Background: Magnetic resonance neurography shows the brachial plexus cords in the subcoracoid tunnel beneath the pectoralis minor. With an ultrasound scan along the brachial line, the brachial plexus cords in the subcoracoid tunnel can be targeted using an in-plane needle approach. We describe this new approach to the infraclavicular block called the “subcoracoid tunnel block.”Case: Twenty patients were administered with the ultrasound-guided subcoracoid tunnel block for the below-elbow surgery. The contact of the needle tip with cords was visible in all 20 patients. With neurostimulation, the posterior cord was identified in 11 (55%) and medial cord in 9 (45%) patients on the first needle pass. The subcoracoid tunnel block was successful in 16 patients (80%). Conclusions Our case series shows that the subcoracoid tunnel block is an excellent alternative technique for the infraclavicular block. Its advantages include better needle-cord visibility and easy identification of the brachial plexus cords.

PURPOSE: The purpose of study was to compare glycemic control using glycated hemoglobin levels (HbA1c) in diabetic patients with chronic generalized periodontitis (CGP) undergoing scaling and root planing (SRP) with and without systemic doxycycline. METHODS: Fifty subjects with type 2 diabetes mellitus (T2DM) and CGP receiving antidiabetic therapy were selected for study. The selected subjects were randomly assigned to two groups (test group [TG] and control group [CG]) comprising 25 patients each. The TG received SRP followed by systemic doxycycline. The CG received treatment with SRP only. The periodontal parameters were recorded at baseline (day zero), and every 1 month for 4 months and included probing depth, clinical attachment level, plaque index, gingival index, and HbA1c level were recorded at baseline (day zero) and at the end of 4 months. RESULTS: A statistically significant effect was demonstrated for the periodontal parameters for both the TG and CG. HbA1c values did not show a statistically significant difference in the treatment group as compared to the CG. CONCLUSIONS: The authors concluded that nonsurgical periodontal therapy improved glycemic control in patients with T2DM in both groups, but no statistical difference was observed with adjunctive systemic doxycycline therapy. A further study with a larger sample size is required.
Chronic Periodontitis ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Doxycycline ; Hemoglobin A, Glycosylated ; Hemoglobins ; Humans ; Periodontal Debridement ; Periodontal Index ; Periodontitis ; Root Planing ; Sample Size

PURPOSE: The purpose of study was to compare blood glucose in capillary finger-prick blood and gingival crevice blood using a self-monitoring blood glucose device among patients with gingivitis or periodontitis. METHODS: Thirty patients with gingivitis or periodontitis and bleeding on probing (BOP) were chosen. The following clinical periodontal parameters were noted: probing depth, BOP, gingival bleeding index, and periodontal disease index. Blood samples were collected from gingival crevicular blood (GCB) and capillary finger-prick blood (CFB). These samples were analyzed using a glucose self-monitoring device. RESULTS: Descriptive statistical analysis has been carried out in the present study. Data were analyzed using a Pearson's correlation coefficient and Student's t-test. A r-value of 0.97 shows very strong correlation between CFB and GCB, which was statistically highly significant (P<0.0001). CONCLUSIONS: The authors conclude that GCB may serve as potential source of screening blood glucose during routine periodontal examination in populations with an unknown history of diabetes mellitus.
Blood Glucose ; Blood Glucose Self-Monitoring ; Capillaries ; Diabetes Mellitus ; Gingival Hemorrhage ; Gingivitis ; Glucose ; Hemorrhage ; Mass Screening ; Periodontal Diseases ; Periodontitis