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Nunna, Mahesh,Dasaraju, Rupak Kumar,Kamatham, Rekhalakshmi,Mallineni, Sreekanth Kumar,Nuvvula, Sivakumar The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.5
Background: This study evaluated the efficacy of virtual reality (VR) distraction and counter-stimulation (CS) on dental anxiety and pain perception to local anesthesia in children. Methods: A prospective, randomized, single-blinded interventional clinical trial with a parallel design was used. Seventy children 7-11 years old who required local anesthesia (LA) for pulp therapy or tooth extraction were recruited and allocated to two groups with equal distribution based on the intervention. Group CS (n = 35) received CS and Group VR (n = 35) received VR distraction with ANTVR glasses. Anxiety levels (using pulse rate) were evaluated before, during, and after administration of local anesthesia, while pain perception was assessed immediately after the injection. Wong-Baker faces pain-rating scale (WBFPS), visual analog scale (VAS), and Venham's clinical anxiety rating scale (VCARS) were used for pain evaluation. Student's t-test was used to test the mean difference between groups, and repeated measures ANOVA was used to test the mean difference of pulse rates. Results: Significant differences in mean pulse rates were observed in both groups, while children in the VR group had a higher reduction (P < 0.05), and the mean VCARS scores were significant in the VR group (P < 0.05). Mean WBFPS scores showed less pain perception to LA needle prick in the CS group while the same change was observed in the VR group with VAS scores. Conclusions: VR distraction is better than CS for reducing anxiety to injection in children undergoing extraction and pulpectomy.
Elicherla, Sainath Reddy,Bandi, Sujatha,Nunna, Mahesh,Saikiran, Kanamarlapudi Venkata,Sahithi, Varada,Nuvvula, Sivakumar The Korean Dental Society of Anesthsiology 2021 Journal of Dental Anesthesia and Pain Medicine Vol.21 No.6
Background: This study aimed to determine the efficacy of Physics Forceps in pediatric dental extractions. Methods: This was a double-blind, randomized controlled trial with a parallel-arm design and identical allocation ratio (1:1). Children (n=104) were randomly divided into two groups for extraction of mandibular primary teeth (group I: Physics Forceps; group II: conventional forceps). The outcome variables assessed in the study were the time taken for extraction, pre- and postoperative anxiety (using RMS pictorial scale), incidence of fractured teeth, and postoperative pain on the first and third days (using the Wong-Baker faces pain scale). Results: A significant reduction (P < 0.001) in intraoperative time, anxiety, and incidence of tooth fracture was confined to group I. The pain significantly reduced from the first to the third postoperative day in both groups, but the mean reduction in RMS scores in the physics forceps group was far better than that in the conventional forceps group. Conclusion: Physics Forceps aid in extraction of primary teeth with minimal trauma to supporting structures, as well as reducing anxiety in the pediatric population.
Sahithi, Varada,Saikiran, Kanamarlapudi Venkata,Nunna, Mahesh,Elicherla, Sainath Reddy,Challa, Ramasubba Reddy,Nuvvula, Sivakumar The Korean Dental Society of Anesthsiology 2021 Journal of Dental Anesthesia and Pain Medicine Vol.21 No.4
Background: This study aimed to evaluate the efficacy of external vibrating devices and counterstimulation on a child's dental anxiety, apprehension, and pain perception during local anesthetic administration. Methods: This was a prospective, randomized, parallel-arm, single-blinded interventional, clinical trial. One hundred children aged 4-11 years, requiring pulp therapy or extraction under local anesthesia (LA), were recruited and allocated equally into two groups (1:1) based on the interventions used: Group BD (n = 50) received vibration using a Buzzy<sup>®</sup> device {MMJ Labs, Atlanta, GE, USA} as a behavior guidance technique; Group CS (n = 50) received counterstimulation for the same technique. Anxiety levels [Venham's Clinical Anxiety Rating Scale (VCARS), Venham Picture Test (VPT), Pulse oximeter {Gibson, Fingertip Pulse Oximeter}, Beijing, China)] were assessed before, during, and after LA administration, while pain perception [Wong-Baker Faces Pain Rating Scale (WBFPS), Visual Analogue Scale (VAS)] was evaluated immediately after injection. Statistical analysis was performed using the Student's t-test to assess the mean difference between the two groups and the repeated measures ANOVA for testing the mean difference in the pulse rates. Statistical significance was set at P < 0.05. Results: Significant differences in mean pulse rate values were observed in both groups. In contrast, the children in the BD group had higher diminution (P < 0.05), whereas the mean VCARS and VPT scores were conspicuous (P < 0.05). Based on the mean WBFPS and VAS scores, delayed pain perception after LA injection was more prominent in the BD group than in the CS group. Conclusion: External vibration using a Buzzy<sup>®</sup> device is comparatively better than counterstimulation in alleviating needle-associated anxiety in children requiring extraction and pulpectomy.
Eon Soo Lee,Md Nasir Uddin Bhuyian,Durgamadhab Misra,Shiqiang Zhua,Harsimranjit Singh,Joo Un Lee,Debdyuti Mandal,Bharath Babu Nunna 나노기술연구협의회 2019 Nano Convergence Vol.6 No.3
Integrating microfluidics with biosensors is of great research interest with the increasing trend of lab-on-the chip and point-of-care devices. Though there have been numerous studies performed relating microfluidics to the biosensing mechanisms, the study of the sensitivity variation due to microfluidic flow is very much limited. In this paper, the sensitivity of interdigitated electrodes was evaluated at the static drop condition and the microfluidic flow condition. In addition, this study demonstrates the use of gold nanoparticles to enhance the sensor signal response and provides experimental results of the capacitance difference during cancer antigen-125 (CA-125) antigen–antibody conjugation at multiple concentrations of CA-125 antigens. The experimental results also provide evidence of disease-specific detection of CA-125 antigen at multiple concentrations with the increase in capacitive signal response proportional to the concentration of the CA-125 antigens. The capacitive signal response of antigen–antibody conjugation on interdigitate electrodes has been enhanced by approximately 2.8 times (from 260.80 to 736.33 pF at 20 kHz frequency) in static drop condition and approximately 2.5 times (from 205.85 to 518.48 pF at 20 kHz frequency) in microfluidic flow condition with gold nanoparticle-coating. The capacitive signal response is observed to decrease at microfluidic flow condition at both plain interdigitated electrodes (from 260.80 to 205.85 pF at 20 kHz frequency) and gold nano particle coated interdigitated electrodes (from 736.33 to 518.48 pF at 20 kHz frequency), due to the strong shear effect compared to static drop condition. However, the microfluidic channel in the biosensor has the potential to increase the signal to noise ratio due to plasma separation from the whole blood and lead to the increase concentration of the biomarkers in the blood volume for sensing.