Chief Complaint Of Pain Research Articles

Suppurative Flexor Tenosynovitis: A Case Report

Background: Suppurative flexor tenosynovitis is an infection of the flexor tendon sheath. This case report presents the clinical course and management of a patient diagnosed with suppurative flexor tenosynovitis. The diagnosis is based on history taking, physical examination, and supporting examination findings. Case Report: A 42-year-old man presented with chief complaints of pain, swelling, and immobility of the index finger of his right hand after being pierced by a fish spine 3 days prior. Physical examination revealed the second digit in a slightly flexed and swollen position, with pain elicited on palpation and passive extension, limiting the patient's range of motion. The patient was diagnosed with suppurative flexor tenosynovitis and treated with antibiotics, debridement, and drainage. Postoperative results were good, with no signs of complications such as spread of infection, tendon necrosis, osteomyelitis, or indications for amputation.Discussion: The treatment for suppurative flexor tenosynovitis involves a combination of antibiotics and surgery. Surgical interventions typically include open drainage and debridement or closed catheter irrigation. Additionally, postoperative rehabilitation is a crucial aspect that requires careful consideration, as it has been shown to accelerate the healing process.Conclusion: Suppurative flexor tenosynovitis is a rare but serious condition that demands early detection and a multidisciplinary approach. Timely surgical debridement and targeted antibiotics, guided by the identification of the causative organism, are essential for positive patient outcomes.

Extensive Synovial Chondromatosis of the Temporomandibular Joint Extending to the Cranial Base.

A 42-year-old male presented to the Department of Oral and Maxillofacial Surgery with the chief complaint of pain and stiffness in the right temporomandibular joint (TMJ). The patient's height was 174 cm and his body weight was 65 kg. The patient's occupation was heavy equipment operator. According to the patient, the pain had initiated a week prior to his first visit and was exacerbated during mastication. Evaluation of the range of motion revealed extensive crepitus along the right TMJ. The active and passive range of motion were measured at 45 mm and 42 mm, respectively, indicating adequate mouth-opening capacity. Occlusion was also favorable, and no other clinical symptoms were shown intraorally.

A case report of arthrocentesis in temporomandibular joint internal derangement

In this case report, a 56-year-old male presented to our department of oral and maxillofacial surgery with a chief complaint of pain during mouth opening on the left joint region. The patient also complained of limited mouth opening and temporomandibular joint (TMJ) pain. Arthrocentesis was performed under aseptic conditions. Clinical evaluation of the patients was done before the procedure, 1 week, 1 month, and 4 months postoperatively. Intensity of TMJ pain and maximal mouth opening were recorded at each follow-up visit. There was a significant improvement in mouth opening and a reduction in pain scores in the postoperative period. Arthrocentesis is a simple and safe procedure for patients with internal derangement with a closed lock for improving mouth opening and decreasing pain.

Unicystic Ameloblastoma Masquerading as Vascular Lesion

Ameloblastoma is a benign epithelial tumor of odontogenic origin which shows variations in its presentation that intrigue the authors. Authors report a case of unicystic ameloblastoma which presented, clinically and radiographically mimicking features of a vascular lesion. Patient reported with the chief complaint of pain and swelling in the left lower-third of the face. The investigations performed gave a diagnosis dilemma and hence deciding on appropriate investigations played a pivotal role to enable precise diagnosis of the lesion and facilitated surgeons to decide on the treatment plan.

Successful Management of Waja’al-Rukba (Knee Osteoarthritis) with Unani Pharmacopeial Poultice: A Case Study

Knee osteoarthritis (Knee OA) is the most common Musculoskeletal disorder, which causes functional disability thus, increasing the economic burden in society. In Unani medicine knee Osteoarthritis is treated with various regimens and drugs. Among these regimens, Dimād (Poultice) is prepared with several single Unani pharmacopeial drugs that exert anti-inflammatory, analgesic and anti-arthritic actions. Keeping this in mind a case study was conducted to assess the efficacy of Dimād-i-jalinus a pharmacopeial Unani formulation in the management of Knee OA. A 63-year-old female patient with chief complaints of pain and swelling in the left knee joint, joint stiffness and mild tenderness feeling severe pain while performing daily activity for the last 6 months was treated at OPD of Hakim Syed Ziaul Hasan Govt. (Auto) Unani Medical College & Hospital, Bhopal. Dimād-i-jalinus was given to the patient, in paste form and the patient was explained to use this paste over the anterior surface of the Left knee joint and the bandage was wrapped to keep the medicines in place overnight every day for 14 days. The patient was assessed at baseline, 7th day and 14th day based on changes in subjective and objective parameters with the help of Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC). The present study reveals that Dimād-i-jalinus is safe and effective in treating Knee OA without any side effects. Therefore, further randomized clinical studies need to be carried out to validate the effectiveness of Dimād-i-jalinus in the management of Knee OA.

A clinical approach in the management of endodontic-periodontal lesions of endodontic origin: Two case reports with 2-year follow-up

Abstract The term “endodontic-periodontal” (endo-perio) lesions describe lesions with the involvement of pulpal tissues and the periodontium of a tooth. These cases regarding the diagnosis, management, and prognosis of teeth are challenging for the clinician. The aim of this article was to discuss two cases of endo-perio lesions in molars with large periapical radiolucencies. Two healthy male individuals came with a chief complaint of pain during chewing. During clinical examination, a deep periodontal pocket of 10 mm and 7 mm, respectively, was noticed in both cases, and large periapical radiolucencies extended to the apical region were confirmed by the intraoral periapical radiographs. Evaluation of the symptoms together with the clinical findings determined the diagnosis endo-perio lesion of endodontic origin and accordingly the decision for the management. The successful treatment outcome with the periodontal healing in both cases was observed soon 40 days after orthograde root canal treatment. Conservative endodontic therapy was the key to the healing of the periapical tissues in endo-perio lesions of endodontic origin. The clinical approach as well as the 2-year follow-up of those compromised endo-perio lesions showed that endodontic therapy resulted in the healing, whereas no periodontal therapy was performed and the initial decision-making was confirmed.

A CASE STUDY ON THE COMBINED APPROACH OF KALABASTHI AND RASAYANA CHIKITSA IN GRDHRASI

Grdhrasi is one among the vataja nanatmaja vyadhi1 , affecting the mamsa, asthi dhatus. The disease is characterized by predominantly pain originating from the lower back (Kati) and pelvic region (Sphik Pradesha), with pain extending down to the legs, resulting in a walking pattern reminiscent of a grdhra (vulture). Timely and appropriate treatment is crucial for relieving pain ,improving function, preventing complication ultimately promoting a better quality of life. A 58-year-old male patient approached to Kayachikitsa OPD Alvas Ayurveda Medical College with the chief complaints of pain in low back region radiating to right leg for 11/2 months (pulling type of pain) . The patient was given Ayurvedic medications along with panchakarma procedures. Gandharvahasthadi Kashaya, Gokshuradi guggulu , Kala basthi, Rasayana medications was given . The results were remarkable. Hence this study was taken to prove that comprehensive Ayurvedic management has remarkable results in Grdhrasi.

Implementing paper-based patient-reported outcome collection within outpatient integrative health and medicine.

To investigate the feasibility of pre- and post-encounter patient-reported outcome (PRO) measure collection within an outpatient integrative health and medicine (IHM) clinic and to characterize factors associated with successful completion. We conducted a retrospective review of 27,464 outpatient IHM encounters including 9,520 chiropractic; 8,237 acupuncture; 5,847 massage; 2,345 IHM consultation; and 1,515 osteopathic manipulation treatment encounters at four clinics offering IHM over 18 months. Patients were asked to complete paper questionnaires rating pain, anxiety, and stress from 0-10 immediately pre- and post-encounter. Generalized linear mixed effect regression models were used to examine the relationship between demographic, clinical, and operational covariates and completing (1) pre-encounter and (2) paired (i.e., pre and post) PROs. Patients (N = 5587, mean age 49 years, 74% white, 77% female) generally presented for musculoskeletal conditions (81.7%), with a chief complaint of pain (55.1%). 21,852 (79.6%) encounters were among patients who completed pre-encounter PROs; 11,709/21,852 (53.6%) completed subsequent post-encounter PROs. Odds of PRO completion were more impacted by provider, operational, and clinical-level factors than patient factors. Covariates associated with increased odds of pre-encounter PRO completion included being female, having additional IHM encounters, and having a pain or anxiety complaint. Covariates associated with increased odds of paired PRO completion included being aged 31-40 vs. 51-60 years and having additional IHM encounters. Implementing a paper-based PRO collection system in outpatient IHM is feasible; however, collecting post-encounter PROs was challenging. Future endeavors should leverage the electronic health record and patient portals to optimize PRO collection and engage patients and clinical providers.

Sheehan’s syndrome of a 50 years old female with bipolar disorder: a case report

Empty Sella syndrome (ESS) pertains to a phenomenon in which the Turkish sale seems through radiography to be larger and perhaps partially or entirely filled with brain fluids. It can be major illness/ develop as a result of pituitary medical procedures, radiation therapy cerebral infarction/bleeding process. A 50 years old female patient was admitted in emergency medicine ward with chief complaint of pain in abdomen, weakness and vomiting. MRI scan of pituitary cerebrospinal fluid (CSF) signal intensity is seen in Sella with no visible anterior pituitary gland tissue noted-likely suggestive of secondary empty Sella (SES). Long-term steroid use is principal therapy for adrenocorticotropic hormone deficiency (IAD). In this instance, ESS, which can be primary/secondary, also noticed.

Cracked tooth and endodontic-periodontal lesion: 2-years follow up of a conservative treatment

This study report diagnosis and management of an endodontic-periodontal lesion in a cracked mandibular tooth after a cyclist’s fall. A 34-year-old female patient with a chief complaint of pain and edema in the region of the mandibular right first molar was evaluated and treated. Patient presented excellent oral health. After clinical, radiographical and tomographic exams, it was diagnosed an acute periapical abscess in stage II combined with tooth cracks and a periodontal involvement (endodontic-periodontal lesion). After emergency dental care it was performed subgingival scaling and root planing, definitive endodontic treatment, indirect definitive restoration (overlay) combined with a reinforcement of the tooth structure with a high-resistance polyethylene tape. Patient was periodically followed up until 24 months and treatment was successful. It can be concluded that a correct diagnosis and a conservative and well-planned and -executed treatment of a compromised tooth by cracks can have good results even endodontic-periodontal lesion is present.

Splenic hydatid cyst: a case report

Hydatid cyst (HD) disease is a parasitic infection caused by Echinococcus granulosus. It occurs worldwide, but its prevalence is higher in the rural communities where sheep and cattle raising constitute a crucial component of the agricultural industry. This is a zoonotic disease which spreads via close contact of humans with sheep and dogs. The most common organs involved in hydatid cyst are the liver and lungs. However, other organs may also foster it, such as the spleen which is a rare clinical condition, with an incidence rate of between 0.5% and 4%. In this study, a 46-year-old male with a primary splenic HC is reported with chief complaint of pain and non-tender palpable mass in left hypochondrium. A 9.7×10.6×11 cm splenic cystic mass was detected on ultrasonography (US) and confirmed by abdominal computed tomography (CT) scan, without involvement of other organs. Splenectomy was done along with excision of intact hydatid cyst. Pathological examinations revealed cystic hydatidosis. We describe this case of an isolated splenic HC, which was successfully treated with total splenectomy, focusing on the management and outcome of this disease.

Prosthetic Rehabilitation of Post Covid Mucormycosis of Maxilla with Definitive Obturator Prosthesis- A 24 Month Follow Up Case Report

The second wave of COVID-19 in April 2021 witnessed a new mutated variant of SARS-CoV2 known as B.1.617 resulting in Mucormycosis. Inhalation, ingestion, or contamination of ulcerated mucosa by fungal spores results in infection and cause Mucormycosis. Objective: To highlight how a complex case of oral mucormycosis can be misdiagnosed due to its similar clinical presentations with other periodontal diseases and benefits of prosthetic rehabilitation of surgical defects with definitive obturator which improves the quality of life by restoring oral function and aesthetics. Case report: A 35-year-old female reported with chief complaint of pain, pus and mobility in upper front teeth region of 2 months and swelling of mid-face. Darkening of skin, swelling with tenderness over bilateral malar- infraorbital regions with epiphora and blurred vision in right eye and discharge from right nostril. She had multiple abscess in attached gingiva in incisor and premolar region of maxilla having probing depths ≤ 4mm with mobility. Conclusion: A precise diagnosis is prerequisite to specific treatment of any disease. Treatment often requires an extensive surgical resection causing facial deformation, masticatory, swallowing and speech problems. It is important to rehabilitate these patients by correcting the defects with the help of obturators and improve their lifestyle.

Functional evaluation after injection on professional athlete with tendinopathy between october-december 2018 at Sports Clinic Dr Soetomo General Hospital

Introduction: Tendinopathy is a common musculoskeletal problem. It is estimated that 30-50% of all sports injury is caused by tendinopathy. Even with the high prevalence, treatment option for tendinopathy is still limited. Platelet Rich Plasma (PRP) is said to be able to repair ligaments, regenerate muscles, and repair cartilage. This paper aims to describe the impact of PRP injection on the function of the extremity. Methods: Patients with tendinopathy who were injected with PRP at Sports Clinic Soetomo General Hospital between October-December 2018 were included as samples. The VAS, SF36, DASH, and KOOS scores from each patient before and after injection were recorded. Results: Data from four patients with tendinopathy were collected. The samples were aged 23.5 ±5.6 years old, 75% (n=3) were women, and all have had tendinopathy for more than six months. All patient has had chief complaint of pain at the location of tendinopathy. Average VAS before and after injection were, respectively, 7±1.2 and 2±0.82. Time to functional improvement for 75% of patient are between 5-10 days and 25% within 10-15 days. Conclusion: PRP injection is found to reduce pain and improve functional outcome of patients with tendinopathy. This result can be used as a basis for further research.

ND:YAG Laser Vitreolysis as The Management of Occluded Tube After Glaucoma Drainage Device Implantation (GDD)

Introduction : Glaucoma Drainage Devices (GDD) implantation surgery can be an alternative therapy for patients with uncontrolled IOP after trabeculectomy. However, tube occlusion is a common complication of GDD implantation. Management of tube occlusion can be done using laser or with surgery. This case presents the management of vitreous occlusion of tube implant using ND:YAG laser-vitreolysis.
 Case Illustration : A 63 year-old male patient came with chief complaint of pain in his right eye. The patient had a history of cataract surgery on the right eye and was diagnosed with glaucoma. An examination showed IOP in the right eye was increased, vitreous in COA and lens was aphakic with posterior capsule rupture. The patient had undergone trabeculectomy, but IOP remained high, so an Aurolab Aqueous Drainage Implant (AADI) GDD implantation was performed. However, six weeks after the procedure, the IOP still increased, and an examination revealed vitreous occlusion of the GDD tube (Figure 1) . The patient underwent Zeiss ND-YAG laser-vitreolysis on his right eye (Figure 2) with laser spot size of 50?m and power of 2.1 MJ. Post laser IOP was decreased.
 Discussion : GDD implantation is a surgical option for primary or secondary therapy, but tube occlusion can cause implantation failure. Laser-vitreolysis is a non- invasive modality to treat tube occlusion caused by vitreous.
 Conclusion : GDD occlusion can occur due to various etiologies, but laser-vitreolysis is a non-invasive treatment option aimed at restoring tube patency and aqueous outflow.

Ayurvedic approach in the functional improvement of Systemic Lupus Erythematosus (SLE) - A Case Report

Systemic lupus erythematosus (SLE) is an auto immune disease in which organs and cells undergo damage mediated by tissue-binding autoantibodies and immune complex.[1]. 90% of patients are women of child-bearing years are affected with this disease. According to Ayurveda, the signs and symptoms can be included under the purview of Vataraktha. Case summary: A 43-year-old female patient approached with chief complaints of pain over bilateral elbow joints, shoulder joints and low back pain, burning sensation over toes for 8 years associated with febrile attacks, coated tongue, mouth ulcer, dryness of mouth aggravated since 2 months. The Ayurvedic diagnosis was made as Vataraktha on the basis of signs and symptoms. The patient was given Sadyovirechana (Purgation therapy), Basti therapy (enema) along with other external procedures and internal medications. Significant improvement was observed after the treatment in terms of VAS Score and other subjective parameters. This case study shows that Ayurvedic treatment is helpful in the functional improvement of SLE and helps in improving the quality of life.

Transdiaphragmatic rupture of hydatid cyst: A rare case report

Hydatid disease is a major zoonotic disease worldwide. It remains a serious health problem in developing countries and in countries where animal husbandry is common. Here, we report the case of a 40-year-old male who presented with chief complaints of pain in the right upper quadrant of the abdomen and swelling of the right side lower chest for 2 days. He mentioned intermittent episodes of pain within the past 7 days, the frequency and severity of which is increasing in the past 2 days. Chest X-ray suggestive of opacity of the right lower hemithorax with blunting of cardiophrenic angle seems like pleural effusion with opacity in the right upper lobe but on ultrasound, cystic area with multiple septations found in right lung parenchyma likely suggestive of hydatid cyst.

Multilocular Cystic Renal Neoplasm of Low Malignant Potential - A Rare Case Report with Literature Review

Multilocular cystic renal cell carcinoma or multilocular clear cell renal cell carcinoma is a rare type of cystic neoplasms of kidney. MCRCC comprises 1-2% of all renal tumors. MCRCC has well defined diagnostic criteria, has low stage The term MCRCC was renamed as MCRNLMP by ISUP in 2013.Only few cases of MCRCC are reported in literature till now We report a rare case of MCRCC / MCRNLMP in 52 years female presented with chief complaints of pain and dragging sensation in the right side of abdomen for 1 year. Keywords: Multilocular, cystic, renal cell carcinoma, nephrectomy, low malignant potential

Presence of radix entomolaris in primary mandibular first molars: A review of rare entity

Numerous developmental anomalies with respect to crown and root are commonly seen in permanent dentition and while rarely in the primary dentition. Radix entomolaris (RE), an extra root seen on the distolingual aspect of mandibular molars, is one such aberration found. The presence of extra root in primary mandibular first molars is of extreme rarity and such two reports its significance had been discussed. Two children of 5- and 7 years old reported to the pediatric and preventive dentistry department with a chief complaint of pain in the right and left mandibular back teeth region, respectively. A diagnosis of chronic irreversible pulpitis was made in both cases with the accidental appraisal of RE in both the primary first molars on intraoral periapical radiographs. Standard pulpectomy was performed in both cases. Pediatric dentists as well as clinicians should update regarding the abnormal morphologies of primary molars and its diagnostic including treatment strategies.

Variation in the Branching Pattern of the Radial Nerve Observed during Fixation of the Humerus Shaft: A Case Report

The posterior cord of the brachial plexus typically maintains a consistent branching pattern, and deviations from this norm are exceedingly rare. Even more infrequently encountered are variations in the branching pattern of the radial nerve. The current case report of a 45-year-old male patient presents a unique clinical scenario involving a middle third and distal third humerus shaft fracture, manifesting as the chief complaint of pain during movement, coupled with localised swelling. A posterior approach was employed for surgical intervention due to the expansile nature of the fracture within the middle and distal thirds. During the surgical exploration, an anomalous branching pattern of the radial nerve was observed when transitioning from the posterior to the anterior compartment. This atypical radial nerve branching consisted of a branch extending into the anterior compartment and an accompanying posteroinferior branch, which notably supplied the medial and long heads of the triceps muscle. The present case underscores the imperative role of the orthopaedic surgeon in considering the radial nerve's intricate anatomy while exposing and stabilising segmental humerus fractures. It is of paramount importance to exercise vigilance, as the conventional practice of splitting the triceps muscle should be abstained from until an unusual branching or splitting of the radial nerve is definitively ruled out. The present case report elucidates the significance of meticulous anatomical awareness and surgical technique when addressing such complex humeral fractures, offering insights into the management of these uncommon clinical presentations.

Dental management of Goldenhar syndrome in a pediatric patient

Abstract: The purpose of the case report was to highlight the various features of Goldenhar syndrome to aid in the diagnosis of this syndrome which has classic clinical features such as microtia, preauricular skin tags, micrognathia, facial asymmetry, midface deficiency, malocclusion of teeth with poor oral hygiene, and carious teeth. A 12-year-old female child reported to the department with a chief complaint of pain in the lower left back tooth region. There was no significant prenatal, postnatal, and medical history. Herein, we report a case of Goldenhar syndrome with hemifacial micrognathia and microtia along with intraoral involvement which was clinically and radiographically assessed and described full-mouth rehabilitation procedures.