ABSTRACT
Background and Purpose: As postoperative pain is inappropriately controlled in children, and because narcotics are not used in children because of respiratory complications, an appropriate analgesic with fewer side effects is essential. The aim of this study has been to investigate the effect of rectal diclofenac and acetaminophen or their combination on postoperative pain in children undergoing cleft palate repair
Methods and Materials: This double blind randomized clinical trial was conducted on 87 children undergoing cleft palate repair surgery. After obtaining informed consent, they were randomly assigned into one of the three groups: rectal diclofenac [Group D] and acetaminophen [Group A] or their combination [Group A+D]. Postoperative pain was measured and recorded 1, 2, 6, 12, 24, 36 and 48 hours after surgery using CHOPES scale. For data analysis, Smearnoff-Kolmogroff, chi-square, Fischer's exact test, ANOVA, and Kruskal-Wallis tests were used in SPSS
Results: According to the findings, patients in Group D showed lower pain score [6.38 +/- 0.89] as compared with Group A [6.83 +/- 1.32] and Group A+D [6.5 +/- 1.12]; also, Group D had less opioid requirements [3 cases in Group D, 26 in Group A and 24 cases in Group A+D]. Patients in Group D were significantly different from those in the other two groups as for the time of first required dose of opioid in the postoperative period; mean for Group D was 2:55 hours after surgery [SD=2:44], group A 00:88 hours [SD=00:48] and Group A+D 00:85 hours [SD=1:12]
Conclusion: The present research suggests that rectal diclofenac [as compared with acetaminophen or a combination of both] is a more effective medication for postoperative pain alleviation in children undergoing cleft palate repair surgery
ABSTRACT
Introduction: diabetes mellitus is one of the most common metabolic diseases in which elevated blood glucose level interferes with activity of Polymorphonuclear [PMN] cells. Prevalence and severity of periodontal diseases in diabetic patients are also reported to be higher than nondiabetics. Considering different opinions regarding the interrelationships of PMN cell dysfunction and destruction of periodontal tissues in diabetics, this study was performed
Materials and Methods: this study was a case-control one. 53 cases [22 with IDDM, 21 with NIDDM and 10 non diabetics] were selected for this study. Diabetic patients [equal males and females] were referred from Mashhad Diabetic Center. The examined parameters were PMN cell function [using NBT test], fasting blood sugar, plaque index, pocket depth, bleeding index and bone loss [using panoramic x- ray]. The data were analyzed using One - Way ANOVA, multivariable analysis, Tukey test and correlation coefficient
Results: the fasting blood sugar level of both diabetic groups were significantly higher than that of nondiabetic groups [P<0.001]. The plaque index was significantly higher in NIDDM group compared with control group [P=0.002]. Bone loss was more severe in NIDDM group than IDDM and control groups. The difference was statistically significant. PMN cell function in IDDM group was significantly lower than NIDDM and control groups [P=0.011]
Conclusion: observing the result, it is tempting to claim that with aging and in the presence of suitable condition for the plaque bacteria, the periodontal disease in the diabetic patients become more server. Prevention of the periodontal diseases will be possible provided that the blood sugar level and the bacterial plaque are controlled