Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections

2021 ◽  
Vol 45 (6) ◽  
pp. 389-394
Author(s):  
Supriya Kumari ◽  
Rachana Bahuguna ◽  
Nishita Garg ◽  
Ramakrishna Yeluri

Objective: To evaluate the efficacy of immersive VR (IVR) and non-immersive VR (NIVR) distraction on perceived pain during intraoral injections in children undergoing dental procedures. The objective was to introduce 3-dimensional nature of virtual reality during the provoking phase of dental treatment as a means of distraction in children. Study design: A total of 200 children were selected for the study, 100 for IVR group and 100 for NIVR group. After randomization, children were introduced to Oculus Go Standalone equipment; MCDAS (f), VAS, WBFRS and the treatment procedure using tell show do technique. Group I children were introduced to oculus go standalone headset with hand held controller to play temple run or roller coaster game while in group II, children watched cartoon movies of their choice. Pre-operative & post-operative MCDAS scores were obtained using MCDAS (f) questionnaire in local language. Post-operatively, VAS and WBFRS scores were also obtained. The data was analyzed using independent t-test and chi-square analysis. Results: Pre-operatively, the mean MCDAS scores were similar in both the groups viz. Group–I (29.20 ± 3.197) and Group–II (29.09 ± 3.803) and is statistically not significant. Post-operatively, the mean MCDAS scores were higher in non-immersive group (20.72 ± 2.822) as compared to immersive group (10.99 ± 2.227). VAS score was higher in non-immersive group (2.72 ± 0.99) as compared to immersive group (0.75 ± 0.88). WBFRS scores were higher in non-immersive group (2.78 ± 1.097) as compared to immersive group (0.82 ± 1.104). Conclusion: Three-dimensional virtual reality was found to be an effective means of distraction in children undergoing dental procedures and especially during the provoking phase. The significant difference obtained clearly indicates irrespective of immersiveness of virtual reality, anxiety had been decreased and on comparison the pain perception to intraoral injection is less in immersive virtual reality environment. Immersive VR distraction technique can serve as an adjunct to traditional behavior management strategies already available to the pediatric dentist.

2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.


Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3024-3024
Author(s):  
Rashida Orlova ◽  
Natalia V. Zhukova ◽  
Anna Malkova ◽  
Ekaterina Kaledina ◽  
Anna Gubal ◽  
...  

3024 Background: One of the discussed predictive markers of the immune therapy efficacy is the index of neutrophils to lymphocytes ratio in peripheral blood (NLr), which reflects the activity of adaptive immunity and correlates with the level of tumor-infiltrating lymphocytes (TILs). High NLr and low TILs are associated with disease progression. Interleukin-1-beta (IL-1β) is one of the main cytokines produced by the tumor microenvironment (TMO). Overexpression of the cytokine leads to a local immunosuppression. For some tumors, elevated serum IL-1β levels have been associated with a poor prognosis. The aim of this work is to analyze the serum IL-1β level as a marker of TMO activity and the NLr as a marker of adaptive immunity activity in relation to the response to therapy with checkpoint inhibitors in patients with various solid tumors. Methods: The study involved 63 patients with various solid tumors who were treated at the City Oncological Dispensary and were prescribed checkpoint inhibitors (nivolumab (n = 33), pembrolizumab (n = 23), ipilimumab + nivolumab (n = 7)). The determination of the level of IL-1β was performed using the ELISA method ("Interleukin-1-beta, ELISA-best", Novosibirsk), a clinical blood test was performed in a dispensary. The response to treatment was assessed 3-6 months after the start of therapy. Statistical analysis was carried out in GraphPad Prism. Results: Among the examined patients 49.21% (31/63) achieved partial regression or stabilization of the process (group I), and 50.79% (32/63) progressed (group II). The mean concentration of IL-1β before treatment in group I was 2.21±0.3 pg/ml, in group II - 0.98±0.2 pg/ml. NLr was increased in 7 patients from group I and in 9 patients from group II, with the mean index level being 2.9±0.39 and 3.2±0.5, respectively. There was no statistically significant difference in the concentration of IL-1β and the NLr between the studied groups. In group II, the number of patients undergoing systemic anticancer therapy before immune therapy (n = 18) was statistically significantly higher than in group I (n = 8), p = 0.033. There was no statistically significant difference in IL-1β concentration and NLr relative to previous treatment. Conclusions: Our study showed that the level of IL-1β corresponds to that of healthy donors and its isolated determination has no prognostic value. The NLr in most patients from the progression group was higher than normal, in contrast to group I, which is confirmed in the literature. The presence of previous systemic anticancer therapy was found to be associated with disease progression. The described feature can be explained by the fact that patients who received therapy before, already have a longer period of illness, a more severe clinical condition. The presence of systemic anticancer therapy does not affect the level of IL-1β and NLr.


2009 ◽  
Vol 2 ◽  
pp. CMENT.S2565
Author(s):  
Amr A El Badry ◽  
Ismail Elmofty ◽  
Amira Helmy

This work assess serum levels of soluble Fas form (sFas) in patients with different stages of laryngeal squamous cell carcinoma(LSCC) to investigate its prognostic significance. We correlate its levels with the morphological changes of peripheral blood cells via buffy coat examinatin. The study population included 70 patients clinically diagnosed and pathohistologically confirmed LSCC in addition to 20 healthy controls. According to TNM classification 33(47.1%) patients were in stage I (group I) and 24(34.3%) in stage II (group II), 13(18.5%) in stage III (group III). The results revealed that the mean serum level of sFas (pg/ml) in the control group was 51.2, in group I was 66.33, in group II was 81.33 and in group III was 112.45. Statistical analysis of the mean of sFas by ELISA test in the patients' groups in comparison to the control revealed a significant increase of both group II and III in comparison to the control group (P < 0.01) but there was no significant difference (P > 0.05) between group I in comparison to either the control or group II. There was a significant difference (P < 0.05) between group I in comparison to group III. LM examination revealed massive extent of the apoptotic cells in group III when compared to both group I and group II. EM examination of the buffy coat revealed apoptotic changes, mainly in the peripheral blood mononuclear cells (PBMNCs), represented by surface membrane ruffles and blebs with clumped nuclear chromatin and vacuolated cytoplasm. In conclusion, this study may help us to better understand one of the escape mechanisms in cancer larynx. This mechanism is represented by the significant increase in both the serum level of sFas and the morphological apoptotic changes that detected in PBMNCs. Soluble Fas may contribute to the progression of laryngeal cancer. It can be used as an attractive target for anticancer therapy and may be considered as a marker of disease progression and poor prognosis in laryngeal cancer.


2021 ◽  
Vol 4 (3) ◽  
pp. 01-08
Author(s):  
Emadeldin R. Matar ◽  
Mohammed H. Goda ◽  
Tamer M. Abuama

Functional TLR4 expression has been linked to HCC development. TLR4 may serve an important role in HCC development by promoting the malignant transformation of epithelial cells and tumor growth. The consequences might be dependent on the complex signaling networks triggered by TLR4 activation and the tumor microenvironment. The study included 90 consecutive subjects classified into 3 group their age from 40 to 70 years old. Group (I): HCC patients on top of chronic HCV infection. they were 45 patients 30 male and 15 females, their age ranged from 45 to 55 who were subdivided into 3 subgroups according to Barcelona clinic liver cancer (BCLC): Group (Ia): included 8 HCC patients in early stage. (stage A). Group (Ib): included 12 HCC patients in intermediate stage (stage B). Group (Ic): included 25 HCC patients in advanced stage. (stage C). Group (II): 30 Cirrhotic patients with chronic HCV, 21 male and 9 females, their age ranged from 50 to 60. This group was subdivided into 2 subgroups according to Child–Pugh score Group (IIa): included 8 Child–Pugh A. Group (IIb): included 22 Child–Pugh B and C. Group (III): controlled group included 15 normal subjects. 10 male and 5 females, their age ranged from 45 to 60. They were selected to match patients’ groups in demographic and socioeconomic standards. In our study where 15 persons are control showed lower level in TLR4 with mean 1.0±0.2, however 30 patients with HCV and other 45 patients with HCC showed higher level in TLR with mean 2.27±0.6 and 4.2±1.06 respectively. In our study there is statistically significant difference in serum TLR4 level between group (Ia) (2.25±0.5) and other subgroups which shows more increase in serum level of TLR4 in Group IB (3.2-1.06) than Group IA. Also shows more increase in serum level of TLR4 in Group IC (4.0±2.0) than Group IA and IB In our study HCC group showed higher level of LPS with mean 4.5±1.26 however lower in HCV group with mean 2.9-1.0 and least in control group with mean 1.1±0.4 In our study there is statistically significant difference in serum LPS level between group (IA) with mean 3.0±0.5 and other subgroups which shows more increase in serum level of LPS in Group IB with mean 4.4-1.0 than Group IA. Also shows more increase in serum level of LPS in Group IC with mean 4.0±1.76 than Group IA and IB In our study there is statistically significant difference in serum LPS level between group (IIB) and group (IIA) which shows more increase in serum level of TLR4 in Group IIB with mean 2.7±1.1 than Group IIA with mean 2.20±0.2 In our study there is statistically insignificant difference of the mean value ± SD of sex as regard to LPS and TLR expression (t = 1.2, p = 0.22). (t = 0.16, p = 0.87) respectively.In our study there is statistically significant positive correlation between ALT, AST, Platelets, alpha fetoprotein and LPS as regard to TLR4 expression in group II more in IIB,C than IA . but insignificant of the mean value ± SD of other parameters. In our study there is statistically significant difference of the mean value ± SD of ALT, AST, Platelets, alpha fetoprotein and TLR4 as regard to LPS expression in group I more in IB, C than IA. but insignificant of the mean value ± SD of other parameters.In our study there is statistically significant difference of the mean value ± SD of ALT, AST, Platelets and TLR4 as regard to LPS expression in group II more in IIB than IIA. but insignificant of the mean value ± SD of other parameters. Conclusion: TLR4 and LPS measurement should be carried for all patient with HCV Who are at risk for HCC with close monitoring. Conduct a study on a Gut microbiota as therapeutic targets for HCC.


2012 ◽  
Vol 7 (2) ◽  
pp. 37-39
Author(s):  
W Nargis ◽  
BU Ahamed ◽  
S Zabeen ◽  
F Alam ◽  
MA Wahab ◽  
...  

Introduction: Nephropathies, as one of the multiple extrahepatic features of Hepatitis E virus (HEV) infection, can occur in clinically improved HEV hepatitis patients which in majority of the cases remain clinically silent for a long period. By the time these are reported, patients have already developed renal insufficiency which may even lead to renal replacement therapy. Proteinuria, a simple test in practice, can be a useful tool for early detection of the underlying renal impairment. Objective: The aim of this study was to detect the presence of proteinuria and to evaluate the degree of proteinuria in HEV- hepatitis patients during post-icteric state. Materials and Methods: This cross sectional study was conducted on 50 diagnosed patients of clinically improved HEV-hepatitis at the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) with active cooperation of the Department of Hepatology, BSMMU, between July 2006 and June 2007. Cases were chosen carefully, to exclude the acute state of illness and the patients of HEV were selected during their third or fourth follow-up, in their post-icteric phase. The study subjects were grouped according to equal age ranges in group-I (18-26 year) and group-II (27-35 year). Depending on the level of spot urinary protein (mg/dl) the subjects were also categorized as having trace, mild and moderate proteinuria. Results: The mean age of HEV infected subjects was 24.72±2.59 years. The mean spot urinary protein in age group-II patients was raised compared to age group-I and the difference was highly significant (p<0.001). Moreover, there was no significant difference (p>0.05) of spot urinary protein of male and female. Majority of HEV patients (42%) presented with mild proteinuria and mostly (53.3%) was of age group-I. Conclusion: Spot urinary protein concentration should be checked in every HEV- hepatitis patient to detect the presence and level of proteinuria. DOI: http://dx.doi.org/10.3329/jafmc.v7i2.10395 JAFMC 2011; 7(2): 37-39


2021 ◽  
Author(s):  
Tarek Gharib ◽  
Ibrahim Abdelal ◽  
Adel Elatreisy ◽  
Elsayed Salih ◽  
Ahmed Sebaey

Abstract Objective: To evaluate effectiveness and safety of a 5mg tadalafil daily treatment for men with erectile dysfunction (ED) and premature ejaculation (PE) and assessment of long-term follow up by persistence of improvement 2 years after stoppage of tadalafil.Materials and Methods: The study included 160 patients diagnosed with erectile dysfunction from April 2018 to June 2020. All were evaluated using the international index of erectile function questionnaire-5 (IIEF-5) to evaluate ED and intravaginal ejaculatory latency time (IELT) for PE. Patients subdivided into two equal groups. I included 80 patients treated with tadalafil 5 mg daily for 3 months, and group II included 80 patients treated with a placebo for same period. After 3 months treatment and 2 years later after stoppage of tadalafil, all patients were assessed for ED and PE using the same questionnaires. Results: The mean IELT and IIEF pretreatment were 37±11.24 s and 13.2±4.2 respectively for group I, while in group II was 35.98±10.8 s and 13.12±4.11, respectively. After 3 months of treatment, the mean value of IELT in group I showed a highly significant improvement from 37±11.24 sec to 120.5±47.37 sec (p-value < 0.001), but for group II, the mean values of IELT showed no significant improvement from baseline 35.98±10.8 to endpoint 39.43±13.6 ( p-value > 0.05). As regarding the IIEF, there was a highly significant improvement from baseline 13.2±4.2 to endpoint 20.45±4.5 in group I (p-value < 0.001) while there was no significant difference in group II from baseline 13.12±4.11 to endpoint 15±4.84 (p-value > 0.05) . 2 years later after stoppage of tadalafil , 75 patients from group I complete follow up and there was significant improvement in IELT and IIEF form base line (37±11.24) (13.2±4.2) to endpoint (98±18.3) (19.1±2.3) respectively but less than the results after 3 months treatment.ConclusionDaily Tadalafil 5 mg was effective, tolerable, and safe treatment for patients suffering from ED and PE. Long-term follow up after 2 years declared persistence of significant improvement.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ashraf Bor’i ◽  
Salah M. Al-Mosallamy ◽  
Tamer G. Elsayed ◽  
Wael M. El-Haig

Purpose. To evaluate the safety and efficacy of a novel modified subscleral trabeculectomy technique in management of primary congenital glaucoma. Methods. This study included 25 infants diagnosed of having bilateral primary congenital glaucoma. For each patient, one eye was assigned to undergo subscleral trabeculectomy with trimming of the edges of the scleral bed (group I), while the contralateral eye underwent subscleral trabeculectomy with application of mitomycin C (0.4 mg/ml for 3 min) (group II). All the patients were followed up for a period of 14 ± 3 months (range 13–22 months). Results. 25 eyes were included in each group. Patients’ mean age was 2.5 ± 0.5 months (range 1.8–6.5 months). The mean preoperative intraocular pressure was 31 ± 4.9 mmHg and 32.1 ± 4.0 mmHg in group I and II, respectively. The mean postoperative intraocular pressure was 9.0 ± 1.0, 11.0 ± 3.2, 12.5 ± 0.9, 13.0 ± 2.9, and 15.5 ± 1.5 mm Hg in group I and was 10.3 ± 1.2, 12.0 ± 2.5, 13.5 ± 1.7, 15.0 ± 1.5, and 17.1 ± 2.8 mm Hg in group II at the first week and 1, 3, 6, and 12 months, respectively. There was no statistically significant difference between the mean intraocular pressure values recorded at both groups preoperatively and at each follow-up visit. Failure necessitating further surgical interventions was recorded in 4 eyes (16%) in group I as compared to 3 eyes (12%) in group II (P>0.05). Postoperative complications included mild hyphema, which occurred in one eye (4%) in group I and 2 eyes (8%) in group II, and shallow anterior chamber in 3 eyes (12%) in group I and in 2 eyes (8%) in group II. One eye (4%) in group I developed drawn-up pupil. Choroidal effusion developed in one eye (4%) at each group. Conclusion. Trimming the edges of the scleral bed adjacent to the sclera flap is a safe and effective surgical step which can be added to the subscleral trabeculectomy procedure to effectively control the intraocular pressure in patients with primary congenital glaucoma, sparing them the hazards associated with mitomycin C application.


2018 ◽  
Vol 21 (1) ◽  
pp. 9-13
Author(s):  
Masoud Nikfarjam ◽  
Kamal Solati ◽  
Saeid Heidari-Soureshjani ◽  
Mohammadreza Nourmohammadi ◽  
Seyed Yahya Kazemi ◽  
...  

Background and aims: Depression is considered a disease which is associated with various complications including suicide and imposes high costs on the health systems. The present study aimed to determine the effectiveness of group religious intervention on spiritual wellbeing and symptom reduction in patients with depression. Methods: In this clinical trial, 72 patients with anxiety were included using convenience sampling technique and then were randomly divided into patients with depression who underwent pharmacotherapy alone (group I) and those who underwent pharmacotherapy and religious intervention (group II). In addition, the religious group II participated in 5 90-minute sessions within three weeks and received the routine drug treatment. Then, a demographic questionnaire, Paloutzian and Ellison’s Spiritual Well-Being scale, and Hamilton Depression scale were completed. Finally, the data were analyzed by the SPSS software, version 18. Results: There was no significant difference between the demographic characteristics of the patients (P>0.05). However, the mean scores of religious and existential aspects of spiritual health, as well as the mean total score of spiritual health after the intervention were significantly higher in group II who received religious intervention compared to group I (P<0.05). Conversely, the mean score of depression significantly decreased in groups I and II after the study (P<0.001). In other words, after intervention, the mean score of depression was significantly lower in group II who received religious intervention compared to the group I (P=0.038). Conclusion: In general, religious intervention, reduced the symptoms of depression in patients in addition to increasing the level of the spiritual health of the patients


2022 ◽  
Vol 8 (1) ◽  
pp. 1-6
Author(s):  
Reshma Shireesha ◽  
Obulesu Obulesu

Background: Aim: To assess the effect of exercise on body composition in obese and overweight. Methods: A total of seventy- two overweight subjects of either gender were enrolled for the study. Two groups were prepared. One group was experimental group (n=36) and the second group was control group (n=36). Parameter such as age, height and weight was recorded. On the basis of variables body mass Index and body fat percentage of every subject was determined. The experiment group were put on aerobic exercises spread over duration of four weeks. Results: The mean height in group I was 163.7 cm and 165.4 cm in group II. Weight was 65.2 kg and 63.5 kgs in group II, BMI (Kg/m2) was 29.4 and 29.1, body fat was 29.3% and 29.6% in group I and II respectively. A significant difference was observed (P< 0.05). The mean pre- test BMI was 29.6 and 38.5 and post- test value was 26.4 and 38.9 in group I and II respectively. A significant difference was observed (P< 0.05). Conclusions: Regular physical activity appears to confer a health benefit to the people. There was a positive relationship between aerobic exercises and overweight women in order to reduce the value of fat in the body.


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