The staining effect of different mouthwashes containing nanoparticles on dental enamel.

Background: This study aimed to evaluate the effects of several mouthwashes containing nanoparticles on discoloration of dental enamel, and compare the results with that of 0.2% chlorhexidine (CHX). Material and Methods: Sixty intact premolars were randomly assigned to six groups. A spectrophotometer was used to measure the color of the teeth (T1) according to the CIELAB system. The specimens in groups 1 to 4 were then immersed in colloidal solutions containing nanoTiO2 (Group 1), nanoZnO (Group 2), nanoAg (Group 3) and nanoCuO (Group 4). In groups 5 and 6, a 0.2% CHX mouthwash and distilled water were used as positive and negative controls, respectively. After 24 hours of immersion, color determination was repeated (T2). The third color assessment was accomplished after brushing (T3). The L, a, and b values were recorded and the color change (∆E) between different stages was calculated. Results: ANOVA revealed significant between-group differences in the color change between T1 and T2 stages, as well as between T1 and T3 time points ( p <0.05), whereas the color change between T2 and T3 was not signifi - cantly different among the study groups ( p =0.09). ∆ET1-T3 was significantly lower in the specimens immersed in distilled water or CHX as compared to the nanoparticle-containing mouthwashes ( p <0.05). The highest ∆E value pertained to the specimens immersed in nanoZnO-containing solution. The TiO2 nanoparticles caused the lowest staining among the tested nanoparticles. Conclusions: The mouthwashes containing nanoparticles produced comparable or even greater enamel discoloration compared to CHX. Brushing had little effect on removal of induced stain

Comparing the Antiemetic Effects of Ondansetron and Metoclopramide in Patients with Minor Head Trauma

Introduction: Nausea and vomiting are the most common complications after minor head trauma that increases the risk of intracranial pressure rising. Therefore, the present study was aimed to compare the antiemetic effects of metoclopramide and ondansetron in the treatment of post-traumatic nausea and vomiting. Methods: The study was a controlled, randomized, double blind clinical trial, which was conducted in the first 6 months of 2014 in emergency department Al-Zahra and Kashani Hospitals in Isfahan, Iran. The patients with minor head trauma associated with nausea and vomiting were randomly divided into 2 groups: treatment with metoclopramide (10mg/2ml, slow injection) and treatment with ondansetron (4mg/2ml, slow injection). The comparison between the 2 groups was done regarding antiemetic efficacy and side effects using SPSS 21 statistical software. Results: 120 patients with minor head trauma were distributed and studied into two groups of 60 patients (mean age 35.6±14.1 years; 50.0% male). Administration of both ondansetron and metoclopramide significantly reduced the severity of nausea (P&lt;0.001). Changes in the severity of nausea in both groups before and after the treatment revealed that nausea had been decreased significantly in both groups (P &lt; 0.001). The incidence of fatigue (p=0.44), headache (p=0.58) and dystonia (p=0.06) had no significant difference in the two groups but the incidence of drowsiness and anxiety in the metoclopramide group was significantly higher (P &lt; 0.001). Conclusion: The present study indicated that the treatment effectiveness of ondansetron and metoclopramide are similar. However, incidence of drowsiness and anxiety in the metoclopramide was considerably higher. Since these complications can have adverse effects on the treatment of patients with brain injury, it is suggested that it may be better to use ondansetron in these patients

Biosorption of Nickel (II) from Aqueous Solutions onto Pistachio Hull Waste as a Low-Cost Biosorbent

There are many different industrial wastewater containing heavy metals that contribute to environmental pollution and raw agricultural waste is an effective adsorbent for the removal of heavy metals. The adsorption behavior of pistachio hull powder (PHP) as a low-cost adsorbent, with respect to nickel (II) ions, has been studied in order to consider its application to the purification of metal finishing wastewater. In this work, adsorption of nickel on pistachio hull has been studied by batch techniques. The adsorption depends on the process time, the pH of the solution, initial concentration of metals and the adsorbent concentration in the suspension. The kinetics of adsorption were relatively fast, reaching equilibrium for less than 60 minutes. Kinetic and isotherm modeling studies demonstrated that the experimental data best fit a pseudo-second order and Freundlich model, respectively. The maximum Langmuir adsorption capacity was 14 mg/g. The optimum pH required for maximum adsorption was found to be 4-6. The initial concentration of the adsorbate and the concentration of pistachio hull strongly affect the process. No influence of particle size was evidenced. A degree of adsorption higher than 75% can be achieved for nickel (II) ions

A systematic review of the cardiotoxicity of methadone

Methadone is one of the most popular synthetic opioids in the world with some favorable properties making it useful both in the treatment of moderate to severe pain and for opioid addiction. Increased use of methadone has resulted in an increased prevalence of its toxicity, one aspect of which is cardiotoxicity. In this paper, we review the effects of methadone on the heart as well as cardiac concerns in some special situations such as pregnancy and childhood. Methods: We searched for the terms methadone, toxicity, poisoning, cardiotoxicity, heart, dysrhythmia, arrhythmia, QT interval prolongation, torsade de pointes, and Electrocardiogram (ECG) in bibliographical databases including TUMS digital library, PubMed, Scopus, and Google Scholar. This review includes relevant articles published between 2000 and 2013. The main cardiac effects of methadone include prolongation of QT interval and torsade de pointes. Other effects include changes in QT dispersion, pathological U waves, Taku-Tsubo syndrome (stress cardiomyopathy), Brugada-like syndrome, and coronary artery diseases. The aim of this paper is to inform physicians and health care staff about these adverse effects. Effectiveness of methadone in the treatment of pain and addiction should be weighed against these adverse effects and physicians should consider the ways to lessen such undesirable effects. This article presents some recommendations to prevent heart toxicity in methadone users

BOTH ORAL PASSIFLORA INCARNATA AND OXAZEPAM CAN REDUCE PRE-OPERATIVE ANXIETY IN AMBULATORY SURGERY PATIENTS: A DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

Objectives: Pre-operative anxiety control without increased post-operative psychomotor dysfunction is an anesthesia concern especially in ambulatory surgery; so, the development of a strong anxiolytic with minimal psychomotor impairment for premedication is desirable. In this study, it was hypothesized that Passiflora incarnata decreases pre-operative anxiety (PAN) similar to oxazepam.Methods: In this double-blinded placebo controlled study, 128 patients were randomized into Passiflora group (n=68) who received oral P. incarnata and oxazepam group (n=60) who received oxazepam (10 mg) as premedication, 90 minutes before surgery. A numerical rating scale (NRS) was used for each patient to assess anxiety before, and 90 minutes following premedication. Psychomotor function was assessed with the trigger dot test (TDT) and the digit-symbol substitution test at arrival in the operating room, and 90 minutes after tracheal extubation.Results: The 90th minutes NRS anxiety scores were significantly lower in the Passiflora group compared with oxazepam group (p&lt;0.001). There were no significant differences in psychological variables, in groups, in the postanesthesia care unit.Conclusion: In outpatient surgery, administration of oral P. incarnata as a premedication reduces PAN with similar psychomotor function impairment compared with pre-operative oral oxazepam

Respiratory issues in patients with multiple sclerosis as a risk factor during SARS-CoV-2 infection: a potential role for exercise

Coronavirus disease-2019 (COVID-19) is associated with cytokine storm and is characterized by acute respiratory distress syndrome (ARDS) and pneumonia problems. The respiratory system is a place of inappropriate activation of the immune system in people with multiple sclerosis (MS), and this may cause damage to the lung and worsen both MS and infections.The concerns for patients with multiple sclerosis are because of an enhance risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The MS patients pose challenges in this pandemic situation, because of the regulatory defect of autoreactivity of the immune system and neurological and respiratory tract symptoms. In this review, we first indicate respiratory issues associated with both diseases. Then, the main mechanisms inducing lung damages and also impairing the respiratory muscles in individuals with both diseases is discussed. At the end, the leading role of physical exercise on mitigating respiratory issues inducing mechanisms is meticulously evaluated. Keywords: COVID-19; Exercise training; Immune system; Multiple sclerosis; Renin–angiotensin system; Respiratory system

The major matters and events in creating and overcoming transition crises in the family life cycle

Background: This study aimed to investigate the major matters and events in overcoming transition crises in the family life cycle. Methods: This study is a qualitative approach and a grounded method. The statistical population included couples living in Karaj in 2020 that 80 of them were selected by purposeful sampling method. They were assigned to 20 people in each period. In the qualitative part, data analysis was performed based on grounded theory by performing three coding steps (open, axial and selective). To describe the data, the usual methods in descriptive and inferential statistics such as preparing frequency tables, calculating statistical indicators were used in SPSS software. Sequential strategy was used to combine quantitative and qualitative data. Results: 20 indicators and 5 components were identified. Economic and social areas such as the difficulty in dividing family responsibilities between spouses, economic and financial issues were some of the influential factors. Factors affecting family experiences such as social, religious and family factors had a great impact on the challenges of Iranian families. Conclusion: In the study population, lived experiences of identity in families located at different stages of the family life cycle can be considered as the concerns of families. It seems that the lived experience of individuals in families is affected by economic and social problems that have overshadowed their needs, such as coronary heart disease, family well-being, housing purchase, high cost of living, children's future and start-ups. Business

Primjena intra-aortne balonske pumpe pri kardiogenom šoku uzrokovanom trovanjem aluminijevim fosfidom

Aluminium phosphide (AlP) is a highly toxic pesticide that inhibits cytochrome oxidase c and causes oxidative stress. Death results from refractory cardiogenic shock due to myocardial dysfunction. There is very little information regarding extracorporeal life support in severe AlP poisoning. Although several therapies are available, none are curative. We report on the use of an intra-aortic balloon pump (IABP) in a 24-year-old woman brought to our hospital after an intentional ingestion of a tablet of AlP (3 g), which caused refractory AlP-induced cardiogenic shock and acute respiratory distress syndrome (ARDS). The patient underwent gastric lavage with potassium permanganate, received sodium bicarbonate intravenously, and was admitted to the intensive care unit. Echocardiography at 36 h post ingestion showed a left ventricular ejection fraction (LVEF) of <20 %. An IABP was inserted and the patient’s vital signs stabilised. After eight days, the IABP was removed and on day 20, the patient’s LVEF increased to 50 %. IABP was successfully used and may improve future prognoses for severely poisoned AlP patients with refractory cardiogenic shock. We encourage clinical toxicologists to examine this new treatment.Aluminijev fosfid (AlP) visoko je toksičan pesticid koji inhibira citokrom c oksidazu i uzrokuje oksidacijski stres. Smrt nastupa nakon refraktornog kardiogenog šoka uslijed miokardijalne disfunkcije. Vrlo je malo literature o izvantjelesnim sredstvima održavanja na životu nakon otrovanja AlP-om. Iako postoji određeni broj terapija, nijedna ne vodi do potpunoga izlječenja. Prikazan je slučaj uporabe intra-aortne balonske pumpe (IABP) kod 24-godišnje žene otrovane namjernim uzimanjem AlP-a (3 g), što je uzrokovalo refraktorni kardiogeni šok i akutni respiratorni distres sindrom (ARDS). Pacijentici je želudac ispran kalijevim permanganatom, intravenozno je primila natrijev bikarbonat te je zbrinuta u jedinici za intenzivnu skrb. Ehokardiografija 36 h nakon uzimanja tablete AlP-a pokazala je ejekcijsku frakciju lijevog ventrikula (LVEF) od < 20 %. Nakon umetanja IABP-a vitalni su se znakovi su se poboljšali. Pumpa je uklonjena nakon osam dana, a dvadesetoga dana LVEF je iznosio 50 %. Naši rezultati pokazuju da bi primjena IABP-a mogla poboljšati prognoze pacijenata s refraktornim kardiogenim šokom uslijed teškog otrovanja s AlPom. Stoga preporučujemo kliničkim toksikolozima da razmotre ovaj novi tretman

The Impacts of Water Pricing and Non-Pricing Policies on Sustainable Water Resources Management: A Case of Ghorveh Plain at Kurdistan Province, Iran

As with other regions of Iran, due to excessive extraction of groundwater for intense agricultural activity, Ghorveh plain, a water-scarce irrigation district in the west of Iran, has faced a serious water crisis during the last decade. The present study investigates the impacts of two scenario policies, namely, non-price policy (as a supply-oriented policy) and water pricing policies (as a demand-oriented policy) on agricultural sector of Ghorveh Plain, using positive mathematical programming (PMP). The model was calibrated by using farm-level data for the crop years in 2016–2017. Our findings indicate that applying water supply constraint policy will change the land use and cropping pattern to the crops with higher water productivity. The increase of water resource constraints can lead to the increase of water economic return which indicates a rising value of water resources shortage, warning the producers of the agriculture sector to allocate water to the crops with higher economic value under the water resources shortage conditions. In addition, the findings underline that in a situation where the price of irrigation water is low due to the low elasticity of water demand in the agriculture sector, formulating the economic instruments such as rising water prices does not solely suffice to achieve sustainable water resource management. However, mixed scenarios emphasized that the water distribution policies should be aligned with the increases in water cost. © 2019 by the authors