Comparative efficacy of three topical anesthetics on 7-11-year-old children: a randomized clinical study

BACKGROUND: This study evaluated the efficacy of three intraoral topical anesthetics in reducing the injection needle prick pain from local anesthetic among children aged 7–11 years old.METHODS: It is a prospective, Interventional, parallel design, single-blind, randomized clinical trial in which subjects (n=90) aged 7–11 years were included in the study based on an inclusion criteria. Subjects were divided into three groups based on computer-generated randomization with an allocation ratio of 1:1:1. Groups A, B, and C received benzocaine 20% jelly (Mucopain gel, ICPA health products Ltd, Ankleshwar, India), cetacaine anesthetic liquid (Cetylite Industries, Inc, Pennsauken, NJ), and EMLA cream (2% AstraZeneca UK Ltd, Luton, UK), respectively, according to manufacturer's instructions, for 1 minute prior to local anesthetic injection. After application of topical anesthetic agent, for all the groups, baseline pre-operative (prior to topical anesthetic administration) and post-operative scores (after local anesthetic administration) of pulse rate was recorded using Pulse oximeter (Gibson, Fingertip Pulse Oximeter, MD300C29, Beijing Choice Electronic). Peri-operative (i.e., during the administration of local anesthesia) scores were recorded using Face, Legs, Activity, Cry, Consolability (FLACC) Scale, Modified Children hospital of Eastern Ontario Pain Scale (CPS) behavior rating scale, and Faces Pain Scale (FPS-R) – Revised (For self-reported pain). Direct self-reported and physiological measures were ascertained using FPS-R – Revised and Pulse oximeter, respectively, whereas CPS and FLACC scales assessed behavioral measures. To test the mean difference between the three groups, a one way ANOVA with post hoc tests was used. For statistical significance, a two-tailed probability value of P < 0.05 was considered as significant.RESULTS: The Cetacaine group had significantly lower pain scores for self-report (P < 0.001), behavioral, and physiological measures (P < 0.001) than the other two groups. However, there was no significant difference between the Benzocaine group and EMLA group during palatal injection prick.CONCLUSION: Cetacaine can be considered as an effective topical anesthetic agent compared to benzocaine 20% jelly (Mucopain gel) and EMLA cream.

The Clinical Effect with the Use of Gel Anesthesia within Gingival Sulcus during Scaling / 치위생과학회지

Although scaling is the primary method for improving oral health, it is also associated with dental fear. The objective of this study was to empirically verify whether the use of gel anesthetic within the gingival sulcus during scaling relieves pain and improves other factors. A total of 128 patients scheduled to undergo scaling at a dental clinic of a general hospital located in the Gyeonggi Province, between July 2014 and July 2015, were enrolled in the study. The participants underwent scaling following the application of 20% benzocaine gel or placebo gel anesthetic within the gingival sulcus, and the data was collected using a questionnaire. There was a significant difference in the severity of pain, participant satisfaction, perceived sensitivity, overall discomfort, and fear of scaling between the two groups. The two groups were compared in terms of perceived need for gel anesthesia, willingness to pay for anesthesia costs, and willingness to receive scaling in the future. There were significant differences in all the three parameters depending on whether gel anesthesia was used or not. There were significant differences between the two groups in perceived sensitivity immediately after scaling and one day after scaling, with no difference seen one week after scaling. With regards to overall discomfort over time, there were significant differences between the two groups immediately after scaling. Based on these findings, we expect that application of gel anesthetic within the gingival sulcus during scaling will reduce pain, perceived sensitivity, overall discomfort, and fear of scaling with increased satisfaction.

Benzocaine, Methemoglobinemia and Methylene Blue / 대한소아치과학회지

The aim of this review is to introduce about the issue of benzocaine and methemoglobinemia. Through blocking the pain during dental treatment, fear and anxiety of patients will be reduced. Thus, anesthetic agent containing benzocaine is commonly used while controlling the pain of patients during treatment. However, on May 28, 2018, the Ministry of Food and Drug Safety reported a medication safety report about restricting the use of benzocaine-containing agents in infants under 24 months and children. Also, they recommended a cautious use to adolescents and adults to prevent methemoglobinemia (MHb). This report was published due to an advice from Food and Drug Administration (FDA) on May 23, 2018. When using agents containing benzocaine, dentists must consider the probability of MHb and prepare for early diagnosis and appropriate action. Since 1930s, methylene blue is known to cure MHb patients. Therefore, the proper use of methylene blue for emergencies and diagnosis methods for early diagnosis of MHb should be familiar to dentists planning for the use of topical anesthetic agents. Dentists should be trained for emergency situation of MHb caused by the use of benzocaine.

Hematological and biochemical characteristics during the transport of dog snapper Lutjanus jocu (Perciformes: Lutjanidae)

The objective of this study was to evaluate stress responses in dog snapper (Lutjanus jocu) during transport by evaluating their hematological and biochemical responses. Twenty-five wild dog snapper specimens were used in the experiment (220 ± 68 g and 24.5 ± 2.5 cm total length). Blood samples were collected prior to transport (control), and fish were placed in two transport boxes, one with anesthetic and one without anesthetic. Immediately after transport and after 24 h, blood was collected from the fish that underwent each treatment (with anesthetic and without anesthetic). Biochemical and hematological results demonstrated the inefficiency of benzocaine as a stress reliever during handling and transport. Biochemical parameters revealed the effects of stress during transport, and after 24 h, glucose levels and hematological parameters (hemoglobin, erythrocytes, leukocytes, neutrophils and MCH) showed a tendency to return to control levels. This study is the first to report stress response measurements of hematological and biochemical indicators in dog snapper, representing an important basis for the planning of future experiments involving the transport and handling of this fish species.(AU)

O objetivo desde estudo foi avaliar as repostas de estresse em dentão (Lutjanus jocu) durante o procedimento de transporte, através de respostas hematológicas e bioquímicas. Vinte e cinco exemplares selvagens de dentão foram utilizados no experimento (220 ± 68 g e 24.5 ± 2.5 cm de comprimento total). Foram realizadas coletas de sangue previamente ao transporte (controle), e os demais peixes foram acondicionados em duas caixas de transporte, uma com anestésico e outra sem anestésico. Imediatamente após o transporte e após 24 h, houve coleta de sangue para cada tratamento (com anestésico e sem anestésico). Os resultados bioquímicos e hematológicos apontam a ineficiência da benzocaína como mitigador do estresse durante o manuseio e transporte. Os parâmetros bioquímicos foram capazes de detectar o efeito do estresse durante o transporte, e após 24 h os níveis de glicose e alguns parâmetros hematológicos (hemoglobina, eritrócitos, leucócitos, neutrófilos e MCH) demonstraram uma tendência de retorno aos níveis do controle. Este trabalho é o primeiro a informar os níveis de resposta basal e de estresse para indicadores hematológicos e bioquímicos em dentão, representando uma base importante para o planejamento de futuras experiências com transporte e manejo dessa espécie.(AU)

Anesthesia by sprinkling method in the gills of tambaqui Colossoma macropomum does not influence intensity and morphology of monogeneans / Anestesia por meio de aspersão nas brânquias de tambaqui Colossoma maropomum não influencia a intensidade e a morfologia de monogeneas

Abstract The present study evaluates the influence of anesthesia on the parasitic fauna of monogenea fish parasites, as its intensity and viability. Two experiments were conducted: Evaluation of an anesthetic method by sprinkling eugenol directly on gills and evaluation of monogenea motility and viability; Comparison of immersion and directly sprinkling on the gills with benzocaine and eugenol followed by evaluation on parasite intensity. The results suggest that the anesthetic sprinkling didn't interfere in the parasite motility, morphology and body surface integrity analyzed by fluorescence method. The monogenean intensity in the gills was lower in fish anesthetized by immersion method compared to the sprinkling method and the control group. This method of anesthesia can be used in parasitological studies.

Resumo O presente estudo avalia a influência da anestesia sobre a fauna parasitária de monogeneas em peixes, sua intensidade e sua viabilidade. Dois experimentos foram realizados: Avaliação de um método anestésico por aspersão eugenol diretamente nas brânquias e avaliação da motilidade das monogeneas e sua viabilidade; e Comparação entre imersão e aspersão diretamente nas brânquias com benzocaína e eugenol, seguido de avaliação sobre a intensidade parasitária. Os resultados sugerem que a aspersão do anestésico não interferiu na motilidade, morfologia, superfície corporal e integridade do parasita, analisadas pelo método de fluorescência. A intensidade de monogenéticos nas brânquias foi menor nos peixes anestesiados pelo método de imersão em comparação com o método de aspersão e o grupo controle. O método de anestesia por aspersão nas brânquias pode ser utilizado em estudos parasitológicos.

Oxidative stress responses of juvenile tambaqui Colossoma macropomum after short-term anesthesia with benzocaine and MS-222

ABSTRACT The present study aimed to evaluate the effects of benzocaine and tricaine methanesulfonate on oxidative stress parameters of juvenile tambaqui tissues. Fish (n=80) were anesthetized with benzocaine (100 mg L-1) or tricaine (240 mg L-1) and two control groups were used (non-anesthetized fish and fish exposed to ethanol-only). After anesthetic induction 10 fish/anesthetic were euthanized after 3, 12 and 24 hours post-anesthesia and tissue samplings (gills, liver and brain) were performed. Samples were submitted to analyses of enzyme activity glutathione-S-transferase (GST), cellular lipid peroxidation (TBARS) and total antioxidant capacity (ACAP). ACAP increased in gills of benzocaine treatment after 12 hours. The liver showed a reduction in ACAP of tricaine treatment after 12 hours. Both anesthetic treatments showed an increase of ACAP at 24 hours compared to control group. The activity of the GST enzyme increased in the gills for treatments benzocaine and tricaine after 3 and 12 hours. Liver showed increased GST activity (benzocaine after 24 hours and tricaine after 3 and 24 hours). Lipid damage decreased in gills (both anesthetics) and brain (tricaine) after 24 hours. The results demonstrate that benzocaine and tricaine did not cause oxidative damage in juvenile tambaqui under the experimental conditions herein established.

Recent advances in topical anesthesia

Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain.

Efectividad de la benzocaina en gel al 20% y la lidocaina en solución al 10% en pacientes que requieren punción en la mucosa oral: un ensayo clínico controlado aleatorizado cruzado a triple ciego / Effectiveness of benzocaine gel at 20% and lidocaine solution at 10% in patients requiring puncture in the oral mucosa: a randomized controlled crossover triple blind clinical trial

El objetivo del presente estudio fue determinar y comparar la efectividad de la Benzocaína en gel al 20% y la Lidocaína en solución al 10% en pacientes que requerían punción en la mucosa oral. El presente es un ensayo clínico controlado aleatorizado a triple ciego y de diseño cross-over. Se llevó a cabo en la clínica dental de la Unidad de Segunda Especialización en Estomatología (USEE) de la Universidad Nacional de Trujillo, durante los meses de Noviembre y Diciembre del 2010 y de Enero a Marzo del 2011. La muestra estuvo conformada por 60 pacientes, cada paciente firmó un consentimiento informado y se le realizó un análisis de su estado de ansiedad mediante la escala de ansiedad estado-rasgo (IDARE). Antes de realizar la punción en la mucosa oral se aplicó 4 preparados (2 anestésicos tópicos y 2 placebos) para después determinar y comparar la efectividad de los preparados en la reducción del dolor usando la escala visual análoga (EVA). Para la recolección de los datos se usó una ficha especial para tal fin. Para la comparación de la efectividad de los preparados se empleó el Análisis de Varianza (ANOVA). La efectividad de los anestésicos en gel y en solución fue evaluada empleando el test de Tuckey para comparaciones múltiples y el T de students. La significación estadística fue del 5%. Se encontró que la Benzocaína en gel al 20% y la Lidocaína en solución al 10% son efectivos para reducir el dolor a la punción y que no existe una relación estadísticamente significativa (p= 0,0575) entre la efectividad de cada uno de ellos. La administración de Benzocaína en gel al 20% o de la Lidocaína en solución al 10% reduce el dolor a la punción en igual magnitud y pueden ser usados indistintamente en la práctica odontológica diaria.

The objective of this study was to determine the effectiveness of benzocaine 20% gel and lidocaine in 10% solution in patients requiring puncture in the oral mucosa. This is a randomized controlled clinical trial to triple-blind, cross-over design. It was held at the dental clinic of the Unit of Second Specialization in Dentistry (usee) of the National University of Trujillo, in the months of November and December 2010 and January to March 2011. The sample consisted of 60 patients, each patient signed an informed consent and underwent a review of their status by anxiety scale state-trait anxiety (STAI). Before the puncture in the oral mucosa four preparations (2 topical anesthetics and 2 placebo) and then determine and compare the effectiveness of preparations in reducing pain using a visual analogue scale (VAS) was applied. For data collection a special token was used for that purpose. For comparison of the effectiveness of preparations Analysis of Variance (ANOVA). The effectiveness of the gel and anesthetic solution was evaluated using Tukey's test for multiple comparisons and students T. Statistical significance was 5%. We found that benzocaine 20% gel and lidocaine in 10% solution are effective at reducing pain at the puncture and that there is no statistically significant relationship (p= 0.0575) between the effectiveness of each. The administration of benzocaine 20% gel or lidocaine in 10% solution to reduce pain puncture equal and can be used interchangeably in everyday dental practice.

Topical Intrapocket Anesthesia During Scaling and Root Planing: a Randomized Clinical Trial

Although the use of injectable anesthesia prior to subgingival scaling and root planing (SRP) reduces pain, many patients report fear and prolonged numbness of adjacent tissues. The aim of the present study was to compare the effects of a eutectic mixture containing 25 mg/g of lidocaine and 25 mg/g of prilocaine, injectable 2% lidocaine, topical 2% benzocaine and a placebo substance on reducing pain during SRP. In this randomized, split-mouth, masked clinical trial, thirty-two patients presenting more than two teeth with probing depth and clinical attachment level ≥5 mm in at least 4 sextants were randomly allocated to four groups: EMLA(r); injectable 2% lidocaine; topical 2% benzocaine and placebo. Pain and discomfort were measured using a visual analogue scale (VAS) and verbal scale (VS). Repeated-measures analysis of variance and Poisson regression were used for analysis. Patient satisfaction with the anesthesia was determined at the end of each treatment session. VAS and VS scores did not differ between injectable 2% lidocaine and EMLA (p>0.05) and both substances showed significantly better pain control compared to 2% benzocaine and placebo (p<0.05). 93.7% and 81.2% of the individuals were satisfied with the injectable anesthetic and EMLA, respectively (p=0.158). Dissatisfaction with benzocaine and placebo was approximately 10 times greater than injectable anesthesia (p=0.001). In conclusion, EMLA showed an equivalent effect on pain control when compared to the injectable anesthesia and performed better than 2% benzocaine in SRP. Thus, EMLA is a viable anesthetic option during scaling and root planning, despite the frequent need for second application.

Embora a anestesia injetável previamente a raspagem e alisamento subgengival (RASUB) reduza a dor, muitos pacientes relatam medo e amortecimento prolongado dos tecidos adjacentes. O objetivo deste estudo foi comparar o efeito de uma mistura eutética contendo 25mg/g de lidocaína e 25 mg/g de prilocaína, lidocaína 2% injetável, benzocaína 2% tópica e um placebo na redução da dor durante a RASUB. Neste ensaio clínico randomizado, cego de boca dividida, trinta e dois pacientes que apresentavam mais que dois dentes com profundidade de sondagem e nível de inserção clínica ≥ 5 mm, em no mínimo 4 sextantes, foram randomicamente alocados em 4 grupos: EMLA(r), lidocaína 2% injetável, benzocaína 2% tópica ou placebo. Dor e desconforto foram mensurados usando uma Escala Visual Analógica (EVA) e Escala Verbal (EV). A satisfação dos pacientes com a anestesia foi determinada ao final de cada consulta. Análise de variância de medidas repetidas e regressão de Poisson foram usadas para análise. Os escores da EVA e EV não demonstraram diferenças estatisticamente significantes entre lidocaína injetável e EMLA(r) (p > 0,05) e ambas as substâncias demonstraram significativamente melhor controle da dor comparadas a benzocaína 2% e placebo (p<0,05). 93,7% e 81,2% dos indivíduos ficaram satisfeitos com o anestésico injetável e EMLA(r), respectivamente (p=0,158). A insatisfação com a benzocaína e placebo foi aproximadamente 10 vezes maior do que com a anestesia injetável (p=0,001). Em conclusão, o EMLA(r) demonstrou um efeito equivalente no controle da dor quando comparado com a anestesia injetável e melhor do que a benzocaína 2% em RASUB. Assim, o EMLA(r) é uma opção anestésica viável durante a raspagem e alisamento radicular, apesar da necessidade frequente de segunda aplicação.

Anatomic and anaesthetic considerations of greater palatine nerve block in Indian population

Background: Greater palatine nerve block holds its importance for anaesthesia and analgesia in different maxillofacial surgical procedures. Accuracy in localization of greater palatine foramen is required for its successful implication in regional block, although racial variations exist in various population groups

Aims: To study the morphometry of greater palatine foramen and its location with nearby anatomical landmarks in Indian population. Material and Methods: A total of one hundred dry skulls [60 males and 40 females] were collected and observed for the study. Various parameters were noted from greater palatine foramen on both sides, together with its location with respect to maxillary molar tooth. Along with that the angle between midline maxillary suture and Incisive foramen-Greater palatine foramen is measured

Results: 198 sides were measured and the most common location of greater palatine foramen was found to be medial to third molar tooth [71.21%]. The mean distance from greater palatine foramen to midline maxillary suture on right and left sides were 14.82 +/- 1.34 mm and 14.79 +/- 1.57 mm, statistically insignificant. The angle between midline maxillary suture and incisive foramen-greater palatine foramen was 20.81 degree +/- 2.47 degree on right side and 20.58 degree +/- 2.69 degree on left side.The direction of the opening of greater palatine canal onto the hard palate was observed to be antero-medial in 60.10% of cases

Conclusions: Our study reveals the importance of usage of various anatomical parameters for precise location of greater palatine foramen, establishment of specific measurements in each population group and thereby applying such measurements for successful greater palatine nerve block

[Efficacy of ketoprofen and benzocaine chewing gums for reducing orthodontic pain]

Pain relief is important during orthodontic treatment. The aim of this study was to compare the efficacy of ketoprofen and benzocaine chewing gums for pain reduction during fixed orthodontic treatment. Thirty patients aged 15-25 years experiencing orthodontic pain were randomly divided into 3 groups, each receiving one of the experimental chewing gums namely ketoprofen, benzocaine and the placebo. Instructions were given to the pa-tients and they received the gums taking into account the washout period. Patients recorded their degree of pain perception at 2, 6 and 24 hours, and 2, 3 and 7 days using the visual analog scale [0-100]. Friedman and Wilcoxon tests were used to compare the mean pain scores among the 3 groups. The mean pain score decreased over time in both genders and all groups [P =0.017]. The mean pain score recorded in benzocaine group was lower than that in the ketoprofen and placebo groups but a significant difference was only observed between benzocaine and the ketoprofen groups during the first two hours using Friedman and Wil-coxon tests [P=0.042]. Compared to the control group, both ketoprofen and benzocaine chewing gums significantly decreased pain at all time points except for day 7. Ketoprofen and benzocaine gums were both significantly effective for or-thodontic pain reduction

Benzocaine and clove oil as anesthetics for pejerrey (Odontesthes bonariensis) fingerlings / Benzocaina e óleo de cravo como anestésicos para alevinos de peixe-rei (Odontesthes bonariensis)

Pejerrey (Odontesthes bonariensis) is a native species from Rio Grande do Sul, Uruguay and Argentina where it is of great economic importance for artisanal fishing. One difficulty in laboratory research with pejerrey is related to its sensitivity, as it presents higher basal cortisol levels than other freshwater species. For this reason, the aim of this work was to evaluate the efficiency of benzocaine and clove oil as anesthetics for pejerrey fingerlings. Two experiments were done where fingerlings (57±7.8mm and 1.1±0.44g) were exposed to benzocaine with concentrations between 40mgL-1 and 120mgL-1 and to clove oil with concentrations between 12mgL-1 and 75mgL-1. Survival, anesthesia induction time and recovery time for each pharmaceutics were evaluated. Both benzocaine and clove oil pharmaceutics showed efficiency as anesthetics for pejerrey fingerlings, with negative correlation between the dose of anesthetics and the anesthesia induction time. For benzocaine, the concentrations between 80mgL-1 and 100mgL-1 showed better results, as for clove oil the optimal concentrations were between 25mgL-1 and 50mgL-1. On the other hand, the anesthesia recovery time did not present significant variation on the different concentrations of the tested products. The tested products are highly metabolizable by pejerrey.

O peixe-rei (Odontesthes bonariensis) é uma espécie nativa do Rio Grande do Sul, Uruguai e Argentina, onde tem grande importância econômica para a pesca artesanal. Uma dificuldade da pesquisa em laboratório com peixe-rei está relacionada à sua sensibilidade, pois apresenta níveis basais de cortisol mais elevados que outras espécies de água doce. Este trabalho avaliou a eficiência da benzocaína e do óleo de cravo como anestésicos para alevinos de peixe-rei. Foram realizados dois experimentos em que alevinos (57±7,08mm e 1,1±0,44g) foram expostos à concentração entre 40mg-1 e 120mgL-1 de benzocaína e entre 12mgL-1 e 75mgL-1 de óleo de cravo. Avaliaram-se a sobrevivência, o tempo de anestesia e o tempo de recuperação para cada um dos fármacos. Ambos os fármacos, benzocaína e óleo de cravo, mostraram eficiência para anestesiar peixe-rei, com correlação negativa entre a dose e o tempo de indução de anestesia. Para benzocaína, concentrações entre 80mgL-1 e 100mgL-1 mostraram melhor resultado, enquanto para óleo de cravo as melhores concentrações ficaram entre 25mgL-1 e 50mgL-1. Por outro lado, o tempo de recuperação do estado de anestesia não apresentou variação significativa nas diferentes concentrações testadas. O peixe-rei tem elevada capacidade de metabolização dos produtos testados.

Benzocaína e eugenol como anestésicos para o quinguio (Carassius auratus) / Benzocaine and eugenol as anesthetics for golden fish (Carassius auratus)

Avaliaram-se os tempos de indução e recuperação de quinguios (Carassius auratus) expostos a dois anestésicos, eugenol e benzocaína. Foram utilizados 128 juvenis com peso médio de 2,07±0,53g e comprimento total médio de 5,51±0,56cm. A benzocaína mostrou ser mais eficiente do que o eugenol em relação ao tempo, tanto para indução ao coma quanto para a recuperação à fuga e também no que diz respeito à sobrevivência. As doses de benzocaína com melhores resultados foram de 87,5 e 100mg.L-1. O eugenol proporcionou demora na indução e na recuperação dos animais, além de ter apresentado mortalidades quando as doses anestésicas foram elevadas.

The aim of this work was to evaluate the induction and recuperation time of quinguio (Carassius auratus) exposed to two anesthetics, eugenol and benzocaine. 128 juveniles with 2.07±0.53g of average weight and 5.51±0.56cm of total length were used. The benzocaine proved to be more efficient than the eugenol regarding the time in inducing a coma and recovering flight, as well as survival. The better results of benzocaine doses were 87.5 and 100mg.L-1. The eugenol resulted in a delay of animal induction and recovery, and also presented mortalities when the anesthetics doses were increased.

Methylene Blue

Methylene blue is a very effective reducer of drug-induced methemoglobinemia. It has dose-dependent oxidation or reduction properties. In most cases, a dose of 1 to 2 mg/kg IV given over 5 minutes and immediately followed by a 15- to 30-mL fluid flush to minimize the local pain is both effective and relatively safe. The onset of action is quite rapid, and the effects are usually seen within 30 minutes. The dose may be repeated after 30 to 60 minutes and then every 2 to 4 hours as needed. The total dose should not exceed 7 mg/kg as a single dose or 15 mg/kg within 24 hours. Repeated treatment may be needed for treating compounds that have prolonged elimination or those compounds that undergo enterohepatic recirculation (e.g., dapsone). Methylene blue can cause dose-related toxicity. At high doses, methylene blue can also induce an acute hemolytic anemia and rebound methemoglobinemia. The reasons for treatment failure with methylene blue include ineffective GI decontamination, the existence of other forms of hemoglobin (e.g., sulfhemoglobin), a low or high dose of methylene blue and the toxicokinetics of some agents, such as aniline, benzocaine or dapsone.

T-CAM, a fastatin-FIII 9-10 fusion protein, potently enhances anti-angiogenic and anti-tumor activity via alphavbeta3 and alpha5beta1 integrins

We made fusion protein of fastatin and FIII 9-10, termed tetra-cell adhesion molecule (T-CAM) that can interact simultaneously with alphavbeta3 and alpha5beta1 integrins, both playing important roles in tumor angiogenesis. T-CAM can serve as a cell adhesion substrate mediating adhesion and migration of endothelial cells in alphavbeta3 and alpha5beta1 integrin-dependent manner. T-CAM showed pronounced anti-angiogenic activities such as inhibition of endothelial cell tube formation, endothelial cell proliferation, and induction of endothelial cell apoptosis. T-CAM also inhibited angiogenesis and tumor growth in mouse xenograft model. The anti-angiogenic and anti-tumoral activity of molecule like fastatin could be improved by fusing it with integrin-recognizing cell adhesion domain from other distinct proteins. The strategy of combining two distinct anti-angiogenic molecules or cell adhesion domains could facilitate designing improved anticancer agent of therapeutic value.

Comparison of the efficacy of lidocaine patch and benzocaine gel reducing injection pain in children

The most important aspect of behavior management in children is pain. control. The most recent topical material used for reducing injection pain is Dentipatch. No study has been performed on the efficacy of this material in Iran. The purpose of this study was to evaluate and compare the effectiveness of Dentipatch with 20% Benzocain gel. For this clinical trial study, sixty children in need of bilateral posterior infiltration of maxillary buccal mucosa were selected. All children completed the General and Dental Anxiety Scale tests, and then received bilateral buccal infiltration either following 10 minutes application of Dentipatch or 2 minutes application of Benzocaine gel. For measuring pain, children were asked to complete a Visual Analogue Scale [VAS] after each injection, and to report which injection was more painful. The tests were performed by two trained observers. For comparison of pain reduction, the data were statistically analyzed using Paired t.test and Wilcoxan Sign Rank test. According to VAS, in children without dental anxiety, the scores of the gel and patch were 66.85 and 29.92 respectively p < 0.001. The dental anxious children reports were 70.85 for the gel and 25.91 for the patch [p < 0.001]. According to child's report, in children without dental anxiety, the gel score was 2.31 and the patch score was 0.54, whereas in dental anxious children the scores changed to 2.81 and 0.66 with a statistically significant difference [p < 0.001]. The effect of Dentipatch in reducing pain was more pronounced than Benzocaine gel. Further investigations are necessary in order to decrease the Dentipatch application time

[Frequency of contact dermatitis in patients with chronic dermatitis referring to dermatology clinics in Kerman]

Allergic and irritant compounds are frequent in nature, and the environmental allergic factors which can induce or exacerbate eczema are different and often unknown in different areas. The aim of this study was to determine the frequency of contact dermatitis in patients with chronic dermatitis referring to dermatology clinics in Kerman. In this descriptive study, standard patch test containing 24 allergens was done for 156 cases [56 males and 69 females] with confirmed chronic dermatitis who had been referred to Afzalipoor Hospital Dermatology Clinics. Evaluation of the results was done for every case 24, 48 and 72 hours after application of the patch test. In whole, 153 positive patch tests were seen in 66 [52.8%] cases of 125 patients who had been examined. The most common allergic agent was nickel sulfate detected in 20 [13.1%] patients [17 females and 3 males]. The hypersensitivity reaction to this agent was significantly more common in females than males [P<0.05]. Potassium dichromate with frequency of 11.1% [12 males and 5 females] was the second common allergic agent and males showed significantly more positive reaction to this agent than females [p<0.05]. There was no statistically significant difference according to the age and sex between groups with positive and negative patch test results [P>0.05]. As the causative agents of contact dermatitis are different in various areas, by doing patch test in each area the allergic agents can be detected for more appropriate preventive measures and treatment strategies. In this study, the first and second common allergens were respectively Nickel and Chrome compounds. Thiorum, Cobalt, benzocaine and theazolin compounds were in the third rank

Evaluation of three topical anaesthetic agents against pain: a clinical study.

AIM: To compare pain responses of children during local anaesthetic infiltration at bilateral buccal sites prepared with topical application of EMLA 5% cream, benzocaine 18% gel or lignocaine 5% ointment and also to find out the rapidity of onset of action of these agents. METHODS: 60 healthy children aged 6 to 12 years old, received bilateral buccal infiltration following application of topical anaesthetic agents applied in a double blind design. Pain responses were compared based on subject self report using visual analogue scale (VAS) and operator assessment using Sound -Eye -Motor (SEM) scale. RESULTS: Benzocaine gel had the rapidest onset of action. EMLA 5% cream proved to be superior in pain reduction compared to benzocaine and lignocaine. Taste acceptance was better with benzocaine gel. Further studies are required for EMLA cream with an improved formulation more suitable for mucosal application before its routine use in dentistry.

Transportation of juvenile tambaqui (Colossoma macropomum) in a closed system

O objetivo deste estudo foi investigar o efeito da densidade, duração e do uso de aditivos na água durante o transporte de juvenis de tambaqui (Colossoma macropomum) e usar estes resultados para estabelecer um protocolo seguro de transporte para esta espécie. Os produtos testados e suas doses foram: sal de mesa (1000, 2000 e 3000 mg/L), gesso (100, 300 e 500 mg/L) e benzocaína (10, 20 e 30 mg/L). Os peixes foram transportados em sistema fechado (saco plástico) em diferentes densidades e por diferentes tempos por até 24 h de transporte. A sobrevivência e os parâmetros de qualidade da água foram monitorados imediatamente após o transporte. Os peixes que sobreviveram ao transporte foram colocados em tanques-rede para avaliar a mortalidade após 96 h. A melhor densidade, tempo de transporte e aditivo foram estimados por modelo linear geral. O efeito do fator de condição na sobrevivência após o transporte e na sobrevivência de 96 h também foi avaliado. Como esperado, a sobrevivência após o transporte e a sobrevivência de 96 h foram significativamente correlacionados com o tempo e a densidade. A sobrevivência após o transporte, mas não a sobrevivência de 96 h, também tem correlação com os aditivos testados. A sobrevivência após o transporte é significativamente igual para o tratamento controle e para os tratamentos que receberam gesso e significativamente menor para os tratamentos que receberam sal e benzocaína. O fator de condição não tem correlação com a sobrevivência após o transporte e a sobrevivência de 96 h. É conclusivo que os aditivos testados não melhoram a sobrevivência de juvenis de tambaqui após o transporte. Modelos lineares foram desenvolvidos para predizer a melhor densidade de transporte em função do tempo.