Langerhans' cell histiocytosis with multiple radiolucent lesions in the body of the mandible,report of a case

Introduction: Langerhans cell histiocytosis (LCH) refers to a group of rare reticuloendothelial system disorders and it occurs most often in young adults and children. A 57-year-old edentulous female patient who complained of dull pain in the posterior region of the mandible referred to the dental office, with a complaint of dull pain in the posterior region of the mandible. The lesion was diagnosed as LCH. Oral manifestations could be the first signs of Langerhans' cell histiocytosis. Therefore, the dentist must be aware of the oral symptoms so in order that the disease is not overlooked

Evaluation of the Quality of Clinical Education Based on the Perspective of Medical Students of Shahroud University of Medical Sciences

Background: Improving the quality of clinical education requires a continuous review of the existing situation to identify strengths and weaknesses. The aim of the study was to evaluate the quality of clinical education based on the perspective of medical students of Shahroud university of medical sciences. Methods: This descriptive-analytical study was conducted at1397-98. Participants were 230 medical students and interns in Shahroud university of medical sciences who were enrolled in the study. The data were collected using the clinical education quality assessment questionnaire, with a range of 0-66 points and divided into three levels: weak, moderate and desirable. T-test was used for data analysis. The Significanl level was set at 0.05. Results: The results showed that the mean of the standard deviation of clinical education quality in terms of goals and curriculum (12.95), teacher performance (10.23), and student treatment (4.09) was desirable from medical students' point of view. (Given that the significance level is less than 0.05, these averages are desirable) while in terms of educational environment (4.60) and supervision and evaluation (4.01), it is not desirable. Conclusions: According to the findings, clinical quality status is desirable in most aspects, but it is necessary to eliminate the weaknesses to improve the quality of clinical education in this university in terms of the educational environment, monitoring and evaluation according to the students' viewpoints. Keywords: Quality, Clinical education, Medical students

Evaluation of the Quality of Clinical Education Based on the Perspective of Medical Students of Shahroud University of Medical Sciences

Background: Improving the quality of clinical education requires a continuous review of the existing situation to identify strengths and weaknesses. The aim of the study was to evaluate the quality of clinical education based on the perspective of medical students of Shahroud university of medical sciences. Methods: This descriptive-analytical study was conducted at1397-98. Participants were 230 medical students and interns in Shahroud university of medical sciences who were enrolled in the study. The data were collected using the clinical education quality assessment questionnaire, with a range of 0-66 points and divided into three levels: weak, moderate and desirable. T-test was used for data analysis. The Significanl level was set at 0.05. Results: The results showed that the mean of the standard deviation of clinical education quality in terms of goals and curriculum (12.95), teacher performance (10.23), and student treatment (4.09) was desirable from medical students' point of view. (Given that the significance level is less than 0.05, these averages are desirable) while in terms of educational environment (4.60) and supervision and evaluation (4.01), it is not desirable. Conclusions: According to the findings, clinical quality status is desirable in most aspects, but it is necessary to eliminate the weaknesses to improve the quality of clinical education in this university in terms of the educational environment, monitoring and evaluation according to the students' viewpoints. Keywords: Quality, Clinical education, Medical students

Mineral Trioxide Aggregate Mixed with Normal Saline, Calcium Chloride or KY Jelly as Apical Plug in Simulated Open Apices: An In vitro Microleakage Study

Introduction: Mineral trioxide aggregate (MTA) mixed with normal saline has short working time, delayed setting time, and poor consistency when used as an apical plug. A preliminary study suggested that substituting normal saline with KY Jelly or 5% calcium chloride (CaCl2) as a vehicle expedites the setting time of MTA. The present in vitro study compared the microleakage of ProRoot MTA mixed with normal saline (MS) to that of ProRoot MTA mixed with KY Jelly and/or 5% CaCl2 in simulated canals with open apices. Materials and methods: Thirty six single-rooted extracted human teeth were cleaned and shaped with ProTaper rotary system to make 36 standardized artificially created open apices. Teeth were randomly divided into three experimental groups (n=10) and two control groups (n=3). In group 1, MTA was mixed with normal saline (MS) and placed into the canals to form 4 to 5 mm apical plugs. In group 2, MTA was mixed with 5% CaCl2 (MC) and in group 3, MTA was mixed with KY Jelly (MK). The other two groups served as positive and negative controls. The remaining canal spaces in the experimental groups were backfilled with thermoplasticized gutta-percha without sealer. Dye penetration and clearing was used to evaluate the sealing ability of each group. The samples were then examined under stereomicroscope to measure the microleakage of different MTA mixtures in mm. Data were statistically analyzed using One-Sample Kolmogorov-Smirnov test for determination of normal distribution and then by one-way ANOVA and Tukey’s tests to detect any significance. Results: Positive and negative controls responded as expected. The MS group showed the least mean dye penetration value. There was a significant difference between MS with other groups (P<0.05) but no difference was found between MC and MK groups. Conclusion: Within the limitations of this in vitro study, we can conclude that among these three vehicles, normal saline mixed with ProRoot MTA has the least amount of microleakage in canals with open apices

The Best Time for EEG Recording in Febrile Seizure

How to Cite This Article: Karimzadeh P, Rezayi A, Togha M, Ahmadabadi F, Derakhshanfar H, Azargashb E, Khodaei F. The Best Time for EEG Recording in Febrile Seizure. Iran J Child Neurol. 2014 Winter; 8(1):20-25.ObjectiveSome studies suggest that detection of epileptic discharge is unusual during the first postictal week of febrile seizure and others believe that EEGs carried out on the day of the seizure are abnormal in as many as 88% of the patients. In thisstudy, we intend to compare early and late EEG abnormalities in febrile seizure.Materials & Methods EEG was recorded during daytime sleep, 24-48 hours (early EEG) and 2 weeks (late EEG) after the seizure in 36 children with febrile seizure (FS), aged between 3 months and 6 years. EEGs that showed generalized or focal spikes, sharp, spike wave complex, and slowing were considered as abnormal EEG.Abnormalities of the first EEG were compared with those of second EEG.ResultsThe most common abnormal epileptiform discharges recorded in the early EEG were slow waves (27.6%) and sharp waves in late EEG (36%). Distribution of abnormalities in early and late EEG showed no significant statistical difference.ConclusionThe early and late EEG recording had the same results in patient with febrile seizure. Reference:Hauser WA, Kurland LT. The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia 1975;16(1):1-66.Freeman JM. Febrile seizures: a consensus of their significance, evaluation, and treatment. Pediatrics 1980;66(6):1009.Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child 2004;89(8):751-6.ILAE. Guidelines for epidemiologic studies on epilepsy, International League against Epilepsy. Epilepsia 1993;34(4):592-6.Annegers JF, Hauser WA, Shirts SB, Kurland LT. Factors prognostic of unprovoked seizures after febrile convulsions. N Engl J Med 1987;316(9):493-8.Berg AT, Shinnar S, Darefsky AS, Holford TR, Shapiro ED, Salomon ME, et al. Predictors of recurrent febrile seizures. Arch Pediatr Adolesc Med 1997;151(4):371-8.Nelson KB, Ellenberg JH. Predictors of epilepsy in children who have experienced febrile seizures. N Engl J Med 1976;295(19):1029-33.Anonymous. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. American Academy of Pediatrics. Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics 1996;97(5):769-72; discussion:773-5.Rosman NP. Evaluation of the child who convulses with fever. Paediatr Drugs 2003;5(7):457-61.Kanemura H, Mizorogi S, Aoyagi K, Sugita K, Aihara M. EEG characteristics predict subsequent epilepsy in children with febrile seizure. Brain Dev 2012;34(4):302-7.Yamatogi Y, Ohtahara S. EEG in febrile convulsions. Am J EEG Techno1 1990;30:267-80.Aicardi J, Chevrie JJ. The significance of electroencephalographic paroxysms in children less than 3 years of age. Epilepsia 1973;14(1):47-55.Tsuboi T. Seizures of childhood: a population-based and clinic based study. Acta Neurol Scand Suppl 1986;110:1-237.Maytal J, Steele R, Eviatar L, Novak G. The value of early postictal EEG in children with complex febrile seizures. Epilepsia 2000;41(2):219-21.Joshi C, Wawrykow T, Patrick J, Prasad A. Do clinical variables predict an abnormal EEG in patients with complex febrile seizures? Seizure 2005;14(6):429-34.Lennox-Buchthal M. Febrile convulsions: a reappraisal. Electroencephalogr Clin Neurophysiol 1973;32:Suppl:1-138.Frantzen E, Lennox-Buchtal MA, Nygraad A. Longitudinal EEG and clinical study of children with febrile convulsions. Electroencephalogr Clin Neurophysiol 1968;24(3):197-212.Kajitani T, Ueoka K, Nakamura M, Kumanomidou Y. Febrile convulsions and rolandic discharges. Brain Dev 1981;3(4):351-9.Sofijanov N, Emoto S, Kuturec M, Dukovski M, Duma F, Ellenberg JH, et al. Febrile seizures: clinical characteristics and initial EEG. Epilepsia 1992;33(1):52-7

A Novel Intervention Technology for Cerebral Palsy: Brain Stimulation

Abstract:A common pediatric disorder with posture and motor dysfunctionin neurological diseases is known as cerebral palsy (CP). Recently,a series of effective techniques have been developed for treatmentof CP. These promising methods need high-tech equipment forbrain stimulation and mainly classified into invasive and noinvasiveapproaches. This study aimed to introduce these techniquesfor treatment of patients who suffer from CP. The potential andperformance of currently available brain stimulation techniques havebeen mentioned in detail. Moreover, the clinical application, safety,efficacy and challenges of these methods have been discussed. Herewe review the recent advances in the CP treatment with an emphasison brain stimulation techniquesKeywords:Cerebral palsy; Brain stimulation; Pediatric disorde

Brucella Antibody Levels in Preschool Children in the North East of Iran

Background: Brucellosis is a zoonotic disease of humans and animals that has affected worldwide. Iran is one of the endemic areas infected with brucellosis. Early diagnosis of this disease may protect the affected children from disabilities and mortalities. This study aimed to evaluate the Brucella antibody levels in preschool children of the Shahroud city in Iran.Methods: This cross-sectional study evaluated 850 participants, in particular, school children from the Shahroud city. General information was collected by interviewing the children’s parents. Moreover, a 5 ml of blood sample was collected from all the children. The samples were studies using standard tube agglutination test (Wright) and 2-Mercaptoethanol. Thereafter, IgG and IgM levels were determined by the ELISA method.Results: A total of 850 children were enrolled, of which 51.2% were boys and 48.8% were girls, with a mean age of 5.17±1.55 years. Of the all children evaluated, 839 (97.5%) children had a titer <1/80 and 21 children (2.5%) had a titer ≥1/80. A significant difference was observed between the antibody titers in terms of gender (P=0.012), whereas no significant association was found among antibody titers with other variables such as age, history of nonpasteurized foods, exposure to animals, history of brucellosis disease, and parental occupation.Conclusions: The antibody titer for suspected brucellosis in preschool children of Shahroud was very low. According to the results of our study, in particular, in the endemic areas, a Wright’s titer of 1/80 in suspected cases for brucellosis can be considered as a diagnostic titer

Brucella Antibody Levels in Preschool Children in the North East of Iran

Background: Brucellosis is a zoonotic disease of humans and animals that has affected worldwide. Iran is one of the endemic areas infected with brucellosis. Early diagnosis of this disease may protect the affected children from disabilities and mortalities. This study aimed to evaluate the Brucella antibody levels in preschool children of the Shahroud city in Iran.Methods: This cross-sectional study evaluated 850 participants, in particular, school children from the Shahroud city. General information was collected by interviewing the children’s parents. Moreover, a 5 ml of blood sample was collected from all the children. The samples were studies using standard tube agglutination test (Wright) and 2-Mercaptoethanol. Thereafter, IgG and IgM levels were determined by the ELISA method.Results: A total of 850 children were enrolled, of which 51.2% were boys and 48.8% were girls, with a mean age of 5.17±1.55 years. Of the all children evaluated, 839 (97.5%) children had a titer <1/80 and 21 children (2.5%) had a titer ≥1/80. A significant difference was observed between the antibody titers in terms of gender (P=0.012), whereas no significant association was found among antibody titers with other variables such as age, history of nonpasteurized foods, exposure to animals, history of brucellosis disease, and parental occupation.Conclusions: The antibody titer for suspected brucellosis in preschool children of Shahroud was very low. According to the results of our study, in particular, in the endemic areas, a Wright’s titer of 1/80 in suspected cases for brucellosis can be considered as a diagnostic titer

The Effect of Adding Fentanyl to Epinephrine-Containing Lidocaine on the Anesthesia of Maxillary Teeth with Irreversible Pulpitis: A Randomized Clinical Trial

Introduction: Deep and long-lasting anesthesia is essential throughout endodontic treatment. This study was conducted to compare the effect of adding fentanyl to epinephrine-containing lidocaine on depth and duration of local anesthesia in painful maxillary molars with irreversible pulpitis (IRP). Methods and Materials: This randomized double-blind, clinical trial with parallel design was conducted on 61 healthy volunteers; the control group received a mixture of normal saline and 2% lidocaine with 1:80000 epinephrine and the experimental group received a mixture of fentanyl and 2% lidocaine with 1:80000 epinephrine. The depth and duration of pulpal anesthesia were evaluated by means of electric pulp testing in 5-min intervals during a period of 60 min. Pain intensity was recorded five times: before injection, after injection, during access cavity preparation, initial file placement and pulpectomy using visual analog scale (VAS). All data were analyzed and compared using the chi-square and Mann-Whitney tests. Results: Except for one patient in the control group, all others had deep and long-lasting anesthesia. The difference between pain intensity of the control and experimental groups was not statistically significant (P>0.05). Conclusion: Addition of fentanyl to conventional local anesthetic solution did not increase the effectiveness of infiltration in patients diagnosed with IRP

سبک زندگی سالم در پیشگیری و درمان افسردگی از دیدگاه طب سنتی ایران

Depression is a common disease that causes disability in affected people. Also it seems that conventional treatments have various side effects and patients face off recurrent relapse. As a fact prevention programs with focus on life style can reduce the prevalence of depression. Sadness that is one of the important Spiritual symptoms and descripted in Iranian Traditional Medicine (ITM) as inner gradual movement of soul is one of the main diagnostic criteria of depression. In this literature review, the methods of prevention of depression based on health maintaining doctrine of ITM have been evaluated. Valid Traditional Iranian Medicine books and various data bases have been searched. Temperate and fresh weather is one of the basis which helps brain and heart to act their function better. Fast foods and inappropriate diet have a direct relationship with depression incidence. Exhilarant herbs can treat depression. Moderate exercise, waste expulsion, good and suitable sleep and good sexual function are the most important criteria for prevention from depression. The emphasis of ITM on the role of prevention should be considered seriously.افسردگی بیماری شایعی است که باعث ایجاد ناتوانی در مبتلایان می‌شود. درمان‌های رایج دارای عوارض جانبی مختلفی بوده و مبتلایان دچار عود بیماری می‌شوند. اجرای برنامه‌های پیشگیری، باعث کاهش شیوع افسردگی می‌شود. غم که یکی از اعراض نفسانی مهم بوده و در طب سنتی، حرکت تدریجی روح به داخل توصیف شده است، از معیارهای اصلی افسردگی می‌باشد. در این مطالعه که یک بررسی کتابخانه‌ای و مروری می‌باشد، به بررسی روش‌های پیشگیری از افسردگی بر اساس اصول حفظ سلامتی ذکرشده در طب سنتی ایران می‌پردازیم. کتب معتبر طب سنتی ایران و پایگاه‌های اطلاعاتی مختلف مورد جستجو قرار گرفتند. هوای معتدل و صاف باعث بهبود عملکرد قلب و مغز می‌شود. غذاهای آماده و تغذیه نامناسب رابطه مستقیمی با افسردگی داشته، استفاده از مفرحات باعث درمان افسردگی می‌شود. ورزش در حد متوسط، دفع مواد زائد، عملکرد جنسی مناسب و خواب خوب و در حد نیاز از عوامل مهم پیشگیری از افسردگی هستند. تأکید طب سنتی ایران بر نقش پیشگیری، باید به صورت جدی مورد توجه قرار گیرد