Milton Keynes, United Kingdom

Postoperative Pain After Full Pulpotomy With TheraCal PT, Biodentin, and MTA

The ethical approval for our study has been obtained from the Clinical Research Ethics Committee of Sivas Cumhuriyet University. The experimental phase of the study will be conducted at the Department of Endodontics, Faculty of Dentistry, Sivas Cumhuriyet University. Patient Selection Criteria: Participants aged between 18 and 45, who present with findings of irreversible pulpitis in the lower first molar tooth and apply to the Department of Endodontics, Faculty of Dentistry, Sivas Cumhuriyet University, will be included in the study. In this study: When α=0.05, β=0.10, and 1-β=0.90 were set, it was decided to include 17 teeth in each group, and the power of the test was found to be p=0.90948. Statistical Method: The data obtained from our study will be recorded in the SPSS 22.0 program. When the assumptions for parametric tests (Shapiro-Wilk) are met, one-way ANOVA will be used to compare measurements obtained from two or more independent groups. If differences are found, a Tukey test will be performed to determine which groups differ. If the parametric assumptions are not met, the Kruskal-Wallis test will be applied, and the Mann-Whitney U test will be used to identify the differing groups. The data will be presented in tables, including arithmetic mean, standard deviation, median, minimum-maximum values, and the error level will be set at 0.05. Inclusion Criteria for the Study: Age between 18 and 45 years, Absence of systemic disease, Apical periodontitis findings may be present or not, Symptoms of irreversible pulpitis must be present, The apex of the tooth must be closed, Pulp sensitivity tests (cold test and electric pulp test) must respond positively, Periodontal pocket depth and mobility must be within normal limits, Rubber dam isolation must be provided for the tooth to be treated, Restorative treatment of the tooth must be possible, The patient's mouth opening must be sufficient. Exclusion Criteria from the Study: Presence of any systemic disease (including conditions requiring prophylaxis), Presence of mental or psychiatric disorders, Presence of any allergic condition, Use of painkillers in the last 12 hours before the procedure or antibiotics in the last week, Loss of tooth structure that cannot be restoratively treated, Presence of a fistula tract or abscess, Negative response to pulp sensitivity tests (cold test and electric pulp test), No bleeding in the pulp or failure to achieve hemostasis within 6 minutes after total pulpotomy, Open apex, Advanced canal calcification observed on periapical radiography, Presence of internal or external root resorption. After clinical and radiographic examinations, pulpal and periapical diagnosis will be established before the procedure. A diagnostic periapical radiograph will be taken using a film holder with the parallel technique to visualize the depth of the carious lesion and evaluate the periapical area. All patients will be informed about treatment details, materials used, possible complications, follow-up dates, and alternative treatment options. A written consent form will be obtained from patients indicating alternative options for root canal treatment, tooth extraction, or withdrawal from treatment. Prior to treatment, the pre-operative pain values of participants will be recorded. The pulpotomy procedure will be carried out according to the following protocol: Anesthesia : Anesthesia will be provided using 4% articaine with 1:100,000 epinephrine. The tooth will be isolated with a rubber dam. The tooth designated for pulpotomy will be disinfected using 5% NaOCl before the procedure. After cleaning the caries, the exposed coronal pulp tissue will be amputated to the level of the canal orifices using a high-speed sterile diamond bur. Pulp vitality will be assessed visually by checking for bleeding at each canal orifice. Hemostasis will be achieved by applying gentle pressure with a cotton pellet soaked in 2.5% NaOCl for 2 minutes, and this will be repeated up to three times (for a total of 6 minutes) if necessary. After achieving hemostasis, the pulp capping material will be randomly selected from ProRoot MTA (Denstply), Biodentin (Septodont), or TheraCal PT (ThPT, Bisco Inc) using www.randomizer.org. The application of materials will be performed according to the manufacturer's instructions. Applications: ProRoot MTA Application : Coronal pulp tissue will be removed using a high-speed sterile diamond bur. Then, hemostasis will be achieved by applying gentle pressure with a cotton pellet soaked in 2.5 % NaOCl for 2 minutes, and this will be repeated up to three times (totaling 6 minutes) if necessary. After confirming bleeding control, the ProRoot MTA material will be placed at the canal openings. After a waiting period of 15 minutes, a thin layer of Resin Modified Glass Ionomer Cement (Vitrebond, 3M; ESPE) will be applied as the base material. Finally, the tooth will receive restorative treatment to complete the procedure. Biodentin Application : Coronal pulp tissue will be removed using a high-speed sterile diamond bur, and hemostasis will be achieved by applying gentle pressure with a cotton pellet soaked in 2.5% NaOCl for 2 minutes, repeated up to three times (totaling 6 minutes) if necessary. After confirming bleeding control, the Biodentin material will be placed at the canal orifices. According to the manufacturer's instructions, after a waiting period of 12 minutes, a thin layer of Resin Modified Glass Ionomer Cement (Vitrebond, 3M; ESPE) will be applied as the base material. Finally, the tooth will receive restorative treatment to complete the procedure. TheraCal PT Application : After the coronal pulp tissue is removed using a high-speed sterile diamond bur, hemostasis will be achieved by applying gentle pressure with a cotton pellet soaked in 2.5% NaOCl for 2 minutes, and this will be repeated up to three times (totaling 6 minutes) if necessary. After confirming bleeding control, the TheraCal PT material will be placed. Following a 10-second irradiation period according to the manufacturer's instructions, a thin layer of Resin Modified Glass Ionomer Cement (Vitrebond, 3M; ESPE) will be applied as the base material. Finally, the tooth will receive restorative treatment to complete the procedure. Monitoring and Pain Assessment: After the treatment, participants will be asked to fill out the Visual Analog Scale (VAS) chart to determine the severity of pain. Participants will be instructed to indicate their pain intensity at that moment on the VAS chart, marking between 0-100 mm, for the 6th hour, 24th hour, 48th hour, 72nd hour, and 7th day. Participants will be contacted in person or by phone for reminders over a 7-day period regarding when to fill out the form. At the end of the week, participants will be asked to return to the clinic with their VAS charts for a follow-up visit.

CAUDAL EPIDURAL BLOCK in PEDIATRIC SURGERY CASES

A successful caudal epidural block can provide safe, effective regional anesthesia. (4). The overall failure rate of caudal epidural block in pediatric patients is approximately 4%, depending on the anatomical and developmental abnormalities of the caudal canal (5,6). Therefore, reliable and rapid evaluation of a successful caudal epidural block is important to optimize anesthesia management in pediatric patients. Evaluating the success of caudal epidural block with traditional methods such as mean arterial pressure (MAP) and heart rate (HR) does not give completely objective results and takes time. Galvanic Skin Response (GSR) is a parameter that shows sweat gland function related to the autonomic nervous system. Physically, the galvanic skin response is the change in the electrical structure of the skin in response to various stimuli (7).Changes in tension measured from the skin surface are recorded. The relaxation and calming response accompanies an increase in skin resistance, while the fight response accompanies a decrease in skin resistance. In general, low conductivity is a sign of relaxation. High conductivity is a sign of emotional, mental or physical arousal (8). Galvanic Skin Response (GSR) evaluation is a non-invasive measurement that allows us to observe skin resistance changes with two probes attached to the fingertip. The aim of this study is to evaluate whether using Galvanic skin response (GSR) values measured with a finger probe will detect the success of caudal epidural block more quickly than other traditional methods in pediatric patients who underwent surgery with caudal epidural block.

The Effect of Therapeutic Touch At Birth on Pain, Birth Duration, Traumatic Birth Perception and Anxiety

Methods: The sample of this randomized controlled experimental research consisted of 66 (intervention group: 33; control group: 33) women. Data were collected using a Personal Information Form, Visual Analogue Scale, State Anxiety Inventory and Traumatic Childbirth Perception Scale.

Analgesic Effect of M-TAPA and TAPB on Laparoscopic Cholesistectomy

Cholecystectomy is the most commonly performed abdominal surgery in developed countries, with laparoscopic cholecystectomy regarded as the gold standard technique for gallstone treatment. Postoperative pain following laparoscopic cholecystectomy is influenced by several factors, making it a complex and predominantly visceral pain. These factors include phrenic nerve irritation due to CO2 insufflation, abdominal distension, port site incisions, the effects of gallbladder removal, and individual patient characteristics. Regional analgesia has gained widespread acceptance from both patients and physicians, becoming a key component of multimodal analgesia techniques. The transversus abdominis plane (TAP) block has proven effective in reducing postoperative pain in surgeries such as hysterectomy, cholecystectomy, cesarean section, and colorectal procedures. The Ultrasound (US)-guided Modified Thoracoabdominal Nerve Block Through Perichondrial Approach (M-TAPA) involves administering a local anesthetic to the underside of the perichondral surface. This technique provides effective analgesia for the anterior and lateral thoracoabdominal regions. The purpose of this study is to compare the efficacy of US-guided M-TAPA block with TAP block for postoperative analgesia following cholecystectomy.

The Relationship Between Upper Extremity Function and Balance and Functional Mobility in Parkinson's Disease

According to the sample size calculation, at least 26 diagnosed PD will be included. Participants' demographic characteristics will be taken initially and the stage will be recorded according to the Hoehn and Yahr Scale. Then, upper extremity functions, balance, and functional mobility will be evaluated.

Study to Evaluate the Effect of Balcinrenone/Dapagliflozin in Patients With Heart Failure and Impaired Kidney Function

The purpose of this study is to investigate the effect of balcinrenone/dapagliflozin compared with dapagliflozin, on the risk of CV death, HF event with and without hospitalisation, in patients with chronic HF, impaired kidney function, and who have had a recent HF event. Eligible patients will randomly be assigned with a 1:1:1 ratio to receive once daily administration of one capsule and one tablet of one of the following treatments: 1. Balcinrenone/dapagliflozin 15 mg/10 mg capsule and matching placebo for dapagliflozin 10 mg tablet 2. Balcinrenone/dapagliflozin 40 mg/10 mg capsule and matching placebo for dapagliflozin 10 mg tablet 3. Dapagliflozin 10 mg tablet and matching placebo for balcinrenone/dapagliflozin capsule The study is event driven, and the average study duration for a participant is estimated to be 22 months including screening period, 20 months blinded treatment period and a one-month follow-up period on open-label dapagliflozin. The study will be conducted at approximately 700 sites in approximately 40 countries globally.

A Study to Compare the Efficacy, Safety, Pharmacokinetics, and Immunogenicity Between SB27 and Keytruda in Subjects With Metastatic Non-squamous Non-small Cell Lung Cancer

The Effect of Inadvertent Perioperative Hypothermia on Surgical Site Infection in Laparoscopic Choleistectomy.

Objective: This study was conducted to examine the effect of inadvertent perioperative hypothermia (IPH) on Surgical Site Infection (SSI) in patients undergoing laparoscopic cholecystectomy. Summary of Background Data: There are conflicting results in the literature explaining the relationship between SSI and IPH. Although the risk of IPH is thought to be lower in laparoscopic surgery types due to the short duration of the surgical procedure, these conflicting results raise doubts about the existence of a relationship between IPH and SSI in laparoscopic surgery patients. Methods: This study will be a quasi-experimental and randomized controlled study in the future. The study will be conducted with patients who will have undergone laparoscopic cholecystectomy in the general surgery clinic and operating room of a university hospital. The study will be completed with a total of 100 patients, 50 in the case group, and 50 in the control group. During the study, preoperative, intraoperative, and postoperative body temperatures, as well as biomarkers of the patients, will be monitored using a form developed by the researchers. Additionally, patients will be followed up postoperatively to evaluate the potential impact of IPH on SSI.

Clinical Evaluation of Moment Tumor Hip Replacement Products

This study is a 6-center, prospective local medical device clinical trial. Trial period is 6 months. Patient recruitment will continue until the target sample number determined by the power analysis is reached. Since the application is surgical, it is within the scope of a one-time application. The patients will be followed for 6 months from the day of surgery. The study was designed as a prospective cohort study planned to be cross-sectional. The aim of this study is to ensure that the patients are functionally adequately and painlessly mobilized with the proximal femoral tumor resection prosthesis used, to increase the survival of patients who underwent wide resection, and to determine the complications of the treatment applied and the clinical performance of the Moment Tumor Hip Replacement Products used and to contribute to the medical literature on proximal femoral resection prosthesis as a result of the study.

Combined ASSNB and ICBPB vs CCBPB in Shoulder Arthroscopy

Patients were divided into two randomized groups: Group 1 (ASSNB+ICBPB Combination group, n=15) and Group 2 (CCBPB group, n=15). All patients will receive the same standard general anesthesia per hospital protocol. All blocks will be applied with the same ultrasonography and block equipment, and by the same physician. Before the anesthesia induction, ipsilateral diaphragmatic excursion will be measured via Ultrasonography (USG). After the anesthesia induction, patients in Group 1 will receive anterior suprascapular nerve block (ASSNB) with 10 mL of 0.25% bupivacaine and infraclavicular brachial plexus block (ICBPB) with 15 mL of 0.25% bupivacaine (with a total volume of 25 mL). Patients in Group 2 will receive costoclavicular brachial plexus block (CCBPB) with 15 mL of 0.25% bupivacaine. All patients will receive Paracetamol 1gr and Dexketoprofen 50mg intravenous (IV) 10 minutes prior to skin closure. After 30 minutes of emergence from anesthesia (upon reaching 9 points on modified Aldrete scoring), ipsilateral diaphragmatic excursion will be assessed again. Pre- and postblock excursion differences will be recorded. Routine analgesic procedure consisting of 3x1gr Paracetamol and 2x50mg Dexketoprofen will be followed postoperatively for 24 hours. Numeric Rating Scale (NRS) will be used to assess postoperative pain on 1st, 6th, 12th, 18th and 24th hours after the surgery. Quality of Recovery-15 Patient Survey will be done both preoperatively for a baseline score, and postoperatively at 24th hour to assess the quality of recovery from the patients' view. Tramadol 50mg IV will be administered as a rescue analgesic for all patients if NRS score is higher than 4. Total Tramadol consumption will be calculated.