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Low back pain (LBP) is the leading cause of disability worldwide. Physical exercise, as a treatment, is beneficial for the improvement of quality of life in patients with LBP, and it is widely accepted.

Targeting programmed cell death protein 1 (PD-1) and indoleamine 2,3-dioxygenase (IDO1) pathways is an appealing option for cancer treatment.

Our objective was to determine the trend and precipitating factors of the severity of diabetic ketoacidosis (DKA) in the population admitted to the Pediatric Intensive Care Unit (PICU) in a large teaching hospital in the Eastern region of Saudi Arabia. We conducted a retrospective, analytical study at King Fahad Hospital, Imam Abdulrahman Bin Faisal University, Alkhobar, Saudi Arabia. We retrieved the complete medical records of 2234 children who were admitted to the PICU during the 10-year period of 2010 through 2019. The children included those with polydipsia, polyurea, abdominal pain, vomiting, dehydration, and weight loss, as well as breathing disturbances due to acidosis and CNS issues such as lethargy or coma and elevated blood glucose level, > 200 mg/dL [> 11.1 mmol/L], venous pH 7.3, serum total CO2 15 mmol/L, and blood- hydroxybutyrate concentration 3 mmol/L or moderate or severe ketonuria. Out of 2234 PICU admissions, 211 (9.4%) were diagnosed with DKA. A persistent increase in the rate of DKA ended up at 14.1% in 2019 (p = .005). The incidence of DKA was 88/2234 (3.93%). The severity of DKA was as follows: 130 (61.6%) had severe and 81 (38.4%) had moderate DKA. Excessive sweet intake without adding insulin in 83 (39.3%) patients and unhealthy lifestyles (35.1%) were the best predictors of severe DKA (p = .001). Over a 10-year period, the DKA pattern was persistently rising and slightly falling, which ended up at the significantly highest rate of 14.1% in 2019. URTI, pneumonia, unhealthy lifestyle, and excess sweet intake were significant precipitating factors associated with severe DKA.

People with spinal cord injury (SCI) frequently develop neuropathic pain (NP) that worsens disability and diminishes rehabilitation efficacy. Chronic NP is presently incurable due to poor understanding of underlying mechanisms. We hypothesized that multilocus neuroinflammation (NIF) might be a driver of SCI NP, and tested it by investigating whether NP coexisted with central NIF, neurotransmission (NTM), neuromodulation (NML) and neuroplasticity (NPL) changes post-SCI.

The association between the single-nucleotide polymorphisms (SNPs) rs28742109, rs12955018, rs987850, rs8093805, rs12965084 and rs145497186 related to gene named NADH dehydrogenase [ubiquinone] flavoprotein 2 (NDUFV2) and lumbar disc degeneration (LDD) was preliminary investigated in a small sample size.

The number of single-child families has been increasing across developing countries during the last decades. We aimed to examine the association between being a single child (SC) and subjective health complaints (SHCs) in Iranian children and adolescents. This study was conducted as a part of the fifth survey of a national surveillance program entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-V). This national survey included a total of 14,400 students 7-18 years and their parents from rural and urban areas in 30 provinces of Iran. Data on demographic characteristics, lifestyle variables, and SHCs were measured using the questionnaire of the World Health Organization on Global School-based Health Survey (WHO-GSHS). Multivariate logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (95%CI) for the association of being an SC with SHCs. Data on 14,151 participants were available for this study, of whom 7.7% (1092) were SCs. The most frequent SHCs were irritability (37.1%, 95%CI: 36.3-37.9%), feeling nervous 32.5%, 95% CI: (31.7-33.3%), and headache 24.3%, 95%CI: (23.6-25.0% ). In the multivariate model, being an SC significantly increased the odds of dizziness [adjusted OR (95% CI): 1.37(1.08-1.72)] and backache complaint [1.22(1.01-1.47)]. The association of being an SC with other SHCs (feeling low, irritability, feeling nervous, difficulty in getting to sleep, headache, stomachache) was not statistically significant (p value > 0.05). Our results suggest that being an SC may be associated with higher odds of dizziness and backache complaints.

This retrospective study aimed to evaluate midterm outcomes of surgical management of multi-segment thoracic spinal tuberculosis by single-stage posterior transforaminal debridement and interbody fusion with instrumentation. From January 2007 to October 2015, 42 adult patients with thoracic spinal tuberculosis involving three or more levels underwent single-stage posterior transforaminal debridement, interbody fusion and instrumentation At a mean follow-up of 73.5 ± 9.6 months, all patients were eligible for final evaluation. All displayed improved biochemical markers and pain scores at 3 months and improved physiologic levels at the end of treatment. Visual analogue and 36-Item Short-Form Health Survey scores were significantly improved compared with preoperative values. All 30 patients with preoperative neurological deficits experienced neurologic improvement. Thoracic kyphosis angle decreased significantly from 34.4° ± 4.5° to 22.0° ± 2.6°. A mean kyphotic angle loss of 1.7° ± 1.1° was recorded at the final follow-up, and bone fusion was observed at a mean of 10.6 ± 2.1 months, with no instrumentation failures. One patient experienced delayed incisional healing and five patients suffered postoperative intercostal neuralgia that were cured by conservative treatment. There were no graft failures or implant breakages. This study showed the utility of a single-staged procedure combining posterior transforaminal debridement and interbody fusion with instrumentation, and demonstrated promising results.

Despite remission or low disease activity non-inflammatory complaints like exhaustion, fatigue, and pain persist in a significant proportion of patients with systemic lupus erythematosus (SLE) and have a considerable impact on health-related quality of life. This study evaluated the effects of balneotherapy on non-inflammatory complaints, quality of life, and work productivity of patients with SLE.

We report the case of a 20-year-old patient who presented a paracentral scotoma in her left eye that had not disappeared after a migraine attack two days before. Ocular examination showed two pale paracentral areas suggesting an acute ischemia insult. Several causes of retinal ischemia were ruled out and the patient was diagnosed with secondary retinal vasospasm. One year later, the patient suffers an atrophy of the inner layers of the affected retina and has a paracentral chronic scotoma in her left eye. Retinal vasospasms can result in irreversible lesions and chronic symptoms due to ischemia and cell destruction. This unusual case reports a permanent damage due to retinal vasospasm secondary to migraine attack. The finding of typical lesions and the history of migraine could be compatible with the diagnosis of paracentral acute middle maculopathy (PAMM).

Intramural hematoma (IMH) is one of the acute aortic syndromes (AAS) along with acute aortic dissection (AAD) and penetrating aortic ulcer (PAU). The three conditions can occur alone or in combination with overlapping presentation. Medical, open surgical and endovascular treatment is tailored depending on clinical presentation, timing and location within the aorta. Among patients who present with acute IMH affecting the ascending aorta (Type A), urgent open surgical repair is considered the primary line of treatment in patients who are suitable candidates and unstable. The management of IMH in the descending aorta and aortic arch (Type B) is similar to that applied to treat acute dissections in the same segment. Medical treatment with sequential imaging is recommended in patients with uncomplicated course, and endovascular repair is indicated in patients with rupture, persistent pain, end-organ ischemia or rapid aortic enlargement. This review discusses the ideal timing for treatment of IMH.