Ferric Sulfate Versus Calcium-Enriched Mixture Cement in Pulpotomy of Primary Molars: A Randomized Clinical Trial

ABSTRACT Objective: To evaluate the postoperative pain and clinical and radiographic success of pulpotomized primary molars using two materials, Ferric Sulfate (FS) and Calcium-Enriched Mixture (CEM) cement, over a period of 3 and 6 months. Material and Methods: This randomized clinical trial was conducted on a total of 38 teeth selected from 19 patients aged 3-9 years. FS 15.5% and CEM cement were used as pulpotomy agents. Permanent restorations were Stainless Steel Crowns (SSCs) in both groups. Patients were recalled for follow-up at 3 and 6 months intervals for clinical and radiographic assessment. Postoperative pain was recorded by using Visual Analogue Scale up to ten days following the treatment. The data were statistically analyzed using chi-square test and repeated measures ANOVA. Results: At 6 months, a 100% clinical success rate was observed in the FS and CEM cement groups. The radiographic success rate in the FS group was 94.7%, whereas 100% in the CEM cement group at 6 months. No statistically significant difference was found between the two groups (p>0.05). There was no significant difference in postoperative pain between the teeth that received either FS or CEM cement as pulpotomy agents following the procedure (p>0.05). Conclusion: There were favorable outcomes of FS and CEM cement in pulpotomy of primary molar teeth.

Effect of Electrocauterization on the Inflammation of the Conjunctiva in Experimental Animal Model

PURPOSE: Recently, conjunctivochalasis repair surgery using electrocauterization has been gaining popularity. However, patients with electrocauterized conjunctivoplasty tend to complain of more postoperative pain than patients undergoing simple excision with suturing. Therefore, we investigated the effects of electrocauterization on inflammation of the conjunctiva using an experimental animal model and compared these with the effects of simple excision with suturing. METHODS: Ten New Zealand white rabbits underwent cauterization in the right eyes and excision and suturing in the left eyes. For each eye, we excised or electrocauterized the inferior bulbar conjunctiva, 1 mm in width and 6 mm in length, 2 mm from the limbus. A fine-needle electrode was inserted subconjunctivally, and electrocauterization was performed. In the contralateral eye, the corresponding area was excised and re-approximated with 10-0 nylon sutures. Sutures were removed after 14 days. Tissue samples were obtained at 21 days post-procedure, and inflammatory cells were counted in five randomly selected fields (x200) on hematoxylin-eosin stained slides. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta concentrations in tears were measured using enzyme linked immunosorbent assays. RESULTS: All cauterized eyes demonstrated smooth surface healing without scarring after 5 days, whereas sutured eyes presented with mild edema with some scarring until the suture was removed. The number of inflammatory cells was significantly greater in sutured eyes compared with cauterized eyes (p = 0.035, Mann-Whitney U-test) at 21 days post-procedure. Tear TNF-alpha and IL-1beta concentrations at 21 days were similar in both groups. CONCLUSIONS: Electrocauterization for conjunctivoplasty seems to be advantageous in terms of inflammation compared with simple suturing and excision.

Eficacia de la técnica de analgesia multimodal en el control del dolor postoperatorio

Uno de los factores determinantes de la calidad de la atención de los pacientes quirúrgicos es el manejo del dolor posoperatorio, el cual tiene como objetivo fundamental evitar la aparición del síntoma y de sus efectos adversos asociados. Para ello en este estudio se aplicó la técnica de analgesia multimodad. Se realizó un estudio prospectivo de 120 pacientes programados a colecistectomía abierta e histerctomía abdominal, los cuales se dividieron en dos grupos: I 60 pacientes que se les aplicó analgesia convencional, es decir la utilizada en el HEODRA, que consistió en la aplicación de tratamiento monofarmacológico a base de INES ya sea diclofenac sódico 75 mg im o ketorolac (dolgenal) 30 mg iv o im. cada 8 horas. El grupo II constituido por 60 pacientes a quienes se les administró analgesia multimodal que consistió en la aplicación de diclofensc sódico 75 mg im. inmediatamente después de la inducción anestésica, morfina 0.1 mg/kg de peso iv o im. 15-30 minutos antes de que terminará el procedimiento y se infiltró con bupivacaína al 0.25 porciento 20 cc antes de ser saturada la incisión. La selección de los pacientes fue al azar, utilizando randomización. Los pacientes de ambos grupos recibieron anestesia general balanceada. Durante la primera hora posquirúrgica se mantuvieron a los pacientes en la sala de recuperación, donde se realizaron las primeras evaluaciones por una persona ajena al estudio...

Feasibility analysis of loop colostomy closure in patients under local anesthesia / Estudo da praticabilidade do fechamento de colostomias em alça em pacientes sob anestesia local

PURPOSE: To verify prospectively the practicability of performing loop colostomy closure under local anesthesia and sedation. METHODS: In this study, 21 patients underwent this operation. Lidocaine 2 percent and bupivacaine 0.5 percent were utilized. Pain was evaluated during the operation, on the first postoperative day and at hospital discharge. Intraoperative events, postoperative complications and the acceptability of this procedure were analyzed. RESULTS: The mean duration of the operation was 133 minutes (range: 85 to 290 minutes). The mean postoperative hospitalization was four days (range: one to twelve days). No patients died. Complications occurred in two patients (9.4 percent): abdominal wall hematoma and operative wound infection. With regard to pain severity, scores of less than or equal to three were indicated in the intraoperative evaluation by 80 percent of the patients (17/21) and on the first postoperative day by 85 percent (18/21). At hospital discharge, 95.2 percent of the patients (20/21) said they were in favor of the local anesthesia technique. CONCLUSION: Loop colostomy closure under local anesthesia and sedation is feasible, safe and acceptable to patients.

OBJETIVO: Verificar a praticabilidade de se efetuar o fechamento de colostomia em alça sob anestesia local e sedação. MÉTODOS: Neste estudo 21 doentes foram submetidos a esta intervenção cirúrgica. Utilizou-se Lidocaína a 2 por cento e Bupivacaína a 0,5 por cento. Avaliou-se a dor em três períodos: intra-operatório, 1° pós-operatório e alta hospitalar; analisando-se intercorrências intra-operatórias, complicações pós-operatórias e a aceitabilidade desse procedimento. RESULTADOS: O tempo médio operatório correspondeu a 133 minutos, oscilando entre 85 e 290 minutos. O tempo médio de internação pós-operatória teve média de quatro dias, variando de três a doze dias. Não houve letalidade. Em dois doentes (9,4 por cento) ocorreram complicações: hematoma de parede abdominal e infecção de ferida operatória. Quanto a intensidade de dor, escores iguais ou abaixo de três foram indicados na avaliação intra-operatória por 80 por cento (17/21) dos doentes; no 1° pós-operatório por 85 por cento (18/21). Na alta hospitalar 95,2 por cento (20/21) dos doentes mostraram-se favoráveis à técnica sob anestesia local. CONCLUSÃO: Fechamento de colostomia em alça sob anestesia local e sedação é praticável, com segurança e aceitabilidade dos doentes.