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Evaluation of Liver Function Tests after Coronary artery bypass surgery (CABG)
Full text linkBackground: Coronary artery bypass graft surgery (CABG) may have systemic effects on the body organs as liver. The purpose of  present study was to evaluate changes in liver function tests(LFT) after on-pump CABG surgery and risk factors associated with LFT changes.Also, the incidence of acute liver injury after on-pump CABG is determined. Methods: 385 patients who underwent on-pump CABG surgery were randomly selected.Preoperative and intraoperative risk factors were obtained from their medical records .Postoperative liver function tests at 24, 48 and 72 hours following surgery and discharge time were compared with the preoperative ones. A univariate linear regression analysis was used to assess the possible relationships between these changes and the preoperative and intraoperative risk factors. Result: Statisitcal analysis revealed direct and significant relationship between LFT changes and  pump time, aortic cross-clamp clamp time and use of intra-aortic balloon pump(IABP). Also a medical history of previous myocardia infarction was significantly related to the changes in direct bilirubin in the first 48 hours following surgery.level of  preoperative left ventricle ejection fraction,smoking and using opium had  significant  correlation  with  postoperative AST changes in different days.In 12.9 of patients, the aminotransferases levels increased to more than three folds over normal upper limit but  the probability for incidence of acute ischemic liver injury (transient increase in aminotransferases to over 500IU/L) was 0.77. Conclusion: Using techniques to reduce clamp and pump time when possible is important during CABG. Probable liver injuries post inserting IABP should be expected for appropriate monitoring and treatment
Effect of different surface treatments on microtensile bond strength of two types of composite substructures with ceramic by resin cements
Full text linkIntroduction: The aim of this study was to investigate the effect of different surface treatments on the microtensile bond strength (µTBS) of two types of composite substructures with Vita Mark II ceramics by resin cement.
Materials & Methods: Sixty-four substructure specimens were molded from two dual-cure composites Core.it and Build-it, equally, and cured by LED light. The specimens of each group were randomly divided into 4 subgroups (n=8) treated by one of HF acid 10%, air abrasion, Er: YAG laser, and one group without any treatment (control group), and then the specimens of each group were bonded to Vita Mark II CAD/CAM ceramic blocks using two Duo-Link and Panavia F 2.0 resin (n=4 and 20 slice in any group). Each final specimen was thermocycled between 5 °C and 55 °C for 2500 cycles and then cut by a slow speed saw to obtain 5 sticks with cross-section dimensions of about 1×1 mm². The µTBS test was done at a speed of 0.5 mm/min by Universal Testing Machine. The fracture pattern was then determined using a stereomicroscope. Statistical differences between groups were determined by one-way ANOVA using Tukey's multiple comparison tests.
Results: Among all 16 groups, the highest µTBS was observed in the group with Core.it substructure composite and Duo-link resin cement without any surface treatment and after that in the second step in build-it substructure composite group and Panavia resin cement without surface treatment. The most common fracture pattern in all groups was cohesive in resin cement (P value<0.05).
Conclusion: According to this study, composite substructure surface treatment by hydrofloridric acid, laser and air abrasion reduced µTBS between substructure- ceramic and so is not recommended
Effect of different curing modes on the Vickers hardness number and curing depth of bulk fill composites
Full text linkIntroduction: The purpose of this study was to compare the Vickers hardness number (VHN) and depth of cure of two types of bulk fill composites in high, low and soft light curing modes.
Materials & Methods: In this experimental study, 60 cylindrical samples were fabricated from two types of bulk fill composites (Tetric N-Ceram and X-tra fil) in a Teflon mold with one semi-circular notch. Then, the samples were randomly divided into the following three subgroups based on the curing modes (high, low and soft) and were light-cured. The samples were removed from the molds, and their VHN and depth of cure were measured. Data were analyzed using One-way ANOVA and Tukey’s post hoc test at the significance level of P<0.05.
Results: The mean VHN of the X-tra fil composite was significantly higher than that of Tetric N-Ceram composite (P<0.001). The depth of cure of X-tra fil composite was also significantly higher than that of Tetric N-Ceram composite in high and soft curing modes (P<0.001).
Conclusion: According to the current results, X-tra fil composite is a convenient material for the restoration of deep cavity in posterior teeth compared with Tetric N-Ceram
Radiographic Comparison of the Relation between Mandibular Third Molar Root and Inferior Alveolar Canal in Panoramic Radiography and Cone-Beam Computed Tomography
Full text linkBACKGROUND AND OBJECTIVE: There is a risk of damage to the inferior alveolar nerve when extracting third molars. A variety of common imaging modalities, such as panoramic radiography (PR) and cone-beam computed tomography (CBCT), are recommended for examination prior to mandibular third molar surgery. The aim of this study was to compare the findings of panoramic radiography and CBCT in evaluating the relation between the root of the mandibular third molar and the inferior alveolar canal.
METHODS: In this cross-sectional study, 75 panoramic and CBCT images were evaluated. Cases in panoramic radiography that were suspected of the relation between the root of the mandibular third molars and the inferior alveolar canal were collected. To determine the type of connection of apex and root canal, the samples were divided into 6 groups: normal, inferior alveolar canal path loss, canal path narrowing, sudden canal path change, radiolucent band over the roots, and root curvature. Cases in the panoramic radiograph that were suspected of root contact with the canal were examined by the CBCT in terms of the position of the canal relative to the tooth (buccal or lingual or middle of the root - upper or lower) and the type of connection (whether the tooth is connected to the canal).
FINDINGS: In panoramic findings, 23 cases (30.7%) were normal, 19 cases (25.3%) showed canal path loss, 9 cases (12%) canal path narrowing, 5 cases (6.7%) sudden canal path change, 3 cases (4%) radiolucent band over the roots and 16 cases (21.3%) showed root curvature. According to CBCT findings, the position of the canal relative to the root apex was lingual in 39 cases (52%) and there was connection between the mandibular canal and the third molar in 39 cases (78.7%). There was no significant relationship between panoramic radiographic and CBCT findings and only in two cases of specific radiolucent band over the roots, there was a complete agreement between panoramic and CBCT findings.
CONCLUSION: Based on the results of this study, if a radiolucent band is observed on the root of the mandibular molars or a sudden change is observed in the canal path, panoramic radiography can be used to detect the relation between the inferior alveolar canal and the root of the third molars
CavatermTM plus treatment in high � risk surgical patients
Full text linkBackground: The purpose of the study was to evaluate the effectiveness and safety of thermal balloon ablation in women with high anesthetic and surgical risk compared to invulnerable women according to the American Society of Anesthesia (ASA) physical status stratification. Methods: This report was based on a retrospective cohort study of women with heavy menstrual bleeding (HMB) who were eligible for treatment with CavatermTM plus during 2012-2017. Women were classified as high-risk (HR) or low-risk (LR) cohorts based on ASA physical status stratification. The primary outcome includes amenorrhea in the twelfth months after the treatment. Risk adjustments were performed using regression models. Results: This research study consisted of 63 women with mean age 44.42±5.48. Mean of body mass index (BMI) in the HR cohort was higher than the LR cohort (31.48±6.22 vs 26.83± 3.51, P=0.005) and results were also similar considering the uterine length (mm) between HR and LR women (58.27±35.70 vs 30.92± 35.30, P=0.01). The primary outcome of treatment after a one-year follow-up in the two groups (HR and LR) was 31 (93.9) and 15 (78.9), respectively. After adjusting for known confounders including age, uterine length, parity, dysmenorrheal, the adjusted odds ratio was 0.94 (95 CI, 0.14– 2.5; P= 0.60). Conclusion: For women with high anesthetic and surgical risks derived from serious underlying co morbidities, endometrial ablation can provide a minimally invasive, safe, and effective therapy for heavy menstrual bleeding
Association between body fat and bone mineral density in non-obese post-menopausal women over 60 years old
Full text linkBackground: Loss of bone mineral density is one of the most important complications of menopause. The results of studies about the relation between body fat and bone mineral density are controversial. The aim of this study is to determine the association between fat mass and bone mineral density on non-obese post-menopausal elderly women. Methods: This cross-sectional study is a part of the second phase of the AmirKola Health and Ageing Project (AHAP) that has been done on 356 elderly women with BMI of 18.5-30. Bone mineral density (BMD) and total body fat were measured using the Hologic Horizon-WI densitometer. Statistical tests were ANOVA and Pearson’s correlation coefficient and P value less than 0.05 was considered significant. Results: The mean age of participants was 70.22±7.34 and the mean age of menopause was 47.68±5.05. Women with highest fat mass, had a greater spine, femur and whole body BMD (p<0.0001). In this study we observed a direct and positive significant correlation between body fat mass and BMD at spine (r=0.308), femur (r=0.420) and whole body (r=0.312) (p<0.0001).  Conclusion: This study showed a positive correlation between fat mass and bone mineral density in all three anatomical sites in post-menopausal women although lean mass had a greater effect on bone mineral density than fat mass. To prevent osteoporosis in post-menopausal women, it is important to target the lean mass more than fat mass
Antioxidant Effect of Montelukast on Acute Lung Injury Induced by Lipopolysaccharide in Dogs
Full text linkBACKGROUND AND OBJECTIVE: Acute lung injury is characterized by accumulation of neutrophils in the lung, interstitial edema, and damage to the alveolar epithelium. Lipopolysaccharide (LPS) causes an inflammatory response and the release of reactive oxygen species and cellular and tissue damage to the lungs. Considering the role of oxidative stress in infections and proving the antioxidant properties of montelukast in several studies, the effect of montelukast on acute lung injury induced by lipopolysaccharide (as a model of infection) in dogs was investigated in this study.
METHODS: In this experimental study, 20 healthy dogs (both male and female dogs of native breed with an average weight of 20 kg) were divided into four equal groups. The first group received oral montelukast (1 mg/kg), the second group received intravenous LPS (0.1 µg/kg), the third group received montelukast one hour before LPS and the fourth group received montelukast one hour after LPS. Bronchoalveolar lavage and blood sampling were performed at hour zero and 1.5 hours after the start of the test and the amount of malondialdehyde, catalase activity, glutathione peroxidase and total antioxidant capacity in serum and lavage fluid were measured using a kit.
FINDINGS: LPS significantly increased malondialdehyde levels (from 10.5 to 139.8 μmol) and decreased catalase activity (from 0.018 to 0.007 μmol) (p= 0.0001), glutathione peroxidase (from 259 to 76.5 nmol) and the total antioxidant capacity (from 0.41 to 0.04 nmol) compared to hour zero. These changes were significantly adjusted by montelukast (p≤ 0.02).
CONCLUSION: The results of this study showed that montelukast can enhance antioxidant defense against acute lung injury induced by LPS
Oral mucosa and Streptococcus mutans count in the saliva. Does graphene oxide nanoparticle mouthwash have a good effect?
Full text linkBackground: This study aimed to assess the effect of graphene oxide (GO) nanoparticles mouthwash on oral mucosa, Streptococcus mutans (S. mutans) count in the saliva of rats, and human enamel surface microhardness, in comparison with fluoride mouthwash. Methods: This study was conducted in two phases namely an animal study, and an in vitro experimental study. GO mouthwash (0.005), sodium fluoride (NaF) mouthwash (0.05), and a combination of both (0.05 NaF-0.005 GO) were prepared. The oral cavity of 36 rats was inoculated with S. mutans, and they were randomly divided into 4 groups according to the type of mouthwash. The control group received saline mouthwash. Fourteen days after using the mouthwashes, all rats were sacrificed, and the salivary S. mutans count was measured. The buccal and tongue mucosa were also histologically examined for the type and severity of inflammation, number of blood vessels, epithelial thickness, and epithelial keratinization. For microhardness testing, 40 sound extracted human premolars were randomly assigned to four groups (n=10) of culture medium with S. mutans and different mouthwashes. The enamel microhardness was measured at 7 and 14 days, and compared with the baseline value. Results: The mean S. mutans count in the saliva of rats in GO and NaF-GO groups was significantly lower than that in other groups (p<0.001). Enamel microhardness in NaF and NaF-GO groups significantly increased at 7 and 14 days, compared with baseline. Conclusion: Addition of GO nanoparticles improved the antibacterial properties without causing adverse mucosal effects such as ulceration, acute inflammation or atrophy of the epithelium of the oral mucosa, but had no effect on surface hardness of the enamel
Flow diverter-coil technique for endovascular treatment of complex wide neck brain aneurysms, Technical point
Full text linkBackground: Treatment of complex wide neck brain aneurysms is a challenging era in neurosurgery. Both surgical and endovascular therapies are considered for treatment of them. In endovascular, there are different ways such as trapping, coiling, stent and balloon assisted coiling. In this study, we use flow-diverter devices to create new vascular lumen and then coiling the aneurysm sac for three patients. Methods: We describe three cases with complex cerebral aneurysm who were treated successfully by flow diverter-coil technique and point to technical nuances. Results: In our patients, wide neck aneurysms, two in distal part of ICA (internal carotid artery) and other in basilar tip. We use flow-diverter-coil technique successfully. On the follow-up, aneurysms are treated completely without any complications. Conclusion: We think flow diverter devices adjunct to coiling is a useful way for the treatment of complex wide neck cerebral aneurysms
Association between iron and zinc deficiency and retinopathy of premature: A Narrative Review
Full text linkContext: Retinopathy of prematurity (ROP) is known as the abnormal growth of retinal blood vessels in premature and very low birth weight (VLBW) infants that can be caused by exposure to high oxygen pressure through oxidative damage and inflammation. Evidence Acquisition: In this review, the keywords zinc deficiency, iron deficiency, and retinopathy of premature was first searched in databases including Scopus, Google Scholar, and PubMed. There were no time limitations for the search. Full-text articles in the English language were included in this study. Searching with these keywords did not yield any results. In the next step, preterm neonate, preterm infant and VLBW infants were added to the keywords. Findings: The results showed that iron and zinc deficiencies are very common in premature and VLBW infants. VLBW and preterm birth are also risk factors for ROP. In addition, the use of zinc and iron supplements in low birth weight and premature infants is also commonly necessary to maintain normal growth and development. Conclusion: It can be concluded that premature infants receiving high doses of zinc and adequate doses of iron inhibited not only inhibit oxidative damage and inflammation caused by hypoxia but also vascular endothelial growth factor (VEGF) expression. In support of this mechanism, our results showed that premature infants receiving high doses of zinc and adequate doses of iron significantly reduce the ROP process. Therefore, monitoring serum zinc and iron levels and normalizing them may play an important preventive role in the development of ROP