Effectiveness of anterior middle superior alveolar injection using a computer-controlled local anesthetic delivery system for maxillary periodontal flap surgery

Tandon, Shruti,Lamba, Arundeep Kaur,Faraz, Farrukh,Aggarwal, Kamal,Ahad, Abdul,Yadav, Neha The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.1

Background: Profound anesthesia with adequate duration is required in periodontal flap surgery, which involves the manipulation of both hard and soft tissues. The anterior middle superior alveolar (AMSA) injection may be an alternative to multiple injections required for this purpose in the maxilla. The present study aimed to assess the effectiveness of AMSA injection using computer-controlled local anesthetic delivery (CCLAD) system to anesthetize buccal hard tissue (BHT), buccal soft tissue (BST), palatal hard tissue (PHT), and palatal soft tissue (PST) around the maxillary teeth. Methods: Thirty-five patients who were indicated for open flap debridement in a whole maxillary quadrant were given AMSA injection using the CCLAD. The effectiveness of anesthesia was evaluated using subjective and objective parameters around each tooth. Supraperiosteal infiltrations were administered to complete the surgery wherever the AMSA injection was ineffective. Results: The AMSA injection was more effective on the palatal tissues than on the buccal tissues, as 94.14% of PST and 87.89% of PHT sites were anesthetized compared to 49.22% and 43.75% of BHT and BST sites, respectively. There was no significant difference in the frequency of anesthesia around the anterior and posterior teeth. The PHT was significantly more anesthetized (P = 0.003) in males than in females. Conclusions: The AMSA injection using CCLAD is highly effective on palatal tissues and could be used as a first-line anesthesia for periodontal flap surgery. However, its effect on buccal tissues is less predictable, with supraperiosteal infiltration often required to supplement the AMSA injection.

Comparison of anxiety and pain perceived with conventional and computerized local anesthesia delivery systems for different stages of anesthesia delivery in maxillary and mandibular nerve blocks

Aggarwal, Kamal,Lamba, Arundeep Kaur,Faraz, Farrukh,Tandon, Shruti,Makker, Kanika The Korean Dental Society of Anesthsiology 2018 Journal of Dental Anesthesia and Pain Medicine Vol.18 No.6

Background: Fear of local anesthesia (LA) is a significant impediment to dental care as many patients delay or avoid treatment to avert pain. Computer-controlled local anesthetic delivery system (CCLAD), with constant and controlled rate of flow, present a painless alternative. The present study aimed to compare anxiety and pain perceived with conventional and computerized systems, for different stages of anesthesia delivery when administering various nerve blocks. Methods: One hundred patients requiring bilateral LA participated in the study. One side was anesthetized using one system and the contralateral side was anesthetized using the other, in two separate appointments. Patients assigned anxiety scores on a 5-point scale and used the visual analogue scale (VAS) for pain determination at needle insertion, during delivery of anesthetic solution, immediately after injection, and at the end of the periodontal procedure. Each patient's preference for the delivery system of future injections was also recorded. Results: Patients reported significantly lower anxiety levels with CCLAD compared to the syringe. Significantly lower mean VAS scores for anesthesia deposition, pain immediately after, and at the end of the periodontal procedure were also noted. However, pain at needle insertion was comparable between the two systems, with no statistical significance. Overall, 64.4% patients preferred CCLAD for future anesthesia. Conclusion: Lower pain perceived with CCLAD and higher preference for the system suggest that CCLAD should replace conventional syringes to allow pain-free dental treatment.

Buffered articaine infiltration for primary maxillary molar extractions: a randomized controlled study

Parag Dhake,Devendra Nagpal,Purva Chaudhari,Gagandeep Lamba,Kavita Hotwani,Prabhat Singh 대한치과마취과학회 2022 Journal of Dental Anesthesia and Pain Medicine Vol.22 No.5

Background: Dental pain management is an important aspect of patient management in pediatric dentistry. Articaine is considered the most successful anesthetic agent for infiltration anesthesia. Buffered articaine has been observed to have faster onset and longer duration of action with less pain on injection. The aim of this study was to evaluate and compare pain on injection, onset of action, and pain during extraction using buffered (using Sodium bicarbonate (NaHCO3)) and non-buffered 4% articaine (with 1:100000 adrenaline) infiltrations for primary maxillary molar extractions in 4–10-year-old children. Methods: Seventy children who required extraction of maxillary primary molars were enrolled in this triple-blind randomized study. Children undergoing extraction were randomly divided into two groups, with 35 in each group. The study group was the buffered articaine group; the control group was the non-buffered articaine group. Buccal and palatal infiltrations were administered with either buffered or non-buffered articaine. Subjective evaluation was done for pain on injection, pain during extraction using Wong–Baker Faces Pain Rating Scale (WBFPR) and onset of anesthesia in seconds. Pain on injection, pain during extraction were objectively evaluated using Sound Eye Motor (SEM) scale and onset of anesthesia was also evaluated objectively by pricking with sharp dental probe. Results: The outcome was, significantly less pain on injection and significantly faster onset of anesthesia with significantly less pain during extraction for both subjective and objective evaluations in the buffered articaine group. Subgroup analysis was also performed and it showed variable results, with only significant difference for WBFPR scores in age subgroup 4–7 years for palatal infiltration. Conclusion: Less pain on injection, faster onset of anesthesia, and less pain during extraction were observed when buffered articaine was used for maxillary primary molar extraction.

Optimization and Bioassay Guided Comparative Techniques for Efficient Extraction of Lutein Esters from Tagetes erecta (Var. Pusa Narangi Genda) Flowers

Dabodhia Kawar Lal,Tripathi Brijesh,Lamba Narendra Pal,Chauhan Manmohan Singh,Bhatia Rohit,Mishra Vivek 사단법인 한국질량분석학회 2024 Mass spectrometry letters Vol.15 No.1

Capacity of the analytical/quantitative evaluation techniques to satisfy both qualitative and quantitative consider- ations for effective extraction of marigold oleoresins/xanthophylls and their potential as anti-mycotic and antioxidant activity was assessed. Accelerated solvent extraction (ASE), Soxhlet extraction (SE), Supercritical fluid extraction (SCFE), Cold extraction (CE), and ultrasonically assisted extraction (USE) techniques were evaluated for extraction of oleoresin/xanthophyll content from Tagetes erecta (Var. Pusa Narangi Genda) with respect to solvent consumption, extraction time, reproducibility, and yield. Followed by the anti- fungal and antioxidant activity evaluation. The overall yield of Tagetes oleoresin was higher in ASE (64.5 g/kg) followed by SE (57.3 g/kg), USE (50.7 g/kg), SCFE (45.3 g/kg) and CE (31.6 g/kg). The lutein esters represented more than 80% of the constituents. Further, xanthophyll/ lutein content in oleoresin was found to be quite higher in HPLC (r 2 =0.996) analysis than in the AOAC recommended UV spectrophotometer analysis. The oleoresin exhibited moderate antioxidant activity (DPPH assay) and antifungal activity against three phytopathogenic fungi. Based on the various parameters, the reproducibility of ASE was better (0.3–8.0%) than that of SE (0.5– 12.9%), SCFE (0.2–9.4%), USE (0.3–12.4%) and CE (0.8–15.3%). ASE with (RSD 1.6%) is preferred being faster, reproducible, uses less solvent, robust and automation allows sequential extraction of the sample in less time.

Recursive Least Squares Based Bussgang Algorithms for Blind Channel Equalization

K. Rama Naidu,Ratnam V. Raja Kumar,T. S. Lamba 대한전자공학회 2005 ITC-CSCC :International Technical Conference on Ci Vol.2005 No.2

Effect of Acupressure on Pain during Inferior Alveolar Nerve Block Injection in Children Aged 5-10 Years Old - An Experimental Study

Gurharikar Ayushi Shashikant,Nagpal Devendra,Yadav Prabhat Singh,Chaudhari Purva,Hotwani Kavita,Lamba Gagandeep 사단법인약침학회 2023 Journal of Acupuncture & Meridian Studies Vol.16 No.4

Background: Acupressure, which is related to acupuncture, is a noninvasive therapy suitable for use in children. However, data examining acupressure’s effects on the pain of local anesthetic injection in children are sparse. Objectives: The purpose of this study was to evaluate acupressure’s effects on the pain of local anesthetic injection in children. Methods: This randomized, double-blind, parallel-group clinical study included 37 5- to 10-year-olds who had an inferior alveolar nerve block (IANB) for a mandibular extraction and were randomized to one of two groups: acupressure (study group) or non-acupressure (control group). The Wong-Baker FACES Pain Rating Scale (WBFPS) and the Sound, Eye, Motor (SEM) scale were utilized for subjective and objective pain assessment during injection. Results: The objective and subjective assessment of pain during injection significantly differed between the groups, with the acupressure group displaying lower scores. Conclusion: Acupressure at the extra one point (EX-HN1) reduced pain during IANB injection in 5- to 10-year-olds and can be used as an adjunct to conventional measures like topical anesthesia to reduce pain.

Endoscopic Ultrasound-Guided Random Omental Fine Needle Aspiration: A Novel Technique for the Diagnosis of Peritoneal Carcinomatosis

Pradeep Kumar Siddappa,Neha Jain,Naveen K. Agarwal,Monika Jain,Gurwant Singh Lamba 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.5

Background/Aims: Diagnostic abdominal paracentesis has been described in literature to have variable sensitivity of 50%–75% forthe detection of peritoneal carcinomatosis (PC). We believe that random needle aspirates from the omentum, even in the absence ofobvious deposits by endoscopic ultrasound (EUS), could prove malignancy in patients with PC. Methods: Consecutive patients who underwent EUS for diagnosis and staging of cancer and found to have ascites were includedafter obtaining informed consent. EUS-guided fine needle aspiration (EUS-FNA) from random sites in the omentum was performedthrough the transgastric route using a linear echoendoscope. Results: Fifty-four patients underwent EUS during October 2015 to April 2017 for detection, staging, or FNA of a suspectedmalignant lesion. Ascites was seen in 17 patients and 15 patients who fulfilled the criteria were included. The procedure wassuccessful in all patients. Cytology was suggestive of malignancy in 12 (80%) but not suggestive of malignancy in 3 (20%) patients. Three patients who tested negative had hyperbilirubinemia with biliary obstruction. Their ascitic fluid analysis result was alsonegative. Conclusions: Random FNA of the omentum in patients with malignancy-related ascites is highly effective in the diagnosis of PC andcould be employed during EUS evaluation of malignancies.

Effect of audio distraction with thermomechanical stimulation on pain perception for inferior alveolar nerve block in children: a randomized clinical trial

Devendra Nagpal,Dharanshi Viral Amlani,Pooja Rathi,Kavita Hotwani,Prabhat Singh,Gagandeep Lamba 대한치과마취과학회 2023 Journal of Dental Anesthesia and Pain Medicine Vol.23 No.6

Background: Pain control is a crucial aspect of pediatric dentistry for patient management. Thermo-mechanical devices (BuzzyTM Pain Care Labs, USA) work on the concept of vibration and cooling and have shown promising results in pain control during local anesthesia in pediatric dentistry. On the other hand, audio distraction has also been used for pain management. The amount of pain endured is determined by the patient's perception and attentiveness. Thus, if audio function is added to the thermomechanical device it might increase its efficiency. Hence, the present study aimed to compare pain on injection using a thermo-mechanical device with and without audio during inferior alveolar nerve block (IANB) injection in children aged 5-10 years old. Methods: Twenty-eight children aged between 5 and 10 indicated for IANB were included in this randomized study. Children who were undergoing the dental procedure were divided into 2 groups, with 14 children in each group. The study group was the thermo-mechanical device with audio distraction; the control group was the thermo-mechanical device without audio distraction. IANB was administered. Subjective pain evaluation was performed using the Wong–Baker Faces Pain Rating Scale (WBFPR) and objective pain evaluation was done using the Faces, Leg, Activity, Consolability, Cry (FLACC) scale. Results: The outcome depicted a significant reduction in pain on injection for both objective and subjective evaluations in the thermo-mechanical device with an audio distraction group. Conclusions: Less pain on injection was observed, when a thermo-mechanical device was used with audio distraction for IANB procedures.