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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.
Weikert Thomas,Rapaka Saikiran,Grbic Sasa,Re Thomas,Chaganti Shikha,Winkel David J.,Anastasopoulos Constantin,Niemann Tilo,Wiggli Benedikt J.,Bremerich Jens,Twerenbold Raphael,Sommer Gregor,Comaniciu 대한영상의학회 2021 Korean Journal of Radiology Vol.22 No.6
Objective: To extract pulmonary and cardiovascular metrics from chest CTs of patients with coronavirus disease 2019 (COVID-19) using a fully automated deep learning-based approach and assess their potential to predict patient management. Materials and Methods: All initial chest CTs of patients who tested positive for severe acute respiratory syndrome coronavirus 2 at our emergency department between March 25 and April 25, 2020, were identified (n = 120). Three patient management groups were defined: group 1 (outpatient), group 2 (general ward), and group 3 (intensive care unit [ICU]). Multiple pulmonary and cardiovascular metrics were extracted from the chest CT images using deep learning. Additionally, six laboratory findings indicating inflammation and cellular damage were considered. Differences in CT metrics, laboratory findings, and demographics between the patient management groups were assessed. The potential of these parameters to predict patients’ needs for intensive care (yes/no) was analyzed using logistic regression and receiver operating characteristic curves. Internal and external validity were assessed using 109 independent chest CT scans. Results: While demographic parameters alone (sex and age) were not sufficient to predict ICU management status, both CT metrics alone (including both pulmonary and cardiovascular metrics; area under the curve [AUC] = 0.88; 95% confidence interval [CI] = 0.79–0.97) and laboratory findings alone (C-reactive protein, lactate dehydrogenase, white blood cell count, and albumin; AUC = 0.86; 95% CI = 0.77–0.94) were good classifiers. Excellent performance was achieved by a combination of demographic parameters, CT metrics, and laboratory findings (AUC = 0.91; 95% CI = 0.85–0.98). Application of a model that combined both pulmonary CT metrics and demographic parameters on a dataset from another hospital indicated its external validity (AUC = 0.77; 95% CI = 0.66–0.88). Conclusion: Chest CT of patients with COVID-19 contains valuable information that can be accessed using automated image analysis. These metrics are useful for the prediction of patient management.
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.
Niharika Reddy Elicherla,Kanamarlapudi Venkata Saikiran,Karthik Anchala,Sainath Reddy Elicherla,Sivakumar Nuvvula 대한치과마취과학회 2024 Journal of Dental Anesthesia and Pain Medicine Vol.24 No.1
Background: The objective of behavioral guidance is to establish effective communication that aligns with a child's requirements to manage disruptive behavior. This study aimed to evaluate the effectiveness of the Tell-Show-Do and Ask-Tell-Ask techniques in managing dental anxiety in children during their initial appointment. Methods: The study included 50 children (28 boys and 22 girls) without any prior experience between the ages of 7 and 11 at their first dental visit. The children were randomly categorized into two groups: Group 1, Tell Shows Do, and Group 2, Ask-Tell-Ask. Subsequently, all children underwent noninvasive treatment procedures such as restorations, sealants, and oral prophylaxis. Furthermore, behavioral management techniques were employed based on the allocated group. Finally, anxiety levels for all children were assessed using the Raghavendra, Madhuri, and Sujata Pictorial Scale (RMS-PS) and heart rate at three different intervals (before, during, and after). The obtained data were entered into Microsoft Excel, and statistical analysis was performed using SPSS software. A paired t-test and Mann–Whitney U-test were used to compare the mean and median values of the two groups and determine their effectiveness. Results: Children in the TSD group exhibited statistically significant heart rates and RMS-PS scores in intra-group comparisons. However, children in the ask-tell-ask group showed a significant reduction only in the RMS-PS scores (P < 0.001) but not in the measures used to assess heart rate (P < 0.001). Conclusion: Tell-Show-Do was more effective than ask-tell-ask in alleviating dental anxiety in children. The simultaneous application of these two strategies can synergistically alleviate dental anxiety during a child’s initial dentist appointment.
A review on EEG artifacts and its different removal technique
Chang Young Jung,Sakala Satya Saikiran 사단법인 미래융합기술연구학회 2016 아시아태평양융합연구교류논문지 Vol.2 No.4
Electroencephalograms are the neurological signals which help in the study of various diseases. These are often contaminated with various artifacts. It is difficult to study and analysis of brain signals in the existenceof these artifacts. EOG, ECG, motion and EMG are the common artifacts which cause disturbance to neurological signal. This review paper focuses on the artifact removal techniques with their features.Important parameters were taken into consideration while the study of various published papers. Strength and weakness of each paper are mentioned. This review of various papers is best of my knowledge.
Elicherla, Sainath Reddy,Bandi, Sujatha,Nuvvula, Sivakumar,Challa, Rama subbareddy,Saikiran, Kanamarlapudi Venkata,Priyanka, Vaka Jeevan The Korean Dental Society of Anesthsiology 2019 Journal of Dental Anesthesia and Pain Medicine Vol.19 No.6
Background: Behavior guidance is a technique used to subdue inappropriate behavior by establishing communication that meets the needs of a child. This study aimed to measure the effectiveness of a mobile app (Little Lovely Dentist) compared to the tell-show-do (TSD) technique in managing anxious children during their first dental visit. Methods: Fifty children (30 boys and 20 girls) without any past dental experience, aged from 7 to 11 years, were randomly allocated into either the dental app group or the TSD group. The pre- and post-operative anxiety of children who underwent prophylactic cleaning was assessed both physiologically and subjectively using a heart rate measurement and the RMS pictorial scale, respectively. Results: The intragroup comparison of heart rate and RMS scores for children allocated to the dental app group was statistically significant (P value ≤ 0.001). However, a significant reduction only occurred in the RMS scores, but not the heart rate measurements, in the TSD group. Conversely, there was an increase in heart rates in the TSD group. Conclusion: Educating the child prior to a dental procedure using a smartphone application such as Little Lovely Dentist can significantly alleviate the anticipatory anxiety and engage children in dental treatment during their first visit.