bluuebunny/crossref_metadata_2025 huggingface dataset:
Trigeminal Neuralgia Induced by Cobra Venom
in the Rat Leads to Deficits in Abilities of
Spatial Learning and Memory
Authors: An Jian-xiong
Published: February 2021

Background: Patients with chronic pain usually suffer from cognitive impairment, with memory
deterioration being the most common deficit that affects daily functioning and quality of life. The
causes for this impairment are not clear despite intensive clinical studies. Few studies have evaluated
impaired learning using animal models of persistent pain.
Objective: In this study, a new trigeminal neuralgia model induced by cobra venom was adopted
to explore effects of chronic pain on spatial learning and memory in rats.
Study Design: Controlled animal study.
Setting: Department of Anesthesiology, Pain Medicine & Critical Care Medicine, Aviation General
Hospital of China Medical University.
Methods: Thirty adult male Sprague-Dawley rats were randomly divided into 2 groups (n = 15): NS
control group and cobra venom group, 0.9% sterile saline or cobra venom solution was injected into
the sheath of the infraorbital nerve (ION), respectively. The development of trigeminal neuralgia was
accessed by changes in free behavioral activity 3 days before the surgery and 3, 7, 12, 20, and 30
days after the surgery to identify whether the model was successful or not. Morris water maze test
determined the abilities of spatial learning and memory at the time points before the surgery, and
2 weeks and 5 weeks after the surgery. We also observed the ultrastructure of the ION and medulla
oblongata of rats following 8 weeks of chronic trigeminal neuropathic pain.
Results: Rats with the cobra venom injection displayed significantly more face grooming and fewer
exploratory activities compared to the NS control group or baseline (P < 0.01). Both groups improved
their latency to reach the platform with the largest difference on the first day (P < 0.01), but without
memory deficits in a probe trial for the second water maze protocol. For the third water maze testing,
the rats in the cobra venom group experienced decreased abilities of spatial learning and memory,
a longer latency with spatial memory deficits during the probe trial (P < 0.05). At the ultrastructural
level, we found changes in the medulla oblongata after cobra venom injection resulting in severe
demyelination and loss of axons that might be implicated in the causes of cognitive deficits.
Limitations: Limitations include partial vision loss in the eye on the lesion side of the rats that
might be missed and the absence of evaluating the ultrastructural changes in other parts of the
brain.
Conclusions: The results of this study suggest that trigeminal neuralgia induced by cobra venom
in adult rats can impair spatial learning and memory function over time and results in demonstrable
changes in the ultrastructure of the medulla oblongata. This new animal model may be useful for
future studies on the effect of chronic pain on learning and cognition.
Key words: Cognitive deficits, memory deterioration, cobra venom, trigeminal neuralgia, electron
microscopy
Intervertebral Disc Temperature Mapping
During Disc Biacuplasty in the Human Cadaver
Authors: Desai Mehul J
Published: February 2021

Background: Intradiscal biacuplasty (IDB) is a novel heating therapy using cooled radiofrequency
(RF), which may offer relief for discogenic pain. Effective neuroablation may be achieved intradiscally
at higher lesion temperatures. The safety of intradiscal heating at elevated temperatures using
cooled RF has never been reported.
Objective: The purpose of this study is to map the intradiscal and peridiscal temperatures
when IDB is performed at increased temperature using a modified lesion approach. The resulting
temperature profiles are used to assess the safety and theoretical efficacy of this approach to ablate
nociceptors in the posterior annulus.
Study Design: Research article.
Methods: Eleven lumbar discs in a non-perfused human cadaver were treated by IDB. Temperature
profiles in the disc during bipolar lesion at 50°C followed by 2 monopolar lesions at 60°C were
mapped using custom thermocouples. Temperatures inside the disc, at the nerve roots, and in the
midline ventral epidural space were monitored in real-time using a data-collection system with
custom RF filters.
Setting: Human research laboratory.
Results: Higher maximum temperature was reached intradiscally, and a larger volume of tissue
was exposed to neuroablative temperature (> 45°C). Temperature at the nerve roots and in the
epidural space increased by 2.4°C ± 2.6°C and 4.9°C ± 1.9°C (mean ± SD), respectively, during
bipolar lesion. Similarly, temperature increased by 2.2°C ± 1.9°C and 0.8°C ± 1.3°C at the nerve
roots and in the epidural space, respectively, during monopolar lesion.
Limitations: Limitations include the ex vivo setting which lacks perfusion and may not reproduce
in vivo conditions such as cerebrospinal fluid dynamics.
Conclusions: The modified treatment paradigm showed intradiscal heating is achieved and
is concentrated in the posterior annulus, suggesting minimal risk of thermal damage to the
neighboring neural structures. Clinical benefits should be evaluated.
Key words: Spine, biacuplasty, thermal, disc, intervertebral
Management of Pain Secondary to
Temporomandibular Joint Syndrome with
Peripheral Nerve Stimulation
Authors: Fernández-Baena Mariano
Published: February 2021

Background: Temporomandibular joint syndrome, or Costen syndrome, is a clinically
diagnosed disorder whose most common symptoms include joint pain and clicking, difficulty
opening the mouth, and temporomandibular joint discomfort. The temporomandibular joint
(TMJ) is supplied by the auriculotemporal nerve, a collateral branch of the mandibular nerve
(the V3 branch of the trigeminal nerve).
Objectives: The aim of this study is to assess the effectiveness and safety of permanent
peripheral nerve stimulation to relieve TMJ pain.
Study Design: This case series is a prospective study.
Setting: Pain Unit of a regional universitary hospital.
Methods: The study included 6 female patients with temporomandibular pain lasting from 2
to 8 years that did not respond to intraarticular local anesthetic and corticoid injections. After a
positive diagnostic block test, the patients were implanted with quadripolar or octapolar leads
in the affected preauricular region for a 2-week stimulation test phase, after which the leads
were connected to a permanent implanted pulse generator. Results of the visual analog scale,
SF-12 Health Survey, Brief Pain Inventory, and drug intake were recorded at baseline and at 4,
12, and 24 weeks after the permanent implant.
Results: Five out of 6 patients experienced pain relief exceeding 80% (average 72%) and
received a permanent implant. The SF-12 Health Survey results were very positive for all specific
questions, especially items concerning the physical component. Patients reported returning to
normal physical activity and rest at night. Four patients discontinued their analgesic medication
and 1 patient reduced their gabapentin dose by 50%.
Limitations: Sample size; impossibility of placebo control.
Conclusion: Patients affected with TMJ syndrome who do not respond to conservative
treatments may find a solution in peripheral nerve stimulation, a simple technique with a
relatively low level of complications.
Key words: Temporomandibular joint disorder, temporomandibular joint syndrome, Costen
syndrome, peripheral nerve stimulation, auriculotemporal nerve stimulation, preauricular block,
clinical safety and effectiveness, trigeminal neuralgia
Successful Treatment of Post Thrombotic
Syndrome with Sequential Lumbar Sympathetic
Block
Authors: Gupta Anita
Published: February 2021

An underappreciated sequelae of deep venous thrombosis (DVT) is the pain associated with
the blood clot in the peripheral extremity. Although most frequently acute in nature, DVT
occasionally presents with chronic pain in the affected limb. Furthermore, many individuals
suffering from prothrombotic states often have recurring pain from DVT. Thus far there has
been a paucity in the medical literature in how to treat post thrombotic pain. Post thrombotic
syndrome (PTS) can cause a significant decrease in quality of life in individuals who have had
a history of a DVT. Symptoms will typically include edema, pain, heaviness of the affected
limb, skin changes, ulcers, varicosities, and gait abnormality. An underappreciated approach
to treating PTS is the utilization of lumbar sympathetic blocks (LSB). A 68-year-old male who
had a history of recurrent right lower extremity deep venous thrombosis presented with
complaints of excruciating pain, discomfort, and erythema in his right lower extremity, which
was negatively affecting his quality of life and prohibiting him from mobility. The patient
attributed his lack of mobility secondary to the thrombotic pain. Compression boot/stocking
therapy was not combating the discomfort associated with the PTS, often increasing the
severity of the patient’s pain. Sequential right lumbar sympathetic blocks were performed,
which nearly completely resolved the patient’s symptoms and improved the patient’s
ambulatory status and ability to perform activities of daily living. Sympathetic nerve blocks
should be considered as a treatment option for patients who suffer with pain from PTS.
Key words: Pain, edema, lumbar, sympathetic, thrombosis, venous
The Potential Impact of Venobasillar System
Morphology and Applied Technique on
Epidural Cement Leakage with Percutaneous
Vertebroplasty
Authors: Bokov Andrey
Published: February 2021

Background: Bone cement leakage during vertebroplasty is a frequently reported complication
with the potential for neural injury.
Objective: To assess risk factors for epidural cement leakage during vertebroplasty.
Setting: Neurosurgical department of a scientific research institute.
Study Design: This is a prospective cross-sectional randomized trial.
Methods: Seventy-five patients with intractable pain due to low energy vertebral compression
fractures between T11 and L5 were treated with vertebroplasty at 150 vertebral levels. Preoperative
computed tomography (CT) scans were utilized to characterize vertebral parameters including the
type of nutrient foramena in the posterior vertebral cortex. Following vertebroplasty, distance from
the needle tracts to the midline and the presence and type of any epidural cement leakage were
determined. Using logistic regression analysis, significant risk factors for cement leakage were
determined.
Results: A smaller distance between the tip of the needle and the midline and a magistral type
of venobasillar system were found to be significant risk factors for epidural cement leakage (P <
0.0001). Use of a bipedicular vs. monopedicular technique did not significantly affect the rate of
epidural cement leakage (P = 0.3869).
Limitations: This study is limited because of the relatively small number of patients and the lack
of any patients who had clinical consequences as a result of extensive epidural cement leakage.
Conclusion: The type of venobasillar system should be taken into account when planning a
vertebroplasty procedure as a magistral type of venobasillar system is associated with the increased
rate of epidural cement leakage. It is important to try and achieve a large distance between the
needle tip and the midline, especially when a magistral type of venobasillar system is present, to
reduce the risk of epidural cement leakage.
Key words: Vertebroplasty, intracanal cement leakage, low energy vertebra fracture
Effect of Epidural Steroid Injection on Bone
Mineral Density in Postmenopausal Women
According to Antiosteoporotic Medication Use
Authors: Suh Jeong Hun
Published: February 2021

Background: No studies to date have compared bone mineral density (BMD) changes after
epidural steroid injection (ESI) between postmenopausal patients taking antiosteoporotic
medication and those who are not.
Objective: The aim of the present study was to analyze the relationship between ESI and BMD
changes in postmenopausal patients according to antiosteoporotic medication use.
Study Design: Retrospective analysis.
Setting: Department of Anesthesiology and Pain Medicine at Asan Medical Center, Korea.
Methods: We retrospectively analyzed postmenopausal women who underwent ESI using
dexamethasone. All women had received a diagnosis of lumbar spinal stenosis and their BMD
had been measured before and after treatment. BMD was evaluated by dual-energy x-ray
absorptiometry at the lumbar spine, femoral neck, femoral trochanter, and total femur, and was
recorded as absolute g/cm2 and T-scores. A total of 126 patients were included in the final analysis.
ESI patients were grouped as follows: group 1 (n = 74) ESI patients who took antiosteoporotic
medication; group 2 (n = 52) ESI patients who did not take antiosteoporotic medication.
Results: In group 1, there were no significant differences between baseline and post-treatment
BMD absolute values (g/cm2) in the lumbar spine, femoral neck, femoral trochanter, and total
femur. In group 2, significant changes in the post-treatment BMD absolute values (g/cm2) from
baseline were observed in the femoral neck (–1.48 ± 3.84%), femoral trochanter (–2.80 ± 7.50%),
and total femur (–2.23 ± 4.52%), but not in the lumbar spine (–2.23 ± 4.52%).
Limitations: This study contained a small sample size, no control group, and no long-term
follow-up of the BMD changes after ESI.
Conclusions: Our data provide new evidence indicating that ESI causes BMD changes in
postmenopausal women who do not take antiosteoporotic medication. Thus, we recommend that
prophylactic antiosteoporotic treatment be considered for postmenopausal women who require
ESI treatment.
Keywords: Glucocorticoid, osteoporosis, bone mineral density, epidural steroid injection,
antiosteoporotic medication, postmenopausal women, dexamethasone
Stimulation of the Spinal Cord and Dorsal
Nerve Roots for Chronic Groin, Pelvic, and
Abdominal Pain
Authors: MacDougall Keith
Published: February 2021

Background: Chronic neuropathic groin pain is a common problem. It can arise following surgery
or trauma, or spontaneously as part of various pelvic pain syndromes. A number of different
stimulation techniques have been reported in the literature to treat this area, but due to the
complex anatomy of the region, it can be difficult to target effectively with paresthesias.
Objectives: In this study we report our results treating patients with chronic
neuropathic groin, pelvic, and abdominal pain, using spinal cord stimulation and dorsal nerve root
stimulation.
Study Design: Open label, prospective study that includes all patients treated with a new trial
stimulator system at a single center between July 1, 2011, and October 31, 2013.
Setting: Academic university neurosurgical pain center, Canada.
Methods: Thirty-two patients had trials of spinal cord stimulation and/or dorsal nerve root
stimulation in the thoracic or lumbar spine. Patients were evaluated on visual analog scale pain
scores, SF-36, and morphine equivalent daily dose. Data were recorded at the pre-implant visit, and
3, 6, and 12 months following permanent implant.
Results: The 15 patients who went on to permanent implants had, on average, significant
pain reduction and improvements in quality of life at the 12 month follow-up. The majority of
patients who were taking opioids at the initial assessment were able to reduce their dose with
treatment. Three patients with successful trials were long-term non-responders, of whom 2 had
the permanent device removed.
Limitations: This study would benefit from a larger sample size that would have adequate
power for comparisons between patient subgroups and stimulation techniques.
Conclusion: Dorsal nerve root stimulation is an effective long-term treatment for neuropathic
groin pain.
Key words: Spinal cord stimulation, nerve root stimulation, lumbar, thoracic, neuropathic pain,
groin pain, pelvic pain, abdominal pain, neuromodulation, clinical effectiveness
Effect of Vitamin D Supplementation on Pain: A
Systematic Review and Meta-analysis
Authors: Scragg Robert
Published: February 2021

Background: There is conflicting evidence from previous qualitative reviews on the effect of
vitamin D supplementation on pain.
Objective: To determine with quantitative methods if vitamin D supplementation lowers pain
levels.
Study Design: Quantitative meta-analysis of published randomized controlled trials (RCTs).
Setting: This meta-analysis examined all studies involving the effect of vitamin D supplementation
on pain score.
Method: Electronic sources (Medline, Embase, Cochrane Central Register of Controlled Trials,
clinical trials website, and Google scholar) were systematically searched for RCTs of vitamin D
supplementation and pain from inception of each database to October 2015.
Results: Nineteen RCTs with 3,436 participants (1,780 on vitamin D supplementation and 1,656 on
placebo) were included in the meta-analysis. For the primary outcome (mean change in pain score
from baseline to final follow-up), 8 trials with 1,222 participants on vitamin D and 1,235 on placebo
reported a significantly greater mean decrease in pain score for the vitamin D group compared to
placebo (mean difference -0.57, 95% CI: -1.00 to -0.15, P = 0.007). The effect from vitamin D was
greater in patients recruited with pre-existing pain (P-value for interaction = 0.03). Fourteen studies
(1,548 on vitamin D, 1,430 on placebo) reported the mean pain score at final follow-up outcome,
and no statistical difference was observed (mean difference -0.06, 95%CI: -0.44 to 0.33, P = 0.78).
In 4 studies which reported pain improvement (209 on vitamin D, 146 on placebo), the effect size
although not significant, shows participants in the vitamin D supplementation group were more
likely to report pain improvement compared with the placebo group (relative risk 1.38, 95%CI: 0.93
to 2.05, P = 0.11).
Limitations: Only a few studies reported the mean score change from baseline to final follow-up,
and we do not have enough data to determine any modifying effect of baseline vitamin D status and
different doses of vitamin D supplementation on pain.
Conclusion: A significantly greater mean decrease in pain score (primary outcome) was observed
with vitamin D supplementation compared with placebo in people with chronic pain. These results
suggest that vitamin D supplementation could have a role in the management of chronic pain.
Key words: Meta-analysis, pain, randomized controlled trials, vitamin D supplementation
Treatment of Neuropathic Pain Using Pulsed
Radiofrequency: A Meta-analysis
Authors: Wu Wen
Published: February 2021

Background: Neuropathic pain (NP) is a major public health problem worldwide. Because of the
unclear mechanism of NP, its treatment is one of the most difficult medical problems. As a targeted,
noninvasive, safe therapy, pulsed radiofrequency (PRF) provides a new method for the treatment of
NP; however, its effect on this treatment still lacks support from evidence-based medicine.
Objective: To conduct a meta-analysis of available randomized controlled trials and to evaluate
the effectiveness and clinical utility of PRF for the treatment of NP.
Study Design: Meta-analysis.
Setting: All selected studies were randomized controlled trials.
Method: A systematic and comprehensive database search was performed of the PubMed,
CENTRAL, EMBASE.com, Cochrane Library, Chinese Biomedical Literature, and Wanfang databases
for literature published from the establishment of the databases to December 19, 2015. According
to inclusion and exclusion criteria, the results of randomized controlled trials supporting PRF for NP
treatment were collected. The risk of bias tool described in the Cochrane Handbook version 5.1.0
was used to assess the quality of each trial. Meta-analysis was performed using RevMan 5.3 software.
Results: A total of 12 randomized controlled trials involving 592 patients met the inclusion
criteria. Overall, the results of the meta-analysis showed that, compared with the control group,
PRF had a better effect on postherpetic neuralgia (PHN) in terms of pain score (one week, one
month, and 3 months), excellent and good rate (one day, one month), and efficiency rate (one
day). But PRF did not have a better effect on radicular pain in pain score (3 months). Side effects
were less frequently found with the PRF treatment.
Limitations: Although we repeatedly tested the key words and used a manual method to prevent
the loss of studies, due to the limitation of the included studies, some of the data were insufficient
to complete the meta-analysis, and we were unable to obtain the original data from some studies.
Some studies did not report the blind design, which decreased the quality of the current study.
Conclusion: PRF did not have a better effect on radicular pain, and PRF is an effective and safe
therapeutic alternative for the analgesia of PHN. However, for a high recurrence rate over a long
period, repeated PRF treatment has limitations.
Key words: Neuropathic pain, pulsed radiofrequency, analgesia, meta-analysis
Anterior Cingulotomy for the Treatment of
Chronic Intractable Pain: A Systematic Review
Authors: Pouratian Nader
Published: February 2021

Background: Anterior cingulotomy for chronic pain aims to modulate patients’ attention or
emotional reaction to pain rather than to modulate pain intensity.
Objectives: To evaluate the clinical efficacy, both short- and long-term, of anterior cingulotomy
in the treatment of chronic pain.
Study Design: Systematic review.
Setting: This systematic review assessed studies reporting anterior cingulotomy for the treatment
of chronic pain.
Methods: A systematic search of Web of Science, Scopus, PubMed, and PsychINFO was performed
using both key words and controlled vocabulary. Articles included in this review included peerreviewed articles describing clinical outcomes or efficacy of cingulotomy in the treatment of chronic
pain with minimum follow-up of 3 months for non-malignant and 2 weeks for malignant pain.
Articles reporting cingulectomies or cingulotomy only as combined with other ablative procedures
were excluded, as were individual case reports.
Results: A total of 11 articles encompassing 224 patients are included in the review, with age
ranging 22 to 85 (mean: 56) years at the time of the operation, 59% of which were men. Greater
than 60% of patients across all studies were reported to have significant pain relief post-operatively
as well as at one year after surgery. Common transient adverse effects included urinary incontinence
and confusion/disorientation, subsiding within days postoperatively. Serious/permanent adverse
effects included seizure in less than 5%, hemiparesis in less than 1%, and personality change in
less than 1% of operations reported across all studies, all of which occurred primarily in operations
where magnetic resonance (MR)-guidance was not used.
Limitations: The limitations of this systematic review include the lack of studies other than
observational reports and the inevitable heterogeneity between included studies.
Conclusions: Despite decreased utilization in recent years, anterior cingulotomy is an effective
neurosurgical intervention in the treatment of pain and carries little risk of permanent or serious
adverse effects.
Key words: Anterior cingulotomy, chronic pain, stereotaxis, systematic review, pain, cingulate
gyrus, cingulotomy, intractable pain
Long-term Prednisolone in Post-stroke Complex
Regional Pain Syndrome
Authors: Kalita Jayantee
Published: February 2021

Background: There is no study on the long-term use of prednisolone in post-stroke complex
regional pain syndrome-1 (CRPS1).
Objective: To evaluate the efficacy and safety of long-term low dose prednisolone in post-stroke
CRPS-I.
Study Design: Open-labeled randomized controlled trial.
Setting: Tertiary care teaching institute.
Methods: Seventy-seven out of 396 (19.4%) patients with stroke had CRPS-1 and 58 met the
inclusion criteria. Their clinical details and CRPS, Visual Analogue Scale (VAS), modified Rankin Scale
(mRS), and Barthel Index (BI) scores were noted. The patients were prescribed 40 mg prednisolone
for 2 weeks followed by tapering in the next 2 weeks. Patients who responded were randomly
assigned prednisolone 10 mg daily (group I) or no prednisolone (group II). They were followed up
for the first and second month of randomization and their CRPS, VAS, mRS, and BI scores were
noted. The primary outcome was improvement in CRPS score and secondary outcomes were VAS,
mRS, BI scores, and severe adverse events (SAE).
Results: Fifty-six of fifty-eight (96.5%) patients responded to the initial high dose prednisolone and
26 each were assigned group I and group II treatment. Group I patients had further improvement
in CRPS score. Fifty percent of patients in group II had deterioration at one month and needed
reinstitution of prednisolone; following which 77% of them improved in the next month. The
improvement in CRPS score paralleled the VAS score but not mRS and BI scores in the first and
second months in group I compared to group II. There was no SAE necessitating withdrawal of
prednisolone.
Limitation: The design of the study is not double blind.
Conclusion: In post-stroke CRPS-I, continuation of low dose prednisolone for 2 months is safe
and effective.
Key words: Shoulder hand syndrome, CRPS, corticosteroid, prednisolone, stroke, Visual
Analogue Scale
Analgesic Effect of Nalbuphine When Added
to Intravenous Regional Anesthesia: A
Randomized Control Trial
Authors: Abd-Elshafy Sayed Kaoud
Published: February 2021

Background: Different adjuvant drugs are currently added to lidocaine for intravenous regional
anesthesia (IVRA) to decrease tourniquet and postoperative pain.
Objective: The aim of the study was to examine the effect of nalbuphine when added to
IVRA.
Study Design: Prospective, randomized, double-blind, controlled clinical trial.
Setting: Assiut University Hospitals.
Methods: One hundred-six adult patients scheduled for unilateral hand surgery under IVRA were
randomized into 2 equal groups. The lidocaine-nalbuphine (LN) group received nalbuphine plus
lidocaine and the lidocaine (L) group received lidocaine. A tourniquet and postoperative pain were
assessed using a visual analogue scale (VAS). The following parameters were measured: onset and
recovery time for both sensory and motor blocks, intra- and postoperative analgesic consumption,
time to first analgesic request, postoperative nausea and/or vomiting (PONV), hemodynamics, and
cortisol levels.
Results: Early tourniquet and postoperative pain were significantly lower in the LN group. The
onset time for both sensory and motor blocks was significantly shorter in the LN group. In addition,
the recovery time for both sensory and motor blocks was longer in the LN group. Intra- and
postoperative fentanyl consumption was significantly lower in the LN group with no significance in
postoperative diclofenac consumption. The patient first analgesic request was significantly delayed
in the LN group (P < 0.0001). There were no significant differences between the 2 groups in PONV,
hemodynamic parameters abnormalities, medications adverse events or cortisol levels.
Limitations: The inclusion of a study group in which the nalbuphine administered systemically
could determine whether its beneficial effects were due to its local or systemic action.
Conclusions: Nalbuphine decreases early tourniquet and postoperative pain after IVRA and
delays the need for analgesic rescue. In addition, nalbuphine accelerates the onset and prolongs
the recovery time for both sensory and motor blocks with no significant adverse events. However,
it has no effect on postoperative cortisol levels.
Key words: Intravenous, regional anesthesia, lidocaine, nalbuphine, pain, postoperative
A Multicenter Clinical Study on Treating PostDural Puncture Headache with an Intravenous
Injection of Aminophylline
Authors: Lian Yajun
Published: February 2021

Background: Post-dural puncture headache (PDPH) is the most common complication of
lumbar puncture. Aminophylline has been reported to be effective in the prevention of PDPH in
some clinical studies, but its efficacy for the treatment of PDPH has been unproven.
Objective: To evaluate the efficacy and safety of an intravenous (IV) injection of aminophylline
on PDPH.
Study Design: The study was a multicenter, open-label study to assess the effectiveness and
safety of aminophylline on PDPH.
Setting: The First Affiliated Hospital of Zhengzhou University, The Fifth Affiliated Hospital of
Zhengzhou University, and Henan Province Hospital of Traditional Chinese Medicine.
Methods: Thirty-two PDPH patients received an IV injection of aminophylline. The primary
and secondary endpoints were the degree of headache and the patient’s overall response to
the treatment, respectively. Treatment safety was evaluated based on the occurrence of adverse
reactions.
Results: Thirty-one patients completed the study. Before the initial aminophylline
administration, the visual analog scale (VAS) score was 7.72 ± 1.65. The VAS scores at 30
minutes, one hour, 8 hours, one day, and 2 days post-treatment were 4.84 ± 2.53, 3.53 ±
2.06, 2.38 ± 1.96, 1.44 ± 1.87, and 0.81 ± 1.79, respectively, and were statistically significantly
different (P < 0.05) compared with those before treatment. More than 50% (17/32) of the
patients reported that they were “very much improved” or “much improved” 30 minutes
after the initial treatment, increasing to 93.8% (30/32) at 2 days post-treatment. One patient
experienced mild allergic reaction after treatment.
Limitation: Although this study had the largest sample size among current studies on
treating PDPH with theophylline drugs, the sample size was still relatively small and the method
employed was not compared with a placebo or other current clinical treatments for PDPH.
Conclusion: An IV injection of aminophylline may be an effective and safe early-stage
treatment for PDPH.
Key words: Post-dural puncture headache, aminophylline, multicenter clinical study
Functional Reorganization of the Primary
Somatosensory Cortex of a Phantom Limb Pain
Patient
Authors: Hu Li
Published: February 2021

Functional reorganization of the somatosensory system was widely observed in
phantom limb pain patients. Whereas some studies demonstrated that the primary
somatosensory cortex (S1) of the amputated limb was engaged with the regions around
it, others showed that phantom limb pain was associated with preserved structure and
functional organization in the former brain region. However, according to the law of use
and disuse, the sensitivity of S1 of the amputated limb to pain-related context should
be enhanced due to the adaptation to the long-lasting phantom limb pain experience.
Here, we collected neurophysiological data from a patient with 21-year phantom limb
pain using electroencephalography (EEG) and functional magnetic resonance imaging
(fMRI) techniques. EEG data showed that both laser-evoked potentials (LEPs) and tactileevoked potentials (TEPs) were clearly presented only when radiant-heat laser pulses
and electrical pulses were delivered to the shoulder of the healthy limb, but not of the
amputated limb. This observation suggested the functional deficit of somatosensory
pathways at the amputated side. FMRI data showed that significant larger brain
activations by painful rather than non-painful stimuli in video clips were observed
not only at visual-related brain areas and anterior/mid-cingulate cortex, but also at S1
contralateral to the amputated limb. This observation suggested the increased sensitivity
of S1 of the amputated limb to the pain-related context. In addition, such increase of
sensitivity was significantly larger if the context was associated with the amputated
limb of the patient. In summary, our findings provided novel evidence for a possible
neuroplasticity of S1 of the amputated limb: in an amputee with long-lasting phantom
limb pain, the sensitivity of S1 to pain-related and amputated-limb-related context was
greatly enhanced.
Key words: Phantom limb pain, primary somatosensory cortex (S1),
functional reorganization, sensory deficit, neuroplasticity, functional sensitivity,
electroencephalography (EEG), functional magnetic resonance imaging (fMRI)
Spinal Cord Stimulation for Complex Regional
Pain Syndrome: A Case Study of a Pregnant
Female
Authors: Ahmed Shaik
Published: February 2021

Background: Spinal cord stimulation (SCS) is a form of neuromodulation, used to treat chronic
neuropathic pain refractory to conventional medical management. Spinal cord stimulators are
treatment options when intractable chronic pain has not responded to more conventional treatment
modalities. Currently, the use of SCS is contraindicated in pregnancy. Nevertheless, many SCS/
neuromodulation recipients are women of child bearing age who may become pregnant. There are
no published reports that focus on the possible side effects of SCS or neuromodulation therapy on
human fertility, fetal development, pregnancy, delivery, or lactation.
Objectives: The purpose of this current report is to present a case study on the use of SCS/
neuromodulation during pregnancy.
Study Design: Presentation of the case of a 24 year old female who became pregnant after
receiving an SCS implantation for pain control secondary to complex regional pain syndrome (CRPS).
The SCS was in use at the time of conception but deactivated when patient became aware of her
pregnancy and intermittently reactivated for five minute intervals throughout the entire pregnancy.
Results: Currently very little documented evidence is available regarding the safety of using a SCS/
neuromodulator during pregnancy; therefore its use during pregnancy is contraindicated. Available
literature suggests that, women who have chosen to keep the SCS/neuromodulator activated
during pregnancy have delivered healthy babies without any life threatening complications.
Limitations: Case presentations do not provide conclusive evidence of treatment effectiveness.
This data is only preliminary and future studies should be used to assess outcomes and measures to
provide quantification of the SCS implantation during pregnancy.
Conclusions: Women of child bearing age who are recipients of SCS/neuromodulation
implantation should be informed of the limited knowledge available regarding the impact of SCS/
neuromodulation use during pregnancy. For current recipients, decisions about ongoing use during
pregnancy should be an individual decision based on the potential risks and benefits.
Key words: Pregnancy and complex regional pain syndrome, pregnancy and reflex sympathetic
dystrophy, pregnancy and spinal cord stimulators, pregnancy and electromagnetic fields, and
pregnancy and neuromodulator.
НЕЙМИНГ: ТИЛДА НОМ ЯРАТИШ ТЕХНОЛОГИЯСИ
Authors: LUTFULLAEVA Durdona , SAPARNIYAZOVA Muyassar
Published: February 2021

Мақолада нейминг технологиясининг мақсади, вазифалари, ном яратишнинг лингвистик асослари, номларга қўйиладиган талаблар, номларнинг семантик-функционал хусусиятлари, ўзбек тилида ном яратишнинг миллий-маданий жиҳатлари ҳақида маълумот берилди. Ишлаб чиқариш, савдо-сотиқ объектлари, маҳсулотлар, уларнинг маркаси (бренди)га берилган номларда нафақат маҳсулот ҳақидаги маълумотлар жамланиши, балки у ҳақидаги тил эгаларининг миллий-маданий қарашлари, тасаввурлари ифода топиши лозимлиги, ном орқали инсон тафаккурида маҳсулотга хос энг муҳим жиҳатлар тасаввури шаклланиши мақсадга мувофиқлиги ҳақида хулосалар баён этилди. Шу билан бирга, ном яратишнинг технологик механизмлари бўйича тавсиялар берилди. Ўзбек тили мисолида миллий тилларга хос ном яратиш моделлари ишлаб чиқилди.
THE FIRST MAJOR CHALLENGE AGAINST THE BRITISH COLONIALISM
BY THE NAGAS: 1879-1880 A CRITICAL APPRAISAL
Authors: Walling Talichuba
Published: February 2021

The Nagas since time immemorial were never under any foreign powers. They lived in a state of nature where any
principality that ever encompassed them was rudimentary, unscathed and the purest that nature could provide them. Their
primordial worlds had endured for generations until the modern century without being bothered and unaware of what was happening around them.
British Colonialism had shaken the world entirely right to its core; altering every fundamental structures in it. Nagas however continued to live in a
state of perpetual bliss on this side of the 'promised land'. Not before long, the ray of the British Empire inltrated into the Naga territory and
disturbed their ethnic environment. What another considered as a convenient expansion of power; turn out to be the abrogation of existence for the
other. In the light of this argument, we shall pursue in studying and observing the underlying factors that led to the Nagas challenging the powerful
British authority over the Naga Hills, and the consequences that followed
Calcificaciones cerebrales: enfermedad o síndrome de Fahr
Authors: Dávila-Hernández Carlos Alberto , Bendezú-Ramos Galo Franks , Torres-Luján Marianella , Del Rosario Cárdenas-Trejo Julissa Enimia , Picoy-Romero4 Diana Esther
Published: February 2021

Paciente mujer de 58 años de edad, fue traída por presentar miclonías, convulsiones tónico-clónicas, con antecedentes de hipertensión, diabetes mellitus, hipotiroidismo, secuela de infarto cerebral. A la exploración clínica se le halló soporosa, pupilas isocóricas, hiporreactivas, hemiparesia derecha. El estudio tomográfico cerebral sin contraste mostró calcificaciones cerebrales y cerebelosas. Se discute sobre los conceptos de enfermedad o síndrome de Fahr.
Miocardiopatía hipertrófica familiar
Authors: Lazo-Soldevilla Marco , Meza-Centeno Lizeth
Published: February 2021

Presentamos el caso de un varón de 16 años de edad con el diagnóstico de miocardiopatía hipertrófica y antecedente de muerte súbita familiar, se realizó la estratificación del riesgo utilizando el modelo de predicción de riesgo clínico para pacientes con miocardiopatía hipertrófica (HCM Risk-SCD), siendo un paciente de alto riesgo por lo que se colocó un desfibrilador automático implantable como prevención primaria.
Tingkat Pengetahuan Akseptor KB Tentang Metode Kontrasepsi Jangka Panjang dengan Keikutsertaan Terhadap Metode Kontrasepsi Jangka Panjang
Authors: ASWITAMI PRAMITA , Purnamayanthi Pande Putu Indah , Udayani Ni Putu Mirah Yunita , Prameswari I Gst Ayu Agung
Published: February 2021

Keluarga Berencana (KB) menurut World Health Organisation (WHO) adalah tindakan yang membantu individu atau pasangan suami istri untuk menghindari kelahiran yang tidak diinginkan, mendapatkan kelahiran yang diinginkan, mengatur interval kelahiran, mengontrol waktu saat kelahiran dalam hubungan dengan umur suami dan istri, menentukan  jumlah anak dalam keluarga. Salah satu faktor yang memengaruhi keikutsertaan sebagai akseptor metode kontrasepsi jangka panjang adalah pengetahuan suami istri mengenai kontrasepsi tersebut. Tujuan penelitian ini adalah untuk mengetahui hubungan tingkat pengetahuan akseptor KB tentang metode kontrasepsi jangka panjang (MKJP) dengan keikutsertaan MKJP di banjar Air Kuning Kecamatan Jembrana. Penelitian ini menggunakan rancangan non eksperimen dengan pendekatan kuantitatif. Desain penelitian yang digunakan adalah penelitian analitik dengan pendekatan cross sectional yaitu melakukan pengumpulan data dalam satu waktu dan tiap subyek penelitian diobservasi sekali saja. Hasil uji statistik chi square (X2) didapatkan hasil hitung untuk tingkat pengetahuan akseptor KB tentang metode kontrasepsi jangka panjang (MKJP) sebesar 61,267 dengan tingkat kemaknaan 95% dengan nilai p<0.05 yang artinya terdapat hubungan yang signifikan antara tingkat pengetahuan akseptor KB tentang metode kontrasepsi jangka panjang (MKJP) dengan keikutsertaan terhadap MKJP. Disarankan kepada petugas kesehatan untuk memberikan edukasi lebih banyak tentang kontrasepsi jangka panjang sehingga akseptor KB MKJP akan bertambah untuk mengontrol kehamilan dengan baik
3D Image Processing using Machine Learning based Input Processing for Man-Machine Interaction
Authors: Sungheetha Akey
Published: February 2021

In various real time applications, several assisted services are provided by the human-robot interaction (HRI). The concept of convergence of a three-dimensional (3D) image into a plane-based projection is used for object identification via digital visualization in robotic systems. Recognition errors occur as the projections in various planes are misidentified during the convergence process. These misidentifications in recognition of objects can be reduced by input processing scheme dependent on the projection technique. The conjoining indices are identified by projecting the input image in all possible dimensions and visualizing it. Machine learning algorithm is used for improving the processing speed and accuracy of recognition. Labeled analysis is used for segregation of the intersection without conjoined indices. Errors are prevented by identifying the non-correlating indices in the projections of possible dimension. The inputs are correlated with related inputs that are stored with labels thereby preventing matching of the indices and deviations in the planes. Error, complexity, time and recognition ratio metrics are verified for the proposed model.
Caminhos do feminino e do masculino: isolamento social e novas tecnologias
Authors: Nardotto Elane
Published: February 2021

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Madres, profesoras, investigadoras, todo a la vez en tiempos de coronavirus: historia de muchas
Authors: Santiesteban Almaguer Yithsell , Torres Diéguez Dayalé
Published: February 2021

Este es un relato que pretende acercar al lector a la realidad de dos mujeres cubanas que en tiempos de coronavirus continuaron, a través del uso de las tecnologías, y sorteando obstáculos para lograr ser resilientes, mantener su labor formativa, científica e investigativa, sin abandonar las tareas como madres y esposas. Se abordan elementos relacionados con la necesidad de utilizar de manera óptima y racional las tecnologías, así como la importancia del proceso formativo que se genera hacia el interior de las universidades y que repercute en una sociedad cada vez más equitativa, en aras de alcanzar un desarrollo sostenible. Historias de vida, en medio de la COVID-19, que pretenden disminuir la brecha entre hombres y mujeres y enaltecer la labor de estas, como justo reconocimiento a su rol actual.
Formação continuada pela internet durante a quarentena: relato de experiência
Authors: Verdun Paola
Published: February 2021

As tecnologias digitais estão presentes na vida pessoal e profissional de algumas pessoas há pelo menos uma década. Este artigo tem como objetivo discutir a possibilidade de utilização de algumas tecnologias digitais por professores para a formação continuada durante o período de pandemia pelo covid-19 (novo coronavírus) no Brasil, que vem ganhando ainda mais espaço no cotidiano dos profissionais devido ao isolamento social. Metodologicamente, optou-se por exibir quatro ofertas gratuitas de cursos aos quais foi possível ter acesso entre 18 de março e 18 de julho deste ano, o que pode viabilizar um processo de educação continuada. O estudo enfocou as modalidades de Educação a Distância e Ensino Remoto. Também é proposta uma breve análise em diálogo com Larrosa (1994) e outros autores, mostrando que o processo de educação continuada pela Internet pode ser constituído pela criação de uma experiência de si e pela transformação da subjetividade de uma professora.
A STUDY OF NON-PERFORMING ASSETS OF ICICI BANK: PRE-MERGER AND POST-MERGER ANALYSIS
Authors: Dr.Navneet Joshi  , Sanjive Saxena  , Shobha
Published: February 2021

The purpose of this paper is to examine the impact of mergers and acquisitions (M&A) of Industrial Credit & Investment Corporation of India (ICICI Bank) and Bank of Rajasthan on non-performing assets (NPAs) of Industrial Credit & Investment Corporation of India (ICICI Bank). The analysis consists of two stages. The methodology adopted in the study is based on descriptive research wherein secondary data was collected from the official websites of ICICI bank. By using MS Excel 2016 software, the data was analysed by using the ratio analysis approach, to determine the variation in the current position and secondly, the change in the efficiency of the banks during the pre-merger and post-merger periods by using descriptive statistics in the context of non-performing assets.
KEYWORDS: Non-performing Assets, Merger Acquisition, Pre-merger and Post-merger, CAGR (Compounded Annual Growth Rate), Earning per share.
On the topic: Typical behavioral disorders and causes and occurrences
Authors:   Azərbaycan Dövlət Pedaqoji Universiteti, Shikhbala Malikov Malik
Published: February 2021

The article analyzes typical behavioral disorders - this is hyperactive behavior (due mainly to the neurodynamic characteristics of the child), as well as demonstrative, protest, aggressive, infantile, conformal and symptomatic behavior (in the occurrence of which the determining factors are the conditions of learning and development, the style of relationships with adults, characteristics family education). The author examines the causes of behavior deviations. Key words: behavior, deviance, personality defects, hyperactive behavior. Demonstrative behavior Protestant behavior Aggressive behavior Infantile behavior Conformal behavior Symptomatic behavior
The possibility and the ways of teaching the autistic children in the instruction process
Authors:   Lənkəran Dövlət Universiteti, Ibrahim Aliyeva Kamala
Published: February 2021

The article named "The possibility and the ways of teaching the autistic children in the instruction process" deals with the diversity of the teaching techniques and its help to the proper organisation of an individual approach to a child in the preschool and little school age period. Choosing the right teaching method and assessment program by the teacher leads to a quick comprohension of the child and time saving. The methods wich the parents can even use easily, will accelerate the learning processes of autistic children are broadly described in the article. Key words: Instruction, game, assessment, behavioral disorder, autism, development, method, ability, program, Doman method, The Son Rise Program
Raport preliminar asupra cercetărilor desfăşurate la Reci-Doboika, jud. Covasna, un sit cu depuneri în gropi din epoca fierului/Preliminary report on the researches in Reci-Doboika (Covasna county) a 1st millennium BC site with deposits in pits
Authors: Maria-Magdalena Ștefan , Dan Buzea , Dan Ștefan , Adela Kovács , József Puskás
Published: February 2021

The article reports on recent geophysical investigations undertaken in the central part of Brașov Depression, in south-eastern Transylvania, at Reci (Covasna County), and offers preliminary information about a rescue excavation which was previously done in the vicinity of the newly prospected areas. A gradiometric survey and a series of magnetic susceptibility measurements were completed on a river terrace, nearby the site of Doboika, where 109 pits dating from various moments of the Iron Age and one from Eneolithic were researched in 2015 by the National Museum of Eastern Carpathians in Sfântu Gheorghe. Some of these pits had as content a certain selection of items’ categories which, despite changes in styling and manufacturing techniques due to time passing, could be recognized as a common model employed in three different stages of the Iron Age: 11th-10th c. BC (Gáva circle), 5th-4th c. BC and 1st c. BC – 1st c. AD (so-called Dacian period).
Entire or almost entire vessels, grinding stones, weight looms, portable fireplaces or fragments of regular fireplaces, clay figurines, miniature vessels, flints and clay-disks were the commonest found functional classes of items. They allude to an intentional depositional practice with a longue-durée appeal and a strong location valorisation, a phenomenon well documented for other sites in the territory of ancient Thrace, too.
Other pits contained only pottery fragments and remain harder to interpret. One of the pits delivered the skeleton of an entire dog. The non-invasive investigations showed the space occupied by pits is actually larger and very crowded, exhibiting also certain patterns in their spatial distribution, a tendency for intentional arrangement already noticed for the Late Iron Age features excavated in 2015. The results of the geophysical investigations corroborated with those of the archaeological dig from 2015 in Doboika can place.