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Posttraumatic headache (PTH) is the most common symptom following mild traumatic brain injury (mTBI) (also known as concussion). Migraine and PTH have similar phenotypes, and a migraine-like phenotype is common in PTH. The similarities between both headache types are intriguing and challenge a better understanding of the pathophysiological commonalities involved in migraine and PTH due to mTBI. Here, we review the PTH resting-state functional connectivity literature and compare it to migraine to assess overlap and differences in brain network function between both headache types. Migraine and PTH due to mTBI have overlapping and disease-specific widespread alterations of static and dynamic functional networks involved in pain processing as well as dysfunctional network connections between frontal regions and areas of pain modulation and pain inhibition. Although the PTH functional network literature is still limited, there is some evidence that dysregulation of the top-down pain control system underlies both migraine and PTH. However, disease-specific differences in the functional circuitry are observed as well, which may reflect unique differences in brain architecture and pathophysiology underlying both headache disorders.

Osteoarthritis (OA) is a chronic, painful, degenerative inflammatory disease of the synovial joints. Regular use of nonsteroidal anti-inflammatory drugs to decrease OA pain can have severe side effects, such as gastric irritation, ulcers, and heart problems. Natural products are extensively used to minimize OA-associated pain and inflammatory reactions. is commonly used to alleviate several diseases through its anti-inflammatory effects. This study examined the impact of extract on alleviating pain and inflammation associated with articular cartilage damage.

The objective of this study was to determine the effects of cervical stabilisation exercises on respiratory strength in chronic neck pain patients with forward head posture. The study was conducted from August 2020 to February 2021, at the Jinnah Hospital, Lahore; 44 patients who fulfilled the eligibility criteria were randomly assigned to two groups-experimental group and control group-. Baseline measurement was taken for numeric pain rating scale, neck disability index, craniovertebral angle, single breath count, and spirometry and all the measurements were retaken at the completion of the fourth week. Results were not significant (p>0.05) before the treatment in both groups but post-intervention results revealed significant differences in both the groups (p<0.05), with the experimental group showing more improvement. Four weeks of cervical stabilisation with isometric exercises is more effective in the management of pain, forward head posture, neck disability and respiratory strength as compared with the four weeks of isometric exercises programme alone.

To assess the discrepancy in terms of history related to coronavirus disease-2019 and symptoms given in the pre-clinic triage and to the doctor attending the patient in a gastroenterology clinic.

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.