Comparison of local anesthetic efficacy of tramadol hydrochloride (with adrenaline) versus plain tramadol hydrochloride in the extraction of upper molar teeth.

PURPOSE: To evaluate the efficacy of local anesthesia using tramadol hydrochloride (HCl) with versus without adrenaline in the extraction of upper molar teeth. PATIENTS AND METHODS: This was a double-blinded study that included 100 patients who required extraction of 1 upper molar by the conventional method and were allocated randomly into 1 of 2 groups: in group A (n = 50), each patient received an initial dose of drug A (tramadol HCl 50 mg and adrenalin 0.0225 mg diluted to 1.8 mL by distilled water); in group B (n = 50), each patient received an initial dose of drug B (tramadol HCl 50 mg diluted to 1.8 mL by distilled water). Degree of pain during tooth extraction, duration of surgery, and total number of cartridges used were recorded intraoperatively. Postoperatively, patients were instructed to record any adverse effects, such as nausea or vomiting, on the first day of the operation. RESULTS: There were significant differences in the number of cartridges used and the degree of intraoperative pain. However, there was no significant difference in duration of surgery or side effects. CONCLUSIONS: The results of this study suggest that tramadol HCl in combination with adrenaline can be used as an alternative local anesthetic in oral and maxillofacial surgery when, for some unusual reason, a patient cannot receive a conventional local anesthetic.

Potential role of oxidative stress on the prescription of rehabilitation interventions in spinal cord injury.

STUDY DESIGN: Review article. OBJECTIVES: To provide an overview of free radical biology, particularly with respect to muscle physiology, as well as the potential effects of muscle morphological changes, physical capacity and nutritional status on oxidative stress in people with chronic spinal cord injury (SCI). The potential implications of these factors for determining the optimal dosage of rehabilitation training interventions in people with chronic SCI will also be presented. SETTING: Vancouver, BC, Canada. METHODS: Literature review. RESULTS: Not applicable. CONCLUSION: There has been a great deal of focus on rehabilitation exercise interventions providing intensive practice of movements to enhance functional recovery and physical capacity following SCI. However, there is still much to be understood about the appropriate dosage of training parameters (e.g. frequency, duration). It has been known for several decades that exercise increases free radical production, leading to oxidative stress. To date, there has been little consideration of the potential interaction of oxidative stress with training parameters on functional outcomes in chronic SCI. Furthermore, individuals with chronic SCI face many secondary consequences of their injury, such as muscle atrophy, change in muscle fiber type, general deconditioning and nutritional status, that are known to influence free radical production and antioxidant capacity. Better understanding of the potential confounding effects of oxidative stress associated with exercise will improve our ability to determine the optimal 'dose' of rehabilitation training to maximize functional recovery following SCI.

Detection of human papillomavirus using in situ hybridization technique in vulvo-vaginal warts.

Human papillomavirus (HPV) is the commonest sexually transmitted viral infection and one of its manifestations is genital warts or condyloma acuminata. Eight cases of vulvo-vaginal warts were diagnosed between January 1992 and December 1993. There were 4 Malays, 2 Chinese and 2 Indians. The patients' age ranged from 22 to 43 years (mean 27.9 years). Formalin-fixed, paraffin-embedded tissues were studied by histology and in situ hybridization using biotinylated probes to detect the HPV deoxyribonucleic acid (DNA) of types 6, 11, 16, 18, 31 and 33. All vulvar and vaginal lesions showed typical histopathological features of condylomatous changes. HPV 6 and HPV 11 were detected in 100% (8/8) and 87.5% (7/8) of all cases, respectively. HPVs 16, 18, 31 and 33 were not found. The positive cells were mainly in the upper layers of the squamous epithelium. The hybridization data indicated that the HPV found in this study one of the same types as found in other studies.

Analysis and outcome of 502 cases of laser excision cone (LEC) at the Samaritan Hospital for Women, London.

When performed based on cytology, histological accuracy of the laser cone specimen improved with the more severe cytology. The incidence of adenocarcinoma in situ is 1.0%. With and without residual disease, the rate of abnormal cytology after laser excision cone are 0.6% and 1.6% respectively. There is good correlation between colposcopic biopsy and cone specimen in the more severe lesions. Out of 139 cases of incomplete excision, only 3 cases had abnormal cytology at follow-up. The complication rates are very low.