A comparative study between different pain rating scales in patients of osteoarthritis.

Study was conducted to assess the sensitivity and simplicity of various pain rating scales in patients of osteoarthritis with chronic pain so that most appropriate scale can be identified. Scales included were Wong-Baker Faces Pain Rating Scale (WBS), Numerical Rating Scale (NRS), Faces Pain Scale- Revised (FPS-R), Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Patients were asked to indicate their pain on these scales and comment about the simplicity of scales. Median mark for WBS, NRS, FPS-R, VAS and VRS was 10, 10, 10, 9.1 and 10 respectively. P value between WBS, NRS, FPS-R, VAS and VRS was insignificant. Most simple, easy to answer scale (83%) was WBS followed by FPS-R (17%). We conclude that all the scales are sensitive for assessment of the chronic osteoarthritis pain and are not different from each others. The most simple and preferred pain rating scale is WBS for the regional population.

An Unusual Simultaneous Occurrence of Diabetes and Hypothyroidism in a Periodontitis Patient: A Case Report.

Periodontal disease, diabetes mellitus, and hypothyroidism are commonly prevalent non-communicable diseases afflicting the human population all over the world, with the added burden on the health care system increasing the overall morbidity. It has been seen through various shreds of evidence that systemic diseases may influence the course of the localized disease and vice versa. Here, we report a case of 38-year-old female periodontitis patient also diagnosed with diabetes mellitus and hypothyroidism. Periodontitis is one of the complications of diabetes. But the occurrence of periodontal disease is a less common intra-oral finding in hypothyroidism as compared to diabetes. All these three chronic diseases were simultaneously observed in this patient, which is a rare occurrence and can adversely affect her overall prognosis. This case report highlights the need for a systematic interdisciplinary approach in the diagnosis and management of such cases.

Severe Chronic Gingivitis in Association With Hypothyroidism and Grade 2 Adenoid Hypertrophy: A Case Report.

Hypothyroidism is the second-commonest endocrine disorder in the world. Similarly, gingivitis is also a highly prevalent oral condition in every population globally. Adenoid hypertrophy and associated mouth breathing may aggravate preexisting gingival inflammation. Here, we are presenting the case of a 22-year-old female gingivitis patient with bleeding from gums on the slightest provocation and with a two-year history of preexisting hypothyroidism. Thorough systemic examinations and investigations ruled out the presence of hematological and/or coagulation disorders. However, she was found to have grade 2 adenoid hypertrophy along with a habit of mouth breathing. Periodontal and systemic management of the patient has resolved her gingival bleeding to a greater extent. Still, there remain a lot of ambiguity and a lack of clarity about the exact etiology and mechanism of pathogenesis behind her oral and general health status. Cases like these pose a diagnostic challenge for the treating dentist or periodontist and thus require a coordinated and collaborative effort of multiple health specialties.

Study of the effect of nortriptyline and fluvoxamine on psychomotor functions in healthy volunteers.

BACKGROUND: Today, many antidepressants are available, but they often cause adverse effects, particularly psychomotor and cognitive. It leads to patient maladjustment and may impair psychomotor performance. Fluvoxamine is a newer antidepressant and hence the present study was planned to investigate its effect on psychomotor functions and compare with nortriptyline and record their adverse reactions. MATERIALS AND METHODS: A total of 26 healthy volunteers were included in this double-blind, placebocontrolled, crossover study. Single oral doses of fluvoxamine 50 mg, nortriptyline 50 mg and placebo were administered following a Latin square design. The objective parameters-six digit cancellation test, digit symbol substitution test, critical flicker fusion test, arithmetic ability test, hand steadiness test and subjective parameters such as visual analogue scale 1, 2, 3 were tested at 0, 2 and 4 h. The side-effects were also investigated. RESULTS: Nortriptyline impaired all subjective and objective psychomotor functions while fluvoxamine did not show any significant effect on objective tests. However, on subjective parameters, there was a significant effect. The side-effects observed were dryness of mouthwith the nortriptyline and nausea and headache with fluvoxamine. CONCLUSION: Fluvoxamine is a better antidepressant drug in comparison with nortriptyline as it causes a less impairment of psychomotor functions.