Comparative Evaluation of Postoperative Pain Scores and Opioid Consumption in Septorhinoplasty After Administration of Single-Dose Preemptive Paracetamol and Ibuprofen: A Randomized Controlled Trial

Abstract Introduction Septorhinoplasty operates on the nose's bone and cartilage and is ensued by severe postoperative pain. Objective The objective of this study is to evaluate the effects of preoperative administration of intravenous (IV) paracetamol and ibuprofen on postoperative pain scores in patients undergoing septorhinoplasty. Methods A total of 150 patients undergoing septorhinoplasty were randomly assigned into 3 groups with 50 patients in each group. The control group (group A) was administered 100 ml saline solution; the paracetamol group (group B) was administered 1,000 mg of IV paracetamol in 100 ml of saline solution; and the ibuprofen group (group C) was administered 800 mg of IV ibuprofen in 100 ml of saline solution before surgery. Opioid analgesics were employed to achieve postoperative analgesia. Postoperative pain was evaluated using the visual analogue scale (VAS). Postoperative opioid consumption and adverse effects were also recorded for each patient. Results In comparison with group A, the score in the VAS of groups B and C was statistically lower in all the time intervals (p < 0.05). In the 1st and 6th hours postoperatively, group C's score in the VAS in was lower than that of group B (p < 0.05). In the control group, total opioid consumption was highest in all time intervals (p < 0.05). In group C, total opioid consumption was significantly lower than in group B in the 0 to 6 and 6 to 12 hours intervals. (p < 0.05). Conclusion The single-dose preemptive administration of ibuprofen has a more profound postoperative analgesic effect than paracetamol in the first 6 hours after septorhinoplasty. After the first 6 hours postsurgery, there is no difference between ibuprofen and paracetamol in terms of analgesic effect.

The oil of garlic, Allium sativum L. (Amaryllidaceae), as a potential protectant against Anisakis spp. Type II (L3) (Nematoda) infection in Wistar rats / O óleo de alho, Allium sativum L. (Amaryllidaceae), como potencial protetor contra Anisakis spp. Infecção tipo II (L3) (Nematoda) em ratos Wistar

Abstract The consumption of inadequately thermally treated fish is a public health risk due to the possible propagation of Anisakis larvae. The present study demonstrated the physiological and histopathological changes that accompanied an oral inoculation of crude extracts from fresh and thermally treated Anisakis Type II (L3) in rats. Worms were isolated from a marine fish and examined and identified using light and scanning electron microscopy. The study was performed in 6 rat groups: control (I), garlic oil (GO) inoculated (II), fresh L3 inoculated (III), thermally treated L3 inoculated (IV), fresh L3 + GO inoculated (V), and a thermally treated L3 + GO inoculated (VI) groups. Rats inoculated with fresh and thermally treated L3 showed abnormal liver and kidney functions associated with the destruction of normal architecture. GO produced a protective effect in rat groups inoculated with L3 extracts + GO via the amelioration of liver and kidney functions, which was confirmed by the marked normal structure on histology. Cooking of L3-infected fish induced severe alterations compared to uncooked fish. The administration of garlic before and after fish eating is recommended to avoid the dangerous effect of anisakids, even if they are cooked.

Resumo O consumo de peixe inadequadamente tratado termicamente representa um risco para a saúde pública, com a possibilidade da propagação de larvas de Anisakis. O presente estudo demonstrou as alterações fisiológicas e histopatológicas acompanhadas de inoculação oral de extractos brutos de Anisakis tipo II (L3) frescos e termicamente tratados em ratos. Os vermes foram isolados de um peixe marinho, examinados e identificados por microscopia de luz e eletrônica de varredura. O estudo foi conduzido em 6 grupos de ratos: controle (I), óleo de alho (GO) inoculado (II), L3 fresco inoculado (III), L3 tratado termicamente inoculado (IV), L3 fresco + GO inoculado (V), e um grupo L3 + GO tratado termicamente inoculado (VI). Observou-se que ratos inoculados com L3 fresco e tratados termicamente mostraram funções hepáticas e renais anormais, associadas à destruição da sua arquitetura normal. GO produziu um efeito protector em grupos de ratos inoculados com extractos L3 + GO através da melhoria das funções do fígado e dos rins, o que foi confirmado pela estrutura normal marcada da sua histologia. A cozedura de peixes infectados com L3 induziu alterações mais graves do que os peixes não cozidos. Recomenda-se a administração de alho antes e depois do consumo de peixe, para evitar o efeito perigoso dos anisakids, mesmo que sejam cozidos.

Magnetic Resonance Cholangio-Pancreatography in Patients with Acute Cholecystitis and Cholestatic Liver Pattern - What to Expect?.

Acute cholecystitis is a potentially serious condition and usually needs to be treated in the hospital. Identification of a common bile duct (CBD) stone before cholecystectomy is of concern for the treating physicians as management may change. Magnetic Resonance Cholangiopancreatography (MRCP) can help in identifying causes of biliary obstruction (if present) and adequately delineate biliary tree in selected patients with limited or abnormal ultrasounds and cholestatic liver pattern. Therefore, we aim to demonstrate imaging findings of MRCP in such patients of acute cholecystitis, and highlight the diagnostic ability of MRCP in biliary ductal evaluation as well. METHODSThis secondary data analysis from hospital records was performed in Radiology department at our Hospital in Dhahran from August 2017 to 2019. All clinically suspected and ultrasound supported cases of acute cholecystitis who were referred for MRCP studies were included. Dilated CBDs (more than 4 mm in caliber) with partial visualization or non-discernible causes of CBD dilatations, rising or persistently raised LFTs (denoting cholestatic pattern) were the common indications for the MRCP referrals. Patients with chronic cholecystitis, previous hepatobiliary surgery, pregnant patients, and those contraindicated to MRI were excluded. RESULTSOf the 104 patients, majority (60%) were females. The mean age was 43 years. Two-thirds of patients were having normal CBDs (68.3%), while nearly one-third (31.7%) had dilated CBDs, and half of these (16.4%) showed identifiable causes of obstruction that were later confirmed on ERCP and histopathology. Thirteen patients (12.5%) had associated anomalies. Sensitivity and specificity of MRCP in CBD evaluation were measured as 90.5% (CI, 79.3-96.8) and 86.2% (CI, 73.7-94.3) respectively. The length of the hospital stay was found to be significantly less in laparoscopic cases compared to open cholecystectomies (P= 0.0005). CONCLUSIONSMagnetic resonance cholangiopancreatography can help in identifying the causes and anomalies in patients with acute cholecystitis having deranged or obstructive liver function.

Oral Habits: Prevalence and Effects on Occlusion Among 7 to 13 Years Old School Children in Aseer, Saudi Arabia

Abstract Objective: To evaluate the prevalence of deleterious oral habits and its effect on occlusion in school going children from 7 to 13 years old, in Aseer region of Saudi Arabia. Material and Methods: A cross-sectional study was conducted by clinical examination for the total sample of 750, who were attending private/ government schools in Aseer region school. Students were selected by stratified cluster random sampling. Clinical findings of each oral habits, including assessment of malocclusion, were examined involving the following parameters, i.e., crowding, spacing, open bite, crossbite and deep bite. Logistic regression analysis was conducted. Results: Boys had 26.2 % of crowded teeth, while 16.3% of girls were found to have crowded teeth; the difference was found to be significant (p=0.002). Spacing was present in 26.4% of boys and 16.7% girls; a significant difference was found between the two (p=0.002). Sleep bruxism was observed more among male subjects than females with a statistically significant difference in detrimental habits (p<0.001). Those subjects having tongue thrusting are 1.264 times at more risk of having crowded teeth than those with no tongue thrusting. Conclusion: There was a high prevalence of malocclusion associated with harmful oral habits in children. This highlighted the need to implement programs of oral care and health education for preventive orthodontic treatment at an early age.