 6 weeks.
Results: The mean size (cm2) in group I was 5.8, 3.4 and 1.6 and in group II was 4.7, 3.2
and 1.2 at baseline, 3 weeks and 6 weeks respectively. A non- significant difference was
observed (P> 0.05). The mean VAS was 2.8, 1.4 and 0.6 in group I and 2.9, 1.8 and 0.8 at
baseline, 3 weeks and 6 weeks in group II respectively. The difference was significant (P<
Conclusion: 0.1% tacrolimus reduced size of the lesion and pain score efficiently than
0.5% clobetasol propionate in patients of oral lichen planus.

Injectable pethidine vs diclofenac as an analgesic for lower limb orthopedic surgeries as postoperative analgesics

Dr. Pavankumar P,Dr.Harish Naik S

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2858-2861

Background: Postoperative pain may be a significant reason for delayed discharge from
hospital, increased morbidity and reduced patient satisfaction. Nowadays opioids are the
mainstay in the treatment of acute postoperative pain. Pethidine is an opioid.But opioids
produce side effects like nausea, vomiting, sedation, pruritis, respiratory depression.
Diclofenac is a non-selective NSAIDs with good tissue permeability. NSAIDs are particularly
Objectives: We conducted this study to compare the efficacy of Injection pethidine and
Injection diclofenac as an analgesic for post-operative patients undergoing Hysterectomy.
Methods: This was an open-label prospective study that included 60 female patients
undergoing lower limb orthopedic surgeries aged 20 years and above. Randomly allocated 30
patients were given Pethidine 50 mg IM three times a day and the rest 30 patients were given
Diclofenac 75mg IV two times a day. Post-operative pain scores were recorded using the
Visual Analog Scale (VAS) at 6,12,24and 48 hrs. Statistical analysis was done using unpaired
Results: The mean pain score was found less in the diclofenac group compared to the
pethidine group at all intervals by VAS (p<0.05). Nausea and dizziness were more commonly
Conclusion: Diclofenac provides effective and better analgesia in acute post-lowerlimb
orthopedic surgery pain than pethidine with fewer adverse effects.

Bilateral Segmental Internal Anal Sphincterotomy Outcomes for Chronic Anal Fissure Treatment

Hesham Bahlul Mohamed Marzogi, Samir Ibrahim Mohammad, Mohamed Farouk Amin, Ashraf Abdel Monem Elsayed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3352-3360

Background: Chronic anal fissures are harder to treat and surgery may be the best
option. The goal of surgery is to help the anal sphincter muscles relax which
reduces pain and spasms, allowing the fissure to heal. The aim of the present study
was to assess the Improving outcome of patients of chronic anal fissure. Patients
and methods: This clinical trial study was conducted in General Surgery
Department, Faculty of Medicine, Zagazig University on 18 chronic anal fissure
cases. All patients were subjected to full history taking, proper local examination
and baseline investigations. Anorectal manometry was performed for all patients
preoperatively. Then, bilateral segmental internal sphincterotomy was done for all
patients. Results: In our study, age was 37.77 ± 6.44 with minimum of 24 and
maximum of 50 years. Regard sex distribution, males and females were matched
(50/50 percentage). Majority were posterior (66.7%) then anterior (22.2%) and
finally both (11.1%). Operation time was 17.77 ± 3.62 with minimum of 12 and
maximum of 25 minutes. After internal sphincterotomy, complete healing was
5.16±1.09 with minimum of 4 and maximum of 7 weeks. VAS significantly
decreased from pre to 1st 24 hours till the end of follow up. Incontinence score
significantly decreased from preoperatively to 1st week till the end of follow up.
Conclusion: bilateral segmental internal sphincterotomy is a novel, safe, and
effective way of treating chronic anal fissure, and it is not associated with any risk
of anal incontinence.

Giant Cell Tumor Treatment by Curettage and Bone Cement in Proximal End of Tibia

Mohammed Basheer Wali, Elsayed Eletawy Soudy, Mohsen Fawzy Omar, Mohamed Ismael Kotb

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4046-4054

Background: Surgical treatment stills the most effective treatment for a giant cell
tumor of bone (GCTB). The aim of the present study was to evaluate the outcomes
of surgical treatment of giant cell tumor in proximal end of tibia by curettage and
bone cement. Patients and methods: This clinical trial study was conducted on 18
patients underwent surgical treatment of giant cell tumor in proximal end of tibia
by curettage and bone cement at orthopedic department, Zagazig University
Hospitals. Their age was ranged from 22 to 41 years. Two thirds (66.7%) of the
studied group were females and one third (33.3%) of them were males (2:1). After
completion of the investigations, staging of the tumor was recorded using
Campanacci's radiological grading method. Postoperative follow up was done to
assess the functional outcome and to detect the presence of complications. Results:
The present study showed that, 83.3% had companaccis grade I and grade II
(16.7%). 88.8% underwent cement and hydrogen peroxide and 11.2%underwent
cement, hydrogen peroxide and internal fixation. Regarding MSTS, only 33.3% of
them had intermediate pain, all patients had enthused emotional acceptance and
66.7% had unlimited walking ability and 22.2% had intermediate gait. Post
operative follow up showed the recurrence rate was zero (0.0%) after a follow up
time (11.2±1.04) months ranged from 9 to12 months. There was only 11.1% of
patients had superficial infection. Conclusion: Surgical treatment of a giant cell
tumor of bone using Cement filling after extended curettage is provide a good
oncological outcome and joint preservation. Curettage with adjuvants is a feasible
first choice treatment option for GCTB with Cement filling does not increase the
recurrence rate.

Addition Of Eccentric Elbow Exercises To Local Corticosteroid Injection For Tennis Elbow – A Prospective Randomized Study

Niranjanan Raghavn Muralidharagopalan; Raghav Gopal; Sugumar Natarajan

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 3528-3537

Lateral epicondylitis or Tennis elbow is a painful condition of the elbow that is characterized by pain and weakness of grip strength. It is usually due to a tendinopathy involving the origin of the ECRB and EDC tendons. Wide variety of treatment options exists. Injection corticosteroids are considered to be a good choice for short term improvement of the problem but has doubtful effects in the medium to long term.
This study is a randomized study that compares the short to medium term effect of addition of eccentric elbow strengthening exercises to local corticosteroid injections
This is a prospective randomized study with 1 year follow up. 24 subjects received corticosteroid injections alone while 26 underwent eccentric elbow strengthening additionally.
The patients were administered VAS , DASH score and tenderness on resisted dorsiflexion of wrist and middle finger initially. This was followed up after 2 weeks, 6 weeks, 3 months , 6 months and 1 year.
The groups were also well matched for age, sex, time since diagnosis.
The VAS, DASH and the tenderness scores were also similar in the two groups.
In the injection only group there was reduction of VAS from 7.08 to 2.83 in 2 weeks which showed a decreasing trend till 6months follow up. Similarly, the DASH scores decreased from 33.40 to 13.63 in 2 weeks and the same trend was seen till 6 months. However, at 1 year follow up both scores showed a slight increase.
In the injection plus exercises group the reduction of VAS and DASH scores continues till one year. Also comparing the two groups the injection plus exercise group shows significant improvement at 2weeks, 6 weeks and 1 year follow up
Addition of eccentric elbow strengthening exercises significantly improves the benefit of having a local corticosteroid injection for tennis elbow