Rejected

Patellar tendinopathy, or jumper's knee is a common musculoskeletal condition characterized by progressive activity-related pain on the anterior aspect of the knee and tenderness on the patellar tendon. A conservative method is often the first choice of treatment, which can include anti-inflammatory medication, injection therapies, physiotherapy, eccentric exercises, extra corporeal shock wave therapy, orthosis, etc. Although there are several treatment options available, the management of patellar tendinopathy is still controversial. The literature reveals many different injection methods are being used by clinicians for the treatment of patellar tendinopathy. Platelet rich plasma, corticosteroids, autologous blood, and aprotinin are the most commonly used injection treatments. Injection therapies give promising results in the management of Patellar tendinopathy. However, due to low quality research and variation in the protocol and population it is difficult to provide a firm conclusion on its effectiveness. More high-quality clinical studies are recommended to determine the effectiveness of injections and at which stage of Patellar tendinopathy they are the most effective. This review can provide insight to clinicians involved in the management of this condition.

This study aims to systematically review the literature to evaluate the association between labor epidural analgesia (LEA) and postpartum depression (PPD).

Acetaminophen is available in a variety of modalities but there is conflicting evidence as to whether intravenous provides superior analgesia than oral formulations METHODS: A prospective, randomized, triple-blinded clinical trial was conducted in which 100 participants, scheduled for any laparoscopic unilateral hernia repair surgery in the ambulatory setting, were computer randomized to receive either 975 mg oral acetaminophen or 1000 mg of intravenous acetaminophen. The primary outcomes evaluated were post-anesthesia care unit (PACU) pain scores at arrival, 1 hour discharge, 6 hour post-op as well as total opioid use intraoperatively and in PACU. Secondary outcomes were PACU length of stay, patient reported total opioid use in the first 24 h, pain scores 24 hour post-op and patient satisfaction.

Cough-associated headache (CAH) is the most distinctive symptom of patients with Chiari I malformation (CMI) and indicates clinically significant disease. We determined the clinical utility of simple 2D anatomic measurements performed on a PACS workstation by assessing their diagnostic accuracy in predicting CAH in CMI patients.

Optic nerve drusen (OND) are abnormal calcified acellular deposits located within the prelaminar portion of the optic nerve. They are usually asymptomatic and detected incidentally during fundoscopic examination. They have a clinical significance due to their appearance which mimicks true papilledema, if the drusen are buried. Misdiagnosis of an OND as papilledema may cause unnecessary and invasive interventions, like lumbar puncture for elevated intracranial pressure.  We present a case of buried OND in a 10-year hyperopic girl who was referred to our clinic with the complaint of headache and swollen optic discs bilaterally. After diagnostic tests, including B-scan ultrasonography (USG) and enhanced depth imaging optic coherence tomography (EDI OCT), she was diagnosed with bilateral OND. Key Words: Children, Drusen, Imaging, Optic Nerve, Papilledema.

As one of the complications after abdominal operation, early postoperative inflammatory small bowel obstruction (EPISBO) is a great trouble for many patients. The use of somatostatin in treating this disease had been widely reported, but its efficacy and safety were controversial. Therefore, the present research carried out a systematic review of the clinical efficacy and safety of somatostatin in treating EPISBO.

This case demonstrates a false elevation of serum lithium concentrations that can occur when blood samples are collected using lithium heparin (green-top) tubes. The patient was a 58-year-old female on chronic lithium therapy for bipolar disorder who presented to the emergency department following an overdose of 5 unidentified medications. The patient was overly sedated and exhibited paradoxical laughter, slurred speech, and mild abdominal pain. The recommended maintenance lithium concentration is 0.6 to 1.0 mmol/L, and she had previously been stable within this therapeutic range. The initial lithium concentration drawn upon admission was 2.05 mmol/L. No intervening treatment was made with the exception of intravenous fluids due to a lack of correlation between clinical presentation and the lithium concentration. Six hours later, a repeat lithium concentration of <0.10 mmol/L was obtained. Upon investigation, it was discovered that the initial blood sample was obtained in a lithium heparin green-top tube instead of the recommended plastic tubes with either sodium heparin or dipotassium ethylenediamine tetraacetic acid as the anticoagulant. As this case demonstrates, lithium heparin tubes have the potential to cause falsely elevated lithium concentrations. It is important for health care professionals to be aware of the false elevations that can occur when blood samples are taken in this type of tube.

Coronavirus disease 2019 (COVID-19) is an infectious disease, caused by severe acute respiratory syndrome (SARS)-CoV-2, that broke out in December 2019. In just four months it has spread to almost every country in the world and up to April 182 020, the virus has infected more than 2 million people. Itch is the most common symptom in dermatology and a frequent one of systemic diseases. The association of itch and viral diseases has been widely documented; however, the actual prevalence of itch in the patients suffering from new the SARS-CoV-2 infection is still unknown. In this paper, we present a review of the available literature on the topic of itch in the affected population. Moreover, we have also analysed different aspects of itch associated with COVID-19 pandemic, not directly related to the viral infection. Those included use of chemicals, hand sanitizers, common use of personal protective equipment and psychosocial stress. This article is protected by copyright. All rights reserved.

While proprioceptive functioning of the cervical extensor muscles has been proposed to be associated with chronic neck pain (NP), the mechanism by which such impairment might contribute to NP is not clear. The aim of this cross-sectional study was to investigate the relevance of proprioception, extensor muscles size, and endurance to chronic NP. A total of 60 participants with (n = 30) or without (n = 30) chronic NP participated in this cross-sectional study. Joint repositioning error (JRE), ultrasonographic parameters of the cervical extensors, and clinical extensor endurance were assessed. Multivariate analysis of variance and logistic regression tests were used to compare the groups and test the predictive value of the dependent variables for chronic NP, respectively. Patients showed comparable JRE scores but smaller multifidus size and lower extensor endurance (Cohen d = 0.66 for both). JRE in the transverse plane (β = 1.20), multifidus muscle size (β = 0.02), and endurance (β = 0.99) were significant predictors for chronic NP odds ratio. The results found multifidus size as the most relevant factor to NP by showing both between-groups difference and considerable odds ratio. As JRE in transverse plane was not different between the groups and extensor endurance demonstrated minimal odds ratio, these 2 factors may be considered as less relevant to NP comparing multifidus muscle size.