Search

Key Clinical Message Inflammatory bowel disease is rare in infants and it includes perianal Crohn's disease, which is inflammation at or near the anus. An early diagnosis is essential to prevent the complications that may affect the development and growth of the child.

Background and purpose: Condensing osteitis is the local reaction of bone to a pulp inflammatory stimulus with low intensity and long duration and is the most common radiopaque pathogen lesion in the jaw. The aim of the present study was to evaluate the frequency of condensing osteitis in apex of teeth with deep caries and restorations in panoramic radiographs. Materials and methods: This cross-sectional study evaluated panoramic radiographs of 2039 patients attending Sari Dental School clinic for dental treatments during 2018-19. Demographic information, including age and sex were recorded. All panoramic radiographs were taken with Cranex D (soredex, Finland) panoramic device and Ortho CP-G Plus films. Lesions in the area of teeth with extensive restoration or deep caries (condensing osteitis) were examined in both jaws. Data were analyzed in SPSS V21 using Kolmogorov-Smirnov test, Fisher's exact test and Chi-square. Results: According to findings, 364 panoramic radiographs had condensing osteitis. The frequency of radiopacity at the apex of teeth with condensing osteitis was significantly higher in women than men (P=0.042). But there was no significant association between condensing osteitis and border, shape, jaw type, tooth type, and age (P

A gastric ulcer is a tear in the stomach lining that manifests as abdominal pain, nausea, vomiting, and weight loss. Its occurrence is lesser in children as compared to adults and its incidence in children ranges between 2% and 8%. Helicobacter pylori and nonsteroidal anti-inflammatory drugs are the most common causes of gastric ulcers. In our case, we report a 2.5-month-old male who presented with severe pallor, hematemesis, and melena with normal weight gain. The patient’s mother was infected with COVID-19 a month ago and recovered within 5 days but kept using aspirin and nonsteroidal anti-inflammatory drugs for a month during breastfeeding. An upper gastrointestinal endoscopy revealed a gastric ulcer and the Helicobacter pylori antigen was positive in the biopsy. A COVID-19 infection was detected later in the patient. The patient was administered proton pump inhibitor, clarithromycin, and amoxicillin for Helicobacter pylori antigen and symptomatic treatment for COVID-19. This case report shows that a stomach ulcer can appear in infancy, but opportune interventions such as timely diagnosis and treatment can solve the problem. It also marks the pathophysiological connection between Helicobacter pylori and gastric ulcer.

Background and purpose: The present study assessed the incidence of Temporomandibular Disorders (TMD) and its relationship with demographic variables, previous orthodontic treatment, and mandibular mobility in patients attending Sari Dental School. Materials and methods: In this cross-sectional study, 68 individuals were randomly selected. Data were obtained by interviewing the patients and clinical examinations. The relation between TMD and other variables was then analyzed applying Chi-square test and exact fisher test in SPSS V22. Results: TMD was found in 75% (n=51), including 35.3% of men and 64.7% of women. Among these, 14 had previously received orthodontic treatment, 34 had a monthly salary of less than one million tomans ($30), and 49 were city dwellers. Maximum mouth opening was 44.52±7 mm in patients without TMD (P= 0.84). People without TMD had greater maximal lateral mandibular movement to the right (P= 0.2) and left (P= 0.84), but this was not statistically significant. Conclusion: A history of orthodontic treatment can contribute to the development of TMD. Nevertheless, good financial status helps in benefiting from more follow-up treatments and decreases the incidence and progression of TMD, although this was not significantly correlated with other variables.

Background and purpose: Coronary artery disease is a major cause of mortality, morbidity, and disability in society and patients incur high expenditure on treatment. Pulp stones are ectopic calcifications of the pulp vessel walls, so, they can have similar pathogenesis as those of other organs and coronary atherosclerosis. The purpose of this study was to investigate the correlation between coronary artery sclerosis and dental pulp calcification in panoramic dental radiography. Materials and methods: This case-control study, was performed in 94 patients aged 30-65 years old attending Sari Touba Clinic for coronary angiography. They were divided into two groups: case group with significant angiography results and control group with normal angiography results. Panoramic dental radiographs were obtained and examined for the presence of pulp stone. Data were analyzed in SPSS V16 using Chi-square test. Results: Findings showed a significant association between coronary artery sclerosis and presence of pulp stone (P

Abstract Background Amblyopia, as a neurodevelopmental preventable visual disorder, affects approximately 1.1 % in Asia. A binocular approach to treating amblyopia has been recently proposed. Whether the binocular playing game treatment is comparable to patching treatment needs further randomized clinical trials. To address this, the present research, designs, develops, and evaluates a new binocular game to treat amblyopia. Methods This study has been designed as a non-inferiority, randomized, two parallel-group, controlled trial. Forty-four patients between 4 and 12 years diagnosed with amblyopia will be randomly assigned to the control and intervention groups. In the intervention group, amblyopia treatment is provided with red-green anaglyphic glasses and a red filter placed in front of the amblyopic eye, along with a game to be played for 30 min twice a day. Those in the control group will receive patch therapy according to amblyopia treatment study protocol. The primary outcome is to change visual acuity in the amblyopic eye from the baseline to 3 months after randomization. Ethics and dissemination The Ethics Committee of Mashhad University of Medical sciences’ approval date was February 28, 2018, with a reference code of IR.MUMS.fm.REC.1396.783. Thus far, the recruitment of participants has not been completed and is scheduled to end in September 2021. The results will be disseminated in a peer-reviewed journal. Trial registration Iranian Registry of Clinical Trials IRCT20180217038768N1 . Registered on 22 April 2019.

Background and purpose: Acute scrotum syndrome is one of the complaints in emergency departments which has several causes. This study was performed to determine the causes and symptoms of acute scrotal pain in patients attending emergency departments in Mazandaran province, Iran. Materials and methods: A cross-sectional study was done in all patients with acute scrotum syndrome in emergency departments affiliated to Mazandaran University of Medical Sciences, 2011- 2016. Patients’ medical records (clinical and paraclinical information, and diagnostic and therapeutic procedures) were investigated. Data analysis was done applying Chi- square test and t-test. Results: The study included 205 patients with a mean age of 34.10±17.34. Patients were diagnosed with testicular torsion (n=60, 29.3%), epididymo-orchitis (n= 63, 30.7%), inguinal hernia (n= 69, 33.7%), varicocele (n=11, 5.4%), and testicular torsion (n=2, 2.1%). In testicular torsion, the pain was most sudden (23.9%) and the duration of symptoms onset and arrival at emergency department was 3.62±4.38 hours. The definitive diagnoses were consistent with ultrasound findings in 91.7% of the cases with testicular torsion, 96.8% of those with epididymis orchitis, 95.7% of patients with hernia, and in 54.5% of cases with varicocele. Conclusion: Younger age, duration of pain, sudden pain, and cremaster reflex are helpful in differentiating testicular torsion from other causes of acute scrotum syndrome. Ultrasonography of the testis should be immediately performed as the main diagnostic measure for acute scrotum syndrome.

Background and purpose: Periapical inflammatory lesions are localized periapical bone reactions that result from pulp necrosis and inflammation or periodontal diseases. Inappropriate treatments are often considered as one of the main factors associated with apical periodontitis. This study was done to evaluate periapical radiolucencies in panoramic radiographs. Materials and methods: In this cross-sectional study, 332 panoramic radiographs of patients attending Sari School of Dentistry (2016-2019) were assessed. The Periapical Index was used to evaluate the presence of periapical lesions. Also, the quality of treated teeth was determined by optimal quality indices. Data analysis was done in SPSS V.016 Results: Periapical lesions (PAI = III-V) were seen in 75.4% of the teeth investigated and in 90.2% of teeth with root canal therapy (RCT) and 68% of untreated teeth. Periapical radiolucencies were mostly found in RCT teeth with inadequate filling density and length. The prevelance of lesions were higher in males. The presence of lesions increased in jaws from the anterior to the posterior, and the frequency of lesions was higher in the maxilla than the mandible. Conclusion: The frequency of periapical lesions in RCT teeth was very high. The findings showed that the quality of density and length of filling has a significant effect on prevelance of preapical lesions. Poor RCT leads to low success rate in the treatment of teeth.

Background and purpose: Renal colic is one of the most common causes of referral to emergency departments. The aim of this study was to determine the outcome and predictive factors for invasive management and readmission in these patients. Materials and methods: A cross-sectional cohort study was performed in all patients with renal colic who were admitted in Emergency Department in Sari Imam Khomeini Hospital, 2016-2017. Diagnostic and therapeutic procedures, the patients’ clinical and paraclinical information, and disease outcome after a month (the need for invasive urologic intervention, recurrence, and readmission) were recorded. Data analysis was done in SPSS V18. Results: There were 581 patients in this study (mean age: 39.88 ±14.49 years). The most common symptoms were flank pain (88.1%) and sudden onset pain (69.2%). Invasive treatment was carried out for 140 (24.1%) patients. Nausea (P = 0.002) and vomiting (P = 0.001) were found to be significantly higher in patients requiring invasive procedure. Abnormal ultrasound findings in patients requiring invasive procedure were significantly higher (P = 0.00). Renal colic recurrence was significantly higher in patients of older age (P = 0.002), those with abdominal pain (P = 0.004), genital area pain (P = 0.041), fever and chill (P = 0.037), history of underlying diseases (P = 0.033) and higher white blood cell counts (P = 0.00). Conclusion: Factors such as age, underlying diseases, fever and chills, nausea, vomiting, white blood cell count, and ultrasound findings in these patients should be considered in order to choose the best treatment option.

Background and purpose: Nowadays, social networks are considered as the major communication tools in communities and throughout the world. This study aimed at investigating the pattern of social network use in medical students who will have important occupations in healthcare system. Materials and methods: This descriptive-analytical study was carried out in 715 medical students in Mazandaran University of Medical Sciences, Sari, Iran 2018. Information on the frequency and pattern of social network use were collected and data were analyzed in SPSS V21. Results: The mean age of students was 21.59±2.7 years old and 711 students (99.4%) were engaged with social networks. The daily median use of social networks was 3 hours. The most common reason for using these networks were communication with friends (40.45%). The average hours of using these networks were significantly higher in single students compared with those of married ones (P

Background and purpose: Hyperbilirubinemia is the most common cause of neonatal hospitalization and can be a sign of urinary tract infection during infancy. Urinary tract infection (UTI) is one of the reasons for prolonged jaundice. This research aimed at studying the prevalence of urinary tract infection in neonates with hyperbilirubinemia admitted to Tonekabon Shahid Rajaei Hospital, 2015. Materials and methods: This cross-sectional study was conducted in 259 infants. The samples were selected by census method. To diagnose the urinary tract infection, urine with a 2-cc syringe was taken by pediatrician through suprapubic method. Data were analyzed by Chi-square test. Results: UTI was identified in 18 (6.9%) neonates, including 10 (55.5%) boys and 8 (44.4%) girls. Urine culture revealed 12 E. coli spp. and 6 Proteus spp. Also, in 49 (91.18%) were found to have prolonged jaundice. Conclusion: Due to the prevalence of UTI in neonates, urine culture is suggested in all infants hospitalized for jaundice even in those without prolonged jaundice.

Background: Diabetes mellitus is a chronic metabolic disease which can have numerous physical effects for patient. Xerostomia is one of these complications. Compared to healthy people, patients with diabetes mellitus, have a worse quality of life, and complications of diabetes are the main determinants of quality of life in these patients. Objective: The aim of this study was to determine the effects of xerostomia and hyposalivation on quality of life of patients with type 2 diabetes mellitus. Methods: This descriptive-analytical epidemiological study was conducted on 200 patients with type 2 diabetes mellitus referred to the diabetes clinic of Shahid Mostafavi in Sari city from October 2015 to January in 2016. A questionnaire containing personal characteristics and medical situation was completed by each person. Then, the Persian Oral Health Impact Profile-14 (OHIP-14-PER) questionnaire was completed by the patients. Eventually, with the use of chewable paraffin for 1.5 min by the patient, stimulated salivary flow rate (SSFR) test was performed, and in order to determine hyposalivation, their saliva amount underwent a gravimetric test. Finally, using statistical software SPSS16, the information was statistically analyzed by independent-samples t-test, Mann-Whitney U, Chi-squared and fisher exact tests. Results: The average age of patient was 56.41 years old (43% male and 57% female). Mean SSFR was 0.7 ml/min in patients and xerostomia were confirmed in 112 patients. Difference between age, gender, drug use, years affecting to diabetes and FBS amount in patient with hyposalivation were not statistically meaningful in proportion to patients without it. But difference between HbA1C and SSFR in patients with hyposalivation were statistically meaningful than to patients without it (p=0.03, p=0.001 respectively). The mean patient score to OHIP-14 were obtained as 38.17. The questionnaire score difference in patients with hyposalivation in proportion to patients without it were not statistically meaningful. Conclusion: Hyposalivation possibility increases in diabetic patients with low metabolic control which can cause more severe side effects in relation to oral health. Xerostomia in diabetic patients has negative effects on oral health related quality of life. Diabetic control and patients’ oral problem improvement is effective in their quality of life promotion

Background: Nitrate due to its high water solubility, poor absorption and having stable composition in the water, has been studied as the best index to indicate groundwater contamination. Borazjan, located in the north of Bushehr province, is one of fertile plains which nitrate contamination of groundwater has occurred in the most parts of it. Detecting the source of pollution and the most vulnerable areas were the aims of this study. Material and Methods: In this study, hydrochemical quality, especially in terms of nitrate, sulfate, chloride sodium, spatial and temporal variations and the origin of them in the groundwater of Borazjan plain, are studied. Groundwater samples from 12 wells were collected in April and August 2012 and assessed to determine the parameters of hydrochemistry and pollution. Results: Based on these results, severe nitrate contamination of groundwater, especially in the southern part of the plain, by agricultural activities, cesspool wells, domestic sewage and livestock and poultry wastewater the influence of the effluent from the aviculture, were occurred. Also, the quality of groundwater resources showed that concentration of Cl- , Na+, SO42- , and NO3- are more than standard limit and only in some areas of plain, concentration of ions such as NO3- and Na+ is less than the standard limit. Conclusion: According to the results of this study, using chemical fertilizers in terms of time period and amount of consumption should be properly managed. Furthermore, domestic wastewater, livestock and poultry wastewater should be controlled and the monitoring system for measuring the exact quantity and quality of groundwater resources must be completed.

There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20). We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We chose a score of 6 as the cutoff and thus achieved a sensitivity of 89% and a specificity of 85% for the DAST-20. During the study, we gathered demographic data, burn features and DAST-20 results for all patients. Patients with scores of 6 or more were considered to be substances abusers. A statistical analysis was conducted using SPSS v16 software. According to the DAST-20 results, 33% of the patients were in the user group. The mean score of DAST-20 was significantly higher among users than it was among nonusers (P

Among the various methods of clinical teaching, rounds and grand rounds are considered as the gold standards. Clinical round includes some standard components and it plays an effective role in student's learning process. The aim of this study was to evaluate the content of teaching rounds in 40 clinical wards in 4 medical teaching hospitals affiliated to Tehran University of Medical Sciences in Tehran, Iran, and also to assess the learners benefit rate from these programs and determine the factors affecting those. This is a cross sectional, descriptive and analytical study conducted on 318 medical learners in different grades, about the content of clinical rounds. The data collection tool was a questionnaire made by researchers. The validity of the questionnaire according to experts opinions and the reliability with a pilot study conducted on 30 cases were confirmed (α=0.826). Data entered into the SPSS software and for analysis Chi-square, Student's t-test, ANOVA and linear regression analysis tests were used. In this study 20 subjects related to clinical rounds content were assessed. The highest score was related to the subject of diagnosis and the lowest one was related to legal issues. Overall, the mean score of the learner's benefit rate to this method was 3.52 out of five. The level of learner's benefit rate was above the average and the benefit rates according to educational grade, number of the students and faculties were significantly different (P

There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20). We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study’s inclusion criteria. We chose a score of 6 as the cutoff and thus achieved a sensitivity of 89% and a specificity of 85% for the DAST-20. During the study, we gathered demographic data, burn features and DAST-20 results for all patients. Patients with scores of 6 or more were considered to be substances abusers. A statistical analysis was conducted using SPSS v16 software. According to the DAST-20 results, 33% of the patients were in the user group. The mean score of DAST-20 was significantly higher among users than it was among nonusers (P