Medicinal, Psychological, and Health Research Journal (MPHRJ)

Abstract Introduction: The choice between regional and general anesthesia for inguinal hernia repair is of significant clinical importance, as it directly impacts postoperative pain, complication rates, recovery trajectories, and long-term patient outcomes. With increasing emphasis on individualized care and enhanced recovery protocols, determining the most effective anesthetic approach is essential to optimizing surgical results, minimizing adverse effects, and improving patient satisfaction, particularly in high-volume procedures with substantial global health implications.

Material and methods: This systematic review assessed the impact of regional versus general anesthesia on postoperative pain and complications following inguinal hernia repair. Using predefined criteria, relevant studies were identified through comprehensive database searches. Data were extracted on pain scores, complications, and recovery outcomes. Risk of bias was evaluated with validated tools, and meta-analyses with subgroup analyses addressed heterogeneity.

Results: This systematic review analyzed five studies comparing regional and general anesthesia in inguinal hernia repair. Regional anesthesia, particularly spinal, was associated with significantly lower postoperative pain scores and shorter hospital stays. While general anesthesia showed higher rates of nausea and vomiting, regional techniques were linked to a greater incidence of urinary retention.

Conclusion: Regional anesthesia for inguinal hernia repair provides superior postoperative pain control and reduces nausea and vomiting compared to general anesthesia. Although urinary retention is more frequent with regional techniques, overall complication rates remain low.

Abstract Introduction: Understanding cardiovascular risk in patients with systemic lupus erythematosus is of paramount clinical relevance, as CVD has emerged as a leading cause of morbidity and premature mortality in this population. Traditional risk models often fail to account for disease-specific mechanisms such as chronic inflammation and autoimmunity.

Material and methods: This systematic review, conducted in accordance with PRISMA guidelines, comprehensively analyzed peer-reviewed studies from multiple databases to evaluate cardiovascular risk in adult patients with systemic lupus erythematosus. Using predefined eligibility criteria, rigorous selection, independent data extraction, and standardized risk of bias assessment, the review synthesized findings from observational and interventional studies.

Results: This systematic review included five eligible studies selected from an initial pool of 2,347 records, highlighting the cardiovascular risk profile in patients with systemic lupus erythematosus. The studies varied in design, geographic origin, and sample size, but consistently reported high prevalence of traditional cardiovascular risk factors—such as hypertension, hyperlipidemia, and diabetes—as well as notable rates of myocardial infarction, stroke, and subclinical atherosclerosis, underscoring the elevated cardiovascular burden in this patient population.

Conclusion: This systematic review highlights a consistently high burden of traditional cardiovascular risk factors and notable rates of subclinical atherosclerosis and clinical events among SLE patients across diverse settings. Hypertension and hyperlipidemia were the most prevalent risk factors. Subclinical atherosclerosis exceeded 35% in all studies, underscoring early vascular involvement. These findings emphasize the need for proactive cardiovascular risk assessment and management in the routine care of patients with SLE.

Abstract Introduction: Understanding and optimizing postoperative pain management in nasal surgeries is critical, as inadequately controlled pain can impede recovery, increase morbidity, and compromise patient outcomes. Investigating the analgesic efficacy and safety profile of intravenous ketamine provides valuable insight into developing opioid-sparing, multimodal analgesic regimens.

Material and methods: This double-blind, randomized controlled trial will assess the efficacy of intravenous ketamine versus placebo for postoperative pain in adult nasal surgery patients. Utilizing rigorous sampling, concealment, and blinding procedures, the study ensures methodological robustness. Comprehensive data collection on pain and adverse events will be analyzed with appropriate statistical methods.

Results: The study demonstrated comparability between the ketamine and control groups at baseline; however, postoperative pain scores were consistently and significantly higher in the ketamine group at all measured time points up to 24 hours post-surgery. These results indicate that intravenous ketamine did not provide the anticipated analgesic benefit for nasal surgery patients and was, in fact, associated with greater pain severity compared to placebo throughout the early and late postoperative periods.

Conclusion: In conclusion, the study demonstrated that intravenous ketamine administration during nasal surgery did not confer the expected analgesic advantage; instead, it was associated with significantly higher postoperative pain scores compared to placebo at all evaluated time points. These findings challenge the presumed efficacy of ketamine for postoperative pain control in this context, underscoring the need for procedure-specific analgesic strategies and highlighting the importance of evidence-based approaches in perioperative pain management.

Abstract Introduction: Familial Mediterranean Fever (FMF) is an autoinflammatory disorder marked by recurrent febrile attacks and serosal inflammation. While musculoskeletal symptoms such as myalgia and arthralgia are well recognized, exercise-induced musculoskeletal pain in FMF patients remains underexplored.

Materials and Methods: This cross-sectional study evaluated 115 genetically confirmed FMF patients at Bouali Hospital in Ardabil. Data on demographic characteristics, MEFV gene mutations, clinical history, and the presence of exercise-related musculoskeletal pain were collected. Statistical analysis was performed to identify associations between pain and clinical/genetic factors.

Results: Out of 115 patients, 50 (43.5%) reported myalgia, arthralgia, or lower limb pain triggered by physical activity. No significant associations were found between pain and gender, age, age at disease onset, area of residence, parental consanguinity, specific MEFV mutations, or family history of FMF (p > 0.05 for all variables).

Conclusion: Exercise-induced musculoskeletal pain is a common but clinically underestimated feature in FMF patients. Its occurrence appears independent of common demographic or genetic markers. Greater clinical attention is needed to address this symptom, potentially through tailored physical activity guidance and adjunctive pain management strategies.