reza tabrizi

In order to design better management for anti-diabetic medication, pharmacoepidemiological studies are required to have an update on the drug utilization. Therefore, the present study was performed with the aim of pharmacoepidemiological analysis on utilization of antidiabetic drugs based on PERSIAN cohort data. In this study, 10138 participants were included by baseline data. Use of anti-diabetic medications based on Anatomical Therapeutic Chemical (ATC) code A10 was provided. Quantitative and qualitative variables were illustrated using mean±standard deviation (SD) and frequency (percent). Logistic regression was employed to define associated factors with categorical outcomes. The descriptive analysis showed that 12.3% (n=1249) of the participants had diabetes, while only 5.3% (n=540) of them had utilized anti-diabetic medications. Totally, 94.7% of the participants did not take any anti-diabetic drug, 3% received monotherapy and 2% reported a combination of anti-diabetic medication therapies. Also, the higher ages showed a more chance for use of anti-diabetic medications (40-59 years: OR=3.72, 95% CI: 2.38-5.81; ≥60, OR=5.61, 95% CI: 3.41-9.22).In addition, married and employed participants were more likely to take anti-diabetic medications. Also, having cardiovascular diseases (CVDs), fatty liver and pregnancy were associated with a higher significant chance of using anti-diabetic medications. Less than half of the patients diagnosed with diabetes received anti-diabetic drugs indicating the importance of medication adherence training programs in this group of patients.

Inflammation is the major contributor to the pathophysiology of ischemic stroke (IS). Long non-coding ribonucleic acids (lncRNAs) metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) and tumor necrosis factor and heterogeneous nuclear ribonucleoprotein L-related immunoregulatory (THRIL) have been demonstrated to be up-regulated in inflammation and atherosclerosis. Therefore, we aimed to study the expression profile of these lncRNAs after IS.

This observational case-control study was conducted in Namazi Hospital, Shiraz, Iran. The real-time polymerase chain reaction (RT-PCR) measured the sequential changes in circulating levels of MALAT1 and THRIL on days 1, 3, and 5 after IS. The receiver operating characteristic (ROC) curve analysis was used to estimate the diagnostic and prognostic potential of lncRNAs with the area under the curve (AUC).

In patients with IS, the relative MALAT1 and THRIL expressions were significantly higher than the controls (P < 0.001 and P < 0.01, respectively), on days 1, 3, and 5 after stroke. We showed a significantly increase in lncRNAs expression on day five compared to days 1 and 3 after stroke. Moreover, a positive correlation was detected between MALAT1 expression and time within the first 24 hours after stroke (r = 0.27, P = 0.03). Logistic regression analysis showed a significant positive association between MALAT1 and THRIL and the risk of stroke evolution. We found a potential diagnostic marker for MALAT1 with an AUC of 0.78.

We demonstrated the significant sequential upregulation in MALAT1 and THRIL expression on days 1, 3, and 5 after IS with a significant positive association with the risk of stroke. MALAT1 also significantly correlated with time within the first 24 hours after stroke.

Vaccine hesitancy is a common phenomenon worldwide, leading to delays in the acceptance or refusal of vaccination despite vaccination services being available. Some of the main reasons for vaccine hesitancy include perceived risks, certain religious beliefs, and lack of awareness.

In this descriptive-analytical study, 537 people were evaluated. The data collection tool was two-part inventory: The first part included demographic information, the second part was to measure awareness, attitude and performance. After performing face and content validity, 32 questions, including 10 awareness, 7 attitude and 6 performance questions, were used. The frequency (percentage) was measured for quantitative variables and linear regression was used for qualitative variables.

The results indicated that the mean (± standard deviation) age of the participants was 12.77 ± 30.90 years, and the majority of participants (73%, 394 individuals) were female. The mean scores for knowledge, attitudes, and behaviors were 74.16 ± 74.2, 57.26 ± 50.4, and 16.26 ± 22.4, respectively. The results also showed that variables such as marital status, education, history of COVID-19 infection, and history of vaccination were associated with knowledge. Attitudes towards vaccination were significantly correlated with age, occupation, education, and vaccination history. Factors such as age, education, and history of COVID-19 vaccination were significantly associated with individuals' behaviors towards vaccination (p<0.05).

According to the findings of this study, increasing knowledge, attitudes, and behaviors of individuals play an influential role in encouraging community participation in vaccination. Therefore, it is essential to consider these factors in educational programs to promote COVID-19 vaccination.

Keratinized mucosa width (KMW) has an essential role in peri-implant health. This study aimed to evaluate the impact of KMW on marginal bone loss (MBL) around overdenture-supported dental implants.

In this cohort study, completely edentulous patients received an overdenture with implants in the maxilla and mandible. Two implants were placed in the maxilla and mandible. Ball attachments were used. KMW was measured, and gingival biotype was determined. MBL was evaluated on digital parallel radiographs taken at 12 and 24 months after loading. KMW was the predictive factor, and MBL was the outcome of the study. Data were analyzed using SPSS 21 via Pearson’s correlation test, independent t-test, and Chi-square test (alpha=0.05). 

Eighty implants in 20 patients were studied. The mean KMW was 2.05±0.88 mm. The mean MBL was 1.32±0.46 mm at 12 months after loading, and 1.71±0.49 mm at 24 months after loading. Analysis of the data demonstrated a correlation between MBL at 12 and 24 months after loading with KMW and dental implant diameter (P<0.001).

It appears that narrow KMW may be associated with an increase in MBL in two-implant-supported overdentures. Gingival biotype may play a role in the detrimental effect of narrow keratinized mucosa on MBL.

Multiple studies have investigated the serum concentrations of calcium (Ca) and magnesium (Mg) in preeclampsia, but the results have been contradictory. The objective of this systematic review and meta-analysis was to examine the association between serum calcium and magnesium levels in patients with preeclampsia and those in the healthy pregnancies.

A comprehensive search was conducted in various online databases, including PubMed/Medline, Scopus, Embase, Web of Sciences, and Cochrane library to identify relevant studies on Ca and Mg levels in preeclampsia up to July 2023. Inter-study heterogeneity across the included studies was assessed using the chi-square test and I2 statistic. Pooled effect size (ES) was calculated as weighted mean differences (WMDs) with corresponding 95% confidence intervals (CI).

A total of 76 articles (comprising 92 studies) were included, with a combined sample size of 10,482 participants (preeclampsia: n=3,991; controls: n=6,491). The random-effects model revealed significantly lower levels of calcium (WMD=-0.807 mg/dL, 95% CI: -0.983, -0.632, P<0.01) and magnesium (WMD=-0.215, 95% CI: -0.338, -0.092, P<0.01) in women with pre-eclampsia compared to the control group. However, the overall pooled WMD for calcium and magnesium levels did not significantly change when individual studies were excluded one by one.

This meta-analysis demonstrates that the circulating levels of calcium and magnesium in patients with preeclampsia are significantly lower than those in the control group.

Multiple sclerosis (MS) affects the central nervous system and creates plaques by demyelination of neurons. Several studies have investigated the effect of selective serotonin reuptake inhibitors (SSRIs) on MS clinical courses. The current meta-analysis was conducted to determine the effect of SSRIs on neurological and depressive symptoms of MS disease based on a systematic review and meta-analysis of randomized controlled trials.

We searched the PubMed/Medline, Scopus, EMBASE, Google scholar, Web of Science, and Cochrane Library until June 2023. The effects of SSRI were assessed through indictors such as symbol digit modalities test (SDMT), expanded disability status scale (EDSS), modified fatigue impact scale (MFIS), and Beck’s depression inventory/psychiatric (BDI).

Considering the inclusion criteria, seven articles (including eight trials) were included in this review. The meta-analysis results demonstrated that SSRIs treatments did not have significant effects on indicators of neurological and depressive symptoms, such as SDMT (Weighted Mean Difference (WMD)=-0.87; 95% CI, -7.74, 5.99, P=0.35; I2=0.0%), EDSS (WMD=-0.05; 95% CI, -0.24, 0.14, P=0.62; I2=0.0%), MFIS (WMD=5.29; 95% CI, -18.10, 28.68, P=0.21; I2=0.0%), and BDI (WMD=-0.47; 95% CI, -2.61, 1.67, P=0.67; I2=32.05%) in patients with MS compared with controls.

This study shows that the consumption of SSRIs in MS patients compared to the control group does not bring about a significant change in the indices related to neurological and depressive symptoms. Further meta-analyses are required in order to provide stronger evidence in the future.

Previous studies have demonstrated the strong association of inflammatory cytokines and vitamin D (VitD) deficiency and ischemic stroke (IS) pathogenesis. Due to the negative correlation between long non-coding RNA (lncRNA) Malat1 and pro-inflammatory factors we decided to investigate the associations between Malat1 expression with serum interleukin-1β (IL-1β), and VitD levels in IS patients.

In this cross-sectional study, 63 IS patients were included. We used enzyme-linked immunosorbent assays to evaluate the serum levels of VitD and IL-1β. Malat1 expression was evaluated by the real-time polymerase chain reaction test. The associations between Malat1expression with VitD and IL-1β were analysed with linear regression (Stepwise model) and Pearson’s correlation analysis.

The Malat1 expression was inversely correlated with stroke severity (r=-0.25, P=0.043). Stepwise regression analysis showed a significant positive relationship between VitD level and Malat1 expression (Beta=0.28, P=0.02), and also showed a non-significant negative relationship between IL-1β and stroke severity. VitD level showed a positive Pearson correlation with Malat1 (r=0.28, P=0.023) and a negative correlation with IL-1β (r=-0.29, P=0.018) while it could not detect a significantly negative correlation with stroke severity.

For the first time the associations between Malat1 expression with IL-1β and VitD in IS patients was analyzed. We found a significant positive relationship between VitD and Malat1. This correlation needs to be investigated with a larger sample size to achieve a strong and reliable association between VitD and Malat1.[GMJ.2023;12:e2457]

One of the methods for evaluating scientific productions that has long received attention is citation analysis. Considering the limitations of citation analysis and the proliferation of social media and its importance in the dissemination of research results, there seems to be a need for new indicators, called altmetrics, in addition to the traditional indicators for research evaluation. Therefore, the aim of the current study is to investigate the status of articles in the field of opioid addiction using bibliometric  indicators and altmetrics, as well as to determine the relationship between the citation performance and the altmetrics performance of articles in this field.

This study is a descriptive-analytical study of an applied type, which was carried out using bibliometric and altmetrics methods. The research population includes 16,803 titles of articles in the field of opioid addiction indexed by the Scopus database from the beginning to 2022. The Scopus database and PlumX tool were used for data collection, and Excel and SPSS were used for data analysis.

80.6% of the studied publications were cited. 95% of these publications were mentioned at least once in one of the social media. The results of the research show that statistically, there is a significant and positive relationship between the number of citations and all the altmetrics.

Considering the positive correlation between citation and altmetrics in this study, it can be said that social media can have a positive impact on the number of citation of scientific articles. Therefore, researchers in the field of opioid addiction can use social media and share their works in various social media to get citations for their scientific activities.

The zygomaticomaxillary complex (ZMC)refers to a main buttress in the skeleton of the midface. When open reduction and rigid fixation is selected as the treatment of choice for a ZMC fracture in pediatric patients, several factors such as immature dentition and growth potential of patient should be taken into account. This case report describes treatment of an old ZMC fracture in a 9-year-old child.   

A 9-year-old child was referred due to left ZMC fracture and orbital floor fracture with severe displacement. Open reduction and internal fixation of the ZMC fracture was performed using titanium plates. The orbital floor was reconstructed with a titanium mesh and the maxillary buttress fracture was reconstructed with an iliac crest bone graft. After surgery, the patient had an appropriate recovery and showed stable results.

In a ZMC fracture with considerable displacement and an orbital floor fracture in children, 3-point fixation with titanium plate and reconstruction of the orbital floor are recommended.

Statement of the Problem:

 Alveolar ridge resorption after tooth extraction may interfere with optimal dental implant placement.

This study aimed to compare the marginal bone loss (MBL) and thickness of the buccal aspect of the augmented site in simultaneous versus delayed implant placement following lateral ramus horizontal ridge augmentation in the posterior mandible.

This prospective cohort study was conducted on patients who required horizontal bone augmentation of the posterior mandible using lateral ramus autogenous bone graft. Patients were divided into two groups of simultaneous implant placement (group 1) and delayed implant placement (group 2). Cone-beam computed tomography (CBCT) images were obtained before augmentation, at the time of implant placement, and 10 months later (6 months after implant loading). MBL and thickness of the buccal aspect were evaluated over time.

There were 18 patients in the group 1 and 16 patients in the group 2. Analysis of the CBCT scans demonstrated that the mean MBL was 1.21±0.35mm in the group 1 and 1.08±0.19mm in the group 2, with no significant difference between the two groups (p= 0.19). Thickness of the buccal aspect of the augmented site at the time of implant placement was 1.85±0.20mm in the group 1 and 2.16±0.29 mm in the group 2, with a significant difference (p< 0.001). However, data analysis regarding changes in the buccal plate thickness showed no significant difference between the two groups (p= 0.36).

According to the results of this study, there was no significant difference in M-BL and post-operative changes in the thickness of the buccal aspect of the augmented sites with onlay lateral ramus bone blocks between simultaneous and delayed implant placement.

The efficacy of melatonin in the treatment of patients with coronavirus 2019 (COVID-19) is controversial. This review has summarized the evidence on the efficacy of oral melatonin compared to placebo in patients with mild to moderate COVID-19 infection. We searched four international online databases and all randomized clinical trials (RCTs) that investigated the effects of melatonin compared with the placebo on clinical outcomes, including mortality, discharge time, O2 saturation (SaO2), and c-reactive protein (CRP) levels in patients with COVID-19 infection, were included. The standard random-effects model with hybrid continuity correction was used to pool the risk ratio (RR), weighted mean difference (WMD), and the I2 index to assess the heterogeneity. A total of 272 patients from five RCTs were included. Our meta-analysis showed melatonin compared to placebo, decreased discharge time (WMD=-0.93 days; 95% confidence interval [CI]:-2.94 to 1.07, P=0.36; I2=56.78%) and the risk of mortality (RR=0.72; 95% CI:0.25 to 2.13, P=0.56; I2=0.0%) in COVID-19 patients. Melatonin intake compared to placebo significantly increased SaO2 (WMD=1.38%; 95% CI:0.09 to 2.68, P=0.04; I2=49.82%) and decreased the CRP levels (WMD=-7.24 mg/l; 95% CI:-11.28 to -3.21, P<0.001) in a sensitivity analysis. Our findings showed the efficacy of melatonin compared to placebo in patients with mild to moderate COVID-19 infection.

A 29-year-old female patient was referred to the Department of Oral And Maxillofacial Surgery in Taleghani Hospital of Shahid Beheshti University of Medical Science, Tehran, Iran, in 2019, complaining of increased volume and pain in the posterior mandibular region. Cone-beam computed tomography and multislice computed tomography were performed, and an incisional biopsy was done. The histopathologic examination confirmed the diagnosis of Odontogenic Keratocyst (OKC). Surgical treatment was performed with marsupialization. After a year of follow-up, the resultant small-sized cyst was curetted, and Leukocyte-Platelet‑Rich Fibrin (LPRF) was placed in the bony depression. The significant healing of the lesion was noted on regular follow-up visits with complete resolution at 15 months. This report showed that the application of LPRF might accelerate the healing of soft tissues and bone regeneration with no inhibitory effect on the natural healing process.

Statement of the Problem:

 Marginal bone loss (MBL) is an important factor in dental implant failure. The number of implants may affect MBL.

The aim of this study was to compare MBL in patients who received two or three implants for replacement of three missing teeth in the posterior mandible.

This prospective cohort study evaluated patients who required replacement of three missing teeth in the posterior mandible with dental implants. The patients were assigned to two groups. In the group 1, the edentulous area was restored with two implants and a pontic while three implants were placed for this purpose in the group 2. The MBL was compared between the two groups at 12 and 24 months after loading.

Forty-two implants were studied in group 1 and 36 implants in the group 2. The mean MBL was 0.90±0.12mm in the group 1 and 0.89±0.12mm in the group 2 at 12 months after loading. The mean MBL was 1.00±0.10mm in the group 1 and 0.98±0.10mm in the group 2 at 24 months after implant loading. The mean of MBL was not statistically different between the two groups at 12 months and 24 months (p> 0.05).

It seems that the use of two or three implants for replacement of three missing teeth in the posterior mandible is not associated with an increase in MBL.

Patients' attitudes about their nose changes after orthognathic surgeries. We aimed to evaluate the patient's opinion about nasal change and morphologic changes following orthognathic surgery.

This was a cross-sectional study. The sample was derived from the population of patients who underwent orthognathic surgery in the Oral and Maxillofacial Surgery Department of Shahid Beheshti University of Medical Sciences, Tehran, Iran between 2017 and 2019. Subjects who underwent orthognathic surgery were studied. Subjects filled a modified nose evaluation form before and nine months after orthognathic surgery. For objective assessment, the nasolabial angle, nasofrontal angle, nasofacial angle, tip projection, and tip deviation and alar width were evaluated. Sixty-two patients were studied.

Forty (64.5%) patients did not absolutely like their nose before orthognathic surgeries, two (3.2 %) expressed a little satisfaction, 17(27.4%) answered they liked more or less, and three liked very much. Nine months after orthognathic surgeries, 4 (6.5%) patients did not like their nose, nine patients (14.5%) liked a little, 30 (48.4%) liked more or less, and 19 liked very much. Analysis of the data demonstrated a significant difference in patients' satisfaction with their noses before and nine months after orthognathic surgeries (P<0.001). Patients’ satisfaction nine months after orthognathic surgery was not affected by nasal morphologic changes.

It seems, patients' satisfaction with their nose improved after orthognathic surgeries. Patients' attitude was not associated with nasal morphologic changes.

Candida auris (C. auris) is the first fungal pathogen considered a global health threat. Because, C. auris is associated with multidrug resistance and associated diseases such as diabetes, sepsis, lung and kidney disease. This study investigated the prevalence and mortality of C. auris infection during Covid-19 pandemic.

Databases were searched for peer-reviewed articles published in the English language up to Jan 18, 2022. Heterogeneity across studies was evaluated using Cochrane’s Q test and the I2 index. The pooled point prevalences and their corresponding 95% confidence intervals (CIs) were estimated usingthe random-effects model.

In our meta-analysis, 11 eligible articles were included. The total pooled prevalence estimation of C. auris infection among COVID-19 patients was 13% (95% CI: 8%, 19%). The estimated pooled mortality rate of C. auris infection was 37% (95% CI: 15%, 61%). In terms of specific conditions, the pooled risk of mortality was higher in people with diabetes 65% (95% CI: 0.45%, 83%), in cases with >21 days admission inintensive care unit (ICU) 44% (95% CI: 21%, 0.68%), and after receiving steroids 43% (95% CI: 18%, 69%).

Our study highlights the high prevalence rate of C. auris infection, particularly among people with a history of metabolic disorders.

Statement of the Problem:

 Caffeine intake affects bone metabolism through inhibition of osteoblast proliferation.

This study aims to assess the effect of caffeine consumption on implant stability in the healing period of patients.

A prospective cohort study is designed to assess implant stability in the posterior of the maxilla. Patients were divided into two groups based on daily caffeine intake as group 1 with consumption of 400 mg/daily caffeine or more, and group 2 with consumption of 100 mg/daily caffeine or less. The implant stability was measured by resonance frequency analysis (RFA). The mean implant stability quotients (ISQs) were calculated. RFA measurements were made at 4, 6 and 8 weeks after implant placement.

A total of 102 patients were studied (51 in each group). The mean of ISQ was 43.49± 2.32 in the group 1 and 42.78±2.34 in the group 2 at four weeks after insertion. The mean of ISQ was 50.86±3.06 in group 1 and 51.37±2.44 in the group at six weeks after implant placement. At eight weeks after implant surgery, the mean of ISQ was 56.78±3.77 in the group 1 and 57.84±1.82 in the group 2. The mean of ISQ between the two groups at 4, 6 and 8 weeks after implant placement was not statistically different. (p = 0.13, p = 0.36 and p = 0.08 respectively) The repeated measure test indicated a similar increase in ISQ in various study times in the two studied groups (p =0.47, df=1, F=0.52).

Acquired data suggest that caffeine intake may not have a negative effect on implant stability in the healing period at the posterior of the maxilla.

An aneurysm is defined as a permanent dilation of an artery diameter more than 50% of its typical diameter. The aneurysm of the finger artery is a sporadic disease that divides into true and false types. A Pseudo-aneurysm of the finger artery is more prevalent than a true aneurysm; caused by penetrating trauma. A patient with a true aneurysm of the finger's artery without trauma history is reported. It was removed after proximal and distal control and heparin IV injection. The finger artery was micro-surgically repaired to maintain distal blood flow and prevent finger ischemia and adverse consequences in future trauma.

Dietary patterns play an essential role in vascular diseases; however, the association of specific dietary patterns and the risk of stroke is unknown. We designed the current study to evaluate several dietary patterns and their association with ischemic stroke.

This case-control study was performed on 300 subjects, including 150 cases with ischemic stroke admitted to a tertiary referral center in Shiraz, Southern Iran, and 150 age- and sex-matched stroke-free individuals as controls. Using a 62-item Simple Stroke Food Frequency Questionnaire (SS-FFQ), we collected data regarding the dietary habits of all the participants. We extracted the major dietary patterns via principal component analysis using the varimax rotation technique with Kaiser Normalization. Finally, adherence to dietary patterns among the participants was divided into quartiles. We investigated the association between dietary patterns and ischemic stroke using multiple logistic regression analyses.

One-hundred and fifty ischemic stroke patients (91 males and 59 females, mean age of 63.9±16.04 years) and 150 age- and sex-matched controls (91 males and 59 females, mean age of 61.99±16.04 years) were included. After adjusting five major dietary patterns for vascular risk factors, we found that diets rich in fibers and plant-based proteins (P<0.001) and micronutrients (P<0.001) had a lower odds of ischemic stroke as compared to high-fat proteins (P=0.003) and empty calories (P<0.001) diets, but consuming healthy animal proteins (P=0.115) had no effects on the occurrence of ischemic stroke.

Based on our study, we suggest that fibers and plant-based proteins, and micronutrient diets could reduce the odds of stroke, so public awareness about the effects of different dietary patterns should be raised.

Statement of the Problem: Methemoglobinemia is a potentially life-threatening rare medical condition, which refers to an increase in the level of oxidized form of hemoglobin (methemoglobin). Excessive replacement of hemoglobin with methemoglobin leads to functional hypoxia and even fatal conditions.
The aim of this study was to evaluate the effect of two common local anesthetic agents namely lidocaine and articaine administered for hemostasis during surgery on methemoglobin level.
This prospective cohort study was conducted from January 2017 to December 2019. Demographic data including age, gender, and weight of patients were collected. Sixty patients were randomly divided into three groups (n=20) regarding the local anesthetic agent administered for hemostasis during surgery as lidocaine group (group 1), articaine group (group 2), and control group (no local anesthetic; group 3). The patients were candidates for orthognathic surgery, reconstruction of the maxillary and mandibular atrophic ridges with autogenous grafts, and reconstruction of maxillofacial fractures. The methemoglobin level was measured before surgery and six hours after the initiation of surgery.
The mean age and weight of patients were not significantly different among the three groups (p= 0.891 and p= 0.416, respectively). No significant differences were observed among the three groups regarding the gender distribution (p= 0.343) or type of surgery (p= 0.990). Statistical analysis did not show any significant difference in the mean baseline methemoglobin level among the three groups (p= 0.109). Although the mean methemoglobin values increased in the three groups, paired sample t-test did not show any significant change in the values at six hours after the initiation of surgery compared with baseline in any of the three groups (p= 0.083 for group 1, p= 0.096 for group 2, and p= 0.104 for group 3).
The results demonstrated that administration of lidocaine and articaine plus epinephrine for hemostasis during general anesthesia are equally safe.

The aim of this study was to assess various smile line problems and treatments and to assess the patients’ satisfaction after treatment. This cross-sectional study assessed patients who had smile line problems. Various smile line problems included vertical maxillary excess (VME), muscle hyperactivity, gingival hyperplasia, short lip, bimaxillary protrusion, asymmetric muscle hyperactivity, maxillary canting, and tooth deformity. All patients filled out a questionnaire one year after the procedures for 23 assessments of satisfaction. The level of satisfaction was evaluated using a visual analog scale (VAS): 0-3 dissatisfaction, 4-7 acceptable, and 7-10 desirable.  One-hundred thirty-seven patients were included in this study. The highest level of satisfaction was noted in patients who had tooth deformity, VME with passive eruption, and gingival hyperplasia or passive supra-eruption (7.75±0.46, 7.66±0.72, and 7.50±0.55, respectively). The lowest level of satisfaction was noted in patients who had asymmetric muscle activity, muscle hyperactivity, and VME+ muscle hyperactivity (4.25±0.96, 4.33±0.78 and5.00±1.09, respectively). Patients with soft tissue problems of the smile line may have low 41satisfaction especially when temporary treatments such as botulinum toxin are used for treatment. Surgery of the hard tissues may result in moderate to high satisfaction in patients with smile line problems.

Phytase has a hydrolysis function of phytic acid, which yields inorganic phosphate. Bacillus species can produce thermostable alkaline phytase. The aim of this study was to isolate and clone a Phytase gene (Phy) from Bacillus subtilis in Escherichia coli.

In this study, the extracellular PhyC gene was isolated from Bacillus subtilis Phytase C. After purification of the bands, DNA fragment of Phy gene was cloned by T/A cloning technique, and the clone was transformed into Escherichia coli. Afterward, the pGEM-Phy was transferred into E. coli Top-10 strain and the recombinants were plated on LB agar containing 100 µg/ml ampicillin. The colonization of 1171 bp of gene Phytase C was confirmed by PCR. The presence of gene-targeting in vector was confirmed with enzymatic digestion by XhoI and XbaI restriction enzymes.

The Phytase gene was successfully cloned in E. coli. The result of cloning of 1171 bp Phytase gene was confirmed by PCR assay.

Our impression of this article is that several methods, such as using along with microbial, plant phytase reproduction, or low-phytic acid corn may be the better way from a single phytase.

Intraosseous Arteriovenous malformation (AVM) is a vascular hamartoma with almost 50% of cases occurring in the head and neck. These lesions are of great importance as they may cause massive bleeding during tooth extraction and surgeries.

Case report: 

A 33 year old female complained of swelling and gingival bleeding on the right side of the maxilla and hard palate. The swelling was noticed during pregnancy and the patient underwent a surgical excision 6 months after labor. The specimen was submitted for histological examination. An intraosseous AVM presenting in maxilla was diagnosed.

Although rare, intraosseous AVM may occur. The role of pregnancy and hormonal changes is still controversial. Clinical, radiographic and histological characteristics of AVM should be thoroughly assessed before surgical excision.

Awareness of the prevalence of hepatitis B (HBV) and hepatitis C virus (HCV) infections, as blood transmitted infections, among blood donors can help policymakers improve the guidelines, share experiences, and estimate the blood safety over the country and in
the region. We aimed to determine the prevalence of HBV and HCV infection in Iranian blood donors based on the present published literature.

A meta-analysis was carried out based on the results of an electronic literature search in the international and national databases for all articles published until October 2020. We selected studies that had appropriate sampling and valid statistical analysis as well as proper measurement methods. The heterogenic indices of the studies were determined using Cochran’s (Q) and I-square (I2) tests. According to the heterogeneity results, a fixed or random-effects model was implemented to estimate the pooled prevalence of HBV and HCV. Meta-regression was conducted to explore the suspected sources of heterogeneity.

We included 61 and 58 eligible studies related to HBV and HCV, respectively. The pooled prevalence of HBV was 0.57% (95% confidence interval (CI): 0.47 – 0.67, I2:99.9%) among the blood donors. The range of prevalence rates of HBV was between
0.10% and 2.34% in different areas of Iran. The pooled prevalence of HCV was 0.22% (95% CI: 0.20 – 0.24, I2: 98.64%) in blood donors, which varied between 0.02% and 1.09% in separate locations. Subgroup and meta-regression analyses revealed that the
year of publication, geographical location, and quality of the studies probably generated the heterogeneity.

The prevalence of HBV and HCV decreased steadily in Iranian blood donors during the past two decades. It should be asserted that most of the health policies and safety measures taken in recent years in Iran have been effective and promising

Spindle-shaped lesions, which include a wide range of reactive lesions from malignant to very invasive, are among the most challenging head and neck pathologies. Herein, we report a case of leiomyosarcoma (LMS) of the mandible for which, immunohistochemistry was performed to find out whether it was a primary or a metastatic tumor.

This case report presents a 23-year-old female with a 3-month history of pain and mild swelling in the anterior mandible. Panoramic radiography and cone-beam computed tomography revealed an osteodestructive lesion in the mandible. The tumor was composed of interlacing fascicles of spindle-like cells with pleomorphism, hyperchromatism, and atypical mitotic figures. Immunohistochemical (IHC) staining revealed that the tumor cells were positive for vimentin, smooth muscle actin (SMA), desmin, and P53 and had negative reactivity for estrogen receptor (ER) and S100. The patient underwent hemi-mandibulectomy with immediate reconstruction via a microvascular fibula flap. The patient died 15 months after surgery due to metastasis to the right pleura.

Primary LMS of the jaws is rare and can be confirmed by IHC staining

There is a vast amount of literature on the effects of driver education. However, the evidence has become somewhat fragmented, making it challenging to understand driver education's effectiveness for improving road safety. The current study aimed to provide the efficacy of pre-LDE and post-LDE interventions aimed at improving the safety of drivers (includes crashes, injuries, or secondary outcomes).

The following online databases were searched up to the 21st of February 2020: Web of Science (WOS), Scopus, PubMed, Cochrane library, and other relevant databases. Systematic reviews (SR) and meta-analyses were selected to investigate the efficacy of driving education in reducing crashes, injuries, or secondary outcomes. Two investigators independently conducted the data extraction and used the assessment of multiple systematic reviews (AMSTAR) tool to conduct a quality assessment of each SR identified.

Out of the 229 potential articles, seven SRs were eligible for the current overview of systematic reviews and meta-analyses. This overview showed that pre-and post-license education by people of all ages led to improvements in secondary outcomes, such as performance, self-perceived driving abilities, behind-the-wheel driving performance, and even a small decrease in traffic offenses. However, education was not effective in reducing crashes or injuries, either at the individual or community level.

There was no evidence that driver education is an effective approach to reducing crashes or injuries. This negative result might be due to ineffective teaching methods. To improve road safety, it appears necessary to change the method or content of driving education since the current approaches to driving education do not reduce traffic crashes or injuries.