ABSTRACT
Objective:To evaluate the effect of eye-covering pretreatment on acute delirium in ophthalmology preschool-age children who underwent binocular and monocular surgery by general anesthesia.Methods:The 300 preschool-age children who underwent general anesthesia of elective ophthalmic surgery in the Second Affiliated Hospital, Zhejiang University School of Medicine, from August 2019 to February 2021 were selected as the research object. They were divided into control group and blindfold group with 150 cases each by random number-table. Children in the control group received regular education on cartoon animation videos before surgery; children in the blindfold group received eye-covering pretreatment on the basis of cartoon animation videos(monocular surgery with monocular cover, binocular surgery with binocular cover). The Modified Yale Preoperative Anxiety Scale (m-YPAS) , the Nursing Delirium Screening Scale(NU-DESC), the incidence rate of delirium and the score of postoperative nursing difficulty were compared between two groups.Results:The 271 cases were completed in this study, including 129 cases(monocular surgery 66 cases, binocular surgery 63 cases) in the blindfold group and 142 cases (monocular surgery 73 cases, binocular surgery 69 cases) in the control group. The preoperative m-YPAS score, the postoperative NU-DESC score, the incidence rate of acute delirium and postoperative nursing care difficulty score of monocular surgery in the blindfold group , monocular surgery was (40.28 ± 15.02) points, 1.00 (0.00, 2.00) points, 27.3%(18/66), 1.00 (1.00, 2.00) points,and binocular surgery was (41.69 ± 16.35) points, 1.00 (0.00, 2.00), 39.7%(25/63), 1.00(1.00, 2.00); in the control group, monocular surgery was (46.28 ± 15.76) points, 2.00 (1.00, 3.00) points, 67.1% (49/73), 2.00 (1.00, 3.00) points, and binocular surgery was (47.77 ± 14.82) points, 3.00 (2.00, 4.00) points, 82.6% (57/69) and 2.00 (1.50, 3.00) points respectively. The difference between the two groups was statistically significant ( t= -2.29, -2.24, Z values were -5.74 - -2.95, χ2= 32.94, 25.78, all P<0.05). The preoperative m-YPAS score, the postoperative NU-DESC score, the incidence rate of acute delirium and postoperative nursing care difficulty score of monocular surgery patients in the blindfold group had no significantly statistical difference with that of binocular surgery patient (all P>0.05) . Conclusions:Monocular/ binocular eye-covering pretreatment can effectively decrease the preoperative m-YPAS score, the postoperative NU-DESC score, incidence rate of acute delirium and the postoperative nursing care difficulty in preschool-age children who underwent general anesthesia both monocular or binocular surgery. There was no difference in the application effect of monocular or binocular surgery.
ABSTRACT
Introduction: Saliva is the most important biological factor to protect against dental caries. When saliva flow is reduced, oral health problems such as dental caries and oral infections can develop. It was suggested that the effect of low salivary pH is more in plaque close to the area of susceptible tooth surface. The presence of saliva in pre-school age children is a significant indicator in oral health assessment oral health. There has been an association between salivary cortisol and socioeconomic variable. Descriptions above have encouraged us to examine the salivary pH, feature, and volume of pre-school-aged community. Thus, this study was aimed to describe the differences in salivary pH, feature, and volume of the children in the three pre-school with different location and socioeconomics aspect. Methods: Descriptive survey, with a population of pre-school students in 3 different kindergartens with different socioeconomic environment. Inclusion criteria were the pre-school-aged community and got permission from parents. Exclusion criteria were a pre-school-aged community under medication treatment causes hyposalivation or hypersalivation and children who did not want to be involved in the study, with total sampling as the sampling technique, resulted in as much a 101 respondents as the study sample. The saliva was collected with unstimulated technique. Data analysis was performed using relative frequency distribution. Results: The salivary pH was slightly higher in male children than female by 0.1. The average pH value was 7.25. The salivary feature was mostly frothy bubbly, followed by thin and watery, and the sticky bubbly feature was found the least. The salivary volume of the pre-school-aged community was mostly in the very less category, followed by the less category, with no normal category was found. the p-values of salivary pH and salivary features were below 0.05 There are no significant differences between the salivary pH and salivary feature of children from the three studied kindergartens. However, there is a significant difference in the salivary volume found in children from kindergartens located in high socioeconomic standard and middle socioeconomic standard areas, which have a higher salivary volume than the children from kindergartens situated in areas with lower socioeconomic standard. Conclusion: since the reduced salivary volume was associated to children with lower socioeconomic standard, this association can justify the higher risk for caries described in the literature (AU)
Introdução: A saliva é o fator biológico mais importante na proteção contra a cárie dentária. Quando o fluxo salivar é reduzido, podem ocorrer problemas na saúde bucal, como cáries e infecções orais. Foi sugerido que o efeito do baixo pH salivar é aumentado na placa, próxima à área de superfície dentária suscetível. A presença de saliva em crianças em idade pré-escolar é um indicador significativo na avaliação da saúde bucal. Houve associação entre cortisol salivar e variáveis socioeconômicas. As descrições acima nos encorajaram a examinar o pH salivar, características e volume da comunidade em idade pré-escolar. Assim, este estudo teve como objetivo descrever as diferenças de pH, característica e volume salivar das crianças de três pré-escolas com localização e aspectos socioeconômicos distintos. Material e Métodos: Pesquisa descritiva, com população de estudantes da pré-escola de três diferentes jardins de infância com diferentes ambientes socioeconômicos. Os critérios de inclusão foram comunidade em idade pré-escolar e permissão dos pais. Os critérios de exclusão foram comunidade em idade pré-escolar sob tratamento medicamentoso que causa hipossalivação ou hipersalivação e também crianças que não quiseram se envolver no estudo, com amostragem total resultando em 101 entrevistados como a amostra do estudo. A saliva foi coletada com a técnica não estimulada. A análise dos dados foi realizada usando distribuição de frequência relativa. Resultados: O pH salivar foi ligeiramente superior nas crianças do sexo masculino do que no feminino em 0,1. O valor médio do pH foi de 7,25. O aspecto salivar era principalmente espumoso com bolhas, seguido de aspecto tênue e aguado, e o aspecto pegajoso e espumante foi o menos encontrado. O volume salivar dos estudantes em idade pré-escolar encontrava-se majoritariamente na categoria inferior a todas, seguida da categoria menos, não sendo encontrada nenhuma categoria normal, onde os valores de p do pH salivar e características salivares estavam abaixo de 0,05. Não há diferenças significativas entre o pH salivar e a característica salivar das crianças dos três diferentes jardins de infância estudados. No entanto, existe uma diferença significativa no volume salivar encontrado em crianças de creches localizadas em áreas de médio e alto padrão socioeconômico, que apresentaram maior volume salivar do que as crianças de creches situadas em áreas de menor padrão socioeconômico. Conclusão: O volume salivar reduzido esteve associado a crianças com menor padrão socioeconômico, logo essa associação pode justificar o maior risco de cárie descrito na literatura. (AU)