Rejected

To better understand how the contextual circumstances and lifestyle of commercial fishermen influence their access to healthcare and potentially contribute to the use and misuse of opioids.

Among the immune-mediated reactions, anaphylaxis is the most severe form. As a postoperative analgesia, diclofenac sodium, and nonsteroidal anti-inflammatory drug is commonly used. Intravenous (IV) diclofenac sodium-induced anaphylaxis is very rare. We are presenting a case of IV diclofenac-induced anaphylactic reaction, occurred during the surgery in a female patient of 21 years of age. The sign and symptoms of the reaction resembled an anaphylactic reaction. Temporal relationship with IV diclofenac administration and development of the clinical features of the reaction found to be probable. The health-care professionals should be aware of such rare and serious reactions so that it can be diagnosed and treated early. The clinical importance associated with the case encouraged us to report this rare complication of IV diclofenac.

Stroke mimics are some of the common causes of misdiagnosis of stroke, with an attendant surfeit of finances and resources.

This study intended to understand the risk of developing temporomandibular disorder among Saudi women who experienced a miscarriage.

Prolonging postoperative analgesia using various adjuvants has become a trend in regional anesthesia practice. There are literally no studies where different routes of dexmedetomidine have been compared in supraclavicular block. We compared perineural dexmedetomidine and intravenous (i.v.) dexmedetomidine when used as an adjuvant with levobupivacaine using a nerve stimulator-guided supraclavicular block.

An ultrasound-guided anesthetic technique targeting the interspace between the popliteal artery and capsule of the posterior knee (iPACK) can provide posterior knee analgesia with preserved motor function after total knee arthroplasty (TKA). This study compared the peroneal nerve motor-sparing effects of iPACK block and tibial nerve block (TNB) when combined with local infiltration analgesia (LIA) and continuous adductor canal block (CACB).

In this study, we identified P14 alternate reading frame (P14ARF) as a novel regulator of inflammation and vascularization in intervertebral disc degeneration (IVDD). We collected IVD tissues from IVDD patients and normal individuals for analysis of P14ARF expression. We also induced experimental IVDD by needle puncture injuries in the caudal intervertebral discs of SD rats, and achieved recombinant adenovirus-mediated P14ARF overexpression in experimental IVDD rats. Regulation relationships between P14ARF and tissue inhibitors of metalloproteinases-3 (TIMP3) were confirmed in P14ARF-overexpressed and TIMP3-depleted nucleus pulposus (NP) cells. Tube formation was evaluated in coculture systems of human umbilical vein endothelial cells (HUVECs) and rat degenerated NP cells (DNPCs). Inflammatory response was assessed from levels of TNF-α, IL-1β and IL-6 and neovascularization from expression of endothelial growth factor (VEGF). The P14ARF and TIMP3 were downregulated in degenerated IVD tissue derived from patients and experimental IVDD rats. Over-expressed P14ARF suppressed inflammatory cytokines levels and vascularization. There was decreased tube formation in response to P14ARF overexpression and TIMP3 elevation. Finally, attenuated inflammatory responses and suppression of VEGF were achieved by P14ARF-mediated promotion of TIMP3 in rat DNPCs. Taken together, the present study reveals that P14ARF/TIMP3 modulation of inflammatory response and vascularization in the context of IVDD highlights a potential target for future therapeutic strategies.

We report the case of a 67-year-old woman who developed a cord of subcutaneous tissue extending from the axilla into the medial arm, accompanied by axillary neuropathic pain, with no history of surgery or infection. The patient was instructed in home exercises, and the condition progressively improved. Four months later, a small cord was visible on abduction with mild axillary dysesthesia, which was less severe than at onset. Diagnosis of exclusion was idiopathic axillary web syndrome (AWS). This syndrome is widely recognized after surgical axillary lymph node removal to treat breast cancer, but the etiopathogenesis is still unknown. Published reports of AWS with no history of surgery are rare, but a few reports have described this entity after infection or intense exercise. There are currently no previous reports of idiopathic AWS. The anatomical and clinical presentation, and clinical course of AWS without prior surgery, are similar to those of postoperative AWS.