فهرست مطالب منیر سادات میرزاده

Radiographic diagnosis of root absorption affects the treatment plan, and consequently, the preservation of the tooth. Therefore, the present study aimed to assess the ability of undergraduate dentistry students to detect root resorption of maxillary primary molars in periapical radiography. Thirty-five parallel periapical radiographs that included maxillary primary molars were selected and converted to PowerPoint slides. A pedodontist and a radiologist determined external root resorption as the gold standard of the study. Twenty-six final-year dental students were enrolled to determine the existence or the absence of resorption in the radiographs. A training class was held to increase the students' ability to diagnose. After two weeks, the students were again asked to identify resorption in radiographic images. Statistical data analysis was performed using SPSS 21 and the results were compared together. The Kolmogorov-Smirnov test was used to assess the normal distribution of variables and a paired t-test was employed to compare the scores of the students before and after the training. The highest scores of the students in diagnosing root resorption in primary maxillary molars belonged to mesiobuccal, distobuccal, and palatal roots in descending order. The mean of the students’ scores before the training session was 97.8462±15.9466, which increased to 101.2308±20.6267 after the instruction session; however, this increase was not statistically significant (P>0.05). The lowest detection ability in both maxillary molars was reported for palatal root. According to the students’ scores before and after the training session, it can be concluded that short-term, theoretical, and traditional education has no significant effect on students’ diagnostic ability.

Aneuploidies are of the most important fetal abnormalities. Diagnostic value and efficacy of NIPT assay in the groups with abnormal results for first trimester combined screening test is not well defined. Therefore, this study was performed aimed to survey the sensitivity and specificity of NIPT for aneuploidies diagnosis in women with moderate risk for trisomy at first trimester combined screening test.

This prospective cohort study was performed in 2017-2018 on 447 women with singleton pregnancy and gestational age of 11 to 13 weeks and 6 days who had moderate risk for trisomy. NIPT analysis was done in all women with moderate risk (1/250 to 1/1500) and was compared with the results from karyotype and phenotype analysis in neonates. NIPT diagnostic accuracy for chromosomal abnormalities was calculated. Data were analyzed using SPSS statistical software (version 22).

Two cases with trisomy 21 (0.06%) and one case with trisomy 18 (0.03%) were diagnosed. These three cases were confirmed with amniocentesis and the pregnancy was ended. The neonates' analysis showed normal phenotype results in all of them and NIPT diagnostic accuracy for trisomy 21 and 18 was calculated 100%.

In addition to maintain combined screening test benefits, using NIPT is accompanied by high diagnostic accuracy for fetal chromosomal abnormalities assessment.

Ectopic pregnancy (EP) occurs in 1.5-2% of all pregnancies and it is the important cause of maternal mortality in the first trimester. The aim of this study was to evaluate EP risk factors in Kowsar hospital in Qazvin.

In this case-control study, 200 pregnant women with sonographic and pathological diagnoses of ectopic pregnancy in Qazvin Kowsar hospital in 2017 were assigned to the case group and 200 pregnant women with no delivery problems were assigned to the control group. The sampling method in this study was based on complete enumeration. All demographic and midwifery data were extracted from the records in the hospital archive. Data were analyzed by t-test, chi-square, and logistic regression in SPSS software version 22. P<0.05 was considered significant.

The mean age of the study population was 30.45±6.51. About 41.8% of the mothers underwent medical treatment with methotrexate, 56.6% of them underwent salpingectomy and 1.5% of them were discharged with personal consent. There was a significant relationship between the incidence of the ectopic pregnancy and using contraception, previous abortion, using in vitro fertilization, congenital diseases, infertility problems, previous pelvic inflammatory disease, previous EP, previous surgical history and hypothyroidism (P<0.05).

The present study also showed that EP was more likely to occur in patients with history of EP, abortion, PID, surgical procedures, infertility and hypothyroidism. Therefore, it is recommended that women should undergo health care before pregnancy and further studies are required to provide solutions to reduce the cases of EP.

Hydatidiform Mole (HM) is a type of gestational trophoblastic disease which causes serious complications and recognizing risk factors can play an important role in reducing the incidence. The aim of this study is to evaluate HM risk factors in Kowsar hospital in Qazvin, Iran.

In this case-control study, 77 pregnant women, by complete enumeration method with sonographic and pathological diagnosis of molar pregnancy in Qazvin Kowsar hospital in 2016-2017, were assigned to the case group and 77 pregnant women with no delivery problems were assigned to the control group. All demographic and midwifery data were extracted from the records in the hospital archive. Before patients were enrolled in this study, written consent was obtained. Data were analyzed by t-test and chi-square in SPSS software version 22. P<0.05 was considered significant.

Mean age in both case and control groups was 27.16 ± 7.26. There was no significant difference in preeclampsia, multiple pregnancy, blood groups, Rhesus (Rh) and contraceptive methods in case and group groups (P>0.05). There was a significant relationship between HM and history of molar pregnancy and multiparity (OR: 2.1; CI: 1.77-2.48; p=0.01, OR: 1.85; CI: 1.07-3.6: p=0.04).

The present study also showed that HM was more likely to occur in multipara patients and patients with history of molar pregnancy. Therefore, it is recommended that women should undergo health care before pregnancy and further studies are required to provide solutions to reduce the cases of HM.

Pathophysiological changes in the mouth of patients with diabetes mellitus (DM) predispose to overgrowth of Candida albicans. Various virulence factors such as proteinase and phospholipase production are involved in the process of degradation of the host cell membrane. These enzymes are involved in binding Candida species, especially in the hyphae stage, to the target tissue. In this study, the proteinase and phospholipase activity of 51 C. albicans strains was evaluated. Overall, the rates of proteolytic and phospholipase activities in controlled and uncontrolled diabetic patients were 90.2% and 72.5%, respectively. No significant difference was observed between proteinase and phospholipase activities in both groups of patients (P>0.05), while there was a significant difference between the activity of hydrolytic enzymes with HbA1C and dentures in the uncontrolled diabetic group (P<0.05). According to the importance of hydrolytic enzymes activity of C. albicans species in diabetic patients, oral health of diabetic patients to control and prevent disease progression in these patients is essential.

Cerebrovascular diseases are the second common cause of mortality worldwide. The onset of reperfusion in the first 3-4.5 hours is a predictive factor of treatment. 

The present study investigated barriers to receiving tissue plasminogen activator in patients with ischemic stroke.

This cross-sectional study examined 191 patients with first-ever stroke referring to the emergency department of the Persian Gulf Martyrs Hospital of Bushehr City, Iran, in 2016. One checklist was completed which included demographic data, history of diseases, knowledge of stroke symptoms, and intervals regarding the onset of symptoms to informing emergency, informing emergency on arrival at the emergency department of the hospital, and making the diagnosis for the patients. The obtained data were analyzed in SPSS v. 19.

Mean±SD age of the patients was 65.92±12.48 years. The majority of patients under investigation (55.5%) were female, 63.4% were married, 56% were illiterate and 72.3% resided in other districts of Bushehr province. Mean duration between onset of symptoms and arrival at emergency department, onset of symptoms and call the emergency service, time of arrival at emergency department to perform brain Computer Tomography (CT) scan and also to be counseled by a neurologist were 699.66, 195.51, 45.11 and 423.62 minutes, respectively. Finally 14.6 percent of patients were qualified to be treated with tPA.

The main barrier to timely therapy is a delay in golden time. Therefore, public education to promote public awareness could be of great benefit in reducing the referral delay time.

Since public health measures are the only way to control the spread of COVID-19, strict quarantine measures have done around the world. This condition will definitely not be without psychological effects. The aim of this study was to determine the factors affecting the stress caused by COVID-19 in the medical staff and the general population.

This cross-sectional study was conducted by a researcher-made questionnaire on 326 people in Qazvin province, Iran in the spring of 2020. The questionnaire consisted of 40 questions, in 3 sections: demographic information, general and main questions related to COVID-19 stress. The questionnaire was made available to the study population in Qazvin through virtual networks.

Of the 326 participants (117 men and 209 women), 71 were medical staff members and 255 in the general population. The mean stress scores of the general population, the medical staff in the corona and non-corona department, were reported 28.7±8.4, 30.1±9 and 27.3±7.8, respectively, with no statistically significant difference among the groups (p=0.374). In the medical staff, access to social response systems (p=0.02), considerable weight change (p=0.019) and reluctance to perform daily activities (p=0.001) were among the factors that had a significant relation with stress score. For the general population, sex (p=0.001), the presence of a high risk elderly person in the family (p=0.001), having a fatal case due to COVID-19 in the family (p=0.014), exacerbation of the underlying disease (p=0.003), job closure (p=0.007), etc had significant relations with stress score.

According to the findings of the present study, the level of stress in the study population was mild, but the psychological effects of coronavirus epidemics are undeniable. Access to psychological counseling systems can be an effective way to improve a personchr('39')s mental state in quarantine.

Background :

As the population pyramid in Iran shifts to aging and the influence of environmental conditions on the elderly people, The need to pay attention to the foundations of well-being, security and comfort is felt more than ever. 

Objective:

 The present study aimed at evaluating the urban open spaces and public buildings/places of Qazvin city in Iran as indicators of an age-friendly city based on the perception of older people and managers.

Methods:

 This is a descriptive/analytical study conducted in 2017 on 200 older people and 40 urban managers. The older people were selected by a random cluster sampling technique, and managers by a convenience sampling method. Data collection tools were a demographic form and Ageing-Friendly City Questionnaire. Data were analyzed using descriptive statistics and t-test.

Findings:

 The mean age of the elderly people was 68.32±6.48 years and for the managers, it was 40.28 ± 5.94 years. The mean score of  public buildings/places was 3.49±1.06 reported by the elderly group and 2.64±0.77 by the managers. For urban open spaces, it was 3.06 ± 0.89 and 2.60 ± 0.52, respectively. There was a significant difference between the opinions of two groups regarding the two surveyed indicators (P<0.001).

Conclusion :

The city of Qazvin is far from ideal in terms of buildings/public places and open spaces for the elderly. Therefore, urban managers should pay more attention to these indicators and take more effective steps to increase their quality.

Common causes of dental discoloration include trauma, drugs, genetic defects, decay, and age. In order to correct discoloration of pulpless teeth, internal bleaching is recommended. The aim of this study was to compare microleakage of resin modified glass ionomer and OrthoMTA used as an intraorifice barrier in non-vital bleaching.

In this experimental study, 36 extracted mandibular premolars were selected and randomly divided into two experimental (n = 16) and two control groups (n = 2). 2mm of OrthoMTA and RMGI cements were placed as intraorifice barriers in the experimental groups. Subsequently, we placed a mixture of sodium perborate and 30% hydrogen peroxide as internal bleaching material into the canal and replaced it every three days. Leakage was measured using pH diffusion method by a digital PH meter. Data were statistically analyzed by using T- independent test and repeated measures and variance analysis (P<0.05).

The pH value of the negative control group was as same as the PH of normal saline while the PH value of positive control group was significantly higher than those of other groups. PH values of Ortho MTA and RMGI at the baseline and on the first, sixth and ninth day did not show significant differences with one another, while microleakage of OrthoMTA group was significantly lower on the third day.

In general, OrthoMTA had less leakage than RMGI but both materials can be used as suitable barriers for internal tooth bleaching.

Drug abuse is one of the most important global issue that has become a psychological, social, and family disaster. The present study was aimed to determine the causes of substance abuse in the elderly. In this descriptive cross-sectional study, 120 addicted elderly people referred to addiction treatment centers of Qazvin, Iran were selected by convenience sampling in 2017. The demographic and researcher-made substance abuse tendency questionnaires were applied for data collection. Data were analyzed by descriptive statistics including frequency, percentage, mean and standard deviation. The mean age and age of the onset of drug abuse were 58.83±8.91 and 34.44±13.37 years, respectively. The majority of the elderly were male (113 subjects, 94.1%), and 102 (85.1%) elders were married. Opium was the most common abused drug (75.8%) and more than half of them (64.2%) experienced drug discontinuation. Environmental factors were the important reason of intendancy towards drug abuse among elderly people. In this study, the most important reason of drug abuse in the elderly people was environmental factors that were consisted; easy access to drug, lack of sports and recreational facilities and the presence of addicted friends.

Considering the key role of midwifes as an effective component of the health system for providing midwifery services to vulnerable communities in the community, mothers and infants, this study aimed to investigate the relationship between job satisfaction and job performance among midwives employed in Qazvin maternity hospitals. In this descriptive-analytical study, 100 midwives working in maternity hospitals in Qazvin city were selected by census method and entered into the study. The data collection tools consisted of the Wysocki & Kromm Job Satisfaction Questionnaire, Paterson's Job Performance Questionnaire, and demographic information form. Validity and reliability of the questionnaires were confirmed in previous studies. Data were analyzed using descriptive and inferential statistical tests. The significance level was considered to be less than 0.05. The results showed that there was no significant correlation between job satisfaction score and job performance score. Most of the research units (60%) had a low job satisfaction. The highest satisfaction level was in supervisor satisfaction (55%). And the lowest was in terms of salary and benefits (34%). Also, the results showed that there was a positive correlation between job satisfactions with all its dimensions. The results of this study also showed that there is a significant relationship between general job satisfaction with age, education and employment status (p <0.05). The results of this study can be used for accurate planning in order to increase the job satisfaction and reparation of their salary and benefits. Because the results of this study indicate that the job satisfaction of the midwifery is low, although there is not a meaningful relationship between this finding and the job performance, this can be a danger to the authorities, because inadequate job satisfaction can lead to inadequate care and ultimately affect the health of mothers and infants.

Osteoporosis is a common problem in health systems and in fact, it is a hidden epidemic. Only the early diagnosis can prevent its complications. Therefore, this study was performed with aim to evaluate knowledge, attitude and performance of high school girls about osteoporosis.
This cross-sectional study was performed on 715 adolescent female students who were educating in six high schools of Boushehr. Data were collected through a questionnaire which included 52 questions about demographic information, knowledge, attitude and performance of adolescent regarding osteoporosis risk factors (physical activity, nutrition, and smoking). Data were analyzed using SPSS software (version 16) and chi-square test. P 621 students (86.9 %) had desirable and 94 (31.1%) had moderate knowledge regarding Osteoporosisrisk factors. 662 of participants (92.6%) had desirable and 53 (7.4%) had moderate attitude and none of them had poor attitude about the factors effective on osteoporosis. In terms of physical performance, 2 students (0.3%) haddesirable, 143 (20%) moderate, and 570 (79.7%) had poor physical activity. There was no significant relation between knowledge and performance (P=0.18) and also between attitude and physical activity (P=0.42).
The girls who participated inthis study had desirable knowledge and attitude regarding osteoporosis, but most of them had poor performance in terms of physical activity. It is suggested that parents and managers design appropriate program to increase physical activity ofadolescents.

To report and evaluate the characteristics of patients referred to the emergency department of Labbafinejad Medical Center with work-related eye injuries during 2005. In this descriptive study, an available sample of patients with work-related eye injures were assessed. Demographic characteristics, causes of ocular trauma, and use of work safety devices were main evaluated variables. Overall, 99 subjects (96% male) with mean age of 31.76±10.55 years were enrolled. Mean time interval between the accident and referral to eye emergency was 2.46±4.46 days (0-30 days). Of these, 66.6% came to the emergency ward on the first day after the incident and 37.1% underwent an eye examination at this center for the first time. The most unsafe activities were grinding (21.4%), welding (20.4%), hammering work (14.3%) and manual work (10.2%). Metal industrial (50%), constructional (17.3%) and mechanical (8.2%) workers had the highest risk for eye injury among different occupations. The major consequence of eye injuries was corneal foreign bodies (72.7%). Of injured patients, only 14 persons (14.1%) had passed job safety educational courses and 93 persons (93.9%) had not used any eye protection device. Most injured patients were young men workers using no safety devices; therefore it seems that occupational safety efforts including eye protection education and training programs in this context is insuffi.

To report the efficacy of a single intravitreal injection of bevacizumab (IVB) alone or in com-bination with intravitreal triamcinolone acetonide (IVT) versus macular laser photocoagulation (MPC) as primary treatment for diabetic macular edema (DME). This randomized three-arm clinical trial included 103 eyes of 97 patients with clinically significant DME and no previous treatment. The eyes were randomly assigned to one of the three study arms: the IVB group received 1.25 mg IVB (37 eyes), the IVB/IVT group received 1.25 mg IVB together with 2 mg IVT (33 eyes), and the MPC group underwent focal or modified grid laser photocoagulation (33 eyes). Primary outcome measure was change in best-corrected visual acuity (BCVA). Changes in BCVA (logMAR) at 12 weeks were -0.22±0.23, -0.13±0.31 and +0.08±0.31 in the IVB, IVB/IVT and MPC groups, respectively. The marginal regression model based on generalized estimating equation analysis demonstrated that changes in visual acuity was statistically significant in the IVB group at both 6 (P<0.001) and 12 (P=0.024) weeks but only at 6 weeks in the IVB/IVT group. Significant decrease in central macular thickness (CMT) was observed in the IVB and IVB/IVT groups at 6 weeks. Up to 12 weeks, IVB treatment in eyes with DME yielded better visual outcome than laser photocoagulation, although it was not associated with a significant decrease in CMT. IVT seemed to have no further beneficial effect in combination with IVB.

To evaluate the incidence of steroid-induced ocular hypertension (OHT) after myopic photo-refractive keratectomy (PRK). Myopic PRK was performed on 506 eyes of 269 patients. Refractive error was between -1.00 and -5.00 diopters of sphere and less than 4 diopters of cylinder. Baseline intraocular pressure (IOP) before the operation and at different time intervals after the operation was measured using Goldman Applanation Tonometry. Corrected IOP more than 21 mmHg was considered as OHT. OHT occurred in 40 (7.9%) eyes. IOP rise occurred after 2-3 weeks in 40% (mean IOP= 23.5±3 mmHg), 4-6 weeks in 50% (mean IOP= 25.06±4.2 mmHg) and 8-12 weeks in 10% (mean IOP= 28.98±3.12 mmHg). There was no correlation between IOP and preoperative spherical equivalent. IOP recovered to normal in all patients after discontinuation of topical steroid and using 0.5% timolol. Mean duration for normalization of IOP was 28.5±27.7 (range 7-108) days. There was no case of steroid-induced glaucoma. Topical steroids may cause OHT in patients undergoing PRK. Early detection of IOP rise and meticulous treatment with close follow-up are recommended. We suggest measuring IOP in post-PRK patients at least after 2 to 3 weeks of corticosteroid treatment initiation.