When it comes to pain, the clinicians know that men and women are not the same. There are conspicuous sex differences in response to experimental painful stimulation, in pain attitude such as reporting pain and pain coping behaviors, in symptoms and signs of painful disorders and in response to pain treatment.

Objectives: This study was planned as a guide for nurses in order to define the coping methods of elderly pain patients.
Methods: This descriptive survey was carried out on the geriatric patients (n=100) aged 60 and above in the inpatient Algol- ogy Unit of a University Hospital between November 28th, 2014 and January 28th, 2015. The data were collected using De- scriptive Characteristics Questionnaire which was prepared by scanning the literature and via one-on-one interviews by using Pain Coping Questionnaire (PCQ). The data were evaluated through descriptive statistical methods, Independent sample t test, One way Anova test and Pearson correlation test.
Results: The duration of the pain of the patients ranged from 1 month to 40 years, and the mean duration of pain was 63.57±82.65 months. The mean subscale scores of the patients received from PCQ were self-management (mean=19.22±6.54), helplessness (mean=13.45±3.86), conscious coping attempts (mean=11.90±3.97) and medical remedies (mean=12.62±3.98). The self-management scores (p<0.05) of the patients with the belief that they are able to control pain on their own, and the medical remedies scores (p<0.05) of the patients believing that pain control is in the nurses were significantly higher.
Conclusion: The ways for coping with the pain varies on geriatric patients and it is recommended that these variations and differences are taken into account in nursing interventions.

Objective: Radiofrequency thermocoagulation (RFT) has been reported to be used safely for the treatment of ischemic lower extremity pain. The object of the present study was to evaluate the efficiency of RFT for the treatment of lower extremity ischemic pain and compare the effectivity of monopolar RFT and bipolar RFT mode.
Material and Methods: Following Ethic committee approval, 30 ASA I-III patients with ischemic lower extremity pain, between 18 and 65 years aged were recruited. Patients were randomly allocated into two groups to receive monopolar radiofrequency thermocoagulation (80°C) for 2 minutes from L2-3 level in group MRT (n = 15) or bipolar radiofrequency thermocoagulation (80°C) for 2 minutes from L2-3 level in group BRT (n=15). Systolic and diastolic blood pressures, heart rate, pain scores and supplement analgesic requirements were recorded at 24 hour, and 7, 30 and 90 days after discharge.
Results: NRS values in both group significantly decreased over time and it was found significantly lower in group BRT than in group MRT only after the first and third months (p<0.05). However, supplement analgesic requirements were similar and there was no significant difference between the two groups at any study period (p>0.05). No adverse event or complication regarding the procedure or treatment was reported.
Conclusion: In patients with ischemic lower extremity pain, both monopolar and bipolar radiofrequency thermocoagulation treatment modalities were found to decrease significantly pain levels. However, bipolar mod led to lower pain scores at the 30 and 90 days and longer duration of analgesia than monopolar mode.

Objectives: The purpose of the study is examining the personal, occupational and psychosocial risk factors affecting the low back pain prevalence in healthcare workers.
Methods: Our study included a total of 1682 participants (1010 female, 672 male) working at Denizli State Hospital. Low back pain part in the general section of Standardized Nordic Musculoskeletal Questionnaire (SNMA) is used in the evaluation of point and annual prevalence. Stress levels were used as Perceived Stress Scale and the job satisfaction was used as Job Satisfaction Scale.
Results: Life-time low back pain prevalence of healthcare workers was determined as 53%, and based on SNMA. It was determined that the low back pain was most common among medical secretaries (56.9%). Elder age, female gender, high Body Mass Index (BMI) (p=0.002), being married and lack of exercise habit (p=0.009), working for more than 4 hours by standing (p=0.012) and sitting at the desk (p=0.021), using computer for more than 4 hours (p=0.0001), increased years of service (p=0.001) and low job satisfaction (p=0.001) were determined as factors increasing the low back pain risk.
Conclusion: Our study has demonstrated that healthcare workers are among the group with high risk of low back pain.

Headaches provoked by triggering factors have been recognized for many decades. In many cases, the development of such headaches is secondary to an underlying pathology. However, in some cases, no abnormality can be identified. Primary headache associated with sexual activity (PHASA) is one of the subgroups of primary headaches. PHASA is a benign form of headache and lifetime prevalence is estimated to be 1% to 1.6% in the general population. A 38-year-old man was admitted to outpatient clinic reporting history of severe headaches during sexual intercourse for the last 2 months. Headaches occurred bilaterally in occipital area just after orgasm and lasted for about 2 hours. Propranolol 40 mg/ day was initiated and on follow-up, patient reported dramatic improvement in 2 weeks. Treatment was maintained for 6 months. Patient has been on regular follow-up for a year and had no recurrence of headache. This is a rare case PHASA. In this patient, prophylactic treatment with low dosage of propranolol was successful.

The diagnosis of sphenoid sinus diseases is difficult due to nonspecific history and physical examination findings. Sphenoid sinus is a rare localization for aspergilloma. Delay in diagnosis and treatment can result in serious complications. Presently described is case of sphenoid sinus aspergilloma. Patient had been treated by department of psychiatry for many years due to sleep disturbances and headache. Clinical and radiological features of rare case of sphenoid sinus aspergilloma are discussed.

Reversible cerebral vasoconstriction syndrome (RCVS), also known as Call-Fleming syndrome, is one of the rare causes of thunderclap headaches, which are most often seen in females aged 20–40 years and which can cause neurological deficits. The cause of RCVS is thought to be multifocal arterial constriction and dilatation caused by transient disregulation of cerebral vascular tonus. Presently described is case of 63-year-old female patient who presented with complaint of sudden onset of recurrent headaches located on the left side. Physical and neurological examinations were normal. Cranial magnetic resonance imaging (MRI) angiography examination showed vasoconstrictions in the distal, particularly in middle cerebral arteries and posterior cerebral arteries. Primary angitis of central nervous system (CNS), first considered in differential diagnosis, was excluded because no parenchymal lesion was seen in cranial MRI and no protein increase was observed in cerebrospinal fluid. Dexamethasone sodium phosphate 4 mg/mL (4 mg/day) and nimodipine 90 mg/day treatment was initiated. Nimodipine dose was gradually increased to 120 mg/day. Headache resolved significantly after discontinuation of antihistaminic agents. The most important feature of RCVS to be highlighted is that clinical signs are reversible, unlike subarachnoid hemorrhage or primary angitis of CNS, which have similar clinical presentations. Although clinical signs of RCVS usually resolve, it should be considered that permanent neurological deficits may occur.

An unusual complication of anesthesia: Unilateral spinal myoclonus

Variations in the arrangement and distribution of brachial plexus and its branches at the infraclavicular region are common The vein position is also markedly variable with respect to the artery and nerves. We report an unusual anatomic variation of vasculature at infraclavicular region determined by ultrasound during infraclavicular block.