Comparison of brief relaxation and music distraction in the treatment of dental anxiety - a randomized controlled clinical trial

Background: Patients with dental anxiety are a heterogeneous group with origins, onset age and manifestations which vary to a great extent between individuals. Among the management options for dental anxiety, non-pharmacological management methods were found to be superior to anxiolytic drug therapies. Medications provide only short term cost effective solutions and an increased patient risk exists due to drug interaction or overdose. Present trend is towards non aversive techniques. Aim and Objectives: To compare the effectiveness of music distraction and brief relaxation method in anxious pediatric patients. Materials and methods: Ninety children of age group of 6-12years were selected randomly by simple random sampling and were divided into three groups with thirty children in each group grouped as - Group A: Control group, Group B: Patients treated with brief relaxation, Group C: Patients treated with music distraction. The patient's subjective anxiety recorded using modified version of the self-report Faces Scale by LeBaron et al. Study investigated using two physiological parameters i.e. heart rate and oxygen saturation, measured with pulse oximetery at different intervals. Results: The study result showed the brief relaxation better efficacy than music distraction in reducing anxiety as indicated by both the subjective and objective parameters except oxygen saturation which were used. But music distraction also helps in lowering the anxiety in children when music distraction group was compared with the control group. Conclusion: Our study found out that even though both brief relaxation and music distraction have the ability to reduce dental anxiety in children, brief relaxation showed more potential in reducing anxiety.

Olfactory neuroblastoma: a tumour to recognise

To study a series of cases of Olfactory Neuroblastoma which is a rare neurogenic tumour. Design: A retrospective study of cases of Olfactory Neuroblastoma in a period of 11 years [From July 1985 to December 1995]. Subjects and Main outcome measures: 10 cases of Olfactory Neuroblastoma seen in last 11 years were assessed with clinical details, histological interpretation and result outcome of the regime of therapy. Age incidence ranged from 3 yrs. to 63 yrs. Males were 70%. 7 cases presented with unilateral nasal mass, nasal obstruction and epistaxis. Proptosis was seen in 2 cases while 3 had regional lymphadenopathy 50% cases were treated with initial surgical excision followed by cobalt therapy and cytotoxic drugs. Rest of the cases were managed by combination of cobalt therapy and chemotherapy. The patients with Olfactory Neuroblastoma must be continuously followed and evaluate for any regional and distant metastasis and also for local recurrence as it is very aggressive and highly malignant neoplasm. Overall survival rate is very poor

Punctate diathermy of the soft palate in snorers

To find out the effect of punctate diathermy of the soft palate in management of snoring. A prospective study of 50 consecutive patients of snoring admitted for management. ENT Unit, Hospitals, attached to Medical College, Bikaner and to Medical College, Kota Rajasthan Stale of India. Fifty patients of simple snoring clinically assessed and graded according to type and severity of snoring. Cured, improved or unchanged by the employed procedure in management. Thirty three patients with simple nonapnoeic snoring of grade II to IV were managed by punctate diathermy of soft palate. Twenty two [66.66%] cured and eight patients showed improvement while three [9.9%] remained unchanged. Punctate diathermy of soft palate results in stiffening of musculature, without comprising its function. Conclusions: Punctate diathermy of the soft palate is being found to be a simple, safe and alternate procedure to clinical surgery [UPPP] in management of simple, less severe non-apnoeic cases of snoring

unusual presentation of endobronchial tuberculosis

To show unusual presentation of Endobronchial tuberculosis mimicking foreign body. Design: Emergency Bronchoscopy in cases with presentation like foreign body aspiration. Setting: Medical College Hospital Kota, Rajasthan, India. Young girl of 6 years age admitted in the hospital with breathlessness and signs of diminished air entry in Rt. Lung. Main outcome measures: Presentation of collapse and consolidation in endobronchial tuberculosis. Air entry restored after removal of mass from Rt. main bronchus through bronchoscopy and complete response took place after completing antitubercular treatment. We conclude that the bronchoscopist while dealing with foreign bodies in children should keep possibility of tuberculosis in mind

Ear, nose and throat injury in children

To find out type of injury and mechanism involved in ear, nose and throat regions children. A retrospective study of 160 cases over a period of 5 years was carried out and related data were analysed. ENT, Department of Prince Bijay Singh Memorial Hospital attached to Sardar Patel Medical College, Bikaner [Rajasthan] India. 160 children from 0-15 years managed in ENT unit. Main outcome measures: Type of injury, mode of injury, complications and preventive measures. Nose was found to be the commonest site [50%] of injury and nasal bone fracture was the commonest injury [26%]. Fall and trauma by pointed object [55%] were the most common modes of injury. In children of less than 5 years, the commonest cause of injury was pointed object in the mouth while in children between 5-10 years, the commonest causes were fall. In children between 10-15 years, the common cause of injury was fall [23%] and road accident [27%]. The pattern of injury of ear, nose and throat region is different in children than in adults. It is also not similar in all age group of children. Not only the type but mechanism involved is also different

Prognostic significance of site of carcinoma of the buccal mucosa

Carcinoma of the buccal mucosa is usually classified by TNM but this is unsatisfactory in assessing the line of therapy and prognosis. New classification of the carcinoma of the cheek mucosa is proposed. The study was conducted on thirty patients of cheek mucosa and these were assessed according to a new proposed classification. The significance of the proposed classification is discussed in relation to selection of therapy and prognosis

Antroscopic study of the maxillary antrum in atrophic rhinitis

Antroscopy is the best method for diagnosis of chronic sinus disease without any surgical or operative exploration. Antroscopy was performed in 20 patients with atrophic rhinitis to find out the type, nature and site of the lesion. Various types of lesions like inflammation, atrophic changes with crusting, thick mucosa, non-specificgranuloma etc. were seen in the antrum. It is suggested that the involvement of maxillary antrum in 55% of atrophic rhinitis patients act as a reservoir of infection causing frequent reinfection resulting in constant factor. So it is suggested that these patients should be managed surgically for antral pathology

Secretomotor dysfunction in etiopathogenesis of rhinolith

Secretomotor dysfunction seems to be an important factor in the formation of a rhinolith. The possible pathophysiology of the process is described in the light of literature

Sexual activity in laryngectomized persons

Regain of sexual activity in laryngectomised persons is of utmost importance to reentry into family dynamic. The present study consists of 40 persons who had laryngectomy in which various factors like phobia-fear complex, feeling of depression, wife interference, social backgrounds etc. are identified for affecting the normal sexual activity. It is emphasized that laryngectomised person is already handicapped, so an attempt should always be made to identify the factors responsible for delayed or decreased frequencies of sexual activity. Proper guidance is essential for family's happiness

Olfaction in hypothyroidism

The sense of smell was assessed in a group of 60 patients of hypothyroidism. The method used and the results obtained are presented. Overall 22-26 percent of patients showed some degree of olfactory dysfunction. Loss of smell is found to be related to severity of hypothyroidism. The possible reasons for anosmia in hypothyroid state is discussed

Toxic effects of cisplatin on olfaction

Thirty patients with advanced malignancy and on treatment with Cisplatin were assessed for impairment in sense of smell [olfaction]. Nine [30%] cases were found to have some degree of anosmia. Olfaction returned to normal within 3-4 months following discontinuation of Cisplatin only in patients with mild degree of loss

Catamential haemotympanum

A case of catamential haemotympanum is reported with possible explanation of its pathogenesis. A line of its management is suggested

simple hot air caloric test

A simple and easy office procedure of Hot Air Caloric Test [HAC] is presented. The test consists of blowing of jet of hot air by hair drier under direct vision in the ear through ear speculum. The present method is compared with the Cold Air Caloric [Dundas-Grant's] method and also with water irrigation method [in dead labyrinth patients]. The comparison revealed that the present HAC Test is equally practical and clinical informative procedure that can be safely used as an office procedure in the ear where tympanic cavity is exposed and water irrigation is contraindicated

Recurrent laryngeal nerve palsy in enteric fever

A rare case of recurrent laryngeal nerve palsy developing during the course of typhoid fever is reported. The possible pathogenesis of its occurrence is discussed in the light of available literature

Chorda-Tympani nerve and polypoidal lesions of the middle ear

Seventy patients with polypoidal lesions were tested to detect affection of Chorda-tympani nerve by an electric taste threshold method. Taste threshold was found to be impaired in 18 patients [25.7%]. Subsequently the patients were classified into three groups, by their histopathological criteria, [a] non-neoplastic group [inflammatory polypi], [b] benign neoplasm group, and [c] malignant tumour group. Six of the 55 patients of non-neoplastic polyp group had raised taste threshold. In benign neoplasm group, four out of seven patients had variable degree of taste sensation impairment. In malignant group, all of the patients had more or less severe degree of loss of taste sensation. Thus the present study indicates that impairment for taste threshold on the side of the lesion is a sign of destructive process or compression. It is concluded that in each case of chronic suppurative otitis media with polypoidal or tumourous lesion, taste threshold should be determined. The patients with impairment of taste sensation should be attended first to prevent severe degree of morbidity

Gestation in hypothyroidism

The sense of taste was assessed in a group of 60 patients of hypothroidism with an electrogustometer. The method used and the results obtained are presented Overall 18.3 per cent of patients showed some degree of taste loss. The possible reasons for loss of taste sensation in hypothyroid state are discussed

Olfactory neuroblastoma

Olfactory neuroblastoma is a rare neurogenic tumour of olfactory epithelium. We have dealt with seven cases in nine years. It mainly occurs in adolescents or adult age. It is more common in males presenting with nasal obstruction epistaxis, numbness of face. The tumour is deceptive even under microscope and should be carefully recognised. It is radio sensitive but combination of surgery and radiotherapy seem to give better and longer regression of the tumour. Chemotherapy plays a palliative role only

Labyrinthine function in hydrophobia

Cold Caloric Test was performed on four patients suffering from rabies. All of them showed hyperactive labyrinth. Thus rabid patients may present to ENT department not only with dysphagia and inability to drink water but also with vertigo

Tumours of the middle ear and mastoid

Twenty two tumours of the middle ear and mastoid encountered between 1974 to 1985 showed a broad spectrum of histopathological lesions, Seven were benign [two osteomas, two haemangiomas and one each of adenoma, fibroma and leiomyoma], 10 were malignant and five were metastatic from thyroid [2], nasopharynx [2] and tibia [1]. Routine biopsy of all the granulomatous and neoplastic diseases of the ear is essential to recognise the nature of the lesion. Patients with malignant tumours usually present in late stage and rarely diagnosed early. Pre-operative clinical and radiological assessment of the extent of the carcinoma involving the middle ear and mastoid is inaccurate and exploration should be done with radical excision. A combination of radical removal of the tumour plus post-operative radiotherapy is the treatment of choice in primary carcinoma involving the middle ear and mastoid