Dentistry

Dental implants have been progressively used in the recent years to support and retain dental prosthesis. Implant surface roughness has been suggested as a crucial factor in implant osseointegration and long term survival of the implant and prosthesis, where a key factor for the success or failure of dental implants is the manner in which stresses are transferred to surrounding bone. In this study completely edentulous patients were rehabilitated by implant retained over denture in which two implant systems with different surface roughness were used. Peri implant bone density in Hounsfield Units (HU) was evaluated by analyze Computerized Tomographic (CT) images to judge the behavior of an implant system under functional loading, where DICOM raw data was imported into the analysis proposed system to correlate the bone density regarding to the HU values. Results are compared with clinical readings and previous findings, which it showed that there is a difference in peri implant bone density around regularly patterned and randomly patterned implant surfaces.

on the occasion of his retirement Hydroxyapatite (HA) has been extensively investigated and used in bone clinical application for more than four decades. The increasing interest in HA is due to its similar chemical composition to that of the inorganic component of natural bone. HA displays favourable properties such as bioactivity, biocompatibility, slow-degradation, osteoconduction, osteointegration, and osteoinduction. HA is commercially available either from a natural source or as synthetic HA. Various methods have been reported to prepare synthetic HA powders which include solid state chemistry and wet chemical methods. For bone applications, pure HA, biphasics with β-tricalciumphosphate (β-TCP) and HA composites have been widely investigated. HA is processed into dense bodies by sintering Avashnee Chetty, Ilse Wepener, Mona K. Marei et al. 2 and sintering temperature, stoichiometry, phase purity, particle grain size,

Background and objectives  Laryngoscopy and tracheal intubation are associated with hemodynamic responses that might increase morbidity and mortality in some patients. Lornoxicam is a nonsteroidal anti-inflammatory drug, which, when added to fentanyl, successfully attenuated the pressor response of intubation. The aim of this study was to evaluate the effect of lornoxicam on the hemodynamic response and serum catecholamine levels following laryngoscopy

Background and objectives Background and objectives Background and objectives Background and objectives: Laryngoscopy and tracheal intubation are associated with haemodynamic responses which might increase morbidity and mortality in some patients. Lornoxicam is a non-steroidal anti-inflammatory drug, which when added to fentanyl successfully attenuated the pressor response of intubation. The aim of this study was to evaluate the effect of lornoxicam individually on the haemodynamic response and serum catecholamine levels following laryngoscopy and tracheal intubation. Methods: Methods: Methods: Methods: Fifty adult patients scheduled for general anaesthesia with endotracheal intubation were enrolled in this randomised, double-blind placebocontrolled study. They were divided into two equal groups to receive intravenously either lornoxicam 16 mg or placebo, half an hour before surgery. Systolic, Diastolic and mean arterial pressure and heart rate were recorded before and after the induction of anaesthesia, and every minute after intubation for 10 minutes. Serum catecholamine levels were measured before induction and 1 minute after intubation. Results: Results: Results: Results: After induction, there was a significant decrease in blood pressure in both groups.In the control group, a significant increase in serum catecholamine levels 1 minute after intubation as well as a significant increase in the haemodynamic parameters was observed in the first 3 minutes after tracheal intubation (P <0.05). Conclusion: Conclusion: Conclusion: Conclusion: Lornoxicam 16 mg attenuates the pressor response to laryngoscopy and intubation of the trachea.

Although the American Society of Anaesthesiologists' (ASA) classification of Physical Health is a widely used grading system for preoperative health of the surgical patients, multiple variations were observed between individual anaesthetist's assessments when describing common clinical problems. This article reviews the current knowledge and evaluation regarding ASA Classification of Physical Health as well as trials for possible modification.

Immediate postoperative care of patients undergoing nasal surgery, e.g. septoplasty or rhinoplasty, could be hazardous as desaturation happens frequently especially if the patient is not fully recovered struggling for nasal breathing while the nose is packed with gauze. 1,2 Moreover, ice may be applied to the nose in the operating room to decrease swelling, and an external splint could be taped by the surgeon onto the patient's face. 3 All make it difficult to apply and fit a Hudson recovery face mask in the post-anaesthesia care unit (PACU) to maintain adequate oxygenation.

Background and objectives: Effective pain management is an important component of intraoperative and postsurgical care; it can prevent pain related clinical complications and improve the patient quality of life. This prospective, randomized, double-blind study was designed to evaluate analgesic efficacy of adding magnesium and midazolam to epidural bupivacaine in patients undergoing total knee replacement. Methods: 120 patients ASA I and II, undergoing total knee replacement surgery were enrolled to receive either bupivacaine 0.5 % or bupivacaine 0.5 % plus magnesium sulphate 50 mg as an initial bolus dose followed by a continuous infusion of 10 mg/h or bupivacaine 0.5 % plus midazolam 0.05 mg/kg as intraoperative epidural analgesia. Postoperatively, all patients were equipped with a patient-controlled epidural analgesia device. Heart rate, mean arterial pressure, oxygen saturation, respiratory rate, pain assessment using a visual analogue scale (VAS),sedation score, patients' first analgesic requirement times and postoperative fentanyl consumption were recorded. Results: The intraoperative VAS was significantly less in magnesium and midazolam groups. Whereas, in the first postoperative hour, VAS was significantly less in magnesium group. The postoperative rescue analgesia as well as the PCEA fentanyl consumption was significantly reduced in magnesium group. Conclusion: Co-administration of epidural magnesium provides better intraoperative analgesia as well as analgesic-sparing effect on PCEA consumption without increasing the incidence of side-effects.

Dilated cardiomyopathy (DCM) is characterized by dilatation and impaired systolic function of one or both ventricles. Five to eight people per 100,000 develop this disorder each year. It is more common in men. Malignant arrhythmias are the most common cause of death in DCM1. Around 50% of cases of nonischaemic dilated cardiomyopathy are idiopathic. Other causes are familial, infectious, infiltrative and connective tissue diseases. This is a report of successful anesthetic management of a patient with severe DCM undergoing a surgical procedure using combined thoracic epidural analgesia (TEA) and general anesthesia (GA).

In 1976, Gonzales-Crussi et al. (Am. J. Dis. Child. 130:1015-18, 1976) introduced the first case of bridging bronchus as a rare bronchial branching anomaly; since then, only 14 worldwide cases was described. We suggest our case might be number 15 and could be the first case of type six of this bronchial anomaly. We present a case of a 10-month-old infant with bridging bronchus, congenital tracheal stenosis, and double outlet right ventricle who underwent major laparoscopic surgery for repair of gastrointestinal anomalies to raise awareness of this rare underdiagnosed congenital anomaly and a thorough discussion of the tracheobronchial anomalies and its clinical implications.

Airway management demands much more than mere technical proficiency with traditional methods of intubation. The anesthesiologists must be highly skilled in assessing the adequacy of the airway and must be familiar with the implications of various forms of airway pathology. Difficulties in intubation have been associated with serious complications, particularly when failed intubation has occurred (1). We describe a successful fiberoptic-guided tracheal intubation following several attempts of failed intubation in a post burn patient with tissue expander.

Pain is an inherently subjective experience and should be assessed and treated as such. Pain has sensory, emotional, cognitive, and behavioral components that are interrelated with environmental, developmental, and sociocultural factors. Suffering occurs when the pain leads the person to feel out of control, when the pain is overwhelming, when the source of the pain is unknown, and when the pain is chronic. The concepts of pain and suffering go well beyond that of a simple sensory experience(1).

Propofol is an IV anesthetic that is often used as an adjuvant during monitored anesthesia care, the addition of ketamine to propofol may counteract the cardiorespiratory depression seen with propofol used alone. Ketofol (ketamine/propofol combination) was used for procedural sedation and analgesia. However, evaluation of the effectiveness of different concentrations of Ketofol in procedural operation regarding changes in haemodynamics, emergence phenomena, recovery time, the doses, and adverse effects was not yet studied, so this randomized, double blinded study was designed to compare the quality of analgesia and side effects of intravenous different concentrations of ketofol in hundred children of both sex undergoing procedural operation, e.g. esophgoscopy, rectoscopy, bone marrow aspiration and liver biopsy participated in this randomized, double-blinded study. Patients received an infusion of a solution containing either combination of propofol: ketamine (1:1) (Group I) or prop...

Background and objectives: Effective pain management is an important component of intraoperative and postsurgical care; it can prevent pain related clinical complications and improve the patient quality of life. This prospective, randomized, double-blind study was designed to evaluate analgesic efficacy of adding magnesium and midazolam to epidural bupivacaine in patients undergoing total knee replacement. Methods: 120 patients ASA I and II, undergoing total knee replacement surgery were enrolled to receive either bupivacaine 0.5 % or bupivacaine 0.5 % plus magnesium sulphate 50 mg as an initial bolus dose followed by a continuous infusion of 10 mg/h or bupivacaine 0.5 % plus midazolam 0.05 mg/kg as intraoperative epidural analgesia. Postoperatively, all patients were equipped with a patient-controlled epidural analgesia device. Heart rate, mean arterial pressure, oxygen saturation, respiratory rate, pain assessment using a visual analogue scale (VAS),sedation score, patients’ first...

Dilated cardiomyopathy is characterized by dilatation and impaired systolic function of one or both ventricles. Five to eight people per 100,000 develop this disorder each year(1). It can develop at any age and is more common in men. Dilated cardiomyopathy conveys a 50% risk of mortality within two years from onset of symptom. Sudden cardiac death resulting from malignant arrhythmias is the most common cause of death in dilated cardiomyopathy. It is the most common indication for cardiac transplant. Around 50% of cases of nonischaemic dilated cardiomyopathy are idiopathic. While other causes could be familial, Infectious causes of myocarditis, toxins (for example alcohol or chemotherapeutic agents), infiltrative disorders, nutritional deficiencies, connective tissue diseases(2). We report our experience of a successful anesthetic management of nephroureterctomy in a patient with dilated cardiomyopathy (DCM) using combined thoracic epidural analgesia (TEA) and general anesthesia (GA).

Objectives: As pain management is important to facilitate early mobilization after surgery, which in turn results in a shorter hospital stay since early discharge and patient satisfaction are important goals in day-case surgery. The aim of this study was to demonstrate the perioperative analgesic efficacy of lornoxicam in minor to moderate day-case ENT surgical procedures. Study design: Hundred and five (105) patients 18 to 52 years (yr), scheduled for day-case ENT surgery, were enrolled in this randomized, double-blind study. They were divided into three equal groups to receive intravenous (IV) lornoxicam 8 mg (group L8) or lornoxicam 16 mg (group L16) half an hour before induction or fentanyl 100 μg (group F) at induction of anesthesia. Mean arterial pressure (MAP), heart rate (HR), electrocardiography (ECG), oxygen saturation (SpO2) and end-tidal capnography (EtCO2) were recorded during the procedure. Pain, additional perioperative analgesic requirements, the incidence of postope...