Evaluation of the effect of endometrial scratch by hysteroscopic scissors on frozen embryo transfer outcomes: A historical cohort study

Background

Endometrial scratch (ES) has been suggested to improve assisted reproductive techniques success rates by investigating implantation failure.

Objective

In this study, we evaluated the effect of ES on the outcomes of frozen embryo transfer (FET) in women with at least 2 failed embryo transfer cycles.

Materials and Methods

In this historical cohort study, medical data of 236 infertile women who underwent in-vitro fertilization-FET at Ebne-sina Infertility Center, Tehran, Iran, from January 2015-December 2021 was extracted from their medical records. Based on having ES before FET, they were assigned to either the scratch (n = 118) or the no-scratch group (n = 118). We compared these groups regarding pregnancy rates and outcomes.

Results

The demographic characteristics were similar in both groups regarding weight, body mass index, the number of previous embryo transfers, and the duration of infertility. However, the scratch group had a slightly higher mean age (32.31 vs. 29.96 yr, p < 0.001). No statistically significant difference was observed between groups regarding pregnancy rate (p = 0.89). No significant association was observed between scratch, infertility duration, the number of previous FET attempts, and the likelihood of pregnancy in a logistic regression model. No major complications were observed.

Conclusion

Hysteroscopic endometrial scratching with scissors probably has no effect on FET outcomes, including pregnancy or live birth rates.

Antibacterial Efficacy of Polymer-Coated Ceramic Microparticles Loaded with a Modified Combination of Antibiotics on the Enterococcus faecalis Biofilm

Introduction

Nano-technology applied for the local delivery of different agents and/or drugs has made its path to endodontics. In the current study, the antibacterial efficacy of biopolymer-coated ceramic microparticles loaded with a modified combination of triple antibiotics, i.e. Penicillin G, Metronidazole and Ciprofloxacin (PMC), was evaluated against two strains of Enterococcus faecalis (E.faecalis); a standard clinical strain obtained from previously root-filled teeth with persistent periapical lesions, and compared to the most common antimicrobials used in endodontics.

Methods and Materials

After synthesis of the polymer-coated microparticles loaded with antibiotics, the 21-day release of antibiotics were evaluated and a stock solution was produced using the maximum released amount of drugs and distilled water. The antibacterial activity of PMC, triple antibiotic paste (TAP), calcium hydroxide (CH), chlorhexidine (CHX) and sodium hypochlorite (NaOCl) against two bacterial strains was determined using "Minimum Inhibitory Concentration" and "Agar Diffusion Test". Additionally, "Microtiter Plate Assay" was performed to assess anti-biofilm properties.

Results

Minimum inhibitory concentration values reported for TAP and PMC were 1/256. PMC showed the maximum diameter of growth inhibition in both strains (33 mm and 35 mm), while CH had the minimum diameters (13 mm and13 mm). Based on microtiter plate assay, TAP showed higher biofilm formation than PMC. Biofilm formation was higher in the standard strain for PMC; however, NaOCl, CHX and CH completely inhibited biofilm formation.

Conclusions

Based on the findings of the present study, it could be concluded that PMC and TAP were the most effective medicaments against E.faecalis in its planktonic form; however, none could inhibit its biofilm formation. Further studies using larger sample size and "Confocal Scanning Laser Microscopy" are recommended.

Comparing Fine and Gross Motor Development in Normal Hearing Children, Rehabilitated, and Non-Rehabilitated Hearing-Impaired Children

Background and Aim: Motor development is a continuous process throughout life. Hearing impairment in childhood may have significant effects on motor development. This study compared the motor development of normal-hearing and hearing-impaired children at early developmental ages. Methods: This research was a cross-sectional study. A total of 149 children aged six to eighteen months were selected and divided into three groups: normal-hearing children (NHC) (55 girls and 65 boys) selected by convenient sampling strategy, non-rehabilitated hearing impaired children group (NRHIC) (11 girls and 13 boys) selected by purposive method, and rehabilitated hearing- impaired children group (RHIC) (3 girls and 2 boys) selected by the census method. The Denver developmental screening test 2 (DDST-ll) was used to assess motor development. The obtained data were analyzed by Kruskal-Wallis, Mann-Whitney U tests, and curve drawing. Results: The fine motor development of the NHC (9.63±28.83) was significantly greater than the RHIC (-18 ±26.83) and NRHIC (–21.25±30.26) groups, but there was no significant difference between the RHIC and NRHIC groups. In gross motor development, the NRHIC (–32.71±41.26) group had a more significant delay compared to the NHC (13.38±37.73) and RHIC (0±21.21) groups, but there was no significant difference between the NHC and RHIC groups. Conclusion: Hearing rehabilitation can partially compensate for the developmental delay in gross skills, but this compensation has not occurred for fine motor skills. The development of fine motor skills requires a precise synergy of small muscles and the nervous system. Keywords: Deafness; hearing impaired rehabilitation; motor skills

Comparison between cheatham-platinum stent and self-expandable uncovered nitinol stent in patients with coarctation of aorta – a randomized controlled trial

Background

Endovascular treatment is considered the main therapeutic approach for native coarctation of aorta (CoA) in adult patients. Balloon-expandable stents (BE) have been introduced as the primary choice for coarctoplasty. However during the recent years, self-expandable (SE) stents with acceptable radial force have been suggested as an alternative. Still, no randomized controlled (RCT) trials have compared the efficacy and safety of both strategies.

Methods

The present study is a prospective, single center, parallel-group, open-label RCT on patients with native CoA (Figure). Patients were randomized into Bare Cheatham-Platinum Stents and Uncovered Nitinol Stent (SE). All patients were scheduled to be followed in 1-, 6-, 12-month and 36-month intervals. The present report, focuses on the one-year outcome of the study.

Results

Of 101 patients with native CoA referred to our center, 93 patients have been randomized into BE- (47 patients) and SE-arm (46 patients). One year follow up is scheduled to be completed on March 2020. In the preliminary analysis of 62 patients, 1 intraprocedural stent migration has occurred in each group. No aortic perforation was detected in the study. Vascular access site complications were similar between the two groups (3 (6.3%) in BE versus 1 (2.1%) in SE, p value= 0.432). One nonfatal stroke occurred in BE group. No mortality or bailout surgical repair happened in one year study in the two groups. One patient with re-coarctations were detected during one year follow up in each of the groups (p value=0.210). No aortic pseudoaneurysm or aneurysmal formation were observed in 12-month follow up aortic CT angiography.

Conclusion

The preliminary results showed no significant difference in efficacy and safety of both treatment modalities. The final result is pending.

Study Flow Chart

Funding Acknowledgement

Type of funding source: None

Inherited thrombophilia in mechanical valve malfunction

Mechanical valve malfunction due to thrombosis is an important and life-threatening complication in patients with prosthetic valves. Our study was performed to determine the prevalence of thrombophilia genes among patients with acute thrombosis of the mechanical pulmonary valves despite acceptable anticoagulation levels. In this cross-sectional comparative study thirthy two consecutive patients with acute thrombosis of pulmonary mechanical valve who had international normalized ratio (INR) levels for prothrombin time of at least 2 at the time of presentation and in the preceding three months were enrolled and the prevalence rates of thrombophilia factor genes among them was assessed. The results showed that 24 patients (75%) had thrombophilia gene mutations. The affected patients had mutations in one gene in 37.5% of cases, two genes in 31.3%, and three genes in 6.3%. Prevalence rate of Factor V Leiden (FVL), prothrombin (PTH), Plasminogen activator inhibitor-1 (PAI-I), Methylenetetrahydrofolate Reductase (MTHFR), and endothelial protein C receptor (EPCR) gene mutations was 3.1%, 6.3%, 50%, 37.5%, and 25%, respectively. In our study the prevalence of thrombophilia factor gene mutations of patients with acute thrombosis of pulmonary valve was higher than that reported in the general population.

Correlation between frontal sinus dimensions and cephalometric indices: A cross-sectional study

Objective:

Growth prediction plays a significant role in accurate diagnosis and treatment planning of orthodontics patients. It was hypothesized that the unique pattern of pneumatization of the frontal sinus as a component of craniofacial structure would influence the skeletal growth pattern and may be used as a growth predictor.

Materials and Methods:

A total of 144 subjects (78 females and 66 males) with a mean age of 19.26 ± 4.66 years were included in this retrospective study. Posterior-anterior and lateral cephalograms (LCs) were used to measure the frontal sinus dimensions. The skeletal growth pattern and relations of craniofacial structures were analyzed on LC using variables for sagittal and vertical analyses. Correlation between the frontal sinus dimensions and cephalometric indices was assessed by the Pearson's correlation coefficient.

Results:

The SN-FH and SNA angles had significant associations with frontal sinus dimensions in all enrolled subjects (P < 0.05). In males, the SN-FH, sum of posterior angles, Pal-SN, and Jarabak index were significantly associated with the size of frontal sinus (P < 0.05). In females, the associations of SN-FH and gonial angles with frontal sinus dimensions were significant (P < 0.05).

Conclusion:

The results show that larger size of frontal sinus was associated with reduced inclination of the anterior cranial base, increased anterior facial height (in males), and increased gonial angle (in females) in the study population.

Granular Cell Odontogenic Tumor, an Extremely Rare Case Report

The granular cell odontogenic tumor is an extremely rare odontogenic neoplasm which about 38 cases has been reported with sufficient documentation in the literature. It has a prominent predilection to occur in the posterior of mandible of middle-aged women. Here, we report a case of mandibular granular cell odontogenic tumor in a 57-year-old female with chief complaint of swelling and tooth mobility. As rarity of these lesions, their clinical behavior and prognosis are not clear; hence, reporting more such cases may be beneficial to correct diagnosis and prevent unnecessary treatment.

The Effect of Ovariectomy and Orchiectomy on Orthodontic Tooth Movement and Root Resorption in Wistar Rats

STATEMENT OF THE PROBLEM

Root resorption (RR) after orthodontic tooth movement (OTM) is known as a multifactorial complication of orthodontic treatments. Hormonal deficiencies and their effect on bone turnover are reported to have influences on the rate of tooth movement and root resorption.

PURPOSE

This study was designed to evaluate the effect of female and male steroid sex hormones on tooth movement and root resorption.

MATERIALS AND METHOD

Orthodontic appliances were placed on the right maxillary first molars of 10 ovariectomized female and 10 orchiectomized male Wistar rats as experimental groups and 10 female and 10 male healthy Wistar rats as control groups. NiTi closed-coil springs (9mm, Medium, 011"×.030", Ortho Technology(®); Tampa, Florida) were placed between the right incisors and the first right maxillary molars to induce tipping movement in the first molars with the application of a 60g force. After 21 days, the rats were sacrificed and tooth movement was measured by using a digital caliper (Guanglu, China). Orthodontic induced root resorption (OIRR) was assessed by histomorphometric analysis after hematoxylin and eosin staining of sections of the mesial root.

RESULTS

The rate of tooth movement was significantly higher in all female rats, with the root resorption being lower in the experimental group. The rate of tooth movement in experimental male rats was significantly higher than the control group (p= 0.001) and the rate of root resorption was significantly lower in the experimental group (p= 0.001).

CONCLUSION

It seems that alterations in plasma levels of estrogen, progesterone, and testosterone hormones can influence the rate of OTM and RR. The acceleration in tooth movement increased OTM and decreased RR.

Spatial accessibility of the population to urban health centres in Kermanshah, Islamic Republic of Iran: a geographic information systems analysis

Geographic information systems (GIS) analysis has not been widely used in underdeveloped countries to ensure that vulnerable populations have accessibility to primary health-care services. This study applied GIS methods to analyse the spatial accessibility to urban primary-care centres of the population in Kermanshah city, Islamic Republic of Iran, by age and sex groups. In a descriptive-analytical study over 3 time periods, network analysis, mean centre and standard distance methods were applied using ArcGIS 9.3. The analysis was based on a standard radius of 750 m distance from health centres, walking speed of 1 m/s and desired access time to health centres of 12.5 mins. The proportion of the population with inadequate geographical access to health centres rose from 47.3% in 1997 to 58.4% in 2012. The mean centre and standard distance mapping showed that the spatial distribution of health centres in Kermanshah needed to be adjusted to changes in population distribution.

Antimicrobial Activity of Nanoparticle Calcium Hydroxide against Enterococcus Faecalis: An In Vitro Study

INTRODUCTION

Enterococcus faecalis (E. faecalis) has the ability to invade the dentinal tubules and resist high pH levels. As a result, calcium hydroxide (CH) is not much effective on this bacterium. In theory, nanoparticle calcium hydroxide (NCH) has smaller size and high surface area that enables it to penetrate into the deeper layers of dentin and be more effective on E. faecalis. This in vitro study was designed to compare the antimicrobial activity of NCH and CH against E. faecalis.

METHODS AND MATERIALS

The antimicrobial activity of NCH against E. faecalis was evaluated by two independent tests: the minimum inhibitory concentration (MIC) of intracanal medicament and agar diffusion test (ADT). The efficiency of the medicament in dentinal tubules was evaluated on 23 human tooth blocks that were inoculated with E. faecalis. The tooth blocks were assigned to one control group (saline irrigation) and two experimental groups receiving CH and NCH as intracanal medication. The optical density in each group was assessed with spectrophotometer after collecting samples from dentin depths of 0, 200 and 400 µm. Data were analyzed by SPSS software ANOVA, Kruskal-Wallis and Dunnett's test.

RESULTS

The MIC for NCH was 1/4 of the MIC for CH. NCH with distilled water (DW) produced the greatest inhibition zone in agar diffusion test. NCH had greater antimicrobial activity in dentin samples from depths of 200 and 400 µm compared to CH.

CONCLUSION

The antimicrobial activity of NCH was superior to CH in culture medium. In dentinal tubules the efficacy of NCH was again better than CH on the 200- and 400-µm samples.