Designing a customized clinical practice guideline regarding antibiotic prophylaxis for Iranian general dentists.

BACKGROUND: Clinical practice guidelines produced by developed countries seemed to be not completely feasible for developing countries due to their different local context. In this study, we designed a customized guideline about antibiotic prophylaxis before dental procedures for Iranian general dentists. METHODS: This study was conducted of two parts, including a qualitative part and a cross-sectional analytic part. A multidisciplinary team searched for related guidelines and other documents, selected the most updated and high quality ones, customized their recommendations based on available antibiotics in Iran, prepared a draft adapted guideline and summarized its recommendations in 3 flowcharts. An expert panel (20 specialists of four Iranian dental universities) participated in a consensus process, afterwards to determine the relevance and clarity of the flowcharts and their items. Then the Content Validity Indices (CVIs) were calculated and any items with CVI higher than 0.79 remained. RESULTS: The adapted recommendations were summarized in flowcharts A to C. Two separate groups of patients who need antibiotic prophylaxis were presented in flowchart A; including those with high risk for distant-site infection (infective endocarditis and prosthetic joint infection) and those at risk for poor healing and orofacial infection (due to impaired immunologic function). Flowcharts B and C described antibiotic regimen and also the dental procedures where antibiotic prophylaxis was needed for mentioned groups. The content validity indices and the percentages of agreement between the expert panel members were considerably high. CONCLUSIONS: A localized, clear and straight forward guideline that addresses all groups of dental patients who need antibiotic prophylaxis has been produced for Iranian general dentists

Gender similarity in low agreement between written and video ISAAC asthma questionnaires

Background and Aim. The prevalence of childhood asthma varies among different nations and appears to have increased in recent years. It has been difficult to determine this prevalence precisely and compare the communities due to the lack of a standardized method. The International Studies of Asthma and Allergies in Childhood (ISAAC) has developed a written and video questionnaire to measure asthma prevalence and overcome these difficulties. This study was carried out to determine the prevalence of childhood asthma in Kashan, the central area of Iran, and to assess the agreement between the ISAAC written and video questionnaires and its gender relationship. Methods. Between December 2002 and June 2003, 2533 school children, aged 13-14 years, in Kashan secondary schools completed sequentially the ISAAC written and video questionnaires. The agreement between responses to the two questionnaires for reported “ever wheeze”, “exercise wheeze”, “night wheeze” and “night cough” was determined, using kappa coefficient and concordance. Results. The prevalence of asthma symptoms were significantly lower in the responses to the video questionnaire compared with the written questionnaire. Kappa coefficient showed only poor to fair agreement (κ = 0.13- 0.24) between video and written questionnaires, although the concordance between them always exceeded 60%. Conclusions. This study showed that reported asthma symptoms based on video questionnaires were significantly lower than the written questionnaire, and that there is low agreement between the two questionnaires which requires further investigation to explain the findings. In addition, this investigation revealed no significant difference between the genders for this low agreement

Validation of a Farsi version of the Early Childhood Oral Health Impact Scale (F-ECOHIS)

<p>Abstract</p> <p>Background</p> <p>The Early Childhood Oral Health Impact Scale (ECOHIS) has recently been developed to assess oral health-related quality of life (OHRQoL) of pre-school children in English speaking communities. This study aimed to translate the ECOHIS into Farsi and test its psychometric properties for use on 2- to 5-year-old children of Farsi speaking Iranian families.</p> <p>Methods</p> <p>EHOHIS questionnaire was translated into Farsi using a standardized forward-backward linguistic translation method. Its face and content validity was tested in two small pilot studies. In the main study, a convenience sample of 260 parents of 2- to 5-year-old children in Isfahan and Tehran were invited to complete the final Farsi version of the ECOHIS (F-ECOHIS) and answer two global self-rating questions about their children's dental appearance and oral health. Association between F-ECOHIS scores and answers to the two self-rating questions, and the correlation between child (9 items) and family (4 items) sections of the F-ECOHIS were used to assess the concurrent and convergent validity of the questionnaire. Internal consistency reliability of the F-ECOHIS was tested using Cronbach's alpha coefficient test and item total and inter-item correlations. One third of participants were invited to complete the F-ECOHIS again after 2 weeks to evaluate the test-retest reliability of the questionnaire.</p> <p>Results</p> <p>Two hundred and forty six parents were included in the main study. The association between the F-ECOHIS scores and the two self-rating questions and the correlation between its child and family sections were significant (P < 0.001). Cronbach's alpha coefficient of the F-ECOHIS and its child and family sections were 0.93, 0.89, and 0.85 respectively. Coefficients did not increase by deleting any item. The corrected item total correlation coefficient ranged from 0.52 to 0.74. The inter-item correlation coefficient ranged between 0.30 and 0.73. Seventy three parents participated in the follow up study for re-testing the questionnaire. Comparison of their test and re-test scores had a weighted kappa of 0.81 and inter-class correlation (ICC) of 0.82.</p> <p>Conclusion</p> <p>The F-ECOHIS questionnaire was valid and reliable for assessing the OHRQoL of 2- to 5-year-old pre-school children of Farsi speaking parents.</p

Utilization of Orthodontic Services in the Fars Province, Iran: The Reasons People Travel to the Capital for Orthodontic Treatment

STATEMENT OF THE PROBLEM: The first step towards appropriately planning orthodontic treatment and prevention services is to understand the needs and demands of the target population. However, this is ignored in most developing countries. PURPOSE: This study aims to evaluate the attitudes of patients in Fars province towards travelling to the provincial capital (Shiraz) to receive orthodontic treatments. MATERIALS AND METHOD: This cross-sectional study randomly selected 420 patients referring to two public and four private orthodontic centers in Shiraz, coming from other regions of Fars province. The patients were interviewed about their demographic status, residing area and the reasons of deciding to receive orthodontic treatment in Shiraz. Data were analyzed by SPSS software, using Chi-square and ANOVA statistical tests. RESULTS: The response rate was 96% (N=403). Near half of the patients (176; 43.7 %) lived 100-200km, and 80 (19.9%) patients lived farther than 200km from Shiraz. Having no orthodontist (54.8%) and no dentist providing orthodontic treatment (39.2%) in their region were the most important factors bringing the patients to provincial capital for orthodontic treatments. High costs of treatment in their home county and hoping to receive treatment of higher quality were the other important motives for lower and higher socio-economic backgrounds, respectively. Friends'/relatives' recommendation was a more important factor in patients using public clinics for choosing their therapist, while referral from dentists was more important for patients going to private clinics. The patients who lived in counties farther than 200km from Shiraz were more concerned about quality of treatment results than those who lived closer (p= 0.010). CONCLUSION: A multifactorial approach is needed to provide the desired orthodontic services for people in Fars province so that they would not need to travel to the capital for such treatments

Simultaneous determination of nitrite and nitrate residues in meat products marketed in Shiraz by high performance liquid chromatography

Nitrite and nitrate are the key ingredients and play a multifunctional role in meat curing technology. Despite all of their desirable effects, the addition of nitrite to meat is the major cause of carcinogenic N-nitrosamines formation. In this study, the amount of residual nitrite and nitrate in meat products containing 61% to 80% meat were assessed. The samples were obtained at the fourth day of their production from Shiraz retails and analyzed using high performance liquid chromatography (HPLC). According to the results, the mean concentrations of residual nitrite and nitrate were estimated at 36.96 ± 7.38 and 85.81 ± 5.5 mg/kg in small-diameter (1.5-2 cm) sausages. Meanwhile, in large-diameter (5.5-8 cm) sausages the residues were estimated at 20.97 ± 3.28 and 124.85±5.3 mg/kg, respectively. In all analyzed samples, the residual nitrite level was found below the permitted level of 120 mg/kg which indicated the application of allowed concentrations of nitrite in such products. The mean values of residual nitrite and nitrate concentrations were statistically different (

The prevalence of pathologic tooth migration with respect to the severity of periodontitis.

AIM: Pathologic tooth migration (PTM) has been defined as tooth displacement that occurs when the balance among the factors that maintain physiologic tooth position is disturbed by periodontal disease. The aim of this cross-sectional epidemiological study was to determine the prevalence of pathologic tooth migration among patients with periodontitis. MATERIALS AND METHODS: Recorded documents of 370 patients (72.4% females, 27.6% males) within the age range of 17 to 70 years (mean 37.77 ± 11.46) were studied. Statistical analysis was carried out using t-test and Chi-square test. RESULTS: Pathologic migration prevalence was 11.4% (35/314 patients), however, there was no pathologic migration in patients with mild chronic periodontitis. The Chi-square test showed that there was no statistically significant difference between males and females. CONCLUSIONS: The results of this study confirm that pathologic tooth migration is relatively common among periodontal patients and its prevalence is increased by the severity of periodontal disease

Study on physico-chemical properties of emulsion type sausage produced with aqueous extract of Biarum carduchcorum tenderizied meat

In order to improve the quality of meat such as tenderness, protein solubility, emulsification and water holding capacity, in the food industries, various methods have been employed. Application of the plant enzymes is considered as one of the most efficient methods for meat tenderization. The purpose of the present study was to evaluate the characteristics of emulsion type sausage made from tenderized cattle meat by hydro extract of Biarum carduchcorum. The proteolytic activity of the extract was determined using bovine milk casein as substrate. Post rigor thigh meat were tenderized by 100 and 150 enzyme units/ kg of the extract before used for production of sausage. Fresh post rigor thigh meat was used as control. Nitrogen solubility index (NSI), stability of sausage emulsion, texture analysis and organoleptic properties of sausages were determined. Our results showed a significant increase in the NSI of the experimental groups compared with the control (