Hemodialysis Patients with High-Flow Arteriovenous Fistulas: An Evaluation of the Impact on Cardiac Function.

Purpose: : Patients undergoing hemodialysis often experience changes in cardiac function when they have a high-flow arteriovenous fistula (AVF). This study aimed to assess the effect of high-flow AVFs on cardiac function in patients undergoing hemodialysis. Materials and Methods: : A longitudinal study was conducted on hemodialysis patients with high-flow AVFs. Echocardiographic parameters, such as left ventricular ejection fraction (LVEF), left atrial diameter (LAD), left ventricular end-diastolic dimension (LVEDD), right ventricular end-diastolic dimension (RVEDD), inferior vena cava diameter (IVCD), systolic blood pressure, and diastolic blood pressure, were measured and compared before and after AVF creation. Results: : One hundred hemodialysis patients with high-flow AVFs (mean age: 55.95±13.39 years, mean body mass index: 24.71±3.43 kg/m²) were studied. LVEF significantly decreased (51.10%±5.39% to 47.50%±5.79%), while LAD, LVEDD, and IVCD significantly increased after AVF creation (P<0.05). Systolic (132.49±16.42 mmHg to 146.60±17.43 mmHg) and diastolic (79.98±8.40 mmHg to 83.33±9.68 mmHg) blood pressure substantially rose post-fistularization (P<0.001). Notably, LVEF reduction was more significant in brachio-cephalic AVFs (46.29%±4.24%) compared to distal radio-cephalic or snuffbox AVFs (49.17%±7.15%) (P=0.014). Conclusion: : High-flow AVFs can significantly affect echocardiographic parameters in hemodialysis patients, thereby increasing the risk of cardiac failure. Close cardiac monitoring may be necessary for early intervention. Distal AVFs may be preferable in patients with decreased cardiac function.

Association among general health, personality traits, and headache severity in patients with migraine.

Background: Because migraine is a common headache, finding ways to approach it better would be useful. So, studying the relation of dimensions of general health and personality types and pain severity in patients with migraine will be useful for fulfilling this aim. Methods: In this cross-sectional study, the number of patients with migraine headache studied in this study was 170. The checklists used in this study were migraine disability assessment (MIDAS), visual analog scale (VAS), Neuroticism-Extraversion-Openness (NEO FFI), and General Health Questionnaire (GHQ-28). Results: The average scores of general health dimensions in migraine sufferers with aura were higher than in migraine patients without aura. But this difference was significant only in the index of physical symptoms (P=0.02). There was a negative correlation between pain intensity and general health dimensions but it was not statistically significan. A positive correlation was observed between headache intensity and extroversion, which was significant (r=0.18 and P=0.01). The score of physical symptoms increases significantly with the increase of disability severity (P=0.007). Conclusion: According to the results, the severity of migraine disability, general health dimensions, and personality types in patients with and without Aura was not different. Also, general health dimensions and personality types were not associated with pain intensity and the severity of migraine disability.

Development and validation of self-report Mizaj identification questionnaire Based on Persian Medicine for the elders (age over 60).

Background: Introduction: Mizaj is the basis of attention to individual differences in Persian Medicine (PM). Regarding the importance of Mizaj for health preservation and treating diseases, it is necessary to achieve a standard tool for Mizaj identification. The purpose of this study was to design a standard self-reporting Mizaj identification questionnaire for elders. Methods: In this exploratory sequential study, criteria of Mizaj identification were extracted by reviewing PM literatures and interview with PM experts and elders. The primary questionnaire was designed and its validity and reliability were assessed, using weighted Kappa statistics, Pearson correlation coefficient (PCC) assessment, receiver operating characteristic (ROC) curve and determining the specificity and sensitivity of cut-off points. Results: Among the 101 items in the primary questionnaire, 73 items had acceptable reliability. The final 20-item questionnaire was obtained after the criterion validity and PCC assessment. The sensitivity and specificity of this questionnaire were 83% and 88% for warmness, 49% and 80% for moderate in warmness-coldness, 72% and 91% for coldness, 57% and 78% for wetness, 30% and 79% for moderate in wetness-dryness, and 81% and 67% for dryness, respectively. Conclusion: The standard Mizaj identification is recommended as a supplementary diagnostic tool for clinicians and researchers in PM. Also, the people with age over 60 can use it to identify their own Mizaj and then, choose the suitable PM or Unani medicine lifestyle recommendations based on their Mizaj.

Phylogenetic analysis, biofilm formation, antimicrobial resistance and relationship between these characteristics in Uropathogenic Escherichia coli.

BACKGROUND: In the present study, we examine the prevalence of phylogenetic groups, O-serogroups, adhesin genes, antimicrobial resistance, the level of gene expression associated with biofilm formation, and the presence of extended-spectrum beta-lactamase (ESBL) in UPEC strains isolated from both pediatric and adult patients. METHODS: In this cross-sectional study, 156 UPEC isolates were collected from UTI patients. ESBL-producing isolates were detected using the double-disc synergy (DDS) method, and biofilm formation was assessed through a microplate assay. The presence of O-serogroups, adhesion factors and resistance genes, including ESBLs and PMQR genes, was detected by PCR, and isolates were categorized into phylogenetic groups using multiplex PCR. Additionally, the quantitative real-time PCR method was also used to determine the expression level of genes related to biofilm. RESULTS: During the study period, 50.6% (79/156) of the samples were obtained from children, and 49.4% (77/156) were from adults. The highest rate of resistance was to NA (91.7%), while FM (10.9%) had the lowest rate of antibiotic resistance. In addition, 67.9% (106/156) of UPEC isolates were ESBL producers. Most of UPEC isolates belonged to phylogenetic group B2 (37.1%). This study revealed that blaCTX-M and qnrS are widely distributed among UPEC isolates. The mean expression levels of fimA genes were significantly higher in non-biofilm producers than in biofilm producers (p < 0.01). CONCLUSIONS: The high antibiotic resistance rates in this study highlight the significance of local resistance monitoring and investigating underlying mechanisms. Our findings indicate the dominance of phylogroup B2 and group D as the prevailing phylogenetic groups. Consequently, it is imperative to investigate the epidemiological aspects and characterize UPEC isolates across diverse regions and time frames.

The impact of social support, physical and psychological performance on sleep outcomes in Iranian older adults: a case-control study.

BACKGROUND: Sleep quality is one of the most important factors to improve the quality of life in older adults and physical and mental health plays an essential role in better sleep quality. This study aimed to determine the impact of social support, and physical and psychological performance on sleep outcomes in Iranian older adults. METHODS: In this case-control study, 400 elder people, who were exposed to sleep problems, and 400 people without sleep problems were randomly selected during 2016-2017 in Amirkola, Iran. Subjects in the case and control groups were matched in terms of gender and age. The demographic characteristics, Duke Social Support Questionnaire (DSSI), Physical Activity Scale for the Elderly (PASE), Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Mini-Mental State Examination (MMSE), and Pittsburgh Sleep Quality Questionnaire (PSQI) questionnaires were used to collect data. T-test, Chi-square, Pearson Correlation coefficient, and multiple Logistic regression were used for data analysis. RESULTS: The mean score of DSSI and its domains including social interaction (DSSI.Int) and social satisfaction (DSSI.Sat) were 28.15 ± 3.55, 9.31 ± 1.23, and 18.84 ± 2.88 in the case group and 28.87 ± 3.20, 9.48 ± 1.10, and 19.83 ± 2.44 in the control group, respectively. In this study, the mean scores of MMSE, PASE, ADL, and IADL were 25.36 ± 3.95, 101.71 ± 56.99, 13/97 ± 0.37, 20.59 ± 2/79; respectively. There was a significant inverse correlation between poor sleep quality with DSSI score (rho = -0.165, P < 0.0001), DSSI.Int (rho = -0.113, P < 0.001), DSSI.Sat (rho = -0.160, P < 0.0001), PASE (rho=-0.160, P < 0.0001), and IADL (rho = -0.112, P < 0.001) score. Therefore, more social support and physical activity improved the quality of sleep. There was a significant negative relationship between DSSI, and its domains with sleep quality in terms of gender. DSSI (rho = 0.25, P < 0.0001), DSSI.Int (P < 0.0001, rho=-0.18), and DSSI.Sat (P < 0.0001, rho=-0.22) was significant in men but not in women. The results of the adjusted logistic regression revealed a significant association between sleep quality problems and DSSI (p < 0.045, OR = 1.40), the use of hypnotic drugs (p < 0.0001, OR = 7.56), and occupation (p <0.03, OR= 12.66). CONCLUSIONS: The results of the present study suggest that low social support and all its domains, PASE, IADL, and using hypnotic drugs may play a role in the development of sleep problems. It can be used as an effective, safe, and low-cost strategy for promoting sleep quality in older adults.

The 30-year incremental pattern of breast cancer: A study in the northern of Iran.

Background: Rapid economic progress and cultural-social changes have led to lifestyle changes and increased risk of breast cancer all around the world, including Iran. This study aims to investigate the 30-year incremental pattern of breast cancer in patients of Shahid Rajaei Radiation Therapy Center in Babolsar, North of Iran.||. Methods: In this cross-sectional study, the data were retrospectively extracted from the physical and electronic files of patients diagnosed with breast cancer from 1992 to 2021 every 5 year by census method, during the study, overall, 1326 patients' information out of 6199 patients was analyzed using SPSSV.22 software at the level of p-value ≤ 0.05. Results: The average age of patients was 49.84 ± 11.26 years, which has been increasing over the years of study. 6143(99.13%) patients were women, the mean and standard deviation of their BMI was 29.63 ± 6.00, the number of patients with stage 1 is increasing, and patients with stage 3 is decreasing. 871(65.70%) people went through Radical Mastectomy (MRM), 261(19.68%) people experienced metastasis. There was a statistically significant relation between the type of surgery, stage of cancer, metastasis, and local recurrence within the years of study (p<0.001). Conclusion: Breast cancer and the age of getting it have increased in recent years. However, advanced stages as well as metastasis and local recurrence have decreased during the investigated years. Therefore, it is recommended to continuously warn women about the risk factors and develop suitable disease screening programs and implement them effectively.

Local autologous blood and corticosteroid injection on pain and function in patients with tennis elbow.

Background: Tennis elbow or lateral epicondylitis is a common complaint involving about a 3-5% cases in a community. Non-surgical treatment is effective in 80% of cases. Recent studies have shown the effect of autologous blood on improving the pain and function of affected patients. The present study aimed to compare the effectiveness of steroid and autologous blood local injection in controlling pain and disability in the short and long term. Methods: The present study was a clinical trial conducted in Shahid Beheshti Hospital of Babol. A total of 60 patients were divided into 3 groups; A group injected at the site of lateral epicondylitis with steroid (methylprednisolone acetate-40mg) and another group with autologous blood (2ml of venous blood), and the other group used a brace for 3 weeks. Patients were followed-up for 15, 30, and 90 days, and the PRTEE assessment questionnaire assessed their pain and disability. Results: On the 15th day, there was no statistically significant difference in pain and function in the three groups, although the injectable groups were relatively more effective. On the 30th day (p=0.001), the local corticosteroid was significantly better than the autologous blood group, while on the 90th day (p<0.001), autologous blood was significantly better than the local corticosteroid. The average day, in which 25% improvement was gained, was lower in the autologous blood transfusion group. Conclusion: Regarding the long-term effect of autologous blood on corticosteroid injections, it was recommended as a lateral epicondylitis treatment.

Serum Vitamin D Status in Older Adults: A Cohort Study.

Background: Vitamin D is best known as a key regulator of bone metabolism and calcium and phosphate homeostasis. This study aimed to assess the effect of different factors on the five-year changes in serum vitamin D concentration among older adults. Methods: This cohort study was conducted on adults aged ≥60 years living in Amirkola, in the North of Iran, from 2012 to 2017. Serum 25-hydroxyvitamin D (25-OH vitamin D) concentrations of <20, 20-29.99, and ≥30 ng/mL, respectively, were used to designate vitamin D deficiency, insufficiency, and sufficiency. Any variation between the second and baseline values of the 25-OH vitamin D concentration was reported as a five-year difference. Data were analyzed using SPSS version 17.0, and Chi square, t test, one-way ANOVA, and Tukey HSD post hoc tests were employed. P values less than 0.05 were considered statistically significant. Results: The mean serum concentration of 25-OH vitamin D at baseline and follow-up examination in 1011 individuals was 34.68±33.18 and 23.88±14.91, respectively (P<0.001). Following a five-year follow-up, vitamin D deficiency, insufficiency, and sufficiency were found in 452 (44.7%), 334 (33.0%), and 225 (22.3%) cases, respectively. The reduction in serum 25-OH vitamin D concentration after five years was significantly influenced by the administration of vitamin D (P=0.013) and calcium (P=0.007) supplements, serum profile of parathyroid hormone (PTH) (P=0.010), calcium (P=0.021), and phosphorous (P=0.021). However, age, sex, body mass index, metabolic syndrome, and physical activity had no significant impact (P>0.05). Conclusion: Regardless of age, sex, body mass index, metabolic syndrome, or physical activity, the mean serum concentration of vitamin D decreased over a five-year follow-up.

Evaluation of Anatomical Variations of the Maxillary Sinus in Patients With and Without Mucous Retention Cyst.

Objectives: Mucous retention cyst (MRC) is a benign and self-limited lesion that can be caused by many risk factors, including anatomical variations of the sinonasal region. This study aims to investigate the relationship between anatomical variations and the presence of MRC. Materials and Methods: In total, 2109 sinonasal cone beam computed tomography images were evaluated for the presence of MRC, and the sinonasal anatomical regions such as the osteomeatal complex (OMC), infundibulum length, ostium height, the diameter of the ostium, the presence of accessory ostium, concha bullosa, and mucosal thickening of the maxillary sinuses. Shapiro-Wilk normality test, independent sample t-test, and chi-square test were used for statistical analysis, and P < .05 was considered significant. Results: The prevalence of MRC was 119 (5.6%) cases. The average diameter of the ostium in cases with and without MRC was 0.49 ± 0.41 mm and 0.99 ± 0.76 mm, respectively, which showed a significant inverse relationship(P < .001). A significant relationship was found between the septum deviation, the ostium height, the concha bullosa, and the accessory ostium with the presence of MRC (P < .001). Conclusions: Sinonasal anatomical variations such as ostium diameter, ostium height, septal deviation, the presence of accessory ostium, and concha bullosa can cause MRC development, and considering that surgery may be necessary in some cases; this could be of great importance to clinicians and surgeons for treatment and prevention of development or recurrence of these pseudocysts in patients.

Comparison of Aripiprazole and Risperidone effectiveness in treating obsessive-compulsive disorder in patients with bipolar disorder: Double-blind, randomized clinical trial.

Background: Obsessive-compulsive disorder (OCD) is a mental illness with a chronic coarse and waxing and waning of symptoms. Treatment of OCD in patients with bipolar disorder (BD) remains challenging. Objectives: The present study aims to compare the safety and effectiveness of Risperidone and Aripiprazole as adjunctive therapy with valproate sodium, in treating mania, depression, and OCD in patients with comorbidity of OCD-BD. Methods: This research is 3 phase, double-blind, randomized clinical trial, with a total number of 64 patients. The diagnostic psychiatrist clinical interview was based on diagnostic and statistical manual of mental disorders, 5th edition (DSM-5) criteria. For assessing severity of OCD, mania, and depression, Yale-Brown obsessive-compulsive scale (Y-BOCS), young mania rating scale (YMRS), and Hamilton depression rating scale (HAM-D) scores were used. Patients were randomly assigned to the two parallel groups. All patients in both group were received valproate sodium, one group was treated with Aripiprazole and the other group was treated with Risperidon as adjective therapy with valproate sodium.The SPSS software (version 22), χ 2 test, t-test, and analysis of variance with repeated measures were used to analyze the data. Results: The dosage and time of both drugs were statistically significant in reducing the mean score of all three mentioned scales, but the effect of group was not statistically significant in HAM-D and YMRS scores, only in terms of OCD, the mean of the Y-BOCS score was significantly lower in the Aripiprazole group (p < 0.001). In relation to side effects, Risperidone induced statistically significant weight gain (p < 0.001) and Aripiprazole induced statistically significant sleep disturbance (p < 0.05). Conclusions: Both Aripiprazole and Risperidone can be used effectively as adjunctive therapy with valproate sodium in treating OCD in patients with BD without any serious and life threatening adverse effect. Aripiprazole is more effective than Risperidone in treating OCD in BD.

Predictors of quality of life and mental health in breast cancer survivors in Northern Iran.

BACKGROUND AND PURPOSE: The global incidence of breast cancer is the highest among all cancers and is the primary reason for cancer-related fatalities. Our study aimed to assess the predictors of quality of life (QOL) and mental health in breast cancer survivors in Northern Iran. METHODS: This cross-sectional study was done on 96 female breast cancer survivors between the ages of 20 and 65 and was based on convenience samples. We gathered information through demographic and fertility data, a QOL survey, and the Hospital Anxiety and Depression Scale (HADS). A significance level of P < 0.05 was set for the analysis. RESULTS: In this study, results showed that 11.5% of women had the optimal quality of life, 31.3% favorable quality of life, and 57.3% undesirable quality of life. The average HADS score was 20.14 ± 3.07, with anxiety scores of 10.21 ± 2.31 and depression scores of 9.93 ± 1.64. On multiple linear regression, marital relationship and the number of children were predictors of quality of life (ß=-17.624, p = 0.023 and ß=-7.427, p = 0.016, respectively), as well as the husband's education and having no history of other cancers in the woman, were the most important predictors of HADS (ß = 0.763, p = 0.039 and ß=-0.528, p = 0.016, respectively). CONCLUSION: It is crucial to provide exceptional care to breast cancer patients during treatment and post-recovery. Emotional and psychological support is a fundamental requirement for their well-being.

Correlation of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) with radiographic features of congestion in chest CT scan of patients with COVID-19.

BACKGROUND: Given the importance of chest computed tomography (CT) to differentiate congestion from COVID-19 pneumonia, and considering the association of chest CT findings with cardiac biomarkers in patients with concomitant COVID-19 and heart failure, this study was conducted to identify the correlation between plasma NT-proBNP level and radiographic features of congestion in patients with COVID-19. This retrospective cohort research was carried out on adult hospitalized patients with COVID-19 and the plasma concentration of NT-proBNP was measured. The most important findings in chest CT have been considered to differentiate COVID-19 pneumonia from congestion. The study population was divided into two groups based on the presence of these imaging characteristics. RESULTS: Totally, 180 patients with a mean age of 59.6 ± 14.6 years were included in the research. The radiographic findings related to congestion have been found in chest CT of 107 (59.4%) patients. Mean plasma concentration of NT-proBNP in patients with and without radiographic features of congestion was 9886.5 ± 12,676 and 2079.9 ± 4209.3 pg/mL, respectively (p < 0.001). The area under the curve of plasma levels of NT-proBNP for identification of patients with COVID-19 who had pulmonary vein enlargement in chest CT was 0.765 (95% CI 0.688-0.842) and 0.731 (95% CI 0.648-0.813) for the individuals who had interlobar fissure thickening (p < 0.001). CONCLUSIONS: The diagnostic accuracy of plasma NT-proBNP and its positive correlation with radiographic features of congestion in chest CT scan of patients with COVID-19 can be helpful for administering appropriate medications to prevent blood volume overload.

Association of age-related eye diseases with cognitive frailty in older adults: a population-based study.

BACKGROUND: Age-related eye diseases and cognitive frailty (CF) are both important predictors of adverse health outcomes in older adults, however, little is known about their association. AIMS: To demonstrate the association between age-related eye diseases and cognitive frailty in a population of Iranian older adults. METHODS: In this cross-sectional, population-based study, we included 1136 individuals (female n = 514) aged 60 years and older (mean 68.8 ± 6.7 years) who participated in the second cycle of the Amirkola Health and Aging Project (AHAP) between 2016 and 2017. Cognitive function and frailty were evaluated based on Mini-Mental State Examination (MMSE) and the FRAIL scale respectively. Cognitive frailty was defined as coexistence of cognitive impairment (CI) and physical frailty (PF), excluding confirmed cases of dementia such as Alzheimer's disease. Cataract, diabetic retinopathy (DR), age-related macular degeneration (AMD), elevated intraocular pressure (IOP ≥ 21 mmHg) and glaucoma suspects (vertical cup to disc ratio (VCDR) ≥ 0.6) were diagnosed based on standardized grading protocols. Associations between eye diseases and cognitive frailty were evaluated through binary logistic regression analysis. RESULTS: Overall, CI, PF and CF were observed in 257 (22.6%), 319 (28.1%) and 114 (10.0%) participants respectively. After adjusting for confounders and ophthalmic conditions, individuals with cataract were more likely to have CF (OR 1.66; p-value 0.043), while DR, AMD, elevated IOP and glaucoma suspects (OR 1.32, 1.62, 1.42, 1.36, respectively) were not significantly associated with CF. Furthermore, cataract was significantly associated with CI (OR 1.50; p-value 0.022), but not with frailty (OR 1.18; p-value 0.313). CONCLUSION: Older adults with cataract were more likely to have cognitive frailty and cognitive impairment. This association demonstrates the implications of age-related eye diseases beyond ophthalmology and substantiates the need for further research involving cognitive frailty in the context of eye diseases and visual impairment.

Comparison of accuracy cone-beam computed tomography and digital bitewing radiography for detection of recurrent caries under various restorative materials: in vitro study.

OBJECTIVE: The aim of this study was to compare and evaluate diagnostic accuracy of two different CBCT scan modes and digital bitewing radiography for detection of recurrent caries under five different restorative materials, and determine the relationship between the types of restorative materials. MATERIALS AND METHODS: In this in vitro study, 200 caries-free upper and lower premolars and molars were selected. A standard deep Class II cavities was created in the middle of the mesial surface of all teeth. In 100 teeth of the experimental and control groups, secondary caries was artificially demineralized. All teeth were filled with five types of restorative material including two types of conventional composite resins, flow composite resin, glass ionomer and amalgam. The teeth were imaged with high resolution (HIRes) and standard CBCT scan modes and digital bitewing. The AUC, sensitivity, specificity and areas under the ROC curve were calculated and verified through SPSS. RESULTS: CBCT technique was the best option in diagnosing recurrent caries. The diagnostic accuracy and specificity of HIRes CBCT scan mode was significantly higher than standard mode (P = 0.031) and bitewing (P = 0.029) for detection of recurrent caries, especially under composite group. There were no significant differences in accuracy value of bitewing and standard CBCT scan mode. CONCLUSION: CBCT showed higher accuracy and specificity on the detection of recurrent caries which was more accurate than bitewing radiography. The HIRes CBCT scan mode achieved the highest accuracy and performed the best in recurrent caries detection.

Determination of the effect of repetitive Transcranial Magnetic Stimulation (rTMS) on the primary visual cortex on improving the visual status of patients with subcortical stroke in the area of the posterior cerebral artery.

Background and objective: Repetitive Transcranial Magnetic Stimulation (rTMS)-induced neuroplasticity to induce trans-synaptic transmission at a site away from the stimulus site is one of the recent possible strategies for brain rehabilitation in patients with stroke. This study aimed to determine the effect of rTMS on the primary visual cortex of the lesion side of the brain on improving the visual status of patients with subcortical stroke in the posterior cerebral artery. Methods: After obtaining written consent, this non-randomized clinical trial study was performed on ten eligible patients. The National Eye Institute 25-items Visual Function Questionnaire (NEI-VFQ) and 30-degree automated Perimetry (visual field test) were used to assess patients' vision status before and after ten rTMS sessions. Paired T-test and Student T-test were used to analyze the data using SPSS software. Findings: A comparison of the mean and standard deviation of the total score of the VFQ-25 for each question did not show a significant difference between pre-test and post-test. In perimetry values based on the Visual Field Index (VFI), the correlation of mean deviation (MD) and the pattern standard deviation (PSD) did not differ significantly before and after the intervention. Conclusion: According to the results of this study, the rTMS method cannot be reliable as an effective method in the treatment of visual impairment caused by stroke. Therefore, our study does not definitively support rTMS as the first-choice method by physicians for stroke rehabilitation with visual impairment.

Clinical, histological, and histomorphometrical comparison of CenoBone® with and without plasma rich in growth factor for edentulous ridge preservation in the dental sockets.

Background: The aim of this study was to compare the clinical, histological, and histomorphometrical outcomes of CenoBone® allograft with and without plasma rich in growth factor (PRGF) for the preservation of edentulous ridge in the dental sockets. Materials and Methods: This study is experimental clinical trial that 14 dental sockets were included the sockets required ridge preservation followed by implant placement in the premolar and molar of the mandible. After extraction of the teeth, the CenoBone® allograft and PRGF were used in the test group and CenoBone® allograft was used alone in the control group. During the first stage of surgery and 5 months later, in the second stage of surgery (implant placement), the vertical changes of the ridge were measured. Furthermore, using Core-Biopsy in the second stage of surgery, criteria of histologic and histomorphometric were determined. Data were analyzed with t-test, Mann-Whitney U-test, and Fisher's exact test at the level of significance of P < 0.05. Results: The mean trabecular thickness in the test group (52.18 ± 5.53) was significantly higher than that in the control group (41.53 ± 10.40) (P = 0.344). However, there were no significant differences in the mean values of vertical bone absorption, bone percentage, remaining biomaterials, inflammation, and blood vessels between the two groups. There was no case of foreign body reaction and the bone was vital in all the cases and in direct contact with the biomaterial. Conclusion: Although CenoBone® allograft with PRGF was effective in some histomorphometric factors such as trabecular thickness, it did not lead to significant clinical changes.

Effects of incorporating zinc oxide and graphene oxide nanoparticles on abrasion, translucency, and microhardness of flowable composite resin: In vitro.

Background: Zinc oxide (ZnO) and graphene oxide (GO) nanoparticles (NPs) have antimicrobial properties. The present study was undertaken to evaluate the effects of incorporating these NPs and their chemical and physical blends on abrasion, translucency, and microhardness of flowable composite resin. Materials and Methods: In the present in vitro study, flowable composite resin samples (Grandio Flow, VOCO, Germany) were evaluated in 5 groups and the sample size was 10 for each group of each experiment (n = 10) as follows: Group 1, without NPs; Group 2, with ZnO NPs; Group 3, with GO NPs; Group 4, containing a physical mixture of GO and ZnO; and Group 5, containing a chemical mixture of GO and ZnO NPs. In all the groups, 1 wt% of the NPs were incorporate into flowable composite resin. Abrasion, translucency, and microhardness of the samples were evaluated. Data were analyzed with analysis of variance, followed by post hoc Tukey's tests at the level of significance of P < 0.05. Results: In Groups 2, 4, and 5 (all the groups containing ZnO), a significant decrease in abrasion and microhardness of flowable composite resin was observed compared to the control group. Incorporation of NPs in all the groups resulted in a significant decrease in translucency compared to the control group. Conclusion: Incorporation of NPs into flowable composite resin resulted in a decrease in translucency. The microhardness was reduced in groups containing ZnO, but the abrasion was also reduced in these groups. The incorporation of GO did not significantly alter the abrasion and microhardness of the composite resin.

Age-specific distribution of intraocular pressure in elderly Iranian population and its associated factors.

Background: The purpose of this study was to determine the distribution of intraocular pressure (IOP) and assess its association with age, sex, systemic blood pressure, diabetes mellitus, body mass index (BMI) and tobacco smoking in Iranian elderly population. Methods: This cohort-based, cross-sectional study assessed elderly individuals aged 60-90 years in Amirkola, northern Iran, in 2016-2017. Past medical history, blood pressure, diabetes mellitus, BMI and tobacco smoking were recorded through an interview and physical examination. IOP was assessed using non-contact tonometry. Results: Total of 1377 individuals participated in this study, out of which 1346 IOP measurements were included for the final analysis. The mean age of participants was 69.4 ± 7.1 years and mean IOP was determined to be 16.7 ± 3.2 mmHg. Majority of the participants were males (56.1% vs 43.1%), 73.8% of participants were overweight or obese, 6.1% smoked tobacco, 28.9% had diabetes mellitus and 84.9% had higher than normal blood pressure. Through multiple regression analysis, it was determined that age (ß=-0.132, p<0.001) was negatively associated with IOP, and the presence of diabetes mellitus (ß=0.118, p<0.001), systolic blood pressure (ß=0.101, p<0.001), and BMI (ß=0.020, P=0.020) were positively associated with IOP. Conclusion: Mean IOP of individuals in this study was higher than average based on other studies. Age, was negatively and systemic blood pressure, BMI and presence of diabetes mellitus were positively associated with mean IOP of elderly Iranian population. Sex and tobacco smoking were not correlated with IOP.

Epilepsy and associated factors in elderly people of Amirkola, North of Iran (The Amirkola Health and Ageing Project).

Background: Knowledge about the associated factors with epilepsy in the elderly in Iran is limited. Therefore, this study aimed to determine the prevalence of epilepsy and associated factors in Amirkola elderly patients. Methods: This cross-sectional study is a part of a comprehensive and cohort research of "The Amirkola Health and Ageing Project". The Mini-mental State Examination was used for cognitive impairment, Geriatric Depression Scale for psychiatric diseases and the Physical Activity Scale for Elderly questionnaire for physical activity. Results: The prevalence of epilepsy was 35 from 1482 participants (24/1000). The significant association between Parkinson's Disease (OR=6.25, 95%CI=1.35-28.4, P=0.001), falls (OR= 3.81, 95%CI=1.62-8.97, P=0.001), depression (P=0.001), hyperphosphatemia (P=0.039) and hypokalemia (P= 0.031) concluded with epilepsy. Past history of stroke (6 % versus 2%, OR= 2.8, 95%CI, 0.97-8.27, P=0.07), increased serum level of triglyceride (OR= 1.96, 95%CI= 0.99-3.88, P=0.06) and low-density lipoprotein (LDL) (P=0. 45) were seen in epileptic patients vs. non-epileptic patients. Conclusion: Parkinson's disease, frequency of falls and depression were the associated factors in epileptic patients and a correlation between past history of stroke, increased serum level of triglyceride and LDL with epilepsy were seen. Associated factors required screening, diagnosis and treatment.

Relationship Between Visceral Adipose Tissue and Bone Mineral Density in Older People: Results from AHAP Study.

INTRODUCTION: Due to discrepancy of the relationship between visceral adipose tissue (VAT) and bone mineral density (BMD), this study was performed to determine the relationship between BMD and VAT in the elderly. METHODOLOGY: This cross-sectional study is part of the second wave of Amirkola Health and Ageing Project (AHAP), including 1,200 people aged 60 years and older. BMD and VAT were measured by dual-energy X-ray absorptiometry (DXA) in Hologic equipment. Based on the amount of VAT, individuals were divided into four quartiles. Then, the data were statistically analyzed by SPSS22 software using chi-square, ANOVA, Pearson correlation coefficient and logistic regression. RESULTS: The mean age of the participants was 69.6 ± 6.9 year and the mean VAT was 862.6 ± 337.8 gram. In this study, people with osteoporosis had less VAT (p<0.0001). Furthermore, with the increase in the amount of VAT, BMD increased in the femoral region and lumbar spine (p<0.0001). There was a positive and significant correlation between VAT and BMD in the femoral region (r = 0.267) and lumbar spine (r = 0.197) (p<0.0001). After performing multiple logistic regression analysis in the presence of factors such as age, gender, body mass index and especially lean mass, the protective role of VAT against osteoporosis was maintained (OR=0.510, CI95% (0.290-0.895)) (P = 0.019). CONCLUSIONS: This study has shown that VAT can independently have a positive association with BMD in the elderly.