Background: The key to a child’s treatment success in a pediatric dental setting is to control discomfort and anxiety. The proposed method supports the execution of a non-aversive behavior management scheme. This study aimed to evaluate the effects of essential oil aromatherapy on anxiety and pain associated with the administration of local anesthesia (LA) in children. Methods: This study included 176 children (87 girls and 89 boys) aged 6–9 years, who were randomly divided into two groups. Group 1 received aromatherapy with essential oil using a nebulizer for 2 min with a 10-min induction period before the administration of LA. Group 2 (control group) was managed using non-pharmacological behavioral techniques. Baseline anxiety levels were recorded for all children before the intervention. LA was administered according to a standard protocol. Postprocedural pain and anxiety were assessed using the Wong–Baker Faces Pain Rating Scale (WBFPRS); Visual Analog Scale (VAS); Sound, Eye, Motor (SEM) scale; and Modified Child Dental Anxiety Scale (MCDAS)(f). Data were analyzed using SPSS version 21.0. Results: The Mann–Whitney U test revealed a statistically significant difference in anxiety MCDAS(f) scores between the groups at both baseline (P = 0.022) and post-procedure (P = 0.001). The Wilcoxon signed-rank test also indicated a statistically significant change in anxiety scores within each group from baseline to post-procedure (P = 0.001). Furthermore, VAS, analyzed using the Mann–Whitney U test, demonstrated a significant difference between the groups (P = 0.001). Pain scores measured using WBFPRS and SEM scales were significantly lower in the aromatherapy group, as determined using the chi-square test. Conclusion Prior use of essential oil aromatherapy can effectively reduce anxiety and pain in children during the administration of LA.

Background: Steatotic liver disease (SLD) encompasses metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (AALD) at extremes as well as an overlap group termed MASLD with increased alcohol intake (MetALD). The Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Index (ANI) was proposed to differentiate ALD from nonalcoholic fatty liver disease (NAFLD). We analysed the performance of the ANI in differentiating within the SLD spectrum. Methods: In a cross-sectional study at a tertiary care center, 202 adults (>18 years) who were prospectively diagnosed with SLD defined by magnetic resonance imaging-proton density fat fraction >6.4% were enrolled.Alcohol consumption (AC) was recorded according to thresholds for significant AC: 140–350 g/week (or 20– 50 g/day) for females and 210–420 g/week (or 30–60 g/day) for males. The ANI was calculated, and area under the receiver operating characteristic curve (AUROC) was generated. Results: Of 202 patients (47 years [interquartile range, IQR, 38 to 55], 23.75% females, 77% obese, 42.1% with diabetes, 38.1% hypertensive, 28.7% statin use), 40.5% were ever-alcohol consumers; 120 (59%), 50 (24.7%), and 32 (15.8%) were MASLD (ANI, –3.7 [IQR, –7 to –1.6]; MetALD, – 1.45 [IQR, –2.4 to 0.28]; and AALD, 0.71 [IQR, –1.3 to 4.8], respectively; P<0.05 for all). The AUROC of the ANI for MASLD and AALD was 0.79 (IQR, 0.72 to 0.84; cut-off <–3.5) and 0.80 (IQR, 0.74 to 0.86; cut-off >–1.49), respectively. The ANI outperformed aspartate transaminase/alanine transaminase (AST/ALT) ratio (AUROC=0.75 [IQR, 0.69 to 0.81]) and gamma glutamyl transpeptidase (GGT) (AUROC=0.74 [IQR, 0.67 to 0.80]). Addition of GGT did not improve model performance (AUCdiff = 0.004; P= 0.33). Conclusion AC is common in MASLD. The ANI distinguishes MASLD and AALD, with individual cut-offs within the intermediate zone indicating MetALD. ANI also outperforms AST/ALT ratio or GGT.

Background: Steatotic liver disease (SLD) encompasses metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (AALD) at extremes as well as an overlap group termed MASLD with increased alcohol intake (MetALD). The Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Index (ANI) was proposed to differentiate ALD from nonalcoholic fatty liver disease (NAFLD). We analysed the performance of the ANI in differentiating within the SLD spectrum. Methods: In a cross-sectional study at a tertiary care center, 202 adults (>18 years) who were prospectively diagnosed with SLD defined by magnetic resonance imaging-proton density fat fraction >6.4% were enrolled.Alcohol consumption (AC) was recorded according to thresholds for significant AC: 140–350 g/week (or 20– 50 g/day) for females and 210–420 g/week (or 30–60 g/day) for males. The ANI was calculated, and area under the receiver operating characteristic curve (AUROC) was generated. Results: Of 202 patients (47 years [interquartile range, IQR, 38 to 55], 23.75% females, 77% obese, 42.1% with diabetes, 38.1% hypertensive, 28.7% statin use), 40.5% were ever-alcohol consumers; 120 (59%), 50 (24.7%), and 32 (15.8%) were MASLD (ANI, –3.7 [IQR, –7 to –1.6]; MetALD, – 1.45 [IQR, –2.4 to 0.28]; and AALD, 0.71 [IQR, –1.3 to 4.8], respectively; P<0.05 for all). The AUROC of the ANI for MASLD and AALD was 0.79 (IQR, 0.72 to 0.84; cut-off <–3.5) and 0.80 (IQR, 0.74 to 0.86; cut-off >–1.49), respectively. The ANI outperformed aspartate transaminase/alanine transaminase (AST/ALT) ratio (AUROC=0.75 [IQR, 0.69 to 0.81]) and gamma glutamyl transpeptidase (GGT) (AUROC=0.74 [IQR, 0.67 to 0.80]). Addition of GGT did not improve model performance (AUCdiff = 0.004; P= 0.33). Conclusion AC is common in MASLD. The ANI distinguishes MASLD and AALD, with individual cut-offs within the intermediate zone indicating MetALD. ANI also outperforms AST/ALT ratio or GGT.

Background: Steatotic liver disease (SLD) encompasses metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (AALD) at extremes as well as an overlap group termed MASLD with increased alcohol intake (MetALD). The Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Index (ANI) was proposed to differentiate ALD from nonalcoholic fatty liver disease (NAFLD). We analysed the performance of the ANI in differentiating within the SLD spectrum. Methods: In a cross-sectional study at a tertiary care center, 202 adults (>18 years) who were prospectively diagnosed with SLD defined by magnetic resonance imaging-proton density fat fraction >6.4% were enrolled.Alcohol consumption (AC) was recorded according to thresholds for significant AC: 140–350 g/week (or 20– 50 g/day) for females and 210–420 g/week (or 30–60 g/day) for males. The ANI was calculated, and area under the receiver operating characteristic curve (AUROC) was generated. Results: Of 202 patients (47 years [interquartile range, IQR, 38 to 55], 23.75% females, 77% obese, 42.1% with diabetes, 38.1% hypertensive, 28.7% statin use), 40.5% were ever-alcohol consumers; 120 (59%), 50 (24.7%), and 32 (15.8%) were MASLD (ANI, –3.7 [IQR, –7 to –1.6]; MetALD, – 1.45 [IQR, –2.4 to 0.28]; and AALD, 0.71 [IQR, –1.3 to 4.8], respectively; P<0.05 for all). The AUROC of the ANI for MASLD and AALD was 0.79 (IQR, 0.72 to 0.84; cut-off <–3.5) and 0.80 (IQR, 0.74 to 0.86; cut-off >–1.49), respectively. The ANI outperformed aspartate transaminase/alanine transaminase (AST/ALT) ratio (AUROC=0.75 [IQR, 0.69 to 0.81]) and gamma glutamyl transpeptidase (GGT) (AUROC=0.74 [IQR, 0.67 to 0.80]). Addition of GGT did not improve model performance (AUCdiff = 0.004; P= 0.33). Conclusion AC is common in MASLD. The ANI distinguishes MASLD and AALD, with individual cut-offs within the intermediate zone indicating MetALD. ANI also outperforms AST/ALT ratio or GGT.

Background: The key to a child’s treatment success in a pediatric dental setting is to control discomfort and anxiety. The proposed method supports the execution of a non-aversive behavior management scheme. This study aimed to evaluate the effects of essential oil aromatherapy on anxiety and pain associated with the administration of local anesthesia (LA) in children. Methods: This study included 176 children (87 girls and 89 boys) aged 6–9 years, who were randomly divided into two groups. Group 1 received aromatherapy with essential oil using a nebulizer for 2 min with a 10-min induction period before the administration of LA. Group 2 (control group) was managed using non-pharmacological behavioral techniques. Baseline anxiety levels were recorded for all children before the intervention. LA was administered according to a standard protocol. Postprocedural pain and anxiety were assessed using the Wong–Baker Faces Pain Rating Scale (WBFPRS); Visual Analog Scale (VAS); Sound, Eye, Motor (SEM) scale; and Modified Child Dental Anxiety Scale (MCDAS)(f). Data were analyzed using SPSS version 21.0. Results: The Mann–Whitney U test revealed a statistically significant difference in anxiety MCDAS(f) scores between the groups at both baseline (P = 0.022) and post-procedure (P = 0.001). The Wilcoxon signed-rank test also indicated a statistically significant change in anxiety scores within each group from baseline to post-procedure (P = 0.001). Furthermore, VAS, analyzed using the Mann–Whitney U test, demonstrated a significant difference between the groups (P = 0.001). Pain scores measured using WBFPRS and SEM scales were significantly lower in the aromatherapy group, as determined using the chi-square test. Conclusion Prior use of essential oil aromatherapy can effectively reduce anxiety and pain in children during the administration of LA.

Background: The key to a child’s treatment success in a pediatric dental setting is to control discomfort and anxiety. The proposed method supports the execution of a non-aversive behavior management scheme. This study aimed to evaluate the effects of essential oil aromatherapy on anxiety and pain associated with the administration of local anesthesia (LA) in children. Methods: This study included 176 children (87 girls and 89 boys) aged 6–9 years, who were randomly divided into two groups. Group 1 received aromatherapy with essential oil using a nebulizer for 2 min with a 10-min induction period before the administration of LA. Group 2 (control group) was managed using non-pharmacological behavioral techniques. Baseline anxiety levels were recorded for all children before the intervention. LA was administered according to a standard protocol. Postprocedural pain and anxiety were assessed using the Wong–Baker Faces Pain Rating Scale (WBFPRS); Visual Analog Scale (VAS); Sound, Eye, Motor (SEM) scale; and Modified Child Dental Anxiety Scale (MCDAS)(f). Data were analyzed using SPSS version 21.0. Results: The Mann–Whitney U test revealed a statistically significant difference in anxiety MCDAS(f) scores between the groups at both baseline (P = 0.022) and post-procedure (P = 0.001). The Wilcoxon signed-rank test also indicated a statistically significant change in anxiety scores within each group from baseline to post-procedure (P = 0.001). Furthermore, VAS, analyzed using the Mann–Whitney U test, demonstrated a significant difference between the groups (P = 0.001). Pain scores measured using WBFPRS and SEM scales were significantly lower in the aromatherapy group, as determined using the chi-square test. Conclusion Prior use of essential oil aromatherapy can effectively reduce anxiety and pain in children during the administration of LA.