Effectiveness of a supportive care program via a smartphone application on the quality of life and care burden among family caregivers of patients with major depressive disorder: a randomized controlled trial.

BACKGROUND: The majority of patients with major depressive disorder require care that has generally affected caregivers' lives. Providing care could cause negative experiences as a care burden and deteriorate quality of life. However, there is a lack of evidence about caregiver training-based informatics and its impact on the caregiver's life. METHODS: This experimental study was carried out in Mashhad, Iran. A total of 60 primary family caregivers of patients with major depressive disorder were included in the study between February and July 2021. The quadruple block randomization method was used to allocate the participants into control and intervention groups. In the intervention group, family caregivers used the application with weekly phone calls for one month. The app contains the most important points of patient care and has the possibility of communicating with the nurse. The Novak and Guest Care Burden Inventory and the short form of the World Health Organization Quality of Life Questionnaire were completed before and after the intervention. Data analysis was performed using chi-squared tests, independent sample t tests, and analysis of covariance. RESULTS: At baseline, the mean scores of care burden and quality of life were homogeneous between the two groups. After the intervention, the mean scores of care burden and quality of life were significantly reduced and improved in the intervention group compared with the control group (p < 0.001). CONCLUSIONS: Using the application with the ability to communicate with the caregiver, along with educational support, helps to strengthen the relationship between the family caregiver and the nurse. Despite the effectiveness of the present intervention, before including this form of implementation of support in care programs, it is necessary to evaluate its other positive aspects in future studies. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT), IRCT20210202050222N1. Registered on 05/02/2022.

Evaluating the association between gingival crevicular blood glucose levels and finger capillary blood glucose levels according to periodontal status.

OBJECTIVES: The aim of this study was to evaluate the association between gingival crevicular blood glucose levels (GCBG) and finger capillary blood glucose levels (FCBG) according to the periodontal status of patients. MATERIALS AND METHODS: In this case-control study, 80 patients were divided into 4 groups according to their periodontal status. In these patients, an area of the maxillary gingiva with the highest probing depth was selected for blood sampling. Blood glucose obtained from this area and the right fingertip was measured with a glucometer. Data were analyzed using ANOVA and Pearson correlation coefficient with a significance threshold of 0.05. RESULTS: The groups studied were matched in regard to their sex and age (P > 0.05). The average FCBG and GCBG were not significantly different according to periodontal status (P > 0.05). The correlation between the FCBG and the GCBG showed a significant positive correlation in the total number of participants (P < 0.05, r = 0.531). CONCLUSION: The study observed a positive association between GCBG and FCBG. However, the relationship with periodontal status appeared to be relatively weak. Further research may be needed to determine the potential efficacy of GCBG in diabetes screening during periodontal examinations. CLINICAL RELEVANCE: Most patients with diabetes do not have proper periodontal health, so it may be helpful to screen for diabetes during periodontal examinations.

The Sexual Function, Desire, and Satisfaction of Couples during the Outbreak of COVID-19 in Qazvin.

Background: The COVID-19 pandemic has significantly affected the lives of the community. The resulting social constraints and the physical and psychological consequences are also expected to affect sexual health. The present study aims to determine the status of sexual function, desire, and satisfaction of couples during the outbreak of COVID-19. Materials and Methods: This is a descriptive online cross-sectional study on 400 married individuals living in Qazvin, Iran, from October 15 to November 12, 2020. The multi-stage random cluster method is used for sampling. The following questionnaires have been used for data collection: Female Sexual Function Index (FSFI), Rosen male sexual function, Larson's sexual satisfaction, and Hurlbert Index of Sexual Desire (HISD). The questionnaires were sent to participants through online messengers. The obtained data were analyzed by SPSS software (v25). Results: The findings show that only 19.20% of study participants had sex three or more times a week. Most of the participating women (56.90%) had sexual dysfunction, while most men (64.30%) had proper sexual function. Also, the majority of participants had moderate sexual desire (46%) and high sexual satisfaction. The primary predictors of sexual dysfunction in men and women during the outbreak of COVID-19 were "employment in health centers" (B = -9.34, p = 0.007) and "spouse working in health centers" (B = -6.16, p = 0.007), respectively. Conclusions: The psychological burdens of the COVID-19 pandemic and resulting measures, such as prevention protocols, affect couples' sexual relations. Therefore, interventions are necessary to improve the quality and health of the sexual life of couples.

The Effect of Using Dexamethasone Tablets Vaginally for Improving Cervical Bishop Score in Nulliparous Pregnant Women: A Randomized Clinical Trial.

Background: Cervix ripening and labor induction are common interventions in obstetrics. For optimal maternal health, labor may be induced under certain situations to improve fetal survival outcomes. Labor induction of an unripe cervix can lead to complications; therefore, several approaches can facilitate the ripening process. Methods: This randomized clinical trial was a triple-blind study that involved 84 pregnant nulliparous women enrolled between October 2019 and June 2021 in the labor ward of Kamali Hospital, Karaj, Iran. The pregnant women in the study underwent labor induction and were randomized into 2 groups: 1 group received vaginal dexamethasone and the other group was given a placebo. Results: There was no significant difference between the groups regarding maternal age, demographic characteristics, and initial Bishop score. The median second Bishop score (6 hours after intervention) was 3.5 in dexamethasone recipients and 3 in placebo recipients (P = 0.48). The median labor latent phase duration was 4 hours in dexamethasone recipients and 5 hours in placebo recipients (P = 0.57). Conclusions: This randomized clinical trial demonstrated that administering dexamethasone tablets vaginally did not significantly improve cervical Bishop scores. (Curr Ther Res Clin Exp. 2023; 84:XXX-XXX). ClinicalTrials.gov identifier: NCT05070468.

Clinicopathological and prognostic value of lncRNA TPT1-AS1 in cancer: A systematic review study and meta-analysis.

INTRODUCTION: Aberrant expression of lncRNAs in cancer cells can impact their key phenotypes. We aimed to summarize available evidence on clinicopathological and prognostic value of lncRNA TPT1-AS1 in cancer. METHODS: A systematic search was performed on Medline and Embase databases using relevant key terms covering lncRNA TPT1-AS1, cancer, and clinical outcomes. The effect size estimates and their 95 % confidence interval (CI) were pooled using random-effects models. Meta- analyses were conducted using STATA 16.0 software. RESULTS: Seventeen articles met our eligibility criteria. Tumor tissue compared to normal tissue showed increased level of lncRNA TPT1-AS1 expression (pooled standardized mean difference (95 % CI): 0.65 (0.52-0.79)). Overexpression of this lncRNA was a significant predictor for poor prognosis (Pooled log-rank test P-value < 0.001); in patients with high-level of lncRNA TPT1-AS1, the risk of death at five years was 1.40 times greater than their counterparts. The pooled Odds ratios for association lncRNA TPT1-AS1 with tumor stage, tumor size, and lymph node metastasis were 1.94 (95 % CI: 0.90-4.19, 8 studies, I2 = 79.6 %), 2.33 (95 % CI: 1.31-4.14, 5 studies, I2 = 40.0 %), and 1.89 (95 % CI: 1.08-3.36, 5 studies, I2 = 61.7 %), respectively. Regarding the identified potential mechanisms, lncRNA TPT1-AS1 plays a role in cancer growth mainly by sponging miRNAs and regulating their downstream targets or controlling the expression of key cell cycle regulators. CONCLUSION: In cancer patients, elevated expression of lncRNA TPT1-AS1 might be associated with a shorter Overall Survival, advanced stages, larger tumor size, and lymph node metastasis.

Diagnostic Accuracy of Salivary Biomarkers including Lactate Dehydrogenase and Hemoglobin A1c for Screening Chronic Periodontitis.

Aims: Periodontitis is one of the most common chronic bacterial infections in humans involving the tooth-supporting tissue. The present study aimed to evaluate and compare salivary biomarkers, including lactate dehydrogenase (LDH) and hemoglobin A1c (HbA1c), between patients with severe chronic periodontitis and healthy individuals. Methods: This study was performed on 29 patients with severe chronic periodontitis and 30 healthy individuals at Zahedan University of Medical Sciences, Zahedan, Iran, in 2021. Salivary samples were taken, and clinical parameters, including the clinical attachment loss (CAL) and probing pocket depth (PPD), were measured. Besides, the levels of LDH and HbA1c were measured using ELISA kits. The sensitivity, specificity, and positive and negative predictive values of HbA1c and LDH were examined for chronic periodontitis diagnosis. Results: Based on the present results, the levels of LDH and HbA1C did not show adequate sensitivity or specificity for screening chronic periodontitis. Conclusion: According to the present findings, salivary biomarkers, including LDH and HbA1c, cannot be used with certainty for screening chronic periodontitis.

The effect of Phase 1 periodontal treatment on the salivary RANKL/OPG ratio in severe chronic periodontitis.

BACKGROUND: RANKL and OPG play an important role in bone resorption. The R A N K L O P G ratio increases in periodontal disease. The present study was conducted to evaluate the effect of Phase 1 periodontal treatment on the salivary R A N K L O P G ratio in patients with severe chronic periodontitis. MATERIALS AND METHODS: Saliva samples were collected from 13 patients with severe chronic periodontitis and 14 healthy controls at baseline and then four weeks after the treatment using unstimulated spitting. The salivary levels of RANKL, OPG and R A N K L O P G ratio were investigated using the ELISA method. RESULTS: The findings of this study showed that the mean R A N K L O P G ratio was significantly higher in the patients with periodontal disease than in the healthy controls (P=0.001). Also, the R A N K L O P G ratio was significantly higher in the patients with a higher mean CAL (P=0/004). The comparison of the salivary R A N K L O P G ratio in patients with periodontal disease before and four weeks after the treatment showed a significant reduction in this value four weeks after the periodontal treatment (P=0/001). CONCLUSION: The results of this study showed a direct relationship between the R A N K L O P G ratio and the severity of periodontal disease. Phase 1 of periodontal treatment was found to be effective in reducing the R A N K L O P G ratio. In other words, the R A N K L O P G ratio can be a good predictor of treatment success. Further long-term studies with larger sample sizes are required for confirming these results.

Comparative Assessment of the Effects of Three Local Anesthetics: Lidocaine, Prilocaine, and Mepivacaine on Blood Pressure Changes in Patients with Controlled Hypertension.

BACKGROUND: Given large number of patients with hypertension attending dental clinics and the profound effects of local anesthetics containing vasoconstrictors, this study aimed to compare the effects of lidocaine 2% + epinephrine, prilocaine 3% + felypressin0.03, and mepivacaine 3% on blood pressure changes. METHODS: The current study was carried out from May 2014 to February 2015.Patients with controlled hypertension (systolic blood pressure<159.94 mmHg before the injection) who attended Zahedan dental school (Zahedan , Iran) for the extraction of a mandibular tooth were selected and randomly allocated to three groups of 20. Groups 1-3 received lidocaine 2% + epinephrine, prilocaine 3% + felypressin 0.03 units, and mepivacaine3%, respectively. Patients were only included if they were injected with a maximum of two 1.8 ml cartridges (3.6 ml) for tooth extraction (maximum epinephrine dose of 0.04 mg was maintained in systemic patients).The collected data were analyzed using the analysis of variance (ANOVA) in SPSS 19.0. (SPSS Inc., Chicago, IL, USA)RESULTS: No significant differences were observed between the systolic and diastolic blood pressure of the three groups. The three evaluated local anesthetic solutions had similar effects in patients with controlled hypertension. CONCLUSION: While no significant changes in blood pressure were observed in three groups, all dental procedures on the mentioned group of patients have to be performed under careful monitoring and aspiration. Moreover, the maximum epinephrine dose (0.04mg) should never be exceeded in these patients.

Does Salivary Calcium and Phosphate Concentrations Adequately Reflect Bone Mineral Density in Patients with Chronic Periodontitis?

BACKGROUND: Periodontitis is the inflammation of the periodontal supporting tissues. The response of periodontal tissues to local bacteria leads to bone resorption and destruction of periodontal junction. Given the possible association between periodontitis and low bone mineral density, the aim of present study was to find if measurement of salivary biomarkers as a less invasive method, can provide an appropriate screening method for assessment of bone mineral density in patients with chronic periodontitis? METHODS: A case-control study was conducted on 53 people, including 28 patients with severe chronic periodontitis and 25 healthy people between April 2014 to March 2015 in Zahedan (southeast of Iran). Following Periodontal examination, salivary samples were collected, and the concentration of salivary calcium and phosphate were measured and reported as mg/dl. Bone mineral density of participants was measured using dual energy x-ray absorptiometry and reported as gr/cm2. RESULTS: No significant association was found between concentrations of salivary calcium and phosphate levels with bone mineral density in either healthy people or in patients with severe chronic periodontitis, despite a significant bone density reduction (in the femur neck and lumbar spine L2-L4) in the periodontitis group compared to healthy people (P=0.006, and P=0.009 respectively). CONCLUSION: Concentration of salivary calcium and phosphate do not appear to be good indicators of bone mineral density. Further prospective studies with larger sample size are recommended.

The Relationship Between Periodontal Disease and Public Health: A Population-Based Study.

BACKGROUND: Periodontal diseases, such as periodontitis, are considered the main cause of tooth loss in the elderly.The present study is aimed to determine the relationship between periodontal condition and quality of life. Quality of life consists of a range of people's objective needs related to the self-perception of well-being. METHODS: This study was done from January 2014 to June 2015 in a healthcare clinic in Zahedan, southeast Iran. Using the random sampling method, the researchers enrolled 700 individuals over 35 years of age. The participants initially completed a demographic questionnaire consisting of data, such as age, sex, educational level, and smoking habit. Then, the periodontal chart was completed. Moreover, patients, based on the number of their natural teeth, were divided into two groups (≥10 teeth in both maxillary and mandible arches and <10 teeth in at least one arch). The body mass index (BMI) was also measured.To assess the participants' general health, the WHO's quality of life questionnaire (WHOQOL-BREF) was used. RESULTS: Of the 700 enrolled individuals, 53.3% were womenand 47.7% were men. Moreover, most of the participants (63.71%) had BMI of less than 25 and 68% did not smoke.We found that as the people's periodontal status deteriorated, their quality of life also declined and the total mean score in all four health domains decreased (P<0.001).Moreover, people with more than 10 teeth in both arches scored higher with respect to life quality than those with less than 10 teeth in at least one arch (P<0.001). CONCLUSION: This studyindicates a decrease in the general quality of life in patients with periodontal disease.The authors suggest performing studies with larger sample sizes andcohort studies for more reliable results.

A comparison of the healing capabilities of various grafting materials in critical-size defects in guinea pig calvaria.

PURPOSE: To estimate the efficacy of various bone grafting materials in the healing of 8-mm-diameter critical-size defects (CSD) in guinea pig calvaria. METHODS: In this randomized trial study, critical-size defects were created in the calvaria of 36 guinea pigs 6 months of age. Animals were assigned into three groups and each received one of three experimental protocols. In protocol A, the right-side defect was filled with macroporous biphasic calcium phosphate (MBCP Gel) and the left side was left empty as a control. In protocol B, the right-side defect was filled with demineralized freeze-dried bone allograft (DFDBA) and the left side was filled with Stypro. In protocol C, the right-side defect was filled with Bio-Oss and the left side was filled with autogenous bone. The percentage of new bone formation was evaluated histomorphometrically after 8 weeks. RESULTS: The mean bone formation was 68.19% for autogenous bone, 66.96% for MBCP Gel, 57.28% for Bio-Oss, 50.19% for DFDBA, 18.79% for Stypro, and 10.61% for the empty control. Except for the MBCP Gel and autogenous bone groups (P = .6), the differences between the other groups were statistically significant (P < .05). CONCLUSION: The results of this study indicated that all the testing materials had different capacities to produce new bone in CSD of guinea pig calvaria. MBCP Gel showed promising results in producing new bone proportionate to the autogenous bone graft group.