Replantation of an Avulsed Maxillary Incisor after 12 Hours: Three-Year Follow-Up

Tooth avulsion is defined as the complete displacement of the tooth out of its alveolar socket. The treatment of choice is immediate replantation or if that is not possible, placement of the tooth in an appropriate storage media. This report presents replantation of an avulsed maxillary central incisor after 12 hours of storage in milk. The tooth was replanted and splinted. One week later, it was treated endodontically and calcium hydroxide dressing was placed for 1 month; subsequently, the tooth was obturated with gutta-percha. During three years of follow-up, no evidence of ankylosis or inflammatory resorption was observed. After three years, the tooth was stable and remained functional and esthetically acceptable

Fusion of Hidden Markov Model and Wavelet Transform to Recognise Breast Cancer

Public health is affected by the health and vitality of women who are the pillars of the families. Among the women between 15 to 54 years old, breast cancer is one of the most important causes of mortality. Every 13 minutes, a woman loses her life due to breast cancer. Statistics show that %12.6 of women suffer from breast cancer. Mammography can be considered as one of the most efficient methods of breast cancer diagnosis; however, this method has still its own limitations. The quality of mammography images can be enhanced by using image processing and the disease can be diagnosed more easily by using image feature extraction. Using Hidden Markov Model and wavelet transform method, a new method for the detection of suspicious areas of breast cancer tumors will be proposed in this study. In addition to the detection of tumors, this method can determine the mass percentage to estimate the progression of the disease. In this study, Markov Model with a tree structure was used to extract statistical properties of the wavelet components. The specific capacity of Markov Model to extract information about edges and the regions of protrusions in image tissues increases the accuracy of cancerous areas detection. The present study sought to estimate the appropriate label (clustering) of the pixels of an image under investigation to segment cancerous areas. Therefore, certain joint distributions were assumed for the pixels of a region or a class and then the maximum similarities between different areas of the examined image and joint distributions were examined through the Maximum-Likelihood Estimation method. To evaluate the proposed method and analyze the results, a combination of the MIAS and PADN databases comprising 150 images was used. The results indicated that the proposed method is more accurate than methods which are solely based on wavelet transform. In the new method, the obtained detection rate was %96 while in the wavelet transform method, it has been reported %71.5 indicating the precision of the proposed method

Exam Night Phenomenon among Students of Babol University of Medical Sciences, Iran

Background & Objective: The exam night phenomenon is a phenomenon observed among Iranian students in recent years. This means that students study the lessons offered during the term only on the night before the exam. The aim of this study was to investigate students’ views and reasons regarding the exam night phenomenon of night. Methods: This qualitative study was conducted through phenomenological method and purposive sampling. The participants consisted of BSc students of Babol University of Medical Sciences (Iran) who had completed at least two half semesters and had experienced the exam night phenomenon. Data were collected through in-depth, semi-structured interviews, and analyzed using open coding and a deep coding. Results: The 3 main themes of personal problems (mental preoccupation, lack of motivation, student’s personality, working while studying, and study methods), educational issues (teacher, textbooks, interest in courses and the field of study, and compact classes and the resulting fatigue), and implicit issues (university atmosphere, family, and the influence of friends) were effective in the exam night phenomenon. Conclusion: According to the results, the exam night phenomenon and its effective factors is an important issue which affects the students’ study method, final score, and many other issues. Key Words: Exam night, Study method, Medical student

Epidemiological Study of Intestinal Parasites in Referred Individuals to the Medical Centers’ Laboratories of Haji-Abad City, Hormozgan Province, Iran, 2015

Background:intestinal parasitic infection is one of the most prevalent health problems in developing countries. This study was conducted to determine the prevalence of intestinal parasitic infection and its correlation with socio-demographic parameters in Haji-abad, 2015.MaterialsandMethods:This cross-sectional descriptive study was conducted on 635 samples. After completing questionnaires, stool samples were assessed macroscopically, and microscopically using direct slide smear with saline and lugol, formalin-ether concentration, Ziehl-Neelsen staining to track Cryptosporidium species and Trichrome staining for the samples suspected to amoeba and other indeterminate cases. PCR using specific primers was conducted for Entamoebahistolytica/E. dispar suspected samples. The results were analyzed using SPSSver.16 software.Results:Of total 635 samples, 198 cases (31.2%) were infected by at least one intestinal parasite. The most common parasites in this area were: Blastocystis sp. (105, 16.5%), Endolimax nana (43, 6.8%), Entamoeba coli (32, 5.0%), Giardia lamblia (31, 4.9%), and Iodamoeba butschlii (11, 1.7%). Enterobius vermicularis (1, 0.2%) was the only detected helminthic infection. Regarding socio-demographic variables, age, residence, sampling month, and job showed a significant correlation with IPIs (p-value=0.031, 0.019, 0.014, 0.012; respectively). None of nine microscopically suspected E. histolytica/E. dispar cases were confirmed by molecular investigations (PCR method) and were considered as E. coli.Conclusion:In agreement with previous studies, helminthes infections show a dramatic decline compare to protozoa in this study. The relatively high incidence of intestinal protozoan infections in studies performed in Iran supports strategies for pre­venting the transmission and expansion of these parasites as a priority

Evaluating the Effect of Cardiac Rehabilitation Care Plan on Quality of Life of Patients Undergoing Coronary Artery Bypass Graft Surgery

Introduction: Cardiovascular surgeries are among the conventional surgeries aimed at increasing the survival rate and improving the quality of life of patients. This study aimed to evaluate the effect of cardiac rehabilitation on quality of life of patients undergoing Coronary artery bypass graft (CABG) surgery.Methods: This was a semi-experimental study performed on 160 patients undergoing CABG surgery. The rehabilitation program was carried out for 13 weeks (three sessions per week) in 40 sessions, six weeks after the CABG surgery. The MacNew standard questionnaire and the general health questionnaire (S-f 36) were completed before the beginning of rehabilitation sessions as well as after completion of these sessions by patients.Results: According to the results, the quality of life of patients significantly increased in the physical and emotional areas after the rehabilitation program. The results also indicated that there was a significant difference between various levels of research in the physical functioning variables, dysfunction due to physical health, dysfunction due to emotional health, energy/fatigue of individuals, emotional well-being, social functioning, pain, and general health.Conclusions: The present results indicated the improved quality of life of patients in all the areas after cardiac rehabilitation intervention, compared to before that. Therefore, paying more attention to cardiac rehabilitation is necessary due to its positive effects on increasing the quality of life of patients

4-Hydroxybutyric Aciduria as a Rare Presentation of Global Developmental Delay in Children: Case Report of Two Different Patients

Succinic semialdehyde dehydrogenase (SSADH) deficiency or 4-Hydroxybutyric Aciduria is an autosomal recessive inherited disorder of amma-aminobutyric acid (GABA) degradation. It is characterized by developmental delay, infantile-onset hypotonia, cognitive impairment language deficit, and ataxia. Epilepsy, aggression, Hyperkinetic behavior, hallucinations, and sleep disturbances have been described in about half of the patients, more frequently in older individuals. Its management is largely symptomatic, conducted at the treatment of seizures and neurobehavioral disorder. We present two girls with chief complaint of hypotonia and developmental delay how referred to department of Pediatrics (Ghaem hospital), Mashhad, Iran

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation

Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18 : a geospatial modelling study

Background More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.Methods We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km x 5 km resolution in 98 LMICs based on 2.1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution.Findings Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205000 (95% uncertainty interval 147000-257000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution.Interpretation Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019

Background: Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10–24 years during the past three decades. Methods: Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10–14, 15–19, and 20–24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. Findings: In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10–24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010–19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010–19. Interpretation: As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low–middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. Funding: Bill & Melinda Gates Foundation