Telogen effluvium (TE) was first termed by Kligman to define an increased shedding of normal club hairs.

Definition

Telogen effluvium (TE) was first termed by Kligman to define an increased shedding of normal club hairs based on the hypothesis that, irrespective of the cause, the follicle tends to act in a similar manner undergoing a premature termination of anagen and precipitating telogen.

Telogen effluvium is a noninflammatory disease characterized by diffuse loss of telogen hair, caused by any disruption of hair cycle which leads to increased and synchronized telogen shedding. It is the leading cause of diffuse hair loss. However, the actual incidence of the disease remains unknown. It has been suggested to result from an abrupt shift of large numbers of anagen hairs to telogen hairs on the scalp with altered ratio of anagen hair to telogen hair from the normal ratio of 90:10–70:30. The degree of telogen effluvium depends on the severity and duration of exposure, but not the type of the agent.

Pathophysiology of telogen effluvium

Telogen effluvium can affect hair on all parts of the body, but, generally, only loss of scalp hair is symptomatic.

Understanding the pathophysiology of telogen effluvium requires knowledge of the hair growth cycle. All hair has a growth phase, termed anagen, and a resting phase, telogen. On the scalp, anagen lasts approximately 3 years, while telogen lasts roughly 3 months, although there can be wide variation in these times between individuals. During telogen, the resting hair remains in the follicle until it is pushed out by growth of a new anagen hair.

In most people, 5-15% of the hair on the scalp is in telogen at any given time. Telogen effluvium is triggered when a physiologic stress or hormonal change causes a large number of hairs to enter telogen at one time. Shedding does not occur until the new anagen hairs begin to grow. The emerging hairs help to force the resting hairs out of the follicle.

Evidence suggests that the mechanism of shedding of a telogen hair is an active process that may occur independent of the emerging anagen hair. The interval between the inciting event in telogen effluvium and the onset of shedding corresponds to the length of the telogen phase, between 1 and 6 months (average 3 mo).

Headington has described 5 functional subtypes of telogen effluvium, based on which portion of the hair cycle is abnormally shortened or lengthened. These subtypes represent variations on the principles discussed above. It is rarely possible to distinguish these subtypes clinically.

Telogen Effluvium causes and risk factors

Disturbances to the hair cycle can be caused by a number of triggers, including:

  • Severe stress. Prolonged periods of stress can result in telogen effluvium. Hair loss typically occurs about 3 monthsTrusted Source after the stressful event.
  • Poor diet. Hair requires key nutrients including protein, iron, B-vitamins, and zinc to grow. A shortage of these nutrients may affect the quality and quantity of a person’s hair.
  • Sudden weight loss. Weight loss or chronic calorie restriction, such as in anorexia nervosa, can cause the hair to shed.
  • Pregnancy and childbirth. During pregnancy, more hair is in the growth phase for longer. Hormonal changes that occur 3 to 6 monthsTrusted Source after birth can cause hair to shed. This is called post-partum telogen effluvium.
  • Hormonal changes that occur during the menopause may also cause telogen effluvium.
  • Certain drugs. Certain medications and recreational drugs can cause hair loss.
  • Underlying health conditions. These can include autoimmune disease, conditions that affect the thyroid gland, and alopecia areata.
  • Depending on the type of procedure, length of stay in hospital, medications, and overall nutritional status.
  • Metal toxicity. Contact with toxic chemicals in metal can lead to hair loss.

Symptoms and Signs of telogen Effluvium

Shedding of hair is the most common sign of Telogen Effluvium. Some more prominent symptoms of Telogen Effluvium are listed below

  • Noticeable hair loss during washing or combing hair
  • Healthy looking scalp
  • A generalised hair thinning
  • Hair loss that is temporary
  • Losing hair that has white bulb and lack of shiny sheath
  • Dry, lusterless hair that are sparse and easily pluckable
  • Hair colour changes from dark to brown or red, brown to blond

Diagnosis of telogen effluvium

Most cases of telogen effluvium can be diagnosed based on medical history and an examination of the scalp and hair. If the hair loss has been occurring for several months, there may be visible thinning patches, but often the hair loss is not dramatic enough for a doctor to notice. If you have large bald patches, you probably don’t have telogen effluvium. If the doctor gently tugs on some hairs on your scalp and four or more hairs come out, you probably have telogen effluvium. Also, the hairs will look like hairs in the telogen phase — they will have a white bulb at the end that was in the scalp, and will not have a gel-like covering around that end of the hair.

You may be asked to gather all hairs that fall out of your head over a 24-hour period, and count them to see if the hair loss is truly excessive. Losing fewer than 100 hairs in a day is considered normal. You also may be asked to gather and count lost hairs every one or two weeks to see when the shedding starts to decline.

In some rare cases, if there is reason to doubt the diagnosis, a biopsy of the scalp may be done. In this procedure, a small piece of the scalp that includes several hair follicles is removed and examined under a microscope. Your doctor also may do blood tests to check for conditions such as thyroid abnormalities that may be contributing to hair loss.

Management and treatment for telogen effluvium

Acute Shedding versus Chronic Shedding

Acute telogen effluvium becomes self-limited if the triggering factor is identified and removed. Causative conditions such as scalp conditions (e.g., psoriasis, seborrheic dermatitis) should be treated. The patient’s drug history should be obtained in detail, and drugs suspected to cause the condition should be replaced or discontinued. The longer the duration of shedding, the more probable the involvement of multiple and repetitive triggers such as nutritional deficiencies, thyroid disease, systemic illnesses, or infections. This makes the search for triggers more difficult and may require frequent visits.

Patient Education

Patient education is important in disease management. Disease correlation with triggers, and the timing of hair loss should be explained and frustrations addressed. Hair is an important part of the human body; the degree of psychological disability due to hair loss varies from person to person.

Correcting Deficiencies

If a measurable deficiency has been found, it should be corrected. A balanced diet and stable body weight are important. Although the use of polyphenolic compounds such as those in green tea has been reported to improve hair loss in mice, no such controlled studies are available for humans.

Minoxidil and Finasteride

The currently available FDA-approved standard drugs minoxidil and finasteride are neither efficient catagen inhibitors nor anagen inducers. Catagen-inducing drugs (e.g., beta-blockers, retinoids, anticoagulants, antithyroid drugs) should be avoided, and catagen-inducing endocrine disorders (e.g., androgen disorders, thyroid disorders, abnormal prolactin levels) should be treated.

Topical Corticosteroids

Topical corticosteroids are employed by dermatologists in the treatment. If the patient reports decreasing trichodynia after the application of topical corticosteroids, it is a sign of the therapy being effective.

Systemic Corticosteroids

In chronic telogen effluvium, corticosteroids can be given systematically especially if telogen effluvium is the manifestation of underlying systemic disorder like SLE.

CNPDA

Davis et al. reported a novel treatment of thinning of hair. This new treatment named CNPDA comprises a combination of caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer. This combination leads to an increased cross-sectional area of individual terminal scalp hair by 10%.

Prevention of telogen effluvium

Harvard Medical School explains that this type of hair loss is temporary, and will usually get better on its own. But the only way to prevent telogen effluvium is to avoid events that may trigger it. While you may not be able to avoid all potential stressors — like surgery or an unexpected illness — there are some simple steps you can take to prevent hair loss due to excessive shedding.

Manage Your Stress Levels

A period of very high stress can trigger telogen effluvium. While some amount of stress is normal and harmless, working to manage stress is important for many aspects of health, including your hair’s health. According to Mayo Clinic, “significant stress pushes large numbers of hair follicles into a resting phase. Within a few months, affected hairs might fall out suddenly when simply combing or washing your hair.”

Eat a Healthy Diet

Major changes to your diet or dramatic calorie restrictions are common causes of telogen effluvium. Not getting enough of certain important nutrients — including zinc, vitamin D, protein, and fatty acids — can lead to excessive shedding.

Take Care of Your Hair

Hair follicles are weakest when they are wet, and recommends allowing hair to dry before brushing it. While keeping your hair healthy and strong cannot prevent telogen effluvium caused by a stressful event in the past, it can help to minimize future hair shedding and breakage.

Don’t Wait. Get Help Today.

The sooner you address the symptoms of hair loss, the more likely you are to prevent irreversible damage. Speak to a medical professional today to begin your journey to a fuller head of hair.

Oneworldvisionnews

Anterior cruciate ligament injury passes in front of another ligament, the posterior cruciate ligament (PCL).

Definition

Anterior cruciate ligament injury passes in front of another ligament, the posterior cruciate ligament (PCL). The cruciate ligaments get their name from the fact they form a cross within the knee as they run in different directions from the thigh to the shin bone. Along with the other ligaments in your knee, your ACL keeps your knee stable and prevents your thigh and shin bones moving out of place.

When your knee ligaments are stretched but not torn, they’re called a sprain. Knee ligament injuries are given different grades depending on how severe they are. Around half of all people with an ACL injury will have injuries to other parts of their knee as well, such as a meniscus tear.

Anatomy of knee

Where is the ACL located in the anatomy of the knee?

The ACL is one of four main ligaments in the knee that attach the thigh bone (femur) to the shin bone (tibia). The kneecap (patella) located in the front of the knee, protects the ACL and other knee ligaments. The ACL and another ligament called the posterior cruciate ligament (PCL) run through the center of the knee. These ligaments prevent the shin bone from sliding too far forward or backward under the thigh bone.

Two other ligaments run along either side of the knee, the medial collateral ligament (MCL) and lateral collateral ligament (LCL). These ligaments prevent the knee from bending too far to either side of the leg. The meniscus provides padding and shock absorption for the knee. There are two menisci in each knee. Without these wedge-shaped pieces of cartilage, the thigh bone and shin bone would rub painfully against each other.

Epidemiology

The ACL injury grading system

An ACL injury may be diagnosed when the ligament is overstretched or torn. The tear may be partial or complete; a complete tear of the ACL is also known as an ACL rupture.

  • Grade I tears refer to a slightly stretched ACL. Symptoms are typically mild. The ligament can still keep the knee stable.
  • Grade II tears refer to stretching of the ACL to the point of looseness. These injuries are often referred to as “partial” tears. Symptoms are more severe than Grade I tears. Range of motion may be restricted and the knee may occasionally feel unstable (the knee feels like it is “giving out”).
  • Grade III tears (ligament rupture) are complete tears (the ACL has been split in two). Grade III tears may also be referred to as an ACL rupture. A person may not be able to bear weight on the injured leg.

ACL tears can produce a range of symptoms, which can make it difficult to diagnose without further examination from a doctor.

Risk factors of Anterior cruciate ligament injury

There are a number of factors that increase your risk of an ACL injury, including:

  • Being female possibly due to differences in anatomy, muscle strength and hormonal influences
  • Participating in certain sports, such as soccer, football, basketball, gymnastics and downhill skiing
  • Poor conditioning
  • Using faulty movement patterns, such as moving the knees inward during a squat
  • Wearing footwear that doesn’t fit properly
  • Using poorly maintained sports equipment, such as ski bindings that aren’t adjusted properly
  • Playing on artificial turf

Causes

ACL injuries can be caused by:

  • Stopping suddenly while running
  • Slowing down while running
  • Changing directions rapidly while running
  • Jumping or landing incorrectly
  • Contact injuries, such as a football tackle
  • Overuse of the leg from repetitive impact activity such as jumping, running, twisting or pivoting

Anterior cruciate ligament injury symptoms

Symptoms of an acute ACL injury include:

  • Feeling or hearing a pop in the knee at the time of injury.
  • Pain on the outside and back of the knee.
  • The knee swelling within the first few hours of the injury. This may be a sign of bleeding inside the knee joint. Swelling that occurs suddenly is usually a sign of a serious knee injury.
  • Limited knee movement because of pain or swelling or both.
  • The knee feeling unstable, buckling, or giving out.

After an acute injury, you will probably have to stop whatever you are doing because of the pain, but you may be able to walk.

The main symptom of chronic ACL deficiency is the knee buckling or giving out, sometimes with pain and swelling. This can happen when an ACL injury is not treated.

Complications

Some complications it may cause include:

  • Risk of developing knee osteoarthritis
  • Deterioration of joint cartilage
  • Less range of motion
  • Limping

Diagnosis and test

Your doctor will want to hear exactly how you injured your knee. They’ll look at both knees to see if the sore one looks different. They may also order any of the following:

Tests: Your doctor may ask you to lie on your back and bend your hips and/or your knees at certain angles. They’ll then place their hands on different parts of your leg and gently shift you around. If any of your bones move in a way that isn’t normal that could be a sign that your ACL is damaged.

X-ray: Soft tissues like the ACL don’t appear on X-rays, but your doctor may want to rule out broken bones.

MRI or ultrasound: These exams can show both soft tissue and bone. If you have a damaged ACL, it should appear on the images.

Arthroscopy: This literally means to “look within the joint.” During the exam, an orthopedic surgeon makes a small cut in your skin. They insert a pencil-sized tool that contains a lighting system and lens (arthroscope) into the joint. The camera projects an image of the joint onto a TV screen. Your doctor can see what type of injury you have and repair or correct it, if needed.

Treatment of anterior cruciate ligament injury

Treatment for an ACL tear will vary depending upon the patient’s individual needs. For example, the young athlete involved in agility sports will most likely require surgery to safely return to sports. The less active, usually older, individual may be able to return to a quieter lifestyle without surgery.

Nonsurgical Treatment

A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, your doctor may recommend simple, nonsurgical options.

Bracing: Your doctor may recommend a brace to protect your knee from instability. To further protect your knee, you may be given crutches to keep you from putting weight on your leg.

Physical therapy: As the swelling goes down, a careful rehabilitation program is started. Specific exercises will restore function to your knee and strengthen the leg muscles that support it.

Surgical Treatment

Rebuilding the ligament: Most ACL tears cannot be sutured (stitched) back together. To surgically repair the ACL and restore knee stability, the ligament must be reconstructed. Your doctor will replace your torn ligament with a tissue graft. This graft acts as scaffolding for a new ligament to grow on.

Grafts can be obtained from several sources. Often they are taken from the patellar tendon, which runs between the kneecap and the shinbone. Hamstring tendons at the back of the thigh are a common source of grafts. Sometimes a quadriceps tendon, which runs from the kneecap into the thigh, is used. Finally, cadaver graft (allograft) can be used.

There are advantages and disadvantages to all graft sources. You should discuss graft choices with your own orthopaedic surgeon to help determine which is best for you.

Because the regrowth takes time, it may be six months or more before an athlete can return to sports after surgery.

Procedure: Surgery to rebuild an anterior cruciate ligament is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital, and quicker recovery times.

Rehabilitation

Whether your treatment involves surgery or not, rehabilitation plays a vital role in getting you back to your daily activities. A physical therapy program will help you regain knee strength and motion.

If you have surgery, physical therapy first focuses on returning motion to the joint and surrounding muscles. This is followed by a strengthening program designed to protect the new ligament. This strengthening gradually increases the stress across the ligament. The final phase of rehabilitation is aimed at a functional return tailored for the athlete’s sport.

Prevention of anterior cruciate ligament injury

Many ACL injuries can be prevented if the muscles that surround the knees are strong and flexible.

Prevention focuses on proper nerve and muscle control of the knee. Exercises aim to increase muscle power, balance, and improve core strength and stability.

The following training tips can reduce the risk of an ACL injury:

  • Train and condition year round.
  • Practice proper landing technique after jumps.
  • When you pivot, crouch and bend at the knees and hips. This reduces stress on the ACL.
  • Strengthen your hamstring and quadriceps muscles. The hamstring muscle is at the back of the thigh; the quadriceps muscle is at the front. The muscles work together to bend or straighten the leg. Strengthening both muscles can better protect the leg against knee injuries.

Oneworldvisionnews

Phantom limb pain (PLP) refers to ongoing painful sensations.

Phantom limb pain – Definition

Phantom limb pain (PLP) refers to ongoing painful sensations that seem to be coming from the part of the limb that is no longer there. The limb is gone, but the pain is real. The onset of this pain most often occurs soon after surgery. It can feel like a variety of things, such as burning, twisting, itching or pressure. It is often felt in fingers or toes. It is believed that nearly 80 percent of the amputee population worldwide has experienced this kind of pain.

The length of time this pain lasts differs from person to person. It can last from seconds to minutes, to hours, to days. For most people, PLP diminishes in both frequency and duration during the first six months, but many continue to experience some level of these sensations for years. People are often reluctant to tell anyone that they are experiencing PLP or phantom limb sensations, for fear that they will be considered “crazy.” However, it is important to report these pains as soon as you begin to experience them so treatment can be started.

Pathophysiology

Despite, the phantom limb sensation was described by French military surgeon Ambroise Pare (1510-1590) in the sixteenth century, even today we do not have a clear explanation of this complex phenomenon and, therefore, the pathophysiology is explained by a wide range of mechanisms. These mechanisms. which are the basis of theories, they are not necessarily mutually exclusive

Peripheral Nerve Changes

During the amputation, there is a significant amount of trauma that occurs in the nerves and surrounding tissues. This damage disrupts the normal afferent and efferent signals involved with the missing limb. The proximal portions of the severed nerves start to sprout neuromas, and the nerves become hyper-excitable due to an increase in sodium-channels and resulting in spontaneous discharges.

Spinal Cord Changes

In the spinal cord, a process called central sensitization occurs. Central sensitization is a process where neural activity increases, the neuronal receptive field expands, and the nerves become hypersensitive. This is due to an increase in the N-methyl-D-aspartate, or NMDA, activity in the dorsal horn of the spinal cord making them more susceptible to activation by substance P, tachykinins, and neurokinins followed by an upregulation of the receptors in that area. This restructuring of the neural components of the spinal cord can cause the descending inhibitory fibers to lose their target sites. The combination of increased activity to nociceptive signals as well as a decrease in the inhibitory activity from the supraspinal centers is thought to be one of the major contributors to phantom limb pain.

Brain Changes

Over the past few years, there has been significant research into cortical reorganization and is a commonly cited factor in phantom limb pain.  During this process, the areas of the cortex that represent the amputated area are taken over by the neighboring regions in both the primary somatosensory and the motor cortex. Cortical reorganization partially explains why nociceptive stimulation of the nerves in the residual limb and surrounding area can cause pain and sensation in the missing limb. There is also a correlation between the extent of cortical reorganization and the amount of pain that the patient feels.

Psychogenic Factors

Chronic pain has been shown to be multi-factorial with a strong psychological component. Phantom limb pain can often develop into chronic pain syndrome and for treatment to have a higher chance of success the patient’s pain behaviors and pain processing should be addressed. Depression, anxiety, and increased stress are all triggers for phantom limb pain.

What Causes Phantom Limb Pain?

Unlike pain that is caused by trauma directly to a limb, PLP is thought to be caused by mixed signals from your brain or spinal cord. This is an important concept to consider, because the treatment for this pain has differences from the treatment you would receive for other kinds of pain. New therapies for PLP all involve trying to change the signals from your brain or spinal cord.

As with any other kind of pain, you may find that certain activities or conditions will trigger PLP. Some of these triggers might include:

  • Touch
  • Urination or defecation
  • Sexual intercourse
  • Angina
  • Cigarette smoking
  • Changes in barometric pressure
  • Herpes zoster
  • Exposure to cold.

If you notice any particular thing triggering an episode of PLP for you, let your healthcare provider know. Some triggers can be avoided – for example, you can prevent constipation or stop smoking. For other triggers, you will just have to understand and treat accordingly. You will not be able to prevent the barometric pressure from changing, but you will be able to understand that your PLP might be more severe on days with big shifts in the weather!

People are often reluctant to tell anyone that they are experiencing PLP or phantom limb sensations, for fear that they will be considered “crazy.” However, it is important to report these pains as soon as you begin to experience them so treatment can be started.

What are the risk factors for phantom limb pain?

Anyone who has an amputation can develop phantom pain. Some people find the pain is worse when they aren’t wearing a prosthetic device.

These factors may trigger phantom limb pain:

  • Angina (chest pain due to low oxygen to the heart).
  • Changes in temperature or barometric pressure.
  • Shingles (herpes zoster).
  • Sex or physical touch.

What Phantom Limb Pain Feels Like?

Not all pain feels the same. The throbbing of a headache, for example, is very different from the sharp ache of a stomach cramp. So it’s no surprise that phantom limb pain is not the same for everyone. Your pain may feel like it’s:

  • Burning
  • Shooting
  • Like “pins and needles”
  • Twisting
  • Crushing
  • Like an electric shock

Aside from pain, you may also sense other feelings from a body part that’s no longer there:

  • Movement
  • Temperature
  • Pressure
  • Vibration
  • Itch

Complications of phantom limb pain

  • One of the main complications of phantom limb pain is difficulty sleeping.
  • Lack of sleep can worsen pain, so it is important to address PLP and sleep disturbances to prevent additional or worsened pain.
  • Another major complication of phantom limb pain involves emotional changes. Depression often accompanies chronic pain, including PLP.
  • The quality of life of individuals with phantom limb pain is often compromised due to impairment of daily activities and an increase in anxiety and depression.

How is Phantom Limb Pain Diagnosed?

There is no medical test to diagnose phantom limb pain. However, doctors identify the condition from the patient’s symptoms and circumstances, such as trauma or surgery, prior to the onset of the pain.

Treatment

Finding a treatment to relieve your phantom pain can be difficult. Doctors usually begin with medications and then may add noninvasive therapies, such as acupuncture.

More-invasive options include injections or implanted devices. Surgery is done only as a last resort.

Medications

Although no medications specifically for phantom pain exist, some drugs designed to treat other conditions have been helpful in relieving nerve pain. No single drug works for everyone, and not everyone benefits from medications. You may need to try different medications to find one that works for you.

Medications used in the treatment of phantom pain include:

Over-the-counter (OTC) pain relievers. Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) might relieve phantom pain. Take these medications only as directed by your doctor. Overuse can cause serious side effects, such as stomach bleeding.

Antidepressants. Tricyclic antidepressants may relieve the pain caused by damaged nerves. Examples include amitriptyline, nortriptyline (Pamelor) and tramadol (Conzip, Ultram). Possible side effects include sleepiness, dry mouth and blurred vision.

Anticonvulsants. Epilepsy drugs — such as gabapentin (Gralise, Neurontin) and pregabalin (Lyrica) — may be used to treat nerve pain. Side effects may include dizziness, sedation and mood changes.

Narcotics. Opioid medications, such as codeine and morphine, may be an option for some people. Taken in appropriate doses under your doctor’s direction, they may help control phantom pain.

However, you may not be able to take them if you have a history of substance abuse. Even if you don’t have a history of substance abuse, these drugs can cause many side effects, including constipation, nausea, vomiting or sedation.

N-methyl-d-aspartate (NMDA) receptor antagonists. This class of anesthetics works by binding to the NMDA receptors on the brain’s nerve cells and blocking the activity of glutamate, a protein that plays a large role in relaying nerve signals.

In studies, NMDA receptor antagonists ketamine and dextromethorphan helped relieve phantom pain. Side effects of ketamine include mild sedation, hallucinations or loss of consciousness. No side effects were reported from the use of dextromethorphan.

Medical therapies

As with medications, treating phantom pain with noninvasive therapies is a matter of trial and observation. The following techniques may relieve phantom pain for some people:

Mirror box. This device contains mirrors that make it look like an amputated limb exists. The mirror box has two openings — one for the intact limb and one for the residual limb.

The person then performs symmetrical exercises, while watching the intact limb move and imagining that he or she is actually observing the missing limb moving. Some studies, though not all, have found that this exercise may help relieve phantom pain.

Acupuncture. The National Institutes of Health has found that acupuncture may ease some types of chronic pain. In acupuncture, the practitioner inserts extremely fine, sterilized stainless steel needles into the skin at specific points on the body. Acupuncture is generally considered safe when performed correctly.

Repetitive transcranial magnetic stimulation (rTMS). This therapy uses an electromagnetic coil placed against the forehead. Short pulses are sent through the coil that cause small electrical currents in the nerves located in a specifically targeted area of the brain.

Research suggests that this therapy may be helpful for phantom pain, though it isn’t yet specifically approved for this condition. The magnetic field is similar to the one used in MRI scans. Side effects may include a mild headache or lightheadedness.

Spinal cord stimulation. Your doctor inserts tiny electrodes along your spinal cord. A small electrical current delivered continuously to the spinal cord can sometimes relieve pain.

Surgery

Surgery may be an option if other treatments haven’t helped. Surgical options include:

Brain stimulation. Deep brain stimulation and motor cortex stimulation are similar to spinal cord stimulation except that the current is delivered within the brain. A surgeon uses a magnetic resonance imaging (MRI) scan to position the electrodes correctly. Although the data are still limited and these treatments aren’t specifically approved for phantom pain, brain stimulation appears to be a promising option in selected individuals.

Stump revision or neurectomy. If the pain is from nerve irritation in the stump, surgery can sometimes be helpful. But, cutting the nerves includes a risk of making the pain worse.

Potential future treatment

Newer approaches to relieve phantom pain include virtual reality goggles. The computer program for the goggles mirrors the person’s intact limb, so it looks like there’s been no amputation. The person then moves his or her virtual limb around to accomplish various tasks, such as batting away a ball hanging in midair.

Although this technique has been tested only on a small number of people, it appears to help relieve phantom pain.

Can you prevent phantom limb pain?

Some studies suggest that using spinal and general anesthesia together during limb amputation surgery may lower the risk of phantom limb pain.

Oneworldvisionnews

Again, bandits attacked communities in Birnin Gwari Local Government Area, shot sporadically and abducted over 36 persons.

Again, bandits have attacked communities in Birnin Gwari Local Government Area, shot sporadically and abducted over 36 locals.

This is coming as students and civil servants of Birnin Gwari extraction but now in the state capital, lamented that they could not travel with ease to the area for Christmas without military escorts. 

Commenting on the fresh attack on Birnin Gwari communities, Abu Muhammadu told journalists that the bandits raided the Jangali Bagoma community and went away with over 36 locals. 

According to him,” they came early Sunday and on Monday, shot indiscriminately and kidnapped the women, children and others from the community. 

The bandits did not kill anybody during the attacks. We are still counting the number of the people they kidnapped.

They attacked twice in less than 2 days. We are helpless, he said.

Journalists are still awaiting police reaction to the latest attack.

Meanwhile, some students of tertiary institutions of Birnin Gwari origin, have said going home was expensive as they have to arrange for a military escort. 

Even our traditional ruler has to beg the military authorities for helicopter, we are in deep trouble, a student who craved for anonymity has said. 

Oneworldvisionnews

Reno Omokri said government should put things in order so that Nigerians will be happy living in Nigeria, instead of traveling out.

It was recently reported that the government of the United Kingdom banned travelers from Nigeria from entering into the country, as a result of Omicron COVID-19 variant that was recently discovered in Nigeria.

Shortly after the ban was announced by the United Kingdom, the Minister of Information and Culture, Lai Mohammed came out and accused the United Kingdom of being a racist nation.

Based on that note, the former special assistant to former president Goodluck Jonathan, Reno Omokri, decided to reply him. While replying him, Reno made him to understand that the UK’s Health Secretary is of Pakistani origin, yet he listed his own country Pakistan before Nigeria. He ended his tweet by asking to know if he is being racist to his own race too.

This is really an important statement from Reno Omokri. I really don’t think that there is any reason why we should be crying just because the United Kingdom banned travelers from Nigeria from entering into their own country. The United Kingdom has every right to decide who comes into their country and who doesn’t.

Those in government should put things in order so that Nigerians will be happy living in Nigeria, instead of looking for a way to travel out.

Oneworldvisionnews

Nigerian Tribune reports that Governor Hope Uzodimma of Imo state made the remark on Tuesday, December 7.

Whether or not to challenge the declaration of Professor Charles Soludo as the winner of the Anambra state election will be made by the national leadership of the All Progressives Congress (APC) and its governorship candidate, Senator Andy Uba.

Nigerian Tribune reports that Governor Hope Uzodimma of Imo state made the remark on Tuesday, December 7, after meeting with President Muhammadu Buhari at the Presidential Villa, Abuja.

The chairman of the APC Anambra State Campaign Council while speaking to State House reporters said the fact that President Muhammadu Buhari had already congratulated Soludo has no bearing on the decision.

According to Uzodimma, the president congratulated Soludo because the Independent National Electoral Commission (INEC) had declared him winner of the keenly contested poll,Daily Trust added.

The Imo state governor also dismissed the insinuation that because of the prevailing economic and security situations in Nigeria, the ruling APC might not return to power.

Meanwhile, a tribunal sitting in Awka, the Anambra state capital city will commence hearing of all the petitions filed against the governor-elect of the state, Chukwuma Soludo on Thursday,December 9.

Leadership reports that a total of 12 political parties have filed different suits against the emergence of Charles Soludo as governor-elect of Anambra in the November 6, governorship election.

Surajo Gusau, the secretary of the Anambra state governorship election petition tribunal sitting in the state judiciary headquarters, said only exparte motions would be taken on Thursday, December 9.

Surajo noted that other processes and applications in the matter would be stalled pending when parties involved have been served and their replies received within the stipulated time allowed by the Electoral Act.

He said petitions against Soludo’s emergence as governor-election had stood at 11 until the Mega Party of Nigeria(MPN) filed its own bringing the total to 12 petitions.

Oneworldvisionnews

Usman Uzairu a rugged motorcycle thief has been arrested by police in Mano state.

Police in Kano State have arrested a 57-year-old notorious motorcycle thief, Usman Uzairu, who has been operating in the state and other states.

Spokesman of the command, DSP Abdullahi Haruna Kiyawa disclosed this after parading the Suspect at the command’s headquarters, Bompai, Kano.

He said the suspect who was held from Katsina State was arrested in a bank, UBA, after he attempted to use his master keys to steal a Suzuki motorcycle at France road, in Fagge Local Government Area of the state.

He said the suspect, who has been on the police watch list, specialized in stealing motorcycles in Kano metropolis and beyond.

The suspect narrated that he has spent over 10 years stealing motorcycles in Kano, Katsina, Bauchi and Gombe states.

Malam Uzairu, who is a family man, said all his four wives left him because of his behaviour.

Kiyawa said the suspect, who was earlier arrested in Kano for allegedly receiving stolen properties got his freedom last two weeks after spending two years in jail.

He said the case is still under investigation and he will be charged to court.

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A Yola Court of Appeal sentence three to death by hanging over killing of pastor.

A Court of Appeal in Yola has upheld the conviction and death sentence for the three killers of a pastor in Adamawa State.

The trio were convicted having been found guilty of charges bordering on the murder of Pastor Hammajulde Dadon.

They are to die by hanging.

The appellate court on Monday affirmed the death sentence, earlier delivered by High Court III, on the three persons.

The convicted persons are Godwin Obidah (25), Thomas Bitrus (27) and Hananiya Ezra (30), all from Tashan-Reke village in the Yola South Local Government Area of the state.

Justice Chidi Nwaoma Uwa of the Appeal Court affirmed the lower court’s verdict and dismissed the appeal seeking to upturn the judgement.

Justice Abdul-Azeez Waziri, who is now an Appeal Court Judge, had convicted and sentenced the three to death by hanging for killing Pastor Dadon, over non-payment of royalty on plaster sand.

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Scores of Armed bandits were reportedly killed by vigilante group in Niger state.

Scores of armed bandits on Monday evening met their Waterloo in the hands of local vigilantes at Kuna village, Kafin Koro District of Paikoro Local Government Area of Niger State when they attempted to invade the village.

The battle between the vigilantes and the bandits in their large number to place about 7:00 pm in the evening when the bandits were trying to cross river Beni with their abducted victims unknowing to them that the local vigilantes had laid siege across the river.

The bandits, it was gathered had invaded nearby villages at Nugwazi and Ruga, and abducted about eight Fulani men after killing one and injured another before luck ran out of them.

Only two of the bandits were said to have escaped the onslaught by the vigilantes whom our source said resisted bullets fired at them by the bandits.

A Fulani man was killed while another man whose bullet could penetrate was macheted and he is currently receiving treatment at the Kafin Koro General hospital.

According to the chairman of the local government, Hon Yohana Yakubu, who confirmed this breakthrough, the local vigilantes were able to rescue unhurt, the eight people that were earlier abducted by the bandits.

The chairman said a number of weapons and motorcycles were recovered from the bandits by the vigilantes and have been handed over to the Divisional Police Office in the area.

Hon Yakubu disclosed that as a result of the latest onslaught by the bandits on some villages in his Council, the number of Internally Displaced People (IDP) had increased from 330 to about 500 in the last few days, adding that “if not for the efforts our local vigilantes, the whole villages in Kafin-koro district would have been taking over by the bandits.

Villages like Kudami, Kuna, Nugwazi, Abolo, Dakolon Daji and Part of Ishau have been deserted by the people, and currently taking refuge at the central primary school at Kafin Koro.

He equally said the vigilantes have been adequately mobilized to affected villages even though the people have relocated to Kafin Koro, adding the vigilantes are fully prepared in their own way to face the bandits.

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