Effect of Oral Care Protocol on Dental and Gingival Plaque Index in Patients with Endotracheal Tube Admitted into the Intensive Care Unit

  Abstract Background and objective: Oral health is one of the most critical aspects of nursing care in critically ill patients. The study aimed to investigate the effect of oral health protocol on dental and gingival plaque index in patients with endotracheal tube admitted into the ICU. Methods: This double-blind clinical trial was conducted on 70 patients admitted into ICU randomly by tossing a coin, and 35 patients were assigned to each of the experimental and control groups. Oral care was performed in the experimental group using the chlorhexidine (CHX) solution, toothpaste, and oral moisturizer protocol; in the control group, according to the routine method, 0.2% CHX was used twice a day. The data were collected at the time of inclusion and four days later, using the MGI and the O'Leary dental plaque index. Results: The mean ages in the experimental and control groups were 38.4±14.4 and 41±14.5 years, respectively. In the experimental and control groups, 77% and 83% of the subjects were male, respectively. After the intervention, the mean gingival index in the experimental and control groups was 0.59±0.31 and 0.90±0.41, and the plaque index was 42.53±15.97 and 53.52±11.9, respectively. The differences before and after the intervention in each group and the difference between the two groups in both gingival and dental plaque indices were statistically significant (P=0.0001). Conclusion: The results showed that the oral health protocol was more effective in improving gingival and dental plaque indices than the routine (CHX) method.   Key words: Dental plaque, gingivitis, oral health, protoco

Effect of Chronic Restraint Stress on HPA Axis Activity and Expression of BDNF and Trkb in the Hippocampus of Pregnant Rats: Possible Contribution in Depression during Pregnancy and Postpartum Period

Introduction: Brain-Derived Neurotrophic Factor (BDNF) and its receptor, TrkB, in the hippocampus are targets for adverse effects of stress paradigms in addition, BDNF and its receptor play key role in the pathology of brain diseases like depression. In the present study, we evaluated the possible role of hippocampal BDNF in depression during pregnancy, Methods: To achieve the purpose, repeated restrain stress (1 or 3 hours daily for 7 days) during the last week of pregnancy was used and alteration in the gene expression of hippocampal BDNF and TrkB evaluated by semi-quantitative PCR. Results: The results showed that in stress group the level of ACTH and Corticosterone is increased showing that our model was efficient in inducing psychological stress we also found that BDNF and TrkB expression are decreased in 3 hours stress group but not in 1 hour stress compared to control group. Discussion: Our results imply that decrease in BDNF and its receptor could contribute in some adverse effects of stress during pregnancy such as elevation of depressive like behavior

Schematic diagram of three-stage differentiation protocols.

<p>Both MenSCs and BMSCs were sequentially treated by three combinations of cytokines, growth factors, and hormones under commitment, differentiation and maturation steps.</p

Evaluation of multipotency and chromosomal stability of isolated MenSCs <i>versus</i> BMSCs.

<p>(A) MenSC and BMSCs differentiation into osteoblasts (ii), chondrocytes (iii) and adipocytes (iiii) judged by Alizarin red staining, immuostaining of Collagen type II and Oil red O staining, respectively; Scale bar: 100 µm. (B) Chromatograms illustrating no chromosomal aberrations in MenSCs at passage 12 compared to cells at passage 2. GeneMarker plots showing results of MLPA analysis. Green lines illustrated the upper and lower limits of acceptable ranges of variations in MLPA analysis. Green dots show the chromosomal locations which are balanced and the red dots in the upper side of the plots show chromosomal gain and red dots in lower side of the plots show chromosomal loss.</p

Functionality characteristics of differentiated MenSCs compared to BMSCs.

<p>(A) ALB levels (ng/ml/48 h) in cell supernatants at days 0, 10, 15, and 25 of differentiation. † indicates significant difference between specified day and the previous time period of differentiation in the same stem cell (<i>P<0.05</i>), ‡ indicates significant difference (<i>P<0.05</i>) between differentiated MenSCs and BMSCs at last day of differentiation. (B) PAS staining of glycogen storage in fetus liver and HepG2 as positive control, undifferentiated and differentiated MenSCs and BMSCs by various protocols (P1–P3). (C) Expression pattern of Cytochrome P450 7A1 (<i>CYP7A1</i>) in reference to GAPDH in differentiated MenSCs and BMSCs by various protocols. Undif: undifferentiated cells, W: water.</p

Sequences of the primers used for analysis of cells differentiation into hepatocyte-like cells.

<p>ALB: Albumin, CK-18: Cytokeratin-18, CK-19: Cytokeratin-19, CYP7A1: Cytochrome P450 7A1, TAT: Tyrosine aminotransferase, GAPDH: Glyceraldehyde 3-phosphate dehydrogenase.</p

Quantitative RT-PCR results of differentiated cells using three protocols.

<p>(A) Data of differentiated MenSCs and BMSCs were normalized to corresponding GAPDH and calculated in reference to undifferentiated cells. Each bar in each differentiation protocol represents the gene expression in ratio to undifferentiated cells (the first three pairs of bars). The second three pairs of bars represent comparisons of a given marker expression between two protocols in each stem cell. † indicates significant difference between differentiated and undifferentiated status of the same stem cell (<i>P</i><0.05), ‡ indicates significant difference (<i>P</i><0.05) between MenSCs and BMSCs. (B) Relative gene expression of differentiated cells compared to isolated adult hepatocytes. Results are shown as % of hepatocyte expression level.</p

<i>In vivo</i> assay of tumorigenicity and immunological reaction of MenSCs.

<p>(A) 2×10⁶ cells were subcutaneously injected in the dorsolateral part of the flank of nude mice (i), No tumor formation was observed in treated mice (ii), The excised tissues were fixed in buffered formalin, embedded in paraffin, and sectioned in 5-µm sections (iii). (B) The sectioned tissues were evaluated using H & E staining. (C) Immunoreactivity of mice sera to cultured MenSCs was evaluated using immunofluorescence staining. The cells (2×10⁴ cells per slide) were fixed in acetone at −20°C for 5 min and were incubated for 1 hour at 4°C with mice sera. Subsequently, the cells were washed three times with PBS and incubated with FITC-labeled sheep anti-mouse IgG at RT for 45 min in the dark. DAPI was used for nuclear staining.</p

Morphology of MenSCs compared to BMSCs during differentiation by three protocols.

<p>The gradual change of MenSC morphology compared with BMSCs under each differentiation protocol (P1–P3) has been shown by phase contrast photographs. Scale bar: 100 µm.</p