Comparative evaluation of serum zinc level in head and neck cancer patients before and after radiation therapy

Background: Head and neck cancers (HNCs) include 5.3 of all cancers and they are the cause of the same 5.3 of cancer deaths. Oxidative stress has a crucial role in cancer progression and cancer therapy. Ionizing radiation causes cell malfunction and death by creating reactive oxygen species. Due to its antioxidant activity, immune system power enhancement and role in apoptosis, zinc is a crucial trace element in oncology including HNCs. We decided to compare serum zinc level of HNC patients before and after RT, to assess the potential effects of ionizing radiation therapy on serum zinc. Methods: Fifty-seven HNC patients, who were candidates for curative radiation therapy (RT), were enrolled and their serum zinc level just before and 2 months after completion of RT were checked in a single laboratory. RT was prescribed by linear accelerator with 60 to 70 Gy by conventional method. Data were analyzed by SPSS 20. Results: Mean serum zinc prior to RT and following RT were 77.64±13.45 mg/dl and 68.28±11.93 mg/dl, respectively, which was lower following RT (p<0.001). Patients’ sex, age and duration from diagnosis to treatment and site of disease didn’t have any impact on serum zinc difference. Conclusion: This study showed that RT of HNCs leads to serum zinc reduction, which is greater in nodal disease because of either larger field or higher dose of radiation. Taking zinc supplements while being treated by RT, may be necessary. &#160

A Rare Case of Association between Pseudohypoparathyroidism and Type 1 Diabetes Mellitus

Background and Objective: Type 1 diabetes mellitus (T1DM) as an autoimmune disease is associated with hyperglycemia and pseudohypoparathyroidism with hypoglycemia. In this study, we report a rare case of association between type 1 diabetes and pseudohypoparathyroidism. Case Report: A 12.5-year-old female patient with a one-month history of polyuria and polydipsia was admitted with severe lethargy and vomiting, and due to high blood sugar and metabolic acidosis, Diabetic Ketoacidosis (DKA) was diagnosed. She was first treated with DKA protocol and then Basal- Bolus Protocol of insulin. The patient had a history of seizures due to hypocalcemia at the ages of 8 days and 2 months. In re-examination during hospitalization due to hypocalcemia-hyperphosphatemia and high parathyroid hormone, the diagnosis of false hypoparathyroidism was proposed and treatment with oral calcium tablet and calcitriol capsule was done and she was discharged after seven days with a good general condition. Conclusion: In patients with pseudohypoparathyroidism, in the event of a disturbance in glucose status, the pattern is usually hypoglycemia, but in our patient, this association was in the form of hyperglycemia and DKA in the context of T1DM, which is an indication of the rare association of these two diseases. Therefore, one should think about early diagnosis and proper treatment of this rare association

An Audit of Nursing Care and Placement of Peripherally Inserted Central Catheter in Infants

Background and Objective: The performance quality of peripherally inserted central catheter (PICC) by nurses has a direct effect on the improvement of patient care and safety. The aim of this study is to audit the placement and nursing care of PICC in infants. Methods: This cross-sectional study was conducted on 130 PICC procedures in the neonatal intensive care units of Rouhani and Amirkola hospitals in Babol in 2018-2021. All infants who needed PICC placement for any reason were selected. In order to collect the data, the observational researcher-made checklist and the infant demographic characteristics questionnaire were used. The checklist included 44 questions and four parts of nursing care before catheter insertion, hand washing, nursing care during the procedure, and nursing care after catheter placement. The scores obtained from the checklist were classified into conversion percentage and two groups of unfavorable placement (less than 67) and favorable placement (68-100). To confirm its reliability, intraclass correlation coefficient was used (ICC=0.90). Findings: A total of 130 cases of PICC placement and nursing care were audited (Rouhani Hospital 98 cases 75.4%, Amirkola 32 cases 24.6%). In the studied sample, 83 (63.8%) were boys and 53 (43.1%) were diagnosed with prematurity. The most common PICC location was the armpit (42.3%). The percentages of compliance of nursing care before PICC insertion according to the standard (97.43%), hand washing (100%), nursing care during the procedure (87.14%) and nursing care after PICC insertion (94.84%) were favorable. Nurses did not use glasses and ultrasound guidance during PICC insertion; (85.4%) and (90%), respectively. Conclusion: According to the results of this study, although the quality of PICC insertion and care in three stages was at a favorable level, nurses need training regarding the use of glasses and ultrasound guidance during PICC insertion

Assessing the Responsiveness of the Persian Version of the Western Ontario Meniscal Evaluation Tool in Patients with Meniscus Injuries

Background and Objective: Responsiveness is one of the important properties of health-related questionnaires in demonstrating the changes in a patient's clinical conditions before and after therapy. The present study was carried out with the aim of assessing the responsiveness of the Western Ontario Meniscal Evaluation Tool (WOMET) and determining its minimal clinically important difference in patients undergoing physical therapy interventions after meniscus injuries. Methods: This cross-sectional methodological study was performed on 100 patients aged 18-70 years with meniscus injuries who underwent physical therapy interventions. Patients completed WOMET and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaires in the first and tenth sessions. The minimum score obtained from the WOMET questionnaire was zero and the maximum was 1600, and the minimum score obtained from the KOOS questionnaire was zero and the maximum was 168. Internal and external responsiveness were the primary outcomes, and effect size tests, ROC curves, and correlation coefficients were used to examine them. The relationship between the WOMET and KOOS questionnaires were considered as secondary outcomes, which were evaluated by calculating the correlation coefficient. Findings: The results of internal responsiveness showed that the standardized response mean for the entire WOMET questionnaire was 0.11 (insignificant) and Cohen's d score for the entire WOMET questionnaire was -1.586 (large). The difference in the mean internal responsiveness between recovered (20%) and unrecovered (80%) patients reached a significant level (p<0.001). This questionnaire had an acceptable external responsiveness; the area under the curve of the ROC curve was greater and equal to 0.7 and the optimal cut-off point was 20.031 (p<0.001). The Pearson correlation coefficient between WOMET and KOOS questionnaires (except the emotions subscale) was moderate to large (0.5-0.8) with p<0.001. Conclusion: The findings of the study showed that the Persian version of the WOMET questionnaire has a high level of responsiveness and is a suitable tool for evaluating the quality of life among patients suffering from meniscus injury

Comparison of Falls and its Determinants in the Elderly with and without Knee Osteoarthritis

Background and Objective: The growth of aging reveals the importance of paying attention to the health needs of the elderly. According to some studies, falls and its consequences are more common in the individuals with knee osteoarthritis (KOA) than those without KOA, but due to lack of evidence, its related factors are still unknown. Thus, the aim of this study was to compare the falls and its determinants in the elderly with and without KOA. Methods: In this case-control study, 700 older adults in two groups of elderly with and without KOA were compared in terms of falls and some variables including KOA, sex, age, body mass index, living status, quadriceps femoris muscle strength, hand muscles strength, balance, number of comorbidities, number of drugs used, walking duration, physical activity and frailty. KOA was diagnosed based on The American College of Rheumatology (ACR) criteria. Findings: In this study, falls were 1.90 times higher in the elderly with KOA than elderly without KOA. Although all variables were significantly different in case and control groups, only female gender (p=0.035) and KOA (p=0.012) were significantly associated with falls. Conclusion: These findings suggest that variables in combination may increase the risk of falls in the elderly with KOA, while each of them alone may not be associated with falls

Learning Medical Pharmacology through Role-Playing Method

Background and Objective: Traditional methods of medical education, despite being easy to implement, do not have long-lasting efficiency. The main aim of this study is to use the help of the learners to teach parts of the medical pharmacology course using role-playing pedagogy. This was done for the first time in Babol University of Medical Sciences with the cooperation of medical students who entered the university in 2016. Methods: Students were divided into 5 groups and a group leader was introduced for each group. Five topics were selected and corresponding scenarios were written. There were three to seven people in each group. The physician together with the hypothetical resident or student examined the patient's problems and prescribed medicine and gave them the necessary recommendations. All participants were given a pre-test and a post-test, and then the findings were statistically analyzed. Findings: 101 students (49 girls and 52 boys) with a mean age of 21.43±1.14 years participated in the study. Except for the topic of poisoning, the mean difference in pre- and post-test scores of female students was lower than that of male students. For example, this difference was observed in the topic of Parkinsonism (p<0.0001). All students involved in the performance obtained better grades in the same topics compared to other students (88.15 vs. 59.71 out of 100). 74% of female students and 79% of male students expressed satisfaction with the implementation of this method. Conclusion: According to the findings, this method has increased the motivation to learn the medical pharmacology course and stabilize the course topics. Therefore, its implementation in difficult courses with diverse and voluminous content not only helps them to learn better, but also helps them maintain their enthusiasm and increase motivation to learn more and consolidate what they have learned

Determination of plasma transcobalamin-II and zinc levels in newly-diagnosed and long-standing grand mal epileptic patients

Background: The changes of plasma transcobalamin-II (TCII) and Zinc (Zn) Levels in epileptic patients are not clearly understood. The aim of the current study was to evaluate the plasma contents of TCII and Zn levels in newly&#8211;diagnosed epileptic seizure patients, long-standing grand mal epileptic patients following treatment with sodium valproate and healthy control group. Methods: Thirty patients aged 36.76&#177;12.91 years with newly&#8211;diagnosed and thirty long-standing grand mal epileptic patients aged 35.56 &#177;12.77 years were diagnosed based on the clinical symptoms. The control subjects were picked out from healthy individuals and matched to the patients, aged 36.30 &#177;12.80 years. Plasma Zn and TCN-2 was evaluated via spectrophotometry at 546 nm and 450 nm, respectively, using chimerical kits. Results: Plasma&#160;level of TCII in the newly&#8211;diagnosed epileptic seizures patients and long-standing grand mal epileptic patients were significantly increased, compared to the healthy controls 14.89 &#177;3.24 and 21.84&#177; 2.73 vs. 9.55&#177;1.24, (n=30), respectively.&#160;Plasma level of Zn was decreased in the newly&#8211;diagnosed epileptic seizure patients, while it was increased in long-standing grand mal epileptic patients compared to the control group 69.28&#177; 6.41&#160;and 80.56 &#177;6.12 and vs.75.80&#177;1.59, (n=30), respectively. Conclusion: This study suggests that sodium valproate may disrupt the homeostatic balance of TCII and Zn, and cause abnormality of their serum level in newly&#8211;diagnosed epileptic seizure patients and long-standing grand mal epileptic patients. Further research is recommended to identify the underpinning for these changes. &#160

The Effect of Intracanal Irrigants on Push out Bond Strength of CEM, Root MTA and Angelus MTA Cements to the Dentin Wall

Background and Objective: To reduce microbial contamination in cases such as perforation treatment, it is necessary to use irrigants after cement placement. The aim of the present study is to investigate the effect of intracanal irrigants on the push out bond strength of CEM, Root MTA and Angelus MTA cements to the dentin wall. Methods: In this laboratory research, 150 cross-section samples from the mid-root region of single canal teeth without caries with a thickness of 1 mm, which were randomly divided into 3 groups of 50 and filled with CEM cement, Root MTA or Angelus MTA, were examined. After the cements were set, the samples of each group were divided into 5 subgroups of 10; 4 subgroups were cleaned with sodium hypochlorite, EDTA, normal saline, 2% chlorhexidine for 30 minutes, and one subgroup was not cleaned as a control group. Then, the push out bond strength of cement with the dentin wall (MPa) and the failure pattern of the samples were evaluated. Findings: Different cleaning methods did not show any significant effect on the bond strength of CEM, Root MTA and Angelus MTA cements. In the cleaning method with saline, the bond strength of Angelus MTA (6.3±1.98) was higher than Root MTA (2.1±3.61) (p=0.004). In the cleaning method with 2% chlorhexidine, the bond strength of Angelus MTA cement (8.72±3.13) was higher compared to CEM (3.87±1.35) and Root MTA (4.66±1.76) (respectively p<0.001 and p=0.001). The most common type of failure in the Angelus MTA group was of the adhesive type, and in the CEM cement and Root MTA groups, it was of the mixed type. Conclusion: The results of the study showed that different cleaning methods have no effect on the push-out bond strength of the examined cements

Relationship between anthropometric indices and Mizaj (temperament) in Persian medicine

Background: The process of diagnosis and treatment in Persian medicine (PM) are based on the concept of Mizaj (temperament). Among the indices of Mizaj determination, anthropometric indices are less influenceable regarding age change and other environmental factors. The purpose of this study was to investigate the relationship between anthropometric indices and Mizaj. Methods: Four PM experts determined the Mizaj of 121 participants. Those who had &#8805;70 agreement in their Mizaj determination by the experts were selected and their anthropometric indices were measured. The best cutoff point of each index and its relationship with the defined Mizaj were extracted using Receiver Operative Characteristic Curve and Binary Logistic Regression. Results: 52 out of 121 participants entered the main study. The warm-Mizaj people had larger dimensions in height, shoulder, chest, palm and sole width, and head height. Cold-Mizaj people had smaller dimensions in weight, height, shoulder, chest and head. High levels of BMI, chest depth and head dimensions had the highest correlation with the wet Mizaj and lower dimensions of these indices had the highest correlation with the dry Mizaj.&#160; Conclusion: Among the anthropometric indices, chest, palm, sole dimensions, head height and weight had the highest correlation with warmness/coldness and BMI, head width and chest dimensions had the highest correlation with wetness/dryness. The BMI which is more closely related to the soft tissue, only correlates with the wetness/dryness, while, bone dimensions are associated with warmness/coldness. Further studies are needed to metricize the anthropometric indices for Mizaj determination

Determining the Demographic and Histopathological Pattern of Basal Cell Carcinoma in the Pathology Laboratories of Babol University of Medical Sciences from 2013 to 2020

Background and Objective: Basal cell carcinoma is the most common human malignancy that has been increasing in recent years. The aim of this study is to determine the demographic and histopathological pattern of this malignancy in the pathology departments of state hospitals in Babol from 2013 to 2020. Methods: In this retrospective study, after reviewing the existing files with the final diagnosis of basal cell carcinoma from 2013 to 2020, the patients' information including age, gender, lesion location and microscopic subgroup were recorded and analyzed. Findings: In this study, 367 cases were obtained from Shahid Beheshti and Shahid Yahyanejad Hospitals in Babol with the diagnosis of basal cell carcinoma. The mean age of people in both genders was 67±10.89 years. 69% of the samples were men and 31% were women (p<0.001). The highest frequency was from the scalp area (134 samples) and the lowest frequency was related to the chest (3 samples). The most common histopathology subtype was nodular type and the rarest types were metatypical and clear cell carcinoma. A statistically significant relationship was observed between the location of the sample and gender (p=0.023); the cheek in men and the nose in women were more common than the other gender. The highest incidence was seen in 2017 with 83 cases, which was a significant increase compared to the previous year. Conclusion: Based on the results of this study, the high incidence of basal cell carcinoma in the head and face area of elderly people, especially men, reveals the need to inform high-risk communities and to be more familiar with therapists, especially dentists who are in close eye contact with the face