Manifestations Of Pain Research Articles

Effectiveness of Comprehensive Intervention Package on Pain and Physical Function among Patients with Arthritis in Selected Old Age Home at Chennai

Nursing, The Tamilnadu Dr. MGR Medical University. Abstract: Arthritis is a painful condition affecting joint, joint tissues and other connecting tissues with the manifestation of joint pain, swelling and stiffness which typically worsen with age. Tai chi and guided imagery could minimize those symptoms. The true experimental research design was used for the study. Simple random sampling technique was used to select 30 patients with arthritis as study participants (15 in experimental group and 15 in control group). The level of pain and physical function among patients with arthritis was assessed by WOMAC Osteoarthritis index. After pretest comprehensive intervention package that includes Tai Chi for 30 minutes thrice weekly and Guided Imagery for 30 minutes twice weekly was implemented to the experimental group for one month and the old age home routine was followed for the control group which was followed by the posttest. The study findings showed that the pretest and posttest mean pain score was 9.73 & 6.67 with standard deviation of 1.22 & 1.29 respectively in experimental group. The paired `t` value was 7.99*** which revealed that there was a highly statistically significant difference between the pretest and posttest level of pain at p<0.001. The pretest and posttest mean physical function score was 40 & 27.53 with standard deviation of 7.38 & 6.23 respectively in experimental group. The paired `t` value was 5.21*** which revealed that there was a highly statistically significant difference between the pretest and posttest level of physical function at p<0.001. The independent ‘t’ test value was 3.10 & 3.11 which revealed that there was a statistically significant difference in the posttest level of pain and physical function between experimental and control group at p<0.01. There was no statistically significant difference in the pretest and posttest mean pain and physical function score in the control group.

Influence of Health System Affiliation and Pain Manifestation on Advanced Oral Cavity Squamous Cell Carcinoma Risk: A Retrospective Cohort Study in a Latin American Population

Background/Objectives: Oral cavity cancer, a subtype of head and neck cancer, is one of the most common malignancies globally. This study assessed the influence of health system affiliation and pain manifestation on the risk of advanced oral cavity squamous cell carcinoma (OCSCC) in a Latin American population. Methods: In this retrospective cohort study, we analyzed medical records from 2015 to 2016, including data from the past 19 years, of 233 patients with OCSCC treated at a public hospital in Medellín, Colombia. Sociodemographic and clinical variables were evaluated, and multivariate regression models incorporated variables significant in bivariate analysis. Results: Among 233 patients, 196 (84.1%) had advanced OCSCC. The sample had a mean age of 63 ± 13 years, 53.6% were male, and 64% came from urban areas with predominantly low socioeconomic levels. Men showed a threefold increased risk of advanced OCSCC (95% CI: 1.3–6.8), while patients referred to pain clinics exhibited a 19.5 times higher risk (95% CI: 2.3–159.5). Patients in the subsidized health system or without health insurance had 2.6 (95% CI: 1.07–6.3) and 2.7 times (95% CI: 1.17–6.4) higher risks, respectively. Conclusions: This study found that male patients, referrals to pain clinics, and subsidized or no health system affiliation significantly increased the risk of advanced OCSCC.

Schwann cell C5aR1 co-opts inflammasome NLRP1 to sustain pain in a mouse model of endometriosis.

Over 60% of women with endometriosis experience abdominopelvic pain and broader pain manifestations, including chronic back pain, fibromyalgia, chronic fatigue, vulvodynia, and migraine. Although the imbalance of proinflammatory mediators, including the complement component C5a, is associated with endometriosis-related pain, the mechanisms causing widespread pain and the C5a role remain unclear. Female mice and women with endometriosis exhibit increased plasma C5a levels and pain. We hypothesize the Schwann cells involvement in endometriotic pain. Here, we show that silencing the C5a receptor (C5aR1) in Schwann cells blocks the C5a-induced activation of the NLRP1 inflammasome and subsequent release of interleukin-1β (IL-1β). Macrophages, recruited to sciatic/trigeminal nerves by IL-1β from Schwann cells, increase oxidative stress, which activates the proalgesic TRPA1 pathway, resulting in widespread pain. These findings reveal a pathway involving Schwann cell C5aR1, NLRP1/IL-1β activation, macrophage recruitment, oxidative stress, and TRPA1 engagement, contributing to pain in a mouse model of endometriosis.

Ex-vivo evaluation of a percutaneous thread technique to palmar/plantar annular desmotomy in horses

Palmar/plantar annular desmotomy (PAD) is a surgical procedure to mitigate pain, lameness, and other clinical manifestations of annular ligament syndrome. This study aimed to describe a minimally invasive technique for PAD and evaluate potential damage to adjacent structures in 15 cadaveric limbs from sound horses (forelimb = 6 and hindlimb = 9). A 6 USP polyglycolic acid thread was positioned around the palmar/plantar annular ligament (PAL) on both sides of the limbs through two incisions (proximal and distal to PAL) through the digital sheath and subcutaneous tissue. Kelly forceps, Gerlach or Obwegeser needles were used to thread placement. A back-and-forth motion allowed the thread to cut the ligament until it exited through the proximal skin incision, and the time was registered. The degree of PAL section and tissue injuries were evaluated. The section of the ligament was complete in all limbs. However, 30% (10/30) of the procedures produced iatrogenic injuries on adjacent structures regardless of the instrument used (p > 0.1). There was a higher frequency of lesions in the neurovascular bundle (NVB) on the medial side regardless of the limb (p = 0.068). The odds of injury in the NVB were correlated to side (lateral or medial (p = 0.042) and limb (hind or forelimb) (p = 0.065) by logistic regression. The Gerlach needle had a shorter execution time than the Kelly forceps (p = 0.003). The percutaneous approach to PAD in specimens was practical, quick, and easy to perform. However, this posed a potential chance of iatrogenic trauma to the surrounding tissue. Although they are all reasonable options, the Obwegeser needle was more efficient for applying the thread than the others.

A distributed brain response predicting the facial expression of acute nociceptive pain.

Pain is a private experience observable through various verbal and non-verbal behavioural manifestations, each of which may relate to different pain-related functions. Despite the importance of understanding the cerebral mechanisms underlying those manifestations, there is currently limited knowledge of the neural correlates of the facial expression of pain. In this functional magnetic resonance imaging (fMRI) study, noxious heat stimulation was applied in healthy volunteers and we tested if previously published brain signatures of pain were sensitive to pain expression. We then applied a multivariate pattern analysis to the fMRI data to predict the facial expression of pain. Results revealed the inability of previously developed pain neurosignatures to predict the facial expression of pain. We thus propose a facial expression of pain signature (FEPS) conveying distinctive information about the brain response to nociceptive stimulations with minimal or no overlap with other pain-relevant brain signatures associated with nociception, pain ratings, thermal pain aversiveness, or pain valuation. The FEPS may provide a distinctive functional characterization of the distributed cerebral response to nociceptive pain associated with the socio-communicative role of non-verbal pain expression. This underscores the complexity of pain phenomenology by reinforcing the view that neurosignatures conceived as biomarkers must be interpreted in relation to the specific pain manifestation(s) predicted and their underlying function(s). Future studies should explore other pain-relevant manifestations and assess the specificity of the FEPS against simulated pain expressions and other types of aversive or emotional states.

A distributed brain response predicting the facial expression of acute nociceptive pain

Pain is a private experience observable through various verbal and non-verbal behavioural manifestations, each of which may relate to different pain-related functions. Despite the importance of understanding the cerebral mechanisms underlying those manifestations, there is currently limited knowledge of the neural correlates of the facial expression of pain. In this functional magnetic resonance imaging (fMRI) study, noxious heat stimulation was applied in healthy volunteers and we tested if previously published brain signatures of pain were sensitive to pain expression. We then applied a multivariate pattern analysis to the fMRI data to predict the facial expression of pain. Results revealed the inability of previously developed pain neurosignatures to predict the facial expression of pain. We thus propose a facial expression of pain signature (FEPS) conveying distinctive information about the brain response to nociceptive stimulations with minimal or no overlap with other pain-relevant brain signatures associated with nociception, pain ratings, thermal pain aversiveness, or pain valuation. The FEPS may provide a distinctive functional characterization of the distributed cerebral response to nociceptive pain associated with the socio-communicative role of non-verbal pain expression. This underscores the complexity of pain phenomenology by reinforcing the view that neurosignatures conceived as biomarkers must be interpreted in relation to the specific pain manifestation(s) predicted and their underlying function(s). Future studies should explore other pain-relevant manifestations and assess the specificity of the FEPS against simulated pain expressions and other types of aversive or emotional states.

Pathophysiology of Pain and Mechanisms of Neuromodulation: A Narrative Review (A Neuron Project).

Pain serves as a vital innate defense mechanism that can significantly impact an individual's quality of life. Understanding the physiological effects of pain well plays an important role in developing novel pain treatments. Nociceptor neurons play a key role in pain and inflammation. Interactions between nociceptors and the immune system occur both at the site of injury and within the central nervous system. Modulating chemical mediators and nociceptor activity offers promising new approaches to pain management. Essentially, the sensory nervous system is essential for modulating the body's protective response, making it critical to understand these interactions to discover new pain treatment strategies. New innovations in neuromodulation have led to alternatives to opioids individuals with chronic pain with consequent improvement in disease-based treatment and nerve targeting. New neural targets from cellular and structural perspectives have revolutionized the field of neuromodulation. This narrative review aims to elucidate the mechanisms of pain transmission and processing, examine the characteristics and properties of nociceptors, and explore how the immune system influences pain perception. It further provides an updated overview of the physiology of pain and neuromodulatory mechanisms essential for managing acute and chronic pain. We assess the current understanding of different pain types, focusing on key molecules involved in each type and their physiological effects. Additionally, we compare painful and painless neuropathies and discuss the neuroimmune interactions involved in pain manifestation.

FRACTIONAL VARIATIONS IN THE AYURVEDIC MANAGEMENT OF DYSMENORRHEA: A REVIEW

Dysmenorrhea is a frequent clinical presentation among women in the reproductive period. It is a highly distressing cyclical issue for which an appropriate intervention is necessary to achieve a better quality of life. The journey of the progression of any disease from its causes to the various clinical manifestations in an individual is contemplated for the classical management in Ayurveda. In addition to the disease's etiological factors and pathogenesis, the host factor's distinctiveness is also assessed for accurate Ayurvedic management. Though Vata (one among the three physiological principles in the body) is the culprit in the manifestation of menstrual pain, the cause, the disease process, and the severity of the vitiation may vary. There can also be differences in host strength. Hence, it is crucial to understand the fraction of variance in the pathogenesis and associated factors in dysmenorrhea for a precise treatment plan.

Late Phase Testicular Torsion in Pre-Geriatic Age: A Case Report

Background: Testicular torsion is a urological emergency caused by a twist of spermatic cord, which result in testicular tissue ischemia and requiring immediate surgery. The incidence occurred generally in children and adolescents, rarely found in adults. Severe Scrotal pain is the most common manifestation of testicular torsion. The definitive treatment for testicular torsion is surgery, either one of orchidopexy or orchidectomy. The prognosis of testicular torsion depends on the onset of symptoms and the decision time for surgery. Case Report: A 52-year-old man presented to emergency department with a history of gradual severe right-sided scrotal pain (visual analogue scale 8) radiated to the right groin in the last 3 day before admission. Previously, the patient's genitals were hit by the table. On physical examination, the testicles were found to be asymmetrical, swollen, redness, tenderness, and the testicle felt hard and immobilized, either the cremaster reflex or the Phren sign test were negative. The TWIST score was 6 (high risk for testicular torsion). Orchidopexy and orchidectomy were performed immediately without Scrotal Doppler Ultrasonography due to operational problems. Histopathology examination of the orchidectomy specimen impression showed an inflammation sign with exudative fluid presentation. Conclusion: Gradual Severe scrotal pain manifestations should be suspected as testicular torsion as soon as possible before it evolves into later phase. One of the causes of late phase testicular torsion is late admission to Hospital. Surgical emergency action should be taken considering theemergency state without waiting for ideal sonography

Dengue Virus Serotypes 1 and 2 Responsible for Dengue Burden in Amazonas: Epidemiological and Clinical Features.

The increase in dengue cases in Amazonas poses a public health risk. This study aimed to examine the circulating serotypes in the region of Amazonas, Peru, from 2021 to 2023, along with the associated clinical and epidemiological characteristics. Serotype identification was determined for 420 serum samples using a multiplex real-time reverse transcription-polymerase chain reaction assay, revealing that 194 patients were infected by dengue virus (DENV)-1 and 226 by DENV-2. Both serotypes co-circulated in all affected provinces. Warning signs were more frequent in patients with DENV-2 (P = 0.004), and the manifestation of abdominal pain was correlated with this serotype (P = 0.004), highlighting its association with severe forms of the disease. In conclusion, this study emphasizes the widespread circulation of DENV-1 and DENV-2 in Amazonas. Furthermore, it underscores the importance of real-time molecular surveillance that could provide an early prognosis of disease severity.

Fatigue levels and associated factors in systemic sclerosis: a cross-sectional study of 2,385 SPIN Cohort participants.

To compare fatigue in a large multinational systemic sclerosis (SSc) cohort to general population data and identify associated sociodemographic, lifestyle and SSc disease factors. Scleroderma Patient-centered Intervention Network Cohort participants completed the Patient-Reported Outcomes Measurement Information System-29 v2.0 fatigue domain. T-scores were compared with the USA general population (mean = 50; SD = 10). Multivariable linear regression was used to assess associations with sociodemographic, lifestyle, and disease-related variables. Among 2,385 participants (mean age 54.9 (SD = 12.6) years, 87% female, 38% diffuse SSc), mean fatigue T-score was 54.6 (SD = 11.0); 438 (18%) reported mild fatigue, 641 (27%) moderate, and 180 (8%) severe fatigue. Fatigue was independently associated with sociodemographic factors age (-0.10 points per year, [95% CI -0.14;-0.07]), male sex (-1.67 points, [-2.96;-0.37]), non-married status (0.97 points [0.04; 1.89]), and country (reference USA; France -2.35 points [-3.48;-1.21] and UK 2.38 points [0.80; 3.97]), and lifestyle factors smoking (4.16 points [2.52; 5.80]), alcohol consumption (-0.18 points per drink per week [-0.28;-0.07]), and body-mass index (0.34 points per unit [0.27; 0.42]). Fatigue was associated with disease-related factors gastrointestinal involvement (4.21 points [2.99; 5.43]), digital ulcers (1.51 points, [0.25; 2.77]), moderate small joints contractures (1.41 points [0.13; 2.69]), rheumatoid arthritis (4.34 points [2.37-6.31]) and Sjögren's syndrome (1.89 points [0.23; 3.55]). When pain was included in the model, its association was large (2.19 points [2.03; 2.34]) and interstitial lung disease was also associated (1.21 points [0.42; 2.00]). In people with SSc, fatigue scores were substantially higher than the general population and associated with multiple disease factors including gastrointestinal involvement, several painful disease manifestations, and lung involvement.

Diagnostic and treatment pitfalls in glossopharyngeal neuralgia: evidence from a case series.

Glossopharyngeal neuralgia (GN) is a rare pain syndrome often underdiagnosed. This study aimed to assess the challenges in diagnosing GN and identify patients at risk of misdiagnosis. Between 2010 and 2019, nine patients underwent microvascular decompression (MVD) of the glossopharyngeal nerve at two tertiary care hospitals. A retrospective analysis examined symptom characteristics, time to correct diagnosis, operative technique, and clinical outcomes. Barrow Neurological Institute (BNI) pain scores were assessed before surgery and on follow-up. Six women and three men, aged 55 ± 14.3years, with unilateral GN were included. Pain was predominantly in the ear (otalgic type) in four patients (44.4%), the pharynx or base of the tongue (pharyngeal type) in four (44.4%), and mixed in one (11.1%). Five patients reported pain radiating to the mandible, all initially misdiagnosed with trigeminal neuralgia (TN) and treated for 2.4(± 3.1) years before presenting to our institution. One case resulted in MVD of the trigeminal nerve and subsequent thermocoagulation of the Gasserian ganglion due to persistent pain. The correct diagnosis of GN was established later in patients with otalgic or mixed pain (3.8 ± 3.4years) compared to those with pharyngeal pain (0.5 ± 1.0years), showing a trend (U = 17.0, p = 0.07). There was a significant association between pain radiation to the mandible and misdiagnosis (x2 = 9.00, p = 0.003). Endoscopically assisted MVD via the median suboccipital subtonsillary approach was performed, resolving neurovascular conflicts with the PICA (9/9) and vertebral artery (3/9). Follow-up after 15.7(± 18.2) months showed significant pain reduction according to the BNI (preoperative BNI = 5.0 ± 0.0, postoperative BNI = 1.7 ± 1.0,t (8) = 10,CI [1.6-5.1], p < 0.001). No permanent surgery-related deficits occurred. Patients with GN, especially those with predominant otalgic pain and pain radiating to the mandible, are at higher risk of misdiagnosis due to similarities with TN. Despite the rarity of GN, increased awareness of its various pain manifestations may lead to earlier correct diagnoses, which is crucial for surgical treatment.

IMPROVEMENT OF THE QUALITY OF LIFE OF PATIENTS WITH CONCUSSION BY MEANS OF PHYSICAL THERAPY

Brain concussion from blast waves is one of the most common injuries in combat. This injury is three times more common than wounds. Blast wave brain concussion has significant consequences and impairs the quality of life for an indefinite period of time, so the use of physical therapy to improve the quality of life of patients with its consequences is an urgent issue. Purpose to prove the effectiveness of physical therapy in improving the quality of life of patients after blast concussion. Methods. To achieve the aim of the study, the scientific literature was analyzed and information was systematised using electronic databases such as PubMed, Google Scholar and others. To assess: sleep function, the Insomnia Severity Index (ISI) was used; pain perception, the Visual Analogue Scale (VAS) and the Verbal Rating Scale were used; changes in emotional functions, the Wessman-Ricks Emotional State Self-Assessment (WESA) was used; and quality of life, the Health Survey (SF-36 v2) was used. Research results. The initial treatment of concussion is of great importance and includes a number of important aspects that can be performed by a first responder. Since concussion leads to partial or complete disability and largely results in disability, which leads to other problems at different levels, the prerequisites for developing a physical therapy programme aimed at improving the quality of life of patients were the selection of ICF components appropriate to the patients' condition. The physical therapy programme was individualised, tailored to each patient individually, taking into account their condition and wishes, with special attention paid to the primary tasks of pain relief and normalisation of sleep function, which is key to reducing all other consequences of concussion and improving the quality of life. After the implementation of the proposed physical therapy programme, patients in the main group improved their sleep, decreased their pain levels and improved their emotional state. All indicators at the end of the study were better in the main group than in the control group, although at the beginning of the study the indicators in both groups did not differ significantly. Comparison of the results of the SF-36 v2 Health Survey proves the effectiveness of the developed physical therapy programme in combination with conventional treatment of blast injury. Conclusions. The results of the study proved the positive impact of the physical therapy programme for patients with blast concussion, which took into account the patient's condition and wishes, and whose primary objectives were to stop the manifestation of pain and normalise sleep function, actively involve the patient in the rehabilitation process through Pilates, Yoga, Nordic walking and an obstacle course with a sports focus. Motivation for action and normalisation of the emotional state are important during the rehabilitation period. The combination of active activities with massage therapy, namely Thai traditional massage, Thai foot massage, Tibetan singing bowl massage and Rebozo massage, contributed to general relaxation, reducing the effects of stress, muscle and emotional stress, harmonising the emotional state, improving blood circulation and restoring all body systems.

STUDY OF THE POTENTIAL ANALGESIC PROPERTIES OF CARBON DIOXIDE FOR THE TREATMENT OF PAIN SYNDROME IN CASE OF OSTEOARTHRITIS

Pain syndrome is a serious global problem that causes and complicates a number of diseases, the main symptom of which is joint pain. One of them is osteoarthritis (OA). Traditional methods of treating OA often have limited efficacy and can cause side effects, so it is important to study new approaches, such as carboxytherapy (use of carbon dioxide). Objective. To investigate the analgesic effect of carbon dioxide (CO2) and its combined use with other agents. Methods. The efficacy of carbon dioxide injections used alone and in combination with other drugs was studied in a formalin model of inflammation in rats. Results. The latent periods of phases I and II increased significantly in the experimental groups, especially in groups V, VI and VII (p &lt; 0.001), indicating a delay in pain reactions. The duration of pain phase I was significantly shorter in the groups receiving CO2 compared to the control group (p &lt; 0.001). The shortest duration was observed in group V, where it decreased by 1.77 minutes. The duration of pain phase II was also significantly shorter in groups V, VI, and VII treated with CO2 compared to group II (p &lt; 0.001). The difference ranged from 7.49 to 12.54 minutes. The number of pain reactions after phase I decreased by 13.25– 16.1 points in the groups receiving CO2 compared to the control group. The data obtained indicate that CO2 significantly increases the duration of latent periods of pain (by 55–65 %), reduces the duration of its phases (by 40–50 %) and reduces the intensity of pain reactions (by 40–50 %) in rats compared to control pathology. The most pronounced effect was observed with the combined use of CO2 with sodium diclofenac or chondroitin sulfate. Conclusions. The results of the study expand the understanding of the analgesic effect of CO2 on the formalin model of inflammation. The use of CO2 significantly reduced the duration of both phases of the pain reaction and reduced the number of painful manifestations, which confirms the prospects of its use as an additional, and in some cases the main means of reducing pain and inflammation.

8063 Cystic Parathyroid Adenoma: A Rare Cause Of Severe Hypercalcemia

Abstract Disclosure: M. Owrangi: None. F. Hasan: None. Introduction: Parathyroid adenomas are the most common cause of primary hyperparathyroidism, but within this category, a rare subtype exists - cystic parathyroid adenomas (CPAs). Comprising only 0.5-1% of all parathyroid lesions, CPAs present unique diagnostic and therapeutic challenges. We report a case of a female patient presenting with severe hypercalcemia caused by a CPA. Case presentation: A 44-year-old African American female with a history of nephrolithiasis presented with abdominal pain and signs of dehydration. Labs were remarkable for serum calcium 13.2 mg/dL, albumin 4.0 g/dL, phosphorus 1.8 mg/dL, iPTH 617.7 pg/mL, 25-OH vit D 12.1 ng/mL, creatinine 0.85 mg/dL. She was initially resuscitated aggressively with IV fluids resulting in an improvement in serum calcium level to 10.3 mg/dL. Thyroid US showed a cystic nodule deep to the left thyroid lobe. Sestamibi parathyroid scan was consistent with a left superior parathyroid adenoma. She underwent 2 gland parathyroidectomy 3 months after the initial presentation. Intraoperatively serum PTH decreased by 91% after resection of the 2 parathyroid adenomas. Pathology confirmed the presence of 2 parathyroid adenomas, the larger one measuring 2.8 cm and weighing 3.8 g. Discussion: We describe a case of a middle-aged female presenting with severe hypercalcemia due to CPA. Her initial presentation was concerning for parathyroid carcinoma given the severity of hypercalcemia. However, the radiologic findings, coupled with surgical pathology, indicated that she had CPA. CPAs can be either functional, causing primary hyperparathyroidism (PHPT) with elevated serum calcium levels, or non-functional, remaining asymptomatic. Clinical features of PHPT associated with CPAs are similar to those with solid adenomas and include fatigue, GI symptoms, nephrolithiasis, bone pain, and neuropsychiatric manifestations. However, CPAs may exhibit certain distinct presentations: i) higher pre-operative serum calcium levels; and ii) increased risk of symptomatic hypercalcemia. Despite their rarity, CPAs deserve special attention due to their unique presentation, challenging diagnosis, and potential for severe hypercalcemia. Surgical parathyroidectomy is the definitive treatment for functional CPAs. Accurate localization and complete excision of the adenoma are crucial to avoid recurrence. Most CPAs occur in the fourth and fifth decade of life and are more common in women (female to male ratio of 2.5:1). 65-85% of cases are located in the neck and the majority arise from the inferior parathyroid glands and are left-sided, and may very rarely be intrathyroidal. Presentation: 6/2/2024

Episodic mandibular tremor in dogs: an idiopathic movement disorder or a manifestation of pain.

Episodic mandibular tremor (EMT), manifested as teeth chattering, is not well described in dogs. The aim of this study was to describe clinical signs, MRI findings, and outcome of dogs with EMT. 11 dogs retrospectively and 31 dogs in an online survey. A retrospective multicenter study of dogs with EMT between 2018 and 2023 and prospective online questionnaire open to owners of pets with teeth chattering. All dogs had rapid and short-lasting (< 1 minute) episodes of EMT in the absence of other neurological signs. Lip smacking occasionally accompanied the tremor in 5 of 11 (45.5%) hospital dog cases. Excitement was a common trigger in 14 of 31 (45.2%) dogs from the survey. Cavalier King Charles Spaniel was the most common breed in both clinical and survey populations. Median age at presentation was 3 years for both hospital cases and the survey dogs. A concurrent medical condition was present in 8 of 11 (72.7%) hospital cases and 20 of 31 (64.5%) survey dogs. In 3 hospital dogs that underwent further investigations, no brain disease was present. EMT and its clinical features are presented for the first time, shedding light on a clinical sign that might resemble an idiopathic movement disorder or a manifestation of pain in dogs.

Recent Insight into Herbal Bioactives-based Novel Approaches for Chronic Intestinal Inflammatory Disorders Therapy.

Inflammatory bowel disease (IBD) is a life-threatening complex disease. It causes chronic intestinal inflammation in GIT. IBD significantly affects people's lifestyles and carries a high risk of colon cancer. IBD involves the rectum, ileum, and colon, with clinical manifestations of bloody stools, weight loss, diarrhea, and abdominal pain. The prevalence of inflammatory disease is increasing dramatically worldwide. Over 16 million people are affected annually in India, with an economic burden of $6.8- $8.8 billion for treatment. Modern medicine can manage IBD as immunosuppressive agents, corticosteroids, tumor necrosis factor antagonists, integrin blockers, and amino-salicylates. However, these approaches are allied with limitations such as limited efficacy, drug resistance, undesired side effects, and overall cost, which cannot be ignored. Hence, the herbal bioactives derived from various plant resources can be employed in managing IBD. Science Direct, PubMed, Google, and Scopus databases have been searched for conclusively relevant herbal plant-based anti-inflammatory agent compositions. Studies were screened through analysis of previously published review articles. Eminent herbal bioactives, namely curcumin, resveratrol, ellagic acid, silybin, catechin, kaempferol, icariin, glycyrrhizin acid, berberine, quercetin, rutin, and thymol are reported to be effective against IBD. Herbal leads are promising treatment options for IBD; they have been shown to display antiinflammatory and antioxidant properties by targeting enzymes and regulating the expressions of various inflammatory mediators. Natural products have been reported to have anti-inflammatory properties in various clinical and preclinical studies, and some are available as herbal preparations. Herbal medicine would be promising in association with the implication of a novel drug delivery system for managing IBD.

Breadth and visibility of children's lower limb chronic musculoskeletal pain: a scoping review.

To identify the types of conditions reported in peer-reviewed literature that result in chronic musculoskeletal lower limb pain in children and adolescents and explore the alignment of these conditions with the chronic pain reporting codes indexed in the International Classification of Diseases 11th Revision (ICD-11). This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Five electronic databases were searched (Medline, EMBASE, PsycINFO, CINAHL and the Cochrane Library). Articles involving children and adolescents under 18 years and reporting on chronic musculoskeletal pain of the lower limb were included. We assigned an ICD-11 code to each condition based on details reported in the study. We recorded whether any of the presenting conditions were linked to an ICD-11 chronic pain manifestation code. From 12 343 records, 418 papers were included. There were 124 unique conditions associated with chronic lower limb pain, the most commonly reported being chronic widespread musculoskeletal pain (24 studies) and juvenile idiopathic arthritis (26 studies). Only 11.1% of presenting conditions were linked to an ICD-11 chronic pain manifestation code. Most presenting conditions associated with chronic pain in the lower limb do not have a chronic pain manifestation code in the new global standard for recording health information. This means chronic pain associated with common lower limb conditions may remain invisible in global statistics.

A study on correlation of liver function tests and outcome in patients of dengue

Dengue, a mosquito-borne viral disease, presents a significant public health threat, particularly in tropical and subtropical regions. This study aims to assess the correlation between elevated serum aminotransferases and dengue severity, focusing on patients at a tertiary care center. The liver is affected to varying degrees in dengue patients, from asymptomatic enzyme elevation to severe hepatitis. The study found that elevated SGOT levels correlate with more severe symptoms, including prolonged fever, abdominal pain, and bleeding manifestations.

The impact of primary headache in children and adolescents

Headache is one of the most common and disruptive pain manifestations in children and adolescents. This review examines the current evidence for the impact of primary headaches on well-being and quality of life in children with headaches. Several studies support that headaches cause a significant reduction in quality of life, which can be related to the headaches themselves and lead to limitations in family, social, and school activities. There is a need for more studies on well-being among children with headaches as well as a greater focus on other primary headache forms than migraine.