Retraction: The Verbal Numerical Rating Scale and Faces Pain Scale-Revised for Children With Acute Pain: A Comparative Study for Determining the Need for Analgesia.

[This retracts the article DOI: 10.7759/cureus.56854.].

The Verbal Numerical Rating Scale and Faces Pain Scale-Revised for Children With Acute Pain: A Comparative Study for Determining the Need for Analgesia.

Introduction The primary complaint in all age groups of patients, including children, is pain, which drives the patient to the hospital. A good assessment of pain severity is necessary to determine the right therapy for this primary complaint. Pain scales, especially in children, are given little importance in all hospitals in India. We need more data about its effectiveness. As a result, we conducted this study to compare the effectiveness of two pain scales in an admitted patient. Methods An observational study was conducted on pediatric patients aged 8-17 admitted to a tertiary care unit in pediatric wards included in the study. The study team identified the participants with painful and nonpainful conditions by asking patients of the above age group if they had "any pain" or "any hurt." The verbal numerical rating scale (vNRS) was determined by asking, "On a scale of zero to 10, where zero signifies no pain and ten means severe pain." The child was advised to select from among the six faces using the faces pain scale-revised (FPS-R), showing increasing levels of pain intensity (from left to right), with score options 0, 2, 4, 6, 8, and 10 demonstrated below each face. Result We enrolled 140 children, of which 22 of vNRS and 15 of FPS-R were removed from the study as these children did not understand vNRS and FPS-R. The two-tailed t-test revealed that the p-value was 0.9144. By conventional criteria, in the context of statistical analysis, conventional criteria typically refer to commonly accepted thresholds for determining statistical significance. The most common threshold for significance is a p-value of 0.05 or less. In the provided scenario, the two-tailed t-test resulted in a p-value of 0.9144. By conventional criteria (i.e., using the threshold of 0.05), this p-value is considered not significant. This means that there is not enough evidence to reject the null hypothesis, which suggests that there is no significant difference between the two groups being compared (in this case, the efficacy and reliability of the two scales). Therefore, based on conventional criteria, the difference in efficacy and reliability between the two scales is considered not significant, indicating that they are likely to be equally effective and reliable. This difference is considered not significant. Hence, it is suggestive of equal efficacy and reliability on both scales.  Conclusion Pain scales are a practical guide for managing and recognizing pain in children. It needs to be considered in identifying children's pain. They can provide a valuable outcome for measuring pain, which, when practiced regularly, can save time and extra burden on health staff. In the present study, both pain scales (vNRS and FPR-R) have equal efficacy.

Neurodevelopmental assessment of children with congenital heart diseases using Trivandrum developmental screening chart.

Objectives: Congenital heart diseases (CHDs) are one of the most important congenital anomalies in children which have high-risk for neurodevelopment delay. This study was conducted to determine the proportion of developmental delay in children with CHD and comparison of delay between acyanotic and cyanotic heart diseases in children. Materials and Methods: A cross-sectional study was conducted on children admitted in pediatric ward of rural hospital from 6 month to 6 years of age who are diagnosed with CHD by 2D ECHO and further classified into acyanotic congenital heart disease (ACHD) and cyanotic congenital heart disease (CCHD). Neurodevelopmental assessment was done using Trivandrum development screening chart (TDSC). Results: Out of total 50 children in study population, 24 children had TDSC delay, distribution as 11 (22%) ACHD and 13 (26%) CCHD. Out of 24 children in the age group of 0-3 years, 13 (54.2%) were ACHD and 11 (45.8%) were CCHD. Out of 26 children in the age group of 3-6 years, 15 (57.7%) were ACHD and 11 (42.3%) were CCHD. Among different ACHD included in the study population (0-3 years) children with ventricular septal defect (VSD) were maximum (n = 5) next in the decreasing order was atrial septal defect (ASD) (n = 3). ACHD included in the study population (3-6 years) children with VSD was maximum (n = 6) next in the order was ASD (n = 4). Proportion of delay in children with ACHD was 22% as compared to 26% in children with CCHD. Conclusion: There is a high proportion of neurodevelopmental delay in children with CHD which can be detected using TDSC which is a simple screening tool and can be used by any health-care professional without training for the assessment of neurodevelopmental outcome in these children. Delay was more in children with CCHD than ACHD.

Stevens-Johnson Syndrome Induced by Herbal Kadha.

Stevens-Johnson syndrome (SJS) is a dreaded hypersensitivity reaction and a rare immune disorder. We present a Stevens-Johnson syndrome induced by herbal kadha, which may be the first case. A ten-year-old boy presented with massive sloughing, redness, oedematous skin, an oral ulcer, and an inability to feed or drink for two days. The present symptoms started after 12 hours of consuming herbal Kadha, given by a private practitioner in clinics where he was treated for fever. After not responding to earlier treatment, the patient was referred to the present Institute. The patient had a history of seizure disorder and had been on tablet phenytoin for seven months with no history of adverse reactions to it. He was treated in the intensive care unit. Fortunately, he responded to treatment and recovered fully. He received treatment in the form of immunoglobulin and steroids. Phenytoin and herbal kadha were withdrawn, and Clobazam was continued. Natural herbal medicines can develop severe adverse effects. Physicians should remain aware that drug interactions can likely be seen with drugs with a narrow therapeutic index combined with herbal preparations. Clinicians should do more research on the interaction between herbal and prescription medications.