Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

Assessing consequences of untreated dental caries using pufa/PUFA index among 6–12 years old schoolchildren in a rural population of Kerala

Context: Dental caries is the most common dental disease of childhood. India with a population of more than 135 crores accounts for a high proportion of dental morbidity. Poor oral health has a significant impact on quality of life, especially in rural areas. The consequences of untreated dental caries include pain, abscess, and space infections which may lead to loss of function and school hours. These consequences are of utmost important while planning a community dental care program. Aims: To assess the prevalence of dental caries, caries experience, and severity of dental caries among 6–12 years old schoolchildren in the rural areas of Kollam District, Kerala State. Settings and Design: A community school-based, descriptive, cross-sectional study in the rural areas of Kollam District. Materials and Methods: A cross-sectional study was carried among 2194 schoolchildren in the rural areas of Kollam District in the age group of 6–12 years. Children from eight randomly selected schools were examined for pufa/PUFA and dmf/DMF indices. Statistical Analysis Used: SPSS version 17.0, Mann-Whitney, t-test, KruskalWallis test. P < 0.05 was considered statistically significant. Results and Conclusions: Overall caries prevalence among the total population was found to be 74%. The prevalence of caries in the deciduous dentition was 61% and a mean decayed, missing, filled teeth value of 2.74 ± 3.200 and for the permanent dentition the caries prevalence of 26.8% and a mean Decayed, Missing, Filled Teeth of 0.66 ± 1.360 were observed. The prevalence of untreated dental caries (pufa/PUFA) was 40.8%. The pufa prevalence in deciduous dentition was 38.3% with a mean pufa of 0.99 ± 1.679. Moreover, the PUFA prevalence in permanent dentition was 4.1% with a mean PUFA of 0.06 ± 0.349. The highest prevalence of untreated dental caries (pufa/PUFA) was found in the 7 years' age group (52%) and the lowest in 12 years' age group (22.4%).

HIV/AIDS antiretroviral treatment and its influencing factors in Yining of Xinjiang / 公共卫生与预防医学

Objective To investigate the current status and its influencing factors of ART coverage and VL inhibition rate of HIV/AIDS in Yining City, Xinjiang, and to provide reference for AIDS prevention and treatment. Methods The ART data for 2017-2019 years in Yining, Xinjiang was retrieved from the National AIDS Antiretroviral Treatment Information System, to analyze the changing trend of ART coverage rate and VL inhibition rate of HIV/AIDS. Logistics regression model was used to analyze the influencing factors of untreated HIV/AIDS and uninhibited VL. Results The coverage rate of antiviral treatment in Yining city from 2017 to 2019 was 73.39%, 78.06% and 87.03%, respectively. The inhibition rates of VL were 83.91%, 85.05% and 86.09%, respectively, showing an increasing trend year by year. Female, other transmission routes, positive sexual partner detection, and testing and special investigation reduced the risks of untreated HIV/AIDS, while other domicile locations, non-marital and non-commercial heterosexual contact, and unawareness of their own VL increased the risks of untreated HIV/AIDS. Female, 26-35 years old, 36-45 years old, 46~55 years old, >55 years old, primary school, junior high school, high school or technical secondary school, junior college or above, and male-male sex behavior reduced the risks of unsuppressed VL of HIV/AIDS, while other domicile locations, non-marital and non-commercial heterosexual contact, and unawareness of their own VL increased the risks of unsuppressed VL in HIV/AIDS. Conclusion The ART coverage rate and VL inhibition rate in Yining, Xinjiang rise year by year, approaching the expected target. Targeted education and supervision should be conducted to promote the realization of “90-90-90” in 2020 and “95-95-95” target in 2030.

Impact of duration of untreated psychosis on remission in first-episode schizophrenia in Thailand: a cohort study

ABSTRACT Background: To scale up the services for first-episode schizophrenia in Thailand, it is essential to understand to what extent health care-seeking is delayed, and how much the delay affects the treatment outcome. Objectives: To investigate the duration of untreated psychosis (DUP) and its impact on remission in first-episode schizophrenia across the country. Methods: 276 outpatients with a first-episode schizophrenia were followed for 6 months and assessed whether they fulfilled the criteria for remission at the follow-up. The proportion of those achieving remission was compared by the DUP. The impact of DUP on remission was estimated in multivariate analyses. Results: At the follow-up, 83% (71/86) of patients who had met the criteria for symptomatic remission at the baseline achieved enduring remission, whereas 63% (119/190) of patients who had not met the criteria for symptomatic remission at baseline met it at the follow-up. The shorter the DUP, the higher the proportion of those who achieved symptomatic or enduring remission at the follow-up. The impact of DUP on symptomatic remission appeared to be significant after controlling for other factors influencing remission. Conclusion: Since the DUP would influence remission of patients with schizophrenia, early detection and intervention services should be provided in Thailand.

A simplified approach for anaesthetic management of diagnostic procedures in children with anterior mediastinal mass

INTRODUCTION@#Children with an anterior mediastinal mass (AMM) need general anaesthesia (GA) or deep sedation for diagnostic procedures more often than adult patients. Anaesthetic management to prevent such complications includes maintenance of spontaneous ventilation (SV) and prebiopsy corticosteroids/radiotherapy.@*METHODS@#We reviewed the medical records of children with AMM who were brought to the operating theatre for diagnostic procedures (prior to chemotherapy) between 2001 and 2013. Our aim was to describe the clinical features, radiological findings and anaesthetic management, as well as determine any association with complications.@*RESULTS@#25 patients (age range 10 months-14 years) were identified during the study period. Corticosteroid therapy was started before the biopsy for one patient. All 25 patients had GA/sedation. A senior paediatric anaesthesiologist was involved in all procedures. Among 13 high-risk patients, SV was maintained in 11 (84.6%) patients, ketamine was used as the main anaesthetic in 8 (61.5%) patients, 6 (46.2%) patients were in a sitting position and no airway adjunct was used for 7 (53.8%) patients. There were 3 (12.0%) minor complications.@*CONCLUSION@#Based on our results, we propose a simplified workflow, wherein airway compression of any degree is considered high risk. For patients with high-risk features, multidisciplinary input should be sought to decide whether the child would be fit for a procedure under GA/sedation or considered unfit for any procedure. Recommendations include the use of less invasive methods, involving experienced anaesthesiologists to plan the anaesthetic technique and maintaining SV.

Perfil clínico epidemiológico de salud oral en comunidades nativas peruanas / Clinical epidemiological profile of oral health in Peruvian native communities

Introducción: Las comunidades nativas forman uno de los grupos humanos más olvidados donde se reagudizan las inequidades y desigualdades en salud oral. Objetivo: Determinar el perfil clínico epidemiológico de salud oral en pobladores de las comunidades nativas de Potsoteni, Boca Sanibeni y Unión Puerto Ashaninka del distrito de Mazamari, provincia de Satipo, departamento de Junín, Perú. Material y Métodos: Se realizó un estudio observacional descriptivo de corte transversal. La muestra estuvo integrada por 169 adultos de las comunidades nativas, se tomaron en cuenta criterios de inclusión y exclusión, y se siguieron las normas éticas en investigación científica. Se evaluó la salud oral mediante una ficha epidemiológica con los indicadores: Índice CPOD, índice de significancia de caries dental (SIC), índice de higiene oral simplificado (IHO-S), índice de necesidad de prótesis dentales de la OMS, clasificación de maloclusión de Angle, índice de consecuencias clínicas de caries no tratadas (PUFA), la evaluación fue realizada con luz natural por observadores calibrados. Los datos se analizaron en el programa STATA v 14 mediante tablas de distribución de frecuencias y figura. Resultados: El 100 por ciento de los pacientes estudiados tenía caries dental (CPO-D = 13,23; SIC=19,01), IHO-S: 5,02 (DS=0,51), la mayoría presentó un tipo de maloclusión y consecuencias clínicas de caries no tratadas 116 (68,63 por ciento ) y 115 (68 por ciento ) respectivamente, la prótesis dental unitaria fue la que más se necesitó en ambos maxilares. Conclusiones: El estado de salud bucal fue preocupante, es necesario fomentar políticas que permitan un mejor acceso a los servicios de salud a fin de revertir estos indicadores(AU)

Introduction: Native communities are one of the most forgotten human groups where inequities and inequalities in oral health are exacerbated. Objective: To determine the epidemiological and clinical profile of oral health in residents of the native communities of Potsoteni, Boca Sanibeni and Union Puerto Ashaninka of Mazamari district, Satipo province, Junín department, Peru. Material and Methods: A cross-sectional descriptive observational study was conducted. The sample consisted of 169 adults from native communities who fulfilled inclusion and exclusion criteria, following the ethical norms in scientific research. Oral health was evaluated through an epidemiological fact sheet with the following indicators: DMFT index, Significant Caries Index (SCI), simplified oral hygiene index (OHI-S), prosthetic need WHO index, classification of Angle malocclusion, and index of clinical consequences of untreated dental caries (PUFA). The evaluation was made with natural light by calibrated observers. The data was analyzed in the STATA v 14 program by means of frequency and figure distribution tables. Results: It was determined that 100 percent of the patients studied had dental caries (DMFT = 13.23, SCI = 19.01), OHI-S: 5.02 (SD = 0.51), the majority of them presented a type of malocclusion and clinical consequences of untreated caries; 116 (68.63 percent) and 115 (68 percent), respectively. The unitary dental prosthesis was the most needed in both jaws. Conclusions: The state of oral health was worrisome; it is necessary to promote policies that allow better access to health services in order to revert these indicators(AU)

An approach to risk isolation for relatively low-incidence conditions: An Australian national model of oral cellulitis

@#The purpose of this study was to develop a risk indicator applicable on a national level, to isolate at relatively highresolution, regions where oral cellulitis risk is high. The method used ten years of Western Australian (1999 to 2008) hospitalisation data, and applying the admission risks gleaned from this database (poverty, socioeconomics, age and Indigenous status) to model across Australia (at SA1 level) the risk profile. Five levels of oral cellulitis risk (low to very high) were mapped to each of the 54,000 SA1s that makeup Australia. Cumulative percentage analysis was used to study the effect of distance from capital city of each state on the number of population at high risk. Highest risk category (category 5) SA1s were not equally distributed amongst States, with the Northern Territory having 12.2% of its population (26011) belonging to category 5 (very high risk). The majority of that population (87.8%) live more than 100km away from the capital city, Darwin. A general trend amongst Australian capital cities was the low number of population at high risk within 5 km from General Post Office (GPO)

The Impact of General Medical Conditions in Obsessive-Compulsive Disorder

OBJECTIVE: The co-occurrence of general medical conditions (GMCs) and major psychiatric disorders is well documented. The aim of this study was to assess the prevalence of GMCs in patients with a primary diagnosis of obsessive-compulsive disorder (OCD) and, secondly, to investigate which clinical variables are associated with the presence of a GMC. METHODS: Subjects with a primary diagnosis of OCD were included. Socio-demographic and clinical characteristics were collected. GMCs were classified using the ICD-10 and grouped according to the Cumulative Illness Rating Scale (CIRS) in: cardiac, vascular, hematopoietic, respiratory, ear/nose/throat, upper and lower gastrointestinal, hepatic, renal, genitourinary, musculoskeletal, neurologic, endocrine/metabolic. The association between the presence of GMCs and demographic/clinical variables of OCD was investigated. RESULTS: A total of 162 patients with OCD were included. 78 (48.1%) patients had at least one comorbid GMC. Most frequent GMCs were endocrine/metabolic diseases (25.9%), followed by upper/lower gastrointestinal (20.5%) and cardio-vascular diseases (13.6%). The presence of a GMC was significantly associated with female gender, older age, duration of untreated illness (DUI), and absence of physical activity. CONCLUSION: Patients with OCD have high rates of comorbid GMCs. A longer DUI is associated with having at least one GMCs; this might be due to the long-lasting adoption of unhealthy lifestyles, not counterbalanced by appropriate treatment and psychoeducation.

Safety and Efficacy of B-domain Deleted Third Generation Recombinant Factor VIII (GreenGene F™) in Korean Patients with Hemophilia A: Data from a Post-marketing Surveillance Study

BACKGROUND: New B-domain deleted third generation recombinant factor VIII (FVIII; GreenGene F™, beroctocog alfa) was launched in 2010. We determined safety and efficacy of GreenGene F™ during routine clinical practice in patients with hemophilia A over a period of 12 months. METHODS: From July 2010 to July 2014, a total of 136 hemophilia A patients were enrolled in a post-marketing surveillance (PMS) study. Among them, 134 patients were assessed for drug safety and 114 patients were analyzed for drug efficacy. Patients with differing hemophilia A severities and medical histories were monitored during 12 months of prophylactic and/or on-demand therapy. RESULTS: Among 134 patients evaluated, 85 (63.4%) had severe hemophilia. Ninety-two received a total of 1,266,077 units for prophylaxis, and 42 received 516,491 units for bleeding episodes. Three patients developed inhibitors. In 112 previously treated patients, one patient (0.9%) developed inhibitor after intensive FVIII treatment for surgery. Among 22 previously untreated patients, inhibitors were observed in 2 infants (9.1%). Overall, there were a total of 47 adverse events (other than inhibitors) of all types in 30 patients (22.4%), 11 in 10 patients (7.5%) of which were considered showing serious adverse events (SAEs); most of which were hemorrhages at different sites. None of the SAEs were judged as product related. An excellent/good efficacy rate of 91.3% for hemostasis and 89.4% for hemorrhage prevention was recorded. CONCLUSION: The results of this PMS study support the use of GreenGene F™ as safe and efficacious in hemorrhage prevention and treatment of hemophilia A. These results are consistent with the findings from previously published GreenGene F™ studies.

Influence of duration of untreated psychosis on cognition and social function in first-episode drug-na?ve schizophrenia / 中国神经精神疾病杂志

Objective To explore the influence of duration of untreated psychosis (DUP)on cognition and social function in first-episode drug-na?ve schizophrenia. Methods Ninety-three first-episode drug-na?ve schizophrenic were enrolled as the schizophrenia group and 93 normal people served as the control group. The Positive and Negative Symptoms Scale (PANSS) were used to assess the degree of mental symptoms. The Matrics Consensus Cognitive Battery (MCCB) was used to evaluate the cognitive function. Personal and Social Performance Scale (PSP) and the Global Assessment Function Scale (GAF) were used to evaluate the social function. Result There were significant differences in scores of Trail Marking Test, Symbol Coding test, Category Fluency test, Stroop color word test, Continuous Performance Test, Spatial Span test, Brief-Visuospatial Memory Test-Revised (HVLT-R), Brief-Visuospatial Memory Test-Revised (BVMT-R) and Maze test between the schizophrenia group and the control group (all P<0.05). There were significant differences in scores of GAF and PSP between the schizophrenia group and the control group (all P<0.05). DUP was negatively related to the score of HVLT-R2 (r=-0.265, P=0.010) or BVMT-R3 (r=-0.328, P=0.001). DUP was negatively related to the scores of GAF score(r=-0.292,P=0.005)or PSP score(r=-0.397,P<0.001). Conclusion There are social function impairment and a wide range of cognitive function impairment in the first-episode drug-na?ve schizophrenic. The length of the DUP is associated with the severity of the social functional and cognitive functional impairment.

Factors affecting duration of untreated psychosis – A retrospective study done in general hospital setting

Background: Duration of the untreated psychosis has been predicted to be one of a factor which affects the outcome of disease and leading to poor prognosis in the patients. Previous studies had predicted that the longer the duration of psychosis the poor the outcome of the treatment. Aim: To assess the factors affecting the Duration of untreated psychosis among patients with first episode psychosis in General hospital setup. Materials and methods: Retrospective study was done on patients who got admitted for the duration of 6 months (1st June 2014 to 31st November 2014). Patients who were diagnosed to have first episode psychosis according to ICD-10 were taken up for the study. Duration of untreated psychosis and the socio demographic details were noted. Results: The duration of untreated psychosis was seen more in male (58%), 45% in age group of 20- 29, 54% were married, 71% in lower middle economic status, 75% of people were from semi urban background and 41% of patients had duration of untreated psychosis for duration of 2-5 weeks. Mean average age is 30.75 and duration of untreated psychosis is 40 days. Conclusion: Mean average age is 30.75 and duration of untreated psychosis is 40 days. Age, gender, marital status, socio-economic status and residence (Environment) acting as a predictor for the long DUP is consistent with previous studies but significant findings couldn’t be found, when two groups Ananthi B, Sabari Sridhar O.T., Kailash S, Shajahan M Ismail, Srinivasan B. Factors affecting duration of untreated psychosis - A retrospective study done in general hospital setting. IAIM, 2017; 4(3): 10-14. Page 11 were compared thus giving the conclusion that Sociodemographic factors alone doesn’t influence on DUP

Neurocognitive Dysfunction in Patients with Obsessive-Compulsive Disorder in Association of Duration of Untreated Illness : A Preliminary Study

OBJECTIVES: Obsessive-compulsive disorder (OCD) is a chronic and disabling psychiatric disorder. The duration of untreated illness (DUI) has been suggested as one of the predictors of clinical course and outcome in various psychiatric disorders. There is increasing evidence that cognitive dysfunction is associated with the prognosis of OCD. The aim of this study was to investigate the influence of DUI on the neurocognitive functions in patients with OCD. METHODS: Sixty-two patients with a DSM-IV diagnosis of OCD from the outpatient clinic were included in this study. We defined the short DUI if the DUI was 2-year or less and the long DUI if it was longer than 2-year. Neurocognitive functions were assessed by visuospatial memory function test and 4 subsets of K-WAIS such as vocabulary, arithmetic, block design and picture arrangement. Differences in neurocognitive functions as well as clinical variables between OCD patients with short DUI and those with long DUI were investigated. Correlation analyses were also performed to determine the correlation between DUI and neurocognitive functions. RESULTS: Compared with the short DUI group, the long DUI group performed worse in the block design test, which measures executive function. The long DUI group also had a higher level of compulsive symptom severity than the short DUI group. However, the DUI was not correlated with neurocognitive functions. CONCLUSIONS: Findings in this preliminary study suggest that the long DUI in patients with OCD is associated with more severe executive dysfunction. Studies with larger samples and longitudinal design are needed to further confirm the prognostic role of the DUI in OCD.

Effects of Group Cognitive-Behavioral Therapy in Young Patients in the Early Stage of Psychosis

OBJECTIVE: To develop a model of group cognitive-behavioral therapy (CBT) for Korean patients with early psychosis. METHODS: The group CBT utilized in the present study consisted of metacognitive training, cognitive restructuring, and lifestyle managements. The Subjective Well-being Under Neuroleptics (SWN-K), Ambiguous Intentions Hostility Questionnaire (AIHQ), Drug Attitude Inventory (DAI), Beck Depression Inventory (BDI), Perceived Stress Scale (PSS), and Clinical Global Impression (CGI) were administered prior to and after CBT sessions. The participants were categorized into two groups according to the median duration of untreated psychosis (DUP; 4 months). RESULTS: A total of 34 patients were included in this analysis. From pre- to post-therapy, there were significant increases in the SWN-K and DAI scores and significant decreases in the hostility subscale of the AIHQ, PSS, and CGI scores. Significant time × DUP interaction effects were observed for the SWN-K, DAI, and BDI scores, such that there were significant changes in patients with a short DUP but not in those with a long DUP. CONCLUSION: The group CBT program had a positive effect on subjective wellbeing, attitude toward treatment, perceived stress, and suspiciousness of young Korean patients with early psychosis. These effects were particularly significant in patients with a short DUP.

Late presentation of ALCAPA syndrome in an elderly Asian lady

Coronary artery anomalies are often discovered incidentally during cardiac catheterization or computed tomography coronary angiography and may involve the affected coronary artery origin and its course. Coronary artery anomalies are associated with congenital heart disease. The affected coronary arteries may have an unusual high take off origin, origin from contralateral or non-coronary sinus, origin from the pulmonary artery, single coronary system or coronary artery fistula.

Duration of untreated psychosis and the related factors among Tibetan patients with schizophrenia in Qing- hai / 中国神经精神疾病杂志

Objective To study related factors of the duration of untreated psychosis (DUP) in Tibetan patients with schizophrenia in Qinghai Province. Methods The related factors on DUP were investigated in totally 188 Tibetan pa?tients with schizophrenia using questionnaires of mental health services and symptom onset for schizophrenia. All the Ti?betan patients were provided with the National Continuing Management and Intervention Program for Psychoses (686 Pro?gram). Results The median (low quartile, upper quartile) of DUP in Tibetan patients with schizophrenia was 375 days (4 days, 1661 days). The patients were divided into short DUP group (DUP≤375days, 90 patients) and long DUP group (DUP>375 days, 98 patients). There were significant differences in mode of onset,marital status, educational level, family type, place of residence between short DUP group and long DUP group (P<0.05). Logistic regression analysis found that lack of family structure (OR=2.340, 95%CI:1.130~4.847, P=0.022), chronic onset (OR=2.136, 95%CI:1.172~3.891, P=0.013) and living in pastoral areas (OR=2.239, 95%CI:1.097~4.571, P=0.027) were risk factors of DUP. Conclusion Ti?betan patients with schizophrenia have a longer DUP and related risk factories of DUP are lack of family structure, chron?ic onset and living in pastoral areas.

Chronic Irreducible Anterior Dislocation of the Shoulder without Significant Functional Deficit

Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint. However, there are cases of even greater rarity in which chronic shoulder dislocations are asymptomatic with minimal functional or structural degeneration in the joint. These patients are usually left untreated, and most show good tolerance to their condition without developing disabling symptoms or significant functional loss over time. We report on one such patient who had a chronic shoulder dislocation for more than 2 years without receiving treatment.

Correlation Between Naso Labial Angle and Effective Maxillary and Mandibular Lengths in Untreated Class II Patients.

The soft tissue profile is one of the main concerns of orthodontic treatment. Naso labial angle (NLA) is one of the soft tissue cephalometric parameters being routinely analyzed in orthodontic diagnosis and treatment planning. A study is undertaken on the correlation of naso labial angle to effective maxillary and mandibular lengths, in patients with class II malocclusion. The mean NLA and maxillary and mandibular lengths in males and females with class II malocclusion and also the mean NLA for subjects in the different categories of crowding (Category 1 and Category 2) in patients with class II malocclusion is presented in the results. Positive correlations observed between NLA and maxillary and mandibular lengths were statistically not significant.

Assessing consequences of untreated carious lesions using pufa index among 5-6 years old school children in an urban Indian population.

Background: Dental caries is a major chronic noncommunicable disease affecting whole of mankind. Nontreatment of caries can have severe consequences such as pain, abscess formation, space infection, etc., which leads to loss of function, working hours or absence from school in children. These consequences are equally important, while planning dental care program for a community. Aim: The aim of this study is to assess the prevalence and severity of consequences of untreated carious lesions using pufa index that is, pulpal involvement, and ulcer due to root fragments, fistula, and abscess index among 5-6 year old school children in an urban Indian population. Materials and Methods: A cross-sectional survey was conducted on 603 school going children of 5-6 year age group in mainly an urban Indian population. Children from 12 randomly selected schools were examined for pufa and decayed extracted filled indices. Results and Conclusions: Overall mean pufa value was 0.9 ± 1.93 and prevalence was 38.6% with major contribution from P component of index. Untreated caries ratio was 35%, suggesting that more than one-third of the developed carious lesions cause adverse events in a population. This study emphasis the need for treating dental caries at its earliest possible stage to avoid severe consequences. The pufa index can be used as tool to highlight these adverse consequences to dental professionals and health authorities.

Mutation analysis of hepatitis B virus reverse transcriptase region among untreated chronically infected patients in Ahvaz city (South-West of Iran).

Background: It has been revealed that mutations can occur spontaneously and naturally in HBV reverse transcriptase (RT) region among untreated patients. These HBV mutants pre-exist as minor viral population in naive patients and can emerge as major viral population, conferring drug resistance and treatment failure. Objectives: The aim of this study was to investigate and identify prevalent mutations of RT region of hepatitis B virus genome in patients with chronic hepatitis B (CHB) untreated with antiviral drugs in South-West of Iran. Materials and Methods: A total of 45 cases with CHB who did not receive the treatment of lamivudine and any other antivirus drugs within the last one year were randomly chosen. After sample collection and HBV DNA extraction, RT region was amplifi ed by polymerase chain reaction (PCR). Then PCR products were sequenced and HBV RT region mutations and amino acid changes were analyzed either manually or using web-based programs, on the basis of comparison of the obtained sequences with a set of HBV reference sequences. Results: A total of 23 (51.1%) mutations and amino acid changes were detected in studied 45 untreated patients. Of these, 3 (6.6%) patients had primary resistance mutation (rtM204I, rtA181T and rtA181S) and 20 (44.4%) patients had secondary resistance mutations. Conclusion: High prevalence of mutations was found in HBV RT region of untreated patients. Most of these mutations were associated with resistance to adefovir and one patient had primary resistance mutation to lamivudine. Awareness of these resistance patterns might help in the antiviral therapy and for predicting clinical outcomes.

Effect of duration of untreated psychosis on gray matter in untreated first-episode schizophrenia / 中华行为医学与脑科学杂志

Objective To investigate the association of duration of untreated psychosis(DUP) and the gray matter volumes in patients with first-episode schizophrenia.Methods 39 patients with first-episode schizophrenia were divided into two groups according to DUP:long-DUP group and short-DUP group.All the subjects underwent T1 weighted magnetic resonance imaging.After transformed with MRIcro software,all the images underwent standardization,segmentation,modulation and smoothing with Statistical Parametric Mapping 5 (SPM5) software.The gray matter volumes of the two groups underwent two-sample t-test with a Voxel-based morphometry (VBM)using SPM5 software.Results Long-DUP schizophrenic patients presented significantly reduced GM volume in the left thalamus(MNI:-6,-16,2;cluster=141 voxels)and the left temporal lobe(MNI:-46,-58,-6;cluster=69 Voxels),compared with short-DUP schizophrenic patients.Conclusion Delayed DUP may increase the loss of gray matter in schizophrenia.