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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.

This study aimed to investigate the personality traits, anxiety sensitivity (AS), anxiety, and depression levels in patients diagnosed with psychogenic pruritus (PP). Certain personality traits may come to the fore in psychosomatic disorders; these traits are thought to make the person vulnerable to psychosomatic diseases. This study aimed to investigate the personality traits, anxiety sensitivity (AS), anxiety, and depression levels in patients diagnosed with psychogenic pruritus (PP).

Pruritis is a common symptom of many systemic and cutaneous localized diseases and diabetes mellitus is a common syndrome with multiple long term complications, including diabetic painful neuropathy. The involvement of small fibre neurons, in diabetic neuropathy, is recognized as the main pathophysiology. While the C fibres that mediate the sensation of pain and pruritus may belong to different neuronal circuits, there is evidence of cross talk between them. We therefore posit that pruritus may be a symptom of diabetic neuropathy. It should be viewed as an equivalent of microvascular disease, with its accompanying clinical significance and therapeutic implications.

Pituitary gonadotroph adenomas are common but very rarely do they secrete biologically active luteinizing hormone (LH) and follicle-stimulating hormone (FSH). There have been case studies reporting high sex hormones (testosterone/estrogen) in the presence of high or normal LH and FSH. Here we report two cases (with their consent) who presented with visual disturbance and headache at a tertiary care hospital (Aga Khan university hospital) Karachi, Pakistan. Brain imaging revealed a pituitary macroadenoma. Further workup was consistent with pituitary gonadotroph adenoma with high FSH (case 1) and normal LH/FSH (case 2) and elevated serum testosterone in both cases. Transsphenoidal resection was performed and the tissue sample histopathology confirmed pituitary adenoma. Postoperatively, improvement in hormonal profile was observed along with a resolution of visual disturbances and headaches. Thus, functional gonadotroph adenoma should be considered in the presence of elevated testosterone/estrogen and normal or elevated follicle-stimulating hormone (FSH)/ luteinizing hormone (LH). Early diagnosis leads to a better outcome.

Non-pharmacologic treatment, including chiropractic care, is now recommended instead of opioid prescriptions as the initial management of chronic spine pain by clinical practice guidelines. Chiropractic care, commonly including spinal manipulation, has been temporally associated with reduced opioid prescription in veterans with spine pain.

Cervical spondylotic myelopathy (CSM) is the leading cause of acquired spinal cord dysfunction worldwide and may be expected to increase in prevalence due to an aging global population. Clinical features of CSM are highly variable, and chiropractors frequently manage patients with common signs and symptoms of CSM such as neck pain, extremity weakness, and gait imbalances. Early recognition of signs consistent with myelopathy may mitigate future disability and improve quality of life. Key predictors of patient outcome are the age of initial presentation, baseline CSM severity (as measured by mJOA score), and the presence of gait disturbances. This report describes three cases of CSM presenting to a chiropractic clinic. Each case illustrates a unique manifestation of CSM, including myelopathy, myeloradiculopathy, and distal neuropathic pain (funicular referral). In addition, a review of CSM terminology, epidemiology, pathobiology, clinical features, imaging, and management is provided.