[Antimicrobial effect of Citrus aurantifolia extract on Enterococcus faecalis within the dentinal tubules in the presence of smear layer]

Instrumentation of the root canals results in formation of smear layer which covers the dentinal tubules. In infected teeth, it is ideal to achieve a material that has the ability to remove the smear layer besides antimicrobial activity. Therefore, this study was designed to evaluate the antimicrobial effect of Citrus aurantifolia extracts [lime juice and rind extract] on Enterococcus faecalis within dentinal tubules in the presence of smear layer. One-hundred and forty dentin tubes were prepared from bovine incisors. After removal the smear layer, the specimens were infected with Enterococcus faecalis. Then, the smear layer was reformed. Test solutions were used as the irrigants in study groups as follows: group 1: 5.25% NaOCl; group 2: 17% EDTA; group 3: NaOCl+EDTA; group 4: Lime juice; group 5: ethanolic rind extract of C.aurantifolia; group 6: 96% ethanol. Dentin chips were collected from inner and outer layers of dentinal walls and optical density was measured. The data were analyzed using one-way ANOVA and Tamphane tests. In outer layer of dentin, the efficacy of rind extract was less than that of NaOCl+EDTA [P<0.05]. Also Lime juice was less effective than EDTA, NaOCl and NaOCl+EDTA [P<0.05]. In inner layer of dentin, Lime juice was significantly less effective than NaOCl and NaOCl+EDTA [P<0.05]. The efficacy of rind extract was less than that of NaOCl + EDTA [P<0.05]. In the presence of smear layer, the antimicrobial activity of Lime juice was less than that of NaOCl but the efficacy of rind extract was similar to that of NaOCl

[Managemental Prioritization of the factors related to patient's satisfaction in hospitals of Rafsanjan]

Nowadays, health and primary health care services are of great importance in all countries regardless of their size and wealth. So health authorities have been trying their best to provide higher and more qualified health care services to ensure that they meet the commitments of the patients to their utmost satisfaction. At the present time, the efficiency of health organizations is assessed using therapeutic indices and the rate of patient's satisfaction. In the modem competitive world, raising the quality of health care is one of the major factors in gaining patients' satisfaction and is a top managerial priority. Therefore, recognizing and understanding factors, affecting patient's wellbeing can guarantee public health and make sure that every patient received the best possible primary and secondary health care. The aim of this study was to find the possible relationship between the patients' satisfaction and the quality and quantity of health care services and to prioritize them. 108 patients admitted to all general wards in Rafsanjans hospitals were included in this research. The patients were questioned using a packed questionnaire and the data were then analyzed with use or relevant statistical methods [abundance tables, graph and percent, X2, Espierman and Kendal, kroskal valis, Manvitini test]. Our findings revealed that there was a direct relationship between the rate of patient's satisfaction and the quality of a health care given to them; I.e. Patients received better service and felt more valued, they found more satisfaction. Also in responding to service recovery, the fastest response to their complains with the shorter waiting list resulted in more satisfaction. Based on these findings, we suggest that health authorities should try their best to find the best ways in providing better care for patients in order to gain their maximum satisfaction based on the existed resources

Evaluation of the laparoscopic adrenalectomy results

Laparoscopic adrenalectomy is the operation of choice for benign adrenal lesion. We report of our experience in laparoscopic adrenalectomy that were performed for first time in Tabriz. From September 2003 to September 2005, six patients with adrenal lesions underwent laparoscopic adrenalectomy through transperitoneal approach. Two of them were simultaneous bilateral adrenalectomy. Preoperative evaluation including CT Scan, MRI, MIBG scan, endocrine tests such as, cortisol, ACTH, mineralocorticoid, 17- hydroxy progesterone and VMA .The results were analyzed by SPSS. Six patients, [3 females and 3 males], underwent on laparoscoic surgery. Mean age was 40.2 [range 30-65] years. Lesion was located at right in 5 patients and 3 at left. Mean operative time was 180 +/- 30.62, [126-300], minutes. Mean hospitalization was 3.1 [3-5] days. Mean size of mass was 4.5 +/- 1.8 [4-8] cm. In one case, because of the adhesion of mass to the posterior side of venacava, convertion was necessary. No significant major intra or post operative complication and we didn't need to transfusion. At the 9 months following, hormonal tests and blood pressure were normal. The mean postoperative follow up time were 9 [range 3-24] months. Due to our limited experience on advanced urologic laparoscopy this study showed that transperitoneal laparoscopic adrenalectomy is an effective and safe approach in the treatment of adrenal disorders with the least morbidity

Transcutaneous ultrasound guided nephrolithotomy: the first report from Iran

To evaluate the safety and efficacy of transcutaneous ultrasound guided nephrolithotomy. From December 1999 to December 2000, 12 patients with renal stone were selected for PCNL. Six patients had failed ESWL and the remainder had multiple and large stones in pelvis and lower calyx. Ultrasonography was used in 11 patients during the entrance to the system and dilatation of the tract. Entrance to the system was impossible in one case for which open surgery with dorsal lumbotomy was performed. The stone was removed by just one session of PCNL in 8 and the residual stone was less than 1 cm in the 3 other cases. Repeated PCNL from the same tract was performed in one case and ESWL was carried out in the other 2 cases. After three months, all of the 11 patients were stone free. It seems that ultrasonography could replace fluoroscopy in patients with dilated collective urinary system and a single large stone in calyx or pelvis