1. What data in particular will be shared?
   Response - All of the individual participant data collected during the trial, after de-identification.
   


2. What additional supporting information will be shared?
   Response -  Study Protocol
   Response -  Statistical Analysis Plan
   Response - Informed Consent Form
   Response - Clinical Study Report
   Response -  Analytic Code
   
   
3. Who will be able to view these files?
   Response - Anyone
   


4. For what types of analyses will this data be available?
   Response - Any purpose.
   


5. By what mechanism will data be made available?
   Response (Others) -  The data will be available in the manuscript in the form of numerical value.


6. For how long will this data be available start date provided 15-10-2024 and end date provided 31-10-2024?
   Response - Immediately following publication. No end date.
   


7. Any URL or additional information regarding plan/policy for sharing IPD? 
   Additional Information - Nil

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), anxiety is the future anticipation of unbalanced, associated with muscle tension and caution in preparation for future hazards. Its extreme condition triggers psychopathological events disturbing an everyday life.¹ It is characterized by feelings of tension, worries, and negative physiological reactions.² In educational settings, Students learning and understandings are assessed through Examination. This situation drives them into psychosomatic disturbance before, during and sometimes after exams leading to Exam anxiety. ³ If it becomes intense, that can impede academic performances. In comparing with other professional courses medical students reported higher prevalence of anxiety and depression. The vast materials of academic and clinical information to memorize, in a short period of time contributes their psychological state.^3,4 Although some levels of anxiety are necessary for academic success, tremendous anxiety such as overwhelming emotions, stressful thoughts can hinder the ability of students to manage the stress response during writing and success in the examinations.⁴ The Hamilton Anxiety Rating Scale is an initial rating scales designed to assess the intensity of perceived anxiety symptoms which, identifies students with anxiety impairment ⁵. It is reliable and valid for educational institutes and exam-anxiety evaluations of the students’ performance.

Acupuncture is a Chinese medical treatment involving in insertion of fine metal needles into the skin and underlying tissues at precise points on the body⁶. Auriculotherapy is a branch of acupuncture, performing stimulation of specific points on external ear and balances the flow energy ^7,8. Auriculotherapy is a less invasive method of stimulation of auricular branch of vagus nerve and trigeminal nerve ⁹¹⁰. Stimulation of specific points on external ear sends signals to central nervous system through the cranial/spinal nerves, inhibiting inappropriate reflexes and modulates the physiological response by increasing the neurotransmitters (norepinephrine and serotonin) release.¹¹ Vagus nerve has parasympathetic control, visceral function, anxiety perception areas.⁷ Ear acupuncture at different points led to activation or deactivation brain structures, which seems to overlap regions belonging to the anxiety’s neurobiology.¹

Previous studies observed that auricular acupuncture at tranquilizing points had induced the activation of parasympathetic nerve tone and kept the Lower Frequency /Higher Frequency ratio at lower levels in post operative patients.¹² Thereby hypothesis is auriculotherapy at Shenmen and Point Zero will alleviate the exam anxiety. This study was aimed to measure immediate effect of auriculotherapy in alleviating the anxiety levels and manage the student’s stress level during the examination. Till today, there are many research study emphasising the effect of auriculotherapy on anxiety but this was to evaluate the immediate effect on exam anxiety.