Rejected

Patients with a displaced fracture of the distal radius are frequently offered surgical fixation. Manipulation of the fracture and moulded plaster casting is an alternative treatment that avoids metal implants, but evidence of its effectiveness is lacking.

The ability to forecast changing trends of COVID-19 can help drive efforts to sustain the increasing burden on the healthcare system, specifically the clinical laboratories. We aimed to assess whether the trends of SARS-CoV-2 testing in Pakistan can be predicted using COVID-19 symptoms as search terms and analyzing the data from Google Trends.

Pediatric positive health refers to children's assessments of their well-being. The purpose of this study was to contrast positive health for children aged 8 to 17 years with and without chronic physical and mental health conditions.

Brachial plexus blockade (BPB) is a procedure of growing popularity amongst surgeons and anaesthesiologists involved with upper limb surgery. The safety and benefit in hand surgery is unclear.

Peripheral nerve blocks (PNBs) have recently been associated with a higher incidence of complications than previously thought. We compared: (1) incidence of PNB-related residual neurological symptoms and (2) patient selection, operative practices, and anesthesia practices for pediatric knee surgery patients before and after changes in PNB administration at our institution.

Septic arthritis A painful, red, and swollen joint may have different causes. Septic arthritis is one of the most serious conditions and should be diagnosed and treated right away. In the native joint, an infection can damage the cartilage within the first 24 hours with impacts on joint function including lingering joint problems leading to possible future joint destruction. An interdisciplinary approach is essential for achieving optimal results. Most infections are caused by bacteria from the patient's own microbiome. In general, the incidence of native joint infections is growing, whether it is due to more appropriate diagnostics, or an actual increase cannot be determined at this point. In case of an acute infection, the patients usually describe a relatively short and acute period of pain, redness, and swelling of the affected joint. For diagnostic purposes the common blood serum laboratory work-up serves as a basis, complemented by puncture of the affected joint. Cell count and cell differentiation in the synovial liquid, microbiological and histopathological workup serve as gold standard in detecting septic arthritis. Septic arthritis lacks a distinctive presentation and other inflammatory conditions, like CPPD and gout must be considered. Prior to antibiotic therapy, joint lavage is the most important method to reduce bacterial load, leading to an improved outcome. Prognosis is determined by a swift diagnosis and initiation of therapy. The patient's comorbidities are significant, especially immunocompromising factors such as rheumatoid arthritis, diabetes or immunomodulating therapy. In case of a second focus of infection, chronic kidney disease or older age, patients are at greater risk for an inferior outcome.

Etopic tooth eruption is the occurrence of the tooth germ in a nonanatomical position. It can be associated with dentigerous cyst, which is the second most seen in the development of odontogenic cyst commonly presented in mandibular region and seen in single form. It is usually accompanied with mandibular third molar followed by canine. Bilateral and multiple dentigerous cysts in nonsyndromic patients are fairly rare phenomenon and barely documented in the literatüre. We report a rare case of bilateral dentigerous cysts associated with ectopic third molars in the maxillary sinuses. Computerized tomography scan confirmed the diagnosis. A 32-year-old female patient manifesting as postnasal discharge accompanied with chief complaint of nasal obstruction, pain at blinking right eye from pressure of cyst at the inferior orbital rim, and headache for the last 1 year. This report presented our management of rarely seen case of bilateral dentigerous cysts related with ectopic third molars in maxillary sinuses. Ectopic teeth eruption in maxillary sinus should be treated as early as possible once it is diagnosed, in consideration of related complication of orbital and nasal involvement. The symptoms totally recovered with the suitable management method for our patient. The prevalence of maxillary third molars ectopic eruption in the maxillary sinus (Antrum of Highmore) is extremely rare in the literature. Lack of treatment protocol for such ectopic eruptions in the maxillary sinus and its rareness deserved to be added to the literature.

Cerebral venous sinus thrombosis (CVST) is a rare type of cerebrovascular disease that affects mainly young to middle-aged adults. The main clinical presentation of CVST includes progressive headache, focal neurological deficit, disturbance of conscious level, and epileptic seizures, which can occur early or late in the disease process. Generalized seizure has been recognised as the most common seizure subtype among patients with CVST and epileptic seizures. Epilepsia partialis continua (EPC), a subclass of focal motor status epilepticus, has rarely been reported as the initial presenting feature of CVST. Here, an encounter of CVST with an isolated initial presentation of EPC involving the right hand is presented. The initial discordant clinical and radiological findings prompted further investigations that revealed patchy venous infarction along the precentral gyrus that attributed to the occurrence of EPC.

Chronic inflammatory pain conditions, specifically myofascial pain (MFP), account for an overwhelming percentage of office visits every day. The combination of the high cost of its treatment and frequent patient visits makes MFP a critical pathology to be investigated. Sharpening our understanding of the molecular mechanisms within MFP will expedite the enhancement of therapeutic approaches. Inflammation plays a critical role in the pathophysiology of MFP. The chief inflammatory mediators of interest in this review related to MFP are interleukin 1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α). This review aimed to determine the impact of inflammatory mediators on fibroblasts and satellite cells, specifically their role in muscle injury and regeneration. Blocking pro-inflammatory mediators such as IL-1β, IL-6, and TNF-α in these cell types could prove to be an effective treatment for MFP. An osteopathic manipulative treatment (OMT) modality, specifically indirect counterstrain therapy, was investigated in the hopes of elucidating a reduction in particular cytokines. In addition, myofascial release (MFR) therapies (OMT modality) were explored as a potentially effective treatment through the acceleration of wound healing, stimulation of muscle regeneration, and decreased inflammation via altered fibroblast activity. Pharmacologic agents such as non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat MFP but have a higher adverse side effect profile compared to OMT therapy. The optimal management of MFP is likely multifactorial, and more treatment modalities must be explored. This literature review analyzed 17 peer-reviewed articles specifically related to MFP management and the role of inflammation in MFP. Chronic inflammation from other etiologies was excluded. Our aim was to elucidate the biochemical mechanisms underlying MFP and inflammation in an effort to promote the medical community's understanding of treatment modalities for this chronic condition. This study revealed that various OMT techniques such as MFR and counterstrain lead to changes on the cellular level in MFP. Discovering similar effects on biochemical inflammatory markers with non-pharmacologic treatment modalities was an exciting revelation and one that could potentially change the way physicians address pain management.

Intracranial dermoid cysts are exceptionally rare tumors. Interestingly, this condition has a low mortality rate but a high morbidity rate due to its numerous complications. We report a case of a 62-year-old man who presented with a headache and was found to have a ruptured dermoid cyst, complicated with the dissemination of lipid droplets within the subarachnoid space.