Rejected

Headache is a common neurological disorder, with a global prevalence of around 50%. It may affect people of any age, gender, education, socioeconomic status and occupation. Tension headache, migraine headache and cluster headache are commonly encountered headache types. The prevalence of headache problems is higher among medical students. This could potentially affect their academic performance and quality of life. The objective of this study is to find out the prevalence of headaches and their clinical characteristics among students of a medical college.

The skin is an important barrier that protects against invasion by foreign substances, including irritants and harmful microorganisms, and holds water in the body. Washing the skin with cleansers and shampoos containing anionic surfactants, for example sodium dodecyl sulfate (SDS), is important for maintaining skin homeostasis. However, surfactants can cause dermatitis, cutaneous hypersensitivity (e.g., alloknesis), and pruritus in humans. Our previous studies revealed an alloknesis response in the skin with SDS-induced dermatitis in C57BL/6 mice. In addition, we found that alloknesis responses and afterdischarge responses following stimulation with light touch are related because they are observed contemporaneously. In this study, we used Hos:HR-1 hairless mice to establish a mouse model to evaluate long-term drug application for alloknesis responses. Alloknesis was observed in HR-1 mice with SDS-induced dermatitis. The mean number of c-Fos (a marker of neural activity) immunopositive neurons was increased in the lamina 1-2 (L1-2) spinal dorsal horn, but not in L3-4, of SDS-treated HR-1 mice compared to vehicle-treated mice. We also discovered that afterdischarge responses were observed in neurons in L1-2. There was also a correlation between the intensity of the afterdischarge responses and depth of the recording site. Thus, the following were suggested: 1) neurons that mediate these afterdischarge responses are located on the superficial layer of the spinal cord; 2) afterdischarge responses can be an index of alloknesis responses, and 3) the mouse model of SDS-induced dermatitis is an appropriate alloknesis model.

Chronic subdural hematoma (CSH) in the posterior fossa is extremely rare and only a few cases have been reported in the literature. We report a case of CSH in the posterior fossa successfully treated with a single burr hole surgery.

Mycosis fungoides is the most common cutaneous T-cell lymphoma. It presents a diagnostic challenge due to resemblance with many other dermatologic conditions. The disease typically follows a progression from patches to plaques to skin-based tumors with potential for visceral involvement. Diagnosis is made by clinical presentation and histology. When early diagnosis is made, there is an estimated 88% five-year survival. This report details a 60-year-old Black man diagnosed with stage IIIA mycosis fungoides with a severe degree of cutaneous involvement. This case is unique due to the aggressive large cell transformation and rapid progression to death within 18 months of diagnosis. We highlight the challenge of diagnosing, treating, and monitoring the therapeutic response of mycosis fungoides. Finally, this case calls for a multi-disciplinary approach to treatment and to include mycosis fungoides on the differential diagnosis for patients presenting with a variety of vague, recurrent cutaneous symptoms, especially with patchy dyspigmentation or plaques.

Although ganglion impar blockade has long been an effective procedure in the treatment of coccydynia, the pulsed radiofrequency (PRF) of the ganglion impar (GI) is a relatively new approach for the management of coccydynia. In the present study, we aimed to retrospectively evaluate patients who underwent GI PRF due to coccydynia.

The risk of possible cross-reactions between serological tests, together with the clinical similarities between dengue fever and COVID-19, can delay diagnosis and increase the risk of both COVID-19 transmission and worsening. The present study aimed to determine the possibility of cross-reactions among rapid serological tests based on clinical symptoms.

Transcutaneous electrical nerve stimulation over an acupoint (acu-TENS), a new technique applied in pulmonary rehabilitation programs, has been gradually used in the management of chronic obstructive pulmonary disease (COPD). However, the effects of acu-TENS have not been fully evaluated. Therefore, this review was conducted to assess the effects of acu-TENS on COPD.

To evaluate transforming growth factor beta (TGF-β) in patients with cervical artery dissection (CeAD).

Previous studies have proved and investigated the mechanism of the analgesic effect of tuina treatment on neuropathic pain. The purpose of this study was to analyze changes in gene expression in the dorsal root ganglia (DRG) and spinal dorsal horn (SDH) after 1-time tuina intervention to investigate the immediate analgesic mechanism by tuina. An improvement in nociceptive behavior in minor chronic constriction injury (CCI) rats after 1-time tuina was observed. 1-time tuina was more effective in the amelioration of thermal hyperalgesia, but no changes were found in the ultrastructure of DRG and SDH. Sixty-five differentially expressed genes (DEGs) modulated by tuina were detected in the DRG and 123 DEGs were detected in the SDH. Potential immediate analgesic mechanisms of tuina were analyzed by the Kyoto Encyclopedia of Genes and Genomes. DEGs were enriched in 75 pathways in DRG, and 107 pathways in SDH. The immediate analgesic mechanism of tuina is related to the calcium signaling pathway, thermogenesis, and regulation of lipolysis in adipocytes.

This study was conducted with the primary aim to distinguish patients with a true stroke versus a stroke mimic based on clinical features and imaging. We conducted a retrospective case-control study on 116 adult patients who received alteplase (tPA) to treat acute stroke at our hospital. We further analyzed 79 patients with a normal computed tomography angiography (CTA). Based on their magnetic resonance imaging (MRI) of the brain, they were divided into cases (stroke mimics) and controls (true strokes). Data were collected retrospectively by reviewing individual medical charts on the electronic medical record (EMR), including age, gender, history of stroke, seizure, hypertension, diabetes, atrial fibrillation, hyperlipidemia, presenting NIH Stroke Scale/Score, hemorrhagic conversion, history of migraine, history of depression, sidedness of symptoms and aphasia. Data were categorized to separate those who were later diagnosed to be stroke mimics by being-postictal, encephalopathic, in acute migraine, suffered post-stroke recrudescence (PSR) due to metabolic insult, or had conversion disorder when symptoms could not be attributed to any medical condition or mental illness. Of the 79 study subjects, 48 (60%) were stroke mimics. The mean age of the cohort was 68.67 years, and 46.8% of the study subjects were females. Based on the multivariate logistic regression analysis, factors associated with being a stroke mimic were older age, history of migraine, and a history of prior stroke. In conclusion, increased attention to history and clinical examination as the first step can aid in the proper diagnosis of strokes versus stroke mimics. Identifying stroke mimics early could help expedite hospital workup and prevent inadvertent investigations, reducing hospital occupancy during the ongoing COVID-19 pandemic. We could potentially avoid the administration of tPA to such patients, reducing both the cost and adverse effects of it. Every stroke can cause neurological deficits, but every deficit need not be a stroke.