Addition of senna improves quality of colonoscopy preparation with magnesium citrate

AIM： To prospectively investigate the effectiveness and patient＇s tolerance of two low-cost bowel cleansing preparation protocols based on magnesium citrate only or the combination of magnesium citrate and senna. METHODS： A total of 342 patients who were referred for colonoscopy underwent a colon cleansing protocol with magnesium citrate alone （n = 160） or magnesium citrate and senna granules （n = 182）. The colonoscopist rated the overall efficacy of colon cleansing using an established score on a 4-point scale. Patients were questioned before undergoing colonoscopy for side effects and symptoms during bowel preparation. RESULTS： The percentage of procedures rescheduled because of insufficient colon cleansing was 7% in the magnesium citrate group and 4% in the magnesium citrate/senna group （P = 0.44）. Adequate visualization of the colonic mucosa was rated superior under the citramag/senna regimen （P = 0.004）. Both regimens were well tolerated, and did not significantly differ in the occurrence of nausea, bloating or headache.However, abdominal cramps were observed more often under the senna protocol （29.2%） compared to the magnesium citrate only protocol （9.9%, P 〈 0.0003）. CONCLUSION： The addition of senna to the bowel preparation protocol with magnesium citrate significantly improves the cleansing outcome.     

Intraoral transnasal approach for surgical extraction of bilateral deeply impacted mesiodens: A case report

We describe a novel modified intranasal approach to minimize the complications of the impacted mesiodens surgical extraction. Also, it can be performed under local anesthesia with proper preoperative workup.