Pain In Children Research Articles

Multiple Dose Pharmacokinetics of Tapentadol Oral Solution for the Treatment of Moderate to Severe Acute Pain in Children Aged 2 to

BackgroundThis prospective, open-label trial was conducted to fulfil a post-approval commitment made to the competent authorities to extend the indication of the strong opioid analgesic tapentadol hydrochloride oral solution (OS) to the pediatric population.Patients and MethodsThe trial assessed the pharmacokinetic (PK) profile of tapentadol, tapentadol-O-glucuronide and tapentadol-O-sulfate after administration of multiple doses of tapentadol OS (1.25 mg tapentadol/kg bodyweight every 4 h for up to 72 h) in children aged 2 to <7 years after a painful event that produces acute pain requiring treatment with a strong analgesic. The obtained PK data were integrated into a previously developed population PK (popPK) model based on single-dose data and then a model-based PK evaluation was performed. The primary trial endpoint was the area under the concentration-time curve at steady state for the dosing interval (AUCτ,ss) for tapentadol.ResultsTen children received tapentadol OS; all completed the trial. Multiple administrations of the trial medication resulted in tapentadol serum concentrations within the concentration range predicted by the previously developed popPK model. The estimated model-based AUCτ,ss values for tapentadol ranged from 142 to 321 h•ng/mL. They were within the predicted exposure range with no higher than expected accumulation for the employed dosing regimen and also within the targeted steady state exposure range observed in adults receiving multiple doses of immediate release tapentadol 50 to 100 mg. The treatment regimen was safe and well tolerated.ConclusionThe findings confirm the linear and predictable PK profile of tapentadol hydrochloride. The good agreement between the observed data and the model predictions shows the value of modelling and simulations in the planning and analysis of pediatric clinical trials and the ability to utilize the established PK models to predict multiple dose exposure.

Non-Pharmacological Management for Vaccine-Related Pain in Children in the Healthcare Setting: A Scoping Review.

PurposeTo examine how research was conducted on non-pharmacological management in children with vaccine-related pain in the healthcare setting, so as to provide reference for the relief of vaccine-related pain in children.MethodsThis study conducted a scoping review guided by the methodological framework of Arksey and O’Malley. MEDLINE, Cochrane Library, EMBASE, CINAHL, PubMed databases were searched in detail, and search strategy included the keyword “vaccine”, the keyword “pain”, and the keyword “children”. Two researchers conducted literature screening and data extraction independently, and any disagreements were resolved through team consultation.ResultsThis study retrieved 1017 literatures, of which 22 were finally included, including 18 randomized controlled studies, 3 quasi-experimental studies and 1 cohort study. Non-pharmacological management measures were summarized in the study, mainly involving taste, tactile, olfactory, visual, exercise, and postural interventions and injection technique. All the above non-pharmacological management were effective in mitigating vaccine-related pain in children. The study population in the included literatures was mainly neonates and infants. Regarding the analgesic effects of taste intervention, breastfeeding was better than sweeteners, and sweeteners were better than sterile water or non-nutritive sucking. However, there was a lack of comparative studies on the analgesic effects of other non-pharmacological management.ConclusionThere are many non-pharmacological management measures with varying analgesic effects. Diversified non-pharmacological management measures can provide more analgesic choices for children. For reducing vaccine-related pain in newborns and infants, breastfeeding is recommended first, then sweeteners, and then non-nutritious sucking. In addition to the taste intervention, the analgesic effects of other non-pharmacological management measures need further comparative studies. Moreover, medical staff can use a combination of non-pharmacological analgesic measures to maximize the analgesic effect, and medical staff should also fully consider the analgesia willingness of children and parents.

Clinical, laboratory characteristics and growth outcomes of children with growing pains

Growing pains (GP), a common and benign pain syndrome of unknown etiology, is characterized by bilateral recurrent leg pain in childhood. There are no standardized diagnostic criteria for GP, and the diagnosis is often made by exclusion. To identify clinical and laboratory features, we included patients < 12 years with GP at National Taiwan University Children’s Hospital between April 2006 and April 2019 in a retrospective study. We also compared body weight and body height z-scores between diagnosis and up to 2 years post-diagnosis to determine if rapid growth was associated with GP. This cohort study included 268 patients with a mean age of 4.7 ± 2.2 years. The most common features of GP were bilateral leg pain, no limitation of activity, intermittent pain, normal physical examination, and being well physically. The average number of Walters' criteria fulfilled by the patients with GP was 6.7 ± 0.9. Elevated serum levels of alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were observed in 37.5% and 15.6% of patients, respectively. Symptomatic medications were used in 33% of patients. Our study indicates that ALP and LDH may be biomarkers associated with GP. There was no significant association between GP and rapid growth within 2 years of diagnosis.

Childhood Adversity Among Adults With Chronic Pain: Prevalence and Association With Pain-related Outcomes.

Adverse childhood experiences (ACEs) have been linked to the development and impact of chronic pain in adulthood. The goal of this study was to investigate the prevalence of ACEs in a treatment-seeking sample of adults with chronic pain and the relationship between number and type(s) of ACEs and pain-related outcomes. Adults (N=1794) presenting for treatment at a multidisciplinary pain management center completed self-report measures of childhood adversity, pain, functioning, emotional distress, and adjustment to pain. Participants endorsing ≥4 ACEs had significantly worse pain-related outcomes and lower quality of life compared with individuals reporting fewer ACEs. Having ≥3 ACEs was associated with higher anxiety and depression levels. Experiences of childhood neglect negatively affected mental health-related outcomes independent of the number of ACEs. Significant sex differences were found in the number and type of ACEs reported but not in the relationship between ACEs and outcome variables. Findings suggest that the number and the type of self-reported ACE(s) are associated with pain-related variables and psychosocial functioning in adults with chronic pain. The results highlight the importance of assessment of ACEs and trauma-informed care with patients with chronic pain.

A rare case of a juvenile polyp of patient with Peutz-Jeghers syndrome, complicated with intussusception of the small intestine

We report a rare case of Peutz-Jeghers syndrome (PJS) in a 35-year-old female. The patient was diagnosed with PJS when she was 11 years old. She has remained under observation since then. We strongly believe that PJS is a very rare diagnosis. However, it can have serious complications such as the intussusception we observed in our patient. Her condition (recurrent abdominal pain and vomiting) in childhood required further diagnostic procedures. Although the diagnosis of PJS was made, among many resected polyps, one of them appeared to be a juvenile polyp. The diagnosis was confirmed in the histopathology report, which was incredibly unique. Genetic testing revealed LKB1/STK11 gene mutation. Clinicians should be aware of the malignant potential in the course of PJS. Hence, these patients require tailor-made management, long-term follow-up, and our particular attention.

DEVELOPMENT OF THE INDONESIAN VERSION OF MULTIDIMENSIONAL ASSESSMENT OF PAIN SCALES (MAPS-I) TO MEASURE POST OPERATIVE PAIN IN CHILDREN

Currently, postoperative pain management in children has not been adequate. There are about 40% of children get postoperative pain of moderate to severe scale. Ineffective pain management will cause chronic persistent postsurgical pain (CPSP) with an incidence of 50% in children. The fact is that postoperative pain management in children is due to the difficulty of assessing children's pain. The method used to assess pain in children is to use a multidimensional self-report to assess the scale of postoperative pain in children. The Multidimensional Assessment of Pain Scale instrument is an instrument that assesses postoperative pain in children multidimensionally but has not been translated into Indonesian validly and reliably. The purpose of this study was to determine the development of the Multidimensional Assessment of Pain Scale to measure postoperative pain in children. The Indonesian version of the Multidimensional Assessment of Pain Scale (MAPS-I) instrument consists of 5 categories with 3 scoring scores from 0-2. This research is quantitative research with a cross sectional design. The validity test that was measured was content validity and construct validity. The reliability test was measured using Cronbach Alpha. The MAPS-I instruments with postoperative child respondents showed good validity with Aiken's value range of 0.83-1. The results of the construct validity of the MAPS-I instrument are all valid items. The results of the factor analysis stated that there were 2 valid items (factor loading&gt;0.5) with 2 factors formed (Eigenvalue&gt;1). Internal consistency reliability shows the results of Cronbach Alpha of 0.804 (&gt; 0.482) for postoperative child respondents. The MAPS-I instrument can be used as an instrument to measure the level of pain in postoperative children that is valid and reliable.&#x0D; Keywords: Children; Postoperative Pain; Multidimensional Assessment of Pain Scale

“Persistent Post-Operative Pain in Children – An Argument for a Transitional Pain Service in Pediatrics”

BackgroundPersistent post-operative pain continues to occur in pediatric patients. Despite the growing amount of literature on causes, there is little discussion on treatment and prevention with a majority of studies focusing on specific surgeries. AimThe aim of this retrospective chart study is to identify risk factors and clinical features of persistent post-operative pain after any surgery in a pediatric quaternary complex pain service, describe the pharmacologic and non-pharmacologic management in children, and explore options to improve outcomes, in particular, the introduction of a transitional pain service. MethodsA retrospective chart review recorded demographics, gender, age, pain location and surgery type, treatment, and outcomes of 31 children identified through relevant registers over a 2-year period. ResultsA total of 31 children were positively identified as having persistent post-operative pain and were seen in the complex pain clinic. Consistent with the literature, most cases represented neuropathic pain and persistent post-operative pain was most commonly seen after orthopedic surgery. All but four children had resolution of their pain after implementing the pain management plan. Management was characterized by early intervention, emphasis on non-pharmacologic strategies, and conservative use of opioids. ConclusionsIdentifying risk factors is useful, however putting strategies into place for prevention is necessary. Early intervention and the implementation of strategies before and immediately after are best provided by a transitional pain service.

‘Just little tricks’: an exploration of treating children in pain

Background: Pain is one of the commonest symptoms in patients of all ages presenting to ambulance services. Children in pain make up a relatively small proportion of the number of those attended by prehospital care and pain management is needed in only 40% of cases. This might go some way to explain why the management of paediatric pain is perceived to be poor. Aim: The primary aim of this study was to explore the experiences of UK paramedics in treating children in pain. Methods: A phenomenological study was undertaken using a purposeful sample of UK paramedics (n=12) to explore their experiences and decision-making during the treatment of children in pain. Results: Five themes became apparent through analysis—preparation and education; adaptation and change of approach; organisational and legal factors; support and guidance; familial and carer impact—with some crossover between themes noted. Conclusion: Clinicians are aware of multimodal techniques for managing pain in children but are often less confident in the use of pharmacological than non-pharmacological management methods. Advances in the use of technology in practice have enabled clinicians to use alternative measures to manage children in pain. However, while using these methods, practitioners lack confidence that they are meeting social expectations of their roles.

Using the Parent Risk Screening Measure (PRISM) to Assess Pain-Related Risk Factors in Parents of Youth Seeking Treatment for Acute Musculoskeletal Pain.

The Parent Risk Screening Measure (PRISM) rapidly assesses parent distress, psychosocial function, and behaviors associated with child pain-related dysfunction in parents of youth with chronic pain. Recognizing the importance of parent pain-related cognitions and responses to pain during the acute pain period, the current study examined the utility of the PRISM in screening parents of youth with acute pain. Participants were 175 parent-youth dyads taking part in a larger study examining risk and resilience in youth with acute musculoskeletal pain. Parents completed the PRISM and a battery of measures reporting on their child's pain-related disability and cognitions and behaviors in response to their child's pain. Youth reported on their pain, pain-related disability, pain-related fear, catastrophizing, and pain self-efficacy. PRISM total scores ( M =2.55, SD=2.77) were correlated with many parent and child report measures (eg, protectiveness, catastrophizing, and pain-related fear), with higher scores associated with greater symptoms. Using published PRISM cutoffs, 86.9% of parents were classified as low and 13.13% as elevated risk. t tests revealed significant differences between elevated and low-risk groups on several measures. Moreover, youth of parents in the elevated risk group were more likely to meet clinical cutoffs on pain catastrophizing and fear avoidance measures. Findings suggest the PRISM is useful in screening for parent distress and behaviors associated with elevated pain symptomatology in a pediatric acute musculoskeletal pain sample. The important next steps are to identify the ideal time for administering the PRISM and to examine the associations among PRISM scores and pain outcomes over time.

Untreated Children's Pain Matters

Every day, healthcare practitioners perform simple medical procedures to assess and treat sick or injured children, and can cause them significant pain and distress.1,2 These common procedures include intravenous cannulation, heel lances, lumbar punctures, urethral catheterizations, wound repair, and medical imaging of injured limbs. Unfortunately, fear of needles is common, and is estimated to affect one quarter of adults and almost 2/3 of children.3 Almost 1/5 Canadian caregivers report needle fear as the primary reason for immunization non-compliance.4 While 5–7% have mentioned needle fear as a contributing factor to their COVID-19 vaccine hesitancy.

Parental Involvement in Psychological Interventions for Recurrent Abdominal Pain in Childhood

ABSTRACT There are a variety of different psychological interventions used to treat recurrent abdominal pain in childhood. Active components in these interventions are unclear. Parents play an important role when it comes to their children's response to pain and management of pain, and are regularly involved in interventions. Four electronic databases were searched (CINAHL Complete, Medline, APA PsychArticles and APA PsychInfo) in order to examine in what ways parents are involved across different therapeutic modalities, and interventions delivered in a variety of formats. In this descriptive review of the literature, 30 studies were included with a total of 1848 participants ranging from age 4–18. The review also discusses the outcomes of studies involving parents. Most of the studies in this review involved parents through psycho-education about pain and strategies for managing pain, however, it remains unclear how parental involvement impacts outcomes. Further research is needed to determine the active components in psychological interventions for recurrent abdominal pain. This research should also include how parental involvement impacts these interventions.

A prospective randomized controlled study on the effects of compound analgesia in ultra-pulsed fractional carbon dioxide laser treatment of post-burn hypertrophic scars in children

Objective: To investigate the effects of compound analgesia on ultra-pulsed fractional carbon dioxide laser (UFCL) treatment of post-burn hypertrophic s in children. Methods: A prospective randomized controlled study was conducted. From April 2018 to March 2020, 169 pediatric patients with post-burn hypertrophic s admitted to the First Affiliated Hospital of Air Force Medical University were randomly divided into general anesthesia alone group (39 cases, 19 males and 20 females, aged 35 (21, 48) months), general anesthesia+lidocaine group (41 cases, 23 males and 18 females, aged 42 (22, 68) months), general anesthesia+ibuprofen suppository group (41 cases, 25 males and 16 females, aged 38 (26, 52) months), and three-drug combination group with general anesthesia + lidocaine+ibuprofen suppository (48 cases, 25 males and 23 females, aged 42 (25, 60) months), and the pediatric patients in each group were treated with corresponding analgesic regimens when UFCL was used to treat s, and the pediatric patients were given comprehensive care throughout the treatment process. The pain degree of pediatric patients scar was evaluated by facial expression,legs,activity,cry,and consolability (FLACC) of children's pain behavior scale at 0 (immediately), 1, 2, and 4 h after awakening from the first anesthesia, respectively. At 4 h after awakening from the first anesthesia of postoperative pain assessment, the self-made analgesia satisfaction questionnaire was used to evaluate the satisfaction for the analgesic effect of the pediatric patients or their families, and the satisfaction rate was calculated. Within 2 h after the first operation, the occurrences of adverse reactions of the pediatric patients, such as nausea and vomiting, headache, dizziness, drowsiness, etc, were observed and recorded. Before the first treatment and 1 month after the last treatment, the Vancouver scar scale (VSS) was used to evaluate the pediatric patients scar, and the difference value between the two was calculated. Data were statistically analyzed with least significant difference test, Kruskal-Wallis H test, chi-square test and Fisher's exact probability test. Results: At 0 h after awakening from the first anesthesia, the FLACC scores of pediatric patients in general anesthesia+lidocaine group, general anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than those in general anesthesia alone group (P<0.01). The FLACC scores of the pediatric patients in anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than that in general anesthesia+lidocaine group (P<0.01), and the FLACC score of the pediatric patients in three-drug combination group was significantly lower than that in general anesthesia+ibuprofen suppository group (P<0.01). At 1 and 2 h after awakening from the first anesthesia, the FLACC scores of pediatric patients in general anesthesia+ibuprofen suppository group and three-drug combination group were both significantly lower than those in general anesthesia alone group and general anesthesia+lidocaine group (P<0.01), and the FLACC score of the pediatric patients in three-drug combination group was significantly lower than that in general anesthesia+ibuprofen suppository group (P<0.01). At 4 h after awakening from the first anesthesia, the FLACC scores of the pediatric patients in general anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than those in general anesthesia alone group and general anesthesia+lidocaine group (P<0.01). At 4 h after awakening from the first anesthesia, the satisfactions rate with the analgesic effect in the four groups of pediatric patients or their families were 79.49% (31/39), 85.37% (35/41), 87.80% (36/41), and 97.92% (47/48), respectively. The satisfaction rate of the pediatric patients in three-drug combination group was significantly higher than those in general anesthesia alone group, general anesthesia+lidocaine group, general anesthesia+ibuprofen suppository group. Within 2 h after the first operation, there was no significant difference in the overall comparison of adverse reactions such as nausea and vomiting, headache, dizziness, and drowsiness of pediatric patients among the 4 groups (P>0.05). The VSS scores of pediatric patients before the first treatment, 1 month after the last treatment, and and the difference value between the two in the 4 groups were not significantly different (P>0.05). Conclusions: Three-drug combination for analgesia has a good effect in the treatment of hypertrophic scars after burn in pediatric patients with UFCL. Pediatric patients or their families are highly satisfied with the effect, and the treatment effect and incidence of adverse reactions are similar to other analgesic regimens, so it is recommended to be promoted in clinical practice.

Pediatric chronic post-surgical pain prevalence, pain scores, and quality-of-life: results of an exploratory patient survey at a single-center tertiary care children's hospital.

Twenty percent of children may develop chronic post-surgical pain (CPSP), but studies investigating pediatric CPSP are limited in scope. In an exploratory patient survey, we sought to assess CPSP prevalence among children of all ages, across a wide range of surgeries, and over an extended period of time after surgery. We conducted a survey study, including patients < 19years of age at the time of their surgery at a single-center, quaternary care academic pediatric hospital. Pediatric patients who underwent surgery from May 2014 to August 2019 were included. Via electronic survey, patients/caregivers were asked whether the child had any pain related to their last surgery at the pediatric hospital. Patients/caregivers who answered yes were asked 11 additional questions about the child's pain and pain-related quality of life. The primary outcome was CPSP prevalence; secondary outcomes were pain scores, quality-of-life scores, and the associations of CPSP with time since surgery, preoperative pain, and patient age. The response rate of completed surveys was 4.0%. 30% of respondents reported CPSP; the median pain score was 4.0 on an 11 point scale (0 to 10). Responses to quality of life questions indicated CPSP negatively impacted many children's lives. Preoperative pain was associated with an odds ratio for CPSP of 1.09 [95% confidence interval (CI): 0.58, 2.04], each year after surgery with an odds ratio of 0.94 (95% CI 0.80, 1.10), and each year of age at surgery with an odds ratio of 1.07 (95% CI 1.02, 1.12). While limited by a low response rate, results from this exploratory survey suggest that CPSP is a considerable problem for children who undergo surgery across many specialties, with marked effects on patient well-being even years after surgery.

Dimensi Culture dalam Perilaku Kesehatan Orang Tua Terhadap Anak Usia Balita di Desa Selandaka, Kabupaten Banyumas

Child health maintenance efforts are aimed at preparing a healthy, intelligent, and qualified generation and to reduce child mortality. Efforts to maintain the health of children are carried out since the fetus is still in the womb, born, after birth, and until the age of 18 (eighteen) years. Child health efforts, among others, are expected to reduce neonatal mortality (AKN), infant mortality (AKB), and toddler mortality (AKBA). Health behavior becomes important to be done by every parent both with the aim to relieve pain and to treat the pain suffered by their children. Related to health behaviors carried out by parents, the cultural dimension is reflected into family habits, especially those carried out by their parents and then passed down to their children. The purpose of this study is to find out the cultural dimension in influencing parents' health behavior in dealing with their child's pain, especially those who are still toddlers. The dimension of culture in relation to the health behavior of parents towards their toddlers who are sick is more due to habits, there are three habits of parents related to health behavior towards their children, namely by using baby shaman massage, treatment to health facilities, and doing self-medication. This happens because the dimension of culture exerts a different influence on each category of informants. The influence is in the form of habits carried out by their families, but also influenced by other factors such as busyness, experience, and education level.

Comparison of the Efficacy of Homeopathic Drug Arnica and Ibuprofen on Postextraction Pain in Children: A Triple-blind Randomized Controlled Trial.

AimTo compare the homeopathic drug Arnica with ibuprofen as an analgesic for postextraction pain control in children.Materials and methodsForty-four healthy children between 8 and 12 years of age requiring two clinical sessions of tooth extraction in two different quadrants of the oral cavity were selected for the study. All the children received both the drugs in this crossover trial with a washout of 10 days. Patient-rated and operator-assessed pain was compared to a 10-point validated Visual Analog Scale at baseline, 24, 48, and 72 hours using the paired t-test. Acceptance to taste and frequency of dosing was recorded at the end of three days using a five-point Likert scale and were compared using the Chi-squared test. Kappa statistics were performed to assess intraoperator variability.ResultsPain reduction by Ibuprofen was significantly more than Arnica only at 48 hours with respect to both patient-reported and operator-assessed pain [(t = 3.567, p < 0.05), (t = 2.834, p < 0.05)]. As the age of the child increased, patient-reported pain significantly decreased. Children preferred the taste of Arnica over that of Ibuprofen (x2 = 56.76, p < 0.0001).ConclusionThere was no difference between Arnica and Ibuprofen in the postextraction pain management in 8–12-year-old children.Clinical significanceThe results of this study suggest that Arnica may be considered as an alternative to ibuprofen in managing postextraction pain in 8–12-year-old children, especially those with asthma, COPD, or known allergy to ibuprofen.How to cite this articleThakur JH, Katre AN. Comparison of the Efficacy of Homeopathic Drug Arnica and Ibuprofen on Postextraction Pain in Children: A Triple-blind Randomized Controlled Trial. Int J Clin Pediatr Dent 2022;15(3):332-337.

VISUAL ANALOGUE SCALE AS A TOOL FOR ASSESSING QUALITY OF LIFE (PEDSQL™) AND EMOTIONAL STRESS IN CHILDREN AFTER ANTERIOR ABDOMINAL WALL SURGERY

Introduction. The prevalence of chronic postsurgical pain can be as high as 54%. Almost 17% of adult chronic pain patients report a history of chronic pain in childhood or adolescence. Untreated chronic pain in children increases the risk of developing mental disorders later in life. Health-related quality of life (HRQoL) is a commonly used indicator of health and well-being that demonstrates the impact of health on quality of life and reflects the desirability of health states relative to perfect health. The simplicity, reliability, validity, and easy determination of visual analogue scale (VAS) scores provides for its wide-ranging application in various clinical cases. The aim of this study was to assess quality of life in children after anterior abdominal wall surgery using the PedsQL™ 3.0 Present Functioning Visual Analogue Scales. Materials and Methods. Following the inclusion and exclusion criteria, a total of 80 children undergoing treatment at the surgical department of a Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council” were enrolled in the study. Among them, 60 children underwent anterior abdominal wall surgery with various types of anesthetic regimens. The patients were asked to fill in the questionnaires repeatedly three and six months after hospital discharge. Results. According to the VAS, three and six months after surgery, quality of life was significantly lower in children who underwent anterior abdominal wall surgery under general anesthesia with opioids and were diagnosed with chronic pain syndrome (p&lt;0.01). Their quality of life was significantly lower due to excessive emotional stress secondary to chronic pain syndrome (p&lt;0.001). Discussion. Three months after surgery, children with chronic pain syndrome who underwent conventional anesthesia had high VAS scores experiencing reduced quality of life and elevated emotional stress as compared to the control group (p&lt;0.001). Six months after surgery, in children who underwent regional analgesia, the levels of quality of life and emotional stress almost approached those in the control group as compared to children who underwent conventional anesthesia (p&lt;0.001). Conclusions. Chronic pain syndrome reduced quality of life in children at the age of 7-18 years who underwent anterior abdominal wall surgery by increasing overall emotional stress. The myofascial block in conjunction with general anesthesia accelerates patient’s recovery, relieves pain, and reduces emotional stress.

Parental knowledge, awareness and acceptance of silver diamine treatment among patients from Modinagar, Uttar Pradesh, India.

Silver diamine fluoride has emerged as a non invasive effective therapy for arresting active carious lesions. Therefore, it is of interest to assess parental knowledge, awareness and acceptance of SDF. A cross sectional questionnaire based survey was conducted among 62 parents visiting the Department of Pedodontics along with their children in Modinagar. A 15 item pre-validated questionnaire was used to record baseline characteristics of child's parents and their knowledge, awareness and acceptance of SDF for their child for prevention of dental caries. 80.6% participants were aware that SDF is painless procedure whereas majority of the participants were not sure about whether placement of filling required post SDF treatment (48.4%), SDF treatment be done outside dental clinic (61.3%), and about any agents that reduce SDF staining (64.5%). Majority 71% participants were aware about SDF treatment's side effects, 90.3% aware whether their child experienced teeth blackening after SDF treatment and 83.9% aware about whether SDF treatment immediately relieves the child's pain. 90.3% preferred SDF treatment, 83.9% opted for SDF treatment despite of its tooth blackening effects. A statistically significant association was found between SDF acceptance and age of their child. There is a lack of knowledge about SDF among the study participants emerging a need for proper education to them when they visit a dental setting with their child. Although it causes discolouration of teeth post SDF treatment, still parents are willing to accept SDF as a treatment modality for their child's oral health.

Effectiveness of art-based distraction in reducing pain and anxiety of hospitalized children during cannulation procedure: A randomized controlled trial.

Peripheral venous cannulation (PIVC) is one of the most common needle procedures associated with the therapies of pediatric patients, which causes pain and anxiety in children. Trace Image and Coloring for Kids-Book (TICK-B) is one of the arts-based interventions to relieve pain and anxiety, but none of the existing studies use the TICK-B to decrease children's pain intensity and anxiety levels during PICV. This study aimed to investigate the effectiveness of the Trace Image and Coloring for Kids-Book (TICK-B) in decreasing children's pain and anxiety during PIVC. A parallel, randomized, double-blind controlled trial was used in this study. Children aged 6-12 years were randomly allocated to one of two groups: intervention or control. The intervention group (n = 48) received the TICK-B during the PIVC, compared to no intervention in the control group (n = 52). The children, their parents, and an observer nurse rated outcomes 1-2 min after completion of the procedure. The patients in both groups were similar in age, gender, duration of hospitalization, injections, mother's age, and education. Faces Pain Scale-Revised (FPS-R), Children's Fear Scale (CFS), and Visual Analog Scale (VAS) were used to measure pain and anxiety. Paired and independent t-tests were used for data analysis. Patients in the intervention group reported significantly reduced pain levels than those in the control group (p <0.001), as reported by children (3.08 vs. 7.06), parents (3.08 vs. 7.13), and the observer nurse (3.06 vs. 7.13), respectively. Anxiety levels were also significantly lower among patients in the intervention group than in the control group (p <0.001), as reported by children (0.88 vs. 3.17), parents (0.94 vs. 3.19), and the observer nurse (0.85 vs. 2.94), respectively. TICK-B is an effective technique for reducing children's pain and anxiety during PIVC. TICK-B is a simple, inexpensive, and effective technique that nurses can use to decrease the levels of pain and anxiety of pediatric patients during intravenous cannulation.

A Delphi Study on the Evaluation and Rehabilitation of Spinal Pain in Children and Adolescents with Overweight and Obesity

The present study aims to reach experts on spinal pain in children/adolescents with obesity and to conduct a Delphi study on the methods used in the evaluation and rehabilitation of the process. Experts experienced in rehabilitation of spinal pain and children/adolescents with overweight/obesity. To collect data, using e-mails, the 16-question form containing assessment and rehabilitation approaches for spinal pain and obesity was sent to clinicians and researchers working on spinal pain in children or adolescents with overweight, obesity. Delphi tour consisted of two rounds. Participants' responses in two rounds were calculated as percentages and numbers. 132 experts were invited, 14 experts participated in the first round and 10 experts participated in the second round. In the first round, eleven experts from Turkey, two experts from Cyprus, one expert was from Malta; in the second round nine experts from Turkey, one expert was from Cyprus. Back pain(n=9), neck pain(n=4), low back pain(n=10) as the spinal pain areas where children/adolescents with obesity often experienced pain in the first round; in the second round, back pain(n=3), neck pain(n=3), low back pain(n=7) were reported. In the evaluation methods of pain, Visual Analog Scale(n=11), Faces Pain Scale(n=7), Numeric Rating Scale(n=4) were used. It was reported that Visual Analog Scale(n=7); Faces Pain Scale(n=2), Numeric Rating Scale(n=2) were used in the second round. Considering the exercises given for spinal pain rehabilitation, in the first round, for spinal stabilization exercises(n=6), resistance exercises(n=12), aerobic exercise bicycle(n=8), walking(n=8); in the second round; resistance exercises(n=5), aerobic exercise bicycle(n=5), reported that they recommended walking(n=8). With all these results, it is seen that different approaches are used in the evaluation and rehabilitation methods of spinal pain in children/adolescents overweight/obesity. This study may guide the development of common ideas in assessment-rehabilitation methods of spinal pain in children/adolescents overweight/obesity in clinics.

The concept of pain inventory for children: The reliability and validity study of the Turkish version

Background and purposePain experiences in childhood are very likely to be reflected in adulthood. The early evaluation of the concept of pain in children may eventually lead to.better patient outcomes in the future. Therefore, we aimed to culturally and developmentally adapt the Concept of Pain Inventory for Children (COPI) for Turkish children. MethodsThis descriptive, correlational study was conducted with 239 post-operative children aged 8–12 years between June and December 2021. The research adhered to COSMIN guidelines. The data were collected using a descriptive information form and the COPI. Factor analysis, Cronbach's alpha, and item–total score analysis were used for the data analysis. ResultsThe resulting unidimensional scale consists of 12 items in Turkish. The scale explained 65% of the total variance. The exploratory factor analysis showed that the factor loadings of items ranged from 0.64 to 0.91. The confirmatory factor analysis showed that the factor loadings of items ranged from 0.66 to 0.92. Goodness of fit indexes were found to be as follows: Normed Fit Index >0.90; Incremental Fit Index >0.90; Comparative Fit Index >0.90; and the Root Mean Square Error of Approximation <0.08. The total Cronbach's alpha coefficient of the scale was 0.78 (reliable). ConclusionsThe 12-item Turkish translation of the COPI was deemed valid and reliable in 8–12-year-old children in a post-operative setting. Practice implicationsEvaluation of children's pain concepts during childhood may contribute to the identification of conceptual gaps for pain science education.