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Chronic struggle: an institutional ethnography chronic pain and marginalization.

There have been several recent calls to "re-think chronic pain" in response to the growing awareness of social inequities that impact the prevalence of chronic pain and its management. This in turn has resulted in new explorations of suffering as it relates to pain. While laudable, many of these clinically oriented accounts are abstract and often fail to offer a critical theoretical understanding of social and structural inequities. To truly rethink pain, we must also reconsider suffering, beginning in the everyday expert knowledge of people with chronic pain who can offer insights in relation to their bodies and also the organization of the social circumstances in which they live. Our team undertook a sociological approach known as institutional ethnography (IE) to explicate the work of people in managing lives beset by chronic pain and the inequities that stem from marginalization. In keeping with our critical paradigm, we describe participant accounts as situated, rather than lived, to de-emphasize the individual in favour of the social and relational. Through our analysis, we offer a new concept of "chronic struggle" to capture how pain, illness, economic deprivation, and suffering constitute a knot of experience that people living with chronic pain are obliged to simplify in order to fit existing logics of medicine. Our goal is to identify the social organization of chronic pain care which underpins experience in order to situate the social as political rather than medical or individual. PERSPECTIVE: This article explicates the health work of people living with chronic pain and marginalization, drawing on their situated experience. We offer the concept of chronic struggle as a conceptualization that allows us to bring into clear view the social organization of chronic pain in which the social is visible as political and structural rather than medical or individual.

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Pain and associated factors in German occupational therapists: a nationwide cross-sectional survey study.

Back pain is a common event in the general German population, but little is known about pain prevalence among occupational therapists (OT).

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Evaluation of electrophysiological changes in migraine with visual aura.

The purpose of this study was to evaluate the electrical responses in the retina and cortex of migraine patients with electrophysiological tests and compare with healthy controls.

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Comparison of Oral versus Intramuscular Clonidine for the Prolongation of Bupivacaine Spinal Anesthesia in Patients Undergoing Lower Abdominal and Lower Limb Surgeries.

Spinal subarachnoid block (SAB) is the first choice anesthesia in lower abdominal and lower limb surgeries. It produces a varying degree of sensory analgesia, motor blockade, and sympathetic blockade depending on the dose, concentration, and volume of the local anesthetic given. This study was undertaken to assess the degree of sensory and motor block with 150 μg of oral versus intramuscular clonidine as an adjuvant to bupivacaine for spinal anesthesia.

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Target-Controlled Inhalational Anesthesia-Isoflurane Consumption with Adequacy of Anesthesia Monitoring in Conventional and Multimodal Analgesia – A Comparative Study.

In a time of increased concern over the environmental impact of chlorofluorocarbons, there is an impetus to minimize inhalational anesthetic consumption. It is possible with multimodal analgesia (MMA) and the use of end-tidal controlled anesthesia (EtCA) which is a low-flow anesthesia technique with adequacy of anesthesia (AoA) monitoring. In MMA, all four elements of pain processing namely transduction, transmission, modulation, and perception are targeted with drugs having a different mechanism of action. In EtCA, anesthetic gases are automatically adjusted for the set minimal alveolar concentration by newer anesthesia work station (GE Healthcare Aisys CS2). AoA is a derived parameter of entropy and surgical pleth index which measures the depth of anesthesia and analgesia, respectively.

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Early versus Late Tracheostomy in Patients with Acute Brain Injury: Importance of SET Score.

Patients with acute brain injury presents are unique subset of neurocritical care patients with its long-term functional prognosis difficult to determine. They often have long intensive care unit (ICU) stay and presents as challenge to decide when to transfer out of ICU. This prospective study aims to assess the benefits of early tracheostomy in terms of ICU-length of stay (ICU-LOS), number of days on ventilator (ventilator days), incidence of ventilator-associated pneumonia (VAP), and mortality rates.

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[NEUROLOGICAL MANIFESTATIONS ASSOCIATED WITH COVID-19 VACCINE].

Coronavirus disease 2019 (COVID-19) has spread rapidly, giving rise to a pandemic, causing significant morbidity and mortality. In this context, many vaccines have emerged to try to deal with this disease.

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Premedication with Diclofenac and Precurarization with Atracurium on Succinylcholine-Induced Myalgia in Laparoscopic Cholecystectomy: A Double-Blinded Randomized Study.

Succinylcholine is the only available depolarizing neuromuscular blocker that has been widely used in the induction of anesthesia, and it is the drug of choice for rapid-sequence induction of anesthesia due to its rapid onset of effect and ultrashort duration of action owing to its rapid hydrolysis by acetyl-cholinesterase. Postoperative muscle pain (myalgia) and muscle stiffness are the most common side effects and are observed most frequently on the 1 postoperative day in ambulatory surgery. The use of succinylcholine in the induction of anesthesia and intubation in routine cases has been discouraged because of such adverse effects. However, because of its cost-effectiveness and easy availability, it is still used by some institutions routinely. This study aimed to study the efficacy of preoperative diclofenac along with atracurium precurarization in alleviating succinylcholine-induced myalgia.

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Dexmedetomidine as an Adjuvant to 0.25% Bupivacaine in Ultrasound Guided Femoral Nerve Block for Preoperative Positioning and Postoperative Analgesia in Patients Undergoing Elective Surgery for Fracture Shaft of Femur.

Femur fracture causes excruciating pain and surgical repair is recommended. To obtain satisfactory patient co-operation in the perioperative period, various analgesics have been used. Femoral nerve block (FNB) provides an excellent alternative for analgesia in the perioperative period. Dexmedetomidine of up to 2 μg.kg has been used in FNB as adjuvants in lower limb surgeries.

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Effect of Different Doses of Buprenorphine in Combination with Bupivacaine in the Management of Postoperative Analgesia: A Comparative Study.

Longer duration of analgesia, ceiling effect on respiratory depression, and the antihyperalgesia property make buprenorphine a good adjuvant for managing moderate-to-severe postoperative pain.

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