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Maternal sleep quality in late pregnancy: The association between preterm birth and sleep quality
Get PDFBackground: A quick look at the existing literature indicates that sleep disturbances during pregnancy could be a risk factor for adverse outcomes. The aim of the study was to assess the prevalence of maternal sleep quality in late pregnancy and the association between preterm births and sleep quality.
Methods: A prospective study was conducted on 300 eligible singleton pregnant women attending the prenatal care clinics, affiliated with Babol University of Medical Sciences. The data were collected through convenience sampling. The self-report Pittsburgh Sleep Quality Index (PSQI) questionnaire was used to measure the pattern and the quality of sleep in pregnant women.
Results: The prevalence of self-reported poor sleep quality was found to be 77% among the pregnant women in Babol, Iran. The chi-square test did not show any statistically significant difference in characteristics between pregnant women with good and poor sleep qualities. Also, the adjusted odds ratio for preterm labor revealed no significant relationships between sleep quality and preterm birth.
Conclusion: The findings demonstrated that there was a high prevalence of poor quality sleep among pregnant women in the third trimester of pregnancy. However, poor sleep quality was not associated with preterm labor, making this problem one of the major problems experienced by pregnant women
Effect of hydrofluoric acid concentration and etching time on microtensile bond strength of suprinity and enamic CAD/CAM ceramics to resin cement
Get PDFIntroduction: The use of dental ceramics has increased due to their beauty and biocompatibility. The aim of this study was to evaluate the effect of hydrofluoric acid concentration and etching time on microtensile bond strength (μTBS) of the Enamic and Suprinity ceramics. Material & Methods: In this in vitro study, two hydrofluoric acid (HFA) concentrations of 5 (A) and 10 (B) were used at the time of 20, 60 and 120 seconds (s) on the Suprinity and  Enamic ceramics of CAD/CAM. The etched surfaces were impregnated with silane coupling agent as well as priming and Clearfil SE bond. Then, the Panavia F 2.0  resin cement was applied on the ceramic surfaces and light-cured. There were groups of EA20, EA60, EA120, EB20, EB60, EB120 for Vita Enamic and SA20, SA60, SA120, SB20, SB60, SB120 for Vita Suprinity. The μTBS between resin cement and porcelains was measured with universal testing machine. Mode of failure was observed under the stereo microscope at 40x magnification. Data were analyzed using ANOVA and Chi-square. Results: The μTBS was significantly different between EB20 and EB60 (p=0.008), EB120 and EB20 (p=0.005), SA120 and SB120 (p=0.013), EA120 and EB120 (p=0.002) as well as EA60 and EB60 (p=0.44). In both ceramics, different concentrations and etching times had significant effect on the mean of μTBS (p=0.016). In both ceramics, the time had no effect on the failure mode. For Suprinity ceramic, the HFA concentration had effect on the failure mode (P=0.028). Conclusion: The best surface treatment for Suprinity ceramic is 120 s with 5 HFA and for Enamic is 20 s with 10 HFA, which create the highest bond strength.  
Effect of hydrofluoric acid concentration and etching time on the surface roughness of CAD/CAM ceramics
Get PDFIntroduction: Dental ceramics are considered as materials that can restore the appearance of natural teeth. Etching the inner surface of a ceramic restoration with hydrofluoric acid (HF) followed by using a silane coupling agent is a well-known and recommended method to increase the bond strength. The aim of etching on ceramic structure is to enhance the surface roughness (Ra) and energy and to cleanse the bonding area. The aim of this study was to evaluate the effect of different HF concentrations and etching times on the Ra of IPS e.max CADTM and Vita mark IITM.
Material & Methods: Two HF concentrations (5% and 10%) and three etching times (20, 60 and 120 seconds) were evaluated. Etched patterns were observed by scanning electron microscopy (SEM) and Ra was measured using atomic force microscopy (AFM). Surface element analysis was performed using energy dispersive X-ray spectroscopy (EDAX). Data were analyzed on SPSS 20 using ANOVA and T-test.
Results: The Ra had no significant difference among various Vita mark IITM specimens (P=0.973). Among IPS e.maxTM specimens etched with 5% HF, the AFM results showed that 20-s etching time had the lowest Ra and among those etched with 10% HF and 120-s etching time had the most Ra. In IPS e.maxTM specimens etched with acid for 20 s, a significant difference was observed in Ra of 5% and 10% acid concentrations (5% HF lower than 10% HF) (p=0.012).
Conclusion: Among IPS e.maxTM specimens etched with 5% and 10% HF, increasing the etching time lead to higher Ra. For both IPS e.maxTM and Vita mark IITM, 20-s etching with 5% HF provides acceptable Ra for the bond
Physiological risk factors for cardiovascular disease in middle-aged (40-60 years) adults and their association with dietary intake, Northern Iran
Get PDFBackground: Considering the importance of healthy diet in the protection of cardiovascular diseases (CVD), this research aimed to assess the physiological risk factors for CVD in middle-aged adults and their association with dietary intake in the north of Iran. Methods: In this cross-sectional study conducted in the years 2016-2017 among the adults aged 40-60 years living in Amirkola, Babol, the participants´ physical activity, dietary intake, body mass index, fat mass, blood pressure, fasting blood glucose and serum lipid profile were reported. The International Physical Activity Questionnaire was used to assess physical activity and a structured 24-hour food-recall questionnaire was used to assess the participants´ dietary intake. Consumed foods and beverages on two separate days were analyzed and transcribed in 10 food groups (gram). Results: Two hundred and ninety-one persons (96.7) had complete participation, 96.2 with at least one CVD risk factor and 75.9 had overweight or obesity; 33 with hypertension; 6.2 had high fasting blood glucose; 64.6 with hypercholesterolemia, 47.8 had hypertriglyceridemia, and 8.9 with low HDL. Mean daily intake values of carbohydrate, protein and fat were all higher than dietary reference intakes for adults. Physical activity less than 1500 MET-minutes per week was significantly associated with having three or more physiological risk factors for CVD adjusted odds ratio: 2.04 (1.08-3.85) (P=0.029). Conclusion: Most of the middle-aged adults in this region had at least one of the physiological risk factors for CVD and daily intakes of carbohydrate and protein were higher than dietary reference intakes (DRIs) for adults
The effect of vitamin D supplementation on the size of uterine leiomyoma in women with vitamin D deficiency
Get PDFBackground: Uterine leiomyomas (fibroids) are the most common benign pelvic tumors in women of reproductive age with an incidence ranging from 5.4 to 77, Also, there is a high prevalence of vit D deficiency in Iran and there are the numbers of in vivo and vitro biological studies on the relationship of vitamin D and uterine leiomyomas. The aim of this study was to evaluate the effect of vit D supplementation on the size of uterine leiomyoma in women with vit D deficiency. Methods: This double-blind prospective clinical trial was performed on 69 patients with uterine leiomyomas who had vit D deficiency. Group A (n=35) was treated with vit D 50,000 IU every 2 weeks for 10 weeks, while group B (n=34) received placebo with same color and shape. Finally, the leiomyoma size in both groups was compared (IRCT: 20160521027998N5). Results: After a 10-week intervention, 25-hydroxyvitamin D3 levels were significantly higher in group receiving vitamin D (36.08 vs 16.25 ng/ml). (P<0.001) Leiomyomas size in vit D group significantly decreased as compared to placebo group (52.58 vs 61.11 mm, respectively). Conclusion: Our results showed that administration of vit D3 may reduce the size of leiomyoma. It seems that vitamin D administration is the effective way to treat leiomyoma
The efficacy of addition of dexmedetomidine to intrathecal bupivacaine in lower abdominal surgery under spinal anesthesia
Get PDFBackground: Spinal anesthesia is the common choice for anesthesia in lower abdomen surgery and intrathecal adjutants have gained popularity with the aim of prolonging the duration of block, quality of block and post operation pain control. The purpose of this study was to evaluate the effects of adding dexmedetomidine to hyperbaric bupivacaine in lower abdominal surgery under spinal anesthesia. The main outcomes were considered pain score, duration of analgesia, hemodynamic changes and adverse side effects like nausea and vomiting. Methods: This double-blind randomized clinical trial was conducted on one hundred patients between 18 to 65 years old scheduled for lower abdominal surgery. Fifty patients were randomly allocated to receive either 12.5mg hyperbaric bupivacaine (2.5cc) plus 5µgr dexmedetomidine (0.5cc) intrathecally while fifty patients received either 12.5mg hyperbaric bupivacaine (2.5cc) and 0.5cc Saline 0.9 intrathecally. Results: Vital sign parameters like heart rate, blood pressure and oxygen saturation levels were registered in the normal range in both groups. The average duration of the onset of pain (230±86 min) in bupivacaine group was significantly (p≤0.000) less than dexmedetomidine group (495±138 minutes). The severity of pain at all times in dexmedetomidine group was significantly (p<0.05) less than bupivacaine group. The severity of shivering and the number of patients who needed treatment for nausea and vomiting in dexmedetomedine group has been less in comparison to bupivacaine. Conclusion: We concluded that intrathecal dexmedetomidine increases the duration of analgesia and reduces postoperative pain without changes in the hemodynamic parameters and adverse side effects. It can be considered as an appropriate adjuvant to intrathecal local anesthetics for lower limb surgeries
P53 expression in various types of hydropic placentas (through ploidy analysis as a complementary tool in diagnosis of samples)
Get PDFBackground: Placentas characterized by hydropic swelling of chorionic villi occur in a spectrum of pathological conditions including hydropic abortion (HA), partial hydatidiform mole (PHM) and complete hydatidiform mole (CHM). The purpose of this study was to investigate whether the expression of p53 tumour suppressor protein could differentiate these various types of hydropic placentas. Methods: p53 immunohistochemical staining was performed in 19 molar (8 PHM and 11 CHM) and 10 non-molar (HA) formalin-fixed, paraffin-embedded tissue samples. Ploidy analysis using flow cytometry was performed as a complementary tool in diagnosis of samples. Results: DNA histograms obtained from all samples had confirmed diploidy in HAs and CHMs and triploidy in PHMs. p53 immunoreactivity was assessed in villous cytotrophoblasts, syncytiotrophoblasts and stromal cells. The p53 positive reaction was predominantly observed in the nuclei of cytotrophoblastic cells and rarely in stromal cells, no reaction was seen in syncytiotrophoblasts. The mean percentage of p53 positive cells were 6.10±3.75 for HA, 25.87±13.4 for PHM and 39.83±18.76 for CHM.  There was a significant difference in P53 immunoreactivity of cytotrophoblastic cells between CHM and HA (P<0.001), and between PHM and HA (P=0.004). There was no significant difference in immunohistochemical reactivity between CHM and PHM (P=0.068). Conclusion: This study confirms that p53 immunostaining may be helpful in distinguishing complete and partial hydatidiform mole from hydropic abortion, but not complete hydatidiform mole from partial hydatidiform mole
Right ventricular metastasis from unclassified Renal Cell Carcinoma
Get PDFBackground: Cardiac metastasis of unclassified renal cell carcinoma (RCC) subtype is very rare, and even more so is an isolated right ventricular (RV) metastasis without vena cava extension or right atrial involvement. To the best of our knowledge, this is the first report of a cardiac metastasis of an unclassified RCC (an aggressive RCC) without vena cava extension. Case Presentation: A 61-year-old African American male with past medical history of hypertension and schizophrenia presented to the emergency room following 2 episodes of syncope and 3-month history of progressive neck mass. CT scan of neck, abdomen and pelvis showed bulky left cervical, supraclavicular and axillary lymph node, mass in anterior aspect of heart, and multiple solid left renal masses and probable right renal mass. Echocardiogram revealed a large RV mass with deformation of the RV free wall suggesting malignant growth. Core biopsy of the right superficial gluteal mass revealed a metastatic poorly differentiated carcinoma of likely renal origin, with a possibility of an unclassified RCC. Due to the extent and burden of metastasis, patient and family members agreed to conservative management and evaluation for hospice care. Conclusion: Cardiac metastasis of unclassified RCC is rare, and even more so is an isolated RV metastasis without vena cava extension or right atrial involvement, and the present case, to the best of knowledge is the first of such rare presentation.  
Libman-Sacks endocarditis in patients with systemic lupus erythematosus with secondary antiphospholipid syndrome
Get PDFBackground: Libman-Sacks endocarditis (LSE) is characterized by sterile lesions that commonly affect the aortic and mitral heart valves. Antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) have been associated with LSE. Cardiac manifestations including LSE could be interrelated with other manifestations and early diagnosis could help in preventing further complications. Case presentation: Here, we report three cases of LSE in SLE patients with secondary APS. All patients presented with neurological manifestations and LSE was diagnosed by Transesophageal echocardiography (TEE). All three patients were treated for the underlying disease and also received anticoagulant therapy. Conclusion: In all patients with SLE and secondary APS, LSE should be considered if a patient manifests any evidence of neurologic involvement
Unilateral eyelid edema and mucosal involvement as the first presentations of Wegener granulomatosis
Get PDFBackground: Wegener granulomatosis or granulomatosis with polyangiitis is a pauci-immune small vessel vasculitis which is usually associated with anti-neutrophil cytoplasmic antibodies (ANCA) mainly in old men. This small vessel vasculitis is usually characterized by necrotizing granulomatous inflammation with multiorgan involvement. Kidneys could be involved as the main and life-threatening condition in Wegener granulomatosis.  Oral or ocular lesions may occur as the first and uncommon presentations before internal organ involvement in these patients and could be misdiagnosed with other diseases. Case presentation: We present a 24-year-old man with erosions and ulcerations on palatal mucosa and a strawberry-like gingival hypertrophy associated with nasal congestion and epistaxis which two stated months ago. Also he had an episode of unilateral blepharitis and upper eyelid edema five months ago. Mucosal biopsy showed perivascular infiltrations of mainly neutrophils, some eosinophils and rare giant cells. He had elevated level of proteinase 3–ANCA or C-ANCA with microscopic hematuria without significant kidney involvement in kidney biopsy. Mucosal lesions and hematuria improved after two months of treatment with oral prednisolone. Conclusion: Unilateral eyelid edema and mucosal erosions in a young man could be the uncommon presentations of Wegener granulomatosis