[ efficacy of CBCT for diagnosis and treatment of oral and maxillofacial disorders: a systematic review]

Cone Beam Computed Tomography [CBCT] has the ability to accomplish rapid volumetric image acquisition by its cone-shaped beam. The aim of this study was to evaluate the safety and efficacy of this imaging modality A standard systematic review was performed. Medline [December 2012] and The Cochrane Library [Issue 3 2012] were searched to identify evidence about the performance [sensitivity, specificity and safety] of CBCT compared with other standard diagnostic methods. The results of the included studies were analyzed using a qualitative method Thirty-one articles were included in the study; the majority of them were diagnostic studies with a small sample size [n<10]. There was limited evidence about the effectiveness of this technology and the available evidence was scattered and sometimes controversial. At present, CBCT technology has greatly advanced and its image quality in terms of resolution is higher than that of MOCT. However, its contrast resolution is still lower than that of MOCT. Therefore, MOCT is preferred for soft tissue imaging. For evaluation of hard tissue in the maxillofacial region, a more clear image with higher resolution can be obtained by CBCT. CBCT technology is now commonly used in developed countries for obtaining detailed information regarding the oral and maxillofacial region and can greatly help clinicians in diagnosis and treatment of maxillofacial disorders

[Pathological study of arthritis induced by type 2 bovine collagen and freund's complete adjuvant in rat]

Because of the pathological similarities between collagen induced arthritis [CIA] and rheumatoid arthritis, the CIA model has been the subject of extensive investigations. This study initiated to evaluate the pathologic lesions of induced arthritis by collagen in a total of 50 female rats [Rattus norvegicus.]. Arthritis was induced by two intrademial injections [14 days interval] of type 2 bovine collagen solution and Freund's complete adjuvant [FCA] into the tail and right leg paw of 40 rats. Severity of arthritis in affected leg was represented in grade to 4. Three weeks after beginning of the experiment, 22, 12, 5 and 1 affected rats were clinically diagnosed with 1, 2, 3 and 4 grades of arthritis respectively. Rats were intradermally injected into the tail showed only slight and moderate [grade 1 and 2] arthritis. Macroscopically, the involved joints were enlarged, swollen and stiff and deformity and ankylosis of affected joints were noticed in severe cases. Deep healing ulcers in planter of the paw were diagnosed in 14 rats. Histopathologic examinations revealed infiltration of mononuclear inflammatory cells and papillary hyperplasia of synovial membrane in mid and moderately affected animals [grade 1 and 2] and erosion of articular cartilage with formation of fibrovascular pannus on its surface in synovial membrane in severe cases [grade 3]. In very severe cases [grade 4], complete destruction of articular cartilage and access of granulation tissue to subchondral bone were noticed. Pathologic lesions of the involved joints were very similar to those reported from rheumatoid arthritis in human, erosive polyarthritis in dog and caprine arthritis/encephalitis

[Patients' satisfaction in first rank hospitals of Tehran university of medical sciences: a cross-sectional study in 2009]

Patients' needs should be acknowledged properly in order to enable hospitals to take responsibility for their expenses. In this study, patients' satisfaction is assessed in various fields which are key elements of hospitals assessment program. In this cross-sectional study, 120 consecutive patients which are randomly selected from Hospitals affiliated to Tehran University of Medical Sciences [TUMS] were enrolled. A questionnaire was completed for their demographic, occupational, insurance status and their satisfaction of clinical services, nutrition, hospital environment and hospital facilities. The age range of participants were11 to 80 years old; 61.9% were females and 38.1% were males. Overall, 78.1% were satisfied in respect to hospitals general status while there were significant differences considering satisfaction in hospital environment and facilities, clinical services and nutrition among recruited hospitals. A strong correlation between the index of hospital environment and patients' satisfaction signifies further enhancements of hospital environment which could potentially increase patients' satisfaction. Also, the relationship between patients well being and satisfaction indicates health care staff role should be emphasized for patients' appreciation. Consequently, hospital administration should focus on current unsatisfied sections to improve health care quality

effect of introducing evidence based medicine on critical appraisal skills of medical students

Evidence Based Medicine [EBM] is a set of methods and resources for finding and employing the best evidences among present resources in order to manage each patient. The aim of this study was to assess the effect of an introductory course of EBM on critical appraisal skills of medical students. This Randomized Clinical Trials [RCT] was performed on clerkship students in Tehran University of Medical Sciences in 2007. Thirty-five clerkship medical students enrolled in a two day EBM workshop in students' Scientific Research Center of Tehran University of Medical Sciences. Each participant filled out a standard questionnaire before and just after the workshop. Paired t-test was used to compare participants' responses to the questions before and after the workshop. According to the findings, a significant change was observed in critical appraisal skills of medical students after the intervention. A short-term introductory course on EBM may increase critical appraisal skills of medical students effectively

[Determining the frequency of neonatal sepsis based on premature rupture of membrane [PROM] -scoring system at Mahdieh Hospital in Tehran]

Premature rupture of membranes [PROM] increases the rate of neonatal sepsis. Using a clinical guideline for initiating the laboratory evaluation and treatment of such neonates, for instance PROM-Scoring system, particularely in developing countries in which the availability of rapid and accurate clinical conveniences are limited, may surprisingly result in reducing the antibiotic consumption, hospital charges and neonatal morbidity. We performed this survey to outline these issues. In this cross-sectional study 270 newborns of whom were born 18 hours or more after PROM were enrolled and studied at Mahdieh hospital for a one year period. The neonates underwent a thorough evaluation and the symptomatic ones were treated for sepsis, whereas the asymptomatc newborns and the ones with a PROM score of less than 3 went under a in-hospital supervision for 3 days. Among the studied newborn, 79 cases were symptomatic and 199 were symptom free. The threshold score of 3 was of an accurate specificity [100%] in diagnosing the affected infants. All the asymptomatic ones have a score below 3. Five cases developed several symptoms mostly during their first 12 hours of lives whom were considered as having sepsis and, therefore, were assessed and treated. None of asymptomatic cases were referred again after their discharge thus far. 14 neonates [5.2%] who all weighed less than 2500gr, died due to either RDS, Asphyxia or congenital anomalies. Based on the achieved results we suggest all the symptomatic newborns and the asymptomatic ones with PROM score of above 3 to be precisely evaluated and consequently treated for sepsis, whereas for asymptomatic infants with a score of less than 3 a 24-72 hours of in-hospital supervision is sufficient

Autoantibodies against thyroid constituents and CIC in Graves' disease associated with exophthalmos

32 patients [19 female, 13 male]- suffering from Graves' disease with exophthalmus and five without exophthalmus were studied for various autoantibodies including anti-thyroglobulin [ATAB], anti-microsomal antibody [AMAB], anti-parietal antibodies [APAB] and also circulating immune complex [CIC]. 43 normal subjects were tested concurrently. Immunofluorescent technique was employed for autoantibody detection. Frozen sections of human thyroid tissue and rat stomach were utilized as antigen sources for thyroid and parietal CIC estimated by PEG [polyethylene glycol] precipitation method and the specific classes of immunoglobulins were detected by SRID [single radial immunodiffusion]. The results were analyzed statistically. From the point of view of presence of antibodies, there were significant differences between patients and control groups [P= 0.005]. Comparing Graves' with or without exophthalmus, no significant difference was seen between autoantibody levels, but higher titers of CIC were elucidated in the latter group. We will discuss that autoantibodies have an important role in thyroid autoimmune diseases and also that CIC may have a critical role in the pathogenesis of exophthalmus associated with Graves' disease

Anti-endothelial cell antibodies and circulating immune complexes, a possible prognostic tool in IDDM angiopathy

52 patients suffering from IDDM [insulin-dependent diabetes mellitus] were studied for anti-endothelial cell antibodies [AEA] and circulating immune complexes [CIC]. 20 had a high CIC level, and eight demonstrated AEA, of whom five had retinopathy and three did not show any obvious vascular complication. It has been shown that C3, C4 and CH5O levels were also decreased. AEA were evaluated by indirect immunoflourescent technique, using rat pancreas tissue as the antigen. To estimate the CIC level, PEG precipitating method was used. It was suggested that by demonstrating AEA, we will be able to evaluate the prognosis of IDDM, especially the long standing phase, with no vascular complication

possible role of IgE in the pathogenesis of minimal change nephrotic syndrome [MCD]

The concentration of IgE was measured in the serum of 39 children with Minimal Change Disease [MCD], 22 suffering from other renal diseases and 55 normal controls. Those children with MCD had significantly higher IgE levels than children with other forms of renal disease. [P < 0.05]. The high mean IgE levels in patients with MCD noted above along with the other previously reported presence of IgE in glomeruli of MCD patients suggest that IgE may play a role in the pathogenesis of this disese. The exact mechanism by which this might occur should be further investigated