Mucoadhesive buccal patches of lornoxicam: II- in-vivo evaluation and clinical efficacy

Lornoxicam is a NSAID of the oxicam class and it has the same side effects of this group when taken orally. In attempts to avoid the systemic side effects of lornoxicam [e.g. gastric irritation] and to achieve sustained release of the drug, several buccal patch formulations containing lornoxicam were prepared using different polymers and were evaluated for in-vitro characteristics in part I of this study. In the current study, the selected formulations [based on the previous in-vitro data] are evaluated for in-vivo performance using experimental animals and clinical efficacy on human volunteers. Pharmacokinetic parameters were assessed following application of the selected patches in rabbits. A comparative clinical study was conducted on patients with post-operative pain and edema following maxillofacial operations. The results of the in-vivo animal experiment showed that lornoxicam formulated in different buccal patches was successfully delivered to the systemic circulation and showed high absolute bioavailability of lornoxicam. The clinical study results revealed that sodium carboxy methyl cellulose [NaCMC, 3%] formulation applied to the buccal mucosa was slightly better or equally effective to the orally administered commercial oxicam product [Feldene Flash tablets] in reducing pain level, swelling and tenderness within a period of 4 days with no observed side effects. These findings suggest that lornoxicam administered in this buccal patch may present a potential therapeutic use as a strong anti-inflammatory and analgesic agent

Evaluation of mandibular elongation by distraction osteogenesis

This study aimed to investigate the elongation of the short mandible by the distraction osteogenesis technique. The results of this study showed a significant increase in the mandibular length after distraction with an improvement of the facial appearance of the patients. In all cases, there was no injury of the inferior alveolar nerve but lower lip hypothesia occurred with distraction and disappeared after its stoppage. Also, the families of the patients noted a marked improvement of snoring and it was completely disappeared after the stoppage of distraction. The side effects of distraction osteogenesis of the mandible were very minimal in the form of the occurrence of partial relapse in two cases and infection around the pin track occurred in one case only and controlled by local antibiotic

Arc to line repair of hare lip geometrical explanation and clinical evaluation

This work was carried out in Assiut University Hospital, Surgery Department, Unit B[2] in the period between August 1996 to October 1997. The study involved 25 patients with males representing 72% and females representing 28% of the total. The age of the patients ranged from 3 month to 8 years where 2-4 years age group has the highest incidence being 28% of the total. Is to evaluate clinically and explain geometrically arc to line repair of the cleft lip. Arc to line repair of the cleft lip. Height of the repaired lip matched the normal side in 88% of the total. [This percentage includes all cases with incomplete cleft lip and most cases of complete cleft lip]. Regular philtrum was obtained in 84% of cases where distorted philtrum occurred in 16% of cases and these were affected by complete cleft lip deformity. Cupid's bow became smooth in 88% of the repaired cases where tented Cupid's bow affected cases with complete cleft lip in three cases [12%]. Smooth vermilion was obtained in 88% of the total where notching of vermilion affected cases with complete cleft lip in three cases [12%] of the total. From these results it will be easy to conclude the following: cleft lip repair by arc to line method suits more cases with incomplete cleft lip where satisfactory results were obtained. Arc to line repair is not advised in complete cleft lip where drawbacks were encountered. This technique has the advantage of being easy to perform by a beginner as it does not need complex measuring steps. It takes short time so minimising the time of exposure to anaesthesia