The Effect of Breathing Exercise Using Bubble Blower on Anxiety and Pain during Inferior Alveolar Nerve Block in Children Aged 7 to 10 Years: A Crossover Randomized Clinical Trial.

INTRODUCTION: The aim of this study was to evaluate the effect of breathing exercise using bubble blower on anxiety and pain during inferior alveolar nerve block (IANB) in children aged 7 to 10 years. MATERIALS AND METHODS: In this randomized crossover clinical trial, thirty-five children with moderate to severe anxiety requiring bilateral pulp therapy of mandibular primary molars were enrolled. Based on random lists, 18 children received the BE + IANB and 17 children received a routine IANB at the first session. This trend became reverse at the second visit for each child. Anxiety was measured using Facial Image Scale (FIS), blood pressure, and pulse rate. Face Leg Activity Cry Consolability (FLACC) scale and Wong-Baker Facial Pain Scale (WBFPS) were used for pain measurement. The Paired Samples Test, Wilcoxon Signed Rank Test, and Interclass Correlation Coefficient were used for data analysis. RESULTS: The means of FLACC, WBFPS, FIS, blood pressure, and pulse rate were higher at the control visit. However, these differences were statistically significant only for FLACC scale and WBFPS (P value <0.05). In subgroup analysis, only girls and children without any previous dental treatment showed significant differences in FLACC scale and WBFPS between the control and bubble blower side (P value <0.05). CONCLUSION: Breathing exercise using a bubble blower may be an efficient distraction and relaxation method to decrease pain of 7- to 10-year-old children with moderate to severe anxiety during inferior alveolar nerve block. However, anxiety levels were lower when applying BE, and the differences were not statistically significant.

Anesthetic efficacy of single buccal infiltration of 4% articaine compared to routine inferior alveolar nerve block with 2% lidocaine during bilateral extraction of mandibular primary molars: a randomized controlled trial.

BACKGROUND: Inferior alveolar nerve block (IANB) using lidocaine 2% is commonly used for anesthetizing primary mandibular molars; however, this technique has the highest level of patient discomfort compared to other local anesthesia techniques. Therefore, alternative anesthesia techniques are necessary. The aim of this study was to evaluate the efficacy of a single buccal infiltration of 4% articaine with IANB using 2% lidocaine, for the bilateral extraction of primary mandibular molars. METHODS: The present study was conducted on 30 patients aged between 6 and 9 years, who required the extraction of bilateral primary mandibular molars. The patients were randomly divided into two groups as follows: In the first session, Group A received IANB with lidocaine 2% and group B received infiltration with articaine 4%. In the second session, another injection method was performed on the opposite side. The Wong-Baker Facial Pain scale (WBFPS), Face Leg Activity Cry, and Consolability (FLACC), and physiologic parameters were used to assess pain perception. RESULTS: The independent t-test showed no statistically significant difference in blood pressure and heart rate before and after extraction (P > 0.05). The mean FLACC index in the lidocaine and articaine groups was 0.89 and 1.36, respectively; there was no statistically significant difference between them (P > 0.05). According to the results of the chi-square test, there was no statistically significant difference between the groups for WBFPS (P > 0.05). CONCLUSION: The articaine infiltration technique may be an alternative to the IANB for the extraction of primary mandibular molars.

Effect of Midwifery-Based Counseling Support Program on Body Image of Breast Cancer Women Survivors

Background: Treatment for breast cancer can give rise to complications with important psychological impact. One change in patients regards body image. The aim of this research was to study the effect of a midwifery-based counseling support program on the body image of breast cancer survivors. Materials and Methods: In this randomized clinical trial, the study population was constituted by 80 breast cancer patients referred to Tuba Clinic in Sari, north of Iran, randomly assigned to two groups. Inclusion criteria included breast cancer diagnosis, mastectomy experience, age of 30 to 60 years, primary school education or higher, being married, and receiving hormone therapy. The Body Image Scale and Beck Depression Inventory were completed by intervention and control groups prior to the intervention and again afterwards. This program was implemented to the intervention group (two groups each consisting of 20 patients) for six weekly sessions, each lasting 90 minutes. The collected data were analyzed suing SPSS through Mann-Whitney U and Wilcoxon tests. Results: The results showed that the average age of participants in the intervention and control groups were 46.8 ± 6.85 and 48.9 ± 5.86, respectively. Body image scores in the intervention and control groups before the support program were respectively 21.82 ± 1.66 and 21.7 ± 1.48, and after the support program they were 7.05± 2.70 and 22.92 ±1.49, respectively. Therefore, the results indicate that the support program was effective in improving body image. Conclusion: This study showed that the support program had a positive effect on the body image of patients. Therefore, it is suggested that it should be used as an effective method for all breast cancer survivors.

Factors Influencing Body Image in Women with Breast Cancer: A Comprehensive Literature Review.

CONTEXT: Many psycho-socioeconomic and other types factors associated with cancer, the treatment process, and changes in patients' physical appearance and sexual function influence the body image of women with breast cancer. The purpose of this study was to determine which factors influence the body image of women with breast cancer. DATA COLLECTION: A narrative literature review was conducted. Electronic databases, including Google Scholar, SID, Magiran, IranDoc, Barekat, Web of Science, Science Direct, Cochrane Library, ProQuest, Scopus, and PubMed, including Medline, were searched to retrieve articles published from 1993 to 2016 using the keywords breast cancer, treatment, body image, and related factors. The quality of selected studies was appraised using a checklist adapted from Samadaee-Gelehkolaee (2016). RESULTS: Of 690 articles retrieved in the search, 190 articles were selected for full text appraisal. Finally, 44 articles were selected for data analysis. The results were classified under three headings: bio-psycho-socioeconomic factors, factors associated with the disease and treatment processes, and physical appearance and sexual function. CONCLUSIONS: The findings of this review showed that many factors can influence the body image of women suffering from breast cancer. These factors were predictors of patients' inter-personal and intra-personal relationships with their partners and others who influenced various other aspects of their lives, possibly leading to many life's issues. These factors must be identified and considered to make the most appropriate decisions for patients. The strength of this study lies in the exploration of factors influencing the body image of women with breast cancer which earlier studies did not consider. Moreover, the authors believe that this research has addressed nearly all the factors that are real concerns in the body image of women with breast cancer.