Relationship between subjective and objective measures of anticipatory anxiety prior to extraction procedures in 8- to 12-year-old children

Background@#This study assessed anticipatory dental anxiety levels among 8- to 12-year-old children based on subjective and physiological measures and their correlation. The variations in anxiety based on sex, age, temperament, and academic performance were evaluated. @*Methods@#An observational study was conducted in 60 children recruited from the waiting room over a 6-month period. The operator recorded subjective anxiety in the children using a novel visual facial anxiety scale. The operator also noted the demographic details and child’s temperament using the nine dimensions of the Thomas and Chess criteria, and graded children as “easy,” “slow to warm-up,” and “difficult.” The academic performance of the children was graded (parental ratings) on a five-point Likert scale. Physiological variables (heartrate [HR], oxygen saturation[SpO2 ], and blood pressure [BP]) were recorded by another evaluator. The correlation between anxiety levels and physiological variables was also assessed. The effects of age, sex, temperament, and academic performance on anxiety were evaluated. @*Results@#The study included 60 children aged 8–12 years, including 36 boys and 24 girls. Seventy percent of children had mild to moderate levels of pre-extraction anxiety, while 30% of children demonstrated high anxiety.A significant positive correlation was noted between anxiety levels and HR (rs = 0.477, P < 0.001*) and systolic BP (rs = 0.294, P < 0.05), while a significant but inverse correlation was observed with SpO2 (rs = −0.40, P < 0.05). Anxiety did not influence diastolic BP. Children with difficult temperament and poor academic performance had significantly higher anxiety. @*Conclusion@#A high percentage (70%) of children aged 8–12 years had mild to moderate anxiety prior to the extraction procedure. Increased HR, systolic BP, and reduced SpO2 were significantly associated with high levels of anticipatory dental anxiety. Pre-extraction anxiety was significantly related to the temperament and scholastic performance.

Quality of life in patients with coronary artery disease and panic disorder: a comparative study

Objectives: The quality of life [QOL] of patients with coronary artery disease [CAD] is known to be impaired. Non-cardiac chest pain referrals are often under-diagnosed and untreated, and there are hardly any studies comparing the QOL of CAD and panic disorder related [non-cardiac] chest pain referrals [PDRC]

Methods: We assessed the psychiatric morbidity and QOL of patients newly diagnosed with CAD [n = 40] at baseline and six weeks post-treatment and compared their QOL with patients with PDRC [n = 40] and age- and gender-matched healthy controls [n = 57]. Psychiatric morbidity in the CAD group was assessed using the General Health Questionnaire [GHQ12] item, Hamilton Anxiety Scores [HAM-A], and Hamilton Depression Scores [HAMD]. QOL measures were determined by the World Health Organization QOL questionnaire [brief ] and Seattle Angina Questionnaire. The CAD group was treated with anti-ischemic drugs [nitrates, betablockers], antiplatelet drugs [acetylsalicylsalicylic acid], anticoagulants [low molecular weight heparin, clopidogrel], and managed for risk factors. The PDRC group was treated with selective serotonin reuptake inhibitors and anxiolytics

Results: Patients with panic disorder had a worse QOL than those with CAD and healthy controls in the physical domain and psychological domain [PDRC vs. CAD vs. healthy controls, p < 0.001]. In the CAD group, smoking was associated with change in angina stability [p = 0.049] whereas other tobacco products were associated with change in angina frequency [p = 0.044]. Psychiatric morbidity was present in 40.0% of patients with CAD. In the PDRC group, a significant correlation of HAM-A scores was noted in the physical [p = 0.000], psychological [p = 0.001], social [p = 0.006], and environment [p = 0.001] domains of QOL. Patients with panic disorder had a significant improvement in anxiety scores after treatment compared to baseline [HAM-A scores difference 21.0 [16.5-25.6]; p < 0.001]

Conclusions: Patients in the PDRC group had a worse QOL than those in the CAD and healthy control groups. This highlights the need for careful diagnosis and prompt treatment of panic disorder in these patients to improve their QOL. Additionally, smoking, the use of other tobacco products, and hypercholesterolemia were associated with angina symptoms in patients with CAD

Pharmacognostical study and establishment of quality parameters of aerial parts of Costus speciosus-a well known tropical folklore medicine

Objective: To evaluate the diagnostic pharmacognostical characters of Costus speciosus (aerial parts) along with their physico-chemical parameters and fluorosence analysis. Method: The pharmacognostical characters were determined in terms of macroscopy, microscopy, powder microscopy, leaf constant, fluorescence analysis and preliminary phytochemical investigation. Results: The findings of macroscopy revealed that leaves elliptic to oblong or oblong-lancoelate, thick, spirally arranged, with stem clasping sheaths up to 4 cm, flowers large, white, cone-like terminal spikes, with bright red bracts. Transverse section of leaflet showed the presence of cuticularised epidermis with polygonal cells on adaxial surface and bluntly angled cells on abaxial surface of lamina, mesophyll cells differentiated in to single layered palisade cells on each surface and 2-3 layered spongy parenchyma, unicellular and uniseriate multicellular covering trichomes, paracytic stomata and vascular bundles surrounded by sclerenchymatous multicellular sheath. Preliminary phytochemical screening exhibited the presence of various phytochemical groups like alkaloids, glycosides, steroids, phenolic constituents. Further, the leaf constants, powder microscopy and fluorescence characteristics indicated outstanding results from this investigation Conclusions: Various pharmacognostical and physico-chemical parameters have pivotal roles in identification, authentication and establishment of quality parameters of the species.

Pharmacognostical study and establishment of quality parameters of aerial parts of Costus speciosus-a well known tropical folklore medicine

<p><b>OBJECTIVE</b>To evaluate the diagnostic pharmacognostical characters of Costus speciosus (aerial parts) along with their physico-chemical parameters and fluorosence analysis.</p><p><b>METHOD</b>The pharmacognostical characters were determined in terms of macroscopy, microscopy, powder microscopy, leaf constant, fluorescence analysis and preliminary phytochemical investigation.</p><p><b>RESULTS</b>The findings of macroscopy revealed that leaves elliptic to oblong or oblong-lancoelate, thick, spirally arranged, with stem clasping sheaths up to 4 cm, flowers large, white, cone-like terminal spikes, with bright red bracts. Transverse section of leaflet showed the presence of cuticularised epidermis with polygonal cells on adaxial surface and bluntly angled cells on abaxial surface of lamina, mesophyll cells differentiated in to single layered palisade cells on each surface and 2-3 layered spongy parenchyma, unicellular and uniseriate multicellular covering trichomes, paracytic stomata and vascular bundles surrounded by sclerenchymatous multicellular sheath. Preliminary phytochemical screening exhibited the presence of various phytochemical groups like alkaloids, glycosides, steroids, phenolic constituents. Further, the leaf constants, powder microscopy and fluorescence characteristics indicated outstanding results from this investigation.</p><p><b>CONCLUSIONS</b>Various pharmacognostical and physico-chemical parameters have pivotal roles in identification, authentication and establishment of quality parameters of the species.</p>