A comparative assessment of intranasal and oral dexmedetomidine for procedural sedation in pediatric dental patients.

OBJECTIVES: The objective of this study was to assess the safety and efficacy of intranasal and oral dexmedetomidine for procedural sedation in pediatric dental patients. MATERIALS AND METHODS: Forty-four uncooperative American Society of Anesthesiologists Grade-I children, requiring dental treatment were randomly divided into four groups who received different doses of dexmedetomidine through intranasal and oral routes. The vital signs were monitored continuously during each visit. RESULTS: In this study, significant (P < 0.05) differences were found in the onset of sedation, duration, and recovery time between intranasal and oral groups. All vital signs were within normal physiological limits with no significant adverse effects in either of the groups. CONCLUSION: Dexmedetomidine is a safe and effective agent for procedural sedation in pediatric dental patients with intranasal route having distinct advantages over oral route.

Assessment of Clinical Pharmacokinetic Drug-Drug Interaction of Antimalarial Drugs α/ß-Arteether and Sulfadoxine-Pyrimethamine.

Antimalarial drug combination therapy is now being widely used for the treatment of uncomplicated malaria. The objective of the present study was to investigate the effects of coadministration of intramuscular α/ß-arteether (α/ß-AE) and oral sulfadoxine-pyrimethamine (SP) on the pharmacokinetic properties of each drug as a drug-drug interaction study to support the development of a fixed-dose combination therapy. A single-dose, open-label, crossover clinical trial was conducted in healthy adult Indian male volunteers (18 to 45 years, n = 13) who received a single dose of AE or SP or a combination dose of AE and SP. Blood samples were collected up to 21 days postadministration, and concentrations of α-AE, ß-AE, sulfadoxine, and pyrimethamine were determined by using a validated liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters were calculated and statistically analyzed to calculate the geometric mean ratio and confidence interval. Following single-dose coadministration of intramuscular AE and oral SP, the pharmacokinetic properties of α/ß-AE were not significantly affected, and α/ß-AE had no significant effect on the pharmacokinetic properties of SP in these selected groups of healthy volunteers. However, more investigations are needed to explore this further. (This study has been registered in the clinical trial registry of India under approval no. CTRI/2011/11/002155.).

Falciparum malaria presenting as subdural hematoma.

Falciparum malaria is a common disease in tropical countries associated with myriad of complications that can be life-threatening. We hereby report an 85 year old male who was suffering from falciparum malaria and presented with subdural hematoma, an unusual complication of central nervous system secondary to severe thrombocytopenia.

Sturge Weber syndrome.

Sturge Weber Syndrome also called as encephalotrigeminal angiomatosis is a sporadically occurring neurocutaneous syndrome, characterized by vascular malformation with capillary venous angiomas that involve face, choroid of eye and leptomeninges with resulting neurological and orbital manifestations. We hereby report a young unmarried girl who diagnosed as a case of SWS on the basis of Port wine stain since birth, past history of seizures since the age of four years and at this time presented with status epilepticus, mental retardation (I.Q.--30 to 35), EEG abnormality and characteristic imaging findings. This may be a common condition for paediatrician and neurologist but as a physician we usually do not see it that often.

Unusual manifestation of dengue fever.

Dengue fever is an important public health problem in India and has various serious manifestations, which if not identified and treated at appropriate time can lead to dire consequences. Quadriparesis during the course of dengue infection is quite unusual and rarely reported. The authors hereby report a case of acute motor quadriparesis due to Guillain-Barre syndrome during the course of dengue infection, who showed gradual response to conservative treatment.