Rejected

Trochleitis has been recognized as one of the causes of eye pain and migraine headaches. This study attempts to investigate the effect of ibuprofen on reducing eye pain and migraine headaches caused by trochleitis.

Cerebral venous sinus thrombosis (CVST) is rare in children, increasingly being recognized of late due to advances in neuroimaging. The aim of the study was to describe the clinical, etiological, and imaging characteristics of CVST and its outcome in children.

Loss of smell or taste are often-cited complications during COVID-19 disease, but there is no clear evidence for affection of the peripheral nervous system.

Labor pain is one of the most intense pains that a woman experiences. Almost 60% of primiparous women described the pain of uterine contractions as unbearable extremely severe or excruciating.

To evaluate the influence of fear-avoidance beliefs, anxiety and depression on dynamic and motor control parameters before and after Functional Restoration Program.

Gout is one of the most common types of inflammatory arthritis. Four stages have been described in its evolution: asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout and chronic tophaceous gout. Monosodium urate crystals deposits are more frequently encountered in hyaline cartilage, tendon sheaths, articular bursae, bone epiphysis, synovium, and skin. Pathological fractures that occur at the formation sites of gout tophi have been rarely described in gout. Bimalleolar fractures often occur following a trauma. We present the case of a 56-year-old patient, diagnosed with chronic gout for over 12 years, with tophi in the upper and lower limbs, who presented accusing mechanical pain in the left tibio-tarsal joint and impaired function of the hands. The clinical examination showed bilateral multiple destructive gout tophi in the hands, forearms, elbows, feet, ankles, and lower legs, while the left ankle exhibited an important varus deformity. Computed tomography examination of the left ankle showed multiple gout tophi with bone erosions and a bimalleolar pathological fracture. The patient underwent pharmacological treatment, physical therapy and the ankle was immobilized in a knee-ankle-foot orthosis, with subsequent orthopedic surgical treatment for fracture fixation, to improve functional status. We have chosen to present this case given the multiple disabilities of the patient, which have improved following the rehabilitation treatment.

Thyroiditis is a general term for inflammation of the thyroid gland. The most common forms of thyroiditis encountered by family physicians include Hashimoto, postpartum, and subacute. Most forms of thyroiditis result in a triphasic disease pattern of thyroid dysfunction. Patients will have an initial phase of hyperthyroidism (thyrotoxicosis) attributed to the release of preformed thyroid hormone from damaged thyroid cells. This is followed by hypothyroidism, when the thyroid stores are depleted, and then eventual restoration of normal thyroid function. Some patients may develop permanent hypothyroidism. Hashimoto thyroiditis is an autoimmune disorder that presents with or without signs or symptoms of hypothyroidism, often with a painless goiter, and is associated with elevated thyroid peroxidase antibodies. Patients with Hashimoto thyroiditis and overt hypothyroidism are generally treated with lifelong thyroid hormone therapy. Postpartum thyroiditis occurs within one year of delivery, miscarriage, or medical abortion. Subacute thyroiditis is a self-limited inflammatory disease characterized by anterior neck pain. Treatment of subacute thyroiditis should focus on symptoms. In the hyperthyroid phase, beta blockers can treat adrenergic symptoms. In the hypothyroid phase, treatment is generally not necessary but may be used in patients with signs and symptoms of hypothyroidism or permanent hypothyroidism. Nonsteroidal anti-inflammatory drugs and corticosteroids are indicated for the treatment of thyroid pain. Certain drugs may induce thyroiditis, such as amiodarone, immune checkpoint inhibitors, interleukin-2, interferon-alfa, lithium, and tyrosine kinase inhibitors. In all cases of thyroiditis, surveillance and clinical follow-up are recommended to monitor for changes in thyroid function.

We report a case of sclerokeratouveitis with an unfavorable response to treatment. To the best of our knowledge, there are no previous reports of this fungus invading the sclera. A 68-year-old diabetic farmer male patient presented with a 3-week history of pain and redness and a decrease in visual acuity occurring 5 days before admittance in the right eye. Examination revealed severe mixed hyperemia and a scleral calcified plaque with a surrounding area of ischemia and lysis. The cornea showed diffuse infiltrates, stromal edema, and hypopyon. Initial scrapings were negative, and empiric antibiotics were started. After a fungus was reported, topical and systemic antifungals were initiated, but there was no clinical response. The eye was enucleated. A slow-growing fungus , resistant to voriconazole, was isolated. Fungal etiology must be kept in mind when dealing with infectious scleritis. Despite treatment, the outcome of this case was unfavorable due to the slow-growing nature of the fungus and this strain's resistance to voriconazole.