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Background: Recurrent aphthous stomatitis (RAS) is a common oral mucosal lesion. Herbal medicine has been explored to treat this condition. This study compared the effectiveness of two oral pastes containing Triamcinolone and Sumac, for the healing, size, and symptomatology of RAS., Methods: This triple-blind randomized clinical trial included 60 patients with minor aphthous ulcers. Participants were informed about the study and provided consent. Exclusion criteria consisted of specific medical conditions and medication use. The patients were divided into three groups and received either Sumac adhesive gel, Triadent oral paste, or a placebo. Ulcer size was measured before and after treatment. The medication was prepared using carboxymethylcellulose-based gel and Sumac powder extract. The study was triple-blinded, and the groups were labelled as A, B, and C. Data analysis was performed using SPSS version 22, employing repeated measurement, student t test, Kolmogorov-Smirnoff, and one-way ANOVA for quantitative data. Statistical significance was set at P ≤ .05., Results: A clinical trial involving 59 participants compared the Sumac, Triadent, and placebo groups. The Sumac group exhibited the shortest healing time, significantly reduced lesion size, and lower Visual Analog Scale scores. Triadent took the longest time to heal ulcers. ANOVA test indicated no significant difference in age and gender distribution., Conclusion: This clinical trial evaluated two oral pastes for treating aphthous ulcers and found that the Sumac group achieved faster healing and reduced lesion size compared to the Triadent and control groups. Sumac shows promise as a treatment option, but further studies are necessary to confirm its efficacy and safety. These favourable results support the use of herbal treatments and suggest their potential for broader utilization in managing diseases such as RAS., Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal associations that could have appeared to influence the work reported in this article., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

One's neurobehavioural and mental health are built during the exact and complex process of brain development. It is thought that fetal development is where neuropsychiatric disorders first emerged. Behavioural patterns can change as a result of neuropsychiatric illnesses. The incidence is rising quickly; nevertheless, providing exceptional care remains a significant challenge for families and healthcare systems. It has been demonstrated that one of the main factors causing the transmission of these diseases is maternal exposure. Through physiologic pathways, maternal health and intrauterine exposures can affect brain development. Our attention has been focused on epigenetic factors, particularly in the gestational environment, which may be responsible for human neurodegenerative diseases since our main mental development occurs during the nine months of intrauterine life. After thoroughly searching numerous databases, this study examined the effect of fat-soluble vitamins, water-soluble vitamins, and minerals and their maternal-level effect on brain development., Competing Interests: Declaration of competing interest The authors have no conflict of interest., (Copyright © 2024 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Objective: To assess the effectiveness of a modified Lichtenstein Repair combined with Herniorrhaphy in reducing postoperative chronic pain and enhancing recovery and quality of life in inguinal hernia patients., Methods: This retrospective study, conducted at the Taleghani training center between January 2021 and February 2023, retrospectively examined 289 hernia surgeries, of which 130 employed a modified Lichtenstein technique. The investigation encompassed a detailed analysis of patient demographics, employed surgical techniques, operative methods with a focus on minimal dissection, and an evaluation of postoperative outcomes., Results: In this study of 289 participants, primarily males aged 60-80 years, the modified technique group demonstrated a notably lower incidence of hernia recurrence (1.5%) compared to the Lichtenstein group (3.1%). Additionally, the modified technique was more effective in reducing postoperative pain, with a significantly lower mean Visual Analogue Scale (VAS) score of 0.15, compared to 0.31 in the Lichtenstein group. This suggests enhanced patient comfort and a potentially quicker recovery in the modified technique group., Conclusion: The modified Lichtenstein hernioplasty technique, characterized by minimal tissue trauma and precise mesh placement, emerges as an effective approach in inguinal hernia repair. It offers significant benefits in reducing postoperative discomfort and chronic pain, thereby enhancing patient recovery and overall quality of life. This method aligns with current surgical trends towards patient-centric and minimally invasive procedures., (© 2024. The Author(s).)

Introduction: Fatigue is a highly prevalent debilitating symptom among patients with multiple sclerosis (PwMS), which markedly affects the quality of life. The present study aimed to evaluate the effect of extended-release fampridine on fatigue in PwMS., Methods: This was a randomized, double-blind clinical trial on 77 PwMS with a complaint of fatigue, aged over 18 years old, randomized to extended-release fampridine (n = 44) or placebo (n = 35) for 12 weeks. Fatigue and motor function were assessed at baseline and end point., Results: A total of 88 patients were recruited, of whom 77 were analyzed. 80.5% were female, with a median age of 38. 87% were diagnosed with relapsing-remitting MS (RRMS) with a median disease duration of 96 months. Fingolimod (37.7%) was considered the most frequently used DMT, followed by ani-CD20s (32.5%). The total median MFIS score was 43.5 and 37 in the fampridine and placebo groups which were not significantly different (p > 0.05). After 12 weeks, the total MFIS improved in both groups compared to the baseline, which was significant in the active group (p = 0.04). However, the final end point total MFIS was still comparable between the two groups (p = 0.11)., Conclusion: The present study revealed a positive short-term effect of extended-release fampridine on MFIS in PwMS. However, this effect was not significantly superior to the placebo., (© 2024. The Author(s) under exclusive licence to Belgian Neurological Society.)

This study investigates the safety and efficacy of 3D-printed polycaprolactone/hydroxyapatite (PCL/HA) scaffolds for patient-specific cranioplasty surgeries, employing liquid deposition modeling (LDM) technology. This research is pioneering as it explores the impact of gamma radiation on PCL/HA scaffolds and utilizes printing ink with the highest content of HA known in the composite. The mechanical, morphological, and macromolecular stability of the gamma-sterilized scaffolds were verified before implantation. Subsequent research involving animal subjects was conducted to explore the effects of sterilized implants. Eventually, three clinical cases were selected for the implantation studies as part of a phase 1 non-randomized open-label clinical trial. It was shown that a 25 kGy gamma-ray dose for sterilizing the printed implants did not alter the required geometrical precision of the printed implants. The implants exhibited well-distributed HA and strength comparable to cancellous bone. Gamma radiation reduced hydrophobicity and water uptake capacity without inducing pyrogenic or inflammatory responses. Personalized PCL/HA substitutes successfully treated various craniomaxillofacial defects, including trauma-induced facial asymmetry and congenital deformities. HA nanoparticles in the ink stimulated significant osteoconductive responses within three months of implantation. Moreover, the results revealed that while larger implants may exhibit a slower bone formation response in comparison to smaller implants, they generally had an acceptable rate and volume of bone formation. This clinical trial suggests the application of a sterilized PCL/HA composite for craniomaxillofacial surgery is safe and could be considered as a substitute for autologous bone., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Bone tissue engineering (BTE) provides the treatment possibility for segmental long bone defects that are currently an orthopedic dilemma. This review explains different strategies, from biological, material, and preparation points of view, such as using different stem cells, ceramics, and metals, and their corresponding properties for BTE applications. In addition, factors such as porosity, surface chemistry, hydrophilicity and degradation behavior that affect scaffold success are introduced. Besides, the most widely used production methods that result in porous materials are discussed. Gene delivery and secretome-based therapies are also introduced as a new generation of therapies. This review outlines the positive results and important limitations remaining in the clinical application of novel BTE materials and methods for segmental defects., (© 2024 IOP Publishing Ltd.)

Background: Coronary artery disease (CAD) is an atherosclerotic disease of an inflammatory nature. Previous studies examining the relationship between triglycerides and high-density lipoprotein cholesterol have highlighted the importance of plasma atherogenic index (AIP) as an important predictor of coronary heart disease. However, due to the lack of adequate information on this topic, this study aimed to investigate the relationship between AIP and coronary heart disease risk., Results: This study included 2,226 women and 1,690 men aged 35-70 years who participated in the Bandar Kong Cohort study and met the eligibility criteria. The data was collected using a checklist and questionnaires, which were designed by experienced individuals. After participants completed a registration form and gave informed consent, face-to-face interviews were conducted by trained experts. The validity and reliability of the questionnaire had been verified by the national cohort team prior to its use. The Ethics Committee of Hormozgan University of Medical Sciences (IR.HUMS.REC.1400.171) approved the study. Data from the initial cohort survey using SPSS software version 25, were analyzed to include several factors, including age, sex, smoking status, body mass index (BMI), physical activity level, socioeconomic status, AIP, systolic blood pressure, and diastolic blood pressure. The prevalence of coronary heart disease was found to be 7.5% higher in people with a BMI of 25 or higher. Also, Individuals with low physical activity had a higher prevalence. Individuals with CAD had significantly higher mean values for the AIP, age, systolic blood pressure, and diastolic blood pressure (0.46, 57.50, 128.43, and 81.10, respectively) compared to those without CAD. Furthermore, patients with CAD had lower years of education (2649.45 and 3.59) than individuals without CAD (P < 0.05). Importantly, our findings showed that AIP increased the odds ratio of coronary heart disease by 1.86 as an independent risk factor., Conclusions: Based on our investigation, the AIP is a valuable and independent predictive risk factor for coronary artery disease. This index can be utilized effectively due to its accessibility and affordability, making it a promising tool for risk assessment in clinical settings., (© 2024. The Author(s).)

Background and Objective: Multiple sclerosis (MS) is a chronic progressive autoimmune disorder of the central nervous system (CNS) that can cause inflammation, demyelination, and axon degeneration. Insulin-like growth factor-1 (IGF-1) is a single-chain polypeptide mainly synthesized in the liver and brain. IGF-1 causes neuronal and non-neuronal cell proliferation, survival, and differentiation. Therefore, it can be used in treating neuro-demyelinating diseases such as MS. The current systematic review and meta-analysis aims to compare the levels of IGF-1 in MS patients and healthy controls and also investigates IGF binding proteins (IGF-BP) and growth hormone (GH) levels between MS patients and healthy controls., Methods: In this study, we systematically searched electronic databases of PubMed, Scopus, Web of Science (WOS), and Google Scholar, up to December 2022. Studies that measured IGF-1, GH, IGFBP-1, IGFBP-2, or IGFBP-3 in MS patients and healthy controls in either blood or cerebral spinal fluid (CSF) were identified. We calculated Standardized mean differences (SMD) to compare levels of IGF-1, GH, IGFBP-1, IGFBP-2, or IGFBP-3 in MS patients and controls., Results: Finally, we included 11 eligible studies from 1998 to 2018. The sample size of included studies varied from 20 to 200 resulting in a total sample size of 1067 individuals, 531 MS patients, and 536 healthy controls. The mean age of the patient and control groups were 38.96 and 39.38, respectively. The average EDSS among patients was 4.56. We found that blood levels of IGF-1 (SMD = 0.20, 95% CI = -0.20 to 0.59, I2 = 82.4%, K = 8, n = 692), CSF level of IGF-1 (SMD = 0.25, 95% CI = -0.06 to 0.56, I2 = 0.0%, K = 3 n = 164) and blood levels of GH were not significantly higher in MS patients than controls (SMD = 0.08, 95% CI = -0.33 to 0.49, I2 = 77.0% K = 3, n = 421). Moreover, the blood levels of IGFBP-1 (SMD = 0.70, 95% CI = 0.01 to 1.40, I2 = 77%, K = 4, n = 255) were significantly higher in MS cases than in controls. However, the blood levels of IGFBP-2 (SMD = 0.43, 95% CI = -0.34 to 1.21, I2 = 64.2%, K = 3, n = 78) and blood levels of IGFBP-3 (SMD = 1.04, 95% CI = -0.09 to 2.17, I2 = 95.6%, K = 6, n = 443) were not significantly higher in patients than controls., Conclusion: Our meta-analysis revealed no significant difference in serum levels of IGF-1, GH, IGFBP-2, and IGFBP-3 between the MS group and healthy controls, except for IGFBP1. However, our systematic review showed that the studies were controversial for IGFBP-3 serum levels. Some studies found an increase in serum level of IGFBP-3 in MS patients compared to the healthy group, while others showed a decrease., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Yaghoobpoor et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Low number of circulating tumor cells (CTCs) in the blood samples and time-consuming properties of the current CTC isolation methods for processing a small volume of blood are the biggest obstacles to CTC usage in practice. Therefore, we aimed to design a CTC dialysis system with the ability to process cancer patients' whole blood within a reasonable time. Two strategies were employed for developing this dialysis setup, including (i) synthesizing novel in situ core-shell Cu ferrites consisting of the Cu-CuFe 2 O 4 core and the MIL-88A shell, which are targeted by the anti-HER2 antibody for the efficient targeting and trapping of CTCs; and (ii) fabricating a microfluidic system containing a three-dimensional (3D)-printed microchannel filter composed of a polycaprolactone/Fe 3 O 4 nanoparticle composite with pore diameter less than 200 μm on which a high-voltage magnetic field is focused to enrich and isolate the magnetic nanoparticle-targeted CTCs from a large volume of blood. The system was assessed in different aspects including capturing the efficacy of the magnetic nanoparticles, CTC enrichment and isolation from large volumes of human blood, side effects on blood cells, and the viability of CTCs after isolation for further analysis. Under the optimized conditions, the CTC dialysis system exhibited more than 80% efficacy in the isolation of CTCs from blood samples. The isolated CTCs were viable and were able to proliferate. Moreover, the CTC dialysis system was safe and did not cause side effects on normal blood cells. Taken together, the designed CTC dialysis system can process a high volume of blood for efficient dual diagnostic and therapeutic purposes.

This study is focused on the importance of nanohydroxyapatite (nHA) particle morphology with the same particle size range on the rheological behavior of polycaprolactone (PCL) composite ink with nHA as a promising candidate for additive manufacturing technologies. Two different physiologic-like nHA morphologies, that is, plate and rod shape, with particles size less than 100 nm were used. nHA powders were well characterized and the printing inks were prepared by adding the different ratios of nHA powders to 50% w/v of PCL solution (nHA/PCL: 35/65, 45/55, 55/45, and 65/35 w/w%). Subsequently, the influence of nHA particle morphology and concentration on the printability and rheological properties of composite inks was investigated. HA nanopowder analysis revealed significant differences in their microstructural properties, which affected remarkably the composite ink printability in several ways. For instance, adding up to 65% w/w of plate-like nHA to the PCL solution was possible, while nanorod HA could not be added above 45% w/w. The printed constructs were successfully fabricated using the extrusion-based printing method and had a porous structure with interconnected pores. Total porosity and surface area increased with nHA content due to the improved fiber stability following deposition of material ink. Consequently, degradation rate and bioactivity increased, while compressive properties decreased. While nanorod HA particles had a more significant impact on the mechanical strength than plate-like morphology, the latter showed less crystalline order, which makes them more bioactive than nanorod HA. It is therefore important to note that the nHA microstructure broadly affects the printability of printing ink and should be considered according to the intended biomedical applications., Competing Interests: No competing financial interests exist., (Copyright 2024, Mary Ann Liebert, Inc., publishers.)

Introduction: This study aimed to assess the efficacy of different educational tools for knowledge enhancement of elementary school staff about the management of traumatic dental injuries (TDIs)., Materials and Methods: This quasi-experimental (pretest-posttest) study was conducted on 126 elementary school staff in Qazvin city, who were randomly selected by the cluster sampling in 2020. The baseline knowledge level of the participants about TDIs was assessed by an online questionnaire. Next, they were randomized into the poster, video clip, and no-intervention control groups (56 samples in each group). An informatory poster and a video clip about TDIs were sent to the participants in the first two groups, respectively, through the WhatsApp instant messaging app, and the knowledge level of the three groups was assessed again after 3 weeks. Data were analyzed by ANOVA, McNemar test, chi-square test, and t -test., Results: A significant correlation was noted between the baseline knowledge level of the participants and their educational level, participation in first aid courses covering TDIs, and history of encountering TDIs ( P < 0.05). The knowledge level of the participants significantly increased after the intervention in the poster and video clip groups ( P < 0.05). Knowledge enhancement was 43.26% in the poster and 36.61% in the video clip group ( P > 0.05)., Conclusion: Despite the low-baseline knowledge level of the elementary school staff in Qazvin city about TDIs, their knowledge level significantly improved after the educational interventions., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Mojtaba Salehi Karizmeh et al.)

Objectives: This study aimed to assess the efficacy of a mobile phone application (app) to improve oral hygiene of patients undergoing fixed orthodontic treatment., Materials and Methods: This randomized controlled clinical trial was conducted with a total of 60 patients undergoing fixed orthodontic treatment in two groups: intervention and control (n = 30 each). A previously designed mobile app (Labkhand) was used by patients in the intervention group. Orthodontic plaque index (OPI) and modified gingival index (MGI) were recorded in the two groups at baseline (first session or T0), and after 1 (T1) and 3 (T2) months. The number of debonded/broken brackets was also recorded, and pain score of the patients was assessed at nine time points. Data were analyzed using the χ 2 test, paired t‑test, and repeated measures analysis of variance (ANOVA; α = 0.05)., Results: The two groups demonstrated no significant difference in OPI and MGI at T0 (P > 0.05). OPI and MGI at T1 and T2 were significantly lower in the intervention group than in the control group (P < 0.05). The number of patients with broken brackets in the intervention group was significantly lower than that in the control group (P = 0.017). The two groups reported no significant difference in pain score (P > 0.05)., Conclusion: The Labkhand mobile app successfully improved oral hygiene indices of patients undergoing fixed orthodontic treatment, and decreased the frequency of broken brackets after 1 and 3 months of use., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Objectives: This study aimed to design and implement a mobile phone application (app) aiming to enhance the cooperation and oral hygiene of orthodontic patients., Methods: An orthodontic app named "Labkhand" was designed by a team of orthodontists and programmers according to the needs and scheduled interventions for patients. The aim of this app was to obviate the orthodontic needs of patients by providing educational content in the form of texts and videos, oral hygiene reminders, appointment reminders, and nutrition reminders. It also enabled instant messaging and chatting between patients and dental personnel. In this study, 61 patients were monitored during their orthodontic treatment procedure. All patients were evaluated using a questionnaire with 7 questions before and after a 6-month treatment period. A total of 31 patients were instructed to use the app, while the other 30 patients received treatment without the app. The collected data were analyzed using paired t‑test and analysis of covariance (ANCOVA) test., Results: While the control group's questionnaire score remained almost the same (P > 0.05), the mean questionnaire score of patients in the intervention group significantly increased after using the app compared to the baseline scores acquired before using the app (P < 0.001). The greatest improvement was noted in topics related to "reminding of appointments", "general information about orthodontic treatment", and "oral hygiene maintenance and instructions". "Quality of services" and "patient-orthodontist communication" showed the least improvement in patient satisfaction., Conclusions: The Labkhand orthodontic app has multiple functions and can obviate the needs of orthodontic patients easily and at a low cost., (© 2022. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Objectives: Dental anxiety is a common phenomenon experienced by children in the dental setting. However, there is limited research on the effectiveness of cognitive-behavioral interventions in managing this anxiety. Therefore, the aim of this study was to evaluate the impact of a cognitive-behavioral psychologic intervention on dental anxiety in children. Materials and Methods: A total of thirty children, aged 7-10 years, underwent prophylaxis and fluoride therapy. The baseline anxiety levels of the children were determined using the Modified Child Dental Anxiety Scale (MCDAS). The intervention group (N=15) received two 30-minute sessions of cognitive-behavioral exercises. Additionally, a short film demonstrating a cooperative child undergoing pulpotomy was created and parents were instructed to show it to their children at home. During the treatment session, the exercises were reinforced at each step, and the MCDAS questionnaire was administered again. The children's behavior was also assessed using the Venham Clinical Cooperation Scale. Independent t-test, Mann-Whitney, chi-square, and Pearson's correlation coefficient were used for statistical analysis and P<0.05 was considered statistically significant. Results: Postoperatively, the MCDAS score in the intervention group was significantly lower compared to the control group. Notably, the intervention group demonstrated a downward trend in anxiety scores, while the control group showed an increase (P<0.001). Conclusion: Cognitive-behavioral interventions were found to be successful in decreasing dental anxiety in children undergoing pulpotomy. These interventions can be successfully implemented in clinical settings., Competing Interests: None declared., (Copyright © 2023 The Authors. Published by Tehran University of Medical Sciences.)

Background: The COVID-19 pandemic has significantly impacted global health and presented challenges to maintaining oral health in children. Efficient management and prevention of oral diseases are therefore crucial in this population., Aim: This cross-sectional study aimed to assess parents' self-reported oral and dental hygiene habits for their children during the COVID-19 pandemic., Methods: A total of 256 parents of primary school children in Qazvin completed an online questionnaire containing demographic, general, and cardinal questions. The collected data were analyzed using SPSS 22 software, and accurate analytical tests were run to reach the results., Results: The study found that 69.1% of parents and 87.1% of children brushed their teeth regularly during the pandemic. Additionally, 80.5% of parents monitored their children while brushing. While some parents expressed concerns about COVID-19 infection, parents from lower socioeconomic status reported a higher willingness to attend dental centers than those from more prosperous areas., Conclusion: These findings suggest that parents' supervision and attitude toward oral health care significantly affect children's oral hygiene habits during the pandemic, possibly due to increased time spent together during lockdowns., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Mahdieh Zarabadipour et al.)

Objectives: Due to the emphasis on the protective and antimicrobial role of Nitric Oxide against gastrointestinal diseases, investigating its relationship with dental caries is a right topic. Therefore, this research has investigated the amount of saliva Nitric Oxide in different volumes of DMFT indicator in adults., Material and Methods: In this descriptive- analytical cross-sectional study, 80 participants (20-35 years old), without a history of systemic disease and drug use participated as research samples, (53.8% of the participants in the study were women). Participants were selected from patients who had visited dental Department. The participants were divided in four groups based on DMFT (DMFT=0, 1≤DMFT≤3, 3

Objective: Adolescents are exposed to a wide range of high-risk health behaviors. This study aimed to investigate the high-risk health behaviors of adolescents in an Iranian adolescent population and gender differences., Method: This cross-sectional descriptive study recruited high school students in Yazd city in center of Iran. Schools were randomly selected. In each school, all selected classes were included. Sampling in each class was census. The study investigated self-reported high-risk health behaviors. Students completed the Global School-based Student Health Survey (GSHS), an anonymous, validated questionnaire., Results: 2420 students participated in this study (52.5% male). The age range was 12-19 years. Daily consumption of ≥1 serving of fruit and vegetables per day was reported by 77.4% and 49.5% of respondents, respectively. Adequate physical activity was reported by only 18.4% of adolescents, and significantly less frequently by girls than boys (p < 0.001). 11.8% were current smokers (M/F ratio: 2.6), and 20.5% (M/F ratio: 1.5) were ever used hookah. The prevalence of ever alcohol and substance abuse was 15.5% and 8.8%, respectively. The prevalence of tobacco and substance use was significantly higher in participants' boys than in girls (p < 0.001). Males were over twice more likely to report frequent fighting in the past 12 months than girls. Overall, girls reported more parental supervision than boys (82.1% vs. 73.4%) and parental monitoring (90.6% vs. 86.8%), while boys reported higher levels of awareness over leisure activities than girls (65.8% vs. 58.4%)., Conclusions: High-risk health behaviors are more common in boys than girls. Health policymakers should use these results in prioritizing and designing health interventions to promote youth health. Further studies are recommended to identify the factors influencing the prevalence of these behaviors., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (© 2023 Published by Elsevier Ltd.)

Background: Patients with chronic kidney disease undergoing hemodialysis are often colonized by Candida species with high possibility of fungal infections. The purposes of this study were to determine the prevalence of Candida species, evaluate antifungal susceptibility profile, biofilm formation, proteinase and phospholipase activities, and the frequency of virulence genes in the Candida species isolated from the oral mucosa of hemodialysis diabetic (DM) and non-diabetic (non-DM) patients., Methods: This study identified several species of Candida isolated from 69 DM and 58 non-DM patients on hemodialysis using phenotypic methods and PCR-RFLP technique. The identification of C. albicans and C. glabrata complex was performed by HWP1 gene and four oligonucleotides (UNI-5.8S, GLA-f, BRA-f, and NIV-f), respectively. Antifungal susceptibility to amphotericin B, fluconazole, itraconazole, voriconazole, and caspofungin was assessed according to CLSI M27-A3/S4. The biomass, metabolic activity of biofilm, proteinase (P rz ), phospholipase (P z ), and molecular study for virulence genes were assessed using crystal violet, XTT assay, agar-based hydrolytic enzyme, and PCR technique, respectively., Results: Candida prevalence was 44.9% with 47.8% and 41.4% among DM and non-DM patients, respectively (P = .045). The species identified were C. albicans (49.5%), C. glabrata (16.5%), C. tropicalis (12%), C. kefyr (8.8%), C. parapsilosis (6.6%), C. dubliniensis (3.3%), and C. lusitaniae (3.3%). The antifungal susceptibility profile showed that all Candida isolates were sensitive to amphotericin B, itraconazole, voriconazole, and caspofungin whereas fluconazole resistance was observed in 6.3% (MIC ≥ 64 μg/mL) of C. albicans and 6.6% of C. glabrata (MIC ≥ 64 μg/mL). The susceptible- dose-dependent rate was found in 10.5% of C. albicans. The P rz values of C. albicans ranged from 0.37 to 0.66 for the DM and 0.44-0.73 for the non-DM group (P < 0.05). The non-albicans Candida (NAC) species produced higher degree of biomass and metabolic activity compared to C. albicans (P < 0.05). Furthermore, significant (p < 0.05) correlations were detected between the biofilm formation with P rz values and fluconazole MICs. The most detected virulence factors were ALS3 and Sap5., Conclusions: These results showed the importance of prevalence of NAC species in hemodialysis patients. Investigating antifungal susceptibility profile made a better understanding of the role of virulence markers in the pathogenesis of Candida strains., (© 2023. The Author(s).)

Objective: Vaginal atrophy, the second most common complication of menopause, can lead to sexual dysfunction. This study evaluated the effect of a vitamin D vaginal suppository on sexual functioning in postmenopausal women., Methods: This three-arm randomized controlled trial was conducted between August 2019 and August 2020. The sample comprised 105 postmenopausal women who were referred to comprehensive health service centers to receive postmenopausal care. The inclusion criteria were as follows: (i) being menopausal for at least 1 year, (ii) being married, (iii) being sexually active, and (iv) having sexual desire. Participants were randomly assigned to three groups for 8 weeks of treatment: intervention (vaginal suppository containing 1,000 units of vitamin D3), placebo (vaginal suppository placebo), or control (no treatment). The main outcome measure was sexual functioning, which was assessed using the Female Sexual Function Scale (FSFI) 4 times during the study (i.e., 1 month before the intervention, immediately after the intervention, 1 month after the intervention, and 2 months after the intervention)., Results: Immediately and 1 month after the trial, the intervention group had the highest FSFI score, followed by the placebo group, both of which were significantly higher than those of the control group (P<0.05). At the 2-month follow-up, the intervention and placebo groups had similar FSFI scores (P=0.08), both of which were significantly higher than those in the control group (P=0.001 and P=0.03, respectively)., Conclusion: Vitamin D vaginal suppositories were more effective at improving sexual functioning among postmenopausal women in the short-term and appeared to prevent aging-related sexual functioning decline in the long term.

Background and Purpose: Sexual health means coordination and adaptation of physical, emotional, intellectual and social aspects of human beings. One of the variables that affect sexual function and sexual satisfaction is health literacy. The aim of this study was to investigate the relationship between health literacy level and sexual function in married women in Qazvin health centers., Methods: In the cross-sectional study, 340 married women were selected from four health centers in Qazvin, Iran, in 2020. These selected centers were chosen randomly from 26 health centers. Participants were included in the study by using the proportional selection method based on the sample size of the all health centers. Data collection tools include three questionnaires: demographic information, The Health Literacy Questionnaire (HELIA), and Female Sexual Function Index (FSFI). Data were analyzed using SPSS 24 software. A significance level of P < 0.05 was considered for statistical analyses., Results: The highest and lowest scores of dimension's sexual function are satisfaction, pain, and lubricant, respectively. The level of women's health literacy in Qazvin was inadequate and borderline (56.4%). Each of the sexual function dimensions had significant positive correlations with health literacy (P < 0.001). There was a significant relationship between health literacy level with age, education, and occupation (P < 0.05). According to linear regression analysis, with the increase in years of marriage, sexual function is decreased (P < 0.02)., Conclusion: Health literacy was inadequate in more than half of the study sample and health literacy was significantly associated with sexual function. Educational programs were necessary in order to promote women's health literacy in health centers., (© 2023. The Author(s).)

Ataxia-telangiectasia (AT) is a rare autosomal recessive disorder with no available curative treatment. Although the positive effects of N-acetyl-DL-leucine on cerebellar ataxia have been reported previously, there is little evidence of N-acetyl-DL-leucine's effects in patients with AT. This study assessed the effect of 16 weeks N-acetyl-DL-leucine supplementation on ataxia symptoms in a 9-year-old female with AT. The subject consumed 4 g/day N-acetyl-DL-leucine (2 g in the morning and 2 g in the evening) for 16 weeks. Safety was assessed via clinical blood chemistry prior to the intervention and after 6 and 16 weeks. Additionally, The Scale for the Assessment and Rating of Ataxia (SARA) score was used to assess the drug's effects on ataxia symptoms at baseline, 6, 12, and 16 weeks. Quality of life has also been evaluated by a specialist using the PedsQL questionnaire.Despite some initial (first week only) nausea and constipation, supplementation with N-acetyl-DL-leucine was well tolerated and safe according to blood chemistry measures. The SARA score progressively improved, and by week 16 had improved by 11.0 points (48.88%). Parent and self-reported quality of life assessments indicated physical, emotional, social, and school functions all improved by 16 weeks. Supplementation with N-acetyl-DL-leucine at a dose of 4 g/day for 16 weeks was well tolerated and significantly improved ataxia symptoms and quality of life measures in a young child with AT., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Normal airways are a key factor during the craniofacial growth of the young. Therefore, sleep-disordered breathing (SDB) without treatment can have harmful consequences for development and health., Objectives: This study aimed to evaluate the cephalometric characteristics in non-snoring individuals and snoring subjects, and investigate differences in the pharyngeal airway space between the 2 groups., Material and Methods: This case-control study included 70 patients aged over 18 years, selected from a radiology center. The patients were divided into 2 groups: case (35 patients with a history of habitual snoring); and control (35 healthy patients). The Berlin sleep questionnaire was administered to the parents of the patients. The nasopharyngeal airway was measured according to the analysis of Linder-Aronson (1970), and 4 indices were measured and analyzed in each of the lateral cephalometric radiographs., Results: No statistically significant differences were observed in the pharyngeal measurements between the 2 groups, although all means in the control group were higher than in the experimental group. However, there was a significant relationship between gender and the Ba-S-PNS and PNS-AD2 indices., Conclusions: Although the patients with nocturnal snoring had smaller airway dimensions, their pharyngeal measurements were not significantly different from the control group.

Background: Comparing the net setting time and radiopacity of an Iranian glass ionomer cement (GIC) and Fuji II (GC, Japan) according to ISO 9917-1:2007 standard., Materials and Methods: In this experimental/ in vitro study, for both tests, we prepared 20 samples of Fuji II glass ionomer (self-cure restorative glass ionomer, batch number: 1608031, GC Corporation, Tokyo, Japan) and Iranian glass ionomer (Ava Tajhiz Dandan-Iran) at P/L of 2/7:1. Then, to determine the net setting time, we prepared a metal mold with dimensions of 10 mm in length, 8 mm in width, and 5 mm in height. Ninety seconds after mixing, the surface of the sample was subjected to the indenter, and the net setting time was recorded as the time elapsed between the end of the mixing and the time needle stopped making a complete circular indentation. To determine radiopacity, the specimens were poured into a mold with a diameter of 15 mm and thickness of 1 mm. Samples and a step wedge were irradiated with X-rays. Particle size analysis and Energy-dispersive X-ray spectroscopy (EDS) analysis were also done for both cements. Test results were investigated with SPSS and through independent t -test ( P < 0.05)., Results: The mean value of net setting time for Fuji II was 4.83 min and for the Iranian Glass ionomer was 3.83 min ( P < 0.05). The mean value of radiopacity for Fuji II was 2.3 mmAL and for Iranian Glass ionomer was 1.9 mmAl ( P < 0.05)., Conclusion: Net setting time and radiopacity of the glass ionomers were within the range of ISO 9917-1:2007. If all properties of the Iranian cement are set appropriately in future investigations, we propose to use it instead of Fuji II GIC. This has the additional benefit of being cost-efficient as Iranian cement costs less than Fuji II cement., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or nonfinancial in this article., (Copyright: © 2022 Dental Research Journal.)

Methods: 119 students of third-grade elementary (65 girls and 54 boys) from government and private schools of Qazvin city participated. The dental plaque index of every participant was primarily recorded by Silness and Loe method. Students were trained by a dental student by face-to-face method, and after 2 weeks, dental plaque indices were recorded again for every individual. After index recording and coding, data analysis was done using SPSS version 21., Results: Results showed that the dental plaque index was statistically significantly different before and after training ( p < 0.001)., Conclusion: Based on the results of this study, students' motivation in addition to proper training, can have a significant impact on oral and dental health. Furthermore, this study shows that face-to-face training along with involving the individual in training and learning was seen as quite helpful., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Mahdieh Zarabadipour et al.)

Statement of the Problem: Periodontitis is a multifactorial disease caused by periopathogens and its severity is determined by the host immune response. Gingival crevicular fluid (GCF) can be used for non-invasive testing to assess the host response in periodontal treatment. Pentraxins are the classic mediators of inflammation and pentraxin-3 can be used as a marker to assess response to therapy, which was investigated in this study., Purpose: This study aimed to assess the effect of non-surgical periodontal therapy on GCF level of pentraxin-3 in patients with chronic periodontitis., Materials and Method: 25 patients with chronic periodontitis (CP) and 25 periodontally healthy controls were evaluated. Pocket probing depth, clinical attachment loss, plaque index, gingival index, and bleeding on probing were measured in both groups. GCF samples were collected using paper strips to assess the level of pentraxin-3. In the CP group, GCF samples were collected from the highest clinical attachment loss, pocket probing depth, and bone loss at baseline and six weeks after non-surgical therapy. The level of pentraxin-3 in the GCF was quantified by enzyme-linked immunosorbent assay (ELISA). Data were analyzed using SPSS version 23., Results: Pentraxin-3 in GCF of CP patients before treatment (6.72±4.63 ng/mL) was higher than the control group (4.43±2.85 ng/mL). Pentraxin-3 in patients after non-surgical therapy (3.2±2.66 ng/mL) decreased significantly compared to the baseline ( p = 0.04) and its level after treatment was not significantly different from the control group ( p = 0.14)., Conclusion: Pentraxin-3 in GCF of CP patients was higher than healthy controls and decreased in response to non-surgical periodontal therapy. Thus, it can be used as an inflammatory marker for detection of patients at risk of CP. However, further studies with larger samples and longer follow-ups in different populations are required to confirm our findings., Competing Interests: The authors declare that they have no conflict of interest., (Copyright: © Journal of Dentistry.)

Statement of the Problem: The dilemma of microleakage at the composite-tooth interface is still a major challenge in operative dental practice., Purpose: This study aimed to compare the microleakage of universal adhesive with self-etch and total-etch bonding strategies for restoration of class-II primary molar cavities., Materials and Method: This in vitro, experimental study was conducted on 75 extracted primary molars. Class-II cavities were prepared in mesial or distal surfaces. The teeth were randomly divided into five groups of Adper Single Bond 2 (3M ESPE; St Paul, MN, USA), Clearfil SE Bond (Kuraray Noritake, Osaka, Japan), G-Bond (GC Corp., Tokyo, Japan), G-Premio Bond (GC Corp., Tokyo, Japan) with total-etch mode and G-Premio Bond with self-etch mode. Cavities were also restored with Nano-hybrid resin composite (Grandio, VOCO, Cuxhaven, Germany) and incubated for 24 hours, followed by thermocycling at 1500× between 5-55°C within a dwell time of 20 seconds. Later, the cavities were placed in 1M silver nitrate solution and evaluated under a stereomicroscope. Finally, microleakage was assessed quantitatively and qualitatively. One tooth in each group was prepared and evaluated under a scanning electron microscope (SEM). Data were analyzed using One-way ANOVA, Tukey's post hoc test and Chi-square test ( p < 0.05)., Results: The microleakage values were significantly different in the study groups (p&lt; 0.05). The highest level of microleakage was noted in G-Bond and the lowest in G-Premio Bond with total etching. There was a significant correlation between the qualitative and quantitative measurements of microleakage., Conclusion: The G-Premio Bond yielded acceptable results in terms of microleakage in total-etch and self-etch modes. However, additional etching is recommended to improve the quality of bonding., Competing Interests: The authors declare that they have no conflicts of interests., (Copyright: © Journal of Dentistry.)

Rehabilitation of an edentulous posterior maxilla with dental implants is challenging, and sinus floor augmentation could be considered as an important surgical procedure for bone augmentation in this region before implant placement. Platelet-rich fibrin (PRF) is a new-generation platelet concentrate with simplified processing: its application in sinus floor augmentation has been widely investigated in literature. However, the biological properties and actual efficacy of this product remain controversial. This study assessed the effect of sinus floor augmentation with PRF versus freeze-dried bone allograft (FDBA) on stability of one-stage dental implants. This split-mouth randomized clinical trial evaluated 10 patients who required bilateral sinus floor augmentation. PRF and L-PRF membrane were used in one quadrant while FDBA and collagen membrane were used in the other quadrant. Implant stability was assessed by resonance frequency analysis (RFA) immediately, and 2, 4, and 6 months after implant placement. The implant stability quotient (ISQ) was compared over time and between the two groups using repeated measures ANOVA and independent sample t-test. The mean ISQ significantly increased over time in both groups (p < 0.001). The increase was greater in the PRF group (p < 0.05). Within the limitations of this study, PRF yielded superior results compared with FDBA regarding the stability of one-stage dental implants.

Background: The establishment of a risk-appropriate care approach for pregnant women and newborn infants under the COVID-19 pneumonia is vital to prevent the main pregnancy complications., Objectives and Design: This study reviewed the vertical transmission (VT) potential of COVID-19 pneumonia in pregnant women. Key-related symptoms and adverse clinical outcomes for mothers and infants before and after childbirth were summarized. Some practical therapies and preventive health solutions were also proposed., Results: There was a high susceptibility in pregnant women to COVID-19 infection, especially in the third trimester of pregnancy. The most common symptoms in 22-40-year-old patients infected with COVID-19 were fever (87.6%), cough (52.3%), dyspnea (27.6%), fatigue (22.4%), sore throat (13.5%), malaise (9.4%), and diarrhea (3.4%), respectively. The viral infection led to an increase in preterm labor and cesarean delivery without any intrauterine infection and severe neonatal asphyxia. No infection in the newborn infants was reported despite a high risk of the VT phenomenon. The most important therapies were the reception of antiviral and antibiotic drugs, oxygenation therapy, psychological interventions, and food supplements with health-promoting effects. The best proposed medical strategies to control the COVID-19 infection were bi-monthly screening and following-up the mothers' and fetuses' health, not using the potent broad-spectrum antibiotics and corticosteroids, providing the delivery room with negative pressure for emergency cesarean section, and the immediate isolation of newborns after childbirth without direct breastfeeding., Conclusion: Babies with respiratory problems may be born to some mothers with COVID-19, who have weak immune systems. Thus, the virus transmission cycle should be disrupted to prevent adverse maternal and fetal outcomes by integrating individual health guidelines, efficient medical care therapies, and hospital preventive practices., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Limited resources and the large number of children in need of services in the pediatric intensive care unit (PICU) emphasize the need for effective allocation of resources for improving the outcome of at-risk patients. This study aimed to evaluate and compare the accuracy of PRISM4 and PIM3 systems in prediction of in-hospital mortality of patients admitted to PICU., Methods: The present retrospective cross-sectional study was a diagnostic accuracy study performed on patients admitted to PICU of Qods Hospital, Qazvin, Iran, during one year. Scores of PRISM4 and PIM3 scales were calculated for each patient using the available calculators, and the outcome of patients regarding in-hospital mortality was recorded. Finally, screening performance characteristics of the mentioned scales in prediction of patients' mortality were calculated and reported., Results: 218 patients with the mean age of 40.68 ± 37.92 (2-160) months were studied (57.8% female). There was a significant direct correlation between PIM3 score and duration of stay in PICU (p < 0.0001; r = 0.259), need for inotropic drug administration (p = 0.001), and mortality rate (p = 0.001). In addition, area under the receiver operating characteristic (ROC) curve of PIM3 and PRISM4 in prediction of mortality among patients admitted to the PICU was 0.939 (95%CI: 0.880 - 0.998) and 0.660 (95%CI: 0.371 - 0.950), respectively (p = 0.001). Based on the findings, the best cut-off point for PIM3 scale in prediction of mortality was the score of 4 and it was estimated to be the core of 8 for PRISM4 scale. Sensitivity and specificity of PIM3 scale in prediction of mortality in the cut-off of 4 points were 100.00 (95% CI: 56.09- 100.00) and 81.51 (95% CI: 75.47- 86.38), respectively. These measures were 42.85 (95%CI: 11.80- 79.76) and 98.10 (95%CI: 94.89- 99.39) for PRISM4 model, which indicates the higher sensitivity of PIM3 system in this regard., Conclusion: based on the results of the present study, the accuracy of PIM3 is significantly higher than PRISM4 in prediction of in-hospital mortality among patients admitted to the PICU. It seems that considering the 100% sensitivity of PIM3 in prediction of outcome, this model is a better tool for screening patients who are at risk for in-hospital mortality in order to pay more attention and allocate more resources to improve their outcome., Competing Interests: The authors declare no conflicts of interest in this study.

Background: Familiarity with the anatomy of the arteries in the sinus wall is essential to prevent the perforation of the sinus membrane and bleeding during dental implant surgery., Objectives: The aim of the study was to evaluate the anatomical position of the posterior superior alveolar artery (PSAA), using cone-beam computed tomography (CBCT)., Material and Methods: A total of 245 CBCT scans met the eligibility criteria for this cross-sectional study. The vertical distance from the lower border of the artery to the lower border of the sinus floor, the diameter of the artery, and the type of artery (intrasinusoidal, intraosseous or superficial) in the first and second premolar and molar regions were measured. The data was analyzed with the t tests, the one-way analysis of variance (ANOVA) and the χ2 tests., Results: The maxillary PSAA was recognized in 187 (76.3%) scans. The mean distance between the artery and the floor of the sinus was 6.87 ±3.68 mm. The mean diameter of the artery was 1.37 ±0.61 mm. The greatest mean diameter of the artery was observed in the second premolar region, and the smallest in the first molar region. As many as 63.6% of the arteries were intraosseous, 28.9% intrasinusoidal, and 7.5% superficial., Conclusions: Due to the high prevalence of the intraosseous type, in most cases of sinus lift surgery there is an increased possibility of PSAA damage. As the largest diameter of the artery was observed in the second premolar region, the possibility of severe bleeding during sinus lift surgery in this area is increased. The average distance between the artery and the floor of the sinus was approx. 7 mm. Consequently, it is recommended that the lower border of the sinus access window should be as high as 7 mm to the floor of the sinus.

Renal transplant therapy is essential in patients with End-Stage Renal Disease (ESRD). It is used in patients awaiting a kidney transplant or those who cannot be a transplant candidate. Central venous catheter is one of the most used access routes worldwide but has been recorded as the one with highest mortality and morbidity rate. Thromboembolic events have played a major part for that. This is a descriptive-analytical study, which conducted in a university treatment center in Tehran, Iran. A total of 225 patients were selected for this study that 108 were excluded because of our criteria. Statistical analysis was performed by SPSS v19 and a total of 117 patients were included in this study. The average age of the patients was 51.62±11.26. 79 (67.5%) and 38 (32.5%) patients had medial and lateral tip direction, respectively. The catheter of 85(72.6%) and 32(27.4%) patients was patent and occluded, respectively. The average catheter tip occlusion time in both groups was 22.5 and 7.5 months. Three-month, six-month, twelve-month, and twenty-four-month patency rate were 99%, 94%, 88%, and 30%, respectively. our findings suggest that medial direction of the tip of the catheter reduces complications caused in CVS. Because our study has been conducted in a small scale and there is lack of similar studies, our team suggests extension to a larger scale to confirm or not our results.

Background: Intubation of critically ill patients is one of the increasing emergency procedures. We designed this study to determine age and sex-related mortality rates after emergency intubation., Methods: This retrospective study collected and analyzed non-trauma intubated patients in a referral hospital from the years 2017-2019 and before the appearance of COVID-19. Patients who were intubated outside of emergency by EMS technicians were excluded. We recorded data of intubated patients, like sex, age, length of being intubated and final diagnosis. P values of less than 0.05 were significant., Results: Data of 520 non-trauma intubated patients were collected and analyzed. More than 64% of the patients were over 65 years old and had a higher mortality rate (86.7%; P < 0.001) than younger patients. The overall in-hospital mortality rate was 80%. More than three quarters of the decedents died within a week of intubation (P < 0.001). There was no significant relationship between sex and mortality rate (P = 0.535)., Conclusion: Our data showed that with increased age there was a decrease in the chance of being extubated., Competing Interests: There is no conflict of interest for any of the authors to be mentioned for this manuscript., (© 2021 Elsevier Ltd. All rights reserved.)

Background: This study attempts to evaluate the safety and effectiveness of 50μgm intracervical misoprostol in comparison with intravaginal and sublingual for the induction of labor at term pregnant women., Methods: This study is designed as a parallel clinical trial study. Three hundred and fifteen term pregnancies requiring induction of labor were treated with the maximum used misoprostol intracervical, sublingual, and vaginal doses. Participants were randomly allocated into three groups of 105. The dose was repeated every 4 h until adequate uterine contraction and Bishop Score were achieved. The duration of induction to births, time to the active phase, the rate of births, and the need for caesarean section were compared in three groups. Additionally, labor course and side effects were recorded and analyzed. Data were analyzed using SPSS software. A significance level of p <  0.05 was considered for statistical analyses., Findings: Labor was successfully induced in all cases most (63%) of which required a single dose of misoprostol. Ninety-three (93.0%, p <  0.05) cervical participants proceeded to vaginal births. This figure was also the same in the vaginal and sublingual group of 83 cases (83.0%). The other 41 cases received caesarean section with more indications of failure to progress and meconium-stained liquor. The results indicated that 278 (92.7%) births were achieved in less than 10 h. Time from start of medication to the active phase of labor and childbirth was 3.01 ± 0.86 and 6.1 ± 1.3 h in the Cervical group, 4.2 ± 0.66 and 8.4 ± 0.92 h in the sublingual group, and 5.06 ± 1.1 and 9.2 ± 1.5 h in the vaginal group respectively (p < 0.001). The Caesarean rate was lower in the cervical group than in the two other groups (p = 0.05). No significant differences were observed between the study groups in terms of Apgar score and meconium-stained amniotic fluid. Furthermore, no maternal and neonatal complications were observed., Conclusion: In addition to the sublingual and intravaginal routes of administration, intracervical misoprostol at a single dose of 50μgm appears to be an effective method for induction of labor in women with an unfavorable cervix. Like all medical interventions, a discussion of the risks, benefits, and alternatives to induction of labor with this medication in each woman should be undertaken before treatment., Trial Registration: This clinical study was approved by the Iranian Registry of Clinical Trials with IRCT ID: IRCT20190415043278N1 . Registration date was on May 13, 2019 and May 27, 2019 respectively ( http://www.irct.ir )., (© 2021. The Author(s).)

Freezing in charged porous media can induce significant pressure and cause damage to tissues and functional materials. We formulate a thermodynamically consistent theory to model freezing phenomena inside charged heterogeneous porous space. Two regimes are distinguished: free ions in open pore space lead to negligible effects of freezing point depression and pressure. On the other hand, if nanofluidic salt trapping happens, subsequent ice formation is suppressed due to the high concentration of ions in the electrolyte. In this case our theory predicts that freezing starts at a significantly lower temperature compared to pure water. In one dimension, as the temperature goes even lower, ice continuously grows until the salt concentration reaches saturation, all ions precipitate to form salt crystals, and freezing completes. Enormous pressure can be generated if initial salt concentration is high before salt entrapment. We show modifications to the classical nucleation theory due to the trapped salt ions. Interestingly, although the freezing process is enormously changed by trapped salts, our analysis shows that the Gibbs-Thompson equation on confined melting point shift is not affected by the presence of the electrolyte.

Purpose: Trichomonas tenax (T. tenax) is a commensal flagellated protozoan found in periodontal microenvironment of the oral cavity, with a possible role in periodontal diseases. The purpose of the present systematic review and meta-analysis was to determine the worldwide prevalence of T. tenax infection and to show the neglected association of this parasitic infection with oral diseases., Methods: To find literatures published until August 2020, five English databases (PubMed, Scopus, Science Direct, Web of Science and Google Scholar) were explored. Finally, 65 papers were qualified to be included in the current study., Results: Our results revealed a global pooled prevalence of 17% (95% CI 14-22%) for T. tenax infection. The highest prevalence was estimated at 56% (42-69%) in Chile, while the lowest prevalence was related to Kenya with 3% (1-6%). The age-based analysis found that the infection was most common in 46-55 mean age group with 15% (0-100%). The overall prevalence regarding culture method, molecular method and direct method was 21% (12-32%), 19% (8-35%) and 17% (12-23%), respectively. Moreover, the subgroup analysis showed the pooled prevalence in patient with candidiasis [22% (3-52%)], gingivitis [21% (9-36%)] and periodontitis [27% (10-48%)]., Conclusion: Our study specified a connection between T. tenax protozoa and periodontitis disease. However, more epidemiological studies as well as clinical trials are needed to precisely identify this relation., (© 2021. Witold Stefański Institute of Parasitology, Polish Academy of Sciences.)

Microwave-assisted extraction (MAE) is an emerging technology to obtain polysaccharides with an extensive spectrum of biological characteristics. In this study, the hypoglycemic, hypolipidemic, prebiotic, and immunomodulatory (e.g., antiinflammatory, anticoagulant, and phagocytic) effects of algal- and plant-derived polysaccharides rich in glucose, galactose, and mannose using MAE were comprehensively discussed. The in vitro and in vivo results showed that these bioactive macromolecules with the low digestibility rate could effectively alleviate the fatty acid-induced lipotoxicity, acute hemolysis, and dyslipidemia status. The optimally extracted glucomannan- and glucogalactan-containing polysaccharides revealed significant antidiabetic effects through inhibiting α-amylase and α-glucosidase, improving dynamic insulin sensitivity and secretion, and promoting pancreatic β-cell proliferation. These bioactive macromolecules as prebiotics not only improve the digestibility in gastrointestinal tract but also reduce the survival rate of pathogens and tumor cells by activating macrophages and producing pro-inflammatory biomarkers and cytokines. They can effectively prevent gastrointestinal disorders and microbial infections without any toxicity., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Trichomoniasis is a sexually transmitted infection (STI), caused by the protozoan parasite, Trichomonas vaginalis. Female sex workers are intensely affected by the infection, since they have frequent direct physical contact. The current systematic review and meta-analysis represents the global prevalence of T. vaginalis in female sex workers. Five databases (Science Direct, Scopus, PubMed, Web of Science, and Google Scholar) were explored for literatures that published from July 1985 to June 2020. Totally, 85 studies (54,515 participants) from 46 countries met the inclusion criteria. The global pooled prevalence of T. vaginalis was 16% (95% CI 13-19%). The estimated pooled prevalence based on methods including wet mount, culture, and molecular techniques was 15% (95% CI 12-19%), 16% (95% CI 10-24%), and 22% (95% CI 13-32%), respectively. Moreover, the infection was most prevalent at the mean age of 30-36 (20%, 95% CI 11-30%). Regarding the World Health Organization (WHO) regions, the highest pooled prevalence was estimated to be in the African region (23%, 95% CI 7-46%). In addition, we indicated that countries with low-income level have the highest pooled prevalence (23%, 95% CI 14-34%). Our results revealed that the worldwide prevalence of T. vaginalis was significant in female sex workers. Therefore, considering a precise strategy such as a health education program with regard to safe intercourse is needed to increase knowledge and prevent T. vaginalis infection in sex workers.

Background: Recurrent aphthous stomatitis (RAS) is one of the most common oral mucosal diseases which are diagnosed with recurrent and painful ulcers. The possible association between psychological factors and salivary stress related factors in patients with aphthous ulcers has been discussed in various studies. The aim of this study was to evaluate salivary cortisol level, anxiety, and depression in patients with RAS., Materials and Methods: In this case control study, 30 patients with RAS and 30 healthy individuals were enrolled by matching their age and sex. Anxiety and depression were assessed by beck anxiety inventory and beck depression inventory. Unstimulated saliva of both groups were collected and then tested by DiaMetra kit and the ELISA method. Data were analyzed by SPSS using an Independent t -test and Mann-Whitney test. A statistical significance level of <0.05 was considered., Results: The mean salivary cortisol in the case group was 5.35 ng/ml and in the control group was 4.73 ng/ml which was not statistically significant ( P > 0.05). There was no significant difference in anxiety and depression level between the two groups ( P > 0.05). According to Spearman correlation coefficient, there was an average, negative, and significant correlation between salivary cortisol and anxiety and depression scores in the case group ( P < 0.05)., Conclusion: This study shows that, although the mean salivary cortisol was slightly higher in patients with aphthous lesions, anxiety, and depression were not possible factors for RAS. There was a moderate, negative correlation between salivary cortisol level and stress and anxiety in patients with RAS., Competing Interests: The authors of this manuscript declare that they have no conflicts of interest, real or perceived, financial or non-financial in this article., (Copyright: © 2021 Dental Research Journal.)

Diabetes mellitus is a well-known dangerous factor for cardiovascular disease with high rate of comorbidities. Patients suffering from this disease have represented more heart failures which is entangled with Ischemic heart disease or high blood pressure. Thus, depending on the recent scientific facts, diabetes mellitus as a separate factor which is independent from CAD, Arterial blood pressure or other factors, is claimed to culminate in advance heart failure. Previous studies have concentrated on the impacts of diabetes and prediabetes on the performance of the left ventricular which leaves right ventricular uncovered. Consequently, the aim of this article is to analyze and compare the systolic and diastolic function of the right ventricular in normal patients and the ones with diabetes and prediabetes without any coronary artery disease., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Nowadays, due to the increasing number of adult orthodontic applicants, who also have multiple dental restorations, it is important to have the ability to bond an orthodontic appliance to restoration surfaces., Objectives: The aim of this paper was to determine the shear bond strength of ceramic brackets of 3 different base designs bonded to amalgam and composite restorations after using different surface treatment methods in vitro., Material and Methods: In an in vitro study, the surfaces of 180 amalgam and composite specimens were prepared by using sandblasting and the erbium, chromium-doped yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser irradiation. Ceramic brackets of 3 base designs, including Star, Cross and Slot, for upper central teeth were bonded to amalgam and composite surfaces by using Transbond™ XT Light Cure Adhesive. All specimens were incubated at a temperature of 37°C for 1 week, and then subjected to shear bond strength tests after 1,000 cycles of thermal cycling. The bond strength of the groups was analyzed by means of the one-way and two-way analysis of variance (ANOVA), and the comparison of the 2 groups was made with Tukey's test. Residual adhesives were also determined by a 4-part criterion (0-3) in different groups and the results were analyzed with the χ2 test., Results: There was a significant difference in the shear bond strength of brackets of 3 base designs bonded to amalgam and composite surfaces with different surface treatment., Conclusions: According to the results of this study, all surface treatment methods and different bracket base designs were able to provide sufficient shear bond strength on composite and amalgam surfaces. As far as the bracket base design is concerned, the use of each of the 3 base designs in the amalgam group brought desirable results in terms of the adhesive remnant index (ARI) and shear bond strength values; the use of the Star base design in the composite group proved to be suitable.

Background: Oral aphthosis is a painful ulceration of mucus membranes characterized by round or oval lesions with central necrosis and erythematous haloes. Due to unknown etiology, treatment is highly controversial and based mainly on individual experience. The aim of this study was to investigate the safety and efficacy of topical penicillin 6.3.3 for the treatment of recurrent aphthous stomatitis., Materials and Methods: This randomized, double-blind, controlled clinical trial was done in Shahid Sadoughi Hospital Clinic in Yazd (2011-2012). Fifty patients aged 15-45 with recurrent oral aphthosis were randomly divided into two groups. After obtaining informed consents, patients in the case and control groups were treated (four times/day for a week), respectively, by topical penicillin 6.3.3 powder and placebo in similar vial. The patients who had acute-onset oral aphthae (≤48 h of appearance) with diameter ≥5 mm were included. History of sensitivity to β-lactam antibiotics and cephalosporin; spontaneous recovery during <5 days in previous episodes; concurrent systemic, infectious, or any autoimmune disorders; history of taking drugs (local or systemic) from 2 weeks prior to presentation; alcohol or drug abuse; smoking cigarette or tobacco; and poor compliance were exclusion criteria. Patients were examined in days 0, 3, 6, and 8. The main outcome measure was reduction in the median pain. Burning, pain, erythema, and inflammation were recorded as complications., Results: Of 25 patients receiving penicillin, 13 were female and 12 were male. Regarding the pain score (mean difference = 1.6 vs. 0.88, P = 0.012) and size of aphthus (mean difference = 9.43 vs. 1.24, P = 0.008), patients who received penicillin had significantly better results than the placebo group on day 8 after the treatment. The mean duration to healing was 3 days for penicillin group and 6 days for placebo group ( P = 0.016). No topical or systemic adverse effects were observed., Conclusion: Our study showed a dramatic response to topical penicillin with respect to placebo. Hence, it seems that penicillin could be a safe and effective option in managing oral aphthosis., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Research in Medical Sciences.)

Background: Mercury (Hg) in dental amalgam is the world's hidden source of mercury contamination. The development of more eco-friendly and cost-effective adsorbents to reduce mercury pollutants in wastewater is highly desirable and is still a major challenge. In this study, a novel nanocomposite was synthesized and used as an efficient adsorbent for the removal of Hg(II) ions from aqueous solution., Methods: A green and cost-effective method was described to the synthesis of SnO 2 -ZnO-eggshell nanocomposites using teucrium polium extract as a renewable reductant and mild stabilizer. The biosynthesized nanocomposites were characterized by various techniques. The novel SnO 2 -ZnO-eggshell nanocomposites were used as an effective adsorbent in the removal of mercury (II) ions. To achieve the maximum absorption efficiency of Hg(II) ions, the effect of operating factors such as pH value, the dose of catalyst, the initial metal concentration of Hg(II) ions, and catalyst type were evaluated., Results: The removal percentage and adsorption capacity of Hg(II) were obtained 99.15% and 396.6 mg.g - 1, respectively, under optimal conditions after 5 minutes. The selectivity of SnO 2 -ZnO-eggshell nanocomposites for the adsorption of metal ions was studied, and the highest selectivity was obtained for adsorption of Hg (II) ions. Furthermore, the SnO 2 - ZnO-eggshell nanocomposites could be recovered and reused at least three times without considerable loss of their efficiency., Conclusions: The present approach has advantages such as rapidity, simplicity, selectivity, low cost and, most importantly, the use of nanocomposites containing a bio-waste material of eggshell for removal of Hg(II) ions from aqueous solution., Competing Interests: Conflict of interestAll authors declare that they have no conflict of interest., (© Springer Nature Switzerland AG 2020.)

Coagulase-negative staphylococci (CoNS) are recognized as comprising the main part of human normal microbiota and are rarely associated with severe and intensive infections. However, these organisms can cause a number of infections in humans, especially immunocompromised patients and neonates. Bacterial meningitis, as an important and acute infection in the central nervous system, is still a major global health challenge and a serious infectious disease, causing a high rate of mortality and morbidity. CoNS as causative agents of meningitis are generally related to trauma or direct implantation of foreign bodies and the presence of a cerebrospinal fluid shunt. Numerous epidemiologic and clinical studies have shown that different CoNS isolates such as Staphylococcus capitis, Staphylococcus lugdunensis, Staphylococcus hominis, Staphylococcus epidermidis, Staphylococcus schleiferi, Staphylococcus saprophyticus, Staphylococcus warneri and Staphylococcus haemolyticus are more frequently associated with meningitis. This study attempts to determine the role of CoNS in meningitis and reviews the reported cases of meningitis induced by CoNS from the year 2000 to 2020 in the literature., (© 2020 The Authors.)

Background: Menopause is associated with changes in sexual function which are partly due to vaginal atrophy in response to estrogen reduction. Estrogen administration temporarily reduces the symptoms of vaginal dryness, but long-term exposure to this drug is likely to be associated with serious complications. Considering the promising results of previous studies concerning the effect of vitamin D on vaginal dryness, the proposed study will investigate the effect of vitamin D vaginal suppository on the sexual function of postmenopausal women., Methods: In a randomized, controlled clinical trial, 105 postmenopausal women will be randomly assigned to three groups receiving vitamin D vaginal suppository, placebo vaginal suppository, or control (no intervention). Vitamin D vaginal suppositories contain 1000 units of vitamin D3. The timing of the use of vitamin D vaginal suppositories and placebo suppositories will be every night in the first 2 weeks, and every other night in the following 6 weeks (8 weeks in total). The primary outcome will be the sexual function of participants which will be assessed using the Female Sexual Function Index (FSFI) before and immediately after the intervention, and at 1 and 2 months after the end of the intervention. The side effects of these suppositories will be examined as a secondary consequence of the study. Data will be analyzed using SPSS software version 25. In the case of normal distribution of data, the mean score of sexual function will be compared between the groups using a repeated measurements ANOVA. If statistical analysis leads to significant results, the post-hoc test will be used to determine the differences between the groups. Comparison of demographic and fertility characteristics of the women will be carried out using statistical tests such as chi-squares and t-tests. A significance level of p < .05 will be used for statistical analyses., Discussion: If vitamin D vaginal suppositories improve sexual function among premenopausal women with long-term effects and minimum side effects, the suppositories will be considered a safe complementary and alternative choice for alleviating sexual dysfunction among this group., Trial Registration: IRCT20180704040346N1 at 2018-10-13 prospectively registered.

Introduction: The aim of this study was to evaluate some virulence factors in Candida albicans isolates from patients with onychomycosis and determine the correlation between these factors and the antifungal resistance profile., Methods: Seventy species of C. albicans were confirmed using polymerase chain reaction amplification of the HWP1 gene. According to the Clinical & Laboratory Standards Institute guidelines, the susceptibility profile of four antifungal agents was investigated, and the production of aspartyl protease, phospholipase, haemolysin, and biofilm was determined. The correlation between these profiles was also investigated., Results: The isolates indicated different levels of resistance and production of virulence factors. Significant correlations were observed between the minimum inhibitory concentration (MIC) of fluconazole/itraconazole and biofilm production, between phospholipase production and fluconazole/itraconazole MIC, and between fluconazole MIC and hemolytic activity in C. albicans isolates. The results also showed significant correlations between phospholipase activity and biofilm production., Conclusions: Our findings will contribute to a better understanding of the pathogenesis of C. albicans and characterize the relationship between virulence factors and antifungal resistance, which may suggest new therapeutic strategies considering the possible involvement of the virulence mechanism in the effectiveness of treatment.

The antioxidant and antimicrobial activities of polysaccharides extracted by microwave-assisted extraction (MAE) were reviewed. An ascending dose-dependent manner was found for the in vitro antioxidant (e.g., nitrite scavenging, phospho-molybdenum reduction, inhibition of lipid peroxidation (ILP), ferric reducing power, and ferrous metal ions chelating), and antiradical (against DPPH, OH, ABTS, NO, and O 2 - ) activities. There was a positive and significant correlation between ILP and erythrocyte hemolysis inhibition, showing the excellent antioxidative properties to prevent the risk of cell damage. These carbohydrate-based polymers in vivo could reduce malonaldehyde and protein carbonyls and increase stress-resistance-related enzymes such as catalase, superoxide dismutase, and glutathione peroxidase. They showed an effective bactericidal activity against a wide variety of gram-negative and gram-positive bacterial infections. The in vitro strong antifungal and antiviral activities of sulfated polysaccharides extracted by MAE were also diagnosed without any cytotoxicity effect. Therefore, these biomacromolecules might be used to develop functional foods and nutraceuticals., (Copyright © 2019 Elsevier Ltd. All rights reserved.)