Rejected

Pain is a common and complex symptom of cancer having physical, social, spiritual and psychological aspects. Approximately 70%-80% of cancer patients experiences pain, as reported in India. Ayurveda recommends use of (Processed) () for the management of pain but no research yet carried out on its clinical effectiveness.

Chronic pain is a prevalent and dynamic condition for both patients and providers. Learning how patients with chronic pain successfully manage their pain may prove helpful in guiding health care providers in their treatment of other patients with chronic pain. This research sought to identify successful strategies for managing chronic pain from interviews with individuals experiencing chronic pain who were able to do "most of what they want on most days." Qualitative, descriptive study. Patients were from metro Denver, Colorado, USA and were recruited from community and health care settings. Appreciative inquiry (AI) was used as an approach to elicit stories of successful pain management. We conducted one-on-one, in person interviews using a semistructured interview guide. Analysis was completed using a grounded hermeneutic editing approach. Twenty-four interviews were completed representing a range of adult ages, genders, race/ethnicities, and underlying reasons for chronic pain. Consistent themes were found in that all patients had developed multiple strategies for ongoing pain management and prevention, as well as a mental approach embedded with elements of positive beliefs and determination. Friends, family, support group members, and health care providers were key in support and ongoing management. Although 10 patients regularly used opioid pain medications, none were dependent, and all stated an active desire to avoid these medications. Successful chronic pain management seems possible as displayed from the patient narratives but requires persistence through individual trial and error. Recommendations for health care provider teams are made to apply these findings to assist patients with chronic pain.

The purpose of this study was to evaluate the efficacy and tolerance of normofractionated stereotactic radiation therapy (RT) and intensity modulated RT with helical tomotherapy for skull base meningioma.

Modern medical care is based largely on a paradigm known as a "biomedical model," in which "objective," high-technology biomarkers guide clinical care, and most health outcomes are determined by health professionals rather than individuals, using drugs as the primary therapy. The biomedical model is spectacularly effective in the acute care inpatient hospital, the setting for 95% of medical education and training, and to guide management of many chronic diseases, such as hypertension and diabetes, for which a "gold standard" biomarker is a major determinant of clinical decisions. This model also has contributed importantly to knowledge of biomarkers, biochemical and structural abnormalities in osteoarthritis (OA) and other rheumatic diseases. However, a biomedical model has many limitations in understanding the long-term course of OA and many chronic diseases in outpatient medicine, the setting of 95% of activities that determine long-term health outcomes. Patient self-report questionnaires provide the most informative data concerning OA patient status and changes in status, and more significant data in the prognosis of outcomes such as mortality than laboratory or radiographic measures. Furthermore, the incidence, prevalence, morbidity, and mortality of OA is considerably greater in individuals of low versus high socioeconomic status. These associations are not unique to OA, and are seen in many diseases, including comorbid conditions which are the acute causes of death in OA. Associations of low socioeconomic and poor health are explained only in small part by limited access to medical services, the conventional explanation. Strong evidence suggests that socioeconomic status is a surrogate marker for patient self-management, actions and environment, in addition to actions of health professionals, in the pathogenesis, course and outcomes of chronic diseases. These observations suggest the value of a complementary "biopsychosocial model" to better understand pathogenesis, principles of treatments, and outcomes in OA and other chronic diseases. Inclusion of clinical information from patient questionnaires and socioeconomic status variables in clinical and research settings could add new understanding of biomarkers and pain in OA for both basic and clinical investigators. Furthermore, the data indicate that poor physical function assessed on a self-report questionnaire might be regarded as an important reversible risk factor in public health and research agendas, for which the OA community might be strong advocates.

There is no ideal postoperative pain management. Simple surgeon-delivered local anesthetic (LA) techniques such as wound infiltration and regional nerve blocks can play a significant role in the improvement of postoperative pain relief.

Corticosteroid and Ketorolac tromethamine is a pain reducing.

Atopic dermatitis (AD) is a highly pruritic skin condition of unclear pathogenesis. Patients with AD are predisposed to colonization by due to deficiencies in the mechanical and immunological functions of the skin barrier. Recent studies indirectly show that may aggravate disease flares in AD.

Inflammatory bowel diseases (IBD) are associated with high psychosocial burden and economic cost. Integrating psychological care into routine management might lead to savings. We performed a 2-year investigation of the effects of integrated psychological care in reducing healthcare use and costs.

Spontaneous Intracranial Hypotension (SIH) remains a diagnostic and therapeutic challenge. Non-specific clinical features and a reluctance to treat without confirmatory imaging evidence undermine management. Investigations are often insensitive, expensive with many patients continuing to an Epidural Blood Patch (EBP) despite negative results. Current diagnostic standards are based upon a literature base skewed towards difficult to treat cases at specialty centers. This study aims to develop a robust diagnostic and treatment algorithm in real-life clinical practice by 1) investigating the prognostic utility of symptoms of SIH and results of associated investigation from which a scoring system is derived and 2) analysing the role of EBP as a diagnostic and treatment tool.