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Evaluation of Bilateral Mental Nerve Block as an Alternative to General Anesthesia for Resection of Lower Lip Tumors

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Surgical Science 2017年第8期8卷 319-325页

作者： Ashraf Khater Islam A. Elzahaby Mohamed Hamdy Mohammad Zuhdy Omar Hamdy Mohamed Ezzat Mahmoud Abdelaziz Ahmad M. Farid Mansour Elmoatasem Amr Hassan khalid atallah Mahmoud Mostafa Saleh Maha A. Abo-Zeid Amr Yassin Ola Taha Abd Eldayem Mona Gad Department of Surgical Oncology Mansoura Oncology Center (OCMU) Faculty of Medicine Mansoura University Mansoura Egypt Anesthesia and Surgical Intensive Care Department Mansoura University Hospital Faculty of Medicine Mansoura University Mansoura Egypt

Objective: Nerve blockade is commonly used in oncosurgical procedures as an alternative to general anesthesia for older patients and those with significant medical problems. We report a single tertiary oncology center experience in performing various lip resections and reconstructive techniques using this technique. Patients and methods: sixty patients with lower lip tumors were enrolled into this study with exclusion of refusing, non-compliant and critically ill patients. A solution of 4 ml 2% Lidocaine and epinephrine was put in a 5 ml syringe. Half the solution (2 ml) was injected into each side with a 23 gauge needle and after 5 minutes the surgical resection was carried out after testing for anesthesia. Results: The mean age was 68 ± 6.2 years. The mean ASA score was 3 ± 0.75. There were 4 cases who expressed painful sensation and their operations were completed with fentanyl increments. Mean hospital stay was 1 ± 0.75 days. There were three cases of wound gaping who were treated with secondary closure in an outpatient basis. One patient expressed postoperative acute ischemic heart pain that was managed with anti-ischemic measurements. Conclusion: Bilateral mental nerve block is a safe and effective alternative to general anesthesia in lower lip tumors’ resection especially in older patients and those with poor tolerance for general anesthesia provided that there is no need for cervical nodal dissection.

关键词： Mental Nerve Block Lip Tumors Lidocaine

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Administration of Zinc with Paroxetine Improved the Forced Swim Test Behavioral Pattern of Treated Mice in Acute and Sub-Acute Study

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Journal of Behavioral and Brain Science 2015年第7期5卷 213-220页

作者： Hesham El Refaey Hasan S. Al Amri Abdelkader E. Ashour atallah F. Ahmed Pharmacology Department College of Pharmacy King Khalid University Abha Saudi Arabia Psychiatry Department College of Medicine King Khalid University Abha Saudi Arabia Department of Pharmacology and Toxicology College of Pharmacy King Saud University Abha Saudi Arabia Department of Pharmacognosy College of Pharmacy King Saud University Abha Saudi Arabia

Despite progressive improvement in treating major depressive disorder (MDD), it remains mostly unresponsive to one antidepressant medication. Zinc is a brain highly abundant trace metal, a brain derived neurotrophic factor (BDNF) inducer, a modulator of synaptic plasticity and potent suppressor of the NMDA receptors. We proposed that co-administration of zinc with the antide-pressants may represent a valuable regimen to improve the efficacy of these drugs. This work has been implemented to evaluate the behavioral changes of acute and sub-acute co-administration of zinc with Paroxtine in mice. Methods: The animals were injected intra-peritoneal with either Paroxtine (20 mg/kg) which was a selective serotonin reuptake inhibitor (SSRI), zinc sulfate (30 mg/kg) or Paroxtine in combination with zinc for one day and one week (once daily). The pattern of the animal behavior was assessed in the forced swim test (FST). Results and Discussion: The behavioral patterns of the animals in the FST include immobility, swimming and climbing. Successful antidepressant should decrease the immobility time with either increase in swimming and/or climbing behavior based on the drug pharmacological activity. Our results revealed a significant decrease of immobility and increase of swimming behavior indicating serotonin-dependent pharmacological activity of Paroxtine or zinc alone as well as in the animals treated with zinc in combination with Paroxtine. There was no significant difference in the animals’ behavior between acute and sub-acute treatment with zinc or even upon its addition to paroxetine. Our data support the concept that co-administration of zinc may provide further antidepressant activity. Zinc may offer additional clinical value particularly in geriatric patients or other populations where zinc level has shown dramatic decrease.

关键词： Depression Antidepressants Paroxetine Zinc

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