3-in-1 Block with Bupivacaine VS Bupivacaine Plus Dexamethasone in Acute Pain Control for Patients Undergoing Hip Nailing Surgery: A Double Blind Randomized Controlled Trial

Background: Femoral 3-in-1 block is one of the most effective methods in cases of hip nailing surgery because of its ease, low cost, and fewer complications. This study aims to evaluate the effect of adding dexamethasone to peripheral nerve block solution.Methods: Forty-four ASA (I,II & III) patients aged between 50-80 years, scheduled for elective hip-nailing surgery who met inclusion and exclusion criteria were enrolled in this double blind randomized controlled trial. Patients were allocated into two groups randomly; at the end of the surgery, femoral 3-in-1 nerve block was performed with 40 ml of bupivacaine 0.25% solution with or without 8 mg dexamethasone. Pain score was measured for 24 hours.Results: We found no significant difference in pain intensity scores until hour 0.5 and the scores were below 1. Thereafter, the VAS scores increased, yet it remained below 3 in the first 12 postoperative hours. Morphine was administered during hours 12-24 in both groups, when VAS scores reached to about 4. The total amount of morphine consumption was a little lower in the case group, although the difference was not statistically significant. Conclusion: Adding dexamethasone to bupivacaine 0.25% for 3-in-1 block has no more benefit than bupivacaine 0.25% alone for acute postoperative pain management after elective hip nailing surgery

Optimization of low-energy electron beam production for superficial cancer treatments by Monte Carlo code

Context: Low energy electron beam has been being used widely for superficial cancer treatments. In the current study a design for production of very low energy electron beam, by different thickness of Perspex spoilers, is presented that may be used for skin cancer. Aims: MCNPX Monte Carlo code was used for modeling and simulations in the current study. An energy spoiler Perspex was modeled for degrading 4 MeV electron beam of Varian 2300 CD Linac. Materials and Methods: The thicknesses of 3, 7, and 10 mm were applied before electron applicator at a distance of 42 cm from phantom surface. Dosimetric properties of new electron beams including Rp, Dmax, E0, as well as the penumbra of the beam were investigated. Results: For the 3 mm spoiler, the superficial beam output decreased to 77%, and the Dmax, R90, R50, and RP were shifted to the depths of 4, 6, 9, and 12 mm, respectively. While for 10 mm filter the results were 5.2, 3.0 and 5.0 mm for R90, R50, and Rp, respectively. In addition, the surface dose was 93% and the Dmax was shifted to the depth of 1mm for the 10mm Perspex spoiler slab. Conclusions: The presented beam provides a novel surface dose, Dmax, and RP which can be applicable for treatment of skin cancers with minimum dose to the beyond normal tissues

Study on the killing effect of cold atmospheric pressure plasma on MRSA Staphylococcus aureus in vitro and in vivo infection model

Aims@#Non-thermal atmospheric-pressure plasma (cold plasma), is described as a partly ionized gas. Cold plasma is a new method of medicine for killing the bacteria, treatment of cancer diseases, accelerates the healing of infectious ulcers, especially in infection caused by Meticillin-resistant Staphylococcus aureus (MRSA). This study aimed to investigate the impact of Non-thermal atmospheric-pressure plasma on MRSA S. aureus organism isolated from burn wound infection in vitro and in vivo. @*Methodology and results@#Five MRSA S. aureus strains were recovered in burn patients from Shahid Motahari Burns Hospital, Tehran, Iran. They confirmed by microbiology and biochemical tests. Antibiotic susceptibility testing was performed using Kirby Bauer Disk Diffusion Method with selected antibiotics. Then, the antibacterial impact of atmospheric non-thermal plasma on MRSA in vitro and in vivo at different times was assessed. After that, the tissue was randomly separated from control and treated mice with plasma and transferred to the Histopathology Laboratory for further evaluation. Results of the inactivation of MRSA by non-thermal atmospheric plasma showed no bacterial growth. Also, results of the impact of non-thermal helium plasma in vivo environment revealed that, in addition to healing in the animal wound, the burn wounds infection was healed and treated according to the histological results. @*Conclusion, significance and impact of study@#Our results confirmed the inactivation of MRSA S. aureus, healing of animal burn wound and complete treatment by non-thermal atmospheric plasma. It recommended that cold plasma can be used for the treatment of burn wounds infection due to the gentle on the human skin.

Prevalence of Catheter-associated bacteriuria in patients who received short-term catheterization in the northeast of Iran

Background: Catheter-associated [CA] bacteriuria is a result of the extensive usage of urinary catheterization. Once a catheter is placed, many patients achieve bacteriuria, even with the use of greatest consideration and care of the catheter. In this study, we decided to evaluate the prevalence of Catheter-associated bacteriuria in patients who received short-term catheterization in the northeast of Iran

Materials and Methods: In this cross-sectional study during one year [among 2014-2015] 275 patients who have admitted recently and have no history of catheterization and drug consumption were included. Three samples were taken from patients before, one day after catheterization and after removal of the catheter. The urine samples were analyzed and cultured on the suitable media. Antibiotics susceptibility testing was performed by disk diffusion method. Then, data analyzed using SPSS software by Student t-test. In addition, the p values less than 0.05 were considered as significant

Results: In general, the rate of catheter-associated bacteriuria in these hospitals was 68% [187 cases of 275]. The mean age of the participants and patients with bacteriuria were 41+/-1.2 and 24.8+/-6.2 years old, respectively. The most common isolated bacteria were Escherichia coli [50.6%] followed by Staphylococcus aureus and Klebsiella pneumonia [21.6%]. The highest sensitivity was reported against kanamycin [68.9%] and highest resistance was observed against ampicillin with a rate of 96.3%

Conclusion: For prevention of healthcare-associated UTI, correct catheterization and use of the closed catheter system is recommended. In addition, before prescribing any antibiotics it should be paying attention to the antibiotics susceptibility testing results

effect of sintering program on the compressive strength of zirconia copings

Statement of the Problem: Considering the limitations of conventional sintering of zirconium oxide [ZrO[2]] copings, shortening the sintering time can be proposed as an alternative method for making the copings

Purpose: This study aimed to assess the effects of sintering time on compressive strength of Yttria Tetragonal Zirconia Polycrystal [Y-TZP] copings

Materials and Method: Thirty copings of pre-sintered 3Y-TZP blanks were milled and sintered in a special furnace for three different durations [n=10 per group]. The sintering time was 1 h 15 min for IPS e.max ZirCAD, 4 h 20 min for Speed ZrO[2], and 7 h 20 min for the conventional ZrO2 group. The specimens were cemented on the brass dies by using conventional glass ionomer cement. The copings were verti-cally loaded until fracture by using a universal testing machine. The data were ana-lyzed through one-way analysis of variance [ANOVA] and post hoc test to compare the mean differences of compressive strength yielded in three study groups [Alpha=0.05]

Results: The mean +/- SD of compressive strength value was [3617 +/- 543.54] N for IPS-e.maxZirCAD group, [2663 +/- 508.11] N for Speed ZrO2 group, and [1662 +/- 466.71 N] for conventional ZrO2 group. There were statistically significant differ-ences among compressive strength values of the tested groups [p< 0.05]. The highest compressive strength values were obtained from the IPS e.max ZirCAD group

Conclusion: Within the limitations of this in vitro study, it can be concluded that compressive strength of the zirconia copings is affected by the sintering time. High compressive strength of zirconia copings can be obtained by shortening the sintering time

Diabetes self-management: a key to better health-related quality of life in patients with diabetes

Objective: The aims of this study were to assess health-related quality of life [HRQOL] among adult patients with diabetes attending primary health care diabetes clinics in Kuwait and to examine the factors associated with the HRQOL of patients with diabetes

Methods: This cross-sectional study was conducted among 503 patients with diabetes attending 26 primary health care diabetes clinics in Kuwait. A self- administered questionnaire on participants'socio demographic and clinical characteristics, in addition to the Diabetes Self-Management Questionnaire [DSMQ] to assess patients' diabetes self-management [DSM], was used. The SF-12 was employed to assess the HRQOL, producing the following 2 outcomes: physical health composite [PHC] and mental health composite [MHC]

Results: The mean age of participants was 52 +/- 0.8 years, and 53.1% were males and 49.0% were Kuwaitis. The median DSM sum score was 6.5. Male patients with diabetes showed a significantly better median DSM sum score than female patients with diabetes. The overall median score of HRQOL was 61.7/100, with a better median PHC versus MHC score of quality of life [66.7/100 and 56.7/100, respectively]. Multivariate analysis revealed a significant direct association between DSM and better primary health composite and MHC scores. It also showed that female gender and reporting 2 or more diabetic complications were significantly associated with a poor PHC

Conclusions: Kuwaiti patients with diabetes showed a modest level of HRQOL. Patients' DSM, gender, and diabetes complications were significant independent correlates to HRQOL. Appraisal of the HRQOL of patients with diabetes as an essential component of diabetes management in clinical settings is suggested. Further studies to examine the impact of good DSM on HRQOL improvement are needed

Hyperuricemia in systemic lupus erythematosus: is it associated with the neuropsychiatric manifestations of the disease? / Hiperuricemia no lúpus eritematoso sistêmico: está associada a manifestações neuropsiquiátricas da doença?

ABSTRACT Objectives: To assess the association between hyperuricemia and different neuropsychiatric manifestations and stroke risk factors in systematic lupus erythematosus (SLE) patients. Methods: This study was conducted on 204 SLE patients who were admitted to a tertiary referral center. A standardized questionnaire was completed for all the participants and the medical records were reviewed regarding the occurrence of arterial or venous thrombotic events, stroke, seizure, depression, headache, psychosis, and peripheral neuropathy. In addition blood samples were drawn to obtain serum uric acid, triglyceride (TG), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and total cholesterol levels. Results: Hyperuricemia (serum uric acid ≥6 mg/dl for women and ≥7 mg/dl for men) was detected in 16.1% of SLE patients and was significantly associated with the occurrence of stroke (OR, 2.38; 95%CI, 1.2-7.24), and peripheral neuropathy (OR, 3.49; 95% CI, 1.52-12.23), independent of hypertension and hyperlipidemia. Hyperuricemia was also significantly associated with hypertension (OR, 7.76; 95% CI, 2.72-15.76), hyperlipidemia (OR, 5.05; 95% CI, 1.59-11.32), and history of arterial thrombosis (OR, 4.95; 95% CI, 1.98-15.34), independent of age and body mass index. Conclusions: Hyperuricemia in SLE patients is independently associated with the occurrence of stroke and peripheral neuropathy. It is also independently associated with hypertension, hyperlipidemia, and history of arterial thrombosis, which are the major stroke and myocardial infarction risk factors in SLE patients.

RESUMO Objetivos: Avaliar a associação entre a hiperuricemia e diferentes manifestações neuropsiquiátricas e os fatores de risco para AVE em pacientes com lúpus eritematoso sistêmico (LES). Métodos: Este estudo foi feito em 204 pacientes com LES que foram internados em um centro de referência de atenção terciária. Todos os participantes preencheram um questionário padronizado e os prontuários médicos foram analisados quanto à ocorrência de eventos trombóticos arteriais ou venosos, acidente vascular encefálico, convulsão, depressão, cefaleia, psicose e neuropatia periférica. Além disso, foram coletadas amostras de sangue para se mensurarem os níveis de ácido úrico, triglicerídeos (TG), lipoproteínas de alta densidade (HDL), lipoproteínas de baixa densidade (LDL) e colesterol total do sangue. Resultados: A hiperuricemia (ácido úrico sérico ≥ 6 mg/dL para mulheres e ≥ 7 mg/dL para homens) foi detectada em 16,1% dos pacientes com LES e esteve significativamente associada à ocorrência de AVE (OR, 2,38; IC 95%, 1,2-7,24) e neuropatia periférica (OR, 3,49; IC 95%, 1,52-12,23), independentemente da hipertensão arterial e da hiperlipidemia. A hiperuricemia também esteve significativamente associada à hipertensão arterial (OR, 7,76; IC 95%, 2,72-15,76), hiperlipidemia (OR, 5,05; IC 95%, 1,59-11,32) e história de trombose arterial (OR, 4,95; 95% CI, 1,98-15,34), independentemente da idade e do índice de massa corporal. Conclusões: A hiperuricemia em pacientes com LES está independentemente associada à ocorrência de acidente vascular encefálico e neuropatia periférica. Também está independentemente associada à hipertensão, hiperlipidemia e história de trombose arterial, que são os principais fatores de risco para acidente vascular encefálico e infarto agudo do miocárdio em pacientes com LES.

Iranian patients' perspective of patients' rights: a qualitative study.

There is an increasing emphasis on “protecting patient rights”, which has a great influence on the patient’s well-being. This study aimed to explore patients’ perspectives of patients’ rights in the hospitals of Kurdistan University of Medical Sciences in Iran. This qualitative study used the content analysis method. The data were collected through in-depth interviews, conducted in Persian at the internal and surgical wards from 2012 to 2013. Consequently, interviews continued to be conducted on 20 patients, using content analysis, until data saturation. The findings highlighted aspects of patients’ rights and five themes emerged from the interviews: having one’s dignity respected, receiving care of the requisite quality, being shown financial consideration, receiving adequate information, and having a desirable and pleasant environment. The patients believed that for their rights to be upheld, it is necessary that together with the provision of enough facilities and equipment, they need to be respected and offered ideal healthcare services. This could be achieved by removing barriers and facilitating procedures.

[Effects of Benson's relaxation technique on self-efficacy among patients receiving hemodialysis]

Background and Aim: End-stage renal disease is a major health challenge worldwide. Patients with this disease need hemodialysis frequently. The disease and hemodialysis both negatively affect patients' self-efficacy. The aim of this study was to investigate the effects of Benson's relaxation technique on self-efficacy among patients receiving hemodialysis

Material and Methods: This clinical trial included 60 patients who had been on hemodialysis in Imam Reza Hospital in Kermanshah. Initially, patients' self-efficacy was evaluated by a General Self-Efficacy Scale. Then, patients were randomly allocated to either the control or the treatment groups. Patients in the treatment group were trained to perform the Benson's relaxation technique on a daily basis for 60 consecutive days at their homes. Patients in the control group received no relaxation intervention. Immediately after the study, the same scale was used for reevaluating patients' self-efficacy. We analyzed the data by independent t-test

Results: 44% of the patients were male and 56% were female with a mean age of 45.31 +/- 14.70 years. There was a significant difference between the mean values of self-efficacy before and after the intervention

Conclusion: Benson's relaxation technique had positive effects on self-efficacy among patients on hemodialysis. Therefore, it can be used for improving patients' self-efficacy in hemodialysis units

Evaluation of Berlin questionnaire validity for sleep apnea risk in sleep clinic populations

Introduction: The Berlin questionnaire [BQ] is a common tool to screen for Obstructive Sleep Apnea [OSA] in the general population, but its application in the clinical sleep setting is still challenging. The aim of this study was to determine the specificity and sensitivity of the BQ compared to the apnea-hypopnea index obtained from polysomnography recordings obtained from a sleep clinic in Iran

Methods: We recruited 100 patients who were referred to the Sleep Disorders Research Center of Kermanshah University of Medical Sciences for the evaluation of suspected sleep-disorder breathing difficulties. Patients completed a Persian version of BQ and underwent one night of PSG. For each patient, Apnea-Hypopnea Index [AHI] was calculated to assess the diagnosis and severity of OSA. Severity of OSA was categorized as mild when AHI was between 5 and 15, moderate when it was between 15 and 30, and severe when it was more than 30

Results: BQ results categorized 65% of our patients as high risk and 35% as low risk for OSA. The sensitivity and the specificity of BQ for OSA diagnosis with AHI>5 were 77.3% and 23.1%, respectively. Positive predictive value was 68.0% and negative predictive value was 22.0%. Moreover, the area under curve was 0.53 [95% CI: 0.49 - 0.67, P=0.38]

Discussion: Our findings suggested that BQ, despite its advantages in the general population, is not a precise tool to determine the risk of sleep apnea in the clinical setting, particularly in the sleep clinic population

Phylogenetic relationships among Staphylococcus aureus isolated from clinical samples in Mashhad, Iran

The spa gene occurs in all strains of Staphylococcus aureus [S. aureus], can function as a genetic marker and might be used distinguish strains at the species level. Hence, due to these advantages, we used spa typing and the Based Upon Repeat Pattern [BURP] to assign the clonal and phylogenetic relationships of S. aureusstrains. The sensitivity of S. aureus strains to methicillin was determined using agar disk diffusion. The extracted DNA from 56 isolates of S. aureus was subjected to PCR to detect the spa gene with specific primers. The spa typing method was performed for each of the isolates, and then, BURP was used to cluster spa types [spa-CCs]. Finally, using relevant software, the phylogenic tree was drawn. The results of this study showed that 25 out of 56 [44.6%] isolates were resistant to methicillin. The typing of S. aureus isolates revealed 24 different spa types among 56 isolates, and BURP analysis clustered the 24 spa types into 5 spa clonal complexes [CCs] and 12 singletons. The process of spa typing, in combination with BURP analysis, provides an efficient method for investigating phylogenetic and clonal relationships among clinical isolates and can be useful for monitoring bacterial spread between hospitals and communities as well as between and within hospitals

Insulin like growth factor 1 as an indicator of growth hormone deficiency

Insulin like growth factor 1 is a protein produced by the liver under the effect of Growth hormone. It is used as a screening test in the evaluation of patients suspected to have growth hormone deficiency. The aim of the study was to determine the value of Insulin like growth factor 1 level as an Indicator of growth hormone deficiency. This is a retrospective simple analytical study of 103 files of clinically diagnosed patients with short stature, was conducted in the period between June 2010 to November 2012 in the endocrine clinic at Queen Rania Al-Abdullah Hospital for Children. Seventy Patients were males while 33 patients were females, age ranged between 2 and 19 years. Al of these patients were evaluated clinically, height recorded using a stadiometer. Baseline routine laboratory studies, thyroid function test, celiac disease screening, and bone age were done for the patients. Insulin like growth factor 1 level and growth hormone stimulation test were performed for every patient. Patients with celiac disease, primary hypothyroidism, Turner syndrome, achondroplasia, Chronic liver diseases and malnutrition were excluded from the study. Of the total 103 patients, 70 [68%] were males, 33 [32%] were females. Mean age was 9.6 years. There was significant correlation between Insulin like growth factor 1 Level and weight, chronological age, bone age. While there was no correlation between sex and insulin like growth factor 1. There was no correlation between Insulin like growth factor 1 and maximum growth hormone level response by growth hormone stimulation test, the correlation r = 0.56, the p value >0.05. Insulin like growth factor 1 level is not a reliable indicator of growth hormone deficiency and lacks specificity. It can support the diagnosis of growth hormone deficiency, but growth hormone stimulation test is still the gold standard test in highly suspected cases of growth hormone deficiency even with normal level of Insulin like growth factor 1

Evaluation of bond strength of pressed and layered veneering ceramics to nickel-chromium alloy

Statement of the Problem: The success of metal- ceramic- restorations [MCR] depends on the presence of strong bond between porcelain and metal substructure

Purpose: The purpose of this study was to evaluate the effect of hot pressing technique on the bond strength of a metal-porcelain composite in comparison to layering technique

Materials and Method: Thirty Nickel-Chromium specimens were produced by two methods; conventional porcelain layering on metal and hot pressing [n=15]. Bond strengths of all specimens were assessed by the means of three-point bending test according to ISO 9693: 1999 [E] instructions. The data were analyzed using Students t-test [p< 0.001]

Results: The mean +/- SD bond strength of conventional and hot pressing technique was 48.29 +/- 6.02 and 56.52 +/- 4.97, respectively. Therefore, the conventional layering technique yielded significantly lower mean bond strength values than hot pressing technique [p< 0.001]

Conclusion: This study showed that it is possible to improve metal-porcelain bond strength significantly by applying an overpressure during porcelain firing

[Short-term effect of foot massage on the values of arterial oxygen saturation in neurosurgical patients admitted to ICU]

Massage is performed in order to adjust the vital signs of patients in the ICU that needs long-term hospitalization. The aim of the study was to determine the short-term impact of foot massage on patients' arterial blood oxygen saturation values that hospitalized at Hospital of Imam Reza [AS] in Kermanshah. The present study is a quasi-experimental study to investigate the short time effect of massage on the feet on arterial oxygen saturation in patients admitted to the neurosurgical intensive care unit. After the pilot study subjects, 78 patients were selected by simple sampling. 39 patients were allocated in the intervention group and 39 patients in the control group. Forms and questionnaires and checklists were used for data collection and methods of data collection were interviews and physiological measurements. The patient's blood oxygen saturation in the first and fifth minutes before the massage was measured in both groups [from the monitor to the patient's bedside]. Then, researcher gave 5 min foot massage and blood oxygen saturation values were recorded. Immediately after the massage, arterial oxygen saturation values in the first and fifth minutes in both groups were recorded respectively and the results evaluated. Results showed that the Spo2 in the intervention group was increased after the first and fifth minutes of foot massage [p = 0.023 and p = 0.019]. It should be noted that the Spo2 levels in the control group were not significant when compared before and after the massage. Results showed that a significant increase in Spo2 level is a result of foot massage. It may be concluded that changes in metabolism occurred after foot massage is followed by decreased oxygen consumption and thus the value of massage increases

Evaluation of retention of two different cast post-core systems and fracture resistance of the restored teeth

Statement of the Problem: The survival of pulpless teeth restored with different post and core systems is still a controversial issue

Purpose: This study compared the retention of two different post and core systems and also the fracture resistance of teeth restored with these systems

Material and Method: Eighty endodontically treated maxillary central incisors were sectioned perpendicular to the long axis at a point 2mm incisal to the cementoenamel junction [CEJ] and then the root canals were obturated. The restored teeth were randomly divided into two equal groups of 40. One group was restored with Nickel-Chromium [Ni-Cr] post and core system and the other group with Non-Precious Gold alloy [NPG] system. For evaluation of fracture resistance of the restored teeth, the specimens [n=20 per each group] were mounted in acrylic resin blocks and a layer of polyvinyl siloxane was applied to cover the roots. Loads were applied at an angle of 45 degrees to the long axis of the teeth and measured with a universal testing machine. The axial retention values of the studied groups [no=20] were measured on an Instron testing machine at a crosshead speed of 0.5 mm/min. Statistical analyses were performed using SPSS version 19.00 and student's t-test [alpha=0.05]

Results: Although retention failure load for Ni-Cr system was lower than NPG system, there was no significant difference between the two systems [p= 0.7]. However, fracture resistance of the teeth restored with Ni-Cr post and core system was significantly higher than NPG group [p= 0.000]

Conclusion: There was no significant difference between the retention of the studied post and core systems. Although significantly higher fracture thresholds were recorded for Ni-Cr post and core group, the failure loads of both systems may rarely occur clinically

Dimensional stability of color-changing irreversible hydrocolloids after disinfection

Disinfection of dental impressions is a weak point in the dental hygiene chain. In addition, dental office personnel and dental technicians are endangered by cross-contamination.This study aimed to investigate the dimensional stability of two color-changing irreversible hydrocolloid materials [IH] after disinfection with glutaraldehyde.In this in vitro study, impressions were made of a master maxillary arch containing three reference inserts on the occlucal surface of the left and right maxillary second molars and in the incisal surface of the maxillary central incisors. Two types of color-changing irreversible hydrocolloid [tetrachrom, cavex] were used. Glutaraldehyde 2% was used in two methods of spraying and immersion to disinfect the impressions. The control group was not disinfected. Casts were made of type IV gypsum. The linear dimensional change of the stone casts was measured with a profile projector. For statistical analysis, Kruskall-Wallis and Mann-Witney tests were used [alpha=0.05].By immersion method, the casts fabricated from tetrachrom were 0.36% larger in the anteroposterior [AP] and 0.05% smaller in cross arch [CA] dimensions; however, the casts prepared after spraying of tetrachrom were 0.44% larger in the AP and 0.10% smaller in CA dimensions. The casts made from Cavex were 0.05% smaller in the AP and 0.02% smaller in CA dimensions after spraying and 0.01% smaller in the AP and 0.003% smaller in CA dimensions after immersion. Generally there were not significant differences in AP and CA dimensions of the experimental groups compared to the control [p > 0.05].Disinfection of the tested color-changing irreversible hydrocolloids by glutaraldahyde 2% did not compromise the accuracy of the obtained casts

Does sildenafil enhance the effect of tamsulosin in relieving acute urinary retention?

Objective To compare the safety and efficacy of combined therapy using sildenafil and tamsulosin for management of acute urinary retention (AUR) with tamsulosin alone in patients with benign prostate hyperplasia (BPH). Materials and Methods 101 patients were enrolled in a randomized placebo-controlled study from June 2009 to April 2012. Patients presenting with an initial episode of spontaneous AUR underwent urethral catheterization and then prospectively randomized to receive tamsulosin 0.4mg plus sildenafil 50mg in group A and tamsulosin 0.4mg plus placebo in group B for three days. Urethral catheter was removed three days after medical treatment and patient’s ability to void assessed at the day after catheter removal and seven days later. Patients who voided successfully were followed at least for three months. Results Mean age of patients was 59.64 ± 3.84 years in group A and 60.56 ± 4.12 years in group B (p value = 0.92). Mean prostate volume and mean residual urine were comparable between both groups (p value = 0.74 and 0.42, respectively). Fifteen patients in group A (success rate: 70%) and nineteen patients in group B (success rate: 62.7%) had failed trial without catheter (TWOC) at 7th day following AUR (p value = 0.3). No significant difference was noted between both groups regarding the rate of repeated AUR at one month and three month follow-up period (p = 0.07 and p = 0.45, respectively). Conclusion It seems that combination therapy by using 5-phosphodiesterase inhibitor and tamsulosin has no significant advantages to improve urinary retention versus tamsulosin alone. .

Effect of chlorhexidine mouth rinse on the colour stability of porcelain with three different surface treatments: an in vitro study

The effect of mouth washes on discolouration of dental ceramics with different surface preparations is not well documented. This in-vitro study has been conducted to evaluate the effect of chlorhexidine [CHX] mouth rinse on colour stability of overglazed [OP], autoglazed, [AP] or polished porcelain [POP] specimens. The restorative material investigated in this study was overglazed, autoglazed, or polished feldspathic porcelain. A total of 48 cylandrical specimens were prepared, [n=16 per each group]. After baseline colour measurements, for a period of14 days 8 specimens of each group were immersed in 15 ml of 0.2% chlorhexidine mouth rinse twice daily for 2 min. After each immersion, the specimens were washed and stored in artificial saliva. Half of the specimens from each group were selected randomly as controls and stored in artificial saliva that was changed daily. The colour change [delta E] of the specimens was measured by a spectrophotometer device. Data were statistically analyzed using 2-Way ANOVA followed by Tukey test All the specimens displayed colour changes after immersion in chlorhexidine mouth rinse. POP specimens exhibited more colour change compared to AP and OP specimens [P=0.001]. AP and OP specimens showed relatively the same colour change which was not significant compared to the control groups [P=0.9].Auto-glazed and over-glazed porcelain can tolerate chlorhexidine mouth rinse better than polished porcelain. However the colour changes of the ceramic with three different surface preparations were not perceivable clinically

[ application of Cox regression model to investigate influential factors on the admission to higher education in holders of health associate degree in Shahrekord University of Medical Sciences]

Introduction and Aims: the present study tries to investigate factors influencing continuing studies among graduates of associate of health sciences, Shahrekord University of Medical Sciences [SKUMS]

Methods: for this descriptive-analytical study, educational profiles of all health graduates of SKUMS between 1986- 2005 were examined and the data was gathered through a researcher-developed checklist and also phone calls. Data analysis was performed by SPSS 16 using Cox regression

Results: from 398 respondents of the study with a mean age of 22.2 +/- 2.25 [range: 20-39], 140 [35.2%] were male and remaining were female. Generally, 206 [51.8%] graduates had been entered to higher education. According to Cox regression, some factors, e.g. age, gender, marital status, residency, and GPA of associate of health sciences, were significantly effective on continuing studies and some others including associate course of study, course period, and diploma GPA had no significant effect on the chance of entrance to higher education levels

Conclusion: growing older, one gradually enters other living arenas like marriage, making continuing studies marginalized. Therefore, it could be assumed that the factors influencing continuing studies should be considered a whole, i.e., the circumstances should be prepared to facilitate continuing studies before growing older and facing consequent life issues

Relationship between prooxidant-antioxidant balance and severity of coronary artery disease in patients of Imam Khomeini hospital of Tehran, Iran

The balance between reactive oxygen species production and antioxidant activity has an important role in oxidative stress associated diseases including coronary artery disease. In this study, the prooxidant-antioxidant balance [PAB] and its correlations with serum lipid levels, uric acid levels, and severity of coronary artery involvement were examined. The aim of this study was to determine the diagnostic value of PAB as a predictor in coronary artery disease [CAD]. Seventy two patients and 68 healthy subjects were selected. PAB was determined using standard solutions and ELISA. Triglyceride, total cholesterol, LDL- cholesterol, HDL-cholesterol and uric acid levels were measured by enzymatic method. Mean PAB was 66.4 +/- 2.84 [HK units] in healthy people, 77.37 +/- 33.51 [HK units] in patients with one vessel CAD, 63.76 +/- 29.47 [HK units] in patients with two vessel CAD and 68.59 +/- 24.51 [HK units] in patients with three or more vessel CAD. There was no significant difference between PAB values in different severity groups [P=0.41]. PAB significantly and indirectly correlated with uric acid level in two vessels CAD. The study shows that PAB can be a predictor of CAD associated with other risk factors, but not alone