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The Role of Preemptive Infiltration Anesthesia in the Management of Postoperative Pain Following Septoplasty.

 Septoplasty is one of the most common surgical procedures in rhinology practice. Two major problems encountered after septoplasty are pain and bleeding. Preoperative administration of analgesics before the surgical stimulus, which is the main concept of preemptive analgesia, decreases postoperative pain.  The present study was designed to investigate whether preincisional lidocaine infiltration to the subperichondrial area during septoplasty surgery reduced or not postoperative pain and analgesic use.  The present prospective, randomized, placebo controlled, double-blind trial was conducted on 64 consecutive patients with nasal septum deviation. Patients were randomly divided into 2 groups; the study group received 2% 20 mg lidocaine/cc (  = 31), and the control group received 6 cc 0.9% NaCl (  = 33). A standard questionnaire was given to each patient to mark his or her pain score between 0 and 10 at the 1 , 3 , 6 , 12 , and 24 hours.  The mean and the range of visual analogue scale (VAS) scores of the patients in the study group at the 1 , 3 , 12 , and 24 hours were 4.03 ± 3.08 (0-10); 3.42 ± 2.39 (0-8); 2.97 ± 2.22 (0-8); 2.87 ± 2.61 (0-9); and 1.94 ± 2.06 (0-9) respectively. The mean and the range of VAS scores of the patients in the control group at the 1 , 3 , 12 , and 24 hours were 4.12 ± 2.7 (0-10); 3.45 ± 2.4 (0-10); 2.94 ± 2.7 (0-10); 2.79 ± 2.34 (0-10); and 1.5 ± 1.8 (0-6), respectively. The statistical analysis revealed no significant difference among the groups.  The preemptive local anesthetic administration to the incision area and under the mucoperichondrial flap before septoplasty does not decrease the level of postoperative pain.

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The effect of a quality improvement project on post-operative opioid use following outpatient spinal surgery.

Prescribing opioids upon discharge after surgery is common practice; however, there are many inherent risks including dependency, diversion, and medical complications. Our prospective pre- and post-intervention study investigates the effect of a standardized analgesic prescription on the quantity of opioids prescribed and patients' level of pain and satisfaction with pain control in the early post-operative period.

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Arthroscopic Treatment of Chronic Acromioclavicular Dislocation With Semitendinosus Autograft and Coracoclavicular Suspension Fixation.

The management of acromioclavicular dislocations remains controversial. On many occasions, these chronic dislocations are asymptomatic. However, there are patients who, despite good rehabilitation treatment, do present with pain, periscapular muscle fatigue, weakness, paresthesia or scapular dyskinesia. In these patients, surgical treatment is indicated.

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Digital headache self-management interventions for patients with a primary headache disorder: A systematic review of randomized controlled trials.

This article systematically reviews the empirical literature examining the efficacy of digital headache management interventions for patients with a primary headache disorder.

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Effect of Repeated High-voltage Long-duration Pulsed Radiofrequency on Herpetic Neuralgia.

Pulsed radiofrequency (PRF) is a commonly used, minimally invasive method to treat herpes zoster neuralgia, but the intensity of standard voltage PRF is limited, resulting in patients not getting a lasting therapeutic effect. The therapeutic effect of repeated high-voltage long-duration PRF on acute herpes zoster neuralgia has not been studied.

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Spinal brucellosis causing spondylodiscitis.

and Importance: Brucellosis is a common prevalent zoonotic disease in developing countries including Somalia. Brucellosis may affect many organs. However involvement in the spine and paravertebral muscles is common and may lead to diagnostic challenges since it presents with non-specific symptoms.

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Investigation of the analgesic efficacy of ultrasound-guided thoracolumbar interfacial plane block in vertebral surgery: A prospective randomized clinical study.

To investigate the effect of thoracolumbar interfacial plane block (TLIP) on analgesic consumption and pain score in vertebral surgery.

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S2k Leitlinie: Diagnostik und Therapie des chronischen Pruritus.

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Percutaneous transhepatic cholangial drainage combined with intra-tumoral iodine-125 seeds implantation and chemotherapy for locally progressive pancreatic head cancer with obstructive jaundice.

To investigate the clinical efficacy of percutaneous transhepatic cholangial drainage (PTCD) combined with intra-tumoral iodine-125 (I) particle implantation and chemotherapy in the treatment of locally advanced pancreatic head cancer (LAPHC) with obstructive jaundice.

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Obstetric Care for Monkey Pox in India: What Every Clinician Should Know.

Monkeypox is a contagious viral disease that spreads between animals and people. The UK government guidance described the first case of 'Monkey Pox' in 1958, when it was found only in monkeys used for research purposes. Fortunately, for a third world fast developing country like India, monkeypox does not spread easily in the population but spread by close physical contact between people, and there is limited information available about the impact on pregnancy. The virus can enter the body through broken skin, the respiratory tract, or mucous membranes (the moist inner lining of cavities and some organs in the body). The signs and symptoms of monkeypox virus infection in people who are pregnant appear similar to those in nonpregnant people. The symptoms include fever, lymphadenopathy, lethargy, pharyngitis, headache, myalgias, and rash. Rash associated with monkeypox virus infection can be found in the anogenital area (most commonly reported location in this current outbreak), trunk, arms, legs, face, and the palms and soles. The diagnostic approach to a patient with suspected monkeypox virus infection is the same for pregnant and nonpregnant people. If a patient is present with signs and symptoms of monkeypox virus infection, diagnostic testing should be considered, especially if the person has risk factors for monkeypox virus infection. There are limited data on monkeypox infection during pregnancy. It is unknown whether pregnant people are more susceptible to monkeypox virus or whether infection is more severe in pregnancy. Monkeypox virus can be transmitted to the fetus during pregnancy or to the newborn by close contact during and after birth. Adverse pregnancy outcomes, including spontaneous pregnancy loss and stillbirth, have been reported in cases of confirmed monkeypox infection during pregnancy. Preterm delivery and neonatal monkeypox infection have also been reported. Monkeypox virus can be transmitted to the fetus during pregnancy or to the newborn by close contact during and after birth. Adverse pregnancy outcomes, including spontaneous pregnancy loss and stillbirth, have been reported in cases of confirmed monkeypox infection during pregnancy. Infection control practices for the care of patients who are pregnant with monkeypox infection are the same as those for patients who are not pregnant with monkeypox infection. This includes appropriate isolation of patients with monkeypox; training for health-care personnel on maternity and newborn care units on correct adherence to infection control practices and personal protective equipment (PPE) use and handling; and ensuring sufficient and appropriate PPE supplies are positioned at all points of care. Furthermore, visitors to pregnant or postpartum patients with monkeypox should be strictly limited to those essential for the patient's care and well-being, and should have no direct contact with the patient. Use of alternative mechanisms for patient and visitor interactions, such as video-call applications, should be encouraged for any additional support. CDC also recommends pregnant, postnatal, and breastfeeding women should be prioritized for medical treatment as there is a significant risk to the baby. They also identify these groups as eligible for treatment.

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