Comparative Evaluation of Efficacy of Hypnosis, Acupressure and Audiovisual Aids in Reducing the Anxiety of Children during Administration of Local Anesthesia

Aim

The present study aimed to assess and compare the efficacy of acupressure, hypnosis and audiovisual aids in reducing anxiety in children during the administration of local anesthesia (LA).

Methodology

Two hundred apparently healthy children were selected randomly between 6 and 10 years of age and were divided into 4 groups with 50 children in each group. Group I: children were subjected to hypnosis, group II: acupressure, group III: AV aids i.e., VPT, and group IV: children were the control group where no anxiety-reducing techniques were used during administration of LA. The anxiety scores were recorded at three different time intervals by recording the pulse rate (PR), respiratory rate (RR) and anxiety rate (AR) and subjected to statistical analysis.

Results

The results showed that, all the three distraction techniques showed a significant reduction in PR, RR and AR at all time intervals, when compared to the control group. A significant reduction in PR, RR and AR was seen in the hypnosis group when compared to acupressure and only PR in comparison to AV aids. There was no significant difference between group II and III in reducing anxiety.

Conclusion

The present study indicates that all the three distraction techniques were effective in reducing anxiety in children. Hypnosis was most promising, followed by audiovisual aids and acupressure.

Clinical significance

The techniques can be utilized in a day-to-day practice to manage patients with anxiety.

How to cite this article

Erappa U, Konde S, Agarwal M, et al. Comparative Evaluation of Efficacy of Hypnosis, Acupressure and Audiovisual Aids in Reducing the Anxiety of Children during Administration of Local Anesthesia. Int J Clin Pediatr Dent 2021;14(S-2):S186-S192.

Implications on dose estimation and dispersion patterns of thoron in a typical indoor environment

A model that describes the pollutant sources/sinks and inlet-outlet can help to assess the indoor exposure. Short half-life of radioactive thoron (²²⁰Rn) makes it vital and an interesting element to study its dispersion behavior. This work presents an extensive depiction of the influence of indoor environment thoron dispersion under fixed boundary conditions within the volume domain of 90 m³ using computational fluid dynamics (CFD) software. For the desirable air flow, inlet and outlet are considered in the room and the k-ɛ model is used. The thoron distribution is studied at different locations and different heights to cover the whole room. Obtained dispersion patterns vary at different locations and indicate non-uniformity of thoron level with elevated values in the room corners. Mean concentration was found to be 11 Bq/m³ with the exhalation rate of 0.102 Bqm^-2 s^-1. Some stagnant zones were found especially at the corners where the concentration is almost 5 times the average concentration. Such varying thoron level results in the overestimation and underestimation of the dose. The inhomogeneous behavior of thoron may cause variation in equilibrium factor. A simulated model is beneficial in understanding the radioactive gas behavior and has its importance in planning to find the correct dose estimation and, therefore, the best mitigation techniques.

Progress in international collaboration on EXFOR library

The EXFOR library has served as the unique repository of experimental cross section and other nuclear reaction data for 50 years. The Nuclear Reaction Data Centres (NRDC) have compiled data sets from more than 22000 experimental works for the EXFOR library. Our collaboration and effort on improvement of EXFOR coverage are described in this paper, as well as tools for digitization of numerical data from graph images developed by us for EXFOR compilation.

Short-term outcomes of a program developed to inculcate research essentials in undergraduate medical students

BACKGROUND

Participation in research during undergraduate studies may increase students' interest in research and inculcate research essentials in them.

AIMS

The purpose of this study was to evaluate the effectiveness of the mentored student project (MSP) program.

SETTINGS AND DESIGN

In the MSP program, students in groups (n = 3 to 5) undertook a research project, wrote a scholarly report, and presented the work as a poster presentation with the help of a faculty mentor. To begin with, the logic model of the program was developed to identify short-term outcomes of the program on students, mentors, and the institution. A quasi-experimental design was used to measure the outcomes.

MATERIALS AND METHODS

A mixed method evaluation was done using a newly-developed questionnaire to assess the impact of the MSP on students' attitude, a multiple-choice question (MCQs) test to find out the impact on students' knowledge and grading of students' project reports and posters along with a survey to check the impact on skills. Students' satisfaction regarding the program and mentors' perceptions were collected using questionnaires. Evidence for validity was collected for all the instruments used for the evaluation.

STATISTICAL ANALYSIS

Non-parametric tests were used to analyze data. Based on the scores, project reports and posters were graded into A (>70% marks), B (60-69% marks), and C (<59% marks) categories. The number of MSPs that resulted in publications, conference presentation and departmental collaborations were taken as impact on the institution.

RESULTS

Students' response rate was 91.5%. The students' attitudes regarding research changed positively (P = 0.036) and score in the MCQ test improved (P < 0.001) after undertaking MSP. Majority of project reports and posters were of grade A category. The majority of the items related to skills gained and satisfaction had a median score of 4. The MSPs resulted in inter-departmental and inter-institutional collaborations, 14 publications and 15 conference presentations. An area for improvement noted was to have the MSP implemented in the curriculum without increasing students' overall workload and stress.

CONCLUSION

The study identified strengths and weaknesses of the MSP program. Our model of undergraduate research project may be incorporated in undergraduate medical programs to foster positive attitude and knowledge base about scientific research and to instil research skills among students.

Fostering research skills in undergraduate medical students through Mentored Student Projects: Example from an Indian medical school

Background Healthcare decision-making is largely reliant on evidence–based medicine; building skills in scientific reasoning and thinking among medical students becomes an important part of medical education. Medical students in India have no formal path to becoming physicians, scientists or academicians. Objectives This study examines students’ perceptions regarding research skills improvement after participating in the Mentored Student Project programme at Melaka Manipal Medical College, Manipal Campus, India. Additionally, this paper describes the initiatives taken for the continual improvement of the Mentored Student Project programme based on faculty and student perspectives. Methods At Melaka Manipal Medical College, Mentored Student Project was implemented in the curriculum during second year of Bachelor of Medicine and Bachelor of Surgery programme with the intention of developing research skills essential to the career development of medical students. The study design was cross-sectional. To inculcate the spirit of team work students were grouped (n=3 to 5) and each group was asked to select a research project. The students’ research projects were guided by their mentors.  A questionnaire (Likert’s five point scale) on students’ perceptions regarding improvement in research skills after undertaking projects and guidance received from the mentor was administered to medical students after they had completed their Mentored Student Project . The responses of students were summarised using percentages. The median grade with inter-quartile range was reported for each item in the questionnaire. The median grade for all the items related to perceptions regarding improvement in research skills was 4 which reflected that the majority of the students felt that Mentored Student Project had improved their research skills. The problems encountered by the students during Mentored Student Project were related to time management for the Mentored Student Project and mentors. Results This study shows that students acknowledged that their research skills were improved after participating in the Mentored Student Project programme. Conclusions The Mentored Student Project programme was successful in fostering positive attitudes among medical students towards scientific research. The present study also provides scope for further improvement of the Mentored Student Project programme based on students’ and faculty perspectives.DOI: http://dx.doi.org/10.3126/kumj.v8i3.6215 Kathmandu Univ Med J 2010;8(3):294-8

Haplotypes in tribal Indians bearing the sickle gene: evidence for the unicentric origin of the beta S mutation and the unicentric origin of the tribal populations of India

To determine the origin of sickle cell anemia (SS) in India, we analyzed haplotypes of the beta gene cluster in beta S-carrying individuals belonging to tribal populations living in the Nilgiris region of southern India and complemented the available data on tribes of east-central India. We found that in the Nilgiris tribes chromosomes bearing the beta S gene are linked in 91% of the cases to the "Asian" (Arab-Indian) haplotype (although 25% of the haplotypes had the epsilon polymorphic site negative, making the 5' portion of the haplotype identical with the African Senegal haplotype). These XmnI (+) chromosomes were associated with high G gamma expression (67.2 +/- 5.9%) and a high percentage of Hb F (15.5 +/- 7.9%; range, 6-25.3%). We have similar findings for tribal groups from west-central India (Gujarat). In east-central India we have confirmed the data of others, finding the same haplotype linked to beta S in tribes living in the east (Orissa, Andhra Pradesh). We conclude that the beta S gene in presently isolated and disperse tribal populations in India is associated with one predominant typical haplotype, suggesting a unicentric origin of the mutation in India. In addition, this finding implies a unicentric origin of the tribal populations themselves: The gene must have arisen and spread before tribal dispersion. Furthermore, we find extremely high frequencies of the (-alpha) haplotype in the Nilgiris (0.89) and in Gujarat (0.95). The beta S gene linkage to a high Hb F-expressing haplotype and the high incidence of alpha-thalassemia predict a mild phenotypical expression of sickle cell anemia in India.

Giant cervical herniation of an apical pulmonary bulla

A 60-year-old woman had a giant air cyst in the right side of the neck, which arose from the apex of the right lung. We are unable to find a similar case report in literature.

Caudate atrophy in irreversible tardive dyskinesia (a pneumoencephalographic study)

Pneumoencephalography done under standard conditions on 5 patients with tardive dyskinesia and 3 matched controls revealed evidence of caudate atrophy in 3 of the dyskinetic patients. The same 3 patients proved refractory to treatment of their dyskinesia. It is concluded that tardive dyskinesia is a heterogenous entity with some patients having irreversible dyskinesia and exhibiting radiologically demonstrable damage.