Is Acoustic modal analysis a reliable substitution for Osstell® device in dental implant stability assessment? An experimental and finite element analysis study.

BACKGROUND: Different methods have been proposed to investigate the fixation stability of dental implants, each of which has its limitations. Among these methods, resonance frequency analysis (RFA) has been widely utilized to measure dental implant stability. This study aimed to assess dental implants with two non-destructive RFA and acoustic modal analysis (AMA) validated with a finite element simulation of the fundamental natural frequency (NF) of the bone analog-implant structure. MATERIAL AND METHODS: A total number of 18 implants were inserted into two Polyurethane (PU) bone blocks with different densities (0.16 g/cc and 0.32 g/cc). AMA was used to measure NF; First, the sound originating from the axial tapping of the implant was recorded with a simple microphone. Secondly, a fast Fourier transformation algorithm was conducted to determine the NF of the implant-bone analog structure. In parallel, the ISQ (Implant Stability Quotient) value was measured using the Osstell® device. Finally, using finite element analysis (FEA), the implant-bone analog structure was modeled for validation. RESULTS: Doubling the bone analog density resulted in an average increase of 82% and 47% in the NF and ISQ using AMA and Osstell®, respectively (P-value<0.05). Furthermore, a strong linear relationship (R2= 0.93) was observed between the measured NF and ISQ values in the linear regression analysis. The NF of the dental implant predicted by FEA was overestimated by about 15.2% and 15.0% than those in the low- and high-density PUs, respectively. Moreover, the FEA predicted an increase of 83% in NF by increasing the bone analog density from 0.16 to 0.32 g/cc. CONCLUSIONS: Having required the minimum process combined with easily available equipment makes it an ideal method for fixation strength studies. The good correspondence between the ISQ values and NFs, in addition to the good accuracy and reliability of the later method, confirms its application for fixation stability assessment.

Linear response theory of open systems with exceptional points.

Understanding the linear response of any system is the first step towards analyzing its linear and nonlinear dynamics, stability properties, as well as its behavior in the presence of noise. In non-Hermitian Hamiltonian systems, calculating the linear response is complicated due to the non-orthogonality of their eigenmodes, and the presence of exceptional points (EPs). Here, we derive a closed form series expansion of the resolvent associated with an arbitrary non-Hermitian system in terms of the ordinary and generalized eigenfunctions of the underlying Hamiltonian. This in turn reveals an interesting and previously overlooked feature of non-Hermitian systems, namely that their lineshape scaling is dictated by how the input (excitation) and output (collection) profiles are chosen. In particular, we demonstrate that a configuration with an EP of order M can exhibit a Lorentzian response or a super-Lorentzian response of order Ms with Ms = 2, 3, …, M, depending on the choice of input and output channels.

First report of methicillin-resistant Staphylococcus aureus carrying the mecC gene in human samples from Iran: prevalence and molecular characteristics.

There is a lack of information concerning mecC clinical methicillin-resistant Staphylococcus aureus (MRSA) strains throughout the world. In the present survey, 345 MRSA strains were characterized by antimicrobial susceptibility testing and staphylococcal cassette chromosome mec element (SCCmec) typing. mecC-positive MRSA isolates were characterized by study of biofilm formability, adhesion and virulence analysis, multilocus sequence typing, accessory gene regulator (agr) typing, S. aureus protein A locus (spa) typing and staphylocoagulase typing. The present study found ten SCCmec types, with the majority being SCCmec type III (38.3%). The presence of mecC was confirmed in three isolates from skin wounds (two isolates) and burn wounds (one isolate). All the mecC-positive isolates carried SCCmec XI and belonged to coa type III. Molecular typing showed that these isolates belonged to clonal complex/ST130-spa type t843-agr type III (two isolates) and clonal complex/ST599-spa type 5930-agr type I. The presence of SCCmec type IV confirms the hypothesis of extensive infiltration from the community to the hospital. Detection of MRSA isolates harbouring the mecC gene highlights the need to perform routine detection methods and molecular investigations in order to identify these emerging strains and limit their transfer in hospitals and communities.

Developing a time-domain method for simulating statistical behavior of many-emitter systems in the presence of electromagnetic field.

In this paper, one of the major shortcomings of the conventional numerical approaches is alleviated by introducing the probabilistic nature of molecular transitions into the framework of classical computational electrodynamics. The main aim is to develop a numerical method which is capable of capturing the statistical attributes caused by the interactions between a group of spontaneous as well as stimulated emitters and the surrounding electromagnetic field. The electromagnetic field is governed by classical Maxwell's equations, while energy is absorbed from and emitted to the (surrounding) field according to the transitions occurring for the emitters, which are governed by time-dependent probability functions. These probabilities are principally consistent with quantum mechanics. In order to validate the proposed method, it is applied to three different test cases: directionality of fluorescent emission in a corrugated single-hole gold nanodisk, spatial and temporal coherence of fluorescent emission in a hybrid photonic-plasmonic crystal, and stimulated emission of a core-shell SPASER (surface plasmon amplification by stimulated emission of radiation). The results are shown to be closely comparable to the experimental results reported in the literature.

Serological Survey of Avian Influenza (H9N2) in Commercial Ostrich Farms in Iran, 2015.

The aim of this study was to determine the seroprevalence of avian influenzaH9N2 subtype in the industrial ostrich farms and its geographical distribution. This cross-sectional study was conducted from January to June 2015. A total of 40 farms were selected from different provinces of Iran, from each of which 11 ostriches (n=440) were sampled. The sera samples were examined using 4 hemagglutination units of H9N2 antigens. A frequency distribution was used to describe the responses to the survey questions. The mean titers between provinces were compared using one-way analysis of variance. According to the results, 21 (47.5%) out of 40 farms and 108 (24.5%) out of 440 ostriches tested positive in the HI-H9N2 test. There were statistically significant differences between the mean titers of samples in different provinces (P&lt;0.001). The current study was conducted on unvaccinated ostriches. The results showed that H9N2 had a high seroprevalence at both farm and bird levels. The findings of this study can be for the further investigation of infection in ostrich farms in order to consider this species in the surveillance programs of the Iranian Veterinary Organization. The detection and isolation of viruses and epidemiological investigation are necessary for the persistent use of H9N2 vaccines in some ostrich farms.

Insertional inactivation of oprD in carbapenem-resistant Pseudomonas aeruginosa strains isolated from burn patients in Tehran, Iran.

In this study, we report the insertion sequence ISPpu21 in the oprD porin gene of carbapenem-resistant Pseudomonas aeruginosa isolates from burn patients in Tehran, Iran. Antibiotic susceptibility tests for P. aeruginosa isolates were determined. Production of metallo-ß-lactamases (MBLs) and carbapenemase was evaluated and the ß-lactamase-encoding and aminoglycoside-modifying enzyme genes were investigated by PCR and sequencing methods. The mRNA transcription level of oprD and mex efflux pump genes were evaluated by real-time PCR. The outer membrane protein profile was determined by SDS-PAGE. The genetic relationship between the P. aeruginosa isolates was assessed by random amplified polymorphic DNA PCR. In all, 10.52% (10/95) of clinical isolates of P. aeruginosa harboured the ISPpu21 insertion element in the oprD gene. The extended-spectrum ß-lactamase-encoding gene in ISPpu21-carrying isolates was blaTEM. PCR assays targeting MBL and carbapenemase-encoding genes were also negative in all ten isolates. The rmtA, aadA, aadB and armA genes were positive in all ISPpu21 harbouring isolates. The relative expression levels of the mexX, mexB, mexT and mexD genes in ten isolates ranged from 0.1- to 1.4-fold, 1.1- to 3.68-fold, 0.3- to 8.22-fold and 1.7- to 35.17-fold, respectively. The relative expression levels of the oprD in ten isolates ranged from 0.57- to 35.01-fold, which was much higher than those in the control strain P. aeruginosa PAO1. Evaluation of the outer membrane protein by SDS-PAGE suggested that oprD was produced at very low levels by all isolates. Using random amplified polymorphic DNA PCR genotyping, eight of the ten isolates containing ISPpu21 were shown to be clonally related. The present study describes a novel molecular mechanism, ISPpu21 insertion of the oprD gene, associated with carbapenem resistance in clinical P. aeruginosa isolates.

Identification of tigecycline- and vancomycin-resistant Staphylococcus aureus strains among patients with urinary tract infection in Iran.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major causes of hospital- and community-acquired infections worldwide. Although S. aureus rarely accounts for urinary tract infections (UTI), untreated UTI can lead to several complications. For decades vancomycin has been used for the treatment of MRSA infections. This study was performed to assess the in vitro activity of vancomycin, tigecycline, linezolid and quinupristin/dalfopristin against MRSA isolates from UTI patients. Thirty MRSA strains from 54 S. aureus isolates were isolated from patients with UTI. The antimicrobial susceptibility patterns of the strains were determined by the Kirby-Bauer disk diffusion and broth microdilution methods. PCR assays were used to detect the vanA gene. The MRSA isolates resistant to vancomycin were confirmed using the broth microdilution method. The results revealed that the MRSA isolates were 100% susceptible to linezolid and quinupristin/dalfopristin but 93.3% susceptible to vancomycin and tigecycline respectively. The broth microdilution method confirmed two MRSA strains (6.6%) to be resistant to vancomycin and tigecycline. The study identified vancomycin resistance among the MRSA isolates from UTI patients. This vancomycin resistance in MRSA isolates poses a challenge in managing S. aureus infections. Our study's results highlight the need to correctly identify patients in whom last-resort therapy such as linezolid and quinupristin/dalfopristin should be administered.

Phenotypic and genotypic study of biofilm formation in Enterococci isolated from urinary tract infections.

BACKGROUND: Urinary tract infection (UTI) is one of the most frequent types of nosocomial and community acquired infections in humans. Management of multidrug-resistant Enterococci UTI due to the limited therapeutic options is a great challenge for physicians and clinical microbiologists. The role of bacterial biofilms in recurrent urinary tract infections and antimicrobial resistance has great importance for public health. The aim of this study was to investigate the antibiotic susceptibility pattern as well as the phenotypic and genotypic biofilm formation ability of Enterococci isolates from patients with UTI. METHODS: A total of 57 isolates of Enterococci were collected from patients with UTI. Enterococcus species were identified using conventional microbiological methods. The antibiotic susceptibility patterns of the isolates were determined by the Kirby-Bauer disk-diffusion. The Modified Congo red agar (MCRA) and Microtiter plate methods used to assess the ability of biofilm formation. All enterococcal isolates were examined for determination of biofilm-related genes, esp, asa1 and ebpR using PCR method. RESULTS: Of 57 enterococcal isolates, 85.9% were recognized as E. faecalis and 14.1% of them were E. faecium. According to our results, linezolid, chloramphenicol and nitrofurantoin were the most effective agents against Enterococcus species. Overall, 26.5% of E. faecalis and 75% of E. faecium isolates were biofilm producers, respectively. Resistance to some antibiotics including penicillin G, ampicillin, vancomycin, nitrofurantoin and chloramphenicol, and ciprofloxacin was significantly higher among biofilm producers than non-biofilm producers Enterococci. The esp, asa1 and ebpR genes were present in 84.2%, 91.2% and 100% isolates. In this study, there was not a significant relationship between presence of these genes and biofilm formation. CONCLUSION: Our findings reinforce the role of biofilm formation in resistance to antimicrobial agents. Quinupristin/dalfopristin, tetracycline and rifampin may be used as an effective treatment for UTI caused by biofilm producers Enterococci. Our results suggest that biofilm formation is complex and depends on various factors but not just esp, asa1 and ebpR genes in Enterococcus strains.

Incidence and Trend of Childhood and Adolescent Cancers in Yazd, Iran.

BACKGROUND: Data on childhood and adolescent malignant tumors incidence are skimp in developing countries. In this study, we analyzed the incidence and trend of childhood and adolescent cancers in Yazd city, center of Iran between Jan 2004 and Dec 2013. MATERIAL AND METHODS: The various types of malignant tumors were grouped pursuant to the International Classification for Cancer in Children. To analyze the data, descriptive and illative statistical methods were used. RESULTS: Two hundred twenty-two patients with a malignancy aged less than 18 years were studied with a male to female ratio of 1.36.The mean age of patients was 9.88 (±5.7) years. Leukemia with the frequency of 84 (37.8%) and after that lymphoid malignancies with the frequency of 49 (22.1%) were the most common cancers. There was a low range of oscillation in the incidence rate of malignancies during this period of time (P value= 0.081). Malignancies were mostly in males (P value=0.057) but the whole process of malignancy incidence had gone toward the higher rate of incidence in females. Incidence rate of cancers types was steady. Malignancy incidence was 3-7 cases in hundred of thousands except a year of which this incidence rate was estimated 13.4. CONCLUSION: Leukemias and lymphomas were the main cancers in the center of Iran. Childhood and adolescent malignancies may be considerably under-recorded in our province .A childhood and adolescent cancer registry is necessary for exact analysis of these types of malignancies.

Hematological Indices in Children with Non-organic Failure to Thrive: a Case-Control Study.

BACKGROUND: Non-organic failure to thrive (NFTT) is the most common cause of failure to thrive (FTT) which is attributed to inadequate nutrition due to economic factors or parental neglect . NFTT can lead to a vicious cycle of poor and inadequate eating and severity of anemia. The aim of this study was to determine the hematological indices in children with NFTT. MATERIALS AND METHODS: In a cross sectional case control study, iron status and blood indices of forty five aged 6-60 months children with NFTT were evaluated and compared with 45 healthy control children (with matching of age and sex). RESULTS: In this study, the prevalence of anemia was 48.9% in NFTT compared to 11.4% in the control group (p<0.001). Microcytic anemia was significantly more prevalent among the subjects than the controls (77.8% versus 27.3%; p<0. 001). The serum iron level was 73.2 and 62.8 mcg/dl for the case and control groups (P=0.29). The ferritin level in the study group was 29.8 versus 35.47 ng/ml in the control group (p=0.227). The prevalence of iron deficiency anemia among children with mild, moderate, and severe underweight was 44.4%, 45.5%, and 48%, respectively. The highest prevalence of iron-deficiency anemia was seen between age group of 12 and 24 months (p<0.05). CONCLUSION: Based on the results of this study, a correlation between malnutrition and anemia was found. However, further studies are needed to assess and confirm the current outcomes.

Silver- and fluoride-containing mesoporous bioactive glasses versus commonly used antibiotics: Activity against multidrug-resistant bacterial strains isolated from patients with burns.

The wound healing process is frequently associated with a number of major clinical challenges, due to the failure of commonly used antibiotics as a remedy for wounds. There have always been fascinating questions about the novel applications of bioactive glasses (BGs) and it is expected that in the next few years these types of materials may play an important role in many aspects of soft tissue regeneration. This research focuses on the feasibility of using silver- and fluoride-containing BGs against multidrug-resistant bacterial strains isolated from patients with burns. According to the results obtained, fluoride did not exhibit antibacterial activity against the tested bacteria, while both 1% and 2% silver-containing BGs inhibited the bacterial growth. It is an important finding that 1% silver-containing BGs showed a potential antibacterial activity without any toxicity against fibroblasts, suggesting that this class of BGs could play a key role in the prevention of infection, reduction of pain, and removal of excessive exudates.

Seroprevalence of Hepatitis B, Hepatitis C and Human Immunodeficiency Viruses among Thalassemia Patients in West North of Iran.

BACKGROUND: Thalassemia patients that are conventionally treated by a regular transfusion regimen are exposed to blood born viral infections.The aim of this study was to investigate the seroprevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human Immunodeficiency virus (HIV) among all multitransfused thalassemia patients in west north of Iran. MATERIAL AND METHODS: A retrospective study was conducted in February 2014, on 32 patients in Urmia, suffering from transfusion dependent thalassemia were admitted to Motahari and Emam Khomeini hospitals. Patients' medical records were studied for HBs antigen and seropositivity for HCV, and HIV antibodies. RESULTS: Out of 32transfusion dependent thalassemia patients aged between 5-17years, 18 (56.25%) and14 (43.75%) were male and female, respectively. All of them were found seronegative for HBs antigen, HCV, and HIV antibodies. CONCLUSION: It seems that screening of blood products is efficient in Urmia, capital of West Azarbaijan, Iran for prevention of blood born viral infections.

Comparison of hematological aspects among children with Malaria and healthy children.

BACKGROUND: Malaria is an acute and chronic illness characterized by paroxysms of fever, chills, sweating, fatigue, anemia, and splenomegaly. Most malarial deaths occur in infants and young children.Anemia in malaria has diverse pathophysiologic mechanisms such as direct invasion of Red cells, In the following, we presented comparison of hematological aspects: children with Malaria and healthy children. MATERIALS AND METHODS: This was a lab trial study. Patients were referred and admitted to the pathobiology laboratory along with physical examination. Then, they underwent a complete blood count and the result of complete blood count was compared with healthy person in the same age. Out of 30 patients, with equally falciparum, vivax, and healthy .The hematological examination was performed. Finally, the data was analyzed using SPSS version 19 software. RESULTS: The levels of HGB (P=0.001), HCT (P=0.001), MCV (P= 0.001), MCH (P=0.001), WBC (P=0.001), and Plt (P= 0.02) decreased significantly in children with falciparum and vivax malaria compared to healthy controls. The levels of RBC (P=0.49) increased significantly in children with falciparum and vivax malaria compared to controls. Blood culture at two times. To investigate malaria; blood smears taken after microscopic study of Plasmodium falciparum ring was observed. CONCLUSION: Malaria is a multisystem disorder which can lead to many diseases. Physicians, especially those in endemic areas, should be aware of the varied manifestations and maintain in a high index of suspicion for the disease in order to that diagnose and treat timely and, morbidity and mortality.

Mouth-rinses for the prevention of chemotherapy induced oral mucositis in children: a systematic review.

BACKGROUND: The purpose of this review was to evaluate studies in basic oral care interventions to update evidence based practice guidelines for preventing oral mucositis (OM) in cancer patients undergoing chemotherapy. MATERIAL & METHODS: Pub Med database and Google Scholar were searched for all papers published between 2000 and December 2014 in English that were conducted using the search terms including ''mocusitis, chemotherapy, mouth-rinses, oral care, oral care protocol, dental care,dental cleaning, oral decontamination, oral hygiene", and the combined phrases in order to obtain all relevant studies. RESULTS: The initial search concluded 151 published papers representing both research and clinical work. Review articles, clinical case reports, literature reviews, and other nonresearch articles were excluded from the review. Following this process, 30 papers remained. CONCLUSION: Among these, chlorhexidine, normal saline, sodium bicarbonate, iseganan, benzydamine, sucralfate and Granulocyte macrophage colony-stimulating factor have been used in the form of mouth-rinse for prevention of chemotherapy induced mucositis. However, none of these mouthrinses have been shown to be definitely effective in preventing chemotherapy induced oral mucositis.

Decellularized human amniotic membrane: more is needed for an efficient dressing for protection of burns against antibiotic-resistant bacteria isolated from burn patients.

Human amniotic membranes (HAMs) have attracted the attention of burn surgeons for decades due to favorable properties such as their antibacterial activity and promising support of cell proliferation. On the other hand, as a major implication in the health of burn patients, the prevalence of bacteria resistant to multiple antibiotics is increasing due to overuse of antibiotics. The aim of this study was to investigate whether HAMs (both fresh and acellular) are an effective antibacterial agent against antibiotic-resistant bacteria isolated from burn patients. Therefore, a HAM was decellularized and tested for its antibacterial activity. Decellularization of the tissue was confirmed by hematoxylin and eosin (H&E) and 4,6-diamidino-2-phenylindole (DAPI) staining. In addition, the cyto-biocompatibility of the acellular HAM was proven by the cell viability test (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide, MTT) and scanning electron microscopy (SEM). The resistant bacteria were isolated from burns, identified, and tested for their susceptibility to antibiotics using both the antibiogram and polymerase chain reaction (PCR) techniques. Among the isolated bacteria, three blaIMP gene-positive Pseudomonas aeruginosa strains were chosen for their high resistance to the tested antibiotics. The antibacterial activity of the HAM was also tested for Klebsiella pneumoniae (American Type Culture Collection (ATCC) 700603) as a resistant ATCC bacterium; Staphylococcus aureus (mecA positive); and three standard strains of ATCC bacteria including Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27833), and S. aureus (ATCC 25923). Antibacterial assay revealed that only the latter three bacteria were susceptible to the HAM. All the data obtained from this study suggest that an alternative strategy is required to complement HAM grafting in order to fully protect burns from nosocomial infections.

The effective differentiation of Salmonella isolates using four PCR-based typing methods.

AIMS: Discrimination of Salmonella strains below the species level is very important to trace the source of outbreaks. To this end molecular typing methods can be successfully applied to routine analysis in nonspecialized laboratories due to their simplicity and speed. Here, the discriminatory ability of four molecular typing methods was investigated in 74 Salmonella enterica isolates. METHODS AND RESULTS: Salmonella strains isolated from human stool, blood, bone marrow, synovial fluid, ascites and urine sources in Iran during the years 2012 and 2013 were differentiated by random amplification of polymorphic DNA (RAPD), enterobacterial repetitive intergenic consensus (ERIC), repetitive extragenic palindromic (REP) and BOX repeat-based (BOXAIR) PCR methods. A total of 74 isolates were obtained, with 67 isolates belonging to eight serotypes/serogroups, while seven were nontypeable. The 74 strains produced 32 fingerprints with OPS-11 primers, 44 RAPD fingerprints using OPP-16 primers and 54 fingerprints with P1254 primers; their discriminatory index (DI) was 0·942, 0·978, and 0·984 respectively. BOXAIR fingerprinting produced 49 patterns (DI 0·985), while REP resulted in 55 patterns (DI 0·991) and ERIC in 48 fingerprints (DI 0·983). The discrimination of Salmonella isolates was improved when methods were combined. The combination of ERIC, REP and BOXAIR as well as the combination of BOXAIR with ERIC or REP could differentiate all 74 investigated Salmonella strains. CONCLUSIONS: The combined use of RAPD and ERIC fingerprinting offers an excellent means of differentiating Salmonella strains. SIGNIFICANCE AND IMPACT OF THE STUDY: The discrimination power of Salmonella molecular typing by combination of ERIC, REP and BOXAIR methods, or by combination of BOXAIR with ERIC or REP, is sufficient to determine genetic relationships for epidemiological purposes.

Composition controlled synthesis of PCL-PEG Janus nanoparticles: magnetite nanoparticles prepared from one-pot photo-click reaction.

The aim of this study is to investigate the effect of polymer nature on the morphology of synthesized nanoparticles. Super paramagnetic iron oxide nanoparticles (SPIONs) were prepared by co-precipitation method and then reacted with (3-mercaptopropyl) trimethoxysilane to obtain thiol-decorated SPIONs. Acrylated poly(caprolactone) and methoxy poly(ethylene glycol) were prepared, and then "thiol-ene click" reaction was performed under UV irradiation to attach two types of polymers on the surface of magnetite nanoparticles via the "photo-click" reaction method. Computational modelling was used for the prediction of the self-assembly of polymers on the surface of SPIONs, which determines the morphology of polymer coated nanoparticles.

Cardiac and Hepatic T2*-Weighted Magnetic Resonance Imaging in Transfusion Dependent Hemoglobinopathy in North West of Iran.

BACKGROUND: Iron overload is the main transfusion related side effects in patients with transfusion dependent hemoglobinopathies. Severe iron deposition in tissues leads to organ dysfunction. Many organs can be affected such as heart, liver, and endocrine organs. Cardiac failure and liver fibrosis are the consequent of Iron overload in transfusion dependent hemoglobinopathy. Magnetic Resonance Imaging (MRI) is a safe, noninvasive, and accurate method for the assessment of iron deposition in different tissues. This study assessed iron levels in liver and heart of the patients with transfusion dependent hemoglobinopathies. MATERIALS AND METHODS: The studied population consisted of 12 patients (7 male and 5 female) with transfusion dependent hemoglobinopathies, aged between 10-18 years old. Then, Cardiac and liver T2*- weighted magnetic resonance imaging (MRI) were obtained. RESULTS: In current study, 1patient (8.33%) had severe, 2 patients (16.66%) had moderate and 2(16.66%) had mild cardiac iron deposition. Out of 12 patients, 1 had severe iron deposition in liver (8.33%), 5(41.66%) and 4(33.33%) had moderate and mild hepatic iron deposition, respectively. Differences between Hepatic and cardiac iron levels were not significant between males and females (p>0.05). CONCLUSION: Since cardiac and liver iron levels were higher than normal in most of the study group, checking ferritin level and liver function test and also echocardiography in shorter intervals (each 3 months) in involved group is suggested instead of checking routinely in 6 month intervals in patients with transfusion dependent hemoglobinopathies.

Nanotechnology and Pediatric Cancer: Prevention, Diagnosis and Treatment.

Despite development of new approaches for the treatment of cancer disease, it is the second cause of mortality in world. Annually, 30000 persons die in Iran due to cancer diseases. Eighty percent of cancer patients are children which about 50% children lead to death. Given the high rate of cancer-related death, the new approaches for prevention, control, early diagnosis, and treatment of this disease seem necessary. Investigation of new strategies is the major challenge for scientists at recent century. Nanotechnology as a new scientific field with novel and small compounds utilized different fields over the past ten years especially in medicine. This science has come to the forefront in the areas of medical diagnostics, imaging, and therapeutic scheduls. Therefore, it has the potential applications for cancer detection and therapy. This review will discuss the therapeutic applications of different nano-materials in diagnosis, imaging, and delivery of therapeutic agents for the treatment of cancer with a major focus on their applications for the treatment of cancer and cancer- related diseases in children. The advancements in established nanoparticle technologies such as liposomes, polymer micelles, and functionalization regarding tumor targeting and controlled release strategies as well as drug delivery were discussed. It will also review the blood toxicity of used nanostructures.

Clinical and laboratory features of pertussis in hospitalized infants with confirmed versus probable pertussis cases.

BACKGROUND: The clinical presentations of pertussis infection have considerable variation. Many infections and illnesses can cause prolonged repetitive paroxysmal cough that could be confused with Bordetella pertussis infection. AIM: This retrospective study was designed to compare the clinico-laboratory findings between two groups of hospitalized infants with confirmed, and those who have clinical pertussis disease; to identify the possible additional diagnostic clues "for the diagnosis of confirmed pertussis disease". SUBJECTS AND METHODS: The study population consisted of infants ≤12 months of age with clinical diagnosis of pertussis that fulfilled the World Health Organization definition for pertussis or those diagnosed by physicians. Clinico-laboratory findings were compared between two groups of patients (confirmed vs. clinical cases). RESULTS: From a total of 118 infants admitted with a clinical diagnosis of pertussis, 16% (19/118) were confirmed by laboratory to have confirmed pertussis. Twelve of 19 (63%) and 71.99% of confirmed and clinical cases were younger than 6 months of age, respectively. For most patients, the duration of symptoms before hospitalization was <14 days. There were no significant differences between two groups of patients for paroxysmal cough and facial discoloration. However, whoop and apnea were more common among confirmed pertussis cases: P = 0.01, and P = 0.02, respectively. Leukocytosis (≥16,000/ml) (P = 0.01) and lymphocytosis (≥11,000) (P = 0.02) were reported significantly more frequently in confirmed pertussis cases. CONCLUSION: Given the unavailability of a highly sensitive diagnostic test, in every afebrile patient with paroxysmal cough lasting for ≥7 days associated with whoop and/or apnea, particularly if accompanied by leukocytosis/lymphocytosis, pertussis disease should be considered. In this situation, prompt administration of empiric treatment for cases, and providing control measures to prevent infection transmission to contacts are recommended.