Rejected

The study aimed to compare the clinical efficacy, safety, and acceptability of buffered lidocaine (8.4% sodium bicarbonate and 2% lidocaine with 1:80,000 adrenaline) versus non-buffered lidocaine (2% lidocaine with 1:80,000 adrenaline) during inferior alveolar nerve block.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder of the hair follicle characterized by intense discharge and pain. Recently, HS intrinsic association with neuropsychiatric disorders has become a focus of attention, and bipolar disorder (BD) emerged as a relevant topic for such an association.

We present a unique case of a 75-year-old Caucasian female who presented with a two-month history of unrelenting proximal muscle pain and stiffness in the neck, shoulders, and pelvic girdle that lasted for 45 minutes each morning upon waking. Due to clinical suspicion of polymyalgia rheumatica (PMR), the patient was started on the standard therapy of low-dose glucocorticoid therapy and was noted to have a dramatic improvement in terms of pain, strength, mobility, and range of motion. Current literature shows high variability in the standard response time to treatment. Typical resolution of symptoms occurs within a span of one day to months. The case presented in our study shows symptom resolution as well as marked improvement in muscle strength and mobility within 12 hours. The purpose of this case report is to provide additional information for physicians when considering symptom-resolution time related to low-dose glucocorticoid therapy and PMR. Additionally, we briefly explore the literature on the correlation between giant cell arteritis (GCA) and glucocorticoid therapy for PMR as well as the data associated with adjuvant therapy using immunomodulatory treatment.

Colonic diverticulitis is one of the most common gastrointestinal diseases. There are several complications in colonic diverticulitis, such as stenosis, perforation, and abscess. Stenosis is a rare complication and can cause bowel obstruction. We report a case of colonic diverticulitis complicated by stenosis causing bowel obstruction. A 66-year-old Japanese man was referred to our hospital for abdominal pain. Computed tomography (CT) scans showed the presence of diverticula, concentric wall thickening, and pericolic fat stranding in the descending colon. He was diagnosed with descending colon diverticulitis. His abdominal pain improved with fasting and intravenous antibiotics. However, after three months, diverticulitis complicated by stenosis occurred in the descending colon. The stenosis was severe and was treated with left hemicolectomy. Histologic examination revealed diverticula, chronic inflammation, and fibrosis in the stenosis, with no malignancy. Stenosis caused by colonic diverticulitis can cause bowel obstruction. Conservative treatment may lead to recurrence, and surgical treatment is preferable.

Transient global amnesia (TGA) is an uncommon clinical syndrome characterized by short-term memory loss and disorientation that resolves in 24 h. Here, we report a 60-year-old male patient who presented with a sudden onset of disorientation and short-term memory loss and started to ask about his whereabouts and what happened. He had no significant past medical or psychiatric disorder. Likewise, the patient did not have a recent history of head trauma, substance abuse, loss of consciousness, seizure disorder, or migraine. Neurologic examination was normal except for mild disorientation and short-term memory impairment. He had a score of 18/30 on the mini-mental state examination. Extensive laboratory investigations did not show any abnormal findings. Brain MRI and EEG were normal. His memory improved and returned to a normal baseline within 24 h from the onset. After the exclusion of potential causes and the patient returned to a normal state of memory, the diagnosis of transient global amnesia was made. At the follow-up visit, the patient was in a state of normal function without a recurrence of memory impairment. Here, we presented this interesting case of transient global amnesia. TGA is a diagnosis of exclusion and is essential to keep in mind when evaluating a patient with acute onset of short-term memory impairment, especially when etiological investigations reveal no potential cause.

Ropeginterferon alfa-2b is a novel mono-pegylated, extra-long-acting interferon. It is administered infrequently and showed good tolerability and clinical activity for the chronic hepatitis B or C treatment in our previous Phase 2 clinical trials. This study aims to validate the potency and safety of this novel agent in a Phase 3 chronic viral hepatitis setting.

An impaired immune system in the perioperative period has important clinical implications in patients with cancer. Despite the immunosuppressive properties of opioid therapy, it is still commonly utilized in the intrathecal or epidural space for the treatment of postoperative pain. Also, intrathecal dexmedetomidine has extended analgesic efficacy in postoperative pain; it can significantly affect immune function in perioperative patients.

The study was conducted to evaluate efficacy of intracameral lidocaine hydrochloride 1% and tropicamide injection 0.02% for anaesthesia and mydriasis in manual small-incision cataract surgery (MSICS) and to report any adverse drug reaction.

The safety, tolerability, and efficacy of the non-bile acid farnesoid X receptor agonist tropifexor were evaluated in a phase II, double-blind, placebo-controlled study as potential second-line therapy for patients with primary biliary cholangitis (PBC) with an inadequate ursodeoxycholic acid response.

An osteolytic lesion on imaging can be considered malignancy until proven otherwise. However, advanced stages of gout have presented with sclerotic rims and lytic lesions thought to be due to overexpression of osteoclasts. Patients have been found to demonstrate osteolytic lesions in patellar regions, which are common locations for gout to manifest; however, to our knowledge, no other cases of osteolytic gout in the acromioclavicular joint have been reported at this time. We report a rare case of a 56-year-old male who presented with acute-on-chronic left upper extremity pain and was found to have an osteolytic lesion of the shoulder on imaging. This lesion was later biopsied and found to be histologically consistent with gout. This case report aims to elucidate further understanding of the various ways that gout can present, to diagnose and treat these patients more effectively.