Rejected

Delivery hemorrhage is the leading cause of maternal mortality in Morocco. It is an obstetric emergency requiring early, effective and multidisciplinary management in patients with severe postpartum bleeding resistant to medical treatment. Advances in interventional radiology and especially, in surgical techniques have provided safe and effective alternatives to hemostasis hysterectomy . We here report a case of uterine necrosis following conservative surgical treatment of delivery hemorrhage based on B-Lynch uterine compression suture combined with Tsirulnikov triple vascular ligation. The patient had sepsis on day 4 after delivery associated with fever and pelvic pain and biological inflammatory syndrome which worsened 48 hours after the onset of abdominal contracture. Abdomopelvic scanner, showed gas bubbles in the uterine myometer suggestive of necrosis. Exploratory laparotomy was performed, which objectified complete necrosis of the uterus. Uterine compression sutures are surgical techniques which play a major role in the therapeutic armamentarium of postpartum hemorrhage during cesarean section. It allows, in addition to or as an alternative to vascular ligation, the preservation of patient's fertility, but it also requires maximum caution and monitoring of complications, the most serious of which is uterine necrosis.

This article critiques the idealization of a biomarker-based "objective pain scale" in order to argue for increased investment in communication-centric approaches to chronic pain diagnosis and treatment. Although new technological advances and the rise of big data have revived old fantasies of objective pain measures, scholars have long affirmed the dangers of converting human experience into numbers, as well as the fundamental impossibility of reducing pain to physiology. Biomarkers can certainly be useful tools, but investments must also be made in fostering the "strong objectivity" that feminist scholars have advocated for and that the incorporation of narrative-driven initiatives can provide. Because expressing pain is notoriously difficult, doing this creative, communication-driven work well requires substantial effort, time, and training. Engaging with chronic pain from a feminist standpoint-one that affirms individuals' situated experiences as valuable data and that attends to the rich multi-modal vocabularies emerging on social media-can pave the way to a more equitable, ethical, and effective future of pain care.

Subdural fluid collection in patients with internal cerebrospinal fluid (CSF) shunts has generally been linked to overdrainage and more rarely to pus accumulation. The authors present a previously unrecognized condition leading to extra-axial CSF accumulation: shunt underdrainage. Treatment of coexisting subdural fluid collection and hydrocephalus, disorders that have previously only been reported concurrently following head trauma or subarachnoid hemorrhage, is controversial. In addition, we intend to provide insight into the physiopathology of abnormal CSF accumulation within both the subdural space and ventricles simultaneously.

Adult sellar region atypical teratoid/rhabdoid tumor (AT/RT) is a rare lesion. We aimed to elucidate clinical, radiologic, and pathological characteristics, treatment strategies, and outcomes of this disease. Five adult sellar AT/RT patients were retrospectively analyzed between January 2015 and December 2018. In addition, we performed a review of the reported data on adult sellar AT/RT. Patients ( = 5) were female with a median age of 50 years. The mean duration of symptoms, of which headache was the most frequent, was 1.6 months (range, 2 weeks-8 months). The average tumor size was 2.82 cm (range, 1.9-4.5 cm). All lesions were irregularly shaped. MRI showed heterogeneous enhancement in three of five lesions. Four of five patients underwent subtotal resection (STR) and one gross total resection (GTR). Whereas, one patient received post-operative adjuvant radiotherapy, one patient received post-operative combination of radio- and chemotherapy. The review of the reported data showed that 39 cases of adult sellar AT/RT had been reported. The estimated median overall survival (OS) was 23 months with a 1-year survival estimate of 59.7%. The median OS for patients with GTR was 28 months and 17 months for patients with STR. Kaplan-Meier analysis showed that patients with high (≥35%) MIB-1/Ki67 index value had a significantly shorter OS compared with those with low (<35%) index value ( = 0.033), and that patients who received post-operative combination radio- and chemotherapy had longer OS than that of those who did not ( < 0.001). Adult sellar region AT/RT is a rapidly growing tumor with a poor prognosis. High levels of MIB1/Ki-67 on histology may indicate aggressive feature of the tumor. Maximal safe resection followed by adjuvant radiotherapy combined with chemotherapy may be the optimal therapeutic strategy for adult sellar region AT/RT.

Low back pain is a prevalent symptom that occurs in all age of people, whereas the pathogenesis is unknown. Iliopsoas tendinopathy is an increasingly recognized hip disorder that may contribute to low back pain. Our purpose is to evaluate the effect of ultrasound-guided local injection of anesthetic and steroid into the trigger point of iliopsoas tendon in treating low back pain caused by iliopsoas tendinopathy.

There are 75,000 neck of femur (NOF) fractures that occur each year in England and Wales. Prompt, adequate analgesia is a major priority in hip fracture management to reduce the risk of delirium and facilitate earlier return to mobility and independence. NICE guidelines recommend the use of fascia iliaca block (FIB) for NOF fracture patients. Current literature suggests that FIB significantly improves pre-operative pain scores; however despite this, the uptake of FIB still varies between centers.

Rheumatoid arthritis (RA) and periodontal disease (PD) are common chronic, immunoinflammatory, destructive, and progressive diseases; however, the correlations between those two are not yet widely discussed. The purpose of this study was to evaluate the relationship between the selected demographic and clinical parameters of RA patients and oral health status parameters, on the basis of self-assessment.

Physical, chemical, thermal injuries along with infectious diseases lead to acute pain with associated inflammation, being the primary cause of hospital visits. Moreover, neuropathic pain associated with diabetes is a serious chronic disease leading to high morbidity and poor quality of life.

Treatment of peripheral neuropathic pain (PNP) remains a challenge. In the absence of clear predictors of response, clinical decision-making involves trial and error. While many classes of pharmacological agent are used and have shown efficacy, one of the most commonly used first-line treatments is pregabalin. However, in the 60% of PNP cases in which the pain is localized, a local treatment may be more suitable. This article will summarize the evidence for the relative effectiveness and tolerability of the capsaicin 179 mg patch and pregabalin in the treatment of PNP and highlight the expert opinion of the authors based on their own clinical experiences.

[This corrects the article DOI: 10.1155/2020/2094948.].