Clinical Efficacy of Celecoxib with and without Caffeine versus Ibuprofen for Pain Control following Crown Lengthening Surgery

Objective: Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly prescribed pain control medications following periodontal surgery. This study aimed to compare the efficacy of three drug regimens namely celecoxib, celecoxib + caffeine and ibuprofen for pain relief following crown lengthening surgery.Methods: This randomized, double blind clinical trial was performed on 45 patients aged 20-60 years requiring crown lengthening of maxillary teeth. The subjects were randomly divided into three groups (n=15) receiving ibuprofen (400mg), celecoxib (200mg) and celecoxib (200mg) + caffeine (30mg). Each patient took one dose of the respective medications 30 minutes prior to surgery. Other doses were prescribed 1, 8, 16 and 24 hours after surgery. Pain scores were recorded using visual analog scale (VAS) at 1, 2, 4, 8, 16, 24 and 48 hours post operation.Results: The mean VAS scores were significantly lower in celecoxib + caffeine group than in celecoxib group at 1 and 2 hours after surgery (H1: 2.33 (1.95) vs. 4.47 (2.56), p=0.026) (H2: 2.47 (1.60) vs. 4.80 (2.40), p=0.009). The pain scores were significantly lower in celecoxib + caffeine group than ibuprofen group at 8, 16 and 24 hours after the procedure (H8: 1.80 (1.21) vs. 3.73(1.94), p=0.012) (H16: 1.07 (1.03) vs. 2.73 (1.87), p=0.012) (H24: 0.47 (0.64) vs. 1.87 (1.25),p=0.004). No significant difference was found in analgesic efficacy of celecoxib and ibuprofen. Conclusion: The combination of celecoxib + caffeine showed higher efficacy than other medications for pain control following crown lengthening surgery. Caffeine may enhance the analgesic effect of celecoxib

Drug interactions in elderly (Amirkola Health and Ageing Project)

Background: Due to physiological changes and co-existing chronic diseases, the elderly has to take various drugs with different mechanisms that may increase the risk of drug interactions and side effects of medications. This study was performed to evaluate the profile of drug interactions of Amirkola elderly patients. Methods: This cross-sectional descriptive-analytical study is part of the Amirkola Health and Ageing Project (AHAP) which was done during 2012-2013 (Amirkola, Babol, Iran). Initial data collection was done on 1616 persons of ages 60 and older by observing their prescribed drugs and those prepared by self-medications. Results: Drug interactions were detected in 31.7 (95 CI; 29.41, 33.95) of the drug prescriptions. This included 28 of mild, 63.3 of moderate and 8.7 of severe drug interactions. Cardiovascular drugs (64.4) were the most frequent drugs that induced drug-interactions. According on Beer criteria 2015, 39.97 of the elderly medications were identified as “inappropriate medication”. NSAIDs had the highest prevalence of inappropriate drugs. There was a significant relationship between female gender, having underlying disease, living alone, having insurance, and polypharmacy with obtained drug interaction results (p<0.05). Conclusion: The findings of the present study indicate considerable drug interactions among the elderly in Amirkola, which highlights the need for careful prescribing and using of drugs in the elderly. &#160

Comparison of the Efficacy of Short-Term and Long-Term Azithromycin Regimen with Metronidazole and Amoxicillin for Treatment of Moderate Chronic Periodontitis in Adults

Objective: Administration of amoxicillin and metronidazole along with scaling and root planning (SRP) is an effective adjunctive therapy for chronic periodontitis. Studies have shown that administration of azithromycin is also effective for treatment of chronic periodontitis. This study aimed to compare the effect of short-term and long-term azithromycin regimen with amoxicillin and metronidazole for treatment of moderate chronic periodontitis in adults.Methods: This experimental study was carried out on 75 patients with moderate chronic  periodontitis aged 35-50 yrs. with at least one pocket with a probing depth of 4-6 mm and  attachment loss of 3-4 mm in each quadrant. Loe and Silness Gingival Index (GI),  Modified Papillary Bleeding Index (MPBI) of Barnett, Loe and Silness Plaque Index (PLI), Probing Pocket Depth (PPD) and Attachment Loss (AL) were calculated at 0, 2 and 4 days, 6 weeks and 2 and 3 months after therapy. The patients underwent SRP and assigned to three groups. Group one received 250 mg metronidazole plus 250 mg amoxicillin 3 times a day for 7 days. Group 2 received 500 mg azithromycin twice daily for 7 days and group 3 received 250 mg azithromycin once a day for one month. Data were analyzed using ANOVA and Repeated Measures ANOVA.Results: PLI, MPBI, GI, PPD and AL parameters showed a significant reduction in all groups at all understudy time points (p<0.05). The reduction in BI, GI and PLI parameters was greater in group 3 compared to groups 1 and 2 (p <0.05); but, no significant difference was observed between groups 1 and 2 in this respect. A greater reduction in PPD was noted in groups 2 and 3 compared to group 1 (p<0.05). AL showed a significant reduction in group 3 compared to groups 1 and 2 only in the final follow-up session (p =0.042).Conclusion: Antibiotic therapy regimens were all effective for treatment of chronic periodontitis but the magnitude of improvement was greater in long-term azithromycin group compared to others

The Effect of Passive Smoking on Total Antioxidant Capacity of Serum and Saliva in Rats

Objective: Active and passive smoking lead to the production of a number of oxidants and antioxidants with various adverse health effects compromising the immune system. Tobacco use increases the production of free radicals as well. The purpose of this study was to determine the effects of passive smoking on total antioxidant capacity (TAC) of serum and saliva in rats.Methods: This experimental study was conducted on 18 rats with an age range of 7-11 weeks weighing 160-200 g; 9 of them were exposed to cigarette smoke 3 times daily for 8 minutes. The 9 controls were not exposed to cigarette smoke. After injection of 0.2 mg/kg midazolam and 0.5  mg/kg pilocarpine, serum and saliva samples were taken from subjects in the exposure and control groups at 0, 15 and 30 days. Serum cotinine was measured using ELISA kit. TAC of saliva and serum was measured using ferric reducing antioxidant power (FRAP) assay. TAC values at different time points were statistically analyzed in each group using Repeated Measures ANOVA and compared between the two groups using t-test.Results: At baseline, no significant difference existed between the two groups in terms of serum cotinine concentration but at days 15 and 30, cotinine serum concentration significantly increased in the exposure group. At baseline and 30 days, no significant difference existed between the two groups of passive smoker and non-smoker in terms of serum TAC values but at day 15, serum TAC values were significantly higher in the exposure group. Also, TAC of salivawas significantly higher in the passive smoker group at baseline and at day 15 but at day 30, the difference in this respect between the two groups was not statistically significant.Conclusion: Based on the obtained results, changes in TAC of serum and saliva in rats due to exposure to cigarette smoke were compensated by their immune system activity. However, further investigations are still required in this respect

Applying GC-MS analysis to identify chemical composition of Iranian propolis prepared with different solvent and evaluation of its biological activity

Background: Propolis as a natural product has shown beneficial effects on human health. This study was aimed to investigate the chemical compositions and biological activity of three different extracts of propolis from two distinct geographic areas in Iran. Methods: The chemical composition of Iranian propolis extracts that were collected in the Spring of 2016 from two provinces in northern Iran: Ardabil and Polur in Mazandaran Province were measured through gas chromatography-mass spectrometry (GC-MS) methods. In addition, antimicrobial activity and cytotoxicity effect on HN5 and LNCaP cell lines were evaluated. The data were analyzed using one-way ANOVA and p<0.05 was considered as significant. Results: The GC-MS analysis identified the presence of compounds that belonged to the different groups such as aromatics acids and their related esters, flavonoid and flavonoid derivatives and terpenes. Flavanone was the most dominant compound of flavonoids. The maximum growth inhibition was observed against S. aureus of ethanolic extract of propolis (p<0.05). Moreover, cytotoxicity showed that ethanolic and dichloromethane extracts had more inhibitory effects on cell lines than the water extract. Conclusion: The results determined that extracts had the highest percentage of flavonoids. Therefore, it is expected that the synergistic effect of the main components of propolis is related to the increase of biological activity of propolis

Evaluation of periodontal health in patients taking atorvastatin

Introduction: Periodontal disease as a chronic inflammatory condition is more prevalent in adults. Considering the anti-inflammatory effect of statins and the need to find out the effects of these drugs on the prevention and treatment of periodontal diseases, this study was conducted to investigate the role of atorvastatin in periodontal health. Material & Methods: In this cross sectional study the effect of atorvastatin on plaque index, probing pocket depth (PPD), gingival index (GI) and bleeding on probing (BOP) index were examined. Patients with plaque index between 1 and 2 were included in the study, and those who had taken atorvastatin for at least 3 months were selected as the case group and those who had not taken atorvastatin were considered as the control group. Results: A total of 138 patients (50 patients for the atorvastatin group and 88 patients for the control group) were included. The mean probing pocket depth in the atorvastatin group was 2.03±0.35 mm and that in the control group was 2.8±0.31 mm (p=0.335). The mean bleeding index in the atorvastatin group was 0.20±0.14 and compared to the control group was 0.20±0.17 (p<0.001). The GI index in the atorvastatin group was 1.29±0.33, compared to the control group was 1.20±0.40 (p=0.218). Conclusion: The results of this study indicate the positive effect of the use of atorvastatin on reducing the bleeding on probing index in patients taking this drug. The probing pocket depth index and gingival index were not significantly different between the atorvastatin group and the group not taking this drug

The effect of Coriandrum sativum seed extract on the learning of newborn mice by electric shock: interaction with caffeine and diazepam

Coriander has been recommended for the relief of pain, anxiety, flatulence, and loss of appetite. In traditional medicine, it is believed that coriander can induce some degree of amnesia in a child when his/her mother uses coriander during the pregnancy. We evaluated the effect of Coriandrum sativum seed extract on learning in second-generation mice. Ethanolic extract (2%) of coriander (100 mg/kg intraperitoneal) was dissolved in sunflower oil (oil) as a vehicle and injected into the control group mother mice during breastfeeding for 25 days at 5-day intervals. After feeding the newborn mice, their learning was evaluated using a step-through passive avoidance task with 0.4 mA electric shock for 2 or 4 seconds. While coriander extract showed a negative effect in the short term (1 hour) after the training session, it potentiated the mice’s learning in later assessments (24 hours post-training [P = 0.022] and 1 week post-training [P = 0.002] by a 4-second shock). Low-dose caffeine (25 mg/kg ip after training) improved the learning after 1 hour (P = 0.024); while diazepam (1 mg/kg ip) suppressed learning at all time points after the 4-second shock training (1 hour, P = 0.022; 24 hours, P = 0.002; and 1 week, P = 0.008). No modification in the pain threshold was elicited by electric stimuli both in coriander and control groups. In conclusion, coriander does not improve learning within a short period of time after training; however, learning after coriander administration can be improved in the long term

Anticholinergic drug use in Older People: A Population- Based Study in Iran

Background: Elderly people are in need of several drugs due to physiological changes and multiple chronic diseases. Studies have shown that anticholinergic drugs can cause cognitive impairment, reduced physical activity, and increased mortality in elderly population. Paying attention to the anticholinergic medication use in older adults can prevent the occurrence of adverse events and increase the quality of health care. This study was conducted to quantify exposure to anticholinergic medicines in older people in Amirkola. Methods: This study is a part of the comprehensive cohort project that was being conducted from 2011 on the case patients of 60 years and above that referred to the Amirkola Health Center. A total of 1532 individuals were included, of whom 54.9 were men. The drug information was obtained by observing the patient&#8217;s prescription and self-report questionnaires and collected data were analyzed by SPSS software. Exposure to anticholinergic medications was measured using the drug burden index-anticholinergic (DBI-Ach) and the anticholinergic drug scale (ADS). Results: Among the 1532 elderly people with an average age of 69.21 years, 29 had DBI&#62;0 and 36.3 had ADS&#62;0. Also, there was a significant correlation between DBI and ADS (R=0.758). In addition, there is a significant relationship between sex variable with DBI and ADS (P=0.0001). So, women in comparison with men had higher values of DBI and ADS. Conclusion: The findings of this study indicate that anticholinergic exposure is relatively high especially in older women, which posed special precautions to avoid inappropriate prescribing in the elderly

Efficacy of different doses of ketamine as a bolus in major depressive disorder

Background: Major depressive disorder is a severe, heterogeneous, common medical illness and a leading cause of disability throughout the world that poses a significant public health issue. Previous studies have shown rapid antidepressant effects following a single administration of ketamine. This study aimed to assess the impact of route of administration and dose of ketamine for the reduction of depressive symptoms and compare the effects of different doses and methods. Methods: A double-blind clinical controlled trial was done on 100 patients with a primary diagnosis of major depressive disorder who were assigned into two groups of 50 subjects at a dose of 0.5 mg/kg and 0.75 mg/kg ketamine and each group was divided into two groups of 25 subjects following a single dose of intravenous bolus and infusion of ketamine. The patient’s severity of depression was evaluated with Hamillton Depression Rating Scale and Beck Depression Inventory scores after 2 days, 7 days, 30 days and 60 days of ketamine administration, then the results were compared between groups. Results: According to Hamilton and Beck score, the treatment response in investigated patients was 64% and 60%, respectively. Conclusions: These data suggest that ketamine effect is related to drug dose and type of administration. The dose of 0.75 mg/kg of ketamine is more effective than 0.5 mg/kg and a bolus injection of low-dose ketamine (0.5 mg/kg) is more effective than infusion and in high-dose ketamine (0.75 mg/kg), there was no difference between the methods of drug administration

Clinical and biochemical effects of dark chocolate in moderate chronic periodontitis

Introduction: Antioxidant agents such as cocoa could have some benefits in treatment of inflammation including periodontitis. The aim of this study was to investigate the effects of cocoa consumption on moderate chronic periodontitis. Materials &Methods: This single-blind randomized clinical trial study was performed on 40 subjects who were randomly divided into two groups. Treatment group received 30 gr dark chocolate (78% cocoa) and control group received 22.5 gr white chocolate three times a day for 4 weeks. Saliva samples were collected from patients at baseline and twenty-eight days after eating chocolate. Probing pocket depth (PPD), Gingival index (GI, Silness and Loe), Modified papillary bleeding index (MPBI, Barnett), Clinical attachment loss (CAL) were recorded at baseline and 2nd, 4th, 6th, 8th weeks later in ramfjord teeth. Total antioxidant capacity (TAC) and lipid peroxidation of saliva were estimated by Ferric reducing antioxidant power (FRAP) and Tiuborbituric acid reactive substances (TBARS) methods. Data of clinical parameters were analyzed using t-test and repeated measures test. Biochemical parameters were analyzed using t-test. Results: Intra-group comparison of clinical parameters demonstrated significant decrease in both groups (p<0.0001) and inter-group comparison showed significant decrease of MPBI in treatment group, (p<0.03). MPBI and GI were significantly decreased in treatment group compared to the control in the weeks of 4th, 6th and 8th, according t-test (GI4, P=0.008-GI6, P=0.008-GI8, P=0.009), (MPBI4, MPBI6, MPBI8, P<0.0001). Treatment group showed the increase in FRAP, (p<0.00001) and decrease in TBARS, (P<0.015) which were statically significant in compare with control group. Conclusion: Consuming dark chocolate could increase TAC and decrease lipid peroxidation, gingival bleeding and inflammation