Distal Forearm Arteriovenous Fistula Maturation in Diabetic Hemodialysis Patients

PURPOSE

Atherosclerotic disease of the forearm arteries can impede the maturation of distal fistulas in diabetic patients. The goal of this study was to look at the maturity of diabetic hemodialysis patients' distal forearm (radiocephalic snuffbox or distal forearm) arteriovenous fistulas.

MATERIALS AND METHODS

Patients with chronic renal failure who were candidates for distal forearm radiocephalic arteriovenous fistula implantation were evaluated in this cross-sectional study. Patients' demographic details, underlying disorders, laboratory measurements, vital signs, and information on their surgery were all noted. Patients were checked for fistula development 1 week, 1 month, 2 months, and then monthly until 6 months after surgery. Arteriovenous fistula maturation characterized by optimal blood flow, vessel dilation, and structural adaptations.

RESULTS

Among 343 patients (56% male, 44% female, mean age: 57.32 ± 12.48 years), hypertension prevailed (81.9%), followed by hyperlipidemia (42.3%) and coronary artery disease history (25.9%). AVFs achieved 58.3% maturation in 64.98 ± 11.05 days; higher BP during creation correlated with successful maturation (17.02 ± 1.46 mmHg vs 13.90 ± 1.93 mmHg, P < .05). No significant statistical difference found in distal forearm arteriovenous fistula maturation between males (57.8%) and females (58.9%) (P > .005). However, 41.7% of AVFs failed in 18.83 ± 17.89 days. Failed AVFs exhibited lower BP during operation and failure (11.75 ± 1.86 mmHg). Kaplan-Meier analysis depicted maturation probabilities over 90 days post-surgery.

CONCLUSION

Diabetes and patient sex did not affect the maturation time of distal forearm AVFs in hemodialysis patients. Increased blood pressure during and after surgery correlated with shorter maturation time.

Health-promoting lifestyle in mothers with vaginal childbirth and cesarean section in the postpartum period

BACKGROUND

In the postpartum period, there are numerous changes in the physical and psychological dimensions of women, which reduce the quality of life of women. The aim of this study was to compare the health-promoting lifestyle of mothers with vaginal delivery and cesarean delivery in the postpartum period.

METHODS

This cross-sectional study was conducted on 77 pregnant women who had delivered vaginal or by cesarean section at Shohadaye Behshahr Hospital and were selected based on inclusion criteria. If the women were willing to participate in the study, a demographic questionnaire was completed, and the telephone numbers of the subjects were recorded so that the Porsline health-promoting lifestyle questionnaire could be sent to them. Data were analyzed with SPSS 22 using the T test, chi-square test and Repeated Measure ANOVA.

RESULTS

There was no difference in the average score of health-promoting lifestyle and its dimensions between the two groups of vaginal delivery and cesarean section at two and six weeks after delivery. However, in both groups, the total score of health-promoting lifestyle decreased significantly over time (P < 0.001).

CONCLUSIONS

There was no difference in health-promoting lifestyle between mothers with vaginal and mothers with cesarean delivery at two weeks and six weeks after delivery. This requires more attention from policy makers to make vaginal childbirth more convenient, and by reducing complications after vaginal childbirth, they can improve women's healthy lifestyles and, in turn, families. Also, it seems that the other variables apart from the method of delivery should be considered, and it is necessary to distinguish these variables such as routine episiotomy in order to prevent the decrease in the level of health-promoting behaviors among women during puerperium period.

Association between gubernacular canals characteristics and teeth eruption status: a cone-beam computed tomography study

Background

There have been few studies that have evaluated the imaging characteristics of the gubernacular canal. Additionally, it is important to understand the role of this structure and its relationship with tooth erupt. Therefore, the objective of this study was to investigate the association between gubernacular canal features and teeth eruption status on cone-beam computed tomography (CBCT) images.

Material and Methods

In this cross-sectional study, 150 CBCT images were obtained from patients referred to a maxillofacial radiology clinic in Babol, northern Iran, in 2021. Eruption status (normal, delayed, and impacted) and the presence of the gubernacular canal were recorded. If the gubernacular canal was detected, its opening site in the alveolar crest (buccal, lingual, and central) and its attachment site to the dental follicle (usual, unusual) were further assessed.

Results

Gubernacular canal was observed in 133 (88.7%) of the total 150 CBCT images. Also, 41 cases (27.3%) had impacted teeth. The detection rate of the gubernacular canal in the normal, delayed, and impacted eruption of teeth was 92.1% (n=93), 75.0% (n=6), and 82.9% (n=34), respectively (p=0.135). Opening the gubernacular canal in the alveolar crest was not associated with teeth eruption status. Also, unusual attachment sites of the gubernacular canal to dental follicles were mostly seen in abnormal eruptions.

Conclusions

According to the findings, observing the presence of the gubernacular canal on CBCT may not help anticipate teeth eruption problems. Key words:Gubernacular canal, Cone-beam computed tomography, Tooth eruption.

The Effect of Warmed Serum on Shivering and Recovery Period of Patients Under General and Spinal Anesthesia: A Randomized Clinical Trial

PURPOSE

Postoperative hypothermia followed by shivering is a common phenomenon in patients undergoing surgery under anesthesia, and should be prevented and treated in postoperative patient care units. This study was conducted to investigate the effect of warmed serum injection on postoperative shivering and recovery period of patients operated under general and spinal anesthesia.

DESIGN

In this clinical trial, patients to be operated on under general and spinal anesthesia were randomly assigned into two groups of test and control. In the test group, patients received warmed intravenous fluids and blood products. All patients were monitored to record vital signs, incidences of hypothermia and shivering, and recovery period.

METHODS

The collected data were analyzed with repeated measures analysis of variance to detect significant differences between groups and significant changes within groups over time.

FINDINGS

The incidence of nausea, vomiting, and shivering in the intervention and control groups was (4.7%, 42%), (2.8%, 16.8%), and (6.6%, 43%), respectively. Patients in the intervention group had higher body temperature than the control group (<0.001). Also, patients under spinal anesthesia had higher body temperature than patients under general anesthesia (<0.001). Blood pressure reduction was also significantly higher in the control group than in the intervention group. The patients who received warm intravenous serum, and especially those who had received spinal anesthesia spent less time in the recovery room (<0.001).

CONCLUSIONS

The use of warmed intravenous serum increased the patients' core temperature, reduced their postoperative shivering, and shortened their recovery period. Considering the potential risks associated with hypothermia, using such methods for hypothermia prevention can be highly effective in preventing shivering and prolongation of the recovery period and other potential complications. Anesthesia specialists and technicians are therefore encouraged to use this method as a preventive measure.

Sexual Function, Religion, Existential Well-being and Mental Health among Iranian Married Women of Reproductive Age

The present study investigates the relationship between sexuality and spirituality with mental health among Iranian married women of reproductive age. It was a cross-sectional, correlational study with a sample size of 120 Iranian married women in 2022. Goldberg general health, Female Sexual Function Index, and Paloutzian and Ellison spiritual health questionnaires were used to collect data. The level of spiritual health scale (SWBS) in more than half of the married women was high (50.8%) and 49.2% at the average level. Sexual dysfunction was reported at 43.3%. Sexual function, religious and existential well-being was predictors of mental health and its dimensions. The risk of sexual dysfunction was 3.33-fold higher in people who had an unfavorable level of SWBS (β = 3.33, CI: 1.558-7.099, P = 0.002) compared to those who had a favorable level of SWBS. Therefore, adhering to sexual health and relying on spirituality are emphasized in preventing mental health problems.

Microtensile Bond Strength of Different Bonding Agents to Superficial and Deep Dentin in Etch-and-Rinse and Self-Etch Modes

Objectives: This study aimed to assess the microtensile bond strength (µTBS) of etch-and-rinse (E&R), self-etch (SE), and universal adhesives to superficial and deep dentin. Materials and Methods: In this in vitro study, 40 sound third molars were randomly divided into two main groups of superficial and deep dentin. Based on our classification, superficial dentin was right beneath the deepest occlusal groove, and deep dentin was 2mm beneath the deepest occlusal groove. Each group was divided into 4 subgroups (n=20) for application of Adper Single Bond 2 (ASB), Clearfil SE Bond (CSE), and Scotchbond Universal (SBU) in E&R and SE modes along with Charisma Smart composite resin on dentin. The specimens were incubated in distilled water at 37°C for 24 hours and their µTBS was then measured. The mode of failure was determined under a stereomicroscope at ×40 magnification. Data were analyzed by one-way ANOVA (alpha=0.05). Results: The highest µTBS belonged to the superficial dentin/SBU/E&R group. The µTBS was significantly higher in superficial dentin than deep dentin for all adhesives (P=0.005). There was no significant difference in mode of failure among the groups. Conclusion: Based on the results obtained in the present study, type of bonding agent and application mode affected µTBS. In use of universal adhesive, E&R mode can improve µTBS.

Role of Marital Relationship Quality in Emotional Disturbance and Personal Growth of Women with Infertility: A Cross-Sectional Study

BACKGROUND

Infertility is a stressful condition that can lead to either emotional disturbance or personal growth. Marital relationship is one of the factors affecting the consequences of infertility. This study aimed to explore the role of marital relationship quality in development of women's personal growth after experiencing infertility.

MATERIALS AND METHODS

In the cross-sectional study, 122 infertile women (mean age 28.79 ± 6.3) were invited to complete the survey, including ENRICH Marital Satisfaction Scale, Posttraumatic Growth, Fertility problem inventory, State-Trait Anxiety Inventory, and Beck Inventory Depression.

RESULTS

Higher scores of quality of marital relationships were a protective factor against infertility stress and state/ trait anxiety. Additionally, infertility stress was a strong negative predictor of personal growth. Furthermore, infertile women with a high level of marital relationships may have more chances to experience personal growth rather than stress in infertility treatments.

CONCLUSION

The study suggests that high quality of marital relationships may provide positive opportunities for women's personal growth after experiencing infertility.

Effects of adding functionalized graphene oxide nanosheets on physical, mechanical, and anti-biofilm properties of acrylic resin: In vitro- experimental study

Background

Polymethyl methacrylate resin is widely used in orthodontic treatments. Graphene oxide (GO) has reactive functional groups on its surface that facilitate binding to various materials such as polymers, biomolecules, DNA, and proteins. This study aimed to investigate the impact of adding functionalized GO nanosheets on the physical, mechanical, cytotoxicity, and anti-biofilm properties of acrylic resin.

Materials and Methods

In this experimental study, fifty samples (for each test) were divided into groups of 10, in the form of acrylic resin discs with concentrations of 0, 0.25, 0.5, 1, and 2 weight percentage (wt%) of functionalized GO nanosheets and also the control group. Samples were evaluated in terms of physical properties (surface hardness, surface roughness, compressive strength, fracture toughness, and flexural strength), anti-biofilm properties (On four groups of micro-organisms, including Streptococcus mutans, Streptococcus sanguis, Staphylococcus aureus, and Candida albicans), and cytotoxicity. Data were analyzed using SPSS software version 22, descriptive statistics, one-way analysis of variance test, and Tukey post hoc test. The significance level was considered P < 0.05.

Results

No significant difference was observed between the different groups with weight percentages of 0.25, 0.5, 1, and 2% nano GO (nGO) and the control group (without nGO) in terms of surface roughness and toughness. However, compressive strength, three-point flexural strength, and surface hardness showed significant differences between the groups. Furthermore, the degree of cytotoxicity increased by increasing the weight percentage of nano-GO.

Conclusion

The addition of functionalized nGO in appropriate concentrations to polymethyl methacrylate can improve the anti-bacterial and anti-fungal biofilm properties without changing or increasing their physical and mechanical properties.

Antifungal Effect of Ginger Essential Oil Spray on Candida albicans Adhering to Self-Cure Acrylic Plates

Objectives: The present study aimed to evaluate the efficacy of ginger essential oil spray for elimination of Candida albicans (C. albicans) adhering to self-cure acrylic plates. Materials and Methods: In this experimental study, 120 self-cure acrylic discs were contaminated with C. albicans and randomly divided into four main groups: exposure to ginger essential oil, nystatin (positive control), distilled water (negative control), and no exposure. The minimum inhibitory concentration (MIC) of ginger oil and nystatin was determined by the microdilution test. The stability of C. albicans was determined by culturing the samples of treated acrylic plates and comparing the mean number of remaining colonies. Data were analyzed using the Kruskal-Wallis test followed by Dunn test with Bonferroni correction.  P<0.05 was considered significant Results: The MIC of ginger essential oil and nystatin was found to be 1560µg/mL and 4µg/mL, respectively. The differences between the mean count of C. albicans colonies before (10175±10730.25) and after the exposure to ginger essential oil (542.86±464.81) and nystatin (257.14±247.67) was statistically significant (P<0.001). The mean number of C. albicans colonies after spraying with nystatin was not significantly different compared with ginger essential oil (P=0.204). The efficacy of nystatin and ginger essential oil at each time was significantly more than distilled water (P<0.001). At 10 and 15min, there was no significant difference between nystatin and ginger essential oil groups (P=0.05). Conclusion: Ginger essential oil spray was found to be a simple and effective method for elimination of C. albicans adhering to acrylic discs.

The effect of instructing mothers in attachment behaviors on short-term health outcomes of premature infants in NICU

BACKGROUND

The birth of a pre-mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short-term health outcomes of pre-mature infants admitted to neonatal intensive care units (NICUs).

MATERIAL AND METHODS

In this quasi experimental study, 80 mothers of pre-mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother-infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant's Maternal Attachment Assessment Strategy. Moreover, infants' short-term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis.

RESULTS

On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4-42/11) and 37 (31/85-42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05).

CONCLUSION

Instructing mothers in attachment behaviors clinically improved short-term health-related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre-mature infants.

The prevalence and correlation of depression and anxiety with disease activity in rheumatoid arthritis

INTRODUCTION

Depression and anxiety share similar symptoms with rheumatoid arthritis (RA) and these conditions are often not diagnosed or overlooked in RA. This study aimed to determine the prevalence of depression/anxiety in RA and their correlation with RA activity.

MATERIAL AND METHODS

Rheumatoid arthritis patients who presented at a rheumatology clinic were selected consecutively. The diagnosis of RA was confirmed by the ACR/EULAR criteria, disease activity was assessed by Disease Activity Score based on the 28-joint count (DAS28) and patients with DAS28 > 2.6 were considered to have active RA. The diagnosis of depression and anxiety was made by the Hospital Anxiety and Depression Scale (HADS). The Pearson test was used to determine the correlation between DAS28 and HADS scores.

RESULTS

Two-hundred patients (female, 82%) with a mean age of 53.5 ±10.1 years and mean disease duration of 6.6 ±6.8 years were studied. Depression was diagnosed in 27 (13.5%) patients and anxiety in 38 (19%) patients. The DAS28 score correlated positively with depression (r = 0.173, p = 0.014) and anxiety score (r = 0.229, p = 0.001). In multiple logistic regression analysis after adjustment for all covariates, age < 40 years and female sex were independently associated with RA activity in patients with depression, with OR = 4.21 (p = 0.002) and OR = 3.56 (p = 0.028) respectively.

CONCLUSIONS

These findings indicate that depression and anxiety are prevalent in RA and correlate positively with active disease in particular in depressive female patients aged < 40 years.

Subjective well-being predicts Covid-19 risk in the elderly: a case-control study

BACKGROUND

Covid-19 is a serious public health concern. Previous studies have shown that although there are concerns about the subjective well-being (SWB) of older people in the Covid period, the link between SWB and the risk of Covid-19 is still unclear. This study aimed to investigate the predictive effect of SWB on the Covid-19 risk in the elderly as well as the determinants of SWB.

METHODS

This case-control study was performed in the elderly over 60 years of age. The case group consisted of all hospitalized patients with COVID-19 and the control group from the same population with no history of COVID-19 matched by age, sex, and place of residence. Data collection tools included a demographic questionnaire and SWB scale of Keyes and Magyarmo to measure emotional, psychological and social well-being. All data were analyzed via SPSS and STATA software. Multiple binary logistic regression was run to predict the probability of Covid-19 risk on the values of total SWB and its three subscales and multiple linear regression to identify SWB determinants.

RESULTS

The results showed that increasing one unit in total SWB reduces the risk of Covid-19 by 4% (OR = 0.969, CI = 0.947-0.991, p = 0.006). Emotional well-being with 0.823 had the highest odds ratio for predicting Covid-19 risk, followed by social well-being with an odds ratio of 0.981. Increasing age and education, better economic status, marriage against celibacy, lack of comorbidity, and a better understanding of own health were associated with greater SWB.

DISCUSSION

This study provides evidence for the protective effect of SWB on Covid-19 risk. To promote SWB, we need to focus on the elderly with higher financial worries and comorbidities, as well as those with less education, health perception and SWB. Therefore, it will be important for the elderly to determine strategies to improve SWB during the epidemic.

Role of spiritual intelligence and demographic factors as predictors of occupational stress, quality of life and coronavirus anxiety among nurses during the COVID-19 pandemic

AIM

This study investigated the impact of spiritual intelligence and demographic factors in the prediction of occupational stress, quality of life and coronavirus anxiety among nurses.

DESIGN

A cross-sectional study was planned.

METHODS

The study was conducted among full-time nurses who were employed in two teaching hospitals of Babol city which were referral centres for caring patients infected with COVID-19 from February-May 2021. One hundred and twenty-nine nurses completed five questionnaires including the demographic questions, Quality of life (WHOQOL-BRIF), Occupational Role Questionnaire (ORQ), Spiritual Intelligence and Coronavirus Anxiety Scale.

RESULTS

The findings revealed that 69% of the nurses experienced moderate occupational stress, moderate quality of life and low coronavirus anxiety. Spiritual intelligence was the only significant negative predictor of occupational stress (β = -0.517, p = <0.001). The only positive predictor of quality of life was perceived income adequacy. Predicting factors of coronavirus anxiety were the perceived income adequacy as protective (β = -0.221, p = 0.022) and the number of children as predisposing (β = 0.401, p = 0.004) factors. These findings should be considered when planning nursing interventions for improvement of occupational stress, quality of life and anxiety especially during crises like the COVID-19 pandemic.

Reliability of Upper Limb Neurodynamic Tests: Median, Radial, and Ulnar Nerves

Objective Upper limb neurodynamic tests are used to evaluate the mechanical sensitivity of the peripheral nerves. However, very little is known about the reliability of upper limb neurodynamic tests, especially for the radial and ulnar nerves. This study aimed to evaluate the reliability of neurodynamic tests of the upper extremities to test median, radial, and ulnar nerves. Materials & Methods In this observational cross-sectional study, 25 asymptomatic subjects aged 19-45 years participated. They were selected using simple non-random sampling. Then two examiners performed the neurodynamic tests on them on two successive days. The goal was to assess the reliability of median, radial, and ulnar neurodynamic tests. During the neurodynamic tests, the participants reported the initial stretching pain and the moment of submaximal pain (substantially obvious pain) in related areas of the nerve distribution, including the anterior side of the elbow and forearm for the median nerve, posterolateral aspect of the elbow and forearm for radial nerve, and medial side of elbow and forearm for the ulnar nerve. At the starting point of painful stretching and the submaximal pain, the angle of elbow extension (for median and radial nerve tests) and shoulder abduction angle (for ulnar nerve test) were measured using a mechanical goniometer. The range between these two points was used to analyze the reliability. The intraclass correlation coefficient (ICC) and the standard error of measurement (SEM) were calculated to examine the relative and absolute reliability, respectively. Using t-test, the difference in the mean of the measurements was calculated. Results No significant difference was found between the mean measurements of the two testers in intra-session and inter-session reliability. For examiners 1 and 2, was obtained 0.94 (SEM:2ο) and 0.89 (SEM:2.85ο) for the median nerve, 0.56 (SEM:6.36˚ ) and 0.93 (SEM:1.82ο) for radial nerve, and 0.42 (SEM:3.27ο) and 0.79 (SEM:1.42ο) for the ulnar nerve. Inter-tester intra-session reliability was obtained at 0.84 (SEM: 3.44ο), 0.54 (SEM: 6.1ο), and 0.55 (SEM: 2.75ο), respectively, for median, radial, and ulnar nerves. Inter-tester inter-session reliability was obtained at 0.97 (SEM:1.43ο), 0.69 (SEM:5.06ο), and 0.51 (SEM: 2.8˚ο), respectively, for median, radial, and ulnar nerves. Conclusion The upper limb neurodynamic tests and measurement of the range between the onset of stretching pain and the point of submaximal pain have moderate to excellent reliability. Therefore, these clinical tests can be used in diagnostic evaluations and treatment interventions. Also, the median nerve neurodynamic test has higher relative reliability than radial and ulnar nerve neurodynamic tests.

The role of psychological self‐care on worry of vaccination against COVID‐19 in Iranian pregnant women: A cross‐sectional study

Background and Aims

Although previous studies have reported some psychological factors to prevent the worry of vaccination against COVID‐19 in pregnant women, the role of psychological self‐care is unclear. The present study aimed to investigate the role of psychological self‐care in pregnant women on the depressive symptoms, psychological distress, and worry of vaccination against COVID‐19.

Methods

The present cross‐sectional study was conducted during the peak of the Delta variant of COVID‐19 in Babol city (North, Iran) from August to November 2021. Two hundred pregnant women referring to three prenatal clinics completed five questionnaires including; demographic characteristics, Edinburgh postnatal depression scale, psychological self‐care, brief symptom inventory 18, corona disease anxiety scale, and acceptance of vaccination‐3 inventory.

Results

Pregnant women were in relatively good condition based on psychological self‐care but were not significantly associated with demographic characteristics, such as age, gestational age, educational background, pregnancy, and risk of parity. It was psychological self‐care of pregnant women which negatively predicted the depressive symptoms (β = −0.311, p < 0.001), anxiety symptoms (β = −0.269, p < 0.001), psychological distress (β = −0.269, p < 0.001), and worry of vaccination against COVID‐19 (β = −0.214, p < 0.001).

Conclusion

Women's psychological self‐care plays a protective role against the depressive symptoms, anxiety symptoms, psychological distress, and worry of vaccination against COVID‐19 during pregnancy. Clinicians need to pay more attention to the role of psychological self‐care as an important factor in preventing the symptoms of anxiety and depression during regular pregnancy visits.

Mortality in patients with myocardial infarction and potential risk factors: A five-year data analysis

BACKGROUND

Coronary artery disease (CAD) is among the most common causes of death in almost all countries across the world. Awareness of risk factors for the management and prevention of the disease can reduce complications and mortality rates. This study was conducted with the aim to investigate the mortality and potential risk factors of myocardial infarction (MI) as well as their relationships in patients who were admitted to one university hospital in the North of Iran from 2014 to 2018.

METHODS

This study had retrospective descriptive design. Using a checklist, all necessary information was extracted from 5-year medical records data of MI patients in the university hospital from 2014 to 2018 (n = 564). The data analysis was performed in SPSS software using descriptive statistics and two binary logistic regression analyses.

RESULTS

The results showed that the mean age of the patients was 62.78 ± 13.38 years, and most of them were men (66.3%). The patients' mortality was 18.6% in a 5-year analysis. However, the number of mortalities was higher in the women (P = 0.001). Descriptive analysis showed that the most common risk factors of the disease in both genders were hypertension (46.6%), diabetes mellitus (DM) (38.5%), hyperlipidemia (24.1%), smoking (20%), and family history of CVDs (18.8%), respectively. However, the results of the adjusted regression model showed that the odds ratio (OR) of the patients' mortality increased in diabetic MI patients (OR: 2.33; 95%CI: 1.42-3.81; P = 0.001), but this ratio decreased in MI patients with a history of hyperlipidemia (OR: 0.23; 95%CI: 0.11-0.44; P ˂ 0.001).

CONCLUSION

Based on the results, individual- and population-based prevention strategies by focusing on hypertension and diabetes are recommended in our health programs. Surprisingly, the mortality rate of MI patients was lower among those with a history of hyperlipidemia. There are different hypotheses for the cause of this. Therefore, laboratory studies with animal models and prospective cohorts are suggested for future studies.

Genetic Diversity, Carbapenem Resistance Genes, and Biofilm Formation in UPEC Isolated from Patients with Catheter-Associated Urinary Tract Infection in North of Iran

BACKGROUND

Infections due to carbapenem-resistant Enterobacteriaceae (CRE) are associated in patients with urinary catheters alarming rate of emergency status. The aim of this study is to investigate the molecular causes of carbapenem resistance among UPEC as well as antimicrobial resistance trends. Additionally, the potential of isolates to produce biofilms, in addition to their clonal and genetic diversity, was investigated. Material and Methods. A cross-sectional study was accomplished on a collection of 76 non-duplicate UPEC isolates obtained from CAUTIs from May 2021 to September 2021. The modified carbapenem inactivation method (mCIM) and EDTA-modified carbapenem inactivation method (eCIM) test was performed for the detection of carbapenemase and metallo-beta-lactamase activity. Also, the presence of carbapenemase genes was determined using PCR assays. In 96-well microtiter plates, biofilm development was evaluated. ERIC-PCR was used to investigate the clonal and genetic variety of isolates.

RESULTS

A total of 76 confirmed UPEC isolates were obtained from patients mentioned to teaching hospitals in Babol, Iran. The results of antibiotic susceptibility testing revealed a high rate of antibiotic resistance against nalidixic acid (81.6%) and trimethoprim-sulfamethoxazole (80.3%). Among UPEC isolates, 63.2% and 13.2% of UPEC isolates were positive for MBL production. The frequencies of the studied genes are in order of bla _NDM (14.5%), bla _OXA-23 (2.6%), and bla _OXA-48 (2.6%). Forty-two isolates (55.3%) were positive for biofilm formation. ERIC-PCR revealed that UPEC isolates could be categorized into nine clusters A-I and five isolates were categorized as a singleton.

CONCLUSION

The high prevalence of MDR and carbapenemase-producing isolates among the UPEC strain in this investigation is concerning. Moreover, the bla _NDM was the most frequent cause of producing metallo-beta-lactamase and carbapenemase. Also, analysis revealed a partial genetic similarity among the studied isolates, indicating that the same UPEC clones may have spread to other hospital units.

One-year prevalence and the association between SARS-CoV-2 cycle threshold, comorbidity and outcomes in population of Babol, North of Iran (2020-2021)

BACKGROUND

The present study aimed to investigate the one-year prevalence of SARS-CoV-2, common comorbidities and demographic information among negative- and positive rRT-PCR in health care workers (HCW), hospitalized and outpatients. Also, the association between SARS-CoV-2 cycle threshold (Ct) and the outcomes of patients were analyzed in Babol, northern Iran.

METHODS

This large retrospective cross-sectional study was performed between March 2020 and March 2021. The records of 19232 hospitalized, outpatients and HCW suspected to COVID-19 were collected from teaching hospitals in the North of Iran.

RESULTS

Out of the 19232 suspected to COVID-19 patients, 7251 (37.7%) had a positive rRT-PCR result; 652 (9%), 4599 (63.4%) and 2000 (27.6%) of those were categorized as HCW, hospitalized and outpatients, respectively. Moreover, between the hospitalized and the outpatient group, 10.2 and 0.8% cases died, whereas no death cases were reported in the HCW. Furthermore, it seems that death rate was significantly different between the three groups of Ct value, the highest mortality in those with Ct between 21 and 30 (group B=7.6%) and the lowest in the group with the highest Ct (between 31 and 40 = 5.5%) (p<0.001).

CONCLUSION

In summary, 37.7% of cases were positive for SARS-CoV-2; of which, 63.4, 27.6 and 9% were hospitalized, outpatients and HCW, respectively. With regard to the mortality rate in hospitalized patients and the significant association with Ct under 20 and 30, it seems that the early detection and the initial quantification of SARS-CoV-2 in the first week of the conflict and therapeutic considerations to reduce the relative load can reduce the mortality rate.

Evaluation of Olfactory Function by Iranian Smell Diagnostic Test in Patients with Parkinson's disease in North of Iran

Introduction

Parkinson's disease is a neurodegenerative and multisystem disorder affecting systems more than the motor system. The olfactory disorder is an early non-motor symptom of Parkinson's disease.

Materials and Methods

The present study was conducted on 110 patients aged 50-95 years with a diagnosis of Parkinson's disease referred to the Neurology Clinic of Babol University of Medical Sciences between 2018-2019. The control group consisted of 50-95-year-old non-neurological patients who were matched for age and gender with patients with Parkinson's disease. Data were collected by examination, demographic and clinical information questionnaire (duration of disease, the severity of disease, symptom index), as well as Iranian smell diagnostic test. A p-value less than 0.05 was considered statistically significant.

Results

The mean age scores of Parkinson's disease and control groups were obtained at 69±9 and 66±9 years, respectively. The mean duration of the disease was 5 years. Patients with Parkinson's disease scored lower on the Iranian smell test, and olfactory function was significantly reduced in the case group (P<0.001). Based on the results, olfactory function in patients with Parkinson's disease was not significantly correlated with gender, marital status, education, place of residence, and occupation(P<0.05). Only olfactory dysfunction was increased with age (P=0.01). In addition, olfactory dysfunction showed no significant relationship with severity of disease, duration of disease, and clinical index sign. Rapid Iranian smell test with a cut-off of 3.5% had a sensitivity of 87.3% and a specificity of 66.4%.

Conclusion

According to the obtained results, olfactory dysfunction is an important non-motor and a primary symptom in patients with Parkinson's disease and is not related to the duration and severity of motor symptoms and symptom index.

Risk of COVID-19 infection in patients with rheumatic disease taking disease-modifying anti-rheumatic drugs

BACKGROUND AND OBJECTIVE

Patients with rheumatic disease taking long-term disease-modifying anti-rheumatic drugs (DMARDs) are expected to have a higher risk of infection due to the alterations in cellular immunity associated with these medications. However, the potential risks associated with these drugs remain unclear. This study aimed to estimate the risk of COVID-19 infection in patients with rheumatic disease taking disease-modifying anti-rheumatic drugs.

METHODS

Patients with autoimmune rheumatic disease taking DMARDs with or without long-term (> 6 months) HCQ treatment prior to the COVID-19 outbreak were selected consecutively. The diagnosis of COVID-19 was made based on the history of symptoms suggestive of the disease and/or serum IgG positivity. During statistical analysis, the risk of COVID-19 infection was calculated in rheumatic patients taking DMARDs versus controls, as well as in patients taking HCQ versus those who are not. The ORs and 95% CIs were also calculated. The participants in the control group were selected from individuals without RD.

RESULTS

A total of 800 patients with RD and 449 controls were analyzed. COVID-19 infection was detected in 16.8% of rheumatic patients versus 17.6% of controls (OR 0.95; 95% CI 0.7-1.28). The proportions of COVID-19 infection in HCQ users versus non-users were 15.3% and 18.1%, respectively (OR 0.87; 95% CI 0.61-1.26). These results remained unchanged after adjusting for all covariates using logistic regression analysis.

CONCLUSION

These findings indicate that rheumatic patients taking DMARDs are not at a higher risk of COVID-19 infection, and that HCQ therapy has no influence on the risk of COVID-19 infection. Key points • The risk of COVID-19 infection is not higher in patients with RD on DMARD therapy. • The prevalence of COVID-19 infection in HCQ users has not significant difference relative to non-users. • Significant percent of RD patients taking DMARDs had asymptomatic infection. • There was a positive association between leflunamide therapy and the risk of COVID-19 infection.

Health-promotion and health-harming behaviours in pregnant women: role of coping strategies, anxiety, and depression

There is a lack information on psychological predictors of health-promotion and health-harming behaviours during pregnancy. The study aimed to examine whether psychological factors including anxiety, depression, and coping strategies could predict the health-promotion and health-harm behaviours of pregnant women. In a cross-sectional study 200 pregnant women with singleton pregnancies, older than 18 years, and with at least 5 years of education were enrolled. The participants completed four questionnaires during their prenatal care appointments. The questionnaires included the prenatal health behaviour scale (PHBS), Revised Prenatal Coping Inventory (NU-PCI), Beck Depression Inventory (BDI-II), and State-Anxiety Inventory. The results revealed that planning-preparation coping was a strong positive independent variable associated with healthy behaviours (health-promoting behavioural/nutrition (β = 0.800, p = .001); health-promoting physical activity (β = 0.191, p = .049)). It was negatively associated with unhealthy behaviours (health-harming behavioural/nutrition (β = 0.290, p < .001) as well as health-harming physical activity (β = -0.290, p = .010)). Anxiety was significantly associated negatively with healthy behaviours. Depression was the strongest positive independent variable correlated with health-harming behavioural/nutrition (β = 0.290, p < .001). Finally, avoidance coping (β = 0.179, p = .037) was significant for health-harming physical activity.Impact statementWhat is already known on this subject? Previous studies have shown that there is a correlation between psychological factors and healthy behaviours of pregnant women.What do the results of this study add? The findings highlight the significant roles of coping strategies, anxiety, and depression for predicting healthy or unhealthy behaviours of pregnant women.What are the implications of these findings for clinical practice and/or further research? The findings implied that pregnant women who use more adaptive coping strategies, especially planning- preparing coping, reported lower levels of anxiety/depression and engaged more in healthy behaviours. The study also suggests that obstetricians and health care providers should pay more attention to the roles of coping strategies, especially planning-preparation and avoidance coping, anxiety, and depression in improving health-promotion/health-harming behaviours of pregnant women.

Evaluation of Impact of Life-Style-Related Risk Factors in Age-Related Cataract

Cataract is a multifactorial ocular disease, resulting in turbidity or opacity of the lens of the eyes, which leads to blindness or reduction of visuality. The different environmental, socio-economical, and lifestyle factors indicate as risk factors of age-related cataracts. The aim of this study was the evaluation of daily activity, dietary regimen, residence location and etc., as risk factors of age-related cataracts. In this census, a crosssectional study was performed on 353 patients with age-related cataract underwent surgery, who referred to Rouhani Hospital in Babol, Iran from 2018 to 2019, and 343 healthy individuals. The lifestyle-related information was collected from all individuals via the designed questionnaire. Our results showed that there were significant correlations between the birth/residence in the village (comparing to city, P<0.001), abnormal sleeping time (P<0.001), daily activity (and being outdoor, P<0.001), and use of solid oil (P<0.001) with increasing in age-related cataracts. Furthermore, the use of antioxidant-containing fruits significantly reduces the risk of age-related cataracts. Our results established that lifestyle clearly has a golden impact on age-related cataracts. The reduction in daily activity, normal sleeping time, and more use of antioxidant-containing dietary regimen play a preventive role in age-related cataracts.

Evaluation of organizational and social commitments and related factors during the coronavirus pandemic of healthcare workers in northern Iran

Background

Serious conditions caused by the coronavirus epidemic are expected to affect the mental and physical health, organizational and social commitments of healthcare workers. Therefore, this study aimed to evaluate the organizational and social commitments and related factors during the coronavirus pandemic of healthcare workers in northern Iran.

Methods

This descriptive-analytical study was conducted in 2020 among 260 healthcare workers of Babol health centers by a stratified-random sampling method. Data were collected according to a valid and reliable questionnaire consisting of three parts: 8 questions about personal and job characteristics, 15 questions from Porter Organizational Commitment Questionnaire (OCQ), 15 questions from Carroll’s social responsibility. Each question was scored on the Likert scale of organizational and social commitment questionnaires. Data were analyzed by chi-square and logistic regression. P < 0.05 was considered as statistically significant.

Results

None of the healthcare workers belonged to the category of low organizational commitments. A portion of 27.7% of the healthcare workers had moderate organizational commitments and 72.3% had high organizational commitments. A portion of 9.2% of the healthcare workers had moderate social commitments and 90.8% had high social commitments. Chi-square showed that education (p = 0.001), job position (p = 0.001) and the area in which healthcare workers were present for service (p = 0.002) were significantly associated with organizational commitments. According to OR in the logistic regression model, healthcare workers with master’s and doctoral education levels had 3.482 times more social commitments than others and the health group had 2.455 times more social commitments compared to the treatment group.

Conclusion

The results of this study showed that at the time of the coronavirus outbreak, the healthcare workers in Babol had very positive and high organizational and social commitments. As the world struggles with the coronavirus pandemic, employee and organizational productivity may decline due to the fear and anxiety of healthcare workers in various organizations. It is expected that managers of health-related organizations, social, economic, and cultural organizations use the results of this study to identify factors affecting the organizational and social commitments of employees and strengthen them.

Cytomorphometric Analysis of Buccal Exfoliated Cells in Patients With Iron Deficiency Anemia

Iron deficiency anemia can cause histopathologic alterations in the oral mucosa. Exfoliative cytology is a cheaper and less aggressive method for early diagnosis. The aim of this study was to compare the cytological and cytomorphometric characteristics of buccal exfoliated cells of iron deficiency anemic patients with those of healthy controls. This case-control study compared a group of 40 patients with iron deficiency anemia (IDA) with an age- and gender-matched control group (C) of 40 healthy individuals. The buccal mucosal smears were stained using the Papanicolaou technique for cytological analyses. Cellular clumping, cytoplasmic diameter (CD), nuclear diameter (ND), cytoplasmic area (CA), nuclear area (NA), nucleus to cytoplasmic area ratio (NA/CA), cellular and nuclear pleomorphism, micronuclei (Mn), binucleation, bacterial colonies, and keratin flakes were evaluated using a light microscope and digital image analysis. Mean values for IDA and C groups were: bacterial colonies (1.88 and 0.65; P=0.002); CA (2209.88 and 1687.79 μm²; P=0.006); Mn (1.60 and 0.60; P=0.02). Significant increases in bacterial colonies, CA and Mn were seen for the IDA group. The number of cellular clumps, CD, ND, NA, NA/CA, cellular and nuclear pleomorphism, binucleation, and the number of keratin flakes didn’t show significant differences between studied groups (P>0.05). There wasn’t any significant difference with respect to overall atypia. This study revealed that IDA was able to induce significant changes in CA and Mn of the oral epithelial cells. Exfoliative cytology and cytomorphometry can be used as a tool to assess the mucosal changes in IDA patients.

Effect of supportive counseling on pregnancy-specific stress, general stress, and prenatal health behaviors: A multicenter randomized controlled trial

OBJECTIVE

The aim of this study was to investigate the effects of group supportive counseling (SC) on pregnancy-specific stress, general stress, and healthy behavior of pregnant women.

METHODS

This randomized controlled trial study was conducted on 80 pregnant women in two groups; SC for six sessions, once a week for two hours (n = 40), and antenatal usual care (AUC) (n = 40). All Participants completed questionnaires measuring pregnancy-specific stress, state anxiety, prenatal health behaviors, perceived stress, and provided a saliva sample for measurement of cortisol at pre-intervention and 6-week post-intervention.

RESULTS

The post-intervention results indicated that the outcome scores decreased more significantly in group SC than in the AUC for total NuPDQ, for state-anxiety, for PSS-14, and for unhealthy behaviors with a large effect size. Also, healthy behaviors were promoted more significantly in SC group than in AUC. However, salivary cortisol levels did not differ between group SC and AUC groups.

CONCLUSION

Group supportive counselling can promote pregnancy stress and healthy behaviors.

PRACTICE IMPLICATIONS

Addition of supportive counseling to prenatal usual care may be suggested for pregnant women with any gestational age who seek methods for improving pregnancy stress and healthy behaviors.

Changes of the Patellar Tendon Moment rm Length in Different Knee Angles: A Biomechanical in Vivo Study

Patellar tendon moment arm length (PTma) changes at different knee flexion angles have not been determined in in vivo studies. We aimed to determine PTma in four different knee angles using Magnetic Resonance Imaging (MRI) to predict in vivo changes in the moment arm length from different knee angles during running. PTma was measured as the perpendicular distance from muscle-tendon line of action to the knee joint axis of rotation at 0° (full extension), 20°, 40°, and 60° flexion of knee by using MRI method. Repeated measure ANOVA method was applied to compare the moment arm length among four degrees of knee flexion (P<0.05). A regression analysis was used to predict the PTma during different knee joint angles. The PTma in the four angles at 0°, 20°, 40°, and 60° of knee flexion were 42.55±4.20, 39.91±2.98, 37.73±2.87, and 36.18±2.90 mm, respectively (P<0.05). The regression analysis provided an equation to predict the PTma from different knee joint angles during running. PTma values decreased from knee extension to flexion in a linear manner. These findings have important implications for estimating PTma using a regression equation model from different knee joint angles.

Psychometric Properties and Factor Structure of the Persian Version of Revised Prenatal Distress Questionnaire in Second and Third Trimesters

Background:

There are no proper tools for measuring pregnancy-specific stress in Iranian population. The aim of this study was psychometric evaluation of the Persian version of Revised Prenatal Distress Questionnaire (NuPDQ) for the first time in Iranian society.

Materials and Methods:

In a descriptive-analytic study, 269 pregnant women completed the NUPDQ at Obstetrics clinics of Mazanderan Province, Iran. The reliability of the 12-item NuPDQ and 17-item NuPDQ was reevaluated using Cronbach's alpha and internal consistency. Concurrent validity was assessed using the Spielberger state-anxiety Inventory. Moreover, exploratory factor analysis was used to assess the structural factors of the questionnaire.

Results:

Factor analysis revealed that the 12-item NuPDQ consisted of four areas in the second trimester including medical and financial problem, physical symptoms, infant health, and parenting with the explained variance of 64.15%. The Persian version of 17-item NuPDQ consisted of 5 areas in the third trimester, including medical and financial problems, physical symptoms, infant health, parenting, and labor and delivery with an explained variance of 61.94%. In addition, interclass correlation coefficient in all 4 areas and overall scale score exceeded 0.90. Finally, the reliability was high based on Cronbach's alpha of 0.78 for 12-item NuPDQ and 0.79 for 17-item NuPDQ.

Conclusions:

The Persian version of 12-item NuPDQ in the second trimester and 17-item NuPDQ in the third trimester, as well as all the extracted subscales, had a good validity and reliability for assessing pregnancy-specific stress in Iranian society and can be used in clinical practice.

Effects of Rheumatoid Arthritis on the Larynx

Introduction:

The aim of the present study was to compare the videolaryngostroboscopic findings between patients with rheumatoid arthritis and vocally healthy controls.

Materials and Methods:

This case-control descriptive study was performed on 113 people, including 50 patients with rheumatoid arthritis and 63 controls. The participants were subjected to videolaryngostroboscopic examinations in order to evaluate fundamental frequency, different structural vocal lesions, patterns of glottal closure, subglottal changes, supraglottis appearance, and movement patterns of the arytenoid cartilage. The obtained results were compared between the two research groups. Data analysis was performed in the Statistical Package for the Social Sciences, version 24.0. A p-value less than 0.05 was considered statistically significant.

Results:

The results revealed a statistically significant difference between the two groups in terms of the complete pattern (P=0.00) and strained state of glottal closure (P=0.00), pattern of subglottal changes (χ²=25.98, df=2; P<0.001), and movement patterns of the arytenoid (χ²=21.16, df=1; P<0.001). Additionally, based on the obtained frequencies, the two groups showed significant differences regarding the normal state of the larynx (P=0.00), hypertrophy of vocal fold (P=0.007), epithelial change (P=0.007), and Reinke's edema (P=0.001). However, the videolaryngostroboscopic examination results revealed no significant difference between the two groups in terms of polyp (P=0.20), nodule (P=0.57), sulcus vocalis (P=0.08), cyst (P=0.45), and atrophy of vocal folds (P=0.45).

Conclusion:

It seems that rheumatoid arthritis affects the patterns of arytenoids movement, some kinds of glottal closure patterns, and subglottal changes. As the results indicated, the occurrence of some laryngeal structural changes was higher in patients with rheumatoid arthritis than in individuals without this disorder.

Effect of Psychotherapy on Reduction of Fear of Childbirth and Pregnancy Stress: A Randomized Controlled Trial

Introduction

The fear of childbirth (FOC) has an adverse effect on the physical and mental health of pregnant women and increases adverse maternal and fetal outcomes. Previous research reported the effect of psychological interventions such as cognitive behavioral therapy, relaxation therapies, and short-term psycho-educational intervention on FOC. We examined whether adding motivational interviewing (MI) psychotherapy to prenatal usual care (PUC) is superior to PUC alone to reduce the scores of FOC, pregnancy stress, and self-efficacy.

Materials and Methods

An RCT with two-arm parallel groups and 1:1 allocation ratio assigned 70 pregnant women (aged 18–50) attending public health centers in an education hospital in Iran to receive five sessions of group MI psychotherapy plus PUC (N = 35) or to receive PUC alone (N = 35). The primary outcomes were the FOC scores (Wijma Delivery Expectancy/Experience Questionnaire, W-DEQ), pregnancy-specific stress (Prenatal Distress Questionnaire, NuPDQ), anxiety (Spielberger state anxiety), and Childbirth Self-Efficacy Index (CBSI) at 5 weeks post-randomization. Additional measures included subscales of the W-DEQ and the NuPDQ, patients’ compliance, and satisfaction with psychotherapy intervention at 5 weeks post-randomization as secondary outcomes.

Main Results

The post-trial results indicated that the outcome scores diminished more considerably in psychotherapy than in PUC for total FOC scale with a large effect size (B = −23.54, p = < 0.001, η²η² = 0.27), for total pregnancy stress with a large effect size (B = −4.51, p = < 0.001, η² = 19), and for state anxiety with a large effect size (B = −12.42, p = < 0.001, η² = 0.22). However, the score of self-efficacy and concern about physical symptoms did not differ between the psychotherapy and PUC groups (P < 0.05).

Discussion

Adding 5 weeks of group psychotherapy to PUC could be considered as an adjunctive care option for reducing FOC, pregnancy stress, and general anxiety in pregnant women in the third trimester. Future research may focus on sustaining the effects and evaluating the economic impacts of adding psychotherapy to PUC.

Comparison of Genotoxic Effect in Buccal Exfoliated Cells between Cigarette and Waterpipe Smokers

BACKGROUND/AIM

Cytogenetic biomarkers such as micronuclei (MN) are used for the evaluation of exposure to carcinogens and genotoxic effects in oral epithelial cells. Tobacco is one of the strongest carcinogens responsible for the development of cancer in oral mucosa. The aim of this study was to compare the genotoxic effect of waterpipe smoking with that of cigarette smoking.

METHODS

This case-control study was performed on 30 waterpipe smokers, 30 cigarette smokers, and 30 nonsmokers. Buccal exfoliated cells were prepared using cytobrushes and stained with the Papanicolaou technique. The cytologic slides were examined under a light microscope for counting the number of MN and the number of cells with MN per 1,000 epithelial cells.

RESULTS

The mean number ± standard deviation (SD) of MN in waterpipe smokers, cigarette smokers, and nonsmokers was 7.55 ± 5.530, 4.95 ± 5.633, and 2.00 ± 2.406, respectively. The mean number ± SD of cells with MN in waterpipe smokers, cigarette smokers, and nonsmokers was 6.20 ± 4.830, 3.50 ± 3.832, and 1.45 ± 1.701, respectively. Numbers of cells with MN differed significantly between waterpipe smokers and cigarette smokers (p = 0.04) and between waterpipe smokers and nonsmokers (p < 0.001). Numbers of MN differed significantly between waterpipe smokers and nonsmokers (p < 0.001). Numbers of MN did not differ significantly between waterpipe smokers and cigarette smokers (p = 0.10). Numbers of MN and of cells with MN did not differ significantly between cigarette smokers and nonsmokers (p = 0.06 and p = 0.052, respectively).

CONCLUSIONS

Waterpipe smoking is associated with a significantly higher frequency of MN, and it seems that waterpipe smoking has a greater genotoxic effect than cigarette smoking.

Comparison of the calcium-related factors in Parkinson's disease patients with healthy individuals

Background:

Parkinson’s disease (PD) is one of the most common neurodegenerative diseases (ND). Studies have demonstrated that biochemical markers have an association with PD. We aimed to investigate an association of biochemical markers including calcium, vitamin D, alkaline phosphatase (ALP), parathormone (PTH), and phosphorous with PD.

Methods:

This study was conducted on 139 PD patients and 100 healthy individuals. Serum levels of calcium, phosphorous, ALP, PTH and vitamin D were evaluated. Furthermore, student’s t-test and logistic regression models were used by SPSS.

Results:

The mean levels of calcium (9.4±0.7 and 9.0±0.8 ) and vitamin D (29.7±22.1 and 25.8±23.7) were higher in PD patients as compared with healthy controls, which only status of calcium being significantly different in the two groups (P<0.001). Levels of ALP (202.4±96.7 and 242.9±142.4) and phosphorous (3.6±0.6 and 4.22±1.1) were significantly different comparing PD patients with healthy subjects (P<0.01, P<0.001, respectively). ALP and phosphorous were significantly different in the two groups (OR=0.996, [CI 95%, 0.994-0.999], P<0.001, OR=0.475, [CI 95%, 0.325-0.694], P<0.001, respectively). Furthermore, increased levels of calcium resulted in an elevated risk of PD (OR=2.175, [CI 95% 1.377-3.435], P<0.001).

Conclusion:

Results show that mean levels of calcium are higher in PD patients relative to healthy controls. Thereby, higher levels of calcium may be associated with PD.

Iranian propolis efficiently inhibits growth of oral streptococci and cancer cell lines

Background

Propolis is a natural bee product with a wide range of biological activities that are related to its chemical composition. The present study investigated the quantification of quercetin (Q) in Ardabil ethanol extract of propolis (AEEP), and then compared its anti-bacterial, anti- biofilm and cytotoxic effects on cancer and normal cell lines.

Method

In the present study, the chemical composition of AEEP was determined through the high-performance liquid chromatography (HPLC). The AEEP and its main component, quercetin (Q), were evaluated in vitro against 57 oral streptococci by a broth micro-dilution method. The biofilm formation was assessed through the crystal violet staining and MTT assays. The impact of AEEP and Q anti-proliferative effect were evaluated on the fibroblast as normal and cancer cell lines (KB and A431).

Results

The Q concentration in the composition of AEEP was 6.9% of all its components. The findings indicated that the AEEP and Q were efficient against the cariogenic bacteria and were able to inhibit the S.mutans biofilm adherence at a sub-MIC concentration. Moreover, electron micrographs indicated the inhibition of biofilms compared to control biofilms. In addition, the AEEP and Q indicated a dose-dependent cytotoxic effect on A431 and KB cell lines. On the contrary, they had no cytotoxic effect on fibroblast cells.

Conclusion

The results indicated that the synergistic impact of main components of AEEP was related to the inhibition of the cancer cell proliferation, cariogenic bacteria and oral biofilm formation. It may play a promising role in the complementary medicine and, it is suggested to be used as food additives.

Curcumin Effect on the Prevention of Gingival Overgrowth Following Phenytoin Consumption in Rats: A Clinicohistological and Immunohistochemical Study

AIM

At the moment there is no clear evidence with clinico-histological and immunohistochemical studies in animals to show the curcumin effect on the gingival overgrowth following phenytoin consumption. The purpose of the present study was to identify this subject.

MATERIALS AND METHODS

In this experimental study, 50 adult male Wistar rats were divided into three groups. The rats in groups I and II received 100 mg/kg of phenytoin per day. Group II also received 20 mg/kg intraperitoneal curcumin per day. The control group received the curcumin vehicle only. Gingival clinical dimensions were measured at the beginning and end of the study. The rats were then sacrificed, biopsy of gingiva was prepared, and the samples were stained with hematoxylin-eosin. Morphometry was performed to evaluate the degree of inflammation, epithelial thickness, number, and cross-sectional area of the blood vessels. Immunohistochemical staining was performed using Ki67 and α-SMA.

RESULTS

Compared to the control group, Phenytoin in group I increased gingival volume. There was significance difference in group II with group I and control after intervention in the clinical view (p = 0.002). The difference in the number of blood vessels between groups I and II was statistically significant (p = 0.001). Significant differences were observed in blood vessel cross-sectional area (p = 0.001), epithelial thickness (p = 0.002), Ki67, and α-SMA expression between groups I and II (p = 0.001).

CONCLUSION

In rats, curcumin seems to exerts its effects in preventing an increase in gingival volume caused by Phenytoin through decreasing the inflammatory infiltration, decreasing the number of blood vessels and increasing their cross-sectional area, decreasing the thickness of the epithelium, and decreasing the expression of Ki67 and α-SMA.

CLINICAL SIGNIFICANCE

It is suggested that curcumin may be effective in treatment of gingival enlargement following Phenytoin consumption in future. Larger sample size and clinical trials study are recommended. How to cite this article: Eftekharian S, Seifi S, Satari FD, et al. Curcumin Effect on the Prevention of Gingival Overgrowth Following Phenytoin Consumption in Rats: A Clinicohistological and Immunohistochemical Study. J Contemp Dent Pract 2019;20(10):1146-1150.

Evaluation of the cone-beam computed tomography accuracy in measuring soft tissue thickness in different areas of the jaws

Purpose:

Due to the extensive use of cone-beam computed tomography (CBCT) in dentistry, especially in measuring thicknesses of hard and soft tissues, and the fact that CBCT has low contrast resolution, the aim of this study was to evaluate the accuracy of CBCT in measuring soft tissue thickness.

Materials and Methods:

In this cross-sectional study, pink baseplate wax as a soft tissue simulation was overlaid in different areas of the jaws on the dry human skull, and the probe was used to determine the thicknesses of 1, 2, 3, and 5 mm. These thicknesses were then measured accurately with a digital caliper by one person four times at interval of a week. The skull was scanned using two CBCT scanners, and the different thicknesses of wax were measured by two observers four times with a week interval. The CBCT measurements were compared with digital caliper measurements as a reference.

Results:

Statistical analysis showed no significant difference between CBCT and digital caliper measurements for thickness < 2 mm (P > 0.05).

Conclusions:

Statistically, the difference between digital caliper and CBCT measurements was < 0.1 mm, but this difference is not clinically important. The accuracy of CBCT in measuring soft tissue thickness was 0.1 mm.

Eosinophil Density in Common Benign and Malignant Salivary Gland Tumors with Congo Red Staining

Purpose: Eosinophils are multifunctional leukocytes with unknown mechanisms in salivary gland tumors. Some researchers associate eosinophils with tumor progression and others have proposed them as antitumoral. The present study was conducted to compare the density of eosinophils in common salivary gland tumors and its relationship with the degree of differentiation in malignant salivary gland tumors. Materials and Methods: In this present descriptive-analytical, cross-sectional study, 15 cases of pleomorphic adenoma, 15 cases of adenoid cystic carcinoma (ACC), 30 cases of mucoepidermoid carcinoma (MEC), and 5 cases of normal salivary glands were extracted. Sections were prepared of these cases for Congo red staining. The malignant salivary gland tumors were classified as high-grade and low-grade malignancies. The slides were observed under ×10, and the highest-density areas were selected and counted in ten microscopic fields under ×40. Results: The density of the eosinophils was 4.5 ± 5.6 in the pleomorphic adenoma, 16.2 ± 6.01 in the low-grade MEC, 1.05 ± 1.1 in the high-grade MEC (Grade III), and the ACC, and 0.4 ± 0.89 in the normal salivary gland. Eosinophil density was significantly higher in low-grade malignancies compared to in benign or high-grade malignant neoplasms and normal salivary gland (P < 0.001). Conclusion: This is suggested which the density of eosinophils is associated with the process of tumorigenesis and the degree of malignancy in malignant salivary gland tumors.

Immunohistochemical expression of TWIST in oral squamous cell carcinoma and its correlation with clinicopathologic factors

Background and Objectives

TWIST is a transcription factor that plays a key role in the development of primary tumor to metastatic stage of cancer. It is an inhibitor of E-cadherin in epithelial-to-mesenchymal transformation process (epithelial-mesenchymal transition). Few studies are available on the use of TWIST as a goal in molecular-targeted therapy. The aim of this study was to evaluate of TWIST expression in oral squamous cell carcinoma (OSCC) and its correlation with clinicopathologic factors.

Materials and Methods

In this cross-sectional study, immunohistochemical staining was for TWIST performed on 30 paraffin-embedded blocks of OSCC. Furthermore, thirty paraffin-embedded blocks of normal oral mucosa with minimum inflammation from the clinical and histopathologic aspects were selected. Staining intensity and percentage of stained cells from nuclear and cytoplasmic aspects were ranked in epithelial cells. TWIST expression and correlation with clinicopathologic factors were analyzed using Cox regression and Chi-square tests.

Results

TWIST expression in OSCC was significantly increased compared to oral normal mucosa. Nuclear expression of TWIST in OSCC was significantly associated with clinical stage (P = 0.01) and lymph node metastasis (P = 0.007). Cytoplasmic expression of TWIST in OSCC was not associated with any clinicopathological factors.

Conclusion

The results support the role of TWIST in carcinogenesis, development of OSCC, and its metastasis to lymph nodes.

Vitamin D deficiency is associated with tibial bone pain and tenderness. A possible contributive role

BACKGROUND

Vitamin D deficiency is associated with osteomalacia and a variety of musculoskeletal pain. This study aimed to determine the association of vitamin D deficiency with tibial bone pain and tenderness.

METHODS

Patients with leg pain, defined as local pain and tenderness over tibial bones for ≥ 6 weeks were consecutively selected. Secondary causes of pain were excluded by appropriate clinical, radiological and laboratory examinations. Serum 25-hydroxyvitamin D (25-OHD) was assessed by enzyme-linked immunosorbent assay method and levels < 20 ng/mL were considered as deficiency. Age- and sex-matched subjects without leg pain served as controls. Multiple logistic regression analysis was used to determine associations.

RESULTS

One hundred and eighteen patients and 114 controls aged 46.8 ± 14.8 and 44.6 ± 14.1 years, respectively (P = 0.93) were analyzed. Mean 25-OHD level was significantly lower (P = 0.001) and the prevalence of 25-OHD deficiency was significantly higher in the patients as compared with the controls (75.4% vs. 23.6%), odds ratio (OR) = 9.54 (95% CI, 5.22-17.45, P = 0.001). There was a negative dose-response relationship between serum 25-OHD and tibial bone pain by OR = 17.33 (95% CI, 6.48-46.3) in subjects with 25-OHD < 10 ng/mL, and OR = 14.7 (95% CI, 6.35-34.6) in serum 25-OHD levels at 10-19.9 ng/mL, and OR = 2.58 (95% CI, 1.08-6.1) in those with 25-OHD at 20-29.9 ng/mL as compared with 25-OHD ≥ 30 ng/mL. After controlling for demographic and biochemical factors, the association reached a stronger level of 19.8 (6.9-56.3) in subjects with serum 25-OHD < 10 ng/mL and 14.4 (5.8-34.6) in those with serum 25-OHD at levels of 10-19.9 ng/mL and 1.85 (0.73-4.6) in 20-29 ng/mL.

CONCLUSION

These findings indicate a possible contributive role for serum 25-OHD deficiency in the development of pain and tenderness over the tibial bone.

Radiographic assessment of maxillary sinus lateral wall thickness in edentulous posterior maxilla

Background and aim

Given the importance of evaluating the maxillary sinus lateral wall thickness (LWT) to avoid complications during surgery, the aim of this study was to examine LWT as well as the effect of residual ridge height (RH), edentulous region, type of edentulism, age and gender on it.

Methods

In this cross-sectional study conducted in 2016, 150 samples of the CBCT imaging archives of the Oral and Maxillofacial Radiology Clinic in Babol, Iran, were evaluated retrospectively. In the coronal section, RH and LWT (at 3, 7, 10 and 15 mm from the lowest point of the sinus floor) were measured in NNT software in millimeters. Data were analyzed using the SPSS v22 software through independent-samples t-test, paired-samples t-test and ANOVA.

Results

In 150 assessed images, by increasing the wall distance from the floor, the mean sinus lateral wall thickness was increased (p=0.01). There was no relationship between gender and age with the sinus lateral wall thickness (p>0.05). RH showed a significant relationship with LWT so that the higher the RH, the greater the LWT (p<0.05). It was also observed that the mean LWT was 1.31±0.3 mm in the partial edentulism and 0.95±0.26 mm in the complete edentulism (p<0.05). The maximum thickness was found in the first molar and the minimum values were in the second premolar and the second molar.

Conclusion

Due to the impact of residual ridge height and type of edentulism on LWT and anatomical variations observed in the maxillary sinus, CBCT assessment is recommended before surgery such as sinus lifting in this area.

Immunohistochemical Expression of CD56 and ALDH1 in Common Salivary Gland Tumors

INTRODUCTION

Natural killer (NK) cells, of which CD₅₆ is a specific marker, play an important role in host defense against tumors. Cancer stem cells, of which aldehyde dehydrogenase isoform 1 (ALDH₁) is an immunohistochemical marker, are a group of tumorigenic cells which are involved in migration and tumor recurrences. We aimed to evaluate the expression of ALDH₁ and CD₅₆ in common salivary gland tumors, as well as their relationship with each other and with a number of clinicopathologic factors.

MATERIALS AND METHODS

Forty-five paraffin blocks of salivary gland tumors (pleomorphic adenoma, mucoepidermoid carcinoma and adenoid cystic carcinoma, 15 samples each) were selected. Malignant tumors were classified into two groups: low-grade (including mucoepidermoid carcinoma grade I) and high-grade (including mucoepidermoid carcinoma grade III and adenoid cystic carcinoma). Immunohistochemical staining for ALDH₁ and CD₅₆ markers was performed. Data were analyzed using SPSS (20) and the Chi-square test.

RESULTS

CD₅₆ expression was significantly higher in benign and high-grade malignant tumors (P=0.01). ALDH₁ overexpressed in all three salivary tumors, but not to statistically significant degree (P=0.54). There was no statistically significant correlation between ALDH₁ and CD₅₆ expression with demographic factors (age, gender, or location of tumor; P>0.05).

CONCLUSION

It appears that the number of NK cells and their function change in different types of salivary gland tumors (benign/malignant) and stroma. NK cells are important components of the anti-tumor system; therefore immune dysfunction is associated with tumor progression in tumors of the salivary gland. ALDH₁ overexpression suggests its role in tumorogenesis, but ALDH₁ is not involved in the morphogenesis of salivary gland tumors.

Efficacy of olanzapine in symptom relief and quality of life in gastric cancer patients receiving chemotherapy

Background:

Considering the incidence and prevalence rates of gastric cancer in Mazandaran Province of Iran, this research was performed to evaluate the efficacy and safety of olanzapine in symptom relief and quality of life (QOL) improvement of gastric patients receiving chemotherapy.

Materials and Methods:

This clinical trial was conducted on thirty new cases of gastric cancer patients whose treatment protocol was planned on chemotherapy and were allocated into two groups by simple random sampling. Intervention group (15 patients) received olanzapine tablets (2.5–10 mg/day) a day before the beginning of chemotherapy; in the 1^st day of chemotherapy to 8 weeks after chemotherapy, besides the routine treatment regimens. The control group received only the routine treatment regimens. The patients were followed for 8 weeks after intervention. All of the patients were assessed with Hospital Anxiety and Depression Scale (HADS) and WHO-QOL-BREF questionnaires; further, Rhodes index was used to evaluate nausea and vomiting (N/V) status.

Results:

All the recruited patients continued the allocated interventions (no lost to follow-up). N/V decreased in the case group, but the difference was not statistically significant (P = 0.438). The patients' appetite and body mass index increased (P = 0.006). Anxiety and depression subscales of HADS had significant differences between the two groups (P < 0.001) in the 4^th and 8^th week after treatment. Among the different subdomains of QOL, only physical health improved significantly after intervention (P < 0.05), but no significant difference was observed in other subdomains and also total QOL score (P > 0.05). No significant increase was observed in fasting and 2-h postprandial blood glucose and lipid profile (P > 0.05).

Conclusion:

Olanzapine can be considered as an effective drug to increase appetite and decrease anxiety and depression in patients with gastric cancer.

Quantitative and Qualitative Evaluation of Iranian Researchers' Scientific Production in Dentistry Subfields

BACKGROUND

As in other fields of medicine, scientific production in the field of dentistry has significant placement. This study aimed at quantitatively and qualitatively evaluating Iranian researchers' scientific output in the field of dentistry and determining their contribution in each of dentistry subfields and branches.

METHODS

This research was a scientometric study that applied quantitative and qualitative indices of Web of Science (WoS). Research population consisted of927indexed documents published under the name of Iran in the time span of 1993-2012 which were extracted from WoS on 10 March 2013. The Mann-Whitney test and Pearson correlation coefficient were used to data analyses in SPSS 19.

RESULTS

777 (83. 73%) of indexed items of all scientific output in WoS were scientific articles. The highest growth rate of scientific productionwith90% belonged to endodontic sub field. The correlation coefficient test showed that there was a significant positive relationship between the number of documents and their publication age (P < 0. 0001). There was a significant difference between the mean number of published articles in the first ten- year (1993-2003) and that of the second one (2004-2013), in favor of the latter (P = 0. 001).

CONCLUSIONS

The distribution frequencies of scientific production in various subfields of dentistry were very different. It needs to reinforce the infrastructure for more balanced scientific production in the field and its related subfields.

Multiple h-index: a new scientometric indicator

Purpose

– This paper aims to evaluate some of the known scientific indexes by using virtual data and proposes a new index, named multiple h-index (mh-index), for removing the limits of these variants.

Design/methodology/approach

– Citation report for 40 researchers in Babol, Iran, was extracted from the Web of Science and entered in a checklist together with their scientific lifetimes and published ages of their papers. Some statistical analyses, especially exploratory factor analysis (EFA) and structural correlations, were done in SPSS 19.

Findings

– EFA revealed three factors with eigenvalues greater than 1 and explained variance of over 96 per cent in the studied indexes, including the mh-index. Factors 1, 2 and 3 explained 44.38, 28.19 and 23.48 of the variance in the correlation coefficient matrix, respectively. The m-index (with coefficient of 90 per cent) in Factor 1, a-index (with coefficient of 91 per cent) in Factor 2 and h- and h2-indexes (with coefficients of 93 per cent) in Factor 3 had the highest factor loadings. Correlation coefficients and related comparative diagrams showed that the mh-index is more accurate than the other nine variants in differentiating the scientific impact of researchers with the same h-index.

Originality/value

– As the studied variants could not satisfy all limits of the h-index, scientific society needs an index which accurately evaluates individual researcher’s scientific output. As the mh-index has some advantages over the other studied variants, it can be an appropriate alternative for them.