Removal of a Broken Instrument from a Tooth with Apical Periodontitis Using a Novel Approach

Instrument breakage during treatment can lead to serious complications and carries the risk of treatment failure. When a file breaks in the canal, bypassing or removal can be difficult and the long-term prognosis of the tooth may be compromised. Sometimes surgery may be indicated for removal of the broken segment. Often some part of the root cannot be cleaned because of blockage by the broken file. This report presents a specific approach in non-surgical removal of a broken file from a maxillary lateral incisor with a buccal sinus tract and a broken instrument in the apical third which was partially over extended into the periapical lesion. The broken file was accessed through the sinus tract and pushed into the canal. The canal was cleaned and shaped, filled with mineral trioxide aggregate (MTA). Conclusion: A sinus tract can be a specific path to reach the root tip and get access to remove the foreign materials pushed beyond the root canal space.Keywords: Apical Surgery; Broken Instrument; Nonsurgical Retreatmen

The Investigation of the Relationship between Financial Leverage and Return on Supply Chain Management

Abstract—The objective of the present study was to investigate the relationship between financial leverage and return on supply chain management and assest of the rural cooperatives. In this study, five ratios have been selected as financial leverage including total debt to total assets, total debt to total shareholders' equity, total long-term debt to total assets, total short-term debt to total assets and total debt to total capital. The return on asset is also calculated from the total debt to annual profit ratio. According to the objective of the research, this work is an applied research and according to the data collection method, it is a descriptive correlational study. The population included all rural cooperatives in the eastern part of the country in which 153 cooperatives were selected using the elimination method. Data analysis and the hypothesis testing were performed by simple linear regression test and using SPSS software. The results showed that three financial leverages have significantly affected the return on assets of the cooperatives which are the total debt to total assets, total long-term debt to total assets, and total short-term debt to total assets ratios. Of these three ratios, the total debt to total assets (-0.304) has the greatest effect on the return in assets of the cooperatives. The two other financial leverage ratios, i.e., the total debt to total shareholders' equity and the total debt to total capital did not have a significant effect on the return on assets of the rural cooperatives in the eastern part of the country. Thus, it is recommended to the cooperatives' Chief Executive Officer to focus more on three ratios of total debt to assets, total long-term debt to total assets, and total short-term debt to total assets in order to increase the return on equity of the cooperative and plan on the financial focus of the cooperative to reduce these ratios based on the efficient supply chain system

The Methodological Accuracy in Interventional Medical Education Articles Published in Approved Iranian Journals from 2005 to 2013

Background & Objective: Evaluation of methodological research reports increases the trust by the readers and users from application of results. This paper aimed to verify the accuracy of methodology in medical education interventional articles published in approved domestic journals. Methods: This cross-sectional study was used with a broad literature review in medical education interventional articles published in approved domestic journals by a review of medical journals archives and search databases. Thirty articles archived and its methodological accuracy was evaluated by special forms. The reliability of the study was confirmed with internal consistency and its validity has been confirmed in previous studies. Results: Over 90% of the suitability of the design was appropriate. Inclusive and exclusive criteria of subjects were found only in 26.8% of the cases. Blindness in 70% of the cases was observed. The reliability and validity of the instrument were not found in 66.7% of the cases. Fallow up length was not determined in 70%, and informed consent was not obtained in 80% of the subjects. Conclusion: There was inaccuracy in cases such as the instruments reliability and validity, sample selection, blindness, groups matching, etc. Journal writers are recommended to pay more attention to accuracy of research methodology in publishing medical education interventional articles. Keywords Medical education Methodology accuracy Iranian approved scientific journa

Inductive and Deductive: Ambiguous Labels in Qualitative Content Analysis

The propounded dualism in Content Analysis as quantitative and qualitative approaches is widely supported and justified in nursing literature. Nevertheless, another sort of dualism is proposed for Qualitative Content Analysis, suggesting the adoption of inductive and/or deductive approaches in the process of qualitative data analysis. These approaches have been referred and labelled as inductive or conventional ; and deductive or directed content analysis in the literature. Authors argue that these labels could be fallacious, and may lead to ambiguity; as in effect, both approaches are employed with different dominancy during the process of any Qualitative Content Analysis. Thus, authors suggest more expressive, comprehensive, yet simple labels for this method of qualitative data analysis

Nursing errors and effect on health care: Perception of risk factors from view of nurse in Qazvin

Background and aims: In order to plan for preventing and decreasing the rate of nursing errors, understanding of nurse’s perception of nursing errors could be very helpful. This study was thus designed to examine the critical care nurses perception of nursing errors from view point of critical care nurses. Methods: This study was conducted in 9 hospitals in Qazvin province located in north of Iran. Using convenience sampling, all registered nurses who worked in critical care units were invited to participate in the study. Data were collected between January and March 2015 with using “predisposing factors of nursing errors questionnaire”. Results: Of 379 nurses participated in this study, 77.8 (N= 213) were women. The mean age of participants was 34±2.2 years and mean years of experience was 8.1±1.5 years. Totally, from view of nurses, most and lowest common cusecs of nursing errors were related to “management aspect” and “Team coordination” items respectively. Conclusion: Nursing educational systems should pay more attention to nurses’ perception to nursing errors and may consider their view during planning and education towards decreasing nursing errors in critical care setting

Incidence of pressure ulcer in patients who were admitted to open heart cardiac surgery intensive care unit

Background and aims: Cardiac surgery patients are at high risk of pressure ulcers. In the present study, we determined the incidence of pressure ulcer in patients who were admitted to open heart cardiac surgery intensive care unit and related risk factors. Methods: With using convenience sampling all the eligible patients who were admitted to Boali cardiac surgery during June to August 2015 were invited to participate in this study. Patients’ skins were assessed using pressure ulcer staging system developed by National Pressure Ulcer Advisory Panel (NPUAP) and Braden scale before operation, after operation (in time of cardiac intensive care unit admission) and one times per day to patients discharge for sign of pressure ulcer development. Data were analyzed using descriptive statistics, Pearson correlation test and independent t-test in SPSS 20.0 statistical software. Results: During 3 months, 70 patients who were eligible were admitted to cardiac intensive care unit. From all, in 32 (45.7%) patient’s pressure ulcer was seen. From those, 41.4% were in stage I and 4.3% were in stage II. Mean score of Braden score in time of ICU admission was 11.1±2.3 and 15.1±2.3 in patients with and without pressure ulcer development (P<0.001). Factors such as lower Braden Scale score (P=0.001), diabetes (P=0.01), hypertension (P=0.001), NPO time after surgery (P=0.006), mean time of surgery (P=0.007), mean time of need to mechanical ventilation after surgery (P=0.003), low ejection fraction (P=0.006) and lower level of hemoglobin after surgery (P=0.012) increased the risk of pressure ulcer development significantly. Conclusion: Our findings indicate that patients who were admitted to open heart cardiac surgery intensive care unit are at high risk of pressure ulcer development. Medical and care-giving teams in the cardiac intensive care unit need further education about risk factors of pressure ulcer development to prevent this

Academic Engagement Concept and its Affecting Factors in Medical Education: A Review Study

Background & Objective: One of factors influencing students' academic achievement is academic engagement. The aim of this study was to perform a comprehensive investigation on conceptual dimensions of academic engagement and the factors affecting it. Methods: A comprehensive search of literature published during 2001-2014 was performed using Persian and English databases including Magiran, SID, Scopus, and PubMed. As a result 190 texts were obtained. After a close study, 22 papers with the keywords of "student engagement, and academic engagement time" were selected. Selection criteria were the existence of any dimension of the concept of academic engagement and factors affecting it in the paper. Results: After assessing 22 articles, the dimensions of academic engagement concept and its influencing factors were made clear. Academic engagement consists of the educational, behavioral, cognitive, and psychological dimensions. Factors which affect academic engagement are the education institution’s characteristics, teaching methods, service-based learning, technology and various levels of academic engagement. Conclusion: Through the recognition of dimensions of academic engagement and by applying factors that influence students' academic engagement the wasting of their time and energy can be prevented, and a valuable work force can be developed. Since university engagement has been less studied in medical sciences in our country, it is recommended that qualitative and quantitative research be performed in this field. Key Words: Academic engagement, University engagement, Medical education, Studen

An efficient method for synthesis of stable phosphorus ylides and 1,4-diionic organophosphorus compounds in the presence of sodium dodecyl sulfate in aqueous media

AbstractStable crystalline phosphorus ylides and 1,4-diionic organophosphorus compounds were obtained in good to excellent yields from the 1:1:1 addition reaction between triphenylphosphine, dialkyl acetylenedicarboxylates and β-dicarbonyl or heterocyclic compounds, such as diethyl malonate, acetyl acetone, 1,3-diphenyl propane-1,3-dione, 1,3-dimethylbarbituric acid, meldrum’s acid, 2-benzoxazolinone, benzotirazole, and 2-thiazoline-2-thiol in the presence of sodium dodecyl sulfate as a surfactant in water. Green synthesis, mild conditions, decreasing timescale of reaction, low cost, and easy workup are the main advantages of this method

Grafting of a novel gold(III) complex on nanoporous MCM-41 and evaluation of its toxicity in Saccharomyces cerevisiae

The goal of this research was to investigate the potential of newly synthesized gold complex trichloro(2,4,6-trimethylpyridine)Au(III) as an anticancer agent. The gold(III) complex was synthesized and grafted on nanoporous silica, MCM-41, to produce AuCl3@PF-MCM- 41 (AuCl3 grafted on pyridine-functionalized MCM-41). The toxicity of trichloro(2,4,6- trimethylpyridine)Au(III) and AuCl3@PF-MCM-41 in Saccharomyces cerevisiae (as a model system) was studied. The gold(III) complex showed a mid cytotoxic effect on yeast viability. Using the drug delivery system, nanoporous MCM-41, the gold(III) complex became a strong inhibitor for growth of yeast cells at a very low concentration. Furthermore, the animal tests revealed a high uptake of AuCl3@PF-MCM-41 in tumor cells. The stability of the compound was confirmed in human serum