Rejected

For effective patient-controlled epidural analgesia (PCEA) without many systemic effects after major intra-abdominal surgeries, optimal analgesic solution, background infusion rates, and settings need to be determined. The primary aim was to compare the efficacy of PCEA versus physician-controlled epidural analgesia (PhCEA) in terms of pain relief after major intra-abdominal surgeries. The secondary aim was, to establish an acceptable PCEA regime, to compare the vitals, amount of drug used, acute pain service (APS) interventions, rescue analgesics, and side effects.

Iron deficiency is the most common cause of anemia in many developing countries including India. Inadequate iron in diet, poor iron absorption, excessive bleeding, or chronic blood loss in the stool/ urine may be the cause. Cameron lesions are mucosa injuries of gastric body or fundus in the background of hiatal hernia.

To examine associations between fatigue and poor sleep quality, depression symptoms, and pain intensity in an adult population with chronic arthralgia/myalgia in the temporomandibular region and to test whether fatigue predicted future pain-related interference above and beyond these other constructs.

Imatinib, a tyrosine kinase inhibitor, primarily used to treat chronic myeloid leukemia, has shown a survival benefit in gastrointestinal stromal tumors (GISTs). The most common toxicities of imatinib include fluid retention, diarrhea, nausea, fatigue, muscle cramps, abdominal pain, and rash. Imatinib-related cardiotoxicity is a rare condition, and its clinical severity varies between asymptomatic mild ventricular dysfunction and severe congestive heart failure (CHF). We report the case of a 64-year-old woman with a history of GIST who presented to our clinic with rapidly progressive dyspnea. After 8 weeks of imatinib treatment, the patient developed CHF. Echocardiography showed decreased ejection fraction. Imatinib was stopped and diuretic therapy was started. Two weeks later, she died. Cardiac shock was her cause of death.

Data on the outcomes of microsurgical resection (SR) and stereotactic gamma knife radiosurgery (GKRS) in patients with trigeminal neuralgia associated with small petrous apex meningiomas are scarce.

D. Don ex sweet traditionally been used as home remedy for backaches, joint pain, colic, and rheumatism. The objective of this study was to investigate the therapeutic benefits of plant in an adjuvant-induced arthritis paradigm. Immune-mediated rheumatoid arthritis was developed by injecting complete Freund's adjuvant (CFA) into the hind paws of rats and the aqueous methanolic crude extract was administered. The animals were physically monitored for changes in paw edema size and arthritic score. Hematological parameters and systemic inflammatory indicators evaluated. Genetic expressions of tumor necrosis factor (TNF-α), interleukins (IL-1β, IL-6), necrosis factor (NF-κB), and cyclooxygenase (COX-II) enzyme were studied using real-time qPCR. PGE2 levels in blood were quantified through Enzyme Linked Immunosorbent Assay (ELISA). On the 14th day, Immunoglobulin E (IGE) exhibited a substantial decline in paw edema and arthritic score. At the doses of 500 mg/Kg ( ≤ .05) and 1000 mg/Kg ( ≤ .001), IGE significantly reduced TNF-α, interleukins, and COX-II mRNA expression. IGE significantly lowered the MDA levels at the doses of 500 and 1000 mg/Kg (13.18 ± .70 and 9.04 ± .26 μM/L respectively) as compared to arthritic control (30.82 ± 1.12 μM/L) group. IGE significantly improved the antioxidant enzyme activities of CAT and SOD ( ≤ .001) in treated animals. TNF-α, interleukins, and COX-II mRNA expression were also significantly reduced at the doses of 300 ( ≤ .05), 500 ( ≤ .01) and 1000 mg/Kg ( ≤ .001) which were expressed as fold changes. This study shows that D. Don ex sweet has a strong potential to alleviate immune-mediated arthritis by lowering oxidative stress and downregulating the proinflammatory cytokines signaling mechanisms.

Calcitonin gene-related peptide (CGRP) is considered a major player in migraine pathophysiology. However, the location and mechanisms of CGRP actions in migraine are not clearly elucidated. One important question yet to be answered is: Does central CGRP signaling play a role in migraine? One candidate site is the cerebellum, which serves as a sensory and motor integration center and is activated in migraine patients. The cerebellum has the most CGRP binding sites in the central nervous system and a deep cerebellar nucleus, the medial nucleus (MN), expresses CGRP (MN). A previous study demonstrated that CGRP delivery into the cerebellum induced migraine-like behaviors. We hypothesized that stimulation of MN neurons might induce migraine-like behaviors. To test the hypothesis, we used an optogenetic strategy using mice to drive Cre-dependent expression of channelrhodopsin-2 selectively in CGRP neurons in the cerebellar MN. A battery of behavioral tests was done to assess preclinical behaviors that are surrogates of migraine symptoms, including light aversion, cutaneous allodynia, and spontaneous pain when MN neurons were optically stimulated. Motor functions were also assessed. Optical stimulation of MN neurons decreased the time spent in the light, which was coupled to increased time spent resting in the dark, but not the light. These changes were only significant in female mice. Plantar tactile sensitivity was increased in the ipsilateral paws of both sexes, but contralateral paw data were less clear. There was no significant increase in anxiety-like behavior, spontaneous pain (squint), or changes in gait. These discoveries reveal that MN neurons may contribute to migraine-like sensory hypersensitivity to light and touch.

Carotid-cavernous fistula (CCF) is an aberrant communication between the main trunk or branches of carotid artery and the cavernous sinus. Most of the cases of CCF occur following head trauma, but congenital and spontaneous cases have been reported. We report an interesting case of bilateral CCF with no history of trauma, thus most likely spontaneous form. Since it is rare, it was a diagnostic challenge. The suspicion of this diagnosis was made due to clinical features of headache, signs of increased Intracranial Pressure (ICP) (nausea, vomiting, and worsening headaches during Valsalva), exophthalmos, periorbital edema, periorbital erythema, chemosis, and conjunctival injection in both eyes. It was diagnosed with a 4-vessel angiography (digital subtraction angiography) which is the gold standard and was managed successfully with endovascular coil embolization.