Rejected

The gate control theory of pain was the starting point of the development of spinal cord stimulation (SCS). We describe the indications for the treatment in pain management and other uses not related to pain.

Textilomas, gossypibomas, muslinomas and gauzomas, otherwise collectively known as Retained Non-absorbable Hemostatic Material (RNHM), are surgical materials such as cotton or gauze pads that are accidentally retained in the surgical bed post-operatively. They may present acutely with signs of infection or may rarely remain chronic and asymptomatic; the latter posing a significant challenge to clinical and imaging diagnosis. Textilomas are not routinely reported due to their medicolegal implications and are usually encountered fortuitously. Here, we report a case of an individual who presented with a non-specific lower backache, had a remote history of lumbar discectomy and in whom a textiloma at the postoperative site was seen to mimic a soft-tissue mass on imaging. In addition, we review current, up-to-date literature on delayed presentations of such retained materials after surgery of the lumbar spine.

Pain is a common complaint following an orthopedic injury; however, the exact cause of nociception can be complex. Multiple tissues can generate a patient's complaint of pain, such as the skin, muscle, ligaments, tendon, nerves, and bones. Regarding the somatosensory system, inflammation around the nerve can create pain and alter movement coordination; this information has resulted in increased awareness of neurodynamic assessments and exercises. Neurodynamic assessments and exercises provide a unique paradigm to effectively assess and treat neural tissue, which may not commonly be considered within the traditional orthopedic examination.

To understand the occurrence of horizontal semicircular canal functional impairment in patients with common vestibular diseases and to explore the characteristics and clinical value of different evaluation methods of horizontal semicircular canal. From July 2013 to December 2016, patients who attended the vertigo clinic of the First Affiliated Hospital of Dalian Medical University and completed more than three horizontal semicircular canal function tests were retrospectively analyzed. A total of 396 patients diagnosed as vestibular migraine （VM）, Ménière's disease （MD）, benign paroxysmal positional vertigo （BPPV）, vestibular neuritis （VN） and 104 patients with unknown diagnosis were enrolled. The results of caloric test （CT）, rotation test （RT）, head-shaking nystagmus test （HSN） and video head impulse test （vHIT） were collected and the abnormal detection rates of different detection methods were calculated. The sensitivity, specificity and coincidence rate of various detection methods were statistically analyzed using CT as the gold standard. ①The abnormal rates of the four evaluation methods from high to low were HSN, CT, RT, vHIT （51.20%, 50.80%, 25.76%, 19.74%, respectively）; ②Taking CT as the gold standard, among these four common vestibular diseases, the sensitivity and specificity of vHIT were 0.13-0.41 and 0.69-1.00, the sensitivity and specificity of HSN were 0.44-0.76 and 0.29-0.69, and the sensitivity and specificity of RT were 0.25-0.45 and 0.50-0.84;③According to statistical analysis, only HSN and CT results showed no statistically significant difference in the 4 diseases. There was no significant difference between RT and CT in VM and BPPV, and vHIT and CT in BPPV. The abnormal rate of HSN results in common vestibular diseases is highest, and it could be recommended as a routine vestibular function screening item. The specificity of vHIT is highest and worthy of promotion. CT is still an irreplaceable method to evaluate the function of horizontal semicircular canal.

Occlusion is a challenging complication of endovenous stenting. The treatment of chronic iliofemoral stent occlusion involves wire recanalization followed by balloon angioplasty. However, this approach will not always be successful. To treat such cases, we have successfully used a laser recanalization technique in 34 limbs (31 patients). This technique involved the use of a laser to first create a channel through the chronically occluded stent, followed by balloon angioplasty to improve the caliber of this recanalized tract. The mean age of the patients was 52 ± 13.6 years (range, 24-73 years). No adverse events related to the use of the laser occurred. Following laser recanalization, the venous clinical severity score had improved from 8.2 ± 4 to 5.1 ± 3.3 ( < .0001). The visual analog scale score for pain had improved from 7.8 ± 2.5 to 4.9 ± 3 ( = .0009). The grade of swelling had improved from 2.7 ± 1.3 to 1.6 ± 1.4 ( = .0001). At 12 months after intervention, the primary stent patency was 60% (standard error of the mean, 9.3%), and the secondary stent patency was 80%. Excimer laser recanalization of chronically occluded venous stents appears to be a rarely required but useful modality with reasonable clinical outcomes. Further reinterventions might be required to maintain long-term stent patency.

Hepatic hemangiomas may rarely arise outside the extra-hepatic capsule. It appears as a pedunculated mass. We report the case of a 58-year-old female presenting with abdominal chronic pain. Incidental diagnosis of a pedunculated hepatic hemangioma was suggested by ultrasonography confirmed by typical imaging features on computed tomography. Dynamic contrast- enhanced computed tomography and MR scan are relevant to approach the diagnosis of hemangioma, showing its origin from the liver edge and typical radiological features Surgical removal of the mass was performed to prevent volvulus along the pedicle. Pathological analysis confirmed the diagnosis of pedunculated benign hepatic hemangioma.

This study aimed to investigate the personality traits, anxiety sensitivity (AS), anxiety, and depression levels in patients diagnosed with psychogenic pruritus (PP). Certain personality traits may come to the fore in psychosomatic disorders; these traits are thought to make the person vulnerable to psychosomatic diseases. This study aimed to investigate the personality traits, anxiety sensitivity (AS), anxiety, and depression levels in patients diagnosed with psychogenic pruritus (PP).

Background In this retrospective study, we aimed to investigate the effect of chlorhexidine digluconate-flurbiprofen spray (Klorhex Plus® oral spray) on postoperative sore throat (POST) and hoarseness (POH) in patients undergoing rhinoplasty. Methodology Patients who underwent rhinoplasty alone in our clinic between April 01, 2021, and February 28, 2022, were enrolled in the study. Patients' demographics such as age, gender, height, and smoking status that could affect sore throat, difficult intubation, and operation time were recorded from the patients' files. Patients were grouped as those who received Klorhex Plus oral spray before the surgery (Klorhex P group) and those who did not (control group). POST and POH were recorded from the patients' postoperative surgery files. Postoperative pain evaluation was performed using the Numerical Rating Scale (NRS) at the postoperative first hour (PPL1h), 12th hour (PPL12h), and first day (PPL1d) from the postoperative nursing files. Results A total of 354 patients who underwent rhinoplasty alone were included in this study. No significant difference was found between the groups in terms of the demographic data. Statistically, PPL1h, PPL12h, and PPL1d were significantly lower in the Klorhex P group compared to the control group (for all, p < 0.001). POST and POH were also significantly higher in the control group (both, p < 0.001). Conclusions The results of this study indicate that Klorhex Plus oral spray is an efficient agent for preemptive analgesia before rhinoplasty. It significantly decreases the postoperative pain level, POST, and POH. However, further comprehensive prospective studies are needed to introduce Klorhex Plus oral spray to rhinology practice.

Background and objective The antiemetic drug is one of the most common armamentariums in an anaesthesiologist's pharmacopoeia to prevent postoperative nausea and vomiting (PONV). PONV is one of the usual side effects after general anaesthesia, especially in female patients (21%) and after laparoscopic surgery (60%). This study aimed to compare the efficacy of ondansetron with ramosetron. Methodology After institutional ethical clearance and informed written consent, one hundred female patients scheduled for laparoscopic gynaecological surgeries were selected for this prospective, double-blinded, randomised interventional study. These patients were further subdivided into two equal groups (50 in groups R and O). Group R received ramosteron 0.3mg, and group O received ondansetron 8mg 30 minutes before the end of surgery. Patients were assessed between 0-2, 2-6, 6-12 and 12-24 hrs in the postoperative period. The primary objective of this study was to compare the effect of a single dose of ramosetron (0.3mg) with a single dose of ondansetron (8mg) for the prevention of PONV after general anaesthesia in laparoscopic surgeries. The secondary goal was to record the time of occurrence of the first episode of PONV, the need for rescue antiemetics, patient satisfaction scores, and to look for any side effects. Results This study shows no significant difference in the reduction of PONV incidence between group O and group R in the first 24 hours of the postoperative period. The overall incidence of PONV was significantly higher in the early postoperative (0-6 hrs) than in the late postoperative period (6-24 hrs), i.e., 51% and 13%, respectively. The requirement of rescue antiemetic was higher in group O than in group R but not statistically significant. In our study, both groups had similar patient satisfaction scores. Headache was the most common side effect and was noted in 9% of the patient population. Conclusion We conclude that ramosetron is as effective as ondansetron in preventing the incidence and severity of PONV up to 24 hours postoperatively.

Injection therapy in refractory cases of lateral epicondylitis might relieve symptoms, although no consensus exists on which material to use. Corticosteroids are widely used but recent literature indicated possible tenotoxic effects and inefficacy in mid- and long-term follow-up (FU). Hyaluronate/hyaluronic acid (HA) might be of better clinical efficacy. Magnetic resonance imaging (MRI) might reflect the clinical changes in the short-term FU.