Background and aim: Preoperative anxiety and fear of separation from parents are some of the most important preoperative problems for children with deaf muteness. Here, the effect of intravenous administration of ketamine and midazolam was compared on sedation in children who candidates for choral cochlear implantation at the time of separation from parents. Patients and methods: This double-blind, prospective clinical study was performed on 74 children with deaf-muteness before cochlear implantation. Patients were randomly divided into two groups, midazolam (0.1 mg /kg) and ketamine (1 mg/kg). The sedation anxiety score scale (SASS) form was filled in to assess the anxiety and sedation status for each child. The children's relaxation score from recovery was assessed by the PACU sedation score scale (PACUSSS). Results: The average of the children's anxiety score after the injection of both drugs during the separation from their parents was 3, and there was no significant difference in the mean of SASS between the two groups (p>0.05). The mean PACU sedation score scale in both ketamine and midazolam groups was 1.08 ± 0.89 and 1.32 ± 1.01, respectively (p = 0.27). The mean of extubation and recovery times in the ketamine group were 10.44 ± 4.47 and 30.27 ± 6.87, respectively, while the mean extubation and recovery times in the midazolam group were 11.83 ± 3.33 and 29.81 ± 6.31 minutes, respectively. Conclusion: Both ketamine and midazolam caused equal sedation scores in children with deaf muteness at the time of separating from their parents.
Background and aim: Preoperative anxiety and fear of separation from parents are some of the most important preoperative problems for children with deaf muteness. Here, the effect of intravenous administration of ketamine and midazolam was compared on sedation in children who candidates for choral cochlear implantation at the time of separation from parents. Patients and methods: This double-blind, prospective clinical study was performed on 74 children with deaf-muteness before cochlear implantation. Patients were randomly divided into two groups, midazolam (0.1 mg /kg) and ketamine (1 mg/kg). The sedation anxiety score scale (SASS) form was filled in to assess the anxiety and sedation status for each child. The children's relaxation score from recovery was assessed by the PACU sedation score scale (PACUSSS). Results: The average of the children's anxiety score after the injection of both drugs during the separation from their parents was 3, and there was no significant difference in the mean of SASS between the two groups (p>0.05). The mean PACU sedation score scale in both ketamine and midazolam groups was 1.08 ± 0.89 and 1.32 ± 1.01, respectively (p = 0.27). The mean of extubation and recovery times in the ketamine group were 10.44 ± 4.47 and 30.27 ± 6.87, respectively, while the mean extubation and recovery times in the midazolam group were 11.83 ± 3.33 and 29.81 ± 6.31 minutes, respectively. Conclusion: Both ketamine and midazolam caused equal sedation scores in children with deaf muteness at the time of separating from their parents.
This study aimed to determine if: 1) C-reactive protein (CRP) level correlated with PTSD symptom severity as measured by PTSD Checklist-5 (PCL-5), and 2) ketone supplement reduced PTSD symptoms. Twenty participants with PTSD were randomly assigned to a ketone supplementation or placebo group and evaluated for 6-weeks for PTSD symptom severity and CRP levels. The Spearman Rank correlation between PCL-5 and CRP was positive, but not statistically significant. Mixed models on the ranks of the data were used to examine the difference in PCL-5 and CRP between ketone and control groups over time. Median PCL-5 at the pre-test was higher than at the post-test in the ketone group but not in the control. The reduction of PCL-5 medians between ketone and control groups at the post-test was not different. The median pre-test CRP was not different from than post-test in the ketone group or control group. This pilot study did not find a correlation between CRP levels and PTSD symptom severity but was limited by a lack of CRP data collection due to the loss of follow-up. PTSD symptom severity was not altered by 6 weeks of chronic ketone salt supplementation compared to the control group but should be examined in a larger sample size for further verification.
Cervical cancer is a major cause of morbidity and mortality among women. It is the fourth most commonly diagnosed cancer in females. Screening strategies such as colposcopy can cause anxiety, discomfort, and pain in patients during this procedure and poor quality of life. The aim of this study was to evaluate the effect of psychoeducation on pain perception and anxiety in women undergoing colposcopy. This randomized clinical trial included 60 women, candidates for colposcopy referred to the surgical clinic of Kashan, Iran. The patients were randomly assigned into two groups: the experimental group, which received 60 minutes of psychoeducation, and the control group. Data were collected with the Spielberger anxiety inventory and visual analog score of pain and were analyzed using independent and dependent t-tests, Chi-square, and co-variance performed with SPSS version 16. The means of anxiety scores were significantly decreased post-psychoeducation in the intervention group, and the differences between the two groups were statistically significant in the anxiety scores (P < 0.0001). A significant difference was observed between the mean anxiety scores of the intervention group prior to and after the psychoeducational program (PEP) intervention (99.50 ± 5.28 vs. 84.89 ± 8.80) (P 0.05). There was no statistically significant difference between the mean pain score between the study and the control group at the end of the study (P= 0.17). Psychoeducation resulted in reduced anxiety in women undergoing colposcopy. Therefore, it is recommended to consider this intervention as a suitable and effective complementary, non-invasive, low-cost method to reduce anxiety in these patients.
The use of dental implants as a treatment for replacing missing teeth has been increasingly prevalent. Historical evidence suggests that the Mayans were among the first to create implants around 600 AD. Over time, this technique has evolved, offering numerous benefits to humanity. Regardless of the causes of tooth loss and the patient's age, it significantly impacts various aspects of an individual's life, including nutrition, psycho-emotional well-being, and social interactions. One of the primary consequences is the negative effect on self-esteem due to the aesthetic concerns associated with missing teeth. Additionally, pronunciation difficulties can lead to communication challenges, reducing the desire and ability to engage with others. Extensive research in the specialized literature explores the psychological impact of dental implant usage. It is widely acknowledged that the dental implant technique is complex and carries inherent risks and potential adverse effects. An illustrative case serves to underscore the significance of psychological considerations in dental implant treatment. In this instance, a 55-year-old woman attempted suicide by throwing herself down the stairs of her home after receiving dental implants in both sections of her oral cavity. The distress she experienced stemmed from the inability to consume anything beyond fluids and semisolid food for an extended period of eight months. This alarming incident underscores the importance of recognizing and addressing the psychological impact that dental implant procedures can have on vulnerable individuals.
