Complaints Of Pain Research Articles

This is a successful removal of more than 450 pieces of metal objects from a patient’s stomach: a case report

BackgroundIngestion of foreign bodies may be seen unconsciously or intentionally in patients with mental health problems. Most cases pass through the esophagus slowly; however, in some cases, the tumor may be located in narrower areas of the digestive tract that require endoscopic or surgical intervention. This study describes a rare case of successful removal of more than 450 pieces of metal objects from the stomach of a 36-year-old man via ingestion of foreign bodies at Imam Khomeini Hospital in Ahvaz.Case presentationA 36-year-old male patient (Aryan race) presented with complaints of chronic abdominal pain, frequent vomiting, and intolerance to liquids and food. The patient’s companions mentioned a history of gradual ingestion of small metal objects 3 months prior. The patient was conscious and had stable vital signs. In the patient’s X-ray and endoscopy, multiple metal objects inside the patient’s stomach were observed, causing gastric outlet obstruction. The patient underwent gastrostomy surgery, and 452 screws, nuts, keys, stones, and other metal parts weighing 2900 g were removed from the stomach. Five days after the operation, the patient was transferred to the psychiatric service in good general condition and was diagnosed with psychosis, and her condition returned to normal at follow-up.ConclusionSuccessful removal of this foreign body is rare. In chronic abdominal pain, especially in the context of psychiatric disorders, attention should be given to the ingestion of foreign bodies. In swallowing large amounts of sharp and metallic foreign objects, surgical intervention is necessary, especially in cases of obstruction, and saves the patient’s life.

Effectiveness of the use of bioactive concentrate of marine fish in patients with back pain

Background. The urgency of pain relief and patient improvement necessitates evaluating the most effective treatment approaches. This includes a comparative analysis of medications with different mechanisms of action, both taken individually and in combination while considering potential drug toxicity and individual patient intolerances. The study purposed to assess the efficacy of a bioactive concentrate derived from marine fish (BCMF), both alone and in combination with a non-steroidal anti-inflammatory drug (NSAID), for the treatment of back pain, in comparison to therapy involving solely oral sodium chondroitin sulfate (CS). Materials and methods. We examined four groups of patients, each comprising 30 male or female subjects with complaints of back pain. Each group was administered one of three medications: NSAIDs in a standard dosage, CS in a daily dose of 1 g (two capsules of 500 mg each), and BCMF in the form of intramuscular injections in a daily dose of 1 ml (0.2 ml per injection). The fourth group of patients received combined treatment, namely, 1 ml of BCMF and NSAIDs in a standard dosage daily. All parti­cipants underwent laboratory tests and instrumental examinations. ­Results. The administration of BCMF, both alone and in combination with NSAIDs resulted in an improved subjective assessment of patients’ psychoemotional well-being, marked by reduced back pain intensity, enhanced quality of life indices, and diminished le­vels of anxiety and depression. The combination of BCMF with NSAIDs demonstrated a more pronounced effect on redu­cing tumor necrosis factor α serum concentration than monothe­rapy with BCMF. The combination therapy positively impacted the condition of lower extremity vessels as indicated by Doppler ultrasonography. Conclusions. BCMF can be an effective addition to the standard therapy of back pain.

Effect of Valuka Swedana Followed by Greeva Basti Along with Physiotherapy and Abha Guggulu in the Management of Asthigata Vata (Cervical Spondylosis)

Aging and degeneration are natural course of life, but in this modern era the advancement of technologies and busy life style contribute to the early degeneration process. Improper continuous postures, jerky movements while travelling, overuse of mobiles etc. will produce undue pressure and stress to the cervical disc and it will lead to inflammatory reaction and eventually degeneration. Cervical spondylosis caused by wear and tear phenomena in cervical spine. It is most frequently involved in the cartilage and bones of the cervical spine and causes loss of normal spine function. According to Ayurvedic perspectives cervical spondylosis can be correlated with Asthigata Vata. A female patient age 23yrs., diagnosed and non-operated case of Cervical spondylosis (19/07/2023 OPD NO.27393, IPD NO. 2150) came to Panchakarma OPD of ITRA, Jamnagar with complaints of pain at nape of neck radiating to right upper limb (Greeva Shoola) since last 5yrs along with restricted ROM of neck (Greeva Stambha) and difficulty in doing daily activities such as reading, etc. The pain aggravated in prolonged reading and morning. She was treated with Valuka Swedana for 3 days followed by Greeva Basti with Ksheera Bala Taila 14 days along with physiotherapy (isometric exercise of neck) and Abha Guggulu. Significant improvements were observed in various subjective and objective parameters after the treatment.

Relationship Between Sitting Position and Sitting Duration with Low Back Pain Complaints in Back Office

Relationship Between Sitting Position and Sitting Duration with Low Back Pain Complaints in Back Office

Early childhood risk factors for later onset of pediatric chronic pain: a multi-method longitudinal study

BackgroundPediatric chronic pain (i.e., pain lasting ≥ 3 months) is prevalent, disabling, and costly. It spikes in adolescence, interrupts psychosocial development and functioning, and often co-occurs with mental health problems. Chronic pain often begins spontaneously without prior injuries and/or other disorders. Prospective longitudinal cohort studies following children from early childhood, prior to chronic pain onset, are needed to examine contributing factors, such as early pain experiences and mental health. Using data from a longitudinal community pregnancy cohort (All Our Families; AOF), the present study examined the associations between early developmental risk factors, including early childhood pain experiences and mental health symptoms, and the onset of pediatric chronic pain at ages 8 and 11 years.MethodsAvailable longitudinal AOF data from child age 4 months, as well as 1, 2, 3, 5, 8, and 11 years, were used. Mothers reported their child’s pain experiences (e.g., hospitalizations, vaccinations, gut problems) at each timepoint from 4 months to 8 years, child chronic pain at age 8, and child mental health symptoms at ages 5 and 8 years. Children reported their chronic pain frequency and interference at age 11. Adaptive least absolute shrinkage and selection operator (LASSO) regressions were used to select predictor variables. Complete case analyses were complemented by multiple imputation using chained equation (MICE) models.ResultsGut problems, emergency room visits, frequent pain complaints, and headaches at age 5 or earlier, as well as female sex, were associated with increased risk of maternal reported child chronic pain at age 8. Maternal reported chronic pain at age 8 was associated with higher levels of child-reported pain frequency and pain interferences at age 11. Boys self-reported lower levels of pain interference at age 11.ConclusionsSome, but not all, painful experiences (e.g., gut problems, ER visits, pain complaints) in early life contribute to pediatric chronic pain onset and should be considered for screening and early intervention.

Sex bias in pain management decisions

In the pursuit of mental and physical health, effective pain management stands as a cornerstone. Here, we examine a potential sex bias in pain management. Leveraging insights from psychological research showing that females' pain is stereotypically judged as less intense than males' pain, we hypothesize that there may be tangible differences in pain management decisions based on patients' sex. Our investigation spans emergency department (ED) datasets from two countries, including discharge notes of patients arriving with pain complaints (N = 21,851). Across these datasets, a consistent sex disparity emerges. Female patients are less likely to be prescribed pain-relief medications compared to males, and this disparity persists even after adjusting for patients' reported pain scores and numerous patient, physician, and ED variables. This disparity extends across medical practitioners, with both male and female physicians prescribing less pain-relief medications to females than to males. Additional analyses reveal that female patients' pain scores are 10% less likely to be recorded by nurses, and female patients spend an additional 30 min in the ED compared to male patients. A controlled experiment employing clinical vignettes reinforces our hypothesis, showing that nurses (N = 109) judge pain of female patients to be less intense than that of males. We argue that the findings reflect an undertreatment of female patients' pain. We discuss the troubling societal and medical implications of females' pain being overlooked and call for policy interventions to ensure equal pain treatment.

A Rare Case of Complex Left Paraduodenal Hernia with Cocoon Abdomen

Paraduodenal hernias are rare congenital hernias that account for approximately 0.2-0.9% of all internal hernias. Among them, left paraduodenal hernias are even rarer, with an incidence of about 0.8%. Cocoon abdomen, also known as sclerosing encapsulating peritonitis, is a rare condition characterized by the encapsulation of the small bowel by a thick fibrous membrane, leading to intestinal obstruction. We present a rare case of a 45-year-old female patient who presented with complaints of left upper abdominal pain, intermittent vomiting, and abdominal distension for two months. Imaging studies revealed a complex left paraduodenal hernia with cocoon abdomen, leading to subacute intestinal obstruction. The patient underwent exploratory laparotomy, reduction of small bowel contents from the hernial sac, excision of the hernial sac, extensive adhesiolysis, and closure of the hernial defect. Intraoperatively, the entire small bowel from the duodenojejunal flexure to the ileocecal junction was encased in a thick peritoneal sac, with dense interbowel adhesions and a thick hernial sac. The postoperative course was complicated by paralytic ileus, which was managed conservatively. The patient recovered well and was discharged on a low-residue diet and appropriate medications. This case highlights the rare coexistence of a left paraduodenal hernia and cocoon abdomen, emphasizing the importance of early diagnosis and timely surgical intervention to prevent potential life-threatening complications

Reabilitação oral utilizando coroas impressas em 3D para amelogênese imperfeita: relato de caso

Amelogenesis imperfecta (AI) is a condition that severely affects tooth enamel. In most cases aesthetics and function are compromised while solutions are scarce and have high cost. The purpose of this case report is to describe a rehabilitation case of a 13-year-old male patient diagnosed with amelogenesis imperfecta. A minimally invasive oral rehabilitation was planned using digital workflow for planning, 3D printing of crowns and S-PRG fillers as an aesthetic and functional solution, with lower cost, in the face of the AI case presented. Case report: 13-year-old male with pain, sensitivity, and aesthetics complaints, the patient has been diagnosed with Amelogenesis Imperfecta Hypomaturation-Hypoplastic, Type IV (AIHHT – OMIM: 104510). Treatment was divided into three phases, preventive and sensitivity management, minimally invasive oral rehabilitation – CAD-CAM and orthodontic treatment. It is possible to conclude that digital flow and 3D printing have many benefits for dentistry such as treatment predictability, chairside and lower material waste, cost and working time. It can also be concluded that digital dentistry allows oral rehabilitation following minimal intervention principles and that it was a successful treatment with aesthetic, function and quality of life improvements.

Case Report : Diagnosis dan Tatalaksanan Pasien Laki-Laki 40 Tahun dengan Kolelitiasis di Rumah Sakit Cut Meutia Aceh Utara

Cholelithiasis or gallstones are pieces of solid material that form in the gallbladder. The prevalence rate of cholelithiasis in developed countries is around 10-15% of the adult population, with the prevalence of cholesterol cholelithiasis. A 40-year-old man came to the emergency room of Cut Meutia Hospital with complaints of pain in the upper right abdomen since 3 weeks ago. The results of the abdominal physical examination found pressure pain in the hypochondrium dextra, murphy sign (+).Based on the examination of bile ultrasound and the results of gallbladder stone multiple. Based on anamnesis, physical examination and elongation examination of the patient was diagnosed with Cholelithiasis + Internal Hemorrhoids Grade I. Surgical management was carried out in the form of laparoscopy, cholecystectomy and postoperative therapy in the form of bed rest, postoperative wound healing, postoperative mobilization and a diet high in fiber and protein and fatty lace diet.

The effect of different subtalar joint pronation amounts on postural stability, function and lower extremity alignment in healthy individuals

IntroductionThe prone foot posture has a negative effect on postural stability, function, and knee valgus, but to our knowledge, the contribution of the degree of pronation has not been examined. Methods39 participants aged 18–40, with Foot Posture Index (FPI) scores between 6–12 and without any pain complaints were included. Participants with 6–9 points were included in the pronation group (PG) (n = 19), and participants with 10–12 points were included in the hyperpronation group (HPG) (n = 20). Static and dynamic postural stability, Foot and Ankle Ability Measure (FAAM), and frontal plane projection angles (FPPA) were measured for all participants. ResultsThe initial data of the participants are distributed homogeneously. In the intergroup evaluation only FPI-1 (p = 0.001; p < 0.05), FPI-4 (p = 0.00; p < 0.05), FPI-5 (p = 0.00; p < 0.05) and FPI-T (p = 0.000; p < 0.05) scores were found significantly different. ConclusionPronation and hyperpronation of the subtalar joint did not lead to a difference in postural stability, function, and knee valgus in healthy individuals. It may be more beneficial to focus on the prone posture rather than the degree of pronation.

Droperidol administration among emergency department patients with abdominal pain, nausea, and vomiting

Study objectiveThe primary objective of this study was to examine the common usage patterns of droperidol in the relatively unrestricted environment of an urban, academic medical center. We focused specifically on the most common use of droperidol in our department: patients with a chief complaint of abdominal pain, nausea, and/or vomiting. MethodsFor this retrospective, observational, single-center study, we extracted records of all administrations of droperidol from August 2019 to August 2020. Patients with a chief complaint of abdominal pain, nausea, or vomiting, or any combination thereof, were included in data analysis. ResultsBetween April 2019 to August 2020, 830 discrete patient visits involving droperidol administration were identified, comprising 706 patients. The average age was 39 years old with a range of 15 to 80. Seven patients (0.08%) were younger than 18, and 35 (4%) were older than 65. Five hundred sixty-five patients (68%) were female. Droperidol doses ranged from 0.625 mg to 5 mg intravenous (IV), with a median dose of 0.625 mg (interquartile range 0.625–1.25 mg), with 590 patients (71%) receiving a dose of 0.625 mg. Only 19 patients (2.3%) had a documented adverse event. Seven had akathisia or restlessness, 7 had anxiety or agitation, 3 had dystonia or stiffness, 1 had fatigue, and 1 had dizziness. For the entire cohort, there were no cardiac dysrhythmias, syncope, seizures, other major adverse events, or fatalities recorded. ConclusionAt one institution, droperidol is being used commonly for the chief complaints of abdominal pain, nausea, and/or vomiting. The preferred dosing is nearly universally below the 2.5 mg IV dose for which the FDA warning applies. Similar to previous studies, identification of adverse events was rare, and no major adverse outcomes such as dysrhythmia or death were identified.

AB069. Type of personality and cancer-related pain in central nervous system (CNS) tumor patients: a cross-sectional study.

Pain is the most common complaint experienced by central nervous system (CNS) tumor patients. Pain, especially cancer pain, involves the whole aspect of a person, such as personality, cognition, and behavior. Personality characteristics play an important role in how a person perceives pain rate and deals with painful situation. This study aimed to describe types of personality and investigate relationship between types of personality and cancer-related pain in CNS patients. This study was conducted at Cipto Mangunkusumo General Hospital from January to December 2023, that was determined by random sampling. The analysis included a total of 99 subjects from inpatient settings. In depth interview was used to assess type of personality and Numeric Rating Scale (NRS) was used to assess intensity of pain. Data analyses were carried out using the Chi-squared and Fisher's exact test to assess the relationship between types of personality and cancer-related pain in CNS patients. There were 99 subjects with mean age of 48.37±12.96 years, mostly women (60.6%). The results showed that in patients with CNS tumor, the most common neurological deficit was cancer pain (93.9%), consisting of no-mild pain (30.3%) and moderate-severe pain (69.7%). The prevalence of narcissistic personality was 73.7%, followed by histrionic personality 15.2%, and other personality (11.1%) such as borderline, obsessive-compulsive, and avoidant personality. Narcissistic personality traits were found in 48.5% of patients with moderate-severe pain. However, bivariate analysis showed that there was no significant relationship between types of personality and intensity of pain in CNS tumor patients (P=0.60). Although there was no significant relationship, cluster B personality (narcissistic, histrionic, and borderline) was found in a large percentage of CNS tumor patients. Research findings showed that intensity of pain was caused by biological components of pain and may be influenced by the patient's perception of pain itself, not solely due to personality. Therefore, it's important for health workers to pay attention and give optimal management to every patient's pain complaint, and not to ignore or minimize it. Psychiatrists can be involved by giving psychotherapy so that patients can deal with their pain in a more adaptive way.

Factors Associated With Survival Among Patients With Multiple Myeloma in Northeastern Tanzania.

This study sought to delineate the clinical, laboratory, and imaging characteristics during multiple myeloma (MM) diagnosis, outline the treatment modalities administered, and ascertain the survival rates among patients with MM over a comprehensive 5-year span in Tanzania. This retrospective cohort study investigated patients diagnosed with MM at the Cancer Care Clinic, Kilimanjaro Christian Medical Centre, between January 2017 and June 2022. Demographic data, clinical profiles, and survival outcomes were collected. The study employed the Kaplan-Meier method to determine overall survival (OS) and survival rates, supported by univariate analysis and a multivariate Cox regression model with significance of P < .05. In this study of 76 patients with MM, bone pain was the most common complaint (76.3%), and patients were age typically older than 50 years (82.5%). Laboratory tests showed frequent abnormalities, such as anemia (51.3%) and hypercalcemia (23.9%). Most patients were at stage III according to Durie Salmon Staging (82.7%), with imaging revealing various bone abnormalities. The median OS was 18.0 months, with 46.1% of patients passing away during the study period. Factors linked to shorter survival included anemia, renal failure, and bone involvement. Infection was the primary cause of death among these patients. The presenting complaint of bone pain significantly affected survival outcomes. This study provides a comprehensive understanding of MM within the Sub-Saharan African context, highlighting age-related disparities in diagnosis, predominant presenting symptoms like bone pain, factors contributing to delayed diagnoses, and the impact on survival rates. The findings underscore the critical need for early recognition, improved diagnostics, and tailored interventions to enhance outcomes for patients with MM in this region.

AYURVEDIC MANAGEMENT OF RHEUMATOID ARTHRITIS WSR TO AMAVATA- A CASE REPORT

Introduction: The Ayurveda described Mandagni as the root cause of all the diseases. The Acharyas mentioned Amavata as one of the common disorders caused by the impairment of Agni, formation of Ama and vitiation of Vata Dosha. The Ama is carried by the vitiated Vata and deposited in Shleshmasthanas producing symptoms like Angmarda, Aruchi, Alasya, Sandhiruk and Sandhishoth. On the basis of sign and symptoms Amavata can be equated to Rheumatoid Arthritis in modern era. Rheumatoid arthritis is a systemic autoimmune disease characterised by inflammatory arthritis and extra articular involvement. The onset of disease, beginning with prodrome of fatigue, weakness, joint stiffness, vague arthralgias followed by pain and swelling of joints. Aim: To evaluate the efficacy of Oral Ayurvedic drugs in management of Amavata. Method: In the present case, a female patient aged 36 years presented in OPD Of Asthi-SandhirogaVibhaga of RGGPG Ayurvedic College Paprola Distt. Kangra (H.P.) with the complaints of pain in multiple joints since 2 years. She also complained of generalised weakness and morning stiffness. The investigations were advised and oral Ayurvedic formulations like Vishtindukvati, Amavatari Ras and TrikatuChurna were prescribed to the patient. Result: The Ayurvedic management showed desired results in relieving the symptoms of patient. Discussion: The Ayurvedic drugs are effective in treating Amavata equated to RA and better alternative to NSAIDS, DMARDS and steroids in Rheumatoid arthritis management in todays world.

Spontaneous Hemothorax from Pulmonary Intralobar Sequestration: A Case Report.

Pulmonary sequestration is a rarely reported phenomenon where aberrant lung tissue exists independently from the rest of the tracheobronchial network. Complications may include hemothorax; however, there is a paucity of descriptions of this condition in the literature. We describe a case of a pulmonary intralobar sequestration resulting in atraumatic tension hemothorax. A 73-year-old woman presented to our facility in extremis and with complaints of acute-onset flank pain. Her evaluation was notable for a large pulmonary sequestration with a presumed, moderate-sized effusion; however, initial review did not reveal an obvious underlying cause for her symptoms. Shortly after her arrival to the emergency department (ED) she experienced a cardiac arrest. On secondary review of her computed tomographic angiography, it was determined that what was previously thought to be a pleural effusion was a large hemothorax. Following this finding, a finger thoracostomy was performed, which resulted in the immediate evacuation of hemothorax. The thoracostomy was then converted into an ED thoracotomy to assess for active hemorrhage with brief return of spontaneous circulation. Prior to proceeding with emergent operative intervention, the patient's spouse requested that all further resuscitative efforts cease, and the patient was allowed to expire. In a review of the case, it was determined that the patient suffered from cardiac arrest due to a spontaneous hemothorax secondary to a large intralobar pulmonary sequestration. Pulmonary intralobar sequestration can result in spontaneous hemorrhage with fatal results. Early and correct interpretation of imaging and surgical intervention are crucial in ED management.

Efficacy of Ultrasound for the Detection of Possible Fatty Liver Disease in Children.

Pediatric MASLD (previously referred to as NAFLD) incidence has continued to rise along with the obesity pandemic. Pediatric MASLD increases the risk of liver fibrosis and cirrhosis in adulthood. Early detection and intervention can prevent and reduce complications. Liver biopsy remains the gold standard for diagnosis, although imaging modalities are increasingly being used. We performed a retrospective study of 202 children seen in a pediatric gastroenterology clinic with a complaint of abdominal pain, elevated liver enzymes or MASLD, or a combination of the three to evaluate screening methods for MASLD. A total of 134 of the 202 patients included in the study underwent laboratory testing and abdominal ultrasound. Ultrasound images were reviewed with attention to liver size and echotexture by a fellowship-trained pediatric radiologist for liver size and echotexture. Overall, 76.2% of the initial radiology reports correctly identified hepatomegaly based on age and 75.4% of the initial radiology reports correctly described hepatic echogenicity that was consistent with increased hepatic fat deposition. Use of screening ultrasound in concert with other clinical evaluations can be helpful to identify children at risk of MASLD. Utilizing ranges for liver span according to age can help to diagnose hepatomegaly, and understanding how to identify hepatic echogenicity is important for identifying possible hepatic steatosis.

Simultaneous choledochal cyst excision and pancreaticojejunostomy (Puestow’s technique) for type IA cyst with associated chronic pancreatitis: a case report

Introduction and importanceCholedochal cysts are congenital conditions that affect the biliary tree, typically identified during childhood. These cysts present as dilations in the biliary system, occurring either in the extrahepatic or intrahepatic regions or in some cases, in both areas. Occasionally, it may have associated chronic pancreatitis posing a challenge to the management of both conditions.In the case reported, a female child was diagnosed with a choledochal cyst along with chronic pancreatitis. She had an excision of cyst and lateral pancreaticojejunostomy simultaneously for both conditions resulting in favorable outcomes.Case presentationAn 8-year-old child visited the clinic with a complaint of upper abdominal pain accompanied by intermittent vomiting. An ultrasound was performed which showed a dilated common bile duct. To confirm the diagnosis, an MRCP and baseline labs including liver function tests were ordered. The findings were suggestive of a type IA choledochal cyst with concomitant chronic pancreatitis. Subsequently, she had choledochal cyst excision with Roux-en-Y hepaticojejunostomy reconstruction plus lateral pancreaticojejunostomy using the classical Puestow’s technique. The patient’s recovery post-surgery was uneventful, resulting in discharge on the fifth post-operative day for routine outpatient follow-up.Clinical discussionPatients afflicted with choledochal cysts are prone to recurrent pancreatitis, though the precise underlying mechanism is unknown. Certain studies propose an association between abnormal pancreatico-biliary junction and recurrent pancreatitis, often defined as a common channel surpassing 15 mm in length. However, this aberration could not be definitively established in the current case. Diagnosis of choledochal cysts can be confirmed through either ERCP or MRCP, with the latter preferred due to its non-invasive nature. The optimal management strategy for choledochal cysts necessitates cyst resection and Roux-en-Y hepaticojejunostomy reconstruction Moreover, in cases associated with chronic pancreatitis, longitudinal pancreatojejunostomy may be undertaken.ConclusionThus, it is concluded that although rare choledochal cysts may have associated chronic pancreatitis. Surgical excision of the cyst and lateral pancreaticojejunostomy can be performed simultaneously resulting in favorable post-operative outcomes.

Identifying Acute Aortic Syndrome and Thoracic Aortic Aneurysm from Chest Radiography in the Emergency Department Using Convolutional Neural Network Models.

(1) Background: Identifying acute aortic syndrome (AAS) and thoracic aortic aneurysm (TAA) in busy emergency departments (EDs) is crucial due to their life-threatening nature, necessitating timely and accurate diagnosis. (2) Methods: This retrospective case-control study was conducted in the ED of three hospitals. Adult patients visiting the ED between 1 January 2010 and 1 January 2020 with a chief complaint of chest or back pain were enrolled in the study. The collected chest radiography (CXRs) data were divided into training (80%) and testing (20%) datasets. The training dataset was trained by four different convolutional neural network (CNN) models. (3) Results: A total of 1625 patients were enrolled in this study. The InceptionV3 model achieved the highest F1 score of 0.76. (4) Conclusions: Analysis of CXRs using a CNN-based model provides a novel tool for clinicians to interpret ED patients with chest pain and suspected AAS and TAA. The integration of such imaging tools into ED could be considered in the future to enhance the diagnostic workflow for clinically fatal diseases.

Recent Advances In Interventional Pain Management

Introduction: Due to limited access to therapy, 60 million individuals worldwide suffer from chronic pain, with a frequency of 20–25% in some nations. Low- and middle-income countries (LMICs) are disproportionately affected by this condition. The yearly cost of diabetes, cancer, and heart disease—including medical expenses, lost productivity, and disability programs—is less than that of pain complaints. Pain management techniques, the most recent discoveries in pain research, and the most recent advancements in pain therapy technology can work together to reduce the prevalence of chronic pain and lessen the financial burden that comes with pain syndrome. Objective: To determine the extent to which the latest technological developments in interventional pain management to personalized treatment techniques according to patient complaints and conditions. The scope of technological development here is not only pain intervention techniques but also advances in understanding the pathophysiology of pain, nerve and tissue regeneration, as well as the modalities of technology used for pain interventions. Review: By conducting literature searches including journals, systematic reviews, library surveys, and case reports from the last 10 years on the latest interventional pain management techniques and serial cases. Summary: Many new minimally invasive pain intervention techniques have been developed and used in the treatment of chronic pain within the past 10 years. The necessity for standardization of processes, safety, efficacy, cost, and accessibility to new technology and techniques are among the issues and debates surrounding technical advancements and strategies for managing chronic pain. Intervention pain management techniques have grown in importance as a less intrusive method of treating chronic pain. For optimal outcomes, used in conjunction with other pain management modalities such as medication, physical therapy, cognitive behavioral change therapy, and others.

AYURVEDIC MANAGEMENT OF AVASCULAR NECROSIS WITH CHANDAN BALA LAKSHADI TAIL AND LAKSHADI GUGGUL

Avascular Necrosis (AVN) is a progressive degenerative condition of bone that mainly affects the bone of the lower region. It is more common in the hip joint. Avascular necrosis of the femoral head refers to the death of osteocytes with subsequent structural changes due to impaired blood supply. People between 30 and 50 years of age are usually affected. It is associated with excessive alcohol intake and long-term use of high-dose steroidal medications. On the contrary, Ayurvedic treatment provides long-term relief and prevents disease progression without drawbacks. it is Vata Pradhana Tridoshaja Vyadhi with Vikruti of Asthi-Majja Dhatu. In modern medicine, no specific treatment other than surgery is available. The present case study is upon a 45year male patient, diagnosed with avascular necrosis involving nearly 50 percent of the femoral head with moderate marrow oedema (stage 3rd) femoral head with complaints of pain in the bilateral hip region since one and half years, which was associated with difficulty in doing normal daily activities such as walking, sitting, squatting along with a change in the gate.