کریم الله حاجیان تیلکی

Knowledge of airway dimensions is important in the process of diagnosing and planning the treatment of orthodontic patients. Therefore, this study was conducted with the aim of performing cephalometric anlysis of airway dimensions in patients with different vertical jaw relations in the specialized clinic of Babol Dental School.

This cross-sectional study was conducted on 150 lateral cephalometric radiographs taken from patients aged 18 to 25 before orthodontic treatment. Based on the FMA angle and Jarabak index, the patients were divided into three groups of 50 according to the vertical skeletal pattern. The width of the upper (UP) and lower (LP) airways was measured in millimeters using McNamara's analysis. Moreover, the width of the nasopharynx (PNS-UPW), oropharynx (U-MPW) and hypopharynx (V-LPW) was recorded in millimeters and compared in three groups.

The studied population included 43 men and 107 women with a mean age of 20.39±2.50 years. The results showed a significant relationship in the dimensions of the upper airway, nasopharynx, and oropharynx between the vertical groups (p=0.001, p=0.001, and p=0.015, respectively). All these parameters in the Hyperdivergent group were significantly lower than the other two groups, and no significant relationship was found between the Hypodivergent and Normodivergent groups. The mean upper airway in Normodivergent group was 13.62±3.05. In addition, the dimensions of the lower airway and hypopharynx were not significantly different between the vertical groups.

The results of the study showed that hyperdivergent patients have a narrower upper airway. However, lower airway dimensions are not affected by vertical growth pattern factors.

Cephalometric analyses are an important tool for diagnosis and orthodontic treatment planning. Some cephalometric analysis programs cannot be used due to the high cost and inability to use all the facilities due to the sanctions. CephNinja® is an available program for cephalometric analyses. The aim of this study is to evaluate the reliability and accuracy of the CephNinja® program for orthodontic cephalometric tracing and compare it with the common manual method in Iranian society.

This cross-sectional study included 100 lateral cephalometric radiographs prepared by the 3D Promax device; The patient's teeth were selected to be in maximum intercuspation and the patient's head was in natural head posture. In every 100 lateral cephalometric radiographs, 24 landmarks were identified and then 20 desired variables were measured by traditional manual method based on Steiner's analysis. Also, the digital file of the same 100 lateral cephalometric radiographs was entered into the CephNinja® software (version 3.51). Again, 24 landmarks were determined and then 20 desired variables were measured based on Steiner's analysis. The obtained data were entered into the software and compared.

The average ANB was 4.02±3.01 degrees in the traditional manual method and 3.08±4.04 degrees in the CephNinja® method. The average Wits was -1.12±3.90 mm in the traditional manual method and -1.13±4.16 mm in the CephNinja® method. The results show that there is no significant difference in the measurements of the two traditional manual methods and the CephNinja® software.

Based on the current study, it can be concluded that CephNinja® software is reliable and can be used similar to traditional manual method for cephalometric analysis in orthodontic patients.

It has been revealed that major depressive disorder (MDD)is a common and debilitating psychiatric disorder. Dysfunctional enzymes involved in neurotransmission glutamate dehydrogenase (GDH), Glutamine synthetase (GS) and Asparagine synthetase (ASNS) may underlie the pathophysiology of MDD. The present project aimed to explore the effects of Ketamine on GDH, GS and ASNS in MDD patients. This study provides evidence of interactions between ketamine and GDH, ASNS and GS levels in patients with MDD.

Patients with MDD are referred to the psychiatric ward of Shaheed Yahyanejad Hospital for regular follow-up. Patients diagnosed with MDD were based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), structured clinical interviews, as well as the severity of depression based on clinical criteria determined by a specialist physician. Serum samples from MDD patients before and after ketamine administration were taken to examine the changes in GDH, ASNS and GS levels. In this project, 29 patients with MDD therapy were evaluated with ketamine (0.75 mg/kg).

Our study showed that after administrating ketamine, the level of ASNS and Glutamate dehydrogenase GDH in patients with MDD was reduced compared to pre-treatment. However, the level of GS was increased compared to before treatment. The results show that ketamine occurs at the metabolism level in MDD patients. Also, our results demonstrated that GDH, ASNS, and GS levels can be measured to evaluate the effect of Ketamine on MDD patients.

Patient success has improved depression after two months of administrating ketamine. Marginally, more than 80% of patients diagnosed with MDD treated with ketamine showed complete remission. Current results may be helpful in understanding the mechanisms responsible for ketamine’s clinical efficacy.

The performance quality of peripherally inserted central catheter (PICC) by nurses has a direct effect on the improvement of patient care and safety. The aim of this study is to audit the placement and nursing care of PICC in infants.

This cross-sectional study was conducted on 130 PICC procedures in the neonatal intensive care units of Rouhani and Amirkola hospitals in Babol in 2018-2021. All infants who needed PICC placement for any reason were selected. In order to collect the data, the observational researcher-made checklist and the infant demographic characteristics questionnaire were used. The checklist included 44 questions and four parts of nursing care before catheter insertion, hand washing, nursing care during the procedure, and nursing care after catheter placement. The scores obtained from the checklist were classified into conversion percentage and two groups of unfavorable placement (less than 67) and favorable placement (68-100). To confirm its reliability, intraclass correlation coefficient was used (ICC=0.90).

A total of 130 cases of PICC placement and nursing care were audited (Rouhani Hospital 98 cases 75.4%, Amirkola 32 cases 24.6%). In the studied sample, 83 (63.8%) were boys and 53 (43.1%) were diagnosed with prematurity. The most common PICC location was the armpit (42.3%). The percentages of compliance of nursing care before PICC insertion according to the standard (97.43%), hand washing (100%), nursing care during the procedure (87.14%) and nursing care after PICC insertion (94.84%) were favorable. Nurses did not use glasses and ultrasound guidance during PICC insertion; (85.4%) and (90%), respectively.

According to the results of this study, although the quality of PICC insertion and care in three stages was at a favorable level, nurses need training regarding the use of glasses and ultrasound guidance during PICC insertion.

Carpal tunnel syndrome is the most prevalent neuropathy caused by trapping and median nerve compression in the wrist. This study aimed at comparing the effects of minimal incision and double incision in treatment of patients with carpal tunnel syndrome.

This randomized controlled trial was performed in 50 patients with carpal tunnel syndrome attending Shahid Beheshti and Ayatollah Rouhani hospitals in Babol, Iran, candidates for surgery. The patients were divided into two groups using random number table to have either minimal incision (n=25) or double incision (n=25). All patients completed the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) and Visual Analogue Scale (VAS) before and three months after the surgery.

The patients included 40 (80%) males and 10 (20%) females. The mean age of the patients was 51.78±8.22 years old. The mean scores for paresthesia, numbness, pain, weakness, nighttime symptoms and functional status (according to BCTQ), and also mean VAS score significantly reduced after the intervention in both groups (P<0.001). The mean scores for these parameters were not significantly different between the two groups neither before nor after the treatment.

The results of treatment with minimal incision and double incision were not different, but minimal incision is suggested as a selective therapeutic approach due to smaller cut.

The rapid decline in the fertility rate has placed Iran among the countries with “below replacement fertility”, which represents a single-child behavior. Social networks (as one of the components of social capital) have been considered in recent years to understand fertility behaviors and changes in the levels of fertility. This study was conducted to investigate the relationship between social capital and single-child behavior in Iranian women workers.

In a cross-sectional study, 600 female workers were recruited by stratified sampling in health care settings in Babol, a city in northern Iran, in 2018. Data collection tools consisted of a questionnaire for demographic characteristics, fertility behavior, and social capital. Data analysis was performed by SPSS-21 software using Poisson regression and logistic regression at a significance level of 0.05.

In this study, 45% of women were single-child and 54.5% did not intend to be pregnant again. There was a significant relationship between the number of pregnancies and social capital (P = 0.039). Similarly, in women with low social capital, the odds of single-child behavior increased although it was not significant (95% CI: 0.899 - 2.220, OR = 1.41).

The results of this study showed that increased social capital was associated with an increase in the number of pregnancies. Attention to social capital should be taken into account in population planning and policy-making.

The use of assisted reproductive technology (ART) is increasing in the world. The rate, efficacy and safety of ART are very different among countries. There is an increase in the use of intra cytoplasmic sperm injection (ICSI), single fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET).

The objective of this study was to compare pregnancy rate in fresh ET and FET.

In this retrospective cross-sectional study 1014 ICSI-ET cycles (426 fresh ET and 588 FET) from 753 women undergoing ICSI treatment referred to Fatemezahra Infertility and Reproductive Health Research Center in Babol, Iran from 2008 to 2013 were reviewed.

There were no significant differences between biochemical pregnancy rate (23% versus 18.8%, OR 1.301; 95% CI. 95-1.774), gestational sac (95.6% versus 100% in FET, OR 0.60; 95% CI 0.54-0.67), and fetal heart activity (87.2% versus 93.6% OR. 46; 95% CI. 16-1.32) in fresh ET and FET cycles, respectively. P< 0.05 was considered statistically significant for all measures.

Although, the result showed no significantly difference between the fresh ET and the FET cycles, however the embryos are able to be stored for subsequent ART. Therefore, we recommend FET cycles as an option alongside the fresh ET.

Abdominal colic during infancy is a common complaint of parents within the first three months after the child’s birth. As the intestinal microflora in these infants is different from non-colic newborns, we aimed to determine the effects of probiotics on the balance of intestinal microflora and reducing restlessness in infants with colic. This randomized clinical trial was performed on 44 breastfed infants (20-60 days old), with a birth weight of > 2500 g, suffering from colic, based on Wessel’s definition. These infants received 1-5 drops of placebo (label 1) per day for five consecutive days. Afterwards, they were administered 2-5 drops of Lactobacillus reuteri (label2) (17938 DSM) per day for 14 consecutive days. The parents were contacted twice on a daily basis and the duration of cramps and restlessness in infants was recorded and evaluated (IRCT=2014012713489). Among 44 infants, 36 cases completed the study. The mean period of restlessness after 5 days of receiving placebo and L. reuteri was 275±142.8 and 172±88.3 min, respectively (p<0.001). Also, after 14 days of L. reuteri administration, the mean period of restlessness was 106±53.67 min. The results showed that probiotic L. reuteri reduced crying and restlessness duration in infants with colic.

Preterm delivery is a serious problem in pregnancy that its incidence is increasing. It is associated with multiple neonatal and long term complications. The aim of this study was to evaluate the correlation between neonatal outcome and umbilical artery pH in order to predict and prevent the neonatal complications that are most likely to occur if there is acidosis.

This case-control study was performed on 181 preterm neonates (27-37 gestational weeks) with acidosis of pH<7. 1 as a case group and 419 preterm neonates without acidosis as a control group who born at Ayatollah Roohani hospital of Babol during one year. Neonatal complications including admission in NICU، respiratory distress syndrome (RDS)، intraventricular hemorrhage (IVH)، retinopathy of prematurity (ROP)، disseminated intravascular coagulopathy (DIC)، necrotizing enterocolitis (NEC)، bronchopulmonary dysplasia (BPD)، sepsis، and neonatal death were compared and analyzed in both groups.

There was a significant relationship between neonatal acidosis and the complications including admission in NICU (OR=24)، RDS (OR=6. 4)، ROP (OR=8. 5)، also there was a significant relationship between acidosis and sepsis، hypoxic encephalopathy، IVH، DIC and neonatal death (p=0. 001) but no significant relationship was observed between BPD، NEC، and neonatal acidosis.

The results showed that in the case of neonatal necrosis، most neonatal complications following preterm birth are likely to increase.