Ocular involvement in oral vesiculobullous diseases: A review on reported cases in the literature.

Introduction: Vesiculobullous disorders are a group of autoimmune diseases manifesting as chronic ulcers in the oral cavity. Ocular involvement may accompany oral ulcers and cause various problems for patients. This review summarizes the data regarding ocular involvement in patients with oral vesiculobullous. Methods: Web of Science, Scopus, PubMed/MEDLINE, and Embase electronic databases were searched according to related keywords. Finally, 58 articles were included, all of which were case reports or series. Characteristics such as the age and sex of patients, location and type of oral lesion, type of ophthalmic injury, the interval between oral and ocular lesion, and treatment of oral and ocular disorders were summarized in tables. Results: Eye involvement was 1.6 times more prevalent in women, and most patients were between 30 and 60 years old (67.4 %). Pemphigus vulgaris accounted for almost half of the cases (48.4 %), though lichen planus is more prevalent in the general population. The most frequently affected oral site was the buccal mucosa (17.5 %), and oral ulcers usually presented as erythema, erosion, or inflammation (22.7 %). Conjunctivitis was the most common type of eye involvement (18.4 %), and ophthalmic lesions regularly appeared 12-60 months after the development of oral lesions (30.1 %). Blindness was reported in only one case. Corticosteroids and immunosuppressives were the most frequent oral and ocular lesion therapies. Conclusion: Considering the serious burdens of any ocular injury, monitoring the ocular health of patients with oral vesiculobullous diseases is highly recommended in high-risk cases, especially middle-aged women with oral pemphigus vulgaris.

Extensive comparison of salivary collection, transportation, preparation, and storage methods: a systematic review.

BACKGROUND: Human saliva as a bodily fluid-similar to blood-is utilized for diagnostic purposes. Unlike blood sampling, collecting saliva is non-invasive, inexpensive, and readily accessible. There are no previously published systematic reviews regarding different collection, transportation, preparation, and storage methods for human saliva. DESIGN: This study has been prepared and organized according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines. This systematic review has been registered at PROSPERO (Registration ID: CRD42023415384). The study question according to the PICO format was as followed: Comparison of the performance (C) of different saliva sampling, handling, transportation, and storage techniques and methods (I) assessed for analyzing stimulated or unstimulated human saliva (P and O). An electronic search was executed in Scopus, Google Scholar, and PubMed. RESULTS: Twenty-three descriptive human clinical studies published between 1995 and 2022 were included. Eight categories of salivary features and biomarkers were investigated (i.e., salivary flow rate, total saliva quantity, total protein, cortisol, testosterone, DNA quality and quantity, pH and buffering pH). Twenty-two saliva sampling methods/devices were utilized. Passive drooling, Salivette®, and spitting were the most utilized methods. Sampling times with optimum capabilities for cortisol, iodine, and oral cancer metabolites are suggested to be 7:30 AM to 9:00 AM, 10:30 AM to 11:00 AM, and 14:00 PM to 20:00 PM, respectively. There were 6 storage methods. Centrifuging samples and storing them at -70 °C to -80 °C was the most utilized storage method. For DNA quantity and quality, analyzing samples immediately after collection without centrifuging or storage, outperformed centrifuging samples and storing them at -70 °C to -80 °C. Non-coated Salivette® was the most successful method/device for analyzing salivary flow rate. CONCLUSION: It is highly suggested that scientists take aid from the reported categorized outcomes, and design their study questions based on the current voids for each method/device.

What is the impact of previous cholelithiasis on sialolithiasis: A systematic review and meta-analysis.

Introduction: A sialolith is a salivary stone usually presenting with swelling and pain in the affected salivary gland, most commonly the submandibular gland. There have been speculations about the association between this condition and other systemic diseases, especially those forming stones, such as nephrolithiasis and cholelithiasis. This systematic review and meta-analysis aimed to summarize the studies assessing the relationship between cholelithiasis and sialolithiasis. Methods: PubMed/MEDLINE, Scopus, Web of Science, and Embase electronic databases were searched according to the keywords related to both disorders without any publication date or language restriction. Case-control and cohort studies evaluating the relationship between salivary and biliary stones were considered eligible. Quality assessment was performed following Newcastle-Ottawa Scale (NOS) for quality assessment of case-control studies. All meta and statistical analyses were performed with Comprehensive Meta-Analysis software. Results: Two studies fully complied with the defined eligibility criteria and were included, both of which were case-control studies using national-scale databases. In both surveys, the prevalence of previous gallstones in patients with sialolithiasis was compared to that of a control group. Though one of the studies found that there is no relationship between sialolithiasis and cholelithiasis, the meta-analysis revealed that previous cholelithiasis is significantly more prevalent among patients with sialolithiasis (P = 0.000), with an odds ratio of 2.04. Conclusion: It seems that cholelithiasis is significantly associated with an increase in salivary stone formation. Therefore, a thorough salivary examination in all patients declaring current or past cholelithiasis is recommended. However, more studies, especially prospective cohorts, are needed to make firmer conclusions.

The Effect of Resistance Exercises Using an Elastic Band on Balance and Fear of Falling in Older Adults With Diabetic Peripheral Neuropathy: A 16-week Randomized Controlled Trial.

OBJECTIVE: The current study aimed to investigate the effect of resistance training using an elastic band on balance and fear of falling in older adults with diabetic peripheral neuropathy. DESIGN: The study was a clinical controlled trial with a repeated measure design. SETTING: Iranian Diabetes Foundation of Mashhad. PARTICIPANTS: The participants were 51 older adults with diabetic peripheral neuropathy and balance impairment (N=51). INTERVENTIONS: Participants were randomly assigned to 2 groups; 1 group received balance training using an elastic band and the other group just received balance training. MAIN OUTCOME MEASURES: The main outcomes were balance and fear of falling that were measured using Berg Balance Scale and a short version of the Fall Efficiency Scale-International, respectively. RESULTS: The results showed that balance resistance training with and without using an elastic band significantly enhances balance and reduces fear of falling in diabetic older adults suffering from balance issues. However, balance resistance training using an elastic band had a significantly better effect on the balance and fear of falling in the participants. The best results were obtained after week 12 (48 sessions of balance training). CONCLUSION: Balance rehabilitation programs may include an elastic band in balance resistance training for 12 weeks (3-4 sessions a week) for enhancing balance in diabetic older adults suffering from balance impairment.

Prevalence of COVID-19 anxiety, geriatric anxiety, and related factors among the elderly in Quchan, Iran during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Anxiety is a prevalent mental disorder among the elderly, leading to discomfort, disability, increased expenses, reduced quality of life, and dysfunction. Consequently, this study was conducted to determine the prevalence of COVID-19 anxiety and geriatric anxiety, along with the factors influencing anxiety, in the elderly population served by urban healthcare centres in Quchan. METHODS: This cross-sectional study involved 650 elderly individuals aged 60-95 years. The participants were selected using a two-stage cluster sampling method. Data were collected through three questionnaires: the Geriatric Anxiety Inventory (GAI), the Corona Disease Anxiety Scale (CDAS), and a questionnaire on factors contributing to anxiety. Data analysis was performed using simple and multiple regression with IBM SPSS 24. RESULTS: The prevalence of geriatric anxiety among the elderly was 40.3%, while the prevalence of COVID-19 anxiety (moderate and severe) was 22.8%. Significant relationships were observed between geriatric anxiety and substance abuse, stressful life events, comorbidities, COVID-19 anxiety, financial support, loneliness, walking habits, and sleep patterns (P < 0.05). CONCLUSION: COVID-19 anxiety and geriatric anxiety are prevalent concerns among the elderly. Factors like substance abuse, stressful life events, COVID-19-related anxiety, comorbidity, living alone, lack of financial support, and poor walking and sleeping habits, which affect anxiety in the elderly, it is essential to address these factors in life planning and provide services through relevant organisations, healthcare teams, and initiatives by the elderly themselves.

Comparison of the Quality of Life of Physically Active and Inactive Grandmothers Caring and Non-caring for Grandchildren: A Cross-Sectional Study.

Background: Nowadays, grandparents have a major role in taking care of their grandchildren. Also, caring for grandchildren is a common and normative experience for many Iranian grandparents. The present study aimed to compare the quality of life of physically active and inactive grandmothers caring and non-caring for grandchildren. Methods: This analytical cross-sectional study was conducted on 300 grandmothers at the age range of 50 to 70 years old, who lived in Bojnurd, northeastern Iran (2018). Data were collected using the questionnaires of 36-Item Short Form Health Survey (SF-36) and Baecke Physical Activity, and demographic information. Results: The total scores of quality of life in caring physically active, physically inactive, non-caring physically active and non-caring physically inactive grandmothers were 76.95±6.33, 71.74±9.41, 75.56±5.9, and 56.06±11.23, respectively. There was a significant difference in the comparison of the quality of life score in caring grandmothers in two active and inactive groups (P<0.001). In addition, the quality of life score of non-caring grandmothers indicated a significant difference in physically active and inactive grandmothers (P<0.001). Conclusion: According to the results of this study, it seems that caring physically active grandmothers have higher quality of life. It can be suggested that the grandmothers who care for their grandchildren may improve their health and quality of life by incorporating the programs to increase physical activities in their daily life.

The effect of comprehensive individual motivational-educational program on medication adherence in elderly patients with bipolar disorders: An experimental study.

BACKGROUND: The number of older adults with bipolar disorder is increasing and medication non-adherence is a major problem that negatively impacts the course of bipolar disorder. This study aimed to determine the effect of a comprehensive individual motivational-educational program on medication adherence in elderly patients with bipolar disorder. MATERIALS AND METHOD: An experimental study with pretest-posttest repeated measures with a control group was conducted on two groups of 62 elderly people with bipolar disorders hospitalized at Ibn Sina Hospital in Mashhad, Northeast Iran, 2019. For the elderly in the intervention group, a comprehensive motivational-educational program was administered for one month (four 30-45 minute sessions), and for the elderly in the control group, routine clinical care was performed. Medication adherence in both elderly groups was measured before, immediately after, one and two months after the intervention. Data were analyzed by SPSS statistical software (version 16) using descriptive statistics and independent t-test, Mann-Whitney, paired t-test, repeated measures analysis of variance (ANOVA), and Chi-square tests. RESULTS: The mean age of elderlies in the intervention and control groups were 69.03 ± 5.75 and 68.50 ± 6.73 years, respectively. Regardless of the groups to which the patients were assigned, a significant difference in medication adherence scores was observed during the study period (time effect; P < 0.001). Also, the medication adherence score was significantly lower in the intervention group, compared to the control group (group effect; P < 0.001). Also, there was a group time interaction between the medication adherence score and the time of evaluation (P < 0.001). CONCLUSION: The results of the present study confirm the positive effect of a comprehensive educational-motivational program on improving medication adherence in elderly patients with bipolar disorder.

The effect of aging on the epidemiology of blood transfusions in North Khorasan province, Iran.

PURPOSE: Additional knowledge on the epidemiology and recipients of blood transfusions will help health-care managers to estimate the future needs. The study was performed to define the blood transfusion rate based on gender, sex, and clinical features of patients receiving blood products in all hospitals of the North Khorasan province of Iran. METHODS: Data on blood transfusion implementation were extracted from blood bank documents. The data for all patients who received at least one blood product were collected from March 2018 to March 2019. RESULTS: Among blood transfused patients, the highest transfusion rate was for packed red blood cells (PRBC) (47.7%). The two other most frequently used products were fresh frizzed plasma (FFP) (27.2%) and platelets (PLT) (21.9%). The patients in the age group of 51-80 years received the majority of PRBCs and FFPs. Patients aged 21-40 and 61-70 yrs had the highest transfusion rates for PLT. Elderly female patients (57.4%) received more blood products than their male counterparts. The highest blood transfusion rates were among patients with neoplasms, anemia, gastrointestinal bleeding, and gastric diseases. CONCLUSION: The primary Iranian blood recipients were elderly patients. Population aging is associated with an increase in the number of blood recipients and simultaneously declines the blood donors pool. It highlights the need for optimizing the use of blood in hospitals and having better strategies for overcoming the shortage of blood.

Experimental and numerical responses of fibroblast and epithelial cells to the frequency of electric toothbrush.

In the oral environment, fibroblast and gingival epithelial cells undergo distinct forces. Chewing, brushing, or force interactions with dental materials like implants can produce these forces. The behavior and response of these cells to forces are determined by their stiffness. Additionally, this behavior can be crucial in mechanosensory and tissue development. In this study, after being cultured using nanomagnet materials, fibroblast and epithelial cells were subjected to magnetic tweezers cytometry testing, and the viscoelastic model was used to determine their stiffness. The reaction of single gingival cells was modeled by determining the stiffness of cells at Gel Point frequencies and the operating frequency of electric toothbrushes and employing the Finite Element Method (FEM). Epithelial cell and fibroblast gel points took place at frequencies of 5Hz and 3Hz, respectively. At these frequencies, the behavior of cells is both quasi-solid and fluid. In addition, the findings of the finite element analysis demonstrated that the cells undergo a greater degree of deformation at the Gel point frequency compared to the operating frequency of toothbrushes. This quantity was approximately 331 times greater in epithelial cells, which reached a maximum of 7.114 µm. Additionally, the maximal fibroblast cell deformation at 3Hz frequency was determined to be 2.981 µm, which is roughly 117 times that at 150Hz frequency.

Relaxation and creep response of the alveolar lung to diagnosis and treatments for respiratory and lung disorders.

BACKGROUND: The lung Extracellular Matrix (ECM) contains a considerable part of the parenchymal cells. It contains three essential components: elastin and collagen within a proteoglycan (PG) viscoelastic network. Elastin provides the lung's elasticity property, a necessity for normal breathing, while collagen prepares structural support and strength, and PGs give stability and cushioning within tissue loading. Bacterial and viral respiratory diseases are dependent on changes in the ECM ingredients, which result in an alteration of the lung tissue strength. PURPOSE: In the present study, this variation was investigated by changing the volume ratio of the ECM ingredients in the viscoelastic model. RESULTS: As a result, the relaxation curves continuously declined by reducing the volume ratios of elastin, collagen, and PGs; subsequently, the lung stiffness decreased. Also, the Standard Linear Solid (SLS) model-based results demonstrated excellent accordance with empirical data with only minor deviations. The resting relaxation modulus and the creep modulus for the ECM tissue were 51 kPa and approximately 0.02 kPa, respectively, and the maximum total modulus of elasticity reached 121 kPa. CONCLUSIONS: Moreover, this model demonstrates individual alveolar mechanical behaviours and adds another pathway to the generalized Kelvin-Voigt and Maxwell models in predicting the progress of lung diseases.

Medical students' satisfaction level with e-learning during the COVID-19 pandemic and its related factors: a systematic review

PURPOSE: This review investigated medical students' satisfaction level with e-learning during the coronavirus disease 2019 (COVID-19) pandemic and its related factors. METHODS: A comprehensive systematic search was performed of international literature databases, including Scopus, PubMed, Web of Science, and Persian databases such as Iranmedex and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Distance learning," "Distance education," "Online learning," "Online education," and "COVID-19" from the earliest date to July 10, 2022. The quality of the studies included in this review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). RESULTS: A total of 15,473 medical science students were enrolled in 24 studies. The level of satisfaction with e-learning during the COVID-19 pandemic among medical science students was 51.8%. Factors such as age, gender, clinical year, experience with e-learning before COVID-19, level of study, adaptation content of course materials, interactivity, understanding of the content, active participation of the instructor in the discussion, multimedia use in teaching sessions, adequate time dedicated to the e-learning, stress perception, and convenience had significant relationships with the satisfaction of medical students with e-learning during the COVID-19 pandemic. CONCLUSION: Therefore, due to the inevitability of online education and e-learning, it is suggested that educational managers and policymakers choose the best online education method for medical students by examining various studies in this field to increase their satisfaction with e-learning.

Accidental displacement of a dental implant into the nasal cavity: Report of a rare case.

Through radiographic evaluation to discover the location of a displaced implant, it was revealed that the implant had migrated to the middle meatus of the nasal cavity. The patient had no signs or symptoms, and no inflammation was observed radiographically. The implant was removed under endoscopy through the nostril.

Scalloped border as a possible diagnostic aid for differentiating jaw lesions: A pictorial essay.

Purpose: The aim of this study was to introduce a category of jaw lesions comprising cysts and tumors associated with scalloped borders. Materials and Methods: General search engines and specialized databases including Google Scholar, PubMed, PubMed Central, and Scopus, as well as an authoritative textbook, were used to find relevant studies by using keywords such as "jaw lesion," "jaw disease," "scalloping," "scalloped border," "scalloped margin," "irregular border," and "irregular margin." Out of 289 articles, 252 records were removed because they were duplicates, did not have a relevant title, or did not mention the frequency of findings described using the term "scalloped border." Finally, 37 closely related articles were chosen. Results: According to the relevant literature, scalloped borders are found most frequently in ameloblastoma, followed by simple bone cyst, central giant cell granuloma, odontogenic keratocyst, and glandular odontogenic cyst. Conclusion: The lesions most frequently reported to have scalloped borders are ameloblastoma, central giant cell granuloma, odontogenic keratocyst, simple bone cyst, and glandular odontogenic cyst.

Using Mirror Therapy to Optimize the Efficacy of Balance Programs for Older Adults With Poststroke Balance Impairment.

PURPOSE: Poststroke rehabilitation is an inevitable element of the treatment for stroke survivors. This study aimed to investigate the effect of balance training with mirror therapy in older adults with poststroke balance impairment. DESIGN/METHODS: The study adopted a two-arm randomized clinical trial and included 38 older adults with poststroke balance impairment. The intervention group received balance exercises with mirror therapy, whereas the control group received the same balance exercises without mirror therapy (a nonreflective plate was used instead). The patient outcome, the balance score, was measured using the Berg Balance Scale. Analysis of covariance was used for statistical analysis. RESULTS: Results showed that balance exercises combined with mirror therapy were significantly more effective than balance exercises without mirror therapy in improving balance in the stroke survivors ( p < .001). CONCLUSION: Mirror therapy combined with regular balance exercises is an effective and practical method for enhancing balance in older adults suffering from balance impairment. CLINICAL RELEVANCE: Balance training combined with mirror therapy may be included in the rehabilitation programs of older adults with poststroke balance impairment.

Morphological Variations of the Posterior Mandible: Proposing a Classification for Ridge Morphology Based on Cone-Beam Computed Tomography Data.

This study sought to assess the morphological variations of the posterior mandible and propose a classification for ridge morphology based on cone-beam computed tomography (CBCT) data. This retrospective, cross-sectional study evaluated 130 CBCT scans of patients with edentulous mandibles. Qualitative variables including lingual and crestal concavity, vertical, horizontal and angular limitations, and ridge morphology were assessed at 631 sites on CBCT scans of 87 males and 43 females. A classification for ridge morphology in the posterior mandible was proposed based on the collected data. The kappa coefficient was calculated to assess the intra-observer agreement, and data were analyzed using the chi-square test and Pearson's correlation test. The frequency of lingual concavity increased from the anterior towards the posterior region relative to the mental foramen (P < 0.05). The maximum frequency of lingual concavity (11.1%) was noted at 21 mm distance from the mental foramen while its minimum frequency (4.1%) was noted at 5 mm from the mental foramen (P < 0.05). Ridge morphology, defined as ridge angulation < 15°, no lingual or crestal concavity, no limitation in width, and 8-10 mm height, had the highest frequency. Its suggested treatment plan included a 10-mm implant without width limitation or severe angulation. The majority of common morphologies had no width limitation with ridge angulation < 15°. Height limitation was only present in two of them, which can be resolved by placement of a short implant or ridge augmentation.

The Role of Family and Friends in Accepting Dental Implant Treatment: A Preliminary Clinical Report on an Iranian Population.

OBJECTIVE: Consenting to a dental implant treatment plan may be a challenging decision for many patients, and they may prefer to consult their family and friends before making the final decision on this matter. The purpose of this preliminary report was to assess the role of family and friends, as the consultees, in consenting to a dental implant treatment plan by patients. MATERIALS AND METHODS: A total of 106 patients with dental implants were questioned about whether they made the final decision regarding their dental implant treatment by themselves or they consulted their family and friends prior to finalizing their decision. RESULTS: The majority of men (52.1%) reported making this decision by themselves and based on their own personal opinion, while most women (48.2%) reported making the decision after consulting their children. CONCLUSIONS: Within the limitations of this preliminary report, it appears that women are more willing to consult their children and friends on this matter compared with men. Also, men mostly consult their wives in making such a decision while women pay more attention to the opinion of their children in this respect.

Clinical competence of Iranian nurses: A systematic review and meta-analysis.

BACKGROUND: One of the most important steps in increasing the nurses' professional competence and consequently improving the quality of nursing care is to evaluate nurses' clinical competency and then take effective actions to enhance it. This study aimed at exploring the clinical competence of Iranian nurses and factors related to it. MATERIALS AND METHODS: In this systematic review and meta-analysis, PubMed, Scopus, Web of Science, Scientific Information Database, and Iranmedex databases and Google Scholar search engine were searched to February 14, 2020. RESULTS: After screening, a total of 25 articles were included. In general, the level of clinical competence of Iranian nurses was at a desirable level. After meta-analysis of the mean score of nurses' clinical competence, the combined mean was 161.13 (95% confidence interval [CI]: 137.78-184.48; P < 0.001; I 2 = 99.8%; P value for heterogeneity = P < 0.001) by the Competency Inventory for Registered Nurses (CIRN) questionnaire. The summarized mean of clinical competency measured by the Nurse Competence Scale (NCS) questionnaire was 70.75 (95% CI: 60.80-80.70; P < 0.001; I 2 = 99.9%; P value for heterogeneity = P < 0.001). Factors affecting nurses' clinical competence were age ≥33 years, nursing work experience ≥9 years, and a master's degree in nursing. However, the clinical competence of nurses had a significant negative relationship with job stress. CONCLUSION: The level of clinical competence of Iranian nurses was desirable. Studies that used the CIRN, reported the highest and lowest clinical competence in clinical care and professional development dimensions, respectively. Studies that used the NCS, reported the highest and lowest clinical competence in dimensions of work role and ensuring quality, respectively.