Nursing students and faculty perception of academic incivility: A descriptive qualitative study.

BACKGROUND: Incivility is one of the significant challenges that affect nursing education. Uncivil behaviors have a significant upward trend compared to the past in nursing education. This study was conducted to explore academic incivility from the perspective of nursing students and faculty. MATERIALS AND METHODS: This study was conducted in 2021 using a descriptive qualitative method. Fifteen baccalaureate nursing students and six faculty were selected using purposeful sampling method. Data was collected through in-depth semi-structured interviews, and a qualitative content analysis was applied for data analysis. RESULTS: Data analysis revealed four categories, namely, ineffective teaching-learning, inapposite/unreasonable requests, behaviors disrupting mutually respectful environment, and academic dishonesty, and 14 subcategories. CONCLUSION: To reduce incivility, closer attention needs to be paid to the admission of faculty as well as training them to use effective communication techniques and interactive teaching methods. In addition, nursing students must be provided with the training about uncivil behaviors. Furthermore, clear and precise rules and regulations concerning incivility incidence should be developed and implemented in the universities.

Assessment of knowledge and practice of cardiovascular nurses regarding warfarin.

BACKGROUND: Despite new anticoagulants' developments, warfarin is still one of the most commonly used medicines, particularly in the cardiovascular system. One of the significant challenges with warfarin is the prevalence of dangerous side effects such as bleeding and drug and food interactions, which can negatively affect patients if not adequately controlled. As health-care team members, nurses have a crucial role in prescribing this medicine and educating patients. In this regard, this study was conducted to determine the knowledge and practice of nurses working in the cardiovascular wards regarding warfarin. MATERIALS AND METHODS: In this cross-sectional, descriptive study, knowledge and practice of 239 nurses working in the cardiovascular wards of teaching hospitals affiliated to Iran University of Medical Sciences have been investigated using European Cardiovascular Nurses Knowledge questionnaire on anticoagulants and the checklist for high-risk drugs safety instructions. The sampling was performed through the stratified sampling method with proportional allocation. Data were analyzed using the SPSS software version 16 through descriptive and inferential statistics (independent t-test, one-way analysis of variance, and Pearson correlation coefficient) (Inc., Chicago, IL, USA). RESULTS: The mean scores of knowledge (18.51 ± 3.87) and practice (10.53 ± 2.12) were slightly higher than the median, and the lowest mean score was related to knowledge on drug interactions (7.62). The practice had a statistically significant relationship with knowledge (P < 0.001). Regarding demographic variables, there was a statistically significant relationship between nurses' knowledge and the education level (P = 0.009) and nurses' practice and age (P = 0.022), work experience (P = 0.032), and work experience in cardiovascular wards (P = 0.036). CONCLUSIONS: Based on the findings of this study, the knowledge of nurses working in the cardiovascular wards about warfarin was not sufficient, and their practice was of poor quality. Nurses' lack of knowledge and improper practice can jeopardize drug safety in patients and cause serious side effects such as bleeding. Proper training of nursing students and nurses about warfarin as a high-risk drug, its side effects, and drug-food interactions, and the emphasis on patient education in patients receiving this medicine can effectively reduce the incidence of side effects.

State-of-the-art progress of metal-organic framework-based electrochemical and optical sensing platforms for determination of bisphenol A as an endocrine disruptor.

Considering the low concentration levels of bisphenol compounds present in environmental, food, and biological samples, and the difficulty in analyzing the matrices, the main challenge is with the cleanup and extraction process, as well as developing highly sensitive determination methods. Recent advances in the field of metal-organic frameworks (MOFs) due to their large surface area, low weight, and other extraordinary physical, chemical, and mechanical features have made these porous materials a crucial agent in developing biosensing assays. This review focuses on MOFs across their definition, structural features, various types, synthetic routes, and their significant utilization in sensing assays for bisphenol A (BPA) determination. Additionally, recent improvements in characteristics and physio-chemical features of MOFs and their functional applications in developing electrochemical and optical sensing assays via different recognition elements for detecting BPA are comprehensively discussed. Finally, the existing boundaries of the current advances including future challenges concerning successful construction of sensing approaches by employing functionalized MOFs are addressed.

Development of a Patient Decision Aid to Help People Living with Inflammatory Bowel Disease.

BACKGROUND: Patient decision aid (PDA) is a tool, which helps the improvement of shared decisionmaking and is a part of the paradigm shift from physician-centered decisions to patient-centered shared decision making. In this study, we aimed to describe the process used to develop a PDA for facilitating shared decision-making about treatment in patients with inflammatory bowel disease (IBD) who need medication (corticosteroid, azathioprine, anti-TNF, and infliximab) or surgery. METHODS: The development process of PDA included: 1) The development of a prototype based on literature review and interview 2) 'Alpha' testing with patients and clinicians 3) 'Beta' testing in real conditions and 4) The production of a final version. This process took about 12 months (2019-2020). The participants were adult patients with IBD, gastroenterologists, and nurses. RESULTS: The final PDA contains four important sections: 1) Introduction about IBD disease, the purpose of developing PDA, and emphasis on shared decision-making 2) Benefits and risks of main medicines 3) The success rate as well as the incidence of complications after surgery, and 4) The conclusion about patients' satisfaction with PDA to choose the treatment options. Besides, PDA evaluation in the real world setting showed that 100% of physicians (n=4) and 86% of patients (n=12) were completely satisfied with the content of the PDA and considered it applicable and useful. CONCLUSION: This PDA can help patients participate in the shared decision-making process and select the best medical and surgical treatment methods. The feedback received from clinicians and patients showed their satisfaction with using the PDA.

The relationship between personality traits of cancer patients and their preferences when receiving bad news.

OBJECTIVE: This study aimed to determine the relationship between the personality traits of cancer patients and their preferences when receiving bad news. METHODS: In this descriptive correlational study, 200 cancer patients who were selected by the continuous sampling method participated. Patients self-reportedly completed the demographic and medical information questionnaire, the Measure of Patients' Preference (MPP) scale, and the short form of the Eysenck Personality Inventory (EPI). RESULTS: The majority of participants were female (73%), 42.5% had higher education, and 47.5% suffered from breast cancer. In this study, the mean scores of extraversion and neuroticism in patients were 14.59 ± 2.47 and 15.17 ± 3.43, respectively. Regarding patients' preferences for receiving bad news, the score obtained by them in the content category was greater compared to two categories of context and support. This study showed a significant and negative correlation between neuroticism and patients' preferences in the support category (P < 0.001 and r = - 0.265). Regarding the categories of the MPP, there was a significant relationship between gender (P = 0.018) and marital status (P = 0.049) with context category, education (P = 0.011) with content category, and marital status (P = 0.003) and employment (P = 0.009) with support category. CONCLUSION: Personality traits and demographic characteristics of cancer patients can influence their preferences for receiving bad news. Therefore, the consideration of these traits by health care team members is of particular importance to communicate with and deliver bad news to patients.

Challenges to Family Caregivers in Caring for Gastric Cancer Patients from Perspectives of Family Caregivers, Patients, and Healthcare Providers: A Qualitative Study.

OBJECTIVES: Cancer affects both patients and their families. Sometimes, the effects of cancer on families are greater than its effects on patients. Family caregivers play significant roles in care for patients with cancer. Nonetheless, the data on the challenges they face in caregiving are limited. The present study explored the perspectives of patients with gastric cancer (GC), their family caregivers, and healthcare providers regarding family caregivers' challenges in caregiving to patients with GC. MATERIALS AND METHODS: This descriptive exploratory qualitative study was conducted in 2019-2020. Six GC patients, six family caregivers, three physicians, and five nurses took part for a total of twenty participants. Purposive sampling was performed, and data were collected through semi-structured interviews and continued up to data saturation. Conventional content analysis was used for data analysis. RESULTS: Caregivers' challenges in caregiving to patients with GC were grouped into five main categories, namely, lengthy process of GC diagnosis, delivery of bad news, management of physical symptoms, altered relationships, and psychological consequences, and 14 subcategories. CONCLUSION: Educating the public about the primary symptoms of GC and the importance of timely seeking medical care as well as using culturally appropriate protocols for delivering bad news is recommended. Empowering family caregivers for the effective management of GC symptoms and caregiving-related challenges are also recommended to reduce their caregiver burden.

Structure-Function Relationships of Nanocarbon/Polymer Composites for Chemiresistive Sensing: A Review.

Composites of organic compounds and inorganic nanomaterials provide novel sensing platforms for high-performance sensor applications. The combination of the attractive functionalities of nanomaterials with polymers as an organic matrix offers promising materials with tunable electrical, mechanical, and chemisensitive properties. This review mainly focuses on nanocarbon/polymer composites as chemiresistors. We first describe the structure and properties of carbon nanofillers as reinforcement agents used in the manufacture of polymer composites and the sensing mechanism of developed nanocomposites as chemiresistors. Then, the design and synthesizing methods of polymer composites based on carbon nanofillers are discussed. The electrical conductivity, mechanical properties, and the applications of different nanocarbon/polymer composites for the detection of different analytes are reviewed. Lastly, challenges and the future vision for applications of such nanocomposites are described.

Sensitive identification of silibinin as anticancer drug in human plasma samples using poly (ß-CD)-AgNPs: A new platform towards efficient clinical pharmacotherapy.

Silibinin is effective in significantly inhibiting the growth of cancer cells which shown significant anti-neoplastic effects in a variety of in vitro and in vivo cancer models, including skin, breast, lung, colon, bladder, prostate and kidney carcinomas. So, development of a new method to its biomedical analysis in clinical samples in highly demanded. In this study, an innovative electroanalysis method for the accurate, sensitive and rapid recognition of silibinin in human plasma samples was proposed and validated. The sensing platform was designed using silver nanoparticles (AgNPs) dispersed on the polymeric layer of ß-cyclodextrin (ß-CD). AgNPs with cubic shape providing a large effective surface area for ß-CD electropolymerization. So, a layer with high electron conductivity boosting the detection electrochemical signals. Also, poly(ß-CD) providing an efficient substrate with cavities to interact with silibinin and its oxidation. Differential pulse voltammetry technique was conducted to measure silibinin concentration in human real samples. Under optimized conditions, proposed sensor indicated linear relationship between the anodic peak current and concentration of silibinin in the range of 0.0103-10.3 µM on the standard and human plasma samples. Based on obtained results, proposed sensor is an efficient platform to efficient therapy of cancer based on recognition of silibinin in clinical samples.

Dry sonication process for preparation of hybrid structures based on graphene and carbon nanotubes usable for chemical sensors.

The combination of graphene (G) and multi-walled carbon nanotubes (MWCNTs) creates three-dimensional hybrid structures particularly suitable as next-generation electrical interface materials. Nevertheless, efficient mixing of the nanopowders is challenging, unless previous disaggregation and eventual surface modification of both is reached. To avoid use of solvents and multistep purification process for synthesis of stable G/MWCNTs hybrids, herein, a novel dry method based on an air sonication process was used. Taking advantage from the vigorous turbulent currents generated by powerful ultrasonication in air that induces strong thermal convection or radiation to and from the particles, it simultaneously ensures disentanglement of the large MWCNT bundles and G exfoliation and their only mild surface modifications. By changing the ratio between MWCNTs and G, a range of hybrids was obtained, different in surface morphology and chemistry. These hybrids have shown great potential as sensing material for designing mass-based sensors for toxic gases and chemiresistor for vapors detection.

Nutritional challenges of gastric cancer patients from the perspectives of patients, family caregivers, and health professionals: a qualitative study.

PURPOSE: This study aims to explore the perceptions of gastric cancer patients, their family caregivers, physicians, and nurses of nutritional challenges. METHODS: Using a descriptive qualitative method, this study was conducted in 2019-2020. Twenty participants (6 patients, 6 family caregivers, 3 physicians, and 5 nurses) were selected through purposive sampling. Data was collected through in-depth semi-structured interviews and examined using qualitative content analysis. RESULTS: Data analysis revealed three categories, each with two subcategories: eating, an unpleasant experience that contains "a feeling like hyperemesis gravidarum" and "childish food excuses"; flexibility while adhering to a proper diet, which consists of "dietary dos and don'ts" and "nutritional leniency"; and nutrition with distress that contains "patient's sense of being an extra burden" and "provision of nutrition with suffering in caregivers." CONCLUSION: Because of the significant physical and psychological impact of nutritional problems on patients and their caregivers, the need to provide care and education to these patients and their families using a multidisciplinary team is becoming more important.

Sensitive monitoring of doxorubicin in plasma of patients, MDA-MB-231 and 4T1 cell lysates using electroanalysis method.

In the present work, an innovative electrochemical sensor was fabricated based on poly toluidine blue modified glassy carbon electrode (PTB-GCE). So, PTB-GCE was used for the detection and determination of doxorubicin hydrochloride (DOX) in cell lysate, and whole human plasma samples. PTB could enhance the rate of electrochemical reaction for the electro oxidation and detection of DOX in real samples. Cyclic voltammetry (CV) technique was used for the electro polymerization of toluidine blue on the surface of GCE with the applied potential ranging from -0.6 to 0.2 V. The sensor construction steps were approved by field emission scanning electron microscopy (FE-SEM), Energy dispersive X-ray spectroscopy (EDX) and electrochemical methods. Also, CV results indicated that the DOX is oxidized via two electrons and two protons process at the optimum pH of 6.5 using PTB modified GCE. Under optimized conditions, differential pulse voltammetry (DPV) technique response exhibited linear relationship between the oxidative peak current and concentration of DOX in the range of 17 nM - 8.6 µM with low limit of quantification (LLOQ) of 17 nM for untreated and treated human plasma samples. Also, determination of DOX in MDA-MB-231 and 4T1cell lysates were performed based on its direct electrochemical oxidation on PTB-GCE. Finally, analytical validation of DOX in human bio-fluids using FDA guideline were done successfully. Results suggested that the proposed electrochemical sensor can be used to the sensitive and selective determination of DOX in biological samples. The interaction results of DOX with cancer cells indicate the developed probe can easily detect candidate drug in cancer cells with high accuracy. To the best of our knowledge this is the first report of the determination of DOX based on the direct electrochemical oxidation on PTB-GCE and determination in MDA-MB-231 and 4T1 cell lysates. It is anticipated that this research open new horizons on the design of new class of electrochemical sensors for determination drugs, and therapeutic drug monitoring (TDM) in human bio-fluids.

Evaluation of in-person continuing education programs from the perspective of ward nurses.

BACKGROUND: Assessing how programs are implemented from the perspective of the learners themselves is one of the most effective ways to improve the quality of continuing education. The aim was to evaluate the implementation of in-person continuing education programs from the perspective of nurses. METHODOLOGY: Setting of the study was the selected hospital of Isfahan University of Medical Sciences (Al-zahra hospital). This study is a descriptive cross-sectional one. Using a researcher-made questionnaire, the implementation of continuing education programs in four areas of the aim, educational techniques, educational content, and educational field was evaluated. The sample consisted of 236 nurses working in these hospitals who participated in the study through convenience sampling. Data were analyzed by SPSS software version 19 using descriptive statistics. RESULTS: Based on the results, "the need for new content learning" was mentioned as the first priority in continuing education programs. The majority of participants scored each of the following domains (aim, educational techniques, educational content, and education field) as well as all items related to the continuing education program evaluation as "moderate." CONCLUSION: Most nurses assessed the implementation of in-person continuing education programs implemented in Isfahan University of Medical Sciences in general and in each of the domains as "moderate." Therefore, in order to improve the quality of programs, it is necessary to take steps to match the goals with the needs of learners, improve teaching techniques, improve the quality of program contents, and optimize the scope of the programs.

Biosensing of prostate specific antigen (PSA) in human plasma samples using biomacromolecule encapsulation into KCC-1-npr-NH2: A new platform for prostate cancer detection.

Prostate-specific antigen (PSA) is a high molecular weight glycoprotein that is used as a marker for the diagnosis of prostate cancer and is therefore important in the medical field. In this study, a novel sandwich type immunoassay was designed based on encapsulation of biotinylated antibody into KCC-1-npr-NH2. KCC-1-npr-NH2 stabilized the stability of the primary antibody. So, encapsulated Ab1 was immobilized on the surface of glassy carbon electrode. Field emission scanning electron microscope (FE-SEM) was employed to monitor the sensor fabrication. The engineered immunosensor was used for the detection of PSA using differential pulse voltammetry (DPVs) and square wave voltammetry (SWVs) techniques. The proposed interface lead to enhancement of accessible surface area for immobilizing a high amount of anti-PSA antibody, increasing electrical conductivity, boosting stability, catalytic properties and biocompatibility. The intensity of electrochemical signals is also increased by the use of AuNPs functionalized with CysA used in secondary antibody (HRP conjugated PSA) structure. Under optimal conditions, the designed immuno-assay provide a good analytical performance for quantifying the PSA marker in the linear range of 1 to 60 µg/l.

Caring Burden and Quality of Life of Family Caregivers in Patients Undergoing Hemodialysis: A Descriptive-Analytic Study.

BACKGROUND: Caring role, especially in chronic diseases, has a negative impact on the health of family caregivers and can affect their quality of life. Therefore, this study aimed to investigate the care burden and quality of life in family caregivers of hemodialysis patients and their relationship with some characteristics of caregivers and patients. METHODS: This study was conducted as a descriptive-analytic study in Isfahan from January to February 2017. Sampling was done using census. The number of participants was 254. The data gathering tools consisted of a three-part questionnaire including demographic characteristics, the Zarit questionnaire for caring burden, and SF-36 quality of life questionnaire. Data were analyzed using descriptive statistics, Pearson correlation coefficient test, Spearman's coefficient, ANOVA, and univariate general linear regression. A significant level of 5% was considered. RESULTS: The mean scores of the quality of life and caring burden were 30.54±9.89 and 44.98±6.82, respectively in caregivers. The age of the patient under care (P<0.001), cost of medications (P=0.008), and hours of care in 24 hours (P<0.001) had a significant relationship with care givers' quality of life. Also, univariate general linear regression revealed that care burden had a significant relationship with the quality of life (P=0.003). CONCLUSION: Family caregivers who experienced more caring burden had a low quality of life. The researchers suggest that supportive and educational programs should be designed and implemented for this group of patients and their caregivers.

Comparison of bond strength of a composite resin with two different adhesive systems and a resin modified glass ionomer to calcium enriched mixture.

CONTEXT: It is necessary to have a proper bond between pulp-capping agent and composite materials to maintain effective coronal seal. AIMS: This study aims to compare the shear bond strength of a composite resin with two different adhesive systems and a resin-modified glass ionomer (RMGI) to calcium-enriched mixture (CEM). METHODS: In this study, 30 acrylic blocks (with a central hole 4 mm diameter and 2 mm height) were prepared and filled with CEM. The blocks were divided into three groups: single bond2 (SB) with Filtek Z250, single bond universal (SBU) with Filtek Z250, and RMGI. The restorative materials were placed on the CEM, and shear bond strength was measured. Data were analyzed using one-way ANOVA and games Howell tests. P < 0.05 was considered statistically significant. RESULT: Bond strength of both composite groups to CEM showed significantly higher values than RMGI-CEM group (both P < 0.001). The type of the adhesive system( total etch or universal) had no significant effect on the bond strength of composite to CEM (P > 0.05). All the failures in composite groups were as cohesive in CEM and in RMGI group was as adhesive. CONCLUSIONS: Shear bond strength of composite resin to CEM cement was higher than RMGI irrespective of the type of the adhesive system. The universal bonding system is recommended for bonding of composite to CEM for ease of use.

CBCT Assessment of Root Dentine Removal by Gates-Glidden Drills and Two Engine-Driven Root Preparation Systems.

INTRODUCTION: The aim of this study was to compare the dentine removing efficacy of Gates-Glidden drills with hand files, ProTaper and OneShape single-instrument system using cone-beam computed tomography (CBCT). METHODS AND MATERIALS: A total of 39 extracted bifurcated maxillary first premolars were divided into 3 groups (n=13) and were prepared using either Gates-Glidden drills and hand instruments, ProTaper and OneShape systems. Pre- and post-instrumentation CBCT images were obtained. The dentin thickness of canals was measured at furcation, and 1 and 2 mm from the furcation area in buccal, palatal, mesial and distal walls. Data were analyzed using one-way ANOVA test. Tukey's post hoc tests were used for two-by-two comparisons. RESULTS: Gates-Glidden drills with hand files removed significantly more (P<0.001) dentine than the engine-driven systems in all canal walls (buccal, palatal, mesial and distal). There were no significant differences between OneShape and ProTaper rotary systems (P>0.05). CONCLUSION: The total cervical dentine removal during canal instrumentation was significantly less with engine-driven file systems compared to Gates-Glidden drills. There were no significant differences between residual dentine thicknesses left between the various canal walls.

Breaking bad news protocol for cancer disclosure: an Iranian version.

In Iran, as in many Asian and Middle Eastern countries, a significant proportion of cancer patients are never informed of their illness. One solution that has been proposed to tackle this challenge is to develop a localized protocol on cancer diagnosis disclosure based on the culture and values of community members, and train healthcare team members to deliver the bad news using this protocol. This article introduces a localized protocol for disclosure of bad news to cancer patients in Iran. This protocol consists of six steps, including assessment, planning, preparation, disclosure, support and conclusion. In the drafting of this protocol an attempt was made to meticulously consider the cultural features of the Iranian society. Although breaking bad news will never be easy, having an appropriate plan of action based on individual's attitudes, considerably helps health-care professionals, and provides more satisfaction in patients.

Perceptions of patients, families, physicians and nurses regarding challenges in cancer disclosure: A descriptive qualitative study.

PURPOSE: The findings of numerous studies have illustrated that there is still a high proportion of cancer patients in Eastern and Middle-East countries including Iran, who are not properly informed of their disease due to the concealment atmosphere which still prevails. This descriptive qualitative study is aimed at exploring perceptions of patients, patients' family members, physicians and nurses regarding cancer disclosure challenges. METHODS: Thirty-five participants (15 patients, 6 family members, 9 physicians, and 5 nurses) were selected through purposive sampling. The data were collected through in-depth interviews; after which they were analyzed using a qualitative content analysis with an inductive approach. RESULTS: Data analysis revealed the following three categories: first, challenges related to healthcare system which deals with the deficiencies, strains and concerns in medical setting and healthcare team training; second, challenges related to family insistence on concealment which includes their fear of cancer disclosure and its negative impact on the patients; and third, challenges related to policy making which consists of deficiencies in legislative and supportive institutions for advocacy of truth telling. CONCLUSIONS: Successful move from concealment to effective disclosure attitude in cancer patients in Iran requires a national determination for resolving challenges in medical education as well as other different social, cultural and policy making dimensions.

Exploring perceptions and preferences of patients, families, physicians, and nurses regarding cancer disclosure: a descriptive qualitative study.

PURPOSE: The aim of this study was to explore perceptions and preferences of cancer patients, their families, physicians, and nurses in disclosing cancer diagnosis. METHODS: We selected 35 participants (15 patients, 6 family members, 9 physicians, and 5 nurses) by purposive sampling. We collected data by in-depth interviews and used qualitative content analysis for analysis. RESULTS: Data analysis resulted in three categories: (1) establishing a basis for breaking bad news; (2) adjusting to the tragedy of bad news; and (3) helping the patient cope with the shattering news. The first category comprised the following subcategories: provision of proper background; adhering to a patient-centered approach; and being unhurried. The second category comprised the following subcategories: cancer as a cultural taboo; death as a frightening vision of unattainable dreams and punishment; hope as an opening in the utter darkness of disease; and empathy as liniment for the injuries of disease. The third category comprised the following subcategories: the family as the most powerful healing source for the patient; the force of spirituality in achieving peace; and a multiprofessional, harmonious physician-centered team. CONCLUSIONS: The findings of this study can help healthcare teams break the bad news of cancer diagnosis in a more effective, satisfactory, and culture-based manner for patients and their families.

Coronal Discoloration Induced by Calcium-Enriched Mixture, Mineral Trioxide Aggregate and Calcium Hydroxide: A Spectrophotometric Analysis.

INTRODUCTION: The aim of this study was to compare the discoloration potential of calcium-enriched mixture (CEM) cement, white mineral trioxide aggregate (WMTA) and calcium hydroxide (CH), after placement in pulp chamber. METHODS AND MATERIALS: Access cavities were prepared in 40 intact maxillary central incisors. Then, a 2×2 mm box was prepared on the middle third of the inner surface on the buccal wall of the access cavity. The specimens were randomly assigned into four groups; the boxes in the control group were left empty, in groups 1 to 3, the boxes were filled with CH, WMTA and CEM cement, respectively. The access cavities and the apical openings were sealed using resin modified glass ionomer (RMGI). The color measurement was performed with a spectrophotometer at the following intervals: before (T0), immediately after placement of the filling material (T1), one week (T2), 1 month (T3), 3 months (T4) and 5 months (T5) after filling of the box and finally immediately after removing the material from the boxes (T6). Color change (Δ E) values were calculated using the sample Kolmogorov-Smirnov test to determine the normal distribution of data, followed by ANOVA, repeated measured ANOVA and post-hoc Tukey's tests. RESULTS: All materials led to clinically perceptible crown discoloration after 1 week. The highest ΔE value belonged to WMTA group. Discoloration induced by CEM cement was not significantly different from CH or the control group (P>0.05). CONCLUSION: CEM cement may be the material of choice in the esthetic region, specifically pertaining to its lower color changing potential compared to WMTA.