Shotblocker or Cold Application; Which One is More Effective in Reducing Anxiety and Pain Associated with the Intramuscular Injection in Children?: A Randomized Controlled Trial

Objective: Pain is associated with most invasive interventions in childhood and considered as an unpleasant condition; thus, it should be relieved. This study aimed at investigating the effect of two different non-pharmacological pain-relief methods on reducing the pain and anxiety associated with intramuscular (IM) injection in children. Methods: This study was a prospective experimental randomized controlled trial. The sample of the study comprised 150 children aged 7 to 12 years who were brought to the pediatric injection room in a university hospital and had IM injection. The children were randomized into the Shotblocker (n=50), cold application (n=50) and control (n=50) groups. Results: The children in the control group felt pain more than did the children in the ShotBlocker and cold application groups. The difference was statistically significant. Assessment of the anxiety level during the IM injection demonstrated that the children in the control group experienced anxiety statistically significantly more than did the children in the ShotBlocker group. Conclusion: The children in the ShotBlocker and cold application groups experienced pain less than did the children in the control group during the IM injection. When compared to the Cold Application method, ShotBlocker method is more effective in reducing IM injection-related pain and fear

The effectiveness of swaddling and maternal holding applied during heel blood collection on pain level of healthy term newborns; randomized controlled trial

This study was a prospective, randomized controlled trial. The study sample consisted of 105 healthy neonates who conformed to the case selection criteria. Neonates were randomly assigned to the following groups: swaddling (S), maternal holding (MH), and controls (C). The study data were obtained using an information form and the Neonatal Infant Pain Scale (NIPS). There were no statistically significant differences between total crying times (C: 81.14 +/- 44.93; S:79.28 +/- 40.74; MH: 69.42 +/- 31.10 sec.) and the time to first calming (C: 71.28 +/- 50.87; S: 59.74 +/- 42.40; MH: 54.85 +/- 35.61) of heel stick procedures between all groups (p>.05). It was observed that procedural pain levels were the lowest in the maternal holding group (5.57 +/- 1.24), followed by swaddling (5.82 +/- 0.92), and the control group (6.40 +/- 0.91). As a result, both swaddling and maternal holding are effective at reducing pain felt during heel stick procedures, but mother holding may be preferred as a priority rather than swaddling

The effectiveness and tolerability of clobazam in the pediatric population: Adjunctive therapy and monotherapy in a large-cohort multicenter study

Objective: To evaluate the effectiveness and tolerability of clobazam therapy in the pediatric population in terms of seizure semiology, epileptic syndromes, and etiological subgroups.Methods: A retrospective cohort study was conducted consisting of 1710 epileptic children from eight centers in seven geographic regions of Turkey. The initial efficacy of clobazam therapy was evaluated after three months of treatment. The long-term effectiveness of the drug, overall seizure outcomes, and overall therapeutic outcomes were evaluated during 12 months of therapy. Results: Analysis of initial efficacy after the first three months of clobazam therapy showed that 320 (18.7 %) patients were seizure-free, 683 (39.9 %) had > 50 % seizure reductions, and 297 (17.4 %) had 50 % seizure reduction) was determined for focal-onset (62.3 %) seizures, epileptic spasms (61.5 %), and generalized onset seisures (57.4). The highest positive response rate among the epileptic syndromes was for self-limited epilepsy with centrotemporal spikes (SeLECTS). The highest negative response rate was for developmental and/or epileptic encephalopathies (DEEs). Magnetic resonance imaging (MRI) revealed a structural etiological diagnosis in 25.8 % of the cohort. A higher positive response rate was observed at MRI in patients with sequelae lesions than in those with congenital lesions. The seizure recurrence rate was higher in the patient group with epilepsy with genetic and metabolic causes, in individuals with more than one seizure type, and in those using three or more antiseizure drugs.Conclusions: This cohort study provides additional evidence that clobazam is an effective and well-tolerable drug with a high seizure-free rate (18.7 %), a significant seizure reduction rate (57.3 %), and with excellent overall therapeutic outcomes with a low seizure relapse rate and considerable reversible benefits in the pediatric population