Journal of Kerman University of Medical Sciences
Volume:26 Issue: 6, Nov-Dec 2019

Oral Health related Quality of Life (OHQoL) as a multi-dimensional concept indicates person’s satisfaction with his/her oral health in terms of various dimensions. This study was carried out to examine impact of oral health on the quality of life of 12 year-old children in Rafsanjan and its relationship with their oral health behaviors.
This descriptive-longitudinal study was conducted on 571 sixth grade elementary students from 8 selected schools of Rafsanjan/ Iran in 2017-18. A three-part questionnaire including demographic characteristics, oral health behaviors and 35 items taken from the standard 35-item OHQoL questionnaire was employed as data collecting tools. Data were analyzed using SPSS-16 Software, one-way ANOVA, independent t- test, and Chi-square at significance level of 0.05.
The mean score of OHQoL index was 30.43±18.1 and there was a significant relationship between the OHQoL index and tooth brushing behavior (P=0.03), tooth brushing duration (P<0.001), using toothpaste (P<0.001), daily and regular snacks consumption (P=0.01), and regular dentist visit (P=0.04); however, this relationship was not significant in terms of dental floss use and frequency of tooth brushing (P>0.05). The highest impact of oral health on children's quality of life was in terms of oral symptoms, functional impairment and emotional health dimensions, respectively.
Despite the optimum mean score associated to oral health-related quality of life, students’ health had been affected in terms of oral symptoms, functional impairment and emotional health and this variable was itself affected by oral health behaviors such as tooth brushing and regular dentist visiting to receive services. Accordingly, planning, implementing and evaluating interventions for other stakeholders, such as families and school authorities, are recommended.

Foodborne infection caused by EnterotoxigenicEscherichia coli (ETEC) and Enteropathogenic Escherichia coli (EPEC) is one of the major health problems, particularly in the developing countries. Therefore, it is vital to identify the origin of food contamination to plan control strategies efficiently.
A total of 219 E. coli isolates from human and calf feces, raw meat, and dairy product samples were screened for virulence genes of ETEC and EPEC pathotypes by duplex-PCR assay. Then, rep-PCR was performed for the pathotypes. DNA fingerprints were analyzed with NTSYS-pc program, and dendrogram was generated.
Among the E. coli isolates, ETEC (6.4%), typical-EPEC (3.2%) and atypical-EPEC (5.5%) were detected. Dendrogram analysis showed two clusters; all human ETEC isolates and one meat ETEC isolate were grouped under cluster A, and all EPEC isolates collected from the four sources along with two animal fecal ETEC isolates and one ETEC isolate from meat products were grouped under cluster B. According to Jackknife analysis, the average percentage of ETEC and EPEC strains that were accurately clustered were 98% and 93.75%, respectively.
Animal source food (ASF) isolates were placed in the same phylogenetic group as calf isolates. Moreover, the positioning of human and animal isolates in two separate groups suggested the genetic diversity between these two groups. Thus, it could be argued that E. coli isolates from animals may be transmitted via meat and dairy products, emphasizing the necessity of applying more accurate standards in the processing of ASFs.

Two main issues that challenge model building are number of Events Per Variable and multicollinearity among exploratory variables. Our aim is to review statistical methods that tackle these issues with emphasize on penalized Lasso regression model.  The present study aimed to explain problems of traditional regressions due to small sample size and multi-colinearity in trauma and influenza data and to introduce Lasso regression as the most modern shrinkage method. Two data sets, corresponded to Events Per Variable of 1.5 and 3.4, were used. The outcomes of these two data sets were hospitalization due to trauma and hospitalization of patients suffering influenza respectively. In total, four models were developed: classic Cox and logistic regression models, as well as their penalized lasso form. The tuning parameters were selected through 10-fold cross validation. Traditional Cox model was not able to detect significance of any of variables. Lasso Cox model revealed significance of respiratory rate, focused assessment with sonography in trauma, difference between blood sugar on admission and 3 h after admission, and international normalized ratio. In the second data set, while lasso logistic selected four variables as being significant, classic logistic was able to identify only the importance of one variable. The AIC for lasso models was lower than that for traditional regression models. Lasso method has practical appeal when Events Per Variable is low and multicollinearity exists in the data.

Dialysis is a process for eliminating extra uremic fluids of patients with chronic renal failure. The present study aimed to determine the variables that influence the survival of dialysis patients using random survival forest model (RSFM) in low-dimensional data with low events per variable (EPV). In this historical cohort study, information was collected from 252 dialysis patients in Bandar Abbas hospitals, Iran. The survival time of the patients was calculated in years from the onset of dialysis to death or until the end of the study in 2016. RSFM was used as the number of events per variable (EPV) was low. The data collected from 252 patients were randomly divided into training and testing sets, and this process was repeated 100 times. C-index and Brier Score (BS) were used to assess the performance of the model in the test set.   In this study, 35 (13.9%) mortality cases were observed. Based on the findings, the mean C-index value in training and testing sets was 0.640 and 0.687, and the mean BS value in training and testing sets was 0.017 and 0.023, respectively. The results of the RSFM revealed that BMI, education, occupation, dialysis duration, number of dialysis sessions and age at dialysis onset were the most important factors. RSFM can be used to determine the survival of dialysis patients and manage low-dimensional data with few-events if the researcher desires to select a nonparametric model.

Nowadays, one of the problems of human beings is drug addiction, which causes individual, economic and social damages. One of the most commonly used substances in parties is ecstasy pills or 3, 4-methylenedioxymethamphetamine (MDMA). This study seeks to assess the effect of curcumin in complications of ecstasy on liver tissue in rats.
48 male Wistar rats in six groups were treated with curcumin (20 µ mol/kg) and MDMA (20 mg/kg) simultaneously and non-simultaneously. At the end of the experiment, blood samples were collected, lipid profile, liver enzymes were measured and morphology of liver was done.
MDMA consumption had adverse effect on lipid profile in comparison to the control group. Treatment of curcumin with MDMA consumption improved this effect of MDMA on lipid profile. Moreover, curcumin treatment concurrent with MDMA consumption increased liver enzymes, whereas consumption of MDMA for 15 days and curcumin treatment in the next 15 days decreased liver enzymes.
Our findings suggest that simultaneous consumption of MDMA and curcumin have a synergistic adverse effect on liver enzymes and liver tissue. It is assumed that MDMA intestinal absorption increased by curcumin. While non-simultaneous treatment of curcumin and MDMA improved undesirable effects of MDMA on liver that is assumed by antioxidant capabilities of curcumin.

Some recent studies have shown that troponin may have a Prognostic value in patients with ischemic stroke. This study seeks to to evaluate the prognostic value of troponin on 3 months mortality and recurrence in patients with ischemic stroke.

In this study 63 patients with ischemic stroke were evaluated. Embolic and lacunar stroke were excluded from the study. In the first 24 hours, serum troponin levels were measured. Patients were evaluated for a three-month period in terms of death and recurrence of stroke, and the results were analyzed using independent t-test and logestic regression.

In this study, 32 (50.8%) were male and the rest were female. Of the 63 patients studied, 8 (12.7%) had an abnormal troponin level. The mean serum level of troponin in patients who had died was 75.52 and patients who did not die was 38.2. This difference was statistically significant (p = 0.013). However, in the regression analysis, this result was not significant. Age (P=0.04) and NIHSS (P = 0.001) had a meaningful relationship with mortality. Of the 53 patients who were discharged, 5 (9.4%) had recurrence after 3 months. The mean serum level of troponin in patients with recurrence was 43.36 ±55.23 and mean serum troponin level in patients who did not relapse was 40.52 ±93.20. This difference was statistically significant (p = 0.54)

Troponin has no prognostic value on three months mortality and recurrence rate in ischemic stroke patients.

We investigated correlation between the retinal nerve fiber layer (RNFL) thickness and the severity of Parkinson's disease (PD).
In this study, the RNFL thickness of 23 patients with Parkinson’s disease (PD) was compared to normal controls (NCs). PD severity was assessed by the MDS-UPDRS (movement disorder society Unified Parkinson Disease Rating Scale) rating scale thoroughly in all parts. RNFL is measured by Ocular Coherent tomography (OCT). Scatter plots were used to evaluate the relationship between disease severity and retinal thickness.
The findings of the study demonstrated that patients with PD had a significantly thinner average RNFL thickness compared with controls (P=0.035). Superior and inferior retinal quadrants were thinnest in PD compared with the healthy group (P=0.021 and P=0.045, respectively). The MDS-UPDRS had a significant reverse correlation with RNFL (r = -0.518, P=0.011) and its temporal quadrant (r = -0.594, P=0.003). Among all parts of MDS-UPDRS scale, Part III had the strongest correlation with OCT findings.
A correlation was found between the severity of the disease and the thinning of RNFL. MDS-UPDRS Part III subscale had the strongest correlation with RNFL thickness. Temporal quadrant RNFL became thinner as Parkinson’s disease severity increased.

Chest X-rays (CXRs) are traditionally performed to determine intra-thoracic injuries in all blunt chest trauma patients in Shahid Bahonar hospital in Kerman. As there are some disadvantages upon CXR and radiation exposure, therefore, this study aimed to evaluate the role of CXR in the diagnosis of intra-thoracic injuries caused by any blunt chest trauma.
This prospective qualitative study was conducted on all patients over 16 years old with blunt chest trauma. Unstable patients with GCS<13/15, RTS<12, dyspnea, intratracheal intubation, pregnancy, intoxication, an accident time longer than 24 hours, patients referred from other centers, and patients who did not agree to participate were excluded. All patients underwent routine CXR and followed up by telephone call 48 hours after admission. Data were analyzed through SPSS version 16.
Of 2850 patients, 1320 cases were encountered and screened using screening tools. Mean age of patients was 31.6±15.6 years. From all, 1022 (67.4%) patients were male. Motor vehicle accident [439 (28.9%)] and motorcycle crash [437 (28.8%)] were the most frequent causes of trauma. The mean accident-visit time was 181.2±72.7 min. There was no trauma-related pathogenic finding in CXRs. None of the patients needed any further emergency treatment.
Some parameters may be used to rule out intra-thoracic injuries, and accordingly, decrease CXR performance. Four areas including physical examination (PE), Revised Trauma Score (R), oxygen saturation (S), and history taking (H), were explained and presented as PERSH criteria. Therefore, there is no need to perform CXR as a standard process of care in stable multiple trauma patients who have negative PERSH criteria.

Schwannoma is a rare benign neural neoplasm derived from Schwann cells of the peripheral nerve sheath. Schwannoma accounts for 25% to 48% of all neoplasm cases in the head and neck region. Oral Schwannoma is an uncommon soft tissue tumor comprising of 1% of all Schwannomas. Tongue is the most common location for oral schwannoma. Occurrence of gingival schwannoma is very rare and less than 10 cases have been reported until now. Oral Schwannoma occurs in the mean age of 43 years. In this report, we present a unique case of Schwannoma in a 12-year-old male child with an enlarged semi-firm nodule on the labial surface of his right mandiular gingiva canine tooth which was provisionally diagnosed as pyogenic granuloma. However, the histopathologic and immunohistochemical evaluation confirmed it as Schwannoma. After the surgery, the patient was kept under regular follow-up and there has been no evidence of recurrence during the last 15 months.

Brucellosis or Malta fever is one of the most common zoonotic diseases in the world. In addition to causing human suffering and dire economic impact on animals, due to the high prevalence of Brucellosis in the western regions of Isfahan province, this study aimed to analyze effective factors in the time of Brucellosis diagnosis using parametric and semi-parametric models and to evaluate the goodness of fit of these models.

This historical cohort study, 412 patients with Brucellosis in Fereydunshahr, Iran who had referred to hospital, rural & urban health centers and physicians' private clinics in Fereydunshahr between 2006 and 2016 were recruited through census sampling. The failure (or event) in this study, was diagnosis of Brucellosis based on positive immunologic tests (2-ME test ≥1:40 and Wright serology ≥1:80). In order to eliminate  confounding variables, effective factors of the time of Brucellosis diagnosis were determined using univariate (P≤0.20) and multivariable (P<0.05) analysis according to Cox semi-parametric model and five parametric models (weibull, exponential, log-logic, log-normal and gompertz) and the best fitted model was identified. Data were analyzed using R software version 3.2.3.

According to the results of this study, occupation (farmer and livestock breeder), place of residence (urban), having a history of direct contact with livestock, simultaneous infection in other family members, and the newness of the disease (vs. recurrence) were identified as predictors of early detection of the disease. 

Despite the researchers' tendency to use Cox method in survival analysis, in this study, according to AIC, “Gopmpertz” parametric model was recognized as the best fitted regression model in the analysis of the effective factors in the definitive time of Brucellosis diagnosis.