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Sublingual Versus Swallowed Morphine: A Comparison.

The optimal route for immediate-release morphine administration is controversial. The known physical characteristics of morphine that allow absorption are counter to the unproven belief that sublingual morphine is absorbed more quickly.

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Evaluating the Influence of IV Ketamine on Postoperative Opioid Use for Surgical Patients at a Tertiary Care Centre.

Subanesthetic doses of ketamine have been shown to improve the efficacy of opioids, increase pain control, and exemplify opioid-sparing effects when used as postoperative analgesia for adults.

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Intrathecal Nalbuphine and Dexmedetomidine as Adjuvants to Bupivacaine versus Plain Bupivacaine for Orthopedic Surgeries under Subarachnoid Block: A Comparative Study.

In long bone surgeries, the severity of pain is more, demanding good intraoperative anesthesia, and prolonged postoperative analgesia. This is achieved in spinal anesthesia with adjuvants to local anesthetics, which act synergistically.

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Sub-tenon Versus Sub-conjunctiva Anaesthesia for Intraocular Surgery.

To compare the pain relief achieved using sub-Tenon anesthesia with that of sub-conjunctival anesthesia technique in intraocular surgery at the Guinness Eye Centre Onitsha Nigeria.

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Comparison of Neurological Manifestations in the Two Waves of COVID-19 Infection: A Cross-Sectional Study.

Coronavirus Disease-19 (COVID-19) is an ongoing pandemic caused by highly contagious virus severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) that has infected millions of people across the world. Most of the countries have seen two wave patterns of the pandemic. The second wave is potentially more challenging due to high influx of cases, differing properties of the emerging mutants, and other dynamics of the evolving pandemic. Neurological manifestations are common among COVID-19 positive patients. In this context, the present study attempts to compare the neurological manifestation in the first and second waves of COVID-19.

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Comments on published article: Erector spinae plane block and transversus abdominis plane block for postoperative analgesia in cesarean section: A prospective randomized comparative study.

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Disease Burden in Patients with von Willebrand Disease Potentially Eligible for Prophylaxis: Post Hoc Analysis of a European Cross-Sectional Study.

Recent international guidelines conditionally recommend von Willebrand factor (VWF) prophylaxis for von Willebrand disease (VWD) patients with a history of severe/frequent bleeds. This post hoc analysis of the Cost of VWD Across Europe, a Socioeconomic Study (CVESS; conducted in 2018), assessed patient characteristics and disease burden in patients aged >1 year with congenital VWD not receiving but potentially eligible for prophylaxis based on severe/frequent bleeds, and those receiving prophylaxis in the previous 12 months. Data were collected using medical records and a patient questionnaire. Patients considered potentially prophylaxis-eligible (n = 102) experienced more bleeds than patients receiving prophylaxis (n = 229) and were more likely to be admitted to the hospital due to bleeding events in the prior 12 months. Quality of life and work productivity were similar between the two groups. Logistic regression analysis showed that the prophylaxis-eligible group was more likely to have poor joint function and moderate chronic pain than the prophylaxis group. This retrospective study suggests that 1/7 patients not receiving VWF prophylaxis had a higher disease burden than patients receiving prophylaxis and would potentially benefit from prophylaxis.

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Contemporary Management of Intracranial Subdural Empyema: An Institutional Experience.

Intracranial subdural empyema (SDE) is a seemingly uncommon life-threatening ailment with varying presentations and outcomes. A variety of risk factors have been associated with predisposition to intracranial SDEs; however, they may be cryptogenic. There is an increased predilection for intracranial SDE in children and teenagers with paranasal sinusitis or middle ear infections. The clinical presentation is non-specific and thus a high index of suspicion is required. Neuroimaging is an invaluable diagnostic tool for early diagnosis and surgical intervention. There have been multiple proponents for either burr hole or craniotomy to treat intracranial SDEs; however, despite surgical intervention, adverse neurologic sequelae and even mortality still occur. Extended antibiotic therapy is mandatory and impacts significantly on patients' outcomes.

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Caution Ahead: Identifying Red Flag Signs and Symptoms in Patients With Migraine.

Headache is a commonly encountered symptom in urgent care and the emergency department. Headache syndromes are classified a primary headache and do not require neuroimaging; however, patients should be assessed at each encounter for changes in their headache symptoms. This case highlights a patient who was suffering from a new headache type, characterized as different from her previous attacks and unyielding to her current acute and preventive treatment methods. The patient was sent for neuroimaging and found to have a mass within her sella turcica that required surgical intervention and removal. Assessing headache patients for red flag symptoms can uncover significant alterations in the patient's symptomatology and indicate a need for further evaluation. By evaluating for red flag symptoms, clinicians can ensure the delivery of high-quality care and better health care outcomes for patients with headache disease.

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Clinical comparative study of standard channel percutaneous nephroscope combined with flexible ureteroscope and traditional standard channel combined with microchannel percutaneous nephrolithotomy in the treatment of multiple renal calculi without hydrone

To evaluate the clinical efficacy of standard channel percutaneous nephroscope combined with flexible ureteroscope and traditional standard channel combined with microchannel percutaneous nephrolithotomy in the treatment of multiple renal calculi without hydronephrosis.

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