Efficacy of gabapentin in trigeminal neuralgia: a non-randomized trial

Objective: To compare the efficacy of Gabapentin with carbamazepine in Trigeminal Neuralgia

Material/Method: The study was conducted in Agha Khan University Hospital and Abbasi Shaheed Hospital for four months. 19 patients of TN were collected through purposive convenience sampling. DN4 questionnaire was used to differentiate between Somatic and Neuropathic pain. Numeric Pain Rating Scale was used to assess the severity of pain

Results: Nine patients of Trigeminal Neuralgia refractory to carbamazepine were put on Gabapentin with male to female ratio of 4:5. All showed favorable response on 800-1600 mg Gabapentin on Numeric Pain Rating Scale. All patients were pain free in three weeks with no side effects. There was significant difference between pain response to carbamazepine and Gabapentin at P< .05. Four patients [44%] had pain relief on 900 mg Gabapentin, three [33%] on 1200 mg, one responded on 800 mg and one on 1600 mg

Conclusion: Gabapentin is effective as first line treatment in Trigeminal Neuralgia

Role of combining long buccal nerve block with inferior alveolar nerve block to improve success of local anesthesia for extraction of mandibular teeth

The aim of this study is to ascertain the role of combining long buccal nerve block with inferior alveolar nerve block in achieving local anesthesia for extraction of mandibular teeth. The study took place at two teaching hospitals simultaneously [Fatima Jinnah Dental College Hospital, Jinnah Medical and Dental College Hospital Karachi], from January 2011 to June 2011. A total of 300 patients were randomly assigned to 3 groups of 100 patients each. Lidocaine 2% with 1:100,000 epinephrine was used for all injections. Group 1: patients received an IAN block using 1 cartridge of L/A + 1 cartridge as Buccal infiltration. Group 2: patients received an IAN block using 2 cartridges of L/A + 1 cartridge as Buccal Infiltration. Group 3: patients received 1 cartridge as an IAN block and 1 cartridge as a long buccal nerve block. A visual analogue scale [VAS] was used to rate pain immediately post-operative while subjective discomfort experienced during the surgical procedure [rated as yes/no]. Data was also collected for patients who would require extra cartridge of IAN block to achieve complete anesthesia. Data was analyzed using SPSS 14.0. The success rates for groups 1 to 3 were 25.20%, 27.27% and 75.54% respectively. Group 3 had significantly better anesthesia compared with group 1 and group 2 [P <0.05]. Combining an IAN block and a long buccal nerve block provided more effective anesthesia in mandibular extraction

Causes of tooth extraction: three years follow-up of two teaching hospitals in Karachi

The objective of this study was to describe the causes on tooth extraction among the general population attending oral surgery outpatient department of two teaching hospitals in Karachi. Demographics of the public and private sector hospitals were compared. Prospective study of a cohort of adults [mean age 33.86 +/- 13.65] who had detailed extraction record and demographic data collected during the previous 3 years [2005 -2007]. The study was carried out at Oral Surgery Outpatient Department Fatima Jinnah Dental College Hospital and at Karachi Medical and Dental College. A total of 24580 subjects from KMDC and 21891 subjects from FJDC were included in the study. The main outcome measures were Chewing habits, education, brushing frequency and brushing timing in relation to tooth loss. The primary causes of dental extraction were dental caries 67.04% [31158], followed by periodontal causes 21.68% [10075] and impacted wisdom teeth 4.64% [2074]. Few extractions were performed in cases in which the patient needed a prosthetic solution 2.63% [1225] or orthodontic treatment 0.28% [130] or due to cosmetic concerns and discoloration 0.05% [26]. Dental carries came out to be the commonest cause of extraction. The results of this study demonstrated the need for policymakers in the country to consider oral health on priority so that people have awareness about the hazards thus leading to reduction of morbidity and tooth loss