Rejected

To investigate the association between pro-inflammatory diets and low back pain in a nationally representative sample of Korean adults.

GLMN is a gene that encodes a critical protein necessary for normal vascular development. Mutations of GLMN predispose individuals to development of glomangiomas, with nearly 100% penetrance by age 30. Glomangiomas are tumors of the glomus body, a thermoregulatory arterial-venous shunt composed of modified smooth muscle cells. Vulvar glomangioma is an exceedingly rare cause of chronic pelvic pain, that may be easily confused for other conditions such as Bartholin's gland abscess or deep angiomxyomas, thereby delaying diagnosis and treatment. Glomangiomas have characteristic pathologic and imaging findings which may aid diagnosis. We herein describe the case of a 24-year-old female who developed chronic pelvic pain in the setting of a vulvar glomangioma. We further delineate the magnetic resonance imaging and biopsy findings critical to her diagnosis, and the appropriate steps taken for surgical management. She was found to harbor a heterozygous GLMN mutation. To the best of our knowledge, this is the first description of such a case in the medical literature.

To assess the discrepancy in terms of history related to coronavirus disease-2019 and symptoms given in the pre-clinic triage and to the doctor attending the patient in a gastroenterology clinic.

Psychedelics are hallucinogenic drugs that alter the state of consciousness substantially. They bring about psychological, auditory, and visual changes. The psychedelics act on the brain, implying that they have a powerful psychological impact. One of the main factors contributing to disability worldwide is pain. The majority of people deal with pain on a daily basis. Living with chronic pain affects daily life and has social implications. Chronic pain can be associated with any disease that may be genetic, idiopathic, or traumatic. The standard management of pain is done with pharmacological intervention and physical therapy. However, with time, patients may become resistant to a particular class of drugs. As these drugs do not help in treating the cause of pain, they act by blocking receptors and suppressing nervous systems, as this pharmacological intervention is not a permanent solution for pain management. Long-term use of the pharmacological intervention, which acts by suppressing the nervous system, may develop other side effects on the body. These standard therapies are not as effective in managing pain. The opioid class of drugs has good pain-relieving properties but causes addiction; it needs therapeutic drug monitoring to monitor that it is not abused. Since the first synthetic psychedelic was developed, until today, we have had a fair chance to understand its effects and side effects.​These drugs are very potent and effective. They have shown promising developments in the field of clinical psychology. There is upcoming research on psychedelics' use in treating pain disorders. In this article, let us understand the effect of psychedelic drugs on the brain and body and how they modulate pain. Even today, the precise mechanism of chronic pain is still not understood completely. Psychedelics' application and uses in future medicine and pain management are being studied. Understanding psychedelics' effects on the brain and how they function allows us to link how they might be used to treat chronic pain.

Chronic low back pain is a prevalent and sometimes debilitating condition. This case report describes a 69-year-old female presenting with axial spine pain. The pain was inadequately controlled by opioids as she was treated unsuccessfully with hydrocodone and remained to have the pain between 7/10 and 10/10. Peripheral neural stimulation (PNS) was trialed and then used to control her pain. PNS is a device-based treatment option that appears effective in a subset of patients. It has been effectively used to treat many different chronic pain syndromes. The patient responded well to the treatment, with her pain intensity going down to between 2/10 and 5/10 on the same scale. She was able to discontinue her use of opioids. PNS can be a safe and effective treatment in patients who have not responded well to pharmacologic analgesia.

Stroke is one of the leading causes of mortality and disability. It can be rarely caused by cardiac myxoma. Sometimes stroke may be its first clinical manifestation. Here we report a case of posterior circulation stroke in left atrial myxoma. A 45-year-old female patient presented with a history of recurrent episodes of dizziness and headache of three months duration. Neurological examination showed impaired tandem gait. Magnetic resonance imaging (MRI) of the brain revealed infarction in the left posteroinferior cerebellar hemisphere. Echocardiography of the patient revealed a large left atrial mass suggestive of atrial myxoma and an ejection fraction of 60%. The patient was operated on for atrial myxoma two days after the diagnosis, and histopathology confirmed the diagnosis. Postoperatively she remained well and was managed on anti-platelet drugs. Atrial myxoma should be considered as a possible differential while evaluating a case of cardioembolic stroke, and echocardiography detects the presence of an atrial myxoma. It is also essential that atrial myxomas are managed early to prevent recurrent strokes.

Background COVID-19 has rapidly spread across the world at an unprecedented rate. The outbreak of COVID-19 infection has led to a significant health burden on infected patients, especially those with existing comorbidities. The aim of this study is to find the most prevalent symptoms, comorbidities, and complications developed during the course of the disease and outline the most prevalent symptoms among the baseline and clinical characteristics of the patients. Methods This is a retrospective study that was performed on the data obtained from medical records of 3999 COVID-19 patients from Prince Mohammed Bin Abdulaziz Hospital in Riyadh, Saudi Arabia. Demographic data, clinical symptoms, and comorbidities were noted on the day of hospital admission. Complications developed during the COVID -19 infection were also observed. Results The average age was 49.55 ± 14.75 years and 73.77% of the study population were male patients. The average Body Mass Index (BMI) of the patients was 29.48 ± 6.94. Fever and cough were the most common symptoms (85.85%) followed by shortness of breath (83.25%). Other reported symptoms were diarrhoea (17.43%), fatigue (16.2%), vomiting (15.38%), headache (15.23%), sore throat (9.3%), and nausea (8.5%) The most common comorbidity recorded was diabetes mellitus (DM) (39.51%), followed by hypertension (HTN) (33.91%), and asthma (9.45%). In COVID-19 patients with comorbidities, 61.90% developed complications of pneumonia, 8.73% had Acute Respiratory Distress Syndrome (ARDS), 7.25% developed pneumonia and ARDS concurrently, while 0.4% of the total patients had septic shock. Conclusion The symptoms of fever, cough, and shortness of breath were higher in individuals with hypertension and diabetes mellitus, and more prevalent in complications of pneumonia, acute respiratory illness, and septic shock.

Idiopathic hypertrophic cranial pachymeningitis (IHCP) is a rare chronic inflammatory disease characterized by diffuse thickening of the dura mater. Although IHCP mostly presents as a diffuse lesion, it may also occur as focal tumour-like lesions. Here we present the first reported case of IHCP associated with a Chiari type I malformation (CMI). A 65-year-old man presented with a one-year history of chronic headache and vertigo exacerbated by standing and neck flexion. The neurological examination was unremarkable except for tongue wasting and fasciculations. MRI demonstrated features of CMI and findings suggestive of IHCP. Posterior fossa decompression resulted in significant symptomatic improvement and the diagnosis of IHCP was confirmed on histopathology. Though there is no consensus about the management of IHCP in this case, we advocate surgical decompression with prolonged steroid therapy.

This study aimed to assess the time to severe coronavirus disease 2019 (COVID-19) and risk factors among confirmed COVID-19 cases in Southern Ethiopia.

Orofacial pain is defined as pain felt in the soft or hard tissues of the head, face, mouth, and neck. Chronic orofacial pain is often challenging to diagnose and difficult to treat. Due to the lack of available information about the prevalence and clinical form of orofacial pain, this study aimed to evaluate the characteristics of chronic orofacial pain in patients presenting at the Department of Oral Medicine of Shahid Beheshti Dental School between 2012 and 2022.