S Modaghegh, Ma Ghoraian, M Moshkgou, A Rezaizadeh,
Volume 2, Issue 2 (8-1988)
Abstract
Phenytoin (PHT), a drug in clinical use for over fifty years as an
anticonvulsant, has heen reported to promote the healing of skin and soft
tissue wounds, ulcers and second degree burns.
We treated 19 patients with war-related missile wounds and 6 with
chronic, non-healing (previously treated at least for.') months with antibiotics
and betadine or acetic acid dressing) civilian ulcers with topical phenytoin
sodium powder daily without antibiotic therapy for up to 4 weeks. Missile
wounds had a mean healing time of2 weeks and civilian intractable ulcers, a
maximum healing time of4 weeks, compared to historical controls requiring
6-8 weeks for missile wounds and at least 5 months of non-effective previous
treatment for intractable wounds.
Twenty two patients showed complete healing within four weeks. Three
required skin grafts for final closure. PHT provided rapid pain relief.
Although seventeen wounds had positive bacterial cultures prior to treatment,
none were positive after one week of PHT treatment. No antibiotics
were required. We believe wider use of this safe, inexpensive, readily
available, and easy-to-use wound healing agent is indicated.
Hassan Motamed, Kambiz Masoumi, Meisam Moezzi, Payam Ghoraian,
Volume 35, Issue 1 (1-2021)
Abstract
Background: Shoulder joint dislocation and displacement is a common clinical condition. The present research aims to compare the clinical efficacy of ketamine versus dexmedetomidine during shoulder joint reduction.
Methods: In this randomized clinical double-blind trial method, patients aged 18 to 65 years with shoulder dislocation referred to the Emergency Hospital of Imam Khomeini Hospital in Ahvaz, Iran, were enrolled. Patients were separated into two groups, patients in group A received 1mg/kg nebu-lized ketamine and patients in group B received 1 μg/kg nebulized dexmedetomidine. Pain score was recorded at 5 different time points: Zero (before intervention), 10 minutes, 20 minutes, 30 minutes, and 60 minutes after intervention., The pain score was evaluated using the visual analog scale (VAS) test. A linear regression test was carried out to compare the slopes. Also, ANOVA repeated measures test variables differences between groups. Then Tukey's multiple comparisons as post-hock were applied to compare the pains at different time points. Using IBM SPSS version 19.0 software, all analyzes were accomplished.
Results: The pain score in both groups significantly decreased during different time points. The pain reduction slope in the group that received dexmedetomidine is meaningfully upper than that of ketamine (-0.08 vs. -0.06, p=0.012). The ketamine action onset time was 20 minutes after the in-tervention. In comparison, the effect of dexmedetomidine has an onset of 10 minutes after the in-tervention.
Conclusion: Overall, the results of current research demonstrated that although nebulized dexme-detomidine and nebulized ketamine produce a significant decrease in pain score, dexmedetomidine provides a faster effect. Therefore, nebulized dexmedetomidine seems to be used as an appropriate choice to induce sedation during shoulder joint reduction in emergency departments.
