Comparing the Effect of Hypnosis and Local Anesthesia Injection on Induction of Local Anesthesia, Anxiety, Hemorrhage and Pain Control during Tooth Extraction

There are cases in dentistry that despite the injection of local anesthesia, the desired numbness for tooth extraction can't be achieved or the use of common local anesthetic is contraindicated for the patient. Therefore, in these cases a complementary treatment can be introduced. The aim of this paper is to compare the effect of hypnosis and local anesthesia injection on induction of local anesthesia, anxiety, hemorrhage and pain control during tooth extraction. This randomized cross over trial research is carried out with 16 patients, with a mean age of 22 years and symmetric erupted third molars who were referred to the department of oral and maxillofacial surgery in Faculty of Dentistry of Rafsanjan University. For each patient the third molars on one side were extracted under hypnosis or local anesthesia and after a week on the opposite side under the other method. The Spielberger State Trait Anxiety Inventory was used to determine patients' anxiety level before and after hypnosis and injection. Pain was scored using VAS (Visual Analogue Scale) to measure hemorrhage volume. After surgery the patient was asked to bite a sterile gauze pad over the surgical site for 3o minutes and if the bleeding was more than slight ooze at, 12, 24 and 48 hours post operatively, they were supposed to mark it on the list. Data was analyzed using SPSS 19 statistical software. When local anesthesia was chosen the number of anesthesia cartilages used, anxiety level and pain intensity at 5 and 12 hours post operatively were higher than the time hypnosis was selected. (p0.050). At clinical aspect, it seems the success of hypnosis in induction of anesthesia was less than injection and as mentioned above there was no significant difference between the two methods in terms of hemorrhage in 24 and 48 hours post operatively. The result of the study indicated that hypnosis can reduce anxiety and postoperatively pain

Multi-drug resistant Staphylococcus aureus isolated from emergency ward of an Iranian hospital

Purpose: To study the prevalence of resistant strains of S. aureus isolated from surfaces, beds and various equipment of an Iranian hospital emergency ward.Methods: Two hundred swab samples were collected from the surfaces, beds, trolleys, surgical equipment and diagnostic medical devices in emergency ward. Samples were cultured and those that were S. aureus-positive were confirmed using polymerase chain reaction (PCR). Antimicrobial resistance pattern was analyzed using disk diffusion method.Results: Nine of 200 samples (4.5 %) collected were positive for S. aureus. Surfaces (8.8 %), beds (5 %) and trolleys (5 %) were the most commonly contaminated. S. aureus isolates exhibited varying levels of resistance against antibiotics with the following being the highest: tetracycline (88.8 %), penicillin (88.8 %) and ampicillin (77.7 %). The prevalence of resistance against methicillin, oxacillin and azithromycin were 44.4, 33.3 and 33.3 %, respectively. There was no pattern of resistance against imipenem.Conclusion: Efficient disinfection of surfaces, beds, trolleys and surgical instruments should be performed periodically to reduce colonization of resistant strains of S. aureus in various areas of emergency health care centers.Keywords: Staphylococcus aureus, Nocosomial infection, Antibiotic resistance, Hospital equipment, Emergency war

Educational Needs Assessment for General Practitioners in the Field of Neurological Diseases in the Regulatory Zone of Rafsanjan University of Medical Sciences, Iran

Background & Objective: Regarding the significance of neurological diseases, training general practitioners has a key role and they should be well-trained in diagnose and approaching different diseases in this field. We focused on educational needs assessment for general practitioners in the field of neurological diseases. Methods: All the general practitioners practicing in the regulatory zone of Rafsanjan University of Medical Sciences, Iran, (urban and rural areas), who agreed to participate, were entered the study. 104 participants of the total of 170 general practitioners in this area completed a researcher-made questionnaire and mailed us. The questionnaire encompassed 54 neurological diseases, four paraclinical tests and 9 approaches for neurological signs and symptoms, as well as their practical framework, satisfaction from their education, and demographic and educational items. Results: In 47.9% of cases, educational expectations were at the level of screening and refer, in that 31.4%, at the level of diagnosis and treatment and in 18.8%, at the level of acquaintance and describing. The remainders (1.88%) were the cases with no need to know and unfamiliar ones. Statistically, screening and refer, just the diagnosis, and the treatment were the mentioned educational expectations, respectively. Most of general practitioners were not fully satisfied from their externship and internship educational programs. Conclusion: This study, in a more systematic way, outlines the general practitioner’s points of view and their tendency to intervene in the procedure of neurological managements which can also be of great use to any further modifications in medical training curricula. Absence of perfect satisfaction about educational programs shows us that we should change our educational methods to more practical and clinical forms. Key Words: Educational needs, Neurological diseases, General practitioner

Bio-effectiveness of the main flavonoids of Achillea millefolium in the pathophysiology of neurodegenerative disorders- a review

The Achillea millefolium L. (Yarrow) is a common herb which is widely being used, worldwide. Achillea is being used for treatment of many disorders since centuries. It is considered safe for supplemental use and flavonoids such as kaempferol, luteolin and apigenin are of main constituents present in Achillea. Most of both antioxidant and anti-inflammatory properties of this herb have been attributed to its flavonoid content. Oxidative and inflammatory processes play important roles in pathogenesis of neurodegenerative diseases. Present review was aimed to review the latest literature evidences regarding application of Achillea and/or its three main flavonoid constituents on epilepsy, Alzheimer's disease, multiple sclerosis, Parkinson's disease and stroke

Sleep Duration, Hypnotic Drug Use, and Risk Factors: Cross- Sectional Study

Both short sleep duration (SSD) and long sleep duration (LSD) are associated with an increased risk of morbidity and mortality. Here, we aimed to assess the prevalence of sleep duration disturbances among adults in association with demographic, medication use, personal habits, and chronic diseases, while also considering the impact of hypnotic drug use. We performed a cross-sectional study of 9991 adult participants of the Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN). Multivariate logistic regression analyses were conducted to assess the association between short (\u3c 6 h) and long (\u3e 9 h) sleep duration with demographic and lifestyle parameters and common non-communicable diseases. Additionally, we performed stratified analysis to investigate the association of sleep duration with the abovementioned factors and diseases, in groups with and without hypnotic drug use. We found higher odds of SSD significantly associated with age (P \u3c 0.001), BMI (P \u3c 0.001), physical activity (P \u3c 0.001), and depression (P = 0.023). LSD displayed a positive association with the female sex (P \u3c 0.001), opium consumption (P \u3c 0.001), and history of MI (P = 0.045), and a reverse connection with education (P = 0.007), physical activity (P \u3c 0.001) and alcohol consumption (P = 0.027). Stratifying for the hypnotic drug use, our sensitivity analyses indicated that in hypnotic drug users, education (P = 0.034) and physical activity (P \u3c 0.001) were associated with LSD, in this group, significantly increased odds ratio of LSD were associated with opium consumption (P = 0.046) and thyroid dysfunction (P = 0.037). Our findings demonstrated the demographic and lifestyle factors and diseases associated with long and short sleep duration in the population of the RCS. Additionally, after stratifying for hypnotic drug use, our results indicated that some diseases are only associated with abnormal sleep duration upon using hypnotic drugs

Magnetic Resonance Imaging (MRI) findings in patients with brain small vessel disease

Background: Cerebral  small  vessel  disease  (SVD)  affects  small  perforating  arteries, causing  both  lacunar  infarction (LI) and  confluent white matter lesions (WML). Small vessel disease or lacunar infarct is one of the major stroke subgroups. Lacunar syndromes may be divided into two groups: the classic group (pure motor hemiplegia, pure sensory stroke, ataxic hemiparesis, dysarthria-clumsy hand syndrome, sensorimotor stroke) and the miscellaneous group, including all other lacunar syndromes. We have evaluated risk factors, clinical syndromes, topography, and laboratory findings of 101 consecutive patients with symptomatic lacunar infarcts diagnosed by magnetic resonance imaging.Methods: We analyzed 101 patients with clinical lacunar infarct   syndrome who were referred to the neurology department of Qa’em hospital, Mashhad in the northeast of Iran. We assessed clinical features, sex, age, risk factors, radiologic findings and laboratory data of these patients.Results: The pure motor hemiparesis (53.5%) constituted the most usual lacunar syndrome. Mean age of the patients was 63.7± 8.5%. Diabetes mellitus was seen in 14 (13.9%) and hypercholesterolemia in 41 (40.6%) of patients. There were significant differences among ataxic-hemiparesis syndrome and hypertriglyceridemia and CVA history. There was a significant difference between miscellaneous syndromes and valve disease history. Also, there was significant correlation between WML and smoking. Thirty percent of the lesions were detected by CT scan.Conclusion: Sixty percent of the cases were associated with white matter signal changes. Diabetes mellitus were found in 14% of patients.  Hypertriglyceridemia, CVA history and valve disease history were associated with some subgroups, but more investigations should be performed for precise assessment of other risk factors

Palladium nanoparticles immobilized on multifunctional ‎hyperbranched polyglycerol-grafted magnetic nanoparticles as a ‎sustainable and efficient catalyst for C-C coupling reactions

This study offers an exclusive class of magnetic nanoparticles supported hyperbranched polyglycerol (MNP/HPG) that was functionalized with citric acid (MNP/HPG-CA) as a host immobilization of palladium nanoparticles. The MNP/HPG-CA/Pd catalyst was fully characterized using some different techniques such as thermogravimetric analysis (TGA), x-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy-dispersive x-ray spectroscopy (EDX), inductively coupled plasma (ICP) and x-ray photoelectron spectroscopy (XPS). The new catalytic system showed high activity for the Suzuki–Miyaura cross-coupling and Heck reaction under mild and green conditions. Besides, the MNP/HPG-CA/Pd was found to be a convenient catalyst for copper-free Sonogashira coupling reaction in water as a green solvent at room temperature. Moreover, the catalyst could be recovered easily and reused several times without significant loss of reactivity. Ease of preparation, oxygen insensitive, phosphine-free, air- and moisture-stable, and high reusability of this immobilized palladium catalyst are the noteworthy advantages of this catalytic system

Association Between Metabolic Syndrome and Stroke: A Population Based Cohort Study

Both metabolic syndrome (MetS) and stroke are associated with increased risk of mortality. Here, we aimed to assess the prevalence of MetS among adults using three definitions (Adult Treatment Panel III (ATP-III), International Diabetes Federation (IDF) and IDF ethnic specific cut-off for Iranian criteria) and its association with stroke. We performed a cross-sectional study of a total of 9991 adult participants of Rafsanjan Cohort Study (RCS), as part of the Prospective epidemiological research studies in Iran (PERSIAN cohort study). The MetS prevalence was evaluated in participants according to the different criteria. Multivariate logistic regression analyses were conducted to assess the association between three definitions of MetS with stroke. We found that MetS was significantly associated with higher odds of stroke according to NCEP-ATP III (odds ratio (OR): 1.89, 95% confidence interval (CI) 1.30-2.74), international IDF (OR:1.66, 95% CI: 1.15-2.40) and Iranian IDF (OR:1.48, 95% CI: 1.04-2.09) after adjusted for variables confounders. Furthermore, after adjustment, in receiver operating characteristic (ROC) curve, the AUROC was 0.79 (95% CI = 0.75-0.82), 0.78(95% CI = 0.74-0.82) and 0.78(95% CI = 0.74-0.81) for presence of MetS according to NCEP-ATP III, international IDF and Iranian IDF, respectively. ROC analyses revealed that all of these three criteria for MetS are moderately accurate for the identification of increased stroke risk.In conclusion, our results showed that MetS was associated with increased odds of stroke. Our findings implicate the importance of early identification, treatment, and ultimately prevention of the metabolic syndrome

TRPV1 receptor-mediated expression of Toll-like receptors 2 and 4 following permanent middle cerebral artery occlusion in rats

Objective(s): Stroke is known as a main cause of mortality and prolonged disability in adults. Both transient receptor potential V1 (TRPV1) channels and toll-like receptors (TLRs) are involved in mediating the inflammatory responses. In the present study, the effects of TRPV1 receptor activation and blockade on stroke outcome and gene expression of TLR2 and TLR4 were assessed following permanent middle cerebral artery occlusion in rats Materials and Methods: Eighty male Wistar rats were divided into four groups as follows: sham, vehicle, AMG9810 (TRPV1 antagonist) -treated and capsaicin (TRPV1 agonist) -treated. For Stroke induction, the middle cerebral artery was permanently occluded and then behavioral functions were evaluated 1, 3 and 7 days after stroke. Results: TRPV1 antagonism significantly reduced the infarct volume compared to the stroke group. Also, neurological deficits were decreased by AMG9810 seven days after cerebral ischemia. In the ledged beam-walking test, the slip ratio was enhanced following ischemia. AMG9810 decreased this index in stroke animals. However, capsaicin improved the ratio 3 and 7 days after cerebral ischemia. Compared to the sham group, the mRNA expression of TLR2 and TLR4 was significantly increased in the stroke rats. AMG9810 Administration significantly reduced the mRNA expression of TLR2 and TLR4. However, capsaicin did not significantly affect the gene expression of TLR2 and TLR4. Conclusion: Our results demonstrated that TRPV1 antagonism by AMG9810 attenuates behavioral function and mRNA expression of TLR2 and TLR4. Thus, it might be useful to shed light on future therapeutic strategies for the treatment of ischemic stroke

A genetic polymorphism in the CYP1B1 gene in patients with squamous cell carcinoma of the esophagus: an Iranian Mashhad cohort study recruited over 10 years

Background: Esophageal-cancer is the seventh most common-cause of cancer-related-deaths in men. Cytochrome-P450-family-1-subfamily-B-polypeptide-1 (CYP1B1) plays a role in the metabolism of xenobiotics, and is associated with several cancers. Here we investigated the association between a genetic-variant, CYP1B1-rs1056836, with the clinical-characteristics of patients with esophagus-squamous-cell-carcinoma (ESCC). Method: 117-patients with ESCC and 208 healthy-subjects were recruited. DNA was extracted and genotyped. Kaplan-Meier curves were utilized to assess overall and progression-free survival. The relationship between clinicopathological-data, disease-prognosis, and survival, were evaluated with the genotypes. Results: the genotypic frequency for GG, GC, and CC were 58.6%, 29.8%, 11.5% respectively in the healthy subjects and 51.8%, 36.14% and 12% in the ESCC group. An association between the GG genotype and stage of ESCC was found. Conclusion: Our findings suggest a relationship between the CYP1B1-rs1056836 genetic polymorphism and clinical features of ESCC, supporting further studies in larger-populations in different-ethnic groups, taking into account potentially important environmental-factors