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Cone Beam Computed Tomography (CBCT) findings of Fungal Sinusitis in Post COVID�19 Patient: A case report
Full text linkBackground: Fungal infections of the paranasal sinus are increasingly recognized in both normal and immunocompromised individuals. It is necessary to distinguish invasive diseases from the non- invasive as the result and prognosis of sinus treatment different in each one. CBCT imaging could help us in this regard. In this case, we describe a fungal sinusitis according to Cone Beam Computed Tomography (CBCT) findings. Case presentation: We present a case of a 48-year-old woman with diabetes mellitus referred to our Maxillofacial Radiology Center in Babol, Iran. The patient has been discharged from the hospital recently after recovering from COVID-19 Considering the background systemic disease (diabetes) and clinical and radiological findings (extension of bone destruction), fungal sinusitis (invasive form) was listed top in the differential diagnosis list , as it is the most common condition in post-COVID-19 patients. Conclusion: CBCT images are very useful for diagnosing normal anatomy variations and sinus lesions especially bone lesions .In this case, its early diagnosis led to rapid recovery of the patient
Relationship between Serum Sodium level and Impairment and Disability in Stroke Patients
Full text linkBackground and Objective: Hyponatremia is associated with adverse outcomes and increased mortality in acute stroke patients. However, the role of hyponatremia as a negative prognostic indicator has been controversial. This study was conducted to determine the relationship between serum sodium level and impairment and disability in stroke patients in Babol, northern Iran.
Methods: This cross-sectional study was conducted in 6 months on 125 stroke patients admitted to Ayatollah Rouhani Hospital in Babol. The National Institutes of Health Stroke Scale and the Modified Rankin Scale were used to determine the impairment and disability caused by stroke. Venous blood was collected to determine the serum concentrations of sodium. The normal ranges were defined as 135-145 mEq/L.
Findings: Of 125 stroke patients, 108 cases (86.4%) were ischemic stroke. Eighty-two cases (65.5%) had hyponatremia. The type of stroke showed statistically significant difference with hyponatremia in 14 hemorrhagic stroke cases (17%) versus 68 ischemic stroke cases (83%) (p=0.01). Furthermore, the difference in gender showed statistically significant difference with hyponatremia in 49 women (59%), and 33 men (41%) (p=0.02). In hyponatremic patients, the severity of impairment at admission (p=0.01) and disability at discharge time (p=0.02) was higher than patients with normal sodium serum level. In patients with a history of smoking, 9 cases (21%) had normal sodium level while 33 cases (79%) had hyponatremia (p=0.03).
Conclusion: The results of the present study showed that the severity of impairment and disability at the time of discharge in stroke patients is related to serum sodium level. Therefore, paying attention and correcting serum sodium level should be considered more in acute stroke patients
Critical Content Analysis of Narrative Version of Islamic Medicine
Full text linkBackground and Objective: The nature of Narrative version of Islamic medicine (NIM) is based on Quran and hadith, exclusive attention to Islamic narrative references and rejection of the strategies of other medical schools. This study was conducted to criticize NIM.
Methods: In this qualitative study of content analysis, after collecting the opinions of 6 prominent scholars of NIM, the criticisms of these opinions were presented and categorized by three doctors specialized in Persian medicine, a cleric in the field of Islamic jurisprudence and a methodologist by holding expert panel meetings.
Findings: Criticisms were raised based on three points of view. The intra-religious area including the routine of Ahl al-Bayt (The holy family of the Prophet Muhammad) in illness and the role of physicians, the place of reason and experience in Islamic sciences, differences in geographical areas, not mentioning the full history of patients and newly occurring diseases was brought up. From a medical point of view, the important points include lack of a research method to check the effectiveness of a medical narrative, lack of diagnostic aspects and an approach to screening. From the viewpoint of religious and social consequences, religious trauma resulting from lack of response to treatment attributed to Ahl al-Bayt, approach to other manifestations of Western civilization, ethical issue of producing, prescribing and selling drugs by a group and loss of life and money due to waste of time in cases with definitive or relative treatment was raised in other medical schools.
Conclusion: Based on the results of this research, the introduction of this theory to society without sufficient investigations in the seminaries and universities of medical sciences may cause physical, mental and religious trauma at the individual and social level
Comparison of Dentinal Microleakage of Class II Composite Restorations Using Universal Bonding: Self-Etch and Selective-Etch of Enamel, with and without Liner
Full text linkBackground and Objective: Microleakage is one of the most important causes of failure in restoration and secondary caries. This study was conducted in order to compare dentinal microleakage of class II composite restorations using Universal Dental Adhesive, with and without liner.
Methods: In this laboratory study, two Class II cavities were prepared in the mesial and distal surfaces of 48 healthy premolar teeth. Then, the samples were divided into 6 groups of 8 according to the application method of Single Bond Universal adhesive and liner: selective etching of enamel (SEE), self-etch (SE) technique, SEE technique and resin-modified glass-ionomer (RMGI) liner, SE technique and RMGI Liner, SEE technique and Flow Liner, and SE technique and Flow Liner. Restoration was done with Filtek Z250 composite. Microleakage was evaluated and compared using 2% fuchsine based on intensity 0 to 3.
Findings: In the SEE group, 56.2% of restorations did not have microleakage. 31.2% had grade 3 microleakage and 12.5% had grade 1 microleakage. However, in the SEE+RMGI group, 81.25% and the SEE+Flow group, 81.2% of the restorations had no microleakage. In the SE group, 18.7% of restorations showed zero microleakage, 50% showed grade 3 microleakage, and 31.2% showed grade 2 microleakage. However, in the SE+RMGI group, 81.25% and in the SE+Flow group, 93.7% of the restorations did not have microleakage. The distribution of dentinal microleakage intensity between SEE and SE methods (p=0.067) and between SEE+RMGI and SEE+Flow groups (p=0.194) was not significant. However, in the SE+Flow and SE+RMGI groups, this difference was significant (p<0.001).
Conclusion: The results of this study showed that in the method of using a liner with Universal adhesive, dentinal microleakage in class II composite restoration decreased
The Effect of Mesalazine on Pain Management in Patients with Diarrhea-Predominant Irritable Bowel Syndrome
Full text linkBackground and Objective: Irritable bowel syndrome is one of the common gastrointestinal complaints that is often resistant to standard treatment. Since mesalazine reduces abdominal pain and diarrhea through its anti-inflammatory effects, this study was conducted to investigate the effect of mesalazine on pain management in patients with diarrhea-predominant irritable bowel syndrome (IBS-D).
Methods: This case-control study was conducted among 100 patients diagnosed with diarrhea-predominant irritable bowel syndrome referred to Ayatollah Rouhani Hospital in Babol. Patients were randomly divided into two groups of 50, receiving standard treatment (amitriptyline 25 mg) and a group that received mesalazine at a dose of 500 mg for 4 weeks three times a day in addition to standard treatment. Subjects were examined and compared in terms of pain intensity and frequency of discharge and recovery.
Findings: The intensity of pain after treatment in the case group was lower than before treatment (4.66±2.29 vs. 7.80±2.01) (p=0.004). Out of 50 patients, 38 people (76.0%) in the case group and only 20 people (40%) in the control group recovered (p<0.001). In the case group, the number of bowel movements after treatment (2.20±0.92) was significantly less than before (4.92±0.92) (p<0.001). In the control group, the number of bowel movements showed a statistically significant difference before and after treatment (5.22±1.07 vs. 2.50±1.19) (p<0.001).
Conclusion: Based on the results of this study, mesalazine is significantly effective in reducing the intensity of pain caused by irritable bowel syndrome. However, there was no difference in the number of excretions
Major and minor criteria for gastric dystemperaments in Persian Medicine: Sari gastric dystemperament criteria-I (SGDC-I)
Full text link<div class="msocomtxt" id="com1" language="JavaScript" onmouseout="msoCommentHide('com1')" onmouseover="msoCommentShow('anchor1','com1')">Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools.  
Determination of serum alkaline phosphatase reference in healthy children aged 1-18 years
Full text linkBackground: The growth and development of children affect biochemical variables. This population-based study was designed to evaluate the reference interval for alkaline phosphatase (ALP) routinely measured in the clinical laboratory. Methods: For this examination, 873 cases were selected among the healthy children and adolescents aged 1-18 years who referred to the endocrinology clinic of Amirkola Children's Hospital for growth evaluation. After overnight fasting, early morning blood samples were obtained to measure the ALP level and other biochemical parameters using an automatic biochemical analyzer. Subjects were categorized by age, sex, and body mass index (BMI) values. The age groups were categorized as follows: 1-4 years, 5-8 years, 9-13 years, and 14-18 years. Results: There was a significant difference among the age and sex categories; on the contrary, there was no meaningful variation between the two groups categorized by BMI. The reference range for ALP was 474.14-517.71 U/L for children aged 1-4 years, 273.47-871.44 U/L for 5-8 years, 215.04-893.69 U/L for 9-13 years, and 228.9-739.22 U/L for 14-18 years. Also, significant positive correlation was found between ALP with length (P=0.000, r=0.134), weight (=0.04, r=0.073), phosphorus (P) (P=0.001, r=0.122), and alanine aminotransferase (SGPT) (P=0.000, r=0.142) respectively. Conclusion: This project's data established a reference interval for ALP in healthy children and adolescents, which will prepare a basis for diagnosis and monitoring liver- or bone-related disorders.  
The Association between Laboratory Blood Parameters and Ocular Manifestations in COVID-19 Patients Admitted to the Intensive Care Unit
Full text linkBackground and Objective: With the spread of coronavirus disease 2019, secondary ocular manifestations were observed as common complications in COVID-19 patients, which can challenge the diagnosis and treatment of ocular diseases. The aim of this study is to investigate the association between laboratory parameters and ocular diseases and to determine their specificity and sensitivity in the diagnosis of ocular diseases in COVID-19 patients admitted to the intensive care unit.
Methods: In this cross-sectional study, 89 patients with COVID-19 admitted to the intensive care unit of Ayatollah Rouhani Hospital in Babol were examined from December 2020 to February 2021. Clinical examinations were performed according to the global standards for ophthalmology examinations for patients, and patients were examined in terms of intraocular pressure, cup-to-disc ratio, ocular manifestations, and ocular diseases. Routine hematology and biochemical laboratory tests were performed for all patients. Patients were compared in the group with an ocular disease (manifestation) and the group without that ocular disease (manifestation).
Findings: Out of 89 patients with COVID-19 hospitalized in the intensive care unit, 44 women and 45 men participated in the study and the mean age of the patients was 58.5±14.64 years. The number of white blood cells was significantly lower in COVID-19 patients with pinguecula compared to non-pinguecula patients (p=0.026). Furthermore, the relative percentage of lymphocytes was significantly lower (p=0.003) in COVID-19 patients with cataract (9.64±13.20%) compared to non-cataract patients (14.25±17.95%). The relative percentage of neutrophils was higher in COVID-19 patients with cataract compared to non-cataract patients (p=0.01). RBC is significantly reduced in COVID-19 patients with chemosis (p=0.024). For the relative percentage of neutrophils greater than or equal to 82.55%, cataract for COVID-19 patients admitted to the intensive care unit with 0.83% sensitivity and 66.7% specificity is positive.
Conclusion: The results of the study showed that blood cells and some biochemical parameters are associated with ocular diseases in COVID-19 patients admitted to the intensive care unit
Depression and quality of life in patients with type 2 diabetes mellitus
Full text linkBackground: Depression as a frequent comorbidity in patients with diabetes requires serious attention, as failure to early detect and treat it can adversely affect the patients' complications. This study was performed to assess the prevalence of depression and quality of life in these patients. Methods: This cross-sectional study was carried-out on adult patients with type 2 diabetes mellitus referred to the endocrinology hospital clinics affiliated to Babol University of Medical Sciences, Babol, Iran, during 2018-2019. The presence and severity of depressive symptoms in patients have been assessed by Beck Depression Inventory-II; and the quality of life was measured by SF-36 questionnaire. Results: Totally, 400 patients with type 2 diabetes mellitus (300 females and 100 males) with mean age of 55.36±11.56 years were recruited. One hundred and thirty (32.5) had depressive symptoms. Of the patients with depression, 115 (28.8) had mild and 15 (3.8) had moderate depression. After entering different variables in logistic regression analysis, gender (P=0.036) and ophthalmic complications (P=0.011) showed a significant association with depressive symptoms. The patients with depression had a worse quality of life compared to those who had not depressive symptoms. Quality of life score in patients with depression was significantly lower than patients without depression (p<0.0001). Conclusions: Nearly one third of the patients with type II diabetes mellitus might have depression. Diabetic patients with depression have a worse quality of life compared to those who have not depression symptoms
The Effect of Metabolic Diseases on the Outcome of Bevacizumab Injection for Central Serous Retinopathy
Full text linkBackground and Objective: Central serous retinopathy (CSR) is an idiopathic retinal disease that causes visual impairment and metamorphopsia. Due to the unknown etiology of CSR, the present study was conducted to investigate the role of metabolic disorders such as hyperlipidemia, diabetes, hypothyroidism, and hypertension (as a cardiovascular disease) in the treatment outcome of CSR patients.
Methods: This cross-sectional study was performed on 55 CSR patients whose problem was approved by ophthalmologic examinations in the Ophthalmology center of Ayatollah Rouhani Hospital, Babol, Iran. The patients were then treated with intravitreal injection of 1.25 mg/0.05 ml bevacizumab (Avastin®) 3 to 4 millimeters away from limbus under sterile conditions. Based on having and not having hypertension, diabetes, hypothyroidism and obesity, all patients underwent ophthalmological examination, including visual acuity (VA) and central macular thickness (CMT) by optical coherence tomography (OCT) before injection and one month after that.
Findings: The mean age of CSR patients (32 men and 23 women) was 42±11.50 years. After treatment, the CMT value in hypertensive patients (328.66±34.00 µm) was significantly higher than non-hypertensive patients (302.56±41.79) (p=0.025). The CMT value after treatment was considerably lower in non-diabetic patients (306.08±42.49 µm) compared to diabetic patients (336.77±17.42 µm) (p=0.039). Neither VA nor CMT was significantly different between hyperlipidemic patients and non-hyperlipidemic patients. In addition, there were no significant differences in VA and CMT between patients with hypothyroidism and without hypothyroidism.
Conclusion: The results of this study showed that hypertension and diabetes are important factors in CSR patients’ response to bevacizumab injection