[Fracture resistance of two different designs in fiber-reinforced composite restorations in mandibular anterior bridges: an in-vitro study]

The purpose of this study was to assess the fracture resistance of two different designs of tooth preparation and fiber placement in fiber-reinforced composite restorations replacing a missing mandibular lateral incisor. Forty newly extracted human mandibular intact teeth [20 centrals and 20 canines] were selected for fabrication of twenty FRC inlay bridges. A box preparation design with straight fibers, and a slot design preparation with curved fibers were implemented. After preparation, the teeth were mounted in self-cured acrylic resin with 6.5 mm distance from each other. PDL was simulated with polyether material. After taking impressions with polyether material, the impressions were poured with dental stone. The two groups of bridges were fabricated and bounded to teeth with panavia F[2]. The cyclic load of 1.2 x 10[6] x 20N x 1.66HZ was applied with 130° angle. The samples were stored in 37°C water for seven days and then thermo cycled [2000 cyles, 5-55°C]. The fracture strength was tested by a universal testing machine [Instron 1195] at a speed of 1 mm/min. The mode of fracture was observed under stereomicroscope. The data was analyzed by using independent sample T-test. The mean fracture resistance for the box design and direct fiber group was 1411.07 N and in the slot and curved fibers group was 377.33 N. The group difference was statistically significant [P=0.012]. It could be concluded that in fiber-reinforced composite restorations, box design with straight fiber has more fracture resistance than slot design with curved fiber

Prophylactic antiemetic effects of midazolam, dexamethasone, and its combination after middle ear surgery

To evaluate and compare the efficacy of the combination of midazolam and dexamethasone, with midazolam and dexamethasone alone, for the prevention of postoperative nausea and vomiting [PONV] in female patients undergoing middle ear surgery. A prospective, randomized, double-blind, placebo-controlled study in 80 female patients [mean age 32.6 years], undergoing middle ear surgery with general anesthesia at Ohud Hospital, Madina, Kingdom of Saudi Arabia from May 2007 to May 2008. Patients were classified into 4 groups. They received intravenous normal saline [S group], midazolam 0.075 mg/kg [M group], or dexamethasone 10 mg [D group], or a combination of midazolam and dexamethasone [MD group], before the induction of anesthesia. Postoperatively for 24 hours observation and assessment of nausea, vomiting, rescue anti-emetics, and side effects of the study drugs such as headache and drowsiness were carried out. There was a significant difference between the 4 groups. The MD group was the least to develop PONV compared to other groups [p<0.01]. Regarding nausea, there was a non-significant difference between the 4 groups, although the MD group developed the least symptoms among the 4 groups, there were no significant differences in pain intensity and side effects such as, headache, dizziness, and drowsiness between the 4 groups. The combination of midazolam 0.075 mg/kg and dexamethasone 10 mg intravenously is better than either drug alone in reducing the incidence of PONV in female patients after middle ear surgery

Topical immunosuprressives in ocular surface disorders

To evaluate the effect of topical immunosuppressives in ocular surface disorders. Cyclosporine A 0.05% eye drops was added to the regimen of the treatment of 30 eyes with different ocular surface disorders. Follow-up period was 6 months. Marked improvement in eyes with dry eye and resistant corneal ulcers at the end of the follow-up period. Topical immunosuppressives [cyclosporine A eye drops, 0.05%] has a curative effect on most of the ocular surface disorders

Spectrophotometric determination of mianserin and risperidone

Simple and sensitive spectrophotometric methods were described for the determination of two drugs; namely, mianserin and risperidone, with n-donating groups. The methods were based mainly on charge transfer complexation reactions, with two acceptors 2,3-dichloro-5,6-dicyano benzoquinone [DDQ] and p-chloranilic acid [p-CA], and ion pair complexation reactions with some acidic dyes, namely, bromophenol blue [BPB], bromothymol blue [BTP] and bromocresol green [BCG]. In the first procedure the drugs were treated with DDQ or p-CA in acetonitrile, the colored products were quantified spectrophotometrically at 587 nm and 520 nm for mianserin and 457 nm and 520 nm for risperidone using DDQ and p-chloranilic acid, respectively. In the second procedure drugs were treated with acidic dyes in chloroform, the complexes formed are measured at 411 nm, 411 nm and 414 nm in case of mianserin and 415 nm, 415 nm and 419 nm for risperidone with BPB, BTB and BCG, respectively. The effect of several variables affecting color development was studied and the molar ratio of reactants was established in each case. Linearity ranges were found to be 12-55 mug ml-1, 40-200 mug ml-1, 2-10 mug ml-1, 2.5-12 mug ml-1 and 3-12 mug ml-1 for mianserin and 25-135 mug ml-1, 40-220 mug ml-1, 3.5-15 mug ml-1, 4-18 mug ml-1 and 4-18 mug ml-1 for risperidone using DDQ, p-chloranilic acid, BPB, BTB and BCG, respectively. The proposed methods were applied successfully for the analysis of both drugs in raw material and in pharmaceutical dosage forms with good accuracy and precision. The results were compared statistically with reference methods commonly used for the determination of the drugs

new analgesia protocol for cataract surgery

Our objective was to describe the safety and efficacy of a new analgesia protocol that enables the surgeon to maintain control over an alert patient experiencing seemingly painless ambulatory cataract surgery, while eliminating the risks and side effects associated with general, local, and intracameral anesthesia. This study was carried out on two thousands cataract surgery cases. This technique produces profound ocular analgesia, avoiding any undesired sedative effects, using very low-dose, titrated, intravenous alfentanil. Complete control of the uncooperative patient, including lid squeezing and ocular and genera! body movements, is obtained whenever necessary using very low-dose, titrated, intravenous propofol. Success was defined as surgery completed in a controlled manner without the need to convert to general, local, or intracameral anesthesia and the patent's experience being perceived as pain free. One thousand nine hundred ninety-five [99.75%] of the cases were successful without ever deviating from the protocol. This analgesia protocol offers advantages for cataract surgery. It virtually eliminates the morbidity of cataract surgery associated with other anesthesia techniques while providing excellent and reliable control with minimal side effects. It allows for an immediate postoperative recovery with instantaneous vision restoration. These patients are generally awake, alert, and retain their protective reflexes

Evaluation of the dose - response potency of intrathecally administered clonidine by itself during first stage of labor with respect to analgesia and maternal and fetal side effects

Intrathecal clonidine produces dose-dependent postoperative analgesia and enhances labor analgesia from intrathecal sufentanil. We evaluated the dose-response potency of intrathecally administered clonidine by itself during first stage of labor with respect to analgesia and maternal and fetal side effects. Forty-five parturients requesting labor analgesia were studied. In a combined spinal-epidural technique, patients with <5 cm cervical dilatation were assigned to receive one of the following intrathecal solutions: either 75 micro g clonidine [n = 15]; 150 micro g clonidine [n = 15]; and 250 micro g clonidine [n = 15]. Visual analog scores for pain, blood pressure, heart rate, ephedrine requirements, sensory levels, incidence of nausea, pruritus and sedation, fetal heart rate tracings continuously, and maternal and cord blood concentrations of clonidine were recorded. Duration of analgesia was defined as time from intrathecal clonidine administration until request for additional analgesia. We found that clonidine produced a reduction in VAPS with all three doses. The duration of analgesia was significantly longer in patients receiving 250 micro g [median, 150; range, 85-220 min] and 150 micro g [median, 120; range; 65-190 min] than 75 micro g [median 50; range, 30 - 160 min], and VAPS was lower in the 250 micro g than in the 75 micro g group. As regards the sensory levels, no patient in any group had sensory changes above T[3]. In the 250 micro g group, hypotension required significantly more often treatment with ephedrine than in the other groups. Also, bradycardia and sedation were more in 250 micro g group than the other two groups. No adverse events or fetal heart rate abnormalities occurred. Clonidine levels were undetectable in maternal and cord serums. In conclusion, the current study showed that 75 micro g to 250 micro g intrathecal clonidine produces dose-dependent analgesia during first stage of labor. Although duration and quality of analgesia were more pronounced with 150 and 250 micro g than with 75 micro g, the high incidence of hypotension, bradycardia and sedation requires caution with the use of 250 micro g for labor analgesia

Safety and efficacy of intracameral injections of preservative - free lidocaine as an adjuvent to topical anesthesia to reduce intraocular sensation versus peribulbar anesthesia

This study was done to evaluate the efficacy and safety of intracameral lidocaine in cataract surgery compared to peribulbar anesthesia. This study was carried out on rabbits [n = 20] and patients [n = 160]. Our primary concern was the potential for corneal toxicity from the intracameral lidocaine. The preliminary study with rabbits showed no significant difference in corneal endothelial toxicity between the 20 rabbit eyes injected with 1% preservative-free lidocaine and the 20 eyes injected with BSS [p = 0.42]. As regards the human studies, a total of 160 cataract patients [160 eyes] participated. Eyes were classified to two groups: one group [n = 80] received 0.2 ml intracameral 1% unpreserved lidocaine combined with topical anesthesia [bupivacaine]; the other group [n = 80] received a peribulbar block with a sharp 26-gauge needle using a solution of lidocaine 2% [3 ml], bupivacaine 0.5% [2 ml], and hyaluronidase [wydase] 150 U before phacoemulsification with sclerocorneal tunnel incision .Duration of surgery was measured; implicit time and amplitudes of the b-waves of the photopic electroretinogram [ERG] potentials [single-flash ERG and the 30-Hz flicker ERG] were recorded; frequencies of intraoperative problems, complications, intraoperative, and postoperative pain were evaluated. Surgeon assessments of operative conditions and patient cooperation were recorded. The attending anesthesiologist recorded any increase in pulse or increase in blood pressure. After lidocaine anesthesia combined with topical anesthesia, similar complications were found, longer operation time [p < 0.001], and significantly better visual acuity immediately after surgery [p < 0.001]. The ERG amplitudes were not significantly reduced after 0.2 ml intracameral lidocaine half an hour after surgery [p > 0.05]. The surgeon assessment showed more patient cooperation in the peribulbar group [p = 0.012]. No patient in either group was rated as poorly cooperative. Intracameral lidocaine 1% combined with topical anesthesia can be recommended as an alternative procedure to peribulbar anesthesia in cataract surgery especially in the following situations: in patients with high myopia, fear of syringes, or prolonged coagulation

Hepatorenal integrity following a long anesthetic exposure: a comparative study between low - flow and high - flow sevoflurane anesthesia

This study assessed the effects of low-flow sevoflurane anesthesia on renal function using BUN, serum creatinine, creatinine clearance and urinary excretion of kidney-specific enzymes, and it compared these values with those obtained in high-flow sevoflurane anesthesia. We also studied the effects of low-flow sevoflurane anesthesia and high flow on the hepatic functions. Forty male patients undergoing oculoplasty or rhinoplasty were studied. Patients were randomized to receive sevoflurane anesthesia with fresh gas flow of 1 L/min [low-flow sevoflurane group; n= 20] or 6-8 L/min [high-flow sevoflurane group; n= 20]. In both groups the carrier gas was oxygen/nitrous oxide. Soda lime was used is the low-flow sevoflurane anesthesia group, The compound A concentration was measured by gas chromatography. Blood samples were obtained before and on days 1, 2 and 3 after anesthesia to measure hepatic functions, serum electrolytes, BUN and serum creatinine. Twenty-four-hour urine samples were collected before anesthesia and for each 24-h period from 0 to 72 h after anesthesia to measure creatinine, NAG and AAP. The maximum compound A concentration was 24,7 +/- 10.1 ppm [mean +/- 80], and the average duration of exposure to this concentration was 4.55 +/- 1.88 h in the low-flow sevoflurane group, Post-anesthesia BUN and serum creatinine concentrations decreased, creatinine clearance increased, and urinary NAG and AAP excretion increased in both groups compared with preanesthesia values, but there were no significant differences between the two groups for any renal function parameter at any time after anesthesia. Total and direct bilirubin increased in the first day postanesthesia in both groups of sevoflurane anesthesia and no significant changes among the two groups, AST increased in the 2nd and 3rd postanesthesia days than the peranesthesia value but there were no significant changes among both groups of sevoflurane anesthesia. LDH increased in the three postanesthesia days than the preanesthesia values but no significant differences among both groups of sevoflurane anesthesia. We concluded that, the only difference between the low-flow and high flow sevoflurane groups was compound A formation, and postanesthesia laboratory data showed no significant effects of compound A formation during sevoflurane anesthesia on renal and hepatic functions

Exploring beta-2 microglobulin-related amyloidosis in pediatric end stage renal disease patients on regular hemodialysis

This study aimed at exploration of dialysis-related amyloidosis [DRA] as a medical problem in end stage renal disease patients [ESRD] on regular hemodialysis [HD], as well as estimation of s. beta-2 microglobulin [B2M] changes in those patients. It comprised 55 patients with ESRD on regular HD therapy, 36 males and 19 females, with a mean age of 11.45 +/- 3.22 years. They were compared to 20 healthy subjects. The patients were subjected to clinical evaluation, biochemical investigations included serum B2M, serum creatinine, creatinine clearance and blood urea nitrogen. S. B2M estimation was repeated after changing the dialyzer membrane from unsubstituted cellulose to synthetic polysulfone in 10 patients. Radiographic examination for cervical and lumbar vertebrae and big joints, M-mode and 2-dimensional echocardiography were done. Pathologic examination for DRA was performed in subcutaneous fat biopsy from 25out of the 55 studied patients. There was a significant higher concentration of s. B 2M in patients 10280 +/- 647 ng/ml compared to the control group 1570 +/- 710 ng/ml p<0.001. A significantly better clearance was achieved by using the synthetic polysulfone membrane dialyzer [14181 +/- 378 dropped to 3 590 +/- 590 ng/ml] p<0.001. Radiographic and echocardiographic findings correlated positively with s. B2M. Four of the biopsied patients [16%] had positive amyloid deposits. Their median duration of dialysis was 33 months and all of them had clinical manifestations of carpal tunnel syndrome [CTS] and bilobed interatrial septal thickening in the echocardiography. To conclude, the ESRD patients receiving regular HD are vulnerable to DRA. S. B 2M as a potential precursor for DRA is significantly elevated in those patients. Better clearance of B 2M can be achieved by using synthetic polysulfone dialyzers

Intraperitoneal lidocaine for pain ralief during and after tubal sterilization

We conducted a randomized, blinded, placebo-controlled study to evaluate the effectiveness of intraperitoneal lidocaine, IM meperidine, or both drugs together for pain relief [intraoperative and postoperative] in postpartum tubal ligation. Sixty postpartum patients scheduled to have tubal ligation were randomly divided into four groups to receive IM isotonic sodium chloride solution [2 mL] and intraperitoneal instillation of 40 mL of isotonic sodium chloride solution [Group I]; IM meperidine [100 mg in 2 mL] and intraperitoneal instillation of 40 mL of isotonic sodium chloride solution [Group II]; IM injection of isotonic sodium chloride solution and intraperitoneal instillation of 1% lidocaine in 40 mL [Group III] and both imeperidine and intraperitoneal lidocaine instillation [Group IV]. The rninilaparotomy was performed after local infiltration with 20 ml of lidocaine. A numerical rating score was used to rate pain on a 0 - 10 scale during and after the surgical procedures. During the surgical procedures, the mean pain scores were 1.8 in group III and 0.7 in group IV. These pain scores were significantly lower than those in groups I and II, which were 6.4 and 6.0, respectively [p < 0.001]. Postoperative mean pain scores at 24 h rest were 2.1 in group III and 0.8 in group IV. These pain scores were significantly lower than those in groups I and II, which were 6.5 and 6.4, respectively [p < 0.001]. Postoperative mean pain scores at 24 h movement were 2.9 in group III and 1.6 in group IV. These pain scores were significantly lower than those in groups I and II, which were 7.5 and 7.3 respectively [p < 0.001]. The plasma lidocaine concentrations reached a maximum in groups III and IV 30 min after instillation begun. The highest mean plasma lidocaine level was 2.6 ug/ml [range 1.2 - 3.6]. In conclusions pain relief was inadequate in patients undergoing post-partum tubal ligation under local anesthesia, even after the administration of IM meperidine. Intraperitoneal lidocaine, however, effectively, decreased intraoperative and postoperative pain in these patients

Soluble interleukin-2 receptor as a predictor of neonatal sepsis

This study aimed at evaluation of soluble interleukin-2 receptor [sIL-2R] as a method of early detection of neonatal sepsis. The study comprised 33 neonates with suspected sepsis, their gestational age ranged from 32 to 42 weeks with a mean value of 37.3 +/- 2.6 weeks. They were compared with 15 healthy neonates. All the patients were subjected to complete history taking, thorough clinical examination, CRP, blood culture, serum sIL-2R assessment by ELISA. SIL-2R was significantly higher in the studied group compared with the control group, indicating T cell activation in the septic group. The elevation of sIL-2R level was also significant in full term septic neonates and those who had no history of premature rupture of membranes [PROM]. There was a strong positive correlation to hematologic score indicating the sensitivity of sIL-2R as a marker for neonatal sepsis. The non-survivors group of the septic neonates had significantly higher levels of sIL-2R suggesting the potential important prognostic value of sIL-2R. In conclusion, sIL-2R can be used as a sensitive marker for early detection of neonatal sepsis with the potentially important prognostic value

Hereditary angioedema [HAE]: study of 30 cases

Hereditary angioedema [HAE] is not a rare condition in Iran. HAE is inherited as an autosomal dominant trait. We studied 30 cases of HAE from 1987 to 1992, twenty females and 10 males, with a mean age of 24.8 years. Clinical presentation was nonpitting edema of the face in all cases. In HAE type I, screening of complement profile revealed a C1 inhibitor deficiency in 60% and C4 deficiency in 66% of cases; but in type II HAE, the complement profile seems to be normal. Complement component study is a good tool for the diagnosis of type I HAE

Salmonellosis in chickens in Upper Egypt

Bacteriological examination of 1250 chickens showed that Salmonella could be isolated from 106 [8.48%]. The most frequent isolations were from the gall bladder followed by liver and intestinal contents. Twelve different serotypes could be identified. Salmonella pullorum-gallinarum was the predominant [50.00%] followed by S. typhimurium [16.98%]. S. enteritidis [10.37%] and S. derby [8.49%], were moderately recovered. S. newport, S. saint-paul [8.49% each], S. manhattan, S. London and S. muenster [1.88% each], were less prevalent, while S. east bourne, S. reading and S. infantis were sporadically isolated. Isolation of Salmonella muenster, S. reading and S. infantis is believed to be first record from chickens in Egypt

use of micro-technique in serogrouping of E coli strains

A micromethod for serogrouping Escherichia coli strains, using microtitre set is described. The optimum agglutination reaction was detected and found to be with the test volume 0.05 ml of each of antigen and antiserum [diluted 1:80] combination. Because of the small amount of antiserum used in this method, it is practical to screen unknown strains directly with individual antisera. The method was found simple, accurate and economic in terms of time, antisera and reagents utilized in the test

Immunological studies of the Egyptian water buffalo [bos bubalis]: preparation of immunoglobulins from buffalo serum

Three classes of buffalo immunoglobulins were chemically precipitated as crude materials. Using column chromatography, they were obtained in pure fractions and were designated as: IgM, IgG I and IgA. The IgG was clearly separated into 2 sub classes: IgGI and IgG2. The purity of the prepared fractions was tested and proved by Ouchterlony and Immunoelectrophoresis techniques against polyvalent and monospecific anti-cow IgM, IgG and IgA antisera

Colisepticaemia in chickens in Upper Egypt

Coliforms were isolated in a pure culture from 138 heart blood samples of 1450 dead chickens investigated, with a recovery rate of 9.52%. All isolates were classified as E.coli by their biochemical reactions and sugar fermentation. Using 55 O and OK sera, 131 strains [94.9%] could be serogrouped into 24 different O groups. 67 strains [48.6%] belong to the following O groups: 086, 02, 0128, 078 and 03 and were the most predominant groups. Strains belonged to O groups 055, 01, 026, 0126, 0114, 0127, 0119 and 0157 were detected in a moderate incidence of 31.2% [43 strains]. Out of the 131 serogrouped strains, 124 [94.7%] were capsulated. The capsular antigens: K1 [L], K71 [B16], K62 [L], K76 [B20] and K80 [B] were the most frequent types and constituted 58.9% of identified capsular antigens. Only 7 strains [5.3%] were bearing no capsular antigen [K-]

Transferable antibiotic resistance [R-factors] in escherichia coli strains isolated from calves with enteritis

The resistant patterns of 98 tetracycline resistant trains of E. coli previously isolated from buffalo-calves with enteritis, were studied. These strains were mated with an Escherichia coli and salmonella typhimurium recipient strains. Fifty nine per cent of them could transfer their tetracycline resistance to the recipient coli strain, while 66% could transfer it to the salmonella recipient strain. The relatively high incidence of transferable tetracycline resistance may be a result of the common practice of its use in controlling and preventing respiratory and diarrhoeal diseases in calves in Egypt. The practical measure to control the spread of this resistance factore is to minimize the use of this drug in veterinary medicine