Clinical Approach of Laser Application in Different Aspects of Pediatric Dentistry

The application of laser in dentistry is considered as a favorable technique for patients due to its many advantages compare to other current methods. One of the main goals in pediatric dentistry is to provide the treatment as comfortable as possible without any risks for the care. Laser is being used in different pediatric dental conditions including caries detection, caries removal and cavity preparation, soft tissue surgery and in low level laser therapy applications. The application of current common lasers in dentistry resulted in less stress and fear in patients during dental procedures, also leading to more conservative non-invasive methods for soft and hard tissues with minimal discomfort and bleedin

A study on the effect of different factors on profitability of banking system

In this paper, we study the effect of different influencing factors on profitability of banking system in Iran for a panel data from 2001 to 2010. The sample of banking system includes ten different banks and two different types of internal and external variables are considered. Internal factors include ownership ratio, ratio of bank customers' deposit to banks' assets, ratio of total loans given to all assets, ratio of total interest free loans on total assets, ratio of interest free revenues on total revenue. External factors include economic growth, actual rate of interest and inflation rate. The proposed model of this paper uses econometrics method to investigate the proposed model and the preliminary results indicate that ownership ratio, ratio of total equity on total assets, along with inflation rate have negative impact on profitability. In addition, the ratio of customers' deposit on total assets, the ratio of total loans on total assets and economic growth have positive impact on profitability

Associated factors with delayed door to balloon time in STEMI patients

Introduction: The time interval from hospital arrival to the balloon inflation of catheter in coronary arteries is defined as Door to Balloon Time (DBT). Door to balloon time is a marker of primary Percutaneous Coronary Intervention (PCI) timeliness. Door to balloon time duration, associated factors and it’s relation to outcomes are not similar in various centers. Herein we aimed to define these issues in our region. Methods: In this study, 188 patients with ST Elevation Myocardial infarction (STEMI) diagnosis eligible for primary PCI were included. Demographic, clinical and time intervals from arrival in hospital to catheterization data of patients were recorded. Patients were followed for six-month in terms of mortality and admission. Results: After excluding patients with missed data, 174 patients were entered in the study. Mean age of patients were 60.8±11.81 years and 78% of patients were male. Median DBT was 70 minutes (IQR 25-75: 55-97 minute). One hundred and twenty three patients (71%) had timely door to balloon time. Patients with delayed door to balloon time had lower age, lower prevalence of typical chest pain and higher prevalence of PCI on Left Circumflex Artery (LCX) than timely group but these differences were not significant. (p values were 0.068, 0.074 and 0.070 respectively). Delayed DBT was evident in three segments of door to ECG, ECG to code and code to cath times (p values were, < 0.0001, 0.009 and < 0.0001 respectively) but the cath to balloon time was not significantly different between two groups (p value: 0.159). Although in-hospital mortality was higher in delayed group than timely group but the difference was not meaningful. (11.7% vs 4.9%, p value: 0.103) Six-month mortality and admission rate were not different between two groups. Conclusion: Door to balloon time was acceptable in this study and was comparable to developed countries. Albeit there is room for improvement due to modifiable delayed parts

Autophagy Role as a Double-Edged Sword in Anesthesiology and Critical Care

Autophagy is a mechanism, which host cells can utilize it to defend against infections. Trapped cargo such as viral cargo and delivered to a lysosome for degradation. Primary immune response against some viruses can start by autophagy mechanism. In this study, we reviewed role of autophagy in viral infections

Brain neural network, development, microbiome, microbial toxins and COVID-19

Although almost 2 years have passed since the beginning of the coronavirus disease 2019 (COVID-19) pandemic in the world, there is still a threat to the health of people at risk and patients. Specialists in various sciences conduct various researches in order to eliminate or reduce the problems caused by this disease. Neural network science plays a vital role in this regard. It is important to note the key points of neuro-microbial involvement in the diagnosis and management of COVID-19 therapy by physicians and patients whose nervous systems are challenged. The relationship between COVID-19, microbiome and the profile of microbial toxins in the body is one of the factors that can directly or indirectly play a key role in the body's resistance to Covid-19 and changes in the neural network of the brain. In this article, we introduce the relationship and behavioral and mood problems that can result from neuronal changes. In linking the components of this network, artificial intelligence (AI), machine learning (ML) and data mining (DM) can be important strategies to assist health providers to choose best decision based on patient’s history.

Determination and comparison miR135a in the serum between women with GDM, non- pregnant type 2 diabetes , healthy pregnant and control group

Abstract Objectives: Diabetes is one of the most important endocrine diseases caused by complex reactions between genetic and environmental factors. Recent studies have shown that microRNAs play an important role in the production, inhibition, and secretion of insulin. Identifying the relationship between key miRNAs that control the genes involved in the pathogenesis of diabetes is clinically important because it provides a way to identify preventive methods or treatments. In the present study, the expression of miR135a in serum samples between women with Gestational diabetes mellitus (GDM), non-pregnant type 2 diabetes, and healthy pregnant women were compared with the control group. Materials and methods: This study was a case-control study and non-random sampling method was used. The present study was conducted among four groups (healthy non-pregnant women (control), non-pregnant Diabetes type 2, GDM, and healthy pregnant). After serum separation, expression of miR-135a was measured using QRT-PCR technique and the results were analyzed by Stata and SPSS21 software Results: The results show that the mean expression of miR-135a gene in control group was 0.9 ± 0.06, control of pregnancy was 1 ± 0.1, GDM group was 1.7 ± 0.3 and non-pregnant diabetic type 2 group was 6 ± 6 / 3. The results of analysis of variance showed that the mean difference of miR-135 gene expression was signifcant higher in the non- pregnant type 2 diabetes than GDM group (F = 2776.3, P <0.001). Conclusion: The widespread role of miRNAs as post-transplantation gene regulators in gestational diabetes mellitus suggests that miR135a may act as a potential indicator of the prevention, treatment, and management of gestational diabetes . Key words: miR135a, non- pregnant type 2 diabetes, gestational diabetes mellitus, QRT-PC

Imaging findings of multisystem inflammatory syndrome in children associated with COVID-19

[Background] A hyperinflammatory immune-mediated shock syndrome has been recognised in children exposed to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19).[Objective] To describe typical imaging findings in children with multisystem inflammatory syndrome associated with COVID-19.[Materials and methods] During the first wave of the COVID-19 pandemic, imaging studies and clinical data from children treated for multisystem inflammatory syndrome were collected from multiple centres. Standardised case templates including demographic, biochemical and imaging information were completed by participating centres and reviewed by paediatric radiologists and paediatricians.[Results] We included 37 children (21 boys; median age 8.0 years). Polymerase chain reaction (PCR) testing was positive for SARS-CoV-2 in 15/37 (41%) children and immunoglobulins in 13/19 children (68%). Common clinical presentations were fever (100%), abdominal pain (68%), rash (54%), conjunctivitis (38%) and cough (32%). Thirty-three children (89%) showed laboratory or imaging findings of cardiac involvement. Thirty of the 37 children (81%) required admission to the intensive care unit, with good recovery in all cases. Chest radiographs demonstrated cardiomegaly in 54% and signs of pulmonary venous hypertension/congestion in 73%. The most common chest CT abnormalities were ground-glass and interstitial opacities (83%), airspace consolidation (58%), pleural effusion (58%) and bronchial wall thickening (42%). Echocardiography revealed impaired cardiac function in half of cases (51%) and coronary artery abnormalities in 14%. Cardiac MRI showed myocardial oedema in 58%, pericardial effusion in 42% and decreased left ventricular function in 25%. Twenty children required imaging for abdominal symptoms, the commonest abnormalities being free fluid (71%) and terminal ileum wall thickening (57%). Twelve children underwent brain imaging, showing abnormalities in two cases.[Conclusion] Children with multisystem inflammatory syndrome showed pulmonary, cardiac, abdominal and brain imaging findings, reflecting the multisystem inflammatory disease. Awareness of the imaging features of this disease is important for early diagnosis and treatment.Peer reviewe

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

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens