[Community intervention to modify beliefs, traditions and practices of oral health in Yahya-Abad village]

Following a qualitative study on beliefs, traditions, and practices on children's oral health in one of the countryside of Qazvin, it was shown that the commitment to wrong beliefs and traditions could lead to various problems associated with practice of health recommendations by villagers. To design a set of guidelines to modify the beliefs, traditions and practices of oral health in Yahya-Abad village. In this community intervention qualitative research, 50-70 persons in two main groups including mothers and teachers of primary schools participated in educational workshops. Tooth brushes, tooth pastes and dental flosses were distributed among the children and their families. During an eight-month period of continuous oral health education, the effect of this practice was evaluated through focus group discussions. The educational program used in our study resulted in an increase in level of knowledge and skill about oral health among the study populations. Although the education program was shown to have little effect on beliefs and practices of the study group yet the majority of individuals gave up some unhealthy traditional self-treatments. The distribution of tooth brushes among children made motivation for dental care only for a short time and the teachers failed to properly perform their roles in improving the healthy behaviors of the students. Although increasing the knowledge of parents and teachers in promoting the degree of oral health is necessary however this alone seems to be inadequate to achieve desirable healthy behaviors

[Traditional beliefs and behaviors of mothers and teachers related to oral health of children in rural districts of Qazvin: a qualitative study]

Traditional Beliefs as part of people's culture can influence the general wellbeing of communities. In order to promote healthy behaviors, it is important to be aware of people's traditional background. This study was performed to identify beliefs, traditions and practices of mothers and teachers related to oral and dental health of children in the rural Qazvin areas. A qualitative study [ethnographic] was conducted in three villages of Qazvin province. Data was collected through interviews, observations, and focus group discussions. Data was coded and classified according to main study findings. Information was classified into 6 categories: tooth eruption and exfoliation, diet and oral health, oral hygiene, dental caries, oral and gum diseases as well as dental trauma. Beliefs such as consuming a great amount of milk can be useful while others like putting un-cooked meat on top of tooth for relief of toothache can be harmful. Beliefs like rubbing onion on the gum during tooth eruption may have unknown or less important outcomes. The identified beliefs, traditions and practices were classified as useful, harmful and unknown effects. It was suggested to organize appropriate training classes for mothers and teachers in order to update their knowledge and improve their behavior regarding the proper oral health care of children based on the findings of this study

Investigating the molars and periodontium health in 7-11 years old children with congenital heart disease in Qazvin

Children with congenital heart diseases require special dental treatment and care compared to ordinary healthy patients. Therefore, awareness of such specific needs is essential for both the patients and their families. The aim of the present study was to investigate the health status of molar teeth and periodontium in children with congenital heart diseases and evaluating the awareness of parents about their children's specific dental care. A complete dental and oral examination was carried out on 32 children aged 7 to 11 with congenital heart disease followed by assessing the parent's awareness over their children's specific dental care using a questionnaire. From 108 permanent molars, 14.8% were with caries and 34.3% with enamel defect. Complete examination of 226 deciduous molars was also indicative of decay and enamel defect in 45.6% and 3.5%, respectively. Of all patients studied, 40.62% were found to have gingivitis and 18.7% with dental abscess. Regarding the parent's awareness, only 56% of children were revealed to have a previous history of visiting a dentist, and 68.7% of parents were aware of their children's specific needs for antibiotic prophylaxis. Considering the data obtained in our study, the children were found to have unfavorable dental conditions. Hence, such children require to be visited by a dentist on a regular basis and at the same time provided by necessary information on preventive dental care, treatment and oral hygiene

Comparison of oral ibuprofen and indomethacin on closure of patent ductus arteriosus in preterm infants

Although intravenous indomethacin and ibuprofen are widely used for closure of patent ductus arteriosus in premature infants, these formulations are unavailable in the Islamic Republic of Iran. In this study of the therapeutic effects of oral treatments, 20 preterm infants were randomized to oral ibuprofen [1x10 mg/kg, then 2x5 mg/kg at 24-hour intervals] or oral indomethacin [3 x 0.2 mg/kg at 24-hour intervals]. Complete ductal closure was seen in 7/10 of the indomethacin and 8/10 of the ibuprofen group. The difference was not significant. There was no reopening after the ductal closure during the hospital stay or in the follow-up visits in either group and no excessive increases in the blood urea nitrogen or serum creatinine levels were observed

[Fluoride content and uptake in sound enamel after the usage of Persica and Irsha in comparison with standard oral-B mouthwash]

Regarding to increasing fluoride consumption by patients and increasing currency of different kinds of mouthwashes like Persica and Irsha that claim to have fluoride, the aim of this study was to determine fluoride content and uptake in sound enamel after usage of Iranian mouthwashes in comparison with standard oral-B mouthwash. In this in vitro experimental study, the fluoride content of mouthwashes were determined. Then 30 extracted human sound premolars were randomly divided into three groups of 10 and each tooth was longitudinally bisected into experimental and control halves. A specified hemi circular area on each experimental half was treated with one of the rinses. Three case-control groups were evaluated after using Oral-B, Irsha and Irsha with brushing. The amount of fluoride uptake in enamel surface [KOH - Soluble fluoride] and structure [structurally bound fluoride] was determined by the method of Caslavska and Mc Cann. The results were analyzed by using paired t, ANOVA and LSD tests. Persica didn't have any considerable fluoride but Irsha was found to have the same amount of fluoride as Oral-B [0.05% NaF]. There was a statistical difference between experimental and control halves in fluoride content [P<0.05]. But there was no significant difference between three groups in fluoride uptake. Persica did not have any considerable fluoride. There is no difference between structurally bound fluoride uptake after using Irsha with or without brushing. But it decreased the amount of KOH-Soluble Fluoride

[ pilot study on the rate of hemoglobinopathies in hyperbilirubinemic term neonates at Nemazee Hospital shiraz, Iran]

Neonatal hyperbilirubinemia is a common disorder and if untreated is potentially neurotoxic. In order to investigate the correlation between hyperbilirubinemia and hemoglobinopathies, in a prospective study we studied a total 100 full term neonates at Nemazi Hospital with total bilirubin greater than 15 mg/dl and direct bilirubin less than 1.5mg/dl. Other known causes of hyperbilirubinemia such as G6PD deficiency and blood group incompatibility, septicemia and common metabolic disorders were excluded and then hemoglobin electrophoresis was done. In this study we found two infants with abnormal HbD [2%]. None of them had alpha thalassemia or sickle cell anemia. Hemoglobinopathies can be considered as one of the causes of neonatal hyperbilirubinemia. Further studies are recommended on a larger scale in the form of multi center study

[Electrocardiogram changes in term and premature healthy newborns]

Introduction: Since electrocardiography along with the other diagnostic procedures, is applied in seeking cardiac disease, so perceiving normal and abnormal electrocardiography patterns in newborns, accelerates the diagnosis of these diseases. On the other side some ECG parameters of term and premature newborns, which changes through life span, are different from each other

Objective: There was no study done in our center to compare the electrocardiogram of term and premature neonates so we decided to compare their EKGs and its differences with other centers in the world

Materials and Methods: During 2002, from 30 term newborns [gestational age of > 38 weeks] and 30 premature [GS< 38 weeks] who were born in hospitals of Shiraz University of medical sciences and age 24-96 ours were chosen. And a complete EKG [12 leads] was conducted on lying position when newborn was calm and alert. All neonates were assessed fully for underlying diseases that could affect their EKG. All EKGS were assessed and compared as regard to heart rate, axis of heart, voltage, P wave duration and R wave in QRS complex. Comparative statistics was done using SPSS soft ware with fisher exact method

Results: QRS axis in full term neonate is shifted to the right and to the left in premature neonates [P<0.05]. Duration of P and QRS waves in term is longer than those in premature babies [P<0.05]. Voltage of P wave in premature neonates is higher than that in the term babies. We didn't find significant difference between R wave voltages in these two groups

Conclusion: The electrocardiogram of premature infants is different from the term ones in axis, P voltage and QRS duration

Effect of Manna from Cotoneaster discolor on infant janndice [effect on blood bilirubin level]

Jaundice is observed during the first week of life in approximately 60% of term infant and 80% of preterm infant. The risk of hyperbilirubinemia is related to the development of kernicterus [bilirubin encephalopathy], hearing loss, spasticity, and convulsion at high serum bilirubin levels. For treatment of neonatal jaundice is recommended that phototherapy and if unsuccessful, exchange transfusion is used to keep the maximum total serum bilirubin below levels at which risk of injury to the CNS occurrs. In Iranian traditional medicine, the manna from Cotoneaster spp. [Shir-e-Khesht] are being commonly used in the treatment of neonatal jaundice. It is also the purpose of this study to design the formulation of drop with exact dose. Shir-e-Khesht with browse of Cotoneaster discolor pojark were prepared from south of Khorassan [a province in east of Iran]. Drop was prepared from total extract of this manna and, then the quantitative and qualitative controls and microbial tests were accomplished on it and were administrated to jaundice newborn. 100 babies [case group] received Shir-e-Khesht drop and phototherapy, and the 100 others [control group] were also given placebo drop with phototherapy. [Dosage: 5 droplets, TID]. On case group the time required to reduce the serum bilirubin level to 10 mg/dl was significantly shorter than control group [p < 0.00001]. The drop in addition to phototherapy was recommended in treatment of neonatal hyperbilirubinemia

Effects of the different light-source distances from the skin surface in conventional phototherapy

Phototherapy is a conventional method of lowering serum bilirubin in newborn jaundice. We evaluated the short distance in relation to conventional long distance phototherapy between the light-source and the skin surface. Healthy jaundiced neonates undergoing phototherapy were r and omized into two groups. The distance between the light-source and the newborn's skin was 20 and 40 centimeters [G20; n==381 and G40; n=393] respectively. Newborns with any history of herbal or Phenobarbital administration were excluded. Bilirubin level was checked 24 hrs after cessation of phototherapy. Both groups were compared regarding the duration of the exposure and its effect on serum bilirubin level and of G6PD deficiency. The respective mean duration of phototherapy in G20 and G40 were 66 +/- 22 and 81.6 +/- 24.6 hrs [P<0.001]. Twenty-four hrs after cessation of phototherapy, 56.1% of G20 newborns had higher levels of rebound bilirubin in contrast with 38.5% of G40 cases. The type of milk had no influence on bilirubin levels. Exposure from 20 cm distance had no side effects on the neonates of various gestational ages and birth weights. This method proved to be safe, rapid and more effective in reducing bilirubin than phototherapy from a longer distance

prospective study on QT dispersion in neonates: a new risk factor

QT dispersion [QTd] especially after ischemic heart disease and myocardial infarction is a prognostic predictor of mortality, in adult medicine. This study was undertaken to determine the correlation between QT dispersion and neonatal stress. Neonates were divided into 3 groups: normal term [30 cases], normal preterm [30 cases] and sick neonates [36 cases], born between October 2001 and June 2002 in Hafez and Nemazee Hospitals affiliated to Shiraz University of Medical Sciences. Electrocardiogram [12 leads] was obtained and QTd was calculated. Result: QT dispersion in sick neonates was significantly higher than normal neonates. The mean QTds in normal term group were 52.4 24.47 ms in normal preterm, 69.3 17.94ms and 100.8 29.01ms in sick neonates. In sick neonates, QTd correlated with the incidence rate of mortality. Conclusions: It is concluded that QTd might be a prognostic factor for estimation of neonatal mortality

Prevalence of phototherapy-induced hypocalcemia

Hyperbilirubinemia is the single most common abnormal physical finding in the first week of life and is commonly managed by phototherapy with its inherent complications. A lesser known complication of the phototherapy is hypocalcemia. To study the prevalence of phototherapy-induced hypocalcemia and to compare it between premature and full-term babies. This study was performed on 153 jaundiced neonates [62 premature, 91 full-term] that were managed with phototherapy. These neonates were completely normal on physical examination. Serum calcium was checked on arrival, 48 hours after starting phototherapy and 24 hours after discontinuation of the treatment. The first samples were considered as controls. A comparative study was made between these groups to determine the prevalence of hypocalcemia. Twenty- two neonates [14.4%] developed hypocalcemia. There were significant differences between the prevalence of hypocalcemia in premature [22.6%] and full-term neonates [8.7%] [p= 0.018]. None of the hypocalcemic neonates was symptomatic clinically. Serum levels of calcium returned to normal 24 hours after discontinuation of phototherapy in almost all hypocalcemic neonates. The study shows that neonates under phototherapy are at high risk of hypocalcemia. This risk is greater in premature neonates

Intravenous immunoglobulin versus exchange transfusion in neonatal sepsis: a prospective study

Newborn infants are prone to septicemia and subsequent high mortality rate. We did a comparative study between intravenous immunoglobulin [IVIG] and exchange transfusion [ET] in the treatment of neonatal sepsis as adjunctive therapy. Thirty two patients, suspected of sepsis with poor condition and having one or more poor prognostic signs: sclerema, bleeding tendency, hepatosplenomegaly, jaundice, progressive decrease in the level of consciousness with or without convulsion, were admitted to this study. Seventeen of the above patients received IVIG and fifteen of them were treated by exchange transfusion beside systemic antibiotic therapy. The mortality rate was compared between the two groups, that was significantly lower in IVIG group 2/17 than in ET group 9/15 [P=0.008]. IVIG is therefore recommended in poor condition septic newborn infants

Histology of pulmonary lesions in victims of chemical warfare

Twenty six patients with chemical warfare exposure have been investigated for possible morphologic changes of the lung. A wide variety of pulmonary changes were seen including both obstructive type lung lesions and interstitial pneumonitis. The most common hazard was ARDS, which resulted in acute respiratory failure in some cases and chronic interstitial fibrosis and respiratory failure in others. Finally, the most dangerous hazard is the risk of lung cancer