Rejected

Thoracotomy is one of the most painful surgeries; therefore, video-assisted thoracoscopic surgery (VATS) was developed to reduce the surgical stress of thoracotomy. Although VATS results in reduced postoperative pain compared with thoracotomy, it is still painful. Serratus plane block (SPB) is a novel technique that provides lateral chest wall analgesia by blocking the lateral branch of the intercostal nerve.

Thoracotomy is associated with significant postoperative pain. While postoperative pain control after thoracotomy is most commonly managed with a thoracic epidural or paravertebral catheter, both are fraught with significant risks and are technically challenging to perform in pediatric patients. The erector spinae plane block is a relatively novel, easy-to-perform block used to provide thoracic wall analgesia. We present a case of a pediatric patient undergoing thoracotomy whose postoperative pain was managed with an erector spinae plane catheter.

Cisplatin (Cis) is an anticancer compound, which is used for the treatment of various cancers. Sumatriptan (Suma) is a selective agonist of 5-hydroxytryptamine 1B/1D (5HT1B/1D) receptor, which is prescribed for the management of migraine. It is well-established that Suma has anti-inflammatory and antioxidant properties. We have explored the protective effects of Suma in the mitigation of Cis-induced nephrotoxicity.

Kaposi sarcoma (KS) is a mesenchymal neoplasm associated with human herpes virus-8. It is often found in patients with primary or secondary immunodeficiency. An iatrogenic form of KS is detectable in patients who have received immunosuppressive therapy. To date, there are few reported cases of patients with KS treated with immunosuppressants for inflammatory bowel disease.

To report preliminary psychometric properties of PROMIS® assessments among emerging adults with sickle cell disease (SCD).

Acquired (non traumatic) brain herniation through the ethmoid is rarely associated with an intracranial mass away from the anterior skull base. A 55-year-old diabetic woman presented with progressive frontal headache, anosmia, and blurred vision without rhinorrhea. Brain MRI showed an intracranial tumor of the left frontal convexity associated with a herniation of the frontal brain (encephalocele) into the left nasal cavity. CT-scan confirmed the anterior skull base defect. The intracranial tumor was totally excised following a left frontal craniotomy with a good outcome. Pathological examination revealed a meningothelial meningioma. However, the patient and her family refused any surgery for the ethmoidal encephalocele. In our case report, this rare phenomenon (secondary non traumatic encephalocele) probably occurred due to long-term increase of the intracranial pressure generated by the meningioma.

Iron deficiency anemia (IDA) is a well-known cause of stroke in children, but its association is relatively rare in adults. We describe a case of 36-year-old woman, a known diabetes mellitus, who presented with recurrent vomiting, headache, and altered sensorium. Investigations revealed severe iron deficiency anemia, thrombocytosis, and ketoacidosis. Magnetic resonance imaging suggested acute infarct of B/L parieto-occipito-temporo-cerebellar region. Patient was worked up for possible causes of stroke in young. She underwent computed tomography angiography of the brain, echocardiogram, and screening for thrombophilia disorders. This, however, did not demonstrate a clear etiology and there were no other evidences of diabetic angiopathy. Some previously published case reports have suggested IDA as a potential cause of ischemic stroke; it is possible that the stroke in this young woman was attributable to severe IDA. Whether cerebrovascular accident has led to diabetic ketoacidosis or vice versa is a topic of discussion which needs further studies. Moreover, such catastrophes could be prevented by early diagnosis and timely management through involvement of primary care physicians.

Intranasal lidocaine has been shown to be effective in treating patients with acute migraines; however, its efficacy is still controversial. The aim of our study is to assess the efficacy and safety of intranasal lidocaine compared with a placebo or an active comparator for the treatment of acute migraine.

Percutaneous radiofrequency (RF) denervation of articular sensory nerves of the hip joint is a minimally invasive neurotomy technique that can provide pain relief in patients with chronic hip pain. There has been an increase in the number of publications on RF denervation of the hip over the last few years although many questions remain regarding anatomical targets, technical aspects, selection criteria, and evidence for effectiveness.

Cluster headache is a primary headache characterized by recurring excruciating pain and autonomic signs, leading to significant suffering and derangement of patients' life. Efficacious new preventive treatments are needed. The pathophysiology of cluster headache comprises mechanisms both in the peripheral and central nervous system, involving the trigeminovascular system, the trigemino-parasympathetic reflex, and central modulating systems. Calcitonin gene-related peptide (CGRP) has an active role throughout these systems. It is increased during spontaneous and provoked attacks, and itself can induce attacks. Recently, drugs against this neuropeptide have been developed for the treatment of different headache disorders. In particular, monoclonal antibodies vs CGRP as galcanezumab and fremanezumab have been tested in cluster headache, with promising results for the episodic form. Considering the relevance of central mechanisms in CH, drugs interfering with the CGRP pathway in the central nervous system can enlarge the therapeutic armamentarium against this highly disabling condition.