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Most cancer patients complain from pain in final part of their disease. One of the aims of health center, in the country is how to relieve pain from such patients. Therefore we tried to carry on a semi-experimental research to find out the effectiveness of Morphine by either continuous infusion or intermittence injection in such patients. We used non-random sampling, the total number of samples were 11 female and 9 male. These patients were on their final phase of disease. The process that we collected the information was based on the check-list which consist of two sections, in first part the demographic characterization of patients was recorded, using observation and interview with patients and in second part of these check-list the level of pain was assessed using visual analogue scale, which marked every two hours and finally the average of this scale in 24 hours is evaluated using as index in our study. Our results indicate that continuous infusion is more effective in relieving pain than intermittence injection (P<0.03). The results of this investigation showed that, age, sex and different type of cancer has got no meaningful variation in changing the main findings of this semi-experimental research.

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Pain is a symptom of disease and most diseases accompanied with pain, specially among hospitalized post-operative patients. Several drugs and routes of administrations have used for post operative pain control. We compared post op analgesic effects of Diclofenac suppository to intramuscular Pethedine in post op inguinal herniorrhaphy patients. This study is a clinical trial on 40 patients who were operated due to unilateral inguinal herniorrhaphy. They divided into two groups incidentally. In Diclofenac Na group each patient received 100 mg Diclofenac Na supp every 8 hours. In Pethedine group each patient received 0.5 mg/kg Pethedine, intramuscularly. Pain severity of the patients controlled for 24 hours with visual comparation method and mean pain severity compared among 2 groups in the first 24 hours. Mean pain severity difference of Pethedine groups patients compared to Diclofenac Na group was 6.10 with standard error of 3.57 with (P<0.212) had no meaningful difference during first post operative phase. We concluded that Diclofenac Na is a suitable substitute of 24 hours intramuscular Pethedine for post op pain relief.

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Compared with older children and adults, neonates are more sensitive to pain and more vulnerable to long-term effects. Despite the clinical importance of neonatal pain, current medical practices continue to expose infants to repetitive, acute, or prolonged pains. This specific intervention are necessary for reduced the neonatal pain experiences. This is an experimental study of determine the effectiveness of skin contact between mother and her healthy full-term newborn to reduce pain experience by the infant during intramuscular injection. The sample population was 30 healthy full-term newborns delivered at university hospital in Gorgan. The samples and controls were chosen randomly. During intramuscular injection case group was being helped by their mothers under cloth that directly were contact with their abdominal and chest skin and newborn in control group swaddled in crib on the bed before, after and during injection. Behavioral responses (Facial changes, crying, …) and physiologic responses (Heart rate and O2 saturation of arterial blood) of newborns were noted before, after and during intramuscular injection. The results show that there was no significant difference in behavioral and physiologic responses caused by pain between two groups, except crying time (38.2 second in control group and 35.5 second in case group). Finding from this study indicate that skin-to-skin contact has a clinically important effect on the pain of intramuscular injection, if we can prepare physically and emotionally a good situation.

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Background and Objectives: Measuring the H-reflex latency (Tp) is an electrophysiologic test to evaluate the S1 root lesions This reflex traverses a relatively long course and its sensitivity to diagnose mild S1 root lesions is low, so investigators have tried to shorten this pathway Evaluation of the central loop of the H-reflex (Tc) is one of these efforts and may be more sensitive in diagnosing S1 radiculopathy (Compared to standard H-reflex latency). We have tried to determine its influencing factors and find the related regression equation. Materials and Methods: Forty volunteers were investigated with their informed consent. Their history, physical examination and a brief electrophysiologic study were normal. H-reflex latencies (Peripheral- central) of right gastrocnemius-soleus muscle as described in literature, right leg length and age were recorded. Results: This group consisted of 26 males (65%) and 14 female (35%). Mean latencies (And SDs) of peripheral and central H-reflexes were 28.8 (SD: 1.66) and 6.78 (SD: 0.3) milliseconds respectively. The correlation between Tc and leg length was significant (P<0.05). There was no significant correlation between Tc and age (P<0.05). Tc and Tp were correlated. These regression equations were found: Tc=0.04L+5.28, Tc=0.05Tp+4.56, Tp=0.04A+0.3L+16.13 (L: leg length in centimeters, A: age in years, Tc and Tp in milliseconds). Discussion: The results of this study, regarding mean and SD of Tc are in line with the previous studies, and regarding the influence of age on Tc are in contrast with only one study and in line with another study. Conclusion: The correlation between Tc and leg length was significant (P<0.05). There was no significant correlation between Tc and age (P<0.05). These regression equations were found. Tc=0.04L+5.28, Tcx=0.07Tp+4.56, Tp=0.04A+0.3L+16.13 (L: Leg length in centimeters, A: Age in years, Tc and Tp in milliseconds). We concluded that it is wise to use leg length for calculating normal Tc and limiting the normal values. On the other hand, the authors believe that more research on specificity and sensitivity of this test (To diagnose S1 radiculopathy) and comparing it with other diagnostic tools is needed.

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Background&Objective: Low back pain (LBP) is common in youth, although `associated with chronic pain in adults. The purpose of this study was to determine the prevalence and risk factors of LBP in school children age 11-14. Materials&Methods: A cross sectional study was carried out on school children aged 11-14 in north of Iran. Using random multistage sampling 5000 children were selected. Demographic, mechanical and lifestyle data as well as the prevalence and LBP characteristics were collected by a questionnaire. Data analysis was carried out using SPSS (version11) software. Results: Of the original sample, 4813 (96.2%) children returned the questionnaire. Point, last month, last 6 months and annual prevalence were 15%, 14.4%, 15.6%, and 17.4%, respectively. LBP was significantly correlated with age (p<0.05), lifting (p<0.05), position and duration of watching TV, doing homework and duration of exercise (p<0.05). Conclusion: The results indicated that the prevalence of LBP in school children is relatively high. Further studies evaluating the effect of different preventive strategies to reduce the prevalence of LBP in school children is strongly recommended.

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Background&Objective: Post operative pain is a common phenomenon that it is one of the important problems in surgery. Different methods have been used to control post operative pain. Morphine and Buprenorphine are classified as narcotics, and their effect on post operative pain relief has been evaluated in this study. Materials&Methods: This randomized clinical trial (RCT) was done on 40 patients with lumbar disk herniation that randomly classified in morphine and buprenorphine group. During induction of anaesthesia 0.2 mg/kg morphine and 4.5/kg buprenorphine were injected intravenously to the corresponding groups, respectively. At the end of anaesthesia, heart rate, systolic and diastolic blood pressure were evaluated as well as severity of pain. Then, collected achieved data were analysed. Results: The severity of pain in buprenorphine group was less than morphine at all the times except the time of discharge from recovery (p<0.05). With respect to sedation there was a meaningful difference between the two groups at the time of entering recovery and 15 minutes later. The sedation was more in buprenorphine group, (p<0.05) There was no meaningful statistical difference in relation to heart rate between the two groups. Systolic blood pressure, between two groups was significant except at the time of entering recovery. Also, systolic blood pressure was not significant between two groups. Conclusion: This study showed the bupernorphine has long anaesthesia and sedation.

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Background&Objective: Using analgesic drugs such as non- steroidal anti-inflammatory drugs can control the pain after cesarean section. This is an experimental study to compare of efficacy of indometacin Suppository and Votaren ampoule on severity of pain, side effect ratio, and need to narcotic analgesic in-patient who had cesarean section delivery under spinal anesthesia. Materials&Methods: In this study, there were 100 pregnant patients that had selected cesarean section and had research conditions. These patients were selected by randomized method and divided in study group (indometacin) and control group (voltaren) that accomplished for 4 months. On the basis of patient's necessity and take of vital analog scale we profile of indometacin suppository in study group and voltaren Amp in control group. Pethedin ampoules were indicated if further necessity were objected. This research was prolonged with 24 hours after operation. Results: In the end after assembling and analyses of information we observed that indomethacin and voltaren both have positive effective on severity of pain after cesarean section (P<0.5), but in comparison with them the voltaren have better effectiveness than indometacin after 4 hours from first dose (p<0.05). There was no difference in two group in necessity by more sedative. But the side effects was lower in study group than control group (P<0.05). Conclusion: It is suggested that indometacin suppository is profile than voltaren in cesarean patients except in 4 hours after surgery.

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Background&Objective: People with cancer commonly experience a range of symptoms, including pain and various types of physical and emotional distress. One of important roles of health care providers is managing these complications. The aim of this study was to the evaluation of Therapeutic Touch on hospitalized cancerous females suffering from pain. Materials&Methods: This quasi-experimental study performed on cancerous females hospitalized in Imam Khomeini hospital at Tehran. It was performed on 3 groups (case, placebo, control) 30 female with different cancers were selected, matched and then divided in 3 groups: the case group received five 20-25-minute session of therapeutic touch, the placebo group 5 ten-minute session with no energy exchange and no intervention for control group. Data gathered by two tools include: demographic questionnaire and Visual Analog Scale of Pain (0-10). Pain severity was measured before and after intervention Data was analyzed by SPSS-11.5 using ANOVA, Repeated measurement analysis variance (Wilks lambda test), qui-square and TUKEY tests. Results: The means of pain score in case, placebo and control groups before intervention was 3.8, 4.1 and 4.16 and after intervention 0.8, 6.4, 4.2 respectively. There was significant difference between 3 groups in pain severity during using ANOVA and repeated measurement analysis variance (Wilks lambda test) (p<0.05). Conclusion: Based on the above findings, Therapeutic touch as a non invasive procedure, and non pharmacologic procedure was recommended for relive pain in cancerous females.

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Background&Objective: Pain, in particular post-operative pains, can produce numerous complications including a delay in healing of wounds in patients. For pain relief in patients postoperatively, different drugs are used, opioids like pethidine and NSAIDs. This study was carried out to compare the effects of the IM pethidine and suppository Diclofenac for pain relief after laminectomy following lumbar disc hernia.
Materials&Methods: this is a randomized control clinical trial study, 100 patients presenting for laminectomy with diagnosis of lumbar disc hernia and eligible for participation in the study, after recieving their informed consent for inclusion in the study non probability convenience sampling were selected by a convenience sampling method and then divided into two groups of Pethidine (P) and Diclofenac (D). Patients’ pain scores were measured by Visual Analogue Scale (VAS). Finally, the data obtained were analyzed by statistical software of SPSS.10, F test, T test and ?² P<0.05 was considered significant.
Results: Mean pain scores within 24 hours after operation were calculated in group P as 2.8±2.02 and in group D as 4.46±2.30. There was a statistically significant difference between the reduction of the pain score after surgery in both groups (p<0.05). Nausea was the greatest side effect observed in group P (23%) and epigastric pain was the most common pain found in group D (18%). However, no statistically significant difference was found between the two groups in terms of the drug adverse effects.
Conclusion: A statistically significant difference was observed between pethidine ampule and Diclofenac suppository regarding the pain reduction after laminectomy. In the other words, Diclofenac suppository has less impact on pain killing in comparision with Pethidine ampule. In other to confirm these results, it is suggested that another study in terms of age and sex and after orthopedical procedures in a large scale-and if possible double blind- to be carried out.

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Background & Objective: Hyperalgesia is considered as one of the marked signs of subchronic diabetes mellitus that could affect the life style of the patients. Considering the evidence on antidiabetic effect of Allium ampeloprasum (AA), this study was designed to investigate the analgesic effect of Allium ampeloprasum on formalin-induced nociceptive response in streptozotocin (STZ)-induced diabetic rats.

 

Materials & Methods: 45 male rats were randomly divided into control, AA-treated control, diabetic, sodium salicylate (SS)-treated diabetic, and AA-treated diabetic groups. For induction of diabetes, STZ was used at a 60mg/kg dose. The treatment groups received oral administration of AA-mixed pelleted food (6.25%) for one month. After one month, for all animals, blood glocuse concentration and formalin test measured. Data analyzed with using student paird t-test and ANOVA.

 

Results: The results showed that diabetic rats exhibited a higher score of pain at both phases of the formalin test (p<0.05) and AA treatment for one month did cause an improvement in this regard (p<0.05). Meanwhile, SS administration significantly reduced pain score only at chronic phase of the test (p<0.05).

 

Conclusion: This study indicated that one month administration of Allium ampeloprasum could attenuate nociceptive score in an experimental model of diabetes mellitus.

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Background & Objective: We have two areas in gluteal region for intramuscular injection‚ Ventrogluteal and Dorsogluteal. This study was done to compare pain intensity and bleeding rate after injection in Ventrogluteal and Dorsogluteal area.

 

Materials & Methods: This clinical trial study was done on 67 males in 5th Azar hospital in Gorgan north of Iran. Patients had 2 injections during 24 hours. For every patient one injection was done in Dorsogluteal area and the second injection was done in Ventrogluteal area. For every patients the pain intensity and rate of bleeding for every injections recorded. Data analyzed by SPSS-11.5 software and Kolmogorov-Smirnov and Wilcoxon tests.

 

Results: In Dorsogluteal area 83.5% of patients had a low and medium pain‚ where as in Ventrogluteal area 88% of patients had a low and medium pain and 9% of them had not any pain. The Mean±SD of pain intensity in Dorsogluteal area was 50.79±1.682 and in Ventrogluteal was 40.79±1.878. The Mean±SD of bleeding in Dorsogluteal and Ventrogluteal areas were 0.73±0.102 and 0.19±0.047 respectively. There were significant differences in pain intensity and bleeding between two groups (P<0.05).

 

Conclusion: We concluded that the injection in Ventrogluteal area has a less pain and bleeding rate in comparison with Dorsogluteal area.

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Background & Objective: Propofol is one of the latest anesthetic agent which has many advantages with few side effects in patients. One of the application problems of this drug is pain at the time of injection. Several methods are investigated to reduce the pain, and one of them is the application of Lidocaine together with Propofol.

Materials & Methods: This randomized clinical trial study was done in 5th Azar teaching during 2007. 272 patients were selected randomly between age of 15-55 years with ASA Class I,II who were the candidates of elective surgery. We injected  Fresenius %1 to the first group with 91 patients, Lipuro %1 to the second group with 90 patients and Propofol drug Lipuro %1 mixed with 20 mg Lidocaine (2 ml of Lidocaine %1) to the third group with 91 patients. Injections was carid out on the supenlial vein of dorsal hand. Patients were asked about the severity of pain at the time of injection, 5-10 seconds after %25 of anesthetic induction doze. Data analyzed with using SPSS software and Chi-Squre test.

Results: The rate (incidence) of pain (Score 1-3) has been 63.91 (%69.2) in the first group, 50.90 (%55.6), and 22.9 (24.2%) in the third group in which there is a significant difference (P<0.001). Moderate and sever intensity of pain (Score 2.3) was 42.91 (46%) For the first group, 18.90 (20%) for the second group and 2.91 (2.2%) for the third group (P<0.001).

Conclusion: On the basis of this study, it is recommended to use lidocaine, at the time of injection, to reduce pain.

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Background & Objective: Chest pain is one of the most important and prevalent symptom in coroner artery diseases , in which the nurse has the key role in its management. This study was done to achieve the objective of assessment of the nurse's role in pain management in patients involved in coronery artery diseases. Materials & Methods: This descriptive study was done by the use of convenience sampling method in Vassaii hospital in Sabzevar city. 95 instances of chest pain were assessed by the nursed participated. In the research project. The tools used was a researcher – made check list and the nurse's role in different aspects, including the assessment of pain, relieve measures and reevaluating of the pain was studied. All the observations was recheck by third person. The Khowledge and perception of the nurses involved this research was studied by another technique prepared. Results: The most of the nurses put priority assessement on the location of pain and the assessment of other features of the pain did not get much attention, for assessing the verbal pain, the use of verbal descriptive was the main method and no one used the visual analog scale in pain intensity. In 92.6% of the instances the nurses practiced to relieve the pain and in most instances (96.8%) medication was used. The findings showed that in 41.1% instances, no specific reassessment was practiced. Conclusion: This study showed that altough the most nurses are aware of their part in relieving the patients pain but they do not fulfill this role in pain mamagement specially in assessing and reevaluating the pain.

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Brucellosis is a zoonosis with a variety of clinical syndromes including spondylitis. Spondylitis and sacroiliitis are the most frequent complications of skeletal system involvement in brucellosis, but muscle infection and abscess formation are a rare complication and frequently secondary to spondylitis. In this article two cases of brucella spondylitis are presented which has led to abscess formation in one of them, these patients referred with back pain, fever, and with subsequeint MRI examination, wright positive test, were diagnosed as spondylitis. The antibiotic regiment including Doxycycline, Refampin, were prescripted for four months. The clinical signs were disapeared subsequently.

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Background and Objective: In clinical situation, pain occurs during intravenous Catheterization (IVC). Finding methods to reduce pain related with insertion of Angiocut. This study was performed to evaluate the effect of types of Transcutaneous Electrical Nerve Stimulation (TENS) on the pain severity regarding to insertion of Angiocut is very important. This study was performed to evaluate the effect of types of transcutaneous nerve stimulation (TENS) on the pain severity regarding to insertion of Angiocut. Materials and Methods: This clinical trial study was performed on the 80 patients of Internal and CCU wards of Fatemieh Hospital in Semnan, Iran during 2001. In this study, severity of pain related with insertion Angiocut assessed and compared in four conditions No TENS, low TENS (5 Hz), high TENS (100 Hz) and burst TENS (with frequence 100 Hz And burst frequence 2 Hz). The severity of pain measured by testes visual analogue scale (VAS), One-way ANOVA, Tukey, and Dunnett tests were used for comparing means of pain severity in different conditions. Results: Findings showed significant difference between severity of pain during Angiocut insertion in four conditions (P<0.05), so that the lower intensity of pain was in the high-TENS group, while higher pain was in the No TENS group. Significant difference was between intensity of pain in the No TENS group with high TENS and burst TENS group (P<0.05), but no significant difference was between low TENS and No TENS groups. Conclusion: This study showed that TENS was a effective method to reduce pain during Angiocut insertion. The lowest severity of pain was obtained in high TENS method. therefore, high TENS method can suggest as a effective method to reduce pain during Angiocut insertion.

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Background and Objective: Anterior cruciate ligament (ACL) tear is one of the most common knee injuries among young adults and sportman. They need reconstruction when they are accompanying with other knee internal derangements to prevent knee osteoarthritis. This study was designed to explore early complication of anterior cruciat ligament reconstruction with bone-patellar tendon- bone graft. Materials and Methods: This prospective and cross-sectional study was done on 13 patients which refered to Qaem hospital in Mashhad-Iran during 2008. The first 3 months complications and problems of anterior cruciate ligament reconstructions, with bone-patellar tendon, bone graft technique, was recorded on regular basis, symptoms and signs were documented. Results: Anterior knee pain and knee stiffness were common as 70% and 38% respectively. We did not observe any infection but in 15% of patients a minor instability (ADT+) was detected. Patients cooperation was low and even 54% of them did not implement, post-operative advices. Conclusion: This study showed that minor instability and subsequent pain are the early problems during the first three month after anterior cruciate ligament constraction.

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Background and Objective: The findings of various research indicated that there are different responses to painful thermal stimulation in male and female Rats. In different estrous phases there are different pain thershold border line due to hormonal reaction. Regarding to anti-nociceptive effect of henbane seed. This study was designed to assess the anti-nociceptive afficacy of alcohole extract of henbane seed in different phases of estroes cycle of female Rates. Materials and Methods: In this experimental study 92 female NMRI strain rats weighing 195-220 grams randomly were divided into three, control, experimental and positive groups. Male Rats (n=8) were chosen as control group. To measure the threshold of acute pain, all animals were exposed to the tail immersion test using 52 degree c water. In the experimental group, alcoholic extract of henbane seed (2000 mg/kg) was injected, intraperitoneally, 25-30 minutes before the tail immersion test. Afterwards, in the all of control and experimental groups of female rats the smear samples were taken to determine the sexual phases. In addition, the analgesic effect of henbane was compared with anti-nociceptive effect of sodium salicylate (300 mg/kg). Results: Injection of alcoholic extract of henbane seed, diminished the tail immersion test-induced acute pain in female rats significantly (P<0.05). also, no significant differences of analgesic effect of henbane extract were seen among various phases of estrous cycle in female rats. There is no significant differences of analgesia between henbane and salicylate-treated groups. Conclusion: This study determined that female rats in different phases of estrous cycle have similar pain thresholds and the alcoholic extract of henbane seed is effective in the relief of pain in the various phases of estrous cycle.

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Background and Objective: Cervical stabilization training is a method of exercise which is designed to improve the mechanisms by which the cervical spine maintains a stable, injury-free state. The aim of this study was to compare effectiveness of muscle stabilization training with dynamic exercises on the chronic neck pain and disability. Materials and Methods: In this double-blind clinical trail study twenty-six patients with chronic neck pain were recruited. Subjects were randomly assigned to either a stabilization (n=13) or a dynamic exercises group (n=13). Before and after intervention, pain was assessed with visual analog scale (ordinal) and Northwick Park Neck Pain Questionnaire (NPNPQ), disability (ordinal) with Neck Disability Index (NDI), neck muscles strength (bar) using Dynatest and cervical ranges of motion (degrees) with specific neck goniometer. A 24 session exercise program which lasted 12 weeks, two sessions per week, and 45 minutes per session was performed for both groups. Independent t-test or Mann-Whitney U and paired t-test or Wilcoxon were used for comparison between the pretreatment and post treatment test results between groups and within groups, respectively. Results: The mean neck pain (NPNPQ) decreased from 18.23±0.77 to 7.54±4.39 in the stabilization group and from 18.31±3.99 to 11.85±3.89 in the dynamic group (P<0.05). The mean disability (NDI) decreased from 22.69±4.99 to 8.23±4.09 in the stabilization group and from 22.23±4.88 to 14.92±5.54 in the dynamic group (P<0.05). After treatment, neck muscles strength and range of extension increased and both neck pain and disability decreased in the stabilization group compared with the dynamic ones (P<0.05). However, there was no significant difference between two groups regarding flexors and left lateral flexors strength and ranges of flexion, right and left lateral flexion. Conclusion: This study showed that neck specific stabilization and dynamic exercises increase, range of motion, decrease pain and disability. Also specific stabilization exercies was more useful than dynamic procedure.

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Background and Objective: Patello femoral pain syndrome is one of the most common orthopeadics complains, which effect athletes, militaries and ordinary people. The symptoms is idiopathic disease, but one of the most important reason for this disease can be the structural problem of lower limb and one of the efficient method of conservative treatment of patients with patello femoral pain syndrome can be using neoprene palumbo and geno direxa stable orthoses, but there is only a few experimental researches supporting the effects of these orthoses. This study was designed to determine the effects of neoprene palumbo and geno direxa stable on pain and daily activity of patients with patello femoral pain syndrome. Materials and Methods: In this clinical trial study 30 male patients (18-40 years old) with patello femoral pain syndrome randomly were divided in 2 groups of 15 patients. Which were placed in Neoprene palumbo and Geno direxa stable orthoses groups respectively. The pain intensity and activity of daily living joint rigidity were assessed before, during and 3 weeks after treatment by visual analogue scale (VAS) and KOOS questionnaire. Following both orthoses application data were analyzed using pair and independent t-test. Results: In both groups the mean of pain intensity decreased and daily physical activity increased after treatment (P<0.05), but there was not significant difference between neoprene palumbo and geno direxa stable methods, on pain and daily physical activities. Conclusion: This study indicated that Neoprene palumbo and geno direxa stable orthoses improved the sign of patello femoral pain syndrome including pain intensity and daily life, activity.

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Background and Objective: Muscle size is considered to be a good indicator of muscle function. Previous studies demonstrated a major role for longus colli muscle in cervical spine stabilization. This study was designed to compare muscle size and shape of cervical longus colli muscle between patients with bilateral chronic neck pain and healthy subjects. Materials and Methods: In this case – control study, bilateral ultrasound images of longus colli muscle, 2 centimeters below the thyroid cartilage were taken in 20 subjects (10 males and 10 females) with bilateral chronic neck pain and in 20 healthy subjects during 2008. Cross sectional area (cm2) and muscle shape ratio (ratio between lateral and anterior posterior dimensions) were measured. T- test was used for comparison of cross sectional area and shape ratio of right and left sides between the two groups. Results: In healthy subjects the cross sectional area of longus colli muscle in right and left sides were 0.85±0.11 and 0.86±0.12 respectively which was greater than that of neck pain patients: 0.76±0.11 and 0.68±0.07 respectively (P<0.05). In addition, longus colli muscle shape ratio of healthy subjects in right and left sides was 1.18±0.17 and 1.16±0.19 respectively which was smaller than that of neck pain patients: 1.50±0.25 and 1.50±0.27 respectively (P<0.05). Conclusion: This study showd that patients with bilateral chronic neck pain had generally smaller cross sectional area and larger shape ratio of longus colli compared to controls.