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A confirmed bite by a Beautiful Pit Viper (Trimeresurus venustus) resulting in local symptoms

Fuchs J, Bessire K, Weiler S

Toxicon, 2019 Mar 20;163:44-47.
PMID: 30902684 DOI: 10.1016/j.toxicon.2019.03.019

This case report describes the effect of an envenomation by the Beautiful Pit Viper Trimeresurus venustus (or Cryptelytrops venustus), which is a green pit viper native to Thailand and Malaysia. A previously healthy 60-year-old snake breeder with no relevant medical history was bitten by his adult T. venustus in the third finger of his right hand while taking it out of the feeding box. The bite was painful and swelling progressed to include his whole hand within an hour after the bite. He was treated symptomatically with pre-emptive antibiotics and analgesics, never developed any hematological disorders such as coagulopathy and bleeding or disseminated intravascular coagulation and was discharged 26 hours after the bite. The clinical course in our patient matched two other well-documented cases reported to our Poisons Centre, and one further case presented as a conference-poster. All patients recovered with symptomatic therapy and never required antivenom. Therefore, bites by T. venustus seem to present with less severe symptoms compared to other Trimeresurus species.

Matched MeSH terms: Pain
Fulltext Health related quality of life (HRQoL) among stroke survivors attending rehabilitation centers in Selangor

Nor Azim, M.N., Rizal, A.M., Wei, Bi L

Malaysian Journal of Community Health, 2009;15(2):83-90.
MyJurnal

Background : A cross-sectional survey was carried out in December 2007 to compare the healthrelated quality of life (HRQoL) of stroke survivors with that of general Malaysian population.
Methodology : Stroke patients were recruited from two community-based rehabilitation centres in Selangor. HRQoL was assessed using Medical Outcome 36-Item Short-Form Health Survey (SF-36).
Result : A total of 61 patients (34 males and 27 females) were interviewed. Majority were Chinese (85%) and a small percentage were Malays (15%). 82% (n=50) were elderly of 60 years and above, and the remaining 18% (n=11) were younger patients. 64% had stroke for one year and more, and 36% were less than a year post-stroke. All subjects were community-dwellers and lived with their families. The result showed that with the exception of bodily pain, the mean score of all SF-36 health domains of stroke patients were lower than that of the general population. The greatest difference was in role physical, followed by physical functioning. Female patients demonstrated higher score than the males in all SF-36 domains, in particular general health (57.2 vs 70.3, p=0.01) and social functioning (52.2 vs 73.1, p=0.00). There were no differences of HRQoL domains after comparison according to poststroke duration (all p>0.05).
Conclusion : HRQoL of stroke survivors is lower than that of Malaysian general population in all SF-36 health domains, with the exception of bodily pain.

Matched MeSH terms: Pain
Fulltext Highly Crosslinked Polyethylene Tibial Post Fracture in the Unafflicted Limb of a Patient with Unilateral Lower Limb Poliomyelitis: A Case Report

Lee WC, Wee L

Malays Orthop J, 2019 Mar;13(1):42-44.
PMID: 31001383 DOI: 10.5704/MOJ.1903.008

We present a unique case of tibial post fracture of a posterior-stabilised total knee arthroplasty (PS-TKA) using highly crosslinked polyethylene (HXLPE) in the unafflicted limb of a patient who had poliomyelitis. The tibial post is an upright structure perpendicular to the PE insert articular surface which articulates with the cam of the femoral component to prevent excessive posterior translation of the tibia. We explore the choice of PS polyethylene (PE) inserts in patients with neuromuscular disorders (NMD). A 74-year old gentleman presented with recurrent knee pain seven years after the index PS-TKA with HXLPE. The TKA was performed on the unafflicted left limb (contralateral to the weak side affected by poliomyelitis). The posterior drawer test was positive. During the single-stage revision surgery, the HXLPE tibial post was noted to be broken. The liner was replaced with a thicker non-HXLPE. The patient achieved an excellent outcome at one-year post-surgery. This is the first report of HXLPE tibial post fracture in the unaffected knee of a patient with NMD affecting the lower limb. The HXLPE's reduced resistance to fatigue crack propagation might not be suitable in PS-TKA where there might be focal stress points on the tibial post, which was amplified in this case as it was the limb that the patient most depended on. When managing end-stage osteoarthritis with TKA in the unafflicted knee of a patient with NMD causing lower limb weakness, the selection of polyethylene material in PS-TKA may need more consideration than previously thought.

Matched MeSH terms: Pain
Rheumatoid arthritis management in the APLAR region: Perspectives from an expert panel of rheumatologists, patients and community oriented program for control of rheumatic diseases

Chopra A, Lin HY, Navarra SV, Saeed MA, Sockalingam S, Thongpooswan S, et al.

Int J Rheum Dis, 2021 Sep;24(9):1106-1111.
PMID: 34375036 DOI: 10.1111/1756-185X.14185

Rheumatoid arthritis (RA) is a major health burden in Asia Pacific affecting the quality of life of patients and consuming healthcare resources. According to recent estimates from the World Health Organization-International League Against Rheumatism-Community Oriented Program for Control of Rheumatic Diseases, prevalence is around 0.3%-0.5%. Management guidelines have helped to improve treatment across this diverse region. To gain better insight into current real-world management applications in view of these guidelines, virtual meetings were conducted in mid-2020 to explore perspectives of rheumatologists and patients, as well as discuss the impact of coronavirus disease 2019 on RA management. Patients and rheumatologists from Hong Kong, Malaysia, Singapore, the Philippines, Thailand, India, Pakistan, and Taiwan were included, representing a diverse mix of healthcare systems, wealth, ethnicity and culture. Despite many countries having prospered in recent years, similar challenges in RA diagnosis and treatment were identified. The daily impact and patient experience of RA were also similar across countries, marked by "silent" pain and disability, and universal misunderstanding of the disease. Late diagnosis and treatment, and barriers to access to appropriate treatment, remain problematic. The experience shared by Taiwan offers a glimmer of hope, however, wherein patient advocacy groups have succeeded in being included in policy-making decisions and securing access to advanced treatment. Real-world solutions that pay heed to the unique local needs and diversity of Asia Pacific are required to improve RA management, which will take time. In the interim, help can be sought from the trained, non-rheumatologist community to reduce some of the disease burden.

Matched MeSH terms: Pain Management/trends*
Fulltext The lived experiences of chronic pain among immigrant Indian-Canadian women: A phenomenological analysis

Mustafa N, Einstein G, MacNeill M, Watt-Watson J

Can J Pain, 2020 Sep 24;4(3):40-50.
PMID: 33987510 DOI: 10.1080/24740527.2020.1768835

Background: Chronic pain is a growing public health concern affecting 1.5 million people in Canada. In particular, it is a concern among the expanding immigrant population, because immigrant groups report higher pain intensity than non-immigrants. In 2011, the Indian population became the largest visible minority group and continues to be the fastest growing. Though the prevalence of chronic pain among Canadian Indians is unknown, research has found a higher prevalence among Indian women than men in India, Malaysia, Singapore, and the United Kingdom, with women reporting more severe pain. An understanding of how pain is experienced by this particular group is therefore important for providing culturally sensitive care.
Aims: This study explores the lived experiences of chronic pain among immigrant Indian women in Canada.
Methods: Thirteen immigrant Indian women participated in one-on-one interviews exploring daily experiences of chronic pain.
Results: Using thematic analysis informed by van Manen's phenomenology of practice, four themes emerged: (1) the body in pain, (2) pain in the context of lived and felt space, (3) pain and relationships, and (4) pain and time. Women revealed that their experiences were shaped by gender roles and expectations enforced through culture. Specifically, a dual gender role was identified after immigration, in which women had to balance traditional household responsibilities of family labor and care alongside employment outside the home, exacerbating pain.
Conclusions: This research uncovers the multifaceted nature of chronic pain and identifies factors within the sociocultural context that may place particular groups of women at greater risk of living with pain.

Matched MeSH terms: Chronic Pain
Fulltext Melioidosis: a localised osteomyelitis in a cat

Lim, M.L., Ismail, S.S., Rahman, N., Watanabe, M.

Jurnal Veterinar Malaysia, 2015;27(1):24-26.
MyJurnal

Melioidosis is a zoonotic disease as a result of infection by Burkholderia pseudomallei. It is of significant public health
concern due to its ubiquitous nature with high morbidity and mortality in humans and animals. In cats, the disease is usually reported
with abscess formation in lung, liver and spleen, however, isolated articular melioidosis is rare. A 1-year-old, a female Domestic
Shorthair cat was presented to University Veterinary Hospital, Universiti Putra Malaysia (UVH-UPM) with swollen right elbow and
non weight bearing lameness of the right forelimb. Physical examination revealed pyrexia, soft tissue swelling and pain upon
palpation of the right elbow joint. Radiographs of the right forelimb revealed osteolysis at the distal third of the humerus and
proximal radius and ulna, cortical thinning at the olecranon and soft tissue swelling around the elbow joint. Bacterial culture of the
joint fluid revealed positive growth for Burkholderia pseudomallei. Unfortunately, the owner opted to euthanise the cat citing
personal reasons. Upon necropsy, there was presence of multiple caseous nodules within the right elbow joint cavity only and none
of the other limbs, lung, spleen and liver was affected. It is important for veterinarian to be aware of septic arthritis and osteomyelitis
form of melioidosis.

Matched MeSH terms: Pain
Fulltext The effect of ketamine on emergence agitation in children: A systematic review and meta-analysis

Ng KT, Sarode D, Lai YS, Teoh WY, Wang CY

Paediatr Anaesth, 2019 12;29(12):1163-1172.
PMID: 31587414 DOI: 10.1111/pan.13752

BACKGROUND: Ketamine is believed to reduce the incidence of emergence agitation in children undergoing surgery or procedure. However, recent randomized controlled trials reported conflicting findings.
AIMS: To investigate the effect of ketamine on emergence agitation in children.
METHODS: Databases of MEDLINE, EMBASE, and CENTRAL were systematically searched from their start date until February 2019. Randomized controlled trials comparing intravenous ketamine and placebo in children were sought. The primary outcome was the incidence of emergence agitation. Secondary outcomes included postoperative pain score, duration of discharge time, and the adverse effects associated with the use of ketamine, namely postoperative nausea and vomiting, desaturation, and laryngospasm.
RESULTS: Thirteen studies (1125 patients) were included in the quantitative meta-analysis. The incidence of emergence agitation was 14.7% in the ketamine group and 33.3% in the placebo group. Children receiving ketamine had a lower incidence of emergence agitation, with an odds ratio being 0.23 (95% confidence interval: 0.11 to 0.46), certainty of evidence: low. In comparison with the placebo, ketamine group achieved a lower postoperative pain score (odds ratio: -2.42, 95% confidence interval: -4.23 to -0.62, certainty of evidence: very low) and lower pediatric anesthesia emergence delirium scale at 5 minutes after operation (odds ratio: -3.99, 95% confidence interval: -5.03 to -2.95; certainty of evidence: moderate). However, no evidence was observed in terms of incidence of postoperative nausea and vomiting, desaturation, and laryngospasm.
CONCLUSION: In this meta-analysis of 13 randomized controlled trials, high degree of heterogeneity and low certainty of evidence limit the recommendations of ketamine for the prevention of emergence agitation in children undergoing surgery or imaging procedures. However, the use of ketamine is well-tolerated without any notable adverse effects across all the included trials.
PROSPERO REGISTRATION: CRD42019131865.

Matched MeSH terms: Pain, Postoperative/drug therapy
Fulltext Effect of single-dose dexmedetomidine on postoperative recovery after ambulatory ureteroscopy and ureteric stenting: a double blind randomized controlled study

Shariffuddin II, Teoh WH, Wahab S, Wang CY

BMC Anesthesiol, 2018 01 05;18(1):3.
PMID: 29304735 DOI: 10.1186/s12871-017-0464-6

BACKGROUND: Ambulatory surgery has recently gain popularity, as it is a good method of optimizinghospital resources utilization. To support ambulatory surgery, anaesthetic goals nowrevolve around patients' early recovery with minimal pain and nausea, expedientdischarge home and prompt resumption of activities of daily living. In this study, weevaluated the effect of a single pre-induction dose of dexmedetomidine on anaestheticrequirements, postoperative pain and clinical recovery after ambulatory ureteroscopy andureteric stenting under general anaesthesia.
METHODS: Sixty patients were randomised to receive IV dexmedetomidine 0.5 μg.kg-1 (Group DEX, n = 30) or IV saline (Group P, n = 30). General anaesthesia was maintained with Sevoflurane: oxygen: air, titrated to BIS 40-60. Pain intensity, sedation, rescue analgesics, nausea/vomiting and resumption of daily activities were recorded at 1 h, and postoperative day (POD) 1-5.
RESULTS: Group DEX patients had significant reduction in sevoflurane minimum alveolar concentration (MAC), mean (SD) DEX vs. Placebo 0.6 (0.2) vs. 0.9 (0.1), p = 0.037; reduced postoperative resting pain at 1 h (VAS 0-10) (mean (SD) 1.00 (1.84) vs. 2.63 (2.78), p = 0.004), POD 1 (mean (SD) 1.50 (1.48) vs. 2.87 (2.72), p = 0.002), POD 2 (0.53 (0.97) vs. 1.73 (1.96), p = 0.001) and POD 3 (0.30 (0.75) vs. 0.89 (1.49), p = 0.001). DEX patients also had less pain on movement POD 1 (3.00 (2.12) vs. 4.30 (3.10), p = 0.043) and POD 2 (2.10 (1.98) vs. 3.10 (2.46), p = 0.040), with higher resumption of daily activities by 48 h compared to placebo, 87% vs. 63%, p = 0.04.
CONCLUSIONS: We conclude that a single dose of dexmedetomidine was a useful adjuvant in reducing MAC and postoperative pain (at 1 h and POD 1-3), facilitating faster return to daily activities by 48 h.
TRIAL REGISTRATION: The Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617001120369 , 31st July 2017, retrospectively registered.

Matched MeSH terms: Pain, Postoperative/prevention & control*
The hemodynamic and pain impact of peripheral nerve block versus spinal anesthesia in diabetic patients undergoing diabetic foot surgery

Lai HY, Foo LL, Lim SM, Yong CF, Loh PS, Chaw SH, et al.

Clin Auton Res, 2020 Feb;30(1):53-60.
PMID: 29196938 DOI: 10.1007/s10286-017-0485-8

PURPOSE: Comparison of hemodynamic profiles and pain scores in diabetic patients undergoing diabetic foot surgery receiving peripheral nerve block (PNB) or spinal anesthesia [subarachnoid block (SAB)].
METHODS: This was a prospective, randomised controlled trial. We recruited diabetic patients aged > 18 years, American Society of Anesthesiologists class II-III, who were scheduled for unilateral diabetic foot surgery below the knee. All patients were assessed for autonomic dysfunction using the Survey of Autonomic Symptoms score. Participants were randomly assigned to receive either PNB or SAB for the surgery. Hemodynamic data, including usage of vasopressors, were recorded at 5-min intervals for up to 1 h after the induction of anesthesia. Pain scores were recorded postoperatively, and follow-up was done via telephone 6 months later.
RESULTS: Compared to the PNB group, the SAB group had a larger number of patients with significant hypotension (14 vs. 1; p = 0.001) and more patients who required vasopressor boluses (6 vs. 0 patients). Compared to SAB group, the patients in the PNB group had a longer postoperative pain-free duration (9 vs. 4.54 h; p = 0.002) and lower pain scores 1 day after surgery (3.63 vs. 4.69; p = 0.01).
CONCLUSION: Peripheral nerve block should be considered, whenever possible, as the first option of anesthesia for lower limb surgery in diabetic patients as it provides hemodynamic stability and superior postoperative pain control compared to SAB.
TRIAL REGISTRATION: Clinical trial registry: ClinicalTrials.gov. ID NCT02727348.

Matched MeSH terms: Pain Measurement/methods*; Pain, Postoperative/diagnosis; Pain, Postoperative/physiopathology; Pain, Postoperative/prevention & control*
Fulltext An unusual case of portal, splenic and mesenteric venous thrombosis presenting with acute abdomen

Yeoh, C.N., Cheah, S.K., Maaya, M., Nadiah, R., Raha, A.R., Wan, Mat W.R.

JUMMEC, 2019;22(1):8-12.
MyJurnal

Porto-spleno-mesenteric vein thrombosis is a rare, life-threatening condition of extrahepatic portal venous
system thrombosis. We report a rare case of a 49-year-old lady with late presentation of acute portal vein
thrombosis in a non-cirrhotic liver with an incidental finding of left adnexal teratoma. She presented with a
one-week history of severe abdominal pain associated with vomiting and diarrhea. She gave no history of prior
risk for venous thromboembolism or liver diseases. Physical examination revealed a tender mass extending from
suprapubic to left iliac fossa. Abdominal computed tomography scans showed a well-defined fat-containing left
adnexal mass, likely a benign teratoma, with no involvement of surrounding structures or calcification. There
was evidence of porto-splenic-mesenteric vein thrombosis with liver infarction, bowel and splenic ischemia.
Management of the extensive thrombosis causing multi-organ failure includes resuscitation, supportive care
and treatment of thrombosis. Treatment options include early anticoagulation and if feasible, thrombolysis.

Matched MeSH terms: Abdominal Pain
Fulltext Anterior stabilisation of sacroilliac joint for complex pelvic injuries

Wan Faisham WI, Nawaz AH, Joehaimey J, Sallehuddin AY, Wan Z

Malays J Med Sci, 2009 Jul;16(3):47-51.
PMID: 22589666 MyJurnal

Sacroilliac joint diasthesis from high energy trauma is always complicated with chronic pain and long term morbidity. Open anterior stabilisation with plate allow direct reduction and stabilisation with biomechanically advantages. Here we report on four cases of pelvic injury with sacroiliac joint disruption treated with anterior plate stabilisation through a surgical approach similar to that used for anterior ring fractures.

Matched MeSH terms: Chronic Pain
Fulltext The Effect of Channa striatus (Haruan) Extract on Pain and Wound Healing of Post-Lower Segment Caesarean Section Women

Ab Wahab SZ, Abdul Kadir A, Nik Hussain NH, Omar J, Yunus R, Baie S, et al.

Evid Based Complement Alternat Med, 2015;2015:849647.
PMID: 26101537 DOI: 10.1155/2015/849647

Channa striatus has been consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives of this study were to compare postoperative pain, wound healing based on wound evaluation scale (WES), wound cosmetic appearance based on visual analogue scale (VAS) scores and patient satisfaction score (PSS), and safety profiles between C. striatus group and placebo group after six weeks of lower segment caesarean section (LSCS) delivery. A randomised, double-blind, placebo-controlled study was conducted. Subjects were randomised in a ratio of 1 : 1 into either the C. striatus group (500 mg daily) or placebo group (500 mg of maltodextrin daily). 76 subjects were successfully randomised, with 38 in the C. striatus group and 35 in the placebo group. There were no significant differences in postoperative pain (p = 0.814) and WES (p = 0.160) between the C. striatus and placebo groups. However, VAS and PSS in the C. striatus group were significantly better compared with the placebo group (p = 0.014 and p < 0.001, resp.). The safety profiles showed no significant differences between the groups. In conclusion, six-week supplementation of 500 mg of C. striatus extract showed marked differences in wound cosmetic appearance and patient's satisfaction and is safe for human consumption.

Matched MeSH terms: Pain, Postoperative
Fulltext Rapidly Growing Huge Lower Back Malignant Peripheral Nerve Sheath Tumour

Abuzarifa N, Al-Chalabi MMM, Wan Sulaiman WA

Cureus, 2021 Mar 05;13(3):e13712.
PMID: 33842103 DOI: 10.7759/cureus.13712

Malignant peripheral nerve sheath tumours (also called neurofibrosarcomas) are a rare, highly aggressive soft tissue sarcomas that arise from the peripheral nerves or cells associated with the nerve sheath, such as Schwann cells, peri-neural cells and fibroblasts. It is representing 10% of all soft tissue sarcomas in which it is considered as an extremely rare malignancy, especially in patients with neurofibromatosis type I. In the general population, it affects approximately 1 in 100,000 people. This article is reporting a 56-year-old Malay female patient who is a known case of neurofibromatosis type I for 20 years, presented with a lower back, pruritic, gradually increasing swelling during the last five months. Last month before the presentation, the lesion rapidly grows, reaching a size of (15×15 cm), accompanied by foul-smelling discharge and pain exacerbated with movement. Although no history of preceding trauma or accident, the mass bleeds within contact. In conclusion, only a few cases of giant malignant peripheral nerve sheath tumours reported in the literature describing its location and growth progression. We present a massive, extremely rapid growth of cutaneous exophytic malignant peripheral nerve sheath tumours over the lower back.

Matched MeSH terms: Pain
Fulltext Post-partum streptococcal toxic shock syndrome associated with necrotizing fasciitis

Chua WC, Mazlan MZ, Ali S, Che Omar S, Wan Hassan WMN, Seevaunnantum SP, et al.

IDCases, 2017;9:91-94.
PMID: 28725564 DOI: 10.1016/j.idcr.2017.05.002

We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Subsequently, she was treated for necrotizing fasciitis, complicated by septicemic shock and multiple organ failures. A consensus was reached for extensive wound debridement to remove the source of infection; however, this approach was abandoned due to the patient's hemodynamic instability and the extremely high risks of surgery. Both the high vaginal swab and blister fluid culture revealed Group A beta hemolytic streptococcus infection. Intravenous carbapenem in combination with clindamycin was given. Other strategies attempted for streptococcal toxic removal included continuous veno-venous hemofiltration and administration of intravenous immunoglobulin. Unfortunately, the patient's condition worsened, and she succumbed to death on day 7 of hospitalization.

Matched MeSH terms: Pain
Fulltext The comparative effects of listening to prayer recitation and music therapy intraoperatively on postoperative pain

Farah Syaza Rahman, Nurlia Yahya, Nor Mohammad Md Din, Azarinah Izaham, Wan Rahiza Wan Mat

International Medical Journal Malaysia, 2018;17(2):107-116.
MyJurnal

Introduction: Non-pharmacological interventions are considered as successful adjuncts to manage pain. We are studying the comparative effects of listening to prayer recitation and music therapy intraoperatively as non-pharmacological interventions on postoperative pain and intraoperative haemodynamics. Materials and Methods: Seventy two muslim patients with acute appendicitis requiring open, emergency appendicectomies under general anaesthesia were recruited and randomised into three groups: Group A: patients who listened to prayer recitation, Group B: patients who listened to music, Group C: control group - patients who did not listen to any prayer or music. Intraoperative blood pressure, heart rate and postoperative pain scores were monitored. Results: The demographic data, pre- and post-headphones application haemodynamics were compared. There were significantly lower heart rates at 10, 20, 30, 40, 50, 60 minutes for Group A and at 50 and 60 minutes for Group B patients when compared to Group C. Significant reduction in postoperative pain scores were seen in Group A patients at 30 minutes and 8 hours as compared to Group C patients. No significant differences in pain scores were seen between Group B and C patients. No significant differences in additional analgesic requirements postoperatively were seen in all three groups. Conclusion: Listening to prayer recitation or music intraoperatively significantly lowered intraoperative heart rates, however only prayer recitation significantly reduced postoperative pain scores as compared to the control group.

Matched MeSH terms: Pain, Postoperative
Fulltext Osteochondromyxoma of Talus

Balakrishnan, Yogambigai, Nor Hasnina Mohd Hassan, Wan Najwa Zaini Wan Mohamed

Borneo Journal of Medical Sciences, 2019;13(3):65-70.
MyJurnal

Osteochondromyxoma is a rare bone tumour. Bone tumours of the talus are also uncommon, and accounts to be between 8% to 23% in tumours of the foot. A 28-year-old man presented with chronic right ankle pain. He had underlying left knee ligament and meniscal injury. Special examination tests for ligament injury were negative. Magnetic Resonance Imaging (MRI) revealed a benign bone lesion of talus with reactive oedema of sinus tarsi. Excision of lesion was done and subsequent histopathological examination confirmed the diagnosis of ostechondromyxoma.

Matched MeSH terms: Pain
Fulltext Effect of Zingiber officinale on spasm

Nadia, Hisamuddin, Nadhirah, Kamarudin, Mohd Roslan, Sulaiman, Wan Mastura, Shaik Mossadeq

The Pertanika Journal of Scholarly Research Reviews, 2019;5(1):27-36.
MyJurnal

Zingiberaceae is one of the largest plant families consisting of rhizomes that are commonly used as spice in soups and curries as well as alternative medications in folklore medicine. Zingiber officinale or commonly known as ginger is extensively employed in Asian, Ayurvedic, Chinese, and Arabian folklore medicine for the treatment of pain, inflammation and various spasm-associated gastric ailments. The past few decades saw rapid advancements in the extraction process of ginger bioactive constituents and validation of their corresponding pharmacodynamic and pharmacotherapeutic activities, and biological properties in vivo and in vitro. Results reported from several biological studies on ginger showed that extracts and compounds from this tuberous rhizome exhibit antiemetic, anticancer, antipyretic, antispasmogenic and antimicrobial activities. This article reviews the effect of Zingiber officinale and its bioactive constituents on isolated organ preparations from several species of animals in view of its potential use as an alternative treatment for muscle spasms and common gastric ailments.

Matched MeSH terms: Pain
Fulltext Vanishing lung syndrome Masquerading as bilateral pneumothorax: A case report

Muhamad NI, Mohd Nawi SN, Yusoff BM, Ab Halim NA, Mohammad N, Wan Ghazali WS

Respir Med Case Rep, 2020;31:101276.
PMID: 33209576 DOI: 10.1016/j.rmcr.2020.101276

Vanishing lung syndrome (VLS) is a rare condition characterized by giant emphysematous bullae. It is frequently misdiagnosed as pneumothorax. We describe a case of a 30-year-old male who presented with shortness of breath, reduced effort tolerance, and pleuritic chest pain for three months. He was initially diagnosed with bilateral pneumothorax based on clinical examination and chest radiograph findings. However, further imaging with a high resolution computed tomography (HRCT) of the thorax confirmed bilateral giant emphysematous bullae. Our patient subsequently underwent video-assisted thoracoscopic surgery (VATS) and bullectomy. In this report, we discuss the clinical presentations, radiological features, and the management of VLS. We also highlight the differentiating features of VLS from a pneumothorax.

Matched MeSH terms: Chest Pain
Fulltext Mental Trauma Experienced by Caregivers of patients with Diffuse Axonal Injury or Severe Traumatic Brain Injury

Syed Hassan ST, Jamaludin H, Abd Raman R, Mohd Riji H, Wan Fei K

Trauma Mon, 2013 Sep;18(2):56-61.
PMID: 24350153 DOI: 10.5812/traumamon.11522

CONTEXT: As with care giving and rehabilitation in chronic illnesses, the concern with traumatic brain injury (TBI), particularly with diffuse axonal injury (DAI), is that the caregivers are so overwhelmingly involved in caring and rehabilitation of the victim that in the process they become traumatized themselves. This review intends to shed light on the hidden and silent trauma sustained by the caregivers of severe brain injury survivors. Motor vehicle accident (MVA) is the highest contributor of TBI or DAI. The essence of trauma is the infliction of pain and suffering and having to bear the pain (i.e. by the TBI survivor) and the burden of having to take care and manage and rehabilitate the TBI survivor (i.e. by the TBI caregiver). Moreover many caregivers are not trained for their care giving task, thus compounding the stress of care giving and rehabilitating patients. Most research on TBI including DAI, focus on the survivors and not on the caregivers. TBI injury and its effects and impacts remain the core question of most studies, which are largely based on the quantitative approach.
EVIDENCE ACQUISITION: Qualitative research can better assess human sufferings such as in the case of DAI trauma. While quantitative research can measure many psychometric parameters to assess some aspects of trauma conditions, qualitative research is able to fully reveal the meaning, ramification and experience of TBI trauma. Both care giving and rehabilitation are overwhelmingly demanding; hence , they may complicate the caregivers' stress. However, some positive outcomes also exist.
RESULTS: Caregivers involved in caring and rehabilitation of TBI victims may become mentally traumatized. Posttraumatic recovery of the TBI survivor can enhance the entire family's closeness and bonding as well as improve the mental status of the caregiver.
CONCLUSIONS: A long-term longitudinal study encompassing integrated research is needed to fully understand the traumatic experiences of caregivers. Unless research on TBI or DAI trauma is given its proper attention, the burden of trauma and injury on societies will continue to exacerbate globally.

Matched MeSH terms: Pain
Fulltext Schoolbag weight, its content, and incidence of back pain in different medium primary schools in Kuala Lumpur

Nor Azlin M. N., Asfarina, Z., Wan Chee, L.

Malaysian Journal of Medicine and Health Sciences, 2010;6(2):59-64.
MyJurnal

Introduction: Schoolbag weight across different types of school and schoolbag content has not been
studied in Malaysia. This cross sectional survey determines the weight of schoolbags, its content and
occurrence of back pain among primary school children in different medium primary school in Kuala
Lumpur. Methods: Students’ body weight, and schoolbags weight were measured using a calibrated
scale. Schoolbag content was examined, and weighed according to necessary learning materials
or unnecessary materials. Back pain in the past one week was assessed using a self-administered
questionnaire, adapted from previous studies. Results: A total of 358 students (167 male, 191 female)
were enrolled, of which 119 were from National School (NS), 122 from Chinese Medium School (CMS)
and 117 from Tamil Medium School (TMS). The mean schoolbag weight was 4.55±1.62kg for NS,
8.53±1.94kg for CMS and 6.06±2.09kg for TMS, which was 11.7%, 22.0% and 16.6% of body weight,
respectively. The mean weight of unnecessary schoolbag content was 0.64(0.91)kg for NS, 2.18(1.49)kg for CMS and 1.96(1.56) for TMS students. Back pain was detected in 87.0% NS students, 68.0% CMS students and 66.7% TMS students. Significant association was found between occurrence of back pain and types of school ( 2=16.64,p=0.00). Conclusions: Students from all the three mediums primary school, in particular Chinese medium school carry school bag heavier than that generally recommended, with unnecessary materials weigh up to 2kg. The occurrence of back pain is high and this is associated with the types of school.

Matched MeSH terms: Back Pain

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