Signaling by the BCR-ABL fusion kinase drives Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) and chronic myelogenous leukemia (CML). Despite their clinical activity in many patients with CML, the BCR-ABL kinase inhibitors (BCR-ABL-KIs) imatinib, dasatinib, and nilotinib provide only transient leukemia reduction in patients in Ph+ ALL. While host-derived growth factors present in the leukemia microenvironment have been invoked to explain this drug resistance, their relative contribution remains uncertain. Using genetically-defined murine Ph+ ALL cells, we identified Interleukin 7 (IL-7) as the dominant host-factor that attenuates response to BCR-ABL-KIs. To identify potential combination drugs that could overcome this IL-7-dependent BCR-ABL-KI-resistant phenotype, we screened a small molecule library including FDA-approved drugs. Among the validated hits, the well-tolerated anti-malarial drug dihydroartemisinin (DHA) displayed potent activity in vitro and modest in vivo monotherapy activity against engineered murine BCR-ABL-KI–resistant Ph+ ALL. Strikingly, co-treatment with DHA and dasatinib in vivo strongly reduced primary leukemia burden and improved long-term survival in a murine model that faithfully captures the BCR-ABL-KI-resistant phenotype of human Ph+ ALL. This co-treatment protocol durably cured 90% of treated animals, suggesting that this cell-based screening approach efficiently identified drugs that could be rapidly moved to human clinical testing
Availability of complete plastid genomes of ten solanaceous species, Atropa belladonna, Capsicum annuum, Datura stramonium, Nicotiana sylvestris, Nicotiana tabacum, Nicotiana tomentosiformis, Nicotiana undulata, Solanum bulbocastanum, Solanum lycopersicum, and Solanum tuberosum provided us with an opportunity to conduct their in silico comparative analysis in depth. The size of complete chloroplast genomes and LSC and SSC regions of three species of Solanum is comparatively smaller than that of any other species studied till date (exception: SSC region of A. belladonna). AT content of coding regions was found to be less than noncoding regions. A duplicate copy of trnH gene in C. annuum and two alternative tRNA genes for proline in D. stramonium were observed for the first time in this analysis. Further, homology search revealed the presence of rps19 pseudogene and infA genes in A. belladonna and D. stramonium, a region identical to rps19 pseudogene in C. annum and orthologues of sprA gene in another six species. Among the eighteen intron-containing genes, 3 genes have two introns and 15 genes have one intron. The longest insertion was found in accD gene in C. annuum. Phylogenetic analysis using concatenated protein coding sequences gave two clades, one for Nicotiana species and another for Solanum, Capsicum, Atropa, and Datura.
Objectives: To evaluate the oral hygiene practices and dentition statuses of transport workers who were working in a public bus transport system (C.T.U.) of Chandigarh (U.T.), India.
Materials and Methods: The data were recorded on a modified W.H.O. format (1997). A total of 1008 subjects constituted the final sample size. Information was obtained regarding the oral hygiene practices and clinical examinations were conducted. Statistical analysis was done by using ANOVA and Z-test.
Results: The mean age of the subjects was 45.3 ± 7.8 years. Mean DMFT of the subjects who were not using tobacco in any form was 5.02. 80.2% (808). 88.7% of the subjects brushed their teeth as least once a day. Mean number of decayed and missing teeth were 1.67 ± 2.16 and 1.46 ± 2.8, respectively and their relation with age was found to be statistically significant.
Conclusion: Dental caries was found to be major indication in all the age groups. More elderly subjects than young needed extractions. This study emphasized the need of an improved dental awareness and availability of dental facilities to transport workers.
Dentition Status; Oral Hygiene Practices; Oral Health; Transport Workers
An outbreak of food poisoning was reported from a Military establishment on 29 May 2011 when 43 cases of food poisoning reported sick in a span of few hours.
A retrospective-prospective study was conducted. Data regarding the onset of symptoms, presenting features and history of food items consumed was collected. A detailed inspection of the mess for hygiene and sanitary status, cooking and storage procedure, and rodent nuisance was also carried out.
A total of 53 cases of food poisoning occurred between 29 and 31 May 2011. All cases had symptoms of diarrohea followed by fever (96.2%), headache (84.9%), abdominal pain (50.1%), nausea and vomiting (49.1%) and bodyache (39.6%) respectively. Based on the Attributable Risk (AR = 46.67%) and Relative Risk (RR = 4.5, 95% CI = 1.22–16.54) Potato-bitter gourd vegetable served during dinner on 28 May 2011 was incriminated as the food item responsible for outbreak.
Symptomatology, incubation period and presence of rodent nuisance suggested contamination of Potato–bitter gourd vegetable with non-typhoidal Salmonella spp.
Food poisoning; Non-typhoidal Salmonella spp; Military establishment
To evaluate the substantivity of different concentrations of Chlorhexidine (CHX) to dentin disks prepared in-vitro
Materials and Methods:
Sixty dentin disks were prepared from extracted human third molars and divided into three groups (each containing 20 disks). All the disks were partially demineralized, as per standard procedure. Group A specimens were then treated with 10 microliters of 0.02% Chlorhexidine, Group B specimens with 10 microliters of 0.2% Chlorhexidine, and Group C specimens were treated with 10 microliters of 2% Chlorhexidine. They were then incubated in 1 ml of Phosphatebufferedsaline PBS (pH 7.4). The substantivity was evaluated after 24 hours and one week of incubation. CHX concentration in the eluates was spectrophotometrically analyzed.
A significant amount of CHX was found retained on the dentin disks in Group B as compared to Group C. Also, Group A performed significantly better than group C. However, no statistically significant difference was observed between Group A and Group B.
Both 0.02% and 0.2% Chlorhexidine can be clinically recommended when being used for prolonging the durability of resin-dentin bond.
Bond strength; chlorhexidine; concentration
Science is a dynamic subject and it was never free of misconduct or bad research. Indeed, the scientific method itself is intended to overcome mistakes and misdeeds. So, we aimed to assess various factors associated with retraction of scientific articles from 2004 to 2013. Data were retrieved from PubMed and Medline using the keywords retraction of articles, retraction notice, and withdrawal of article in April 2014 to detect articles retracted from 2004 to 2013. Statistical analysis was carried out using t-test and Karl Pearson's correlation coefficient. Results showed that a total of 2343 articles were retracted between 2004 and 2013, and original articles followed by case reports constituted major part of it. Time interval between submission and retraction of article has reduced in recent times. Impact factor and retraction do not have any significant correlation. We conclude that although retraction of articles is a rare event, its constant rise in scientific literature is quite worrisome. It is still unclear whether misconduct/mistakes in articles are increasing hastily or the articles are retracted at a rapid rate in recent times. So, it should be considered as an urgent issue and it is the responsibility of journal editors to track misconduct by following Committee on Publication Ethics (COPE) guidelines and making an effective strategy.
Duplication of article; Plagiarism; Retraction of articles; Self-correction
Although fibromatosis of the mesentery is a very rare locally aggressive benign condition, the uncertain treatment modalities, the natural history of the disease, and the other common differential diagnosis of the condition along with inexperience of the general clinicians with this disease pose a challenge to the professionals. The prolonged periods of stability and even regression in size of the tumor offer a hope for treatment. Accounting for 0.03 % of all neoplasms, it is also known as deep fibromatosis and desmoid tumor. Here, we discuss one case of primary mesenteric fibromatosis in a young male patient who presented to us with chronic abdominal pain after he was treated for acid peptic disease for the same at a local hospital. This case shows how management of this disease can be delayed due to unfamiliarity among clinicians of this condition. In our patient, a palliative surgical management plan was undertaken due to symptomatic mass in the abdomen, owing to unresectability.
Mesentery; Mesenteric tumors; Fibromatosis; Desmoid tumors; Gardner’s syndrome
Improper hand hygiene by healthcare workers (HCWs) is responsible for about 40% of nosocomial infections resulting in prolonged illnesses, hospital stays, long-term disability and unexpected high costs on patients and their families, and also lead to a massive additional financial burden on the health-care system.
To assess knowledge and practices regarding hand hygiene among HCWs of a tertiary health care facility.
A cross sectional, questionnaire and observation based study was carried out in a tertiary care health care facility in Pune. Based on sample size calculations, 100 HCWs working in medical and surgical wards were studied.
The proportion knowledgeable about hand hygiene practices was 85% and 73% HCWs were of the belief that unclean hands are an important route of cross transmission. WHO guidelines regarding procedure were being followed by 90% for hand washing with soap and water and 64% for alcohol based rubs. Majority preferred hand washing with soap and water over hand rubbing with alcohol based solutions. 21% of HCWs were missing hand hygiene opportunities 1 in 5 times. Heavy workload (38%), non availability (52%) and inaccessibility (9%) of hand hygiene facilities were the common reasons for non-compliance. Availability of ‘one time use paper towels’ was low (12%).
Inadequate compliance despite knowledge and false sense of security by alcohol based rubs was seen. A multi disciplinary, multifaceted approach is required to tackle issues of non-compliance.
Hand hygiene; Health care workers; Nosocomial infections; Universal precautions; Tertiary health care facility
Removal of jammed titanium screws can be difficult due to the problem of stripping of the hexagonal heads of the screws. We present a technique of extraction of stripped screws with the use of a standard 4.5 mm stainless steel hollow mill in a patient of peri-implant fracture of the radius fixed with a titanium locking plate 2 years back. The technique is quick, safe, and cost effective.
Hollow mill; stripped screws; titanium locked plates; titanium plates
Efficient identification of subject experts or expert communities is vital for the growth of any organization. Most of the available expert finding systems are based on self-nomination, which can be biased, and are unable to rank experts. Thus, the objective of this work was to develop a robust and unbiased expert finding system which can quantitatively measure expertise.
Medical Subject Headings (MeSH) is a controlled vocabulary developed by the National Library of Medicine (NLM) for indexing research publications, articles and books. Using the MeSH terms associated with peer-reviewed articles published from India and indexed in PubMed, we developed a Web-based program which can be used to identify subject experts and subjects associated with an expert.
We have extensively tested our system to identify experts from India in various subjects. The system provides a ranked list of experts where known experts rank at the top of the list. The system is general; since it uses information available with the PubMed, it can be implemented for any country.
The expert finding system is able to successfully identify subject experts in India. Our system is unique because it allows the quantification of subject expertise, thus enabling the ranking of experts. Our system is based on peer-reviewed information. Use of MeSH terms as subjects has standardized the subject terminology. The system matches requirements of an ideal expert finding system.
Medical Subject Headings; Data Mining; Online Systems; Expert Systems; Professional Competence
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether tricuspid valve (TV) repair with an annuloplasty ring leads to an improved outcome over a conventional suture annuloplasty for patients with severe tricuspid incompetence. Altogether, 306 papers were found using the reported search, of which 14 presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. We found seven studies supporting the use of ring annuloplasty over De Vega's suture annuloplasty. Five studies found no significant difference in outcome between the two techniques. We found only two studies supporting the use of De Vega's suture annuloplasty over ring annuloplasty. Therefore, most of the tabulated studies show good evidence in support of ring annuloplasty compared with De Vega's suture repair for treatment of moderate to severe TV regurgitation. One cohort study identified a 20.4% postoperative failure rate for tricuspid regurgitation (TR) repair and concluded non-application of ring as a predictor for reoperation. One cohort study with a mean follow-up of 17 months reported success rates as high as 97% with ring annuloplasty for TV regurgitation. One large cohort study of 2277 patients with TR who had undergone repair reported a sustained reduction in TR and the rate of recurrence in a 5-year echocardiographic follow-up. One cohort study of 129 patients concluded that ring annuloplasty has the lowest rate of recurrence compared with De Vega's suture repair. An old randomized controlled trial (RCT) on the subject also reported a similar result to the mentioned studies. In contrast, we reviewed one recent study and four older studies and found no significant difference between the two techniques. We reviewed one study that reported De Vega's suture repair as a superior technique to ring annuloplasty. We conclude that there is good evidence supporting ring annuloplasty over conventional De Vega's suture annuloplasty.
Tricuspid valve; Suture; Cardiac valve annuloplasty
Hashimoto encephalopathy remains a Rubik's cube for the present generation of clinical research. Myriad presentations have been noted, and observations recorded in few subgroups of patients have gone on only to be trashed by a second group of patients with a completely different clinical profile. Steroids have been traditionally held to be the treatment for this condition, but long-term side effects associated with it limits its use. Although multiple drugs have been tried, yet there exists no data for their long-term efficacy in maintaining remission. No radiological findings have been consistently associated with this condition. We report the use of azathioprine in maintaining long-term remission in one such patient with Hashimoto encephalopathy and the presence of lactate peak in magnetic resonance spectroscopy of the patient, which showed dramatic regression with institution of immunosuppression.
Anti-thyreoperoxidase; azathioprine; encephalopathy; lactate peak; methylprednisolone; MRI-spectroscopy
Cyanide (CN) toxicity is a serious clinical problem and can occur with sodium nitroprusside (SNP), accidental smoke inhalation, industrial mishaps and bio-terrorism. In this study we induced severe CN toxicity independently with SNP or sodium cyanide (NaCN) in a juvenile pig model to demonstrate reversal of severe CN toxicity with a new antidote, sulfanegen sodium, a prodrug of 3-mercaptopyruvate.
SNP study: A pilot study in eleven anesthetized, mechanically ventilated juvenile pigs allowed us to determine the dose of SNP to induce CN toxicity. Blood CN, serum lactates and blood gases were monitored. CN toxicity was defined as the occurrence of severe lactic acidosis accompanied by significant elevation in blood CN levels. Based on this pilot study, eight anesthetized pigs received a high-dose IV infusion of SNP (100mg/hr) for 2 hours to induce CN toxicity. They were then randomized to receive either sulfanegen sodium or placebo. Four pigs received 3 doses of sulfanegen sodium (2.5g IV) every hour after induction of severe CN toxicity, while 4 pigs received placebo.
A pilot study was conducted in four spontaneously ventilating pigs sedated with propofol plus ketamine to demonstrate hemodynamic and metabolic stability for several hours. After this, 6 pigs were similarly sedated and given NaCN in bolus aliquots to produce CN toxicity ultimately resulting in death. Hemodynamics and metabolic variables were followed to define peak CN toxicity. In another group of six pigs, severe CN toxicity was induced by this method, and at peak toxicity, the animals were given sulfanegen sodium (2.5 g IV) followed by a repeat dose 60 minutes later in surviving animals.
SNP study: The pilot study demonstrated the occurrence of a significant increase in blood CN levels (p<0.05) accompanied by severe lactic acidemia (p<0.05) in all pigs receiving a high dose of SNP. Administration of the sulfanegen antidote resulted in progressive significant reduction in blood lactate and CN levels with 100% survival (p<0.05), whereas the placebo-treated pigs deteriorated and did not survive (p<0.05).
NaCN injection resulted in CN toxicity accompanied by severe lactic acidosis and mortality in all the pigs. Sulfanegen sodium reversed this toxicity and prevented mortality in all the pigs treated with this antidote.
CN toxicity can be successfully induced in a juvenile pig model with SNP or NaCN. The prodrug, sulfanegen sodium, is effective in reversing CN toxicity induced by SNP or NaCN.
The visualization and quantification of mitochondria-associated proteins with high power microscopy methods is of particular interest to investigate protein architecture in this organelle. We report the usage of a custom-made STimulated Emission Depletion (STED) fluorescence nanoscope with ~20 nm lateral resolution for protein mapping of Percoll-purified viable mitochondria from murine heart. Using this approach, we were able to quantify and resolve distinct protein clusters within mitochondria; specifically, cytochrome c oxidase subunit 2 is distributed in clusters of ~20 and ~28 nm; whereas the voltage dependent anion channel 1 displays four size distributions of ~22, ~33, ~55 and ~83 nm.
STED; mitochondria; subdiffraction-resolution; imaging; VDAC1; Cox2
Bevacizumab is a recombinant humanized monoclonal IgG1 antibody that targets vascular endothelial growth factor-A, and is indicated in the treatment of various tumors (colon, lung, renal, and glioblastoma). It has been recently approved for the treatment of ovarian cancer in various countries. This review summarizes the activity and toxicity of bevacizumab in the treatment of ovarian cancer, both as single-agent drug and in combination with cytotoxic chemotherapy. As a single-agent drug, it has shown response rates of 16–21% in the treatment of recurrent ovarian cancer. Two phase III randomized trials have been published evaluating the addition of bevacizumab to standard chemotherapy as front-line treatment of advanced ovarian cancer. In addition, trials evaluating the combination with chemotherapy in recurrent ovarian cancer (platinum-sensitive and platinum-resistant disease) have also been reported. All these trials showed a statistically significant improvement in progression-free survival although no improvement in overall survival has been reported. The main adverse event is hypertension. Other serious, but uncommon adverse events include gastrointestinal perforation as well as renal and central nervous system toxicity.
bevacizumab; combination therapy; single-agent therapy; ovarian cancer; progression-free survival
Mutations of the orphan transporter ABCC6 (ATP-binding cassette, subfamily C, member 6) cause the connective tissue disorder pseudoxanthoma elasticum. ABCC6 was thought to be located on the plasma membrane of liver and kidney cells.
Mouse systems genetics and bioinformatics suggested that ABCC6 deficiency affects mitochondrial gene expression. We therefore tested whether ABCC6 associates with mitochondria.
Methods and Results
We found ABCC6 in crude mitochondrial fractions and subsequently pinpointed its localization to the purified mitochondria-associated membrane fraction. Cell-surface biotinylation in hepatocytes confirmed that ABCC6 is intracellular. Abcc6-knockout mice demonstrated mitochondrial abnormalities and decreased respiration reserve capacity.
Our finding that ABCC6 localizes to the mitochondria-associated membrane has implications for its mechanism of action in normal and diseased states.
PXE; vascular calcification; ABCC6/MRP6; MAM; mitochondria; cardiovascular disease
The emergency department of every tertiary care teaching hospital is the backbone of community health care service.
This study was undertaken to identify the pattern of emergencies in the hospital, and to identify the risk factors associated with these emergencies.
Materials and Methods:
This was a retrospective record analysis of the emergency department from Jan 2010 to Dec 2010. The data were analyzed for various types of medical emergencies presented at the hospital at Guru Gobind Singh Medical College and Hospital, Faridkot.
A total of 2310 patients presented in the emergency department of which nearly half were males; a great majority were in the age group of 15–40 years. The diseases related to the cardiovascular system, 367 (15.89%), topped the list of which hypertension was noted in 267 (11.56%) cases. This was followed by morbidities related to the neurological system, diabetes, hepatobiliary, respiratory, renal 168 (7.27%), poisoning, pyrexia of unknown origin, and multi-organ involvement. With regard to the specific diseases, the majority were contributed by coronary artery disease 217 (9.39%), stroke 178 (7.71%), alcoholic liver disease 160 (6.93%), and chronic obstructive lung diseases 90 (3.90%). In our series, we noted that a great majority of cases were in the 41–60 age groups except poisoning (majority less than 40 years). The age groups were significantly related with selected morbidities.
There are transparent evidence that we need an organized emergency care system in India as relatively the younger age group (15–40 years) comprised nearly half cases.
Emergencies; emergency department; fever
There is substantial germline genetic variability within angiogenesis pathway genes, thereby causing inter-individual differences in angiogenic capacity and resistance to anti-angiogenesis therapy. We investigated germline polymorphisms in genes involved in VEGF-dependent and –independent angiogenesis pathways to predict clinical outcome and tumor response in metastatic colorectal cancer patients (mCRC) treated with bevacizumab (BV) and oxaliplatin-based chemotherapy.
A total of 132 patients treated with first-line BV and FOLFOX or XELOX were included in this study. Genomic DNA was isolated from whole blood samples by PCR-RFLP or direct DNA-sequencing. The endpoints of the study were progression-free survival (PFS), overall survival (OS) and response rate (RR).
The minor alleles of EGF rs444903 A>G and IGF-1 rs6220 A>G were associated with increased OS and remained significant in multivariate COX regression analysis (HR 0.52; 95%CI 0.31–0.87; adjusted-P=0.012 and HR 0.60; 95%CI 0.36–0.99; adjusted-P=0.046, respectively). The minor allele of HIF1α rs11549465 C>T was significantly associated with increased PFS, but lost its significance in multivariate analysis. CXCR1 rs2234671 G>C, CXCR2 rs2230054 T>C, EGFR rs2227983 G>A and VEGFR-2 rs2305948 C>T predicted tumor response, with CXCR1 rs2234671 G>C remaining significant in multiple testing (Pact=0.003).
In this study we identified common germline variants in VEGF-dependent and – independent angiogenesis genes predicting clinical outcome and tumor response in patients with mCRC receiving first-line BV and oxaliplatin-based chemotherapy.
bevacizumab; oxaliplatin; colorectal cancer; angiogenesis; polymorphisms
To study the effect of intravenous magnesium sulfate infusion on clinical outcome of patients of acute stroke.
Materials and Methods:
Sixty consecutive cases of acute ischemic stroke hospitalised within 24 h of an episode of stroke were taken as subjects. All subjects underwent a computed tomography head, and those found to have evidence of bleed/space-occupying lesions were excluded from the study. The subjects taken up for the study were divided into two groups of 30 subjects each. Both the groups received the standard protocol management for acute ischemic stroke. Subjects of Group 1 additionally received intravenous magnesium sulfate as initial 4 g bolus dose over 15 min followed by 16 g as slow infusion over the next 24 h. In all the subjects of the two study groups, serum magnesium levels were estimated at the time of admission (Day 0), Day 1 and Day 2 of hospitalization using an atomic absorption spectrometer.
Statistical Analysis Used:
Scandinavian stroke scores were calculated on Day 3, day of discharge and Day 28. Paired t-test was employed for comparison of stroke scores on Day 3, day of discharge and Day 28 within the same group and the unpaired t-test was used for the intergroup comparison, i.e. comparison of stroke scores of control group with corresponding stroke scores of magnesium group.
Comparison of stroke scores on Day 3 and day of discharge, on the day of discharge and Day 28 and on Day 3 and Day 28 in the magnesium group produced a t-value of 5.000 and P <0.001, which was highly significant. However, the comparison of the mean stroke scores between the magnesium and the control groups on Day 3, day of discharge and Day 28 yielded a P-value of >0.05, which was not significant.
The study failed to document a statistical significant stroke recovery in spite of achieving a significant rise in serum magnesium level, more than that necessary for neuroprotection, with an intravenous magnesium sulfate regime.
Ischemic stroke; magnesium sulfate; neuroprotection
The biomedical research community relies on a diverse set of resources, both within their own institutions and at other research centers. In addition, an increasing number of shared electronic resources have been developed. Without effective means to locate and query these resources, it is challenging, if not impossible, for investigators to be aware of the myriad resources available, or to effectively perform resource discovery when the need arises. In this paper, we describe the development and use of the Biomedical Resource Ontology (BRO) to enable semantic annotation and discovery of biomedical resources. We also describe the Resource Discovery System (RDS) which is a federated, inter-institutional pilot project that uses the BRO to facilitate resource discovery on the Internet. Through the RDS framework and its associated Biositemaps infrastructure, the BRO facilitates semantic search and discovery of biomedical resources, breaking down barriers and streamlining scientific research that will improve human health.
Ontology; Biositemaps; Resources; Biomedical research; Resource annotation; Resource discovery; Search; Semantic web; Web 2.0; Clinical and Translational Science Awards
A number of techniques have been described to reattach the torn distal biceps tendon to the bicipital tuberosity. We report a retrospective analysis of single incision technique using an endobutton fixation in sports persons.
Materials and Methods:
The present series include nine torn distal biceps tendons in eight patients, fixed anatomically to the radial tuberosity with an endobutton by using a single incision surgical technique; seven patients had suffered the injuries during contact sports. The passage of the endobutton was facilitated by using a blunt tipped pin in order to avoid injury to the posterior interosseous nerve. The patients were evaluated by Disabilities of the Arm, Shoulder and Hand (DASH) score and Mayo elbow score.
The average age of the patients was 27.35 years (range 21–42 years). Average follow-up was 41.5 months (range 24–102 months). The final average flexion extension arc was 0°–143°, while the average pronation and supination angles were 77° (range 70°–82°) and 81° (range 78°–85°), respectively at the last followup. All the patients had a Disabilities of the Arm, Shoulder and Hand (DASH) score of 0 and a Mayo elbow score of 100 each. All the seven active sports persons were able to get back to their respective game. There was no nerve injury or any other complication.
The surgical procedure used by us is a simple, safe and reproducible technique giving minimal morbidity and better cosmetic results.
Autograft; biceps tendon; elbow; tendon repair; tendon rupture
From time immemorial, fear and anxiety have been associated with dental treatment. Coping with this fear and anxiety has been one of the most vexing problems with which the individual dentist, as well as the profession has had to contend. Hence this study was undertaken to evaluate a new technique for management of such anxious patients.
The aim of this study is to evaluate the efficacy of using ‘Perceived control’ for the management of anxious patients undergoing endodontic therapy.
Settings and Design:
‘A communication device designed by the author and named as “Touch N’ Tell” (Patent no: 234291, Government of India) was installed on the dental chair which helps to create an effective communiqué between the patient and dentist during the dental procedure.
Materials and Methods:
Sixty anxious patients were selected using Modified Dental Anxiety Scale (MDAS), and were divided into two groups. For group A, the patients were treated along with the use of ‘communication system’ installed on the dental chair, whereas the patients were managed in a routine manner for Group B. The post operative MDAS scores were recorded for both the groups.
The mean change in anxiety levels was calculated for both the groups. Statistical analysis was done using unpaired t-test.
Result and Conclusion:
A significant decrease in the mean anxiety levels was observed in the group where ‘communication system’ was used as a measure of perceived control.
Anxiety; dental treatment; perceived control