Frequency of Post Obturation Pain after Single versus Multiple Visits Endodontic Therapy by using Hybrid Root Canal Preparation Technique

Background/objective: The hybrid root canal preparation technique is better in a single visit as compared to multiple visit endodontic therapy in reducing the incidence of post endodontic pain. Relationship of post obturation pain and canal preparation has been studied in the past for the better outcomes of the treatment and for the patient’s belief in the treatment. The objective of this study was to compare the frequency of post obturation pain after single versus multiple visits endodontic therapy by using hybrid root canal preparation technique. Materials and methods: This randomized clinical trial (RCT) was carried out in the Department of Operative Dentistry, College of Dentistry, BAMDC, Multan, Pakistan, between 15th December 2017 and 14th June 2018. After approval from the Institutional Ethical Review Committee, a total of 140 patients with acute pulpitis and non-vital asymptomatic maxillary central incisor to first molar teeth were divided into 2 equal groups. In both groups, canal preparation was done by following hybrid canal preparation technique. Group A patients were treated in a single visit and Group B patients were treated in 2 visits. Patient’s pain response was recorded after 24 hours of treatment, using a Visual Analogue Scale. Data were analyzed using SPSS version 20.0. Results: After 24 hours, when post-operative pain was compared in two groups, it was found that in one visit Group A post obturative pain was significantly less as compared to the 2 visit Group B. In one visit Group A, 18 (25.7%) patients reported pain as compared to the two visits Group B where 38 (54.3%) patients complained of pain. When both the groups were compared by Chi-square test p-value was found 0.001, which was highly significant. Conclusion: Single visit endodontic therapy is better than multiple visits endodontic, in relation to post obturation pain when hybrid root canal preparation technique was used.

Frequency of post obturation pain by using ibuprofen and ibuprofen/dexamethasone infiltration in single visit root canal treatment cases

Background: Pain after root canal treatment is a challenging problem for the operative dentists over the last few years. The development of pain is dependent on the intensity of tissue damage. Inflammation is characterized by a series of vascular events in response to tissue injury. The release of mediators is responsible for much of the pain. The rationale of this study is to use NSAIDs alone or in combination with dexamethasone to reduce post treatment swelling and pain following endodontic therapy. The objective of the study was to compare the frequency of post obturation pain by using ibuprofen or ibuprofen/ dexamethasone infiltration in single visit endodontic cases.Methods: This study was carried out in the Operative Dentistry, Department (AFID), Rawalpindi, Pakistan from December 2015 to May 2016 after approval from the Institutional Ethical Review Board. After an informed consent, 128 patients fulfilling inclusion criteria were divided in to two equal groups. In Group A, after root canal treatment, an additional single shot local infiltration of 0.5 mg dexamethasone was given in periapical area. Both the patient groups were prescribed ibuprofen 400 mg three times a day. Patient’s pain response was recorded after 24 hours of treatment, using visual analogue scale. Data was analyzed using SPSS version 17.Results: After 24 hours, 6 (9.4%) patients showed the pain in group A while 16 (25.0%) patients complained of pain in group B.Conclusions: The results of this study showed, group A showed less postoperative pain as compared to group B where only ibuprofen was given.

Rota virus diarrhea in hospitalized children

To determine the frequency and clinical features of Rota virus diarrhea in children presenting in a tertiary care hospital. A cross-sectional, observational study. National Institute of Child Health, Karachi, from January to June 2007. A total of three hundred children of either gender aged 1 month to 5 years, who presented with diarrhea of < 7 days as a primary illness were enrolled. Children with bloody diarrhea or nosocomial gastroenteritis acquired during hospitalization for other disease were not included. Detection of Rota virus in stool was done by enzyme linked immunoassay. Out of 300 children, 188 [63%] tested positive and 112 [37%] tested negative for Rota virus. Positive Rota virus cases in 7 - 12 months of age was [n = 34, 18.08%]. Overall, 151 [80.3%] children with Rota virus were less than 3 years old. 182 [60.7%] had fever, 118 [39.3%] had vomiting and 156 [82.9%] children had both fever and vomiting. This study shows that Rota virus is a common organism causing diarrhea in children less than 3 years of age. There is a need to incorporate Rota virus vaccine in the national EPI program to decrease the disease burden as highlighted in this study

Left paraduodenal hernia: a rare cause of large bowel obstruction and gangrene

Internal hernias are a rare cause of intestinal obstruction. Paraduodenal hernias are the most common type of internal hernias. Although small bowel obstruction is associated with internal hernias, large bowel obstruction is unique. The authors here report a case of left para duodenal hernia with simultaneous small and large bowel obstruction and gangrene. The patient underwent emergency laparotomy and generous resection of gangrenous small and large bowel was carried out and stoma was created. Postoperatively, the patient had a smooth recovery and was discharged after a few days. Reversal of stoma was carried out after 2 months

Local dexamethasone infiltration after dental implant placement - a comparative study

Objective of this study was to evaluate the efficacy of the co-administered dexamethasone and diclofinac potassium in controlling pain and swelling after dental implant surgery. The study was done in the PN Dental Centre [PNDC], PNS Shifa hospital Karachi from Aug 2009 to Dec 2010. It was a cross sectional comparative study. One hundred patients were selected in this study and divided into two equal groups, A and B of 50 patients each. In group A only Diclofinac potassium was given and in group B patients intraoral infusion of Dexamethasone was given along with Diclofinac potassium. In Group B patients reported good control over pain and swelling in first 24hours as compared to the group A

Pilonidal sinus: following the Aristotelian middle!

Pilonidal sinus of the sacrococcygeal region is a fairly common malady. Many surgical and non-surgical methods have thus far been described with variable success rates. No standard operation is in practice, owing to discouraging rates of recurrence. A simple excision and primary repair is described with fairly good results. Thirty two patients with this condition were operated upon by the author between January 2003 and December 2007. A simple excision and primary repair were undertaken in all. Their retrospective data were tabulated from the respective files and analysed. Mean follow-up period was 11.7 months [range, 6-24 months]. Only two patients had partial dehiscence of the suture line that responded to conservative management. There was no full-fledged recurrence in the duration of follow-up. Simple excision and primary closure is a straightforward procedure with good results. A meticulous technique, including follow-up advice [hygiene, depilation etc.] can have a beneficial effect on post-operative outcomes