Active Distraction Research Articles

Enhancing Pediatric Dental Care: The Influence of Virtual Reality.

The purpose of this study was to assess the effects of virtual reality (VR) in reducing pain and anxiety levels in children. The study also compared active and passive distraction methods using VR during the delivery of inferior alveolar nerve blocks (IANBs) in dental procedures in children. The study comprised 45 preschool patients, aged between 4 and 6 years, with no prior dental anesthetic experience. The participants were randomly assigned to three groups based on the sort of management style: Group A used the tell-show-do technique, Group B engaged in passive distraction by watching cartoons using a VR headset, and Group C participated in active distraction by playing games using a controller with the VR headset. Pain and anxiety were evaluated using physiological measurements, namely by analyzing the variations in blood pressure, heart rate, and oxygen saturation before and after the administration of IANB. Psychological assessments were conducted using the Wong-Baker faces scale, Modified Dental Anxiety scale questionnaires, and Revised Face, Legs, Activity, Cry and Consolability scale after administering IANB. The physiological outcomes revealed no statistically significant differences in blood pressure and oxygen saturation. However, there was a statistically significant increase in the heart rate in group A compared with groups B and C. In terms of psychological measurements, groups B and C exhibited a significant improvement in pain experience and a decrease in anxiety. This study concluded that VR reduced pain and anxiety levels in its passive and active forms.

Reduction of Dental Anxiety in Children Using Virtual Reality: A Randomised Controlled Trial.

The aim of this research is examining the effectiveness of Virtual Reality (VR) in the reduction of dental anxiety in children with novel methods. The three arm parallel-group randomised clinical study was conducted in children aged 6-10 years. Pulpotomy procedure was performed on randomised 90 selected children (n=30 in each group; AG: group applied active distraction using VR glasses, PG: group applied passive distraction, i.e., watching cartoons on a screen mounted onto a dental unit, CG: control group). Before and after the procedure, children were administered Facial Pain Scale (FIS), Children's Fear Rating Scale (CFSS-DS) and Frankl Behaviour Rating Scale (FBRS). The pulse rate was measured to check the anxiety levels of all treated children at five different time points. Statistical significance was determined as p<0.05. VR has been found to positively contribute to the performance of children in adapting to dental treatment. The VR application aims to create positive attitude in children by providing them a safe atmosphere and becoming a useful tool in the dental profession.

Comparing the use of colored Trace Images in Kids' Books with passive distractions to decrease pain and fear during cannulation in children: A randomized clinical trial

IntroductionCannulation can be frightening and a source of pain and fear for pediatric patients. The study evaluated the effectiveness of Trace Image and Coloring for Kids-Book (TICK-B) as active distraction with two passive distractions in reducing children's pain and fear during cannulation. MethodsThis study employed a prospective, controlled, randomized experiment conducted from January 2023 to April 2023 at Heevi Pediatric hospital in the Kurdistan region of Iraq. A total of 176 participants were randomly assigned in to one of four study groups, with 44 participants assigned to each group. The interventions were administered 2–3 min before continued until the cannulation procedure finished. Data were collected through interviews conducted before and after the procedure. Children reported pain using Wong-Baker FACES® scale, and fear evaluated with the Child Fear Scale as an outcome after the cannulation procedure. Children's outcomes during and after procedure were measured 2–3 min after completed procedure. ResultsAll distraction methods significantly reduced children's pain and fear compared to the control group. TICK-B showed large effects in reducing average pain (mean difference = -4.65, 95 % CI: -5.67 to -3.65) and fear (mean difference = -2.18, 95 % CI: -2.67 to -1.69) during cannulation. Post-procedure, TICK-B maintained large pain relief (mean difference = -4.10, 95 % CI: -4.98 to -3.22) and fear reduction (mean difference = -1.89, 95 % CI: -2.39 to -1.39) effects. Music listening and cartoon watching both showed improvements compared to the control group, with minimal differences between them in terms of pain and fear during the procedure. Also, the differences were the same after the procedure. No adverse events were reported. ConclusionAll distraction techniques effectively and safely decreased children's pain and fear during cannulation. The TICK-B technique most effectively reduced children's pain and fear during cannulation procedures compared to music-listening and cartoon-watching techniques. Trial registrationNCT04977323.

Protective factors of psychological vulnerability in Rescue 1122 workers with vicarious traumatization.

This study aimed to determine the protective factors of psychological vulnerability in Rescue 1122 workers and to find out the difference in work mattering, coping, grittiness, and psychological vulnerability between rescue workers of fire service and ambulance service department with vicarious traumatization. A cross-sectional design was used in this study. A sample of 112 male rescue workers was collected from Rescue 1122 department, including participants from the ambulance service (n = 56) and fire service (n = 56) departments through a purposive sampling technique. Rescue workers who experienced vicarious trauma were enrolled in this study after screening through the secondary traumatic stress tool. Work mattering scale, coping strategies questionnaire, short grit scale, and the four-dimensional symptom questionnaire were used. Age, marital status, spouse age, and father's age were significantly positively correlated with distress. Colleagues becoming a target of violence and death of a colleague during duty were significantly positively correlated with somatization. The number of children was a significant positive predictor, and members requiring financial support were a significant negative predictor of psychological vulnerability. Interpersonal mattering, active focused, and active distracting coping emerged as significant negative predictors of distress, anxiety, and depression after controlling for covariates. A significant difference was found in active distraction coping between the fire service and ambulance service departments. Rescue workers who considered that their work mattered used religious coping and distraction or adopted a practical approach toward dealing with stress, and those who were grittier were less vulnerable to psychological symptoms. So, these can be considered as protective factors of psychological vulnerability.

Features of virtual reality impact effectiveness of VR pain alleviation therapeutics in pediatric burn patients: A randomized clinical trial.

Key features of virtual reality (VR) that impact the effectiveness of pain reduction remain unknown. We hypothesized that specific features of the VR experience significantly impact VR's effectiveness in reducing pain during pediatric burn dressing care. Our randomized controlled trial included children 6 to 17 years (inclusive) who were treated in the outpatient clinic of an American Burn Association-verified pediatric burn center. Participants were randomly assigned (1:1:1) to active VR (playing the VR), passive VR (immersed in the same VR environment without interactions), or standard-of-care. On a scale from 0 to 100, participants rated overall pain (primary outcome) and features of the VR experience (game realism, fun, and engagement). Path analysis assessed the interrelationships among these VR key features and their impact on self-reported pain scores. From December 2016 to January 2019, a total of 412 patients were screened for eligibility, and 90 were randomly assigned (31 in the active VR group, 30 in the passive VR group, and 29 in the standard-of-care group). The current study only included those in the VR groups. The difference in median scores of VR features was not statistically significant between the active (realism, 77.5 [IQR: 50-100]; fun, 100 [IQR: 81-100]; engagement, 90 [IQR: 70-100]) and passive (realism, 72 [IQR: 29-99]; fun, 93.5 [IQR: 68-100]; engagement, 95 [IQR: 50-100]) VR distraction types. VR engagement had a significant direct (-0.39) and total (-0.44) effect on self-reported pain score (p<0.05). Key VR features significantly impact its effectiveness in pain reduction. The path model suggested an analgesic mechanism beyond distraction. Differences in VR feature scores partly explain active VR's more significant analgesic effect than passive VR. Trial Registration: ClinicalTrials.gov Identifier: NCT04544631.

Implementation of Mandibular Distraction Osteogenesis for Patients With Pierre Robin Sequence in a Developing Country Through International Collaboration: A Paradigm for Success.

Though it has made significant strides, Vietnam remains a resource-constrained country of 98 million people. Vietnam National Children's Hospital (VNCH) provides tertiary care to a catchment of 40 million people and is the sole national children's hospital. As such, it is one of the few referral centers in the country equipped to take care of patients diagnosed with Pierre Robin sequence (PRS) as this requires pulmonary, critical care, otolaryngology, and plastic surgery expertise. Before 2015, the only surgical options were tongue lip adhesion or tracheostomy. Only 20% of patients successfully avoided tracheostomy, mechanical ventilation, or death. From 2015 to 2019, mandibular distraction osteogenesis (MDO) was introduced by visiting international surgeons on a short-term basis. Since 2020, local surgeons at VNCH have refined their technique and widely use MDO independently. This report seeks to capitulate their experience and identify factors leading to success. A retrospective review was conducted of patients diagnosed with PRS at VNCH from 2015 to 2022. Paper records were digitized, translated, and reviewed for inclusion criteria, including demographics, indications, hospital course, and postoperative outcomes. Complete records satisfying inclusion criteria were available for 53 patients with a diagnosis of PRS who underwent MDO from 2020 to 2022. From 2015 to 2019, there were 19 cases of MDO, though records were incomplete. The median age at the time of MDO was 50 ± 43 days. Forty patients (75.5%) had isolated PRS and 13 (24.5%) were syndromic. Forty-four patients (83%) had a cleft palate. Fifty-one (96.2%) of patients required preoperative supplemental oxygen or mechanical ventilation. The active distraction and consolidation phase was 4.8 ± 1.3 months. The median days to discharge after surgery was 19.0 ± 8.3 days. Median weight at birth, at the time of surgery, and at the time of device removal were 6.8 ± 1.2, 7.7 ± 1.9, and 14.8 ± 2.8 pounds, respectively. Fifty-two patients (98.1%) had obstructive sleep apnea preoperatively with an average Apnea Hypopnea Index of 25.0 ± 10.6. Post-MDO, only 4 (7.5%) had obstructive sleep apnea and the average Apnea Hypopnea Index was 5.2 ± 0.6. No patients (0) required a tracheostomy for a 100% success rate. The tremendous success of the implementation of MDO by local surgeons in Vietnam after its introduction by visiting international surgeons illustrates a paradigm for capacity-enhancing global surgical endeavors. Mandibular distraction osteogenesis has replaced tongue lip adhesion as the surgical treatment of choice for PRS patients at VNCH. Surgical techniques can be transferred to operating environments with basic infrastructure through collaboration and resource optimization. These results demonstrate that global surgical engagement may be scalable and repeatable with direct benefits for patients in lower-middle-income countries.

Poster Session II: Attentional modulation of the achromatic and chromatic reversal VEP.

Previous literature has consistently revealed attentional modulation of the Visual Evoked Potential (VEP) response to achromatic pattern reversal stimuli but little to no attentional modulation of the VEP response to chromatic pattern onsets. Magnetic Resonance Imaging (MRI) research, however, has reported modulation of the responses to both achromatic and chromatic pattern reversal stimuli. Numerous methodological differences including mode of presentation, stimulus contrast, and attentional demand, make comparison of these results difficult. In this study, we report the results of experiments using comparable perceptual contrasts, pattern reversals, and a coextensive and highly-demanding, multiple object tracking (MOT) task. Our findings support prior VEP results indicating that although achromatic VEPs are modulated by attention, chromatic VEPs are more robust to attentional modulation, even for highly demanding distractor tasks. We also found that when compared to a non-attentional condition, the attenuation of the VEP when attending to the MOT task was greater in magnitude than the enhancement of the VEP when attending to the VEP stimulus. This supports prior conclusions, that while avoiding active distraction is likely important, insuring an "attentive state" is not always necessary when recording VEPs. Further experiments are underway to investigate why attentional modulation of chromatic signals in early visual cortex are observed in MRI but not VEP recordings.

The effect of two different methods on reducing the pain and fear during phlebotomy to children: A randomized controlled trial

IntroductionReducing pain and fear during painful medical procedures in children is important since mismanagement of pain causes the child and parent to feel anxious, which can have negative long-term consequences. This study aimed to evaluate the effects of two different distraction methods in reducing pain and fear during the phlebotomy procedure in children. MethodThe study, which has a randomized controlled experimental design was conducted between July and October 2020 with 111 children aged 6–12 years who underwent phlebotomy in the emergency department of a public hospital and their parents. The children were randomly assigned to soap bubble blowing (n:37), ball squeezing (n:37) and control (n:37) groups. During the phlebotomy, soap bubble blowing, and ball squeezing methods were used as active distraction methods. Data were collected using the Wong Baker Faces Pain Rating Scale, and the Children’s Fear Scale. ResultsThe pain scores of the soap bubble blowing group and the ball squeezing group during the phlebotomy procedure were found to be lower than the control group (p < 0.001). In addition, the soap bubble blowing group had lower fear scores than the ball squeezing and control groups (p < 0.001). ConclusionThe active distraction methods used in the study reduced pain and fear during the phlebotomy procedure. In addition, the method of soap bubble blowing was found to be a more effective method in reducing fear. Distraction methods should be used as a nursing intervention to reduce pain and fear during the phlebotomy procedure in children.

Active versus passive distraction for reducing procedural pain and anxiety in children: a meta-analysis and systematic review

BackgroundProcedural pain is very important in clinical children care. We aimed to evaluate the effects of active versus passive distraction for reducing procedural pain and anxiety in children.MethodsTwo researchers searched the Web of Science, PubMed, EMBASE, Cochrane, SinoMed, Wanfang, China National Knowledge Infrastructure, Weipu databases for the randomized controlled trials(RCTs) on the active versus passive distraction affecting procedural pain and anxiety in children until May 18, 2023. The literature screening and data extraction were carried out by two researchers independently. Review Manager 5.3 software was used for data analysis.Results13 RCTs were finally included. 553 children received active distraction intervention and 551 children received passive distraction intervention. There were no significant differences in the children self-reported procedural pain betweent active and passive distraction. The parent-reported procedural pain, medical staff-reported procedural pain, children-reported procedural anxiety, parent-reported procedural anxiety, medical staff-reported procedural anxiety in the active distraction were significant less than that of active distraction. Egger regression analysis showed that there was no publication bias in the results.ConclusionsExisting evidence suggests that active distraction may be more effective in reducing operational pain and anxiety in children than passive distraction. More studies on the effects of active distraction versus passive distraction in children with larger sample size are needed in the future.

The Effect of Play Therapy on Children's Anxiety Level Age 4-6 years During Hospitalization at the Kronjo Health Center

Anxiety is an emotional state characterized by consistent fear, tense mood, unstable state of mind, and increased blood pressure and body chemistry. This includes the cognitive perception of the behavioral, physical and social aspects of the emotion. Anxiety makes children uncooperative and creates difficulties in carrying out treatment. Usually children are more anxious during the waiting period before treatment and this time can be used for behavior management to minimize anxiety. Children's distraction provides an effective relaxing experience during painful treatment. Cognitive behavioral therapy (CBT) is a form of active distraction, in which children are encouraged to engage in activities that calm them from anxiety. Passive distraction includes audiovisual (AV) distraction, in which children remain still and engage in visual and auditory scenes. The aim of writing several systematic reviews is to compare the provision of image recognition play therapy in children aged 4-6 years. As a comparison or comparison is without play therapy. The outcome or outcome that is measured is anxiety. Articles were searched through the database from 2019 - 2020. Searches were obtained from the PUBMED database. The keywords used are “Play Therapy And Anxiety” or “Cognitive Behavioral Play Therapy (CBT) and Anxiety” Free full text in English or Indonesian. The subjects used were children aged 4-6 years. The research design was a randomized controlled trial. Based on the results of the study that the application of therapeutic games to children who are hospitalized reduces preoperative anxiety and can reduce postoperative pain, improve behavior and attitudes, and reduce anxiety during a hospital stay. Conclusion: play therapy has a beneficial impact on the care of hospitalized children and should be implemented in pediatric units after assessing the resources and training required for pediatric nurses.

Assessment of Different Distraction Behavioral Methods in Pediatric Dental Clinic: A Systematic Review.

Dental anxiety is one of the main problems dentists may face during the treatment of pediatric dental patients; therefore, clinicians tend to perform different behavior management techniques to reduce dental anxiety in children. This review aimed to systematically compare and evaluate the published literature regarding the effects of distraction techniques on anxiety,pain perception, and patient experience during dental practice. A detailed electronic search was conducted on 3 databases including PubMed, Google Scholar, and Cochrane Library. The databases were searched for articles published in the English language between 2015 and 2022. Among 102 studies, 27 studies fulfilled the criteria of eligibility and were included in this study to be analyzed. Numerous approaches have been proposed for the reduction of dental anxiety, out of which the use of audio-visual aids and instruments, active distraction such as tablets, smartphones, and virtual reality glasses showed governance in decreasing the children's anxiety followed by cognitive and behavioral methods.

Effects of two different ball types on pain and anxiety during venous blood draw in children: A randomized controlled study

BackgroundChildren presenting to hospitals for healthcare are often exposed to venous blood draw procedures which cause significant pain and stress for children. ObjectivesTactile stimulation and active distraction methods can be used during procedural pain management in children. This study was conducted to determine and compare the effects of tactile stimulation and active distraction methods on levels of pain and anxiety during venous blood draw procedure in children. MethodsA randomized controlled study design was adopted with a parallel trial design to compare four different intervention groups with a control group. The children's anxiety levels were evaluated using the Children's Fear Scale, and their perceived pain levels were evaluated using the Wong Baker Pain Scale. ResultsThe results of the child and observer evaluations revealed the perceived level of pain during the procedure to be lower in the intervention groups than in the control group, and lower in the spiky ball groups than in the round ball groups. The level of anxiety during the procedure was found to be significantly lower than that recorded prior to the procedure, based on the self-evaluation of the child and the evaluation of the observer in the intervention groups. A positive correlation was found between pain and anxiety levels during the procedure. Practice implicationsThe results of this study support the effectiveness of the spiky ball method to reduce perceived pain and anxiety in children during venous blood draw procedures in the pediatric blood draw units.

Decoding of Working Memory Contents in Auditory Cortex Is Not Distractor-Resistant.

Working memory enables the temporary storage of relevant information in the service of behavior. Neuroimaging studies have suggested that sensory cortex is involved in maintaining contents in working memory. This raised the question of how sensory regions maintain memory representations during the exposure to distracting stimuli. Multivariate pattern analysis of fMRI signals in visual cortex has shown that the contents of visual working memory could be decoded concurrently with passively viewed distractors. The present fMRI study tested whether this finding extends to auditory working memory and to active distractor processing. We asked participants to memorize the pitch of a target sound and to compare it with a probe sound presented after a 13 s delay period. In separate conditions, we compared a blank delay phase (no distraction) with either passive listening to, or active processing of, an auditory distractor presented throughout the memory delay. Consistent with previous reports, pitch-specific memory information could be decoded in auditory cortex during the delay in trials without distraction. In contrast, decoding of target sounds in early auditory cortex dropped to chance level during both passive and active distraction. This was paralleled by memory performance decrements under distraction. Extending the analyses beyond sensory cortex yielded some evidence for memory content-specific activity in inferior frontal and superior parietal cortex during active distraction. In summary, while our findings question the involvement of early auditory cortex in the maintenance of distractor-resistant working memory contents, further research should elucidate the role of hierarchically higher regions.SIGNIFICANCE STATEMENT Information about sensory features held in working memory can be read out from hemodynamic activity recorded in human sensory cortices. Moreover, visual cortex can in parallel store visual content and process newly incoming, task-irrelevant visual input. The present study investigated the role of auditory cortex for working memory maintenance under distraction. While memorized sound frequencies could be decoded in auditory cortex in the absence of distraction, auditory distraction during the delay phase impaired memory performance and prevented decoding of information stored in working memory. Apparently, early auditory cortex is not sufficient to represent working memory contents under distraction that impairs performance. However, exploratory analyses indicated that, under distraction, higher-order frontal and parietal regions might contribute to content-specific working memory storage.

Long-term patient-reported outcomes after anterior distraction osteogenesis of the maxilla in patients with cleft

Maxillary growth inhibition in patients with cleft lip and palate (CLP) is an undesired effect that may occur in the teens despite proper primary care. Dental malocclusion and distortion of facial appearance can be treated with external distraction osteogenesis (DO) of the maxilla. This entails a Le Fort I osteotomy, fastening a semi-circular distractor to the skull, distraction for three weeks, and fixation for three months before removal of the device. The aim of this descriptive long-term follow-up study was to evaluate DO of the maxilla from the patient-reported long-term perspective. Fourteen patients underwent a long-term follow-up including a questionnaire regarding their experience of DO. Sex, CLP diagnosis, age at DO and follow-up, and time required for active distraction and fixation were noted. Furthermore, documentation on rhinoplasty, lip plasty and velopharyngeal plasty after DO was registered. Objective results were assessed by a positive dental overjet in the front. Ten patients considered the distractor an everyday constraint, but all thought the procedure was worthwhile and would recommend it to others. Thirteen patients experienced improved bite and chewing, whereas one considered function unchanged. All were satisfied with their dental alignment. Three patients underwent a velopharyngeal plasty after DO. Moreover, six rhinoplasties and two lip plasties were performed. Despite a long and challenging treatment, teenagers and young adults with CLP and maxillary hypoplasia tolerate DO of the maxilla very well. Secondary measures to improve speech and appearance are often indicated.

The effect of active distraction compared to midazolam in preschool children in the perioperative setting: A randomized controlled trial

PurposeThe primary purpose of this study was to compare the effect of active distraction to midazolam as a non-pharmacological method of reducing preoperative anxiety in preschool children. A secondary purpose was to compare emergence delirium, sedation/agitation, and length of stay between groups. Design and methodsPreschool children (N = 99) scheduled for elective surgery participated in this 2-group randomized controlled trial: the active distraction (tablet) group (n = 52) had unlimited playtime with a tablet and the midazolam group (n = 47) were medicated approximately 10 min before mask induced anesthesia. Data were collected using the modified Yale Preoperative Anxiety Scale, Pediatric Anesthesia Emergence Delirium scale, and Richmond Agitation Sedation Score. Length of stay (LOS) was measured in minutes from PACU admission to discharge. Wilcoxon rank sum, Pearson's chi square, and Fischer's exact tests were used in analysis. ResultsPreschool children (3–5 years old), predominantly male (61%) and White (85%) presented for ear, nose, throat, ophthalmology, urology, and general surgery at a pediatric surgical center within a large Midwestern hospital. There was no significant difference in anxiety, emergence delirium, or sedation/agitation scores between midazolam and tablet groups. Children assigned to the tablet group had shorter LOS (p = 0.021). ConclusionActive distraction with a tablet as an anxiolytic was as effective as midazolam for pre-school aged children with no side effects and reduced length of stay. Practice implicationsPreoperatively, non-pharmacological methods such as active distraction with a tablet should be considered for preschool children as an alternative to medication.

Relapse rate and magnitude of relapse after mandibular distraction osteogenesis (MDO) in adult retrognathic patients

ObjectivesThe objective of the present study was to analyze the relapse rate and the magnitude of relapse after mandibular distraction osteogenesis (MDO) using cephalometric measurements. Materials and methodsThe sample comprised 63 patients (49 women, 14 men) with moderate to severe mandibular retrognathia, mean age of 22.6 years, who underwent MDO between 2010 and 2021. Data were collected from CBCTs recorded preoperatively (T0), after the active distraction phase (T1), and 12 months after the distraction phase (T2). Two-dimensional cephalometry analyses were performed. ResultsThe mean cephalometric advancement was at T1 for mandibular body length (MBL) 10.30 mm, for mandibular unit length (MUL) 8.00 mm, and for SN-Pog 4.84°. At T2, MUL decreased by 0.26 mm (p = 0.14), and MBL by 0.22 mm (p = 0.39). A positive correlation between the magnitude of distraction and the magnitude of relapse was identified (MBL p = 0.045; MUL p = 0.002). ConclusionsMDO is a reliable method of advancing the mandible in retrognathic adult patients.

Penggunaan Teknologi Sistem Informasi dan Manajemen sebagai Tehnik untuk Menurunkan Nyeri dan Ansietas pada Pasien Anak

This study aims to synthesize evidence/literature on the use of information system technology in applying active and passive distraction techniques to reduce pain scores in pediatric patients. The research method used in this study is a literature review. The research results based on the search for articles using the PICOT framework in the database Google Scholar were limited to the range of the last ten years, 2010-2020, which obtained five journals. The results showed that active and passive distraction techniques reduced pain scores in pediatric patients. In conclusion, active and passive distraction techniques can be used as non-pharmacological therapy that nurses can do to score pain in pediatric patients.&#x0D; &#x0D; Keywords: Distraction, Pain, Pediatric Patients

Smoking Affects Bone Healing and Blood Perfusion

Nicotine is the primary component in cigarettes that is responsible for the negative effects that tobacco has on the body. Nicotine is also the primary component responsible for the addiction that can develop from smoking. Tobacco addiction is also primarily caused by nicotine, which is another component of tobacco. Aim: The effect that nicotine has on the rate at which bones can recover after being shattered is still a topic of ongoing debate. The study of bone repair and regeneration is made a great deal easier by the utilisation of a model that is known as distraction osteogenesis. The mandibular extension of a rabbit model is serving as the subject of the inquiry that is now being conducted. Duration &amp; Place of Study: October 2018 to March 2021 Rashid Latif medical college Lahore Method: Using the rabbit as a test subject, the purpose of this study is to evaluate the influence that nicotine has on blood perfusion, angiogenesis, and bone formation. There were a total of forty rabbits, and they were distributed among the control group, which received no nicotine, and the nicotine group, which received nicotine. The bunnies were distributed to the several groups in a haphazard manner. It was discovered that each rat had been exposed to nicotine or a placebo for a total of seven weeks during the course of the experiment. After a period of consolidation time ranging from two to four weeks post osteotomy, the animals were slaughtered and their mandibles were removed. After this, there was a lag time of three days, and then there was active distraction for eleven days. Utilizing the techniques of Laser Doppler monitoring and Collagen IV immunohistochemical labelling, respectively, allowed for the assessment of both vascularization and blood perfusion. Studies that were radiographic, histological, and immunohistochemical in nature were carried out in order to investigate the development of bone. Result : According to the findings, being exposed to nicotine led to an increase in the density of microvessels, but it had a detrimental effect on the flow of blood and the development of bones. In addition to this, it was found that the expression of bone morphogenetic protein (BMP)-2 in osteoblasts was lower than it had been in the past. In the process of distraction regeneration, ischemia and a low oxygen tension were both present, and the creation of cartilage islands on a consistent basis was a sign of both of these circumstances. Result: As a result of our investigation, we got to the realisation that nicotine consumption slows down the process of bone regeneration. We hypothesise that this takes place as a result of the fact that nicotine leads to ischemia and has an effect that is directly inhibitory on osteoblastic cells. It has been demonstrated that nicotine causes an increase in angiogenesis; however, this improvement is not adequate to compensate for the harmful effect of vasoconstriction caused by nicotine.

Virtual reality and its use in post-operative pain following laparoscopy: a feasibility study

Pain following laparoscopic surgery remains a neglected healthcare issue. Virtual reality-mediated therapy’s (VRT) analgesic potential could address this. However, its effect in this setting remains unexplored. We aimed to establish the feasibility and safety of VRT as an adjunct analgesic following gynaecological laparoscopy and explore differences between active distraction and passive meditation content. 35 women were enrolled into an open crossover pilot and randomised to either intervention group 1 (active then passive content) or intervention group 2 (passive then active content) following surgery. VRT was administered in two 10-min segments with a 10-min washout period in between. Pain scores, opioid requirements and side effects were recorded before and after each segment whilst questionnaires evaluated acceptability. We observed a significant reduction in pain over time for the entire study population (F = 8.63, p < 0.0005) but no differences between intervention groups, in contrast to many studies demonstrating an increase in pain during this time. During segment one, intervention group 1 (n = 18) were administered significantly less opioid than intervention group 2 (n = 17) [0.0 (0.0–7.5) vs. 3.0(0.0–10.0), p = 0.04]. Intervention group 1 rated the VRT experience significantly higher than intervention group 2 (7.97 vs. 6.62. p = 0.017). 97.1% (n = 34) would recommend VRT to a friend and use it as the standard-of-care in future procedures. These results demonstrate that post-operative VRT is feasible and safe. However, adequately powered studies are needed to appropriately determine its efficacy.

Histologic features of bone regenerated by means of negative pressure in the context of odontogenic keratocyst.

The objective of the present research is to describe the histologic features of the bone regenerated by means of negative pressure (sugosteogenesis) in a group of patients diagnosed with odontogenic keratocyst (OKC) who underwent active decompression and distraction sugosteogenesis (ADDS) at our institution. The authors designed a retrospective case series study. The population included patients with a histologic diagnosis of odontogenic keratocyst in whom active decompression and distraction sugosteogenesis followed by enucleation was performed. All patients were seen and followed from July 2019 to January 2021. The investigation was approved by the Institutional Review Board, and it observed the Declaration of Helsinki on medical protocol. Variables of this study included age, gender, anatomic location (mandible or maxilla), and histologic characteristics of the bone regenerated by means of negative pressure. Histologic features were defined as being consistent or inconsistent with viable mature bone. Bone biopsies of 6 patients were considered. In total, 83.33% of patients were males and 16.66% females. One hundred percent of the bone samples subjected to negative pressure showed features of viable mature bone. In this study, the histological features of the bone subjected to negative pressure demonstrated the normal characteristics of the mature, normal bone.