European Journal of Molecular & Clinical Medicine

Objective: The role of medical thoracoscopy in the diagnosis by pleural diseases is increasingly being recognized. This study was done to assess the role of medical thoracoscopy in the diagnosis of undiagnosed pleural effusion patients by pleural biopsy from abnormal pleura under direct vision.
Materials and Methods: We analyzed retrospectively data of 65thoracoscopic pleural biopsy performed at our centreon patients with undiagnosed pleurisy in the past 18 months. Medical thoracoscopy was performed under conscious sedation with midazolam (2 mg) and fentanyl (50 mcg) and local anesthesia with lignocaine 2% (10–15 ml), through a single port 10 mm diameter thoracoscope.
Results: A total of 65 patients (48 males and 17 females) underwent medical thoracoscopy during the study period. The mean age was 47.5(range, 18–72). The final diagnosis by thoracoscopic pleural biopsy was made in 59 (90.7%) patients and infective pathology were confirmed in 42 (tuberculosis in 24, parapeumoniceffusion in 8 and nonspecific inflammation in 10), malignancy in 17 patients and 6 remained undiagnosed. There were no major procedure-related complications that required intervention.
Conclusion: Pleural effusion without diagnosis after initial evaluation is a frequent problem in a respiratory division, for which thoracoscopic pleural biopsy is regularly necessary. Medical thoracoscopy has a high diagnostic yield, and is generally safe, certainly compared with the diagnostic and therapeutic importance.

Aim Purpose of our research was to compare and analyze the efficacy of sedation regimens frequently used in dentistry by intravenous approach.
Methodology A total of 50 patients were provided one of four treatments: placebo; midazolam provided (mean dose, 8.6 milligrams); fentanyl (1.4 micrograms/kilogram) plus midazolam to get similar amount of sedation (mean dose, 5.7 mg); or fentanyl (1.4 (μg/kg), midazolam (mean dose, 5.8 mg) and methohexital (mean dose, 61.0 mg) used in the surgery.
Results Each drug regimen decreased anxiety during surgery when compared with placebo, with the combination of midazolam, fentanyl and methohexital resulting in drastically less anxiety in as compared to other treatment groups. Pain felt by patients during surgery decreased significantly by the combination of fentanyl, midazolam and methohexital.
Conclusion It was observed that drugs and doses evaluated resulted in therapeutic benefit for patients undergoing dental procedures, with less possibility of potentially serious adverse effects