[Association between healthy lifestyle score and upper gastrointestinal disorders in Iranian adults]

Background and Objective: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders [FGIDs], there is no epidemiologic data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia [FD], its symptoms and gastro-esophageal reflux disease [GERD] in a large group of Iranian adults

Methods: This descriptive -analytic study was conducted on 3363 Iranian adults [19-70 yr], whom were working in 50 health centers across Isfahan province in Iran during 2012. We used easy non-random sampling to select participants. The "healthy lifestyle score" for each participant was calculated by summing up the binary score given for five lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. A validated Persian version of ROME III questionnaire was used, to assess functional gastrointestinal disorders

Results: The prevalence of FD and GERD among study participants was 14.5 and 23.6%, respectively. After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD [95% CI: 0.05-0.92, OR: 0.21, P=0.03] and GERD [95% CI: 0.09-0.69, OR: 0.26, P=0.01], respectively, compared with those with the lowest score. They were also less likely to have early satiation [95% CI: 0.11-0.73, OR: 0.28, P=0.001], postprandial fullness [95% CI: 0.09-0.50, OR: 0.22, P<0.001] and epigastric pain [95% CI: 0.21-0.92, OR: 0.44, P=0.03]. In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits and non-smoking were separately associated with FGIDs [P<0.05]

Conclusion: This study showed that adherence to a healthy lifestyle was associated with lower odds of GERD, FD and its symptoms in this group of Iranian adults. Individual lifestyle-related factors were also associated with these conditions

[Effect of different decontamination procedures for saliva-contaminated uncured bonding system on shear bond strength of composite to enamel]

Prevention of contamination during the procedural steps is a requisite for achieving a satisfactory composite restoration. The aim of this experimental study was to compare the shear bond strength of composite to enamel in two different decontamination procedures of uncured bonding and uncontaminated conditions. Thirty-six extracted sound human premolars and incisors were selected. Enamel of buccal surface was ground flat. The teeth were divided into 3 groups of 12 each. In the control group [1], 3M Single Bond adhesive was used according to the manufacturer's instructions, without any contamination. In groups 2 and 3 uncured adhesive was saliva contaminated and then: [2] rinsed, dried, etched [5 seconds], rinsed, dried, adhesive was reapplied and [3] cured, dried, etched [5 seconds], rinsed, dried and adhesive was reapplied. Then composite cylinders were bonded to enamel surfaces. Finally, samples were sheared using Instron testing machine and shear bond strength data were subjected to one-way ANOVA. The mean bond strength was 16.5317 MPa in the control group, 16.2308 MPa in rinsed contaminated bonding group and 15.8025 MPa in cured contaminated bonding group. No statistically significant difference was found in the mean shear bond strength of groups 1,2 and 3 [p=0.954]. Both decontamination protocols [groups 2 and 3] resulted in acceptable bond strength and both were comparable with uncontaminated condition

[Effect of chromium supplementation on lipid profile in patients with type 2 diabetes mellitus]

Although current data shows that chromium supplementation in type 2 Diabetic patients can improve control blood sugar and lipids there are controversial results about its relevance to improving blood sugar and lipids in diabetes. This study investigates the effect of chromium picolinate supplement on blood sugar and lipids control in patients with type 2 diabetes. This randomized, double-blind,placebo-controlled study was carried out at the Diabetes Clinic of the Loghman Hospital in collaboration with Taban Diabetes Clinic. In this clinical study of 60 patients with type 2 Diabetes, participants were randomized into the doubleblind treatment and control groups for 3 months of treatment with 200 g of chromium picolinate or placebo respectively. Blood sugar and lipids profile were assessed at the beginning and end of the study. Based on the result of this study it has been found that 200 micrograms of chromium consumed over three months could decrease of TG levels dramatically, compared to placebos. TG changes were significantly different between the two groups, [P=0.048], without any change in other lipid profiles of the two groups. Findings showed that chromium picolinate treatment for 90 days produced significant improvements in glycemic control compared to placebo, based on significant reductions in both FPG and HbA1c levels in patients with type 2 diabetes mellitus, with significant changes between the two groups [P<0.001]. Results of this study recommend that chromium picolinate prescribed to type 2 diabetes patients could decrease TG, HbA1c and FPG levels

[Comparison of alexithymia, anxiety, depression and digestive symptoms between patients with functional gastrointestinal disorders and psychiatric patients]

The purpose of this study was to compare alexithymia, anxiety, depression and severity of gastrointestinal symptoms in patients with functional gastrointestinal disorders and psychiatric patients. This was a comparative study. Study subjects consisted of 210 individuals; 129 patients with functional gastrointestinal disorders [FGID] who referred to the Psychosomatic Disorders Clinic [GI] and 81 psychiatric patients who referred to the Mood Disorders Clinic of Noor Hospital, Isfahan, Iran during 1387 [2008]. Subjects' symptoms were scored according to the Toronto Alexithymia Scale [TAS-20], Hospital Anxiety and Depression Scale [HADS] and Gastrointestinal Symptoms Rating Scale [GSRS]. Data were analyzed using multivariate analysis of variance. The results showed significant differences between two group of FGID and psychiatric patients in terms of alexithymia, anxiety, depression and severity of gastrointestinal symptoms. The study showed that in comparison to psychiatric patients, FGID patients have higher rates of alexithymia, anxiety, depression and more severe gastrointestinal symptoms. Alexithymia plays an important role in understanding symptoms and referrals to doctor's offices. Regardless of which treatment is selected by the patients, a high proportion experience concurrent psychiatric and functional somatic symptoms. Therefore, evaluation and attention to this factor is necessary for the treatment of psychosomatic disorders

Comparison between shear bond strength of composite resin following surface conditioning with Er Cr YSGG laser and acid etch on the enamel surface in primary canines

In recent years with the introduction of laser in dentistry, numerous researches have been conducted to evaluate its efficacy for improving resin material bond on the enamel and dentin. Based on the available literature, no research has been performed on resin shearing bond strength by preparing the tooth surface with YSGG laser on the enamel of the primary teeth. The present study seeks to determine and compare resin shearing bond strength between two groups of surface preparation with acid etch and laser. Twenty primary canine teeth which were extracted for orthodontic purposes were collected and were halved with a diamond disc. Each of the halves was mounted in transparent acrylic resin. The teeth were then randomly divided into two groups; in group 1, surface preparation was done with YSGG laser and in group 2, the teeth were prepared with acid etching. Next, the composite was put on the tooth surface by a plastic matrix and cured. The shearing bond strength was measured with instron. The collected data were analyzed using Student's t-test and Kolmogorov-Smirnov statistical methods. The average bond strength was 27.87 +/- 6.136 mpa in the laser group [group 1] and 21.55 +/- 5.62 mpa in the acid etch group [group 2] demonstrating a statistically significant difference between the two groups [p<0/05]. It may be concluded that resin bond strength is significantly higher in group 1 [YSGG group] compared with Group 2 [acid etch group]

Evaluation of intelligence quotient in children with early first permanent molar eruption

There are many unknown systemic and local factors influencing tooth growth and development. Likely, tooth eruption may be under such influence as well. Despite delayed tooth eruption, studies on early tooth eruption are very scarce. Therefore, this study was conducted in order to evaluate the relationship between intelligence quotient [IQ] and early tooth eruption in normal children [with no disease or disorder]. By using study criteria, 44 children were recruited after oral examination of 652 children [337 boys and 315 girls]. Oral examination was conducted by one dentist using plastic disposable mirror, under day light. The Raven's test was taken blindly under standard conditions for all subjects by a psychologist. [Case] subjects were defined as individuals who had partially or fully erupted molars earlier than the expected normal time. [Control] subjects were similar to [cases] but without erupted molars. Statistical analysis was conducted using student T-test. The intelligence test was performed on 44 subjects consisted of 22 boys [IT'case] and 1 T'control]] and 22 girls [11 [case] and 11 [control]]. IQ in two sexes did not have significant difference [P<0.05]. But the mean IQ difference between [case] and [control] groups was about 11 points that was statically significance [P<0.01]. Healthy children with early first permanent molar eruptions, have higher IQ compared to their peers [P<0.01]. This criterion may be used to identify high IQ children for provision of special care and training for faster advancement of individual and society

Effect of relaxation with drug therapy on the psychological symptoms in patients with irritable bowel syndrome-diarrhea dominant [IBS-D]

Irritable bowel syndrome is the most prevalent functional bowel disorder which is characterized by chronic abdominal pain and altered bowel habit in the absence of organic disease. Psychological factors are of the major factors involved in this disease. The aim of this study was comparison of the effect of relaxation with and without drug therapy on the psychological symptoms in patients with irritable bowel syndrome-diarrhea predominant [IBS-D]. This clinical- trial study was performed on 32 IBS-diarrhea dominant patients. Patients were randomly divided into two groups. One group was treated by using relaxation technique without drug therapy and another group was treated by using relaxation technique combined with drug therapy. Diagnostic characters of Rome-II and III were used for diagnosing the IBS-D patients and SCL-90 test was used for evaluating the psychological symptoms. The study was performed in three steps, pretest, post test and 4 months after last intervention [follow up group]. Data were analyzed using analysis of covariance [ANCOVA] method. The average age of the patients in this study was 37 +/- 15.43 years. Our study demonstrated that there was a significant reduction in psychological symptoms scores in post test and follow up groups compared to the pre test group. This reduction was higher in patients receiving relaxation combined to drug therapy compared to the drug therapy group [P<0.05]. Based on the results of this study, Combination of relaxation and drug therapy is effective for reducing the psychological symptoms in irritable bowel syndrome patients

[Prevalence of missing and supernumerary teeth in 3-5 years-old, kindergarten children of Tehran]

Missing and supernumerary teeth are considered as dental developmental anomalies. These anomalies may lead to problems and complications such as dental asymmetry, poor esthetics, midline shift, dental crowding, malocclusions, caries, diastema, ectopic eruption, impactions, delayed eruption, external root resorption as well as loss of adjacent tooth's vitality in some cases. The aim of this study was to investigate the prevalence of missing and supernumerary teeth in 3 to 5 years old kindergarten children of Tehran in 2005. This cross-sectional study was conducted by oral examination of 1000 children. Kindergartens were randomly selected in three major areas of Tehran province, namely Rey, Tehran-city and Shemiranat regions. Oral examination was carried out by counting the teeth under adequate lighting. The prevalence of supernumerary and missing teeth in this study was 0.3% and all the anomalies were observed in boys. All cases of supernumerary teeth were in maxilla. From the three cases with missing teeth, two cases were in the maxilla [83%] and one case in the mandible. The anomalies observed in two samples occurred unilaterally in the lateral incisors [67%].Since missing and supernumerary primary teeth may lead to problems in the permanent dentition, early diagnosis and continuous monitoring of successors seem to be necessary to avoid further problems and therefore complicated treatments

Comparison of four ways in treatment of acute conversion disorder

In spite of high prevalence of conversion disorder, there is no widely acceptable effective treatment for it. In this study, we compared four ways of treatment in acute conversion disorder and it's recurrent after one month. In a clinical trial study, we selected 80 patients with acute conversion disorder using simple sampling method. They were divided randomly into four treatment groups. [Suggestion, simple muscle relaxation, hypnosis, and diazepam injection] The speed of syndrome elimination, recovery frequency, and one month's recurrence were compared. The results were analyzed with chi-square, Fisher's exact test and ANOVA. Mean recovery time was significantly less in muscle relaxation group compared to the hypnosis and diazepam injection groups [P < 0.05]. In patients with co-morbidity, the mean recovery time was shorter than the mean recovery time in none co-morbidity [P < 0.05]. There was no significant relation between one month recurrent and way of treatment or other variables. All four ways of treatments bring significant recovery, but in muscle relaxation, recovery is faster than hypnosis and diazepam infusion

[Positive and negative perfectionism in migrainus patients compared with control group]

The positive and negative effects of perfectionism on human cognition, affection and behavior have been emphasized. Perfectionism has been conceptualized as a multidimensional construct, with both adaptive and maladaptive aspects, which is one of the common personality traits that cause lifelong stress in human and results in anxiety, depression and physical and mental distress. The aim of this study was to assess the positive and negative perfectionism in migrainus patients in comparison with control group. This is an analytical [Case-control] study which was performed on 91 migraine patients and 88 healthy individuals. The patients and controls completed a standard 40 item questionnaire for perfectionism - PAN PS [20 for positive and 20 for negative perfectionism]. The patients in both groups were matched for gender and age. Mean of positive and negative perfectionism scores for two groups was statistically analysed using SPSS software. Mean positive perfectionism score was 83.47 +/- 8.5 for migraine group and 65.47 +/- 7.54 for control group [p=0.0001]. The difference between two groups was significant. Mean of negative perfectionism score was 74.12 +/- 10.6 for migraine group and 51.79 +/- 7.8 for control group [p=0.0001]. The results show that migraine patients have higher mean of perfectionism scores than healthy individuals. Based on this study and other clinical experiences more attention to psychotherapy is necessary for better management of migraine and recognition of personality profile in migraine patient helps to reduce patient's complaints

[ relative frequency and socio-demographic correlates of bipolar spectrum disorders in divorced volunteers]

During the recent years, increasing rate of divorce, affects families and community. Identifying divorce risk factors seems to be very important. The aim of this study was to assess the frequency and some demographic correlates of mood Bipolar Spectrum Disorder [BSD] in volunteers of divorce referred to Family-Counseling Centers. This was a descriptive-analytic study on divorced volunteers referred to family counseling centers of Isfahan in winter-spring 2007. The sample consisted of 96 volunteers selected through randomized cluster sampling. All participants were administered Mood Disorder Questionnaire [MDQ as well as a demographic questionnaire. Data were analyzed by SPSS13 software, using descriptive statistics, CHI2 and Mann-Whitney tests. BSD was significantly more prevalent among females [p < 0.031] and among housewives [p < 0.05]. No significant difference was seen in the frequency of BSD between different age groups [p = 0.47] and educational levels [p = 0.11]. Our findings indicated that psychiatric disorders including BSD may have a role in divorce. Marriage and/or divorce counseling may serve as a means for recognizing BSD in consults. Hence, it may play a role in reducing the rate of divorce through patients' referral for appropriate specialized treatment

Effect of rinsing direction of etched enamel surfaces on fissure sealant retention

Numerous Clinical studies have reported the effectiveness of fissure sealants in prevention of dental caries. However, the retention and longevity of sealants are highly dependent on clinical methods. The purpose of this study was to examine the effect of different rinsing direction [45°, 90° angles] of etched enamel surfaces on sealant-enamel bond strength. This experimental study was conducted on 31 premolar teeth, with two bonding surfaces located on the buccal and lingual sides. The selected smooth and vertical enamel surfaces that were prepared using a high-speed hand-piece that was mounted on a surveyor. After etching the enamel, the buccal surfaces were rinsed at 90° and the lingual surfaces were rinsed at 45° angles. After drying and application of sealant, the specimens were stored in distilled water at 37°C for 24 hours prior to testing with Instron testing machine. Data were analyzed using Pearson correlation and paired T-tests. The statistical analysis revealed that the bond strength in 90° angle group was higher than the 45° angle group. However, the group difference was not statistically significant. [P = 0.221]. This experimental study showed that there was no significant difference in sealant bonding strength with different rinsing angles [90°, 45°]

[Different domains of quality of life [QOL] in schizophrenic patients]

Schizophrenia is a chronic psychiatric disorder which results in severe impairments in job, education and family relationships. We compared different domains of Quality Of Life [QOL] in schizophrenic patients with those in healthy persons. In a descriptive analytic study, a total number of 160 participants, including 80 schizophrenic patients [case group] and 80 healthy persons [control group] were studied. They were 15 to 45 years old. In order to get them matched regarding the psycho-socio-cultural status, we selected the control group participants from the patients' family members. We also matched the two groups for age, marital status and educational level. Patients' were in the remission phase and 2 years or more had passed from the onset of their psychiatric disorder. We applied Hawthorne and Richardson QOL questionnaire for assessing QOL. Data were analyzed using T student test by SPSS-software. Each group contained 48 men and 32 women. A number of 39 participants were married and the others were single, divorced or widowed. Mean age of the patient group [38.2 +/- 4.3 years] was not significantly different from the control one [40.5 +/- 3.1 years]. Mean score of QOL was 33.9 +/- 4.75 in the case group and 54.6 +/- 1.12 in the control one, which indicates a significant difference. The case and the control groups' scores for different domains of QOL were respectively as follows: [the domain of] disease [4.5 +/- 15 vs. 10.8 +/- 0.98], independent life [8.10 +/- 1.14 vs. 10.9 +/- 0.83], social relations [6.4 +/- 1.97 vs. 11 +/- 0.77], bodily sensations [8.7 +/- 1.49 vs. 10.90 +/- 0.70], and psychiatric rehabilitation [6.2 +/- 1.89 vs. 11 +/- 0.9]. The mean score of each domain showed a significant difference between the two groups. Schizophrenic patients were found to have a lower QOL than healthy individuals. This was true in all of the QOL domains. The patients' lowest score was in the disease domain and their highest score was in the bodily sensation domain. This can be considered in determining priorities for pharmaceutical, psycho-logical and social interventions

Add-on topiramate in treatment of schizophrenia

Using Glutamate antagonists such as topiramate has been suggested on the basis of glutamate hypothesis for schizophrenia; as its properties encourage its exploration and possible development as a medication for the treatment of schizophrenia. A randomized, double-blind, placebo controlled clinical trial was performed on 18-45 years old schizophrenic patients. Baseline information including vital signs, height, weight, smoking status, demographic characteristics, [past] psychiatric history, medication history and medication-related adverse effects was collected. Patients were randomly assigned to topiramate or placebo group. Efficacy was assessed by administering positive and negative syndrome scale [PANSS], and tolerability was recorded in both groups on days 0 [baseline], 28, and 56. Total PANSS score in topiramate group was 96.87 [85.37-108.37], 85.68 [74.67-96.70] and 76.87 [66.06-87.69] compared with 101.87 [90.37-113.37], 100.31 [89.29-111.32] and 100.56 [89.74-111.37] in placebo group in baseline, 28th and 56th days, respectively [95% confidence interval]. General linear Model for repeated measure analysis showed that topiramate has lowered PANSS score significantly [p<0.05]. Significant decline pattern was also found in all three PANSS components [negative, positive and psychopathology symptoms] [p<0.05]. Topiramate can be an effective medication in controlling schizophrenic symptoms, because of its effect on decreasing negative symptoms and controlling antipsychotic-associated weight gain

[ prevalence of Fusion and Gemination in 3-5 year-old children in Tehran]

Fusion and gemmation [double teeth] are developmental anomalies of unknown etiology. It is not always possible to differentiate clinically between these two abnormalities. The presence of primary double teeth may cause problems in the permanent dentition. The purpose of this study was to determine the prevalence of fusion and gemination in the primary dentition of 3-5 year-old kindergarten children in Tehran. In this cross-sectional study, several kindergartens located in Tehran, Rey, and Shemiranat were randomly selected and 1000 children with an age range of 3-5 years were examined. The prevalence of double teeth was%0.8 from which%87.5 showed fusion and%12.5 revealed gemination. All fusions were observed in the mandible and all geminations in the maxilla. Double teeth were distributed evenly among both sexes, but when considered separately,%57 of the fusions were observed in girls and all geminations in boys. The most common double teeth were the central and lateral incisors which occurred in the mandible. Gemination of the primary lateral incisor was observed in%12.5 of the double teeth and was encountered in the maxilla. Further examination of the permanent dentition was performed in a number of cases and aplasia of the permanent lateral incisor and succedaneous teeth were observed in these subjects, which were due to fusion of the lateral primary incisor and canine. Considering that primary double teeth may be followed by problems in the permanent dentition, early diagnosis and continuous monitoring of successors is suggested to avoid further complications

[Serum lipids in patients with mixed anxiety depressive disorder]

Psychiatric disorders especially depression has known association with coronary artery disease but the relationship with other psychological conditions still obscure. To evaluate the lipids profile in patients with anxiety and depressive disorder. This cross-sectional study was performed on 100 patients arranged in four groups using random sampling. Group 1 [25 patients] with major depressive disorder; group 2 [25 patients] with generalized anxiety disorder; group 3 [25 patients] with mixed anxiety and depression; and group 4 [25 patients] as control group. Data was collected using a questionnaire including demographic information, past history of patient, and also Beck and Kettel questionnaire. Blood samples were collected to measure total cholesterol, triglycerides, HDL and LDL-C. The data were analyzed using SPSS10 and t-test, X[2], and ANOVA tests. Out of 100 patients, 75% were females. Means of TC [226.75 +/- 45.35], TG [189.37 +/- 69.84], HDL-C [45.51 +/- 10/48] and LDL-C [150.35 +/- 36.65] were higher in mixed anxiety depressive disorder. Regarding the data obtained in our study, high lipid levels were found in mixed anxiety depressive disorder. To reduce the chance of atherosclerosis, measurement of lipids level in such patients is recommended

[Efficacy of lamotrigin in treatment of avoidance / numbing in post-traumatic stress disorders]

Post-traumatic stress disorder [PTSD] is a chronic illness which is difficult to treat; yet, it is a common disorder which is associated with significant morbidity and mortality. The hypothesis that exposure to traumatic events may sensitize or kindle limbic nuclei has led to efforts to treat PTSD with anticonvulsants based on the kindling hypothesis. This double-blind clinical trial assesses clinical response to lamotrigine as a potential treatment. Thirty patients with PTSD were randomly assigned in a double-blind design. They were treated for 3 months with lamotrigine [N=1 5, 150-500 mg/day] as odd-on or placebo [N=15]. The patients were measured in the first visit and at the end of 3 months by clinician administration. PTSD scales [CAPS] paired t-test, and Friedman and Will Coxon were used for data analysis. The mean score of frequency of PTSD criteria in Lamotrigine group in the first visit was 10.1 +/- 2.2 and in placebo group was 12.75 +/- 2.24. The mean score of these criteria in lamotrigin group after treatment period was 9 +/- 2.5 and for placebo group was 12.45 +/- 2.7. The analysis of these sores showed a significant difference in Lamotrigine group and a non significant difference in placebo group. The mean score of Intensity of PTSD criteria in Lamotrigine group in first visit was 9.4 +/- 1 .2 and in placebo group was 9.1 +/- 1-9. The mean score of these criteria in Lamotrigine group after treatment group was 8.4 +/- 2 and for placebo group was 9.1 +/- 2. The analysis of these scores showed a significant difference in lamotrigine group and a non-significant difference in placebo group. In placebo group, the analysis of mean sores of all intensity and frequency of criteria before and after taking placebo showed a non-significant difference. In Lamotrigine group, the analysis of mean scores of intensity and frequency of criteria such as avoidance of thoughts or feelings, avoidances of activities, place, people, inability to recall important aspect of trauma and diminished interest in activities before and after taking lamotrigine showed a significant difference and in other criteria showed a non-significant difference. Comparison of mean of decline in CAPS scores before and after treatment in placebo and lamotrigine group showed a significant difference in the four symptoms in lamotrigine group. Results of the study suggest that lamotrigine is a safe, well tolerated and significant effective treatment for avoidance numbing of PTSD

Evaluation of marginal circumference and marginal thickness changes in precrimped stainless steel crowns, after recrimping

The need for recrimping precrimped stainless steel crowns by the dentist in clinic is controversial. This study aimed to evaluate the rate of marginal circumference and marginal thickness change of precrimped stainless steel crowns after recrimping. In this experimental study, 30 primary photos were taken from margins of 30 S.S.Cs [3M, Ni-Cr] related to tooth 85 with a digital camera fixed at a determined distance. Margins of crowns were crimped by 114 and 137 pliers with a controlled force [0.2 N] and then 30 secondary photos were taken in the same conditions. The circumference of crown margins in primary [group A] and secondary [group B] photos were assessed by a digitizer system. Comparing the circumferences of crown margins in primary and secondary photos showed a significant decrease after crimping. Thickness of 30 random points on the crown margins of a crown similar to mentioned cases was measured by SEM [x150]. Then similar procedures including taking a primary photo, crimping and taking a secondary photo was done for the sample crown. After significant reduction in margin circumference, thickness of 30 other random points on the crown margin were measured by SEM. Data were analyzed by paired sample t-test with p<0.05 as the limit of significance. The mean marginal circumference of precrimped stainless steel crowns was reduced by 7.3% which was significant [P<0.001]. On the other hand the mean marginal thickness of sample stainless steel crown showed 18 p. increase. According to the results of this study, marginal circumference of precrimped stainless steel crowns [3M, Ni-Cr] showed a significant decrease after crimping. It is concluded that crimping the stainless steel crowns even for precrimped ones seems necessary

[ survey on frequency of drug-induced akathisia in psychiatric wards using two methods: clinical diagnosis and Barnes rating scale]

Akathisia syndrome is one of the medication induced movement disorders that is found is patients who take neuroleptic drug. In this disorder the patients has an inner sense of restlessness and there are some restless movement in patients' limbs. Akathisia can cause drug noncompliance. To make a proper decision for treating the patients and using the best kinds of drugs, a proper rating scale for diagnosing akathisia should be determined. This cross sectional study was performed in descriptive - analytic style. Samples were 156 hospitalized patients who were on psychiatric drugs. For each patient two data collection forms were prepared. The first form involved questions about diagnosis and akathisia management by physicians. The second form involved Barnes rating scale for Akathisia [BARS]. The data analysis was performed using SPSS, tests were t-student and statistical significance was assessed at the 5% alpha level. This study was performed in Noor, Farabi and Modares hospitals in the spring and summer of 1383 [2004] in Isfahan [Iran]. Among 156 patients, akathisia was diagnosed in 15.4% by BARS scale and in 9.6% by physicians. There was significant difference between the diagnosis of Akathisia by BARS and the diagnosis by physicians. Among patients who had akathisia [in BARS], 29.2% had mild akathisia, 50% had moderate akathisia, 20.8% had marked akathisia Pseudoakathisia was diagnosed in 2.6% of 156 samples. All of the patients, who had akathisia, were taking Antipsychotic drug [83.3% Typical and 16.7% atypical antipsychotic]. For treatment, the physicians reduced the dosage of antipsychotic drugs in 80% of the akathisia patients, and added a new drug for 60% of the patients and changed the antipsychotic drug for 20% of them. In our study, akathisia was diagnosed for 24 patients by BARS. But the physicians did not diagnose akathisia in some of these patients. This might have negative effects on treatment of the patients. Therefore, it's necessary to introduce the Barns akathisia rating scale [BARS] to all physicians and encourage them to apply in all wards to suspicious cases

[Comparison of the efficacy of two combinations; sodium valproate with lithium and sodium valproate with olanzapine treatment of acute mania]

Acute mania is a psychiatric emergency state that often requires rapid management. There are many different therapeutic protocols for this emergent situation. One of them is combination of moodstabilizers and antipsychotics. Olanzapine which is now available in our country can be used for this purpose. In this study, we compared the effectiveness, rapidity of response and side effects of sodium valproate plus olanzapine [group I] with sodium valproate plus lithium [group II] in acutely manic or mixed bipolar patients. In this randomized, double blind, parallel group study, 44 acutely manic or mixed patients according to DSM IV-TR criteria were randomly assigned to receive combinations of sodium valproate [20mg/kg per day] with either olanzapine [5-15mg/day] or lithium [900mg/day] during a ten-day course. Efficacy was measured with Young Mania Rating Scale [YMRS]. Effectiveness measures included YMRS response [YMRS reduction >/= 50%] and YMRS remission [YMRS<=12]. Data was entered in SPSS11 software program and analyzed by Mann-Whitney, Fisher exact test and Wilcoxon tests [P-values < 0.05 were significant]. Total number of patients were 44 [mean age 27.18 +/- 7.34], 21 in group I and 23 in group II. Response rate was 85.7% [18 patients] and 73.9% [17 patients] in group I and II, respectively; with no significant differences between the two groups[P=0.33]. Remission rate was 42.9%[9 patients] and 43.5% [10 patients] in group I and II, respectively; with no significant differences between two groups[P=0.97]. The reduction in total scores in YMRS on the 2nd, 7th and 10th days of study were significant in both groups [P<0.05], but the rapidity of response was similar. The rates of adverse effects between two groups were not statistically significant. Both combinations of drugs were effective in acutely manic or mixed patients. Both treatments were safe and well tolerated