Rejected

We sought to determine the baseline demographic and clinical characteristics of patients with Chronic Venous Disease (CVD) across the Caribbean, and to evaluate patients' compliance to conservative therapy and the effectiveness of such therapy in reducing patients' CVD symptoms.

Postoperative opioid use following gynecologic surgery may be necessary for effective treatment of pain; however, it can result in significant side effects, adverse reactions, and negative health consequences, including prolonged problematic use. Surgeons and healthcare providers of patients recovering from gynecologic procedures should be aware of effective strategies that can decrease the need for opioid use, while providing high-quality pain management. These include adherence to Enhanced Recovery After Surgery Protocols, particularly the use of multimodal analgesia management. When prescribing opioids, providers should adhere to responsible prescribing practices to minimize the risk of inappropriate and/or long-term opioid use.

This study aims to describe the longitudinal trajectory of opioid prescribing at the practice level and assess factors associated with utilization, including Health Boards and socioeconomic status.

It remains unclear whether idiopathic chronic neck pain is associated with changes in muscle stiffness alongside alterations in neuromuscular control. Therefore, the purpose of this study was to determine the influence of idiopathic chronic neck pain on the muscle stiffness and muscle activity of the upper trapezius and sternocleidomastoid muscles during the maintenance of unilateral and bilateral functional reaching tasks. Surface electromyography (EMG) and ultrasound shear wave elastography were collected from the sternocleidomastoid and upper trapezius muscles in 18 individuals with idiopathic chronic neck pain and 18 matched healthy controls. Participants completed three functional reaching tasks; 1) unilateral forward reach, 2) bilateral forward reach, and 3) unilateral upward reach, and held at the top of each reaching movement for data to be collected bilaterally. A univariate ANOVA was utilized for each outcome measure (mean EMG amplitude and shear wave velocity) and each reaching task. Individuals with idiopathic chronic neck pain exhibited significantly lower upper trapezius activation during bilateral reaches without corresponding changes to stiffness during similar trials. Similarly, this cohort exhibited decreased sternocleidomastoid stiffness during forward reaching, without corresponding activation changes. Lastly, women demonstrated consistently higher sternocleidomastoid activation and stiffness when compared to men. These findings indicate individuals with idiopathic chronic neck pain may adapt their movement strategies, possibly for pain avoidance. The demonstrated changes in muscle stiffness independent of changes in muscle activity highlight the importance of evaluating both muscle stiffness and activation in individuals with idiopathic chronic neck pain prior to designing rehabilitation programs.

Suture exostosis is an intriguing and not uncommon pathology that has to be included in the differential diagnosis for horses with swelling of the head. Although several singular case reports have been published, no large case series is available. The aim of this study is to report a multicentric retrospective collection of suture exostosis cases. Data concerning horses with suture exostosis in the facial region were collected retrospectively. Information regarding breed, age, gender, history, imaging findings, initiated treatment, response to treatment and follow up was recorded. One hundred and five cases of various breeds were reported. Analysis revealed the cases could be grouped into four entities: 45 developed following sino-nasal surgery, 23 following trauma, seven with underlying sinus pathology and 25 idiopathic. Treatment consisted of sequestra removal, plate fixation, antimicrobial and anti-inflammatory drugs or no treatment. Whereas initial localized pain fades within few days or weeks, resolution or reduction of the swelling was obtained in most cases after 3 months to 1.5 years. The etiopathogenesis of suture exostosis seems to consist of different entities. Identification of an underlying cause, particularly the presence of a bone sequester and infection is important to speed up resolution and before concluding an idiopathic case. When performing sinusotomies, it is important to provide as little trauma as possible to the surgical site in order to prevent suture exostosis as a complication.

The purpose of this triple-blind randomized study is to compare the postoperative analgesic efficacy of Mid-Point Transverse Process Pleura Block (MTP) and Paravertebral Block (PVB) in patients undergoing breast surgery.

Regional anesthesia technique has been reported to exert excellent analgesic efficacy for various surgeries. Erector spinae plane block (ESPB) and transversus abdominis plane (TAP) block are good ways to relieve postoperative pain after abdominal surgery. However, the analgesic efficacy between them remains controversial. This meta-analysis evaluated the analgesic effect between these two blocks in abdominal surgery with statistical and clinical interpretation.

The neuromuscular system is responsible for performing adequate muscle activities to maintain postural balance. Since COVID-19 can cause damage to this system, long-term sequelae might alter control of postural stability. This study aimed to evaluate the postural balance of patients with post-acute COVID-19 syndrome (PCS) who were not hospitalized and to evaluate the correlations of changes in postural balance with general fatigue, muscle strength, and quality of life (QoL).

Single nucleotide polymorphisms (SNPs) in IRGM are reported to affect Mycobacterium tuberculosis (M.tb) degradation pathway. Here, we aim to screen promoter-region regulatory SNPs of IRGM in Pakistani population. DNA extracted from blood of cohort containing 70 TB patients (TB) and 30 controls subjects (Ctrl), was amplified for IRGM promoter region, followed by DNA sequencing. Group-specific variations were found in allelic frequencies at four loci. Allele T (p-value = 0.03) at -1161T/C, allele G (p-value = 0.027) at -1133G/A; allele C (p-value = 0.029) at -1049C/T; and allele G (p-value = 0.02) at -708G/A, showed higher associations with TB in our cohort. These SNPs display strong linkage disequilibrium (LD) in Pakistani population. Haplotype analysis showed a significant association of haplotype -1161T/-1133G/-1049C/-708G (p-value = 0.007) to TB. This 4-SNP haplotype also represents an expression quantitative trait locus (eQTL), associated with Crohn's disease and chronic inflammatory diseases. Our findings show that variants -1161T/C, -1133G/A, -1049C/T, and -708G/A are associated with IRGM expression and susceptibility to TB in a Pakistani population.

Pregnancy and childbirth are known risk factors associated with the development of pelvic organ prolapse; specific intrapartum risk factors are not well characterized.