reutzfeldt-Jakob disease (CJD) is a rare, degenerative, fatal brain disorder affecting about one in every 1 million persons/year worldwide [1]. It is the prototype of a family of rare and fatal human degenerative conditions characterized by progressive brain dysfunction. CJD falls into four categories: sporadic, familial, iatrogenic, and variant. Sporadic CJD (sCJD), thought to occur worldwide, is the most common form and represents about 85% of all CJD cases; the incidence ranges between 0.5 and 1.5 cases per million inhabitants per year [2]. An early diagnosis is important for counseling the patient and their family members, as also for optimal management of symptoms and to avoid any iatrogenic transmission. However, any delay in diagnosing the disease is due to a combination of its rarity as well as heterogeneity in the early stages of the disease [3].We report our coronavirus disease (COVID-19) intensive care unit experience in a patient of sCJD who presented with respiratory symptoms and seizures, which were different from the typical neuropsychiatric presentation of sCJD. Hence, we describe the challenges faced in diagnosis, management, and precautionary measurements taken for such a patient, whose condition got aggravated and worsened by the concurrent COVID-19. CASE REPORTA 61-year-old female presented with symptoms of heaviness over the base of the head which progressively worsened over 2 months, along with difficulty in walking, "tremulousness" and low-grade fever on and off. Gradually, she developed a few episodes of confusion with irrelevant and abnormal behavior which worsened over a week along with visual hallucinations.The clinical presentation of the patient suggested some neurodegenerative disease for which, she was referred to the Institute of Human Behavior and Allied Sciences, Delhi, India, where the diagnosis of CJD was made based on the clinical symptoms, typical electroencephalograph (EEG), and magnetic resonance imaging (MRI).The patient was admitted for the above complaints, where she was clinically suspected to be a case of autoimmune encephalitis. Contrast-enhanced MRI was done which revealed empty "sella turcica," and she was treated with methylprednisolone and intravenous immune globulin. The patient's condition showed little improvement for a while and later started to develop

Persistent chronic pain is the most common residual complaint in cancer survivors; its etiology being neoplastic process, postcancer treatment, or any other concurrent disorders. Growing concern about pain management in cancer survivors throws a mammoth challenge because more than 40% of cancer survivors now live longer than 10 years. Due to limited studies on persistent chronic pain in cancer survivors other than breast cancer, this enormous challenge remains in pain management in these cancer survivors. There are innumerable predictive factors for the development of persistent pain after cancer surgeries. It would be more prudent to concentrate on chronic pain mechanisms despite holding on to categorial risk factors and implanting them into patient outcomes. An effort should be made to a more holistic management of nociceptive and neuropathic pain in cancer survivor patients of Head and Neck, Prostate, and Lung carcinoma patients. In this article, we have tried to review the literature on managing chronic persistent pain in all cancer survivors, excluding carcinoma of the breast. In conclusion, we would like to emphasize that for an improved or excellent outcome of chronic persistent pain in cancer survivors, a holistic, multimodal approach encompassing pain relief techniques and pain relief strategies, relaxation exercises, cognitive behavioral therapy, and neuro-rehabilitative strategies would prove to be of immense help. A joint understanding between the pain management expert and the cancer survivors can result in beneficial outcomes.

Fetal pain is one of the most controversial topics in medicine because of the disagreement between people whether the fetus can perceive pain or not and the absence of any direct objective method for the assessment of fetal pain. Although fetus is incapable of declaring pain, various studies have shown that the mere experience of pain without the aptitude of self-contemplation is worth paying attention to, and that the pain in fetus need not be comparable to that of a mature adult to matter. Furthermore, refusing to acknowledge fetal pain in late preterm fetuses would jeopardize the advances in neonatal care because it would question the use of analgesia in neonates of similar gestational age. This systematic review article examines the neuroanatomical and physiological evidence of nociception in the fetus and its implications, which compel the need for its alleviation. It looks into the adequacy of International Association for the Study of Pain definition of pain to define fetal pain. The article also provides a brief overview of the existing literature on whether safe analgesia and anesthesia techniques exist for abortions and therapeutic fetal procedures. We performed a literature search for English-language articles using the electronic database with keywords: controversy in fetal pain, fetal anaesthesia, fetal analgesia, fetal pain, fetus, neuroanatomy of fetal pain, neurophysiology of fetal pain, nociception, and recent advances in understanding of fetal pain