Accuracy of the painDETECT screening questionnaire for detection of neuropathic components in hospital-based patients with orofacial pain: a prospective cohort study

Background

Better tools are required for the earlier identification and management of orofacial pain with different aetiologies. The painDETECT questionnaire is a patient-completed screening tool with utility for identification of neuropathic pain in a range of contexts. 254 patients, referred from primary care for management of orofacial pain and attending a secondary care centre, were prospectively recruited, and completed the painDETECT prior to consultation. The aim of this study was to determine the accuracy of the painDETECT to detect neuropathic components of orofacial pain, when compared to a reference standard of clinical diagnosis by experienced physicians, in a cohort of hospital-based patients.

Results

For the 251 patients included in the analysis, the painDETECT had a modest ability to detect neuropathic components of orofacial pain (AUROC, 0.63; 95% CI, 0.58–0.70; p?=?0.001). Patients with orofacial pain diagnoses associated with neuropathic components had higher painDETECT scores than those with non-neuropathic components. However, the painDETECT was weaker at distinguishing patients with mixed pain types, and multiple diagnoses were associated with poor accuracy of the painDETECT.

Conclusion

In secondary care settings, the painDETECT performed modestly at identifying neuropathic components, and underestimates the complexity of orofacial pain in its mixed presentations and with multiple diagnoses. Prior to clinical applications or research use, the painDETECT and other generic screening tools must be adapted and revalidated for orofacial pain patients, and separately in primary care, where orofacial pain is considerably less common.

     

Awareness and current knowledge of Parkinson’s disease: a neurodegenerative disorder

Context: Parkinson’s disease (PD) is the second common progressive neurodegenerative disease, distressing older men and is prevalent Worldwide.

Objectives: This article is aimed to review the epidemiology, etiology, pathogenesis, clinical manifestation, diagnosis and management of PD.

Methods: A google search was performed to recognise studies that review the characteristics of PD. Search terms included ‘Parkinson’s disease’, ‘epidemiology’, ‘etiology’, ‘pathogenesis’, ‘clinical manifestations’, ‘diagnosis’ and ‘management of Parkinson disease’.

Results: PD is linked to factors such as environmental chemicals, aging, family history and pesticide exposure such as the use of synthetic heroin. PD is characterised clinically by tremors at rest, postural instability, expressionless countenance, lead pipe rigidity and less commonly cognitive impairment. After 60 years of age, PD is commonly prevalent in 1–% of the population, no racial differences are apparent, but the prevalence of PD is more common in men than women. There has also been a better understanding that the disorder may be linked with major non-motor trouble in addition to the additional generally recognised motor complications. There are various management options for the timely management of PD. As the ailment advances, further management strategies are existing; however, the management of non-motor manifestations and late stage motor complications remains mainly testing and will advantage from additional clinical studies.

Conclusions: In this article, we have discussed current progress in the understanding of the epidemiology, clinical manifestations, pathogenesis and management strategies of the disease.     

Initiation of a fixed- dose four- factor prothrombin complex concentrate protocol

Journal of Thrombosis and Thrombolysis -     

Progress and prospects in the management of psoriasis and developments in phyto‐therapeutic modalities

The aim of this study is to review the efficacy of herbal and allopathic drugs used to manage and treat psoriasis. The review has been compiled using reference materials from major databases, Online Journals, Science Direct, Scopus, Open J Gate, Google Scholar and PubMed. Psoriasis is a common skin disease affecting 2–3% of the world's population. It is cosmetically debilitating and chronic disease, which occurs both in developing and developed countries. It can affect any part of the body, but the most common sites are the elbows, knees, and scalp. It is usually treated with synthetic medicine either given systematically or applied locally. The prescribed synthetic medicines used for the treatment of psoriasis are associated with severe side effects and complications, thus researchers around the world are trying to explore new, more effective, and safer drugs from natural resources. Medicinal plants are safe and efficacious, and most of the people all over the world rely on herbal medicine due to their easy availability, low cost, and efficacy for treating psoriasis. A number of medicinal plants having therapeutic potential with high efficacy are used in the treatment of psoriasis have been described. Moreover, studies should be conducted to isolate and investigate the mechanism of actions of phytochemicals responsible for anti‐psoriasis potential.     

The working conditions for personal support workers in the Greater Toronto Area during the COVID-19 pandemic: a mixed-methods study

ObjectiveDuring the height of the COVID-19 pandemic, personal support workers (PSWs) were heralded as healthcare ‘heroes’ as many of them cared for high-risk, vulnerable older populations, and worked in long-term care, which experienced a high number of COVID-19 outbreaks and deaths. While essential to the healthcare workforce, there is little understanding of PSW working conditions during the pandemic. The aim of our study was to examine the working conditions (including job security, work policies, and personal experiences) for PSWs in the Greater Toronto Area during the COVID-19 pandemic from the perspectives of PSWs.MethodsThis study used a mixed-methods design. From June to December 2020, we conducted a survey of 634 PSWs to understand their working conditions during the COVID-19 pandemic. Semi-structured interviews with 31 survey respondents were conducted from February to May 2021 to understand in greater depth how working conditions were impacting the well-being of PSWs.ResultsWe found PSWs faced a range of challenges related to COVID-19, including anxiety about contracting COVID-19, reduced work hours, taking leaves of absences, concerns about job security, and losing childcare. While the COVID-19 pandemic highlighted the PSW workforce and their importance to the healthcare system (especially in the long-term care system), pre-existing poor work conditions of insecure jobs with no paid sick days and benefits exacerbated COVID-19–related challenges. Despite these hardships, PSWs were able to rely on their mental resilience and passion for their profession to cope with challenges.ConclusionSignificant changes need to be made to improve PSW working conditions. Better compensation, increased job security, decreased workload burden, and mental health supports are needed.Supplementary InformationThe online version contains supplementary material available at 10.17269/s41997-022-00643-7.