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BackgroundResponses to experimental pain have suggested central and peripheral sensitisation in adult patients with sickle cell disease (SCD). Recent studies have proposed an algometry‐derived dynamic measure of pain sensitisation, slowly repeated evoked pain (SREP), which is useful in the discrimination of painful conditions related to central sensitisation. Pain and fatigue are two symptoms that affect the general functioning of patients with SCD most significantly, however, research about experimental dynamic pain measures and their relation to the main symptoms of SCD (pain and fatigue) is still scarce.ObjectiveThis preliminary study aimed to test the utility of the SREP protocol for detecting pain sensitisation in patients with SCD, and to evaluate the associations of pain sensitisation, pain threshold, and pain tolerance with the main clinical symptoms of SCD, pain and fatigue.MethodsTwenty‐two female outpatients with SCD and 20 healthy women participated. Pain threshold, pain tolerance, and pain sensitisation were assessed by algometry in the fingernail. Clinical pain, fatigue, anxiety, depression and pain catastrophizing were evaluated.ResultsNo group differences were found in pain threshold and tolerance. However, using the SREP protocol, pain sensitisation was greater in patients than in healthy participants, even after controlling for psychological variables and body mass index. Pain threshold and tolerance were inversely associated with fatigue levels in the SCD group, with pain tolerance being the main predictor.ConclusionsPain threshold and tolerance did not discriminate between patients and healthy individuals, but were useful for predicting fatigue severity in SCD. The SREP protocol provides a useful dynamic measure of pain for the discrimination and detection of enhanced pain sensitisation in patients with SCD, which could contribute to more personalised pain evaluations and treatment for these patients.
BackgroundResponses to experimental pain have suggested central and peripheral sensitisation in adult patients with sickle cell disease (SCD). Recent studies have proposed an algometry‐derived dynamic measure of pain sensitisation, slowly repeated evoked pain (SREP), which is useful in the discrimination of painful conditions related to central sensitisation. Pain and fatigue are two symptoms that affect the general functioning of patients with SCD most significantly, however, research about experimental dynamic pain measures and their relation to the main symptoms of SCD (pain and fatigue) is still scarce.ObjectiveThis preliminary study aimed to test the utility of the SREP protocol for detecting pain sensitisation in patients with SCD, and to evaluate the associations of pain sensitisation, pain threshold, and pain tolerance with the main clinical symptoms of SCD, pain and fatigue.MethodsTwenty‐two female outpatients with SCD and 20 healthy women participated. Pain threshold, pain tolerance, and pain sensitisation were assessed by algometry in the fingernail. Clinical pain, fatigue, anxiety, depression and pain catastrophizing were evaluated.ResultsNo group differences were found in pain threshold and tolerance. However, using the SREP protocol, pain sensitisation was greater in patients than in healthy participants, even after controlling for psychological variables and body mass index. Pain threshold and tolerance were inversely associated with fatigue levels in the SCD group, with pain tolerance being the main predictor.ConclusionsPain threshold and tolerance did not discriminate between patients and healthy individuals, but were useful for predicting fatigue severity in SCD. The SREP protocol provides a useful dynamic measure of pain for the discrimination and detection of enhanced pain sensitisation in patients with SCD, which could contribute to more personalised pain evaluations and treatment for these patients.
Sickle cell disease (SCD) is a hereditary hemoglobinopathy characterized by the presence of abnormal hemoglobin, primarily hemoglobin S (HbS), resulting from a point mutation in the β-globin gene. ErbaQik Sickle Cell Rapid Test Card developed by Transasia Diagnostics Pvt Ltd will aid in rapid detection of Sickle cell disease particularly in resource & laboratory infrastructure limited settings.To ensure the accuracy of ErbaQik Sickle Cell Rapid Test Card, a robust validation was conducted and compared with gold standard HPLC method to check the sensitivity, specificity, precision and clinical utility. This study was conducted under the guidance of Consultant Paediatrician, from Dec 2023 to Feb 2024 at Nagpur center run by Thalassemia and Sickle cell Society of India in collaboration with Rughwani Child Care Centre to evaluate the performance of ErbaQik Sickle Cell Rapid Test Card with HPLC method which is the benchmark for comparison in this study. A total of 181 blood samples were analyzed for hemoglobin variants. The evaluation of the ErbaQik Sickle Cell Rapid Test Card produced significant findings For Sickle-SS 32 samples were tested, all of which were correctly identified, yielding a sensitivity and specificity of 100%. Similarly 27 Trait-AS samples were all accurately detected, maintaining 100% sensitivity and specificity. These results indicate the test's high reliability and precision in identifying Sickle Cell Disease and Trait conditions. For Wild-Normal samples, the test was performed on 120 samples resulting in 100% sensitivity and specificity. In the case of Thalassemia samples, only 2 samples were tested, with 1 correctly identified, resulting in a sensitivity and specificity of 50%. The ErbaQik Sickle Cell Rapid Test Card demonstrated high sensitivity and specificity for detecting Sickle Cell Disease (SS) and Trait (AS), aligning with gold-standard methods like HPLC.
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