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Clinical Characteristics and Management of Ovarian Vein Thrombosis: A Case Series.

Ovarian vein thrombosis (OVT) is an uncommon condition, occurring in ~1 in every 600-2,000 pregnancies. It is associated with various conditions, including thrombophilia, malignancy, sepsis, intra-abdominal and pelvic inflammatory conditions, pregnancy, and the postpartum period, and specific surgical interventions, particularly gynecological surgeries. Thus, this study aims to identify the associated factors for OVT and elaborate on the standard treatment strategies for its management.

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Metamizole as a Rare Cause of Drug-Induced Liver Injury.

Drug-induced liver injury (DILI) is a heterogenous entity with a wide range of pathogenetic mechanisms and clinical manifestations. DILI is a diagnosis of exclusion. Metamizole (dipyrone) is an analgesic increasingly used in Europe, but there is limited information on its adverse effects. We report the case of a 56-year-old man with acute fever, malaise and general deterioration. Onset of symptoms occurred 12 hours after intake of metamizole for shoulder pain. The patient's medical history was remarkable for three episodes of an inflammatory syndrome with hepatitis of unknown aetiology during the previous 3 years. However, retrospective enquiry showed each episode was preceded by metamizole intake shortly before symptom onset. Relevant differential diagnoses such as infection, vasculitis, autoimmune or metabolic diseases were excluded. Liver biopsy was compatible with DILI. Discontinuation of metamizole led to rapid clinical improvement and normalization of liver transaminases. Metamizole is a very rare and poorly known cause of DILI with only a few published case reports in the literature. Careful medical history taking is important to identify the causative agent. Prompt recognition and discontinuation of the drug is crucial. Patients must be informed to avoid this medication in future.

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A Comprehensive Update of Prolotherapy in the Management of Osteoarthritis of the Knee.

This is a comprehensive review of the literature focusing on the use of prolotherapy in the treatment of osteoarthritis of the knee. It covers the background, efficacy, and advantages of prolotherapy in the management of osteoarthritis symptoms and then covers the existing evidence of the use of prolotherapy for this purpose. Current treatments for osteoarthritis of the knee are numerous, yet patients continue to endorse chronic pain and poor quality of life. Prolotherapy is a treatment that has been inadequately studied with poor sample sizes and lack of standardization between trials. However, in recent years the literature on prolotherapy in the treatment of knee osteoarthritis has grown. Although there is still a lack of homogeneity, trials have shown that dextrose prolotherapy, autologous conditioned serum, hyaluronic injections, and normal saline administered either intra- or peri-articularly are comparable in reducing pain scores to other primary treatment options. The mechanism of action for prolotherapy is still unclear, but researchers have found that prolotherapy plays some role in cartilage growth or chondrogenesis and has been shown to have improved radiographic outcomes. Prolotherapy appears to be a safe treatment alternative that has been shown to improve stiffness, pain, function, and quality of life in osteoarthritis of the knee. Knee osteoarthritis is remarkably prevalent in the United States and is one of the most common causes of disability in the elderly population. Although there are many treatment options, patients continue to live with chronic pain which can incur high costs for patients. A safe, long-term, and effective solution has not yet been identified. Prolotherapy has been shown to be a safe option for improving pain, function, and quality of life as effectively as other treatment options.

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A Retrospective Analysis of Clinical Features and Treatment of the Inflammatory Bowel Disease in China.

To retrospectively collect and analyze demographic information as well as symptoms, laboratory results, endoscopic and pathologic findings, and treatment of ulcerative colitis (UC) and Crohn's disease (CD) patients in Wuhan, China.

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A Height-Based Dosing Algorithm of Bupivacaine in Spinal Anesthesia for Decreasing Maternal Hypotension in Cesarean Section Without Prophylactic Fluid Preloading and Vasopressors: A Randomized-Controlled Non-Inferiority Trial.

There is a high incidence of maternal hypotension in spinal anesthesia for cesarean section. The aim of the study is to investigate whether there is a height-based dosing algorithm of bupivacaine that provides adequate anesthesia with less maternal hypotension.

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Predictors of mass psychogenic illness in a junior secondary school in rural Botswana: A case control study.

In March 2019, students at Lempu Secondary School in Kweneng District, Botswana displayed symptoms including headache, abnormal leg movements and difficulty walking. Within days, 133 students were admitted to Scottish Livingstone Hospital where mass psychogenic illness (MPI) was diagnosed.

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Be Kind to Your Behind: A Systematic Review of the Habitual Use of Bidets in Benign Perianal Disease.

Benign perianal disease carries significant morbidity and financial burden on the healthcare system. Given that sitz baths are recommended as a treatment modality, we considered whether using a continuous stream of water, in the form of a bidet, offers a convenient and effective alternative. Bidet use is the predominant form of perianal hygiene in Asia, but its role in perianal disease is unknown.

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Efficacy of Linn. Pod’s Sitz Bath plus Vaginal Pessary in Syndromic Management of Abnormal Vaginal Discharge: A Randomized Controlled Trial.

Abnormal vaginal discharge () is a common public health problem that significantly disrupts the health-related quality of life (HRQoL). Syndromic management infers the concurrent treatment of two or more infections. Hence, a comparative, single-blind study was planned to determine the efficacy of ( Linn.) pod's sitz bath () plus vaginal pessary () vs. placebo in abnormal vaginal discharge syndromic management, its associated symptoms, and women's HRQoL.

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Effects of Oxaliplatin on Facial Sensitivity to Cool Temperatures and TRPM8 Expressing Trigeminal Ganglion Neurons in Mice.

The chemotherapeutic agent oxaliplatin is commonly used to treat colorectal cancer. Although effective as a chemotherapeutic, it frequently produces painful peripheral neuropathies. These neuropathies can be divided into an acute sensitivity to cool temperatures in the mouth and face, and chronic neuropathic pain in the limbs and possible numbness. The chronic neuropathy also includes sensitivity to cool temperatures. Neurons that detect cool temperatures are reported to utilize Transient Receptor Potential Cation Channel, Subfamily M, Member 8 (TRPM8). Therefore, we investigated the effects of oxaliplatin on facial nociception to cool temperatures (18°C) in mice and on TRPM8 expressing trigeminal ganglion (TRG) neurons. Paclitaxel, a chemotherapeutic that is used to treat breast cancer, was included for comparison because it produces neuropathies, but acute cool temperature sensitivity in the oral cavity or face is not typically reported. Behavioral testing of facial sensitivity to 18°C indicated no hypersensitivity either acutely or chronically following either chemotherapeutic agent. However, whole cell voltage clamp experiments in TRPM8 expressing TRG neurons indicated that both oxaliplatin and paclitaxel increased Hyperpolarization-Activated Cyclic Nucleotide-Gated channel (HCN), voltage gated sodium channel (Na), and menthol evoked TRPM8 currents. Voltage gated potassium channel (K) currents were not altered. Histological examination of TRPM8 fibers in the skin of the whisker pads demonstrated that the TRPM8 expressing axons and possible Merkel cell-neurite complexes were damaged by oxaliplatin. These findings indicate that oxaliplatin induces a rapid degeneration of TRG neuron axons that express TRPM8, which prevents evoked activation of the sensitized neurons and likely leads to reduced sensitivity to touch and cool temperatures. The changes in HCN, Na, and TRPM8 currents suggest that spontaneous firing of action potentials may be increased in the deafferented neurons within the ganglion, possibly producing spontaneously induced cooling or nociceptive sensations.

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Combination of Preoperative Multimodal Image Fusion and Intraoperative Dyna CT in Percutaneous Balloon Compression of Trigeminal Ganglion for Primary Trigeminal Neuralgia: Experience in 24 Patients.

We retrospectively assessed the surgical results of PBC with preoperative multimodal image fusion and intraoperative Dyna Computed Tomography (CT) in 24 patients with primary trigeminal neuralgia (PTN) to explore a valuable aid for Percutaneous balloon compression (PBC).

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