Painful Swelling Research Articles

Analisis Asuhan Keperawatan Pada Pasien Dengan Gangguan Sistem Pencernaan

According to data released by the Ministry of Health of the Republic of Indonesia regarding the incidence of appendicitis in Indonesia in 2016, the number of patients with appendicitis in Indonesia reached 591,819 people and increased in 2017 by 596,132 people (Soewito, 2017). The incidence of appendicitis in 2018 reached 7 of the world's population. In 2018 the incidence of appendicitis in most parts of Indonesia is still high. In Indonesia, the number of patients suffering from appendicitis is about 7% of the total population or about 179,000 people (Depkes, 2018). The author's goal is to be able to provide nursing care for post-operative appendectomy patients with acute pain nursing problems. Appendicitis is a painful swelling of the appendix with the management of appendectomy, namely surgery to remove the appendix, surgery is indicated when the diagnosis of appendicitis has been established. The research method used is a case study. Samples were taken according to the inclusion criteria of patients with post-appendectomy digestive system disorders with acute pain problems. The care was carried out for 3 days at the Bekasi District Hospital. Data was collected by: interviews, observations, physical examinations, and documentation studies. Data were analyzed narratively based on a comparison of two patients. Patient data 1 and 2 have been supportive to raise the problem of acute pain and its implementation has been implemented and there are no obstacles.

Delayed neurological dysfunction following posterior laminectomy with lateral mass screw fixation: A case report and review of literature

BACKGROUND While most complications of cervical surgery are reversible, some, such as symptomatic postoperative spinal epidural hematoma (SEH), which generally occurs within 24 h, are associated with increased morbidity and mortality. Delayed neurological dysfunction is diagnosed in cases when symptoms present > 3 d postoperatively. Owing to its rarity, the risk factors for delayed neurological dysfunction are unclear. Consequently, this condition can result in irreversible neurological deficits and serious consequences. In this paper, we present a case of postoperative SEH that developed three days after hematoma evacuation. CASE SUMMARY A 68-year-old man with an American Spinal Injury Association (ASIA) grade C injury was admitted to our hospital with neck pain and tetraplegia following a fall. The C3-C7 posterior laminectomy and the lateral mass screw fixation surgery were performed on the tenth day. Postoperatively, the patient showed no changes in muscle strength or ASIA grade. The patient experienced neck pain and subcutaneous swelling on the third day postoperatively, his muscle strength decreased, and his ASIA score was grade A. Magnetic resonance imaging showed hypointense signals on T1 weighted image (T1WI) and T2WI located behind the epidural space, with spinal cord compression. Emergency surgical intervention for the hematoma was performed 12 h after onset. Although hypoproteinemia and pleural effusion did not improve in the perioperative period, the patient recovered to ASIA grade C on day 30 after surgery, and was transferred to a functional rehabilitation exercise unit. CONCLUSION This case shows that amelioration of low blood albumin and pleural effusion is an important aspect of the perioperative management of cervical surgery. Surgery to relieve the pressure on the spinal cord should be performed as soon as possible to decrease neurological disabilities.

An outbreak of acute hemorrhagic conjunctivitis due to Coxsackievirus A24 in a residential school, Naharlagun, Arunachal Pradesh: July 2023

PurposeAn acute conjunctivitis outbreak was investigated at a residential school in Naharlagun, Arunachal Pradesh, Northeast India, in July 2023. We aimed to identify the etiological agent and assess any complications in follow-up cases. MethodsWe used a structured questionnaire to record clinical findings and followed up with cases one-month post-conjunctivitis. Sixty-one cases were examined and eight conjunctival and oropharyngeal swab samples were collected after obtaining informed consent from guardians/school authorities. We screened for 33 viral and bacterial pathogens using an IVD-approved Real-time PCR assay. Further, the samples were subjected to nucleic acid sequencing. ResultsAmong 465 screened students and staff, 80 individuals (approximately 17.2%) showed acute hemorrhagic conjunctivitis symptoms among which 61 cases were available for clinical examination. We identified the Enterovirus responsible by targeted sequencing using next-generation sequencing. The etiological agent was found to be Coxsackievirus A24, a member of Enterovirus C, in seven out of eight samples subjected to sequencing. Common symptoms included conjunctival hyperemia and foreign body sensation (100%), bilateral eye involvement (73.8%), eye pain (70%), watery discharge (49.2%), and eyelid swelling (38%). Only 6.5% had purulent discharge. Most cases resolved within 5-6 days, with only 9.8% reporting abdominal symptoms post-conjunctivitis. No serious complications occurred within one month. Throat swabs aided in diagnosing enterovirus infections alongside eye swabs. ConclusionsThe outbreak of acute conjunctivitis was caused by Coxsackievirus A24, a member of Enterovirus C. Cases resolved spontaneously within 6-7 days, with no severe complications. Collecting oropharyngeal swabs alongside conjunctival swabs could improve enteroviral conjunctivitis diagnosis.

Efficacy and Safety of High Density LED Irradiation Therapy for Patients With Hand Osteoarthritis: A Single-Center Clinical Study.

To assess the safety and effectiveness of high-density light-emitting diode (LED) irradiation therapy in patients with hand osteoarthritis (OA) and compare the pre- and post-intervention symptoms. Twenty-three patients with hand OA underwent eight sessions of high-density LED irradiation therapy directed at the five most painful areas in the finger joints. Each session lasted for 18 minutes; and the sessions were conducted twice a week, for 4 weeks. We evaluated the degree of pain using the visual analogue scale, ring size, and passive range of motion (flexion+extension) for two most painful joints from the baseline to post-therapy (weeks 4 and 6). High-density LED irradiation therapy significantly reduced the pain posttreatment compared with that observed at the baseline (p<0.001). Although improvements were observed in ring size and joint range of motion at 4 and 6 weeks, they were not statistically significant (p>0.05). No adverse events were observed. We examined the safety and effectiveness of high-density LED irradiation therapy in reducing pain and hand swelling and improving joint mobility in patients with hand OA. These results suggest that high-density LED irradiation therapy has the potential to be an important strategy for managing hand OA.

Male’s Primary Breast Lymphoma: Rare Entity of Breast Malignancy, Wad Madani Teaching Hospital, Gezira State, Sudan, August 2023

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Primary breast lymphoma is a malignant lymphoma primarily involving breast in absence of previously detected lymphoma localizations. &amp;lt;i&amp;gt;Method&amp;lt;/i&amp;gt;: A male of forty years old admitted to Department of Surgery; Wad Madani Teaching Hospital; Gezira State; Sudan; complaining of left breast lump for three months. Condition observed as a painful swelling in left breast, increasing gradually in size, associated with continuous high-grade fever, no rigors and relieved by analgesia, no nipple discharges. Had significant weight loss, anorexia, fatigability, back pain, dry cough with no hemoptysis, no history of headache, and no past or family history of similar condition. Examination: patient looks ill, pale, and not jaundiced. Breast examination: Left breast was larger than right one. Left breast: no nipple destruction, nipple was directed downward medially, no skin changes or dimpling, and no ulceration. There was a mass in left upper outer quadrant, measuring 6*7 cm, smooth surface, hard in consistency with well-defined edges, and attached to muscles but not to skin. No palpable axillary lymph nodes. Right breast was normal. Chest and abdominal examination were unremarkable. Investigations: Fine needle aspiration cytology showed poorly differentiated carcinoma. Incisional biopsy revealed: high grade Non-Hodgkins Lymphomas (Diffuse Large B Cell Lymphoma). He was referred to oncological department for neoadjuvant chemoradiotherapy. Conclusion and &amp;lt;i&amp;gt;Recommendation&amp;lt;/i&amp;gt;: Primarily breast lymphoma is extremely rare among male, showing features mimicking breast carcinoma. Incisional biopsy was recommended for investigation of breast lump especially among males.

Pacinian neurofibroma of index finger in young adult: a rare case report

Pacinian neurofibroma (PN) of index finger (hand) is a rare entity with only few cases reported till now. Although it’s a neurofibroma but the association between PN and neurofibromatosis has not been established. We present a rare case of young adult coming with painful swelling on palmer aspect of base of index finger. Patient didn’t respond to the conservative line of management so on excision biopsy it revealed out to be PN.

Juvenile eosinophilic fasciitis: a single center case series

BackgroundEosinophilic fasciitis (EF) is a rare disease characterized by skin induration and musculoskeletal abnormalities. Diagnostic criteria for EF are based on adult populations. There is a need to expand the literature on EF in children due to limited reported cases and potential differences compared to adults.MethodsWe conducted a retrospective review of medical records for six pediatric patients diagnosed with EF at our institution between November 2011 and April 2023. Inclusion criteria required patients to be under 18 years of age at the time of diagnosis and to have confirmed diagnosis through clinical history, imaging, and histology.ResultsMost of our cohort were female (83%) and non-Hispanic white (50%). Age at diagnosis ranged from 4 to 16 years. Duration of symptoms before diagnosis varied from 1 to 12 months. Follow-up periods ranged from 14 to 123 months. Concurrent medical conditions included localized scleroderma, acquired thrombophilia, and juvenile idiopathic arthritis. Patients presented with progressive painful swelling, severe joint limitations, and positive prayer sign. Initial regimens involved corticosteroids and methotrexate. Hydroxychloroquine, immunoglobulin, mycophenolate mofetil, rituximab, and tocilizumab were also used depending on the patient’s disease severity and course.ConclusionsJuvenile EF may manifest as swelling and progressive induration without apparent skin abnormalities. Unlike adult populations, no underlying malignancies or associations with trauma were observed in our cohort. Our cases did not exhibit systemic involvement observed in previous studies on juvenile EF. While non-specific, the prayer sign may aid in early recognition of juvenile EF and help prevent long-term disability.

Rescue From Permanent Kidney Injury in Acute Thrombosis of Both Renal Veins, the Inferior Vena Cava, and Both Iliofemoral Veins by Catheter-Based Thrombectomy.

A 33-year-old man with previously diagnosed lupus membranous nephropathy presented with painful swelling in both legs. Laboratory tests revealed acute kidney injury, and imaging studies by duplex ultrasound and computed tomography scan showed acute thrombosis of both renal veins, the infrahepatic inferior vena cava, and both iliofemoral venous segments. Initially, pharmacomechanical thrombolysis led to an insufficient morphological result. The therapeutic breakthrough was achieved by catheter-based mechanical thrombectomy of the infrarenal vena cava and both renal veins, which successfully cleared all affected venous segments from thrombus, paralleled by improvement of the patient's condition. However, after 1 week, the patient experienced recurrent thrombosis of the right renal vein with hemorrhagic infarction of the right kidney. After further optimization of immunomodulatory and antithrombotic therapy, a repeated catheter-based mechanical thrombectomy resulted in sustained clinical improvement and preservation of renal venous drainage and kidney function. Extensive acute thrombosis of both renal veins, the inferior vena cava, and both iliofemoral venous segments is a rare emergency potentially threatening kidney function. Immediate effective thrombus removal is essential to preserve kidney function and can be achieved by catheter-based mechanical thrombectomy embedded in a comprehensive immunomodulatory and antithrombotic therapeutic concept. This case demonstrated the efficacy of a catheter-based therapeutic approach in patients with extensive thrombosis of the venous system. A catheter-based approach must be embedded in a comprehensive medical therapeutic concept, which is essential to achieve a sustainable result.

Sudden Ocular Complication after Snake Bite

Introduction : A snakebite constitutes a common acute medical emergency and has several systemic and even ocular consequences. Snake venom neurotoxins act mainly on the peripheral nervous system at the neuromuscular junction and can affect the cranial nerves. Neurological symptoms that relate to cephalic muscle paralysis include exotropia, ptosis, diplopia and ophthalmoplegia.&#x0D; Case Illustration : A 17 years old man came to emergency department with painful swelling on his left hand and sudden blurred vision right after his left hand were bitten by venomous snake in the rice field. Diplopia and ptosis were developed several hours after admission. On eye examination, visual acuity was 0,05 on right eye and 0,8 on left eye, abnormal pupillary reflects on both eyes were present, pupil dilatation, limited eye movement and ptosis were present, Intraocular pressure were 23,7 mmHg on right eye and 24,5 mmHg on left eye. Antivenom was administered immediately. He received cycloplegic, timolol eyedrop, and prednisolone eyedrop for ocular treatment&#x0D; Discussion : Ocular complications are rare and uncommon but they may lead to sight-threatening conditions. Snake venom neurotoxins act mainly on the peripheral nervous system at the neuromuscular junction and can affect the cranial nerves. Mild neurological symptoms that relate to cephalic muscle paralysis include exotropia, ptosis, diplopia and ophthalmoplegia.&#x0D; Conclusion : This study presented a rare case of systemic ocular complication as a result of a snake bite. Ophthalmoplegia induced ocular discomfort for an extended period is a rare symptom of snake-bites. Combined treatment of steroid with antivenom may improve the recovery from sudden ocular manifestation in snake bite.

Tranexamic Acid for Rotator Cuff Repair: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Several randomized controlled trials (RCTs) have been conducted to assess the use of tranexamic acid (TXA) in the setting of arthroscopic rotator cuff repair (ARCR). However, these studies have shown mixed results, with some showing improved intraoperative visualization, subsequent operative times, and pain levels, and others finding no difference. To perform a systematic review of the RCTs in the literature to evaluate the use of TXA on ARCR. Meta-analysis; Level of evidence, 1. Two independent reviewers performed the literature search based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, with a third author resolving any discrepancies. RCTs comparing TXA with a control in ARCR were included. Visualization, postoperative pain, operative time, pump pressures, and shoulder swelling were evaluated. A P value < .05 was deemed statistically significant. Six RCTs with 450 patients were included in this review. Overall, 5 studies evaluated intraoperative visualization, with 3 studies finding a significant difference in favor of TXA. With TXA, patients had a lower mean postoperative visual analog scale (VAS) score of 3.3, and with the control, patients had a mean VAS score of 4.1, which was statistically significant (P = .001). With TXA, the mean weighted operation time was 79.3 minutes, and with the control, the mean operation time was 88.8 minutes, which was statistically significant (P = .001). No study found any difference in intraoperative pump pressures or swelling. TXA improved visualization, operative time, and subsequent postoperative pain levels in patients undergoing ARCR.

Coronary pseudoaneurysm with a superficial mass and accompanying Brucella infection

Background and aimsTo our knowledge, no previously reported clinical data of a coronary artery fistula forming a pseudoaneurysm and presenting as a anterior chest wall lump. We reported a rare case of Coronary pseudoaneurysm with a superficial mass and accompanying Brucella infection. The patient was successfully treated with surgery.Materials and methodsThe patient case data was extracted from hospital records.ResultsA 64-year-old male presented with a history of paroxysmal left-sided chest pain and painful anterior chest wall lump. Coronary computed tomography (CT) angiography revealed the RCA pseudoaneurysm that showed a peripherally calcified soft-tissue mass in the anterior mediastinum and communicated with the chest wall lump through intercostal spaces. The patient underwent the resection of chest lump and RCA pseudoaneurysm under cardiopulmonary bypass, along with a combined antimicrobial therapy. The patient was discharged successfully after the surgery.Discussion and conclusionWe report this rare case and highlight the possible origin of the anterior mediastinal mass and anterior chest wall lump as a pseudoaneurysm formed by a coronary artery fistula.

February 2024 Imaging Case of the Month: Connecting Some Unusual Dots

No abstract available. Manuscript truncated after 150 words. Clinical History: A 37-year-old woman presents with abdominal pain, tongue and throat swelling, and intermittent shortness of breath and dyspnea on exertion. She also notes some pain on swallowing. The patient’s past medical history was largely unremarkable. Her one prior surgery included cholecystectomy for cholelithiasis, and she was not taking any prescription medications. The patient is a lifelong non-smoker, her only reported allergy due to medications containing sulfa, and she drinks alcohol only socially and denied illicit drug use. Laboratory: A complete blood count showed a normal white blood cell count at 9.7 x 109/L (normal, 3.4 – 9.6 x 109/L), with an elevated absolute neutrophil count of 8.18 x 109/L (normal, 1.4 – 6.6 x 109/L); the percent distribution of lymphocytes, monocytes, and eosinophils was normal. Her hemoglobin and hematocrit values were 15 gm/dL (normal, 13.2 – 16.6 gm/dL) and 46% (normal, 34.9 – 44.5%). The platelet count was normal at 220 x …

Bisphosphonate therapy in the management of diffuse sclerosing osteomyelitis of the mandible: a systematic review and narrative synthesis

Background: Diffuse sclerosing osteomyelitis (DSO) affecting the mandible is an uncommon condition characterised by recurrent pain and functional disturbances. Traditional treatments involving antibiotics, steroids, and analgesics have generally yielded unsatisfactory results. Numerous articles have proposed the utilisation of bisphosphonate therapy as an alternative approach to achieve sustained symptom relief. This study aims to consolidate the available evidence on the effectiveness of bisphosphonate therapy in managing DSO. Methods: A systematic review protocol was registered with PROSPERO and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies were devised, and studies were screened based on predefined inclusion and exclusion criteria. Results: Ten articles met the eligibility criteria, encompassing a total of 135 patients diagnosed with DSO who received bisphosphonate treatment. All included studies consistently reported a reduction in pain levels and swelling, along with a decrease in the cumulative use of analgesics. The majority of patients reported long-lasting symptom improvement with bisphosphonate therapy. Notably, four studies documented improvements in maximal mouth opening, with one study reporting a mean increase of 9.6mm. Furthermore, six studies observed improvements in panoramic radiographs and cone beam computed tomography scans, with one publication describing two patients exhibiting near-normal bone architecture. Importantly, all studies reported the absence of long-term complications. Conclusions: Bisphosphonate therapy emerges as a promising treatment modality for DSO, exhibiting efficacy in symptom alleviation and radiological enhancement while conferring lasting benefits. Nevertheless, further prospective studies are warranted to refine treatment protocols and substantiate these findings.

Anaphylactic shock following the mad honey consumption: a case report

Introduction: Mad honey consumption is a common practice in Nepal for medicinal and consumption purposes, but it can lead to severe adverse effects. Grayanotoxin I and Grayanotoxin III isoforms found in rhododendron interfere with voltage-gated sodium channels resulting in gastrointestinal symptoms, and cardiovascular effects such as low blood pressure, abnormal heart rhythms, cardiac arrest, and abnormal electrical conduction in the heart, as well as rare central nervous system disorders. Here the authors report a case of Mad honey consumption leading to anaphylactic shock along with its investigations and management. Case presentation: The authors present a case of a 51-year-old female who developed anaphylactic shock after consuming mad honey. The patient experienced symptoms including nausea, vomiting, abdominal pain, sweating, dizziness, facial and lip swelling, but no chest pain, loss of consciousness, abnormal body movement, or dyspnoea. The patient had no prior medical conditions, regular medications, or history of allergic reactions to honey or pollen. Discussion: Mad honey intoxication is caused by grayanotoxins, with distinct cardiac effects for different types of grayanotoxins. Symptoms include bradycardia, hypotension, abdominal pain, dizziness, and nausea, which subsided within 24 h following the initial management. The presence of grayanotoxin can be detected using specialized instrumentation, but it may not be available in all medical facilities. Co-intoxication with alcohol or propolis may also occur. Conclusion: This case highlights the importance of recognizing and managing complications associated with mad honey consumption, particularly in regions where it is prevalent. Prompt medical attention is advised if unusual symptoms occur after honey consumption.

Effectiveness of Traditional Chinese Medicine With Liver-Soothing Function for Hyperplasia of Mammary Glands: A Systematic Review and Meta-analysis

ObjectivesHyperplasia of the mammary gland (HMG) is a proliferative condition triggered by an imbalance in endocrine hormones. Studies have revealed the potential role of Traditional Chinese Medicine (TCM) in treating endocrine disorders. TCM offers the advantages of multi-target regulation, significant therapeutic effects, and fewer side effects. TCM exhibits a liver-soothing function, improving clinical efficacy and relieving symptoms including hyperplasia and pain. Therefore, in this systematic review, we investigated the efficacy and safety of TCM with liver-soothing effects in alleviating HMG. MethodsEight databases were searched to obtain randomized controlled trials “(RCTs)” on the use of “Traditional Chinese Medicine with the liver-soothing function” for “hyperplasia of mammary glands.” The quality of collected studies was evaluated using Cochrane Collaboration’s risk of bias tool. Data were extracted from good-quality studies using RevMan. Stata 15.0 software was used for meta-analysis. ResultsIn total, 24 studies with 2,584 patients were included in this investigation. Among them, 1,312 patients in the intervention group received TCM with liver-soothing function and 1,272 patients in the control group received conventional Western medicine or other TCM. TCM with liver-soothing function outperformed the control group in terms of clinical efficacy. Furthermore, TCM with liver-soothing function significantly decreased HMG-associated adverse events, breast pain score, lump score, and other scores. ConclusionTCM with liver-soothing properties can effectively improve clinical efficacy and prevent adverse reactions in patients with HMG. More rigorous RCTs are warranted in the future to provide more concrete evidence.

Complex regional pain syndrome as acause of acute painful limb swelling &amp;ndash; acase report

Complex regional pain syndrome (CRPS) is a complex condition characterised by severe pain and various sensory and motor abnormalities. This case report is of an 18-year-old woman presenting with painful upper limb swelling for a few days, with skin mottling and dysesthesia, with significant disability. With negative investigations, a diagnosis of CRPS was made. The case emphasises the importance of early recognition and appropriate management of CRPS, as delayed diagnosis leads to poor quality of life and functional impairment. Healthcare professionals should maintain a high index of suspicion for CRPS in patients with unexplained limb pain and associated sensory and motor abnormalities, ensuring a comprehensive multidisciplinary approach to optimise patients' quality of life.

New minimally invasive view of tibial pilon fractures: Experience of the A4 orthopaedic traumatology department at CHU Ibn Rochd in Casablanca

Tibial pilon fractures are rare and serious fractures, given their complexity and therapeutic difficulty. Closed-focus osteosynthesis is an interesting alternative for treating these fractures. In order to assess the clinical and radiological results of treating tibial pilon fractures with closed-focus osteosynthesis, we conducted a retrospective descriptive study of a series of 80 tibial pilon fractures treated at the Traumatology-Orthopedics Department A4 of CHU Ibn Rochd in Casablanca, over a period from January 2017 to December 2022. The mean age in our study was 42.5 years, with a M/F sex ratio equal to 3. Etiological circumstances were dominated by high-energy mechanisms, including falls from a high place in 43% and MVAs in 42% of cases. Clinical diagnosis was guided in 100% of cases by functional impotence, pain and localized swelling. We performed an ankle radiograph in front and side views, complemented by a CT scan, in all our patients to confirm the diagnosis and classify the different fracture types. Surgical treatment with closed-focus osteosynthesis was performed by combined treatment in 50% of cases; external fixator in 20% of cases; and minimally invasive treatment under arthroscopy in 30% of cases. According to CAFFINIERE criteria, functional and radiological results were good and satisfactory in 80.57% of cases, and poor in 19.43%. Complications included algodystrophy in 28.75% of cases, infection in 10%, joint stiffness in 13.75%, pseudarthrosis in 11.25%, arthrosis in 11.25% and callus in 7.5%. Finally, analysis of our results showed that the majority of our patients treated with closed-focus osteosynthesis had good functional, clinical and radiological results, demonstrating the effectiveness of this surgical method in tibial pilon fractures.

Mandibular odontogenic cyst atypically extended into the submandibular region with thickened bone formation: A case report

AbstractBackgroundOdontogenic cysts can cause thinning and expansion of the surrounding cortical bone; however, bone formation extending into the submandibular region, resembling periosteal reactions, is rarely observed in odontogenic cysts.Case PresentationA 52‐year‐old man presented with painful submandibular swelling and dyspnea. Computed tomography revealed an extensive mandibular cystic lesion extending to the submandibular region accompanied by thickened bone formation, mimicking lobulated shell‐type periosteal reaction. Percutaneous cystectomy with extensive mandibular bone resection was performed.ConclusionProlonged existence of extensive cystic lesion and inflammatory stimulation may result in bone elongation into the submandibular region, mimicking periosteal reaction.

Traditional Therapy in Postpartum Care: A Qualitative Study in Neniari Village, Manggarai Regency, East Nusa Tenggara

The postpartum period is an important period for mothers to recover their physical and psychological condition after giving birth. In Indonesia, there are various traditional practices carried out to care for postpartum mothers. This research aims to explore traditional therapeutic practices in postpartum care in Neniari Village, Manggarai Regency, East Nusa Tenggara. This research uses a qualitative study method with a phenomenological approach. Data was collected through in-depth interviews with 10 postpartum mothers and 3 traditional birth attendants. The research results show that there are three types of traditional therapy that are commonly practiced in Neniari Village, namely: Herbal concoctions: Herbal concoctions are used to treat various complaints experienced by postpartum mothers, such as bleeding, abdominal pain and breast swelling. Ukup: Ukup is a massage technique performed to improve blood circulation, reduce pain, and improve mood. Rahu: Rahu is a steaming technique performed to warm the body, tone the uterine muscles and increase breast milk production. The research results show that traditional therapy has many benefits for postpartum mothers, both physically and psychologically. Traditional therapy can also be an alternative postpartum care that is affordable and easy to obtain.

Real-world reporting rates of administration-site reactions with on-demand treatment of hereditary angioedema attacks.

Background: Hereditary angioedema (HAE) is characterized by recurrent and unpredictable episodes of subcutaneous and/or submucosal swelling. Objective: To characterize the real-world treatment burden associated with existing on-demand therapies, we analyzed administration-site adverse drug reactions (ADR) associated with approved on-demand HAE therapies reported in the U.S. Food and Drug Administration's (FDA) Adverse Event Reporting System (FAERS). Methods: We searched the FAERS database from October 1, 2009, to March 31, 2022, for reports of all FDA-approved on-demand therapies for HAE: plasma-derived C1-inhibitor (pdC1-INH), ecallantide, icatibant, and recombinant C1-inhibitor (rhC1-INH). ADRs in which the drug was listed as the "primary suspect" were recorded for each drug. ADR preferred terms were grouped into 18 ADR domains based on semantic and/or clinical similarity, and the number of reports for each drug was calculated per year from the time of approval through March 2022, and descriptive results were presented. Preferred terms associated with administration-site ADRs identified from clinical trials and denoted on approved HAE drug U.S. package inserts were examined in a complementary analysis. Results: The highest reported rates of administration-site ADRs per year were site pain (17.9 reports per year), site erythema (7.4 per year), and site swelling (6.7 per year). RhC1-INH was the only drug for which access-site complications and/or malfunctions were reported (9.5 per year). PdC1-INH had the highest rate of incorrect route of product administration (3.7 per year). PdC1-INH showed statistically significant elevated reporting rate of injection-site reactions (reporting odds ratio [ROR] 3.59 [2.36-5.46]; empirical Bayesian geometric mean [EBGM] 1.97 [1.39]). Icatibant and rhC1-INH showed a statistical trend toward an increased reporting rate of administration-site reactions. Conclusion: Real-world data from FAERS were generally consistent with adverse events reported in clinical trials and suggest that patients experience substantial treatment burden associated with FDA-approved parenteral on-demand therapies for HAE attacks. It should be noted that ADR rates are not exposure adjusted and are based on spontaneous reporting.