Gender Differences in COVID-19 Deceased Cases in Jahrom City, South of Iran

Objective: To evaluate the clinical and epidemiological features of deceased patients and comparing the discrepancies between male and female patients based on high prevalence of coronavirus disease 2019 (COVID-19), its irreversible effects and the rising mortality rate in Jahrom city. Methods: This is a descriptive-analytical retrospective study that was conducted from the beginning of March 2020 to the end of November 2020. The study population were included all patients with COVID-19 who admitted to Peymaniyeh Hospital in Jahrom and died of COVID-19. Clinical and demographic data were collected from medical records and analyzed by SPSS software. Results: In this study, 61 patients (57.54%) were men and 45 patients (42.36%) were women. The mean age was 68.7±18.33 in men and 68.82±14.24 in women. The mean hospitalization length was 9.69±7.75 days in men and 9.69±7.75 days in women patients. There was no statistically significant difference between men and women patients (p>0.05). The results showed that 17 (27.87%) men and 28 (45.9%) of women patients had hypertension and the prevalence of this disease was significantly higher in women than men (p=0.01). In this study, 7 (11.48%) men and 13 (21.31%) women had hyperlipidemia. The frequency of hyperlipidemia in women caseswas significantly higher than in men patients (p=0.024). Men cases’ diastolic blood pressure (mean=77.53) was significantly higher than women’s diastolic blood pressure at the same time with a mean of 71.42 (p <0.05). Conclusion: The findings of the study represented the mortality rate in men which is higher than women patients. The prevalence of underlying diseases such as hypertension and hyperlipidemia were higher in women than men. Despite higher mortality among women, symptoms such as fever and dyspnea were less common in women than men

Clinical and Radiographic Evaluation of Success Rate with MTA Plug in Open Apices

INTRODUCTION: The ideal endodontic treatment for the teeth with in complete root-ends and necrotic pulps may involve the use of material which forms an immediate apical barrier instead of long term calcium hydroxide therapy. Such procedure may lead us to a single appointment endodontic treatment. The purpose of the present study was to evaluate clinical and radiographic success rate in necrotic teeth with open apices treated with MTA as an apical plug. MATERIALS AND METHODS: Thirty five patients between the ages of 8-16 with total number of 41 necrotic anterior teeth containing open apices were selected. In the first visit, root canals were debrided and filled with calcium hydroxide. After one week, calcium hydroxide was removed and MTA with the thickness of 3 to 4 mm was put in the apical region of the canals. After 24 hours, the remaining part of the canals was filled with guttapercha and sealer and the teeth were restored with composite. All the cases were evaluated clinically and radiographically after 3 and 6 months and data were analyzed by McNemar test. RESULTS: No clinical symptoms were observed in 97.6% of the teeth after 3 months and in none after 6 months. The study showed a significant difference from pretreatment status. After 3 months radiographic evaluation showed that in 17 cases (41.5%), lesions were reduced and in 14 cases (34.1 %), lesions remained the same, and in 10 cases (24.4%) lesions disappeared. After 6 months in 21 cases (51.2%), lesions were reduced, in 3 cases (7.3%) lesions remained the same and in 17 cases (41.5%) lesions disappeared. These finding were statistically different from pretreatment data. CONCLUSION: The results indicate that MTA can be used as an apical plug in the teeth with open apices following root canal debridement and disinfection with calcium hydroxide. Further investigations with longer follow-ups are recommended in order to evaluate the effect of this material

The Effect of Magnesium Sulfate on Pain Intensity and Menstrual Blood Loss in Students With Primary Dysmenorrhea: A Randomized Controlled Trial

Background: No evidence exists for the lowest effective dose of magnesium on menstrual pain. Objective: To determine and compare the effects of two different doses of magnesium on pain intensity and menstrual blood loss in students with primary dysmenorrhea. Methods: Sixty dysmenorrhea patients were randomly assigned to one of two therapeutic groups and one placebo group (receiving one tablet a day of 300 or 150 mg magnesium sulphate or placebo from the 15th cycle day until no pain existed on the following cycle). Visual analogue scale (VAS) and Hjgham collected data for two cycles before and two cycles after the intervention. The data were analyzed using one-way ANOVA and ANCOVA tests. Findings: No significant difference was observed between the groups in terms of baseline characteristics. Both intervention groups outperformed the placebo group in terms of pain intensity (adjusted differences of -2.9, 95% confidence intervals of -3.3 to -2.4 and -1.9, -2.4 to -1.5, respectively) and menstrual bleeding (-20.0, -26.0 to -14.0, and -13.0, -19.0 to -7.0, respectively), as well as the secondary outcome, i.e. rest duration and ibuprofen consumption. In terms of pain alleviation and menstrual bleeding, participants in the 300 mg magnesium group outperformed those in the 150 mg magnesium group. No significant difference was observed between intervention groups regarding secondary outcomes. Conclusion: Both magnesium levels are useful in alleviating pain and reducing menstrual bleeding, although 300 mg of magnesium was more effective

Performance of CARE rule in ruling out acute coronary syndrome in non-traumatic chest pain, an external validation study

Objective: About one out of every 10 patients with chest pain in the emergency department (ED) are finally diagnosed with acute coronary syndrome (ACS). A HEART score of ≤ 3 has been shown to rule out ACS with a low risk of major adverse cardiac event (MACE) occurrence. It has been proposed that a negative CARE rule (≤ 1), which stands for the first four elements of the HEART score and excludes the troponin assay requirement, may have similar rule-out reliability. This study aimed to externally validate the CARE rule.&nbsp;Methods: In this multicenter, observational study a convenience sample consisting of patients over the age of 15 who had at least one troponin study were included. The performance of the CARE rule at the cut-off ≤1 for MACE prediction was assessed and compared to a HEART score of ≤3 and physicians’ gestalt. MACE was defined as myocardial infarction, coronary angioplasty, coronary artery bypass graft, and all-cause mortality in 6 weeks.&nbsp;Results: The data of 154 patients was analyzed. Of these, 121 patients had a negative CARE score of ≤1 and 33 individuals had a positive CARE score. Of those with a negative CARE score, only 1 (3.00%) experienced an adverse cardiac event while in those with a positive CARE score, 25 individuals (16.23%) experienced MACE. The sensitivity of the CARE rule was 96.00% and the specificity was 24.81% with a negative likelihood ratio (-LR) of 0.16. The indices for HEART score were 88.00%, 59.69%, and 0.2, respectively. In comparison, physicians' gestalt had a sensitivity of 96.00%, specificity of 49.22%, and a –LR of 0.08. Of note, utilizing the CARE rule with a cut-off of &lt;3 showed sensitivity of 96.00%, specificity of 41.86%, and a -LR of 0.1.&nbsp;Conclusion: The CARE rule miss rate in MACE was more than 2% and while its performance was better than the HEART score, physicians’ gestalt outperformed both rules for ruling out MACE