Constant Dull Pain Research Articles

Approach of Individualised Medicine in a Complicated Case of Cholelithiasis, Elongated Uterus with Ovarian Cyst—An Evidence-Based Case Report

AbstractGallstones are the most common biliary pathology. They are formed because of abnormal bile composition. Symptomatic gallstones present as pain in the right upper quadrant or epigastric region, which may radiate to the back. Ultrasonography of the gallbladder is very accurate in the identification of gallstones. Laparoscopic cholecystectomy is a minimal-access approach for the removal of the gallbladder together with its stones. A 28-year-old lady presented with complaints of pain in the right upper quadrant of abdomen, which was relieved by pressure, nausea and occasionally vomiting especially after having a rich meal for 1 month with constant dull pain in lower abdomen during menses for 2 to 3 months. Her ultrasonography of whole abdomen revealed cholelithiasis (stone size 8mm), elongated uterus with left ovarian cyst. Individualised medicine Natrum muriaticum was prescribed in a centesimal scale which showed a positive effect in the case within a short span of time. Causal attribution of changes in her condition to the homoeopathic treatment was assessed by Modified Naranjo Criteria. Future observational studies and randomised control trials are suggested to ascertain the efficacy of homoeopathic medicine in such cases.

OVARIAN CYST WITH BULKY UTERUS TREATED WITH HOMOEOPATHIC CONSTITUTIONAL MEDICINE PULSATILLA NIGRICANS – AN EVIDENCE-BASED CASE REPORT

ntroduction: Ovarian cyst is an endocrine disorder, more commonly reported in women of reproductive age group. It affects approximately 30% of all women. They may be asymptomatic or produce local discomfort, menstrual disturbances, infertility, or in rare cases, cause acute symptoms due to complications like haemorrhage, rupture or torsion. Hormonal therapy and oral contraceptive pills may be helpful in causing resolution in some cases. The patients are generally advised for surgical intervention in the conventional mode of therapy. Thus, Homoeopathy is the second choice of therapy as it is a simple system of medicine that treats the patient not the disease. We intend to report a case treated with homoeopathic constitutional medicine in women of reproductive age group suffering from bilateral ovarian cysts with a bulky uterus. A 40-year-old female presented with complaints of irregular menstrual bleeding,Case summary: constant dull pain in the lower abdomen and low backache. Ultrasound of the whole abdomen suggested bilateral ovarian cysts with a bulky uterus. Constitutional medicine Pulsatilla nigrican was prescribed on a centesimal scale which showed a positive effect in the case. Causal attribution of changes in her condition to the homoeopathic treatment was depicted by modied Naranjo criteria. Future observational studies and randomized control trials are suggested to ascertain the efcacy of homoeopathy in the case of ovarian cysts.

Association of Chiropractic Colleges Research Agenda Conference 2021 Abstracts of Proceedings.

Association of Chiropractic Colleges Research Agenda Conference 2021 Abstracts of Proceedings.

Pelvic inflammatory disease treated with homoeopathic medicine Calcarea carbonica: A case Report

Introduction: Pelvic Inflammatory Disease (PID) is a polymicrobial infection of the upper genital tract characterised clinically by triad of symptoms and signs: pelvic pain, cervical motion with adnexal tenderness and fever. Conventional treatment is with broad-spectrum antibiotics. The alternative medicine, especially Homoeopathy, is the second choice of therapy as per the WHO. Case reports of PID in the medical literature are scant. We aim to report a case treated with homoeopathic constitutional medicine in a woman suffering from PID. Case Summary: A 29-year-old female presented with the symptoms of white discharge per vagina, constant dull pain in the lower abdomen, low backache, fever and lassitude for 2 weeks. Clinical findings and ultrasound of the whole abdomen suggested PID. Individualised homoeopathic medicine Calcarea carbonica was prescribed in centesimal potency which showed a positive role in the treatment of PID. Causal attribution of changes in her condition to the homoeopathic treatment was depicted by modified Naranjo criteria. Future observational studies and randomised control trials are suggested to ascertain the efficacy of homoeopathy in the cases of PID.

Trigeminal neuralgia and persistent idiopathic facial pain

Trigeminal neuralgia (TN) and persistent idiopathic facial pain (PIFP) are two of the most puzzling orofacial pain conditions and affected patients often are very difficult to treat. TN is characterized by paroxysms of brief but crucial pain, followed by asymptomatic periods without pain. In some patients a constant dull background pain may persist. This constant dull pain sometimes makes the distinction from PIFP difficult. PIFP is defined as continuous facial pain, typically localized in a circumscribed area of the face, which is not accompanied by any neurological or other lesion identified by clinical examination or clinical investigations. The pain usually does not stay within the usual anatomic boundaries of the trigeminal nerve distribution and is a diagnosis of exclusion. Epidemiologic evidence on TN and even more so on PIFP is quite scarce, but generally both conditions are considered to be rare diseases. The aetiology and underlying pathophysiology of TN and more so PIFP remain unknown. Treatment is based on only few randomized controlled clinical trials and insufficiently evaluated surgical procedures.

Trigeminal neuralgia and persistent idiopathic facial pain

Trigeminal neuralgia (TN) and persistent idiopathic facial pain (PIFP) are two of the most puzzling orofacial pain conditions and affected patients are often very difficult to treat. TN is characterized by paroxysms of brief but severe pain followed by asymptomatic periods without pain. In some patients a constant dull background pain may persist. This constant dull pain sometimes makes the distinction from PIFP difficult. PIFP is defined as continuous facial pain, typically localized in a circumscribed area of the face, which is not accompanied by any neurological or other lesion identified by clinical examination or clinical investigations. The pain usually does not stay within the usual anatomic boundaries of the trigeminal nerve distribution and is a diagnosis of exclusion. Epidemiologic evidence on TN, and even more so on PIFP, is quite scarce, but generally both conditions are considered to be rare diseases. The etiology and underlying pathophysiology of TN, and more so PIFP, remain unknown. Treatment is based on only few randomized controlled clinical trials and insufficiently evaluated surgical procedures.

Pathological Fracture of the Fibula Due to a Late Presenting Posterior Tibial Artery Pseudoaneurysm

Accidental penetrating injury of the leg is common in the emergency room setting, and some patients have no bone injury on radiographs. We report a delayed sequel of vascular injury to the posterior tibial artery, following penetrating injury to the leg, which was later additionally complicated by pathological fracture of the proximal part of the fibula. Early diagnosis is important to provide timely treatment. The case of this patient illustrates that the delayed sequel of vascular injury may be confused clinically and on radiographs with a soft-tissue neoplasm. The patient was informed that data concerning the case would be submitted for publication, and he consented. A thirty-year-old man sustained a penetrating wound to the lateral aspect of the proximal part of the right leg fifteen months before presenting to our institution. After a radiograph showed normal findings, he was diagnosed as having a simple penetrating wound and was treated at a primary health center. He subsequently developed constant dull pain and mild swelling over the proximal part of the leg. The swelling and pain gradually increased. When the pain began to interfere with his daily activities, he presented to a private tertiary-care hospital. The radiographic provisional diagnosis was soft-tissue neoplasm. For further evaluation, fine-needle aspiration cytology, magnetic resonance imaging, and a radionucleotide scan were recommended. For economic reasons, he was unable to obtain these studies. He next presented to us with leg swelling and severe pain that interfered with his sleep and daily activities fifteen months after the injury. Clinical examination revealed a diffuse, tender 8 × 10-cm mass on the posterolateral aspect of the proximal part of the right leg. The overlying skin was warm and shiny. The mass was fixed with variable consistency from soft to firm. There was no palpable or …

Case 6-1988

Presentation of Case A 36-year-old woman was admitted to the hospital because of a pelvic mass. Seven years earlier a total abdominal hysterectomy was performed elsewhere because of pelvic pain of five days' duration and the finding of an enlarged uterus; pathological examination showed uterine leiomyomas. The pain persisted, and four years before entry bilateral salpingo-oophorectomy was performed at the same hospital, with relief of pain; endometriosis was found in both ovaries. Treatment with conjugated estrogens was begun. Eleven months before entry the patient began to have almost constant dull pain in the left lower abdominal quadrant, together with low . . .

Metastatic carcinoma in the liver simulating the acute surgical abdomen. Report of three cases.

Fever, leukocytosis, and right upper quadrant pain is a common symptom complex seen on every Surgical Service. However, intra-abdominal carcinoma with liver metastases is not usually found as a cause for, or in association with, the above clinical traid. Recently we had three patients on our Surgical Service, each presenting with symptoms of a right upper quadrant inflammatory lesion. At emergency laparotomy all three patients were found to have diffuse liver metastases from an unsuspected intraabdominal carcinoma. Report of Cases Case 1. —Two months prior to admission, this 26-year-old white man experienced sudden onset of constant dull pain in his right upper quadrant and at McBurney's point. The pain disappeared slowly over a three-week period, only to recur again one week later, lasting again for three weeks and subsiding. At the time of admission to the hospital, the patient had an exacerbation of the right upper quadrant pain with tenderness,

Ureteral Obstruction in Carcinomatous Cervix

DURING the last four years we have been intensely interested in the urologic complications of late carcinomatous cervix. In going over 27 consecutive autopsy records of carcinomatous cervix in patients who died on our service, we found that ureteral obstruction with associated renal damage occurred in 22 of the cases, and in only five patients did distant metastasis have the opportunity to develop. Carcinoma of the cervix, as you know, may extend in one of three ways, namely, either posteriorly, with invasion of the rectal wall, anteriorly to the bladder wall, or laterally into the broad ligament. With posterior extension, the symptoms are rectal pain, obstipation, tenesmus, and rectal bleeding. With extension to the bladder, dysuria, frequency of urination, and hematuria are the important signs. Here differentiation must often be made from an old radium burn, since practically all of these cases have had intensive radium therapy. Cystoscopic examination in late carcinoma of the cervix with anterior extension will often reveal large masses of bullous edema with areas of papillary projections and, finally, the formation of a vesico-vaginal fistula. However, the greatest number of cases in our series presented themselves with signs and symptoms of ureteral obstruction. Usually, the patient complains of a constant dull pain located deep in the groin, referred to the thigh and leg, and often simulating an attack of sciatica. The pain may be referred to the sacrum, simulating sacro-iliac disease, or, what is most common, to one or both kidneys, especially when complete occlusion of the ureter has taken place. As infection intervenes secondary to this obstruction, and its associated urinary stasis, chills and fever commonly occur, with anorexia, general malaise, and prostration. The urine often is turbid. However, with complete unilateral occlusion, the urine may be persistently clear, although evidences of a large hydronephrosis are present. Gastro-intestinal symptoms are usually pronounced and are associated with the hydronephritic condition which is present. This type of patient often develops a marked distaste for food; we have had patients gain from 10 to 100 pounds after the obstruction has been removed and their appetites have returned. Physical examination with the finger in the rectum or the vagina reveals some degree of induration of the parametria. However, cystoscopy and ureteral catheterization establish the diagnosis very positively. We have found these obstructions to be unilateral in about 75 per cent of the cases. Ureteral catheterization meets with obstruction in the terminal portion of the ureter, and in most cases nothing will go by the point of obstruction, and sodium iodide injected through the catheter for ureteral pyelography will regurgitate back into the bladder.

Pregnancy in a patient with complete double uterus

Menses began at eleven years; the patient had had marked dysmenorrhea starting three days before each period and lasting until three days after the period was over. In 1929, when fifteen years old, she had several attacks of acute abdominal pain, usually starting on one side and crossing to the opposite side. There was no vomiting; the attacks lasted for about twenty-four hours and disappeared. There was. however, during this time an almost constant dull pain in the right side, which frequently became sharp -xhen rising from a sitting position. After an acute attack in July of this year, the patient was sent to the hospital and an appendectomy and right oophorectomy were performed. The pathologic 1abora;ory report states that the appendix was enlarged, with obliterated lumen, densely fibrotic walls, atrophied muscle and obliterated glands. The right ovary consisted mainly of a large luteal cyst filled with hyaloid material; the cyst walls and cortex were thin and sclerotic. A diagnosis of obliterative appendicitis and luteal cystic ovary was made and the patient was discharged on the seventeenth day in good general condition. The family was informed at this time that the girl’s genital organs were abnormal. In 1932, the patient came to the gynecological clinic for treatment of the dysmenorrhea which for the past three or four months had become increasingly severe and necessitated remaining in bed for several days of each month. The pain started just above the symphysis and radiated chiefly to the left side, left loin, and down t.he left leg. On physical examination the patient appeared to be a perfectly normal seventeenyear-old white female, but pelvic examination revealed a double introitus and llouble vagina, each side .aith a small buttonlike cervix. The uterus could not be easily palpated because of abdominal rigidity. The adnexa were not palpable. Dilatation of both cervices was advised as a palliative measure, and this was done May 3, 1932. At o,peration, a Rubin test showed the left tube patent at a pressure of 80 millimeters of mercury. The right tube was not patent. At attempt at lipiodol injection and x-ray was unsuccessful. The vaginal septum was removed at the request of the mother. After the operation there was partial relief from dysmenorrhea for several months, then the patient married as.d moved to another state. In a short time it was reported that the dysmenorrhea was becoming progressively more severe. On one occasion the patient became comatose just before onset of menses. At this point cervical dilatation was again resorted to and several of the subsequent periods were acco~npanied by greatly diminished dysmenorrhea.

MANIPULATIVE (CHIROPRACTIC) DISLOCATIONS OF THE ATLAS

Unintelligent manipulations of the structures of the region of the upper cervical spine may result in undesired sequelae, such as have occurred in the three cases here presented. A forward dislocation of the atlas on the axis has been a consequence in each of the cases, one with fracture of the odontoid process; all of the cases were apparently the result of chiropractic treatments. One of them resulted in death, the second in constant dull pain and limitation of motion, with a material loss in efficiency of the patient, while the third appears to be progressing satisfactorily in spite of the dislocation of the atlanto-axial joint, although there is a marked reduction in the movements of the head. ANATOMIC CONSIDERATIONS The articulation of the atlas with the axis is a joint of complicated nature, as it is made up of four distinct parts or joints. These are: (1) a pivot