A Laboratory and Clinical Comparison of National Local Formulation and Universal Formulation of Topical Prednisolone Acetate 1% in Reducing Inflammation After Phacoemulsification

Purpose: To evaluate and compare the pharmacological characteristics and clinical efficacy of two topical steroid prednisolone preparations (Redmond®, prednisolone acetate 1%; and Pred Forte®, prednisolone acetate 1%) in reducing postoperative inflammation in patients having phacoemulsification surgery with IOL implantation, which will support our trust in national products considering it's availability and lower costs compared with universal products. Methods: I- Laboratory Study: Direct microscopic examination of the ophthalmic suspension for both formulations. II- Clinical Study: This study was interventional, prospective, randomized controlled study included 60 eyes of patients undergoing emulsification surgery with IOL implantation. Patients were assigned to one of two treatment groups, The first group (30 eyes) received Redmond® while the second group (30 eyes) received Pred Forte® in addition to standard therapy. Study drug was administered postoperatively every 2 hours while awake for 7 days, then four times daily for 7 days, then twice daily for 7 days, then once daily for 7 days. Clinical efficacy was compared for differences in visual acuity, anterior chamber cells (scale 0-4), fundus and macula, drug's ocular adverse effects: foreign body sensation and irritation (scale 1-3), and intraocular pressure (IOP). Results were compared on day 1, day 3, 1 week, 2 weeks, and 1 month postoperatively. Results: I- Average particle size in ophthalmic suspension for both formulations was (< 1 μm). (Redmond® = 0.95 μm, Pred Forte® = 0.77 μm). II- No statistical differences in clinical efficacy or safety were seen between the two formulations tested at any time point evaluated with respect to visual acuity, anterior chamber cells, fundus and macula, foreign body sensation and irritation, and intraocular pressure (IOP). Conclusions: In this study of routine cataract patients, both prednisolone acetate 1% formulations are comparably effective and safe when administered for the reduction of inflammation after phacoemulsification surgery with IOL implantation. Direct microscopic examination showed that both formulations achieved the condition that particle size in ophthalmic suspension must be less than one micron.

Clinical Evaluation of Post-operative Sensitivity in Composite Restorations by using Eighth Generation of Bonding Agents A Comparative Clinical Study

To compare postoperative sensitivity following composite restoration placed in class I cavities using Eighth generation self etch adhesive" Futurabond" and fifth generation total etch adhesive.

The effect of early oral postoperative carbohydrates feeding on postoperative outcome

Introduction: Ileus commonly occurs after abdominal surgery, and is associated with complications and increased length of hospital stay. Post-operative ileus (POI) is an important reason for remaining patients not permit oral (NPO) in post-operative period. The tradition was that when patients passed flatus, they were ready to consume a liquid diet, and then a solid food diet was gradually introduced. This approach was taken to avoid aspiration, gastric and intestinal distension, and anastomotic dehiscence. Although studies demonstrated that the conventional strict feeding regimens were not necessary, many surgeons still hesitated to allow early oral feeding. There has been concern that early oral intake would result in vomiting and severe paralytic ileus with subsequent aspiration pneumonia, wound dehiscence and anastomotic leakage. This belief has become surgical dogma, unsupported by scientific evidence. Aim: to investigates the effect of early oral postoperative carbohydrates feeding on postoperative outcome. Material and methods: forty abdominal surgery patients were randomly assigned to early oral postoperative feeding group (20) or traditional feeding group (20). In the early feeding group (study group), patients were initially started on clear fluid only 16 h after surgery and progressed to liquids (after 24 h) and then soft and regular diet in next day (after 48 h). In the post-operative period, the patients were visited each 12 h and clinical signs and symptoms such as, time of passed flatus and moved their bowels, nausea and vomiting, and the length hospital stay were assessed. Conclusions: This study showed that early oral postoperative carbohydrates feeding group passed flatus and moved their bowels much sooner than the control group thus reducing the duration of POI and hospital stay, but there is no increase in occurrence of of nausea and vomiting between tow groups.

Comparison of the Effects of Celecoxib and Ibuprofen on Pain Control after the Surgical Placement of Dental Implants

Surgical placement of dental implants may cause a certain degree of pain and discomfort to some patients. Conventional nonsteroidal anti-inflammatory drugs have been widely used in the control of postoperative pain, but sparse information is available about the efficacy of celecoxib, a selective cyclooxygenase-2 inhibitor, after surgical placement of dental implants. The aim of this study was to compare the analgesic efficacy of celecoxib and ibuprofen on pain control after the surgical placement of dental implants .

The effects of oral preoperative carbohydrates administration on postoperative outcome

Introduction: Ileus commonly occurs after abdominal surgery, and is associated with complications and increased length of hospital stay (LOHS). Traditionally, preoperative practice has been to fast the patient for up to 12 h prior to surgery. The rationale for this is to reduce gastric acidity and volume with a consequent decrease in the risk of gastric content aspiration during surgery. However, A Cochrane review found no increased risk of aspiration in patients who were allowed fluids 2–3 h prior to surgery compared to patients having undergone a traditional fasting period .. A carbohydrate-rich beverage given before anaesthesia and surgery alters metabolism from the overnight fasted to the fed state. This reduces the catabolic response (insulin resistance) after operation, which may have implications for postoperative recovery. Aim : to investigates the effect of preoperative carbohydrate treatment on postoperative ileus in adult patients undergoing abdominal surgery. Material and methods: fifty abdominal surgery patients were randomly assigned to preparation with a 12.5% carbohydrate drink (CHO) (25), or overnight fasting group (25). The CHO group were given 600 mL to drink on the evening before and 400 mL on the morning of surgery. The patients' complains of nausea and vomiting was noted, the length hospital stay and the duration of postoperative ileus (POI), was measured in tow groups. Conclusions: This study showed that pre-operative carbohydrate drink may be used safely and also improves patient's comfort as decrease rate of nausea and vomiting and reduce the length of hospital stay in patients undergoing abdominal surgery.

Clinical Study of Healing process as a Result of Using CO2 Laser in Management of Benign Tumors and Leukoplakia in the Oral Cavity

Objective: to study and evaluate the surgical operative process in the management of Benign Tumors and Leukoplakia in the Oral Cavity by using Laser CO2. Materials and methods: a total of 18 patients (10 males and 8 females) with mean age 50 years, and diagnosed with Benign tumorous Lesions or Leukoplakia on mucosa of the oral cavity, were treated by Vaporization by using CO2 Laser in Al-Assad university hospital. The postoperative complications were recorded within 7 days after the surgery, and the wounds was assigned until entire healing. Results: 8(44%) patients had week pain after 24 hour of surgery, and reduced to 2(11%) patients in the third day. Edema was seen by 8(44%) patients after 24 hour of surgery, and reduced to 1(6%) patient in the third day.5 (28%) patients showed disturbance within oral functions, and became 1(6%) patient in the third day. No complications were seen after 7 days of surgery. No infection or bleeding were recorded within following time.no statistically significant differences between Lesion kind and pain degree, and no relationship between Pain degree and Disturbance of the Lesions. Entire healing was satisfactory in all Wounds and no scar were seen . Conclusion: CO2 Laser is effective method in manage and minimize the complications during Healing process after the management of Benign Tumors and Leukoplakia in oral cavity.

Effect of deep breathing exercises on postoperative pain management in orthopedic patients in University Alassad Hospital

- Introduction: Postoperative pain is an important factor which exerts several physical effects in the cardiovascular, gastrointestinal, and urinary systems. In addition, psychologic effects that cause stress and anxiety. - Aim: This study aimed to examine the effect of breathing exercises on relieving postoperative pain in orthopedic patients. - Method: This study carried at Universal Alassad Hospital in Latakia, on a sample of 60 patients who underwent orthopedic surgery between March 2015 and June 2015, aged between 18-70 years. The sample was divided to two equal groups: control group (30) that has been left to hospital routine, and study group (30) that has been applied deep breathing exercises for 3 days after surgery as 3 times, each breathing exercise session took 5-10 minutes, then patients’ pain levelsin two group was assessed by verbal and visual pain scale.

The Incidence of Complications and Pain Following Periodontal Treatment

Both dentists and patient are interested to know the complications following periodontal therapy. The purpose of this study was to document this incidence following periodontal therapy carried out in a postgraduate periodontal clinic at Damascus university, and to identify factors that influence postprocedural pain. 214 patients between 18 to 57 years of age, most of them women ( 57,94% ) enrolled in this study. Pain was reported by 51,86% of the patients, which means they needed analgesics after the first post operative day. Infections were present in only 4 patients, two of them were under antibiotics. Females experienced significantly more pain than males after periodontal treatment. Pain decreased significantly in patients over 45. Also smoking and prophylactic antibiotic reduced the incidence of postprocrdural pain. In this study , ther e were no correlation between pain and the following: periodontal dressing, systemic diseases, oral hygiene, types of periodontal surgery and extent of the surgery. Surgical periodontal treatment is more painful than non-surgical treatment, but even non-surgical therapy is painful sometimes. 29,72% of the non-surgical therapy patients experienced postprocedural pain. On the basis of this study ,it appears that minimal complications were associated with periodontal therapy.