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Kantasrila R, Pandith H, Balslev H, Wangpakapattanawong P, Panyadee P, Inta A. Ethnobotany and phytochemistry of plants used to treat musculoskeletal disorders among Skaw Karen, Thailand. PHARMACEUTICAL BIOLOGY 2024; 62:62-104. [PMID: 38131672 PMCID: PMC10763916 DOI: 10.1080/13880209.2023.2292261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023]
Abstract
CONTEXT Musculoskeletal system disorders (MSD) are prevalent around the world affecting the health of people, especially farmers who work hard in the field. Karen farmers use many medicinal plants to treat MSD. OBJECTIVE This study collects traditional plant-based remedies used by the Skaw Karen to treat MSD and evaluates their active phytochemical compounds. MATERIALS AND METHODS The ethnobotanical study was conducted in six Karen villages in Chiang Mai province using semi-structured interviews were of 120 informants. The data were analyzed using ethnobotanical indices including use values (UV), choice value (CV), and informant consensus factor (ICF). Consequently, the 20 most important species, according to the indices, were selected for phytochemical analysis using LC-MS/MS. RESULTS A total of 3731 use reports were obtained for 139 species used in MSD treatment. The most common ailments treated with those plants were muscular pain. A total of 172 high-potential active compounds for MSD treatment were identified. Most of them were flavonoids, terpenoids, alkaloids, and steroids. The prevalent phytochemical compounds related to treat MSD were 9-hydroxycalabaxanthone, dihydrovaltrate, morroniside, isoacteoside, lithocholic acid, pomiferin, cucurbitacin E, leonuriside A, liriodendrin, and physalin E. Sambucus javanica Reinw. ex Blume (Adoxaceae), Betula alnoides Buch.-Ham. ex D.Don (Betulaceae), Blumea balsamifera (L.) DC. (Asteraceae), Plantago major L. (Plantaginaceae) and Flacourtia jangomas (Lour.) Raeusch. (Salicaceae) all had high ethnobotanical index values and many active compounds. DISCUSSION AND CONCLUSIONS This study provides valuable information, demonstrating low-cost medicine plants that are locally available. It is a choice of treatment for people living in remote areas.
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Affiliation(s)
- Rapeeporn Kantasrila
- Department of Biology, Faculty of Science, Chiang Mai University, Thailand
- The Botanical Garden Organization, Queen Sirikit Botanic Garden, Chiang Mai, Thailand
| | | | - Henrik Balslev
- Department of Biology, Aarhus University, Aarhus C, Denmark
| | | | - Prateep Panyadee
- The Botanical Garden Organization, Queen Sirikit Botanic Garden, Chiang Mai, Thailand
| | - Angkhana Inta
- Department of Biology, Faculty of Science, Chiang Mai University, Thailand
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Hassan H, Shado R, Novo Pereira I, Mistry M, Craig D. Efficacy and cost analysis of intravenous conscious sedation for long oral surgery procedures. Br J Oral Maxillofac Surg 2024; 62:523-538. [PMID: 38797651 DOI: 10.1016/j.bjoms.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 05/29/2024]
Abstract
The aim of this study was to determine what is considered a long oral surgery and conduct a cost-effective analysis of sedative agents used for intravenous sedation (IVS) and sedation protocols for such procedures. Pubmed and Google Scholar databases were used to identify human studies employing IVS for extractions and implant-related surgeries, between 2003 and July/2023. Sedation protocols and procedure lengths were documented. Sedative satisfaction, operator satisfaction, and sedation assessment were also recorded. Cost estimation was based on The British National Formulary (BNF). To assess bias, the Cochrane Risk of Bias tools were employed. This review identified 29 randomised control trials (RCT), six cohorts, 14 case-series, and one case-control study. The study defined long procedures with an average duration of 31.33 minutes for extractions and 79.37 minutes for implant-related surgeries. Sedative agents identified were midazolam, dexmedetomidine, propofol, and remimazolam. Cost analysis revealed midazolam as the most cost-effective option (<10 pence per procedure per patient) and propofol the most expensive option (approximately £46.39). Bias analysis indicated varying degrees of bias in the included studies. Due to diverse outcome reporting, a comparative network approach was employed and revealed benefits of using dexmedetomidine, propofol, and remimazolam over midazolam. Midazolam, dexmedetomidine, propofol, and remimazolam demonstrated safety and efficacy as sedative agents for conscious IVS in extended procedures like extractions or implant-related surgeries. While midazolam is the most cost-effective option, dexmedetomidine, propofol, and remimazolam offer subjective and clinical benefits. The relatively higher cost of propofol may impede its widespread use. Dexmedetomidine and remimazolam stand out as closely priced options, necessitating further clinical investigations for comparative efficacy assessment.
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Affiliation(s)
- Haidar Hassan
- Barts & The London School of Medicine & Dentistry, Queen Mary University, Centre for Cutaneous Research, Blizard Institute of Cell and Molecular Science, 4 Newark Street, Whitechapel, London E1 2AT, United Kingdom; Barts & The London School of Medicine & Dentistry, Queen Mary University, Institute of Dentistry, Royal London Dental Hospital, Turner Street, London E1 2AD, United Kingdom.
| | - Rawand Shado
- Barts & The London School of Medicine & Dentistry, Queen Mary University, Institute of Dentistry, Royal London Dental Hospital, Turner Street, London E1 2AD, United Kingdom
| | - Ines Novo Pereira
- University of Porto, Faculty of Dental Medicine, R. Dr. Manuel Pereira da Silva, 4200-393 Porto, Portugal
| | - Manisha Mistry
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - David Craig
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
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Diniz JA, Dourado ACAG, Barbirato DDS, de Oliveira MSV, de Lira VLBDO, de Melo Filho SMC, da Silveira KG, Laureano Filho JR. Evaluation of the effects of pregabalin and dexamethasone coadministration on preemptive multimodal analgesia and anxiety in third molar surgeries: a triple-blind randomized clinical trial. Clin Oral Investig 2024; 28:304. [PMID: 38717697 DOI: 10.1007/s00784-024-05700-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/28/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To evaluate the efficacy of pregabalin and dexamethasone coadministration in preemptive analgesia and anxiety control in lower third molar surgery. MATERIALS AND METHODS A triple-blind, split-mouth clinical trial conducted with patients divided into two groups: control group, receiving placebo and dexamethasone, and test group, receiving pregabalin and dexamethasone preoperatively. The evaluated variables were pain, measured by the Visual Analog Scale (VAS), anxiety assessed through the State-Trait Anxiety Inventory (STAI) questionnaires, hemodynamic parameters [Blood Pressure (BP), Heart Rate (HR), Oxygen Saturation (SpO2)], and sedation assessed by the Ramsay scale. RESULTS A total of 31 patients were included. The test group exhibited a significant reduction in pain at 2,4,6,8,12,16,24, and 48 h after surgery and in the consumption of rescue analgesics. Anxiety, evaluated by STAI and VAS, showed a significant decrease in the test group (p < 0.001). Additionally, there was a significant decrease in BP at most of the assessed time points (p < 0.05) and a significant reduction in HR at two different time intervals (p = 0.003 and p = 0.009), indicating a positive effect in the test group. There was no significant difference in SpO2 between the groups. Sedation assessment revealed a significant difference at all time points favoring the test group (p < 0.05). There were no significant postoperative adverse effects. CONCLUSIONS Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as a sedative effect. CLINICAL RELEVANCE The coadministration of pregabalin with dexamethasone may presents potential advantages in both pain modulation and psychological well-being of individuals undergoing third molar surgeries. TRIAL REGISTRATION Brazilian Clinical Trials Registry (REBEC), No. RBR-378h6t6.
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Affiliation(s)
- Jiordanne Araújo Diniz
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, 50100-130, PE, Brazil.
| | | | - Davi da Silva Barbirato
- Postdoctoral Fellowship in Oral and Maxillofacial Surgery, University of Pernambuco, Recife, PE, Brazil
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Re: Postoperative nausea and vomiting in facial fracture patients: a randomized and controlled trial on the effect of dexamethasone. Int J Oral Maxillofac Surg 2018; 47:1227-1228. [DOI: 10.1016/j.ijom.2018.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/20/2018] [Indexed: 11/18/2022]
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Eshghpour M, Samieirad S, Attar AS, Kermani H, Seddigh S. Propofol Versus Remifentanil: Which One Is More Effective in Reducing Blood Loss During Orthognathic Surgery? A Randomized Clinical Trial. J Oral Maxillofac Surg 2018; 76:1882.e1-1882.e7. [PMID: 29902418 DOI: 10.1016/j.joms.2018.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 04/14/2018] [Accepted: 05/08/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE Propofol and remifentanil are 2 useful drugs used in induced hypotensive anesthesia. The purpose of this study was to compare the effects of these drugs on intraoperative blood loss, transfusion requirements, and hemodynamic status during standardized orthognathic surgical procedures. MATERIALS AND METHODS In this double-blind randomized clinical trial, 50 consecutive healthy patients with Class III skeletal deformity were candidates for bimaxillary orthognathic surgery at Qaem Hospital, Mashhad University of Medical Sciences (Mashhad, Iran), from November 2016 until December 2017. These patients were randomly assigned to 2 equal-number groups to receive hypotensive anesthesia with propofol or remifentanil. Neither the surgeon nor the patients were aware of the study groups, whereas both the student and anesthesiologist were not blinded. Age and gender were recorded, and mean blood loss, mean arterial pressure, and mean heart rate, as well as duration of surgery and duration of general anesthesia, were monitored intraoperatively. The hypotensive anesthetic drugs were the primary predictor variables and the mean blood loss volume was the main outcome in this research. The independent t test and χ2 test were performed for data analysis using SPSS software (version 16; SPSS, Chicago, IL). RESULTS In this study, 25 patients with a mean age of 22.25 ± 3.31 years were investigated in each group. The mean blood loss volume was 578.26 ± 95.14 mL and 366.67 ± 64.92 mL in the propofol and remifentanil groups, respectively. The independent-samples t test showed that mean blood loss was significantly lower in the remifentanil group than in the propofol group (P = .001). Furthermore, the mean arterial blood pressure was significantly lower in the remifentanil group than in the propofol group (85 ± 20 mm Hg vs 95 ± 15 mm Hg, P < .001). CONCLUSIONS Hypotensive anesthesia with remifentanil, in comparison with propofol, significantly reduces mean blood loss during orthognathic surgery, which decreases the transfusion requirements and disadvantages of transfusion and blood loss.
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Affiliation(s)
- Majid Eshghpour
- Associate Professor, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahand Samieirad
- Assistant Professor, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Sharifian Attar
- Associate Professor, Endoscopic & Minimally Invasive Surgery Research Center, Department of Anesthesiology, Qaem Hospital, and Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Kermani
- Assistant Professor, Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sadaf Seddigh
- Dental Student, Student Research Committee, Dentistry Faculty, Mashhad University of Medical Sciences, Mashhad, Iran.
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