ABSTRACT
Statement of the Problem: It is postulated that attention deficit/hyperactivity disorder [ADHD] with or without medication has an inhibitory effect on the chil-dren's growth and development
Purpose: This study aimed to assess the dental age and cervical vertebral matura-tion [CVM] stage in ADHD patients with or without medication
Materials and Method: This cross-sectional study evaluated the pretreatment panoramic and lateral cephalograms of 129 patients [70 males, 59 females aged 8-14 years]. Demirjian index and Baccetti's CVM index were used to determine the dental age and CVM stage, respectively. The subjects were evaluated in two groups of ADHD [case, n=59] and healthy individuals [control, n=70]. The ADHD pa-tients were divided into two groups of AWT [ADHD with Treatment, n=43] and AW [ADHD without treatment, n=16] based on the use of methylphenidate. Paired t-test was used to compare the mean dental age between the groups. Linear and ordered logistic regression models were used to detect differences between the groups. The association between dental and chronological age was assessed by using Pearson correlation coefficient [p< 0.05]
Results: After age and sex adjustment, the skeletal maturity stage was found to be similar to the control group based on the presence of the disorder or use of medica-tion [p= 0.711 and p= 0.436, respectively]. Similarly, the patients' dental age was similar to the controls in AW and AWT groups [p= 0.180 and p= 0.421, respective-ly]. The correlation between dental age and chronological age was 0.79 in AWT, 0.88 in AW, and 0.88 in control group [p< 0.001 for all the three]
Conclusion: After age and sex adjustment, the dental and skeletal age of ADHD patients with or without Methylphenidate treatment do no manifest a significant delay compared with the controls
ABSTRACT
Regarding the role and importance of paradigm of evidence based practice and its remarkable impact on the effectiveness and efficiency of clinical services and healthcare, development of an integrated system seems necessary in order to manage dispersed data and ensure using evidence in clinical decision making, thus the aim of this study was designing a model for implementing national system of evidence based health care in Iran. This paper is a study of comparative type which has been written in three stages: investigation of structure and process of evidence based practice in selected countries, investigation and analysis of current status in Iran in this regard and recommendation of strategies which make model implementation feasible in the country. Such methods as review of literature, focus group discussion and Delphi technique were used for investigation. According to studies, insuring an evidence based practice culture in the country requires a system called National Evidence Based Health Care System which consists of three subsystems including national system of clinical knowledge management, national evidence-based practice system and integrated national network of clinical effectiveness. The ultimate goal of health care system in every country is maintaining and improving community health. Achievement of this goal depends on effectiveness of delivered services and consistency of the services with national and local priorities. In order to achieve clinical effectiveness, the best practice should be realized in the country, implementation of which requires a set of macro and micro strategies enabling facilitation, promotion or guaranteeing clinical knowledge application in the country