Sedative effect and physiological changes in horses treated with intramuscular injection of detomidine and morphine

ABSTRACT: This study aimed to elucidate the sedative effect and physiological changes associated with the intramuscular injection of detomidine combined with morphine in horses. Six healthy crossbred horses, aged 2 to 10 years, were included. A crossover experimental design was used to compare the effects of intramuscular injection of 30 µg/kg of detomidine alone (IMD) and intramuscular administration of 30 µg/kg of detomidine and 0.1 mg/kg of morphine (IMDM). The degree of sedation, height of head above ground, were assessed at the time points before and 5, 10, 20, 30, 40, 50, 60, 75, 90, 105, and 120 minutes after drug administration, and heart rate, respiratory rate, systolic blood pressure, rectum temperature and intestinal motility were assessed at the time points before and 10, 20, 30, 40, 50, 60, 75, 90, 105, and 120 minutes after drug administration. The physiological parameters were analyzed using the Kruskal-Wallis test with Dunn’s post-hoc test and analysis of variance with t-test for independent samples and the sedation scores using the Friedman test and Mann Whitney U-test. P-values <0.05 indicated a statistically significant difference. IMDM promoted a higher sedative effect as compared to IMD, but the sedation occurred inconsistently. Additionally, a reduction in intestinal motility was observed with IMDM at 60, 75, 90, and 105 minutes after administration. IMDM promoted more variable sedation and prolonged reduction in the intestinal motility in the horses as compared to IMD.

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Abstract 469: Residential Lifestyle Interventions Reduce Blood Pressure in 18 Days

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.36.suppl_1.469 ◽

2016 ◽

Vol 36 (suppl_1) ◽

Author(s):

Francisco E Ramirez ◽

Jill Siebold ◽

Linda Ivy ◽

Kathelyn Antuna ◽

Albert Sanchez ◽

...

Keyword(s):

Blood Pressure ◽

Diastolic Blood Pressure ◽

Linear Trend ◽

Lifestyle Interventions ◽

Blood Pressure Medication ◽

Significant Linear Trend ◽

Time Points ◽

Positive Effects ◽

Significant Difference ◽

Post Hoc

Background: Tight control of blood pressure can have long term positive effects, non-pharmacological interventions to achieve it are documented in this study. Hypothesis: Vegan diets together with other lifestyle changes can safely decrease blood pressure. Methods: Twelve years of data was used, 1196 patients participated in a lifestyle program in Weimar California. The intervention consisted in whole food plant based diet (WFPD), exercise, sleep hygiene, medical, psychological and spiritual therapies. Treatments of massage and hydrotherapy were also given. A physician monitored the progress of each patient during the 18 days. Blood pressure was measured at baseline, at the end of the first week (time 1) and at the end of the second week (time 2) and at the end of 18 days. Some patients need it to decrease their blood pressure medication during the 18 days. Data was process with SPSS statistics package. Results: From 1196 patients, 764 of them were females. Mean age at baseline was 60.7 SD 15. Both systolic and diastolic blood pressure were reduced throughout treatment. For systolic on average (in mm HG) at baseline: 132.21, at time 1: 125.3, at rime 2: 121.96, at the end : 121.4. For diastolic on average (in mm HG) at baseline: 76.1, time 1: 72.2, time 2: 70.86, at the end : 69.9. A repeated measures ANOVA determined that mean systolic blood pressure differed significantly between time points (F(3,3585) = 69.008, P < .001). Post hoc polynomial contrasts revealed a significant linear trend in the data from start to end (F(1,1195 = 206.474. p<.001, partial η 2 = .14)). A similar pattern was found for diastolic blood pressure. The overall ANOVA found a significant difference in time points (F(3,3585) = 34.738, P < .001). Post hoc polynomial contrasts also showed a significant linear trend (F(1,1195 = 109.031. p<.001, partial η 2 = .08). Participants lost 4.8 pounds on average by the end of the program. Conclusion: WFPD together with lifestyle interventions are associated with a significant reduction of systolic and diastolic blood pressures. Many patients reduced their blood pressure medication. Lifestyle interventions options should be offered to patients with hypertension.

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Function and Knee Range of Motion Plateau Six Months following Lateral Tibial Plateau Fractures

The Journal of Knee Surgery ◽

10.1055/s-0039-1678676 ◽

2019 ◽

Vol 33 (05) ◽

pp. 481-485 ◽

Cited By ~ 2

Author(s):

Anthony V. Christiano ◽

Christian A. Pean ◽

David N. Kugelman ◽

Sanjit R. Konda ◽

Kenneth A. Egol

Keyword(s):

Range Of Motion ◽

Tibial Plateau ◽

Tibial Plateau Fractures ◽

Lateral Tibial Plateau ◽

Post Hoc Analysis ◽

Time Points ◽

Significant Difference ◽

Friedman's Test ◽

Post Hoc ◽

Bicondylar Tibial Plateau

AbstractThe purpose of this study is to determine when functional outcome no longer improves following tibial plateau fracture. A patient series of operatively treated tibial plateau fractures was reviewed. Patients were evaluated using the short musculoskeletal function assessment (SMFA), range of motion (ROM) assessment, and pain levels at visual analog scale (VAS) at 3, 6, and 12 months postoperatively. Fractures were classified by the Schatzker's classification using preoperative imaging. The case series was divided into two groups based on fracture patterns. Friedman's tests were conducted to determine if there were differences in SMFA, ROM, or VAS throughout the postoperative course. A total of 117 patients with tibial plateau fractures treated operatively, with complete follow-up and without complication, were identified. Seventy-seven patients (65.8%) sustained lateral tibial plateau fractures (Schatzker's I–III). Friedman's test demonstrated significant differences in SMFA (p < 0.0005) and ROM (p < 0.0005) at the three time points. Post hoc analysis demonstrated a significant difference in SMFA (p < 0.0005) and ROM (p = 0.003) between 3 and 6 months postoperatively but no significant difference in either metric between 6 and 12 months postoperatively. Friedman's test demonstrated no significant difference in VAS postoperatively (p = 0.210). Forty patients (34.2%) sustained medial or bicondylar tibial plateau fractures (Schatzker's IV–VI). Friedman's test demonstrated significant differences in SMFA (p < 0.0005) and ROM (p < 0.0005) at the three time points. Post hoc analysis demonstrated a strong trend toward significance in SMFA between 3 and 6 months postoperatively (p = 0.088), and demonstrated a significant difference between 6 and 12 months postoperatively (p = 0.013). ROM was found to be significantly different between 3 and 6 months postoperatively (p = 0.010), but no difference was found between 6 and 12 months postoperatively (p = 0.929). Friedman's test demonstrated no significant difference in VAS postoperatively (p = 0.941). In this cohort, no significant difference in function, ROM, or pain level exists between 6 and 12 months after treatment of lateral tibial plateau fractures. However, there are significant improvements in function for at least 1 year following medial or bicondylar tibial plateau fractures.

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A randomized clinical trial comparing butorphanol and buprenorphine within a multimodal analgesic protocol in cats undergoing orchiectomy

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x19886132 ◽

2019 ◽

Vol 22 (8) ◽

pp. 760-767

Author(s):

Kira LM Moser ◽

Michelle MM Hasiuk ◽

Tatum Armstrong ◽

Marta Gunn ◽

Daniel SJ Pang

Keyword(s):

Clinical Trial ◽

Pain Scale ◽

Rescue Analgesia ◽

Treatment Groups ◽

Time Points ◽

Single Intramuscular Injection ◽

Significant Difference ◽

Scale Scores ◽

Sedation Scores ◽

To Receive

Objectives The aim of this study was to compare the effects of butorphanol and buprenorphine, as part of a multimodal analgesic protocol, on recovery and analgesia in cats undergoing orchiectomy. Methods In a prospective, randomized, blind clinical trial, 47 adult male cats were randomly assigned to receive either butorphanol (0.3 mg/kg, n = 24) or buprenorphine (0.02 mg/kg, n = 23) in combination with dexmedetomidine (25 μg/kg) and alfaxalone (2 mg/kg) as a single intramuscular injection for the induction of general anesthesia. Isoflurane carried in oxygen was supplemented as needed during orchiectomy. All cats received lidocaine (2 mg/kg intratesticular), meloxicam (0.3 mg/kg SC) and atipamezole (125 μg/kg IM) postoperatively. Pain and sedation scales were applied at baseline, and 2, 4 and 6 h postoperatively. Time to achieve sternal recumbency and to begin eating were also recorded. Results Pain scale scores were low and showed no difference between the treatment groups at all time points ( P ⩾0.99, all time points). Four cats exceeded the analgesia intervention threshold for rescue analgesia (butorphanol, n = 3; buprenorphine, n = 1). There was no difference in sedation scores between groups at any time point ( P >0.99, all time points). Significantly more cats in the buprenorphine group (n = 12) required isoflurane than in the butorphanol group (n = 2) ( P = 0.0013; relative risk 6.3, 95% confidence interval [CI] 1.8–23.5). There was no significant difference in time to achieve sternal recumbency ( P = 0.96, 95% CI –20 to 20) between groups or in return to eating ( P = 0.48, 95% CI –92.0 to 113.5), with most cats eating within 1 h of surgery (butorphanol, 79%; buprenorphine, 83%). Conclusions and relevance There were no significant differences in analgesia or recovery between butorphanol and buprenorphine treatment groups as part of a multimodal injectable anesthetic protocol. Butorphanol is associated with superior depth of anesthesia, facilitating injectable anesthesia.

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Assessment of Cell Viability of Fresh Osteochondral Allografts in N-Acetylcysteine-Enriched Medium

Cartilage ◽

10.1177/1947603518786547 ◽

2018 ◽

Vol 11 (1) ◽

pp. 117-121

Author(s):

Rafael Calvo ◽

Maximiliano Espinosa ◽

David Figueroa ◽

Luz María Pozo ◽

Paulette Conget

Keyword(s):

Cell Viability ◽

Femoral Condyle ◽

Control Group ◽

Storage Medium ◽

P Values ◽

Significant Difference ◽

Total Knee ◽

Osteochondral Tissue ◽

Post Hoc ◽

Phosphate Buffered Saline

Objective The purpose of this study was to evaluate the effect of N-acetylcysteine (NAC)-enriched storage medium on fresh osteochondral viability at 4°C. Our hypothesis was that the cell viability of chondrocytes obtained from human osteochondral tissue and stored at 4°C significantly improves in the presence of NAC. Design Controlled laboratory study. For this study, 8 samples of femoral condyle osteochondral tissue were obtained from patients undergoing total knee replacement. The samples were stored at either 4°C in phosphate-buffered saline (PBS) or at 3 different concentrations of NAC (NAC 1, 2, and 5 mM). Cell viability was analyzed at time 0 and 4 weeks by flow cytometry. The results of cell viability (median) were analyzed statistically using analysis of variance and Tukey’s post hoc test. P values <0.05 were considered statistically significant. Results The viability at time 0 was 95.5% ± 3.7%. At 4 weeks, the cell viability was 56.8% ± 20.1% in the control group (PBS), 83.8% ± 11.9% in the group stored with NAC 1 mM, 73.4% ± 13.6% in the group stored with NAC 2 mM, and 66.4% ± 27.7% in the group stored with NAC 5 mM. A statistically significant difference from the baseline viability (time 0) was observed in the PBS control group ( P = 0.0018) but not in the other groups. A statistically significant difference was observed in the NAC 1 mM group compared with the PBS group ( P = 0.0255). Conclusion The use of NAC at 1 mM concentration improves cell viability after 4 weeks of storage in chondrocytes obtained from human osteochondral tissue.

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Effect of laser therapy on the inflammatory response induced by endodontic medications implanted into the subcutaneous tissue of rats

Revista de Odontologia da UNESP ◽

10.1590/rou.2014.055 ◽

2014 ◽

Vol 43 (5) ◽

pp. 343-350 ◽

Cited By ~ 2

Author(s):

Felipe de Souza MATOS ◽

Andréa Ferreira SOARES ◽

Ricardo Luiz Cavalcanti de ALBUQUERQUE JÚNIOR ◽

Samuel de Oliveira RIBEIRO ◽

Gustavo Danilo Nascimento LIMA ◽

...

Keyword(s):

Quantitative Analysis ◽

Mast Cells ◽

Inflammatory Response ◽

Calcium Hydroxide ◽

Laser Therapy ◽

Toluidine Blue ◽

Subcutaneous Tissue ◽

Time Points ◽

Significant Difference ◽

Post Hoc

INTRODUCTION: Endodontic medications contain toxic components that cause varying degrees of inflammation.OBJECTIVE: This study evaluated the effect of laser therapy on the inflammatory response induced by intracanal medications implanted into the subcutaneous tissue of rats using a quantitative analysis of mast cells.MATERIAL AND METHOD: Polyethylene tubes containing the medications were implanted in the dorsum of 60 rats divided into six groups, including HS (P.A. calcium hydroxide paste), HL (P.A. calcium hydroxide paste and laser therapy), HPS (P.A. calcium hydroxide paste with camphorated paramonochlorophenol), HPL (P.A. calcium hydroxide paste with camphorated paramonochlorophenol and laser therapy), IS (iodoform with saline) and IL (iodoform with saline and laser therapy). The animals were euthanized eight or fifteen days after surgery, and samples were removed and embedded in paraffin. Histological sections were stained with 0.2% toluidine blue for the quantification of mast cells. Analysis of variance (ANOVA) and Tukey's post-hoc test were applied to determine significant differences in the number of mast cells between groups (p<0.05).RESULT: There was a decrease in mast cells for the HL, HPL and IL groups when compared with the HS, HPS and IS groups at both time points. There was no statistically significant difference between the HPS and HPL groups at the eight-day time point.CONCLUSION: Laser therapy was effective at modulating the inflammatory response induced by endodontic medications by significantly reducing the number of mast cells.

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Oral Versus Intramuscular Ondansetron for Reducing Vomiting in Children with Acute Gastroenteritis: A Single-Blind Randomized Clinical Trial

Iranian Journal of Pediatrics ◽

10.5812/ijp.106115 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Kambiz Eftekhari ◽

Sahar Mohammadpour ◽

Elham Shahgholi ◽

Hosein Shabani Mirzaee ◽

Mohsen Vigeh ◽

...

Keyword(s):

Clinical Trial ◽

Success Rate ◽

Randomized Clinical Trial ◽

Drug Administration ◽

Acute Gastroenteritis ◽

Intramuscular Injection ◽

High Rate ◽

Significant Difference ◽

Single Blind ◽

Oral Ondansetron

Background: Acute gastroenteritis is one of the most common diseases in children with a high rate of nausea and vomiting. Drugs such as ondansetron are used to treat vomiting. Objectives: The aim of the study was to compare the success rate of oral vs intramuscular ondansetron to reduce vomiting in children with acute gastroenteritis. Methods: A single-blind randomized clinical trial study was conducted on 100 children with acute gastroenteritis. Two groups of patients were created; one group received an intramuscular injection of ondansetron and the other received oral ondansetron. The vomiting rate, hospitalization, and side effects were evaluated 30 minutes, 4, and 48 hours after drug administration. Results: Fifty-nine (59%) boys with a mean age between 3.07 ± 2.20 years were included. There were no significant differences between the groups in terms of age, weight, and rate of vomiting before the treatment was launched. No significant difference between the drug administration route and the outcome of vomiting during the first half, 4, and 48 hours after receiving the drug was found either. Conclusions: The study showed that the success rate of oral ondansetron did not vary significantly compared to intramuscular injection in terms of reducing the vomiting rate in children with acute gastroenteritis.

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Perbedaan sensitivitas tetes telinga antibiotik terhadap Pseudomonas aeruginosa pada otitis media supuratif kronik

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v42i2.22 ◽

2012 ◽

Vol 42 (2) ◽

Author(s):

Anton Budhi Darmawan ◽

Dwi Utami Anjarwati

Keyword(s):

Pseudomonas Aeruginosa ◽

Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Test Results ◽

Sectional Study ◽

Suppurative Otitis Media ◽

Number Of Patients ◽

Significant Difference ◽

Cochran Test ◽

Post Hoc

Background: Chronic suppurative otitis media (CSOM) is one infectious disease of the middle ear, most commonly caused by Pseudomonas aeruginosa. A high number of patients come to the ENT outpatient clinic with active benign type of CSOM. The bacteria Pseudomonas aeruginosa is capable of producing biofilm which protects itself from penetration of antibiotics, and therefore creates resistance towards antibiotics and difficult to eradicate. Objective: The aim of this study was to compare the sensitivity levels of chloramphenicol, polymyxin-neomycin, cyprofloxacin and ofloxacine against Pseudomonas aeruginosa in patients with active benign type CSOM in ENT clinic. Method: The method used was across sectional study on 25 patients, from August 2010 until December 2010. Samples were taken withear swab and then put on sensitivity test to chloramphenicol, polymyxin-neomycin, cyprofloxacin andofloxacine using the diffusion disc method. The analysis used in this study was Cochran test. Results: Results showed a significant difference in sensitivity among chloramphenicol (38,70%), polymyxinneomycin(83,87%),cyprofloxacin(90,32%)andofloxacin(58,06%)withp=0,000(p<0,05).PostHocanalysisusing the Mc Nemar indicated that there were significant differences in sensitivity betweenpolymyxin-neomycin to chloramphenicol with p=0,000 (p<0,05), ciprofloxacin to chloramphenicol andciprofloxacin to ofloxacine with p= 0,002, but there were no significant differences between cyprofloxacinto polymyxin-neomycin with p=0,687, polymyxin-neomycin to ofloxacin p=0.057 and ofloxacin tochloramphenicol p=0,109. There were significant differences in antibiotic ear dropssensitivity to Pseudomonas aeruginosa in patients with active benign type of CSOM. Cyprofloxacin andpolymyxin-neomycin were more sensitive than ofloxacin and chloramphenicol. Keywords: Pseudomonas aeruginosa, active benign type of chronic suppurative otitis media, antibioticear drops. Abstrak : Latar belakang: Otitis media supuratif kronik (OMSK) merupakan penyakit infeksi kronik telinga tengah yang sering dijumpai di klinik THT. Penyebab tersering OMSK adalah bakteri Pseudomonasaeruginosa. Pseudomonas aeruginosa mempunyai kemampuan untuk membentuk biofilm yangmelindunginya dari penetrasi antibiotik sehingga menimbulkan resistensi terhadap antibiotik dan sulituntuk eradikasinya. Tujuan: Untuk mengetahui perbandingan tingkat sensitivitas kloramfenikol,polimiksin-neomisin, ciprofloksasin dan ofloksasin terhadap isolat Pseudomonas aeruginosa padapasien OMSK benigna aktif di klinik THT RSMS. Metode: Metode yang digunakan adalah crosssectional terhadap 29 pasien OMSK di klinik THT RSMS periode bulan Agustus 2010 - Desember2010. Pengambilan sampel dilakukan dengan swab telinga. Uji sensitivitas terhadap kloramfenikol,polimiksin-neomisin, ciprofloksasin dan ofloksasin dilakukan dengan metode cakram secara difusi.Analisis yang digunakan dalam penelitian ini adalah Cochran dan analisis post hoc. Hasil: Didapatkansensitivitas kloramfenikol sebesar 38,70%, polimiksin-neomisin sebesar 83,87%, ciprofloksasin sebesar90,32% dan ofloksasin sebesar 58,06% dengan p=0,01 (P<0,05), yang menunjukkan adanya perbedaansensitivitas yang bermakna antara kloramfenikol, polimiksin-neomisin, ciprofloksasin dan ofloksasinterhadap Pseudomonas aeruginosa. Analisis post hoc menggunakan Mc Nemar menunjukkan bahwaterdapat perbedaan sensitivitas yang bermakna antara tetes telinga polimiksin-neomisin terhadapkloramfenikol, dan ciprofloksasin terhadap kloramfenikol p=0,000 (p<0,05), serta terdapat perbedaanyang bermakna antara tetes telinga ciprofloksasin terhadap ofloksasin, p=0,002, tetapi tidak terdapatperbedaan yang bermakna antara ciprofloksasin terhadap polimiksin-neomisin, p=0,687, polimiksinneomisinterhadap ofloksasin p=0,057, dan kloramfenikol terhadap ofloksasin p=0,109. Kesimpulan:Terdapat perbedaan sensitivitas yang bermakna tetes telinga antibiotik terhadap Pseudomonas aeruginosa pada pasien OMSK benigna aktif. Ciprofloksasin dan polimiksin-neomisin tetes telinga mempunyai sensitivitas yang lebih baik dibanding ofloksasin dan kloramfenikol. Kata kunci: Pseudomonas aeruginosa, otitis media supuratif kronik, tetes telinga antibiotik

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Time Course of Simulator Sickness in Asian Military Pilots

Aerospace Medicine and Human Performance ◽

10.3357/amhp.5674.2020 ◽

2020 ◽

Vol 91 (11) ◽

pp. 892-896

Author(s):

Janine En Qi Loi ◽

Magdalene Li Ling Lee ◽

Benjamin Boon Chuan Tan ◽

Brian See

Keyword(s):

Air Force ◽

Time Course ◽

Simulator Training ◽

Simulator Sickness ◽

Time Points ◽

True Prevalence ◽

Subjective Scale ◽

Significant Difference ◽

Simulator Sickness Questionnaire ◽

Military Pilots

INTRODUCTION: This study sought to determine the incidence, severity, and time-course of simulator sickness (SS) among Asian military pilots following flight simulator training.METHODS: A survey was conducted on Republic of Singapore Air Force pilots undergoing simulator training. Each subject completed a questionnaire immediately after (0H), and at the 3-h (3H) and 6-h (6H) marks. The questionnaire included the simulator sickness questionnaire (SSQ) and a subjective scale to rate their confidence to fly.RESULTS: In this study, 258 pilots with a median age of 31.50 yr (range, 2155 yr) and mean age of 32.61 6.56 yr participated. The prevalence of SS was 48.1% at 0H, 30.8% at 3H, and 16.4% at 6H. Based on a threshold of an SSQ score >10, the prevalence of operationally significant SS was 33.3% at 0H, 13.2% at 3H, and 8.1% at 6H. The most frequent symptoms were fatigue (38.1%), eye strain (29.0%), and fullness of head (19.9%). There was no significant difference in mean scores between rotary and fixed wing pilots. Older, more experienced pilots had greater scores at 0H, but this association did not persist. A correlation was found between SSQ score and self-reported confidence.DISCUSSION: To our knowledge, this study is the first to report the prevalence of operationally significant SS in Asian military pilots over serial time points. Most pilots with SS are able to subjectively judge their fitness to fly. Sensitivity analysis suggests the true prevalence of SS symptoms at 3H and 6H to be closer to 23.8% and 12.0%, respectively.Loi JEQ, Lee MLL, Tan BBC, See B. Time course of simulator sickness in Asian military pilots. Aerosp Med Hum Perform. 2020; 91(11):892896.

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Influence of moderate cigarette-smoking on the peri-implant clinicoradiographic inflammatory parameters around cement- and screw-retained dental implants

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-19-00352 ◽

2020 ◽

Author(s):

Mana Alqahtani

Keyword(s):

Cigarette Smoking ◽

Dental Implants ◽

Smoking History ◽

Inflammatory Parameters ◽

Significant Difference ◽

Implant Retention ◽

Level Of Significance ◽

Soft Tissue Inflammation ◽

Post Hoc ◽

Adjustment Test

The aim was to assess the influence of moderate cigarette-smoking on the clinical (bleeding on probing [BoP] and probing depth [PD]) and radiographic (crestal bone resorption [CBR]) around cement- and screw-retained dental implants at 5 years’ follow-up. A questionnaire was used to collect information about age, gender, smoking history, duration of implants in function, jaw location of the implant, and daily toothbrushing and flossing. Peri-implant BoP, PD and CBR were measured in all groups. Group comparisons were performed using one-way analysis of variance and for multiple comparisons, the Bonferroni Post hoc adjustment test was performed. Level of significance was set at P<0.05. Forty-eight patients (25 smokers and 23 non-smokers) had cement-retained dental implants; and 48 (24 smokers and 24 non-smokers) had screw-retained dental implants. Among patients with cement and screw-retained dental implants, PD (P<0.05) and CBR (P<0.05) were significantly higher among smokers than non-smokers. The peri-implant sites that demonstrated BoP were statistically significantly higher among non-smokers (P<0.05) than smokers among patients with cement- and screw-retained dental implants. There was no statistically significant difference in peri-implant PD and CBR among smokers with cement- and screw-retained dental implants. Among non-smokers with cement and screw-retained dental implants, there was no statistically significant difference in BoP, PD and CBR. Cigarette-smoking is associated with an increased PD and CBR around cement- and screw-retained dental implants. Cigarette-smoking increases peri-implant soft tissue inflammation as well as loss of crestal bone and this relationship is independent of the type of implant retention protocol used.The author recommends that cement- and screw-retained dental implants are suitable for prosthesis restoration in non-smokers. Further studies on dual-smokers (individuals smoking cigarettes and other forms of tobacco products) are needed related to the clinicoradiographic inflammatory parameters around cement- and screw-retained dental implants

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Clinical Impact of Co-medication of Levetiracetam and Clobazam with Proton Pump Inhibitors: A Drug Interaction Study

Current Drug Metabolism ◽

10.2174/1389200221666200218121050 ◽

2020 ◽

Vol 21 (2) ◽

pp. 126-131

Author(s):

Bhuvanachandra Pasupuleti ◽

Vamshikrishna Gone ◽

Ravali Baddam ◽

Raj Kumar Venisetty ◽

Om Prakash Prasad

Keyword(s):

Plasma Concentration ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Plasma Concentrations ◽

Control Group ◽

Drug Concentrations ◽

Significant Difference ◽

Post Hoc ◽

Hydrolysis Of ◽

Cytochrome P 450

Background: Clobazam (CLBZ) metabolized primarily by Cytochrome P-450 isoenzyme CYP3A4 than with CYP2C19, Whereas Levetiracetam (LEV) is metabolized by hydrolysis of the acetamide group. Few CYP enzymes are inhibited by Proton Pump Inhibitors (PPIs) Pantoprazole, Esomeprazole, and Rabeprazole in different extents that could affect drug concentrations in blood. The aim of the present study was to evaluate the effect of these PPIs on the plasma concentrations of LEV and CLBZ. Methods: Blood samples from 542 patients were included out of which 343 were male and 199 were female patients and were categorized as control and test. Plasma samples analyzed using an HPLC-UV method. Plasma concentrations were measured and compared to those treated and those not treated with PPIs. One way ANOVA and games Howell post hoc test used by SPSS 20 software. Results: CLBZ concentrations were significantly 10 folds higher in patients treated with Pantoprazole (P=0.000) and 07 folds higher in patients treated with Esmoprazole and Rabeprazole (P=0.00). Whereas plasma concentration of LEV control group has no statistical and significant difference when compared to pantoprazole (P=0.546) and with rabeprazole and esomeprazole was P=0.999. Conclusion: The effect of comedication with PPIs on the plasma concentration of clobazam is more pronounced for pantoprazole to a greater extent when compared to esomeprazole and rabeprazole. When pantoprazole is used in combination with clobazam, dose reduction of clobazam should be considered, or significance of PPIs is seen to avoid adverse effects.

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