Designing, implementation and evaluation of story reading: a solution to increase general empathy in medical students.

BACKGROUND: Communication and mutual understanding among healthcare providers is a significant concern within the healthcare system, and enhancing empathy is one way to foster effective communication and mutual understanding. The aim of this research is to evaluate and compare the impact of story reading on the level of empathy in medical students at Mazandaran University of Medical Sciences. METHODS: The study employed an intervention educational design (a quasi-experimental), with a convenience sample of 51 medical students selected as the statistical population. The process of story reading was conducted over six two-hour virtual sessions in the students' classroom, spanning six weeks. Selected stories were discussed in an online virtual class under the supervision of an instructor, focusing on story elements. To assess students' empathy in this educational program, the Davis General Empathy Questionnaire was administered before each of the six sessions, after, and one week later at the end of the course. Statistical analysis of the collected data was performed using repeated measures analysis of variance and Bonferroni's post hoc test through SPSS version 28 software, with a significance level set at 0.05. RESULTS: The findings revealed that 27 participants (58.7%) were female students, with the remaining being male students, having an average age of 19.5 ± 0.86 years. The level of general empathy among the students significantly increased after the intervention compared to before the intervention (P<0.001). Furthermore, the analysis of variance with repeated measures indicated a significant effect of the story reading program on enhancing empathy in terms of emotional and cognitive transfer among students in the intervention group (P<0.001). CONCLUSIONS: The research findings suggest that the story reading program effectively enhances the overall sense of empathy among medical students at the University of Medical Sciences. Therefore, implementing this method in universities, higher education centers, libraries, and psychology centers for teaching empathy can be valuable in fostering empathy skills and improving healthcare.

Impact of Intimate Partner Violence on Iranian Children's Growth and Development: A Descriptive-analytical Study.

Objectives: This study aimed to determine the prevalence of different types of intimate partner violence (IPV) experienced by married Iranian women and their impact on the growth and development of their children. Methods: For this descriptive-analytical study, we recruited the mothers of one-year-old children attending primary health centers in Gonbad-e-Kavoos city, Iran. The data was collected using a questionnaire comprising the World Health Organization Domestic Violence, Ages and Stages Questionnaire-12; and queries related to the participants' socio-economic, obstetrics, demographic, and anthropometric characteristics. The body mass index z (BMI z) scores of the children were divided into five categories based on the World Health Organization's classification: severely underweight (z < -3), underweight (-3 ≤ z < -2), normal (-2 ≤ z < 1), overweight (1 ≤ z ≤ 2), and obese (z > 2). The data were subjected to descriptive analysis, chi-square test, and regression. Results: A total of 596 of mother-child dyads were included in this study. The prevalence of psychological, physical, and sexual IPV was 29.5%, 7.4%, and 2.4%, respectively. Most children (91.7%) had normal weight while the rest were overweight or obese. Developmental problems were reported in 1.7% of children. The education level of the father was significantly related to IPV (p =0.001) while the type of his occupation was related to delay in child growth (p =0.020). There was no significant difference between BMI z-score and developmental disabilities in the children of women exposed and not exposed to any type of IPV. Conclusions: The prevalence of psychological IPV was high while those of physical and sexual IPV were low. The rates of poor child growth and development were also low. The father's educational and socio-economic status influenced IPV and the children's growth deficits.

Efficacy of drug regimen with and without oseltamivir in hospitalized patients with COVID-19: A retrospective study.

Introduction: Coronavirus disease 2019 (COVID-19) is the most critical issue in nowadays medicine. We aimed to evaluate the use and therapeutic outcomes of oseltamivir, an antiviral drug for patients with COVID-19. Materials and method: In an observational study conducted at Imam Khomeini Hospital in Amol, Iran, data for 544 patients with laboratory and CT scan result confirmed COVID-19 were retrospectively collected between February 24th and April 13th 2020. To compare the characteristics of patients based on gender, the chi-square test was used. Logistic regression was used to evaluate the effect of oseltamivir on the outcome of treatment. Logrank test were used to compare the length of hospital stay in people treated with oseltamivir and drugs other than oseltamivir. Results: Kaplan-Meier and logrank test showed no significant reduction in hospitalization time and survival rate following treatment with oseltamivir. However, a significant increase in lymphocytes count and reduction of C-reactive protein (CRP) level detected. Conclusion: Administration of oseltamivir for patients with COVID-19 didn't show any improvement in hospitalization duration and survival rate.

Introducción: la enfermedad por coronavirus 2019 (COVID-19) es el tema más crítico en la medicina actual. Nuestro objetivo fue evaluar el uso y los resultados terapéuticos de oseltamivir, un medicamento antiviral para pacientes con COVID-19. Materiales y método: en un estudio observacional realizado en el Hospital Imam Khomeini en Amol, Irán, los datos de 544 pacientes con resultados de laboratorio y tomografía computarizada confirmados de COVID-19 se recopilaron retrospectivamente entre el 24 de febrero y el 13 de abril de 2020. Para comparar las características de los pacientes en función del género se utilizó la prueba de chi-cuadrado. Se utilizó regresión logística para evaluar el efecto de oseltamivir en el resultado del tratamiento. Se utilizó la prueba de rango logarítmico para comparar la duración de la estancia hospitalaria en personas tratadas con oseltamivir y otros fármacos distintos del oseltamivir. Resultados: Kaplan­Meier y la prueba de rango logarítmico no mostraron una reducción significativa en el tiempo de hospitalización y la tasa de supervivencia después del tratamiento con oseltamivir. Sin embargo, se detectó un aumento significativo en el recuento de linfocitos y una reducción del nivel de proteína C reactiva (PCR). Conclusión: la administración de oseltamivir para pacientes con COVID-19 no mostró ninguna mejora en la duración de la hospitalización y la tasa de supervivencia.

Motor Exercises Effect on Improving Shoulders Functioning, Functional Ability, Quality of Life, Depression and Anxiety For Women With Breast Cancer.

PURPOSE: This research aimed to study the effects of motor exercises on improving shoulder functioning, functional ability, quality of life, depression, and anxiety in patients. PATIENTS AND METHODS: A randomized clinical trial in which 70 eligible patients referred to the oncology ward participated in two intervention and control groups. The intervention group (N=35) had been doing motor exercises for five weeks. Before the surgery, two days, and five weeks after surgery, shoulder Range Of Motion (ROM) was measured with a goniometer, and the functional capacity level was measured by the 6-Minute-Walk-Test. Quality of life, depression, and anxiety were measured using the EORTC QLQ-C30 and QLQ-BR23; and HADS questionnaires, respectively, at baseline and five weeks after surgery. Descriptive statistics, the T-test, and the Chi-Square t-hotelling model were used to analyze the data. RESULTS: The results showed that motor exercises had a significant statistical increase in the distance of 6MWT (P<.001) and ROM (P≤.001) compared to the control group. Moreover, there were significant differences in dimensions of patients' quality of life, depression, and anxiety in the intervention group, compared to the control group (P<.05). CONCLUSION: Motor exercises had positive effects on improving physical functioning, shoulder ROM, and decreasing patients' anxiety and depression symptoms, consequently enhancing the quality of life.

Comparison of the incidence of contrast-induced nephropathy after primary PCI in patients receiving high-dose rosuvastatin and atorvastatin.

Introduction: Contrast-induced nephropathy (CIN) is associated with increased disability and death. Randomized clinical trial studies have shown that short-term treatment with statins prior to cardiac intervention was capable of reducing the incidence of CIN. Therefore, the aim of this study was to compare the incidence of CIN after primary PCI in patients receiving high-dose rosuvastatin and atorvastatin. Methods: This clinical trial was performed in Mazandaran Heart Center Hospital on patients referred to the emergency department who underwent primary PCI with a diagnosis of STEMI. Patients received 1 cc/kg/h normal saline from PCI for up to 12 hours. Patients with EF less than or equal to 35% received intravenous normal saline at half the usual dose. SPSS software version 24 was used for data analysis. P value less than 0.05 was considered to be statistically significant. Results: 206 patients were included in the study that the most underlying diseases of patients (79, 38.3%) were hypertension, followed by anemia (76, 36.9%) and diabetes mellitus (52, 25.2%). Among these, in the first criterion, 10 (8.1%) and 4 patients (4.8%) were in the atorvastatin and rosuvastatin groups, respectively, which did not have a statistically significant difference (P = 0.264). Examination of GFR subgroups also showed that GFR above 30 had significant differences between the two groups. Conclusion: The use of different statins has had similar results in the prevention of CIN in patients undergoing primary PCI. Rosuvastatin has no special advantage over atorvastatin, showing that the use of any of these drugs can be useful in patients requiring angiography.

Prevalence, risk factors, and molecular analysis of vancomycin-resistant Enterococci colonization in a referral neonatal intensive care unit: a prospective study in northern Iran.

OBJECTIVES: Vancomycin-resistant enterococcus (VRE) is an emerging drug-resistant organism responsible for increasing nosocomial infections. Few data are available on the epidemiology of VRE colonization or infection in neonates, and is of recent interest. This study analyzes the prevalence of neonatal VRE colonization in a neonatal intensive care unit (NICU), and describes risk factors and molecular phenotypes associated with VRE colonization. METHODS: We performed a prospective epidemiological study on neonates admitted to an NICU. We compared neonates with VRE isolates detected in rectal swab cultures to those without. Association of VRE colonization with risk factors was tested by using univariate and multivariate methods. RESULTS: During a period of 18 months, amongst 180 neonates enrolled in the study, 76 (42.2%) were colonized by VRE. VRE isolates were resistant to amikacin in 68%, gentamicin in 26%, and ampicillin in 17.1% of cases. Molecular analysis showed the vanA gene in all isolates. Two VRE-positive patients developed infection during the observation time. No deaths occurred during this period. Prematurity (P = 0.023), low birth weight (P = 0.019), history of admission in other hospitals (P = 0.00), and antibiotic therapy for more than seven days (P = 0.01) were identified as risk factors for VRE colonization. CONCLUSION: Newborn susceptibility to early colonization with VRE in NICUs is increased in preterm and low birth weight newborns. All VRE colonization in the NICU was related to the acquisition of the vanA gene. Adherence to infection control policies and antimicrobial stewardship strategies are of the highest importance.

Investigating the effects of vermicomposting process using Eisenia Fetida earthworms on the reduction of parasites population.

PURPOSE: The existence of parasite agents in natural organic fertilizers can lead to health problems and infection transmission. The aim of the present study was to survey the parasites' population reduction during the vermicomposting of the mixtures of municipal sewage sludge (SS) and cow dung (CD) using E. fetida earthworms. METHODS: The vermicomposting process was performed by using earthworms of E. fetida species. The composting process was conducted in 27 pilots for 3 months. The identification and counting of the parasites' population were carried out by Mac Master Slide, according to Bailenger method. RESULTS: The results indicated that the type and number of parasite elements decreased with increasing vermicomposting time. The cumulative removal percent of parasites for sewage sludge (96.10%) was more than the SS + CD (93.65%) and CD (92.93%) treatments. The results showed that after 90 days of vermicomposting, the highest cumulative reduction in the number of parasites was obtained for the treatments with 40 earthworms (98.48%), while the corresponding value for the treatments without earthworms was (88.66%). The statistical analysis indicated that in terms of the parasite's population, a significant difference was observed for the three kinds of compostable materials (P < 0.05), however, this difference was not significant for the three levels of the earthworms (P > 0.05). CONCLUSION: The results showed that the mixture of sewage sludge and cow dung in combination with sawdust could lead to greater and faster reduction in the parasite's population. In addition, the bio-transformed product can be used as useful manure.

Comparison of the effect of continuous intravenous infusion of sodium valproate and midazolam on management of status epilepticus in children.

BACKGROUND AND OBJECTIVES: Status epilepticus as a pediatric emergency requires rapid seizure control in order to prevent subsequent disabilities. Therefore, the present study was conducted to compare the efficacy and side effects of continuous intravenous infusion of sodium valproate versus midazolam as a third-line treatment of status epilepticus in children. METHODOLOGY: This randomized clinical trial study included all children with convulsive and non-convulsive status epilepticus admitted to the pediatric intensive care unit (PICU) of the Bu-Ali Sina Hospital in Sari City (Mazandaran Province, Iran) who had not responded to first-line treatment with diazepam and second-line treatment with phenytoin or phenobarbital. They were consequently treated with continuous intravenous infusion of sodium valproate or midazolam to control persistent seizures. RESULTS: The study comprised 70 patients who were randomly assigned to two equal groups of sodium valproate or midazolam treatment. The mean age of patients in group A (sodium valproate) and group B (midazolam) was 3.97 ± 3.33 and 3.84 ± 2.93 years, respectively. In the present study, the most common etiology of status epilepticus was remote symptomatic, accounting for 35% of cases in the two groups. Sodium valproate was effective in controlling status epilepticus in 91.4% of patients, while midazolam was found to be effective in 85.7% of patients (p > 0.05). Patients who received sodium valproate had shorter seizure duration after administration of the drug compared to those who received midazolam (p = 0.01). Eight patients in the midazolam group and two patients in the sodium valproate group were intubated (p = 0.023). The mean duration of stay in the PICU was 3.2 ± 1.4 and 5.6 ± 2.8 days in groups A and B, respectively, showing a significant difference (p = 0.001). CONCLUSION: According to our findings, intravenous infusion of sodium valproate can be used as an effective and relatively safe treatment in children with all types of status epilepticus, especially in challenging situations such as lack of intensive care units or respiratory problems.

The effect of an empowerment program on the moral sensitivity and caring behaviors of emergency nurses in Iran.

AIM: The present study aimed to evaluate the effect of an empowerment program on the moral sensitivity and caring behaviors of nurses in emergency departments in Iran. BACKGROUND: Emergency department is often a high stress environment. Nurses who worked in the emergency departments are expected to work under pressure to many standards, guidelines and protocols related to patient care. It will expose emergency department nurses to psychological pressures and moral conflicts. A nurse's sensitivity to ethical issues is necessary to provide humane care; it is considered to be a professional competence for nurses. METHODS: This study had a controlled quasi-experimental design. Data were collected before, immediately after, and 1 month after the intervention using a moral sensitivity questionnaire and a caring behavior questionnaire. A total of 131 emergency department nurses from 4 teaching hospitals were divided into an intervention group and a control group. The intervention group received six 60-minute training sessions; the control group did not receive the training. RESULTS: The mean moral sensitivity and caring behavior scores for both groups increased significantly immediately and 1 month after the intervention. However, the significance was higher in the intervention group than in the control group. A comparison of the mean moral sensitivity and caring behavior scores between the groups immediately and 1 month after the intervention did not show a statistically significant difference. CONCLUSIONS: Implementing a training program on ethical issues could thus have a significant impact on the clinical performance of nurses, which could be maintained through follow-up.

Comparing the effects of teach-back method, multimedia and blended training on self-care and social support in patients with heart failure: A randomized clinical trial.

BACKGROUND: The knowledge level of caregivers and their support for patients can affect the self-care of patients with heart failure (HF). The present study was conducted to compare the effects of teach-back, multimedia, and blended training methods on self-care and social support in patients with HF and on knowledge in their caregivers. MATERIALS AND METHODS: In a randomized clinical trial, a total of 150 HF patient-caregiver dyads were randomly allocated into three equally sized training groups, using a simple number table (n = 50). The study was conducted between May to October 2018 in Sari, northern Iran. In the teach-back, multimedia and blended training groups, patient-caregiver dyads participated in 20-30-min training sessions held face-to-face, using digital video disc (DVD) and combination of teach-back and DVD on 4 consecutive days at the bedside of hospitalized patients in coronary care unit, respectively. Data were collected using the European Heart Failure Self-Care Behaviour Scale and the multidimensional scale of perceived social support for patients. Caregivers' level of knowledge was measured using the HF Knowledge Scale. Data were measured on the first day of hospitalization, 1 day before discharge and 4 and 8 weeks after patients' discharge. Data were analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). RESULTS: All three educational methods improved self-care behaviors in patients. The comparison of self-care behavior scores in patients with HF among the three groups at different time points showed no statistically significant differences (P > 0.05), except 1 day before discharge (P = 0.04). There were no statistically-significant differences between the teach-back, multimedia and the blended training group in terms of perceived social support at any of the four-time points (P > 0.05). All three training methods improved the level of knowledge of caregivers. However, the score in the blended training groups was higher than the other groups (P < 0.001). CONCLUSION: According to the results of the present study, it seems that all three educational interventions can improve self-care behaviors in HF patients and increase knowledge in their caregivers. However, using the blended training method was associated with better outcomes.

Nomogram to Predict the Overall Survival of Colorectal Cancer Patients: A Multicenter National Study.

BACKGROUND: Colorectal cancer (CRC) is the third foremost cause of cancer-related death and the fourth most commonly diagnosed cancer globally. The study aimed to evaluate the survival predictors using the Cox Proportional Hazards (CPH) and established a novel nomogram to predict the Overall Survival (OS) of the CRC patients. MATERIALS AND METHODS: A historical cohort study, included 1868 patients with CRC, was performed using medical records gathered from Iran's three tertiary colorectal referral centers from 2006 to 2019. Two datasets were considered as train set and one set as the test set. First, the most significant prognostic risk factors on survival were selected using univariable CPH. Then, independent prognostic factors were identified to construct a nomogram using the multivariable CPH regression model. The nomogram performance was assessed by the concordance index (C-index) and the time-dependent area under the ROC curve. RESULTS: The age of patients, body mass index (BMI), family history, tumor grading, tumor stage, primary site, diabetes history, T stage, N stage, and type of treatment were considered as significant predictors of CRC patients in univariable CPH model (p < 0.2). The multivariable CPH model revealed that BMI, family history, grade and tumor stage were significant (p < 0.05). The C-index in the train data was 0.692 (95% CI, 0.650-0.734), as well as 0.627 (0.670, 0.686) in the test data. CONCLUSION: We improved a novel nomogram diagram according to factors for predicting OS in CRC patients, which could assist clinical decision-making and prognosis predictions in patients with CRC.

A Model for Organizational Entrepreneurship with Organizational Culture Approach in Iran's Teaching Hospitals.

BACKGROUND: One of the most basic tools and strategies for developing new ideas and entrepreneurship is establishing the entrepreneurial culture in the organization. Thus, the purpose of this study was to examine the effect of organizational culture on entrepreneurship of district 1 teaching hospitals in Iran. METHOD: The study was applied in terms of purpose and descriptive-analytical of survey type in terms of nature that was conducted in 2019 on 946 staff members of district 1 teaching hospitals in Iran using census sampling method. The measurement tools used were standard questionnaires of Margaret Hill Entrepreneurship and Edgar Schein Organizational Culture. Pearson correlation coefficient was used to determine the relationship between organizational culture and organizational entrepreneurship. Partial least squares (PLS) was used for structural equation modeling (SEM) and analyzed in Smart pls2 software. RESULTS: The results showed that there is a significant direct relationship between the organizational culture and organizational entrepreneurship (r=0.94). Also, there was a relationship between the internal consistency component with organizational entrepreneurship (r=0.93), between the external compatibility component with organizational entrepreneurship (r=0.90). (p≤0.05). CONCLUSION: The results indicated a positive and significant relationship between organizational culture and its dimensions (internal consistency and external compatibility) with organizational entrepreneurship. Thus, making the decisions that concentrate on the organizational culture of the hospitals and taking steps to coordinate people's values and norms that promote organizational culture and enhance organizational entrepreneurship are recommended.

Comprehensibility of pharmaceutical pictograms: Effect of prospective-user factors and cognitive sign design features.

BACKGROUND: The people's comprehensibility regarding the meaning of internationally recommended pictograms is an important factor in the correct usage of medications. OBJECTIVE: To investigate the relationship between the guessability of the pharmaceutical pictograms, the cognitive sign features, and prospective-user factors. METHODS: A total of 351 Iranian people participated in this study. Two questionnaires were used to measure guessability and cognitive design features regarding the pharmaceutical pictograms. A single-sheet questionnaire was also developed to collect demographic data. RESULTS: According to the 67% correctness criterion suggested by ISO 3864:P3, 18 pictograms were understandable by the participants. Moreover, of the five cognitive features, "semantic closeness" and "meaningfulness" had the most correlation with the guessability score. In terms of personal factors, understanding of the pictograms' meaning was negatively correlated with age, while it had no association with the occupation. CONCLUSIONS: Some pharmaceutical pictograms developed by reliable international organizations can be used in a community only after redesigning and testing among the prospective users. The findings indicated that some pharmaceutical pictograms were not comprehensible for most participants. It is therefore expected that using a combination of pictograms with written messages and training could help in conveying the messages by pharmaceutical pictograms.

Prevalence of Intestinal Parasites among Patients with Chronic Urticaria in Northern Iran.

BACKGROUND: Chronic urticaria (CU) has a range of clinical demonstrations and causes. Parasitic infections are mentioned as one of the main causes of the CU. OBJECTIVES: The aim of this study was to investigate the prevalence of intestinal parasites in patients with CU (with duration time of more than 6 weeks) compared healthy subjects. METHODS: A total of 169 cases and 210 controls were included in this study. Ages ranged from 1 to 77 years old. Three samples were gathered from each patients and direct wet mount, formol-ether concentration, Ziehl-Neelsen and trichrome staining were used. RESULTS: Out of the 379 individuals examined here, 208 were from urban areas and 171 from rural areas. Three stool samples were taken from each patient in three consecutive days. Based on parasitological tests, 7 (4.1%) cases from 169 patients with CU and 6 (2.9%) cases from 210 non- CU group individuals were positive for intestinal parasites. CONCLUSION: The prevalence of various parasites between case and control groups was not significant.

Comparison of Limberg Flap and Karydakis Flap Surgery for the Treatment of Patients With Pilonidal Sinus Disease: A Single-Blinded Parallel Randomized Study.

PURPOSE: Pilonidal sinus disease is a common condition, which mostly affects young men. While various surgical techniques have been introduced for treating intergluteal pilonidal disease (IPD), controversies still exist regarding the best surgical approach. The purpose of this study was to compare the efficiency and the short-term outcomes of Limberg flap and Karydakis flap surgeries for the treatments of patients with IPD. METHODS: A total of 80 patients with IPD who had underwent either Karydakis flap (KF group: n = 37) or Limberg flap (LF group: n = 27) surgery between January 2015 and January 2016 at Imam Khomeini Hospital of Sari in the North of Iran were recruited for inclusion in this randomized, single-blind study. RESULTS: Compared to the KF group, the LF group showed faster complete wound healing, longer duration of surgery and hospital stay, larger wound size, and shorter period of incapacity for work. The overall patient satisfaction in the LF group was significantly higher than that in the KF group. The visual analogue scale score of pain was lower in the LF group than in the KF group. Also, the overall frequency of postoperative complications was higher in the KF group than in the LF group. Recurrence was reported in one patient from the KF group. CONCLUSION: Given the lower rate of postoperative complications and greater cosmetic satisfaction of patients, the Limberg flap procedure should be selected, instead of the Karydakis flap procedure, as the standard technique for treating patients with IPD.

Determinant factors for mortality during treatment among tuberculosis patients: Cox proportional hazards model.

BACKGROUND: Investigating the survival of tuberculosis (TB) patients is one of the main parts of the TB control program. It can be related to many factors. This study aimed to estimate the survival experience and its associated factors among these patients. METHODOLOGY: All TB patients detected during March 2005 to 31 September 2014 were entered into this prospective cohort. Each patient was investigated from the diagnosis date and followed until the last available information during treatment. Data analysis was performed using Kaplan Meier and multivariate Cox regression models. RESULTS: The survival experience of 2493 TB patients was investigated 73.7% of which were pulmonary type. Mean and median survival time were 6.5 and 6.2 months respectively. The incidence rate of death among patients during the treatment courses was 0.99 (95% confidence interval: 0.84-1.1) per 100 person-months. Controlling the confounders, the incidence (95% confidence interval) of death was significantly higher among men (HR=1.8; 1.2-2.6), diabetic patients (HR=1.7; 1.2-2.6), cancerous patients (HR=4.8; 2.6-8.8) and HIV positive patients (HR=22.1; 7.3-66.4). CONCLUSION: This study showed that male gender, TB/HIV co-infection and concurrent development of TB and cancer were determinant factors of death during the treatment period of TB.

A comparison of microleakage in self-etch fissure sealants and conventional fissure sealants with total-etch or self-etch adhesive systems.

OBJECTIVE: The present study was conducted to compare microleakage in self-etching fissure sealants and conventional fissure sealants with total-etch or self-etch adhesive systems. SETTINGS AND DESIGN: This experimental in vitro study was conducted on 60 healthy third molars extracted from humans. The first group received Acid etch + Clinpro sealant, the second group received Acid etch + Single bond 2 + Clinpro sealant, the third group received Single bond universal (self-etching bonding) + Clinpro sealant, and the fourth group received prevent seal self-etching sealant. MATERIALS AND METHODS: An incision was made on the teeth after they were immersed in methylene blue 5%. The samples were then examined under a stereomicroscope and the dye penetration rate was measured based on the Williams and Winter criteria. STATISTICAL ANALYSIS USED: The Kruskal-Wallis and Mann-Whitney tests were used for data analysis in SPSS-18 (P < 0.05). RESULTS: Group 1 which was treated with the conventional technique (acid + fissure sealant) had the highest rate of microleakage compared to Groups 2 and 3 (P < 0.001). CONCLUSION: The results showed that the use of bonding results in a significant reduction in the microleakage of fissure sealants. The microleakage caused when using self-etch fissure sealant was not different from that caused by the use of the conventional method.

Alterations in oxidative stress markers and its correlation with clinical findings in schizophrenic patients consuming perphenazine, clozapine and risperidone.

BACKGROUND AND OBJECTIVE: Today, the role of oxidative stress in development of schizophrenia has gained attention. Also, some atypical antipsychotic agents showed antioxidant properties. Therefore, in this study, we evaluated the level of oxidative stress parameters between patients treated with perphenazine, clozapine and risperidone and their relationship with schizophrenia symptoms' severity. MATERIALS AND METHODS: This was a descriptive study on 100 patients with chronic schizophrenia. Patient selection was done based on the DSM-IV-TR criteria for at least 3 months regular use of clozapine or risperidone or perphenazine and a minimum period of 2 years of schizophrenia. Ten ml of patient's blood samples were used to assess serum levels of glutathione (GSH), protein carbonyl, lipid peroxidation (LPO), superoxide dismutase (SOD) and Ferric Reducing Ability of Plasma (FRAP). Also, the severity of symptoms was assessed with the positive and negative syndrome scale (PANSS scale). P-values of less than 0.05 were considered significant. RESULTS: The results showed a significant difference between clozapine and risperidone with perphenazine in all subscales of PANSS. Also, there was a positive correlation between MDA and PANSS all subscales in risperidone and perphenazine groups and a negative correlation between MDA and PANSS in all subscales in the clozapine group. Serum level of GSH and negative symptoms in patients receiving clozapine showed a negative correlation. The results also represented that clozapine significantly increased SOD levels in comparison to perphenazine and risperidone and reduced LPO in comparison to perphenazine and risperidone, While the protein carbonyl level did not show a significant difference between three groups (p-value = 0.8). CONCLUSION: This study showed that clozapine, as an atypical antipsychotic agent, has significant antioxidant effects compared to risperidone and perphenazine. Especially, it increased SOD and GSH levels and reduced LPO in patients with schizophrenia. Therefore, clozapine's antioxidant effect may be contributive to improving negative symptoms of schizophrenic patients.

Biomonitoring-based exposure assessment of benzene, toluene, ethylbenzene and xylene among workers at petroleum distribution facilities.

Elevated emissions of volatile organic compounds, including benzene, toluene, ethylbenzene, and o, p, and m-xylenes (BTEX), are an occupational health concern at oil transfer stations. This exploratory study investigated personal exposure to BTEX through environmental air and urine samples collected from 50 male workers at a major oil distribution company in Iran. Airborne BTEX exposures were evaluated over 8h periods during work-shift by using personal passive samplers. Urinary BTEX levels were determined using solid-phase microextraction with gas chromatography mass spectrometry for separation and detection. Mean exposure to ambient concentrations of benzene differed by workers' job type: tanker loading workers (5390µg/m3), tank-gauging workers (830µg/m3), drivers (81.9µg/m3), firefighters (71.2µg/m3) and office workers (19.8µg/m3). Exposure across job type was similarly stratified across all personal exposures to BTEX measured in air samples with maximum concentrations found for tanker loading workers. Average exposures concentrations of BTEX measured in urine were 11.83 ppb benzene, 1.87 ppb toluene, 0.43 ppb ethylebenzene, and 3.76 ppb xylene. Personal air exposure to benzene was found to be positively associated with benzene concentrations measured in urine; however, a relationship was not observed to the other BTEX compounds. Urinary exposure profiles are a potentially useful, noninvasive, and rapid method for assessing exposure to benzene in a developing and relatively remote production region.

Single-dose intravenous sodium valproate (Depakine) versus dexamethasone for the treatment of acute migraine headache: a double-blind randomized clinical trial.

OBJECTIVE: Migraine headache is a chronic and disabling condition in adults. Some studies have investigated the efficacy of sodium valproate in the treatment of acute migraine, but the effectiveness and tolerability of intravenous valproate as abortive therapy remains unclear. This study aimed to evaluate the effects of sodium valproate and dexamethasone in the treatment of acute migraine. METHODS: We conducted a double-blind randomized clinical trial including 90 patients aged 18 to 65 years with acute migraine headache but no aura. Patients were randomized to receive intravenous dexamethasone (8 mg) or sodium valproate (400 mg) diluted into 4 mL of normal saline. The primary outcome measure was pain relief after 0.5, 1, 3, or 6 hours after administration. The secondary outcome criteria were the associated symptom recovery, rate of headache recurrence after 24 hours, and medication side effects. Pearson's chi square and the t-test were employed in the data analysis. RESULTS: Of the 90 patients, 80 were investigated. The percentage of headache improvement at 0.5 hours after treatment was 55% and 67.5% in the sodium valproate and dexamethasone groups, respectively. Before-treatment and 0.5 hour after treatment pain severity visual analog scale scores were 9.05±0.90 and 3.8±3.09 in the sodium valproate group and 8.92±0.79 and 3.10±2.73 in the dexamethasone group, respectively. There were no significant intergroup differences. CONCLUSION: This randomized clinical trial showed that the intravenous injection of sodium valproate 400 mg has similar effects to those of dexamethasone for improving acute migraine headache.