Rejected

Crowned dens syndrome (CDS) is a relatively uncommon presentation of calcium pyrophosphate dihydrate (CPPD) deposition disease that manifests as acute attacks of neck pain with fever, neck rigidity and elevated inflammatory markers related to radiodense deposits of CPPD in ligaments around the odontoid process. We present a case of CDS.

Cinnamomum verum is the widely used spice for its medicinal and culinary uses since ages. It is native to Sri Lanka and southern India but also distributed in many Asian, Caribbean, Australian and African countries. It is widely used in food preparations and industrial products like candies, chewing gums, mouthwash and toothpaste. It is also used to treat asthma, bronchitis, diarrhea, headache, inflammation and cardiac disorders. Cinnamaldehyde, eugenol, caryophyllene, cinnamyl acetate and cinnamic acid are the major compounds found in its essential oil. These compounds exhibit a wide range of pharmacological activities including antioxidant, antimicrobial, anti-inflammatory, anticancer, antidiabetic, wound healing, anti-HIV, anti-anxiety and antidepressant, etc. This review highlights its comprehensive and up-to-date information on taxonomy, ethnomedicinal uses, phytochemical composition, pharmacological and toxicity activities. Structure-activity relationship, mechanism of action and some research gaps has also been provided. Owing to its immense medicinal importance, more well-designed in-vivo and clinical studies are required.

A prospective clinical trial evaluated the effect of Ga-DOTATOC positron emission tomography-computerized axial tomography (PET-CT) on change in management of patients with lung, pancreatic, and small bowel neuroendocrine tumors. The primary eligibility criterion was a histologically proven tumor with positive somatostatin receptor subtype 2A immunohistochemistry. The primary and secondary end points were change in patient management and safety.

There is good evidence that spinal cord stimulation (SCS) is effective for reducing chronic back and leg pain (CBLP). SENZA-RCT showed high-frequency (10▒kHz) stimulation (10▒kHz-SCS) is clinically superior to traditional low-frequency SCS (LF-SCS).Undertake cost-consequence and cost-effectiveness analysis of 10▒kHz-SCS compared with LF-SCS.

Viral infections are one of the challenging health hazards of the present medical care. One among such viral infections is "Oro-facial Herpes", caused by the Varicella Zoster Virus (HSV-1). This case report shows the successful treatment of "Oro-facial herpes" and its complication only through Ayurveda. In which, there will be closed grouped vesicles on an erythematous base in the dermatomal pattern, with burning type of pain. The condition in Ayurveda can be co- related to 'Visarpa'. We present a case of 72-year, male, with sudden onset of edema over upper gums, with 3 to 4 vesicles over the left upper lip, left part of face within 2 days, along with reduced sensation to touch and temperature. The patient had redness, watering and burning sensation of left eye. Clinically the patient was diagnosed with "Oro- Facial Herpes". As pitta dosha and raktadhatu vitiation was noticed the case was managed by Nitya pitta rechaka (cholegogue), the dravy's with tikta, sheetaveerya and ruksha in nature. The patient showed improvement over 5 months of treatment from 10-Apr to 15-Aug-2018. The complaints of pain in the lesions reduced from 8 to 2, headache from 8 to 1 (VAS) and burning sensation reduced by 90%.

Juvenile Spondyloarthropathies are the inflammatory arthritis before the age of 16 years and are characterized by the involvement of both synovium and enthesis leading to spinal and oligoarticular peripheral arthritis, principally in genetically predisposed (HLA-B27) individuals. These arthropathies are having poorer chance of remission with conventional treatment in comparison to other juvenile arthritis; with less than 20% going into remission within five years of diagnosis. This paper is a retrospective observational study of this condition in one patient receiving Ayurvedic treatment in Paediatric Unit of Ch. Brahm Prakash Ayurved Charak Sansthan. A 15 years adolescent boy with the complaints of inability to stand and walk due to pain and swelling in large joints of body; was carried to Balroga OPD by parents. On the basis of history, physical examination and investigations, the condition is diagnosed Aamavata as per ayurvedic approach and juvenile spondyloarthropathy as per modern medical science. This case is managed on the principle of treatment of Aamavata with administration of Ajamodadi churnam and Mishreya ark as deepana-pachana drugs followed by administration of Simhnad Guggulu and Lakshadi Guggulu with Maharasnadi kashayam and Dashmoolaristam for 3 months. Rheumayoga gold was also given from 4th week onward for 3 months. Panchkarma in the form of Baluka swedana and Kshara basti was also administered for 2 weeks after one month of oral medication. This treatment results in complete remission of all the signs and symptoms including pain and swelling of joints. The case is followed up for next three years without any relapse or progression in the disease. The case study infers that early intervention of Ayurvedic treatment in juvenile spondyloarthropathies may result in complete remission as well as may prevent progression of the disease. The case study provides a good hope for the management of this ailment as well as new ray for research.

Ketoprofen (KET) represents one of the most common drugs used in the topical treatment of pain and inflammations. However, its potential is rather limited due to the very low solubility and photochemical instability. The local administration of KET by conventional products, such as gels, emulgels, creams, and foams, does not guarantee an efficacious and safe treatment because of its low absorption (due to low solubility) and its sensitivity to UV rays. The photodegradation of KET makes many photoproducts responsible for different adverse effects. In the present work, KET was intercalated into the lamellar anionic clay ZnAl-hydrotalcite (ZnAl-HTlc), obtaining the hybrid ZnAl-KET with improved stability to UV rays and water solubility in comparison to the crystalline form (not intercalated KET). The hybrid was then formulated in autoadhesive patches for local pain treatment. The patches were prepared by casting method starting from a hydrogel based on the biocompatible and bioadhesive polymer NaCMC (Sodium carboxymethycellulose) and glycerol as a plasticizing agent. The introduction of ZnAl-KET in the patch composition demonstrated the improvement in the mechanical properties of the formulation. Moreover, a sustained and complete KET release was obtained within 8 h. This allowed reducing the frequency of anti-inflammatory administration, compared to the conventional formulations.

Radiosurgery is an increasingly popular treatment for trigeminal neuralgia (TN); however, several treatment variables require further study. This meta-analysis was conducted to clarify ambiguity in the current literature and optimize treatment parameters.

Trigeminal neuralgia is characterized by extensive spreading of pain, referred to as ectopic pain, which describes the phenomenon of the pain passing from the injured regions to uninjured regions. Patients with orofacial pain often show no response to commonly used analgesics, and the exact mechanism of ectopic pain remains unclear, which restricts the development of specific drugs. The present review aims to summarize the contribution of the two families of transmembrane proteins, connexins (Cxs) and pannexins (Panxs), to the induction and spreading of orofacial pain and to provide potential targets for orofacial pain treatment. Cxs and Panxs have recently been shown to play essential roles in intercellular signal propagation in sensory ganglia, and previous studies have provided evidence for the contribution of several subtypes of Cxs and Panxs in various orofacial pain models. Upregulation of the expression of Cxs and Panxs in the trigeminal ganglia is observed in most cases after trigeminal injury, and regulating their expression or activity can improve pain-like behaviors in animals. It is speculated that after trigeminal injury, pain-related signals are transmitted to adjacent neurons and satellite glial cells in the trigeminal ganglia directly through gap junctions and simultaneously through hemichannels and pannexons through both autocrine and paracrine mechanisms. This review highlights recent discoveries in the regulation of Cxs and Panxs in different orofacial pain models and presents a hypothetical mechanism of ectopic pain in trigeminal neuralgia. In addition, the existing problems in current research are discussed.