Effective Relief Research Articles

Laxative Properties of Microencapsulated Oleic Acid Delivered to the Distal Small Intestine in Patients with Constipation after Bariatric Surgery or Treatment with Glucagon-Like- Peptide 1 Analogues

BackgroundConstipation is prevalent after bariatric surgery and glucagon-like-peptide 1 (GLP-1) analogues. Increasing fat content in the distal small intestine and colon can enhance colonic peristalsis, potentially alleviating symptoms of constipation.AimWe investigated whether oleic acid can ameliorate constipation in patients undergoing bariatric surgery or receiving GLP-1 analogues.MethodologyFourteen adults with chronic constipation according to Rome IV criteria following bariatric surgery or GLP-1 analogues were on stable treatment for constipation for more than 4 weeks. This randomized double-blind crossover trial compared microcapsules containing 21.25 g of oleic acid delivered in the distal small intestine or the stomach. The primary outcome was changed in the number of bowel motions over 24 h. Exploratory endpoints included alterations in straining, diarrhoea, faecal leakage over 24 h and hunger, fullness, nausea and calorie intake for the 3 h after ingesting the microcapsules.FindingsReceiving oleic acid into the distal small intestine increased number of bowel movements per day (2.5 vs 1.1, p = 0.009) and caused softer stool consistency (p = 0.03). 9/14 of the control group passed motions and 13/14 of the intervention group passed motions in 24 h (p = 0.059). No significant differences were observed in straining (p = 0.65), rapid bowel movements (p = 0.08), accidental leakage (p = 0.32), hunger, fullness, nausea or food intake between the groups (all p > 0.05). There were no disparities in safety profile between groups.ConclusionMicrocapsules containing oleic acid delivered to the distal small intestine appear to be a safe and effective relief from chronic constipation in patients undergoing bariatric surgery and/or receiving GLP-1 analogues.Graphical

Endovascular Treatment for Transplant Renal Artery Stenosis: 10 Years' Experience from a Single Center.

Transplant renal artery stenosis (TRAS) is a common post-renal transplant complication. Although endovascular treatment is widely used to treat TRAS, previous research has been limited by small sample sizes. This article aimed to present the clinical outcomes of endovascular treatment for TRAS in a large sample. Between January 2010 and December 2019, this study included patients with TRAS who were admitted to our center. All patients' clinical symptoms, comorbidities, imaging data, treatment, and follow-up results were reviewed retrospectively. Seventy two patients participated in this study. The median time between renal transplantation and TRAS was 5.25 months. Out of 72 patients, 55 (76.4%) received balloon dilatation in conjunction with stent deployment, 10 (13.9%) received drug-coated balloon dilatation alone, and 7 (9.7%) received balloon dilatation alone. The median follow-up period was 27 months. Primary patency rates were 100%, 81.8%, 74.5%, 64.6%, and 61.8% at 1, 3, 6, 12, and 24 months. A total of 23 patients were found to have restenosis during follow-up, with 6 (26.1%) requiring reintervention and none remaining restenosis after the second treatment. In the subgroup analysis of the three types of stenosis, patients with transplant renal stenosis at the anastomosis had a significantly higher rate of primary patency. Between endovascular treatments, the primary patency rate, postoperative creatinine clearance, and mean systolic blood pressure did not differ significantly. Endovascular treatment resulted in favorable short-term patency as well as effective relief of renal dysfunction and renal hypertension in TRAS patients.

Rathke's cleft cysts: from pathophysiology to management.

Rathke's cleft cysts (RCCs) are benign, non-neoplastic lesions located in the sellar and suprasellar regions of the brain, originating from remnants of Rathke's pouch, an embryonic precursor to the anterior pituitary gland. Although RCCs are frequently asymptomatic and discovered incidentally during imaging studies, they can present with a variety of symptoms, including headaches, visual disturbances, and endocrine dysfunction due to the compression of adjacent neural structures. The management of RCCs is particularly challenging, as the decision to pursue conservative monitoring or surgical intervention depends heavily on the cyst's size, growth potential, and the severity of symptoms. Transsphenoidal surgery is the primary treatment for symptomatic RCCs, offering effective relief from symptoms through decompression of the cyst. However, recurrence remains a significant issue, with rates reported up to 33%, prompting debates about the extent of cyst wall removal during surgery. Recent advancements in minimally invasive endoscopic techniques have improved surgical outcomes, yet the risk of postoperative complications such as hypopituitarism and cerebrospinal fluid leaks persists. Additionally, stereotactic radiosurgery has emerged as a potential alternative for patients with recurrent RCCs or those who are not suitable candidates for repeat surgery. Despite its promise, the long-term safety and efficacy of radiotherapy in RCC management require further investigation. This narrative review aims to provide a comprehensive overview of RCCs, integrating the latest research and clinical guidelines to discuss pathophysiology, clinical presentation, and management strategies, emphasizing the need for a personalized approach to treating this complex condition.

Evaluating The Therapeutic Potentials Of Riboflavin, Folic Acid, And Niacinamide In The Treatment Of Oral Ulcers: A Comprehensive Review

Oral ulcers are a common clinical problem, causing significant discomfort and impacting the quality of life. Traditional therapeutic approaches often fall short in providing effective relief, prompting the exploration of alternative treatments. Vitamins such as riboflavin, folic acid, and niacinamide have shown promise in this context, with various studies highlighting their roles in enhancing mucosal healing and modulating immune responses. This review synthesizes the existing literature on the efficacy of these vitamins in treating oral ulcers, examining their mechanisms of action, therapeutic potentials, and clinical outcomes. Through a comprehensive analysis of peer-reviewed studies and clinical trials, the review aims to elucidate the scientific basis for the use of these vitamins as therapeutic agents, thereby offering insights into their integration into current treatment paradigms. The findings suggest that while each vitamin displays unique benefits, their combined application could potentially amplify therapeutic effects, meriting further investigation in clinical settings.

Levitating Magnetic Insoles: A Novel Approach to Alleviating Plantar Fasciitis Through the Reduction and Redistribution of Plantar Pressures

Plantar fasciitis, a leading cause of foot pain, affects a significant portion of the population, with an estimated prevalence of 10% during an individual’s lifetime. This debilitating condition can result in substantial healthcare costs and decreased quality of life. The pain is attributed to the inflammation of the plantar fascia, which is crucial for supporting the foot's arch. Risk factors for plantar fasciitis include obesity, sedentary lifestyles, improper footwear, and biomechanical abnormalities. Current treatment options are primarily conservative, with varying levels of success. In response, an affordable, lightweight, and soft, magnetic insole was developed as a novel approach to alleviate plantar fasciitis by reducing and redistributing plantar pressures with neodymium magnets. The final prototype achieves a magnetic repulsion force of approximately 84.57 lbs. and incorporates sensor modules to monitor data. The device also facilitates real-time data visualization between Arduino and personal devices, providing valuable insights into plantar pressure and walking characteristics for various patients. Data analysis and structural optimization are further enhanced through the use of MATLAB and Excel, which generate heatmaps to visualize plantar pressure distribution. Future research should focus on increasing the magnetic intensity to improve pain relief effectiveness and incorporating personalized disease-specific adjustments to optimize the magnet placement within the sole. By addressing the prevalent issue of foot pain and offering a potential solution for plantar fasciitis, our levitating magnetic insoles demonstrate significant potential for enhancing the quality of life for a large portion of the population.

Complex Hiatal Hernia with Gastric Volvulus Successfully Managed by Hiatal Plasty and Nissen Fundoplication: A Case Report

Background: Hiatal hernias, particularly those complicated by gastric volvulus, represent a rare but potentially life-threatening condition. Prompt diagnosis and surgical intervention are crucial to prevent severe complications such as strangulation and ischemia of the stomach. This case report details the presentation, diagnosis, and successful surgical management of a Type IV hiatal hernia with an associated gastric volvulus using hiatal plasty and Nissen fundoplication. Case Presentation: We present the case of a 65-year-old male with a history of recurrent epigastric pain, nausea, and postprandial vomiting, who was diagnosed with a Type IV hiatal hernia complicated by an organoaxial gastric volvulus. Imaging studies confirmed the diagnosis, revealing significant herniation of the stomach into the thoracic cavity. The patient underwent elective surgical repair involving a hiatal plasty to restore the diaphragmatic hiatus, followed by a Nissen fundoplication to prevent recurrence. Postoperative recovery was uneventful, with resolution of symptoms and no recurrence at a six-month follow-up. Conclusion: This case underscores the importance of timely recognition and appropriate surgical management of hiatal hernias complicated by gastric volvulus. The combined approach of hiatal plasty and Nissen fundoplication provides effective relief and prevents recurrence, contributing to favorable long-term outcomes.

Palliative Thoracic Radiotherapy in the Era of Modern Cancer Care for NSCLC.

Palliative thoracic radiotherapy provides rapid and effective symptom relief in approximately two-thirds of NSCLC patients treated. In patients with poor performance status, the degree of palliation appears unrelated to the radiation dose or fractionation schedule. Conversely, in patients with good performance status, higher radiation doses administered over longer periods have shown modest survival benefits. These findings stem from studies conducted before the advent of immunotherapy and targeted therapy in clinical practice. Currently, there are no large prospective studies specifically dedicated to palliative radiotherapy conducted in this new treatment era. Modern radiotherapy technologies are now widely available and are increasingly used for palliative purposes in selected patients, reflecting the expanded array of therapeutic options for disseminated NSCLC and improved prognosis. Some traditional tenets of palliative thoracic radiotherapy, such as the improvement of overall survival with a protracted radiation schedule and the use of simple, cost-effective radiation techniques for palliative purposes, may no longer hold true for patients receiving immunotherapy or targeted therapy. The application of IMRT or SBRT in the context of palliative radiotherapy for NSCLC is not yet sufficiently explored, and this is addressed in this review. Moreover, new risks associated with combining palliative radiotherapy with these systemic treatments are being explored and are discussed within the context of palliative care. The optimal timing, doses, fractionation schedules, and treatment volumes for radiotherapy combined with immunotherapy or targeted therapy are currently subjects of investigation. In emergencies, radiotherapy should be used as a life-saving measure without delay. However, for other indications of palliative thoracic radiotherapy, decisions regarding doses, timing relative to systemic treatments, and treatment volumes should be made in a multidisciplinary context, considering the patient's prognosis, anticipated outcomes, and access to potentially effective treatments. We still lack robust data from prospective studies on this matter. This review examines and discusses available evidence on the use of palliative thoracic radiotherapy within the framework of modern treatment strategies for NSCLC.

Identification of formulation parameters that affect the analgesic efficacy of ProGel-Dex – A thermoresponsive polymeric dexamethasone prodrug for chronic arthritis pain relief

The relief of joint pain is one of the main objectives in the clinical management of arthritis. Although significant strides have been made in improving management of rheumatoid and related forms of inflammatory arthritis, there are still major unmet needs for therapies that selectively provide potent, sustained and safe joint pain relief, especially among patients with osteoarthritis (OA), the most common form of arthritis. We have recently developed ProGel-Dex, an N-(2-hydroxypropyl) methacrylamide (HPMA) copolymer-based thermoresponsive dexamethasone (Dex) prodrug, which forms a hydrogel upon intra-articular administration and provides sustained improvement in pain-related behavior and inflammation in rodent models of arthritis. The focus of the present study was to investigate the impact of ProGel-Dex formulation parameters on its physicochemical properties and in vivo efficacy. The results of this study provide essential knowledge for the future design of ProGel-Dex that can provide more effective, sustained and safe relief of joint pain and inflammation.

Disability Assessment with WHODAS 2.0 of People with Fibromyalgia in Poland: A Cross Sectional-Study.

BACKGROUND Fibromyalgia (FM) is a multifactorial syndrome characterized by chronic widespread pain, fatigue, sleep and cognitive impairment and functional symptoms. The aim of this study was to assess disability and its associated factors. The study was conducted among 691 patients with fibromyalgia in Poland using an online survey. MATERIAL AND METHODS This was a cross-sectional study of the disability of patients with fibromyalgia aged 18 years and over in Poland. The study was conducted by means of an online questionnaire distributed to patients affiliated with the National Association of Patients with Fibromyalgia. A total of 691 records were analyzed. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 36-item version was used to assess disability. The Beck Depression Inventory was used to assess the participants' emotional state. Sociodemographic and selected health data were collected. RESULTS The study group had a significant general level of disability as measured by the WHODAS 2.0 (mean=49.69). The greatest limitations were found in the following areas: life activity (mean=73.43), social participation (mean=64.59), and mobility (mean=62.07). The categorical sociodemographic variables that statistically significantly differentiated the participants in terms of general level of disability were occupational status (P<0.005), pain level (P<0.001), number of medications taken (P=0.005), and level of depression (P<0.001). CONCLUSIONS Disability is present in fibromyalgia and is a major concern. Understanding the determinants of disability in fibromyalgia can contribute to the development of effective therapies and symptom relief.

Improved interfacial mechanical properties between PZT piezoelectric ceramic and Ag metallization layer by in-situ-formed CuO nanoparticles

In-situ-formed CuO nanoparticles were used to improve the interfacial mechanical properties between lead zirconate titanate (PZT) ceramic and metallization layer. The effects of CuO particles on the mechanical properties of PZT/Ag interfaces were studied, and the damage evolutions of the PZT-CuO/Ag interfaces were analyzed. The results showed that both the maximum peeling stress σmax and shear stress τmax of the PZT-CuO/Ag interfaces increased by approximately 200 %, while the critical fracture energy GIC of the interface was increased at most by seven times. The enhanced mechanical properties of the PZT-CuO/Ag interfaces originated from the high bonding strength between CuO and Ag layer and the effective stress concentration relief. Crack deflection and crack pinning effects promoted the enhancement of interfacial fracture toughness. The optimal size of the CuO particles at the PZT/Ag interface was approximately 100 nm. Notably, the electron transport between the PZT ceramic and Ag layer was not degraded with the introduction of CuO nanoparticles.

Internal and External Factors on Profitability of Islamic Banks in Indonesia Mediated by Operating Expenses Operating Income (Period 2013 to 2023)

Lucrativeness is a vital element for evaluating Islamic banks' monetary achievement. It's critical to grasp the determinants that influence Indonesian Islamic banks' lucrativeness. The objective of this examination is to explore the factors—such as problematic financing, financing to store ratio, currency rates, price rises, and operational proceeds as an intermediary variable—that impact the productivity of Islamic banks in Indonesia. This research intends to provide choice makers in the Islamic fiscal industry a more comprehensive discernment of the budgetary operation of Islamic banks by scrutinizing these guidelines. This research methodology uses a panel data approach using secondary data from Islamic banks in Indonesia. Through panel data analysis, this study examines the effect of these variables on the profitability of Islamic banks. The conclusions showed that, in Sub-structural I, Financing to Deposit Proportion (FDR) favorably affects the productivity (ROA) of Indonesian Islamic banks, while Non-Performing Financing (NPF), Currency Ratios, and Rising Prices have no consequence on operational expenses operational proceeds (BOPO). As indicated by sub-structural II, profitability is impacted by inside factors (NPF and BOPO), outer variables (expansion and cash rates) have no significant effect on productivity, and financing to store proportion (FDR) has no impact on productivity. In this examination, the BOPO fills in as a mediating variable that just intercedes the effect of the Financing to Deposit Ratio on Lucrativeness. Concerning the other autonomous factors, it has no bearing. Other than featuring the significance of hazard relief and operational effectiveness in accomplishing positive monetary outcomes, this exploration illuminates the variables influencing the productivity of Islamic banks in Indonesia.

Research and Analysis on the Pathogenesis of Allergic Rhinitis in Children and Its Treatment by Chinese and Western Medicine

Allergic rhinitis in children is a common allergic disease, when it recurs, the symptoms are significant, long-lasting, to children's daily life and learning has brought a huge burden.Western medicine has abundant clinical experience in treating this kind of disease, but the unique dialectical thinking and treatment system of traditional Chinese medicine also show undeniable advantages.The purpose of this study was to explore the etiology of allergic rhinitis in children, the relationship between allergic rhinitis and TCM syndrome types, and the advantages and disadvantages of TCM and WM treatment.It is found that allergen, heredity, environmental factors and immune imbalance are the common causes leading to high incidence of diseases. On the whole, TCM can classify different syndrome types and apply corresponding treatment methods, effective relief of the disease, improve the quality of life.We hope this paper can provide a new perspective and guidance for clinical diagnosis and treatment.

Did COVID-19 discriminate in the global South? Revealing heterogeneity of urban households’ livelihood resilience based on evidence from Bangladesh, China, India and Philippines

“Lives or livelihoods” is a hard trade-off when confronting COVID-19, especially for cities in the Global South. Countermeasures to protect people's lives may exert negative impacts on urban households and test their livelihood resilience. Did COVID-19 discriminate? Did livelihood resilience vary among different urban households within and across different countries and cities? Established studies focused on rural households' livelihood resilience under climate change or natural hazard based on single country context. Little is known about the variety of urban households' livelihood resilience under COVID-19 across countries and cities. This study aims to fill this gap by revealing heterogeneity of livelihood resilience at both individual urban household level and country level. First-hand questionnaire survey data (N ​= ​4374) were collected from seven cities from Bangladesh, China, India, and Philippines. Using a combination of quantitative and qualitative analytical methods, it's found that: COVID-19 did discriminate. Urban households with larger household size, no home ownership, no financial assets, and household heads with low education level, informal employed and no flexibility to transfer to work from home, were vulnerable groups. COVID-19 also discriminated across cities. Cities with a high ratio of informal workers, no effective economic relief policies and long stringent mobility restriction measures performed worse.

CARING FOR THOSE WHO CARE: CHALLENGES AND STRATEGIES TO ALLEVIATE OVERBURDEN IN CAREGIVERS OF ONCOLOGY PATIENTS

Introduction: Cancer is a growing public health issue in Brazil, and it is clear that caregivers of cancer patients play a crucial role in supporting patients. However, they face a series of emotional, physical, and financial challenges that can exacerbate their burden. Therefore, the aim of this study is to analyze the various facets of the burden of caregivers of cancer patients, highlighting its origins, manifestations, and repercussions, with the purpose of devising effective relief strategies. Methodology: This literature review analyzed 15 articles published between 2021 and 2023, selected based on relevance and currency on the topic of caregiver burden in oncology. The following factors contributing to caregiver burden were identified: emotional burdens (negative emotions such as stress, anxiety, and depression), physical burdens (tasks such as mobility, hygiene, and medication administration), and financial burdens (significant treatment costs leading to financial difficulties). Results and Discussion: The research reveals that patient performance is the primary factor associated with caregiver burden. Other factors include the caregiver-patient relationship, such as degree of kinship, gender, age, emotional and financial burden, along with the social and family context, such as marital status, education, occupation, and employment status of the caregiver, as well as the hours dedicated to care. The results underscore the importance of identifying and addressing the factors contributing to caregiver burden. Conclusion: Caregiver burden is a serious issue that needs to be addressed. Developing effective strategies to mitigate it is essential to improve the quality of life for both caregivers and cancer patients.

Surgical decompression in spinal Paget's disease: illustrative case.

Paget's disease of bone (PDB) is a common bone metabolic pathology in older adults, characterized by mixed osteolytic, osteoblastic, and quiescent periods. Surgical guidelines for PDB involving the spine are not well-defined and are reserved for cases refractory to medical treatments, typically bisphosphonates like zoledronic acid. This case study describes a 52-year-old male with PDB who presented with rapidly progressing myelopathy symptoms refractory to standard medical treatment, warranting surgical decompression. Surgical decompression and fusion, involving laminectomy with partial facetectomies, placement of pedicle screw instrumentation, and posterolateral arthrodesis spanning beyond the pathological segment, was performed. Follow-up visits indicated progressive improvement in symptoms and mobility, and imaging showed stable postsurgical changes with increased sclerosis in the affected vertebrae on a 2-year postsurgical course. This case underscores that PDB of the spine can transition from asymptomatic to significant impairment and demonstrates that surgical intervention can provide effective symptomatic relief in myelopathy secondary to PDB. The case contributes to the growing evidence of the effectiveness of surgical decompression in PDB involving the spine. https://thejns.org/doi/10.3171/CASE24203.

Endoscopic polidocanol foam sclerobanding for the treatment of grade II-III internal hemorrhoids: A prospective, multi-center, randomized study.

Endoscopic rubber band ligation (ERBL) is a nonsurgical technique for the treatment of symptomatic internal hemorrhoids but is limited by recurrence and post-procedural pain. To evaluate satisfaction, long-term recurrence, and post-procedural pain in managing internal hemorrhoids using a combination of polidocanol foam sclerotherapy and ERBL. This was a prospective, multicenter, randomized study. A total of 195 consecutive patients diagnosed with grade II-III internal hemorrhoids were enrolled from four tertiary hospitals and randomly divided into a cap-assisted endoscopic polidocanol foam sclerobanding (EFSB) or an ERBL group. All patients were followed-up for 12 months. Symptom-based severity and post-procedural pain were assessed using a hemorrhoid severity score (HSS) and a visual analog scale (VAS). Continuous variables were reported as medians and interquartile range. One hundred and ninety-five patients were enrolled, with 98 in the EFSB group. HSS was lower in the EFSB group than in the ERBL group at 8 weeks [4.0 (3.0-5.0) vs 5.0 (4.0-6.0), P = 0.003] and 12-month [2.0 (1.0-3.0) vs 3.0 (2.0-3.0), P < 0.001] of follow-up. The prolapse recurrence rate was lower in the EFSB group at 12 months (11.2% vs 21.6%, P = 0.038). Multiple linear regression analysis demonstrated that EFSB treatment [B = -0.915, 95% confidence interval (CI): -1.301 to -0.530, P = 0.001] and rubber band number (B = 0.843, 95%CI: 0.595-1.092, P < 0.001) were negatively and independently associated with the VAS score 24 hours post-procedure. The median VAS was lower in the EFSB group than in the ERBL [2.0 (1.0-3.0) vs 3.0 (2.0-4.0), P < 0.001]. Cap-assisted EFSB provided long-term satisfaction and effective relief from the recurrence of prolapse and pain 24 hours post-procedure.

ROLE OF VAMANA - AN AYURVEDIC PANCHAKARMA THERAPY (MEDICATED EMESIS) IN THE EFFECTIVE MANAGEMENT OF SHWASAROGA (BRONCHIAL ASTHAMA): A CASE STUDY.

Shwasa Vyadhi can be correlated with bronchial asthma and is said to be chronic. It obstructs the air pathway, which impedes the free flow of oxygen due to inflammation and accumulation of mucus in the respiratory sys-tem. It is a hyperactive respiratory disease that is aggravated after coming in contact with a cold environment, eating cold food, and lying down. Shwasa Vyadhi is Kapha-Vata dominant in nature and originated from Amashaya. According to Ayurveda Shodhan (bio-purification), vitiated dosha provides complete relief from dis-ease. Vaman (medicated emesis) is one of the best Shodhana Panchakarma therapy, which is mainly preferred for Kapha Pradhan Vyadhi, and it also facilitates Vatanuloman, which is indicated in getting relief from Shwasa Vyadhi. The present case study is of a 31-year-old female patient who has suffered from bronchial asthma, i.e., Shwasa Vyadhi, since childhood and got effective relief from all the signs and symptoms of Shwasa Vyadhi after Vama-na—an Ayurvedic Panchakarma Therapy (Medicated Emesis).

Management of Corn Using Agnikarma

Corns (clavi) are a common painful condition caused by hyperkeratosis due to repetitive friction or pressure. Agnikarma, an Ayurvedic thermal cauterization technique, is traditionally used to treat various musculoskeletal and dermatological conditions. This case study evaluates the efficacy of Agnikarma in treating a corn on the sole of a patient's foot. Patient Profile: A 45-year-old male school teacher presented with a painful corn on the plantar aspect of her right foot. The corn had been persistent for six months, causing severe discomfort while walking or standing. The patient opted for Agnikarma after conventional treatments were discussed. Method: The corn was marked and the surrounding area cleaned. A heated Shalaka (metal rod) was applied to the corn in a circular motion to achieve a therapeutic burn. Post-procedure care included keeping the area clean and dry with regular dressing changes. Results: The patient experienced significant pain relief one week post-procedure, with the corn reducing in size by four weeks. By eight weeks, the corn had completely resolved with no recurrence or complications. The patient reported no discomfort and was able to resume normal activities. Conclusion: Agnikarma provided effective and immediate relief for the patient’s corn, showcasing its potential as a minimally invasive and cost-effective treatment. This technique promotes localized tissue necrosis and healing, making it a valuable alternative to conventional treatments, particularly for patients seeking prompt pain relief and reduced recurrence.

Giving individual remedies in social rights litigation their due

As courts enforce socio-economic rights, reliance on individualized relief continues to be controversial. These remedies risk rewarding individuals for their ‘sharp elbows’, while ignoring others who suffer from similar deprivations. They can undermine the integrity of priority-setting schemes for distributing resources, and they can encourage inefficient public spending. Worse still, these orders can have the effect of starving social programs which support the vulnerable. More generally, this form of relief can neglect the need for structural change, and may fail to promote truly transformative constitutionalism. In the face of these criticisms, this article attempts to give individual remedies in socio-economic rights litigation their due. It develops a framework that identifies three spaces in which individualized relief is warranted. First, individual remedies can compensate for implementation gaps in public policy and administrative disfunction. Second, weak-form engagement orders can promote greater rights awareness and special attention for individuals experiencing poverty. Third, individual remedies can provide urgent relief from unreasonable priority-setting schemes. These remedial paths challenge conventional accounts of the judicial role by positioning judges to be more sensitive to their orders’ distributive implications. The article then theorizes the individual remedy’s contributions to the broader project of transformative constitutionalism. It stresses that when coupled with a democratization of legal procedure, individual orders can offer more timely and effective relief than complex, structural remedies. Individualized relief can also catalyze broader policy and administrative reform. Last, individual remedies can set the stage for structural remedies that would otherwise prove too daunting or provocative.

Fluoroscopic C-Arm Guided versus Ultrasound Guided Therapeutic Injection of Lower Cervical Radiculopathies

Abstract Background The burden of cervical radicular pain on patients and systems of health in different countries is an important medical issue that needs more significant medical researches to find a new solutions, treatment and limited interventional methods to improve patient's quality of life, prevent complications and decrease the cost on health systems. Objective To compare the effectiveness of cervical injection guided by either ultrasonography or fluoroscopy. Patients and Methods Sixty patients with lower cervical radiculopathy resistant to medical treatment were included in this study. Randomly, patients received cervical block ultrasonography guided or Fluoroscopic guided. Patients were followed up at 14 days and 90 days by Brief Pain Inventory Scale. Results In our study both groups showed significant decline in pain Inventory scale from baseline till 90 days after injection. Conclusion Both ways of injection guided by either ultrasonography or fluoroscopy showed the same effectiveness in relief of pain in lower cervical radiculopathy at 14 days and 90 days.