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This study aimed to determine the short-term effects of dry needling (DN) combined with a standard exercise program on pain and quality of life in patients with chronic mechanical neck pain (CMNP).

Symptomatic irreversible pulpitis is a painful clinical condition with a broad inflammatory component. Dental anesthesia in these patients is affected by the inflammatory process, reporting a high incidence of anesthesia failure. The aim of this systematic review and meta-analytical evaluation was to determine the effect of pre-treatment with tramadol in patients with symptomatic irreversible pulpitis, as well as for pain control and adverse effects. This study was registered in PROSPERO (ID: CRD42021279262). PubMed was consulted to identify clinical investigations comparing tramadol and placebo/local anesthetics in patients with symptomatic irreversible pulpitis. Data about the anesthesia, pain control, and adverse effects were extracted. Both the anesthetic success index and the adverse effects of local tramadol and placebo were compared with the Mantel-Haenszel test and odds ratio. Data analysis showed that the local administration of tramadol increased the anesthetic success rate when compared to placebo in patients with symptomatic irreversible pulpitis ( = 228; I = 0; OR = 2.2; 95% CIs: 1.30 to 3.79; < 0.004). However, local administration of tramadol increased the risk of adverse effects when compared to placebo/local anesthetics ( = 288; I = 0; OR = 7.72; 95% CIs: 1.37 to 43.46; < 0.02). In conclusion, this study shows that the local administration of tramadol increases the anesthetic success index when compared to placebo in patients with symptomatic irreversible pulpitis.

Lumbar epidural analgesia (EA) is the most commonly used method for reducing labour pain, but its impact on the duration of the second stage of labour and on neonatal and maternal outcomes remains a matter of debate. Our aim was to examine whether EA affected the course and the outcomes of labour among patients divided according to the Robson-10 group classification system.

The use of mouthwash is often recommended by dental experts for dental healing. A double-blind, randomized clinical study was conducted to evaluate the efficacy of two mouthwashes (myrrh and chlorhexidine gluconate) on postoperative pain and their effects on tissues after dental implant placement in 35 patients (18 in the myrrh group and 17 in the chlorhexidine gluconate group). Soft tissue healing was evaluated in terms of wound closure, soft tissue swelling, and the color of the gingiva at 1 week postoperative. To decrease the chances for error, only the participants who did not show preoperative symptoms of infection and those who committed to practicing better oral hygiene were included in the study. The samples were evaluated for the infiltration of inflammatory cells (using inflammatory extent and inflammatory cellularity grades), maturation of collagen (osteoblast activity), and arrangement of cells (for detecting the remodeling phase). A questionnaire pertaining to mouthwash satisfaction, the duration of postoperative pain after the procedure, the time of stoppage of bleeding at the surgical site, and any sensitivity at the surgical site was given to the patients. The Chi-square test and Mann-Whitney U-test were used to analyze the data. The difference in postoperative surgical swelling, pain, bleeding, and redness in the patients was not statistically significant between the myrrh and chlorhexidine gluconate mouthwash groups. However, in the acute phase, the myrrh mouthwash showed a positive impact on the process of wound healing after implant placement. The small sample size and inability to compare wound healing in different anatomical areas of the oral cavity were the study limitations.

Migraine is caused by genetic susceptibility that is triggered by environmental as well as biological factors, and it is also linked to many somatic comorbidities, including clinical and subclinical hypothyroidism. We aimed to estimate the potential association between subclinical hypothyroidism (ScH) and migraine in children at our tertiary hospital. Using a case-control strategy, 200 children and adolescents were assigned to two equal groups: a case group (patients with migraine) of 100 patients and a control group of 100 patients without migraine. Clinical and biochemical parameters (TSH, FT4) were compared between the groups using statistical analysis. Thyroid function comparison between the groups showed higher TSH but normal FT4 among children with migraine headache compared to the control group, which means more frequent ScH cases among the migraine group relative to the control (17% vs. 2%, < 0.001). Obesity and overweight were more frequent among patients with migraine than the control group (8 and 5% vs. 2 and 1%, respectively). The (overweight/obese) patients with migraine had about 77% ScH and 15.4% overt hypothyroidism compared to 8% ScH and no overt hypothyroidism among normal body weight migraine patients ( < 0.001). No significant difference in the prevalence of nodular goiter between patients with migraine and controls was found. Based on our results, subclinical hypothyroidism is significantly linked to childhood migraine. Obesity and being overweight are more frequent among patients with migraine. Therefore, it may be logical to test the thyroid function in migraineur children, especially those with high BMI. Further studies are recommended to discover the mechanism of this association in children.

: Most Koreans obtain medical information from the Internet. Despite the vast amount of information available, there is a possibility that patients acquire false information or are dissatisfied. Chronic ankle instability (CAI) is one of the most common sports injuries that develops after an ankle sprain. Although the information available on the Internet related to CAI has been evaluated in other countries, such studies have not been conducted in Korea. : The key term "chronic ankle instability" was searched on the three most commonly used search engines in Korea. The top 150 website results were classified into university hospital, private hospital, commercial, non-commercial, and unspecified websites by a single investigator. The websites were rated according to the quality of information using the DISCERN instrument, accuracy score, and exhaustivity score. : Of the 150 websites, 96 were included in the analysis. University and private hospital websites had significantly higher DISCERN, accuracy, and exhaustivity scores compared to the other websites. : Accurate medical information is essential for improving patient satisfaction and treatment outcomes. The quality of websites should be improved to provide high-quality medical information to patients, which can be facilitated by doctors.

Rhombencephalitis refers to inflammation of the brainstem and cerebellum, and can be caused by infections, autoimmune disorders or paraneoplastic syndromes. The most common infective cause is the bacterium   is the predominant species to cause human listeriosis, and is commonly due to the ingestion of contaminated foods. Symptoms include a mild gastroenteritis, fever (often with extreme temperature variations), headache, and myalgia. In more severe cases, invasive disease may lead to bacteraemia and neurolisteriosis. Pregnant women are more susceptible to listeriosis, which is believed to be due to pregnancy-related immune modulation. Maternal-neonatal infection with adverse pregnancy outcomes include neonatal listeriosis, spontaneous miscarriage and intrauterine fetal demise. Diagnosis may be challenging due to initial nonspecific symptoms and low sensitivity and specificity of confirmatory diagnostic laboratory tests. Here, we describe a case of rhombencephalitis in pregnancy, attributed to , and review the clinical features, diagnosis and multidisciplinary management. Lastly, we describe the immunological response to and show in vitro pro-inflammatory effects of on peripheral blood mononuclear cells and placental explants.

Herbal extracts are part of the solution to the increased demand for organic health care products. Traditionally, the different extracts prepared from (Forsskal) A. Juss () have been widely used to treat a wide range of illnesses. The aim of this study is to evaluate the antioxidant, analgesic, anti-inflammatory, and wound healing potential of the aqueous (HTAE) and ethanolic (HTEE) extracts of this plant as well as identify its major phytochemical components using LC-MS. Phytochemical analysis of both extracts revealed a rich composition and especially high amounts of glycosylic flavonols, 65.37% and 68.77% for the HTEE and HTAE, respectively. The antioxidant assays performed (DPPH, FRAP and TAC) indicated the excellent activity of the ethanolic extract while the in vivo activities (analgesic, anti-inflammatory, and healing potential) indicated the excellent activity of the aqueous extract. These findings support the therapeutic use of this plant by preventing pain and inflammation and promoting wound healing. To uncover, identify, and isolate compounds of potential medicinal and therapeutic significance, more studies on this species are required.

The erector spinae plane (ESP) block can be used to reduce pain and opioid requirements after abdominal surgery. We evaluated the effect of the ESP block on postoperative pain score, analgesic use, and quality of recovery (QoR) score in patients undergoing laparoscopy. Fifty-nine patients undergoing elective laparoscopic colorectal surgery were randomly assigned to control ( = 30) or ESPB ( = 29) groups after anesthesia induction. In the ESPB group, an ultrasound-guided ESP block was performed immediately after induction using 20 mL of 0.5% ropivacaine bilaterally. The primary outcome was the postoperative pain score, which was evaluated using the 11-point numeric rating scale (NRS) (0 = no pain, 10 = worst imaginable pain), in the recovery room. NRS "at rest" and "on cough" and total dose of fentanyl rescue (in the recovery room) as well as NRS "at rest" and the cumulative administered fentanyl dose of patient-controlled analgesia (24 h post-surgery) were significantly lower in the ESPB group than in the control group. The postoperative QoR score did not differ between the groups. Bilateral ESP block after induction reduced pain scores and opioid requirements for 24 h postoperatively but did not improve the QoR in patients undergoing laparoscopic colorectal surgery.

Current chronic pain treatments primarily target symptoms and are often associated with harmful side-effects and complications, while safer non-invasive electrotherapies like H-Wave device stimulation (HWDS) have been less explored. The goal of this study is to evaluate first responder-reported effects of HWDS on job-related and quality-of-life measures. This is a retrospective cohort study where first responders were surveyed following voluntary use of HWDS regarding participant experience, frequency of use, job-related performance, and quality-of-life. Responses were analyzed using means comparison tests, while bivariate analysis assessed responses associated with HWDS usage. Overall, 92.9% of first responder HWDS users (26/28) reported a positive experience ( < 0.0001), with 82.1% citing pain reduction ( = 0.0013), while 78.6% indicated it would be beneficial to have future device access ( = 0.0046). Participants using H-Wave were at least six times more likely to report higher rates of benefit (100% vs. 0%, = 0.022), including pain reduction (91.3% vs. 8.7%, = 0.021) and improved range-of-motion (93.3% vs. 69.2%, = 0.044). Spending more time with family was associated with better job performance following frequent HWDS use (50% vs. 8.3%, = 0.032). Repetitive first responder H-Wave use, with minimal side effects and easy utilization, resulted in significant pain reduction, improvements in job performance and range-of-motion, and increased time spent with family, resulting in overall positive experiences and health benefits. Level of Evidence: III.