Rejected

Arteriovenous fistula is a common vascular abnormality of spinal cord and meninges. This disease is more common in young men. Clinical manifestation includes progressive sensitive and motor disorders. However, acute symptoms including impaired consciousness, head or back pain are also possible. The authors describe a rare case. A 15-year-old boy experienced acute depression of consciousness accompanied by headache, vomiting, weakness in the upper limbs and sensitive disorders. The patient was hospitalized to the intensive care unit and examined for subarachnoid hemorrhage. MRI of the head and cervical spine and direct invasive angiography were performed. Perimedullary AVF of cervical spinal cord was diagnosed. Complete clinical regression was observed within a month. Microsurgical removal of AVF was performed in scheduled fashion. Postoperative follow-up period was over 6 months.

Suicide is an unresolved psychiatric and public health emergency, claiming 800,000 lives each year, however, its neurobiological etiology is still not understood. In spite of original reports concerning the involvement of in interaction with recent stress in the appearance of suicidal ideation and attempts, replication studies have yielded contradictory results. In our study, we analyzed the association between and lifetime suicide attempts, current suicidal ideation, hopelessness and thoughts of death as main effects, and in interaction with childhood adversities, recent stress, and different types of recent life events in a general population sample.

Despite having some benefits, self-medication increases risks such as unnecessary use of medication, extended duration of consumption, incorrect diagnosis, drug-drug interactions, and polypharmacy. Thus, the purpose of this study is to compare self-medication practice between medical and nonmedical students of the University of Gondar, Northwest Ethiopia. An institutional-based cross-sectional comparative study was conducted on medical and nonmedical students of the University of Gondar from March 25 to May 15, 2018. A comparative sample of 213 medical and 212 nonmedical students were enrolled in the study. Data were collected by physically visiting the students in their campuses, using a semistructured questionnaire. Of the participants with a history of medication use in the past 12 months, 64.5% practiced self-medication. The prevalence of self-medication was 59.7% among medical students and 69.0% among nonmedical students. "Knowing the treatment of the disease" was the most frequent reason behind self-medication. Analgesics/antipyretics were the most common categories of medications used, whereas headache was the predominant ailment for which the medications were used. Self-medication practice was found to be higher in the fifth year students and nonmedical students ( < 0.05). In conclusion, self-medication is common among students of the University of Gondar. Nonmedical students were more likely to have practiced self-medication as compared to medical students.

To investigate the clinical characteristics of tracheobronchopathia osteochondroplastica (TO).

To evaluate the short term safety and potential therapeutic effect of allogenic adipose tissue-derived stromal/stem cells (ASCs) + cholecalciferol in patients with recent-onset T1D. Prospective, phase II, open trial, pilot study in which patients with recent onset T1D received ASCs (1 × 10 cells/kg) and cholecalciferol 2000 UI/day for 3 months (group 1) and were compared to controls with standard insulin therapy (group 2). Adverse events, C-peptide (CP), insulin dose, HbA1c, time in range (TIR), glucose variability (continuous glucose monitoring) and frequency of CD4FoxP3+ T-cells (flow cytometry) were evaluated at baseline (T0) and after 3 months (T3). 13 patients were included (8: group 1; 5: group 2). Their mean age and disease duration were 26.7 ± 6.1 years and 2.9 ± 1.05 months. Adverse events were transient headache ( = 8), mild local reactions ( = 7), tachycardia ( = 4), abdominal cramps ( = 1), thrombophlebitis ( = 4), mild floaters ( = 2), central retinal vein occlusion ( = 1, complete resolution). At T3, group 1 had lower insulin requirement (0.22 ± 0.17 vs. 0.61±0.26IU/Kg; = 0.01) and HbA1c (6.47 ± 0.86 vs. 7.48 ± 0.52%; = 0.03) than group 2. In group 1, 2 patients became insulin free (for 4 and 8 weeks) and all were in honeymoon at T3 (vs. none in group 2; = 0.01). CP variations did not differ between groups (-4.6 ± 29.1% vs. +2.3 ± 59.65%; = 0.83). Allogenic ASCs + cholecalciferol without immunosuppression was associated with stability of CP and unanticipated mild transient adverse events in patients with recent onset T1D. NCT03920397.

Nefopam is a non-opioid, non-steroidal, central acting drug used effectively for postoperative pain. The efficacy of nefopam for cancer pain remains unclear. We aimed to evaluate the analgesic efficacy of nefopam for cancer pain in a randomized controlled trial. : Patients with moderate to severe cancer pain (n=40) were randomly divided into two groups. The nefopam group (n=20) received three 20 mg doses of nefopam every 8 hours. The placebo group (n=20) received normal saline. Intravenous patient-controlled analgesia with morphine was given for breakthrough pain for 48 hours. The primary outcome was significant pain reduction. Secondary outcomes were morphine consumption over 48 hours and incidence of side effects. The nefopam group showed pain reduction at 12 hours (65% of patients), 24 hours (80%), 36 hours (85%), and 48 hours (65%). The placebo group showed pain reduction at 12 hours (70%), 24 hours (75%), 36 hours (80%), and 48 hours (60%). However, there were no statistically significant differences between the groups (p>0.05). The median dosage of morphine consumption in 48 hours was lower in the nefopam group (25.5 mg) compared with the placebo group (37 mg), but this was not statistically significant (p=0.499). There were no statistically significant differences in blood pressure and heart rate between the groups. Side effects in both groups were comparable. At dosage of 60 mg in 24 hours, nefopam did not provide significant pain reduction in moderate to severe cancer pain patients. However, there was a trend of reduced opioid consumption. Further studies with larger sample sizes, longer duration, or higher doses of nefopam are warranted. Thai Clinical Trail Registry (TCTR) ID TCTR20181016001; registered on 12 October 2018.

Novel anaesthetic formulation LHT-15-32 was studied. The experimental study involved 66 white mice, 15 Rana radibunda frogs and 50 male Sprague Dawley rats. Its acute intravenous and subcutaneous toxicity was determined in mice. Pain sensitivity threshold of upper second molar was determined in rats with experimental periodontitis. Oxidative stress activity and total antioxidant capacity were determined in rats' gingival mucosa by induced chemiluminescence. Tissue IL-1β, IL-10 and TNF-a concentration was quantitatively assessed by ELISA. LHT-15-32 Na-blocking activity was studied on isolated neurons of Limnea stagnalis para-pharyngeal ganglion. Rana radibunda isolated sciatic nerve was perfused with LHT-15-32 to assess its conductivity. LHT-15-32 acute intravenous and subcutaneous toxicity was lower then that of its active substance LHT-4-00. The formulation infraorbital administration induced deep dental anaesthesia lasted longer than 70 min, activated local antioxidant defence system and decreased IL-1β level in gingival tissue. At 10 to 10 M LHT-15-32 inhibited sciatic nerve conductivity and blocked Na-channels of isolated neurons in dose-dependent manner. LHT-15-32 proved to be less toxic than active substance and lidocaine. The agent provides deep and prolonged anesthesia of the upper molar of rats in chronic apical periodontitis, lowers tissue concentration of pain cascade cytokines and oxidative stress activity and suppresses the action potential amplitude of a sensory nerve due to Na-blocking activity.

Histamine H1 receptor antagonists (antihistamines) are recommended as adjunctive therapy for atopic dermatitis (AD). However, their long-term usefulness and the effect of updosing have not been clarified.

Endometriosis is a chronic disease that involves the development of endometrium outside the uterine cavity with pain component predominance. The aim of the study was to discuss the occurrence of health problems in patients with endometriomas and simple cysts and the effect of these problems on the daily functioning of the patients.

 A persistent left superior vena cava (PLSVC) is the most common congenital anomaly of the thoracic venous return.  During atrial septal defect repair, a pulmonary artery (PA) catheter was placed via the left internal jugular vein. Although placement of the PA catheter in the main PA was confirmed by transesophageal echocardiography, the central venous pressure (CVP) waveform was abnormal. Intraoperatively, the PA catheter was seen exiting the coronary sinus with the CVP port within the coronary sinus.  The diagnosis of PLSVC is discussed and the differential diagnosis of the abnormal "ventricular" pattern of the CVP waveform is reviewed.