Journals Portal, Shahid Beheshti University of Medical Sciences
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Management of a Late Complication of Strip Perforation with Overextended Gutta-percha Using Intentional Replantation: A 10-Year Follow-up Case Report
Full text linkStrip perforation is a severe procedural complication during root canal therapy, often associated with poor prognosis, especially when combined with overextended gutta-percha. While surgical or nonsurgical retreatment is commonly indicated, patient-centered decision-making and long-term follow-up may influence the management strategy. This case report describes the conservative follow-up and eventual successful treatment of a mandibular second molar with an extensive midroot strip perforation and extruded gutta-percha, ultimately managed with intentional replantation and root-end filling using calcium-enriched mixture (CEM) cement. In 2015, a 40-year-old female patient presented for routine examination. A previously treated mandibular second molar (#37), which had a severe strip perforation in the mesial root and overextended gutta-percha one year prior, remained asymptomatic and functional. The patient declined retreatment and opted for annual monitoring. Over five years, the tooth remained functional and symptom-free, and the extruded gutta-percha showed gradual radiographic resorption. In 2023, the patient returned with a symptomatic apical periodontitis and a large periapical lesion associated with the same tooth. Intentional replantation was performed with midroot resection of the mesial root, root-end filling using CEM cement, and immediate replantation. At the 1-year follow-up, the tooth remained functional, asymptomatic, and radiographically healed. The case highlights the long-term clinical risks of untreated strip perforations, the unpredictable resorption of overextended materials, and the efficacy of minimally invasive surgical interventions in preserving tooth function
Investigating the effects of outer membrane vesicles derived from Campylobacter jejuni on the survival of HT-29 epithelial cells in vitro
Full text linkBackground: Campylobacter jejuni is an important pathogenic bacterium that is associated with diarrhea and gastroenteritis in several animal species and humans. The secretion of virulence factors is a crucial strategy that enteric bacterial pathogens use to interact with host cells, promote their survival, and damage the host. Many bacterial pathogens utilize outer membrane vesicles (OMVs) to deliver virulence factors into host cells. C. jejuni can produce nanosized OMV cargos, which have been proposed to have a key role in disease progression, pathogenesis, and immune system modulation. This study aimed to assess the effect of OMVs derived from C. jejuni on the survival of HT-29 intestinal cells in vitro.
Materials and Methods: In this work, C. jejuni clinical strain RIGLD 4-151 was used. C. jejuni OMVs were isolated using ultracentrifugation and were analyzed by scanning electron microscopy (SEM) and dynamic light scattering (DLS). HT-29 human colon cancer epithelial cells were treated with OMVs for 24, 48, and 72 hours. Cell viability of HT-29 cells exposed to OMVs was measured by MTT assay.
Results: Our results showed that C. jejuni strain RIGLD 4-151 released round-shaped nanovesicles ranging from 10 to 250 nm. The cytotoxicity assays unveiled a dose-dependent reduction in cell viability following exposure to various concentrations of C. jejuni OMVs.
Conclusion: The present study demonstrated that OMVs derived from C. jejuni strain RIGLD 4-151 can significantly affect viability of HT-29 cells. Further research is required to elucidate the definite role of OMVs derived from C. jejuni strain RIGLD 4-151 in the pathogenesis of C. jejuni
Awareness of Forensic Odontology Amongst Dentists of Qassim Region: Awareness of forensic odontology amongst dentists
No full textBackground: Forensic odontology utilizes dental evidence to identify individuals in criminal investigations and disasters and to determine age and gender. This study aimed to evaluate the awareness of forensic odontology among dentists in Saudi Arabia and pinpoint potential areas for enhancing education and practice.Methods: A survey involving 266 dentists in the Qassim region of Saudi Arabia was conducted. The survey evaluated the dentists’ understanding of forensic odontology concepts, perspectives on the field, and readiness to manage forensic cases.Results: The findings indicate that the dentists firmly grasped the fundamental principles of forensic odontology. Nevertheless, gaps in knowledge exist, especially in alternative identification methods, solved forensic cases, and child abuse protocols. The dentists showed a keen interest in additional training in forensic odontology and endorsed incorporating the field into the dental undergraduate curriculum.Conclusion: This research offers an overview of the present level of forensic odontology knowledge within the dental field. Although the general performance is positive, recognizing and resolving knowledge gaps with specific interventions can enhance the integration of this important field in dental practice. Forensic odontology plays a significant role in raising awareness among dentists in Saudi Arabia
From Color to Clue, Unraveling the Forensic Significance of Pink Teeth in Postmortem Analysis
Full text linkBackground: The postmortem pink teeth phenomenon (PTP) is a notable change in tooth color, resulting in a pinkish hue after death. Observed in various forensic contexts, including drowning, poisoning and physical trauma, the correlation between PTP and specific causes of death has remained ambiguous.Case Presentation: This study discusses two cases involving cadavers exhibiting the PTP, where we conducted an analysis of pink teeth alongside other findings concerning the postmortem interval.Conclusion: A comprehensive analysis of PTP requires consideration of various forensic elements. The phenomenon is closely associated with decomposition processes and is often observed in water immersion cases. A multidisciplinary approach involving forensic medicine and odontology is essential for understanding the physiological changes after death and assessing the potential significance of PTP as a postmortem indicator. By integrating these diverse aspects, forensic investigators can gain deeper insights into the circumstances surrounding death. Although PTP is not pathognomonic for any specific cause of death, it serves as a valuable indicator that can assist in forensic investigations. Further studies are necessary to clarify its implications in various forensic contexts and enhance its application in medico-legal assessments
Prostate Cancer and the Rise of Focal Laser Therapies: A Narrative Review of Benefits and Limitations: Focal laser therapies in prostate cancer
No full textIntroduction: Prostate cancer is the second most prevalent cancer in men and remains a major global health concern. Traditional treatment modalities such as radical prostatectomy (RP) and radiation therapy, while effective, often result in significant morbidity, including urinary incontinence and sexual dysfunction.
Methods: A narrative review was conducted to synthesize current evidence on focal laser therapy for prostate cancer. A comprehensive literature search was performed across three major databases: PubMed, Scopus, and Web of Science. The search strategy employed the following Medical Subject Headings (MeSH) terms and keywords: (“Prostatic Neoplasms” [MeSH] OR “prostate cancer”) AND (“Laser Therapy” [MeSH] OR “laser ablation” OR “focal therapy”). The search was limited to studies published between 2000 and 2024.
Results: The initial search retrieved 1,444 articles. After a rigorous screening of titles, abstracts, and full-texts, 79 studies met the inclusion criteria and were incorporated into the review. The selected literature enables a comprehensive and critical evaluation of the current state of research on focal laser therapy in the management of prostate cancer.
Conclusion: While focal laser therapies offer promising outcomes with fewer side effects, their long-term efficacy and survival benefits remain uncertain. High-quality studies with long-term follow-up are essential to better define their role in the prostate cancer treatment landscape and inform optimal patient selection
Senior-Loken Syndrome: A Rare Case Report of A Novel NPHP4 Gene Mutation in A Child From Bangladesh: Senior-Loken Syndrome
No full textBackground and Aim: Senior Loken syndrome describes patients with nephronophthisisalong with retinal dystrophy. The first signs of renal involvement include polyuria andpolydipsia, which occur due to impaired urinary concentration capabilities. Nephronophthisisprogresses to end-stage renal disease by the age of 20. Retinal abnormalities can range fromsevere infantile retinal dystrophy to the more typical form of retinitis pigmentosa. Otherassociated features of this syndrome include skeletal and dermatological abnormalities, aswell as cerebellar issues.Case Presentation: Here, we reported a case of Senior‒Loken syndrome with polyuria,polydipsia, and nocturnal enuresis followed by the features of advanced renal disease, such asgrowth retardation and moderate anemia. He was also myopic and demonstrated tessellatedfundus during the fundoscopic examination.Conclusion: To date, there are no case reports published in the Bangladeshi medical literatureregarding this rare autosomal recessive disorder among pediatric patients. Therefore, thiscase report aims to increase awareness among clinicians to detect these patients early, as themanagement implemented may prevent or delay the need for renal replacement therapy andpreserve eyesigh
ناخنک چشم و درمانهای آن در طب سنتی ایران
No full textBackground and Aim: Pterygium is a relatively common ocular condition that grows on the conjunctiva and may progress toward the cornea and the visual axis, potentially leading to vision impairment. This condition can also cause complications such as dry eye, inflammation and particularly cosmetic concerns. In cases where the pterygium is progressive or there is a risk of vision loss, surgery is recommended, although the likelihood of recurrence is high. This condition has also been mentioned in Iranian traditional medical texts, with various treatments. The aim of this study is to describe the disease and its treatment methods in post-Islamic Iranian medicine.
Methods: In this library review study, the terms "Zafrah" and "Nakhonak" were first searched in selected medical reference books from the 3rd to the 14th century AH using the Noor software. Subsequently, the definitions, causes, symptoms, as well as the treatment methods were extracted, noted and categorized. The recommended simple and compound drugs were presented in a table and the most commonly used ones were also extracted.
Ethical Considerations: Honesty and trustfulness were observed by referring to the used texts and references.
Results: Iranian physicians, like their Greek counterparts, were familiar with this disease and described it in the oldest medical and ophthalmology texts after Islam. They believed the cause of this disease to be the accumulation of thick humor and considered it more prevalent in dry temperaments, old age, the autumn season and arid climates. Various treatment methods were recommended for this disease. In the early stages, more attention was given to cleansing the body and local treatments, using herbal, mineral and animal-based medicines either individually or in combination. Cumin, licorice, rose oil, myrrh, ammoniacum and yellow myrobalan were among the most common medicinal herbs used in singular form. However, in more advanced cases, surgery and removal of the lesion were performed, the steps of which are similarly described in most medical texts.
Conclusion: The descriptions provided by Iranian physicians and the used surgical methods are very similar to Greek sages’ knowledge. On the other hand, the description of the disease and related epidemiological points are consistent with modern findings. Although surgery and specific medications are currently used to treat this disease, it may be possible to utilize recommended treatments, particularly herbal medicines, to control the disease and improve patients' quality of life after surgery, considering the frequent recurrence of the disease or even in its early stages.زمینه و هدف: ناخنک یکی از ضایعات چشمی نسبتاً شایع است که بر روی ملتحمه رشد میکند و ممکن است به سمت قرنیه و محور بینایی پیشروی کرده و باعث کاهش دید شود. این عارضه همچنین میتواند عوارضی مانند خشکی چشم، التهاب و به ویژه مشکلات زیبایی ایجاد کند. در مواردی که ناخنک پیشرونده باشد یا احتمال کاهش دید وجود داشته باشد، جراحی توصیه میشود، هرچند احتمال عود آن زیاد است. این بیماری در متون طب سنتی ایرانی نیز مورد اشاره قرار گرفته و درمانهای مختلفی برای آن توصیف شده است. هدف از این مطالعه، توصیف بیماری و روشهای درمانی آن در طب ایرانی پس از اسلام است.
روش: در این مطالعه مروری کتابخانهای، ابتدا کلمات «ظفره» و «ناخنک» در کتب مرجع طبی منتخب از قرن سوم تا چهاردهم قمری با استفاده از نرمافزار نور جستجو شد، سپس تعریف، اسباب، علائم بیماری و همچنین روشهای درمانی استخراج، یادداشتبرداری و دستهبندی گردید. مفردات و مرکبات توصیهشده در جدولی ارائه و پرکاربردترین موارد نیز استخراج شد.
ملاحظات اخلاقی: در این پژوهش صداقت و امانتداری در ارجاع متون به منابع مورد استفاده رعایت گردیده است.
یافتهها: حکمای طب ایرانی مانند اطبای یونانی این بیماری را میشناخته و در قدیمیترین کتب طبی و چشمپزشکی بعد از اسلام آن را توصیف کردهاند. آنها علت این بیماری را تجمع خلط غلیظ و شیوع آن را بیشتر در مزاجهای خشک، سنین پیری، فصل پاییز و اقلیمهای خشک میدانستند. برای درمان این بیماری، روشهای مختلفی توصیه شده است. در مراحل اولیه، بیشتر به پاکسازی بدن و درمانهای موضعی توجه میشد و از داروهای گیاهی، معدنی و حیوانی به صورت تکی یا ترکیبی استفاده میکردند. زیره، شیرینبیان، روغن گل، مُرّ مکی، اشق و هلیله زرد از رایجترین گیاهان دارویی بودند که به صورت مفرده به کار میرفتند، اما در موارد پیشرفتهتر، جراحی و برداشتن ضایعه انجام میشد که مراحل آن به طور مشابه در اکثر کتب طبی توصیف شده است.
نتیجهگیری: توصیفهای موجود از پزشکان ایرانی و روشهای جراحی به کاررفته، شباهت قابل توجهی به دانستههای حکمای یونان دارد. از سوی دیگر، توصیف بیماری و نکات مرتبط با اپیدمیولوژی آن نیز با یافتههای امروزی همخوانی دارد، هرچند در حال حاضر از جراحی و داروهای اختصاصی برای درمان این بیماری استفاده میشود، اما ممکن است پس از جراحی و با توجه به عود مکرر بیماری یا حتی در مراحل ابتدایی آن، بتوان از داروهای توصیهشده، به ویژه گیاهان دارویی، برای کنترل بیماری و بهبود کیفیت زندگی بیماران بهره برد
بررسی معماری حمام تاریخی افتخارالاسلام طباطبایی بروجرد و انطباق آن با اصول طب ایرانی ـ اسلامی
No full textBackground and Aim: Since ancient times, there has been a close connection between medical knowledge and architecture in the construction of traditional buildings such as baths. The Iftikhar al-Islam Tabatabaei bath is one of the historical baths in Boroujerd city, built during the Qajar period by Iftikhar al-Islam Tabatabaei Nabavi Boroujerdi. This research aims to study the architecture of this bath and its compliance with the principles of Persian medicine.
Methods: This descriptive-analytical research was conducted using library documents and field studies.
Ethical Considerations: In this research, the ethical aspects of library study including the authenticity of the text, honesty and trustworthiness have been observed.
Results: The findings indicate that Iftikhar al-Islam Tabatabaei bath consists of four main sections or chambers, which are, in order: The first chamber (cold and dry), the second chamber (cold and moist), the third chamber (hot and moist) and the fourth chamber (hot and dry) based on Iranian traditional medicine. The components of the bath include the entrance, sarbineh (dressing hall), miandar (transitional space), restroom, garmkhaneh (hot room), sardab (cool underground area), khazineh (hot water pool) and the furnace. In the construction of this building, the fundamental principles of Iranian architecture, namely "people-centeredness, avoidance of excess, structural integrity, self-sufficiency, and inwardness" has been observed. The depictions of birds and flowers on the tilework in the sarbineh walls induce a sense of relaxation, warmth and moisture in individuals, while the presence of cold water in the sardab helps adjust body temperature to match that of the sarbineh space.
Conclusion: The Iftikhar al-laslam Tabatabaei bath, as an architectural and medicinal masterpiece from the Qajar period, not only exemplifies the integration of Iranian architectural art and medicine but also plays a significant role in preserving the health and well-being of individuals.زمینه و هدف: از دیرباز ارتباط تنگاتنگی میان دانش پزشکی و معماری در ساخت بناهای سنتی همچون حمامها وجود داشته است. حمام افتخارالاسلام طباطبایی از جمله حمامهای تاریخی شهرستان بروجرد است که در دوره قاجاریه توسط افتخارالاسلام طباطبایی نبوی بروجردی ساخته شد. هدف از پژوهش حاضر بررسی معماری این حمام و انطباق آن با اصول طب ایرانی است.
روش: این پژوهش به روش توصیفی ـ تحلیلی و با استفاده از اسناد و مدارک کتابخانهای و مطالعات میدانی انجام شده است.
ملاحظات اخلاقی: در این پژوهش، جنبههای اخلاقی مطالعه کتابخانهای شامل اصالت متن، صداقت و امانتداری رعایت شده است.
یافتهها: یافتههای پژوهش نشان میدهد که حمام افتخارالاسلام بر اساس طب ایرانی از چهار بخش یا خانه اصلی تشکیل شده است که به ترتیب عبارتند از: خانه اول (سرد و خشک)، خانه دوم (سرد و تر)، خانه سوم (گرم و تر) و خانه چهارم (گرم و خشک). اجزای تشکیلدهنده حمام شامل ورودی، سربینه، میاندر، سرویس بهداشتی، گرمخانه، سرداب، خزینه آب گرم و آتشدان بودند. در ساخت این بنا اصول اصلی معماری ایرانی یعنی «مردمواری، پرهیز از بیهودگی، نیارش، خودبسندگی و درونگرایی» رعایت شده بود. تصاویر مرغ و گل در کاشیهای دیوار در سربینه موجب انبساط و گرمی و تری در افراد و وجود آب سرد در سرداب موجب تطبیق دمای بدن با دمای فضای سربینه میشد.
نتیجهگیری: حمام افتخارالاسلام طباطبایی بروجرد، به عنوان یک اثر معماری و طبی در دوره قاجار، نهتنها الگویی از هماهنگی بین هنر معماری و طب ایرانی را نشان میدهد، بلکه نقش مهمی در حفظ بهداشت و سلامت افراد نیز داشته است
بررسی تاثیر آموزش کادر درمان بخش خصوصی در معرفی مادران باردار به مراکز بهداشتی درمانی
No full textBackground and Aims: Because not all pregnant mothers visit health centers, this study aimed to assess the impact of training private sector healthcare personnel on identifying pregnant women and referring them to health centers.
Materials and Methods: In this quasi-experimental study, 58 healthcare personnel from Torghabeh and Shandiz County (Mashhad) were randomly assigned to intervention and control groups. The training program was implemented for private sector specialists in Torghabeh. The number of identified pregnant women in both groups was compared before and after the intervention. Ethical principles were strictly adhered to at every phase of the study. Data were analyzed using SPSS version 23.
Results: According to the results, the number of registered pregnant women in the Sina system in the intervention group increased from 111 to 148 over the six-month intervention period—a 33% growth. In contrast, the number in the control group decreased from 170 to 166, indicating a reduction of four individuals compared to the same previous period. However, these differences were not statistically significant (P<0.05). In total, 63 individuals were registered in the “My Health” system, of whom 24 had never previously been registered in the Sina system.
Conclusion: The findings suggest that collaboration and training of private sector healthcare providers in identifying pregnant women and similar cases can enhance public utilization rate of health center services.زمینه و اهداف: از آنجایی که همه مادران باردار به مراکز بهداشت مراجعه لازم را ندارند، این مطالعه با هدف تعیین تاثیر آموزش کادر درمان بخش خصوصی در زمینه شناسایی مادران باردار و معرفی به مراکز بهداشت اجرا شد.
مواد و روشها: در این مطالعه نیمه تجربی، 58 نفر از همکاران شهرستان طرقبه و شاندیز مشهد به روش تصادفی به دو گروه مداخله و کنترل تقسیم شدند. برنامه آموزشی برای متخصصین بخش خصوصی طرقبه برگزار شد. سپس میزان مادران شناسایی شده در دو گروه در زمانهای قبل و بعد از اجرای برنامه با هم مقایسه گردید. رعایت ملاحظات اخلاقی در تمام مراحل اجرای مطالعه در نظر گرفته شد. تحلیل دادهها با نرم افزار SPSS23 انجام شد.
یافتهها: بر اساس یافتهها در گروه مداخله، میزان مادران ثبت شده در سامانه سینا طی 6 ماه مداخله از 111 نفر به 148 نفر افزایش یافت که 33 درصد رشد داشت؛ در حالی که گروه کنترل از 170 نفر به 166 نفر تغییر یافت که نسبت به دوره مشابه قبلی چهار نفر کاهش یافت اما این تفاوتها از نظر آماری معنیدار نبود (0/05>P). در مجموع در سامانه سلامت من تعداد 63 نفر ثبت شدند که از این تعداد، 24 نفر مادرانی بودند که تاکنون هرگز در سامانه سینا ثبت نشده بودند.
نتیجهگیری: نتایج نشان داد که با استفاده از تعامل و همکاری همراه با آموزش کادر درمان بخش خصوصی در زمینه شناسایی مادران باردار و موارد مشابه میتوان میزان استفاده مردم از خدمات مراکز بهداشتی درمانی را افزایش داد
ارزیابی ریسک بهداشتی مواجهه استنشاقی با هیدروکربنهای آروماتیک چندحلقهای متصل به ذرات PM2.5 در هوای شهرتهران
No full textBackground and Aims: Polycyclic aromatic hydrocarbons (PAHs) with high carcinogenic properties are widely present in the environment. Today, these compounds have attracted more attention due to their adverse effects on human health, concurrent with the increasing air pollution. This study aimed to evaluate the concentration and inhalation health risk associated with PAHs bound to fine particulate matter (PM2.5) in ambient air of Tehran city.
Materials and Methods: Data were collected from four monitoring stations across the city during the period of October to December 2021. After extraction and analysis of the samples using gas chromatography-mass spectrometry (GC-MS), the carcinogenic risk of the compounds was evaluated using the method proposed by the United States Environmental Protection Agency (USEPA) and the Monte Carlo model. Ethical considerations were taken into account throughout all stages of the study implementation.
Results: The mean total concentration of PAHs at selected stations varied between 65.92 ng/m³ and 142.76 ng/m³. The results also showed that some PAH compounds, such as dibenzo [a,h]anthracene, had significant carcinogenic risks (CR=5×10−6), while their non-carcinogenic risks were within acceptable levels (HQ=0.0016).
Conclusion: The results of this study emphasize that reducing the emission of PAHs from various sources, especially vehicle exhaust and industrial activities, is essential to prevent the harmful effects of these pollutants on public health.زمینه و اهداف: هیدروکربنهای آروماتیک چند حلقهای (PAHs) با خاصیت سرطانزایی بالا به طور گسترده در محیط زیست حضور دارند. امروزه این ترکیبات همزمان با افزایش روزافزون آلودگی هوا به دلیل اثرات نامطلوب بر سلامت انسان توجه بیشتری را به خود جلب کردهاند. مطالعه حاضر به ارزیابی غلظت و ریسک بهداشتی استنشاقی ناشی از مواجهه با PAHs باند شده به ذرات معلق ریز (PM2.5) در هوای شهر تهران پرداخته است.
مواد و روشها: دادههای این مطالعه از چهار ایستگاه مختلف شهر تهران در پاییز سال 1400 جمعآوری شدند. پس از استخراج و تجزیه و تحلیل نمونهها با استفاده از کروماتوگرافی گازی- طیف سنجی جرمی(GC-MS)، ریسک سرطانزایی ترکیبات با استفاده از روش پیشنهادی سازمان حفاظتی محیط زیست آمریکا (USEPA) و مدل مونت کارلو ارزیابی شد. رعایت ملاحظات اخلاقی در تمام مراحل اجرای مطالعه در نظر گرفته شد.
یافتهها: میانگین غلظت کل PAHs در ایستگاههای منتخب بینng/m³ 65/92 تا 142/76 متغیر بود. همچنین؛ نتایج نشان داد که برخی از ترکیبات PAHs مانند دیبنزو [ah]آنتراسن دارای ریسک سرطانزایی قابل توجهی بودند (CR=5×10−6)، در حالی که ریسک غیرسرطانزایی این ترکیبات در سطح قابل قبول قرار داشت (HQ=0/0016).
نتیجهگیری: نتایج این مطالعه تاکید میکند که کاهش انتشار PAHs از منابع مختلف، به ویژه اگزوز خودروها و فعالیتهای صنعتی، ضروری است تا از اثرات زیانبار این آلایندهها بر سلامت عمومی جلوگیری شود