ABSTRACT
Agents of choice may be introduced in to the mouth via dental restorations, but this concept is only in embryonic stages and needs to be explored, modified, controlled and gauged to make it useful. This study aims at indicating the common therapeutic agents that are being delivered via dental restorations, modern restorative materials successfully delivering agents, and methods of agent incorporation; elaborating the potential for future use of such systems. Relevant publications from the last fifty years were included by searching 'dental restorations', and 'drug delivery systems' via [Mesh terminology]. Specific exclusion and inclusion criteria were set. It was found that the arena of drug delivery via dental restorations seems to be restricted to fluoride, the most commonly delivered agent via restorations. Glass ionomer cements including resin modified GICs; composites including compomers, and nanocomposites; and to some extent amalgam are the materials being researched upon. Although most research surrounds systems that rely upon recharge, modern microcapsules have been designed that can be used to incorporate the agent into the restoration. There is a dearth of work been done on the factors affecting the delivery of agents. So far, the dicalcium phosphate anhydrous [DCPA] incorporated nanocomposite is the most promising fluoride-delivering restorative material with a competent blend of fluoride releasing and mechanical properties. DCPA-incorporated nanocomposite and ion impregnable microcapsules are new horizons for drug delivery using dental restorations
ABSTRACT
Objective: The objective of this study is to determine the per-operative factors responsible for difficulty in performing laparoscopic cholecystectomy and lead to conversion
Study Design: Prospective analysis study
Place and Duration of study: This study was carried out in General Surgery Department of Dow University Hospital Ojha Campus and Civil Hospital Karachi, from Jan 2011 to July 2012
Methodology: This study consisted of one hundred and forty six patients with gallstone disease. All patients had full clinical examination and right hypochondrium was especially examined for assessment of murphy's sign, palpable mass and visceromegaly. Base line and specific investigations were done in all patients especially ultrasound of abdomen as diagnostic modality and for assessment of gallstone disease. Inclusion criteria was that all patients diagnosed as case of gallstone disease. LC procedure was not attempted in patients with history of abdominal surgery, pregnant ladies due to risk of foetal loss, carcinoma of gall bladder acute pancreatitis, obstructive jaundice and unfit patients for general anesthesia
Results: Out of 146 patients included in this study 133 were female [91%] and 13 male [9%]; with female to male ratio of 10.2:1. The mean age was 39.21+6.20 years. Per Operative findings were adhesions in calot's triangle 24[16.43%] cases, severe and tight adhesions around gallbladder and calot's triangle 21[14.38%] cases, obscured anatomy in calot's triangle 17[11.64%] cases, intrahepatic gallbladder 11[7.53%] cases, adhesions around gallbladder 26[17.80%] cases, empyema 13[8.90%] cases, mucocele 9[6.16%] and anatomical variation 14[9.58%] cases. We observed out of 21 patients who had Severe and tight adhesions around gallbladder and calot's triangle, lead to difficulty in performing laparoscopic cholecystectomy in 11[52.38%] cases followed by 17 cases of obscured anatomy in calot's triangle and 14 cases anatomical variation also lead to performing difficult laparoscopic cholecystectomy in 6[35.29%] and 5[35.71%] cases respectively. Four [2.73%] cases out of 146 had to be converted to the open cholecystectomy procedure
Conclusions: We conclude our study revealed that various peroperative factors which make the difficult laparoscopic procedure and lead to open cholecystectomy are severe adhesions in calot's triangle, severe and tight adhesions around gallbladder and obscured anatomy in calot's triangle
ABSTRACT
Background: The radicular cyst is very common odontogenic cyst of the jaws, which is usually associated with a tooth with necrotic pulp. The cyst formation requires proliferation of the epithelial rest cells of Malassez present in the periodontal ligament.. Proliferation of epithelial rest cells of Malassez is an essential event in the Pathogenesis of radicular cyst. The wall of the cyst contains epithelial cells, macrophages, fibroblasts and other cells. TNF is one of inflammatory mediators, which is produced by macrophages and monocytes. This study was carried out to investigate the role of tumour necrosis factor in the pathogenesis of radicular cyst, which is by far the commonest cystic lesion of the jaws. Methods: Explants from 20 radicular cysts were cultured in vitro to grow the epithelial cells. However, the cultures were rapidly contaminated with fibroblasts and it was impossible to grow the epithelial cells separately. Therefore, the proliferative effect of Tumour Necrosis Factor [TNF] was studied on mammalian epithelial cells. Results: TNF at low concentration had a proliferative effect on the epithelial cells, which may play some role in pathogenesis of radicular cyst. Conclusion: TNF stimulated the epithelial cell proliferation in low concentration and inhibit the proliferation in higher concentrations. These two effects may have some implications in the pathogenesis of radicular cyst