Comparison of therapeutic efficacy between acupuncture and low level laser in the treatment of cervical myofascial pain syndrome: a single blinded randomized clinical trial study

Abstract Background: Neck pain is a medical and public problem with a prevalence of 9-18 percent in general population. Myofascial pain syndrome (MPS) is a regional pain syndrome that is characterized with muscular tender and triggers points. Laser therapy and acupuncture are two methods applied in the treatment of MPS. The aim of this study was to compare the effects of acupuncture and low level laser in cervical MPS treatment. Material and Methods: In a randomized clinical trial study, during a 15-month period, 60 patients with CMPs, referred to physical medicine and rehabilitation clinic, were divided into three groups Gr1 underwent acupuncture plus drugs, Gr2 laser therapy plus drugs and Gr3 only medication. Pain severity using visual analogue scale (VAS), Range of motion (ROM) with goniometry, palpation sensitivity with finger compression and daily function with neck questionnaire were assessed before, immediately after and two months after treatment. The obtained data were analyzed using statistical software SPSS version 16. Results: Sixty patients of CMPs were included in this study. In acupuncture group, 5 male and 15 female (mean age of 38.8&plusmn;6.36), in laser group, 6 male and 14 female (mean age of 37.7&plusmn;5.64) and in control group, 8 male and 12 female (mean age of 37.6&plusmn;5.17) were evaluated. There was significant difference in majority of parameters in two treatment groups compared to control group. But neck ROM in left lateral bending and VAS score, showed better improvement in acupuncture group than the other 2 groups (P<0.001). Nevertheless two months afterwards, no significant difference was detected between laser and acupuncture groups. Conclusion: This study demonstrated that both acupuncture and laser therapy along with exercise and drugs are more effective than routine and only medication treatments in management of CMPs. However, with respect to myofascial pain pathology, acupuncture, at least in short term has more beneficial effects in pain improvement and neck range of motion than laser or medical therapy alone

Electrical interferential current stimulation versus electrical acupuncture in management of hemiplegic shoulder pain and disability following ischemic stroke-a randomized clinical trial

Abstract Background Hemiplegic Shoulder Pain (HSP) is among common complications occurring after stroke leading to disability. This study was conducted to compare the effects of electrical Interferential Current stimulation (IFC) and Electrical Acupuncture (EAC) on pain intensity, range of motion, and functional ability in patients with HSP and also comparing the two modalities regarding improvement of above indices. Methods In this randomized clinical trial, 46 patients with HSP caused by ischemic stroke were recruited and assigned into 2 groups. Conventional exercise trainings were applied for both groups. Group A received additional IFC with medium frequency of 4000 HZ, and Group B received additional EAC two times a week for a total of 10 sessions. Pain severity, daily function, and shoulder Range of Motion (ROM) were evaluated using Visual Analogue Scale (VAS), Shoulder Pain and Disability Index (SPADI), and goniometry, respectively before and 5 weeks after the treatment. Results Both groups showed relative improvement in pain severity, SPADI score, and its subscales, and also active and passive shoulder ROM after the treatment. However, IFC group compared to EAC group had higher mean changes of active ROM in abduction (28.00 ± 3.81 vs. 12.25 ± 2.39) and functional subscale of SPADI (11.45 ± 1.88 vs. 5.80 ± 1.66) after the treatment. On the contrary, EAC group showed higher percentage of VAS changes (46.14 ± 6.88 vs. 34.28 ± 5.52), indicating better pain improvement compared to IFC group. Other parameters did not show significant difference between two groups. Conclusion Both IFC and EAC caused short term improvement in functional state, increased motion, and decreased pain in patients with HSP. Although pain control was more evident in acupuncture group, IFC resulted in better effects on function and active ROM of abduction, and seems to have higher efficacy. Trial registration This clinical trial was registered in the Iranian Registry of Clinical Trials at 2016-07-16 with a registry number of IRCT201602153217N10

Random Urine Protein Creatinine Ratio as a Preadmission Test in Hypertensive Pregnancies with Urinary Protein Creatinine Ratio

To evaluate the value of random urinary protein creatinine ratio in prediction of 24h proteinuria in hypertensive pregnancies. Method: Random urine samples and routine 24h urine collections were collected from hypertensive pregnant women (n=100). Reliability of random urinary protein-creatinine ratio was assessed by receiver operator characteristic (ROC) curve to detect significant proteinuria (300mg/day) using 24h. Urine protein as a gold standard. Forty six patients (46%) had significant proteinuria. The random protein creatinine ratio was correlated to 24h urine protein excretion (r2=0.777, P<0.001) Area under ROC curve to predict proteinuria was 0.926 (95% CI: 0.854-0.995, P<0.001). A cut off value of 0.22mg/mg for protein creatinine ratio best predicted significant proteinuria with sensitivity, specificity, positive and negative predictive values of 87%, 92.6%, 90.6% and 89.3% respectively. Random urinary protein creatinine ratio is a simple inexpensive and excellent alternative to 24h urine collection. It's helpful in diagnosis of preeclampsia and can be used as a pre admission test in PIH cases

Extreme βHCG levels in first trimester screening are risk factors for adverse maternal and fetal outcomes

Abstract Multiples of the normal median (MoM) of free βHCG is a valuable parameter in evaluation of risk of adverse pregnancy outcomes. In the current retrospective study, we assessed the maternal and fetal outcomes in pregnant women having free βHCG MoM levels  5 in their first trimester screening (FTS). Relative risk of trisomy 21 was significantly higher in patients having free βHCG MoM > 5. On the other hand, relative risk of trisomies 13 and 18 and Turner syndrome were higher in those having free βHCG MoM  5. Relative risk of hydrocephaly and hydrops fetalis was higher when free βHCG MoM was below 0.2. On the other hand, relative risk of low birth weight was higher when free βHCG MoM was above 5. Moreover, frequency of gestational diabetes mellitus, preeclampsia, preterm delivery and vaginal bleeding increased with levels of free βHCG MoM. However, polyhydramnios had the opposite trend. Frequencies of premature rupture of membranes and pregnancy induced hypertension were highest among pregnant women having levels of free βHCG MoM  5 can be regarded as risk factors for adverse maternal or fetal outcomes irrespective of the presence of other abnormalities in the FTS results