This equivalence, randomized, clinical trial aimed to compare the postoperative pain of root canal therapy (RCT) with pulpotomy with mineral trioxide aggregate (PMTA) or calcium-enriched mixture (PCEM) in permanent mature teeth. In seven academic centers, 550 cariously exposed pulps were included and randomly allocated into PMTA (n = 188), PCEM (n = 194), or RCT (n = 168) arms. Preoperative “Pain Intensity” (PI) on Numerical Rating Scale and postoperative PIs until day 7 were recorded. Patients’ demographic and pre-/intra-/postoperative factors/conditions were recorded/analysed. The arms were homogeneous in terms of demographics. The mean preoperative PIs were similar (P=0.998), the mean sum PIs recorded during 10 postoperative intervals were comparable (P=0.939), and the trend/changes in pain relief were parallel (P=0.821) in all study arms. The incidences of preoperative moderate-severe pain in RCT, PMTA, and PCEM arms were 56.5%, 55.7%, and 56.7%, which after 24 hours considerably decreased to 13.1%, 10.6%, and 12.9%, respectively (P=0.578). The time span of endodontic procedures was statistically different; RCT = 69.73, PMTA = 35.37, and PCEM = 33.62 minutes (P<0.001). Patients with greater preoperative pain, symptomatic apical periodontitis, or presence of PDL widening suffered more pain (P=0.002, 0.035, and 0.023, resp.); however, other pre-/intra-/postoperative factors/conditions were comparable. Pulpotomy with MTA/CEM and RCT demonstrate comparable and effective postoperative pain relief.

Under limitations of this study, using low-power laser with mentioned parameters, clinically reduces pain, swelling and trismus after surgical removal of impacted mandibular wisdom, but not statistically significant.

Neither nitrous oxide/oxygen or fentanyl appeared to be superior to the other in relieving moderate to severe pain among emergency patients presenting with isolated limb fracture or dislocation. In an ED, increased use of nitrous oxide might reduce the overall need for opiate analgesia, and in our setting, the need for constant monitoring.

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Introduction: Cryptococcosis is an opportunistic fungal infection mostly in immunocompromised patients. Here we present the immunocompetent case with crypotoccosis. Case Presentation: A 60-year-old man without any history of immunodeficiency or major risk factor of fungal infection, referred to the emergency department with systemic symptoms and low back pain. The patient's condition gradually deteriorated within days by forming the clinical picture of a multi−system disease and eventually leading to a fatal outcome. The results of skin biopsy, BAL, gastrointestinal biopsy samples and post mortem lung and liver necropsies confirmed the disseminated Cryptococcus neoformans infection in smears and cultures. Discussion: This case emphasizes the need for a high index of suspicion for fungal infections in patients with multi−organ involvements who are unresponsive to treatment. Even without any obvious history or sign of immunodeficiency.