Rejected

Impatiens balsamina is an annual herb of the Balsaminaceae family, which is cultivated extensively in Asia as an ornamental plant. Notably, as a folk medicine, I. balsamina has been long prescribed for the treatment of rheumatism, isthmus, generalized pain, fractures, inflammation of the nails, scurvy, carbuncles, dysentery, bruises, foot diseases, etc. AIM OF THE STUDY: The paper overviews comprehensive information on ethnobotanical uses, phytochemistry, pharmacological activity, and toxicity of I. balsamina, aiming at laying a sturdy foundation for further development of I. balsamina.

The purpose of this study was to assess the quality of evidence informing on common pharmacologic modalities used in upper extremity complex regional pain syndrome (CRPS).

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to control pain and fever. However, their effect on COVID-19 infected patients has not been fully studied. In this study, we investigated the effect of the duration of NSAIDs use on COVID-19 infection and clinical outcomes. In South Korea, 25,739 eligible patients who received COVID-19 testing between 1 January and 31 July 2020, were included in this retrospective observational cohort analysis. Based on the date of the first COVID-19 test for each patient, NSAID prescription dates were used to separate patients into two groups (short-term group: <2 weeks; long-term group: 8-12 weeks). COVID-19 infectivity and clinical outcomes were analyzed. We used the propensity score-matching (PSM) method. Of the 580 patients who had taken NSAIDs before the date of COVID-19 test, 534 and 46 patients were grouped in the short- and long-term NSAID-use groups, respectively. We did not find a statistically significant increased risk of COVID-19 infection (adjustment for age and sex, = 0.413; adjustment for age, sex, region of residence, comorbidity, Charlson Comorbidity Index, and current use of medication, = 0.259) or change in clinical outcomes, including conventional oxygen therapy, admission of intensive care unit, artificial ventilation, or death, between the two groups in which the PSM method was applied. The duration of NSAIDs use did not have a statistically significant effect on COVID-19 infectivity or clinical outcomes. However, further studies looking at clinical presentation and laboratory test results in a large number of people should be performed.

The aim of this study was to compare the clinical outcomes and hospital costs associated with two different meshes in robotic transabdominal preperitoneal inguinal hernia repair (IHR). Patients who underwent IHR were assigned to either the polyester self-gripping (PSG) or the polypropylene (PP) group depending on the mesh used. A propensity score matching analysis was performed to obtain balanced populations. Postoperative variables included complications such as surgical site events and recurrences. Hospital costs included all possible expenses generated by the surgery during the hospitalization period. From a database of IHR performed between February 2012 and July 2022, 131 PSG patients were matched to 131 PP repairs. Median operative time was shorter in the PSG group [55 (40-78) vs. 80 (60-116) minutes, p < 0.001]. No intraoperative complications were recorded. Patients who received the PSG mesh experience reduced immediate postoperative pain compared to the PP group. Average follow-up time was 35.2 months in the PSG group vs. 12.5 months in the PP group (p < 0.001). Median Comprehensive Complication Index was comparable in both groups (p = 0.489), with no surgical site infections logged. No cases of chronic pain were noted. Only two recurrences were recorded in the cohort, both of them in the PSG repairs. Hospital costs were USD $232 higher in the PP group but did not statistically differ (p = 0.523). There were no differences between the polyester self-gripping and the polypropylene mesh in terms of postoperative complications, clinical outcomes and hospital costs. Surgeons may opt for either meshes depending on their preferences and familiarity with each of the products.

Digital solutions have emerged as an alternative to conventional physiotherapy, particularly for chronic musculoskeletal pain (CMP) management; however, its long-term effects remain largely unexplored. This study focuses on patients reporting CMP, assessing 1-year clinical outcomes after a multimodal digital care program (DCP) versus non-participants, who enrolled in the program but never engaged in a single exercise session or partook of the educational content made available to them. In this longitudinal study ad-hoc analysis, pain and functionality outcomes at 1-year reassessment were studied, focusing on the odds of reaching minimal clinically important difference (MCID) and, overall average reduction in both outcomes. Healthcare utilization was additionally studied within the same period. From 867 individuals allocated to the study, 460 completed the 1-year reassessment (intervention group: 310; comparison group: 150). The intervention group presented sustained and greater pain reduction until 1-year reassessment than the comparison group, reflecting greater odds ratio of achieving the MCID both in pain and functionality (1.90 95% CI: 1.27-2.86, = 0.002 and 2.02 95% CI: 1.31-3.12, = 0.001, respectively). A lower healthcare utilization during the 1-year follow-up was observed in the intervention group than in the comparison group. This study suggests that a digital CMP program may have a lasting impact on improved pain and functionality in patients with CMP.

Cervicogenic headache is a secondary headache, and manual therapy is one of the most common treatment choices for this and other types of headache. Nonetheless, recent guidelines on the management of cervicogenic headache underlined the lack of trials comparing manual and exercise therapy to sham or no-treatment controls. The main objective of this systematic review and meta-analysis was to assess the effectiveness of different forms of manual and exercise therapy in people living with cervicogenic headache, when compared to other treatments, sham, or no treatment controls.

Acute appendicitis is one of the most common causes of abdominal pain in the emergency department and the most common surgical emergency reason for children younger than 15 years of age, which could be enormously dangerous when ruptured. The choice of radiological approach is very important for the diagnosis. In this way, unnecessary surgery is avoided. The aim of this study was to examine the validity of the American College of Radiology appropriateness criteria for radiological imaging in diagnosing acute appendicitis with multivariate decision criteria. In our study, pediatric patients who presented to the emergency department with abdominal pain were grouped according to the Appendicitis Inflammatory Response (AIR) score and the choice of radiological examinations was evaluated with fuzzy-based Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) and with the fuzzy-based Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) model for the validation of the results. As a result of this study, non-contrast computed tomography (CT) was recommended as the first choice for patients with low AIR score (where&amp;nbsp;Φnet=0.0733) and with high AIR scores (where&amp;nbsp;Φnet=0.0702) while ultrasound (US) examination was ranked third in patients with high scores. While computed tomography is at the forefront with many criteria used in the study, it is still a remarkable practice that US examination is in the first place in daily routine. Even though there are studies showing the strengths of these tools, this study is unique in that it provides analytical ranking results for this complex decision-making issue and shows the strengths and weaknesses of each alternative for different scenarios, even considering vague information for the acute appendicitis diagnosis in children for different scenarios.

Intrapleural fibrinolytic therapy (IPFT) is one of the treatment options for complex pleural effusion. In this study, the IPFT agent used was alteplase, a tissue plasminogen activator (t-PA). This study aims to determine the difference in the outcome of patients with complex pleural effusion between IPFT and surgery in terms of radiological improvement, inflammatory parameters, length of stay, and post-intervention complications.

Myogenous temporomandibular disorders (M-TMDs) are the most common chronic orofacial pain, affecting the masticatory muscles and, thus, jaw movement. While a concise diagnosis is crucial to formulate a rational treatment plan, the similarities in clinical presentations that M-TMDs share with other neuromuscular disorders affecting the temporomandibular joint (TMJ) could easily confuse physicians. In addition to the basics, such as thorough history taking and meticulous clinical examinations, different imaging techniques are useful adjuncts to facilitate the diagnostic process. This review presents an overview of the current understanding on a variety of diagnostic and treatment modalities for M-TMD patients. It is essential to highlight that there is not a single treatment for all, and the benefits of multidisciplinary strategies have been noted for the effective management of myogenous TMD pain. Treatment modalities ranging from conservative to minimally invasive options are discussed in this review.

Benzydamine hydrochloride is a locally-acting Non-Steroidal Anti-Inflammatory Drug (NSAID) with combined local anesthetic and analgesic properties, indicated for the symptomatic relief of pain in acute sore throat. The aim of this study was to obtain an European Consensus among pharmacists, general practitioners and pediatricians on the appropriate use of benzydamine hydrochloride in the treatment of sore throat.