Numbness Sensation Research Articles

Coumarins rather than alkylamides evoke the numbing orosensation of pomelo peel

Liangpingyou, a well-known Chinese pomelo (Citrus grandis L.) variety, elicits a unique and uncharacterized numbing aftertaste. To understand the molecular bases and characteristics of the pomelo-induced numbing sensation, we first determined that hydroxyl sanshools, the major Sichuan pepper chemosensates, were not responsible via silylation-GC–MS analysis. Pomelo peel juice was then subjected to solid-phase extraction to form 4 fractions, and key sensory-active substances were screened via taste dilution analysis. Three simple coumarins, meranzin hydrate, isomeranzin, and marmin, were identified to induce numbing, which has not been previously reported. Sensory studies via extensively modified half-tongue tests and verification steps revealed recognition thresholds within 0.49–1.78, 0.32–1.56, and 0.43–1.46 μmol/L for numbness, pungency, and astringency, respectively. The temporal dominance trends showed the following taste notes: Meranzin hydrate–numbing dominated, isomeranzin–numbing and pungent, and marmin–astringent and numbing. Molecular docking analysis suggested that coumarins target the receptors TRPV1, TPRA1, and KCNK3

Qualitative somatosensory evaluation of recipient and donor sites of subepithelial connective tissue grafts: a preliminary study.

The subepithelial connective tissue graft (SCTG) plus coronal advanced flap is commonly evaluated by clinical parameters, but potential sensory changes (patients' perception of painful or painless sensations) need to be further explored. This preliminary study aimed to qualitatively evaluate the somatosensory profile of recipient and palatal donor sites of SCTG. Sensory tests were applied at SCTG recipient and donor sites at baseline, after 3 and 6 months. A single calibrated examiner applied Douleur Neuropathique 4 questionnaire (DN4), qualitative sensory test (QualST), discriminating the areas as hypersensitive, hyposensitive or normosensitive, and two-point acuity test. Descriptive statistics, non-parametric Kruskal Wallis test for QualST evaluation and ANOVA for Two-point test (p < 0.05) were used. QualST revealed that recipient areas presented no significant differences in tactile, pressure and thermal tests. Brush test revealed hyposensitivity after 3 months (p = 0.03). In donor areas, only thermal evaluation showed a significant difference (p = 0.01), being hypersensitive after 3 months and hyposensitive after 6 months. At baseline, all evaluations in recipient and donor areas were normosensitive. According to DN4, no patient reported pain in recipient and donor sites. Non-painful sensory perception was reported as numbness in recipient (3.14% of patients) and donor (18.4%) areas. No significant differences were found for two-point acuity test values. Somatosensory variations were observed in donor and recipient areas using qualitative tests, with no detection of painful sensations, only non-painful sensations of numbness and electric shock. This preliminary study demonstrated that alterations of hypo- and hypersensitivity may occur in donor and recipient areas of gingival grafts. However, when present, these alterations were non-painful and did not impact oral functions. ReBEC #RBR-7zz3b6p.

Virtual reality: a game-changer in the diagnosis and surgical planning of astrocytoma grade III: a case report

BackgroundIn the dynamic realm of modern medicine, the advent of virtual reality technology heralds a transformative era, reshaping the contours of diagnosis and surgical planning with its immersive prowess. This study delves into the groundbreaking application of virtual reality in the intricate dance of neurosurgery, particularly spotlighting its role in the management of astrocytoma grade III—a cerebral challenge of significant complexity.Case presentationA 30-year-old Middle Eastern man from Syria grappled with the invisible tendrils of pain, manifesting as persistent headaches and a numbing sensation that crept into his neck and extremities. For two relentless months, the morning sun brought not hope but an intensification of his agony, rendering him unable to partake in the daily dance of life. The usual sentinels of relief, analgesic drugs, stood defeated, offering no respite. The neurological examination was normal, there were no pathological findings on sensory and motor examination, and he exhibited normal reflexes and neither meningeal nor cerebellar signs. He showed a family history of breast cancer. The initial foray into the enigmatic depths of his brain via computed tomography and magnetic resonance imaging imaging unveiled a finding in the right temporal lobe, a lesion that suggested something more sinister. Previous medical interventions included analgesic medications prescribed for persistent headaches, but they offered no relief. No other therapeutic interventions were administered prior to the current diagnosis. It was here that virtual reality technology emerged not as a mere tool but as a beacon of precision, casting a three-dimensional light on the shadowy intruder. This technological marvel allowed for meticulous measurement 21.8 × 14.5 mm and localization within the temporal theater, setting the stage for what was to come. With the path laid clear, the patient embarked on a surgical odyssey, a quest to excise the unwelcome guest. The operation was a triumph, a testament to human ingenuity and the symbiotic relationship between flesh and machine. The postoperative verdict was delivered through the lens of histopathology, confirming the presence of an astrocytoma grade III, a cerebral interloper known for its rapid proliferation. The battle, however, was far from over. Complementary radiotherapy and chemotherapy were enlisted as allies in this ongoing war, their potent forces working in concert to stave off the cellular insurgence. The patient’s journey through the healing arts was charted by periodic clinical and neurological examinations, with laboratory tests and the vigilant gaze of brain magnetic resonance imaging ensuring a watchful eye was kept on any potential resurgence.ConclusionsIn this narrative of resilience and technological prowess, we witness the harmonious fusion of human touch and digital precision, a partnership that redefines the boundaries of medicine and the art of healing, by use of virtual reality technology in the diagnosis of astrocytoma and enhancing the accuracy, effectiveness, and safety of neurosurgical procedures, which can ultimately benefit patients with brain tumors.

Electrophysiological Assessment of Paresthesia in Patients Following Radial Angiography: AProspective Study.

Radial angiography, preferred for its safety and comfort in percutaneous coronary interventions, occasionally leads to paresthesia-a tingling or numbing sensation in the hand. This study aimed to investigate the presence of nerve damage in patients experiencing paresthesia post-radial angiography through electrophysiological examination. This prospective study involved 77 patients who developed hand paresthesia following radial angiography. Excluded were those with malignancy, pregnancy, pace-makers, or recent angiography. Nerve conduction studies were performed using the Neuropack MEB 9102K EMG device, assessing sensory and motor amplitudes, latencies, and velocities of median, ulnar, and radial nerves. The study included 77 patients (23 females, 54 males; average age 58.39 ± 10.44 years). In 11 diabetic patients, polyneuropathy was detected. For the remaining 66 patients, electrophysiological evaluations showed no significant pathological findings. Comparative analysis of both upper extremities revealed no significant differences in nerve conduction parameters between the side where angiography was performed and the other side. Despite paresthesia complaints, no electrophysiological evidence of nerve damage was found, suggesting that symptoms might be due to local irritation rather than direct nerve injury. This aligns with the safety profile of radial angiography and underscores the importance of distinguishing between transient paresthesia and serious nerve complications. Paresthesia post-radial angiography, while clinically notable, is not typically associated with nerve damage. This study is significant as it is the first in the literature to demonstrate that radial angiography does not cause nerve damage.

Cooking beyond flavors: Exploring the chemical reactions in the preparation of duck in Tucupi of Pará - Brazil

Regional cuisine is a cultural treasure that offers a wealth of unique flavors, techniques, and traditions. In the Brazilian gastronomic scene, the State of Pará stands out for its culinary diversity and emblematic dishes representing the fusion of indigenous, African, and European influences. "Pato no tucupi" is a typical dish from the region that delicately enchants residents and visitors due to its unique characteristics. Even though it is a traditional preparation, duck in tucupi has attributes that justify the study to understand better the transformations involved in this preparation. This work aimed to understand the chemical transformations associated with the main ingredients of this dish, which are duck, jambu, and tucupi. Bibliographic exploration encompassed Google Scholar, books, articles, and specialized gastronomy and food magazines, supplemented by observational inquiries into tucupi production in a flour mill. Several chemical reactions have been identified in these ingredients, such as the formation of hydrocyanic acid from the enzymatic hydrolysis of the glycosides linamarin and lotaustralin. The duck also undergoes important changes related to non-enzymatic browning through the occurrence of Maillard and protein denaturation caused by heating during preparation. In turn, jambu leaves stand out in the dish's composition due to the sensation of numbness caused by the presence of the aliphatic alkylamine spilanthol. Cooking these leaves leads to the formation of chlorophyllide and pheophytin from chlorophylls a and b. This study delves into the traditional knowledge shaping regional cuisine while offering more profound insights into the chemical reactions driving this culinary process.

Differences of Typical Wuyi Rock Tea in Taste and Nonvolatiles Profile Revealed by Multisensory Analysis and LC-MS-Based Metabolomics.

Wuyi Rock tea, specifically Shuixian and Rougui, exhibits distinct sensory characteristics. In this study, we investigated the sensory and metabolite differences between Shuixian and Rougui. Quantitative description analysis revealed that Rougui exhibited higher intensity in bitter, thick, harsh, and numb tastes, while Shuixian had stronger salty and umami tastes. Nontargeted metabolomics identified 151 compounds with 66 compounds identified as key differential metabolites responsible for metabolic discrimination. Most of the catechins and flavonoids were enriched in Rougui tea, while epigallocatechin-3,3'-di-O-gallate, epigallocatechin-3,5-di-O-gallate, gallocatechin-3,5-di-O-gallate, isovitexin, and theaflavanoside I were enriched in Shuixian tea. Catechins, kaempferol, quercetin, and myricetin derivatives were positively correlated with bitter taste and numb sensation. Sour taste was positively correlated to organic acids. Amino acids potentially contributed to salty and umami tastes. These results provide further insights into the taste characteristics and the relationship between taste attributes and specific metabolites in Wuyi Rock tea.

Spinal Anaesthesia Success: An Observational Study Assessing Subjective Sensations During Spinal Anaesthetic Drug Injection

Introduction: Spinal Anaesthesia (SA) has stood as the most favoured and dependable technique in regional anaesthesia for the past century. However, despite its widespread use, there are instances of occasional SA failure. Currently, there is no straightforward, cost-effective, and easily administered real-time test-aside from the positive aspiration of Cerebrospinal Fluid (CSF)-that can reliably confirm the deposition of local anaesthetic in the subarachnoid space. Aim: To evaluate the predictive value of subjective sensations (warmth/tingling/numbness) during the administration of SA for enhancing success rates. Materials and Methods: A prospective observational study preceeded the recruitment of 500 patients for this investigation. Following the confirmation of CSF aspiration upon injecting the SA drug, Bupivacaine, patients were queried about the sensations of warmth and/or tingling numbness in the lower limb, saddle part, and inner thighs. This assessment was conducted at 30 seconds and one minute after injection. Additionally, patients were asked to report any increase in the area and/or intensity of these sensations. The adequacy of SA was determined by achieving a sensory block upto the desired dermatome level and reaching a Bromage scale score of IV. Evaluations were performed at two minutes, five minutes, 10 minutes, and 15 minutes from the initiation of SA. Results: The population, predominantly ASA Class-I (60%) and II (40%), exhibited a median age of 45 years, with 54% being male. Intraoperative vital signs, including Heart Rate (HR), Systolic Blood Pressures (SBP), and Diastolic Blood Pressures (DBP), showed a consistent declining trend post-SA administration. Efficacy assessments revealed that Bromage Grade-IV was achieved in 99% of patients at 15 minutes. Notably, subjective sensations of warmth, tingling, and/or numbness proved to be robust predictors of successful SA, with a 218-fold increased likelihood. The diagnostic model demonstrated a high sensitivity of 98%, specificity of 85%, and a Positive Predictive Value (PPV) exceeding 99%. Conclusion: This study highlights the crucial role of warmth, tingling, and numbness as reliable indicators for successful SA, supported by a robust 97% success rate. Incorporating these patient-reported sensations in assessments provides a practical and accessible approach to improve the efficacy of SA procedures.

Characteristics of Carpal Tunnel Syndrome Sufferers in Tailors at PT. Elite

Carpal Tunnel Syndrome (STK) is a condition of the median nerve in the wrist area compressed by the surrounding structure resulting in a tingling and numbness sensation in the hand. Risk factors such as occupational and non-occupational factors. There are still many cases in Indonesia because many tailors use manual sewing machines. Based on data from Basic Health Research (Riskesdas) in 2018, the prevalence of joint disease in Indonesia is 7.3%, especially in upper limbs as much as 32.7%. To determine the prevalence of STK incidence in employees at PT. Elite and assess the relationship of STK incidence with influencing factors. This research is an analytical research with a cross-sectional research design. Sampling is carried out using a non-random sampling technique of purposive sampling type. Data taken using questionnaires and physical examinations were then processed using SPSS statistical tests. The prevalence of STK incidence in employees of PT. Elite as many as 40 respondents from 107 respondents. Age factors ?40 and &gt;40 years, normal body mass index and obesity II and rheumatoid arthritis p value &lt;0.05. Pregnancy status, diabetes mellitus, length of service and smoking history p value &gt;0.05. There are &lt;50% of STK incidents in PT. Elite employees. There is a significant relationship between the ages of ?40 and &gt;40 years. Normal body mass index and obesity II and rheumatoid arthritis were significantly associated with the incidence of STK. There was no significant relationship between pregnancy status, diabetes mellitus, length of service and smoking history with the incidence of STK in PT Elite

THU022 A Case Of Delayed Diagnosis Of Acromegaly

Abstract Disclosure: K. Blanchard: None. C. Musurakis: None. A. Havrylyan: None. A 57-year-old hispanic female with hypertension, prediabetes, hyperlipidemia, and uterine leiomyomata with hysterectomy one year ago presented to our emergency department with sensations of numbness, tingling, and pressure on the top of her head for 12 days’ duration and left eye blurred vision with photosensitivity for 3 days’ duration. Physical exam was significant for evident enlarged facial features including macroglossia, macrognathia, separation of teeth, enlarged lips, enlarged ears and increased size of hands and feet with thickening of the skin on the fingers and toes. Many skin tags were noted on the neck and chest. She reported noticing these changes gradually over the past five years, as well as noticing an increase in shoe size and ring size. Admission labs were significant for IGF-1 965 ng/mL (47-236), Glucagon 172 ng/mL (0.05-8.00), AM cortisol 24 ug/dL (6.7-22.6), ACTH 29.6 pg/mL (7.2-63.3), FSH 13.22 mIU/mL (16.74-113.59), LH 3.79 mIU/mL (10.87-58.64), and Prolactin 24.3 ng/mL (2.74-19.64). Hemoglobin A1c was 5.8% (&amp;lt;5.7) and lipid profile was significant for triglycerides of 202 mg/dL (&amp;lt;150). TSH was within normal limits. A chest x-ray showed no cardiomegaly. An echocardiogram showed no cardiomyopathy. A CT scan of the brain showed a hyperdense sellar/suprasellar mass measuring 2.1 x 0.7 x 2.4 cm with mass effect on the optic chiasm and intracranial optic nerve not excluded. An MRI brain confirmed a large pituitary macroadenoma measuring 2.7 x 2.5 x 2.2 cm with mass effect on the optic chiasm and pituitary stalk. In addition to the above workup, we recommended Neurosurgery evaluation for symptomatic macroadenoma with optic chiasm mass effect, Ophthalmology evaluation for visual fields testing, and referral to a tertiary care center for evaluation and treatment of acromegaly. The patient was discharged with Neurosurgery and Endocrinology outpatient follow-up, but unfortunately did not attend her appointments. Acromegaly is a rare condition with a prevalence of 60 cases per million. While the mean age of occurrence is 32 years, the mean age of diagnosis is 40 to 45 years, highlighting a persisting delay in the diagnosis. The changes associated with acromegaly occur slowly and therefore can be overlooked by the patient, their family members, and even physicians. Left untreated, continued exposure to increased levels of growth hormone and IGF-1 leads to development of comorbidities including Cushing’s disease, cardiovascular disease, diabetes, arthralgias, decreased bone mineral density, sleep apnea, and uterine leiomyomata, as well as increased mortality and decreased quality of life. This case highlights the importance of physicians in all specialties being familiarized with the symptoms and physical features of acromegaly to aid in timely diagnosis. Presentation: Thursday, June 15, 2023

Plexiform Schwannoma of Digital Nerve.

Plexiform schwannoma is an uncommon benign tumour that grows in a plexiform pattern. We report a 47-year-old man with a mass on the palmar aspect of the metacarpophalangeal joint of the right index finger that had been growing gradually for more than 10 years. The mass was palpated from the distal carpal tunnel to the ulnar aspect of the proximal interphalangeal joint of the index finger, with tingling and numbness sensation. The tumour was a multinodular tumour involving the first common palmar digital nerve to the ulnar proper palmar digital nerve. It was resected and reconstructed with a sural nerve graft. Plexiform schwannoma is rare in the digital nerve, with only six cases reported. Generally, classic schwannomas can be enucleated without causing neurologic deficits; however, plexiform schwannoma may require nerve resection. There have been reports of recurrence of plexiform schwannoma; definitive resection and long-term follow-up are necessary. Level of Evidence: Level V (Therapeutic).

Systemic manifestation of necrotic erythema nodosum leprosum: A case report of a fatal leprosy.

Necrotic erythema nodosum leprosum (ENL) is an uncommon manifestation of type 2 lepra reaction, encountered in lepromatous and borderline lepromatous cases of leprosy. Necrotic ENL is associated with the involvement of multiple organs, therefore delayed diagnosis and treatment will lead to complications and poor prognosis. The aim of this case report was to report a challenging case of necrotic ENL misdiagnosed with multiple cellulitis since there were no signs of prior leprosy nor had any antimycobacterial treatment. A 45-year-old man was presented to the surgery department of Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, with complaints of fever, joint pain, and painful tender skin lesions with ulceration over the trunk, extremities, and ears for one month. The patient was diagnosed clinically with multiple cellulitis and underwent a debridement procedure. Clinical improvement was absent, the patient was then consulted to the dermatology department. Physical examination showed normal vital signs, madarosis, inguinal lymphadenopathy, thickening of nerves, and sensation of numbness in both hands and feet. Laboratory examinations on admission showed leucocytosis, anemia, thrombocytopenia, hypoalbuminemia, hypocalcemia, and elevated creatinine and ureum level. A slit skin smears examination yielded positive acid-fast bacilli (AFB) with a bacteriological index (BI) value of 3+ and morphological index (MI) of 72%. The patient was diagnosed with lepromatous leprosy with necrotic ENL reaction. Intravenous methylprednisolone and cefoperazone-sulbactam were given. Multidrug therapy mulitbacillary (MDT-MB) without dapsone, and ofloxacin 400 mg was initiated. On day 17, the patient had septic shock. The patient became unconscious and experienced death. This case highlights that medical professionals should be aware of the various manifestations of necrotic ENL to correctly diagnose and provide treatment as soon as possible to prevent mortality, especially in leprosy-endemic country, Indonesia.

Research advance on structure and function of amides in Zanthoxylum plants

Zanthoxylum belongs to the Rutaceae family, and there are 81 Zanthoxylum species and 36 varieties in China. Most of the Zanthoxylum plants are used as culinary spice. In recent years, scholars in China and abroad have carried out in-depth research on Zanthoxylum plants, and found that the peculiar numbing sensation of Zanthoxylum plants originates from amides. It is also determined that amides are an important material basis for exerting pharmacological effects, especially in anti-inflammatory analgesia, anesthesia and other aspects. In this paper, 123 amides in 26 Zanthoxylum plants and their pharmacological activity that have been reported were summarized, which provided scientific reference for the clinical application of Zanthoxylum plants and the research and development of new drugs, and also facilitated the sustainable development and utilization of Zanthoxylum plant resources.

Notalgia Paresthetica Review: Update on Presentation, Pathophysiology, and Treatment

Notalgia paresthetica (NP) is a chronic cutaneous neuropathy primarily characterized by localized pruritus and associated dysesthesias, including sensations of pain, numbness, and tingling. The sensory neuropathy characteristic of NP is thought to result from spinal nerve entrapment caused by degenerative changes in the spine or musculoskeletal compression. This review summarizes the current medical literature with a focus on the past five years regarding NP, its pathophysiology, presentation, and current treatment options. Though treatments exist with varying efficacy, to date, there exists no definitive treatment for NP. Treatment options for NP are varied and range from topical and oral agents to interventional procedures and physical therapy. Of the treatments evaluated, topical capsaicin remains the most efficacious treatment for NP. The lack of established treatment guidelines makes treating NP complicated as it dramatically affects patients' quality of life. Further research with larger sample sizes is needed to evaluate better the most effective treatment and dosing regimen for patients afflicted with NP.

SERS determination of hydroxy-α-sanshool in spicy hotpot seasoning: The strategy to restrain the interference of capsaicin and its mechanism

Hydroxy-α-sanshool (α-SOH) is the principal ingredient responsible for the numbing sensation in spicy hotpot. However, utilizing surface-enhanced Raman scattering (SERS) to analyze the α-SOH in hotpot seasoning is challenging due to the significant interference of capsaicin (CAP). Therefore, two schemes were proposed to address CAP interference in hotpot seasoning, namely laccase-catalyzed conversion and metal–organic framework (MOF) interaction. Among them, Fe-BTC MOF exhibited significant anti-interference effect and the underlying mechanism is elucidated. The motion of CAP aromatic ring was constrained by steric hindrance and electrostatic interactions of Fe-BTC. Additionally, the interaction between CAP aromatic ring and conjugated triene group in α-SOH was quenched, enhancing the α-SOH SERS signal. The proposed method had a significant anti-interference effect on α-SOH quantification in the presence of CAP, significantly enhancing the α-SOH SERS signal in a range of 0.85 to 4.00 × 107. The linearity and reproducibility of the proposed hotpot seasoning testing method were also validated.

Application of Preoperative Multimodal Image Fusion Technique in Microvascular Decompression Surgery via Suboccipital Retrosigmoid Approach

To explore the application value of preoperative multimodal image fusion technique in microvascular decompression (MVD) surgery via the suboccipital retrosigmoid approach. Comprehensive data of 13 patients with primary trigeminal neuralgia (TN) and 13 patients with hemifacial spasm (HFS) treated by MVD surgery via the suboccipital retrosigmoid approach at the Department of Neurosurgery in Zhuhai People's Hospital from January 2021 to December 2021 were retrospectively analyzed. Preoperatively, all patients underwent cranial thin-section computed tomography and magnetic resonance examinations. Three-dimensional (3D) digital images of the skull, brainstem, nerves, and blood vessels were constructed by the 3D-slicer software or RadiAnt DICOM Viewer, which were then applied to design the surgical approach and surgical plan. The multimodal image fusion results, clinical characteristics, intraoperative data, surgical outcomes, and complications of all patients were summarized. The 3D digital images after fusion reconstruction can vividly show the anatomical relationship between the skull, brainstem, nerves, and blood vessels and was helpful to tailor the surgical strategy. All 26 patients underwent a smooth surgery. During the surgery, the key points were accurately located, the corners of the transverse sinus and sigmoid sinus were completely exposed, and no venous sinus injury occurred in all 26 patients. The key point was approximately located at the top point of the digastric groove, 12.3±0.46mm vertically above and 6.3±0.6mm laterally to the Frankfurt horizontal plane. The average cranial opening time was 30.4 (±3.6) min, and the mean operating time was 104.7 (±12.1) min. The diameter of the bone window was about 2.0 cm-3.0cm, and the bone flap was restored. Among the 13 patients with primary TN, 12 (92.3%) exhibited complete relief of pain and 1 had significant relief. Complications of surgery included facial sensory numbness in 1 case, vertigo in 2 cases, and herpes at the corners of the mouth in 1 case. Of the 13 patients with HFS, 12 (92.3%) had complete relief of facial twitching symptoms and 1 had significant relief, and the complications included mild facial palsy in 2 (15.4%) cases and facial sensory numbness in another 2 (15.4%) cases. The mean follow-up time after surgery ranged from 6-16months, and 1 of 26 patients experienced recurrence of HFS during the follow-up period. Preoperative multimodal image fusion technology can provide adequate preoperative assessment for patients and assistance in designing surgical approaches, which is an important guideline for MVD surgery via the suboccipital retrosigmoid approach for primary TN and facial muscle spasm.

Evaluation and management of the dysesthetic patient.

Dysesthesia is symptomatology that includes but is not limited to sensations of pain, burning, crawling, biting, numbness, piercing, pulling, cold, shock-like, pulling, wetness, and heat. These sensations can cause significant emotional distress and functional impairment in affected individuals. Although some cases of dysesthesia are secondary to organic etiologies, most cases exist without an identifiable infectious, inflammatory, autoimmune, metabolic, or neoplastic process. Ongoing vigilance is required for concurrent or evolving processes, including paraneoplastic presentations. Elusive etiologies, unclear treatment regimens, and stigma leave patients and clinicians with a difficult path forward marked by "doctor shopping," lack of treatment, and significant psychosocial distress. We address this symptomatology and the psychosocial burden that often comes with it. Although notoriously labeled as "difficult to treat," dysesthesia patients can be effectively managed, making life-changing relief possible for patients.

Symptom descriptors and patterns in lumbar radicular pain caused by disc herniation: a 1-year longitudinal cohort study

ObjectiveThe objective of the present study was to explore the diversity, quality, severity and distribution of symptoms in patients with radicular pain and a lumbar disc herniation.DesignLongitudinal cohort study.SettingHospital-based back...

AYURVEDIC MANAGEMENT OF GRIDHRASI WITH SPECIAL REFERENCE TO SCIATICA: A CASE REPORT

Background: Gridhrasi is one of the most common disorders of Vata Dosha described in Ayurveda classics according to sign and symptom it can be related to sciatica. Sciatica is characterized by pain &amp; discomfort associated with the pathology of sciatic nerve root in people. It is associated with Low back pain, pain radiates to lower limb till toes, tingling and numbness sensation in the buttock region. This is an epidemic disease of modern era with industrial region and more common with office workers. Methodology: The present case study was carried out by following good clinical practice guidelines, studies on Gridhrasi and Ayurveda textual references. Written informed consent of the patient was taken before starting the treatment. A detailed patient history with all necessary clinical and physical examination and laboratory investigations were carried out. This is a single case study. A 49-year-old male patient presented with the complaint of low back pain radiating to left lower limb, tenderness at L4 and L5 region difficulty in walking for long distance and with associated symptom like fever, cough and cold. Sahacharadi Kashayam, Dhanwataram 101 Avarthi, Vyoshadi Vatakam, Dasamoolakadutrayam Kashayam were given for 20 days along with external therapy. Result and conclusion: After 20 days of treatment there was significant changes in subjective and Objective parameter of patient like reduction in pain (VAS scale), tenderness, &amp; other symptoms.

Guillain- Barré Syndrome (GBS) after Sinopharm vaccination

Neurological complication following Sinopharm vaccination is extremely rare and Guillain-Barre syndrome (GBS) is among the least common complication. Here we report a case of a 62-year-old male with GBS secondary to Sinopharm vaccination. A diagnosed patient with schizophrenia presented with three-day history of lower limb weakness with preceding sensation of numbness. Nerve conduction study was suggestive of GBS, and lumbar puncture shows cytoprotein dissociation. He was managed with IV immunoglobulin and supportive management and drastic improvement was noted. The patient made an uneventful recovery with full muscle power.

Comparison of Patient-Controlled Caudal Epidural Analgesia and Patient-Controlled Intravenous Analgesia After Perianal Surgery: A Randomized Controlled Trial.

IntroductionThis study aimed to compare the efficacy between patient-controlled caudal epidural analgesia (PCCA) and patient-controlled intravenous analgesia (PCIA) after perianal surgery, to provide a feasible solution to postoperative pain.MethodsThis was a prospective, randomized controlled trial comprising 100 patients who underwent caudal epidural block on perianal surgery at Chengdu Shang Jin Nan Fu Hospital of West China Hospital at Sichuan University between April and August 2020. Patients were randomly divided into the PCCA and PCIA groups. Visual analog scale (VAS) scores were recorded at 2, 4, 6, 24, 48, and 72 h after surgery, and at the first dressing change and first defecation. The lower limb mobility in the post-anesthetic recovery room (PACU) was determined. The analgesic effect, usage amount of patient-controlled analgesia (PCA), usage amount and frequency of remedial analgesic measures, number of individuals who must be catheterized, and incidence of adverse reactions were recorded. Satisfaction of postoperative analgesic effect and convenience of PCA were also assessed.ResultsThe patients in the PCCA group had significantly lower VAS scores at 4, 6, 24, 48, 72 h, the first dressing change, and the first defecation compared with the PCIA group. There were more patients receiving postoperative remedial analgesics in the PCIA group than in the PCCA group. The outcome of the number of PCA and catheterization rates did not differ significantly between the groups. There were two cases of sensory numbness below the S3 plane. The major postoperative complications in the PCIA group were pruritus (3/47, 6.4%), nausea, and vomiting (6/47, 12.8%) (one case combined with pruritus). Patients in the PCCA group were more satisfied with the analgesic effect, while those in the PCIA group were more satisfied with the convenience.ConclusionIn the postoperative analgesia program of perianal surgery, PCCA may provide a better analgesic effect without increasing the incidence of complications.Trial RegistrationChinese Clinical Trial Registry identifier, ChiCTR2000038425, September 2020, retrospectively registered.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40122-022-00411-y.