Relationship between health literacy level and sexual function in women in the Northwest of Iran in 2020- a cross sectional study.

BACKGROUND AND PURPOSE: Sexual health means coordination and adaptation of physical, emotional, intellectual and social aspects of human beings. One of the variables that affect sexual function and sexual satisfaction is health literacy. The aim of this study was to investigate the relationship between health literacy level and sexual function in married women in Qazvin health centers. METHODS: In the cross-sectional study, 340 married women were selected from four health centers in Qazvin, Iran, in 2020. These selected centers were chosen randomly from 26 health centers. Participants were included in the study by using the proportional selection method based on the sample size of the all health centers. Data collection tools include three questionnaires: demographic information, The Health Literacy Questionnaire (HELIA), and Female Sexual Function Index (FSFI). Data were analyzed using SPSS 24 software. A significance level of P < 0.05 was considered for statistical analyses. RESULTS: The highest and lowest scores of dimension's sexual function are satisfaction, pain, and lubricant, respectively. The level of women's health literacy in Qazvin was inadequate and borderline (56.4%). Each of the sexual function dimensions had significant positive correlations with health literacy (P < 0.001). There was a significant relationship between health literacy level with age, education, and occupation (P < 0.05). According to linear regression analysis, with the increase in years of marriage, sexual function is decreased (P < 0.02). CONCLUSION: Health literacy was inadequate in more than half of the study sample and health literacy was significantly associated with sexual function. Educational programs were necessary in order to promote women's health literacy in health centers.

Phenotypic and genotypic characterization of virulence markers and antifungal susceptibility of oral Candida species from diabetic and non-diabetic hemodialysis patients.

BACKGROUND: Patients with chronic kidney disease undergoing hemodialysis are often colonized by Candida species with high possibility of fungal infections. The purposes of this study were to determine the prevalence of Candida species, evaluate antifungal susceptibility profile, biofilm formation, proteinase and phospholipase activities, and the frequency of virulence genes in the Candida species isolated from the oral mucosa of hemodialysis diabetic (DM) and non-diabetic (non-DM) patients. METHODS: This study identified several species of Candida isolated from 69 DM and 58 non-DM patients on hemodialysis using phenotypic methods and PCR-RFLP technique. The identification of C. albicans and C. glabrata complex was performed by HWP1 gene and four oligonucleotides (UNI-5.8S, GLA-f, BRA-f, and NIV-f), respectively. Antifungal susceptibility to amphotericin B, fluconazole, itraconazole, voriconazole, and caspofungin was assessed according to CLSI M27-A3/S4. The biomass, metabolic activity of biofilm, proteinase (Prz), phospholipase (Pz), and molecular study for virulence genes were assessed using crystal violet, XTT assay, agar-based hydrolytic enzyme, and PCR technique, respectively. RESULTS: Candida prevalence was 44.9% with 47.8% and 41.4% among DM and non-DM patients, respectively (P = .045). The species identified were C. albicans (49.5%), C. glabrata (16.5%), C. tropicalis (12%), C. kefyr (8.8%), C. parapsilosis (6.6%), C. dubliniensis (3.3%), and C. lusitaniae (3.3%). The antifungal susceptibility profile showed that all Candida isolates were sensitive to amphotericin B, itraconazole, voriconazole, and caspofungin whereas fluconazole resistance was observed in 6.3% (MIC ≥ 64 µg/mL) of C. albicans and 6.6% of C. glabrata (MIC ≥ 64 µg/mL). The susceptible- dose-dependent rate was found in 10.5% of C. albicans. The Prz values of C. albicans ranged from 0.37 to 0.66 for the DM and 0.44-0.73 for the non-DM group (P < 0.05). The non-albicans Candida (NAC) species produced higher degree of biomass and metabolic activity compared to C. albicans (P < 0.05). Furthermore, significant (p < 0.05) correlations were detected between the biofilm formation with Prz values and fluconazole MICs. The most detected virulence factors were ALS3 and Sap5. CONCLUSIONS: These results showed the importance of prevalence of NAC species in hemodialysis patients. Investigating antifungal susceptibility profile made a better understanding of the role of virulence markers in the pathogenesis of Candida strains.

Pregnant women and infants against the infection risk of COVID-19: a review of prenatal and postnatal symptoms, clinical diagnosis, adverse maternal and neonatal outcomes, and available treatments.

BACKGROUND: The establishment of a risk-appropriate care approach for pregnant women and newborn infants under the COVID-19 pneumonia is vital to prevent the main pregnancy complications. OBJECTIVES AND DESIGN: This study reviewed the vertical transmission (VT) potential of COVID-19 pneumonia in pregnant women. Key-related symptoms and adverse clinical outcomes for mothers and infants before and after childbirth were summarized. Some practical therapies and preventive health solutions were also proposed. RESULTS: There was a high susceptibility in pregnant women to COVID-19 infection, especially in the third trimester of pregnancy. The most common symptoms in 22-40-year-old patients infected with COVID-19 were fever (87.6%), cough (52.3%), dyspnea (27.6%), fatigue (22.4%), sore throat (13.5%), malaise (9.4%), and diarrhea (3.4%), respectively. The viral infection led to an increase in preterm labor and cesarean delivery without any intrauterine infection and severe neonatal asphyxia. No infection in the newborn infants was reported despite a high risk of the VT phenomenon. The most important therapies were the reception of antiviral and antibiotic drugs, oxygenation therapy, psychological interventions, and food supplements with health-promoting effects. The best proposed medical strategies to control the COVID-19 infection were bi-monthly screening and following-up the mothers' and fetuses' health, not using the potent broad-spectrum antibiotics and corticosteroids, providing the delivery room with negative pressure for emergency cesarean section, and the immediate isolation of newborns after childbirth without direct breastfeeding. CONCLUSION: Babies with respiratory problems may be born to some mothers with COVID-19, who have weak immune systems. Thus, the virus transmission cycle should be disrupted to prevent adverse maternal and fetal outcomes by integrating individual health guidelines, efficient medical care therapies, and hospital preventive practices.

Labor induction with randomized comparison of cervical, oral and intravaginal misoprostol.

BACKGROUND: This study attempts to evaluate the safety and effectiveness of 50µgm intracervical misoprostol in comparison with intravaginal and sublingual for the induction of labor at term pregnant women. METHODS: This study is designed as a parallel clinical trial study. Three hundred and fifteen term pregnancies requiring induction of labor were treated with the maximum used misoprostol intracervical, sublingual, and vaginal doses. Participants were randomly allocated into three groups of 105. The dose was repeated every 4 h until adequate uterine contraction and Bishop Score were achieved. The duration of induction to births, time to the active phase, the rate of births, and the need for caesarean section were compared in three groups. Additionally, labor course and side effects were recorded and analyzed. Data were analyzed using SPSS software. A significance level of p <  0.05 was considered for statistical analyses. FINDINGS: Labor was successfully induced in all cases most (63%) of which required a single dose of misoprostol. Ninety-three (93.0%, p <  0.05) cervical participants proceeded to vaginal births. This figure was also the same in the vaginal and sublingual group of 83 cases (83.0%). The other 41 cases received caesarean section with more indications of failure to progress and meconium-stained liquor. The results indicated that 278 (92.7%) births were achieved in less than 10 h. Time from start of medication to the active phase of labor and childbirth was 3.01 ± 0.86 and 6.1 ± 1.3 h in the Cervical group, 4.2 ± 0.66 and 8.4 ± 0.92 h in the sublingual group, and 5.06 ± 1.1 and 9.2 ± 1.5 h in the vaginal group respectively (p < 0.001). The Caesarean rate was lower in the cervical group than in the two other groups (p = 0.05). No significant differences were observed between the study groups in terms of Apgar score and meconium-stained amniotic fluid. Furthermore, no maternal and neonatal complications were observed. CONCLUSION: In addition to the sublingual and intravaginal routes of administration, intracervical misoprostol at a single dose of 50µgm appears to be an effective method for induction of labor in women with an unfavorable cervix. Like all medical interventions, a discussion of the risks, benefits, and alternatives to induction of labor with this medication in each woman should be undertaken before treatment. TRIAL REGISTRATION: This clinical study was approved by the Iranian Registry of Clinical Trials with IRCT ID: IRCT20190415043278N1 . Registration date was on May 13, 2019 and May 27, 2019 respectively ( http://www.irct.ir ).

Global prevalence of Trichomonas vaginalis among female sex workers: a systematic review and meta-analysis.

Trichomoniasis is a sexually transmitted infection (STI), caused by the protozoan parasite, Trichomonas vaginalis. Female sex workers are intensely affected by the infection, since they have frequent direct physical contact. The current systematic review and meta-analysis represents the global prevalence of T. vaginalis in female sex workers. Five databases (Science Direct, Scopus, PubMed, Web of Science, and Google Scholar) were explored for literatures that published from July 1985 to June 2020. Totally, 85 studies (54,515 participants) from 46 countries met the inclusion criteria. The global pooled prevalence of T. vaginalis was 16% (95% CI 13-19%). The estimated pooled prevalence based on methods including wet mount, culture, and molecular techniques was 15% (95% CI 12-19%), 16% (95% CI 10-24%), and 22% (95% CI 13-32%), respectively. Moreover, the infection was most prevalent at the mean age of 30-36 (20%, 95% CI 11-30%). Regarding the World Health Organization (WHO) regions, the highest pooled prevalence was estimated to be in the African region (23%, 95% CI 7-46%). In addition, we indicated that countries with low-income level have the highest pooled prevalence (23%, 95% CI 14-34%). Our results revealed that the worldwide prevalence of T. vaginalis was significant in female sex workers. Therefore, considering a precise strategy such as a health education program with regard to safe intercourse is needed to increase knowledge and prevent T. vaginalis infection in sex workers.

Investigating the effect of vitamin D vaginal suppository on sexual function among postmenopausal women: study protocol for a randomized controlled trial.

BACKGROUND: Menopause is associated with changes in sexual function which are partly due to vaginal atrophy in response to estrogen reduction. Estrogen administration temporarily reduces the symptoms of vaginal dryness, but long-term exposure to this drug is likely to be associated with serious complications. Considering the promising results of previous studies concerning the effect of vitamin D on vaginal dryness, the proposed study will investigate the effect of vitamin D vaginal suppository on the sexual function of postmenopausal women. METHODS: In a randomized, controlled clinical trial, 105 postmenopausal women will be randomly assigned to three groups receiving vitamin D vaginal suppository, placebo vaginal suppository, or control (no intervention). Vitamin D vaginal suppositories contain 1000 units of vitamin D3. The timing of the use of vitamin D vaginal suppositories and placebo suppositories will be every night in the first 2 weeks, and every other night in the following 6 weeks (8 weeks in total). The primary outcome will be the sexual function of participants which will be assessed using the Female Sexual Function Index (FSFI) before and immediately after the intervention, and at 1 and 2 months after the end of the intervention. The side effects of these suppositories will be examined as a secondary consequence of the study. Data will be analyzed using SPSS software version 25. In the case of normal distribution of data, the mean score of sexual function will be compared between the groups using a repeated measurements ANOVA. If statistical analysis leads to significant results, the post-hoc test will be used to determine the differences between the groups. Comparison of demographic and fertility characteristics of the women will be carried out using statistical tests such as chi-squares and t-tests. A significance level of p < .05 will be used for statistical analyses. DISCUSSION: If vitamin D vaginal suppositories improve sexual function among premenopausal women with long-term effects and minimum side effects, the suppositories will be considered a safe complementary and alternative choice for alleviating sexual dysfunction among this group. TRIAL REGISTRATION: IRCT20180704040346N1 at 2018-10-13 prospectively registered.

Dalfampridine in the treatment of primary fatigue in patients with multiple sclerosis: a randomized clinical trail.

INTRODUCTION: Fatigue is a highly prevalent debilitating symptom among patients with multiple sclerosis (PwMS), which markedly affects the quality of life. The present study aimed to evaluate the effect of extended-release fampridine on fatigue in PwMS. METHODS: This was a randomized, double-blind clinical trial on 77 PwMS with a complaint of fatigue, aged over 18 years old, randomized to extended-release fampridine (n = 44) or placebo (n = 35) for 12 weeks. Fatigue and motor function were assessed at baseline and end point. RESULTS: A total of 88 patients were recruited, of whom 77 were analyzed. 80.5% were female, with a median age of 38. 87% were diagnosed with relapsing-remitting MS (RRMS) with a median disease duration of 96 months. Fingolimod (37.7%) was considered the most frequently used DMT, followed by ani-CD20s (32.5%). The total median MFIS score was 43.5 and 37 in the fampridine and placebo groups which were not significantly different (p > 0.05). After 12 weeks, the total MFIS improved in both groups compared to the baseline, which was significant in the active group (p = 0.04). However, the final end point total MFIS was still comparable between the two groups (p = 0.11). CONCLUSION: The present study revealed a positive short-term effect of extended-release fampridine on MFIS in PwMS. However, this effect was not significantly superior to the placebo.

Parent's Attitudes toward Their Children's Oral Health Care during the COVID-19 Pandemic: A Cross-Sectional Study.

Background: The COVID-19 pandemic has significantly impacted global health and presented challenges to maintaining oral health in children. Efficient management and prevention of oral diseases are therefore crucial in this population. Aim: This cross-sectional study aimed to assess parents' self-reported oral and dental hygiene habits for their children during the COVID-19 pandemic. Methods: A total of 256 parents of primary school children in Qazvin completed an online questionnaire containing demographic, general, and cardinal questions. The collected data were analyzed using SPSS 22 software, and accurate analytical tests were run to reach the results. Results: The study found that 69.1% of parents and 87.1% of children brushed their teeth regularly during the pandemic. Additionally, 80.5% of parents monitored their children while brushing. While some parents expressed concerns about COVID-19 infection, parents from lower socioeconomic status reported a higher willingness to attend dental centers than those from more prosperous areas. Conclusion: These findings suggest that parents' supervision and attitude toward oral health care significantly affect children's oral hygiene habits during the pandemic, possibly due to increased time spent together during lockdowns.

Knowledge Enhancement of Elementary School Staff about Traumatic Dental Injuries Using Different Educational Tools.

Introduction: This study aimed to assess the efficacy of different educational tools for knowledge enhancement of elementary school staff about the management of traumatic dental injuries (TDIs). Materials and Methods: This quasi-experimental (pretest-posttest) study was conducted on 126 elementary school staff in Qazvin city, who were randomly selected by the cluster sampling in 2020. The baseline knowledge level of the participants about TDIs was assessed by an online questionnaire. Next, they were randomized into the poster, video clip, and no-intervention control groups (56 samples in each group). An informatory poster and a video clip about TDIs were sent to the participants in the first two groups, respectively, through the WhatsApp instant messaging app, and the knowledge level of the three groups was assessed again after 3 weeks. Data were analyzed by ANOVA, McNemar test, chi-square test, and t-test. Results: A significant correlation was noted between the baseline knowledge level of the participants and their educational level, participation in first aid courses covering TDIs, and history of encountering TDIs (P < 0.05). The knowledge level of the participants significantly increased after the intervention in the poster and video clip groups (P < 0.05). Knowledge enhancement was 43.26% in the poster and 36.61% in the video clip group (P > 0.05). Conclusion: Despite the low-baseline knowledge level of the elementary school staff in Qazvin city about TDIs, their knowledge level significantly improved after the educational interventions.

Comparison of the pharyngeal airway in snoring and non-snoring patients based on the lateral cephalometric study: A case-control study.

BACKGROUND: Normal airways are a key factor during the craniofacial growth of the young. Therefore, sleep-disordered breathing (SDB) without treatment can have harmful consequences for development and health. OBJECTIVES: This study aimed to evaluate the cephalometric characteristics in non-snoring individuals and snoring subjects, and investigate differences in the pharyngeal airway space between the 2 groups. MATERIAL AND METHODS: This case-control study included 70 patients aged over 18 years, selected from a radiology center. The patients were divided into 2 groups: case (35 patients with a history of habitual snoring); and control (35 healthy patients). The Berlin sleep questionnaire was administered to the parents of the patients. The nasopharyngeal airway was measured according to the analysis of Linder-Aronson (1970), and 4 indices were measured and analyzed in each of the lateral cephalometric radiographs. RESULTS: No statistically significant differences were observed in the pharyngeal measurements between the 2 groups, although all means in the control group were higher than in the experimental group. However, there was a significant relationship between gender and the Ba-S-PNS and PNS-AD2 indices. CONCLUSIONS: Although the patients with nocturnal snoring had smaller airway dimensions, their pharyngeal measurements were not significantly different from the control group.

The Effectiveness of Cognitive-Behavioral Intervention on Dental Anxiety during Pulpotomy in 7-10 Year-Old Children: A Clinical Trial.

Objectives: Dental anxiety is a common phenomenon experienced by children in the dental setting. However, there is limited research on the effectiveness of cognitive-behavioral interventions in managing this anxiety. Therefore, the aim of this study was to evaluate the impact of a cognitive-behavioral psychologic intervention on dental anxiety in children. Materials and Methods: A total of thirty children, aged 7-10 years, underwent prophylaxis and fluoride therapy. The baseline anxiety levels of the children were determined using the Modified Child Dental Anxiety Scale (MCDAS). The intervention group (N=15) received two 30-minute sessions of cognitive-behavioral exercises. Additionally, a short film demonstrating a cooperative child undergoing pulpotomy was created and parents were instructed to show it to their children at home. During the treatment session, the exercises were reinforced at each step, and the MCDAS questionnaire was administered again. The children's behavior was also assessed using the Venham Clinical Cooperation Scale. Independent t-test, Mann-Whitney, chi-square, and Pearson's correlation coefficient were used for statistical analysis and P<0.05 was considered statistically significant. Results: Postoperatively, the MCDAS score in the intervention group was significantly lower compared to the control group. Notably, the intervention group demonstrated a downward trend in anxiety scores, while the control group showed an increase (P<0.001). Conclusion: Cognitive-behavioral interventions were found to be successful in decreasing dental anxiety in children undergoing pulpotomy. These interventions can be successfully implemented in clinical settings.

Mobile app for comprehensive management of orthodontic patients with fixed appliances : Design and use.

OBJECTIVES: This study aimed to design and implement a mobile phone application (app) aiming to enhance the cooperation and oral hygiene of orthodontic patients. METHODS: An orthodontic app named "Labkhand" was designed by a team of orthodontists and programmers according to the needs and scheduled interventions for patients. The aim of this app was to obviate the orthodontic needs of patients by providing educational content in the form of texts and videos, oral hygiene reminders, appointment reminders, and nutrition reminders. It also enabled instant messaging and chatting between patients and dental personnel. In this study, 61 patients were monitored during their orthodontic treatment procedure. All patients were evaluated using a questionnaire with 7 questions before and after a 6-month treatment period. A total of 31 patients were instructed to use the app, while the other 30 patients received treatment without the app. The collected data were analyzed using paired t­test and analysis of covariance (ANCOVA) test. RESULTS: While the control group's questionnaire score remained almost the same (P > 0.05), the mean questionnaire score of patients in the intervention group significantly increased after using the app compared to the baseline scores acquired before using the app (P < 0.001). The greatest improvement was noted in topics related to "reminding of appointments", "general information about orthodontic treatment", and "oral hygiene maintenance and instructions". "Quality of services" and "patient-orthodontist communication" showed the least improvement in patient satisfaction. CONCLUSIONS: The Labkhand orthodontic app has multiple functions and can obviate the needs of orthodontic patients easily and at a low cost.

Salivary Nitric Oxide Levels in Adults with Different DMFT Scores in a Selected Iranian Population: A Cross-Sectional Study.

Objectives: Due to the emphasis on the protective and antimicrobial role of Nitric Oxide against gastrointestinal diseases, investigating its relationship with dental caries is a right topic. Therefore, this research has investigated the amount of saliva Nitric Oxide in different volumes of DMFT indicator in adults. Material and Methods: In this descriptive- analytical cross-sectional study, 80 participants (20-35 years old), without a history of systemic disease and drug use participated as research samples, (53.8% of the participants in the study were women). Participants were selected from patients who had visited dental Department. The participants were divided in four groups based on DMFT (DMFT=0, 1≤DMFT≤3, 3

Effect of vitamin D vaginal suppository on sexual functioning among postmenopausal women: A three-arm randomized controlled clinical trial.

OBJECTIVE: Vaginal atrophy, the second most common complication of menopause, can lead to sexual dysfunction. This study evaluated the effect of a vitamin D vaginal suppository on sexual functioning in postmenopausal women. METHODS: This three-arm randomized controlled trial was conducted between August 2019 and August 2020. The sample comprised 105 postmenopausal women who were referred to comprehensive health service centers to receive postmenopausal care. The inclusion criteria were as follows: (i) being menopausal for at least 1 year, (ii) being married, (iii) being sexually active, and (iv) having sexual desire. Participants were randomly assigned to three groups for 8 weeks of treatment: intervention (vaginal suppository containing 1,000 units of vitamin D3), placebo (vaginal suppository placebo), or control (no treatment). The main outcome measure was sexual functioning, which was assessed using the Female Sexual Function Scale (FSFI) 4 times during the study (i.e., 1 month before the intervention, immediately after the intervention, 1 month after the intervention, and 2 months after the intervention). RESULTS: Immediately and 1 month after the trial, the intervention group had the highest FSFI score, followed by the placebo group, both of which were significantly higher than those of the control group (P<0.05). At the 2-month follow-up, the intervention and placebo groups had similar FSFI scores (P=0.08), both of which were significantly higher than those in the control group (P=0.001 and P=0.03, respectively). CONCLUSION: Vitamin D vaginal suppositories were more effective at improving sexual functioning among postmenopausal women in the short-term and appeared to prevent aging-related sexual functioning decline in the long term.

Efficacy of a mobile phone application for the improvement of oral hygiene of patients undergoing fixed orthodontic treatment : A randomized controlled clinical trial.

OBJECTIVES: This study aimed to assess the efficacy of a mobile phone application (app) to improve oral hygiene of patients undergoing fixed orthodontic treatment. MATERIALS AND METHODS: This randomized controlled clinical trial was conducted with a total of 60 patients undergoing fixed orthodontic treatment in two groups: intervention and control (n = 30 each). A previously designed mobile app (Labkhand) was used by patients in the intervention group. Orthodontic plaque index (OPI) and modified gingival index (MGI) were recorded in the two groups at baseline (first session or T0), and after 1 (T1) and 3 (T2) months. The number of debonded/broken brackets was also recorded, and pain score of the patients was assessed at nine time points. Data were analyzed using the χ2 test, paired t­test, and repeated measures analysis of variance (ANOVA; α = 0.05). RESULTS: The two groups demonstrated no significant difference in OPI and MGI at T0 (P > 0.05). OPI and MGI at T1 and T2 were significantly lower in the intervention group than in the control group (P < 0.05). The number of patients with broken brackets in the intervention group was significantly lower than that in the control group (P = 0.017). The two groups reported no significant difference in pain score (P > 0.05). CONCLUSION: The Labkhand mobile app successfully improved oral hygiene indices of patients undergoing fixed orthodontic treatment, and decreased the frequency of broken brackets after 1 and 3 months of use.

Effects of Educational Intervention on Dental Plaque Index in 9-Year-Old Children.

Methods: 119 students of third-grade elementary (65 girls and 54 boys) from government and private schools of Qazvin city participated. The dental plaque index of every participant was primarily recorded by Silness and Loe method. Students were trained by a dental student by face-to-face method, and after 2 weeks, dental plaque indices were recorded again for every individual. After index recording and coding, data analysis was done using SPSS version 21. Results: Results showed that the dental plaque index was statistically significantly different before and after training (p < 0.001). Conclusion: Based on the results of this study, students' motivation in addition to proper training, can have a significant impact on oral and dental health. Furthermore, this study shows that face-to-face training along with involving the individual in training and learning was seen as quite helpful.

Evaluating the Ability of PRISM4 and PIM3 to Predict Mortality in Patients Admitted to Pediatric Intensive Care Unit; a Diagnostic Accuracy Study.

Introduction: Limited resources and the large number of children in need of services in the pediatric intensive care unit (PICU) emphasize the need for effective allocation of resources for improving the outcome of at-risk patients. This study aimed to evaluate and compare the accuracy of PRISM4 and PIM3 systems in prediction of in-hospital mortality of patients admitted to PICU. Methods: The present retrospective cross-sectional study was a diagnostic accuracy study performed on patients admitted to PICU of Qods Hospital, Qazvin, Iran, during one year. Scores of PRISM4 and PIM3 scales were calculated for each patient using the available calculators, and the outcome of patients regarding in-hospital mortality was recorded. Finally, screening performance characteristics of the mentioned scales in prediction of patients' mortality were calculated and reported. Results: 218 patients with the mean age of 40.68 ± 37.92 (2-160) months were studied (57.8% female). There was a significant direct correlation between PIM3 score and duration of stay in PICU (p < 0.0001; r = 0.259), need for inotropic drug administration (p = 0.001), and mortality rate (p = 0.001). In addition, area under the receiver operating characteristic (ROC) curve of PIM3 and PRISM4 in prediction of mortality among patients admitted to the PICU was 0.939 (95%CI: 0.880 - 0.998) and 0.660 (95%CI: 0.371 - 0.950), respectively (p = 0.001). Based on the findings, the best cut-off point for PIM3 scale in prediction of mortality was the score of 4 and it was estimated to be the core of 8 for PRISM4 scale. Sensitivity and specificity of PIM3 scale in prediction of mortality in the cut-off of 4 points were 100.00 (95% CI: 56.09- 100.00) and 81.51 (95% CI: 75.47- 86.38), respectively. These measures were 42.85 (95%CI: 11.80- 79.76) and 98.10 (95%CI: 94.89- 99.39) for PRISM4 model, which indicates the higher sensitivity of PIM3 system in this regard. Conclusion: based on the results of the present study, the accuracy of PIM3 is significantly higher than PRISM4 in prediction of in-hospital mortality among patients admitted to the PICU. It seems that considering the 100% sensitivity of PIM3 in prediction of outcome, this model is a better tool for screening patients who are at risk for in-hospital mortality in order to pay more attention and allocate more resources to improve their outcome.

Effect of Sinus Floor Augmentation with Platelet-Rich Fibrin Versus Allogeneic Bone Graft on Stability of One-Stage Dental Implants: A Split-Mouth Randomized Clinical Trial.

Rehabilitation of an edentulous posterior maxilla with dental implants is challenging, and sinus floor augmentation could be considered as an important surgical procedure for bone augmentation in this region before implant placement. Platelet-rich fibrin (PRF) is a new-generation platelet concentrate with simplified processing: its application in sinus floor augmentation has been widely investigated in literature. However, the biological properties and actual efficacy of this product remain controversial. This study assessed the effect of sinus floor augmentation with PRF versus freeze-dried bone allograft (FDBA) on stability of one-stage dental implants. This split-mouth randomized clinical trial evaluated 10 patients who required bilateral sinus floor augmentation. PRF and L-PRF membrane were used in one quadrant while FDBA and collagen membrane were used in the other quadrant. Implant stability was assessed by resonance frequency analysis (RFA) immediately, and 2, 4, and 6 months after implant placement. The implant stability quotient (ISQ) was compared over time and between the two groups using repeated measures ANOVA and independent sample t-test. The mean ISQ significantly increased over time in both groups (p < 0.001). The increase was greater in the PRF group (p < 0.05). Within the limitations of this study, PRF yielded superior results compared with FDBA regarding the stability of one-stage dental implants.

The Effect of Dental Adhesive Composition and Etching Mode on Microleakage of Bonding Agents in Primary Molar Teeth.

Statement of the Problem: The dilemma of microleakage at the composite-tooth interface is still a major challenge in operative dental practice. Purpose: This study aimed to compare the microleakage of universal adhesive with self-etch and total-etch bonding strategies for restoration of class-II primary molar cavities. Materials and Method: This in vitro, experimental study was conducted on 75 extracted primary molars. Class-II cavities were prepared in mesial or distal surfaces. The teeth were randomly divided into five groups of Adper Single Bond 2 (3M ESPE; St Paul, MN, USA), Clearfil SE Bond (Kuraray Noritake, Osaka, Japan), G-Bond (GC Corp., Tokyo, Japan), G-Premio Bond (GC Corp., Tokyo, Japan) with total-etch mode and G-Premio Bond with self-etch mode. Cavities were also restored with Nano-hybrid resin composite (Grandio, VOCO, Cuxhaven, Germany) and incubated for 24 hours, followed by thermocycling at 1500× between 5-55°C within a dwell time of 20 seconds. Later, the cavities were placed in 1M silver nitrate solution and evaluated under a stereomicroscope. Finally, microleakage was assessed quantitatively and qualitatively. One tooth in each group was prepared and evaluated under a scanning electron microscope (SEM). Data were analyzed using One-way ANOVA, Tukey's post hoc test and Chi-square test (p< 0.05). Results: The microleakage values were significantly different in the study groups (p< 0.05). The highest level of microleakage was noted in G-Bond and the lowest in G-Premio Bond with total etching. There was a significant correlation between the qualitative and quantitative measurements of microleakage. Conclusion: The G-Premio Bond yielded acceptable results in terms of microleakage in total-etch and self-etch modes. However, additional etching is recommended to improve the quality of bonding.

Comparative evaluation of net setting time and radiopacity in Fuji II (GC-Japan) restorative glass ionomer and Iranian glass ionomer.

Background: Comparing the net setting time and radiopacity of an Iranian glass ionomer cement (GIC) and Fuji II (GC, Japan) according to ISO 9917-1:2007 standard. Materials and Methods: In this experimental/in vitro study, for both tests, we prepared 20 samples of Fuji II glass ionomer (self-cure restorative glass ionomer, batch number: 1608031, GC Corporation, Tokyo, Japan) and Iranian glass ionomer (Ava Tajhiz Dandan-Iran) at P/L of 2/7:1. Then, to determine the net setting time, we prepared a metal mold with dimensions of 10 mm in length, 8 mm in width, and 5 mm in height. Ninety seconds after mixing, the surface of the sample was subjected to the indenter, and the net setting time was recorded as the time elapsed between the end of the mixing and the time needle stopped making a complete circular indentation. To determine radiopacity, the specimens were poured into a mold with a diameter of 15 mm and thickness of 1 mm. Samples and a step wedge were irradiated with X-rays. Particle size analysis and Energy-dispersive X-ray spectroscopy (EDS) analysis were also done for both cements. Test results were investigated with SPSS and through independent t-test (P < 0.05). Results: The mean value of net setting time for Fuji II was 4.83 min and for the Iranian Glass ionomer was 3.83 min (P < 0.05). The mean value of radiopacity for Fuji II was 2.3 mmAL and for Iranian Glass ionomer was 1.9 mmAl (P < 0.05). Conclusion: Net setting time and radiopacity of the glass ionomers were within the range of ISO 9917-1:2007. If all properties of the Iranian cement are set appropriately in future investigations, we propose to use it instead of Fuji II GIC. This has the additional benefit of being cost-efficient as Iranian cement costs less than Fuji II cement.