G6PD deficiency in neonates: A prospective study

One thousand consecutively born babies were screened for G6PD deficiency and observed for seven days for development of jaundice. Frequency of the deficiency was 3.9%, being 5% in males and 2.8% in females. Religion did not have any bearing on the frequency. Parental screening in cases of babies deficient in G6PD enzyme revealed deficiency of the enzyme in majority of the mothers. Hyperbilirubinemia developed in 48.7% of babies having G6PD deficiency : It is recommended that any neonate presenting with jaundice must be screened for G6PD deficiency not only to define the etiology of hyperbilirubinemia but also to prevent future hemolytic episodes.     

Preoperative Intraligamentary Injection of Dexamethasone Can Improve the Anesthetic Success Rate of 2% Lidocaine during the Endodontic Management of Mandibular Molars with Symptomatic Irreversible Pulpitis

IntroductionThe aim of this randomized, double-blind clinical trial was to evaluate the effect of preoperative administration of intraligamentary injections of diclofenac sodium and dexamethasone on the anesthetic efficacy of 2% lidocaine given as an inferior alveolar nerve block in the endodontic management of symptomatic irreversible pulpitis.MethodsOne hundred seventeen patients randomly received 1 of the 3 intraligamentary injections before the endodontic treatment: 0.9% normal saline, 25 mg/mL diclofenac sodium, or 4 mg/mL dexamethasone. After 30 minutes, patients received an inferior alveolar nerve block with 2% lidocaine and 1:80,000 epinephrine. The teeth were tested with electric pulp testing after 10 minutes. In case of a positive response, the anesthesia was considered as “failed.” If the electric test response was negative, a rubber dam was applied, and endodontic treatment was started. Any pain during the treatment was recorded. The anesthesia was considered successful if the patients experienced no pain or faint/weak/mild pain during root canal access preparation and instrumentation (Heft-Parker visual analog scale score <55 mm). The effect of intraligamentary injections on maximum heart rates was also recorded. The anesthetic success rates were analyzed with the Pearson chi-square test at 5% significance.ResultsThe control, diclofenac sodium, and dexamethasone groups had anesthetic success rates of 32%, 37%, and 73%, respectively. Dexamethasone was significantly more successful than the control and diclofenac sodium groups (P < .001, χ²₂ = 14.7). There were no differences between the control and diclofenac groups (P > .05). All the solutions did not significantly affect heart rates.ConclusionsThe administration of an intraligamentary injection of dexamethasone before endodontic intervention of mandibular molars with symptomatic irreversible pulpitis increases the success rates of an inferior alveolar nerve block with 2% lidocaine.     

Relationship of cochlea with surrounding neurovascular structures and their implication in cochlear implantation

Purpose

The purpose of this investigation was to evaluate the topographic relations of cochlea with vital neurovascular structures and their implications for cochlear implantation (CI).

Methods

Sixty cadaveric human temporal bones were microdissected to expose the basal turn (BT) of cochlea, the carotid canal, the facial canal (FC) and the jugular fossa (JF). The minimum distances of BT of the cochlea from the carotid canal, the FC and roof of the JF were measured.

Results

The mean minimum distances of BT of the cochlea from the carotid canal, the FC and roof of the JF were found to be 1.38 ± 0.82, 1.06 ± 0.46 and 4.68 ± 2.21 mm, respectively. The abutment and impingement of carotid canal on anterior cochlear wall was found in three (5 %) and six (10 %) cases, respectively. Thin bone separation was observed between cochlea and FC (0.1 mm) in one case (1.67 %).

Conclusions

The preoperative knowledge of the variant anatomy of BT of cochlea in relation to adjacent vital structures like abutment and impingement of carotid canal and thin bone separation of the BT of cochlea from FC and JF is of immense importance in CI, which may otherwise lead to disastrous consequences during surgery.

     

Preventive and curative effect of methanolic extract of Gardenia gummifera Linn. f. on thioacetamide induced oxidative stress in rats

ObjectiveTo evaluate the antioxidant and antihepatotoxic effect of methanolic extract of Gardenia gummifera Linn. f. root (MEGG) on thioacetamide (TAA) induced oxidative stress in male Wistar rats.MethodsIn the preventive study, rats were administered with 125 and 250 mg/kg of MEGG for 9 days prior to TAA administration (100 mg/kg s.c.). In post-treatment groups, rats were treated with MEGG at doses of 125 and 250 mg/kg, 2, 24 and 48 h after TAA intoxication. Silymarin was used as a standard drug control (100 mg/kg). Hepatotoxicity was assessed by quantifying the serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH). The antioxidant potential of MEGG was evaluated by the estimation of catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione-S-transferase (GST), reduced glutathione (GSH) and lipid peroxidation [thiobarbituric acid reactive substances (TBARS)] in hepatic and renal tissues. Histopathological changes were also evaluated.ResultsMEGG significantly (P≤0.05) prevented the elevation of serum AST, ALT, ALP, LDH and tissue malondialdehyde levels in both experimental groups, when compared to the TAA alone treated groups. The rats receiving TAA plus MEGG exhibited significant (P≤0.05) increases in hepatic and renal antioxidant activities including GSH, GST, GR, GPx and CAT levels. Quantification of histopathological changes also supported the dose dependent protective effects of MEGG.ConclusionsThese observations suggest that MEGG has dose dependent hepatoprotective and antioxidant effect against TAA induced oxidative stress.     

Paclitaxel and its formulations

Paclitaxel (Taxol) is a promising anti-tumor agent with poor water solubility. It is effective for various cancers especially ovarian and breast cancer. Intravenous administration of a current formulation in a non-aqueous vehicle containing Cremophor EL may cause allergic reactions and precipitation on aqueous dilution. Moreover, the extensive clinical use of this drug is somewhat delayed due to the lack of appropriate delivery vehicles. Due to this there is a need for the development of alternate formulation of paclitaxel having good aqueous solubility and at the same time free of any side effects. Various approaches employed so far include cosolvents, emulsions, micelles, liposomes, microspheres nanoparticles, cyclodextrins, pastes, and implants etc. which are discussed in this paper.