The effects of breastfeeding position and the change in nutritional habit on infantile colic: A randomized clinical trial

Aims: We decided to investigate the role of non-pharmacological method of breastfeeding and maternal nutrition in the treatment of infantile colic in order to reduce the role of pharmacological method. Materials and Methods: This study was a double-blinded clinical trial study on 62 infants less than 4 months of age referred to Emergency ward of Mofid Hospital in 2014. The infants were randomly divided into two groups that one group received routine colic treatment without any intervention (as the control group) and the other group received hypoallergenic lactation and also were trained on how to breastfeed appropriately. On the second and tenth days, all mothers were contacted and the duration of crying and restlessness of the infant was assessed. Results: The severity of colic significantly lower in intervention group as compared to control group on the second and tenth days of intervention. In this regard, the mean change in severity of colic at the end of assessment was 2.4 ± 2.2 in intervention group and 0.7 ± 1.5 in control group (p < 0.001). The mean change in colic intensity in subgroups with complete, partial and low adherence was 4.1 ± 2.4, 2.5 ± 1.6, and 0.2 ± 1.6 respectively indicating a significant difference (p < 0.001).  Conclusion: Comprehensive mothers' training on how to breastfeed and determine the best breastfeeding position along with the change in nutritional habit can significantly reduce colic severity.  &nbsp

How Does Voxel Size of Cone-beam Computed Tomography Effect Accurate Detection of Root Strip Perforations

Introduction: Our study aimed to assess the diagnostic accuracy of different voxel sizes for cone-beam computed tomography (CBCT) when detecting strip perforations of variable sizes. We used 0.2 and 0.3 mm3 voxel for detecting root strip perforations. Methods and Materials: This was an in vitro study conducted on 155 extracted humans' mandibular first molars. The teeth were randomly divided into five groups (n=31). Perforation were not induced in the control group. In the remaining four groups, strip perforations of 0.5, 1, 1.5, and 2 mm diameters were created in the mesiolingual canal using #3 Gates Glidden drills. The CBCT scans were taken first with a 12×9 cm field of view (FOV), 90 kVp, 4 mA, and 0.2 mm3 voxel size for 24 sec and then with a 12×9 cm FOV, 90 kVp, 2 mA, and 0.3 mm3 voxel size for another 24 sec. Two observers evaluated the images and reported the largest diameter of perforations. The results were compared with the gold standard values (determined by an electronic digital caliper) using statistical methods, including the kappa coefficient and generalized estimating equation (P<0.05). Results: Based on the findings of our study, the inter-observer agreement ranged from 58-100%, while the intra-observer agreement was reported to be around 100%. The difference in accuracy between 0.2 and 0.3 mm3 voxel sizes was not statistically significant (P>0.05). In addition, the accuracy of detecting different perforation sizes in the CBCT did not follow a specific pattern.  Conclusion: This in vitro study showed that CBCT is a reliable diagnostic tool, and even in lower dosages of 0.3 mm3 voxel size, image resolution and diagnostic accuracy was not affected. Moreover, smaller root perforations could be detected as accurately as larger ones with CBCT

Efficacy of ProTaper and Mtwo Retreatment Files in Removal of Gutta-percha and GuttaFlow from Root Canals

Introduction: The aim of this in vitro study was to compare the efficacy of ProTaper retreatment (ProTaper R) and Mtwo retreatment (Mtwo R) files in removing gutta-percha and GuttaFlow from endodontically treated straight root canals. Methods and Materials: The root canals of 60 human mandibular single-rooted premolars were prepared and randomly divided into two groups (n=30). In groups A and B the root canals were obturated using lateral condensation of gutta-percha plus AH 26 and GuttaFlow, respectively. The canal orifices were temporarily sealed and the roots were incubated for 3 months at 37ºC and 100% humidity. Primary cone-beam computed tomography (CBCT) images were taken after incubation period. The specimens in each group were randomly divided into two subgroups (n=15). ProTaper R files (D1, D2, and D3) were used in groups A1 and B1 while Mtwo R files (25/0.05 and 15/0.05) were used in groups A2 and B2. The time required to extirpate the root filling was also recorded. After retreatment, another CBCT scan was taken at the same position. The volume of remaining filling materials inside the canals was calculated before and after retreatment. The data was analyzed using the two-way ANOVA and independent t-test. Results: The remaining filling materials in the canals treated with ProTaper were less than Mtwo. The remaining volume of GuttaFlow was less than gutta-percha regardless of the system applied. Mtwo R files removed root fillings faster than ProTaper R. Conclusion: ProTaper R removed filling material more efficiently compared to Mtwo R which required less time to remove root filling material.Keywords: Gutta-Percha; Mtwo Retreatment Files; ProTaper Retreatment Files; Root Canal Retreatmen

Calcium Enriched Mixture and Mineral Trioxide Aggregate Activities against Enterococcus Faecalis in Presence of Dentin

Introduction: The purpose of this in vitro study was to compare the antibacterial activity of Calcium Enriched Mixture (CEM) with ProRoot Mineral Trioxide Aggregate (MTA) against Enterococcus faecalis (E. faecalis) in the presence/absence of dentin powder. Materials and Methods: Two series of freshly mixed (10, 50, and 100 mg), set crushed powder (10, 50, and 100 mg), and pieces of uncrushed set (50, 100 mg) of CEM and MTA were prepared (n=32 groups). All samples were suspended in normal saline for direct exposure test against E. faecalis; in the second series, 50 mg of the dentin powder was also added to the solution. Dentin powder suspension and bacterial suspension served as negative and positive control groups, respectively (n=2). The suspensions were incubated at room temperature for 1, 60, and 240 min; each group was tested five times and survival of the bacteria in test solutions was assessed by 10-fold serial dilutions and cultured on Brain Heart Infusion (BHI) plates. The plates were incubated at 37ºC. The mean values of log10 CFU were calculated and compared in all tested groups. The total number of tests added up to 510 times. Results: In presence of dentin powder, freshly mixed powder from set materials, and pieces of uncrushed set materials of both tested cements killed >95% of the bacterial cell in 1 min. Adding dentin powder caused an increase in antibacterial activity of freshly mixed powder from crushed set CEM and MTA but no acceleration in bacterial killing was observed, when dentin was mixed with set or uncrushed cements. Dentin powder alone reduced the number of viable bacteria in the 4-hour duration. There were no significant differences between different weights of freshly mixed, crushed set powder and uncrushed set of CEM cement and MTA at different times. Conclusion: Under the conditions of this in vitro study, CEM cement as well as MTA have antibacterial effects against E. faecalis. The addition of equal amounts of dentin powder to the suspension of CEM or MTA resulted in swifter elimination of bacteria

Penetration Depth of Sodium Hypochlorite in Dentinal Tubules after Conventional Irrigation, Passive Ultrasonic Agitation and Nd:YAG Laser Activated Irrigation

Introduction: The penetration depth of irrigating solutions in dentinal tubules is limited; consequently, bacteria can remain inside dentinal tubules after the cleaning and shaping of the root canal system. Therefore, new irrigation systems are required to increase the penetration depth of irrigating solutions in dentinal tubules.Methods: A comparative study regarding the penetration depth of sodium hypochlorite (NaOCl) solution in dentinal tubules using four methods, (1) conventional irrigation (CI), (2) smear layer removal plus conventional irrigation (gold standard), (3) passive ultrasonic agitation (PUA) and (4) Nd:YAG laser activated irrigation (LAI), took place on 144 extracted mandibular teeth with a single root canal. After decoronation with a diamond disc and working length determination, the apical foramen was sealed with wax. The canals were prepared up to #35 Mtwo rotary file and 5.25% NaOCl was used for irrigation during preparation. To study the penetration depth of NaOCl, smear layer was eliminated in all samples. Dentinal tubules were stained with crystal violet and after longitudinal sectioning of teeth, the two halves were reassembled and root canal preparation was performed up to #40 Mtwo rotary file. Then the samples were distributed into four experimental groups. Depth of the bleached zone was evaluated by stereomicroscope (20X). Data were analyzed by Kruskal-Wallis test.Results: The highest and lowest average for NaOCl penetration depth in all three coronal, middle and apical sections belonged to CI + smear layer removal and CI. A statistically significant difference was seen when comparing the penetration depth of CI + smear layer removal group to CI and PUA groups in coronal and middle third, in which the average NaOCl penetration depth of the gold standard group was higher (P < 0.05). A statistically significant difference was seen between CI + smear layer removal group and the other three groups including CI, PUA and LAI in apical third, in which the average NaOCl penetration depth in the gold standard group was higher (P < 0.001).Conclusion: The standard protocol for smear layer removal led to more effective smear layer elimination and deeper penetration depth of irrigation solutions. PUA and LAI groups exhibited less smear layer elimination and penetration depth of irrigation solutions. Therefore, CI+smear layer removal should still be considered as the gold standard

Evaluation of Obesity, Insulin Resistance and Metabolic Syndrome in Childhood Leukemia Survivors

Background: Leukemia is one of the most common malignancies in childhood, accounting for about 40 per million children under the age of 15 years. Acute lymphoblastic leukemia accounts for about 75% of these cases of leukemia. Regarding the improvement in life expectancy and the prolonged life of patients with acute lymphoblastic leukemia, identifying the long-term complications and effects of treatment in patients is necessary.Methods: The present applied study is a cohort study based on the case-control method. In order to achieve the purpose of the study, 50 patients who had improved acute lymphoblastic leukemia were selected as a case group; the selections were conducted in a sequential manner in Mofid Children Hospital. 50 other people who had no history of ALL disease were selected as the control group. All information gathering processes including patient history, physical examination, and necessary tests were done by a pediatric hematology oncology subspecialties fellow and trained personnel with full supervision of Pediatric hematologist - oncologist. Blood samples were taken at 10-cc of fasting blood. Blood samples after centrifugation and storage at 20 ° C were used to measure serum fasting blood glucose, triglyceride (Slovak based on serum lipid profile), and insulin levels. All demographic information, BMI, clinical symptoms, laboratory tests, and treatments were recorded in both forms. Data were finally entered into SPSS version 21 and analyzed using the GEE method.Results: the incidence of obesity was significantly higher in patients with ALL as compared with the controls. The risk of obesity in ALL patients was found to be approximately 9 times higher than the controls. In this study 6 (12%) patients in cases and 4 (%8) patients in controls had metabolic syndrome. There was no statistically significant difference between the groups in the incidence of metabolic syndrome, insulin resistance, and visceral obesity.Conclusion: It is suggested that after acute lymphoblastic leukemia treatment in children, in addition to regular follow up for disease recurrence, the patients should be monitored about metabolic syndrome or any of its components, especially weight gain, and obesity

Evaluation of the concavity depth and inclination in jaws using CBCT

Introduction: Nowadays, using implants as a choice in patient's treatment plans has become popular. The aim of this study was to determine the prevalence of mandibular lingual and maxillary buccal concavity, mean concavity depth and angle and its relation to age and gender. Materials &Methods: In 200 CBCT, concavity depth and angle were measured in 2 mm superior to the inferior alveolar canal in the mandibular first molar area and in 1 mm distance from nasal floor in the midpoint region of maxillary lateral incisor and canine. Concavity depth and angle relationships with age and gender have been evaluated using Spearman Correlation and a t-test. Results: Mean and standard deviation of lingual concavity, concavity angle and ridge angle in mandible were 1.3±1.54 mm, 15.45±16.19 and 10.13±6.1. Mean and standard deviation of buccal concavity and concavity angle in maxilla were 5.35±1.03 mm and 30.6±5.75. Mandibular concavity depth was zero in 44% of subjects and more than zero in 56%. Results were more than 3 mm in maxillary samples. There was a linear relationship between mandibular concavity depth and age equaled to -0.27, p=0.007 and for mandibular concavity angle and age equaled to -0.25, p=0.01. There was no significant relationship between mandibular ridge angle and age. In maxilla, there was no linear relationship between age and gender with any other variables. Conclusion: It is necessary to provide more information on these regions' anatomy using CBCT cross sections before implant placement

Association between CETP Taq1B and LIPC -514C/T polymorphisms with the serum lipid levels in a group of Tehran's population: a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Low level of high density lipoprotein cholesterol (HDL-C) has high prevalence in the Tehran Lipid and Glucose Study (TLGS) cohort. About 50% of the inter-individual variation in serum HDL-C levels is genetically determined. Polymorphisms in cholesteryl ester transfer protein (CETP) and hepatic lipase (LIPC) genes have been found to be associated with the metabolism and serum concentration of the HDL-C.</p> <p>Objectives</p> <p>To determine the association between Taq1B polymorphism in CETP gene and -514C/T polymorphism in LIPC gene with serum lipid levels and lipid peroxidation in a subgroup of the TLGS population.</p> <p>Results</p> <p>Serum HDL-C level had significant association with CETP Taq1B polymorphism and B2B2 subjects had the highest HDL-C levels compared to B2B1 and B1B1 genotypes (37.9 vs. 36.9 and 35.3 mg/dl, respectively; <it>P </it>= 0.01). However, carriers of "B1" allele, in comparison to the non carriers (B2B2), had significantly lower levels of TC (200.1 vs. 215.2 mg/dl; <it>P </it>= 0.005), HDL-C (35.8 vs. 37.9 mg/dl; <it>P </it>= 0.009) and malondialdehyde MDA (4.5 vs. 5.0 nmol/mL; <it>P</it>=0.031). Carriers of the "T" allele in -514C/T polymorphism in LIPC gene had higher means of HDL-C than non carriers (37.7 vs. 35.7 mg/dl, <it>P </it>= 0.04). No other association was found between -514C/T polymorphism and any other serum lipids or MDA level.</p> <p>Conclusion</p> <p>This study demonstrates the association between Taq1B and -514C/T polymorphisms in the CETP and LIPC genes with the serum HDL-C levels.</p

Performance and Predictive Value of First Trimester Screening Markers for Down Syndrome in Iranian Pregnancies

Objective: To investigate the performance of first trimester Down syndrome (DS) screening markers in Iranian pregnancies.Although sonographic and serum markers are currently recommended for the first trimester screening of Down syndrome, the screening performance of the markers depends on the race and ethnicity. Materials and methods: A retrospective case-control study using first trimester screening results recorded with the prenatal diagnostic multi-centers in Iran. A total of 6,384 pregnant women were examined from March 2012 to February 2017. Totally 100 Down syndrome cases and 266 matched controls were selected and the maternal characteristics, sonographic and biochemical screening data were collected. Statistical analysis was performed using logistic regression and descriptive statistics. A decision tree model was designed using the chi-squared automatic interaction detection method based on serum markers. Results: For screening of DS pregnancies, PAPP-A (cut-off 0.795 MoM) yielded the highest sensitivity (86%) and NB marker presented highest specificity (96.24%). combination of the biochemical markers PAPP-A and β-hCG (cut-off: 1.55 MoM) showed the highest sensitivity over other combined markers. The decision-tree model based on serum markers improved (91% DR For a 5% FPR) first trimester screening performance. Conclusion: The novel decision-tree model base on serum markers revealed a better predictive value to achieve high sensitivity and specificity of first trimester Down syndrome screening in Iranian population

Complications following Bacille Calmette-Guérin Vaccination in Children under the Age of 18 Months: A Multi-center Study

Background: The BCG vaccine, used since 1921 to prevent tuberculosis (TB), considered the world's most widely used vaccine. This study aimed to investigate the frequency and the type of complications associated with Bacillus Calmette-Guérin (BCG) vaccination in Iranian children. Materials and Methods This cross-sectional study conducted for 6months among children aged up to 18 months who presented to primary health care centers in Tehran (under supervision of all three Medical Universities of Tehran) for their routine vaccinations. All children had received BCG vaccination at birth. We investigated the occurrence of BCG complications through history taking from the parents and physical examination by the study physician. Complications categorized into four major groups: local, regional, remote, and generalized and the rate of occurrence compared between the two genders. Results: Finally, 14,095 children enrolled during the study period; 574 patients (4%) had experienced at least one complication following BCG vaccination. The most common complications were local side effects observed in 304 children (2.1%); followed by lymph node involvement detected in 270 children (1.9%). Lymph node involvement was more common in males (