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Hyponatremia is defined as a serum sodium concentration of less than 135 mEq/L. Severe hyponatremia is defined as a serum sodium concentration of less than 125 mEq/L and is a life-threatening complication that must be managed promptly to avoid irreversible neurological damage. One particular cause of hyponatremia is the ingestion of recreational drugs, such as 3,4-Methylenedioxymethamphetamine (MDMA), also known as Ecstasy. Another drug with limited understanding of its adverse effects on specific individuals and is widely available to purchase legally is Kratom (). Here, we present the case of severe hyponatremia secondary to the ingestion of Kratom. Kratom is believed to act on various pain-modulating receptors and may explain its role in causing hyponatremia. Unfortunately, Kratom remains poorly understood and underreported. Our case illustrates the need for further in-depth studies to determine the complete toxic profile of Kratom, providing awareness to clinicians in anticipation of severe complications that may develop.

Injection therapy in refractory cases of lateral epicondylitis might relieve symptoms, although no consensus exists on which material to use. Corticosteroids are widely used but recent literature indicated possible tenotoxic effects and inefficacy in mid- and long-term follow-up (FU). Hyaluronate/hyaluronic acid (HA) might be of better clinical efficacy. Magnetic resonance imaging (MRI) might reflect the clinical changes in the short-term FU.

Hypocalcemia is a rather uncommon condition that may be encountered in the outpatient setting. It may be associated with a wide range of clinical symptoms and signs. It is unclear that the primary cause of symptom is hypocalcemia, as these symptoms are usually discrete and ambiguous. Signs of muscle cramp and tetany are considered the expressions of overexcitability of peripheral nerves or central nervous system in case of hypocalcemia in the nerve. In this case, we present a 59-year-old female who presented with persistent muscle cramp and pain of both upper and lower extremities and underwent an investigation that revealed electromyographic changes due to hypocalcemia during an electromyographic study.

This study aims to compare the short-term efficacy of mud-pack (MP) and hot-pack (HP) treatments with the same temperature and duration on sleep, function, depression, and quality of life for chronic non-specific neck pain (CNNP) patients.

To assess onset of effect in three placebo- or nonsteroidal anti-inflammatory drug (NSAID)-controlled trials of tanezumab in patients with moderate-to-severe osteoarthritis.

Remote knee osteoarthritis (OA) management programs are becoming more popular. This systematic review examined the efficacy of remote exercise programs for relieving pain in persons with knee OA.

Modic changes (MC) are vertebral bone marrow lesions seen on magnetic resonance images, that associate with disc degeneration and low back pain (LBP). Few studies described MC histopathology qualitatively based on a few patient samples. CD90-positive bone marrow stromal cells were shown to be pro-fibrotic in MC. We aimed to provide the first semi-quantitative histomorphometric analysis of MC bone marrow. We hypothesized a role of CD90-positive cells in MC pathomechanisms.

The aim of this study was to determine the effects of licorice gargle juice on aphthous ulcers, which is a common and painful disease that causes loss of normal mucous tissues and results in inflammatory ulcers in the oral mucosa. A randomized double-blind placebo-controlled trial involving primary care patients suffering from aphthous ulcer was performed. The intervention group received licorice gargle juice for 1 and 2 days. Of the 54 patients that participated in the study, 30 were included in the intervention group and 24 in the placebo group. A 10-point visual analog scale (VAS) was used to assess the patients' self-assessed pain levels before and after treatment. Statistical analyses were performed by using the nonparametric Mann-Whitney test. The licorice gargle juice group had a significantly reduced pain level rate compared with the placebo group at day 1 (mean VAS, 2.47 [95% CI, 1.95-2.98] vs. 4.75 [3.96-5.54]; P<0.001) and day 2 (mean VAS, 1.07 [95% CI, 0.81-1.32] vs. 4.08 [3.23-4.94]; P<0.001).The current study indicates that licorice gargle juice rapidly reduce pain and healing time and thus can improve the quality of life of a patient with aphthous ulcer.

Ten to 12 percent of the adult population globally suffers from migraine, which is the second most frequent type of primary headache, according to the American Academy of Neurology. Even though pain and attack-related impairment scored first, cognitive symptoms were the second most common. ; The current study intended to measure the latency of P300 wave during and after an acute attack of migraine among a group of patients known to have migraine in order to introduce an objective method to measure the cognitive function of migraineurs during migraine attack. ; This is a potential cohort study conducted at the neurological outpatient's clinics of Basra hospitals to the period from January until August 2021. The total number of subjects included in the study were forty-eight (48), thirty (30) patients and eighteen (18) age and gender matched control subjects. Patients were examined and selected by senior neurologist and diagnosed as having common migraine, then refereed to the neurophysiology clinic to perform cognitive function tests, for each patient two tests were done; first one during the acute migraine attack and second one after one month far ahead from the end of the migraine attack. In addition, one cognitive function test was done for the control group.; We discovered a highly important variance of the mean P300 latency of the patients during the acute attack of migraine as compared to the same group of the patients after repeating the exam one month far ahead from the end of the last migraine attack and one week ahead of being medication free. Also, we found the mean P300 latency of the patients during the acute attack of migraine is significantly higher than the mean P300 latency of the control subjects (P. value <0.00).; We found that all migraineurs in our study are having higher P300 latency values than control group during moderate migraine attack and this difference was significant which indicates that during moderate migraine attacks there is obvious impairment of cognitive performance abilities of those patients.