Accuracy Evaluation of Pediatric Appendicitis Scoring (PAS) Method in Differentiating Nonspecific Abdominal Pain from Appendicitis.

Background: This study aimed at evaluating the accuracy of the pediatric appendicitis scoring method in differentiating nonspecific abdominal pain (NSAP) from appendicitis. Methods: This cross-sectional study was conducted on 391 children who were hospitalized in the emergency ward due to acute abdominal pain suspected of appendicitis . Pediatric Appendicitis Score (PAS), C-reactive protein (CRP), and appendicitis pathology results of patients undergoing surgery were recorded. Results: The results showed that the no significant difference was found among patients in the three experimental groups (appendicitis, specific abdominal pain except appendicitis, and NSAP) with respect to temperature (p = 0.212), but the other variables were significantly different. Findings showed that high CRP frequency, pain migration to right lower quadrant (RLQ), tenderness in right iliac fossa (RIF), anorexia, leukocytosis, high neutrophil, and mean tenderness in RLQ in the appendicitis group were higher than those in the other two groups (p = 0.001). The PAS questionnaire can also be used as a reliable questionnaire with appropriate sensitivity (0.929) and specificity (0.993), and this questionnaire along with detailed clinical examinations could reduce the rate of negative appendectomy to less than 1%. Conclusions: This study showed high accuracy of PAS in diagnosing children with appendicitis and differentiating appendicitis from cases of NSAP and specific abdominal pain other than appendicitis. The PAS system could also significantly reduce cases of negative appendicitis. Although high CRP had an excellent ability to diagnose appendicitis, its accuracy was lower than PAS.

A Monte Carlo study on dose perturbation due to dental restorations in a 15 MV photon beam.

AIM: The main purpose of this study is to evaluate the effect of dose perturbation due to common dental restoration materials in the head and neck radiotherapy with a 15 MV external photon beam. SETTING AND DESIGN: Teeth with three dental restorations such as tooth filled with Amalgam, Ni-Cr alloy, and Ceramco were simulated by MCNPX Monte Carlo code. In this simulation, the dental materials were exposed by a 15 MV photon beam from a Siemens Primus linac, inside a water phantom. MATERIALS AND METHODS: A Siemens Primus linear accelerator and a phantom including: tooth only, tooth with Amalgam, tooth with Ni-Cr alloy, and tooth with Ceramco were simulated by MCNPX Monte Carlo code, separately. The percentage dose change was evaluated relative to dose in water versus depth for these samples on the beam's central axis. The absolute dose by prescription of 100 cGy dose in water phantom at 3.0 cm depth was calculated for water, tooth, tooth with Amalgam, tooth with Ni-Cr alloy, and tooth with Ceramco. RESULTS: The maximum percentage dose change is related to tooth with Ni-Cr alloy, tooth, tooth with Ceramco, and tooth with Amalgam with amounts of 7.73%, 6.95%, 4.7%, and 3.06% relative to water at 0.75 cm depth, respectively. When 100.0 cGy dose was prescribed at 3.1 cm, the maximum absolute dose was 201.0% in the presence of tooth with Ni-Cr alloy at 0.75 cm. CONCLUSION: Introduction of the compositions of dental restorations can improve the accuracy of dosimetric calculations in treatment planning and protect the healthy tissues surrounding teeth from a considerable overdose.

Experimental study of the influence of dental restorations on thermal and fast photo-neutron production in radiotherapy with a high-energy photon beam.

In head and neck radiation therapy, the presence of dental restorations can increase unwanted neutron dose to the patient. This study aimed at the measurement of secondary neutron production induced by irradiation of a healthy tooth, Amalgam, Ni-Cr alloy and Ceramco with a photon beam generated in the treatment head of a Siemens Primus linac at a voltage of 15 MV. The irradiation field amounted to 10 × 10 cm2. The measurements of thermal and fast-neutron equivalent doses were performed by means of CR-39 detectors positioned in various depths of a Perspex (polymethyl methacrylate) phantom as at open field as at presence of corresponding dental restorations. The general trend of thermal neutron as well as fast-neutron equivalent dose behind the denture samples reveals their reduction with increasing depth. The maximum values of thermal-neutron dose related to Amalgam, Ceramco and Ni-Cr alloy amount to 1.45 mSv/100 MU, 1.38 mSv/100 MU and 1.32 mSv/100 MU, whereas the corresponding maximum values of fast-neutron dose at the depth of 1.8 cm amount to 0.19 mSv/100 MU, 1.04 mSv/100 MU and 0.97 mSv/100 MU, respectively. The present study investigates the neutron dose accompanied with radiotherapy. It is recommended that attempts have to be made to ensure that dental restorations are not in the path of the primary high-energy photon beam. Considering treatment planning, the guidelines of radiation protection should be improved.

Effectiveness of Teaching Emotion Regulation Strategies in Improving Cognitive-Emotional Regulation Among Female Students in Addiction-Stricken Areas of Kermanshah City.

Objective: To evaluate emotion regulation as one of the important aspects of preventing and treatment of substance abuse. Materials and methods: This study had a quasi-experiment research method and a pretest-posttest design with the control group. The statistical population of this study included all the female students who lived in the addiction-stricken areas of Kermanshah city. 60 female students (mean: 16.78 and standard deviation: 0.69) who were eligible to participate in the study were selected by convenient sampling and were placed randomly in two test and control groups. The tools that were used in this study included Granefski et al. (2007) cognitive-emotional regulation scale and demographic information sheet. Eight weekly sessions of emotion regulation strategies based on Gross method (2002) were held for the experimental group. Results: Multivariate covariance analysis results indicated that teaching emotion regulation strategies has been effective in improving adapting strategies and reducing maladaptive strategies of emotion regulation (p < 0.05). Conclusion: Therefore considering the effectiveness of the mentioned intervention, this strategy can be applied beside other methods in order to improve adaptive emotion regulation and reducing maladaptive strategies among female teenagers who live in addiction-stricken areas.

Effect of various dental restorations on dose distribution of 6 MV photon beam.

AIM: The purpose of this study is to evaluate the effect of various dental restoration materials on dose distribution in radiotherapy of head and neck cancer with 6 MV photon beam of a medical linac. SETTING AND DESIGN: The dental restorations include tooth, tooth with amalgam, tooth with Ni-Cr alloy, and tooth with Ceramco. Dose perturbation due to the dental restorations on 6 MV beam of Siemens Primus linac was calculated by MCNPX Monte Carlo code. These dental materials were separately simulated in a cubic water phantom. MATERIALS AND METHODS: Photon percentage dose change in the presence of tooth, tooth with amalgam, tooth with Ni-Cr alloy, and tooth with Ceramco was calculated at various depths on the central axis of the beam relative to the dose in water. In another evaluation, the absolute dose (cGy) for water, tooth, tooth with amalgam, tooth with Ni-Cr alloy, and tooth with Ceramco was obtained by calculating 100 cGy dose at 0.75 cm depth in the water phantom. RESULTS: Based on the calculations performed, maximum percentage dose change due to backscattering was 11%, 8%, 6%, and 4% for amalgam, Ni-Cr alloy, Ceramco and tooth at depth of 0.75 cm, respectively. The maximum dose perturbation by amalgam is due to its higher mass density and atomic number. CONCLUSION: Ignoring the effect of dental restoration compositions on dose distribution causes discrepancy in clinical treatment planning system calculations.

Evaluating the effect of various intracavitary applicators on dosimetric parameters of (192)Ir, (137)Cs, and (60)Co sources.

The purpose of this research is to study the effect of various applicator compositions on dosimetric parameters and dose distribution of (192)Ir, (137)Cs, and (60)Co sources, using Monte Carlo simulation techniques. To study the effect of applicators on source dosimetry, the dose rate constant, and radial dose function and isodose curves for the above noted sources were calculated in the presence and absence of plastic, titanium, and a stainless steel applicators. The effects of the applicators on the dosimetric parameters and isodose curves of these sources were dependent of the source type and materials of the applicator. The (192)Ir source with the stainless steel applicator has the maximum difference of dose rate (4.2 %) relative to the without applicator case. The (60)Co source with plastic applicator has the minimum dose variation. Moreover, this effect is higher for lower energy sources. Ignoring the effect of applicator composition and geometry on dose distribution may cause discrepancies in treatment planning. Plastic applicators have the least radiation attenuation compared to the other applicators, therefore, they are recommended for use in brachytherapy. A table of correction factors has been introduced for different sources and applicators with different materials for the clinical applications.

The Effect of Aqueous Extract of Glycyrrhiza glabra on Herpes Simplex Virus 1.

BACKGROUND: Herpes Simplex Virus 1 (HSV-1) resistance to drugs and the side effects of drugs have drawn the attention of investigators to herbal plants. OBJECTIVES: The main aim of the current research was to investigate the effects of Glycyrrhiza glabra (liquorice root) on HSV-1. One of the objectives of the current research was to determine the efficacy and the effect of the elapsed incubation time of treating the Vero cells infected with HSV-1 by G. glabra. In addition, the effect of cells pretreatment with licorice root extract, preincubation of virus with licorice root extract, and the antiviral activity were assessed. PATIENTS AND METHODS: Vero cells were incubated after adding different concentrations of aqueous extracts of G. glabra. The cells were incubated during various time courses. Cytotoxicity assay, determining the 50% tissue culture infectious dose (TCID50), and incubation of HSV-1 with licorice root extract prior to viral infection were performed. RESULTS: Internal association among different experiment groups showed the significant difference in the efficacy of the extract with regard to incubation period between one and four hours, one and eight hours, four and 12 hours, and eight and 12 hours. Moreover, there was a significant difference with regard to efficacy among the pretreatment of cells with extract for two hours, incubation of virus with extract for one hour, incubation of virus with extract for two hours. CONCLUSIONS: G. glabra showed the characteristics of a novel antiviral medication; however, more in vitro experiments are needed to determine the antiherpetic activities of the G. glabra.