Rejected

The aim: To investigate the clinical features of the chronic pancreatitis (CP) clinical course in patients with concomitant arterial hypertension.

Many patients with osteoarthritis experience pain which can lead to higher healthcare expenditures. It is important to understand the factors that drive the excess expenditures associated with pain in osteoarthritis.

Due to the rarity of the condition, Valentino's syndrome is an underrated differential diagnosis for acute appendicitis. We describe a patient with Valentino's syndrome in whom preoperative and intraoperative diagnoses were challenging due to misleading clinical, investigative, and morphological findings. A 31-year-old woman who was on methylprednisolone for sensory radiculopathy presented to the emergency department with acute right lower quadrant pain. The clinical diagnosis of acute appendicitis was supported by the elevated inflammatory markers and ultrasonographic findings. An appendicectomy and an ovarian cystectomy were performed due to the findings of mild appendicitis and right ovarian endometrioma, respectively. Postoperatively, she developed peritonitis with a purulent bile-stained discharge from the surgical site and per vagina. Contrast-enhanced computed tomography of the abdomen showed a retroperitoneal collection at the second lumbar vertebral level extending along the right paracolic gutter to the pelvis and intraperitoneal fluid collections in right lower quadrant and pelvis. An emergency exploratory laparotomy confirmed a perforation at the posterior aspect of the duodenum which was repaired with an omental patch. Unfortunately, relaparotomy and end ileostomy were required due to colonic perforation with the eroded drain tube. She made an uneventful recovery with intensive care and underwent ileostomy reversal after 12 weeks. We emphasize the clues to have a high degree of suspicion during preoperative and intraoperative evaluation to recognize this lethal mimicker of acute appendicitis.

We aimed to describe the characteristics of individuals infected by BA.4 or BA.5 in France in comparison to BA.1, and analyze the factors associated with hospitalization among BA.4 and BA.5 cases.

Epidural nerve block and analgesia are basic anesthetic techniques for anesthesia. Epidural catheter rupture and partial retention are adverse events and rare complications of epidural catheterization technique. The probability of occurrence when applied by novice doctors is high. Removal of the residual catheter by conventional surgery causes more trauma and bleeding, slows recovery, and may causes medical disputes. We hypothesized that percutaneous spinal endoscopy a safe and effective remediation technique. This study was to analyze the efficacy and safety of removing the residual dural catheter by a percutaneous full-endoscopic technique(PFET) and discuss the clinical technique and precautions.

To explore changes of depression, anxiety and sleep disturbance in patients with episodic cluster headache inside and outside the attack period and assess the therapy to improve the treatment.

Perforation of the gallbladder (PG) is a dreaded complication of an acute cholecystitis and is associated with increased morbidity and mortality. Cholecystocutaneous abscess (CCA) is an extremely rare complication. There is usually a history of cholecystolithiasis or neglected chronic gallbladder disease. We report a case of perforated gallbladder into the abdominal wall.

Spinal Cord Injury (SCI) or Acquired Brain Injury (ABI) leads to disability, unemployment, loss of income, decreased quality of life and increased mortality. The impact is worse in Low-and Middle-Income Countries (LMICs) due to a lack of efficient long-term rehabilitative care. This study aims to explore the feasibility and acceptability of a telerehabilitation programme in Nepal.

Pain control after thoracoscopy is one of the important issues in patient health care. Pre-emptive analgesia can reduce acute postoperative pain and also prevent chronic pain. This study aimed to evaluate the effectiveness of gabapentin (GABA analog) as pre-emptive analgesia in reducing pain and reducing opiate consumption after video-assisted thoracoscopic surgery (VATS) surgery.

Thromboembolic manifestations like pulmonary embolism and deep venous thrombosis are often reported and contribute to a significant mortality from acute and chronic COVID-19 infections. These phenomena are a result of the activation of the coagulation cascade by the COVID-19 induced inflammatory state. Majority of the thrombotic incidences are reported as a venous thrombosis but extremely rarely, arterial thrombi can be a manifestation of acute COVID-19 infection. The patient in our case report was an unvaccinated 47-year-old female who presented with fever, nausea, abdominal pain and vomiting. The imaging confirmed the presence of a non-occlusive thrombus in the descending aorta, multiple splenic infarctions and paralytic ileus. She was treated with systemic anti-coagulation. A hyper-coagulable workup was performed on the patient and no other risk factors that could contribute to a thrombus was identified.