Rejected

[This corrects the article DOI: 10.1016/j.bjae.2021.12.008.].

Bladder pain syndrome (BPS)/interstitial cystitis (IC) is a debilitating condition characterised by bladder/pelvic pain and pressure as well as persistent or recurrent urinary symptoms in the absence of an identifiable cause. It is hypothesised that in addition to organ specific visceral hypersensitivity, contributions of the hypertonic pelvic floor, peripheral sensitisation, and central sensitisation exacerbate this condition. The aim of this paper is to investigate outcomes of treating underlying neuromuscular dysfunction and neuro-plastic mechanisms in BPS/IC patients.

Fractures of the lesser tuberosity of the humerus are typically traumatic in nature, most commonly occurring in association with multi-part fractures of the humeral head, often in the setting of a posterior shoulder dislocation. Isolated fractures of the lesser tuberosity are considerably more rare and are difficult to diagnose on standard shoulder radiographs without an axillary view. These fractures have been associated with 3 main types of injury: acute abduction/external rotation injury, acute injury or repetitive stress injury in adolescent overhead or throwing athletes, and rarely as a seizure associated injury. The mechanism of injury in these cases has been posited to relate to the subscapularis tendon, either resisting forced abduction/external rotation in the setting of trauma, exerting chronic or acute avulsive traction in the setting of adolescent overhead or throwing athletes, or violently contracting and avulsing the lesser tuberosity in the setting of seizures. We present an unusual case of a 27-year-old male with a history of alcohol use disorder with bilateral shoulder pain after minor trauma and observed seizure-like activity. Clinical work-up revealed bilateral isolated avulsion fractures of the lesser tuberosities, which was thought to be on the basis of seizure-related violent contraction of the subscapularis muscles. The clinical relevance of this case is that a high clinical index of suspicion is needed in order to detect lesser tuberosity avulsion fractures and avoid the consequences of untreated injury such as instability or impingement.

Multimodal perioperative pain management including nonopioid analgesia is a major pillar of enhanced recovery after surgery programs. The aim of this study was to investigate the analgesic efficacy of the preoperative combination of 2 nonopioid drugs, oral pregabalin and intravenous magnesium sulfate, in patients undergoing posterolateral lumbar spinal fusion.

Background Plantar heel pain (PHP) can be a common medical complaint among people with both sedentary and active lifestyles due to varied causes. It can affect the quality of life and result in significant disability. Despite many studies on PHP, few have focused on a specific population, such as school teachers. School teachers represent a significant proportion of the population of Medina, and addressing such a complaint and its possible relevant factors, which are most likely to be common among them due to their comparable job duties, will aid us in determining the relationships between personal characteristics, work-related factors, and PHP, as well as in formulating management plans. This study aims to identify the prevalence of PHP and its determinants among school teachers in the Medina region of Saudi Arabia. Methodology This cross-sectional study aims to identify the prevalence of PHP in school teachers. It was conducted in the Medina region of Saudi Arabia. A self-administered, online, validated questionnaire was created and used for data collection. Consent was taken from all participants before answering the questionnaire. Participation was voluntary, and all participants could withdraw from the study at any time. Data were kept confidential and only accessible by the primary investigator, co-investigators, and the statistician; hence, secondary and tertiary blinding was not done. Results Among those who reported PHP, the highest prevalence was among those who did not exercise regularly (94.7%), followed by middle-aged women (64.3%) and those with a high body mass index (44.5%), previous foot problems (43.2%), and chronic medical diseases (41.9%). PHP was less prevalent in male teachers, those with normal body mass index, and those who spent less time standing, had no previous foot problems, and exercised regularly. Most (88.1%) participants with PHP had other musculoskeletal pain, particularly in the lower back (62.6%) and knee (40.1%). Conclusions Teachers can be apprised about the importance of consuming a well-balanced diet and exercising regularly to maintain a healthy weight. We advocate educational programs as they can assist people to understand the need to obtain medical help when they are experiencing pain.

Introduction Normal pressure hydrocephalus (NPH) has conventionally been treated by placement of a ventriculoperitoneal shunt. However, it can also be treated with a less invasive technique, an endoscopic third ventriculostomy (ETV). Unfortunately, there is a lack of evidence on the characteristics of NPH patients who are most likely to benefit from ETV. This study seeks to identify if patients at risk of dementia with NPH should be candidates for an ETV. Methodology Thirty-six NPH patients who underwent ETV at two institutions between July 2007 and December 2014 were pre-surgically assessed for various risk factors. At the time of ETV, a cortical biopsy was obtained and assessed for plaques consistent with dementia. Post-procedure, patients were followed and assessed for symptoms such as gait improvement, headache, memory problems, incontinence, and dementia. ETV success was defined as an improvement in gait. Results The mean age of patients with successful ETVs was 65.8 ± 6.0 versus 74.5 ± 7.0 for failed ETVs. Sixty-seven percent of patients with negative biopsies showed gait improvement by the final follow-up appointment as compared to only 33% of patients with positive biopsies (p>0.05). Younger age was correlated with successful ETV (p=.003). Memory disturbance (p<0.05) and incontinence (p<0.05) after surgery were both associated with a lack of gait improvement at the final follow-up. Conclusion Biopsy was not a significant predictor of ETV success; however, there was a correlation between younger age and ETV success. Additional studies are required to determine if there is a relationship between cortical biopsy findings and ETV success.

We are presenting a case of complicated unsafe abortion that landed in sepsis. A 21-year-old morbidly febrile but conscious female patient was brought on a stretcher by her attendants in the Gynecology emergency room. A foul fecal stench was coming from her body. On detailed and sympathetic questioning, the patient revealed she underwent an abortion by a local birth attendant in her village at 19 weeks of pregnancy. After that, she had pain abdomen, intermittent bleeding per vagina, difficulty in passing stool, loss of appetite, and fever. She took some local treatment but her condition gradually deteriorated and fecal-smelling vaginal discharge started. The patient was immediately shifted to the Intensive Care Unit. The decision for laparotomy was made by the team of gynecologists and surgeons as the patient's condition was not improving. During laparotomy, fetal parts present in the paracolic gutter were taken out. Post laparotomy, the patient was shifted to ICU, and her condition gradually improved then she was shifted to the recovery ward after five days.

Introduction Menopause is an important period in a woman's life. It is the permanent cessation of menses for 12 months or more. Menopause can develop over a long period of time. The average age for menopause to start is 52 years, but it can begin at any time from age 40 to 58 years. Many symptoms are related to postmenopausal syndrome: hot flashes, irritability, mood swings, insomnia, dry vagina, difficulty concentrating, mental confusion, stress incontinence, urge incontinence, osteoporotic symptoms, depression, headache, and vasomotor symptoms. Quality of life (QOL) has been defined by the World Health Organization (WHO) as an "individual's perceptions of their position in life in the context of the cultural and value systems in which they live and in relation to their goals, expectations, standards, and concerns." Methods A cross-sectional study was conducted among participants from Aseer's Healthy Cities. The sample was calculated using the formula of Swinscow and Cohen, and a total of 823 main cities were the target sample size. The sample was simply picked at random from October to December 2021. The Menopause Rating Scale (MRS)-related questionnaire is used to evaluate the symptoms of menopause in people who answer the questions themselves. Result The study included 869 participants, 98.3% of which are Saudi nationals. Of the participants, 82.1% were married. As regards the lifestyle of the participants in the study, 69% live with a husband and children. The mean age of the study participants was 42.5 (standard deviation (SD): 8.883) years. The mean number of participants with somatic vasomotor symptoms was 0.74 (SD: 94). The majority of the participants have sleep issues such as difficulty falling asleep, difficulty sleeping through the night, and waking up early (mean: 0.97, SD: 1.3), followed by hot flashes and sweating (mean: 0.65, SD: 1.165), and heart discomfort (mean: 0.63, SD: 12). Psychosocial symptoms are also common (mean: 0.95, SD: 1.16); the majority have depressive moods (mean: 1.09, SD: 1.35), followed by irritability (mean: 0.93, SD: 1.2), and anxiety (mean: 0.84, SD: 1.22). Physical symptoms are also prevalent, with a mean and SD of 0.91 and 1.03, respectively, with bladder problems having a mean and SD of 0.55 and 1.017, respectively. Finally, there were also sexual symptoms (mean: 0.70, SD: 1.09), with sexual problems having a mean and SD of 0.81 and 1.28, respectively. Conclusion The study found a high percentage of unawareness about menopause and a need to improve healthcare access and symptomatic treatment. The regression model of psychosocial risk factors is found to have a significant association with the increase of symptoms and using other medications for any reason, menstrual cycle pattern, and marital status.

Both corticosteroids and hypertonic dextrose injections are commonly used for chronic supraspinatus tendinopathy.