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It’s Not De Quervain Tenosynovitis – A Diagnosis to Consider in Persistent Wrist Pain.

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Fremantle Back Awareness Questionnaire in Chronic Low Back Pain (Frebaq-I): Translation and Validation in the Indian Population.

The Fremantle Back Awareness Questionnaire (FreBAQ) has been found to possess adequate psychometric properties in low back pain (LBP) patients worldwide. The aim of this study was to translate the questionnaire into a classical Indian language (Odiya) and validate in the Indian population (FreBAQ-I).

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Comparison of Analgesic Efficacy of Ultrasound-Guided Transversus Abdominus Plane Block and Caudal Block for Inguinal Hernia Repair in Pediatric Population: A Single-Blinded, Randomized Controlled Study.

Caudal analgesia was a widely practiced regional anesthesia technique in pediatric population. Transversus abdominus plane block (TAP) block has recently emerged as a promising analgesic method in pediatric lower abdominal surgeries.

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The sex difference in gait speed among older adults: how do sociodemographic, lifestyle, social and health determinants contribute?

This study explores whether a sex difference in sensitivity to (strength of the association) and/or in exposure to (prevalence) determinants of gait speed contributes to the observed lower gait speed among older women compared to men.

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[Joint hypermobility syndrome].

Joint hypermobility syndrome is an inherited disorder with autosomal dominant pattern; is characterized by joint hyperlaxity and musculoskeletal pains. Thermal hypermobility refers to the increase in active or passive movements of joints based on their normal ranges. Joint hypermobility syndrome also has gastrointestinal symptoms, sleep disorders, fibromyalgia, psychological disorders, migraine headache, ophthalmic, autonomic, among others. To diagnose hypermobility syndrome, Brighton's criteria are generally accepted and published in 1998. This criteria also known as benign joint hypermobility syndrome. The term benign is used to distinguish it from other more severe conditions such as Ehler-Danlos (classic or vascular type), Marfan syndrome, and imperfect osteogenesis. Treatment with physiotherapy and pharmacological means help improve patients' quality of life.

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Emergency Department Utilization Among People Living With HIV on Chronic Opioid Therapy.

Chronic pain among people with HIV (PWH) is a driving factor of emergency department (ED) utilization, and it is often treated with chronic opioid therapy (COT). We conducted a cross-sectional analysis of a prospective observational cohort of PWH on COT at 2 hospital-based clinics to determine whether COT-specific factors are associated with ED utilization among PWH. The primary outcome was an ED visit within 12 months after study enrollment. We used stepwise logistic regression including age, gender, opioid duration, hepatitis C, depression, prior ED visits, and Charlson comorbidity index. Of 153 study participants, n = 69 (45%) had an ED visit; 25% of ED visits were pain-related. High dose opioids, benzodiazepine co-prescribing, and lack of opioid treatment agreements were not associated with ED utilization, but prior ED visits (p = 0.002), depression (p = 0.001) and higher Charlson comorbidity score (p = 0.003) were associated with ED utilization. COT-specific factors were not associated with increased ED utilization among PWH.

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Presence of opioid safety initiatives, prescribing patterns for opioid and naloxone, and perceived barriers to prescribing naloxone: Cross-sectional survey results based on practice type, scope, and location.

The opioid epidemic is a public health crisis in the United States (US) and is associated with devastating consequences, including opioid misuse and related overdose. In response to the opioid crisis, the US Department of Health and Human Services is advancing improved practices in pain management. Strategies to help mitigate opioid risks include physician safety programs, hospital- or practice-based initiatives, patient education, and harm reduction campaigns that include the use of naloxone. To date, little information is available regarding the use of these strategies among healthcare providers. A survey was conducted to identify the presence of opioid safety initiatives, prescribing patterns of opioids and naloxone, and perceived barriers to prescribing naloxone. The presence of these strategies was compared between different practice types (hospital-based/academic vs. private practice), practice scope (chronic pain vs. "other"), and practice location (in the US vs. outside the US) Regarding "outside the US," the actual geographical distribution of those countries was not captured by respondents.

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Posterior Fossa Epidural Hydatid Cyst in the Adult.

Hydatid cyst is an important parasitic disease especially in endemic regions. Hydatid cysts are most commonly found in the liver and lungs and only 1% to 2% of the cysts reach the brain. Intracranial hydatid cysts are usually supratentorial and majority of cases are children and young adults. In this case report, a 55-year-old woman who lives in rural area in Turkey, admitted to our clinic with severe headache, neck pain, gait disturbance, and vomiting. Her neurological examination revealed cerebellar ataxia and left dysmetria. Radiological findings were compatible with hydatid cyst. On the 3rd of antihelmintic therapy, the patient underwent suboccipital craniotomy and epidural cyst was excised using Dowling technique without rupture of the cyst wall. Patient's symptoms improved postoperatively. Although hydatid cyst in posterior fossa is a very rare entity, it should be kept in mind in patients with intracranial cystic lesions who live in endemic regions.

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Prevention of Pruritis following Spinal Morphine for Scheduled Cesarean Birth.

Intrathecal morphine provides effective analgesia after cesarean birth, yet up to 90% of women who receive it experience excessive itching, an undesirable dose-dependent effect. Pruritis may increase nursing workload, delay breastfeeding, and decrease patient satisfaction. When 0.1 mg spinal morphine is given, pruritis is markedly reduced while analgesia is preserved.

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How to remove those bloody collections: Nonsurgical treatment options for chronic subdural hematoma.

Chronic subdural hematoma (CSDH) is one of the most prevalent neurosurgical disorders. Patients with CSDH commonly present with altered mental status, focal neurological deficit, and/or headache. The first-line treatment for CSDH is surgical evacuation. Although the surgical procedures for CSDH have been considered relatively "straightforward," they are not without any risk. The elderly are especially prone to show poor surgical outcomes. To make matters worse, many elderly patients are on anticoagulants and antiplatelet agents, increasing the risk of re-bleeding before and after surgery. These complications have led clinicians to search for nonsurgical alternatives. Dexamethasone should be used with caution for selected patients given its side effects. Tranexamic acid may be utilized as an adjunct therapy to surgery, but more randomized clinical trials are needed to evaluate its definitive efficacy. Interesting results of middle meningeal artery embolization (MMAE) have been reported from case studies. However, the risks associated with MMAE, including intracerebral hemorrhage, stroke, and vasospasm, have not been properly studied yet. The clinical benefits of atorvastatin and angiotensin-converting enzyme inhibitors are uncertain for CSDH. In conclusion, surgical intervention continues to be the first-line treatment while nonsurgical treatment options may be considered an adjunct therapy especially for recurrent hematoma or to reduce the volume of a hematoma.

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