Use of single- and multi-drug regimens in the management of classic (idiopathic) trigeminal neuralgia: an 11-year experience at a single Sri Lankan institution

Aim: The aim of this retrospective study was to evaluate the outcome of medical treatment of classic trigeminal neuralgia and to assess the factors affecting the choice of drug regimen (single or multiple), and the duration of treatment for pain control.\ud \ud Methods: A total of 260 consecutive patients were included in the study. Sixty-one patients with less than 6 months' follow up were excluded. All patients were treated with carbamazepine alone or in combination with other drugs. The dosage was adjusted according to the level of pain control and side-effects.\ud \ud Results: Treatment was terminated in 99 patients (49.7%) after a mean follow-up period of 36.46 months (standard deviation: ±26.5). Of these, 39.4% were on a single drug. Carbamazepine was the drug used in 36 patients. The rest (61%) needed various combinations of drugs. One-hundred patients (50.3%) continued with medical treatment during the follow-up period. Of these, 67.4% were on multi-drug therapy.\ud \ud Conclusion: The present study showed that the administration of multidrug regimens is a useful alternative in controlling trigeminal neuralgia in patients who are unable to tolerate higher doses of carbamazepine. Age, sex, ethnicity, and the side of affliction did not have a significant influence on the choice of drug regimen and the duration of treatment for pain control

Patients\u27 preference for acrylic resin major connector analogues formulated for titanium alloy removable partial dentures

Purpose: Aim of this study was to determine patients\u27 preference to acrylic resin major connector analogues (MCA) that simulated strengthened major connector designs formulated for Ti-6Al-7Nb alloy. Materials and methods: Four MCA namely wide design (Wide), design with 2 strengthening ridges (2SR), design with 1 strengthening ridge (1SR), and thick design (Thick) were fabricated using light-polymerizing acrylic resin for 10 patients with Kennedy Class I or II partially edentulous maxillary arches. They were asked to wear each MCA in the mouth for 30 seconds in 6 pairs, and to report their preference for each pair. Using these data the 4 MCA were ranked in a descending preference order for each patient. A within-subject comparison of preferences was performed with the Friedman test and multiple comparisons with Wilcoxon Signed Ranks test. Results: A statistically significant preference order was revealed: Wide, 1SR, 2SR, and Thick (P<0.008). The wide design (P<0.004) and the 1SR (P<0.01) were significantly preferred to the thick design. However, individual data showed that the first preference varied depending upon the subject. Conclusion: Thinner designs tended to be preferred to the thicker design by the subjects, while none of the designs tested were consistently selected as the best design

The Sinhala version of the Pain Catastrophizing Scale: validation and establishment of the factor structure in pain patients and healthy adults

Objective: This study was conducted to translate the Pain Catastrophizing Scale into and adapt it to the Sinhala language and to examine its psychometric properties and factor structure in pain patients and healthy adults in Sri Lanka.\ud \ud Setting and Design: A cross-sectional study was conducted, recruiting pain patients from multiple clinics and healthy adults from the community as convenience samples.\ud \ud Methods: Cross-cultural adaptation of the Pain Catastrophizing Scale for Sinhala speakers was carried out using recommended methods. The adaptation's psychometric properties and factor structure were tested in 149 pain patients and 172 healthy adults. Temporal stability was tested in a sample of 104 young adults. Pain intensity of patients was assessed using a visual analog scale, and personality traits of all participants were assessed with the Eysenck Personality Questionnaire.\ud \ud Results: Factor analysis revealed that the three-factor structure of the original version of the Pain Catastrophizing Scale was the best fit to the data from participant samples. Cronbach's alpha values of the three components and total scores for patients and healthy adults ranged from 0.72 to 0.87. Pain catastrophizing exhibited moderate positive correlations with neuroticism in patients and healthy adults and with pain intensities in patients. A high intraclass correlation coefficient of agreement (0.81) revealed an acceptable temporal stability in young adults.\ud \ud Conclusions: The results suggest that the Sinhala version of the Pain Catastrophizing Scale retains the original three-factor structure. It is a stable, valid and sufficiently reliable tool to assess pain catastrophizing in Sinhala-speaking individuals in Sri Lanka