Preoperative intravenous dexamethasone combined with glossopharyngeal nerve block: role in pediatric postoperative analgesia following tonsillectomy

Tonsillectomy is one of the most frequently performed ambulatory surgical procedures in children (Litman et al. in Anesth Analg 78:478–481, 1994). Several techniques have been described for alleviation of pain (Ginstrom et al. in Acta Otolaryngol 125:972–975, 2005). the objective of this study determination of the postoperative analgesic efficacy of the pre-surgical intravenous administration of dexamethasone together with glossopharyngeal nerve block (GNB) in children undergoing tonsillectomy. Prospective double blind randomized control study using both pre-operative injection of 0.5 mg/kg dexamethasone iv and 3 ml of 0.5% bupivacaine local injection for bilateral glossopharyngeal nerve block. Patients in group B had significantly less visual analogue scale values, longer absolute analgesia time, lesser swallowing difficulty and they were discharged earlier from the hospital when compared to patients in both groups D and G. Using both pre-operative dexamethasone IV injection with GNB has reduced postoperative pain and morbidity to a great extent than using either alone.     

Bioequivalence study of two metformin formulations

A randomized single-dose cross-over study was conducted on 24 healthy male volunteers to compare the bioavailability of two metformin (CAS 657-24-9) tablet formulations, Emiphage (test) and a commercially available original preparation (reference). A dose of 850 mg was administered after an overnight fast with a washout period of seven days. Eighteen blood samples were collected over 32 h. Metformin concentrations in deproteinized serum were determined by a locally validated High Performance Liquid Chromatographic (HPLC) assay, and pharmacokinetic parameters were analyzed by the standard non-compartmental method. Mean +/- SD maximum concentration (C(max)), time to reach maximum concentration (T(max)), area under the curve (AUC(0 --> t) and AUC(0 --> infinity)), and elimination half-life (t(1/2)) were 1.73 +/- 0.54 and 1.86 +/- 0.67 microg/ml, 2.6 +/- 1.2 and 2.0 +/- 1.0 h, 10.72 +/- 3.93 and 10.82 +/- 3.72 microg x h/ml, 11.53 - 4.14 and 11.6 +/- 3.84 microg x h/ml, and 3.1 +/- 0.7 and 3.1 +/- 0.9 h for the test and reference formulation, respectively. The parametric 90% confidence intervals on the mean of the difference (test - reference) between log-transformed values of the two formulations were 82.92% to 98.78%, 85.95% to 101.47%, and 77.82% to 100.4% for AUC(0 --> t), AUC(0 --> infinity), and C(max), respectively. The results indicate that the two formulations can be considered equivalent in the extent of absorption under fasting conditions.     

Immediate and delayed micro-tensile bond strength of different luting resin cements to different regional dentin

We sought to evaluate immediate and delayed micro-tensile bond strength of Panavia F2.0 and Multilink Sprint resin cement to superficial, deep and cervical dentin. Thirty-six freshly extracted non-carious human molars were sectioned in the mesiodistal direction to expose three different dentin regions including superficial dentin (1 mm below the dentine-enamel junction), deep dentin (1 mm above the highest pulp horn) and cervical dentin (0.5 mm above the cemento-enamel junction and 0.5 mm below the dentine-enamel junction). Resin cements were applied on dentin surfaces and composite blocks were luted under constant seating pressure. Each group was divided into three subgroups according to time intervals. Specimens were sectioned to obtain sticks of 1 mm² in diameter and subjected to microtensile bond strength testing at a cross head speed of 1 mm/min. Both resin cements showed higher micro-tensile bond strength to superficial dentin than that to deep or cervical dentin (P < 0.001). Micro-tensile bond strengths of Panavia F2.0 were higher than those of Multilink Sprint at different dentin regions (P < 0.001). Immediate micro-tensile bond strengths were higher than those of delayed micro-tensile bond strengths for both resin cements (P < 0.001). It was concluded that resin cements with different chemical formulations and applications yield significantly different micro-tensile bond strengths to different dentin regions.     

Outcome of Acute Kidney Injury in Sudanese Children — An Experience from a Sub-Saharan African Unit

♦ Background: Acute Kidney Injury (AKI) is an important cause of morbidity and mortality in developing countries. Although continuous renal replacement therapy is gaining more popularity worldwide, peritoneal dialysis (PD) in children remains an appropriate therapy for AKI in children for all age groups including neonates.♦ Methodology: We retrospectively reviewed all children who have been admitted with AKI at the pediatric nephrology unit, Soba University Hospital, Khartoum, during the period from January 2005 to December 2011.♦ Results: Over 7 years we recorded 659 children of whom 362 (54.9%) were male. The spectrum of age was variable with the majority being neonates, 178 (27.1%). The average patient admission rate was 94 patients per year, with an estimated incidence of 9.8 patients/million population/year. Common causes of AKI were sepsis 202 (30.8%), acute glomerulonephritis 75 (11.5%) and obstructive uropathy due to stones 56 (8.5%). The most common dialysis modality used was PD, 343 (52.4%), and peritonitis was reported in 53 (15.4%) patients. Recovery from AKI was achieved in 450 (68.9%) children, 37 (5.7%) went into chronic kidney disease (CKD), 33 (5.1%) referred to the pediatric surgery and 194 (29.7%) died.♦ Conclusion: In the setting of developing countries where AKI is a common cause of morbidity and mortality, reasonably equipped renal units with adequately trained medical staff may save many lives. International funding programs for communicable diseases and charity organizations should include AKI management in their programs. Acute PD remains the treatment modality of choice for AKI in developing countries.     

Cardioembolic strokes resulting from a self‐inflicted needle puncture involving both sides of the heart

Foreign bodies in the heart are rare occurrences with a limited evidence base to guide recommendations on management. We report a case of multiple cardioembolic strokes as a result of a self‐inflicted sewing needle puncture from the anterior chest through the right ventricle and interventricular septum with its tip in the left ventricle close to the subvalvular apparatus in a 39‐year‐old psychiatric patient. We discuss issues surrounding decision making and ongoing care and highlight the importance of further follow‐up and reporting of cases to form a robust evidence base to guide future recommendations.     

Correction to: A Preliminary Toxicology Study on Eco-friendly Control Target of Spodoptera frugiperda

Bulletin of Environmental Contamination and Toxicology - The original version of the article unfortunately contained a mistake in first author. Li-Kui Wang and Fen Li are co-first author in this...