Evaluation of post operative analgesic efficacy of intramuscular pethidine, compared to indometacin and diclofenac Na suppositories in unilateral inguinal hernioplasty patients

We compared analgesic effects of intramuscular pethidine to diclofenac sodium and indometacin suppositories. This study is a semiexperimental clinical trial study over 55 patients of 17 to 60 years old who had undergone unilateral inguinal hernioplasty. These patients divided into 3 groups incidentally the first group including 17 patients who received 100 mg indometacin suppository every 8 h to relief postoperative pain. The second group of 18 patients who received 100 mg Diclofenac Na suppository every 8 h and the third group including 20 patients who received 0.5 mg kg-1 body weight pethidine intramuscularly every 8 h and the first dose of each drug started 2 h after termination of operation. The severity of pain was checked by Visual Analogue Scale (VSA) method every 2 h for 24 h. Mean pain severity checked and compared in 6 h intervals. Mean pain severity and standard deviation in the first 24 h were 23±12 for indometacin and 27±12 for pethidine and 31±9 for diclofenac Na groups respectively. There is no meaningful difference in pain relief during the first post op day. We concluded that Indometacin and diclofenac Na suppositories are good substitutes of intramuscular pethidine to relief post op pain during the first post op day

Implication of invalidation concept in fibromyalgia diagnosis

Objectives: The invalidation or social pain is an important but neglected issue in polysymptomatology of fibromyalgia (FM). This study sought whether tracing-perceived invalidation could be effective to discriminate between the presence and absence of FM in chronic pain patients with respect to five different sources, including spouses, family, colleagues, health professionals, and social services. Methods: A total of 207 consecutive chronic pain patients were evaluated for the presence of FM by rheumatologic assessment. Invalidation was measured by the Illness Invalidation Inventory (3*I). Receiver operator characteristic (ROC) analyses were used to evaluate the ability of 3*I dimensions and sources to discriminate having FM among chronic pain patients. Binary logistic regression analyses were performed. Results: The perceived discounting and lack of understanding from spouse and family sources were higher in FM rather than non-FM patients. ROC analyses demonstrated that invalidation dimensions stemming from spouse and family could appropriately discriminate between the presence and absence of FM. The area under the curve (AUC) for other sources showed non-significant values. Adjusted logistic regression analysis by age, education level, and work status showed that discounting by family and lack of understanding by the spouse could be significant predictors of FM (OR 2.30; 95 CI 1.29�4.11, P = 0.005; OR 1.72; 95 CI 1.08�2.74, P = 0.022, respectively). Conclusions: This study elucidated the discriminatory power of invalidation in identification of FM from non-FM patients, especially when originated from spouse and family. Our results provide a basis to propose the invalidation as a salient component in the FM dictionary parallel to other famous FM symptoms.� The incorporation of newly highlighted social definition of pain seems warranted in the pain practice.� Despite proposing invalidation in painful conditions, its diagnostic role in FM remains unexplored.� Acknowledging of invalidation or social pain in polysymptomatology of FM could shift the paradigm of diagnosis of FM. © 2021, International League of Associations for Rheumatology (ILAR)

Implication of invalidation concept in fibromyalgia diagnosis

Objectives: The invalidation or social pain is an important but neglected issue in polysymptomatology of fibromyalgia (FM). This study sought whether tracing-perceived invalidation could be effective to discriminate between the presence and absence of FM in chronic pain patients with respect to five different sources, including spouses, family, colleagues, health professionals, and social services. Methods: A total of 207 consecutive chronic pain patients were evaluated for the presence of FM by rheumatologic assessment. Invalidation was measured by the Illness Invalidation Inventory (3*I). Receiver operator characteristic (ROC) analyses were used to evaluate the ability of 3*I dimensions and sources to discriminate having FM among chronic pain patients. Binary logistic regression analyses were performed. Results: The perceived discounting and lack of understanding from spouse and family sources were higher in FM rather than non-FM patients. ROC analyses demonstrated that invalidation dimensions stemming from spouse and family could appropriately discriminate between the presence and absence of FM. The area under the curve (AUC) for other sources showed non-significant values. Adjusted logistic regression analysis by age, education level, and work status showed that discounting by family and lack of understanding by the spouse could be significant predictors of FM (OR 2.30; 95 CI 1.29�4.11, P = 0.005; OR 1.72; 95 CI 1.08�2.74, P = 0.022, respectively). Conclusions: This study elucidated the discriminatory power of invalidation in identification of FM from non-FM patients, especially when originated from spouse and family. Our results provide a basis to propose the invalidation as a salient component in the FM dictionary parallel to other famous FM symptoms.� The incorporation of newly highlighted social definition of pain seems warranted in the pain practice.� Despite proposing invalidation in painful conditions, its diagnostic role in FM remains unexplored.� Acknowledging of invalidation or social pain in polysymptomatology of FM could shift the paradigm of diagnosis of FM. © 2021, International League of Associations for Rheumatology (ILAR)