Vital Pulp Therapy with Calcium-Silicate Cements: Report of Two Cases

This article describes successful use of calcium-enriched mixture (CEM) cement and Biodentine in apexogenesis treatment in two 8-year-old patients, one with immature permanent molar diagnosed primarily with irreversible pulpitis and the other with partially vital maxillary central incisor. After access cavity preparation, partial pulpotomy in molar and full pulpotomy in central was performed, and the remaining pulps was capped with either Biodentine or CEM cement, in each tooth. The crowns were restored with composite filling material at the following visit. The post-operative radiographic and clinical examinations (approx. average of 16 months) showed that both treated teeth remained functional, with complete root development and apex formation. A calcified bridge was produced underneath the capping material. No further endodontic intervention was necessary. Considering the healing potential of immature vital pulps, the use of CEM cement and Biodentine for apexogenesis might be an applicable choice. These new endodontic biomaterials might be appropriate for vital pulp therapies in an immature tooth. However, further clinical studies with longer follow-up periods are recommended.Keywords:Apexogenesis; Calcium-Silicate Cements; Dental Pulp; Pulpotomy; Vital Pulp Therapy

Evaluation of healthcare usage rate in HIV/AIDS patients in Isfahan, Iran in 2018

Introduction: Universal health coverage (UHC) was introduced in Iran in 2014. The aim of this study was to evaluate the usage rate of health services by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients after UHC implementation. Material and methods: In 2018, in a cross-sectional study, we evaluated the outpatients’ needs (within its previous month) and inpatients’ needs (within its previous 6 months) of HIV/AIDS patients in Isfahan province (the center of Iran). Concurrently, we estimated the essential health care services that HIV/AIDS patients have to receive regularly, including vaccination for hepatitis B, measurement of CD4, tuberculosis (TB) assessments and TB treatment, anti-retroviral therapy, examination of viral load, treatment approach, and drug side effects counseling. Two checklists were used for assessing the utilization of health services and essential health cares for HIV/AIDS patients, validated by the Ministry of Health and Medical Education of Iran. Data were analyzed by χ2 test, Pearson’s correlation coefficient, and Spearman’s correlation test. Results: Two hundred and thirteen HIV/AIDS patients completed the questionnaires. The mean age of participants was 41.14 ± 9.23. The outpatient service utilization rate was 31.94% in the previous month and the rate of hospitalization was 126 per 1,000 HIV/AIDS patients in the previous 6 months. The majority of HIV/AIDS patients received essential health services more often than the national standard goals estimation. Conclusions: After UHC implementation, the utilization rate of outpatients and inpatients services in HIV/AIDS patients was more than similar indices in the general population. In addition, HIV/AIDS patients received essential health services adequately

Clinical Features and Seroepidemiology of Anti-HDV Antibody in patients With Chronic Hepatitis B Virus Infection in Iran: A Meta-Analysis

Context: Hepatitis delta virus (HDV) leads to the most severe form of chronic viral hepatitis.Objectives: To determine the prevalence of HDV and create pooled estimations of possible risk factors, a systematic review was conducted to collect all epidemiological studies on HDV among chronic hepatitis B patients in Iran.Data Sources: In this systematic review, databases such as PubMed, Embase, ISI, Google scholar, and Iranian databases (MagIran, Iranmedex, and SID) were searched.Study Selection: Studies that clearly stated information about the number of HBsAg positive patients infected with HDV were selected.Data Extraction: The name of the city, the author's name, year of study, HDV detection method, sample size, HBsAg positive frequency, mean age, total prevalence of HDV, and risk factors were extracted.Results: The pooled HDV prevalence was 7.8% (95% CI: 5.89 - 9.71). In the survey-data analysis, HDV prevalence was 6.61%. HDV prevalence was 30.47% (95% CI: 9.76 to 51.19), 14.4% (95% CI: 7.72 to 21.07), and 4.94% (95% CI: 3.73 to 6.15) in cirrhotic, chronic-hepatitis, and inactive-carrier patients, respectively. Pooled ORs were calculated for several factors common to Iranian HBsAg-positive patients, including history of blood transfusion [OR: 1.1 (95% CI: 0.40 to 2.98)], intravenous drug abuse [OR: 1.6 (95% CI: 0.78 to 3.21)], previous hemodialysis [OR: 1.72 (95% CI: 0.79 to 3.76)], and HBeAg-positive status [OR: 1.26 (95% CI: 0.66 to 2.4)].Conclusions: The prevalence of HDV is less common in Iran than in endemic regions such as Italy and Turkey; however, it is a severe form of hepatitis in HBsAg-positive patients. The most probable route of HDV transmission is hematologic, which suggests the importance of blood screening for HDV, especially in groups with numerous blood transfusions

Identification of Risk Factors Associated with Tuberculosis in Southwest Iran: A Machine Learning Method

BackgroundTuberculosis is a principal public health issue. Reducing and controlling tuberculosis did not result in the expected success despite implementing effective preventive and therapeutic programs, one of the reasons for which is the delay in definitive diagnosis. Therefore, creating a diagnostic aid system for tuberculosis screening can help in the early diagnosis of this disease. This research aims to use machine learning techniques to identify economic, social, and environmental factors affecting tuberculosis.MethodsThis case-control study included 80 individuals with TB and 172 participants as controls. During January-October 2021, information was collected from thirty-six health centers in Ahvaz, southwest Iran. Five different machine learning approaches were used to identify factors associated with TB, including BMI, sex, age , marital status, education, employment status, size of the family, monthly income, cigarette smoking, hookah smoking, history of chronic illness, history of imprisonment, history of hospital admission, first-class family, second-class family, third-class family, friend, co-worker, neighbor, market, store, hospital, health center, workplace, restaurant, park, mosque, Basij base, Hairdressers and school. The data was analyzed using the statistical programming R software version 4.1.1.ResultsAccording to the calculated evaluation criteria, the accuracy level of 5 SVM, RF, LSSVM, KNN, and NB models is 0.99, 0.72, 0.97,0.99, and 0.95, respectively, and except for RF, the other models had the highest accuracy. Among the 39 investigated variables, 16 factors including First-class family (20.83%), friend (17.01%), health center (41.67%), hospital (24.74%), store (18.49%), market (14.32%), workplace (9.46%), history of hospital admission (51.82%), BMI (43.75%), sex (40.36%), age (22.83%), educational status (60.59%), employment status (43.58%), monthly income (63.80%), addiction (44.10%), history of imprisonment (38.19%) were of the highest importance on tuberculosis.ConclusionThe obtained results demonstrated that machine-learning techniques are effective in identifying economic, social, and environmental factors associated with tuberculosis. Identifying these different factors plays a significant role in preventing and performing appropriate and timely interventions to control this disease

Human papilloma virus E6/E7 messenger RNA as a biomarker for detecting the risk evaluation of cervical cancer progression: overview of recent clinical trials

Cervical cancer is one of the major women health problems, which is considered to be responsible for significant percentage of cancer related deaths in low and middle income countries. While Human Papilloma virus (HPV) DNA testing has an established role in cervical cancer prevention, there is a need to use other biomarkers with higher specificity and prognostic value to recognize patients at risk of progressive illness. There are evidences suggest that, direct detection of HPV messenger RNA transcripts may establish a more specific method for defining clinically important infection than viral DNA detection. Our objective was to provide an overview of the literature on specificity of HPV mRNA testing compared to DNA testing for detecting the risk evaluation of cervical intraepithelial neoplasia and invasive cervical cancer. We focused on recent clinical studies that support the application of HPV E6/E7 mRNA as a marker in advanced cervical cancer screening program. We provide overview of sample size, recruitment setting, age, HPV mRNA and HPV DNA assays for researches included in our review. The pooled review of clinical studies provided evidence that HPV mRNA might be a relevant diagnostic biomarker but additional studies need to be developed in order to make strong conclusio

Vitamins and Stomach Cancer : A Hospital Based Case-Control Study in Iran

Background: This study investigated the association between vitamins intakes and risk of gastric cancer (GC) among Iranian population. Methods: In this hospital-based case-control study, 178 pathologically confirmed GC patients and 276 healthy controls were interviewed to answer a valid diet history questionnaire. Unconditional logistic regression, in which potential confounders were taken into account, was applied to determine the association of vitamin intakes and odds of GC in total population and in stratums of body mass index (BMI), helicobacter pylori (H-pylori) infection, and smoking. Results: GC was directly associated with vitamin D (OR 1.59; CI 95% 1.07, 2.36) and cobalamin (OR 1.25; CI 95% 1.08, 1.44). Thiamin (OR 0.50; 95%CI 0.30, 0.83), pantothenic acid (OR 0.71; 95%CI 0.58, 0.87), folate (OR 0.99; 95%CI 0.99, 0.99) and vitamin E (OR 0.98; 95%CI 0.96, 0.99) were inversely associated with GC. In 231 H-pylori infected participants, consumption of thiamin (OR 0.3; 95% CI 0.59, 0.86), pyridoxine (OR 0.52; 95%CI 0.31, 0.85), and folate (OR 0.99; 95%CI 0.99, 0.99) reduced GC risk. In H-pylori negative participants, only vitamin E (OR 0.96; 95%CI 0.93, 0.99) reduced the risk and vitamin D (OR 1.99; 95%CI 1.18, 3.36), riboflavin (OR 1.91; 95%CI 1.37, 2.66), pantothenic acid (OR 1.34; 95%CI 1.13, 1.64), biotin (OR 1.03; 95%CI 1.01, 1.05), and cobalamin (OR 1.36; 95%CI 1.13, 1.64) increased the risk. In BMI stratums, only vitamin D (OR 1.81; 95%CI 1.07, 3.08) was associated with the risk of GC among normal weight participants. Vitamin E was associated with lower risk of GC in ever smokers (OR 0.97; 95%CI 0.95, 0.99) and thiamin (OR 0.41; 95%CI 0.19, 0.86) and niacin (OR 0.93; 95%CI 0.87, 0.99) were associated with lower risk in never smokers. Positive associations were observed by increasing vitamin D (OR 2.08; 95%CI 1.12, 3.85) and cobalamin (OR 1.33; 95%CI 1.08, 1.65) in never smokers. Conclusion: This study provided support for a possible protective effect of vitamin E, thiamin, pantothenic acid, and folate on GC risk. Vitamin D and cobalamin intake increased the risk.publishedVersionPeer reviewe

CTLA-4 Blockade of Natural Killer Cells Increases Cytotoxicity against Acute Lymphoid Leukaemia Cells Neda

Objective: There is interest in using cytotoxic T lymphocyte antigen-4 (CTLA-4) immunotherapy to treat blood cancers.Unfortunately, patients with acute lymphoblastic leukaemia (ALL) frequently exhibit resistance to treatment and naturalkiller (NK) cell exhaustion. This study aims to increase the cytotoxic potency of natural killer cells by using CTLA-4 toblock the Nalm-6 leukaemia cell line.Materials and Methods: In this experimental study, NK cells were purified from the peripheral blood mononuclear cells(PBMCs) of 10 healthy people and assessed by flow cytometry for purity and viability. The purified cells were activatedovernight at 37°C and 5% CO2 with interleukin-15 (IL-15, 10 ng/ml) followed by evaluation of expressions of CTLA-4,activating and inhibitory receptors, and the release of interferon gamma (IFN-γ) and granzyme B (GZM B). CTLA-4expression on NK cells from recurrent ALL patients was also evaluated. Finally, the cytotoxic activity of NK cells wasassessed after the CTLA-4 blockade.Results: The purity of the isolated cells was 96.58 ± 2.57%. Isolated NK cells activated with IL-15 resulted in significantlyhigher CTLA-4 expression (8.75%, P<0.05). Similarly, CTLA-4 expression on the surface of NK cells from patientswith ALL was higher (7.46%) compared to healthy individuals (1.46%, P<0.05). IL-15 reduced NKG2A expression(P<0.01), and increased expressions of NKP30 (P<0.05) and NKP46 (P<0.01). The activated NK cells released moreIFN-γ (P<0.5) and GZM B (P<0.01) compared to unactivated NK cells. Blockade of CTLA-4 enhanced the NK cellkilling potential against Nalm-6 cells (56.3%, P<0.05); however, IFN-γ and GZM B levels were not statistically differentbetween the blocked and non-blocked groups.Conclusion: Our findings suggest that CTLA-4 blockage of Nalm-6 cells causes an increase in antitumour activity ofNK cells against these cells. Our study also provides evidence for the potential of cancer immunotherapy treatmentusing blocking anti-CTLA-4 mAbs

Bushehr Elderly Health (BEH) programme: study protocol and design of musculoskeletal system and cognitive function (stage II).

Abstract INTRODUCTION: Musculoskeletal disorders and cognitive diseases are prevalent, and they are significant determinants of morbidity and mortality in older adults. The aim of this study is to investigate the prevalence of musculoskeletal and cognitive diseases and their risk factors and also to assess their associations during future follow-ups. METHODS AND ANALYSIS: Bushehr Elderly Health (BEH) programme is a population-based prospective cohort study being conducted in Bushehr, a southern province of Iran. A total of 3000 older people aged ≥60 years participated in the first stage from which 2772 were eligible to participate in the second stage, which started after 2.5 years. Data including demographic status, lifestyle factors, general healthandmedical history, and mentalandfunctional health are collected through a questionnaire. Anthropometric measures, performance testsandmuscle strength, blood pressure and and body composition measurements are done. A total 25 cc venous blood is taken, and sera are stored at -80°C for possible future analyses. ETHICS AND DISSEMINATION: The study protocol was approved by the ethics committee of Endocrinology and Metabolism Research Institute, affiliated to Tehran University of Medical Science as well as the Research Ethics Committee of Bushehr University of Medical Sciences. A written informed consent was signed by all the participants. The study findings will show the prevalence of musculoskeletal disease, cognitive impairment and their risk factors in an elderly population. The participants will be followed during the study to measure the occurrence outcomes.This study will also have the potential to inform the development of beneficial interventions to improve the management of musculoskeletal and cognitive impairment in Iran and other countries in the Middle East.Our findings will be disseminated via scientific publication as well as presentation to stakeholders, including the patients, clinicians, the public and policymakers, via appropriate avenue

Bushehr Elderly Health (BEH) Programme, phase I (cardiovascular system)

Purpose: The main objective of the Bushehr Elderly Health Programme, in its first phase, is to investigate the prevalence of cardiovascular risk factors and their association with major adverse cardiovascular events. Participants: Between March 2013 and October 2014, a total of 3000 men and women aged ≥60 years, residing in Bushehr, Iran, participated in this prospective cohort study ( participation rate=90.2%). Findings to date: Baseline data on risk factors, including demographic and socioeconomic status, smoking and medical history, were collected through a modified WHO MONICA questionnaire. Vital signs and anthropometric measures, including systolic and diastolic blood pressure, weight, height, and waist and hip circumference, were also measured. 12-lead electrocardiography and echocardiography were conducted on all participants, and total of 10 cc venous blood was taken, and sera was separated and stored at –80°C for possible future use. Preliminary data analyses showed a noticeably higher prevalence of risk factors among older women compared to that in men. Future plans: Risk factor assessments will be repeated every 5 years, and the participantswill be followed during the study to measure the occurrence of major adverse cardiac events. Moreover, the second phase, which includes investigation of bone health and cognition in the elderly, was started in September 2015. Data are available at the Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran, for any collaboratio

The reliability and heritability of cortical folds and their genetic correlations across hemispheres

Cortical folds help drive the parcellation of the human cortex into functionally specific regions. Variations in the length, depth, width, and surface area of these sulcal landmarks have been associated with disease, and may be genetically mediated. Before estimating the heritability of sulcal variation, the extent to which these metrics can be reliably extracted from in-vivo MRI must be established. Using four independent test-retest datasets, we found high reliability across the brain (intraclass correlation interquartile range: 0.65-0.85). Heritability estimates were derived for three family-based cohorts using variance components analysis and pooled (total N > 3000); the overall sulcal heritability pattern was correlated to that derived for a large population cohort (N > 9000) calculated using genomic complex trait analysis. Overall, sulcal width was the most heritable metric, and earlier forming sulci showed higher heritability. The inter-hemispheric genetic correlations were high, yet select sulci showed incomplete pleiotropy, suggesting hemisphere-specific genetic influences