Background and Aims:Organophosphate compound poisoning (OPCP) is associated with high incidence of delirium. Melatonin has been tried in the treatment of delirium and has shown a beneficial effect in OPCP. This study was conducted to know the effect of melatonin on duration of delirium and recovery profile in OPCP patients.Methods:Double-blind randomised placebo control trial in which 56 patients of OPCP confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged >18 years and weighing between 50 and 100 kg, and Acute Physiology and Chronic Health Evaluation II score of <20 were studied. Group M (n = 26) received tablet melatonin 3 mg and Group C (n = 30) received placebo tablet at 9 PM, every night throughout the Intensive Care Unit (ICU) stay. Delirium was assessed using the Confusion Assessment Method for ICU, thrice a day. Sedation was provided with injection midazolam, fentanyl and lorazepam. Duration of mechanical ventilation, vital parameters, ICU stay, sedative and atropine requirement, were recorded.Results:The time taken to be delirium free was significantly lower in Group M (6 ± 2.92 days) compared to Group C (9.05 ± 2.75 days) (P = 0.001) and prevalence of delirium was significantly decreased in Group M compared to Group C from day 3 onwards. The requirement of midazolam (Group M - 2.98 ± 4.99 mg/day, Group C - 9.68 ± 9.17 mg/day, P < 0.001) and fentanyl (Group M - 94.09 ± 170.05 μg/day, Group C - 189.33 ± 156.38 μg/day, P = 0.03) decreased significantly in Group M. There was no significant difference in the average atropine consumption (P = 0.27), duration of mechanical ventilation (P = 0.26), ICU stay (P = 0.21) and the number of patients requiring mechanical ventilation (P = 0.50).Conclusion:Orally given melatonin in organophosphate compound poisoning patients reduces the duration of delirium and the requirement of sedation and analgesia.
INTRODUCTION: Several dietary additives are reported to be effective to enhance the immune function. Licorice has been frequently used as herbal medicine to supress inflammation. It has anti stress effects, enhance detoxification in liver and supress inflammatory reaction and enhance the immune function.
OBJECTIVES: To evaluate effect of licorice on immunomodulatory (Ig A) before and after SRP
METHODOLOGY: Twenty subjects were randomly assigned into two groups. Group A (Supplemented with licorice along with SRP ). Group B (SRP Only). All the clinical parameters like gingival index, probing depth, clinical attachment level along with serum levels of Ig A were evaluated before and after SRP.
RESULTS: There was a statistically significant increase of Ig A levels in group A compared to group B.
CONCLUSION: The present study showed that licorice extract significantly effect on enhancing the immunomodulatory effect not only the periodontal health status of chronic periodontitis and also significant effect on overall health status.
<p class="abstract"><strong>Background:</strong> Comedonal acne commonly seen in adolescents and young patients which is refractory to standard treatments. This study is being undertaken to determine the efficacy and adverse effects of oral isotretinoin, electrodessication and comedone extraction in patients of comedonalacne.</p><p class="abstract"><strong>Methods:</strong> A total of 120 patients of comedonal acne were enrolled and randomly divided into 4 groups of 30 patients each. Group A, B, C and D patients were treated with isotretinoin (20 mg daily), electrodessication, comedone extraction (4 weeks interval) and topical antibiotic daily for 12 weeks. The response in each group was assessed based on decrease in total comedonal count after 12 weeks of treatment. Statistical analysis was done using chi square test.<strong></strong></p><p class="abstract"><strong>Results:</strong> Eighty seven (72%) cases had predominantly closed comedones and 33 (27%) cases showed open comedones. After 12 weeks of treatment, more than 75% decrease in comedonal count was seen in 60% of patients in electrodessication group followed by 30% (isotretinoin), 13.3% (comedone extraction). The decrease in total number of comedone was significantly higher with electrodessication (84.4%) followed by isotretinoin (73%), comedone extraction (43.2%) and topical antibiotic (5.7%). After follow up of 3 months, recurrence of comedones was least with isotretinoin followed by comedone extraction and electrodessication.</p><p class="abstract"><strong>Conclusions:</strong> For comedonal acne, initial electrodessication followed by isotretinoin over 12 weeks gives the best outcome of quick remission and least recurrence. Electrodessication and comedone extraction are the preferred modalities in patients with predominantly closed and open comedones respectively.</p><p class="abstract"> </p>
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