Comparison of Diagnostic Accuracy of Cone Beam Computed Tomography and Digital Radiography for Detection of Vertical Root Fractures with and without Gutta Percha

Objective: Diagnosis of vertical root fractures (VRFs) is critical in endodontics; which most of the times occurs in endodontically treated teeth with root canal fillings such as gutta percha. Despite Cone Beam Computed Tomography (CBCT) has significantly enhanced image quality compared to digital radiography (DR) which aid the diagnosis, artifacts has remained as a problem in VRF detection. The aim of this study was to compare accuracy of CBCT and digital radiography system in vertical root fracture with presence and absence of gutta-percha.Methods: In this experimental in vitro study, 60 premolar teeth were cut at the cementoenamel junction .The teeth were randomly divided into two groups; for one group root canal therapy was done and the roots filled with gutta-percha. The other group was the control one .At the first stage CBCT scan and digital radiography was done and subsequently, vertical root fractures were induced for all samples. Then all the teeth were scanned by CBCT and digital radiography system and three observer assessed CBCT images and digital radiographies for presence of vertical root fracture. ANOVA and weighted Kappa tests estimated the diagnostic accuracy values and inter-observer agreement.Results: All values for CBCT were higher than Digital radiography except for absolute specificity and negative predictive value (p=0.409, p=0.053). In both imaging systems, there was no statistical difference between presence and absence of gutta-percha. (p=0.599, p=1.000, p=0.673, p=0.373).Conclusion: Diagnostic accuracy of vertical root fracture was not influenced by presence or absence of gutta-percha. Additionally, CBCT imaging system had higher diagnostic accuracy in comparison of digital radiography

Antileishmania activity of Levandula officinalis essence against Leishmania major in in vitro media

زمینه و هدف: با افزایش ایجاد مقاومت دارویی در درمان بیماری ها به ویژه بیماری های انگلی، همچنین وجود عوارض جانبی ترکیبات شیمیایی، استفاده از داروهای گیاهی در درمان بیماری های انگلی در سرتاسر جهان به شدت افزایش یافته است. مطالعه حاضر با هدف بررسی اثر ضد لیشمانیایی اسانس گیاه اسطوخودوس (Lavendula officinalis) و مقایسه آن با داروی گلوکانتیم انجام شده است. روش بررسی: در این مطالعه تجربی ابتدا اسانس روغنی از گیاه تازه خشک و پودر شده به روش تقطیر با بخار آب تهیه شده و سپس غلظت های 5/0، 5/1، 5، 10، 15 و 20 درصد از اسانس و غلظت 8/33 درصد از داروی گلوکانتیم بطور جداگانه به محیط کشت دارای 106 پروماستیگوت انگل لیشمانیا ماژور در هر میلی‌لیتر اضافه شد. تعداد انگل های زنده پس از اضافه کردن اسانس و دارو در زمان های 24، 48 و 72 ساعت به وسیله رنگ تریپان بلو 10 و با استفاده از لام نئوبار شمارش شدند. یافته‌ها: نتایج نشان داد که سرعت تکثیر پروماستیگوت‌ها پس از افزودن اسانس گیاه به میزان قابل توجهی نسبت به گروه شاهد کاهش یافت. در غلظت های 10 درصد و بیشتر اثر کشندگی نیز مشاهده شد، به طوری که در زمان 72 ساعت هیچ انگل زنده‌ای در گروه های مذکور مشاهده نشد. نتیجه گیری: نتایج این مطالعه بیانگر اثر ممانعت کننده رشد و کشندگی اسانس گیاه اسطوخودوس در شرایط آزمایشگاهی بر روی شکل پروماستیگوت لیشمانیا ماژور می‌باشد؛ بنابراین پیشنهاد می‌شود، مطالعات بیشتر برای پی بردن به اثر ضد لیشمانیایی گیاه اسطوخودوس بر روی شکل آماستیگوت انگل صورت گیرد

Prevalence of idiopathic osteosclerosis on cone beam computed tomography images

Objectives This study was performed to investigate the prevalence of idiopathic osteosclerosis on cone beam computed tomography (CBCT) images of patients.Methods In this descriptive, cross-sectional study, 240 CBCT scans of patients (125 women, 115 men) referred to a private oral and maxillofacial radiology clinic in Tehran in 2013 were selected and evaluated. Presence of idiopathic osteosclerosis and its features including its location in the jaw, its association with teeth, presence or absence of root resorption, number, shape and size of lesions and age and gender of patients were assessed. Descriptive statistics were reported. Chi-square test and independent t-test were used for statistical analysis.Results Idiopathic osteosclerosis was seen on CBCT images of 20 patients (8.33%). The lesion was more frequent in women than men, but the difference was not significant (P = 0.50). Also, the lesion was more common in the mandible than the maxilla (95.6% vs. 4.4%). Most lesions were observed in the molar (56.5%) and premolar (34.7%) areas of the lower jaw. Most lesions did not have any association with teeth (73.9%). More than half of the lesions (56.5%) were round in shape and the rest (43.4%) were irregular. The mean size of the lesions was 5.4 ± 1.8 and 5.7 ± 1.4 mm in the mesiodistal and superior-inferior aspects, respectively.Conclusion The prevalence of idiopathic osteosclerosis of the jaws on CBCT images of an Iranian population was within the range reported by other studies. The lesions were more common in the mandibular molar region with no relation to teeth

Serum Klotho Level and its Related Factors Among Male Opioids Addicts With Normal Renal Function Compared to Healthy Male Non-smokers and Smokers in Tabriz, Iran

Background: Klotho is an aging-suppressor gene that encodes a single-pass transmembrane protein and acts as a hormone. In this study, we aim to investigate the serum α-Klotho level in male opioids addicts with normal kidney function compared to healthy male non-smokers and smokers in Tabriz, Iran. Methods: Participnts were 87 men with normal kidney function referred to Sina Educational Research and Treatment Center in Tabriz, Iran (29 opioids addicts, 29 healthy non-smokers, and 29 healthy smokers). Blood samples were collected to measure the soluble a-Klotho level using an ELISA kit. Furthermore, blood creatinine (Cr) and hemoglobin (Hb) levels was measured. Body mass index (BMI) was also calculated for all participants.Results: In addicts, BMI, Hb, and Cr levels were significantly lower than in healthy non-smokers and smokers, but their Klotho level was higher (P>0.05). The Klotho level in healthy smokers was significantly lower than in healthy non-smokers and addicts. The Klotho level of healthy smokers decreased as the pack year increased, but the duration of opioid addiction had no significant association with the Klotho level. There was no significant difference in the Klotho level between control groups (non-smokers and smokers) and men with addiction to different types of opioids. Conclusion: The Klotho level in male opioid addicts is significantly higher than in smokers. There is a significant negative correlation between BMI and Klotho levels among men with normal BMI and overweight. Further studies are recommended in these fields

Health workers readiness and practice in malaria case detection and appropriate treatment: a meta-analysis and meta-regression

BACKGROUND: Health workers (HWs) appropriate malaria case management includes early detection and prompt treatment with appropriate anti-malarial drugs. Subsequently, HWs readiness and practice are considered authentic evidence to measure the health system performance regarding malaria control programme milestones and to issue malaria elimination certification. There is no comprehensive evidence based on meta-analysis, to measure the performance of HWs in case management of malaria. This study aimed to evaluate HWs performance in early malaria case detection (testing) and the appropriate treatment. METHODS: The published literature in English was systematically searched from Medline, Scopus, Embase, and Malaria Journal up to 30th December 2020. The inclusion criteria were any studies that assessed HWs practice in early case detection by malaria testing and appropriate treatment. Eligibility assessment of records was performed independently in a blinded, standardized way by two reviewers. Pooled prevalence estimates were stratified by HWs cadre type. Meta-regression analysis was performed to explore the impact of the appropriateness of the method and risk of bias as potential sources of the heterogeneity in the presence of effective factors. RESULTS: The study pooled data of 9245 HWs obtained from 15 included studies. No study has been found in eliminating settings. The pooled estimate for appropriate malaria treatment and malaria testing were 60%; 95% CI: 53-67% and 57%; 95% CI: 49-65%, respectively. In the final multivariable meta-regression, HWs cadre and numbers, appropriateness of study methods, malaria morbidity and mortality, total admissions of malaria suspected cases, gross domestic product, availability of anti-malarial drugs, and year of the publication were explained 85 and 83% of the total variance between studies and potential sources of the heterogeneity for malaria testing and treating, respectively. CONCLUSION: HWs adherence to appropriate malaria case management guidelines were generally low while no study has been found in eliminating countries. Studies with the inappropriateness methods and risk of bias could be overestimating the actual proportion of malaria appropriate testing and treating. Strategies that focus on improving readiness and early identification of acute febrile diseases especially in the countries that progress to malaria elimination should be highly promoted

Development and validation of an online tool for assessment of health care providers' management of suspected malaria in an area, where transmission has been interrupted.

Background The alertness and practice of health care providers (HCPs) in the correct management of suspected malaria (CMSM) (vigilance) is a central component of malaria surveillance following elimination, and it must be established before malaria elimination certification can be granted. This study was designed to develop and validate a rapid tool, Simulated Malaria Online Tool (SMOT), to evaluate HCPs' practice in relation to the CMSM. Methods The study was conducted in East Azerbaijan Province, Islamic Republic of Iran, where no malaria transmission has been reported since 2005. An online tool presenting a suspected malaria case for detection of HCPs' failures in recognition, diagnosis, treatment and reporting was developed based on literature review and expert opinion. A total of 360 HCPs were allocated to two groups. In one group their performance was tested by simulated patient (SP) methodology as gold standard, and one month later by the online tool to allow assessment of its sensitivity. In the other group, they were tested only by the online tool to allow assessment of any possible bias incurred by the exposure to SPs before the tool. Results The sensitivity of the tool was (98.7%; CI 93.6-99.3). The overall agreement and kappa statistics were 96.6% and 85.6%, respectively. In the group tested by both methods, the failure proportion by SP was 86.1% (CI 80.1-90.8) and by tool 87.2% (CI 81.4-91.7). In the other group, the tool found 85.6% (CI 79.5-90.3) failures. There were no significant differences in detecting failures within or between the groups. Conclusion The SMOT tool not only showed high validity for detecting HCPs' failures in relation to CMSM, but it had high rates of agreement with the real-world situation, where malaria transmission has been interrupted. The tool can be used by program managers to evaluate HCPs' performance and identify sub-groups, whose malaria vigilance should be strengthened. It could also contribute to the evidence base for certification of malaria elimination, and to strengthening prevention of re-establishment of malaria transmission