Cymbopogon citratus

years, transcutaneous electric nerve stimulation was used to treat a variety of painful conditions, including reflex sympathetic dystrophy.’4’6 Two earlier reports from this institution [r]

ar if peripheral stimulation of the gland results in a re- flex facilitation of central output from the salivatory nucleus of the medulla. The early investigators of elec- trostimulation postulated that normal physiologic sali- vary reflexes are augmented. [16] Salivation is con- trolled by both sympathetic and parasympathetic effer- ent nerves. [17] Sympathetic stimulation produces sparse, viscous saliva. In order to electrically stimulate sympathetic salivation, higher frequencies and longer pulse duration is required. [18] On the other hand, elec- tric stimulation of parasympathetic nerves of the sali- vary glands produces copious amounts of watery saliva at lower frequencies, and it is this voluminous, serous saliva of the parotid gland that would be clinically most useful for managing xerostomia. [16] Within this dual autonomic system it is clear that salivation is primarily under parasympathetic control.

effectiveness of transcutaneous electric nerve stimulation on reductive of labor pain during the active phase of.. labor pain among prim gravid mothers in selected [r]

The aim of pain management is reduce post-surgical complication, while providing adequate analgesia and help to rehabilitation. Today we have various methods to provide adequate post-op pain relief including analgesic drugs, acupuncture [3] , aromatic therapy [5] , Transcutaneous Electric Nerve Stimulation (TENS) [6] , Low-Level Laser [1] , PCA device [7] , That needs multidisciplinary teams with multimodal analgesia.. [2-7] The major goal to pain management is provide less dependence on opioids and avoid their adverse effects. [8] Opioids are potent drugs for pain control such as Pethidine and tramadol but with side effect like nausea, vomiting, pruritus, urinary retention, respiratory depression, physical dependence and addiction. [9-10]

The neuroregulation of urination consists of two nerve centers (supraspinal reflex and spinal reflex centers) and three sets of nerves (sympathetic, parasympathetic, and somatic nerves). These nerves arise from the lateral horn of L1–L4 and S1–S4, and they are distributed in the trigone of the urinary bladder, external urethral sphincter of the bladder neck, and transverse perineus. The conus medullaris (S2–S4), the spinal reflex center of parasympathetic and somatic nerves, plays a leading role in promoting urination among these nerves. This theoretical basis is extremely important in the location of TENS, which has a direct influence on the outcomes. As one of the low frequency electric stimulation therapies, TENS is used extensively in neurological rehabili- tation. TENS has been a widely used therapeutic approach in acute and chronic pain syndromes. 19,20 Wong et al 21 found

Transcutaneous electrical nerve stimulation (TENS) is a low frequency electrical modality, which is used as a physiotherapeutic resource of clinical purpose in the symptomatic relief of pain [7]. It is considered an efficient, easy-to-apply, non-invasive, non-toxic, comfortable procedure for the patient in 95% of cases, and is a relatively low-cost method [8,9]. The application is made through an electric current generated by the device and transmitted by means of electrodes that are placed on the skin [10]. The mechanism of action of TENS works according to the gate control theory postulated by Melzack and Wall [11]. Overstimulation of type A gamma fibers promotes the blockade of stimulus entry by type C fibers (nociceptors) in the gates of the posterior horn of the spinal cord (gelatinous substance) influence the first central transmission (T) cells of spinal cord, thus promoting analgesia [8,11]. Due to the effect of TENS, it can be administered in the postoperative routine of several surgical conditions, as an adjunct to conventional opioid analgesia [12].

This study is done to test comparative efficacy of Transcutaneous Electrical Nerve Stimulation [TENS] and pendular Exercises V/S Ultra Sound and Rhythmic Stabilization in clinically Diagnosed Frozen Shoulder (Adhesive Capsulitis).After 1 year of study on 24 samples with clinically diagnosed Frozen Shoulder, in which Transcutaneous Electrical Nerve Stimulation [TENS] and Pendular Exercises are given to 8 patients (Group A) and Ultra Sound and Rhythmic Stabilization are given to other 8 patients (Group B) and Electric heat pack therapy and shoulder active exercises to another 8 patients (Group C – control group) for the duration of 1 month. On the basis of Shoulder pain and disability index (SPADI) scale, it is inferred that Transcutaneous Electrical Nerve Stimulation [TENS] and Pendular Exercises V/S Ultra Sound and Rhythmic Stabilization. Both groups are effective in reducing in pain and disability in clinically diagnosed frozen shoulder (Adhesive Capsulitis). When compared to the post test result of the control group. Statistical analysis and data suggests that comparative efficacy between these two groups is non-significant. These two groups are significant when compared to control group in decreasing pain and disability in clinically diagnosed frozen shoulder (Adhesive Capsulitis).

TTNS was done with a stimulating Neuro Track TENS unit (Verity Medical, UK). Stimulation was done on the tibial nerve route using a self-adhesive surface stimulation electrode (16, 22). A negative electrode was placed on the ankle skin behind the internal malleolus with the positive electrode be- ing placed 10 cm above the negative one. The ade- quate position of the electrode was determined by slowly increasing the electric current until sensory and / or motor responses were evident. Typical re- sponses included foot sole sensation and / or great toe flexion (15). The appropriate electric current in- tensity level was determined based on the intensity immediately under the threshold motor contrac- tion and varied from 18 to 38 mA. The fixed pulse width of 200 μs and a frequency of 20 Hz were ap- plied in a continuous mode for 30 min. TTNS was done in the Outpatient Department twice weekly for 6 weeks (12 procedures) (15).

The pain relief method used should be safe, effective, and with minimal side effects. Transcutaneous elec- trical nerve stimulation is a non-pharmacological and non-invasive pain relief for nociceptive, neuropathic, and musculoskeletal pain involving delivering pulsed electric current across skin [6]. It reduces labor pain and postpones the use of pharmacological analgesics in laboring women [7]. It has also been reported as redu- cing pain and increasing patients’ satisfaction when used in office hysteroscopy without sedation [8]. It has not been studied as a pain relief method for oocyte re- trieval in assisted reproduction.

The use of electrical stimulation of the skin for symptomatic relief of pain is an age-old technique with the ancient Egyptians (circa 2500 B.C.) and the ancient Romans (circa 15 A.D.) using live electric fish placed on the skin to relieve pain for various ailments (Gildenberg, 2006). Nowadays, electrical stimulation of the skin is achieved using battery operated devices that generate pulsed currents that are delivered across the intact surface of the skin using self-adhering electrodes and lead wires (Figure 1). The technique is called transcutaneous electrical nerve stimulation (TENS). The goal of TENS is to stimulate peripheral nerves as this has been shown to reduce transmission of pain-related information in a manner similar to rubbing the skin (Johnson and Bjordal 2011). Therefore, TENS is used to “electrically rub pain away”.

The US was a 20 ms electric shock that was delivered to the wrist of the non-dominant hand. A conductive gel was used between the electrodes and the skin. The shock was delivered using a Grass S48 stimulator. Shock inten- sity was determined at the start of the experimental procedure. The intensity was individually set at a level that was very uncomfortable, but not painful. Participants received shocks of gradually increasing intensity, starting at 1 mA and increasing in 5 mA increments. After every shock, participants were asked to rate what they had felt and whether the shock intensity would have to be increased to reach a level that was ‘very uncomfortable, but not painful’. Once participants felt that they had reached a shock intensity that corresponded to this level, the shock intensity was kept stable at this level for the rest of the experiment.

Various management protocols ranging from palliative management to systemic drug administration, acupuncture and others treatment modalities have been utilized with moderate success but still requires a safe and efficient modality of management. Use of TENS in production of saliva has been studied in the past which showed promising results (Vilas et al., 2009). The mechanism by which TENS unit worked on parotid gland is not clear. The early investigators of electro stimulation postulated that normal physiologic salivary reflexes are augmented on electro-stimulation (Hargitai et al., 2005). Electric stimulation of parasympathetic nerves of salivary glands produce copious amounts of watery saliva at low frequencies, and it is this voluminous, serous saliva of parotid gland that would be clinically most useful for management of xerostomia (Garret et al., 1987). Therefore TENS possibly thought to act by directly stimulating the auriculotemporal nerve that supplies secretomotor drive to the parotid gland (Hargitai et al., 2005). Results of preliminary investigations of non-invasive electronic stimulation of reflex salivation in xerostomic patients have been encouraging (Steller et al., 1988). Very few studies are conducted so far to find out the effects of transcutaneous electrical nerve stimulation in patients with xerostomia. Research in this area has been sparse thus requiring further study in this regard. The purpose of the present study was to find out the difference between the whole saliva flow rates in healthy adult subjects and patients with xerostomia and to determine the efficacy of transcutaneous electric nerve stimulaton (TENS) in stimulation of the whole saliva in these subjects. As an increase in salivary flow rate in these patients with xerostomia, may be helpful in reducing the symptoms and risks associated with xerostomia, like increased plaque formation, dental caries, opportunistic fungal infections, difficulty in eating and swallowing, malnourishment, oral pain and others.

We have previously said that the heart rate regulation in healthy humans is known to exhibit complex variability over an extensive time dynamic range. Specifically, in the beat-to-beat RR interval, the variability of such heart rhythm is intrinsic and of fundamental importance. In previous papers we have also shown that it exhibits scale-free characteristics [36] [37] [38] and Ivanonv et al. and Sassi et al. have shown that it is of multifractal type [39] [40]. The conclu- sion is that scale-free component of the heart rate variability (HRV) is of basic importance. It also develops relevant information in the clinical context since a diminishing fractal HRV is consistently reported as related to a serious ANS dysfunction that of course we observe in several psychological disorders. This is to say that different factors influence HRV scale-free dynamics, and in such context, the potential contribution of the central nervous system (CNS) cannot be ignored. On the other hand the sympathetic (SNS) and parasympathetic (PNS) branches of the autonomic nervous system (ANS) realize a complex inte- raction between SNS and PNS that requires advanced investigation. In fact, it has been studied that SNS blockade by drugs has a minor effect on the multi- fractal property of HRV. Therefore we have arrived to the central point: stimula- tion of the vagus nerve by a signal that is intrinsically multifractal induces a strong heart related neuro-modulation that enables the subject to recover ANS dysfunction related to his/her psychological disorder. In this framework, the use of tVNS based on a Nu Calm mutifractal output signal results is of decisive im- portance. We stimulate researchers to experimentally verify such new line of re- search by using the tVNS NuCal device that, as previously observed, has a valua- ble output multifractal signal able to induce the expected neuro-modulation in subjects having anxiety, depression and stress. Experimental applications will be able to evaluate also the limitations in the different clinical cases of application.

A key objective of this study was to determine if baseline characteristics predict response to FS-TENS. This informa- tion may enhance our scientific understanding of TENS induced analgesia and has clinical implications. None of the baseline characteristics showed statistically significant dif- ferences between the responder and non-responder groups. This finding may be interpreted within the traditional view that TENS generates localized analgesia. In particular, if the FS-TENS device is limited to providing lower extremity pain relief, consistent with its upper calf location, then we must assume that this local analgesia lowered the participants’ overall chronic pain sufficiently to result in a positive PGIC rating (ie, improved or much improved). While possible, this interpretation appears unlikely. First, lower extremity sites accounted for only 31.4% (SD 29.1%) of the pain sites among responders. Second, 29.6% of responders did not report any lower extremity pain sites. A more likely explanation is that a portion of the FS-TENS benefit was from analgesia outside of the stimulation area, either proximally in the low back region or extra-segmentally in the upper extremity. These analgesic effects are likely secondary to activations of descending pain inhibition. 13,20 In support of this hypothesis, prior stud-

Introduction: Post-varicocelectomy pain is a considerable pain with proba- bility of promotion toward chronicity. Some reasons, including surgical tech- nique or nerve injury and inappropriate attention to treatment of acute pain play role in the emergence of acute pain. The pain could lead to limitation in movement and working, patient dissatisfaction and waste of medical re- sources. Transcutaneous electrical nerve stimulation (TENS) therapy as the patient control analgesia (PCA) is associated with reduction of pain intensity and analgesic consumptions. This study aimed to evaluate the effect of TENS therapy on reducing the acute and chronic pain following varicocelectomy. Methods and Materials: The study was conducted after obtaining the ap- proval of the local Institute Ethics Committee and written informed consent from all of the patients. Eighty patients scheduled for undergoing varicoce- lectomy, were randomly classified according to a randomization list prepared using online software at a 1:1 ratio to Groups A (intervention group) and B (placebo group). In postoperative and recovery period, Group A received TENS therapy for 30 minutes in parallel to surgical scar with high frequency by sensory level. Group B was treated with off-device. The treatment course was replicated for the two groups at 2, 6, 12 and 24 hours after operation. Then, postoperative pain was measured by VAS (visual analogue scale) at the same time and after 1 week and 1, 2 and 3 months. The amount of used anal- gesics was recorded. Results: The results showed that based on the VAS, pain significantly decreased after intervention in 2 hours (25% with VAS = 5 versus 32.5% with VAS = 8 in control group). The differences among, amount of used analgesics at 2, 6 and 12 hours were significant with p-value = 0.001, <0.0001 and =0.02, respectively. Conclusion: TENS therapy could efficiently decrease pain degree for hours, weeks and months after varicocelectomy; this How to cite this paper: Agamohammadi,

The patients in both groups demonstrated significant improvement in the pain, AROM and walking speed af- ter six weeks of treatment. This finding buttresses the outcome of the previous clinical trials in which significant benefits of both modalities, in addition to other conservative treatment methods were reported [7] [8] [11] [17]-[19]. The concepts of pain modulation with TENS is anchored on Melzack and Wall’s gate control theory as well as Sjolund and Eriksson’s endorphin release theory [19]. The former is premised on the assumption that stimulation of the thick myelinated nerve fibers causes a neural inhibition at the spinal level which blocks the transport of pain stimuli to the brain via the non-myelinated nerve fibers (High intensity, low frequency TENS). The endorphin release theory on the other hand, stipulates that central nervous system can be stimulated to re- lease endogenous opiates in the body thereby causing pain suppression (high-frequency, low-intensity). The recorded improvements in TENS group may be partly attributed to these physiological effects.

TENS acts on the afferent nerve fibers to block nerve transmission, an effect known as gating theory, or sti- mulates the release of opioids by the central nervous system [8]. These are both mechanisms that are known to decrease pain. In the context of this known inter- action of pain and inflammation, this study sought to answer the following questions: (I) Can the blockage of nociception caused by TENS reduce proinflammatory cytokine levels? (II) If so, what are the application pa- rameters of TENS required to change the proinflamma- tory cytokines?

Does transcutaneous electrical nerve stimulation reduce pain and improve quality of life in patients with idiopathic chronic orchialgia.. A randomized controlled trial.[r]

Among these non pharmacological measures are often simple, safe and relatively inexpensive. These include cutaneous stimulation strategies such as relaxation and breathing techniques, imagery distraction, music therapy, hydro therapy, aroma therapy, massaging technique, accupressure, reflexology etc. Reflexology is the complementary therapy, based on touch, stimulates the skin and activates the larger diameter fibers and thus provide for natural healing. The advantage of reflexography is that it can be performed anywhere, requires no special equipment and does not interfere with the patient’s privacy.

Abbreviations: EST, electrical stimulation therapy; VLUs, venous leg ulcers; N, number of patients; CT, controlled trial; TENS, transcutaneous electrical nerve stimulation; RCT, random[r]