Intrathecal 1% 2-chlorprocaine for short gynecological day care procedures: Prospective, randomized, dose finding study.

Background and Aims: Establishing the optimum dose of intrathecal 1% 2-chlorprocaine may reduce the discharge time and encourage more widespread use of spinal anesthesia for day care procedures. The aim of this study was to compare the efficacy and recovery characteristics of three different doses of intrathecal 1% 2-chlorprocaine for short gynecological day care procedures. Material and Methods: Fifty-one patients scheduled for elective day care gynecological procedures lasting less than 60 min and were randomly divided into three groups of 17 each to receive 35 mg, 40 mg, or 45 mg intrathecal 1% 2-chlorprocaine. Demographic data, time required to achieve readiness for surgery, time required to attain discharge criteria, maximum block height achieved, and adverse effects were recorded in each group. Results: The time required to achieve readiness for surgery was similar between the three groups (P = 0.306). However, 35 mg group required the shortest time to ambulate and there was a significant difference as compared with both 40 mg (P = 0.012) and 45 mg (P = 0.001). Voiding and the fulfillment of the discharge parameters were also attained more rapidly in the 35 mg group [133 (120,155) min] as compared with both 40 mg [164 (145,175) min, P = 0.000] and 45 mg [160 (150,175) min, P = 0.000]. None of the patients reported neurological symptoms during the follow-up. Conclusion: The 35 mg intrathecal 1% 2-chlorprocaine not only provides reliable anesthesia for short gynecological procedures but also facilitates faster achievement of the discharge parameters as compared with the 40 mg and 45 mg doses.

Validation of leaf and microbial pectinases: commercial launching of a new platform technology.

Almost all current genetically modified plant commercial products are derived from seeds. The first protein product made in leaves for commercial use is reported here. Leaf pectinases are validated here with eight liquid commercial microbial enzyme products for textile or juice industry applications. Leaf pectinases are functional in broad pH/temperature ranges as crude leaf extracts, while most commercial enzyme products showed significant loss at alkaline pH or higher temperature, essential for various textile applications. In contrast to commercial liquid enzymes requiring cold storage/transportation, leaf pectinase powder was stored up to 16 months at ambient temperature without loss of enzyme activity. Commercial pectinase products showed much higher enzyme protein PAGE than crude leaf extracts with comparable enzyme activity without protease inhibitors. Natural cotton fibre does not absorb water due to hydrophobic nature of waxes and pectins. After bioscouring with pectinase, measurement of contact-angle water droplet absorption by the FAMAS videos showed 33 or 63 (leaf pectinase), 61 or 64 (commercial pectinase) milliseconds, well below the 10-second industry requirements. First marker-free lettuce plants expressing pectinases were also created by removal of the antibiotic resistance aadA gene. Leaf pectinase powder efficiently clarified orange juice pulp similar to several microbial enzyme products. Commercial pilot scale biomass production of tobacco leaves expressing different pectinases showed that hydroponic growth at Fraunhofer yielded 10 times lower leaf biomass per plant than soil-grown plants in the greenhouse. Pectinase enzyme yield from the greenhouse plants was double that of Fraunhofer. Thus, this leaf-production platform offers a novel, low-cost approach for enzyme production by elimination of fermentation, purification, concentration, formulation and cold chain.

Modified functionally generated path technique to develop occlusal scheme in single complete denture.

Single maxillary denture often represents vigorous challenge to the practicing dentists. The difficulty arises when the maxillary dentures are set to fit the occlusion of natural mandibular teeth. The functionally generated pathway technique registers occlusal pathways of the posterior teeth in functional wax and is described as the "three-dimensional static expression consists of dynamic tooth movement." The current article represents a technique for a patient who was rehabilitated with a maxillary complete denture, and a harmonious occlusion was achieved between the complete denture and the mandibular natural dentition. Functional maxillary denture is therefore in medical dentistry the successful culmination of human's high practice and represents the golden goal sought by every dental practitioner and expected by every denture patient.

Implant Placement into the Nasopalatine Foramen: Considerations from Anatomical and Surgical Point of View.

Implant placement is a challenge in the anterior maxilla if the available bone is reduced and esthetics is challenging. The ideal implant position should be considered in all three dimensions: mesiodistal, apicocoronal, and orofacial. This article includes a review and a case report for the anatomical and clinical perspective of implant placement in nasopalatine foramen (near incisal canal). In this case report, the edentulous space is mutilated in between the area #12 and #21 teeth. Therefore, only one, 3.0 W/10.00 L implant (bone size 4.2 mm width and 11 mm length) could be placed. Radiographically, D2 bone quality was diagnosed. Before surgery, an emphasis was given over the proper implant selection to avoid oversized implants due to critical anatomical landmark. Careful and with minimal trauma, the soft tissue was handled and implant placement was performed in a proper position, using information from panoramic radiograph, 3-D Dentascan. A surgical guide was used for placement of the implant. Finally, immediate loading of temporary implant prosthesis was done. The primary outcome was satisfactory, as after 72 h, no swelling and numbness were reported. The patient has been recalled after healing period of 24 weeks for permanent restoration.

Customized Implant Full-Mouth Rehabilitation: A Biomechanical Depiction.

The rationale for implant full-mouth rehabilitation is believed to present the better quality of life to the older population. This type of modalities preserves the soft and hard tissue of oral cavity. It is also helpful to check the temporomandibular joint disease. Literature exposes that implant full-mouth fixed rehabilitation is one of the taxing procedures in the field of prosthodontics. The current clinical report discusses a customized biomechanical approach for the fabrication of implant complete-mouth rehabilitation. A systematic approach in managing this patient can lead to a predictable and favorable prognosis. This article also presents the stages of prosthodontic rehabilitation from diagnosis to final treatment planning as a customized radiographical Gutta Percha template, precise implant surgery of 12 implants (ADIN, Dental Implant System, Israel) over the both the arches and provisional restorations with group function occlusion. Lastly, full-mouth restorations were fabricated as cement-retained (open hole) metal-ceramic restoration. Advocated patient is absolutely happy with customized implant full-mouth rehabilitation.