[Silent stroke and related risk factors]

The silent brain infarctions are common in first-ever stroke. Some recent studies show the possible role of silent brain infarction in ischemic stroke. The aim of this study was to evaluate the frequency of silent brain infarction in acute first-ever ischemic stroke and its association with stroke risk factors. This descriptive - analytical study was carried out on 203 [94 males, 109 females] patients with acute first-ever ischemic stroke in Shafa hospital in Kerman, Iran during 2010. The diagnosis of ischemic stroke was made by physical examination and was confirmed by MRI and CT Scan. A questionnaire containing demographic information and risk factors including hypertension, diabetes, hyperlipidemia, cigarette smoking, ischemic and non-ischemic heart disease for stroke as well as presence of silent stroke was completed for each patient. Data were analyzed using SPSS-16 and logistic regression test. The mean age of patients was 62.56 +/- 17.35 years. Among our patients history of hypertension, hyperlipidemia, cigarette smoking, diabetes, history of ischemic heart disease, history of other cardiac disease and silent stroke were observed in 66 [32.5%], 26 [12.8%], 16 [7.9%], 40 [19.7%], 27 [13.3%], 16 [7.9%] and 31 [15.3%], respectively. The probability of silent stroke among patient with hyperlipidemia, was 3.7 times more than those without hyperlipidemia [95%CI: 1.556-12.780, P<0.05]. There was no significant correlation between silent stroke and the above risk factors. Silent stroke was found in 15% of patients with ischemic stroke. Control of hyperlipidemia can have a vital role in the prevention of silent stroke

[ effect of medical equipment maintenance management system implementation on Valie-Asr hospital costs situated in Arak 2006]

Medical equipment improvement and tremendous expenditure is allocated costs annually, so that optimum and proper maintenance management of equipment would have outstanding effects on health and treatment of medical training and research economies of the country. Present research was implemented aiming to examine effect of the medical equipment maintenance management systems on the hospital setting expenditures. In an interventional research, the model of medical equipment maintenance management system implemented in Imam Khomeini Hospital was examined precisely and based on appropriate software for Vali-e-Asr Hospital was designed. According to the model for all available medical instruments in Vali-e-Asr Hospital with usage of more than 5 years [240 medical equipment]; all costs were recorded in 2006 and compared with previous year [2005]. There wasn't any training for medical equipment operators and for its implementation necessity on 21.7% of equipment in the installation and start up phase with for 83.7% of equipments the operator was not fixed using of medical equipment maintenance management system, the repair events decreased from 78 events in 2005 to 58 events in 2006. Vali-e-Asr hospital recorded costs for maintenance and repair of medical equipment in 2006 was 801765375 Rials [Iran] which decreased to 513212912 Rials [Iran] according to accurate calculation of costs and auditing by medical equipment engineer and shows 36% saving in expenditures by medical equipment maintenance management system. Medical equipment computer-based maintenance, management system implementation and also using of medical engineers potentialities in hospital are necessary

EEG signals processing for diagnosis petitmal [absence] and grandmal epilepsies using artificial neural network

Epileptic seizures are manifestation of epilepsy. Understanding of the mechanisms causing epileptic disorder needs careful analyses of the electroencephalograph [EEG] records. The detection of epileptic form discharges [spike wave] in the EEG is an important component in the diagnosis of epilepsy. Approximately one in every 100 persons will experience a seizure at some time in their life. Already intelligence spike detection method discucsed but purpose of this research is diagnosis of different kind of epilepsy [grandmal and Petitmal] by design of an intelligence diagnosis processing. In this descriptive study, 100 EEG signals of brain hemispheres from different person in healthy, interictal and ictal conditions were used. Fifty Hz noise and artifact signals were removed by soft ware procedure then signals separated by expert neurologist to three categories, healthy [frequency band 8-12 Hz], petitmal seizures [typical 3 Hz], grandmal seizures [clonic stage with 4 Hz frequency] and divided each of them to 6 seconds segments. Information of this signals [background alpha, spike and slow, poly spike and poly sharp] were extracted by wavelet transform and classified by soft ware procedure neural network to there groups healthy, ptitmal and grandmal epilepsy. In designed software accuracy of diagnosis ptitmal and grandmal epilepsies was obtained about 80%. This method introduced intelligent diagnosis of epilepsy [ptitmal and gradmal] and automatically detected healthy person from epileptic patients. One of the other advantages is help to neurologist for detection of sickness clearly and expendable different kinds of other epilepsy

[Evaluation of the effect of adjunctive use of calcium hydroxide combined with periodontal dressing on dentin hypersensitivity after periodontal surgery]

Dentinal hypersensitivity is one of the most common complications which many patients complain in different ways. Dentinal hypersensitivity is caused by the opening of dentinal tubules to an oral cavity due to fractures, attritions, etc. It is a common complications after periodontal surgery. Many treatments have been suggested for this problem, till now. Calcium hydroxide is one of the materials used for treatment of root hypersensitivity after periodontal surgery. The aim of this study was to evaluate the effect of calcium hydroxide combined with periodontal dressing on root hypersensitivity after periodontal surgery. This study was done on 30 patients with severe periodontitis who needed periodontal surgery for both quadrants in each jaw. In each patient one quadrant was treated as a test and the other side was used as a control. In the test group 90mg of Calcium Hydroxide powder mixed with 1cm of Co-pack covered the site surgical. Twenty-one patients completed the procedure After surgery, a periodontal dressing combined with calcium hydroxide covered the area on the test side. The other side was used as a control and covered with a pure dressing. After one week the dressing was removed and the amount of hypersensitivity was measured with air flow and an explorer using the visual analog scale. Data were analyzed using the Wilcoxon sign rank test. The results showed that there were not any significant differences between the two sides in root sensitivity, but Plaque index in the test sides was lower than the control side. The periodontal dressing can not be used as a carrier for calcium hydroxide to reduce root hypersensitivity after periodontal surgery. Decrease in plaque accumulation after using the combination of calcium hydroxide and periodontal dressing may accelerate surgical wound healing but further investigations are necessary

Periodontal considerations in chemotherapy of patients with head and neck cancers

Dental clinics may encounter patients who are involved with head and neck cancer and are under chemotherapy. This review discuss about oral and periodontal complications due to chemotherapy and current ways to decrease this complications. 20 articles about chemotherapy and related complications were used for this review. Periodontist has to participate before and during the treatment of patients with head and neck cancers who receive chemotherapic agents and his / her cooperation with oncologist is necessary to achieve the best results. Participation of periodontist in all treatment stages of patients with head and neck cancers is critical. Participation of periodontist is necessary before beginning of treatment of patients with head and neck cancers and this cooperation must continue during and after treatment to achieve the best results

Implantation of Octacalcium phosphate to enhance osteogenesis of alveolar ridge defect in rat mandible

Reconstruction of craniofacial bone defects remains one of the most challenging problems encountered by maxillofacial surgeons. This study was designed to investigate the process of bone formation caused by implantation of octacalcium phosphate at mandibular alveolar ridge of rat. In this experimental animal study, 20 male Sprague Dawley rats were used. Synthetic octacalcium phosphate [OCP] was implanted into the bony defect measuring 3 mm in diameter and 2 mm in depth which was surgically created with a bur in the rat mandible. Bone formation at the alveolar ridge was examined histologically between 1 and 4 weeks after implantation. Osteogenesis was initiated in the center of the defect between the OCP particles and multinucleated giant cells appeared on the implanted materials in 1 week. More apposition of new bone was observed on the implanted octacalcium phosphate in week 2. In addition to bone formation locally around the OCP particles, more apposition of new bone was observed near the defect margin in week 3. At week 4, the defect was almost completely filled with bone, which was in close contact with host bone and implanted OCP was surrounded by newly formed bone. In the control group, bone formation was observed only along and near the defect margin. Octacalcium phosphate could be used to enhance atrophic alveolar ridge or for filling a tooth socket after extraction

Identification of D-Gal and Gal/GalNac terminal sugars in basal and squamous cell carcinomas of the skin

Basal and squamous cell carcinomas comprise 90% of all skin malignancies. Cell surface and extracellular glycoconjugates change in neoplastic cells along with morphological changes of cancer cells. In many cases of malignant diseases, these changes of terminal sugars are responsible for invasive and metastatic properties of cancer cells. Recent studies have shown that the reaction of cancer cells change to lectins in course of neoplastic changes. The aim of the present study was to identify D-Gal and Gal/GalNac in basal and squamous cell carcinomas of the skin. In this descriptive study paraffin blocks of a total number of 20 patients [10 SCC and 10 BCC] were selected from pathology file of Khatam Al Anbia hospital in Zahedan. After confirmation of previous diagnosis, from each block 4 sections were prepared and stained by WGA and PNA/Alcian blue [pH=2.5]. After staining, sections were studied blindly by two persons. Histopathological reports were prepared according to staining intensity and the location of reaction to lectins. Brown precipitate in cell and extracellular matrix were recognized as positive reaction. The presence of Gal/GalNac terminal sugar was confirmed by PNA lectin in squamous cell carcinoma of the skin. The nuclei of cancer cells did not react to lectin. Cancer cells in Basal cell carcinoma did not react to WGA lectin for D-Gal terminal sugar either. The presence of D-Gal was confirmed in basal cell carcinoma. Neoplastic cells in squamous cell carcinoma did not react to WGA. It seems that in neoplastic changes, terminal sugars of glycoconjugate change with different patterns in skin malignancies, so that PNA lectin is a good marker for SCC and WGA for BCC

[ evaluation of periodontium in patient's with spastic parapareseis related to HTLVI virus]

HTLVI virus is one of human's retroviruses which is the cause of T Lymphocytes Leukemia and spastic parpareseis or HTLVI associated myelopathy and some other inflammatory diseases, in some patients. Regarding that HTLVI is an endemic virus in Khorasan and the lack of studies and researches about its intraoral clinical signs, we decided to study periodontal status in patients with HTLVI associated Spastic Paraparesis. This was a case- control study with easy sampling that performed on about 30 patients [10 men and 20 women] with the mean age of 42 years in Mashhad dental school in 2004. Patients, whose HTLV1 involvement had been proved, took part in this study. Patients were chosen among people refered to neurology Department of Mashhad Ghaem hospital. Periodontal state, gingival disease, pocket depth, presence of leukoplakia, gingival linear erythema, candida infection, ANUG, NUP, were studied and three indices including Debris, Calculus Index [Green and Vermelion] and Gingival Index [Loe and silness] were recorded. In the view of Debris, Calculus and gingival indices, there were significant differences between control and case groups but there were no significant differences between two groups in pocket depth, leukoplakia, candida infection, ANUG and NUP. The patients with HAM/TSP have higher plaque, calculus and inflammation, compered to the healthy individuals. To eliminate Plaque and prevent of gingival disease, good oral hygiene is recommended

[-vitro evaluation of periodontal dressing plus calcium hydroxide on L929 fibroblast cells]

In most cases, after the surgical procedures were completed, the area was covered with a surgical pack. Dentin hypersensitivity is one of the common problems after periodontal surgeries. Calcium Hydroxide is an inexpensive and available material used for desensitizing. The purpose of this study was to evaluate the cytotoxicity of mixture of calcium hydroxide and periodontal dressing on L929 fibroblasts. In this study Rat fibroblasts were used. For preparing extracts, we added 0, 1, 5 and 10 mg of calcium hydroxide to 1 gr of periodontal dressing. Then, they were placed in autoclave followed by 5[cc] of basal media [DMEM].A control group consisting of L929 fibroblasts plus basal media was also considered. After 24, 48 and 72 hours incubation, we examined the numbers [quantity] as well as the morphology of the cells [quality]. For quantitative evaluation [MTT assay] after adding Tetrazolium salt to cells, we read the optical density of each plate using ELISA reader. The data were analyzed statistically using chi-square and Kruskal wallis test. All of the plates had the same quality but the cells in the control group showed more proliferation. All of the plates had plenty of vital and normal fibroblasts but in comparison with the control group the cells had developed less proliferation. Statistical test analysis of the data showed a significant difference between the optical density of the experimental plates and the control group indicating that the number of vital cells in control group was significantly greater than the test groups. Because the number of active vital cells in the plates with periodontal dressing was equal to other plates but less than control group, it can be concluded that the cytotoxic effects in the different plates were related to periodontal dressing, not Calcium hydroxide

[Ultrastractural study of cells involved in the healing of the parietal bone defects after implantation of octacalcium phosphate [OCP] combined with bone matrix gelatin [BMG] in rat]

This study was designed to identify the cells involved in the healing of the parietal bone defects after implantation of octacalcium phosphate [OCP] combined with bone matrix gelatin [BMG]. Sixteen young male Sprague Dawley rats [5-6 weeks age] were used. A full thickness standardized trephine defects, 5mm in diameter, was made in the rat parietal bone and OCP combined with BMG [in 1/4 ratio] was implanted into the defect. No OCP/BMG particles were implanted in control group that was otherwise treated identically. Cellular identification was carried out on days 7th and 14th after implantation, by light and transmission electron microscopy. Ultrastractural identification of cells involved in the healing of the defects in experimental group on day 7th after implantation, showed full secretory chondroblasts and also showed the integration of newly formed matrix with the defect margins. On day 14th after implantation the results revealed the typical osteoblasts that are active in the defect margins. In experimental group, bone defects were healed through intramembranous ossification route

Review of Microbiologic Similarities of Refractory periodontitis and refractory Periapical Periodontitis

Treatment resistance cases in both endodontal and periodontal diseases are sometimes encountered in spite of a good treatment. These cases may be caused by microbial agents and / or inefficient host responses. The microbial factors need further investigation and host response in discussed in this section. Thirty two articles and two text were reviewed for this discussion. The main cause of innate and specific immune system involvement in refractory periapical periodontitis are microbial factors, where as in refractory periodontitis the bacterial factor is less prominent and cigarette smoking is considered the main factor with emotional stressors micronutient deficiency and herpesviruses being contributing factors

study of distribution and number of nucleolar organizer region [NOR] associated proteins in gastritis and gastric carcinoma

Nucleolar organizer region associated proteins are a group ofnon histone proteins which act in r-DNA transcription and r-RNAprocessing. The amount of these proteins increase in transition from G1 toS phase in cell cycle. Hence these proteins can show the proliferativeindex of the cells. Material and For this purpose 40 patients [30 gastritis, 10 carcinoma] with average age of 45 years were chosen from pathology fileof Khatam AL Anbia of Zahedan and Shiraz Namazi Hospitals during theyears 1999-2001. Paraffin blocks were cut with 3-5 um thickness andstained with H-E and colloidal silver nitrate. The number of NOR werecounted blindly by two persons. Pearson correlation test showed significant correlation of NOR counting [P < 0.001, r = 96] by two persons. Mann-Whitney test showedsignificant difference of NOR between gastritis and carcinoma. The shapeand distribution of NOR in gastritis looked like diffuse black dots in nuclei,but in neoplastic cells the number of NOR were increased and theirdistribution differed extensively. It seems that NOR number is a reliable indicator of cellularproliferation in carcinoma of the stomach