bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Peripheral Neurectomy vs. Medical Treatment for Migraine
Authors: Bajaj Jitin , Doddamani Ramesh , Chandra Sarat P , Ratre Shailendra , Parihar Vijay , Yadav Yadram , Sharma Dhananjaya 
Published: May 2021

Background:
Migraine is a common form of primary neurologic headache. Many patients are chronic migraineurs and suffer from a significant disability and adverse effects of drugs. There are various surgical options available to treat migraines, including peripheral neurectomies.

Objective:
To study the surgical and functional outcomes of migraine surgeries using peripheral neurectomies and compare them with conservatively treated patients.

Materials and Methods:
Migraine patients who had a unilateral onset pain were given local bupivacaine block at the suspected trigger site, and those who were relieved were given the option for surgery. In the operative group, the peripheral nerve of the trigger site was lysed under local anesthesia. The conservative group was continued with the standard treatment. Evaluations with a baseline and 6 months visual analog score (VAS), migraine headache index (MHI), migraine disability assessment test (MIDAS), and pain self-efficacy questionnaire (PSEQ) scores were done.

Results:
A total of 26 patients got benefitted with the local bupivacaine block, out of which 13 underwent surgery. At baseline, the VAS, MHI, MIDAS, and PSEQ scores were similar in both the groups. The operative group had significant (P < 0.001) improvement in all these parameters 6 months after the surgery. All patients of the operative group got free from prophylactic migraine treatment; however, 11 out of 13 patients still needed occasional use of analgesics. There was one complication of transient temporal numbness.

Conclusion:
Migraine surgery using peripheral neurectomies was more effective than chronic drug treatment in appropriately selected patients.
Microvascular Decompression for Trigeminal Neuralgia
Authors: Singh Daljit , Dutta Gautam , Jagetia Anita , Singh Hukum , Srivastava Arvind K , Tandon Monica , Ganjoo Pragati 
Published: May 2021

Background:
Trigeminal neuralgia (TN) is a devastating condition causing significant patient discomfort and morbidity hampering quality of life. Of the many treatment options available, microvascular decompression (MVD) of the trigeminal nerve is widely performed. However, the procedure is not risk-free.

Objective:
The study aimed to describe our experience of treating TN via MVD and long-term follow-up of the patients treated by this modality.

Materials and Methods:
It is a 5-year retrospective analysis of the database of patients with idiopathic TN treated with MVD at our institute. A total of 106 patients fulfilling the criteria of idiopathic TN by International Classification of Headache Disorders, 3rd ed.ition and available for follow-up for at least 1-year post-procedure were included in the study.

Results:
Of the 106 patients, 58 (54.7%) were female and 48 (45.3%) were male with a mean age of 55 years (range 22–75 years). Vascular compression of the trigeminal nerve was seen in all cases; arterial compression in 82%, both artery and vein 14.5% while unidentified vessels were the culprit in 3.8% of the patients. There were no intra- or post-operative deaths. The best response was achieved at 1 month following the procedure where 85% of the patients achieved excellent outcomes.

Conclusion:
In experienced hands, MVD is still a safe and cost-effective modality over a myriad of treatment options available for TN in patients of all ages. The absence of adhesions, indentations, and distortion of the trigeminal nerve are positive predictors of excellent outcomes in the long run.
Role of Functional Neuroimaging in Primary Headache Disorders
Authors: Naegel Steffen , Obermann Mark 
Published: May 2021

Background:
Key structures for the pathophysiology of primary headache disorders such as migraine, cluster headache, and other trigeminal autonomic cephalalgias were identified by imaging in the past years.

Objective:
Available data on functional imaging in primary headache disorders are summarized in this review.

Material and Methods:
We performed a MEDLINE search on December 27th, 2020 using the search terms “primary headache” AND “imaging” that returned 453 results in English, out of which 137 were labeled reviews. All articles were evaluated for content and relevance for this narrative review.

Results:
The structure depicted most consistently using functional imaging in different states of primary headaches (without and with pain) was the posterior hypothalamus. Whole-brain imaging techniques such as resting-state functional resonance imaging showed a wide-ranging association of cortical and subcortical areas with human nociceptive processing in the pathophysiological mechanisms underlying the different TACs. Similarities of distinct groups of primary headache disorders, as well as their differences in brain activation across these disorders, were highlighted.

Conclusion:
The importance of neuroimaging research from clinical practice point of view remains the reliable and objective distinction of each individual pain syndrome from one another. This will help to make the correct clinical diagnosis and pave the way for better and effective treatment in the future. More research will be necessary to fulfill this unmet need.
SUNCT and SUNA
Authors: Duggal Ashish K , Chowdhury Debashish 
Published: May 2021

Background:
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache with autonomic symptoms (SUNA) are rare and disabling primary headache disorders that are subtypes of Short-lasting unilateral neuralgiform headache attacks (SUNHA).

Aim:
The aim of this narrative review was to provide a comprehensive update on headache phenotype, pathophysiology, and various treatment options available for SUNCT and SUNA.

Methods:
References for this review were identified by searches of articles published in the English language in PubMed between 1978 and October 2020 using “short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)”, “short-lasting unilateral neuralgiform headache with autonomic symptoms (SUNA)”, “short-lasting unilateral neuralgiform headache attacks (SUNHA)”, “trigeminal autonomic cephalalgias” as keywords in various combinations.

Results:
Of a potential 1103 articles, seven case series describing clinical characteristics of SUNCT/SUNA patients were identified for this review. For symptomatic/secondary SUNCT/SUNA, 53 individual case reports, and one case series were reviewed. One placebo-controlled trial and 11 open-label case series that evaluated various medical and surgical treatments in SUNCT/SUNA were also reviewed. Available literature suggests that SUNCT and SUNA are subtypes of the same disorder characterized by severe side locked short duration headache with ipsilateral prominent cranial autonomic symptoms and signs. Pathophysiology may involve both peripheral and central mechanisms. Lamotrigine is the most effective preventive therapy while intravenous lidocaine is the most efficacious drug as transitional therapy for severe disabling attacks. Surgical options including microvascular decompression in those having neurovascular conflict, occipital nerve stimulation, and hypothalamic deep brain stimulation can be alternative treatment options for medically refractory patients.
Cervicogenic Headache
Authors: Verma Satish , Tripathi Manjari , Chandra P Sarat 
Published: May 2021

Background:
Cervicogenic headache is a distinct type of headache described in 1980s by Sjaastad, a Norwegian neurologist. It is a not so uncommon headache, which is usually under-diagnosed resulting in suboptimal quality-of-life.

Objective:
The aim of this study was to review the current recommendations on diagnosis and management of cervicogenic headache.

Methods and Material:
A PubMed search was done for the recent articles on 'cervicogenic headache' published in English literature with the aim of recognizing the current perspectives on cervicogenic headache.

Results:
The diagnosis of cervicogenic headache is based on clinical criteria mentioned by the International Headache Society (IHS) and Cervicogenic Headache International Study Group (CHISG). Cervical nerve block may confirm the nociceptive source in majority of cases and is included in CHISG criteria. Non-invasive diagnostic methods like echogenicity of muscles, diffusion tensor imaging (DTI) and single-photon emission tomography (SPECT) are proposed by some authors for avoiding complications associated with blocks. Mainstay of management is physical therapy. Surgical interventions for cervical degenerative disease may relief an associated headache but such interventions are not performed solely for cervicogenic headache.

Conclusion:
Headaches with a cervical spine nociceptive source are increasingly being recognized. Current diagnostic criteria and management options are reviewed here.
Acute Treatment of Migraine
Authors: Yang Chun-Pai , Huang Kuo-Ting , Chang Ching-Mao , Yang Cheng-Chia , Wang Shuu-Jiun 
Published: May 2021

Background:
Migraine is the most prevalent neurological disorder and the leading cause of disability in individuals under 50 years of age. Two types of migraine therapies have been defined: acute therapy (abortive or symptomatic treatment), the purpose of which is to interrupt migraine attacks, and preventive treatment (prophylactic treatment), the purpose of which is to reduce the frequency and severity of migraine attacks.

Objective:
This paper reviews research advances in new agents for acute therapy of migraine.

Material and Methods:
This review provides an overview of emerging new drugs for acute treatment of migraine based on clinical evidence and summarizes the milestones of different stages of clinical development.

Results:
Two new formulations of sumatriptan, DFN-11 (3 mg doses of subcutaneous sumatriptan) and DFN-02 (a nasal spray of sumatriptan 10 mg and a permeation-enhancing excipient), have been developed, and both of them showed a fast-onset action with efficacy for acute treatment of migraine with fewer adverse events. New drug discovery programs shifted the focus to the development of ditans, a group of antimigraine drugs targeting 5-HT1F receptors. Only lasmiditan has progressed to phase III clinical trials and was finally approved by the Food and Drug Administration (FDA) for acute migraine treatment. The other target for acute therapy is CGRP receptor antagonists, namely, gepants. Ubrogepant and rimegepant demonstrated statistically significant efficacy, and both were recently approved by the FDA. These 5-HT1F receptor agonists and CGRP receptor antagonists did not cause vasoconstriction, offering advantages over the current mainstay of specific acute migraine treatment.

Conclusions:
Overall, these new agents have expanded the available acute therapies for migraine treatment and will likely change the strategy with which we treat patients with migraine in the future.
Home healthcare in Iran
Authors: Masoumi Nasrin , Hosseinzadeh Mina , VanSon Catherine , Ghezeljeh Tahereh Najafi 
Published: May 2021

Background:
Healthcare is changing from a focus on acute care health issues to one of managing chronic conditions. This change has resulted in the development of home health-care systems as a way of managing chronic conditions outside the hospital. The aim of this study was to analyze the concept of home healthcare using a hybrid model.

Materials and Methods:
This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical. Science Direct, PubMed, ProQuest, and Scopus were searched with related terms in the theoretical phase. In the fieldwork phase, six professionals with experience in home healthcare were interviewed and after each interview, qualitative content analysis was conducted. During the final phase, descriptions and themes from the first two phases were combined.

Results:
In the theoretical phase, the definition of home healthcare included descriptions answering the Who, What, When, Where, and Why questions. In the fieldwork phase, the results were divided into three areas: 1-comprehensive care; 2-extent of services; and 3-outcomes. The final analysis phase of this study indicated that the home health-care concept is a comprehensive, professional, and holistic care system accompanied by medical services and professionals whose goals are to support an individual's health and provide care in their home. Healthcare provided in one's home was found to preserve a patient's dignity and reduce health-care costs.

Conclusions:
The definition of the home healthcare concept establishes a foundation for developing a comprehensive home health-care system. This concept analysis for home healthcare could be a guide for future studies.
Home Care Nurses’ Attitude Towards and Knowledge of Home Palliative Care in Iran
Authors: Dehghannezhad Javad , Hassankhani Hadi , Taleghani Fariba , Rahmani Azad , SattarPour Simin , Sanaat Zohreh 
Published: May 2021

Background:
Chronic and cancer diseases are expected to rise with the growing population of the elderly in the world. Home palliative care might be a possible solution for improving these patients' quality of life; therefore, the present study sets out to investigate home care nurses' attitude towards and knowledge of home palliative care.

Materials and Methods:
This is a descriptive cross-sectional study (2018-19), in which 168 home care nurses and nursing assistants in East Azerbaijan Province (Iran) were included (2018). The questionnaire used was specifically designed by Shimizu et al. in 2016 for determining the nurses' attitude towards and knowledge of home care. Data analysis was carried out using descriptive and inferential statistics (T-test and ANOVA).

Results:
In this study, 95 (56.60%) and 113 (67.90%) of the participants were found to have negative attitudes and limited knowledge, respectively. The other participants seemed to have neutral attitudes towards and average knowledge of home palliative care. The Mean (SD) attitude score on terminal home care was estimated 2.33 (0.83), and the knowledge score on dying care was calculated 41.76%, which were the lowest in comparison with the scores of other dimensions.

Conclusions:
The home care nurses' attitude towards and knowledge of home palliative care were found to be negative and limited, respectively, which underscores the need to endeavor to improve the attitude towards home care and the knowledge of dying care.
Nurse Managers’ Perceptions and Experiences during the COVID-19 Crisis
Authors: Deldar Kolsoum , Froutan Razieh , Ebadi Abbas 
Published: May 2021

Background:
Coronavirus disease-2019 (COVID-19) pandemics are an international threat to global health and health systems and then healthcare providers. Nurses' managers who are responsible for organizing the nurses and their activities grapple with even more challenges, which are overlooked. This study was conducted to elaborate on the nurse managers' experiences facing the Coronavirus pandemic.

Materials and Methods:
This study adopted a conventional approach to qualitative content analysis. Semi-structured interviews were conducted with 18 nurse managers working at the University Hospitals of Mashhad University of Medical Sciences from April 5, 2020 to June 15, 2020. The interviews continued until data saturation. Data analysis was performed using the method proposed by Lundman and Graneheim.

Results:
Participants described their experiences about facing COVID-19 pandemic into three categories of 'facing the personnel's mental health', 'Managerial and equipment provision challenges', and 'adaptability and exultation process', with 13 sub-categories.

Conclusions:
Dealing with critical conditions could make the frontline managers, and specially nurse managers, face serious challenges. However, in case of proper crisis management andadaptation of sufficient supporting strategies, these threats could turn into an opportunity to exault the individuals and consequently the organizations engaged.
The Effect of an Educational Intervention based on Pender's Health Promotion Model on Treatment Adherence in the Patients with Coronary Artery Disease
Authors: Faroughi Forough , Shahriari Mohsen , Keshvari Mahrokh , Shirani Farymah 
Published: May 2021

Background:
Increasing of hospitalization rates of Coronary Artery Disease (CAD) management have created major challenge for the health system. Poor adherence to treatment is one of the main reasons for treatment failure, prolongation of treatment, and increase care costs. The aim of this research was to determine the effect of educational intervention based on Pender's Health Promotion Model (HPM) on adherence in patients with CAD.

Materials and Methods:
This randomized controlled clinical trial was held in an educational hospital in Isfahan, Iran, February 2018–May 2019. Data were collected from 64 patients with CAD, before, 1 and 3 months after the intervention. The instrument used included treatment adherence questionnaire and a checklist Pender's HPM. The study group received dietary, exercise, and medication education based on Pender's HPM in four sessions which were held in 4 weeks. The control group received the routine educational program of the hospital. The data was analyzed using descriptive statistics, repeated measures ANOVA, independent t, Chi-square, and Mann–Whitney tests via SPSS software.

Results:
The mean score of treatment adherence was significantly different between two groups in one (z = 5.28, df = 2, p < 0.001) and three (z = 4.51, df = 2, p < 0.001) months after the intervention. The mean (SD) of treatment adherence in the study group was 139.82 (27.44) 3 months after the intervention.

Conclusions:
Educational intervention based on Pender's HPM is more effective on treatment adherence than the routine method in the patients with CAD. It is recommended to integrate the Pender's HPM as a nursing care program for these patients.
Factors Contributing to Mother–Daughter Talk about Sexual Health Education in an Iranian Urban Adolescent Population
Authors: Harchegani Maryam Torki , Dastoorpoor Maryam , Javadnoori Mojgan , SHiralinia KHadijeh 
Published: May 2021

Background:
Parent–adolescent dialog on sexual issues reduces high-risk sexual behavior in adolescents. However, many adolescents are deprived of such training. Several factors may affect the sexual dialog between parents and adolescents. This study aimed to investigate the factors associated with mother–adolescent daughter dialog on sexual health matters in Iran.

Materials and Methods:
This cross-sectional study was carried out on 363 female adolescents aged 14-18 years in Ahvaz-Iran, between June 2015 and January 2016. Data collection was conducted utilizing multi-stage cluster sampling in high schools using the Parent–adolescent sexual dialog questionnaire and the parent–adolescent general dialogue questionnaire. The validity of the questionnaires was confirmed using content and face validity and their reliability was confirmed through internal consistency. The data were analyzed using descriptive statistics, Pearson's correlation coefficient, independent one-sample and two-sample t-tests, one-way ANOVA, and Post-HOC (Duncan) test.

Results:
The mean score of mother–daughter sexual dialog had a significant relationship with mother's education (F = 4.03, p > 0.003), adolescent's major (F = 4.48, p < 0.004), mother–daughter general communication (p < 0.001), and emotional relationship with parents (F = 6.47, p < 0.002). The more is the mother–daughter general communication, the more will be their sexual communication (p < 0.001). There was no relationship between the score of mother–daughter sexual communication and the age of mother or adolescent, parents' job, parents' marital status, and having sisters (p = 0.86).

Conclusions:
Some demographic characteristics of parents and adolescents, and the parent–adolescent emotional relationship can affect the communication between them about sexual issues. So efforts to enhance this communication should consider these factors as mediator variables.
Exceptional Prices of Medical and Other Supplies during the COVID-19 Pandemic in Ecuador
Authors: Ortiz-Prado Esteban , Fernandez-Naranjo Raul , Torres-Berru Yeferson , Lowe Rachel , Torres Irene 
Published: May 2021

Abstract.Shortages of essential supplies used to prevent, diagnose, and treat COVID-19 have been a global concern, and price speculation and hikes may have negatively influenced access. This study identifies variability in prices of products acquired through government-driven contracts in Ecuador during the early pandemic response, when the highest mortality rates were registered in a single day. Data were obtained from the National Public Procurement Service (SERCOP) database between March 1 and July 31, 2020. A statistical descriptive analysis was conducted to extract relevant measures for commonly purchased products, medical devices, pharmaceutical drugs, and other goods. Among the most frequently purchased products, the greatest amounts were spent on face masks (US$4.5 million), acetaminophen (US$2.2 million), and reverse transcriptase quantitative polymerase chain reaction assay kits (US$1.8 million). Prices varied greatly, depending on each individual contract and on the number of units purchased; some were exceptionally higher than their market value. Compared with 2019, the mean price of medical examination gloves increased up to 1,307%, acetaminophen 500 mg pills, up to 796%, and oxygen flasks, 30.8%. In a context of budgetary constraints that actually required an effective use of available funds, speculative price hikes may have limited patient access to health care and the protection of the general population and health care workers. COVID-19 vaccine allocations to privileged individuals have also been widely reported. Price caps and other forms of regulation, as well as greater scrutiny and transparency of government-driven purchases, and investment in local production, are warranted in Ecuador for improved infectious disease prevention.
Incidence of Traumatic Brain Injury in a Ghanaian Tertiary Hospital
Authors: Adam A. , Alhassan A. , Yabasin I. 
Published: May 2021

Traumatic brain injury (TBI) is considered as one of the most silent epidemics and its incidence is rising worldwide due to injuries associated with the increased use of motor vehicles and bad road network, particularly in middle-income and low-income countries including Ghana. The aim of this study was to assess the incidence of TBI, cause of injury as well as outcomes of patient’s care in the Tamale Teaching Hospital in Ghana. This retrospective study was carried out at the Tamale Teaching Hospital, the only Tertiary referral hospital in the whole of the savanna ecological zone of Ghana over 43 months from January 2009 to July 2012. All patients admitted into the hospital and diagnosed as having TBI were included in the study. The medical records of a total of 671 patients who were diagnosed with TBI were reviewed. Information regarding the age, sex, occupation and initial external cause of injury was retrieved. Data regarding length of hospital stay and treatment outcome were also retrieved. External cause of injury was classified according to International Classification of Diseases (ICD) guidelines as Road Traffic Accidents (RTA) (irrespective of type), fall from height, assault, gunshot, game or sport related accident and other causes. Road traffic accident accounts for relatively high incidence of hospitalized TBI. Majority of the patients were male within the 21-30 year age group. The high number of Intensive Care Unit (ICU) fatalities may indicate that more resources and facilities (intensive care nurses and equipment to monitor intracranial pressure) are needed to help in the management of cases particularly head injuries. Journal of Medical and Biomedical Sciences (2016) 5(2), 5-12