EFFECT OF DULOXETINE ON PAIN RELIEF IN PATIENTS UNDERGOING ARTHROPLASTY SURGERY: A SYSTEMATIC REVIEW

Duloxetine is a dual reuptake inhibitor of norepinephrine and serotonin. Serotonin or 5-hydroxytryptamine acts by affecting a wide range of receptors, including the 5-HT2A receptor, which plays a role in modulating neuropathic or inflammatory pain. This systematic review was aimed to consider the effect of duloxetine on reducing the pain in patients undergoing arthroplasty surgery. Articles with key words "Pain, Duloxetine, Postoperative pain, Total knee arthroplasty, Arthroplasty" were searched in four international databases PubMed, Scopus, Science Direct, and Web of Science. Nine articles which fulfilled the inclusion/exclusion criteria were selected of which 3 were conducted in China, 3 in Korea, 1 in Netherlands, and 2 in the USA. In three studies duloxetine was used in a dose of 30 mg, while in all other studies 60 mg was used. In all reviewed articles (except for the two), duloxetine reduced the pain of total knee arthroplasty patients. It is therefore recommended to prescribe this drug to reduce the pain in these patients, while recommending more studies in this field

Role of vitamin D on knee osteoarthritis pain: a systematic review

Vitamin D3 (Cholecalciferol) has the chemical formula of (C27H44O), molecular weight (384.6), exact mass (384.339216023), and mono-isotopic mass (384.339216023). The researchers conducted this study to examine the role of Vitamin D on the knee osteoarthritis pain. The original published articles (interventional or correlational) aimed to investigate the role of vitamin D on Knee OA pain. The search was done by using the keywords "pain, knee osteoarthritis, osteoarthritis, Vitamin D, Vitamin D3, knee, Cholecalciferol, and vitamin D deficiency" and these mentioned keywords were used by "OR" and "AND" search methods. Regarding gray texts, all related articles and their references were reviewed. Based on the findings of 15 articles, there was no relationship between vitamin D and pain in 2 articles, pain was lower in the high vitamin D group (No significance < 0.05) in 1 article, and increasing vitamin D reduced pain in 12 articles. In 9 articles, the search method was Randomized Trial, and in 6 ones, it was cross-sectional. According to the findings, although in most reviewed articles, vitamin D led to the reduction of Knee OA pain, in some of them, the difference in pain reduction between the group receiving vitamin D and the placebo group was not significant. Therefore, acceptable evidence for its effectiveness is not available and it is necessary to conduct more studies in this field. © Global Journal of Engineering Education.All right reserved

Prevalence of Orthopedic Pains in Children and Adolescents: A Systematic Review and Meta-analysis

Context: Musculoskeletal disorders are among the main causes of death and disability and can impose high costs on individuals and countries. Considering the importance of pain, the present meta-analysis study aimed to investigate the prevalence of orthopedic pains in Iranian children and adolescents. Methods: The present study was reported in line with PRISMA. The searching process was carried out using keywords, including ado-lescents, pain, youth, school-age children, shoulder pain, neck pain, shoulder, and neck, AND/OR operators for the articles published during 2000 and 2022 in Scopus, Embase, PubMed, Scientific Information Database, Magiran, International Statistical Institute, and Islamic World Science Citation Center databases. This study reviewed the articles that reported the prevalence of orthopedic pains (i.e., wrists/hands, shoulders, elbows, and knees) among the 5-18-year age group in Iran and extracted their results. Two researchers conducted the search quite independently and extracted the necessary data using a researcher-made checklist. The collected data were analyzed using Comprehensive Meta-Analysis software (CMA3). Results: Initially, 418 articles were identified, and 14 articles were entered into the systematic review stage. The prevalence rates of pains related to wrists/hands, shoulders, elbows, and knees were 6.6 (95 confidence interval CI: 3.2-13.0), 26.9 (95% CI: 17.0-39.7), 2.9 (95% CI: 1.3-6.3), and 6.6 (95% CI: 3.0-14.2), respectively. Conclusions: The prevalence of shoulder and knee pains in individuals under 18 years in Iran was high. Therefore, it is necessary to make necessary interventions and take preventive measures. © 2023, Author(s)

Investigating the Prevalence of Delirium as a Psychiatry Disorder in Patients Undergoing Hip Joint Surgery

Background: Delirium is a severe organic disorder in the brain and a type of disorder in the cognitive state associated with reduced attention and cognition. This study aimed to investigate the prevalence of delirium in patients undergoing hip joint surgery.Methods: In cross sectional study, the patient's demographic profile form and a checklist of intervening factors designed which were used to measure the prevalence of delirium. The researcher checked the delirium status of the patients on the day before the surgery, 6, 12, 24, and 48 hours after the surgery, and at the time of discharge. Ethical criteria in the research included obtaining informed consent of patients, keeping patients confidential, notifying the delirium status patients to the attending physician for further actions, and not imposing costs on patients. The data were analyzed using Spss software version 16 and descriptive and analytical tests.Results: Result showed, the overall prevalence of delirium in patients was equal to 58 (46.4), and 92 (73.6) of patients without a spouse, 112 (89.6) of patients with poor economic status, 63 (50.4) of smoking patients, 14 (11.2) with a history of drug use, 54 (43.2) with a history of hospitalization in the ICU. Also, the mean (SD) age of the patients was 75.44 (8.43).Conclusions: According to the findings, the prevalence of delirium in patients with hip joint surgery was high, that is why it is necessary to carry out preventive interventions to reduce delirium in these patients. ASEAN Journal of Psychiatry, Vol. 24 (1) January, 2023; 1-6

PREVALENCE OF SPINAL FRACTURES AND ORTHOPEDIC FRACTURES CAUSED BY ROAD TRAFFIC INJURIES

Background: Road traffic injures (RTIs) are the third leading cause of death in the world after heart diseases and cancer. The aim of the present study was to determine the prevalence of spinal cord fractures (SCF) and other general orthopedic fractures (GOF) caused by road traffic injuries.Materials & Methods: This was a retrospective cross sectional study performed on patients with RTIs-related fractures or SCIs from January 2020 to January 2021.The study population consisted of the medical records of patients admitted to Imam Khomeini Hospital with a diagnosis of GOFs or SCFs. The participants were included in the study by census method. Inclusion criteria included RTIs-related orthopedic fractures or SCIs. The data was analyzed using the SPSS 16 software.Results: The study result showed, that the prevalence of two types of fracture in patients was 9.33. Also, the prevalence of spinal cord fractures was in the form of Multiple spinal levels with a rate of 88 (32.6) and the lowest rate was in the Dorsal spine area with a rate of 38 (14.1). Regarding general orthopedic fractures, the result showed Multiple Orthopedic regions with a rate of 67 (24.8) and the lowest rate was in the Pelvis region with a rate of 29 (10.7).Conclusions: The prevalence of spinal cord and general orthopedic fractures in the examined patients was high, so it is necessary to take corrective measures to prevent traffic accidents

Pitfalls in diagnosis of cord tethering in scoliosis: Lessons learned from a series in a single centre

Study design: Case-series.Purpose: We intend to introduce three challenging cases suspicious of spinal cord tethering, who were managed in our center and their diagnosis was not so straightforward. Overview of literature: Diagnosis of spinal cord tethering in scoliosis can be challenging. This is especially true when the tip of conus medullaris is slightly lower than its normal location and the patients are asymptomatic before corrective spinal surgery.Clinical presentation: Although in all three cases the tip of conus medullaris was in a relatively abnormal place (at the level of L2-L3), two of them did not show any evidences of spinal cord tethering in urodynamic study (UDS) and prone magnetic resonance imaging (MRI), thus corrective scoliosis surgery without previous un-tethering procedure was allowed. Spinal realignment was performed on these two cases with a favorable outcome. In the third case, un-tethering was done due to evidence of urinary impairment, which was suggested in (UDS) and tight filum terminale, which was detectable in lumbosacral MRI in prone position. In the follow-up period, the UDS properties of the patient turned into normal and later an uneventful corrective spinal surgery was performed.Conclusions: The main goal of this article is to highlight the ongoing controversy existing in the diagnosis and optimal management of spinal cord tethering in patients with scoliosis