Rejected

Postoperative peritoneal adhesions are considered the major complication following abdominal surgeries. The primary clinical complications of peritoneal adhesion are intestinal obstruction, infertility, pelvic pain, and postoperative mortality. In this study, regarding the anti-inflammatory and antioxidant activities of we aimed to evaluate the effects of on the prevention of postsurgical-induced peritoneal adhesion. Male Wistar-Albino rats were used to investigate the preventive effects of extract (0.5%, 0.25% and 0.125% /) against postsurgical-induced peritoneal adhesion compared to pirfenidone (PFD, 7.5% /). We also investigated the protective effects of PFD (100 g/ml) and extract (100, 200, and 400 g/ml) in TGF-1-induced fibrotic macrophage polarization. The levels of cell proliferation and oxidative, antioxidative, inflammatory and anti-inflammatory, fibrosis, and angiogenesis biomarkers were evaluated both and models. extract ameliorates postoperational-induced peritoneal adhesion development by attenuating oxidative stress [malondialdehyde (MDA)]; inflammatory mediators [interleukin- (IL-) 6, tumour necrosis factor- (TNF-) , and prostaglandin E (PGE)]; fibrosis [transforming growth factor- (TGF-) 1, IL-4, and plasminogen activator inhibitor (PAI)]; and angiogenesis [vascular endothelial growth factor (VEGF)] markers, while propagating antioxidant [glutathione (GSH)], anti-inflammatory (IL-10), and fibrinolytic [tissue plasminogen activator (tPA)] markers and tPA/PAI ratio. In a cellular model, we revealed that the extract, without any toxicity, regulated the levels of cell proliferation and inflammatory (TNF-), angiogenesis (VEGF), anti-inflammatory (IL-10), M1 [inducible nitric oxide synthase (iNOS)] and M2 [arginase-1 (Arg 1)] biomarkers, and iNOS/Arg-1 ratio towards antifibrotic M1 phenotype of macrophage, in a concentration-dependent manner. Taken together, the current study indicated that reduces peritoneal adhesion formation by modulating the macrophage polarization from M2 towards M1 cells.

Puerperal sepsis (PP sepsis) is a leading cause of maternal mortality globally. The majority of maternal sepsis cases and deaths occur at home and remain undiagnosed and under-reported. In this paper, we present findings from a nested case-control study in Bangladesh and Pakistan which sought to assess the validity of community health worker (CHW) identification of PP sepsis using a clinical diagnostic algorithm with physician assessment and classification used as the gold standard.

Paraspinal abscesses are most commonly caused by and some Gram-negative bacteria. In developing countries, (MTB) contributes to almost 50 % of cases. Even in proven cases of tubercular paraspinal abscesses, secondary infection of aerobic or anaerobic bacteria is possible and should be carefully evaluated for proper management.

For more than 60 years, the synthetic opioid fentanyl has been widely used in anaesthesia and analgesia. While the intravenous formulation is primarily used for general anaesthesia and intensive care settings, the drug's high lipophilic properties also allow various noninvasive routes of administration. Published data suggest that intranasal administration is also attractive for use as intranasal patient-controlled analgesia (PCA). A newly developed intranasal fentanyl formulation containing 47 g fentanyl, intravenous fentanyl, and oral transmucosal fentanyl citrate were characterised, and bioavailability was compared to assess the suitability of the intranasal formulation for an intranasal PCA product.

Pineal region tumors (PRTs) affect all ages, with a remarkable proportion of cases occurring in children. They are mainly classified into three categories, namely germ cell tumors (GCTs), pineal parenchymal tumors (PPTs), and other tumors such as gliomas and tumors of the surrounding structures. The purpose of this article is to review the current literature regarding pathophysiological mechanisms of the presenting clinical features of patients with PRT. The usual presentation of PRTs is the symptoms of obstructive hydrocephalus and intracranial hypertension, such as headache and vomiting. However, there is a remarkable spectrum of clinical findings that can be caused by such lesions. These include ophthalmologic and endocrinologic disturbances, motor and sensory abnormalities, and cognitive and psychiatric symptoms. The unique anatomic location of the pineal gland, which is close to many vital brain structures, is crucial for the explanation of most of those findings. In rare cases, manifestations of intracranial bleeding may be the presenting feature of a PRT. Tumor histology and patient's age can affect the clinical presentation. Hydrocephalus is the most common clinical syndrome of a PRT because of the location of the pineal gland. Presenting symptoms also include ophthalmologic, endocrinologic, motor, sensory, cognitive, and psychiatric symptoms. Clinicians should be aware of the initial symptoms of PRTs, including the misleading ones, in order to avoid delay in the diagnosis and management of these life-threatening lesions.

Neuropathic pain remains a clinical challenge with limited effective treatments. Previous studies have found that magnolol (Mag), an ingredient existing in some herbs, showed neuroprotective effect. However, it remains unclear whether Mag can alleviate neuropathic pain.

Severe acute post-cesarean delivery (CD) pain has been associated with an increased risk for persistent pain and postpartum depression. Identification of women at increased risk for pain can be used to optimize post-cesarean analgesia. The impact of labor prior to CD (intrapartum CD) on acute post-operative pain and opioid use is unclear. We hypothesized that intrapartum CD, which has been associated with both increased inflammation and affective distress related to an unexpected surgical procedure, would result in higher postoperative pain scores and increased opioid intake.

Chronic neck pain (CNP) incidence in the general population is high and contributes to a significant health problem. Kinesiophobia (fear of pain to movement or re-injury) combined with emotions and physical variables may play a vital role in assessing and managing individuals with CNP. The study's objectives are 1) to evaluate the relationship between kinesiophobia, neck pain intensity, proprioception, and functional performance; 2) to determine if kinesiophobia predicts pain intensity, proprioception, and functional performance among CNP individuals. Sixty-four participants with CNP (mean age 54.31 ± 9.41) were recruited for this cross-sectional study. The following outcome measures were evaluated: Kinesiophobia using the Tampa Scale of Kinesiophobia (TSK), neck pain intensity using the visual analog scale (VAS), cervical proprioceptive joint position errors (in flexion, extension, and rotation directions) using cervical range of motion (CROM) device and handgrip strength as a measure of functional performance using the Baseline® hydraulic hand dynamometer. Kinesiophobia showed a strong positive correlation with neck pain intensity (r = 0.81, p<0.001), a mild to a moderate positive correlation with proprioception joint position errors (JPE) in extension, rotation left and right directions (p<0.05), but no correlation in flexion direction (p = 0.127). Also, there was a moderate negative correlation with handgrip strength (r = -0.65, p<0.001). Regression analysis proved that kinesiophobia was a significant predictor of pain intensity, proprioception, and functional performance (p<0.05). This study infers that kinesiophobia in individuals with CNP predicts pain, proprioception, and functional performance. Kinesiophobia assessment should be considered in regular clinical practice to understand the barriers that can influence rehabilitation outcomes in CNP individuals.

Scalp psoriasis is usually refractory to treatment. Excimer devices have been proved to be a promising therapeutic option in psoriasis. Greater efficacy of phototherapy can be achieved by concurrent use of coal tar derivatives. We aimed to compare efficacy and safety between 308-nm excimer lamp monotherapy and a combination of 308-nm excimer lamp and 10% liquor carbonis detergens in the treatment of scalp psoriasis. In this randomized, evaluator-blinded, prospective, comparative study, 30 patients with scalp psoriasis received either 308-nm excimer lamp monotherapy or a combination of 308-nm excimer lamp and 10% liquor carbonis detergens twice per week until complete remission of the scalp or for a total of 30 sessions. Efficacy was evaluated by the improvement of Psoriasis Scalp Severity Index (PSSI) score, itch score, and Scalpdex score. Both treatments induced significant improvement in PSSI score with greater reduction observed in the combination group. At 30th visit, a 75% reduction in PSSI (PSSI75) was attained by 4 (28.6%) and 9 (69.2%) patients treated with monotherapy and combination therapy, respectively ( < 0.05). Excimer lamp is well-tolerated in patients with scalp psoriasis and liquor carbonis detergens can be used as a combination therapy to improve the efficacy of excimer lamp.

The aim of this case series is to clarify if a physiotherapy program can reduce the frequency, intensity and duration of the headache episodes in patients with cluster headache. A 7-case series with cluster headache patients was conducted. Every subject received physiotherapy treatment based on manual therapy and exercise, maintaining pharmacological treatment prescribed by the neurologist. Frequency, intensity and duration of the episodes, pressure pain thresholds (PPT) and psychological variables were measured 5 times: pre-intervention, post-intervention, 1 month follow-up, 2 months follow-up and 3 months follow-up. Two of the seven subjects decreased their frequency of headaches over 50 % and another in 16,67 %. There were no significant changes in duration or intensity. Results also showed an improvement in impact of headache in 6 of 7 cases. Those cases that decreased more their headache frequency also decreased their pain catastrophizing. A program of physiotherapy based in manual therapy and exercise, might be an effective and safe complement to decrease the frequency of the episodes of CH in short-term (4 months follow-up) including interdisciplinary working with neurologists and other health care professionals.