Objectives: To evaluate the effectiveness and safety of wet cupping therapy as a single treatment for persistent nonspecific low back pain (PNSLBP).Design: Randomized controlled trial comparing wet cupping versus no treatment in PNSLBP.Setting: Outpatient clinic in three secondary care hospitals in Saudi Arabia.Patients: Eighty eligible participants with PNSLBP for at least 3 months were randomly allocated to an intervention group (n=40) or to a control group (n=40).Interventions: Six wet cupping sessions within 2 weeks, each of which were done at two bladder meridian (BL) acupuncture points among BL23, BL24, and BL25. Only acetaminophen was allowed as a rescue treatment in both groups.Outcome measures: The Numeric Rating Scale (NRS), McGill Present Pain Intensity (PPI), and Oswestry Disability Questionnaire (ODQ) were used as outcome measures. Numbers of acetaminophen tablets taken were compared at 4 weeks from baseline. Adverse events were recorded.Results: At the end of the intervention, statistically significant differences in the three outcome measures favoring the wet cupping group compared with the control group were seen: NRS score, 29.2 (95% confidence interval [CI], 24.6–33.8) versus 57.9 (95% CI, 53.3–62.6), respectively; PPI score, 1.17 (95% CI, 0.96–1.4) versus 2.3 (95% CI, 2.1– 2.7); and ODQ score, 19.6 (95% CI, 16.5–22.7) versus 35.4 (95% CI, 32.3–38.5) (p=0.0001). This improvement continued for another 2 weeks after the end of the intervention. Acetaminophen was used less in the wet cupping group, but this difference was not statistically significant. No adverse events were reported.Conclusions: Wet cupping is potentially effective in reducing pain and improving disability associated with PNSLBP at least for 2 weeks after the end of the wet cupping period. Placebo-controlled trials are needed.
Patient: Female, 68-year-old
Final Diagnosis: Pleural effusion
Symptoms: Breathlessness • shortness of breath
Medication: —
Clinical Procedure: Arthroscopic Rotator Cuff repair
Specialty: Orthopedics and Traumatology
Objective:
Unusual or unexpected effect of treatment
Background:
Airway compromise caused by massive fluid extravasation in association with arthroscopic shoulder surgery is rare. However, it is even more rare to occur as a result of pleural effusion. We present this case to increase the awareness of this rare complication and show how to minimize the likelihood of this uncommon incident.
Case Report:
We describe a case of a 68-year-old woman who underwent elective shoulder arthroscopy for rotator cuff repair. She had immediate postoperative shortness of breath and was found to have bilateral pulmonary edema and pleural effusion accompanied by metabolic acidosis. She was managed conservatively in the intensive care unit and then transferred to the general ward after clinical and radiological improvement the next day.
Conclusions:
This uncommon complication was self-limiting, and the patient recovered uneventfully. High clinical suspicion is required to address this event so proper rapid management can be made.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.