Rejected

Peripheral arterial diseases (PADs) is defined as a systemic arterial disorders involving the lower extremity arteries, iliac, and carotid, which is developed more common in patients with chronic kidney disease (CKD) than individual with normal renal function. Concurrence of mesenteric artery disease and lower extremity artery disease (LEAD) is rare. The presence of PADs in patients receiving hemodialysis leads to a dramatic increase in risk of cardiovascular mortality. However, the early diagnosis of PADs in patient with CKD remains a challenge to nephrologists, which adds an adverse effect on prognosis.

To compare the characteristics of neuropathic pain in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS).

This case report describes the long-term effect of the high-intensity laser therapy (HILT) in a patient with chronic shoulder pain refractory in comparison to other treatments.

Overloading of tendon tissue with resulting chronic pain (tendinopathy) is a common disorder in occupational-, leisure- and sports-activity, but its pathogenesis remains poorly understood. To investigate the very early phase of tendinopathy, Achilles and patellar tendons were investigated in 200 physically active patients and 50 healthy control persons. Patients were divided into three groups: symptoms for 0-1 months (T1), 1-2 months (T2) or 2-3 months (T3). Tendinopathic Achilles tendon cross-sectional area determined by ultrasonography (US) was ~25% larger than in healthy control persons. Both Achilles and patellar anterior-posterior diameter were elevated in tendinopathy, and only later in Achilles was the width increased. Increased tendon size was accompanied by an increase in hypervascularization (US Doppler flow) without any change in mRNA for angiogenic factors. From patellar biopsies taken bilaterally, mRNA for most growth factors and tendon components remained unchanged (except for TGF-beta1 and substance-P) in early tendinopathy. Tendon stiffness remained unaltered over the first three months of tendinopathy and was similar to the asymptomatic contra-lateral tendon. In conclusion, this suggests that tendinopathy pathogenesis represents a disturbed tissue homeostasis with fluid accumulation. The disturbance is likely induced by repeated mechanical overloading rather than a partial rupture of the tendon.

Faisalabad is one of the major industrial cities of Pakistan, which may cause noise pollution to the local residents due to the development of robust industrial and transport systems. This study aimed at (i) mapping the noise pollution levels at various locations of Faisalabad city; (ii) comparing noise pollution levels in the morning, the afternoon, and the evening for each source; and (iii) assessing nonauditory effects of noise on human health. Two industries and 43 famous/busy locations of Faisalabad Sadar were selected to study noise pollution by using the sound level meter for the period of 24 h. A questionnaire-based survey was carried out near the sampling points to get a public perception about the health impacts of noise pollution. The measured equivalent sound pressure levels (SPLeq) were higher than the permissible limits at all the sampling locations during morning, afternoon, and evening hours. The maximum sound pressure level (SPL) was 102 dB inside the production unit in the afternoon at Mian Muhammad Siddiq Textile Loom industry. The average SPL was found at State Bank road (102 dB), Children's Hospital (101 dB), Jhang Bazar (100 dB) in the afternoon and at Punjab Medical College in the evening (97 dB). Based on the survey, 94% of respondents reported headache, 76% sleeplessness, 74% hypertension, 74% physiological stress, 64% elevated blood pressure levels, and 60% dizziness due to noise. Noise pollution is higher than the standard limits and causes auditory as well as nonauditory effects on humans. The vehicles and industrial machinery should be maintained, and sound proofing and protection equipment should be provided to the workforce in order to protect them from extreme noise levels.

Chronic visceral pain is a complex and often a serious burden on patients' life. It is strongly implicated in the etiology of many diseases, which often are complicated by co-morbid depression and other psychiatric disorders, all of which pose significant health risks. Understanding the mechanisms of nociception is an important step in treating pain-associated chronic diseases. The inflammatory process that is often associated with nociception produces a number of mediators, which activate nociceptors by interacting with ligand-gated ion channels, activation of different signal transduction pathways or by sensitizing primary afferent neurons located within the dorsal root ganglia (DRG). Primary afferents studied or are well-accepted models to examine various nociceptive and anti-nociceptive signals in peripheral nervous system. This review focuses on the recent work in the area of peripheral modulation of chronic pain at the level of visceral primary afferent neurons. Many studies intended to develop a coherent framework for a better understanding of heterogeneity of nociceptive neurons functioning as a gate for pain transmission and novel therapeutic tool for pain relief. Specifically, recent studies from the author's research group helped to define the role of ATP-sensitive purinergic and vanilloid-sensitive TRPV1 receptors in DRG-mediated nociceptive pathways. Tropic and physiological changes associated with chronic visceral pain indeed are mediated through different pathways; therefore, designing new and specific anti-nociceptive therapies will have a major impact on quality of life in patients by significantly reducing pharmacological and therapeutic interventions.

Sports-related concussions affect over 280,000 adolescents each year while the general public remains ill-informed about concussions, signs/symptoms, and treatments. Adolescents may be at an increased risk for experiencing adverse physiological and psychological effects from concussions, underscoring the critical need for effective concussion education strategies. While mobile apps are increasingly being used in education and healthcare settings, none were found to offer comprehensive concussion education capable of reaching diverse audiences. The interactive mobile app "Rebound: Beating Concussions" has the potential to be an effective teaching tool for school athletic programs and medical professionals to communicate important concussion-related information to student athletes, parents, and sports coaches. A mixed methods study was used to determine the app's ability to convey information about concussions to student athletes in grades 5 through 12, parents of student athletes, and sports coaches. Concussion knowledge and participant opinions were assessed via a pre/post model and administered before and after app use. Participants demonstrated knowledge gains in the identification of concussion symptoms, treatments, and misconceptions. Additionally, participants demonstrated positive opinions on the content of the app, its relevance to everyday life, and its potential as a teaching tool.

Self-medication practice is the use of medications without healthcare professional requests. It can lead to inappropriate medication usage, wastage of resources, increased chance of microbial resistance, and adverse drug reactions. Therefore, this study aimed at assessing the prevalence and associated factors of self-medication practice among teachers' education training college students in the Amhara region, Ethiopia. A multicentre cross-sectional study was conducted on 344 teachers' education training college students in the Amhara region, Ethiopia, from January 1 to February 28, 2020. Data on sociodemography, the practice of self-medication, and factors associated with self-medication practice were collected through a self-administered structured questionnaire. Systematic random sampling was used to select participants. Descriptive statistics and univariate and multivariate logistic regression analyses were done to determine various variables and factors associated with self-medication practice. Out of the 344 respondents, 234 (68.0%) practiced self-medication. The most commonly cited indication for self-medication practice was headache (75, 32.05%), followed by abdominal discomfort (53, 22.6%). The respondents who were older than 26 years of age (AOR: 2.47, 95% CI: 1.18-3.94), were in the third year of study (AOR: 3.14, 95% CI: 1.94-5.79), lived in urban residence (AOR: 2.97, 95% CI: 1.06-3.64), had accessibility to a nearby pharmacy (AOR: 2.12, 95% CI: 1.43-4.46), and had peer/family pressure (AOR: 2.34, 95% Cl: 1.53-3.56) were significantly associated with self-medication practice. More than two-thirds of the study participants practiced self-medication. Being from an urban area, having access to a private pharmacy, and higher year of study positively affect self-medication practice.

This review aimed to present the current evidence-based answers to a questionnaire which was developed to evaluate the beliefs and knowledge of dental professionals concerning temporomandibular disorder (TMD). A literature review was conducted using the PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane, Google Scholar, and Scopus search engines from January 1980 to June 2020 corresponding to TMD diagnosis, causes, management, and consequences. A total of 50 articles were considered relevant and selected for full review. The etiology of TMD is multifactorial and complicated and involves several direct and indirect factors. Orthodontic treatment does not appear to either prevent or relieve TMD to a great degree. Nevertheless, condylar and occlusal stability reduces the risk of TMD development. As a result, an assessment of the function of masticatory system prior to beginning orthodontic therapy is fundamental. If signs and symptoms of TMD are significantly present, they should be managed before any orthodontic intervention. Moreover, psychological disorders are strongly associated with joint and facial pain. Thus, professionals who work with chronic TMD patients need to be aware of the psychological aspects of chronic pain and refer the patient for psychological evaluation when warranted. Future research elucidating a cause-effect relationship and neurobehavioral processes underlining chronic pain should be performed.

Extremity vascular injury (EVI) causes significant disability in Veterans of the Afghanistan/Iraq conflicts. Advancements in acute trauma care improved survival and decreased amputations. The study of wartime EVI has relied on successful limb salvage as a surrogate for vascular repair. We used imaging studies as a specific measure of arterial repair durability.