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The application of barrier membranes in guided bone regeneration (GBR) has become a commonly used surgical technique in periodontal research. The objectives of this study were to evaluate the in vitro biocompatibility and osteogenic differentiation of mesenchymal stem cells (MSCs) on two different collagenous coatings (nano electrospun fibrous vs. solid wall) of bilayered collagen/chitosan membrane and their histological evaluation on bone regeneration in rabbit calvarial defects. It was found that chitosan-nano electrospun collagen (CNC) membranes had higher proliferation/metabolic activity compared to the chitosan-collagen (CC) and pristine chitosan membranes. The qRT-PCR analysis demonstrated the CNC membranes induced significant expression of osteogenic genes (Osteocalcin, RUNX2 and Col-α1) in MSCs. Moreover, higher calcium content and alkaline phosphatase activity of MSCs were observed compared to the other groups. Histologic and histomorphometric evaluations were performed on the uncovered (negative control) as well as covered calvarial defects of ten adult white rabbits with different membranes (CNC, CC, BioGide (BG, positive control)) at 1 and 2 months after surgery. More bone formation was detected in the defects covered with CNC and BG membranes than those covered by CC and the negative control. No inflammation and residual biomaterial particles were observed on the membrane surface or in the surrounding tissues in the surgical areas. These results suggest that bilayer CNC membrane can have the potential for use as a GBR membrane material facilitating bone formation.

Aim: The purpose of this clinical trial experiment was to compare the effects of the combination of dry needling (DN) and the muscle energy technique (MET) on the upper trapezius latent myofascial trigger point., Method: Sixty female patients, aged 18-30 with latent myofascial trigger points in the upper trapezius muscle were randomly divided into three groups: group 1 (n = 20) received DN and MET, group 2 (n = 20) received only MET, and group 3 (n = 20) received only DN. The visual analogue scale (VAS), pressure pain threshold (PPT), and range of active contra lateral flexion (CLF) were measured before each treatment. The patients were treated for three sessions in a one-week period with at least a two-day break between each session, and in session four, an assessment of primary outcomes was conducted without any treatment., Results: All three treatment groups showed decreases in pain (p = 0.001) and increases in PPT levels (p = 0.001) as well as increases in CLF (p = 0.001). But the group receiving trigger point DN together with MET showed more significant improvement than the other two groups in VAS, PPT and ROM. No significant differences were found between the MET-only group and the DN-only group., Conclusion: Our results indicate that all three treatments used in this study were effective for treating MTP. According to this study, DN and MET is suggested as a new method for the treatment of MTP., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: To translate the STarT Back Screening Tool (SBT) into Persian and to investigate the psychometric properties of the new version in a group of patients with Non-Specific Low Back Pain (NSLBP)., Background: The STarT is a validated questionnaire used for subgrouping LBP patients at three levels of low-, medium-, and high-risk, based on the risk of chronicity. It has previously been translated and validated in different languages., Methods: The translation and validation of the original questionnaire were carried out in accordance with the standard guidelines. To approve the construct validity, 295 patients with NSLBP completed a questionnaire package. The package comprised of the STarT, Roland-Morris Disability questionnaire (RMDQ), Tampa Scale for Kinesiophobia (TSK), Coping Strategies Questionnaire (CSQ), and Hospital Anxiety and Depression Scale (HADS). To evaluate test-retest reliability, 35 randomly selected NSLBP patients completed the STarT questionnaire within min. 24-hour interval., Results: Factor analysis confirmed two subscales of the STarT. The Cronbach α was .83 and .81 for the STarT and the subscale, respectively. This questionnaire showed excellent test-retest reliability (ICC = .85) (p < 0.01). The correlations between the STarT and RMDQ, CSQ, TSK, and the two subscales of HADS were estimated to be .81, .70, .71, .74, and .71, respectively. The Area under the Curve was also calculated for 6 items and the range was between .734 and .860., Conclusions: The Persian version of the STarT is reliable and valid, and consistent with the original questionnaire. Therefore, clinicians to subgroup Persian-speaking NSLBP patients can use it., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: there is a consensus that the adoption of evidence-based practice contributes to the improvement of maternity care. Iranian National Guidelines for Normal Childbirth included evidence-based practice and were disseminated to hospitals in 2006 but little is known about the success of implementation. This study investigates the provision of care during labour and childbirth in comparison with national guidelines in four public hospitals in Tehran., Design: this was a descriptive evaluation study and investigated the provision of care during labour and childbirth using current evidence-based practice as the indicator of quality., Participants and Setting: the observational and interview data were collected using checklist and interview guide based upon standards for evidence-based care in four public hospitals in Tehran. In 24 women who were admitted in normal labour, practices were observed until the end of the third stage of labour, to determine concordance with Iranian National Guidelines for Normal Childbirth. A further 100 postpartum woman were interviewed about their care during labour and childbirth in the early postpartum period before discharge from the postnatal ward., Findings: beneficial and lifesaving practices such as assessing mothers' well-being; removal of the placenta in the third stage of labour, as well as skin-to-skin contact and early initiating of breast feeding were recorded in most cases. However, the use of practices such as routine augmentation and induction of labour, fundal pressure, conducting routine episiotomy were noted., Key Conclusions: this evaluation study shows good practice and areas for improvement as practices fail to meet evidence based standards. Thus, there is potential for quality improvement and economic savings in Tehran maternity hospitals. However closing the gap between guidelines based on best evidence and actual clinical practice in childbirth is a challenge. Practical solutions to enable implementation of evidence-based guidelines for normal childbirth in low risk women require further studies, especially from the providers' perspective., Implications for Practice: national programs which focus on organisational framework, interventions to change providers' attitudes towards the development of a culture of birth as a normal and physiological process are more likely to be important in the Iranian context. Involving professional midwives more in the care for normal childbirth may help to improve quality of care during normal labour and childbirth in terms of evidence-based practice., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aim: The aim was to evaluate the effect of sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and xylitol on salivary Streptococcus mutans., Materials and Methods: A total of 60 dental students of 20-25 years old, who volunteered after checking their health condition and signing an informed consent, were randomly allocated to receive one of the following interventions: (A) Chewing gum containing CPP-ACP; (B) containing xylitol. Subjects within the experimental groups were taken the gums 3 times daily, after each meal for a period of 3 weeks. Pre- and post-intervention unstimulated saliva samples were quantified for S. mutans counts., Results: A statistically significant reduction of salivary S. mutans was displayed in both groups A and B after the intervention when compared with baseline (P < 0.001), and group A shows more statistically significant reduction of salivary S. mutans than group B (P = 0.011)., Conclusion: Daily consumption of chewing gum containing CPP-ACP and xylitol significantly reduces the level of salivary S. mutans, but chewing gum containing CPP-ACP can reduce the level of salivary S. mutans in more than xylitol chewing gum.

Objective: Recently, self-etching fissure sealants have been introduced to reduce technical sensitivity; however, their efficacy should be assessed. The aim of this study was to assess of the microshear bond strength of self-etching and conventional fissure sealants., Materials and Methods: Thirty non-carious third molars were randomly divided into three groups (N=10). Microcylinders of Concise fissure sealant were bonded to prepared buccal and lingual surfaces using the two following procedures. In the first group, phosphoric acid was used to prepare the substrate; whereas in group two, Concise was used in combination with Prompt L-Pop. In group 3, a self-etching fissure sealant (Enamel Loc) was utilized per se. After 24 hours, the samples were subjected to 500 rounds of thermocycling and shear bond testing using a microtensile tester machine with a crosshead speed of 0.5mm/min. Data were analyzed using one-way repeated measure ANOVA and Bonferroni Post HOC tests (SPSS version 16)., Results: THE MEAN AND STANDARD DEVIATION OF MICROSHEAR BOND STRENGTH OF THE GROUPS WERE AS FOLLOWS: Group 1: Concise+ etching (14.59 ± 1.19 MPa), Group 2: Concise+Prompt L-Pop (12.86 ± 1.98 MPa), and Group 3: Enamel Loc (5.59 ± 0.72 MPa). One-way ANOVA revealed that all the differences were significant and the conventional sealant exhibited the highest mean bond strength., Conclusion: Conventional sealant using phosphoric acid etch application prior to fissure sealant application demonstrated more bond strength in comparison with that of self-etch bonding and self-etch sealant.

Aim: The aim of this study was to compare alternatives methods for analysis of zero inflated count data and compare them with simple count models that are used by researchers frequently for such zero inflated data., Background: Analysis of viral load and risk factors could predict likelihood of achieving sustain virological response (SVR). This information is useful to protect a person from acquiring Hepatitis C virus (HCV) infection. The distribution of viral load contains a large proportion of excess zeros (HCV-RNA under 100), that can lead to over-dispersion., Patients and Methods: This data belonged to a longitudinal study conducted between 2005 and 2010. The response variable was the viral load of each HCV patient 6 months after the end of treatment. Poisson regression (PR), negative binomial regression (NB), zero inflated Poisson regression (ZIP) and zero inflated negative binomial regression (ZINB) models were carried out to the data respectively. Log likelihood, Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare performance of the models., Results: According to all criterions, ZINB was the best model for analyzing this data. Age, having risk factors genotype 3 and protocol of treatment were being significant., Conclusion: Zero inflated negative binomial regression models fit the viral load data better than the Poisson, negative binomial and zero inflated Poisson models.

Aim: This study aims to employ random effect model to evaluate prognostic factors of hepatitis C., Background: In recent years, Hepatitis C virus (HCV) infection has been a major cause of liver diseases worldwide and represents a major public health problem. Evaluation of risk factors and a community intervention in order to decrease the problem is one of the solutions which help protect people from the infection., Patients and Methods: The data was collected from a longitudinal study during 2005-2010. The response variable in this study was the viral load of each HCV patient during the treatment, immediately after the treatment and 3 to 4 months after the end of the treatment. The outcome variable of interest is the viral load of HCV patients. For analyzing repeated measure viral load of HCV patients, random effect models were used., Results: The results obtained from random effect model showed that treatment protocol and time statistically significant. The variance component was statistically differing with zero., Conclusion: According to the results time had a positive effect on rate of viral load of patient. Combination therapy of Peg-interferon plus Ribavirin increased the rate of virological response.