Effects of high-frequency bio-oxidative ozone therapy in temporomandibular disorder-related pain

It was the aim of this study to compare the efficacy of ozone therapy and drug treatment in patients with painful temporomandibular joint [TMJ] disorder [TMD]. A total of 63 patients with TMD were enrolled; 33 were treated with bio-oxidative therapy and 30 with a ketoprofen tablet thiocolchicoside capsule 2 x 1 for 7 days. Maximum voluntary interincisal mouth opening [MMO] was measured in millimeters using a scale and recorded during the pre- and posttreatment periods. The patients evaluated their subjective pain using a visual analogue scale[VAS]. Data were analyzed using the Mann-Whitney U test, the Kol-mogorov-Smirnov test, and the independent t test. The mean MMO of the group that received ozone therapy during the pretreatment period was 46.51 +/- 8.2 mm, and it immediately increased to 48.78 +/- 7.5 mm after 1 week of ozone therapy, which was statistically significant [p = 0.04]. For those who received medication, the mean MMO during the pretreatment period was 46.30 mm, and at the end of 1 week it was 46.9 mm. In the ozone group, 29% of patients showed a gradual decrease in their VAS pain scores compared to pretreatment values [6.3 +/- 2.1 to 3.0 +/- 2.2]. In the medication group, 24% of patients showed a significant decrease in VAS pain scores during the follow-up period [6.9 +/- 1.4 to 5.0 +/- 1.5]. This study showed that bio-oxidative therapy was a more effective treatment than medication therapy for relieving TMJ pain

Ineffective Doses of Dexmedetomidine Potentiates the Antinociception Induced by Morphine and Fentanyl in Acute Pain Model

The aim of this study was to evaluate the synergistic potentiation effect of ineffective doses of dexmedetomidine on antinociception induced by morphine and fentanyl in acute pain model in rats. Seventy albino Wistar rats were separated into 7 groups. Data for the control and sham groups were recorded. The ineffective dose of dexmedetomidine was investigated and found to be 3 micro g/kg. Each group was administered the following medications: 3 mg/kg morphine (intraperitoneal) to Group 3, 5 microg/kg fentanyl (intraperitoneal) to Group 4, dexmedetomidine 3 micro g/kg (subcutaneously) to Group 5, dexmedetomidine 3 microg/kg (subcutaneous)+3 mg/kg morphine (intraperitoneal) to Group 6 and finally 3 microg/kg dexmedetomidine (subcutaneous)+5 microg/kg fentanyl (intraperitoneal) to Group 7. Just before the application and 15, 30, 60, 90 and 120 min after the administration of medication, two measurements of tail flick (TF) and hot plate (HP) tests were performed. The averages of the measurements were recorded. TF and HP latencies were the main outcomes. The analgesic effect of the combinations with dexmedetomidine+morphine (Group 6) and dexmedetomidine+fentanyl (Group 7), compared to the analgesic effect of morphine alone and fentanyl alone was significantly higher at 15, 30, 60 and 90 minutes after administration. In this study, dexmedetomidine in ineffective doses, when combined with morphine and fentanyl, potentiates the effects of both morphine and fentanyl.

Epidemiology and risk factors of intensive care unit-acquired infections: a prospective multicentre cohort study in a middle-income country

<p><b>INTRODUCTION</b>This study aimed to determine the incidence and risk factors of infections among patients admitted to intensive care units (ICUs) in tertiary care hospitals in Turkey.</p><p><b>METHODS</b>Adult patients who were admitted to the ICUs of five tertiary care hospitals for over 48 hours between June and December 2007 were monitored daily. Potential risk factors such as age, gender, comorbidities, diagnosis at admission, severity of disease (Acute Physiology and Chronic Health Evaluation II scores), exposure to antibiotics, history of invasive procedures and significant medical interventions were evaluated. A multivariate analysis of these risk factors was carried out using Cox regression.</p><p><b>RESULTS</b>A total of 313 patients with a median ICU stay of 12 days were selected for the study. 236 infectious episodes (33.8/1,000 ICU-days) were diagnosed among 134 patients (42.8/100 patients) in this group. Multivariate analysis revealed that exposure to a cephalosporin antibiotic (hazard ratio [95% confidence interval] 1.55 [1.10-2.19]) was an independent risk factor, whereas having a tracheostomy cannula (0.53 [0.36-0.81]) or nasogastric tube (0.48 [0.33-0.70]) was protective. Patients admitted to the ICUs from surgical wards were significantly more exposed to cephalosporins.</p><p><b>CONCLUSION</b>ICU-associated infections, which are quite high in Turkey, are largely due to inadequate infrastructure and facilities and understaffing. Abuse of antibiotics, particularly in patients who have undergone surgery, and prolonged ICU stays are significant risk factors for such infections.</p>

Persistent status epilepticus due to bupropion intoxication

Bupropion is a generally well-tolerated drug and has adverse effects such as headache, dizziness, dry mouth, nausea, constipation, tremor, drowsiness, agitation, insomnia, hallucinations, allergic reactions and seizures. Although seizures have been reported with therapeutic doses of bupropion, there are few reports presenting development of status epilepticus due to bupropion intoxication with different doses. This rare case of persistent status epilepticus due to intoxication with 9 gm bupropion describes a surviving patient after one of the highest ingested dose cited in literature. We indicate that early management is crucial for patients with intoxication with massive doses of bupropion

Perioperative anaphylactic shock in a patient with unruptured hepatic hydatid cyst: a case report

Hydatid cyst disease is an infection most frequently caused by the larval form of a parasite named Echinococcus granulosus. Spillage of hydatid fluid during open surgery has been shown to result in serious anaphylactic reaction. We report a case of 46 years old male with hydatid cyst of liver, who had a sudden onset of intra-operative hypotension, tachycardia, flushing, edema and bronchospasm. He was managed with adrenaline, antihistaminics, steroids, supplementary fluids and vasopressors, and after successful resuscitation, was shifted to ICU for further management. Four days later, he was weaned off from vasopressors and ventilatory support and shifted to the surgical ward. Early diagnosis and intervention are crucial for successful management of the anaphylactic reactions

The Effects of Intravenous Ephedrine During Spinal Anesthesia for Cesarean Delivery: A Randomized Controlled Trial

We designed a randomized, double-blinded study to determine the efficacy and safety of 0.5 mg/kg intravenous ephedrine for the prevention of hypotension during spinal anesthesia for cesarean delivery. Patients were randomly allocated into two groups: ephedrine group (n=21) and control group (n=21). Intravenous preload of 15 mL/kg lactated Ringer's solution was given. Shortly after the spinal injection, ephedrine 0.5 mg/kg or saline was injected intravenous for 60 sec. The mean of highest and lowest heart rate in the ephedrine group was higher than those of control group (P<0.05). There were significant lower incidences of hypotension and nausea and vomiting in the ephedrine group compared with the control group (8 [38.1%] vs. 18 [85.7%]); (4 [19%] vs. 12 [57.1%], respectively) (P<0.05). The first rescue ephedrine time in the ephedrine group was significantly longer (14.9+/-7.1 min vs. 7.9+/-5.4 min) than that of the control group (P<0.05). Neonatal outcome were similar between the study groups. These findings suggest, the prophylactic bolus dose of 0.5 mg/kg intravenous ephedrine given at the time of intrathecal block after a crystalloid fluid preload, plus rescue boluses reduce the incidence of hypotension.