Device use in chronic pain

Interventional treatments are of vital importance in patients with chronic pain who do not respond to conventional drug therapy. Neuraxial drug delivery systems can be used for intractable cancer-induced pain. These devices, which are frequently used today and have advanced technological equipment, provide effective analgesia to patients. Another technique preferred especially in neuropathic pain is implantable devices that provide neurostimulation. Spinal cord stimulation (SCC) and Dorsal root ganglion stimulation (DRG-S) are the most commonly used. This article describes frequently used devices that provide neurostimulation and nöraxial drug delivery device are mentioned, and their working principles, application techniques, and technological features. Pubmed and Google scholar were used to search the articles, and Google was used for device images and manufacturer information

Locomotor differences in Mongolian gerbils with the effects of midazolam administration in the form of eye drops

Background: Midazolam is a sedative-hypnotic agent with amnestic and anticonvulsant properties that can be administrated to mammals through various routes, such as intravenous, intramuscular, oral, intrathecal, rectal, and buccal. Midazolam administration in the form of eye drops through the conjunctiva is not reported in the literature. Aim:This study aims to demonstrate the possible central nervous system effects of midazolam administration as eyes drops in Mongolian gerbils. Materials and Methods: Fourteen gerbils were randomly assigned to one of two equal sized groups. The active arm received 2 ml of 10 mg midazolam as eye drops in both eyes. Control group received a total of 2 ml of physiological saline(0.9% NaCl). We subjected the gerbils to an adapted “Open Field” to determine the possible effects on central nervous system of midazolam. Gerbils were allowed to move freely in the open field. Before and after the drug administration, locomotor activities of each gerbil have been recorded. Frequency of loss of righting reflex was quantified. Results: Conjunctival Midazolam administration resulted with the transient loss of righting reflex (p=0.017) and suppressed exploration motion (p=0.018) in the open field test compared to control subjects. Conclusions: In the present study, administration of conjunctival midazolam as an eye drop may affect gerbil’s locomotor activities and open field behaviors. We argue that, using a sedative and anticonvulsive drug such as midazolam via conjunctival route may be useful in some clinical situations. Therefore, it could be beneficial to develop a new conjunctival formulation of midazolam. Also, there is a need for trials in humans with pharmacokinetic studies.Keywords: Righting reflex; Conjunctival Midazolam; Gerbillinae; Midazolam; Eye drop; New administration routeAfrican Health sciences Vol 14 No. 1 March 201

A Comparison of Cormeck-Lehane and Mallampati Tests with Mandibular and Neck Measurements for Predicting Difficult Intubation

Objective: Various prediction tests were formulated to forecast difficult intubation. The Mallampati test, Wilson score, Cormack-Lehane test and thyromental distance are the most commonly used tests pre-operatively to assess the airway. The objective of the present study was to investigate whether a combination of the Mallampati and Cormack-Lehane's classification to predict difficult intubation compared with sternomental and thyromental distances, mandibular length, width and neck length and circumference

Volumetric evaluation of the relations among the cerebrum, cerebellum and brain stem in young subjects: a combination of stereology and magnetic resonance imaging

The Cavalieri estimator using a point grid is used to estimate the volume of three-dimensional structures based on two-dimensional slices of the object. The size of the components of intracranial neural structures should have proportional relations among them. The volume fraction approach of stereological methods provides information about volumetric relations of the components of structures. The purpose of our study is to estimate the volume and volume fraction data related to the cerebrum, cerebellum and brain stem. In this study, volume of the total brain, cerebrum, cerebellum and brain stem were estimated in 24 Young Turkish volunteers (12 males and 12 females) who are free of any neurological symptoms and signs. The Volume and volume fraction of the total brain, cerebrum, cerebellum and brain stem were determined on magnetic resonance (MR) images using the point-counting approach of stereological methods. The mean (+/-SD) total brain, cerebrum and cerebellum volumes were 1,202.05 +/- 103.51, 1,143.65 +/- 106.25 cm(3) in males and females, 1,060.0 +/- 94.6, 1,008.9 +/- 104.3 cm(3) in males and females, 117.75 +/- 10.7, 111.83 +/- 8.0 cm(3) in males and females, respectively. The mean brain stem volumes were 24.3 +/- 2.89, 22.9 +/- 4.49 cm(3) in males and females, respectively. Our results revealed that female subjects have less cerebral, cerebellar and brain stem volumes compared to males, although there was no statistically significant difference between genders (P > 0.05). The volume ratio of the cerebrum to total brain volume (TBV), cerebellum to TBV and brain stem to TBV were 88.16 and 88.13% in males and females, 9.8 and 9.8% in males and females, 2.03 and 2.03% in males and females, respectively. The Volume ratio of the cerebellum to cerebrum, brain stein to cerebrum and brain stein to cerebellum were 11.12 and 11.16% in males and females, 2.30 and 2.31% in males and females, 20.7 and 20.6% in males and females, respectively. The difference between the genders was not statistically significant (P > 0.05). Our results revealed that the volumetric composition of the cerebrum, cerebellum and brain stem does not show sexual dimorphism.The Cavalieri estimator using a point grid is used to estimate the volume of three-dimensional structures based on two-dimensional slices of the object. The size of the components of intracranial neural structures should have proportional relations among them. The volume fraction approach of stereological methods provides information about volumetric relations of the components of structures. The purpose of our study is to estimate the volume and volume fraction data related to the cerebrum, cerebellum and brain stem. In this study, volume of the total brain, cerebrum, cerebellum and brain stem were estimated in 24 young Turkish volunteers (12 males and 12 females) who are free of any neurological symptoms and signs. The volume and volume fraction of the total brain, cerebrum, cerebellum and brain stem were determined on magnetic resonance (MR) images using the point-counting approach of stereological methods. The mean (±SD) total brain, cerebrum and cerebellum volumes were 1,202.05 ± 103.51, 1,143.65 ± 106.25 cm3 in males and females, 1,060.0 ± 94.6, 1,008.9 ± 104.3 cm3 in males and females, 117.75 ± 10.7, 111.83 ± 8.0 cm3 in males and females, respectively. The mean brain stem volumes were 24.3 ± 2.89, 22.9 ± 4.49 cm3 in males and females, respectively. Our results revealed that female subjects have less cerebral, cerebellar and brain stem volumes compared to males, although there was no statistically significant difference between genders (P > 0.05). The volume ratio of the cerebrum to total brain volume (TBV), cerebellum to TBV and brain stem to TBV were 88.16 and 88.13% in males and females, 9.8 and 9.8% in males and females, 2.03 and 2.03% in males and females, respectively. The volume ratio of the cerebellum to cerebrum, brain stem to cerebrum and brain stem to cerebellum were 11.12 and 11.16% in males and females, 2.30 and 2.31% in males and females, 20.7 and 20.6% in males and females, respectively. The difference between the genders was not statistically significant (P > 0.05). Our results revealed that the volumetric composition of the cerebrum, cerebellum and brain stem does not show sexual dimorphism