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4% lidocaine versus 4% articaine for inferior alveolar nerve block in impacted lower third molar surgery

  • Boonsiriseth, Kiatanant;Chaimanakarn, Sittipong;Chewpreecha, Prued;nonpassopon, Natee;Khanijou, Manop;Ping, Bushara;Wongsirichat, Natthamet
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.17 no.1
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    • pp.29-35
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    • 2017
  • Background: No study has compared lidocaine with articaine, each at a concentration of 4% and combined with epinephrine. The purpose of this study was to compare the effectiveness of 4% lidocaine with that of 4% articaine, with a concentration of 1:100,000 epinephrine added to each, in an inferior alveolar nerve block for surgery on impacted lower third molars. Method: This study was conducted at the Faculty of Dentistry, Mahidol University in Bangkok, Thailand. The randomized, single-blind, comparative split-mouth study was carried out in patients with symmetrically impacted lower third molars, as identified on panoramic radiographs. Each patient underwent surgery for the removal of the lower third molars by the same surgeon under local anesthesia at two separate visits, 3 weeks apart. The onset and duration of local anesthesia, intra-operative pain, surgical duration, and number of additional anesthetics administered were recorded. Results: The subjective and objective onset of action for the local anesthetics showed statistically significant differences (P < 0.05). However, the intra-operative pain, surgical duration, duration of local anesthesia, and number of additional anesthetics administered did not show statistically significant differences. Conclusion: The use of 4% articaine for the inferior alveolar nerve block was clinically more effective in the onset of subjective and objective anesthesia as compared with the use of 4% lidocaine. Based on the pain scores from the visual analogue scale, 4% lidocaine provided more analgesia during the procedure, and patients noted less intra-operative pain than with 4% articaine; however, the difference was not clinically significant.

THE COMPARATIVE STUDY ON THE EFFICACY OF CHLORAL HYDRATE AND HYDROXYZINE OF DIFFERENT DOSES IN SEDATING YOUNG PEDIATRIC DENTAL PATIENTS (Chloral hydrate와 병용투여 시 Hydroxyzine용량에 따른 진정효과의 비교연구)

  • Lee, In-Cheon;Kim, Jong-Soo;Kwoon, Soon-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.3
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    • pp.430-440
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    • 2001
  • Orally administered chloral hydrate is often used, because of it's wide margin of safety and relatively few sideeffects. Hydroxyzine is an antihistamine with sedative and anti-emetic properties. It has been used in conjunction with chloral hydrate to reduce the incidence of nausea and vomiting. But, it's therapeutic drug concentration has not been established. The purpose of this study was to assess the sedative effect and physiologic parameter of hydroxyzine of different doses in sedating young pediatric dental patients. Fifty uncooperative children, mean age 33.2 months, who needed at least four separate restorative visits, requiring local anesthesia participated in this study. On every visit, one of the following 4 different sedative regimen was given (1) 70mg/kg CH (2) 70mg/kg CH and 1mg/kg HD (3) 70mg/kg CH and 2mg/kg HD (4) 70mg/kg CH and 3mg/kg HD. Physiologic parameter was recorded and behavior was videotaped and rated using Ohio State University Behavior Rating Scale by one investigator, blind to the dose. The analyzed sedative effect of combined oral administration of 70mg/kg chloral hydrate and 2mg/kg hydroxyzine was superior to the other regimens. Evidence of adverse effect was not detected or reported during and/or after the procedures.

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The Effects of Curl-up Exercise using XCO on Trunk Muscle Activation in Healthy Adults

  • Lim, Jae-Heon;Cho, Woon-Su
    • The Journal of Korean Physical Therapy
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    • v.32 no.4
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    • pp.210-216
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    • 2020
  • Purpose: This study examined the effects of curl-up using XCO® on trunk muscle activation in healthy adults. Methods: This study design was a single-blind randomized controlled trial. Twelve participants were enrolled in this study. The subjects were instructed to perform curl-up exercise in STCU (straight curl-up), LTCU (left twist curl-up), RTCU (right twist curl-up), TWCU (twist curl-up), and PPCU (power push curl-up). Electromyography was used to assess the percent maximal voluntary isometric contraction (%MVIC) of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles. The data were analyzed using two-way ANOVA with a repeated measure. The statistical significance level was set to α=0.05 Results: The IO showed significant differences in the main effect of the group and the interactions between the group and exercise (p<0.05). In particular, the IO represented the interactions between group and exercise in the RTCU and PPCU (p<0.05). The RA, EO, and ES did not show significant interactions between the group and exercise (p>0.05). The RA, IO, and EO showed significant differences in the main effect of the group (p<0.05). The EO showed a significant difference in the main effect of exercise (p<0.05). Conclusion: These findings suggest that XCO® can be used to increase the muscle activation of the internal oblique, which is the lumbar stabilizing muscle, when XCO® is combined in the curl-up exercise with rotation. In the future, research on the intensity, frequency, and duration of XCO® exercise will be needed according to the individual characteristics and preferences.

Clinical and microbiological effects of egg yolk antibody against Porphyromonas gingivalis as an adjunct in the treatment of moderate to severe chronic periodontitis: a randomized placebo-controlled clinical trial

  • Xu, Yan;Selerio-Poely, Tshepiso;Ye, Xingru
    • Journal of Periodontal and Implant Science
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    • v.48 no.1
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    • pp.47-59
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    • 2018
  • Purpose: To evaluate the clinical and microbiological effects of the local use of egg yolk immunoglobulin against Porphyromonas gingivalis (anti-P.g. IgY) as an adjunct to scaling and root planing (SRP) in the treatment of moderate to severe chronic periodontitis. Methods: This was a randomized, placebo-controlled, double-blind trial involving 60 systematically healthy patients with moderate to severe chronic periodontitis. Subjects (n=20/group) were randomly assigned to receive SRP combined with subgingival irrigation of anti-P.g. IgY and anti-P.g. IgY mouthwash, subgingival irrigation of 0.2% chlorhexidine and 0.2% chlorhexidine mouthwash, or subgingival irrigation of placebo and placebo mouthwash for 4 weeks. Probing pocket depth, clinical attachment level, bleeding on probing, and the plaque index were evaluated at baseline and at 4 weeks. Subgingival plaque, gingival crevicular fluid, and saliva were simultaneously collected for microbiological analysis. Results: Our results showed that anti-P.g. IgY mouthwash was as effective as chlorhexidine at improving clinical parameters over a 4-week period. All the groups showed a significant reduction in levels of P.g. at 4 weeks. No significant difference was observed in the test group when compared to placebo regarding the reduction in the levels of P.g. Anti-P.g. IgY significantly suppressed the numbers of red complex bacteria (RCB) in subgingival plaque and saliva in comparison with placebo. No adverse effects were reported in any of the subjects. Conclusions: Within the limitations of the study, the present investigation showed that passive immunization with anti-P.g. IgY may prove to be effective in the treatment of chronic periodontitis due to its ability to improve clinical parameters and to reduce RCB. No significant differences were found between the anti-P.g. IgY and placebo groups in the reduction of P.g.

Effects of an Aromatherapy Education Program on Stress, Self-efficacy, and Autonomic Nervous System Function of Female College Students Preparing for Employment (아로마테라피 교육 프로그램이 취업준비 여대생의 스트레스와 자기효능감 및 자율신경계에 미치는 영향)

  • Eun-Joo Lee;Eun-Jin Lim
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.3
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    • pp.11-23
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    • 2023
  • Purpose : The stress of job-seeking college students is gradually worsening due to the continuing recession in the job market. Therefore, this study aims to verify whether intervention with an 'aromatherapy education program,' which combines theory and practice, has greater effect on stress, self-efficacy, and autonomic nervous system function than simple inhalation of essential oils in female college students preparing for employment. Methods : A single-blind, randomized controlled trial was conducted once a week for a total of 4 weeks with 29 female college students preparing for employment. Interventions included essential oil inhalation combined with an aromatherapy education program (experimental group(EG), n=14) and essential oil inhalation alone (control group(CG), n=15); measurements were taken before, immediately after, and 2 weeks after completion of the intervention. Evaluations were conducted using the job-seeking stress scale, stress VAS, self-efficacy scale, and a pulse-wave measuring instrument. Results : There were significant differences between the CG and EG groups with repeated measurements of job-seeking stress (p=.003), cognitive stress (p<.001), and self-efficacy (p<.001). There was a significant interaction between group and time. There were also significant differences between the CG and EG in terms of autonomic nervous system changes stress index(p=.047), total power(p=.029), high frequency(p=.036), and low frequency/high frequency ratio(p=.049). However, there was no significant difference in low frequency between the groups. Conclusion : The aromatherapy education program was more effective in improving job-seeking stress, cognitive stress, self-efficacy, and autonomic nervous system function than simple essential oil inhalation. For the aromatherapy education program to be useful as a complementary intervention for stress management in job seekers, it will be necessary to gather additional evidence of its efficacy by conducting follow-up studies with diverse participants and expanding the numbers, and durations, of the interventions.

Effects of Suboccipital Muscle Inhibition and Neck Muscle Stabilization Exercise on Pain and Range of Motion in Patients with Chronic Non-Specific Neck Pain (뒤통수밑근 억제기법과 목 안정화 운동이 만성 비특이적 목 통증 환자의 통증과 관절가동범위에 미치는 영향)

  • Chool-Hyeong Rhee;Eun-Jin Lim
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.1
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    • pp.125-138
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    • 2024
  • Purpose: The aim of this study was to apply suboccipital muscle inhibition combined with neck muscle stabilization exercise to 20~30s IT industry employees who suffer from chronic non-specific neck pain. Methods: This study was designed as single-blind and randomized controlled trial. The study participants were 20~30s IT industry employees with chonic non-specific neck pain (VAS 3/10) who were divided into an experimental group (n= 20) subjected to suboccipital muscle inhibition with neck muscle stabilization exercise, and control group (n= 20); suboccipital muscle inhibition only. The intervention was applied three times per week for eight weeks. The neck pain·pressure pain threshold·range of motion, and disability index were measured at the 1st, 8th, and 10th week at follow up, then analyzed with an analysis of variance(ANOVA) using the SPSS program. Results: The total number of study participants was 37 (experimental group 19, mean age 34.6±5.3, control group 18, mean age 35.7±4.9). The comparison and analysis of change in VAS, the pressure pain threshold, and the range of motion except the extension (p>.05) revealed a statistically significant decrease between groups over eight weeks and follow up measurement (p<.01). Regarding the within the group differences, the right side of the neck pressure pain threshold showed a statistically significant decrease over eight weeks in the control group (p<.01). The right and left lateral flexion, and the right and left rotation were statistically significant for the experimental group over eight weeks and follow up measurement, but only the left lateral flexion (p<.05) for the control group over eight weeks. The neck disability index showed a slight decrease but this was not satistically significant for the between-grop or the within-group differences (p>.05). Conclusion: The intervention of suboccipital muscle inhibition and a neck muscle stabilization exercise are more beneficial for neck pain and the range of motion than the application of suboccipital muscle inhibition alone.

The Effect of the Combination of Ginseng, Tribulus Terrestris, and L-arginine on the Sexual Performance of Men with Erectile Dysfunction: a randomized, double-blind, parallel, and placebo-controlled clinical trial

  • Reza Tahvilian;Mohammad Amin Golesorkhi;Farajollah Parhoudeh;Fatemeh Heydarpour;Hossein Hosseini;Hojjat Baghshahi;Hossein Akbari;Mohammad Reza Memarzadeh;Mehdi Mehran;Hosna Bagheri
    • Journal of Pharmacopuncture
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    • v.27 no.2
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    • pp.82-90
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    • 2024
  • Objectives: Nitric oxide is the most important mediator of penile erection after the onset of sexual excitement. It activates cyclic guanosine monophosphate (cGMP), increasing penile blood flow. Most pharmaceutical medications prevent enzyme phosphodiesterase type 5 (PDE-5) from breaking down cGMP, thus keeping its level high. However, due to the adverse effects of pharmacological therapies, herbal drugs that improve sexual function have gained attention recently. This study aimed to investigate the combined effects of ginseng, Tribulus terrestris, and L-arginine amino acid on the sexual performance of individuals with erectile dysfunction (ED) using the 5-item version of the International Index of Erectile Function (IIEF-5) questionnaire. Methods: Over three months, 98 men with erectile dysfunction were randomly assigned to receive either 500 mg of herbal supplements or placebo pills. Each herbal tablet contained 100 mg of protodioscin, 35 mg of ginsenosides, and 250 mg of L-arginine. Results: The results showed that the changes in the average scores of ILEF-5 within each group before and after the intervention indicated that all parameters related to the improvement of sexual function in patients with erectile dysfunction improved in the herbal treatment group (p < 0.001). The herbal group significantly improved IIEF-5 scores in nondiabetics (p < 0.05). However, there was no significant difference in the changes of IIEF-5 scores between the two intervention and control groups in diabetic patients. Conclusion: In conclusion, ginseng, Tribulus terrestris, and L-arginine have properties that increase energy and strengthen sexual function, making them suitable for patients with sexual disorders.

Comparing the efficacy of adrenaline, clonidine, and dexmedetomidine in enhancing local anesthesia for impacted third molar extraction: a randomized controlled trial

  • Akash Doshi;Nitin Bhola;Anchal Agarwal
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.4
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    • pp.285-295
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    • 2024
  • Background: In human dentition, the most commonly impacted teeth are the mandibular third molars (M3M). The removal or extraction of these teeth often causes anxiety in patients due to the perceived pain involved in the process. Therefore, pain must be effectively managed using anesthesia. The use of newer local anesthetic drugs can help minimize side effects and drug interactions. Traditionally, adrenaline is used as a vasoconstrictor along with lignocaine. When combined with lignocaine, the alpha agonists dexmedetomidine and clonidine can extend the duration of anesthesia, thereby reducing the need for additional pain-relieving medications. Methods: This study used a randomized, triple-blind, parallel-arm design. Sixty patients were screened, and 45 systemically healthy patients requiring unilateral surgical removal of impacted mandibular third molars with similar difficulty (moderate-to-difficult according to the Modified Pederson's Index) were included in the study. Patients were allocated into three groups as follows: Group A: 2% Lignocaine Hydrochloride with 1:100,000 Adrenaline, Group C: 2% Lignocaine Hydrochloride with 15 ㎍/mL Clonidine, and Group D: 2% Lignocaine Hydrochloride with 1 ㎍/mL Dexmedetomidine. The evaluated parameters were the time of onset of anesthesia, depth of anesthesia, hemodynamic parameters, and duration of postoperative analgesia. Results: Group D had a faster onset of action and prolonged duration of postoperative analgesia compared with Groups A and C. No statistically significant differences were observed between the three groups in terms of the depth of anesthesia and hemodynamic parameters. Conclusion: Group D exhibited a significantly more rapid onset of anesthesia than Groups A and C, and the postoperative analgesic effect in Group D was significantly prolonged (7.22 hours) compared with that in Groups A (4.54 hours) and C (2.1 hours). Patients receiving the Group D solution experienced an extended period of comfort without the need for analgesics for up to 7.22 hours post-procedure.

Photobiomodulation by soft laser irradiation with and without ibuprofen improves success rate of inferior alveolar nerve block using 2% lignocaine with adrenaline in symptomatic irreversible pulpitis of mandibular molar teeth: a double-blind, randomized placebo-controlled trial

  • Shahnaz;Sweta Rastogi;Vivek Aggarwal;Sanjay Miglani
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.5
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    • pp.341-350
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    • 2024
  • Background: Achieving successful pain control and adequate anesthesia through an inferior alveolar nerve block for endodontic treatment in cases with symptomatic irreversible pulpitis (SIP) is difficult, especially in mandibular molars. This study was designed to compare the effect of oral medication with ibuprofen and soft laser therapy on inferior alveolar nerve block during endodontic treatment. Methods: The trial comprised 180 patients (45 each group) with SIP. Four groups of patients were created: group 1 received 400 mg of ibuprofen; group 2 received soft laser irradiation; group 3 received a combination of soft laser and ibuprofen 400 mg; and group 4 received a placebo 1 h prior to local anesthesia. Patients recorded their pain scores on the Heft-Parker visual analog scale (VAS) before the start of intervention, 15 min after anesthesia, during access cavity preparation, and ultimately during root canal instrumentation. Each patient also rated their level of discomfort on a VAS. Every stage with no or minimal discomfort was deemed successful. The chi-square, Kruskal-Wallis, and one-way analysis of variance tests were used to evaluate the data. Results: The best success rate was achieved for soft laser ibuprofen combination, ibuprofen and soft laser groups reported similar success results, and control group recorded the least pain scores. The mean pain scores were lowest for group 3 and highest for group 4 (P < 0.001). Ibuprofen and soft laser combination was significantly better than control group (P < 0.001). There was no significant difference between ibuprofen and laser groups (P = 0.24). Conclusions: For teeth with irreversible pulpitis, preoperative ibuprofen treatment combined with soft laser irradiation greatly improved the success rates of inferior alveolar nerve block anesthesia.

Radiation Therapy of Nasopharyngeal Cancers (비인강암의 방사선치료성적)

  • Shin, Sei-One;Kim, Sung-Kyu;Kim, Myung-Se
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.312-320
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    • 1992
  • Radiotherapeutically, nasopharyngeal cancer is an important disease in korea. Because of its blind anatomic location, early detection is relatively uncommon. Clinically, most of cases are locally advanced and nodal involvement are common. Recently better understanding of nature of the disease and improvement of radio-therapy technique permit better treatment results, including locoregional control and survival rate, and minimal normal tissue damages comparing with previously published data. We analyzed 31 patients of pathologically proven and previously untreated naso-pharyngeal carcinoma with different treatment techniques, retrospectively. Minimal and maximal follow up period of the survuor is 6 months and 68 months, respectively. Thirteen patients with squamous cell carcinoma are included in this analysis. The median age is 49 years(range from 20 to 64 years). Twenty two patients are stage III. Eleven patients are treated with radiotherapy alone and 20 are treated with comblined modalities treatment. The degree of responses after radiotherapy are categorized by 3-classes, i.e. complete response, partial response. In spite of simioarities of complete response rate and 1-year survival rate between two different treatment techniques, those patients with undifferentiated carcinoma appear to benefit from the adjuvant chemotherapy. In addition, systemic failure is more prominant in radiotherapy alone group than in combined modalities treatment group. These results suggest that adjuvant therapy in the radiotherapeutic management of nasopharyngeal cancers needs additional research according to histologic types and future extensive clinical trials.

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