Kashan University of Medical Sciences

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    Minimally invasive management of a dental trauma: Two years of follow-up in Biodentine-induced maturogenesis

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    Dental trauma is an ordinary complication in childhood period. Most of the traumas are crown fractures in the permanent dentition. Complicated crown fracture, introduced as a crown fracture accompanied by pulp exposure. Treatment plan and long-term prognosis could be modified by different factors, such as fracture line position, root development, alveolar bone fracture, and occlusion. In traumatized open apices teeth, apexogenesis can be occurred after traumatic exposure by vital pulp therapy procedures such as pulp capping, partial or complete pulpotomy in pertinent to the size of the exposure. In this complicated crown fracture case, cervical pulpotomy was performed with a silicate-based biomaterial. Patients smile and esthetic demands play an important role in the perception and judgment that people have of others appearance and character. To reconstruct the patient's smile line, the adhesive reattachment of the coronal fractured fragment to the remaining tooth structure was planned. Reattachment could be suggested as an ideal treatment procedure for crown fracture cases. This technique could be applied to achieve excellent esthetic outcomes and normal function. At 1-year follow-up visit, the patient had no complaints of pain. The clinical and radiographic examination showed a stable reattachment and good periodontal health. Apex diameter was decreased significantly. Physiological root-end closure was obvious. Secondary dentin and calcific barrier were also observed on the radiograph below the Biodentine layer

    A woman with knife In situ of chest

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    The violence can be physical, psychological or sexual. Physical violence can be by the use of sharp objects. Chest stab wounds with retained penetrating objects are rare. Here, we have reported a case with a knife impaled in her upper back who was treated successfully without any complications. A 35-year-old woman presented to our emergency department with an in situ knife at T4-T5 level. Neurologic examination revealed normal and bed side sonography reveals no free fluid in the abdomen, but lung sliding was disrupted on the left hemithorax without evidence of tamponade. A portable chest-x ray showed that the knife passes through an oblique track from right to left. The patient transferred to the operating room and the 50 cm knife removed without traumatic force. Limited thoracotomy with chest tube placement was done. We have reported a case report of an in situ knife at the upper back of a young woman who was successfully treated. The patient was stabbed in the upper back due to her husband's violence and the knife passes through an oblique track from right to left without any vascular injury. We stabilized the patient and used bedside sonography as a modality for diagnosis and decision making

    An Insight into the Sex Differences in COVID-19 Patients: What are the Possible Causes?

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    Studies have reported a sex bias in case fatalities of COVID-19 patients. Moreover, it is observed that men have a higher risk of developing a severe form of the disease compared to women, highlighting the importance of disaggregated data of male and female COVID-19 patients. On the other hand, other factors (eg, hormonal levels and immune functions) also need to be addressed due to the effects of sex differences on the outcomes of COVID-19 patients. An insight into the underlying causes of sex differences in COVID-19 patients may provide an opportunity for better care of the patients or prevention of the disease. The current study reviews the reports concerning with the sex differences in COVID-19 patients. It is explained how sex can affect angiotensin converting enzyme-2 (ACE2), that is a key component for the pathogenesis of COVID-19, and summarized the gender differences in immune responses and how sex hormones are involved in immune processes. Furthermore, the available data about the impact of sex hormones on the immune functions of COVID-19 cases are looked into

    Usability evaluation of a comprehensive national health information system: A heuristic evaluation

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    Aim: to evaluate the usability of a comprehensive national health information system by the heuristic method. Introduction: Presently, information systems are widely being used in healthcare settings. Methods: Five independent evaluators assessed the user interface design of this system in terms of its compliance with a set of predetermined standard principles, also known as Jakob Nielsen's 10 general principles. Problems were reassessed in the presence of all evaluators, and similar cases were merged and a single list of unique problems was prepared. After a second assessment, the evaluators determined and categorized problem severity in five domains, including: the absence of a problem (zero point), a cosmetic problem (1 point), a minor problem (2 points), a major problem (3 points) and a catastrophic problem (4 points). Data were then analyzed in a spreadsheet using descriptive statistical tests. Results: The “recognition rather than recall” principle with 13 problems (21.3 of all cases) had the greatest frequency among all problems, while the “match between system and the real world” and “help and documentation” principles with 1 problem (1.6 of all cases) had the least frequency. Moreover, principles such as “help users recognize, diagnose and recover from errors”, “error prevention”, and “help and documentation” had a mean severity of 2.8, 2.8, and 3.4, respectively. Consequently, they were considered as catastrophic and major problems. Conclusions: Based on the viewpoint of evaluation experts, a large portion of problems in this system were classified into major and catastrophic categories, which primarily indicates the poor usability of this system. Therefore, it is highly recommended that authorities be notified of the issues in writing in order to resolve them in a future update. Finally, special consideration should be given to the meticulous evaluation of these systems during preliminary stages of design and development, so as to encounter fewer issues on a national level at the time of implementation. © 2020 The Author

    Regulation of DNA methylation machinery by epi-miRNAs in human cancer: emerging new targets in cancer therapy

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    Disruption in DNA methylation processes can lead to alteration in gene expression and function that would ultimately result in malignant transformation. In this way, studies have shown that, in cancers, methylation-associated silencing inactivates tumor suppressor genes, as effectively as mutations. DNA methylation machinery is composed of several genes, including those with DNA methyltransferases activity, proteins that bind to methylated cytosine in the promoter region, and enzymes with demethylase activity. Based on a prominent body of evidence, DNA methylation machinery could be regulated by microRNAs (miRNAs) called epi-miRNAs. Numerous studies demonstrated that dysregulation in DNA methylation regulators like upstream epi-miRNAs is indispensable for carcinogenesis; consequently, the malignant capacity of these cells could be reversed by restoring of this regulatory system in cancer. Conceivably, recognition of these epi-miRNAs in cancer cells could not only reveal novel molecular entities in carcinogenesis, but also render promising targets for cancer therapy. In this review, at first, we have an overview of the methylation alteration in cancers, and the effect of this phenomenon in miRNAs expression and after that, we conduct an in-depth discussion about the regulation of DNA methylation regulators by epi-miRNAs in cancer cells. © 2020, The Author(s), under exclusive licence to Springer Nature America, Inc

    The effects of traditional lecture and flipped classroom on learning, learning retention, and satisfaction among operating room students: A comparative study

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    Background: Rapid changes in communities necessitate the use of new-teaching methods in universities. Objectives: This study aimed to determine and compare the effects of traditional lecture and flipped classroom (FC) on learning, learning retention, and satisfaction among operating room students. Methods: This two-group quasi-experimental study was conducted in 2018-2019 in the Faculty of Nursing and Midwifery of Isfahan University of Medical Sciences, Isfahan, Iran. Forty-four operating room students who had enrolled in anesthesiology course were selected and randomly allocated to a lecture and a FC group. Data were collected using a researcher-made satisfaction questionnaire and two researcher-made knowledge examinations. Data analysis was performed using the Chi-square, independent-samples t, and paired-samples t-tests. Results: The mean scores of knowledge in the first and the second examinations in the FC group (i.e. 18.85 ± 0.83 and 17.47 ± 1.42, respectively) were significantly greater than the corresponding mean scores in the lecture group (i.e., 16.21 ± 1.99 and 12.90 ± 2.64, respectively) (P < 0.05). Moreover, the mean score of satisfaction in the FC group was significantly higher than the lecture group (169.44 ± 17.82 vs. 115.56 ± 17.57;P < 0.05). Conclusion: FC is more effective than traditional lecture in promoting students' satisfaction and short- and long-term learning

    New trends in glioma cancer therapy: Targeting Na+/H + exchangers

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    Glioma is the oneof the most prevalent primarybrain tumors. There is a variety of oxidative stresses, inflammatory pathways, apoptosis signaling, and Na+/H + exchangers (NHEs) involved in the pathophysiology of glioma. Previous studies have indicated a relationship between NHEs and some molecular pathways in glioma. NHEs, including NHE1, NHE5, and NHE9 affect apoptosis, tumor-associated macrophage inflammatory pathways, matrix metalloproteinases, cancer-cell growth, invasion, and migration of glioma. Also, inhibition of NHEs contributes to increased survival in animal models of glioma. Limited studies, however, have assessed the relationship between NHEs and molecular pathways in glioma. This review summarizes current knowledge and evidence regarding the relationship between NHEs and glioma, and the mechanisms involved. © 2019 Wiley Periodicals, Inc

    The role of melatonin on doxorubicin-induced cardiotoxicity: A systematic review

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    Purpose: Doxorubicin, as an effective chemotherapeutic drug, is commonly used for combating various solid and hematological tumors. However, doxorubicin-induced cardiotoxicity is considered as a serious adverse effect, and it limits the clinical use of this chemotherapeutic drug. The use of melatonin can lead to a decrease in the cardiotoxic effect induced by doxorubicin. The aim of this review was to evaluate the potential role of melatonin in the prevention of doxorubicin-induced cardiotoxicity. Methods: This review was conducted by a full systematic search strategy based on PRISMA guidelines for the identification of relevant literature in the electronic databases of PubMed, Web of Science, Embase, and Scopus up to January 2019 using search terms in the titles and abstracts. 286 articles were screened in accordance with our inclusion and exclusion criteria. Finally, 28 articles were selected in this systematic review. Results: The findings demonstrated that doxorubicin-treated groups had increased mortality, decreased body weight and heart weight, and increased ascites compared to the control groups; the co-administration of melatonin revealed an opposite pattern compared to the doxorubicin-treated groups. Also, this chemotherapeutic agent can lead to biochemical and histopathological changes; as for most of the cases, these alterations were reversed near to normal levels (control groups) by melatonin co-administration. Melatonin exerts these protection effects through mechanisms of anti-oxidant, anti-apoptosis, anti-inflammatory, and mitochondrial function. Conclusion: The results of this systematic review indicated that co-administration of melatonin ameliorates the doxorubicin-induced cardiotoxicity. © 2019 Elsevier Inc

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