Background: and Purpose Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily attacks the respiratory system, but there are also several reports of the involvement of the central nervous system, with one of the manifestations being encephalopathy. The relatively new emergence of COVID-19 means that few studies have investigated the clinical profile of encephalopathy associated with this disease. This study aimed to determine the clinical profile, laboratory, and imaging results of encephalopathy associated with COVID-19. Methods: Three databases, namely PubMed/MEDLINE, Embase, and Scopus, were systematically searched for case reports and case series related to COVID-19-associated encephalopathy published from January 1, 2019 to July 20, 2020. Results: This review included 24 studies involving 33 cases. The most-reported neurological symptoms were disorientation/confusion (72.72%), decreased consciousness (54.54%), and seizures (27.27%). Laboratory examinations revealed increases in the C-reactive protein level (48.48%), the lactate dehydrogenase level (30.30%), and lymphopenia (27.27%). Brain imaging did not produce any pathological findings in 51.51% of the cases. Electroencephalography showed generalized slowing in 45.45% of the cases. Elevated protein (42.42%) and lymphocytosis (24.24%) were found in the cerebrospinal fluid. Fifteen patients were reportedly discharged from the hospital in a stable condition, while four cases of mortality were recorded. Conclusions The clinical, laboratory, and imaging findings in this review support the hypothesis that cerebral damage in COVID-19-associated encephalopathy is caused by cytokine-immunemediated inflammation rather than by direct invasion.

The purpose of this systematic review and meta-analysis is to evaluate the safety and efficacy of anti-inflammatory-impregnated gelatin sponges in spine surgeries. Gelatin sponges are increasingly used as delivery vehicles for anti-inflammatory and analgesic drugs during spine surgeries. However, concerns about their safety and efficacy persist. A comprehensive literature search was conducted to identify original research articles investigating the use of anti-inflammatory-impregnated gelatin sponges in spine surgeries from 2006 to 2024. Case reports, case series, animal studies, cadaveric studies, and abstract-only articles were excluded. The risk of bias was assessed using Cochrane Risk of Bias 2.0 (Cochrane, UK) for randomized controlled trials (RCTs) and the Newcastle Ottawa Scale (NOS) for observational studies. Meta-analysis was performed using Cochrane Review Manager Web. Thirteen studies (six RCTs, six cohort studies, and one case-control study) were included. Pooled analysis revealed a significant decrease in Visual Analog Scale (VAS) score for back pain (mean difference [MD], −0.62; 95% confidence intervals [CI], −0.78 to −0.46; p<0.00001), VAS score for leg pain (MD, −0.60; 95% CI, −0.87 to −0.34; p<0.00001), and length of hospital stay (MD, −0.99; 95% CI, −1.68 to −0.31; p=0.0004). Additionally, there was a significant increase in the Japanese Orthopedic Association score (MD, 0.98; 95% CI, 0.00 to 1.96; p=0.05). However, no significant difference was observed in the disability index (MD, −0.59; 95% CI, −1.88 to −0.70; p=0.37). The use of anti-inflammatory-impregnated gelatin sponges during spine surgeries decreases postoperative back pain and leg pain, reduces length of stay, and improves neurological function. Larger, prospective, randomized trials are required to obtain more robust evidence.

The purpose of this systematic review and meta-analysis is to evaluate the safety and efficacy of anti-inflammatory-impregnated gelatin sponges in spine surgeries. Gelatin sponges are increasingly used as delivery vehicles for anti-inflammatory and analgesic drugs during spine surgeries. However, concerns about their safety and efficacy persist. A comprehensive literature search was conducted to identify original research articles investigating the use of anti-inflammatory-impregnated gelatin sponges in spine surgeries from 2006 to 2024. Case reports, case series, animal studies, cadaveric studies, and abstract-only articles were excluded. The risk of bias was assessed using Cochrane Risk of Bias 2.0 (Cochrane, UK) for randomized controlled trials (RCTs) and the Newcastle Ottawa Scale (NOS) for observational studies. Meta-analysis was performed using Cochrane Review Manager Web. Thirteen studies (six RCTs, six cohort studies, and one case-control study) were included. Pooled analysis revealed a significant decrease in Visual Analog Scale (VAS) score for back pain (mean difference [MD], −0.62; 95% confidence intervals [CI], −0.78 to −0.46; p<0.00001), VAS score for leg pain (MD, −0.60; 95% CI, −0.87 to −0.34; p<0.00001), and length of hospital stay (MD, −0.99; 95% CI, −1.68 to −0.31; p=0.0004). Additionally, there was a significant increase in the Japanese Orthopedic Association score (MD, 0.98; 95% CI, 0.00 to 1.96; p=0.05). However, no significant difference was observed in the disability index (MD, −0.59; 95% CI, −1.88 to −0.70; p=0.37). The use of anti-inflammatory-impregnated gelatin sponges during spine surgeries decreases postoperative back pain and leg pain, reduces length of stay, and improves neurological function. Larger, prospective, randomized trials are required to obtain more robust evidence.

The purpose of this systematic review and meta-analysis is to evaluate the safety and efficacy of anti-inflammatory-impregnated gelatin sponges in spine surgeries. Gelatin sponges are increasingly used as delivery vehicles for anti-inflammatory and analgesic drugs during spine surgeries. However, concerns about their safety and efficacy persist. A comprehensive literature search was conducted to identify original research articles investigating the use of anti-inflammatory-impregnated gelatin sponges in spine surgeries from 2006 to 2024. Case reports, case series, animal studies, cadaveric studies, and abstract-only articles were excluded. The risk of bias was assessed using Cochrane Risk of Bias 2.0 (Cochrane, UK) for randomized controlled trials (RCTs) and the Newcastle Ottawa Scale (NOS) for observational studies. Meta-analysis was performed using Cochrane Review Manager Web. Thirteen studies (six RCTs, six cohort studies, and one case-control study) were included. Pooled analysis revealed a significant decrease in Visual Analog Scale (VAS) score for back pain (mean difference [MD], −0.62; 95% confidence intervals [CI], −0.78 to −0.46; p<0.00001), VAS score for leg pain (MD, −0.60; 95% CI, −0.87 to −0.34; p<0.00001), and length of hospital stay (MD, −0.99; 95% CI, −1.68 to −0.31; p=0.0004). Additionally, there was a significant increase in the Japanese Orthopedic Association score (MD, 0.98; 95% CI, 0.00 to 1.96; p=0.05). However, no significant difference was observed in the disability index (MD, −0.59; 95% CI, −1.88 to −0.70; p=0.37). The use of anti-inflammatory-impregnated gelatin sponges during spine surgeries decreases postoperative back pain and leg pain, reduces length of stay, and improves neurological function. Larger, prospective, randomized trials are required to obtain more robust evidence.

We conducted a hospital based study to collect data on the clinical characteristics of neuropathic pain (NP) patients in neurology outpatients in 13 big cities in Indonesia. We aimed to identify the clinical characteristics of NP among patients with the symptoms of pain. A simple questionnaire was conducted to explore the clinical symptoms and signs. Participants who reported of NP symptom was 1,779 (21.8%) among 8,160 patients. The higher prevalence of NP was reported in 41-60 years old (n= 1,030; 57.9%). It was more prevalent in male (n=1,104; 62.1%). The group of patients with low educational level has higher prevalence of pain with NP (n=1,177; 66.1%). There are five main clinical symptoms of NP patients, pinprick sensation (n=589; 33.1%), electric shock like sensation (n=542, 30.5%), burning (n=407, 22.9%), paresthesia (n=401; 22.5%) and hyperalgesia (n=351, 19.7%). In this study, NP was mostly associated with low back pain (n=509, 28,6%), carpal tunnel syndrome (n=343; 19.3%), frozen shoulder syndrome (n=191, 10.7%), diabetic neuropathy (n=170, 9.6%) and brachialgia (n=108, 6.1%). The most frequent modality to treat NP symptoms were adjuvant analgesics, antidepressants or anticonvulsants (n=1,199; 67.4%), non-steroidal anti-inflammatory drugs (n=1,177, 66.2%), non-opioids analgesics (n=606; 34.1%), non-pharmacological treatment (n=366; 20.6%) and opioid treatments (n=100, 5.6%).

We conducted a hospital based study to collect data on the clinical characteristics of neuropathic pain (NP) patients in neurology outpatients in 13 big cities in Indonesia. We aimed to identify the clinical characteristics of NP among patients with the symptoms of pain. A simple questionnaire was conducted to explore the clinical symptoms and signs. Participants who reported of NP symptom was 1,779 (21.8%) among 8,160 patients. The higher prevalence of NP was reported in 41-60 years old (n= 1,030; 57.9%). It was more prevalent in male (n=1,104; 62.1%). The group of patients with low educational level has higher prevalence of pain with NP (n=1,177; 66.1%). There are five main clinical symptoms of NP patients, pinprick sensation (n=589; 33.1%), electric shock like sensation (n=542, 30.5%), burning (n=407, 22.9%), paresthesia (n=401; 22.5%) and hyperalgesia (n=351, 19.7%). In this study, NP was mostly associated with low back pain (n=509, 28,6%), carpal tunnel syndrome (n=343; 19.3%), frozen shoulder syndrome (n=191, 10.7%), diabetic neuropathy (n=170, 9.6%) and brachialgia (n=108, 6.1%). The most frequent modality to treat NP symptoms were adjuvant analgesics, antidepressants or anticonvulsants (n=1,199; 67.4%), non-steroidal anti-inflammatory drugs (n=1,177, 66.2%), non-opioids analgesics (n=606; 34.1%), non-pharmacological treatment (n=366; 20.6%) and opioid treatments (n=100, 5.6%).
Neuralgia