Single- and double-dose of platelet-rich plasma versus hyaluronic acid for treatment of knee osteoarthritis: A randomized controlled trial

BACKGROUND

Platelet-rich plasma (PRP) and hyaluronic acid have been shown to be useful in the treatment of knee osteoarthritis. However, investigations comparing the efficacy of these two drugs together are insufficient.

AIM

To compare the outcomes of PRP vs hyaluronic acid injections in three groups of patients with bilateral knee osteoarthritis.

METHODS

This randomized controlled trial study involved 95 patients. Thirty-one subjects received a single injection of PRP (group PRP-1), 33 subjects received two injections of PRP at an interval of 3 wk (group PRP-2) and 31 subjects received three injections of hyaluronic acid at 1-wk intervals (group hyaluronic acid). The patients were investigated prospectively at the enrollment and at 4-, 8- and 12-wk follow-up with the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Visual Analogue Scale questionnaires.

RESULTS

Percentages of patients experiencing at least a 30% decrease in the total score for the WOMAC pain subscale from baseline to wk 12 of the intervention were 86%, 100% and 0% in the groups PRP-1, PRP-2 and hyaluronic acid, respectively (P < 0.001). The mean total WOMAC scores for groups PRP-1, PRP-2 and hyaluronic acid at baseline were 63.71, 61.57 and 63.11, respectively. The WOMAC scores were significantly improved at final follow-up to 42.5, 35.32 and 57.26, respectively. The highest efficacy of PRP was observed in both groups at wk 4 with about 50% decrease in the symptoms compared with about 25% decrease for hyaluronic acid. Group PRP-2 had higher efficacy than group PRP-1. No major adverse effects were found during the study.

CONCLUSION

PRP is a safe and efficient therapeutic option for treatment of knee osteoarthritis. It was demonstrated to be significantly better than hyaluronic acid. We also found that the efficacy of PRP increases after multiple injections.

Relationship of obesity with serum concentrations of leptin, CRP and IL-6 in breast cancer survivors

INTRODUCTION

Several mechanisms have been proposed to explain the adverse effect of obesity on quality of life among women with breast cancer, including alteration in some inflammatory markers. The aim of this study was to determine the status of serum levels of leptin, IL-6 and CRP in obese, overweight and normal weight breast cancer survivors in order to determine the relationship between inflammatory markers' levels and obesity.

MATERIALS AND METHODS

This cross-sectional study was done on 75 women with breast cancer, 30 obese, 15 overweight and 30 normal weight patients. Serum leptin, IL-6, CRP, total protein, albumin and lipid profile as well as anthropometric parameters were measured in three groups.

RESULTS

Serum leptin levels of obese patients were significantly higher than those of overweight and normal weight patients (P<0.05). Higher serum CRP and lower albumin levels were observed in obese patients in comparison with normal weight patients (P<0.05). HDL-C level was significantly different between overweight and normal weight patients (P<0.05). Significant differences in serum IL-6 levels were not observed between the study groups (P>0.05). Moreover, multiple regression analysis showed that leptin was significantly associated with BMI (P<0.001), while albumin was negatively correlated with BMI (P<0.05). CRP levels were significantly correlated with BMI and waist-to-hip ratio (WHR) (P<0.05).

CONCLUSIONS

In conclusion, high leptin levels and alteration in acute phase proteins in obese patients may exaggerate the inflammation status. As inflammation has the potential to increase the susceptibility of the patients to metastasis development, it is necessary to decline its rate.

Arbutin reduces cognitive deficit and oxidative stress in animal model of Alzheimer's disease

Objectives: Recent evidences have shown the beneficial effects of natural products for treating of Alzheimer's disease (AD). Arbutin is derived from Pyrus biossieriana and exerts a wide range of pharmacological activities including anti-inflammatory and anti-oxidant effects. The present study was designed to examine the protective effects of arbutin on streptozotocin (STZ)-induced neurotoxicity in rats. Materials and methods: The spatial memory impairment was induced by intracerebroventricular (i.c.v) microinjection of STZ (3 mg/kg, 10 μL). Animals received the pretreatment of arbutin (50 mg/kg) for 21 days before STZ injection. The Morris Water maze (MWM) task was used to study the spatial learning and memory. The levels of oxidative stress markers including malondialdehyde (MDA), nitrite and carbonyl were measured in serum and hippocampus samples. In addition, antioxidant level was assessed by ferric reducing antioxidant power (FRAP) test. Results: The obtained result indicated that administration of STZ is led to memory impairment and increases the levels of oxidative stress markers in the hippocampus tissues. Conversely, arbutin improves spatial memory and reduces oxidative and nitrosative stress, as evidenced by a significant decrease in the amount of MDA and nitrite in the serum and hippocampus. In addition, an increase in FRAP levels of hippocampus was observed in arbutin receiving animals. The protein carbonyl content was not reduced in arbutin receiving animals. Conclusion: It could be concluded that arbutin protects the brain against STZ-induced memory impairment and oxidative damage in the hippocampus. The neuroprotective effect of arbutin might be mediated through its antioxidant and free radical scavenging effects.

Effect of different surface treatments on the shear bond strength of nanofilled composite repairs

Background. Repairing aged composite resin is a challenging process. Many surface treatment options have been proposed to this end. This study evaluated the effect of different surface treatments on the shear bond strength (SBS) of nano-filled composite resin repairs.

Methods. Seventy-five cylindrical specimens of a Filtek Z350XT composite resin were fabricated and stored in 37°C distilled water for 24 hours. After thermocycling, the specimens were divided into 5 groups according to the following surface treatments: no treatment (group 1); air abrasion with 50-μm aluminum oxide particles (group 2); irradiation with Er:YAG laser beams (group 3); roughening with coarse-grit diamond bur + 35% phosphoric acid (group 4); and etching with 9% hydrofluoric acid for 120 s (group 5). Another group of Filtek Z350XT composite resin samples (4×6 mm) was fabricated for the measurement of cohesive strength (group 6). A silane coupling agent and an adhesive system were applied after each surface treatment. The specimens were restored with the same composite resin and thermocycled again. A shearing force was applied to the interface in a universal testing machine. Data were analyzed using one-way ANOVA and post hoc Tukey tests (P < 0.05).

Results. One-way ANOVA indicated significant differences between the groups (P < 0.05). SBS of controls was significantly lower than the other groups; differences between groups 2, 3, 4, 5 and 6 were not significant. Surface treatment with diamond bur + 35% phosphoric acid resulted in the highest bond strength.

Conclusion. All the surface treatments used in this study improved the shear bond strength of nanofilled composite resin used.

Effect of hydrofluoric acid surface treatments on micro-shear bond strength of CAD/CAM ceramics

Introduction

Dental ceramics are appreciated as highly esthetic restorative materials that can simulate the appearance of natural dentition better than other materials. The aim of this study was to evaluate the effect of hydrofluoric acid concentration and etching time on micro-shear bond strength (μSBS) to IPS e.max CAD and Vita Mark II of a dual cured resin cement (Panavia F2.0).

Methods

This study was an experimental in vitro study, performed in the dental material research center of Babol University of Medical Sciences in 2016. Two hydrofluoric acid concentrations (5% and 10%) and three different etching times (20, 60 and 120 seconds) were used to etch the specimens respectively. A silane coupling agent (Clearfil porcelain activator) and priming and bonding agent (Clearfil SE bond) were used on the etched surfaces in accordance to the manufacturer’s instructions of use. Then resin cement was applied on the prepared ceramic surfaces and light cured. μSBS between resin cement and the porcelains were measured with a universal testing machine. Mode of failure was observed with 40× magnification by means of a Stereo microscope. Data were analyzed with ANOVA and independent-samples t-test and Chi-square tests.

Results

In both e.max and Vita Mark II groups, μSBS were not significantly different when different etching times (one-way ANOVA) and HF acid concentrations (Independent-samples t-test) were used (p>0.05), but the highest μSBS was shown in e.max specimens etched 60 s with 5% HF and Vita Mark II specimens etched 20 s with 10% HF. μSBS of e.max was significantly higher than Vita Mark II (p=0.00).

Conclusion

Best surface treatment for e.max and Vita Mark II ceramics is 20 s etch using 5 % hydrofluoric acid.

Oral health-related quality of life in diabetic patients: comparison of the Persian version of Geriatric Oral Health Assessment Index and Oral Health Impact Profile: A descriptive-analytic study

BACKGROUND

Diabetes mellitus is one of the systemic disease which is show important oral manifestation and influence oral health. This study describes how diabetes mellitus affects oral health and oral health-related quality of life. The aim of this study was to evaluate the oral health and oral health-related quality of life of diabetic patients and compare the discriminative capability of Persian versions of two GOHAI and OHIP-14 questionnaires in these patients.

METHODS

A total of 350 patients with Type II diabetes mellitus, referring to the Diabetes Clinic, were selected and data were collected by GOHAI and OHIP-14 questionnaires completed by patients and clinical examinations. Oral health parameters (CAL,BI,GI,PLI,DMFT and xerostomia) were measured, also concurrent validity and conformity of two questionnaires were assessed. In order to test Discriminant analysis capabilities of two questionnaires, ADD and SC scores of questionnaires were divided into two parts and a logistic regression model was designed, which included subjective and objective variables.

RESULTS

Mean patients age was 55 years (with 75.4% female patients). The results showed that some oral conditions such as xerostomia, clinical attachment loss, number of missing teeth and plaque index were correlated to diabetes control level (HbA1c) and type of anti-diabetic medication. ADD and SC scores of two questionnaires were at high level. However, the effect of oral problems on decreasing OHRQoL was evident. Both questionnaires had acceptable concurrent validity and conformity. Moreover, there was a strong correlation between GOHAI and OHIP-14. OHIP-14 questionnaire had a higher discriminant analysis capability compared to GOHAI and better diagnosed patients who needed dental treatments: patients with higher GI, xerostomia and those wearing partial dentures.

CONCLUSION

Diabetic patients did not show acceptable oral health status and in some extent, oral problems affected oral health-related quality of life. Psychotherapy courses and solving oral problems of the patients can improve OHRQoL. OHIP-14 had higher discriminant analysis capability and was more effective in diagnosing oral problems.

The effect of adding oral oestradiol to progesterone as luteal phase support in ART cycles - a randomized controlled study

INTRODUCTION

Luteal phase support in assisted reproductive technology (ART) cycles is still controversial. The present study was conducted to evaluate the effect of adding oral oestradiol to progesterone during ART cycles.

MATERIAL AND METHODS

In this prospective case control study, infertile women under 35 years old who were candidates for IVF/ICSI cycles in Royan Institute were enrolled. A long gonadotropin-releasing hormone (GnRH) agonist protocol was used for ovarian stimulation. Patients were randomly divided into two groups for luteal phase support: the control group received vaginal administration of progesterone supplementation alone starting on the day after oocyte retrieval and continued until the tenth week if the chemical pregnancy test was positive. In the oestradiol group, 2 mg of oestradiol valerate was initiated orally with progesterone. The control group received a placebo instead of oestradiol.

RESULTS

Ninety-eight women were studied as oestradiol (N = 47) and control groups (N= 51). There were no significant differences in the mean number of retrieved oocytes, number of transferred embryos, or chemical and clinical pregnancy rates between the two groups. Although the serum progesterone concentration was higher in the oestradiol group in comparison to the control group on day 7, 10 and 12 after embryo transfer, these differences were not statistically significant.

CONCLUSIONS

The results suggested that adding oral oestradiol to vaginal progesterone supplementation does not improve the chemical and clinical pregnancy rates of IVF/ICSI cycles.

Polycystic ovary syndrome in Iranian adolescents

OBJECTIVE

Polycystic ovary syndrome (PCOS) is linked with metabolic syndrome, which includes obesity, insulin resistance, dyslipidemia, and endocrine function in patients with PCOS. The aim of this study was to determine the prevalence of adolescent PCOS and characteristics associated with PCOS in adolescents in Babol, Iran.

MATERIALS AND METHODS

A cross-sectional study was conducted on 1549 girl high school students aged 16-20 years who were living in Iran. After overnight fasting, blood samples were collected to determine hormones and lipid levels in PCOS patients between the first and fifth days of their menstrual period or withdrawal bleeding.

RESULTS

The overall prevalence of adolescent PCOS was 129 (8.3%) (95% CI; 4.0, 12.0). Irregular menstruation was observed in 24.1% of adolescents. A total of 68% of PCOS adolescents had insulin resistance. Compared with non-PCOS adolescents, the OR of adolescent PCOS for family history of hirsutism was 1.53 (95% CI, 1.06-2.20; p=0.024), family history of irregular menstrual cycle was 2.27 (95% CI, 1.56-3.30; p<0.001), menarche age <13 years was 1.95 (95% CI, 1.36-2.81; p<0.001), hirsutism was 1.14 (CI 95%, 1.10-1.17; p<0.001), acne was 5.10 (CI 95%, 3.52-7.40; p<0.001), and wrist circumference was 1.28 (CI 95%, 1.07-1.54; p=0.007).

CONCLUSION

The presenting findings showed the high prevalence of PCOS among Iranian adolescents. Emphasis should be placed on clinical screening in adolescents with high-risk factors, including irregular menstrual, menarche <13 years, hirsutism, acne, high wrist circumference, and paternal obesity to help reduce the risk of developing metabolic disturbance and to find ways to improve long-term health.

Otomycosis in Adolescent Patients Referred to the Therapeutic Centers in Babol City, Iran

Background:

Otomycosis is an external ear canal infection caused by various fungi. This disease is prevalent in some tropical and subtropical regions or countries.

Objectives:

Given the crucial role of fungal agents in the treatment of the disease, the aim of the present study was to identify the fungi in ear canal of patients with otomycosis admitted to the hospitals in Babol City, Iran.

Patients and Methods:

This study included 56 patients with otomycosis. After removal of ear infectious samples, some of them were placed on the slides for direct examination and also a portion of them was plated on the Sabouraud dextrose agar with chloramphenicol for fungal growth. The slides were studied for the presence of fungal elements. Conventional methods were performed to determine fungal colonies.

Results:

Thirty-three patients (55.36%) were female and the rest were male. Fungal elements were observed in 11 cases (19.64%) in the direct examination, alone, and 45 specimens (80.36%) had fungi and bacteria combined. Septate mycelia, with 43 cases, had the most frequent fungal elements in direct examination. Aspergillus and Candida genera were the prevalent fungal colonies in culture media.

Conclusions:

According to the role of different genera of fungi in the process of otomycosis, much attention on the macroscopic and microscopic examination of the samples leads to special treatment decisions of a physician.

Effect of Ginger and Novafen on menstrual pain: A cross-over trial

OBJECTIVE

Menstrual pain is a periodic pain which happens during the days of menses. The menstrual disturbances as a health problem among young girls affect not only reproductive, but also psychical health and quality of life. This study was done with the goal of comparing the effect of Ginger and Novafen on the menstrual pain.

MATERIALS AND METHODS

This crossover clinical trial study was done in Iran on 168 single girl students 18-26 years old in Babol University of Medical Sciences with primary menstrual pain. The participants were randomly allocated to two groups receiving the drugs Novafen and Ginger. At the beginning of pain, in the two groups 200 mg capsule was given every 6 h for two serial cycles. Pain severity was measured by the visual scale before treatment, 1 h after consuming the drug (for 24 h) and 48 h after the onset of drug.

RESULTS

The mean age of participants was 21.83 ± 2.07 years. It has been reported that the intensity of pain from dysmenorrhea decreased in the Novafen and Ginger groups. Before treatment, the average pain intensity in Novafen and Ginger users were 7.12 ± 2.32 and 7.60 ± 1.84, respectively and after treatment pain intensity decreased to 3.10 ± 2.69 and 2.97 ± 2.69, respectively. Differences between two groups each time showed no statistical significance (p > 0.05).

CONCLUSION

Both drugs reduced menstrual pain. Ginger as well as Novafen is effective in relieving pain in girls with primary dysmenorrhea . Therefore, treatment with natural herbal medicine, non-synthetic drug, to reduce primary dysmenorrhea is recommended.

Overexpression of serum MicroRNA-140-3p in premenopausal women with newly diagnosed breast cancer

AIMS

The purpose of the present study was to evaluate microRNA-140-3p expression level in breast cancer patients in comparison to healthy controls.

PATIENTS & METHODS

Serum microRNA-140-3p level was quantified by realtime quantitative reverse transcription PCR in 40 women with breast cancer and 40 healthy subjects.

RESULTS

Serum microRNA-140-3p level in patients compared to healthy subjects was significantly up-regulated (P = 0.01). MicroRNA-140-3p had a good diagnostic accuracy for discrimination of the two groups (AUC = 0.667; sensitivity = 70%; specificity = 50%). Serum microRNA-140-3p level was overexpressed in premenopausal patients who were ≤48 years old. ROC curve showed a similar pattern again (AUC = 0.690; sensitivity = 73%; specificity = 50%).

CONCLUSIONS

microRNA-140-3p has the potential for detection of breast cancer, especially in premenopausal and in ≤48 years old women.

Maternal mid- and late-pregnancy distress and birth outcome: A causal model of the mediatory role of pregnancy-specific distress

Background

There is lack of information about the effect of general distress and pregnancy-specific distress in mid- and late-pregnancy separately on neonatal outcome.

Objective

The aim of this study was to assess the effects of mid-maternal distress on late-maternal distress and birth outcomes with a causal model of relationships among general distress and pregnancy-specific distress.

Materials and Methods

In this longitudinal descriptive study, 100 low-risk pregnant women participated. Participants completed three questionnaires at mid-pregnancy (13–26 wk) and at late pregnancy (27–40 wk). Pregnancy-general distress was assessed by the Perceived Stress Scale and the Hospital Anxiety Depression Scale. Pregnancy-specific distress was evaluated by the Prenatal Distress Questionnaire. The pregnant women were followed to after birth and neonatal outcome were assessed.

Results

All total effect pathways were significant as predictors of birth outcomes (height, weight, and head circumference). Mid-pregnancy-specific distress had a significant relationship with late pregnancy-specific distress. However, mid-maternal distress was not related directly to birth outcomes. The effect of mid-maternal distress on birth outcomes was related indirectly to late-maternal distress. Both late general distress and late pregnancy-specific distress had direct negative effects on three indexes of birth outcome. The negative effect of late general-pregnancy distress and mid-pregnancy-specific distress on birth outcome was mediated through late pregnancy-specific distress.

Conclusion

Both late pregnancy-general distress and pregnancy-specific distress have negative effects on birth outcomes. These findings support a role for negative effect as mediating the relationship between late pregnancy-specific distress and birth outcomes.

Evaluation of Apical Micro-leakage of Different Endodontic Sealers in the Presence and Absence of Moisture

Background and aims. With availability of hydrophilic sealers, drying of the canals before endodontic obturation is still a matter of debate. The aim of this study was to compare the apical micro-leakage of AH26, Excite DSC, MTA Fillapex, and ZOE sealers in dry and moist root canals.

Materials and methods. This experimental study was performed on 90 extracted maxillary central incisors. Rotary files were used for preparation of the canals. Root canals were filled with a single gutta percha cone, using one of the four sealers, under dry and moist root canal conditions (10 teeth in each group). Orifices were sealed with glue wax and all root surfaces were covered with nail polish except the positive control group. After ten days in 100% humidity, teeth were placed in methylene blue, and then were cut in longitudinal axis. Blue color permeability was measured by stereomicroscope in micrometers. Data were analyzed by t-test, ANOVA and Scheffe post hoc test using SPSS V.18 software at P < 0.05.

Results. Mean apical micro-leakage was significantly lower in the dry groups (P < 0.001). Minimum and maximum micro-leakage was seen in AH26 and ZOE, respectively. MTA Fillapex did not exhibit a significant difference in apical micro-leakage between dry and moist conditions (P > 0.05). Apical micro-leakage was significantly higher in the Excite DSC groups (P < 0.001).

Conclusion. AH26 provided the least apical micro-leakage under dry conditions while ZOE had the highest micro-leakage under moist conditions. MTA Fillapex provided acceptable apical seal regardless of moisture.

Health Promotion Behaviors and Its Predictors Among the College Students in Iran

The health-promoting behaviors form typically during adolescence and youth. This study was conducted to determine the status of the health-promoting behaviors in the students of Babol University of Medical Sciences and its predictors. This cross-sectional study was done on 350 students from April 2016 to July 2016. The applied questionnaires were health-promoting lifestyle profile II, general self-efficacy scale, and sociodemographic variables. Data were analyzed using the SPSS software by descriptive tests, one-way analysis of variance, and multivariable linear regression. The mean total health-promoting lifestyle profile II score was 126.79 ± 19.28. In the subscales, the participants scored the highest in interpersonal relations (24.62 ± 4.59) and the lowest in physical activity (16.53 ± 4.17). Analyses of the data showed that there was a significant association among some subscales of health-promoting behaviors and gender, family size, living in dormitory and also showed that self-efficacy remained as significant factor in relation to all subscales of health-promoting behaviors.

Light transmittance of CAD/CAM ceramics with different shades and thicknesses and microhardness of the underlying light-cured resin cement

Objectives

The aim of this in vitro study was to evaluate the effects of the thickness and shade of 3 types of computer-aided design/computer-aided manufacturing (CAD/CAM) materials.

Materials and Methods

A total of 120 specimens of 2 shades (A1 and A3) and 2 thicknesses (1 and 2 mm) were fabricated using VITA Mark II (VM; VITA Zahnfabrik), IPS e.max CAD (IE; IvoclarVivadent), and VITA Suprinity (VS; VITA Zahnfabrik) (n = 10 per subgroup). The amount of light transmission through the ceramic specimens was measured by a radiometer (Optilux, Kerr). Light-cured resin cement samples (Choice 2, Bisco) were fabricated in a Teflon mold and activated through the various ceramics with different shades and thicknesses using an LED unit (Bluephase, IvoclarVivadent). In the control group, the resin cement sample was directly light-cured without any ceramic. Vickers microhardness indentations were made on the resin surfaces (KoopaPazhoohesh) after 24 hours of dark storage in a 37°C incubator. Data were analyzed using analysis of variance followed by the Tukey post hoc test (α = 0.05).

Results

Ceramic thickness and shade had significant effects on light transmission and the microhardness of all specimens (p < 0.05). The mean values of light transmittance and microhardness of the resin cement in the VM group were significantly higher than those observed in the IE and VS groups. The lowest microhardness was observed in the VS group, due to the lowest level of light transmission (p < 0.05).

Conclusion

Greater thickness and darker shades of the 3 types of CAD/CAM ceramics significantly decreased the microhardness of the underlying resin cement.

Evaluation of scalp hair nickel and chromium level changes in patients with fixed orthodontic appliance: a one-year follow-up study

BACKGROUND AND OBJECTIVES

The release of metal ions from orthodontic appliances is part of the dissolution and biomechanical processes of alloys. Nickel (Ni) and chromium (Cr) are the elements commonly used in the manufacture of various components of fixed orthodontic appliances, including bands, brackets and wires. This study was aimed to measure the Ni and Cr ions levels in the scalp hair of patients treated with fixed orthodontic appliances in comparison of the control group.

MATERIALS AND METHODS

The patient group consisted of 24 patients treated with fixed orthodontic appliances for one year, while the control group included 28 healthy individuals without orthodontic appliances. Analysis of the Cr and Ni was performed using atomic absorption spectrophotometer by graphite furnace method. The data were analyzed via student and paired samples t-test and ANOVA repeated measurement test.

RESULTS

After one year, the levels of Ni and Cr in two groups showed significant differences (0.086 ± 0.007 and 0.258 ± 0.009 µg/g for control group and 0.149 ± 0.010 and 0.339 ± 0.013 µg/g for patient group, respectively for Ni and Cr, p < .001). ANCOVA test by removing the effects of age, gender and the baseline levels of Ni and Cr showed that changes in these ions in the scalp hair of both groups after one year were statistically significant.

CONCLUSION

Due to the slightly elevated levels of Ni and Cr ions in the scalp hair of patients treated with fixed orthodontic appliances and considering the cytotoxic and allergic effects of these ions, changing the ingredients in fixed orthodontic appliances is suggested for the future.

Comparison of Surface Hardness of Various Shades of Twinky Star Colored Compomer Light-cured with QTH and LED Units

Introduction

Colored compomers are a group of restorative materials that were introduced in 2002 to repair primary teeth, and they provide attractive color and ease of use in pediatric dentistry. The aim of this study was to evaluate the effect of QTH and LED light-curing units on the surface hardness of different colors of Twinky Star compomers.

Methods

In this experimental study, a composite resin (Z250, 3M, and USA), an ionosit compomer (DMG, Germany) with A3 shade and 8 different Twinky Star colored compomer (Voco, Germany) samples were used. In all, 100 samples were prepared with 10 samples in each group, i.e., 10 Z250 composite resin, 10 ionosit compomers, and 10 Twinky Star compomer samples of each color. The samples were prepared in a 4×4-mm Teflon mold. Half of the samples were light-cured with QTH and the other half with LED units. Then, the surface microhardness was measured by Vickers hardness test. The data were analyzed with IBM-SPSS version 22, using the t-test and ANOVA.

Results

Two-way ANOVA showed that the mean surface hardness of the compomer samples cured with the QTH unit was significantly higher than that cured with the LED unit (p < 0.001). In each curing unit, surface hardness of some materials exhibited significant differences with the highest hardness being observed in the Z250 composite resin (650.35 ± 56.320) and the lowest hardness being detected in the ionosit compomers (461.10 ± 96.170). One-way ANOVA also showed that, among the different colors of the Twinky Star compomer, the lowest hardness with both units (QTH and LED) was observed in the gold color (214.32 ± 22.026 and 175.116 ± 15.918, respectively).

Conclusion

The colored compomer and the type of light-curing unit affected the microhardnesses of the surfaces. Different colors of Twinky Star compomers exhibited different surface microhardnesses.

Comparing the Efficacy of Tadalafil Versus Placebo on Pulmonary Artery Systolic Pressure and Right Ventricular Function in Patients with Beta-Thalassaemia Intermedia

BACKGROUND

Conventional oral therapies in the management of pulmonary hypertension in people without haemoglobinopathies are of limited value in thalassaemia patients because of toxicity and poor effectiveness. This study was conducted to assess the effect of tadalafil on pulmonary artery pressure and right ventricular systolic function in patients with beta-thalassaemia intermedia.

METHODS

Forty-four patients with beta-thalassaemia intermedia with pulmonary hypertension based on transthoracic echocardiography (TTE) were entered in the study. Patients with hepatic or renal insufficiency and also patients who were treated with organic nitrates or alpha-blockers were excluded. The patients were randomly divided into two groups (n=22) and they were treated for six weeks with tadalafil (40mg daily) or placebo. The pulmonary artery systolic pressure (PASP), tricuspid regurgitation velocity (TRV) and parameters related to systolic function of the right ventricle were measured by the TTE before and after treatment.

RESULTS

Significant improvement in TRV (3.02±0.02 m/s-2.52±0.06 m/s), PASP (45.31±0.66 mmHg-34.26±1.15mmHg) and parameters related to systolic function of the right ventricle were observed in the group who received tadalafil compared to placebo (p< 0.05).

CONCLUSIONS

Tadalafil significantly decreased PASP and TRV in patients with beta-thalassaemia intermedia. Likewise, tadalafil improved right ventricular systolic function in the patients.

Comparative in vitro study of the effectiveness of Green tea extract and common storage media on periodontal ligament fibroblast viability

Objective:

Green tea extract (GTE) was shown to be effective in preserving periodontal ligament fibroblasts (PDLFs) of avulsed teeth. This study aimed at determining the potential of GTE in preserving the viability of PDLFs comparing with different storage media.

Materials and Methods:

Periodontal ligament cells were obtained from freshly extracted healthy impacted third molars and cultured in Dulbecco's Modified Eagle Medium (DMEM). Cell viability was determined by storing the cells in seven media; DMEM, tap water, Hank's balanced salt solution (HBSS), whole milk, hypotonic sucrose solution, GTE, and GTE + sucrose for 1, 2, 4, and 24 h at 37°C using tetrazolium salt-based colorimetric (3-[4, 5-dimethylthiazol-2-yl]-2, 5-diphenyl tetrazolium bromide) assay. Statistical analysis was performed by one-way analysis of variance and post hoc tests.

Results:

GTE showed significantly higher protective effect than HBSS at 2, 4, and 24 h (P = 0.009, P = 0.02, P = 0.016), DMED at 2 h (P = 0.003), and milk at 4 h (P = 0.039).

Conclusion:

Although with undesirable osmolality and pH, GTE had a good ability in preserving the PDLFs comparing with other studied media.

Developing machine learning-based models to predict intrauterine insemination (IUI) success by address modeling challenges in imbalanced data and providing modification solutions for them

Background

This study sought to provide machine learning-based classification models to predict the success of intrauterine insemination (IUI) therapy. Additionally, we sought to illustrate the effect of models fitting with balanced data vs original data with imbalanced data labels using two different types of resampling methods. Finally, we fit models with all features against optimized feature sets using various feature selection techniques.

Methods

The data for the cross-sectional study were collected from 546 infertile couples with IUI at the Fatemehzahra Infertility Research Center, Babol, North of Iran. Logistic regression (LR), support vector classification, random forest, Extreme Gradient Boosting (XGBoost) and, Stacking generalization (Stack) as the machine learning classifiers were used to predict IUI success by Python v3.7. We employed the Smote-Tomek (Stomek) and Smote-ENN (SENN) resampling methods to address the imbalance problem in the original dataset. Furthermore, to increase the performance of the models, mutual information classification (MIC-FS), genetic algorithm (GA-FS), and random forest (RF-FS) were used to select the ideal feature sets for model development.

Results

In this study, 28% of patients undergoing IUI treatment obtained a successful pregnancy. Also, the average age of women and men was 24.98 and 29.85 years, respectively. The calibration plot in this study for IUI success prediction by machine learning models showed that between feature selection methods, the RF-FS, and among the datasets used to fit the models, the balanced dataset with the Stomek method had well-calibrating predictions than other methods. Finally, the brier scores for the LR, SVC, RF, XGBoost, and Stack models that were fitted utilizing the Stomek dataset and the chosen feature set using the Random Forest technique obtained equal to 0.202, 0.183, 0.158, 0.129, and 0.134, respectively. It showed duration of infertility, male and female age, sperm concentration, and sperm motility grading score as the most predictable factors in IUI success.

Conclusion

The results of this study with the XGBoost prediction model can be used to foretell the individual success of IUI for each couple before initiating therapy.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-022-01974-8.

Evaluating the Microshear Bond Strength and Microleakage of Flowable Composites Containing Zinc Oxide Nano-particles

INTRODUCTION

Preventive resin restorations (PRR) are the conservative choice for the most common carious lesions in children. Thus, new age flowable resin composites with higher filler content are readily used. The aim of this study was to evaluate the microshear bond strength and microleakage of two flowable resin composites containing different percentages of nano zinc oxide (NZnO) particles, which have proven to have antimicrobial properties.

METHODS

This experimental in-vitro study was carried out in the Dental Material Research Center of Babol University of Medical Sciences in 2015. One nanohybrid and one nanofill flowable resin composite were chosen and modified with the incorporation of 1% and 3% Wt NZnO particles. Six groups (n=10, 0%, 1%, and 3%) of resin composite sticks on dental enamel (2×2mm) were prepared to be placed in the microtensile tester. The microshear bond strength magnitude (MPa) was recorded at the point of failure. A class I box (3×0.8×1 mm) was prepared on 60 premolars and filled using the resin composites (6 groups, n=10). The specimens were immersed in a 5% basic fuschin solution and sectioned bucco-lingually to view the microleakage using a stereomicroscope. One-way ANOVA and Tukey tests for microshear and Wilcoxon and Kruskal-Wallis tests for microleakage were used to analyze the data in the IBM SPSS Statistics version 22 software.

RESULTS

The bond strength of the 3% clearfill group significantly decreased while no significant change occurred in the bond strength in other groups. The Z-350 group had significantly lower microleakage as nanoparticles increased. No significant difference was observed in the clearfill group.

CONCLUSION

Up to 3% Wt incorporation of NZnO particles will not diversely alter the bond strength, but it will be beneficial in providing antimicrobial effects with lower microleakage rates.

Prevalence and anatomical variations of maxillary sinus septa: A cone-beam computed tomography analysis

Background

Detailed understanding the anatomy and variations of maxillary sinus septa is necessary. We aimed to investigate prevalence and various anatomical variations of maxillary sinus septa using cone-beam computed tomography (CBCT) images.

Material and Methods

In this retrospective cross-sectional study, CBCT scans of 809 patients referred to a specialist dental and maxillofacial radiology clinic in Babol, northern Iran, during 2014-2020 were evaluated. Location, morphology, height, and direction of septa in different planes were recorded.

Results

Sinus septa were observed in 37.9% (n=307) of the participants. There were 117 cases with septa only in left sinus, 83 cases with septa only in right sinus, and 107 cases with septa in both sinuses. Totally, 414 septa were seen in the subjects. Prevalence of partial septa was considerably higher than complete septa (77.5% versus 22.5%). Regarding septa location, middle area with a prevalence rate of 58.7% was found more prevalent than other sinus areas. The mean septum height on the left and right sinuses was 6.0±3.1 mm 5.7±3.9, respectively (p<0.001). Regarding left sinus, directions of vertical (63.8%), oblique (30.8%), and straight (63.8%) were the most prevalent compared with other directions in sagittal, frontal, and axial planes, respectively. In relation to right maxillary sinus, direction of vertical in sagittal and frontal planes (72.6% and 24.2%, respectively), and direction of straight in axial plane (58.4%) were the most prevalent directions compared with others in the same planes.

Conclusions

Septa prevalence in maxillary sinus was relatively high, with various directions, locations, heights, and shapes. It is recommended to use CBCT for a careful evaluation of toothless area prior to surgeries on the sinus (especially sinus lift) in three plans, in order to take careful measures and prevent postoperative complications in case septa exist.

Key words:Maxillary sinus septa, anatomical variation, cone-beam computed tomography, dental implant.

The Effect of Brief Supportive Psychotherapy on Prevention of Psychiatric Morbidity in Women with Miscarriage: A Randomized Controlled Trial about the First 24-hours of Hospitalization

OBJECTIVES

Miscarriage is a common pregnancy complication causing substantial psychiatric complications. This study was designed to investigate whether the administration of brief supportive psychotherapy (BSP) is effective on the management of women with miscarriage when conducted in the first 24 hours of hospitalization in order to prevent symptoms of anxiety, depression, and grief at four-months post-miscarriage.

METHODS

We conducted a randomized clinical trial on 79 women with miscarriage hospitalized in Ayatollah Rohani teaching hospital. The women were randomly assigned into two groups (39 in the experimental group and 40 in the control group). All interventions were implemented for two study groups during the first 24 hours of hospitalization in a private room in the hospital. The experimental group received a two-hour BSP. The objective outcomes were assessed using Hospital Anxiety and Depression Scale and Perinatal Grief Scale (PGS), which has three subscales (active grief, difficulty coping, and despair) and were measured before the intervention and at four-months post-miscarriage.

RESULTS

The results of pre-tests in the follow-up of the trial suggested that the participants who received BSP reported significant reductions in the mean scores of active grief (-34.2±9.7 vs. 28.1±-6.9), difficulty coping (27.1±6.4 vs. 23.3±4.3), despair (28.0±8.4 vs. 22.8±5.2), and total PGS (89.6±23.1 vs. 74.4±15.3), in contrast to participants in the control group who did not report such results. Further, the results of generalized estimating equations models revealed that brief supportive psychotherapy caused a significant decrease in the level of factors including active grief, difficulty coping, despair, total perinatal grief, anxiety symptoms, and depressive symptoms in subjects in the experimental group compared to those in the control group after miscarriage. Also, the frequency of anxiety symptoms (13.5% vs. 60.5%), depressive symptoms (32.4% vs. 71.1%), and grief symptoms (10.8% vs. 65.8%) was found to be significantly lower in the group receiving psychotherapy than in the control group at four-months follow-up.

CONCLUSIONS

Administration of BSP session during the first 24 hours of hospitalization for women with miscarriage can be considered a reliable method to prevent anxiety symptoms, depression symptoms, and perinatal grief at four-months follow-up.

Integron types, gene cassettes and antimicrobial resistance profile of Acinetobacter baumannii isolated from BAL samples in Babol, north of Iran

Multi-drug resistant isolates of Acinetobacter baumannii have created therapeutic problems worldwide. This current study was intended to determine the Integron types, gene cassettes and antimicrobial resistance profile of A. baumannii isolated from BAL samples in Babol, north of Iran. During a 15-month period, 35 A. baumannii isolates were studied. Different classes of antimicrobial agents were used to determine the resistance ratios. Multiplex-PCR was used to detect different types of integrons and associated gene cassettes. The resistance rates to GM, FEP, AK, TOB, CP, PIP, SAM, IPM, SXT, CTX, CAZ, CL, TIM, MEM, and TZP were 85.7%, 100%, 91.4%, 68.5%, 94.3%, 88.5%, 97.1%, 94.3%, 100%, 100%, 100%, 0.0%, 91.4%, 94.3% and 91.4%, respectively. The distribution analysis of int genes showed that 25.7%, 88.6% and 28.6% of isolates carried the intI, intII and intIII genes, respectively. The prevalence of aadB, dfrA1, bla-OXA₃₀ and aadA1 genes were 94.3%, 77.1%, 40% and 5.7%, respectively. The current study showed that a high level of A. baumannii isolates harbor integrons in our therapeutic center, which may lead to distribution of multiple antimicrobial resistance. The different types of gene cassette arrays in the present study highlight the important role of geographical features in MDR isolates dissemination which could be credited to different profiles of drug consumption in different areas. The findings emphasized that the need for continuous surveillance to prevent distribution of multidrug resistance among A. baumannii strains in Iran.