Cheminformatics identification of modulators of key carbohydrate-metabolizing enzymes from C. cujete for type-2 diabetes mellitus intervention.

Purpose: The therapeutic use of oral hypoglycaemic agents in the management of type-2 diabetes mellitus (T2DM) is without adverse effects; thus, calls for alternative and novel candidates from natural products in medicinal plants. Method: The study explored molecular docking and molecular dynamics (MD) simulation approaches to identify key antidiabetic metabolites from Crescentia cujete. Results: Molecular docking results identified four and/or five best compounds against each target enzyme (alpha-glucosidase, dipeptidyl peptidase-IV, aldose reductase, and protein tyrosine phosphatase-1B (PTP-1B)) implicated in diabetes. The resulting complexes (except against PTP-1B) had higher docking scores above respective standards (acarbose, Diprotin A, ranirestat). The MD simulation results revealed compounds such as benzoic acid (-48.414 kcal/mol) and phytol (-45.112 kcal/mol) as well as chlorogenic acid (-42.978 kcal/mol) and naringenin (-31.292 kcal/mol) had higher binding affinities than the standards [acarbose (-28.248 kcal/mol), ranirestat (-21.042 kcal/mol)] against alpha-glucosidase and aldose reductase, respectively while Diprotin A (-45.112 kcal/mol) and ursolic acid (-18.740 kcal/mol) presented superior binding affinities than the compounds [luteolin (-41.957 kcal/mol and naringenin (-16.518 kcal/mol)] against DPP-IV and PTP-1B respectively. Conclusion: While isoflavone (alpha-glucosidase), xylocaine (DPP-IV), luteolin (aldose reductase,) and chlorogenic acid (PTP-1B) were affirmed as the best inhibitors of respective enzyme targets, luteolin, and chlorogenic acid may be suggested and proposed as probable candidates against T2DM and related retinopathy complication based on their structural stability, compactness and affinity for three (DPP-IV, aldose reductase, and PTP-1B) of the four targets investigated. Further studies are warranted in vitro and in vivo on the antihyperglycaemic effects of these drug candidates. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01249-7.

An Analysis of Lidocaine Usage in the Treatment of Squamous Cell Carcinoma.

Squamous cell carcinoma (SCC) is a form of skin cancer that can be treated using a procedure known as Mohs surgery. Mohs surgery is a safe and effective procedure for eliminating SCC. This surgery requires the usage of an analgesic known as lidocaine. Additional anesthetics were also reported to be necessary for this procedure to be conducted in a manner that significantly minimizes patient harm. According to the review, it was found that SCC was treated with lidocaine as a topical analgesic outside of Mohs surgery. This review analyzes the usage of lidocaine in the treatment of SCC. It was also discovered that lidocaine, as an agent, has the potential to slow the progression of SCC, but more research is needed to see if this is truly the case. On average, it was reported that the concentration of lidocaine used in the in vivo studies was significantly higher than that in the in vitro investigations. Further exploration may be needed to verify the conclusions that were based on the analysis of the papers within the review.

BUCCAL INFILTRATION WITH 4% ARTICAINE MAY BE AN ALTERNATIVE OPTION TO INFERIOR ALVEOLAR NERVE BLOCK WITH 2% LIDOCAINE FOR PULP THERAPY IN PRIMARY MANDIBULAR MOLARS.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Can 4% Articaine Buccal Infiltration Replace Inferior Alveolar Nerve Block (IANB) with 2% Xylocaine for Pulp Therapy in Primary Mandibular Molars? A Systematic Review. Sunny P Tirupathi, Srinitya Rajasekhar, Mayuri Ganesh, Abhishek Vamshi, David Tyro, Int J Clin Pediatr Dent. 2021;14(3):420-425. SOURCE OF FUNDING: The authors did not state any funding support. TYPE OF STUDY/DESIGN: Systematic review.

The application of xylocaine 10% pump-spray to improve immediate post-adenotonsillectomy pain in children: A randomized controlled trial.

INTRODUCTION: Post-adenotonsillectomy pain is often severe, requiring substantial analgesia in the first 48-72 h. This pain is not only distressing to the patient and his or her parents, but often reflects poorly on an otherwise well performed procedure. Safe, simple and effective post-adenotonsillectomy pain control is still clinically elusive, even though a multitude of surgical and analgesic interventions have been proposed. OBJECTIVES: To investigate the analgesic properties of immediate post-operative application of xylocaine 10% pump spray to the tonsillar fossae in children having undergone adenotonsillectomy and how this impacts on anesthetic emergence and pain control in the first 24-h. METHODS: In this double-blinded, randomized, placebo-controlled trial, 80 children were stratified into two groups: Group I (3-8 years-old) and Group II (9-14 years-old). Within these groups, participants were randomized to receive either xylocaine 10% pump spray or normal saline 0.9% post-operatively. A standardized anesthetic/analgesic regime was used intra-operatively. The same surgeon performed all surgeries using bi-polar diathermy. Outcome variables included state of anesthetic emergence; pain scores at specific intervals; need for rescue analgesia; post-operative nausea and vomiting; time to first oral intake and comfort associated with initial oral intake. RESULTS: Xylocaine 10% pump spray consistently provided superior pain control at all time intervals compared to normal saline 0.9% (p = 0.011). This was most pronounced in children 3-8 years old (Group I). Xylocaine 10% pump spray and normal saline 0.9% provided similar pain relief in children 9-14 years old (Group (II) (p = 0.640). Children receiving xylocaine had a decreased incidence of emergence delirium and consistently required less rescue analgesia (p = 0.005). Children who received xylocaine did not eat sooner post-operatively, but they experienced less pain when ingesting liquids (p = 0.003) and solids (p = 0.000). Children who received xylocaine did not experience increased post-operative complications (p = 1.000) or nausea and vomiting (p = 0.153). CONCLUSION: Xylocaine 10% spray may serve as a valuable adjunct to effective pain control post-adenotonsillectomy, especially if long acting opioids are contraindicated, as with patients with obstructive sleep apnea. The benefit of xylocaine appears to be negligible when a long acting opioid is administered. The benefits of xylocaine were most noteworthy in children aged 3-8 years old. This is the largest trial (n = 80) to date to assess the efficacy of xylocaine spray in isolation post-adenotonsillectomy. Xylocaine also offers improved comfort with oral intake and decreases emergence delirium and need for rescue analgesia without any increase in post-operative complications. Local anesthesia may decrease costs and help to solve the conundrum of a painless adenotonsillectomy especially in resource-limited settings.

The use of lidocaine spray (Xylocaine) as a topical anaesthetic for minor ear procedures.

BACKGROUND: Injectable anaesthetic agents, topical creams and aqueous solutions have previously been used to anaesthetise the tympanic membrane for minor ear procedures. Topical creams take 20-30 minutes to work and injectable anaesthetics can cause canal swelling. The effectiveness of lidocaine spray has not previously been investigated in patients undergoing minor ear procedures. METHODS: Eighteen participants attending for out-patient grommet insertion or intratympanic steroid injection were prospectively recruited for this study over six months. Post-operatively, they were asked about their perceived level of pain and overall experience. RESULTS: The median level of pain measured on an 11-point visual analogue scale was 2 out of 10. Forty-four per cent reported the overall experience as pleasant, with the remainder selecting slightly unpleasant (66 per cent). All participants stated they would undergo the procedure again. CONCLUSION: Xylocaine spray is simple to administer, rapid-acting and well tolerated by patients for anaesthesia of the tympanic membrane during minor ear procedures in the out-patient setting.

The efficacy of magnesium sulphate as an adjunct to local anaesthetics for perineal pain relief after episiotomy.

BACKGROUND: Episiotomy is a deliberate surgical incision of the perineum with the aim of increasing the vulval outlet to facilitate childbirth. However, it could be associated with some complications, such as pain, hemorrhage, and wound infection. It is a surgical procedure that requires adherence to basic surgical principles of providing adequate analgesia. AIM: To determine the efficacy of magnesium sulphate (MgSO4) as an adjunct to local anesthetics for analgesia during episiotomy repair among women that had vaginal delivery at Usmanu Danfodiyo University Teaching Hospital Sokoto, Sokoto, Nigeria. SUBJECT AND METHODS: This was a single-blind randomized clinical trial. Pregnant women who had episiotomy during the study period were randomized into two groups. Those in Group A had xylocaine administered alone, whereas those in Group B had xylocaine + MgSO4 administered for repair of episiotomy. Pain was assessed by numeric rating scale at commencement of the repair, at 2 and 6 h after the repair. Patient's level of satisfaction, request for additional analgesia, and side effects were also assessed. RESULTS: The pain score in the xylocaine + MgSO4 group was lower throughout the period of assessment. There was no significant difference in the pain scores between the two groups at 0 and 6 h. However, there was significant difference in the mean pain scores between the two groups at 2 h (P < 0.001). There was no significant difference in the level of satisfaction, request for additional analgesia, and side effects between the two groups. CONCLUSION: Both xylocaine alone and xylocaine with MgSO4 provide adequate perineal pain relief during episiotomy repair. MgSO4 improves the analgesic effect of xylocaine at 2 h after episiotomy repair without any significant side effect.

Apical peri-prostatic nerve block versus intra-rectal xylocaine gel for trans- rectal ultrasound guided prostate biopsy among Nigerian patients: A prospective randomized study.

AIMS: This study compared the analgesic effect of apical peri-prostatic block with that of intra-rectal xylocaine gel for trans-rectal ultrasound guided prostate biopsy (TRUS-PBx) in Nigeria. METHODS: This is a prospective randomized comparative study carried out over one year in University of Benin Teaching Hospital, Edo State, Nigeria. The participants were randomized into two groups; Group A had 10 mls of intra-rectal xylocaine gel instillation while Group B had apical infiltration of 10 mls of 1% xylocaine all before TRUS-PBx. RESULT: There was a statistically significant difference in the mean pain score during and one hour after TRUS-PBx between Group A and Group B of the study population respectively (p < 0.0001). Those that had intra-rectal xylocaine gel (Group A) had more pain during and after biopsy. There was no difference in the mean pain score during probe insertion between the two groups (p = 0.952). CONCLUSION: This study demonstrated the superiority of apical peri-prostatic nerve block over intra rectal xylocaine gel instillation during TRUS-PBx with respect to its anesthetic efficacy. Therefore, centers providing TRUS-PBx in Nigeria should consider apical peri-prostatic nerve block as their mode of anesthesia for the procedure due to its efficacy and high safety profile.

[Feticide procedures in second and third trimesters terminations of pregnancy]. / Geste d'arrêt de vie fœtale : techniques pour les interruptions médicales de grossesse des deuxième et troisième trimestres.

Performing a feticide as part of termination of late pregnancy is recommended in many countries. Feticide avoids a live birth of a severely affected premature newborn and prevents fetal pain. There are limited data on feticide procedures since only a few countries in the world authorize late termination of pregnancy. The objective of this review was to assess the most appropriate feticide procedure based on published data during the last thirty years. Administration of an initial fetal analgesia followed by a lethal lidocaine injection through the umbilical cord, under ultrasound guidance, appears to be the most effective, safe and ethical way to perform feticide. According to the current knowledge regarding the risk of fetal pain and survival of extremely preterm infants, a feticide should be discussed as early as 20-22 weeks of gestation.

Relation of viscous lidocaine combined with propofol deep sedation during elective upper gastrointestinal endoscopy to discharge.

Fusing topical pharyngeal anesthetics (TPAs) to intravenous sedation during esophagogastroduodenoscopy (EGD) has been controversial. This double-blind, randomized, placebo-controlled trial assessed the association of TPA with patient recovery time, post-EGD to discharge. Supplementary aims were to determine the association of TPA with patient and practitioner satisfaction (both measured on a 100-mm visual analog scale), total propofol dose, and side effects. The study included 93 patients (mean age 53.8 years, range 44-67; 37 men and 56 women) undergoing elective EGD at a single academic medical center from September 2015 to October 2016. Urgent or therapeutic EGDs were excluded. Interventions were 7.5 mL 2% lidocaine viscous solution and 7.5 mL placebo solution (3% methylcellulose). There were no statistically significant differences between the lidocaine (n = 46) and placebo (n = 47) groups with respect to recovery time (42 ± 17.8 vs 39 ± 15.9 minutes; P = 0.23), procedure time (6.5 ± 2.7 vs 7 ± 3.6 minutes; P = 0.77), endoscopist satisfaction (83.2 ± 24.4 vs 77 ± 27.7, P = 0.23), patient discomfort (16.6 ± 19.8 vs 24.0 ± 29.7, P = 0.37), or total propofol administered (2.3 ± 1.3 vs 2.3 ± 1.0 mg/kg, P = 0.55). Compared to placebo, topical viscous lidocaine does not appear to delay recovery time or adversely affect sedation-related outcomes.

Current trends in needle-free jet injection: an update.

BACKGROUND: Jet injection can be defined as a needle-free drug delivery method in which a high-speed stream of fluid impacts the skin and delivers a drug. Despite 75 years of existence, it never reached its full potential as a strategic tool to deliver medications through the skin. OBJECTIVE: The aim of this review was to evaluate and summarize the evolution of jet injection intradermal drug delivery method including technological advancements and new indications for use. METHODS: A review of the literature was performed with no limits placed on publication date. RESULTS: Needleless injectors not only reduce pain during drug delivery but also confine the drug more evenly in the dermis. Understanding skin properties of the injection site is a key factor to obtain optimal results as well as setting the right parameters of the jet injector. Until the advent of disposable jet injectors/cartridges, autoclaving of the injector remains the only reliable method to eliminate the risk of infection. Needle-free intradermal injection using corticosteroids and/or local anesthetics is well documented with promising indications being developed. LIMITATIONS: Limitations of the review include low-quality evidence, small sample sizes, varying treatment parameters, and publication bias. CONCLUSION: New developments may help reconsider the use of jet injection technology. Future studies should focus on measurable optimized parameters to insure a safe and effective outcome.

Laparoscopic versus open approach to neurolytic celiac plexus block in inoperable pancreatic cancer.

BACKGROUND: Neurolytic celiac plexus block (NCPB) is an effective method of palliative pain control. The purpose of this study was to evaluate the feasibility and effectiveness of the laparoscopic NCPB versus open approach. METHODS: Eight patients (Group A) underwent diagnostic laparoscopy which revealed an inoperable pancreatic cancer. Forty millilitres of solution (20 mL of 95% ethanol mixed with 20 mL of xylocaine) was injected into either side of para-aortic soft tissue. The same solution was injected in 10 patients (Group B), with inoperable pancreatic body cancer diagnosed during laparotomy. RESULTS: There were no intraoperative or post-operative, NCPB related, complications. Patients in both groups, reported significant pain relief in the early post-operative period. Using the visual analogue scale preoperatively, in second post-operative day, first and third post-operative month, no significant different was observed between the two groups. The mean hospital stay in both groups was 2.1 versus 5.2 (P = 0.0005) and the mean survival 8.1 versus 7.9 months (ns). CONCLUSIONS: The NCPB is feasible method for palliation in inoperable pancreatic cancer. Laparoscopic NCPB gives excellent results and could still be considered in selected cases, as an effective alternative during staging laparoscopy.

Effect of Addition of Fentanyl to Xylocaine Hydrochloride in Brachial Plexus Block by Supraclavicular Approach.

AIM: This study was designed to quantitatively compare the effects of 1.5% xylocaine with 1.5% xylocaine and fentanyl (1 µg/kg) mixture for supraclavicular brachial plexus block. MATERIALS AND METHODS: Sixty patients between the age group of 20-60 and scheduled for upper limb surgery were divided into two groups (xylocaine group and xylocaine plus fentanyl group). After performing supraclavicular brachial plexus block, an assessment was made for onset of analgesia, duration and degree of analgesia, block intensity, and for any other side effects. RESULTS: Mean duration of analgesia is Group I is 2.1 h and in Group II is 8.1 h; a four-fold increase in duration of analgesia. CONCLUSION: Addition of fentanyl to xylocaine for supraclavicular brachial plexus block has no significant effect on onset or quality of analgesia, but duration of analgesia is significantly prolonged.

Effects of iodinated contrast agent, xylocaine and gadolinium concentration on the signal emitted in magnetic resonance arthrography: a samples study.

OBJECTIVE: To investigate the effects of dilution of paramagnetic contrast agent with iodinated contrast and xylocaine on the signal intensity during magnetic resonance arthrography, and to improve the paramagnetic contrast agent concentration utilized in this imaging modality. MATERIALS AND METHODS: Samples specially prepared for the study with three different concentrations of paramagnetic contrast agent diluted in saline, iodinated contrast agent and xylocaine were imaged with fast spin echo T1-weighted sequences with fat saturation. The samples were placed into flasks and graphical analysis of the signal intensity was performed as a function of the paramagnetic contrast concentration. RESULTS: As compared with samples of equal concentrations diluted only with saline, the authors have observed an average signal intensity decrease of 20.67% for iodinated contrast agent, and of 28.34% for xylocaine. However, the increased gadolinium concentration in the samples caused decrease in signal intensity with all the dilutions. CONCLUSION: Minimizing the use of iodinated contrast media and xylocaine and/or the use of a gadolinium concentration of 2.5 mmol/L diluted in saline will improve the sensitivity of magnetic resonance arthrography.

OBJETIVO: Investigar, mediante quantificação da intensidade do sinal emitido em amostras, se a diluição do agente de contraste paramagnético com contraste iodado e xilocaína alteram o sinal emitido pelo meio de contraste paramagnético durante o exame de artrorressonância magnética, e aperfeiçoar a concentração de contraste paramagnético utilizada no exame. MATERIAIS E MÉTODOS: Foi realizada sequência de pulso fast spin eco ponderada em T1 com saturação de gordura, utilizando três diferentes concentrações de contraste paramagnético diluídas em solução salina, contraste iodado e xilocaína. As amostras foram colocadas em frascos e a análise gráfica da intensidade do sinal em função da concentração de contraste paramagnético foi realizada. RESULTADOS: Constatou-se que as diluições de contraste paramagnético em contraste iodado e xilocaína diminuíram, em média, a intensidade do sinal em 20,67% para o contraste iodado e 28,34% para a xilocaína, em comparação com as amostras de concentração idêntica diluídas apenas em solução salina. Porém, o aumento da concentração de gadolínio nas amostras ocasionou a diminuição da intensidade do sinal emitido pelo gadolínio, para todas as diluições. CONCLUSÃO: Minimizar o uso do meio de contraste iodado e da xilocaína e/ou a utilização de uma concentração de gadolínio com 2,5 mmol/L, diluída em solução salina, irá aperfeiçoar a sensibilidade do exame de artrorressonância magnética.

Effects of iodinated contrast agent, xylocaine and gadolinium concentration on the signal emitted in magnetic resonance arthrography: a samples study / Efeitos do contraste iodado, da xilocaína e da concentração de gadolínio no sinal emitido em exames de artrorressonância magnética: estudo por amostras

Objective: To investigate the effects of dilution of paramagnetic contrast agent with iodinated contrast and xylocaine on the signal intensity during magnetic resonance arthrography, and to improve the paramagnetic contrast agent concentration utilized in this imaging modality. Materials and Methods: Samples specially prepared for the study with three different concentrations of paramagnetic contrast agent diluted in saline, iodinated contrast agent and xylocaine were imaged with fast spin echo T1-weighted sequences with fat saturation. The samples were placed into flasks and graphical analysis of the signal intensity was performed as a function of the paramagnetic contrast concentration. Results: As compared with samples of equal concentrations diluted only with saline, the authors have observed an average signal intensity decrease of 20.67% for iodinated contrast agent, and of 28.34% for xylocaine. However, the increased gadolinium concentration in the samples caused decrease in signal intensity with all the dilutions. Conclusion: Minimizing the use of iodinated contrast media and xylocaine and/or the use of a gadolinium concentration of 2.5 mmol/L diluted in saline will improve the sensitivity of magnetic resonance arthrography. .

Objetivo: Investigar, mediante quantificação da intensidade do sinal emitido em amostras, se a diluição do agente de contraste paramagnético com contraste iodado e xilocaína alteram o sinal emitido pelo meio de contraste paramagnético durante o exame de artrorressonância magnética, e aperfeiçoar a concentração de contraste paramagnético utilizada no exame. Materiais e Métodos: Foi realizada sequência de pulso fast spin eco ponderada em T1 com saturação de gordura, utilizando três diferentes concentrações de contraste paramagnético diluídas em solução salina, contraste iodado e xilocaína. As amostras foram colocadas em frascos e a análise gráfica da intensidade do sinal em função da concentração de contraste paramagnético foi realizada. Resultados: Constatou-se que as diluições de contraste paramagnético em contraste iodado e xilocaína diminuíram, em média, a intensidade do sinal em 20,67% para o contraste iodado e 28,34% para a xilocaína, em comparação com as amostras de concentração idêntica diluídas apenas em solução salina. Porém, o aumento da concentração de gadolínio nas amostras ocasionou a diminuição da intensidade do sinal emitido pelo gadolínio, para todas as diluições. Conclusão: Minimizar o uso do meio de contraste iodado e da xilocaína e/ou a utilização de uma concentração de gadolínio com 2,5 mmol/L, diluída em solução salina, irá aperfeiçoar a sensibilidade do exame de artrorressonância magnética. .

An influence of adrenaline (1:80,000) containing local anesthesia (2% Xylocaine) on glycemic level of patients undergoing tooth extraction in Riyadh.

OBJECTIVE: Aim is to compare the glycemic level among patients before, and after local anesthesia containing adrenaline 1:80,000 among patients who need dental extraction. MATERIALS AND METHODS: 60 patients were randomly selected including 30 healthy and 30 with a diabetes history for this study in Riyadh city. First the blood glucose level was measured before administering local anesthesia containing adrenaline after taking their history with glucocheck according to instructions, then blood Sugar level was recorded after administering local anesthesia containing adrenaline 1:80,000 concentrations. Blood sugar level was also checked 5 min after the tooth extraction procedure. RESULTS: There were no significant results found after the administration of local anesthesia containing adrenaline in both healthy and diabetic patients (p > 0.05). However, change of significance (p < 0.05) was noticed in diabetic patients who had not taken their hypoglycemic medication; there was a rise in their blood glucose level after extraction. CONCLUSION: The study concluded no significant effect on the glycemic level of patients after the administration of local anesthesia containing adrenaline 1:80,000 in healthy and diabetic patients whether hypoglycemic medication was taken or not but a rise in blood sugar level was found among diabetic patients who did not take their hypoglycemic medications undergoing tooth extraction.

Acetazolamide encapsulated dendritic nano-architectures for effective glaucoma management in rabbits.

The present investigation was aimed to develop topically effective acetazolamide loaded poly(propylene imine) dendrimer nanoarchitectures and evaluate their intraocular pressure lowering potential. The 5.0G PPI dendrimers were synthesized using ethylendiamine as dendrimer core through divergent approach and characterized and loaded with acetazolamide (ACZ). The developed dendrimeric formulations were characterized for size, loading efficiency. The surface morphology of dendrimer was studied by Transmission Electron Microscopy. The developed dendrimer formulations were evaluated for hemolytic toxicity, ocular irritation index and intra ocular pressure reduction using normotensive adult male New Zealand albino rabbits as in vivo model. The maximum drug entrapment efficiency was found to be 56±2.3%. The in vitro release data of ACZ-5.0G PPI dendrimers showed sustained release of ACZ which was found to be 83.5±1.8 and 80.4±1.6% in phosphate buffer saline (pH 7.4) and simulated tear fluid (pH 7.4), respectively in 24h. Ocular irritancy, ocular residence time and intraocular pressure lowering effect were performed. The study revealed that in lower concentrations the aqueous solutions of dendrimer formulations were found to be weakly irritant to the eyes. The sustained and prolonged reduction in intraocular pressure suggested that drug entrapped in dendrimers can be used for higher retention in ocular cul-de sac. Further, the PPI dendrimer based formulation seems to enhance the ocular drug residence time and exhibits better intraocular pressure lowering effect for glaucoma treatment, more safely, both in vitro and in vivo.

Local anesthetic effects on gene transcription in human skeletal muscle biopsies.

INTRODUCTION: We examined if epinephrine in the local anesthetic to help control incision-related bleeding interferes with molecular measurements obtained with the Duchenne-Bergström percutaneous needle biopsy technique for sampling human skeletal muscle. METHODS: Three groups received 2.5-3.0 ml of 1% lidocaine in 2 injections: (1) 0.5-1.0 ml superficially, which varied among the groups according to (i) -Epi; intra- and subcutaneous without epinephrine, (ii) +Epi -Fascia; intra- and subcutaneous with epinephrine, avoiding the fascia, and (iii) +Epi +Fascia; intra- and subcutaneous with epinephrine, directing a small amount (∽0.2 ml) into the fascia area; and (2) ∽2.0 ml without epinephrine into the fascia area for all subjects. A muscle biopsy was obtained 5-10 min later for IL-6 and MuRF-1 mRNA levels. RESULTS: IL-6 mRNA levels were low in -Epi and +Epi -Fascia, but ∽300-fold higher in +Epi +Fascia. MuRF-1 mRNA levels were similar among the groups. CONCLUSIONS: Lidocaine with epinephrine can confound intramuscular measurements from needle biopsies, but this can be avoided with a careful injection approach.

Comparing the preventive effect of 2 percent topical lidocaine and intravenous atropine on oculocardiac reflex in ophthalmological surgeries under general anesthesia.

BACKGROUND: The current study aimed to determine preventive effect of 2 percent topical xylocaine on oculocardiac reflex in ophthalmological surgeries except strabismus, including retinal detachment and vitrectomy with scleral buckling under general anesthesia. METHODS: A randomized controlled clinical trial was carried out on 150 patients aged 18-90 years undergoing ophthalmological surgeries under general anesthesia. Samples randomly divided into the experimental group (received four drops of 2 percent topical xylocaine instilled in desired eye) and control group (received 0.5 mg atropine sulfate injection). Systolic, diastolic and mean arterial blood pressure of patients and baseline heart rate were recorded. They were compared regarding the incidence of bradycardia, heart rate less than 60 beats/minute, hypotension and blood pressure less than 90 mm/Hg. Data were analyzed by Statistical Package for the Social Sciences software version 20 using Chi-square and ANOVA. RESULTS: The difference between two groups was not statistically significant regarding demographic and basic variables. The incidence of bradycardia in both groups was respectively (90.7 percent vs. 17.3 percent), heart rate less than 60 beats/minute (40 percent vs. 13.3 percent), hypotension (76 percent vs. 32 percent) and blood pressure less than 90 mmHg was (28 percent vs. 8 percent). Accordingly, the differences between both groups were statistically significant (P > 0.001). CONCLUSIONS: The preventive impact of topical xylocaine upon oculocardiac reflex in ophthalmological surgeries such as retinal detachment and vitrectomy with scleral buckling under general anesthesia was less effective than that of atropine injection. Therefore, to avoid this reflex in high-risk patients, injecting atropine would be safer.

Preliminary studies on local anesthetic and antipyretic activities of Spilanthes acmella Murr. in experimental animal models.

OBJECTIVE: Spilanthes acmella Murr. (Family: Compositae) is a herb that grows throughout the tropics. It is used in the treatment of rheumatism, fever, sore throat, and hemorrhoids. A tincture of the flowers is used to relieve toothache. The leaves and flowers produce numbness of the tongue when eaten as salad. The present study was undertaken to evaluate the local anesthetic and antipyretic activities of S. acmella in experimental animal models. MATERIALS AND METHODS: Aqueous extract of S. acmella Murr. (SAM) was tested for local anesthetic action by (i) intracutaneous wheal in guinea pigs and (ii) plexus anesthesia in frogs. In both the models, 2% xylocaine was used as the standard drug. The anti-pyretic activity was determined by yeast-induced pyrexia in rats. Aspirin 300 mg/kg was used as the standard drug. RESULT: The test drug in concentrations of 10% and 20% produced 70.36% and 87.02% anesthesia respectively by the intracutaneous wheal compared to 97.22% anesthetic effect produced by 2% xylocaine (P<0.001). The mean onset of anesthesia with the test drug was 5.33±0.57 min compared to 2.75±0.31 min (P<0.001) for the standard drug in the plexus anesthesia model. In the anti-pyretic model, ASA in doses of 100, 200, and 400 mg produced dose-dependent reduction in mean temperature at various hours of observation. CONCLUSION: The present study shows that SAM has significant local anesthetic and antipyretic activities.