Search

Aim To evaluate the potential of antimicrobial photodynamic therapy ( aPDT) as an adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis. Material and Methods In a single-centred randomized and controlled clinical trial, 90 patients (51 females and 39 males) with untreated chronic periodontitis were randomly assigned to receive SRP with aPDT (test group) or SRP alone (control group). Clinical parameters and halitosis were recorded for 6 months after treatment by a periodontist who was blinded to the procedure. Results Inter-group and intra-group statistical analyses were performed. Significant difference between the two groups with respect to each variable was assessed using non-parametric Rank Order ancova. Probing pocket depth and clinical attachment levels showed statistically significant reduction in the test group on evaluation at 3 months and 6 months as compared to the control group ( p < 0.05). A statistically significant improvement in gingival index and gingival bleeding index was seen for the test group after 2 weeks and 1 month of aPDT ( p < 0.01), whereas the improvement in gingival index and gingival bleeding index at 3 months and in plaque index at 2 weeks after aPDT was less ( p < 0.05). Also, a significant difference was detected for the test group at 1 month in terms of halitosis ( p < 0.05), which did not persist for long. Conclusions Antimicrobial photodynamic therapy acts as a beneficial adjunct to SRP in non-surgical treatment and management of chronic periodontitis in short-term. Further studies are required to assess the long-term effectiveness of aPDT. [ABSTRACT FROM AUTHOR]

Background and Objective As thyroid surgery is being performed as an ambulatory procedure, recent studies concerning post thyroidectomy analgesia have focused on regional techniques such as bilateral superficial cervical plexus block ( BSCPB) and bilateral combined superficial and deep cervical plexus block. But, data regarding the efficacy of BSCPB are controversial. Hence we compared the efficacy of BSCPB with 0.25% bupivacaine with and without clonidine in thyroidectomy, as preventative analgesia. Methods Patients ( n = 60) undergoing thyroidectomy were randomized into 3 groups ( n = 20 each) to receive BSCPB using 15 mL of 0.25% bupivacaine (group B) or 0.25% bupivacaine with 1 μg/kg clonidine (group BC) or 0.9% normal saline (group S) on each side after induction. Intraoperative (fentanyl) and postoperative (morphine) analgesic requirements were assessed. Postoperative pain scores, nausea, vomiting, and sedation were assessed for 24 hours. Results Intraoperative fentanyl requirement was significantly lesser in groups B and BC ( P = 0.012). Postoperative pain scores were significantly lower in group BC (compared to S) at 2 ( P = 0.002), 4 ( P = 0.016), and 8 ( P = 0.012) hours. First analgesic requirement time (min) was significantly higher in groups B and BC ( P = 0.002), and postoperative morphine requirement was significantly lower in groups B and BC ( P = 0.001). Incidence of postoperative vomiting was significantly reduced in group BC ( P = 0.022). Conclusion BSCPB with 0.25% bupivacaine with or without clonidine is effective in reducing both intraoperative and postoperative pain and analgesic requirements in thyroidectomy, and adding clonidine to bupivacaine reduces postoperative vomiting. [ABSTRACT FROM AUTHOR]

Aim: Retained placenta is an important cause of maternal mortality. The present study was aimed to determine the efficacy of umbilical injection of oxytocin as a treatment modality in this condition. Material and Methods: This was a single-center randomized controlled trial incorporating 58 women with retained placenta of more than 30 min, equally distributed into two study arms of intra-umbilical injection of oxytocin (50 IU oxytocin diluted with normal saline [NS] to a total volume 30 mL) and intra-umbilical injection of NS (30 mL). Primary outcome was expulsion of the placenta within 30 min following intervention. All the data were analyzed on an intention-to-treat basis. Results: The success rate in the intra-umbilical oxytocin group was 51.72% compared to 20.69% in the control arm. This difference in the primary outcome was statistically significant with a P-value < 0.05 ( P = 0.014) favoring intra-umbilical oxytocin infusion with an efficacy rate of 1.5 and a number-needed-to-treat of 3. The peripartum bleeding complications were more in the NS group with a statistically higher ( P < 0.001) requirement of extra oxytocin to control post-partum bleeding. There were no differences between the two groups in respect to other secondary outcomes, such as post-partum fever, antibiotic requirement and hospital stay. Conclusion: Umbilical vein injection of 50 IU oxytocin in 30 mL of NS delivered effectively via the umbilical cord with milking in cases of retained placenta seems a simple and promising technique to reduce the incidence of a potentially morbid procedure and other complications. [ABSTRACT FROM AUTHOR]

Objective: To ascertain the prevalence of urinary incontinence in a sample of women from northern India, and the impact of behavioral therapy to treat its occurrence and severity.Methods: A randomized controlled trial conducted from 2005-2006 to test the null hypothesis that behavioral therapy would not have an effect on urinary incontinence. Following a prevalence study, a total of 198 women with urinary incontinence were randomized into 2 groups: an intervention group (behavioral therapy) and a control group (no therapy).Results: The prevalence of urinary incontinence was 11.6%. After an 8-month follow-up period, 41 women (52.5%) in the intervention group had become continent, and severity had shifted from severe to mild in 19 women (24.4%). In contrast, 11 women (12.8%) in the control group had become continent. In the intervention group, mean daytime voiding frequency decreased from 9.56 to 7.64, mean nighttime voiding frequency decreased from 1.45 to 0.69, and mean episodes of urine leakage decreased from 1.97 to 0.23.Conclusion: Behavioral therapy was effective in treating urinary incontinence, particularly in women with mild and moderate incontinence. [ABSTRACT FROM AUTHOR]