Objective: This study aimed to present four cases of Behçet's disease (BD) wherein recurrent calf pain was the first and prominent symptom experienced by the patients. Methodology: The case series described the clinical features, disease development, management, and outcomes of these patients. Written consent was obtained from each participant for the review and publication of their case. Results: All cases presented with chronic and recurrent calf pain, three of whom were bilateral. All four had skin changes on the lower extremities that may have contributed to leg pain. Only probing was a history of oral ulcers reported in all four; none had genital ulcers, eye abnormality, or sensory or motor deficits. All presented with elevated acute phase reactants. Based on the 2013 International Criteria for Behçet’s Disease (ICBD), a diagnosis of possible BD was made due to the presence of oral ulcers, skin lesions, and absence of other findings pointing to another connective tissue disease or systemic vasculitides. All four cases were given oral corticosteroids and colchicine, but two required the addition of methotrexate and azathioprine for control of symptoms. Conclusion A complaint of recurrent calf pain warrants inquiry and examination of the skin lesions over the affected area and other areas like the oral cavity and genital area. It also warrants consideration of a vasculitic process, especially in the background of oral ulcers and skin changes. In such cases, BD is the right differential diagnosis to be considered.
Pain

Abodominal pain in elderly can be the signs of a large variety of diseases and condition such as those in bile duct canal, appendicitis, diverticulitis, mesenteric ischemia, intestinal occlusion, abdominal arteriectesia, gastroduodenal ulcer, gastritis, intestinalitis. The diagnosis was conducted by laparo-ultrasound, CT scan, chest X-ray. Diagnostic accuracy decreases with age increasing. The mortality varies largely depending on the potential pathology. An approximation of 30-40% of patients needed a surgical intervention with a mortality of 10% approximately
Aged ; Pain ; Abdominal Pain

No abstract available.
Pain Clinics* ; Pain Management*

No abstract available.
Pain Clinics* ; Pain Management*

Neck pain presents as a symptom of dull pain or discomfort mainly along the trapezius muscle. Dry needling is an invasive procedure which uses acupuncture needle directed at myofascial trigger points. The aim of the study was to evaluate the effectiveness of dry needling in managing patients with neck pain. A pre-test-post-test interventional study design was used. Patient education package was provided to 32 respondents who fulfilled the inclusion criteria. A 13-item Pain Catastrophizing Scale (PCS) questionnaire was used to assess Rumination, Magnification and Helplessness. Subjective pain intensity was measured by Visual Analogue Scale (VAS). These questionnaires were given before and after the dry needling intervention. The findings reported that respondents scored high in pre-test total PCS score (27.41±13.652). Post-test result revealed a significant improvement in total PCS score (23.06±13.938) (p = 0.000). Post-test VAS score (4.78±1.237) was also significantly better than pre-test (6.47±1.414) (p = 0.000). There was no significant difference in pre-test PCS in terms of marital status (p > 0.05) whereas there was significant difference between marital status and rumination in post-test (Z = -2.303, p = 0.021). There was significant difference between pre-test magnification in terms of respondents’ occupation (p = 0.008) and race (p = 0.035) but no significant difference in post-test. Respondents’ age group showed no significant differences between pre-test and post-test PCS and VAS (p > 0.05). In conclusion, patients who received dry needling showed improvement in pain intensity and catastrophizing towards neck pain.
Neck Pain

There is a growing awareness and acceptance of the benefits for cancer pain patients derived from psychiatric contributions to pain control. Unfortunately, cancer patients with pain are more vulnerable to psychiatric complications of cancer such as depression, anxiety and delirium. Knowledge of the indications and usefulness of the psychotropic drugs in the cancer pain population will be the most rewarding, particularly because these drugs are useful not only in the treatment of psychiatric complications of cancer, but also as adjuvant analgesic agents in the management of cancer pain.
PAIN MANAGEMENT

Mid-aortic syndrome (MAS) is a rare clinical entity that is characterized by coarctation involving the distal thoracic and/or abdominal aorta and its major branches accounting for 0.5–2% of all cases of coarctation of the aorta (1). Renovascular hypertension can be a significant sequelae - it is the main symptomatic presentation of this disease among children and adolescents. We describe a 9-year-old girl who presents with recurrent abdominal pain and symptomatic hypertension. Due to significant left ventricular systolic dysfunction and uncontrolled hypertension, percutaneous balloon angioplasty was performed to treat the coarctation. To our knowledge, this is the first reported case of MAS in Malaysia. This case report highlights the clinical presentation, the role of computed tomography angiogram (CTA) in the diagnosis and current options in the management of MAS.
Abdominal Pain

Suprascapular neuropathy is a rare cause of non-specific shoulder pain affecting all age groups. Magnetic resonance imaging is the most common modality utilized to investigate the cause of suprascapular neuropathy. We report here a case of 22 year old man who presented with diffuse right shoulder region pain and severe wasting of the right infraspinatus muscle of 2 months duration. He was engaged in regular overhead activities at a gymnasium for about 2 years. A possible diagnosis of suprascapular nerve entrapment was considered. The patient was investigated with high resolution neurosonography, which showed a ganglion (paralabral) cyst at the spinoglenoid notch compressing the suprascapular nerve. We propose the use of neurosonography as an economical and effective tool for initial screening of non-specific shoulder pain with or without wasting/weakness of scapular muscles. An early identification of the cause of the neuropathy prior to the onset of muscle weakness/ wasting, and therapeutic intervention is able to avoid permanent disability
Shoulder Pain

No abstract available.
Abdominal Pain

No abstract available.
Abdominal Pain*