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Objective:To systematically review the relationship between gingival biotype (GT) and malocclusion.Methods:The review followed PRISMA standards of quality for systematic reviews and meta-analyses reporting with PROSPERO registration number CRD42020126543. The systematic database search included MEDLINE, Scopus, Embase, PsychINFO, CINAHL, and other key journals; the article search was performed until February 2020. Cochrane’s risk of bias in non-randomized studies-of interventions (ROBINS-I) was used to grade the methodological quality of the included studies.Results:The systematic search identified 105 studies, six studies satisfied the inclusion criteria for eligibility. The study participants ranged from 26 to 200 (total n=812), with a mean of 135. Study participants were aged between 14 and 32 years. Five studies were graded as the moderate risk of bias and one study as low risk of bias. Two studies showed thin GT among individuals with severe crowding compared to mild crowding. Three studies showed a thin GT with a narrow zone of the keratinized gingival width compared to a thick GT. No relationship was found between GT and Angle’s classification of malocclusion.Conclusion:No relationship was observed between Angle’s classification of malocclusion and GT. Thin GT was prevalent among individuals with pro-inclination of incisors. Keratinized gingival width was narrow among individuals with thin GT.

Aim of Study: To study the clinico-epidemiological profile and identify risk factors for the development of COVID-19-associated mucormycosis (CAM) among the patients treated at our regional mucormycosis center. Materials and Methods: This was a cross-sectional single-centre observational study. All CAM patients admitted to Government Rajaji Hospital, Madurai from April 2021- August 2021 were included in the study. Information regarding clinical features, potential risk factors, diagnostic workup, and comorbid illness was collected. Results: A total of 164 patients of CAM were admitted to our hospital with a mean age of 51.7 years. Out of 164 patients, 12 patients were not covid positive, based on imaging and RT-PCR, however subclinical infection could not be ruled out. Out of the 164 patients studied, 160 patients had diabetes, out of which 66% (n = 105) patients had a previous history of diabetes, and 34% (n = 55) had newly detected diabetes. Most of the patients admitted with mucormycosis had uncontrolled diabetes (94%) and were not on insulin therapy, but were on oral antidiabetic drugs alone. The majority of the patients (68%) have received steroids (IV/oral) during the COVID-19 illness. 74% of these patients were under hospitalization for COVID-19 disease. Only 30% (n = 50) of CAM patients had a history of oxygen therapy and 7% of these patients were treated in ICU during active COVID-19 illness. 59% of patients used cloth masks without adequate hygiene, rest 41% (n = 67) patients reused disposable masks. We also found that 87% of the patients developing mucormycosis had exposure to organic material in the convalescence period of COVID-19 illness. Conclusions: From our study, we found steroid use, poorly controlled diabetes mellitus, reuse of masks, daily steam inhalation, and exposure to organic matter to be more associated with CAM, but oxygen therapy was less associated with CAM. Hence, we could suggest screening for hyperglycemia and daily use of disposable surgical masks to be continued for at least 4 weeks post-COVID-19. It is preferable to continue insulin in titrated doses along with OHA for at least 4 weeks following steroid cessation in the post-COVID-19 period as there is are considerably increased inflammatory cytokine levels in the convalescence phase. Clean environmental hygiene would also help prevent CAM.

Public speaking is an essential skill for the workforce, yet many professionals lack confidence when speaking in front of an audience. While the 4-H Youth Development Program helps young people learn and practice public speaking, little is known about which specific 4-H activities foster these skills. We conducted a study to explore 4-H members' public speaking confidence and to identify specific 4-H activities that bolster young people's public speaking confidence. Quantitative and qualitative survey analyses revealed that, regardless of age, the longer 4-H members spend in the program, the more their self-confidence in public speaking improves. The 4-H program offers unique opportunities for public speaking at club meetings and formal presentations. There is room to expand these opportunities by offering youth more instructional “how to present” materials and increasing low-stakes speaking venues.

Abstract Background Accreditation is one of the most important methods of quality assurance and improvement in medical education. In Iran, there are no specific midwifery education accreditation standards. This study was designed to develop accreditation standards for midwifery clinical education in Iran. Methods This study was performed in Iran in 2021. It consisted of two phases. In the first phase, accreditation standards for midwifery education in the United Kingdom, the United States, Australia and the International Confederation of Midwives were thoroughly examined through a narrative review. The domains obtained from this phase were used as a framework for coding in the second phase. In the second phase, a qualitative study was conducted with a directed content analysis approach to determine standards and criteria for clinical midwifery education accreditation in Iran. Participants were policymakers and senior managers of midwifery education, faculty members of midwifery departments with clinical teaching experience, and final year undergraduate midwifery students. The participants were selected by purposive sampling method, and data collection continued until data saturation. Results The standards and accreditation criteria of midwifery education from the review study were formed 6 domains: Mission and goals; Curricula; Clinical instructors; Students, Clinical setting; and Assessment. In the second phase, data analysis led to the extraction of 131 codes, which were divided into 35 sub-subcategories, 15 sub-categories, and 6 main categories. Conclusion Implementing the specific and localized standards of clinical midwifery education in Iran can lead to improved quality of clinical education programs.

Introduction: The role of vitamin-D in various diseases, including heart disease, has been a subject of interest in recent years. Many studies revealed low vitamin-D status in patients with Acute Coronary Syndrome (ACS). Studies have shown statistically significant low Vitamin-D levels in patients with Myocardial Infarction (MI) in recent years with some studies showing association of vitamin-D deficiency with worse outcome in patients with severe deficiency. Aim: To determine serum vitamin-D levels in patients with acute ST-Elevation Myocardial Infarction (STEMI), and its association with in-hospital prognosis. Materials and Methods: An exploratory observational study was conducted in 100 patients with STEMI consulting a General Medicine Department, JSS Hospital (Tertiary Healthcare Centre), Mysuru, Karnataka, India, from May 2015 to June 2016. The patients were followed-up for in-hospital prognosis. Serum vitamin-D was estimated by ECLIA (Enhanced Chemiluminiscence Immunoassay) method. Electrocardiogram (ECG), Echocardiogram (ECHO) and Coronary Angiogram (CAG) were done in all patients using standard procedures. In-hospital prognosis of the subjects with vitamin-D deficiency and those with normal vitamin-D levels were compared. Data was analysed using Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: Of total 100 patients, majority (n=59, 15.36%) were in the age group of 50-69 years and there were 81 males and 19 females. The results showed 72% of the subjects were deficient and 19% had insufficient vitamin-D levels, therefore, a total of 91% of the STEMI patients had abnormally low vitamin-D levels. Those with Diabetes Mellitus (DM) (n=52) and past Ischaemic Heart Disease (IHD) (n=9) had significantly low vitamin-D levels, suggesting that the association of vitamin-D deficiency with these risk factors may also contribute to the role of vitamin-D deficiency in STEMI. Among those with cardiac failure (44%), 86.3% had deficient and 11.6% had insufficient vitamin-D levels. Conclusion: Vitamin-D deficiency was seen in majority of the STEMI patients. Significantly deficient level of vitamin-D was observed in STEMI patients who progressed to cardiac failure (44%) as a complication.

Aims: To investigate the mechanisms of action of natural products with bactericidal (cinnamon root powder, peppermint oil, trans‐cinnamaldehyde, menthol and zingerone) or bacteriostatic (fresh garlic bulb extract, garlic clove powder, Leptospermum honey and allicin) activity against two Clostridium difficile strains. Methods and Results: Bactericidal products significantly reduced intracellular ATP after 1 h (P ≤ 0·01), quantified using the BacTiter‐Glo reagent, and damaged the cell membrane, shown by the leakage of both 260‐nm‐absorbing materials and protein, and the uptake of propidium iodide. Bacteriolysis was not observed, determined by measuring optical density of treated cell suspensions at 620‐nm. The effect of three bacteriostatic products on protein synthesis was quantified using an Escherichia coli S30 extract system, with Leptospermum honey (16% w/v) showing significant inhibition (P < 0·01). Lastly, no products showed elevated minimum inhibitory concentrations against antimicrobial‐resistant C. difficile, determined by broth microdilution. Conclusions: Cytoplasmic membrane damage was identified as a mechanism of action that may contribute to the activity of several natural products against C. difficile. Significance and Impact of the Study: This study describes the possible mechanisms of action of natural products against C. difficile, yet the efficacy in vivo to be determined. [ABSTRACT FROM AUTHOR]

Aims and Objectives: Clinical, biochemical, and radiological profiles of Addison's disease and to assess the various etiological spectrum of primary adrenal insufficiency (PAI) in adults. Materials and Methods: A retrospective cohort study was carried out in the Department of Endocrinology, Madurai Medical College, Madurai between January 2014 and January 2021 over a 7-year period. Inclusion Criteria: All the patients with clinical symptoms and or signs of suspected PAI, such as hyperpigmentation, weight loss, persistent nausea or vomiting, fatigue, and hypotension, were recruited. All suspected cases underwent measurement of 8-AM plasma ACTH and cortisol levels. In possible cases and equivocal cortisol levels, patients underwent Co-syntropin/ACTH stimulation test. To know the underlying etiology of PAI, 21-hydroxylase autoantibodies (21OHAb), thyroid function test, Anti TPO, calcium, parathyroid hormone (PTH), LH and FSH, CT of chest and abdomen, and sputum AFB based on the clinical pattern of involvement were performed. Exclusion Criteria: Patients with onset of PAI at infancy and childhood, secondary adrenal insufficiency or exogenous Cushing's syndrome, and central hypocortisolism, including Sheehan's syndrome, were excluded. Results: Thirty-six patients were diagnosed with PAI in this study; 19 (53%) were females and 17 were males (47%). The median age of diagnosis was 35 years. Patients were divided into acute presentation and subacute presentation. Twenty-six patients presented with acute presentation and ten were presented with progressive evolved symptoms. Non-tuberculous etiology was the predominant finding noted in our cohort study (87%, 31 out of 36 patients). The other causes of Addison disease included isolated auto-immune PAI, polyglandular autoimmune syndrome type 1 and II, APLA Syndrome, and adrenal metastasis. Conclusion: Non-tuberculous causes of PAI are the leading etiology in our retrospective study. Autoimmune PAI and Polyglandular autoimmune syndromes are increasingly being recognized as the cause of Addison's disease. PAI individuals require lifelong surveillance for possible development of coexisting autoimmune syndromes and need for glucocorticoid/mineralocorticoid therapy.

Abstract The nanofluid flows play a vital role in many engineering processes owing to their notable industrial usage and excessive heat transfer abilities. Lately, an advanced form of nanofluids namely “hybrid nanofluids” has swapped the usual nanofluid flows to further augment the heat transfer capabilities. The objective of this envisaged model is to compare the performance of two renowned hybrid nanofluid models namely Hamilton–Crosser and Yamada–Ota. The hybrid nanoliquid (TiO 2-SiC/DO) flow model is comprised of Titanium oxide (TiO 2) and Silicon carbide (SiC) nanoparticles submerged into Diathermic oil (DO). The subject flow is considered over a stretched surface and is influenced by the magnetic dipole. The uniqueness of the fluid model is augmented by considering the modified Fourier law instead of the traditional Fourier law and slip conditions at the boundary. By applying the suitable similarity transformations, the system of ordinary differential equations obtained from the leading partial differential equations is handled by the MATLAB solver bvp4c package to determine the numerical solution. It is divulged that the Yamada–Ota model performs considerably better than the Hamilton–Crosser flow model as far as heat transfer capabilities are concerned. Further, the velocity reduces on increasing hydrodynamic interaction and slip parameters. It is also noted that both temperature profiles increase for higher hydrodynamic interaction and viscous dissipation parameters. The envisioned model is authenticated when compared with an already published result in a limiting case.

In this paper, we describe generalized fractional integral operator and its inverse with generalized Bessel-Maitland function (BMF-Ⅴ) as its kernel. We discuss its convergence, boundedness, its relation with other well known fractional operators (Saigo fractional integral operator, Riemann-Liouville fractional operator), and establish its integral transform. Moreover, we have given the relationship of BMF-Ⅴ with Mittag-Leffler functions.

In the operation of farming processes, the limitation of the civilian quadrotor UAV transport and the features of its powerful collar would yield more significant interference to the aviation control version. Mainly utilize traditional PID regulator, but the mood adjustment of the murmur will have a big overshoot. This article sets on the application of fuzzy controllers in courteous four-rotor UAVs for this case. By creating and improving the fuzzy rule tableland, rather than changing PID parameters often back. Additional sound control of energy outcome to support system steady-state implementation. By utilizing MATLAB to imitate flying perspective and compare with the simulation effects of the traditional algorithm of PID control. The outcomes numerical results indicate that the process may enhance PID capability and decrease the fluctuation of aviation perspective control throughout process.

Double Outlet Right Ventricle (DORV) with Transposition of Great Arteries (TGA) is a rare variant. The ventriculoarterial discordance due to this anatomical defect leads to parallel circulation. The postnatal survival depends on mixing of oxygenated and deoxygenated blood at various levels by defects like Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), Patent Ductus Arteriosus (PDA). Anaesthetising children with cyanotic Congenital Heart Disease (cCHD) and brain abscess necessitates use of anaesthesia protocol appropriate to both cCHD and intracranial surgery. Anaesthetic considerations related are maintenance of intravascular volume and preload, avoidance of precursors to acidosis such as hypothermia, hypercarbia, and hypotension and challenge for anaesthesiologist is to maintain Pulmonary Vascular Resistance (PVR) and Systemic Vascular Resistance (SVR) by pharmacological and ventilatory means. This report is about a seven-year-old child who was posted for emergency craniotomy and abscess drainage, after routine preanaesthetic check-up. Induced with fentanyl, ketamine and atracurium, anaesthesia was maintained on oxygen, air and sevoflurane. Intraoperatively, normothermia was maintained, and blood pressure was maintained by noradrenaline infusion, metabolic acidosis was corrected with soda-bicarbonate. In between the procedure, the patient had an episode of Supraventricular Tachycardia (SVT), which was managed with lidocaine, metoprolal and adenosine. In such cases, it is vital to pay attention to any potential anaesthetic interactions.

Youth development programs designed for Latinx youth remain understudied. However, some research reports indicate that having bilingual and bicultural facilitators and developing culturally-infused programs may be effective. Extension educators developed a hands-on youth educational program specifically designed for Latinx youth. Educators hypothesize that adapting programs for Latinx youth will increase the knowledge and confidence levels of Latinx youth compared to their non-Latinx youth counterparts. Results from ourstudy revealed Latinx youth reported greater knowledge gain in most concepts compared to their non-Latinx youth counterparts who simultaneously participated in the same program. In addition, Latinx youth were significantly more likely to understand what can be challenging when starting a business and the skills needed to be an entrepreneur. Findings also indicated that all youth, regardless of identified race and ethnicity, showed positive learning outcomes when programs were culturally adapted. More research on Latinx youth program development and implementation is needed to further understand successful strategies for improved program effectiveness for participants.

BACKGROUND: Molar incisor hypomineralization (MIH) is a frequently encountered oral condition that varies from mild opacities to posteruptive enamel breakdown. No previous published studies have investigated the frequency of MIH and associated risk factors among children with special health care needs (CSHCN) to our awareness. OBJECTIVES: Assess the frequency of MIH and associated risk factors among CSHCN. DESIGN: Cross-sectional. SETTING: Schools in provincial city of Saudi Arabia. PATIENTS AND METHODS: The study was conducted among 400 (180 boys and 220 girls) special needs children. Diagnosis of MIH was according to the European Academy of Paediatric Dentistry criteria. MAIN OUTCOME MEASURE: Result of logistic regression analysis that assessed the association between MIH prevalence and associated prenatal, perinatal, and postnatal factors. SAMPLE SIZE: 400 (180 boys and 220 girls) special needs children. RESULTS: Among 400 CSHCN, 98 (24.5%) presented with MIH. Children with multiple disabilities had a 3.89 times greater risk of MIH (95% CI: 1.91–6.19, P=.002). Children with positive prenatal factors had an adjusted odds ratio (aOR) of 2.31 times for MIH (95% CI: 1.22–4.73, P=.012). Children with a childhood infection history had an aOR of 2.43 times for MIH (95% CI: 1.31–5.85, P=.014). Children with a breastfeeding history >18 months had an aOR of 3.73 for MIH (95% CI: 1.62–8.60, P=.002). Permanent maxillary first molars were the most frequently affected teeth, and demarcated opacity was the most frequent MIH type. CONCLUSION: MIH should be recognized as one of the prevalent oral health problems among CSHCN to prevent tooth mortality. LIMITATIONS: A cross-sectional study cannot establish a causal relationship. CONFLICTS OF INTEREST: None.

Abstract Background Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age. This study was designed to investigate the effects of melatonin and/or magnesium supplementation on metabolic profile and levels of sex hormones in PCOS women. Methods In an 8-week randomized double-blind placebo-controlled trial, 84 subjects with PCOS aged 18–40 years were randomly assigned based on the random block procedure to take magnesium, melatonin, magnesium plus melatonin, and placebo. Fasting blood samples were obtained at the beginning and end of the study. Results After intervention, the mean Pittsburg Sleep Quality Index score decreased significantly in both co-supplementation and melatonin groups (P

Introduction: Metered-dose inhalers (MDI) are the most used inhalers worldwide. However, improper MDI techniques remain a significant problem and cause uncontrolled asthma. Studies worldwide have reported that the causes of inefficient inhaler technique are multifactorial. However, this topic has been less well studied in the Asian population. This study aimed to evaluate the MDI technique and associated factors among adults with asthma in a primary care setting in Malaysia. Method: This was a cross-sectional study with universal sampling conducted between July and October 2017. A total of 146 patients with asthma aged 18 years and older in a primary care clinic in Putrajaya, Malaysia were recruited. Logistic regressions were used for statistical analysis to examine the association between improper MDI techniques and their related factors. Results: The majority (83%) of respondents were female with a median age of 37 (IQR = 30.75–49.25) years, and the median duration of asthma of 20 (IQR = 10–30) years. An improper MDI technique was observed in 100 (71.9%) patients. The most frequently missed step was exhaling gently and fully before inhalation (51.4%). Respondents who were not on an MDI preventer (adjusted OR: 2.487, 95% CI: 1.121–5.519, p = 0 .025) or had used an MDI 5 years or fewer (adjusted OR: 3.369, 95% CI: 1.425–7.964, p = 0.006) were more likely to employ an improper MDI technique. Conclusion: There was a high proportion of improper MDI techniques among patients with asthma. Patients not using an MDI preventer or who had used an MDI less than 5 years were at higher risk of improper MDI technique.

Background: Leptospirosis is most often diagnosed clinically, and a laboratory test with high diagnostic accuracy is required. Methods: IgM and IgG ELISAs using Leptospira antigens were established and evaluated in relation to the microscopic agglutination test (MAT). Antigen preparation consisted of saprophytic Leptospira biflexa to detect genus-specific antibodies (genus-specific ELISA) and a pool of the five most prevalent Leptospira interrogans serovars in Sri Lanka to detect serovar-specific antibodies (serovar-specific ELISA). IgM and IgG immune responses were studied in severe and mild leptospirosis patients (n = 100 in each group). Results: The ELISAs showed high repeatability and reproducibility. The serovar-specific IgM-ELISA showed a sensitivity of 80.2% and specificity of 89%; the genus-specific IgM-ELISA showed a sensitivity of 83.3% and specificity of 91%. The serovar- and genus-specific IgG-ELISAs showed sensitivities of 73.3% and 81.7%, respectively, and specificities of 83.3% and 83.3%, respectively. The commercial IgM-ELISA showed a sensitivity of 79.2% and specificity of 93%. The commercial IgG-ELISA showed a sensitivity of 50% and specificity of 96.7%. IgM levels observed in mild and severe leptospirosis patients were significantly higher than in the healthy control group, with mean absorbance values of 0.770, 0.778, and 0.163, respectively. Severe leptospirosis patients had significantly higher mean anti-leptospiral IgG levels compared to both mild leptospirosis patients and healthy control group subjects (0.643, 0.358, and 0.116, respectively; ANOVA, p < 0.001). The presence of anti-leptospiral IgG above an optical density of 0.643 at 1:100 could predict a high risk of severe disease. Conclusion: The serovar-specific in-house ELISA could be used for the laboratory diagnosis of leptospirosis in endemic settings. The high levels of anti-leptospiral IgG observed suggest its value as a predictor of disease severity.

The transmission of healthcare-associated infections (HCAIs) in healthcare settings is a serious challenge in the medical fraternity. Medical devices, such as stethoscopes used by healthcare workers (HCWs), are likely to harbor a considerable number of pathogenic microbes, which may result in the transmission of HCAIs. This study sought to investigate bacterial contamination of stethoscopes used by HCWs at Bharatpur Hospital, Nepal. During the study period of 3 months from December 2019 to February 2020, a total of 87 stethoscopes were examined; bacterial pathogens were isolated and identified by culture and biochemical tests, and their susceptibilities against different antibiotics were determined using standard protocols of the Clinical and Laboratory Standards Institute (CLSI). The disc diffusion method was used primarily to screen for extended-spectrum beta-lactamase (ESBL)- and metallo-beta-lactamase (MBL)-producing isolates, followed by their confirmation using cephalosporin/clavulanate combination discs and the disc potentiation methods, respectively. In addition, molecular detection of blaCTX-M and blaVIM genes was performed using conventional polymerase chain reaction (PCR). Of the 87 stethoscopes examined, more than a quarter (28.7%) were colonized with different pathogenic bacteria. Bacterial contamination of stethoscopes was found to be significantly associated with various factors, such as disinfecting routine, method of disinfection, and department of the hospital (p < 0.05). A higher rate of bacterial contamination was observed on the diaphragm of the stethoscope (12.64%) and among HCWs who overlooked hand hygiene practices (45.45%). The prevalence of methicillin-resistant S. aureus (MRSA) was 44.44%, and approximately half of the Gram-negative isolates (47%) were multidrug resistant (MDR). Imipenem (81.25%) and chloramphenicol (83.33%) were found to be the most effective antibiotics for Gram-negative and Gram-positive bacteria, respectively. Phenotypic screening showed that 43.75% of isolates were ESBL producers, and 18.75% were MBL producers, but blaCTX-M and blaVIM genes were detected in only 31.25% and 6.25% of isolates, respectively. The results of the study call for effective stethoscope disinfection practices along with the judicious use of antibiotics by HCWs in order to minimize cross-contamination, emergence of resistance, and spread of nosocomial infections in clinical settings.

BACKGROUND: Special needs children are at a higher risk of dental trauma because of neurological, physical, mental, and behavioral impairments. They are also at higher risk of developing obesity due to the side effects of medication. OBJECTIVE: Assess the association between traumatic dental injuries (TDIs) and obesity in children with special health care needs. DESIGN: Analytical cross-sectional study. SETTING: Schools for special needs children. STUDY POPULATION AND METHODS: Special needs children with a diagnosis of TDI according to the Andreasen criteria were included in the study. Data on the disability status were obtained from a national demographic survey in 2016. Demographic and dental variables were measured for analysis. Multivariable logistic regression was used to analyse any relationship between TDI prevalence and obesity. MAIN OUTCOME MEASURE: Relationship of body mass index (BMI) to TDI prevalence. SAMPLE SIZE: 350 (131 boys and 219 girls) special needs children with a median (interquartile range) age of 12.0 (2.0) years. RESULTS: Eighty-one (23.1%) children presented with TDIs. The mean (standard deviation) BMI for the entire study population was 24.7 (7.8). Children with obesity had a 30.3% TDI prevalence compared normal-weight children (20.6%) (P=.035), but BMI category was not statistically significant in the regression analysis (P=.541), which showed that children with an overjet of >3 mm were 4.82 times (CI: 2.55–9.09, P=.001) more likely to have TDI than children with an overjet of ≤3 mm. Those with inadequate lip coverage were 2.85 times (CI: 1.49–5.44, P=.002) more likely to have TDI. Children with cerebral palsy were 3.18 times (CI: 1.89–11.32, P=.024) more likely to have TDI than children with other disabilities. CONCLUSION: The study showed a significant association between TDI prevalence and increased overjet, inadequate lip coverage, and cerebral palsy. The prevalence of TDI among obese special needs children was statistically significant according to bivariate analysis, but not in a multivariate analysis that adjusted for other variables. LIMITATIONS: Causal relationship cannot be established with cross-sectional study. CONFLICT OF INTEREST: None.

BackgroundThe issue of infertility is a worldwide challenge, estimated to affect around 50 million couples. This study aimed to evaluate the relationship between infertility stress and sexual function in men and women with infertility.MethodsIn this cross-sectional study, 300 men and women with infertility were recruited. A demographic questionnaire, the Fertility Problem Inventory, the Female Sexual Function Scale (FSFI), and the International Index of Erectile Function (IIEF) were used to collect data. Independent t-test, Chi-square, and linear and logistic regressions were used to assess the data.ResultsThe total score of sexual function in women and men was 22.18 ± 7.86 and 57.7 ± 17.8, respectively. Infertility duration and the ability to pay for the costs of infertility treatment had a significant relationship with sexual function in women. A significant association was found between communication concerns and sexual function scores in men with infertility. Infertile women had more sexual concerns, while infertile men had more communication concerns.ConclusionThis study showed that women with infertility had more infertility stress than men with infertility. Women with higher infertility duration and the inability to pay for the infertility treatment costs impaired sexual function. Women with infertility had more sexual concerns, while Men with infertility had more communication concerns. Policymakers need to consider strategies such as counseling for men and women with infertility to help them cope with their problems, especially their psychological problems. The lack of random enrollment of participants and lack of control group were the limitations of this study.

Thin samples (about 4 μm in thickness) of membrane foil of a Pd-Cu solid solution have been grown on the surface of a SiO/Si heterostructure by magnetron sputtering. The key features of $$\beta \rightleftharpoons \alpha $$ phase transformations have been identified using X-ray diffraction, Auger electron spectroscopy, energy dispersive X-ray microanalysis, and resistivity measurements during a heating-cooling cycle. The results demonstrate that the phase transformations are reversible only in solid solutions containing an excess of copper in the concentration range corresponding to limiting temperatures near the temperature stability limit of the β-phase. Thermal conditions of membrane element operation have been found that ensure stability of the ordered atomic structure of the foil and, accordingly, its high performance. The $$\beta \rightleftharpoons \alpha $$ phase transformation has been shown to be reversible after holding the foil at t = 830°C, in a state with a disordered atomic structure, which ensures restoration of its high hydrogen permeability after diffusion bonding to the case of a membrane element. [ABSTRACT FROM AUTHOR]

Introduction: Patello-femoral complications are the most common complications in postoperative Total Knee Arthroplasty (TKA) patients especially overstuffing of Patello - Femoral Joint (PFJ). So, to study the effects of overstuffing of PFJ in postoperative TKA patients we put forth a new dimension - "PATELLO - FEMORAL COMPOSITE (PFC)". This is the maximum distance between anterior cortical line of femur shaft and the anterior cortex of patella with knee in full extension. Aim: To calculate chances of overstuffing of PFJ in postoperative TKA patients and document the effect of overstuffing of PFJ on the passive knee Range of Motion (ROM) in post- op TKA patients. Materials and Methods: This was a prospective observational study which included 51 consecutive primary TKAs. Preoperative and postoperative (24 weeks) passive knee ROM was measured. Preoperative and postoperative radiological parameters {PFC, Anterior Femur Offset (AFO), Patellar thickness (PT)} was recorded using Computed Tomography (CT) Scanogram image of patient in lateral view with knee in full extension and perfect overlap of both femur condyles, using DICOM format of the CT Scanogram image on the DICOM viewer. Results: The postoperative PFC was more than its Preoperativevalue in 80.39% TKAs. Patients who had increased postoperative PFC had significantly less Preoperative AFO. Female patients in our study had significantly less Preoperative AFO compared to males. Thus, we deduced that female patients with lesser Preoperative AFO undergoing TKA had increased postoperative PFC than male patients. PFC not only accounted for the overstuffing of the PFJ because of the patellar component, but also because of the femoral component; thus was a better measure of PFJ overstuffing compared to isolated PT. Passive knee ROM in the postoperative TKA patients approximately decreased by 2 degrees for every 1 mm increase in PFC compared to its Preoperative-value in the patients with PFJ overstuffing. Conclusion: We conclude that overstuffing of the PFJ in postoperative TKA is present in 80.39% patients. Higher chances of postoperative PFJ over stuffing are present in female patients and those with thinner anterior cortex of distal femur. Postoperative passive knee ROM decreases significantly in patients with postoperative PFJ overstuffing (Every 1 mm increase in the postoperative PFC, passive knee ROM decreased by approximately 2 degrees). [ABSTRACT FROM AUTHOR]

Background: The phenomenon of infertility may be derived from different factors - either in males or females or both genders, including few unexplained factors. It is generally managed by medical and surgical treatments. Objective: To find a relation of occurrence of spontaneous pregnancy (SP) with effective factors in infertility. Materials and Methods: This cross-sectional study was conducted at two referral infertility centers (university and privacy center) in the southwest of Iran from March 2015 and March 2016 on 655 infertile couples, who were divided in two groups of with (n = 31) and without (n = 624) SP. The variables included female and male age, male smoking, male job, the place of living, the causes of infertility, the type and duration of infertility, and the subgroups of infertility causes. Results: Infertility may be caused due to both male- and female- related factors (47.5%). While female-related infertility was found in 31.5%, male-related infertility in 14.5%, and infertility due to unexplained factors in 6.6% of our patients. The rate of SP was 4.7%, which had a significant relation with the duration of infertility (p = 0.01), with women's age (p = 0.048), unexplained infertility (p = 0.001), and husband's job (p = 0.004). Conclusion: The occurrence of SP in infertile couples was related to age of the female partner, the duration of unexplained infertility, and the male partner's job.

Abstract Background Vitamin D3 (Vit.D3) is an antioxidant that can improve sperm motility. However, the specific mechanisms of Vit.D3’s effect on sperm are not yet elucidated. Since heat shock protein 70 (HSP70) and oxidative stress (OS) are effective in sperm motility and it has been shown that vitamin D3 is associated with these factors, thus this pilot study evaluated the effects of Vit.D3 on HSP70 and OS levels in normal and asthenozoospermic semen samples. Results In this study, the level of HSP70 proteins was evaluated by western blotting and immunocytochemistry in eight normal and nine asthenozoospermic samples. Additionally, malondialdehyde (MDA) assay and nitroblue tetrazolium (NBT) test were used for measuring OS. The results showed that the amount of HSP70 protein was higher in the groups treated with Vit.D3 compared to the control groups. Likewise, in normal and asthenozoospermic samples, OS was increased in treatment groups, but the increase was insignificant in asthenozoospermic samples. Conclusion According to the data, HSP70 and OS levels were increased in the sperm cells after incubation with Vit.D3; thus, vitamin D3 might improve sperm motility via these factors in vitro.

Objective:This systematic review intends to evaluate the dimensional changes in upper airway dimensions (UAD) of the respiratory tract subsequent to orthodontic treatment of skeletal Class II malocclusion with Twin Block Appliance (TBA).Methods:The quality of reporting systematic reviews and meta-analyses was decided by the PRISMA standards with PROSPERO registration number CRD42017060317. The systematic search included EMBASE, MEDLINE, Psych INFO, Scopus, CINAHL, and other reference journals and review articles. The article search was performed from March 2017 until November 2017. Cochrane's risk of bias in non-randomized studies – of interventions (ROBINS-I) was used to grade the methodological quality of the included studies.Results:The screening procedure identified 302 studies, among which seven studies satisfied the inclusion criteria for eligibility. The UAD at the pretreatment time varied from 7.2 mm to 41.9 mm with a mean of 14.16 mm. The post-treatment change in UAD ranged from 8.2 mm to 43.7 mm with a mean of 15.6 mm.Conclusion:There was a significant increase in UAD following the TBA treatment in the patient group as compared to the control group.

Background: A considerable evidence suggests that maternal inflammation dysregulation may play as a risk factor for both maternal and neonatal outcomes. Objective: The study's objectives were designed to evaluate the correlation between serum C-reactive protein (CRP) levels, as an inflammation factor, preterm delivery, and small for gestational age (SGA) births. Materials and Methods: This prospective cohort study was conducted on 120 singleton pregnant women with gestational age less than 20 wk. Maternal CRP serum concentration was measured before 20 wk gestation. Patients were followed-up until the delivery and final outcomes of pregnancy were recorded in terms of preterm delivery and SGA births. Results: Serum CRP levels in participants with normal fetuses and SGA births were 4.09 ± 1.35 mg/l and 6.04 ± 3.29 mg/l, respectively (p = 0.19), while in cases of preterm delivery, it was 9.63 ± 5.78 mg/l (p < 0.001). By using receiver operating characteristic (ROC) curve, serum CRP levels (cut-off point 5.27 mg/l, area 0.836) had acceptable diagnostic accuracy value in distinguishing preterm delivery (sensitivity (75%), specificity (86.1%), positive predictive value (37.5%), negative predictive value (96.87%), accuracy (85%)) and serum CRP levels (cut-off point 6.67 mg/l, area 0.673) in distinguishing SGA births (sensitivity (50%), specificity (91.2%), positive predictive value (23.07%), and negative predictive value (97.19%), and accuracy (89.16 %)). Conclusion: Higher maternal serum CRP levels measured early in pregnancy may associate with higher risk of preterm delivery and SGA.