Perimenopausal and menopausal symptoms are common and may significantly impact quality of life. Menopausal hormone therapy is the most effective treatment but may not be appropriate in all cases. Nonhormonal alternatives range from lifestyle changes and dietary supplements to medical interventions and prescription therapies. This review will summarize the newest advancements in nonhormonal therapies for bothersome perimenopausal and menopausal symptoms.

Appendicectomy is a common procedure in children. Regional anaesthesia helps reduce requirements for opioids and hospital stay and enhances recovery. Laparoscopic-assisted Transversus Abdominus Plane block (L-TAP) was shown to be efficient and potentially superior to port site infiltration (PSI); however, this was not previously studied in paediatric appendicitis. This study aimed to evaluate the effectiveness of L-TAP compared to PSI in children undergoing laparoscopic appendicectomy (LA).

The brachial plexus block is one of the peripheral blocks, beneath which the majority of upper limb surgical procedures are carried out. During upper limb surgery, a supraclavicular nerve block is an excellent substitute for general anesthesia.

Females of reproductive age are increasingly using attention deficit hyperactivity disorder (ADHD) medication, but its use during pregnancy and breastfeeding is largely unknown. The aim of this study is to examine the prevalence of ADHD medication fills during pregnancy and breastfeeding, including characteristics of these females and cohort differences over time.

In epidural anaesthesia, the addition of an adjuvant to local anaesthetics enhances the efficacy, thereby providing increased duration and intensity of blockade in lower limb surgeries. The aim was to compare the efficacy, onset, and duration of sensory and motor blockade; haemodynamic changes; and sedative and analgesic effects of nalbuphine, clonidine, and dexmedetomidine as an adjuvant to ropivacaine in epidural anaesthesia.

Radiotherapy and chemotherapy are widely employed as primary non-surgical cancer treatments; however, their non-selective cytotoxicity often leads to adverse events such as oral mucositis (OM), particularly in head and neck cancer therapies. International guidelines provide recommendations for managing chemoradiotherapy-induced OM in various clinical contexts. Subsequently, emerging researches have introduced evidence supporting novel approaches or existing regimens for OM prevention and treatment. The repurposing of established drugs has garnered significant interest due to its shorter development timeline, improved safety profiles, and lower costs compared to new drug development. For example, clinical trials assessing established drugs such as melatonin, clonidine, and pentoxifylline indicate promising potential for managing OM. Additionally, several emerging pharmacological interventions have demonstrated considerable efficacy; SAMITAL and rhIL-11 are supported by phase II clinical trials and prospective studies, while probiotics like Streptococcus salivarius K12 and curcumin have shown effectiveness in randomized clinical trials. Furthermore, recent high-level studies have reinforced the efficacy of non-pharmacological interventions, such as photobiomodulation (PBM) and cryotherapy, over the past two years. In all, given the evidence supporting different strategies, PBM and oral cryotherapy are highly recommended for managing OM when feasible. Topical clonidine, melatonin, oral pentoxifylline, topical SAMITAL or rhIL-11, oral SsK12, and curcumin may also be utilized but would benefit from validation in larger trials. Besides, Verbascoside, Palifermin, Amifostine, and Avasopasem manganese can be suggested for OM management, while the side effects should be monitored. The accessibility and cost/effectiveness of specific managing strategies of OM should be considered when selecting appropriate options.

The management of postoperative pain in pediatric patients undergoing emergency surgical procedures, particularly in non-pediatric hospitals, presents significant challenges due to the unique physiological requirements of children. The utilization of opioid analgesia may result in severe complications, necessitating a transition toward multimodal analgesia, which integrates various pain management strategies to enhance effectiveness while mitigating adverse effects. Locoregional anesthesia techniques, such as fascial plane blocks, provide targeted pain alleviation, reducing dependence on opioids. Recent advancements in ultrasound-guided methodologies have markedly improved safety and precision in this context. This report presents two cases involving pediatric patients aged eight and 12 years who underwent urgent posttraumatic open splenectomy. Both patients exhibited stable hemodynamic parameters and had no significant prior medical history. Following surgery, they received an ultrasound-guided rectus sheath block (RSB) and dynamic transversus abdominis plane blocks (TAPBs) utilizing a mixture of ropivacaine, dexamethasone, and clonidine. Fentanyl was administered before and during the surgical procedures, which lasted approximately 75 minutes. Upon regaining consciousness, both patients indicated a visual analog scale (VAS) pain score of 0. They required only a single dose of intravenous acetaminophen for pain relief, demonstrating effective opioid-free pain management and achieving a high level of parental satisfaction. Combined RSB and TAPB provide adequate and safe postoperative pain management for pediatric patients undergoing emergency splenectomy in a non-pediatric hospital setting. This approach can reduce opioid dependence and improve patient outcomes. Further research is warranted to explore the broader application of locoregional anesthesia techniques for pediatric emergency surgery in non-pediatric settings.

This study aimed to investigate the effect of antihypertensive drugs on reproductive function in Rattus norvegicus and demonstrate the potential role of oxidative stress in reproductive dysfunction. Rattus norvegicus were selected as the experimental animals and divided into the following groups: healthy (control group), clonidine (CL), rilmenidine (RLD), methyldopa (MTL), amlodipine (ALD), and ramipril (RML). Each individual in each group was marked from one to six. Doses of clonidine (0.075 mg/kg), rilmenidine (0.5 mg/kg), methyldopa (100 mg/kg), amlodipine (2 mg/kg), and ramipril (2 mg/kg) were administered orally via gavage to each Rattus norvegicus. Using blood obtained from Rattus norvegicus, the absorbance of the pink-colored complex formed by thiobarbituric acid (TBA) and malondialdehyde (MDA) was measured spectrophotometrically at the 532 nm wavelength. Blood samples were collected from the tail veins to analyze serum malondialdehyde (MDA) and total glutathione levels in the serum of all Rattus norvegicus. After sampling, two mature male Rattus norvegicus were introduced to every group of six female Rattus norvegicus and accommodated in a controlled laboratory environment for two months. Any female Rattus norvegicus that became pregnant during this time was transferred to a solitary cage within a controlled setting. Rattus norvegicus that did not become pregnant and did not give birth during this period were considered infertile. The results were compared among the groups. Total glutathione (tGSH) levels were determined using a spectrophotometer. According to our study, the increase in MDA levels observed was not statistically significant in the CL and RLD groups compared to that in the control group. MDA levels were significantly increased in the methyldopa, amlodipine, and RML groups. While total glutathione levels in the CL group were similar to those in the control group, the RLD, MTL, ALD, and RML groups showed a statistically significant decrease. While the animals in the CL and RLD groups were not infertile, infertility was apparent in the groups treated with MTL, ALD, and RML. Thus, it was determined that the antihypertensive drugs MTL, ALD, and RML had different effects on fertility, and that the use of such drugs could cause infertility by increasing oxidative stress and decreasing antioxidant levels.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric psychiatric disorders and is frequently diagnosed and treated by pediatricians. Stimulant medications are the first-line treatment for ADHD but may not be a good fit for many patients due to side effects, inadequate treatment response, or family preference. Non-stimulant ADHD medications provide a useful alternative for patients that cannot tolerate stimulants, have an incomplete treatment response to stimulants, are at risk for stimulant diversion, or whose family prefers to avoid stimulants. Nonstimulant ADHD medications can be used as monotherapy or added to a stimulant as an augmentation strategy. The recommended nonstimulant ADHD medications include alpha agonists (eg, guanfacine extended-release [ER], clonidine ER) and norepinephrine reuptake inhibitors (eg, atomoxetine, viloxazine). Other nonstimulant medications (eg, buproprion, tricyclic antidepressants, polyunsaturated fatty acids) have been used off-label for ADHD but are not recommended and should only be considered as a third-line option. .