Journal of Kerman University of Medical Sciences
Volume:26 Issue: 5, Sep-Oct 2019

 This study aimed to assess the fracture resistance of zirconia restorations fabricated with rapid layer (RL group) technique and zirconia computer-aided design/computer-aided manufacturing (zir/CAD/CAM) system (ZC group).

This study evaluated 30 all-ceramic crowns in two groups of 15. After fabricating the metal dies and scanning them by the CAD/CAM scanner, the crowns in RL group were anatomically designed and divided into two parts of the core and the veneering. Each part was milled separately by the machine. The core and the veneering were fabricated and cemented. An index was obtained from the restorations and used for the fabrication of samples in the ZC group. In the latter group, the metal dies were scanned and zirconia cores were milled by the machine. The veneering porcelain powder was then applied. Samples in both groups were cemented over metal dies using a glass ionomer cement. The fracture resistance of the complex was measured by a universal testing machine. Data were analyzed using SPSS software version 16.

The mean fracture resistance of RL and ZC groups was not significantly different (P>0.05). The mode of failure was adhesive in all samples in RL group and cohesive in 85% of samples in ZC group. The remaining samples in ZC group showed a total fracture in the core and the veneering.

 The fracture resistance of restorations fabricated by the zir/CAD/CAM and RL systems is not significantly different.

Production of β–lactamases by enterobacteriacea, especially Klebsiella pneumoniae</em>, is one of the emerging health problems in the world. The purpose of this study was to assess the frequency of bla</em>CTX-M15</sub> gene in K. pneumoniae</em> isolates and determine the molecular diversity of CTXM producing isolates.

In this descriptive cross-sectional study, 100 K. pneumoniae</em> strains were tested for susceptibility to cephalosporins category by using disk diffusion method and the prevalence of bla</em>CTX-M-1, </sub>bla</em>CTX-M-2, </sub>bla</em>CTX-M-9</sub> and bla</em>CTX-M-15</sub> genesin these isolates were determined by PCR method. Eventually, a number of isolates were sequenced and typed using single locus sequence typing (SLST) of bla</em>CTX-M group1</sub> gene. The phylogenetic relatedness of all CTX-M producing isolates was determined using enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR).

The rates of resistance to cephalosporins category were in the following order: cefepime(57%), ceftazidime (54%), cefotaxime (36%), cefoxitine (32%), and ceftriaxone (31%). Of all 100 K. pneumoniae</em> isolates, 31 were harboring CTX-M genes, and the bla</em>CTX-M-15</sub> (77.5%) was the most common of the genes investigated. The results of SLST showed that all of the sequenced isolates were divided into two groups. ERIC-PCR method represented ten different genotypes in CTX-M positive isolates.

The results of this study showed that one of the most important reasons for resistance to cephalosporins is the presence of bla</em>CTX-M</sub> genes. In addition, there was a high genetic variation among bla</em>CTX</sub>-M</sub> genes positive isolates.

 There is a relationship between diseases and the quality of life. Epilepsy is a disease that is unpredictable and uncontrollable and its actions are limited to scattered and brief education. Therefore, this study aimed to investigate the effect of family-centered empowerment program on the quality of life of mothers with epileptic children.

This clinical trial was undertaken on 60 mothers with epileptic children. Thirty mothers with epileptic children participated in family-centered empowerment sessions and 30 mothers with epileptic children served as the control group. Personal information form and quality of life questionnaire were administered at baseline and 75 days after intervention. In order to analyze data, chi-square test, independent t-test, paired t-test, and covariance were used accordingly.

The quality of life between the two groups was not significantly different at the beginning of the study, but it was significantly different 75 days after the onset of the empowerment program. In other words, the family-centered empowerment program had a significantly positive impact on the quality of life of mothers with epileptic children (P = 0.03).

According to the results of this study, the family-centered empowerment program can be considered as a potent alternative in health care system to enhance the quality of life of families with epileptic children.

</strong> Although advances in cancer therapy continue to develop, the overall survival rate is poor for some cancer cases. The search for a new adjuvant strategy is the focus of cancer treatment. There is some evidence suggesting a change in the mechanism of cell function by a change in the content of deuterium in the medium. So, the aim of this study was to investigate the effect of deuterium depleted water (DDW) and deuterium enriched water (DEW) on the cell growth and cytotoxicity of two A549 and HepG2 cell lines.

</strong> TheA549 and HepG2 cell lines were cultured in media at different concentrations of deuterium and different exposure times. Cell proliferation was carried out by trypan blue dye exclusion technique.  The cytotoxicity effects of DEW and DDW were determined by MTT assay on different exposure times (24, 48 and 72 h).

</strong> In this study, DEW acted as a dose- response growth inhibitor at deuterium concentration of 50×103</sup> ppm and greater, while no considerable effect was seen upon short and long term exposures to DDW (31 ppm and 127 ppm deuterium).  Both DEW and DDW at used deuterium concentrations were found not to be toxic on the studied cell lines.

</strong> In conclusion, long term treatment with DEW could inhibit the proliferation of A549/HepG2 cell lines. Therefore, it can be considered as an adjuvant in cancer therapy.

 Preservation of sedation is vital and of great significance to successfully carry out diagnostic-therapeutic procedures in children and researchers believe that it is indispensable to offer a safe medication with appropriate administration in this regard. Hence, the present study aimed at evaluating the efficacy of different doses of submucosal Midazolam to induce sedation in children undergoing diagnostic procedures.

The present study was a clinical trial, in which 99 patients undergoing diagnostic procedures within the age range of 3 months to 5 years were selected and divided into three groups (n=33) of receiving submucosal Midazolam administration with doses of 0.3, 0.4, and 0.5 mg/kg. Then, the onset time of sedation, level of sedation, and duration of drug action were recorded and compared among the three groups.

 In the present study, the level of sedation 30 min after the administration of Midazolam 0.3 mg/kg with the mean value of 2.42±0.83 was significantly lower than that of Midazolam 0.4 and 0.5 mg/kg with the mean values of 3.51±0.62 and 3.36±0.60, respectively (p</em>-value <0.001). However, two doses of 0.4 and 0.5 mg/kg did not differ significantly.

The best sub-mucosal dosage of midazolam for sedation with the least complications for pediatric diagnostic procedures is 0.4mg/kg.

Nowadays, one of the main challenges of the blood transfusion organization is the procurement, distribution, and monitoring of the appropriate use of blood and its products. Therefore, the aim of this study was to investigate the prevalence of Transfusion Transmitted Infections (TTIs) including human immunodeficiency virus (HIV+), hepatitis B virus (HBV+), and hepatitis C virus (HCV+), and also to determine the relationship between the prevalence of Transfusion Transmitted Infections and characteristics of Infected blood donors, which can be useful in the selection of blood donors.

 This retrospective study was conducted on all blood donors in Kerman Province during five years (from March 2014 to February 2019). Individuals whose initial test and supplementary test results were positive, were considered as definitely positive. Chi-square test was used to investigate the relationship between measured factor and outcome. Data were analyzed by SPSS version 20. Statistically significant value was considered at P≤0.05.

After confirmatory tests, it was revealed that 500 cases were infected with one of the three blood-borne viruses of HIV+, HBs+, and HCV+. Considering a 95% confidence interval, the prevalence of HIV+, HBs+, and HCV+ was, 0.0006%, 0.1%, and 0.04%, respectively. There was a significant relationship between the prevalence of infections and age, educational status (P=0.008), and donation status (P=0.007), but there was no significant relationship between the prevalence of infections and gender and marital status (P>0.05).

 The overall prevalence of TTIs among blood donors of Kerman province was 0.14%, indicating that the prevalence of TTIs is very low, it can be due to the appropriate screening of blood donors prior to the blood donation and performing advanced screening approved by the World Health Organization. According to the results, the healthiest blood donors are regular blood donors and those with a history of blood donation.

 The World Health Organization (WHO) considers people over the age of 65 as older adults. These people usually suffer from chronic diseases including Coronary Heart Disease (CHD). Coronary Artery Bypass Grafting (CABG) surgery is a common surgery operated on these patients to increase survival and improve patients’ Quality of Life (QOL); however, previous studies have provided inconsistent results in terms of true benefits of CABG in older adults. We aimed to assess QOL in older adults after CABG.

 In this cross-sectional study, 150 patients over 65 and 150 patients under 65 were contacted for follow-up 10 weeks after CABG. The SF36 questionnaire was used to measure QOL and between-group comparisons were carried out using descriptive statistics.

 Physical functioning, physical role, and the total score of QOL were significantly lower in older patients than the younger patients (p =0.001).

 During the ageing period, different factors such as retirement and physical damages among other factors affect an individual’s actions and moods. In addition, elderlies are usually dealing with several illnesses and consequently take a number of different drugs. This indicates that the quality of life in elderlies does not improve after CABG surgery compared to their younger years.

Expression of granulocyte colony stimulating factor (G-CSF) and its receptors in embryo and endometrium implicates the involvement of this glycoprotein on implantation process. In the present study, we aimed to evaluate the impact of routine use of subcutaneous administration of G-CSF on pregnancy outcomes in intracytoplasmic sperm injection (ICSI) patients.

In this retrospective study, ICSI outcomes were compared between two groups of patients: the first group (n=108) who received subcutaneous G-CSF (300 mcg) two hours before the embryo transfer and the second group (n=110) who did not receive it. Pregnancy outcome was compared between the two groups. P-value<0.05 was considered statistically significant.

There was no significant difference between G-CSF and control groups with respect to the rate of implantation (respectively, 23%vs. 23%, p=0.49), chemical (respectively, 43.5%vs. 50%, p=0.34) and clinical (respectively, 40.7% vs. 46.4%, p=0.23) pregnancy. In logistic regression analyses, subcutaneous G-CSF administration was not associated with clinical pregnancy in both crude and adjusted odds ratios (OR) with 95% confidence interval (CI) (crude OR: 0.8, CI: 0.47-1.36, p=0.4, and adjusted OR: 0.99, CI: 0.48-2.07, p=0.99).

In the present study, subcutaneous G-CSF did not improve pregnancy outcomes in patients undergoing ICSI; therefore, the routine use of this cytokine is not suggested for all patients.

The Knowledge of variations in the lung can help surgeons to control bleeding during pulmonary lobectomy or might be used to reduce post-operative complications. Due to the importance of the knowledge of variations in lungs for clinicians, especially surgeons and radiologists, we report a case with lung lobe and fissure. During the autopsy of a 27-year-old man at the Legal Medicine Organization of Mashhad/ Iran in 2016, lung variations were observed. He was a resident of Mashhad and had died of head trauma. On examining the lungs, three fissures (two complete fissures and one incomplete accessory fissure) and four lobes were observed in the right lung. The left lung had two superior and inferior lobes and two fissures (a complete oblique fissure and an incomplete accessory fissure). Conclusion The knowledge of anatomical variations in the lungs is important for clinicians because otherwise, it might lead to wrong interpretation of X-ray images and CT scans. For example, accessory fissure(s) may alter the pattern of lung collapse and lead to an erroneous diagnosis. Accessory fissure can also be confused with linear atelectasis and pleural scars.

Adrenal myelolipoma is a rare benign tumor that is composed of hematopoietic cells and mature fat. Mostly, these nonfunctioning tumors are distinguished incidentally during autopsy or radiologic investigations. Here, we report a case of 46-year-old man presented with nonspecific abdominal pain for one year, who had right adrenal mass with fat density detected by radiologic investigation. Histopathological assessment of right adrenalectomy specimen revealed the diagnosis of adrenal myelolipoma.

Aluminum phosphide (AlP) is an important fumigant, a commendable and very effective outdoor and indoor insecticide. AlP, locally named “rice tablet”, is widely used to protect rice. As soon as taking a very small amount of an AlP tablet, phosphine vaporizes due to the exposure to the air and affects different kinds of organs. Although, in most cases, clinical history can help making the final diagnosis, analytical tests such as gas chromatographic method in post-mortem specimens and survivors have been developed to measure the level of phosphine and to distinguish between ZnP and AlP poisoning.
AlP poisoning management should be started quickly. In addition to supportive therapy, various antioxidant agents, as candidate protective factors, such as N-acetylcysteine (NAC), melatonin, glutathione, magnesium, β-carotene, and vitamin C and E have also been recommended to decrease oxidative damage and cardiotoxicity due to the limited antioxidant defense systems.
The present study highlights the fact that Antioxidant therapy in severe ALP poisoning confers different survival benefits. This literature review showed that the administration of antioxidant therapy in addition to the supportive treatment may decrease the mortality rate and could be considered in the treatment of acute AlP poisoning in combination with other therapeutic protocols.