This is an initial study assessing the use of N(2)O for insufflation; the results of our study suggest N(2)O PP has a definitive advantage over CO(2) PP. Further multicentric randomized trials are necessary before N(2)O becomes the standard insufflating agent.
Background
Behavioral management techniques are employed for children who are fearful and uncooperative. Pharmacologic sedation and anesthesia are frequently utilized to manage pain and anxiety in pediatric dental patients.
Aim
To evaluate the intraoperative and postoperative pain levels during dental treatment of children sedated with 1.5 μg/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide.
Materials and methods
In this crossover study, 24 children between the ages of five and seven years were randomly assigned to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhaled nitrous oxide during three different visits. At each visit, a single pulp therapy procedure was conducted after administering the respective sedative agent, and the pain levels were documented. There was a one-week interval between each visit to allow for a washout period. The data were analyzed using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp, Armonk, NY, United States) using the Wilcoxon signed-rank test and Kruskal-Wallis H test (p < 0.05).
Results
All three sedative agents were equally effective in controlling postoperative and intraoperative pain. Although there was no statistically significant difference among the groups, clinically, midazolam showed lower intraoperative pain levels (mean 1.78 ± 1.42).
Conclusion
In pediatric dental patients, intranasal midazolam at a dosage of 0.3 mg/kg and intranasal dexmedetomidine at a dosage of 1.5 μg/kg demonstrate comparable effectiveness to nitrous oxide sedation in pain management. These options serve as effective alternatives for anxious children who may not tolerate nitrous oxide sedation.
Ollier's disease is characterized by multiple skeletal enchondroma. There are published data regarding Ollier's disease being associated with vascular malformations and non-skeletal neoplasms. We report a case of Ollier's disease in a young male associated with osteochondroma, low grade glioma in the insular cortex of brain and Gilbert's syndrome. Technetium-99m methylene diphosphonate whole body bone scan is a sensitive investigation to ascertain the complete extent of skeletal involvement particularly the asymptomatic sites.
Tumors that commonly metastasize to the bone are carcinomas arising in the prostate, breast, lung and neuroblastoma. Rarely epithelial tumours of the ovary metastasize to the bone and bone marrow. There are only few case reports in the literature describing bone and bone marrow metastasis from primary as well as secondary Krukenberg tumours of the ovary. We present a case of an adenocarcinoma of stomach and bilateral metachronous ovarian Krukenberg tumour (secondary) who was referred to our department with complaints of generalised bone pains. Technetium 99m (Tc 99m) MDP whole body bone scan was done which revealed metastasis throughout skeletal system (super scan). JMS 2014;17(2):64-68
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