Fracture Resistance of Premolars Restored by Various Types and Placement Techniques of Resin Composites

To verify the fracture resistance of premolars with mesioocclusodistal preparations restored by different resin composites and placement techniques. Sixty premolars were randomly divided into two groups based on type of composite resin: Filtek P60 or Nulite F, and then each group was separated into three subgroups: bulk, centripetal, and fiber insert according to the type of placement method (n = 10). Single-bond adhesive system was used as composite bonding according to the manufacturer's instructions. Specimens were restored in Groups 1, 2, and 3 with Filtek P60 and in Groups 4, 5, and 6 with Nulite F. After being stored 24 hours at 37°C, a 4 mm diameter steel sphere in a universal testing machine was applied on tooth buccal and lingual cusps at a cross-head speed of 5 mm/min until fracture occurred. Groups 3 and 6 showed higher fracture resistance than Groups 1, 2, 4, and 5. Among the placement techniques, the fiber insert method had a significant effect, but the type of composite was ineffective. The insertion technique in contrast to the type of material had a significant influence on the fracture resistance of premolar teeth

Enabling informed policymaking for chronic kidney disease with a registry:Initiatory steps in Iran and the path forward

Objectives: Chronic kidney disease (CKD) registries have been used for more than half a century. Iran lacks a comprehensive registry to capture data of all CKD patients for an informed care planning and policy making. We aimed to identify the objectives and possible challenges for developing a CKD registry and also to define its minimum data set (MDS) in our healthcare context.Methods: This was a mixed-method study conducted in Iran from fall 2016 till summer 2017. The qualitative part included document analysis and 26 semi-structured interviews with 17 clinicians and managers involved in CKD care. This data was analyzed using the "grounded theory". Then, a modified Delphi survey was conducted. Percentages and mode values were used for analysis.Results: Our participants' leading interest in a CKD registry was centered on providing a coordinated, good-quality care for all CKD stages with particular emphasis to capture events and monitor trends for patients in earlier stages. They highlighted the required financial, technical and human resources as main challenges for a smooth registry implementation. Furthermore, a clinically oriented MDS comprising of 168 elements (with a majority having more than 90% agreement with mode 2) was extracted. It mainly collects demographics, medical history, encounter sessions, diagnostic examinations, medications, vaccinations and mortality data.Conclusions: We reported the initiatory steps taken to establish a CKD registry in an Iranian healthcare context. We focused on the information needs and priorities of our main stakeholders and based our intended registry on addressing those needs. We hope this approach will facilitate its endorsement and advance the efforts for a sustainable, good-quality CKD care. (C) 2018 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved

Enabling informed policymaking for chronic kidney disease with a registry:Initiatory steps in Iran and the path forward

Objectives: Chronic kidney disease (CKD) registries have been used for more than half a century. Iran lacks a comprehensive registry to capture data of all CKD patients for an informed care planning and policy making. We aimed to identify the objectives and possible challenges for developing a CKD registry and also to define its minimum data set (MDS) in our healthcare context.Methods: This was a mixed-method study conducted in Iran from fall 2016 till summer 2017. The qualitative part included document analysis and 26 semi-structured interviews with 17 clinicians and managers involved in CKD care. This data was analyzed using the "grounded theory". Then, a modified Delphi survey was conducted. Percentages and mode values were used for analysis.Results: Our participants' leading interest in a CKD registry was centered on providing a coordinated, good-quality care for all CKD stages with particular emphasis to capture events and monitor trends for patients in earlier stages. They highlighted the required financial, technical and human resources as main challenges for a smooth registry implementation. Furthermore, a clinically oriented MDS comprising of 168 elements (with a majority having more than 90% agreement with mode 2) was extracted. It mainly collects demographics, medical history, encounter sessions, diagnostic examinations, medications, vaccinations and mortality data.Conclusions: We reported the initiatory steps taken to establish a CKD registry in an Iranian healthcare context. We focused on the information needs and priorities of our main stakeholders and based our intended registry on addressing those needs. We hope this approach will facilitate its endorsement and advance the efforts for a sustainable, good-quality CKD care. (C) 2018 Fellowship of Postgraduate Medicine. Published by Elsevier Ltd. All rights reserved

Global Study of Viral Meningitis: A Systematic Review and Meta-analysis

Meningitis can quickly become a life-threatening sickness and therefore is considered a medical emergency. Viruses, after bacteria, are known as main pathogens involved in meningitis; therefore, we investigated the prevalence of viral meningitis worldwide and evaluated the clinical and preclinical features for rapid detection of viral meningitis. The results showed that the most prevalent viruses in viral meningitis are Enterovirus, Coxaci, Tick-borne encephalitis virus, Herpesviridae family; and the most prevalent viruses in aseptic meningitis are Echovirus, Enterovirus, Coxaci and HSV. The findings revealed differences in the prevalence of various viruses in these two types of meningitis, even though there was no significant difference in clinical manifestations between viral and bacterial meningitis. This indicates the importance of laboratory diagnostic methods for discriminating between these two types of meningitis