Open Access Case Study

Endodontic Management of Maxillary Canine with Two Canals

Kaustubh Khatod, Ajay Saxena, Manoj Chandak, Aditya Vardhan Patidar, Rama Khatod

Journal of Advances in Medical and Pharmaceutical Sciences, Page 164-168
DOI: 10.9734/JAMPS/2015/15276

Aim: To report a case of endodontic treatment of a maxillary right canine in which an extra canal was located and successfully treated.

Presentation of Case: A 35 year old male reported with pain in maxillary right canine. Pain was dull and intermittent in nature. Instrumentation revealed the presence of another root canal. Endodontic treatment was performed and the patient reported complete relief of pain and found to be asymptomatic after a 3-month period.

Discussion: A thorough knowledge of both the external and internal anatomy of teeth is an important aspect of root canal treatment and is essential for the highest possible chances of success. Failure to locate and treat an extra canal/s is one of the most common causes of failure of root canal treatment. In the teeth particularly with additional root canals or anatomical variations, root canals are often left untreated because the clinicians fail to identify their existence.

Conclusion: This case report shows presence of two canals in single-rooted maxillary canine. Practitioner must have a thorough understanding of the internal anatomic relationships of teeth and be able to visualize this relationship before understanding the endodontic therapy. The clinician must be familiar with the various pathways of root canals to the apex. The pulp system is complex, and canals may branch, divide and rejoin. 


Open Access Original Research Article

Phytochemical Screening and Polyphenolic Contents of Dialium dinklagei and Diospyros monbuttensis, Two Ivorian Medicinal Plants Used to Treat Malaria

Tuo Karim, Béourou Sylvain, Touré André Offianan, Ouattara Karamoko, Silué Kigbafori Dieudonné, Tano Konan Dominique, Adagba Marius, Koffi David, Yao Serge Stephane, Djaman Allico Joseph, Coulibaly Adama

Journal of Advances in Medical and Pharmaceutical Sciences, Page 144-153
DOI: 10.9734/JAMPS/2015/13779

Introduction: Malaria is a deadly parasitic infection in its severe form. It is caused by an endoparasite protozoan transmitted by a mosquito vector. Despite considerable efforts to eradicate it, this endemic disease remains a public health problem because of its high frequency, severity and the consequences it generates. Furthermore, the existing treatments are increasingly ineffective; it is therefore urgent to find new anti-malarial drugs.

Objective: From the phytochemical screening and the determination of the polyphenolic content of Dialium dinklagei and Diospyros monbuttensis used in traditional medicine in Côte d'Ivoire to treat malaria, we identified families of chemical compounds that can guide us towards pharmacological studies. These studies allow us to identify new molecules which could be a possible alternative antimalarial reference used today because of their effectiveness in treating malaria.

Materials and Methods: From Dialium dinklagei and Diospyros monbuttensis, we obtained extracts decoction and hexane extracts, methanolic and aqueous extraction after three solvents of increasing polarity (n-hexane, methanol, water), respectively. The crude extracts obtained were tested for chemical identification of groups that may be the basis of the expected therapeutic effects. Moreover, the decoction and methanol extracts were used to determine the polyphenolic compounds.

Results: The results vary from one plant species to another and from one sample to another. Abundant presence of alkaloids in all samples and an absence of steroids in other extract except decoction extract of Diospyoros monbuttensis were observed. Therefore, the other chemical groups are present in all plants in varying proportions but depending on the mode of extraction. A higher content of phenols and tannins in Dialium dinklagei over Diospyros monbuttensis was observed. However, the content of flavonoids of Dialium dinklagei is relatively lower compared to that observed in Diospyros monbuttensis.

Conclusion: The overall results of the phytochemical screening and polyphenolic content would partly explain the traditional healers’ infatuation to these plants as antimalarials.


Open Access Original Research Article

The Efficacy of Intravenous Immunoglobulin in the Treatment of Patients with Acute Disseminated Encephalomyelitis

Iryna Lobanova, Olena Myalovitska

Journal of Advances in Medical and Pharmaceutical Sciences, Page 154-163
DOI: 10.9734/JAMPS/2015/14216

Background: Acute disseminated encephalomyelitis (ADEM) is a monophaseprocess nevertheless sometimes aggravated by relapses (so-called multiphasecourse of the disease). In such case the treatment must be targeted at reducing clinical manifestations of the disease and prevention of its relapses. The aim of our work was to analyze efficacy of intravenous immunoglobulin as therapeutic option in the treatment of patients with ADEM.

Methods: Therapeutic efficacy of intravenous immunoglobulin was analyzed in the treatment of 47 patients with ADEM: 19 men and 28 women aged 17–53 (average index 31.7±1.6). All patients were being treated at the Kiev city centre of multiple sclerosis (Kiev city hospital number 4, Alexandrovskaya City Clinical Hospital, Kiev city, Ukraine) and were under observation for 2 years. The patients were randomly separated into two groups depending on the treatment method. The treatment in both main and control group was preceded by premedication with hormonal pulse-therapy, using methylprednisolone in the dose of 500-1000 mg daily in 200 ml of isotonic sodium chloride solution (within 5 days). The patients of the main group were daily administrated intravenous immunoglobulin in the dose of 0.4 g per 1 kg of mass of body within 5 days 1 month after the hormonal pulse-therapy. The treatment was followed by monthly administration of human normal immunoglobulin – 0.4 g per 1 kg of body mass within 24 months. The participants of this group were given placebo treatment (200 ml of isotonic sodium chloride solution).

Results: One month after beginning of the treatment in patients of both groups we observed the decrease of neurological deficit, measured according to the EDSS scale, compared to the indices before treatment (p<0.01). 24 months after beginning of the treatment even more significant reduction of the level of neurological disorders of the patients of the main group (p<0.05) and its increase in the patients of the control group (p<0.05) was observed, which is explained by development of demyelination disease relapses over a 24-month observation period. Over a 24-month observation period, the patients of the main group had 2 relapses of disseminated encephalomyelitis, the patients of the control group–7 relapses, two of them demonstrated transformation of ADEM into MS.

Conclusions: The investigation proved positive therapeutic efficacy of intravenous immunoglobulin in the treatment of patients with ADEM–reduction of clinical manifestations of the disease, in particular a decrease in neurological deficit level. Monthly intravenous immunoglobulin administration also has great prognostic significance for prevention of the disease relapses (multiphase ADEM course).


Open Access Review Article

The Effect of Co-administered Drugs and Food on the Absorption of Artemether–Lumefantrine Tablet

Sunday O. Awofisayo, Augustine O. Okhamafe

Journal of Advances in Medical and Pharmaceutical Sciences, Page 126-134
DOI: 10.9734/JAMPS/2015/15333

The physicochemical properties of drugs, their dosage forms and routes of administration affect the rate and extent of drug absorption. Oral administration of drugs presents with variable absorption profiles due to multifarious factors. The first fixed-dose artemisinin-based combination therapy (ACT), artemether-lumefantrine widely employed for the treatment of uncomplicated Plasmodium falciparum malaria is being threatened by the report of rapidly developing drug resistance in some part of the world. Success from this therapy has been linked to the synergistic effect of the component drugs which is anchored on the artemether and more importantly, lumefantrine exposure. The drug and food effect on the pharmacokinetic profiles of artemether and lumefantrine antimalarial agents are reviewed.


Open Access Review Article

A Practical Approach for Restoring Homeostasis in Diseases Characterized by a Chronic Oxidative Stress

Velio Bocci, Emma Borrelli

Journal of Advances in Medical and Pharmaceutical Sciences, Page 135-143
DOI: 10.9734/JAMPS/2015/15549

The leading cause of death across the globe is due to cardiovascular diseases complicated by a chronic oxidative stress only partially corrected with orthodox drugs. About 80% of deaths occur in low and middle-income countries of every continent. In order to reduce the burden of these diseases, it appears indispensable to integrate orthodox drugs with novel approaches capable of stimulating the natural defense system, which are able to restore homeostasis. Several approaches have been and ozone therapy has been selected because particularly effective.