Local Administration Research Articles

Pebble tracing experiment at the Promenade des Anglais (Nice, France): A contribution towards beach management efforts

In this paper, the results of a short-term tracing experiment carried out at a beach compartment along the Bay of Nice (southern France) are presented. Nice urban beach is characterized by persistent offshore sediment loss issues that force the local administration to operate frequent artificial replenishments to maintain the current configuration, which also protects the well-renown Promenade des Anglais from high-energy events. As beach refills are quite expensive, the aim of the paper is to provide novel insights about the transport processes of pebble-sized tracers, which might support the Municipality to better adjust future interventions. Pebbles were tracked by means of the Radio Frequency Identification technology, largely used in such settings because of its reliability and efficiency. In addition, the morphology of the beach was monitored during the three-days-long experiment by airborne and ground topographic surveys, as well as the shape and the size of the tracers. Finally, a wave model was produced to simulate wave propagation in the nearshore, which validates the observed transport patterns. The results documented a low recovery rate (56%) 4 h after tracer injection, which is uncharacteristic considering that it jumped to 91% after the second survey, 24 h after the injection. At the end of the experiment (48 h), the recovery rate sank to 14%. These data were adequate to identify a few trends in pebble transport: tracer recovery rate in the swash zone was very low, while many marked pebbles were found at the step crest. Although this transport pattern may corroborate the offshore movement of the sediments, the topographic surveys revealed the destruction and re-formation of the fair-weather berm overnight, which would imply the presence of a shoreward transport under low energy wave conditions. While size did not single out any tendency, shape did: spheres rolled down the beachface earlier than disks; by contrast, disk-shaped pebbles moved for longer distances than spheres. These findings will be useful for local coastal managers because next beach fills will be planned and optimized based on the observed transport patterns. Though the selection of disk-shaped pebbles implies increasing costs, replenishments would be more efficient and fine-tuned for this sector of coast, which would ultimately save resources reducing negative impacts on the environment along the way. These considerations are valid for the Bay of Nice, but they might be useful wherever coarse-clastic beaches need recurring replenishments.

EU awareness: unlocking the European potential of cities and regions

ABSTRACT This article provides insights from a 1-year-long collaboration of four cities, a university of applied sciences and the regional authorities of South-Holland (Netherlands) on how to increase awareness of European (funding, knowledge-sharing, influencing) opportunities for local and regional administrations. Increased Europeanisation can bring significant opportunities for cities and regions, while a lack of awareness amongst directors and decision-makers in local and regional authorities can hinder the ability of these organisations to capitalise on these European opportunities. On the basis of the community of practice a toolbox with 13 practical lessons was developed, and this article provides practical strategies for unlocking the European potential of cities and regions.

A Review of Indigenous Knowledge Systems and Their Application in Sustainable Solid Waste Management

Indigenous communities have always used their knowledge systems to improve their quality of life. For example, rural communities’ resort to indigenous cultural practices to manage their own waste when local administration lacks coordinated ways to manage waste. In the context of indigenous knowledge systems, the idea of waste is non-existent. As indigenous knowledge is believed to provide a holistic framework for an approach that effectively promotes sustainability. As such, the current study conducted a systematic review to evaluate the extent to which indigenous solid waste management practices contribute to sustainable waste disposal methods. Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a literature search was carried out in the field of indigenous solid waste management practices. The results indicate a significant imbalance in the amount of conclusive evidence that has been produced to date that suggests the sustainability of indigenous solid waste management practices. It is for this reason that the current study has discovered a substantial literature gap in sustainable solid waste management associated with indigenous knowledge systems. This is an unprecedented trend, especially for a knowledge system that is supposed to promote sustainability practices. However, to improve the likelihood of incorporating indigenous solid waste disposal methods into modern practices, it is imperative to understand the foundational elements that contribute to the advancement of sustainability, lest the sustainability aspect associated with this knowledge system in the discipline of solid waste management remain a mere rhetoric.

The impact of the COVID-19 epidemic on the district medical officer's role - a qualitative study.

We wished to examine the role of the district medical officer in five Norwegian municipalities to provide new knowledge of how the experience from the pandemic might have led to changes to the district medical officer's role. Semi-structured interviews were conducted with 14 persons who had held key positions in local crisis management teams during and after the pandemic. The informants were recruited from five municipalities within the same county, and they all held leadership roles in health care (district medical officers), local politics or administration. The investigation followed up a study undertaken during the pandemic on an approximately identical study sample. After the pandemic, the function of the district medical officer had been expanded in terms of a greater full-time equivalent percentage, while their organisational placement had remained unchanged in the local administrations that were studied. Political and administrative leaders stated that as a result of their collaboration during the pandemic, they had become more familiar with the district medical officer as a professional and as a resource person in the organisation. The district medical officers reported a higher demand for their expertise in community health. Close and frequent collaboration between the district medical officers and the local administration has helped enhance their mutual knowledge. The expertise of the district medical officers has become better recognised in the organisations, and the parties find it easier to contact each other to draw on each other's competence.

Continuous iontronic chemotherapy reduces brain tumor growth in embryonic avian in vivo models

Local and long-lasting administration of potent chemotherapeutics is a promising therapeutic intervention to increase the efficiency of chemotherapy of hard-to-treat tumors such as the most lethal brain tumors, glioblastomas (GBM). However, despite high toxicity for GBM cells, potent chemotherapeutics such as gemcitabine (Gem) cannot be widely implemented as they do not efficiently cross the blood brain barrier (BBB). As an alternative method for continuous administration of Gem, we here operate freestanding iontronic pumps – “GemIPs” – equipped with a custom-synthesized ion exchange membrane (IEM) to treat a GBM tumor in an avian embryonic in vivo system. We compare GemIP treatment effects with a topical metronomic treatment and observe that a remarkable growth inhibition was only achieved with steady dosing via GemIPs. Daily topical drug administration (at the maximum dosage that was not lethal for the embryonic host organism) did not decrease tumor sizes, while both treatment regimes caused S-phase cell cycle arrest and apoptosis. We hypothesize that the pharmacodynamic effects generate different intratumoral drug concentration profiles for each technique, which causes this difference in outcome. We created a digital model of the experiment, which proposes a fast decay in the local drug concentration for the topical daily treatment, but a long-lasting high local concentration of Gem close to the tumor area with GemIPs. Continuous chemotherapy with iontronic devices opens new possibilities in cancer treatment: the long-lasting and highly local dosing of clinically available, potent chemotherapeutics to greatly enhance treatment efficiency without systemic side-effects. Significance statementIontronic pumps (GemIPs) provide continuous and localized administration of the chemotherapeutic gemcitabine (Gem) for treating glioblastoma in vivo. By generating high and constant drug concentrations near the vascularized growing tumor, GemIPs offer an efficient and less harmful alternative to systemic administration. Continuous GemIP dosing resulted in remarkable growth inhibition, superior to daily topical Gem application at higher doses. Our digital modelling shows the advantages of iontronic chemotherapy in overcoming limitations of burst release and transient concentration profiles, and providing precise control over dosing profiles and local distribution. This technology holds promise for future implants, could revolutionize treatment strategies, and offers a new platform for studying the influence of timing and dosing dependencies of already-established drugs in the fight against hard-to-treat tumors.

Spermidine-Functionalized Injectable Hydrogel Reduces Inflammation and Enhances Healing of Acute and Diabetic Wounds In Situ.

The inflammatory response is a key factor affecting tissue regeneration. Inspired by the immunomodulatory role of spermidine, an injectable double network hydrogel functionalized with spermidine (DN-SPD) is developed, where the first and second networks are formed by dynamic imine bonds and non-dynamic photo-crosslinked bonds respectively. The single network hydrogel before photo-crosslinking exhibits excellent injectability and thus can be printed and photo-crosslinked in situ to form double network hydrogels. DN-SPD hydrogel has demonstrated desirable mechanical properties and tissue adhesion. More importantly, an "operando" comparison of hydrogels loaded with spermidine or diethylenetriamine (DETA), a sham molecule resembling spermidine, has shown similar physical properties, but quite different biological functions. Specifically, the outcomes of 3 sets of in vivo animal experiments demonstrate that DN-SPD hydrogel can not only reduce inflammation caused by implanted exogenous biomaterials and reactive oxygen species but also promote the polarization of macrophages toward regenerative M2 phenotype, in comparison with DN-DETA hydrogel. Moreover, the immunoregulation by spermidine can also translate into faster and more natural healing of both acute wounds and diabetic wounds. Hence, the local administration of spermidine affords a simple but elegant approach to attenuate foreign body reactions induced by exogenous biomaterials to treat chronic refractory wounds.

Fiscal decentralisation and the attenuating effects of inter‐governmental transfers and economic development on corruption in China

AbstractThe consensus in the literature is that fiscal decentralisation is a means to reduce corruption. For China, the attenuating effects of fiscal decentralisation are often enhanced by other factors. This paper argues that prior findings serve to facilitate the design of anti‐corruption measures but they do not address why individuals may engage in corruption. This is especially as individual evidence suggests that engaging in corruption is against professional ethos in China. This paper suggests that intergovernmental transfers and the relative level of economic development of where a public servant is serving influence the decision of whether to engage in corruption. Specifically, intergovernmental transfers and a higher level of local economic development directly affect the resources that a local administration has. In turn, this affects the extent to which one may realise their motivations for a career in the public sector. Empirical estimates for 1998–2013 serve to support the hypothesis.Points for practitioners Fiscal decentralisation mitigates the prevalence of corruption in China in conjunction with other complimentary factors. But engaging in corruption is inconsistent with motivations for a public sector career which include engaging in work for society's greater benefit. Corruption may emerge because public servants feel that they may be unable to achieve their aims for joining the public sector because of local resource constraints. Empirical findings suggest that increased resources to local administrations from intergovernmental transfers and economic development may discourage public servants from deviating from their stated career motivations, that is, engaging in corruption.

In situ chemoimmunotherapy hydrogel elicits immunogenic cell death and evokes efficient antitumor immune response

BackgroundChemoimmunotherapy has shown promising advantages of eliciting immunogenic cell death and activating anti-tumor immune responses. However, the systemic toxicity of chemotherapy and tumor immunosuppressive microenvironment limit the clinical application.MethodsHere, an injectable sodium alginate hydrogel (ALG) loaded with nanoparticle albumin-bound-paclitaxel (Nab-PTX) and an immunostimulating agent R837 was developed for local administration. Two murine hepatocellular carcinoma and breast cancer models were established. The tumor-bearing mice received the peritumoral injection of R837/Nab-PTX/ALG once a week for two weeks. The antitumor efficacy, the immune response, and the tumor microenvironment were investigated.ResultsThis chemoimmunotherapy hydrogel with sustained-release character was proven to have significant effects on killing tumor cells and inhibiting tumor growth. Peritumoral injection of our hydrogel caused little harm to normal organs and triggered a potent antitumor immune response against both hepatocellular carcinoma and breast cancer. In the tumor microenvironment, enhanced immunogenic cell death induced by the combination of Nab-PTX and R837 resulted in 3.30-fold infiltration of effector memory T cells and upregulation of 20 biological processes related to immune responses.ConclusionsOur strategy provides a novel insight into the combination of chemotherapy and immunotherapy and has the potential for clinical translation.

The Perceived Nighttime Economy Impacts: Its Binary and Multidimensional Natures

Purpose: This study examines the perceived impacts of the nighttime economy in an emerging country: Vietnam. Theoretical framework: The literature about the nighttime economy in developed contexts was reviewed to guide this study. Method/design/approach: Two exploratory studies were implemented. The first one involved the qualitative analysis of user-generated content. The second one was related to an analysis of data gathered via a structured survey. Results and conclusion: The qualitative analysis of public opinions (n = 538) revealed the positive and negative aspects of the perceived impacts. The quantitative survey (n = 352) exposed the hidden elements of the perceived impacts, including the economic, sociocultural, environmental, and health impacts. Research implications: The differences in findings between this study and the prior research were highlighted to expand the literature on the nighttime economy. Implications for local administrators when projecting and managing this new economic activity were also discussed. Originality/value: The binary and multidimensional natures of nighttime economy impacts are simultaneously taken into account to enrich the literature on these particular issues.

Geographic dispersion, tax administration and corporate tax burden: evidence from China

PurposeFrom the perspective of local government tax administration, the impact of geographic dispersion on the corporate tax burden is investigated in this paper.Design/methodology/approachUsing unbalanced panel data with a sample of listed companies from 2003 to 2020 in China, this paper focuses on the effect of geographic dispersion on corporate tax burden and the mechanisms.FindingsIt is found that corporate tax burden is positively related to geographic dispersion. It is also found that geographic dispersion affects the corporate tax burden by increasing the effort of local government tax administration. In addition, the relation between geographic dispersion and corporate tax burden is more pronounced for local SOEs prior to the implementation of Golden Tax Project III and in cases where local governments face stronger financial pressure to obtain revenue.Originality/valueThis study has important implications for the promotion of the coordinated development of the regional economy, as well as the legalization, modernization and informatization of tax administration.

On Local Governments Ombudsman in Turkey: A Comparative Analysis with the Local Governments Ombudsman in Uk and Italy

Objective: The Ombudsman is essentially an independent, national-level institution that operates in response to complaints from citizens in order to steer public administrations away from bad administrative practices and behavior. However, it is impossible for an ombudsman with such a broad mandate at the national level to deal with all administrative complaints within the state. Therefore, in order to get more efficiency from the national Ombudsman, it has been divided into different sub-types. Theoretical Framework: One of these is the Ombudsman for local governmentrs, which deals only with complaints from local administrations. Although there is a national ombudsman in Turkey, there is no ombudsman specialized in local governments. Method: This study aims to make some suggestions for the Ombudsman for local governments envisaged to be established in Turkey in the future by analyzing the local governments ombudsman offices in the UK and Italy in terms of their structural-institutional and functional aspects. In this context, the study, with a comparative approach, provides suggestions for the basic aspects, qualities and characteristics of the Turkish local government ombudsman and, thus, for its structural-institutional and functional aspects. The method of the research is literature review. Results and Discussion: According to the results of this research; Establishing an ombudsman for local governments in Turkey by law, cooperating with other ombudsmen in the vicinity, examining and correcting the mismanagement and bad behavior of local governments upon public demand, ensuring easy and cheap access, fulfilling their duties, and quickly and systematically addressing the faults of local governments. Warning, making suggestions, preparing reports and then reporting the situation to local decision-making boards and the public will be effective in providing public services more effectively and efficiently and strengthening local democracy. Originality/value: In the study, original suggestions are made for local government ombudsman in Turkey, based on the examples of UK and Italy.

Bio fabrication of Fe2O3 NPs and their analgesia efficiency for post-operative epidural anaesthetic applications- study of chronic inflammatory pain model in mice

ABSTRACT The current study reported the synthesis of ferric oxide nanoparticles (Fe2O3 NPs) using the leaf extract of Amaranthus spinosus Linn and studied their analgesia efficiency in chronic inflammatory pain model in mice. X-RD, TEM results showed that the spherical Fe2O3 NPs having rhombohedral crystalline structure with an average particle size of 10 nm. Additionally, inflammatory pain models were designed through FCA injection on the CD1 mice hind paw with various Fe2O3 NPs doses and analgesic behaviour was monitored. The prepared Fe2O3 NPs showed a dose-dependent analgesic activity with considerable decrease in inflammatory cells, ROS production and pro-inflammatory markers. Additionally, the expression of enzymes responsible for ROS production were decreased. The outcomes of present work revealed the local administration of Fe2O3 NPs caused the substantial analgesia through reduction of pro-inflammatory signalling and inflammatory cellular infiltration along with micro-environmental free radical scavenging in mouse inflammatory pain model.

Pain Perception During Local Anesthesia Administration in Pediatric Dental Patients and The Impact of Pre-Cooling The Injection Site: An in-vivo Study.

Examining how pre-cooling affects children's experience of pain during local anesthetic administration is the primary goal of this study. This study was conducted in vivo and involved 60 child patients who required local anesthetic in order to undergo dental procedures. Patients were divided into two groups based on a random chance: Group I was the control group, which did not receive any pre-cooling. Group II was the pre-cooling group, which allowed the injection site to be chilled with an ice pack for one minute prior to the administration of anesthesia. The Wong-Baker FACES Pain Rating Scale was used to evaluate the participants' level of pain perception immediately following the administration of the anesthetic injection. The group that received pre-cooling showed a reduction in pain levels that was statistically significant when compared to the group that received control (P < 0.05). Pediatric dental patients may decrease local anesthesia pain by pre-cooling the injection site. This technique can be simply used in dental practices to improve patient experience, especially for children with dental anxiety or needle phobia.

Favorable osteogenic activity of vericiguat doped in β-tricalcium phosphate: In vitro and in vivo studies.

Recently, more and more studies have shown that guanylate cyclase, an enzyme that synthesizes cyclic guanosine monophosphate (cGMP), plays an important role in bone metabolism. Vericiguat (VIT), a novel oral soluble guanylate cyclase stimulator, directly generates cyclic guanosine monophosphate and reduce the death incidence from cardio-vascular causes or hospitalization. Recent studies have shown beneficial effects of VIT in animal models of osteoporosis, but very little is currently known about the effects of VIT on bone defects in the osteoporotic states. Therefore, in this study, β-tricalcium phosphate (β-TCP) was used as a carrier to explore the effect of local VIT administration on the repair of femoral metaphyseal bone defects in ovariectomized (OVX) rats. When MC3T3-E1 was cultured in the presence of H2H2, VIT, similar to Melatonin (MT), therapy could increase the matrix mineralization and ALP, SOD2, SIRT1, and OPG expression, reduce ROS and Mito SOX production, RANKL expression, Promote the recovery of mitochondrial membrane potential. In the OVX rat model, VIT increases the osteogenic effect of β-TCP and better results were obtained at a dose of 5mg. Local use of VIT can inhibit increased OC, BMP2 and RUNX2 expressions in bone tissue, while decreased SOST and TRAP expressions by RT-PCR and immunohistochemistry. Thereby, VIT stimulates bone regeneration and is a promising candidate for promoting bone repair in osteoporosis.

Microplastic pollution in the Chapora River, Goa, Southwest India: spatial distribution and risk assessment.

The amount of information available on the microplastic (MP) contamination in Goa's riverine water systems is currently limited. The abundance, size, colour, and polymer composition of microplastics in Chapora River surface water were investigated in this study. MPs in Chapora River surface water ranged from 0.1 particles/L (station 13) to 0.47 particles/L (station 5). The mean (± standard deviation) MP concentration was 0.25 (± 0.13) particles/L. Fibre was the dominant shape (77.15%), followed by fragments (12.36%), films (9.36%), and foam (1.12%). Most MPs were found in the 0.1-0.3mm size range, then in the 0.3-1mm and 1-5mm. The dominant type of polymer studied was polyethylene terephthalate (PET; 46%), followed by high-density polyethylene (HDPE; 14%), polypropylene (PP; 5%), and polystyrene (PS; 1%). The risk assessment study indicated high risk with respect to PHI, while PLI shows low risk in the area. The source of MPs was mostly anthropogenic in nature in the region. When compared with other tropical rivers, MP pollution was relatively lower in the Chapora River. Nevertheless, the baseline data will help the local administration take mitigation measures to reduce the impact of MP pollution in the region.

Evaluation of the Efficacy of a Customized Mucosal Vibrator in Alleviating Pain Perception Associated with Local Anesthesia Administration in Children Aged 6-10 Years.

Local anesthetics are used to alleviate pain, but the prick of the injection delivering anesthesia is known to cause anxiety and pain that affect dental treatment. The most difficult aspect of pediatric dentistry is minimizing discomfort while the intraoral local anesthetic is administered. This pain has been treated using physical, psychological, pharmacological, and combinations of these approaches. Recently, the idea of vibration, which is based on the gates control theory, has gained popularity as a way to reduce discomfort while local anesthesia (LA) is being administered. The aim of this trial was to evaluate the efficacy of mucosal vibrators in children aged 6-10 years to alleviate pain associated with LA administration. A total of 60 patients aged 6-10 years requiring inferior alveolar nerve block were enrolled for this randomized, single-blind clinical trial. In group I, before and during LA administration, the customized mucosal vibrator was placed at the injection site. In group II, the topical local anesthetic gel was applied to the injection site prior to the administration of LA. Then, the local anesthetic solution was deposited using a disposable syringe needle on both groups. The pain was evaluated using the physiological scale (pulse rate and oxygen saturation), the subjective scale (Wong-Baker scale), and the objective scale [Face, Legs, Activity, Cry, Consolability (FLACC) scale] by an experienced assistant who was unaware of the procedure. A customized mucosal vibrator along with local anesthetic injections resulted in significantly less pain (p = 0.001*) when compared with the injections with topical anesthetic gel. The results show that the customized mucosal vibrator is an effective and inexpensive means to reduce pain during LA administration. Tatiya N, Singh C, Surana P, et al. Evaluation of the Efficacy of a Customized Mucosal Vibrator in Alleviating Pain Perception Associated with Local Anesthesia Administration in Children Aged 6-10 Years. Int J Clin Pediatr Dent 2024;17(4):404-409.

THE EFFECT OF LOCAL ANESTHESIA ON HEALING TIME PERINEUM WOUNDS ON NIFAS' MOTHER AT PMB NUNUNG TANGERANG

Background: WHO in 2020, stated that maternal deaths during pregnancy, childbirth and postpartum were 295,000 worldwide. Africa, Sub-Saharan and South Asia account for about 86%. Meanwhile, the maternal mortality rate in Indonesia in 2020 is 230 per 100,000 live births. One of the causes of maternal death is bleeding and infection. Suturing perineal tears with anesthesia is one of the maternal care programs, which aims to reduce the pain experienced by mothers during the suturing process of birth canal wounds. Giving anesthesia can also cause damage to the immune system which results in a decrease in body resistance so that there will be a lengthening of wound healing 2-3 days than without anesthesia. Research Objective: Knowing the administration of local anesthesia on the healing duration of perineal wounds in puerperal mothers. Research Method: Quasi-experiment with post-test group design. The samples in this study were all postpartum mothers who experienced perineal injuries at PMB Nunung in November-December 2023 as many as 40 people. The sampling technique uses the total sampling technique. Results of the study: The frequency distribution of long healing of perineal wounds in the majority intervention group was slow and in the majority control group was fast. The effect of local anesthesia on the healing time of perineal wounds in puerperal mothers (p. value 0.000). Conclusion and Suggestion: The effect of local anesthesia on the healing time of perineal wounds in puerperal mothers. It is expected that midwives provide counseling to postpartum mothers to properly care for perineal wounds and eat nutritious foods to accelerate the healing of perineal wounds.

Comparative evaluation of intranasal dexmedetomidine, intranasal midazolam, and nitrous oxide for conscious sedation of anxious children undergoing dental treatment: A randomized cross-over trial.

Pharmacological methods, specifically sedatives, have gained popularity in managing the behavior of children during dental appointments. The aim of this study was to compare 1 m/kg intranasal dexmedetomidine, 0.3 mg/kg intranasal midazolam, and nitrous oxide in evaluating the level of sedation, behavior of the child, onset of sedation, physiologic signs, and adverse effects. In this cross-over trial, 15 children aged 6-8 years were randomized to receive intranasal atomized dexmedetomidine, intranasal atomized midazolam, and inhalation nitrous oxide at three separate visits. After administering the sedative agent, a single pulpectomy was performed during each appointment, and the outcomes were recorded. The washout period between each visit was 1 week. All three sedative agents were equally effective in controlling overall behavior. Dexmedetomidine showed lower sedation level scores (agitated; score 9) than the other groups. There was a statistically significant difference in the onset of sedation, with dexmedetomidine having the longest onset of 36.2 ± 9.47 min. Coughing and sneezing were predominantly observed after administration of intranasal midazolam. Oxygen saturation levels were statistically lower in the intranasal midazolam group during local anesthesia administration and post-treatment. 0.3 mg/kg intranasal midazolam is as effective as nitrous oxide sedation for controlling behavior and providing adequate sedation in pediatric dental patients. However, 1 m/kg dexmedetomidine did not provide the same level of sedation and had a significantly longer onset. 0.3 mg/kg intranasal midazolam is an effective alternative to nitrous oxide sedation in anxious children.

The local governance of COVID‐19: Lessons learned and ways forward in rural Bangladesh

AbstractThis article investigates how a district administration in Bangladesh managed COVID‐19 pandemic risk governance. Interviews were conducted with civil administrators, local government representatives, and representatives from community‐based organizations and nongovernmental organizations. The findings indicate that, despite limited health facilities, widespread ignorance of the virus, joblessness among wage earners, economic pressure, and a massive outbreak of COVID‐19, the district administration has demonstrated its diligence, professionalism, local knowledge, and promptness in providing optimal public services through coordination and information sharing among all stakeholders. The synergies and coordination between local administration, security forces, and local government representatives were great challenges in implementing nonpharmaceutical polices and support programs.

A comparative evaluation of the efficiency of warm local anesthetic solution delivered on precooled injection sites with the conventional local anesthetic technique in 7-9-year-old children: A randomized split-mouth cross-over trial.

Both precooling the site and injecting a warm anesthetic solution have proven to be efficient in reducing pain individually. However, there is insufficient data on evaluating the efficiency of precooling the site of injection along with the simultaneous administration of a warm local anesthetic solution on the same site in a single patient. The aim of this study was to evaluate and compare the efficacy, pain perception, hemodynamic changes, and adverse effects of a warm local anesthetic solution injected on precooled injection sites using 2% lignocaine with the conventional local anesthetic technique during inferior alveolar nerve block in 7-9-year-old children. A split-mouth, double-blinded, randomized clinical trial was conducted on 70 children who received 2% lignocaine with either technique A or B during the first or second appointment of the treatment procedure. The pain perception, anesthetic efficacy, pulse rate, oxygen saturation levels, and adverse events were evaluated. Pain during injection and treatment after administration of the warm local anesthesia (LA) technique was less as compared to the conventional block technique. Anesthetic success was observed with a faster onset of action (212.57 ± 32.51 s) and shorter duration of LA (165.16 ± 33.09 min) in the warm local technique as compared to the conventional technique. No significant differences were found with regard to heart rate and oxygen saturation levels between the two techniques. Administrating warm LA solutions at precooled injection sites revealed fewer adverse events. Injecting warm LA solution on precooled injection sites causes less discomfort and anxiety in children, which makes it more suitable for the child as well as the pediatric dentist.