Background:Radiofrequency (RF) is a minimally invasive target-selective technique that has been used with success for many years in the treatment of different pathologies, such as low back pain, trigeminal neuralgia, and others.Aim:The aim of this study is to compare different mode of RF - continuous RF (CRF) versus pulsed RF (PRF) along with steroid in the management of low back pain of discogenic origin.Setting and Design:Prospective, randomized, double-blind trial.Materials and Methods:Forty patients with chronic discogenic low back pain were randomized to receive CRF plus intradiscal triamcinolone 40 mg (Group 1) or to receive PRF plus intradiscal triamcinolone 40 mg (Group 2). Outcome measured includes immediate as well as long-term pain relief using visual analog scale, the Oswestry Disability Index and straight leg raising test.Statistical Analysis:The continuous variables were compared by one-way analysis of variance test. Discrete variables were compared by Fisher's exact test/Chi-square test/Student's t-test, whichever appropriate. The value of P < 0.05 was considered statistically significant.Results:There was a significant decrease in pain score after CRF without any added side effect. Pain relief after PRF was insignificant.Conclusion:CRF with steroid seems to be better for treatment of chronic discogenic low back pain than PRF with steroid.
To compare the incidence of oculocardiac reflex(OCR) between hang-back and conventional method of rectus muscle recession in horizontal strabismus. Materials and Methods: In this prospective, randomized, double blind study, 40 consecutive patients of horizontal strabismus were evaluated. The patients were randomized into two groups based on the type of surgical recession technique employed for squint correction. Twenty patients were operated by Hang-back technique (group-1) and 20 by conventional rectus muscle recession where the muscle tendon was sutured directly to the globe (group-2). All patients underwent pre-operative evaluation which included refraction, keratometry and assessment of angle of deviation etc. ECG was monitored before surgery. During surgery heart rate (HR) was recorded as heart rate baseline (HRB), after 5 minutes of intubation (HR5), during muscle traction (HRT), Minimum heart rate during traction of muscle (HRMin), Maximum increase in heart rate (HRMax). OCR was defined as > 20% reduction in HR during muscle traction as compared to baseline HR. Results: Out of total 40 patients 17(42.50%) were having exotropia and 23 (57.50%) had esotropia. The overall incidence of OCR in conventional recession was found to be greater than that in hang-back recession. The mean baseline HR was 72.00± 7.391 beat/min in conventional recession group and 77.55± 7.494 beat/min in hang-back recession group. The mean HR reduction in conventional procedure was 56.05± 8.787 beat/min. and that in hang-back procedure 61.80 ± 9.317 beat/min., which was statistically significant (p<0.01). This was probably attributed to the shorter duration of surgery and lesser manipulation during surgery in hang-back as compared to conventional procedure. Conclusion: OCR is a common complication encountered during manipulation of muscle during strabismus surgery. Hang-back recession is a safe and effective method of muscle recession as it offers a shorter surgical time and better exposure along with lesser incidence of OCR with similar success rates when compared to conventional muscle recession.
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