• Title/Summary/Keyword: randomized clinical

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Efficacy of alpha-lipoic acid in patients with burning mouth syndrome compared to that of placebo or other interventions: a systematic review with meta-analyses

  • Christy, Jessica;Noorani, Salman;Sy, Frank;Al-Eryani, Kamal;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.5
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    • pp.323-338
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    • 2022
  • Burning mouth syndrome (BMS) is a chronic oral disorder of unknown etiology which presents therapeutic challenges. Alpha-lipoic acid (ALA) has been studied as a potential treatment for BMS. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of ALA compared to that of placebo or other interventions in individuals with BMS. Randomized controlled trials (RCT) using ALA to treat BMS were identified from MEDLINE, Cochrane Library, EMBASE, and Web of Science up to February 3, 2021. The assessment of the risk of bias in the included studies was based on the Cochrane guidelines. The primary outcome evaluated was the visual analog scale (VAS) pain intensity. ALA was compared with placebo, clonazepam, gabapentin, pregabalin, ALA plus gabapentin, capsaicin, Biotène®, and laser therapy. Altogether, 137 records were scanned for inclusion/exclusion, and nine RCTs (two unclear and seven at high risk of bias) were included in the qualitative and quantitative analyses, with a total of 594 patients with BMS included in this review. All studies reported an improvement in VAS pain scores ranging from -0.72 to -2.77. Meta-analysis results showed a non-significant reduction in pain intensity for ALA (P = 0.616) compared to that of placebo on a VAS of 0-10. Patients taking ALA were 1.923 times more likely to show an improvement in self-reported BMS symptoms (P = 0.031) than those in the placebo group. Clonazepam and pregabalin showed a significant VAS pain reduction of 4.08 and 4.68 (P < 0.001), respectively, compared to that with ALA. Although ALA intervention provided a non-significant improvement in the pain score and was more likely to produce a reduction in BMS symptoms, the evidence was of low quality. Further research is needed to establish clear guidelines for the use of ALA for BMS treatment.

Improved postoperative recovery profile in pediatric oral rehabilitation with low-dose dexmedetomidine as an opioid substitute for general anesthesia: a randomized double-blind clinical trial

  • Naveen, Naik B;Jaiswal, Manoj Kumar;Ganesh, Venkata;Singh, Ajay;Meena, Shyam Charan;Amburu, Vamsidhar;Soni, Shiv Lal
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.5
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    • pp.357-367
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    • 2022
  • Background: Low-dose dexmedetomidine may be a suitable alternative to opioids for pediatric ambulatory procedures under general anesthesia (GA). However, the recovery profile remains unclear. Herein, we aimed to evaluate the effects of low-dose dexmedetomidine on the recovery profile of children. Methods: Seventy-two children undergoing ambulatory oral rehabilitation under GA were randomly and equally distributed into two groups (D and F). Group D received an infusion of dexmedetomidine 0.25 ㎍/kg for 4 min for induction, followed by maintenance of 0.4 ㎍/kg/h. Group F received an infusion of fentanyl 1 ㎍/kg over 4 min for induction, followed by maintenance at 1 ㎍/kg/h. The primary outcome was the extubation time. The secondary outcomes were awakening time, end-tidal sevoflurane (ET-Sevo) requirement, change in hemodynamic parameters, Richmond Agitation-Sedation Scale (RASS), Children's Hospital of Eastern Ontario pain scale (CHEOPS) score, length of PACU stay, and incidence of adverse events. Results: Statistically significant differences were observed in the recovery profile between the groups: the median time for extubation was 3.65 (3.44-6.2) vs. 6.25 (4.21-7) minutes in groups D vs. F (P=0.001), respectively, while the corresponding awakening times were 19 (18.75-21) and 22.5 (22-24) minutes, respectively (P < 0.001). The mean ET-Sevo was low in group D (1.1 vs. 1.2; P < 0.001). The heart rate was significantly low across all time points in group D, without resulting in bradycardia. The median RASS and CHEOPS scores were also significantly lower in group D. No significant differences were observed in the mean arterial pressure, incidence of adverse events, or length of PACU stay. Conclusion: Low-dose dexmedetomidine was more effective than fentanyl as an opioid substitute at providing a better recovery profile in pediatric ambulatory oral rehabilitation under GA. Dexmedetomidine also significantly reduced sevoflurane consumption without causing adverse events or prolonging hospital stay.

A Systematic Review of Cognitive Orientation to Daily Occupational Performance for Children with Developmental Coordination Disorder (발달성협응장애 아동의 인지기반 작업수행(Cognitive Orientation to daily Occupational Performance; CO-OP) 중재에 대한 체계적 고찰 )

  • Choi, Yeon-Woo;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.20 no.3
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    • pp.72-85
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    • 2022
  • Objective : This study was conducted to examine self-selected goals and the outcome measures used in the Cognitive Orientation to daily Occupational Performance (CO-OP) approach for Developmental Coordination Disorder. Methods : Studies published from January 2012 to October 2022 in the PubMed, Embase, ScienceDirect, Cochrance Library databases were searched. Keywords used for search were ('developmental coordination disorder' OR 'DCD') AND ('Cognitive Orientation to daily Occupational Performance' OR 'Cognitive Orientation to Occupational Performance' OR 'CO-OP'). Among 211 searched studies, 7 selected studies that match the thesis of this study were analyzed. Results : The selected studies showed a relatively high level of evidence overall, including two randomized experimental studies, one non-random two-group study, three non-random one-group studies, one single-subject study. The self-selected goals preference of the children was high in the order of play, education, and daily life activities. Most of applicable sessions were conducted 10 times during a 1-h period, and intervention effects showed positive outcomes on the occupation performance motor domain. To measure the effectiveness of CO-OP, the improvement of occupational performance was evaluated using Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS), and the improvement of motor skills was evaluated using Movement Assessment Battery for Children (M-ABC). Conclusion : This study is expected to be used as basic clinical data when applying the CO-OP approach to Developmental Coordination Disorder.

A Systematic Review on the Intervention of Group Sensory Integration Therapy for Children in Korea (국내 아동을 대상으로 하는 그룹 감각통합치료 중재에 관한 체계적 고찰)

  • Bak, Ah-Ream
    • The Journal of Korean Academy of Sensory Integration
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    • v.20 no.3
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    • pp.60-71
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    • 2022
  • Objective : This study aimed to summarize and present the effects of group sensory integration treatment applied to children with and without disabilities in Korea. Methods : The search period was from January 2010 to December 2021, and databases of 'The Journal of Korean Academy of Sensory Integration', 'The Korean Journal of Occupational Therapy', 'Koreanstudies Information Service System', 'Research Information Sharing Service', 'DBpia' were used for data search. A total of 11 studies were selected, and the Patient, Intervention, Comparison, Outcome method was applied to organize them systematically. Results : As a result of the study, single-group non-randomized studies were the most common with 8 out of 11 studies (72.73%). There were 99 subjects, ranging in age from 3 to 11, and an average of 7.39. Among them, there were more children with disabilities, and 40 out of 99 (40.41%) were diagnosed with developmental disabilities the most. A total of 5 to 45 treatment intervention sessions were provided, and 60 minutes were the most frequently provided once or twice a week. The Canadian Occupational Performance Measure and The Penn Interactive Peer Play Scale were the most commonly used evaluation tools in 4 times each (12.90%). As the treatment intervention goal, social interaction skills was the most common with 8 studies (36.36%). As a result of treatment intervention, 8 studies showed significant results. Conclusion : Based on this study, it is expected that in the future, various methods of intervention of sensory integration therapy based on high quality levels can be systematically presented and used as useful information in clinical practice.

Comparison of ultrasound-guided subacromial corticosteroid and ozone (O2-O3) injections in the treatment of chronic rotator cuff tendinopathy: a randomized clinical trial

  • Merve Orucu Atar;Nurdan Korkmaz;Sefa Gumruk Aslan;Ozge Tezen;Sinem Uyar Koylu;Yasin Demir;Serdar Kesikburun
    • The Korean Journal of Pain
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    • v.36 no.1
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    • pp.128-136
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    • 2023
  • Background: The authors aimed to compare the effects of a one-time ultrasound (US)-guided subacromial corticosteroid injection and three-time ozone (O2-O3) injection in patients with chronic supraspinatus tendinopathy. Methods: Participants were randomly assigned to the corticosteroid group (n = 22) or ozone group (n = 22). Injections in both groups were administered into subacromial bursa with an US-guided in-plane posterolateral approach. Primary outcome measure was the change in the Western Ontario Rotator Cuff Index (WORC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale and Shoulder Pain and Disability Index scores. Assessments were recorded at baseline, and 4-weeks and 12-weeks post-injection. Results: Forty participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both the groups showed clinically significant improvements in shoulder pain, quality of life, and function. Baseline, 4-week post-injection, and 12-week post-injection WORC scores (mean ± standard deviation) were 57.91 ± 18.97, 39.10 ± 20.50 and 37.22 ± 27.31 in the corticosteroid group, respectively and 69.03 ± 15.89, 39.11 ± 24.36, and 32.26 ± 24.58 in the ozone group, respectively. However, no significant group × time interaction was identified regarding all outcome measures. Conclusions: Three-time ozone injection was not superior to a one-time corticosteroid injection in patients with chronic supraspinatus tendinopathy. It might be as effective as corticosteroid injection at 4-weeks and 12-weeks post-injection in terms of relieving pain and improving quality of life and function.

Effects of Exercise-Based Intervention Before and After Lung Cancer Surgery: A systematic review in pubmed database (허파암 수술 전과 후에 적용한 운동의 효과: PubMed 내 연구에 대한 체계적 문헌고찰)

  • Boram Oh;Heesu Kim;Sookyoung Park
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.23-35
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    • 2023
  • Purpose : Lung cancer induces a decrease in physical activity and a deterioration of respiratory ability. Exercise is an effective treatment to reduce side effects of anti-cancer treatments, also influence the survival and successful rehabilitation in lung cancer patients. However, there is insufficient evidence to show which period is the most effective to apply exercise for lung cancer patients. Therefore, this study was conducted to evaluate the efficacy of exercise-based interventions before and after surgery. Methods : Clinical trials (CTs) and randomized controlled trials (RCTs) reported in PubMed database were investigated. The trials investigated in this study were published for 10 years before August 20, 2022. The risk of bias was judged according to the Cochrane guideline. The materials included in this meta-analysis were 6-minute walk test (6MWT), pulmonary function, and quality of life (QOL). Results : 1 CT and 9 RCTs were selected in current study. In the meta-analysis, exercise increased 6MWT in preoperation (mean difference [MD] 29.49; 95 % confidence interval [CI] .99 to 57.99; p=.04; I2=0 %), 3 months postoperation (MD 54.97; 95 % CI 31.85 to 78.09; p<.001; I2=45 %) and 6 months postoperation (MD 85.59; 95 % CI 45.06 to 126.12; p<.001; I2=47 %). Exercise, also enhanced the lung function such as FEV1/FVC (%) in postoperation (MD 7.64; 95 % CI 6.26 to 9.02; p<.001; I2=19 %). Additionally, exercise improved QOL, such as preoperative EORTC-QLQ-C30-LC13 in mental function (MD 3.21; 95 % CI .64 to 5.79; p=.01; I2=0 %) and postoperative SF-36 in mental component summary (MD 9.24; 95 % CI 4.94 to 13.54; p<.001; I2=0%). Conclusion : These results indicate that exercise-based intervention can elevate the ability to exercise and the mental componentof QOL within 3 months.

Incidence of postoperative pain after using single continuous, single reciprocating, and full sequence continuous rotary file system: a prospective randomized clinical trial

  • Umesh Kumar;Pragnesh Parmar;Ruchi Vashisht;Namita Tandon;Charan Kamal Kaur
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.2
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    • pp.91-99
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    • 2023
  • Background: Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. Methods: Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7th day using a visual analogue scale. Result: There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. Conclusion: The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.

Orthodontic pain control following arch wire placement; a comparison between pre-emptive tenoxicam and chewing gum: a randomized clinical trial

  • Basam, Lakshman Chowdary;Singaraju, Gowri Sankar;Obili, Sobitha;Keerthipati, Thejasree;Basam, Ram Chowdary;Prasad, Mandava
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.22 no.2
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    • pp.107-116
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    • 2022
  • Background: Pain during fixed orthodontic treatment can have a detrimental effect on patient treatment compliance. To overcome this, there is a definite need to establish the best pain-relieving methods suitable for orthodontic patients in terms of efficacy and use. The objective of this study was to compare the effect of chewing gum and pre-emptive tenoxicam on pain after initial archwire placement and to evaluate the pain perceptions of orthodontic patients in the two groups while performing various functions at specific time intervals. Methods: Forty-two patients were selected and randomly divided into two groups: group A (chewing gum) and group B (pre-emptive tenoxicam). Pain perception was documented by patients immediately; at 4 h; at bedtime on the day of archwire placement; the next morning; at 24 h; and at bedtime on the 2nd, 3rd, and 7th day after the initial archwire placement. Pain scores were noted during fitting of the posterior teeth, biting, and chewing using a visual analog scale. The data obtained were subjected to statistical analysis. Results: Group A showed a significant increase in pain until the next morning while fitting the posterior teeth, biting, and chewing [36.2, 52.0, 33.4, respectively]], followed by a gradual decrease by the 7th day. Group B showed a significant increase in pain at bedtime on biting, with a peak value of 47.5. Pain on chewing, fitting posterior teeth, peaked the morning of the next day (100.0, 45.0). The Freidman test showed a statistically significant difference with a p-value of < 0.01. Higher pain scores were observed while chewing and biting compared with that while fitting the posterior teeth in both groups. The overall comparison of pain control between the two groups was not statistically significant [P > 0.05] between the two groups. Conclusions: Chewing gum was not inferior to pre-emptive tenoxicam. Thus, chewing gum is a non-pharmacological alternative to analgesics for orthodontic pain control that eliminates the chance of adverse reactions and can be used in the absence of adult observation.

The effectiveness and safety of acupuncture combination treatment on smoking cessation: A protocol for systematic review (금연에 대한 침술 병용 치료의 효과 및 안전성 : 체계적 검토를 위한 프로토콜)

  • In Suh Choi;Won-Suk Sung;Min-gi Jo;Jung-Hyun Kim;Yeon-Cheol Park;Eun-Jung Kim;Yong-Hyeon Baek;Geun-Woo Kim;Byung-Kwan Seo
    • Journal of Convergence Korean Medicine
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    • v.3 no.1
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    • pp.5-13
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    • 2022
  • Objectives: Smoking had a long negative impact on public health. The ingredients of a cigarette are major risk factors for several diseases. Owing to the problems about economic and quality of life, we need to ensure smoking cessation (SC). There are several approaches for SC including pharmacological therapy, nicotine replacement therapy, education, and behavioral intervention. However, due to some limitations, other alternative approaches are gaining popularity. Acupuncture has been reported to have few side effects and be more effective than some conventional treatments in several articles. However, there are no systematic reviews on the comparison of acupuncture combination treatment with other conventional monotherapies. Methods: Randomized controlled trials that used acupuncture as an adjunct treatment for SC will be searched and data will be summarized according to the predefined criteria. The primary outcome will be the abstinence rate, and secondary outcomes will be adverse events and biochemical indicators. We will use Review Manager to perform a meta-analysis, Cochrane Collaboration Risk of Bias tool for the risk of bias assessment, and the Grades of Recommendation, Assessment, Development and Evaluation approach to determine the quality of evidence. We will investigate the efficacy and safety of acupuncture combination treatment for SC with this study. Ethics and dissemination: This study will provide reliable clinical evidence on additional effect of acupuncture on smoking cessation. We will publish our results in a peer-review journal.