Group PF Research Articles

Reconciliation between the Islamic Human Rights and International Law: Prospects and Complications

The relationship between International Human Rights and Islamic Law has been always an arguable debate at the international level. This issue can be considered by jurists in two aspects. First, from National Law perspective, especially in the countries in which the law, to some extent is affected by Islamic rules. Second, by view of International Law to see that to what extent, there would be compatibility or likely contradiction between human rights norms and Islamic Law.Considering the historical aspect of the issue, this article is suggesting that although from the outset, International Law tried to separate religion from policy, but this historical fact would not prevent theoretical conciliation between religion and Human Rights rules. The review of the content of International Human Rights Law reveals that the rules in the systems in most part are compatible. However, in some cases the incompatibility between these two group pf rules is observed. The existence of different basis under Islamic Law and International Law makes the least difference unavoidable. The constant dialogue between Islamic scholars and publicists can decrease this difference in future.

Tailored Surgery in Inguinal Hernia Repair. The Role of Subarachnoid Anesthesia: A Retrospective Study.

Safety and effectiveness evaluation of subarachnoid anesthesia implemented with hyperbaric Prilocaine in reduced dose (30mg) in combination with Fentanyl (20mcg), for the purpose of ensuring an optimal analgesia in open inguinal hernia repair.Although the local anesthesia is the first line treatment for open inguinal hernia repair, a minority of patients is not eligible because of obesity or big groin hernia, requiring a high dose of local anesthetic. Subarachnoid anesthesia implemented with hyperbaric Prilocaine in reduced dose in combination with Fentanyl may be a good alternative.Thirty patients were treated with intrathecal association of Prilocaine 30 mg and Fentanyl 20 mcg (group PF); they were compared to a group of fifty three ones, previously treated with a classic procedure with intrathecal Prilocaine 60 mg (group P).The sensitive blockage remained within an higher limit at T12 level in the patients of PF group, and a lower limit at S1 level 50 minutes after the anesthesia, while in the P group the anesthetic tended to migrate (p<0.0001). In PF group 70 minutes after the anesthesia 21 patients had a Bromage score equal to 0 and 9 patients equal to 9 (in P group, 19 patients had a score equal to 3, 8 to 2 and 3 to 1, p<0.0001).Subarachnoid anesthesia using Prilocaine 30 mg + Fentanyl 20 mcg could be stated as a viable alternative to local anesthesia in selected patients.

BIS guided conditions for ProSeal laryngeal mask airway insertion – A comparison of Propofol versus sevoflurane with or without fentanyl

BIS guided conditions for ProSeal laryngeal mask airway insertion – A comparison of Propofol versus sevoflurane with or without fentanyl - IJCA- Print ISSN No: - 2394-4781 Online ISSN No:- 2394-4994 Article DOI No:- 10.18231/j.ijca.2019.061, Indian Journal of Clinical Anaesthesia-Indian J Clin Anaesth

Dexmedetomidine with propofol versus fentanyl with propofol for insertion of Proseal laryngeal mask airway: A randomized, double-blinded clinical trial

Background and Aims:Successful insertion of the proseal laryngeal mask airway (PLMA) requires much greater doses of propofol as compared to classic laryngeal mask (CLMA). Dexmedetomidine and fentanyl are equally effective adjuvants for CLMA insertion. We designed this study to compare the efficacy of these two drugs as sole adjuvant in PLMA insertion.Material and Methods:Seventy four American Society of Anesthesiologists (ASA) I and II patients were randomly allocated to receive either dexmedetomidine 1 μg/kg [Group PD] or fentanyl 1 μg/kg [Group PF]. Study drugs were diluted in 10 ml NS and administered over 10 min prior to induction of anesthesia with 2.5 mg/kg propofol. PLMA insertion condition was measured according to the Muzi scoring system. Score ≤2 was considered optimal for PLMA insertion. Patient's cardio-respiratory parameters, emergence time, and postoperative pain were also recorded.Results:In our study 83.8% patients in the group PF and 91.9% in the group PD achieved optimal insertion condition (not significant). Hemodynamic stability was maintained in both the groups but the incidence of apnea was significantly higher in the PF group (P = 0.011). We also observed that emergence time was prolonged but postoperative pain scores were significantly lower in the PD group (P < 0.001).Conclusion:We conclude that both dexmedetomidine and fentanyl in a dose of 1 μg/kg when used before induction with propofol provide comparable conditions for successful PLMA insertion. Dexmedetomidine has additional advantage of preserving spontaneous respiration and providing better analgesia.

Canal Transportation and Centering Ability of WaveOne Gold in Combination with and without Different Glide Path Techniques

IntroductionThe aim of this study was to compare centering ability and transportation values of the Primary WaveOne Gold (PWOG; Dentsply Sirona, Ballaigues, Switzerland) instrument with or without different glide path techniques. Centering ability and transportation were also compared between the 3 different glide path preparation groups. MethodsThe mesiobuccal canals of 60 extracted human mandibular molars (curvature angles between 25° and 35° and radii ≤10 mm) were selected and randomly divided into 4 groups with 15 canals each. Canals were negotiated to patency with a #8 K-file. Canal preparations were performed by a single operator using precurved #10, 15, and 20 stainless steel manual K-files (group KF); a #10 stainless steel manual K-file followed by PathFiles #1–3 (Dentsply Sirona) (group PF); a #10 stainless steel manual K-file followed by the WaveOne Gold Glider (Dentsply Sirona) (group WOGG); and no further glide path preparation (group NG). Micro–computed tomographic imaging was used to scan teeth before and after glide path preparation. The final canal preparation was performed with PWOG; after which, all 60 specimens were scanned again using micro–computed tomographic imaging. Canal transportation and centering ratio values were determined over levels 3 mm, 5 mm, and 7 mm from the root apex after glide path preparation and again after final preparation with PWOG. One-way analysis of variance was used to statistically compare groups. The significance level was set at P < .05. ResultsNo statistically significant difference in the mean centering ratios was found after glide path preparation when the KF, PF, and WOGG groups were compared (P > .05). The mean combined transportation values after glide path preparation were statistically significantly higher in the KF group compared with the PF and WOGG groups (P > .05). There was no statistically significant difference in the mean combined centering ratios or transportation values of the NG and 3 glide path groups in combination with PWOG over the 3 levels (P > .05). ConclusionKF group showed the highest mean transportation values during glide path preparation. However, the PWOG instrument's performance regarding centering ability and transportation was not influenced by the different glide path/no glide path preparation groups.

The stem fixation technique do influence the tibial alignment in TKA revisions. A comparative study between cemented and cementless / hybrid cemented tibial stems using 3D-CT

Aims and Objectives: Purpose of the study was to investigate if the fixation technique for intramedullary stems in total knee arthroplasty revisions (rTKA), influence the alignment of the components, leg axis and the rates of complications, reoperations and revisions. Materials and Methods: Sixteen patients with cemented tibial stems (Group C) and twenty-six patients with either cementless or hybrid cemented tibial stems (Group PF) were collected. All patients underwent regular clinical follow-up (41.5 months) and postoperative 3D-CT scans. Mean values of the three-dimensional rTKA component position and of the leg axis were compared between groups with the T-test. The tibial components were graded on the transversal plane into internal, neutral and external rotated, and, on the coronal plane, in neutral and varus/valgus aligned. The graded measurements and the incidences of postoperative complications, reoperations and revisions were analysed with a Chi2-Test. Results: The mean measurements of the component position did not significantly differ between groups (p < 0.05). Group C showed a tendency to internal rotation (Group C: 62.5%; Group PF: 34.6%) and a significant higher coronal alignment accuracy (p = 0.004). Group PF instead a tendency to external rotation (Group C: 25.0%; Group PF: 46.2%) (p = 0.094). Both groups presented a neutral leg alignment (Group C: 0.00° ± 3.37; Group PF: 1.04° ± 2.6) (p = 0.268). Group PF showed a tendency to more complications (Group C: 35.7%; Group PF: 60.9%; p = 0.138). No significant differences were seen between rates of reoperations (Group C: 35.7%; Group PF: 30.4%; p = 0.565) and revisions (Group C: 28.6%; Group PF: 8.7%; p = 0.894). Conclusion: The stem fixation technique influence the tibial component alignment. A more accurate coronal alignment was achieved in Group PF.

Anxiety-depressive disorders of patients with external genital endometriosis

Aim. To study the prevalence of anxiety and depression in patients with external genital endometriosis and other gynecologic pathology. Methods. The study involved 152 women. The main group consisted of 100 patients with external genital endometriosis diagnosed by laparoscopy and histologically confirmed. The comparison group included 52 women with other gynecologic pathology (infertility, hysteromyoma, ovarian benign tumours). Exclusion criteria were oncology, acute gynecologic and somatic pathology. To determine the prevalence of anxiety and depression in the groups, the hospital anxiety and depression scale was used. Results. In the group pf females with endometriosis 33 (33%) patients had anxiety and 9 (9%) patients - depression. In the comparison group (N2=52), anxiety disorder was revealed in 18 (34.6%) women, and depression - in three patients (5.8%; p 0.05). To study the features of anxiety and depression in patients with different clinical presentation of endometriosis, females with asymptomatic disease (n1=26), infertility (n2=29) and pain syndrome (n3=43) were compared. Analysis of the results demonstrated that significantly more frequently anxiety and depression developed in patients with pain syndrome. The number of women suffering from anxiety in group n3 was 22 (51.2%), in group n2 - 6 (20.7%) and in group n1 - 2 (7.8%). The number of women with depression in group n3 was 8 (18.6%), in group n2 - 1 (3.4%) and in group n1 there were no women with depression. Conclusion. The conducted study showed no significant differences in the prevalence of anxiety and depression among patients with external genital endometriosis and other gynecologic pathology; anxiety and depression develop more frequently in the presence of pain syndrome.

Incidence and predictors of osteoporotic fractures in patients with Barrett's oesophagus: a population-based nested case-control study.

Proton pump inhibitors (PPI) are inconsistently associated with osteoporotic fractures. Barrett's oesophagus (BO) patients are treated with high PPI doses for prolonged periods, but there are limited data on the incidence of osteoporosis and fractures in this group pf patients. To estimate the incidence of (and risk factors for) low bone mass (osteoporosis and/or osteopenia) related fractures in a population-based BO cohort. All subjects with BO and a diagnosis of osteoporosis and fractures were identified using Rochester Epidemiology Project resources. The incidence rates of all and osteoporotic fractures in these subjects were compared to an age- and gender similar population in Olmsted County to determine standardised incidence ratios (SIR). Predictors were assessed using Cox proportional hazards models. Five hundred and twenty-one patients were included (median [IQR] age 61 [52, 72]years; 398 [76%] men) of whom 113 (21.7%) had fractures, and 46 (8.8%) had osteoporotic fractures. The incidence of all fractures and osteoporotic fractures was comparable to that of an age- and gender-matched population (SIR 1.09; 95% CI 0.92-1.29: SIR 1.05; 95% CI 0.85-1.29). PPI use, dose or duration of use was not associated with osteoporotic fracture risk (HR 0.87; 95% CI 0.12-6.39). Independent risk factors for osteoporotic fractures included older age, female gender and higher co-morbidity index. The incidence of osteoporotic fractures was not increased in BO patients compared to the general population. In addition, PPI use was not associated with increased fracture risk regardless of the duration of therapy or dose.

Comparison of Ketamine and Fentanyl with Propofol for Procedural Sedation and Analgesia for Dilatation and Curettage

Introduction: Dilatation and curettage (D&amp;C) is a common procedure that generally causes considerable pain and usually done under procedural sedation and analgesia. Propofol is an ideal intravenous anaesthtic agent for short interventional procedure like D&amp;C but lack of analgesia remains it’s main shortcoming therefore it is always combined with an analgesic. Ketamine and fentanyl are the popular analgesic in this context. Objectives: This prospective clinical study was designed to evaluate to compare propofol ketamine combination versus propofol fentanyl combination in respect of hemodynamics and recovery time for procedural sedation and analgesia in patients undergoing D&amp;C. Methods: This prospective randomized study was performed on 100 patients who underwent elective D&amp;C procedure. Patients were randomly allocated into two groups of fifty each: group PK received propofol 2mg/kg + ketamine 1mg/kg for induction and propofol 4mg/kg/hr + ketamine 1 mg/kg/hr for maintenance anesthesia, group PF received propofol 2 mg/kg + fentanyl 2 ìg/kg for induction and propofol 4 mg/kg/hr + fentanyl 1ìg/kg/hr for maintenance of anesthesia. The pulse rate, systolic and diastolic arterial blood pressures and peripheral oxygen saturation were recorded. Recovery times, side effects of sedation were also recorded. Results: Demographic data were found similar in two groups. There were no significant differences in heart rate, systolic and diastolic arterial blood pressure in all time intervals among groups except there was statistically significant fall in systolic blood pressure after induction in PF group (P=0.005). Recovery time was statistically significant increase in Group PK compared to Group PF (p=0.004). There were no significant differences among groups in regard to side effects. Conclusion: Propofol ketamine and propofol fentanyl had similar hemodynamic stability without any important side effects for procedural sedation and analgesia in patients underwent D&amp;C but propofol ketamine had longer recovery time. JBSA 2017; 30(1): 14-20

Comparison of apical extrusion of intracanal bacteria by various glide-path establishing systems: an in vitro study.

ObjectivesThis study compared the amount of apically extruded bacteria during the glide-path preparation by using multi-file and single-file glide-path establishing nickel-titanium (NiTi) rotary systems.Materials and MethodsSixty mandibular first molar teeth were used to prepare the test apparatus. They were decoronated, blocked into glass vials, sterilized in ethylene oxide gas, infected with a pure culture of Enterococcus faecalis, randomly assigned to 5 experimental groups, and then prepared using manual stainless-steel files (group KF) and glide-path establishing NiTi rotary files (group PF with PathFiles, group GF with G-Files, group PG with ProGlider, and group OG with One G). At the end of canal preparation, 0.01 mL NaCl solution was taken from the experimental vials. The suspension was plated on brain heart infusion agar and colonies of bacteria were counted, and the results were given as number of colony-forming units (CFU).ResultsThe manual instrumentation technique tested in group KF extruded the highest number of bacteria compared to the other 4 groups (p < 0.05). The 4 groups using rotary glide-path establishing instruments extruded similar amounts of bacteria.ConclusionsAll glide-path establishment instrument systems tested caused a measurable apical extrusion of bacteria. The manual glide-path preparation showed the highest number of bacteria extruded compared to the other NiTi glide-path establishing instruments.

The curative effect of early use of enteral immunonutrition in postoperative gastric cancer: a meta-analysis.

The clinical efficacy of early enteral immunonutrition in postoperative gastric cancer patients is uncertain. The aim of this study is to assess its clinical efficacy. Use of the search engine database incuding the PubMed, the Cochrane library, Web of Science, Medline, and Embase, which present comparative studies of early efficacy of enteral immune nutrition and standard enteral nutrition after gastric cancer operation. We used the RevMan 5.3 software to meta-analyze the CD4, CD8, CD4/CD8, the length of hospitalization, postoperative complications, and postoperative weight loss. A total of 6 randomized control articles were included in this study, which comprised 606 patients. Among them, there were 308 cases of early postoperative enteral nutrition in patients with gastric cancer, and 298 cases were in standard enteral nutrition. Early postoperative enteral immune nutrition on seventh day of the CD4, CD8, and CD4/CD8 value greatly compared with standard enteral nutrition, CD4 (WMD=2.71, CI: 2.71~7.79, P<0.01), CD8 (WMD=2.71, CI: 2.71~7.79, P<0.01), CD4/CD8 (WMD=0.29, CI: 0.29~0.65, P<0.01). Postoperative complications occurred in patients with gastric cancer after operation (OR=0.46, CI 0.46 to 0.46, P<0.01), the postoperative weight loss (WMD=1.00, CI 1.00 to 2.82, P<0.01), length of hospitalization, and the value of early postoperative enteral immune nutrition group were lower than the group pf early standard enteral nutrition. The treatment which could improve the clinical efficacy of patients should be considered for future management of postoperative gastric cancer.

Safety and efficacy of dexmedetomidine sedation for elective fiberoptic bronchoscopy: A comparative study with propofol

BackgroundDexmedetomidine has sedative and sympatholytic effects. The use of dexmedetomidine in flexible fiberoptic bronchoscopy will attenuate hemodynamic response without respiratory depression. The aim of this study was to evaluate the clinical efficiency and safety of dexmedetomidine, and to compare it with the combination of propofol-fentanyl as sedation during flexible fiberoptic bronchoscopy.Patients and methodsSeventy-two patients scheduled for elective fiberoptic bronchoscopy were included and divided into two equal groups. In propofol-fentanyl group (group PF) patients received 0.5–1 mg/kg propofol and 1 μg/kg of fentanyl. Boluses of 20 mg of propofol were given to give a sedation level of 3–4 according to Ramsay sedation score. In dexmedetomidine group (group D), dexmedetomidine 1 μg/kg over 10 min was given as a loading dose, followed by a maintenance infusion of 0.2–0.7 μg/kg/h to keep the same level of sedation. Heart rate, blood pressure and oxygen saturation were recorded.ResultsHeart rate and mean arterial blood pressure values were significantly lower in group D compared to group PF all over the procedure. Group D had higher oxygen saturation values than group PF. Incidence of desaturation was more frequent in PF group (16.66%) compared to 5.55% in group D. There was no significant difference in patient satisfaction between the two groups.ConclusionDexmedetomidine and propofol-fentanyl are effective sedatives for patients undergoing flexible fiberoptic bronchoscopy. The sympatholytic and respiratory stability effects of dexmedetomidine make it an attractive and safe alternative for sedation during FOB.

Effect of C-typenatriuretic peptide on paraquat-induced pulmonary fibrosis in mice

Objective To evaluate the effect of C-type natriuretic peptide (CNP) on paraquat-induced pulmonary fibrosis in mice. Methods Fifty-four male Kunming mice, aged 8-10 weeks, weighing 30-35 g, were randomly divided into 3 groups (n=18 each) using a random number table: control group (C group), pulmonary fibrosis group (PF group) and CNP group.Paraquat 10 mg/kg (in 0.1 ml of normal saline) was injected intraperitoneally once every 3 days for 5 times in total in PF and CNP groups, and in addition CNP 3 μg/kg (in 0.1 ml of normal saline) was simultaneously injected via the tail vein once every 2 days for 14 times in total in group CNP.The equal volume of normal saline was given instead of paraquat in group C. On days 1, 8 and 15 after the end of administation of paraquat, 6 mice were sacrificed, and lungs were removed for determination of wet to dry weight ratio (W/D ratio), hydroxyproline (HYP) content (using alkaline hydrolysis), and transforming growth factor-beta 1 (TGF-β1) content (using enzyme-linked immunosorbent assay) in lung tissues. Results Compared with group C, the W/D ratio and contents of HYP and TGF-β1 in lung tissues were significantly increased at each time point after the end of administation of paraquat(P<0.05), and the pulmonary fibrosis was obvious in group PF.Compared with group PF, the W/D ratio and contents of HYP and TGF-β1 in lung tissues were significantly decreased at each time point after the end of administation of paraquat(P<0.05), and the pulmonary fibrosis was significantly attenuated in group CNP. Conclusion CNP can reduce paraquat-induced pulmonary fibrosis in mice. Key words: Natriuretic peptide, C-type; Paraquat; Pulmonary fibrosis

Micro-computerized tomography analysis of cement voids and pull-out strength of glass fiber posts luted with self-adhesive and glass-ionomer cements in the root canal

This study evaluated the pull-out strength of different glass fiber posts and measured volume of cement and voids in the cement in the root canal utilizing micro-computerized tomography (micro-CT) analysis after they were cemented with two different luting cements. Canine teeth (N = 40) were endodontically treated and randomly divided into four groups depending on the fiber post and the cement type (n = 10 per group) as follows: Group RU: (RelyX + RelyX U200), Group PU: (PINpost + RelyX U200), Group RF: (RelyX + FujiCEM 2), Group PF: (PINpost + FujiCEM 2). Each tooth was scanned using micro-CT and the percentage of cement and void volume at the coronal, middle, and apical levels was calculated. Pull-out tests were performed by applying tensile load parallel to the long axis of the posts (0.5 mm/min). Data were analyzed using, ANOVA, Kruskal–Wallis, and Mann–Whitney U tests (α = 0.05). Regardless of cement type, the percentage (%) of cement volume in the RelyX post groups (RU:31–36; RF:29–40) was significantly higher than that in the PINpost groups (PU:19–23; PF:18–22) (p < 0.05). The percentage of void volume at the PINpost groups (PU:6–11; PF:8–13) was significantly lower than that in the RelyX groups (RU:2; RF:3) (p < 0.05). No significant differences were observed in pull-out strength (N) between the four experimental groups (RU:358.8 ± 56.2; RF:299 ± 64.8; PU:311.9 ± 61.3; PF:293.1 ± 91.3) (p > 0.05). The micro-CT analysis demonstrated that the percentage of cement and void volumes vary depending on the type of fiber post and cement used. No correlation between cement, void volume, and pull-out strength was observed.

CONTENT OF CYTOSKELETON PROTEINS IN OOCYTES OF THIRD GENERATION DROSOPHILA MELANOGASTER FRUIT FLIES OBTAINED AFTER A 44.5-DAY SPACE FLIGHT.

Third-stage larvae of the third generation of Drosophila melanogaster Canton S fruit flies were obtained after a 44.5-day flight of spacecraft a<Foton-M4> (Russia, 2014). In laboratory, the larvae grew into a third generation of flies. On the second day of emergence ovaries were extracted from female flies (group pF). Similarly, a third generation of flies (group C) was raised in the synchronous experiment. Real-time RT-PCR and Western blotting were used to determine the content of cytoskeletal proteins and mRNA of respective encoding genes. The content of mRNA genes encoding beta (Act57B and Act87E), gamma-actin (Act5C), acting-binding proteins (Arpc3, Tmod, Svil, Fim and Actn), and tubulin (Betatub85D) and tubulin-binding proteins (Msps, T-cpl, Cct5, T-cpleta) was less in group pF but not in the control group. The relative content of actin cytoskeleton components reduced significantly both in membrane and cytoplasmic fractions in group pF as compared to group C; however, reduction of the cytoplasmic fraction was more dramatic. On the contrary, content of beta-tubulin, a component of the tubulin cytoskeleton, reduced more significantly in the membrane fraction in group pF but not in group C. However, the acetylated tubulin content of ovarian membrane or cytoplasmic protein fraction was found unchanged both in the pF and C groups. The data suggest the presence in animal cells, oocytes specifically, of a mechanism regulating segregation of these proteins depending on external mechanical factors.

Measuring skin to subarachnoid space depth in Egyptian population: A prospective cohort study.

Background:Lumbar puncture is a difficult medical skill and is used for administering subarachnoid anesthetic medications. Estimation of skin to subarachnoid space depth (SSD) helps to reduce post spinal anesthetic complications.Aims:To measure the SDD in overall Egyptian population and to find a formula for predicting SSD in Egyptian patients.Settings and Design:Four hundred patients of American Society of Anesthesiologist class I and II adult Egyptian patients undergoing surgery using spinal anesthesia in general and obstetric surgery unit, Mansoura University main hospital, were included in this prospective, observational study.Subjects and Methods:Patients were divided into three groups: Males (Group M), nonpregnant females (Group F), and pregnant females (Group PF). SSD was measured after performing lumbar puncture. The relationship between SSD and patient characteristics was studied; correlated and statistical analysis was used to find a formula for predicting SSD.Statistical Analysis Used:Statistical analysis was done using Statistical Package for Social Sciences (SPSS 19.0, Chicago, IL, USA). One-way ANOVA with post hoc (Bonferroni correction factor) analysis was applied to compare the three groups. All the covariates in the study further were taken for multivariate analysis. Multivariate regression analysis was performed to evaluate important covariates influencing SSD for each group separately.Results:Mean SSD was 4.99 ± 0.48 cm in the overall population. SSD in adult males (4.93 ± 0.47 cm) was significantly longer than that observed in females (4.22 ± 0.49 cm) but was comparable with SSD in parturient (4.32 ± 0.47 cm). Formula for predicting SSD in the overall population was 2.1+ (0.009 × height) + (0.03 × weight) + (0.02 × body mass index [BMI]) + (0.15 × body surface area [BSA]). Craig's formula when applied correlated best with the observed SSD.Conclusions:SSD in adult males was significantly longer than that in both pregnant and nonpregnant females, but it was nearly the same in pregnant and nonpregnant females. SSD in Egyptian population can be calculated based on height, weight, BMI, and BSA. Craig's formula was the most suitable to be applied to Egyptian population.

Estimation of Skin to Subarachnoid Space Depth: An Observational Study.

In a patient, the skin to Subarachnoid Space Depth (SSD) varies considerably at different levels of the spinal cord. It also varies from patient to patient at the same vertebral level as per age, sex and Body Mass Index (BMI). Estimation of the skin to SSD reduces complications related to spinal anaesthesia. To measure the skin to SSD in the Indian population and to find a formula for predicting this depth. Three hundred adult patients belonging to American Society of Anaesthesiologist class I and II, undergoing surgery using spinal anaesthesia in various surgical specialities of Gauhati Medical College were selected by systemic sampling for this prospective, observational study. Patients were divided into three groups: Group M containing male patients, Group F containing non-pregnant female patients, and Group PF containing pregnant female's patients. SSD was measured after performing lumbar puncture. The relationship between SSD and patient characteristics were studied, correlated and statistical analysis was used to find a formula for predicting the skin to SSD. Statistical analysis was done using Statistical Package for Social Sciences (SPSS 21.0, Chicago, IL, USA). One-way ANOVA with post-hoc(Bonferroni correction factor) analysis was applied to compare the three groups. Multivariate analysis was done for the covariates followed by a multivariate regression analysis to evaluate the covariates influencing SSD for each group separately. Mean SSD was 4.37±0.31cm in the overall population. SSD in adult males was 4.49±0.19cm which was significantly longer than that observed in female's 4.18±0.39cm which was comparable with SSD in parturient 4.43±0.19 cm. The formula for predicting the skin to SSD in the male population was 1.718+0.077×BMI+0.632×Height, in nonpregnant female population was 1.828+0.077×BMI+0.018×Height+0.007×Age and 0.748+0.209×BMI+4.703×Height-0.054×weight in parturient females, respectively. Skin to SSD correlated with the BMI in all the patients in our study.

In the Light of the Midnight Sun

In the Light of the Midnight Sun

Shear Bond Strength of Enamel-Composite Resin-Zirconia Joints

Statement of Problem: Adhesive cementation is essential to provide reliable bond strength, an improved marginal seal and esthetic performance to the zirconia fixed partial dentures. However, there are still some problems in establishment of a strong adhesive bond with zirconia, because zirconia has little or no silica content. Purpose: The aim of this study is to observe and compare the shear bond strengths of the enamel-composite resin-zirconia joints luted with different adhesive cementation protocols. Materials and Methods: Thirty pieces of zirconia discs were fabricated and divided in 3 groups. Each disc was luted to the enamel tissue of a tooth embedded in acrylic resin cylinder according to one of the following adhesive cementation protocols: 1. Hydrofluoric acid application, silanization and luting with methacrylate based composite resin cement (Group HF). 2. Silica coating, silanization and luting with methacrylate based composite resin cement (Group SC). 3. Luting with methacrylatephosphate based composite resin cement (Group PF). The shear bond strength was tested with a universal testing machine. Data were analyzed with ANOVA and multiple comparisons were made by Dunnett T3 (α =.05). Results: ANOVA revealed that the bond strengths differed significantly between all groups ( P= .00). The group SC exhibited the highest shear bond strength value, while the group HF exhibiting the lowest. Conclusions: Among the tested luting protocols, silica coating followed by silanization and luting with resin composite cement should be considered in priority for the cementation of the zirconia fixed partial dentures. Clinical Implications: Preference of the luting protocol is important to obtain long term clinical success of the zirconia fixed partial dentures.

Effects of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia

Objective To evaluate the effects of different sequences of intravenous administration on fentanyl-induced cough during induction of general anesthesia.Methods One hundred patients of both sexes,aged 18-70 yr,weighing 42-88 kg,of ASA physical status Ⅰ or Ⅱ,scheduled for elective surgery under general anesthesia,were equally randomized to 2 groups using a random number table:fentanyl-propofol group (group FP) and propofol-fentanyl group (group PF).In FP group,fentanyl 3 μg/kg was injected intravenously over 3 s,and then propofol 1.5 mg/kg was injected intravenously.In PF group,propofol 1.5 mg/kg was injected intravenously,and then fentanyl 3μg/kg was injected intravenously over 3 s.The development,intensity and onset time of cough were recorded within 1 min after fentanyl injection.Results Compared with FP group,the incidence of cough was significantly decreased,and no significant change was found in the intensity and onset time of cough in PF group.Conclusion Administration in the propofol-fentanyl sequence can reduce the development of fentanyl-induced cough as compared with that in the fentanyl-propofol sequence during induction of general anesthesia. Key words: Fentanyl; Propofol ; Cough ; Anesthesia, general