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Acute Otitis Media
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Local Anesthetic Injection Techniques 
Local Anesthetic Injection Techniques 
Local Anesthetic Techniques -  The technique of local anesthetic administration is an important consideration in pediatric patient behavior guidance.3 Age-appropriate nonthreatening terminology, distraction, topical anesthetics, proper injection technique, and nitrous oxide/oxygen analgesia/anxiolysis can help the patient have a positive experience during adminis- tration of local anesthesia.3-5 In pediatric dentistry, theIntrapulpal Injection Deposition of local anesthetic directly into the pulp chamber of a pulpally involved tooth provides effective anesthesia fro pulpal extirpation and instrumentation zThe intrapulpal injection may be used on any tooth when difficulty in providing profound pain control exists z z techniques anesthesia Traumatic deposited. control* anesthesia.Advanced local anesthetic techniques include the Vazirani-Akinosi mandibular block, intraseptal injections, and pre-puncture technique for the C-CLAD.NEW! Coverage of dynamic and emerging topics include newer anesthetic agents, buffering of anesthetics, determination of drug dosages, armamentarium and syringe preparation, maxillary and mandibular injection techniques and �The improvements in techniques for local anesthesia are probably the most significant advances that have occurred in dental science. This paper provides an update on comparatively newer gadgets that are less commonly used to deliver local anesthetics. Keywords: Computer controlled local anesthesia delivery system (CCLAD), Intraosseous Injection delivery system, Local anesthesia delivery device
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Necrotizing
Necrotizing
Crohn's disease is a disease of the bowel, typically presenting with diarrhea, weight loss, and abdominal pain. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease who presented for the first time with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease as the initial 1. Introduction Crohn's disease is primarily a disease of the bowel, which typically presents with diarrhea, weight loss, and abdominal pain. It most commonly affects the distal ileum and colon. It is characterized by extensive fibrosis, strictures, and fistulas [1]. Complications such as abscesses, fistulas, and strictures may require surgical intervention. We would like to report a patient with Crohn's disease, who primarily presented with left lower extremity necrotizing fasciitis. There are very few reports of necrotizing fasciitis in Crohn's disease [2], none in which fasciitis was the primary presenting symptom. 2. Case report A 62 year old man presented to the Emergency Department with three weeks of left thigh edema, new onset erythema and excruciating pain to light touch. He had no known past medical history, was taking no medications, and was a heavy smoker. The patient was cachectic on general examination. He was tachycardic with elevated white cell count and erythrocyte sedimentation rate. A computed tomography (CT) scan was obtained which revealed extensive subcutaneous gas and fluid from the anterior superior iliac scpine to the iliopsoas, and circumferentially along all fascial planes. Additionally, a small fluid collection was seen along the left psoas muscle bed; no other fluid collections were noted radiographically. General Surgery was consulted and the patient was brought emergently to the operating room. The anterior and posterior compartments contained a significant amount of purulent, foul-smelling fluid, and the degree of necrosis necessitated hip disarticulation Surgical specimen after hip disarticulation. The anterior and posterior compartments contained a significant amount of purulent, foul-smelling fluid. Extensive necrosis was evident up to the level of the iliopsoas.
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