effects of simulated patient training on senior dental student's confidence and skills in delivering a tobacco cessation counseling program in school of dentistry, Shahid Beheshti university of medical sciences, 2010-2011

Simulated patients are highly effective in the medical education and are potentially useful to present tobacco cessation counseling. Although, some studies have reported the advantages of this method in TCC, different aspects of it did not clarified yet. The present study assessed the effects of training by the standardized patients on the confidence and skills of dental students in Shahid Beheshti Medical Sciences University to provide TCC on 2010-2011. In this controlled non randomized trial, 28 students of semester 11 [controls] and 39 students of semester 12 [cases] were selected and their confidence and skills in providing TCC were determined using a questionnaire. Case students received training by means of standardized patients and TCC was presented according to WHO guidelines of 5A's and 5R's. Finally, confidence and TCC skills of the students were assessed using the same measures. The changes occurred in the confidence and TCC skills of both groups were statistically analyzed using student t and ANCOVA tests. The mean skills scores of the case participants were 5.10 and 13.05 before and after training while the values were 5.14 and 5.25 for the controls. Furthermore, the mean confidence scores were 43.19and 47.13 for the cases with the means of 43.75 and 43.32 for the control participants before and after the training. Significant differences were noted between two groups regarding the increased confidence [p<0.001] and skills scores [p<0.001] while ANCOVA test showed training via standardized patients significantly affected the final confidence and skills of the participants after adjustment for age, gender, marriage status and the primary confidence and skills [both: p<0.001]. According to the results, TCC training via standardized patients improved the dental students' confidence and skills as compared to the control participants

Vulnerable household women's health assessment [VH-WHAT]: protocol design and implementation

The gender-based approach can identify women's health problems on the basis of biological differences and their social, familial and individual roles. Unequal power relationship between men and women, fewer chances of education and employment, repeated pregnancies, longer life-spans, a greater proportion of the world's poor, inappropriate familiarity with their health risks increase their need to better benefit from primary healthcare. As determinants of health, poverty and social class indicate that women and especially deprived women require a greater focus on their health. This study attempts to identify modifiable health risk factors of these individuals. The women-headed households under cover in 11 provincial centers were included in the study. Medical consultation, general physical examination, fasting blood sugar level, blood cell count, lipid profile and systematic examinations, specific examinations of breast, pelvis, mammography and Pap Smear were performed according to the protocol. As a pilot study, 2730 individuals were assessed and their demographic features were obtained. The mean age of participants in the pilot study was 47.6 +/- 10.2 years ranging from 22 to 88 years of age. We expect that the study's findings would provide the opportunity to compare the differences of the special subgroups of vulnerable women with the data available in the country, and if necessary implement changes suitable with the vulnerable groups' health status

[Relationships between smoking and IL-1 beta concentrations in chronic periodontal patients]

Cigarette smoking is a significant risk factor in pathogenesis and progression of periodontal diseases. Smoking could interfere with pro-inflammatory cytokines in inflammatory process. IL-1 beta is a main inflammatory cytokine in gingival crevicular fluid [GCF] which contributes in periodontitis. In fact it is a key molecule in pathogenesis of periodontitis. This study aimed to investigate the correlation between cigarette smoking and concentration of cytokine interleukin [IL]-1 beta in GCF of patients with moderate-to-sever chronic periodontitis. Sixty subjects were entered into this analytical case-control study, divided equally into smokers and non smokers. Two groups were matched in clinical parameters, age and sex. GCF samples were collected in one diseased and one healthy site from each subject. The IL-1 beta concentration in all 120 samples was determined by ELISA kits, specific for IL-1 beta. The observed data were analysed with SPSS 13 software using T, Paired T, Chi-square and Mann-whitney tests. Mean concentration of GCF IL-1 beta in healthy sites of the smokers was significantly more than non smokers [p<0.01]. But in diseased sites no significant differences were shown between the two groups. The differences between concentration of IL-1 beta in smokers and nonsmokers were not significant. Although no significant differences were found in concentration of IL-1 beta between all smokers and all non smokers, there were significant differences between two groups in healthy sites, which require more investigations

[Coronally advanced flap with connective tissue graft with or without epithelial collar in the treatment of localized gingival recession and increasing width of Keratinized gingiva a comparative study]

Regarding to the prevalence of gingival recession, esthetic and sensitivity problems of denuded roots, a variety of surgical techniques have been used to cover recession type defects. This sequential matched randomized double blind clinical trial was designed to compare the clinical outcome following treatment of localized gingival recession by subepithelial connective tissue graft [SeCTG] with and without epithelial collar. Nine consecutively patients with bilateral 24 Miller class I gingival recession in non - molar teeth, were participated in this study. The surgical areas were randomly selected as split mouth and were treated by SeCTG with or without epithelial collar. Clinical measurements including recession height [RH], recession width [RW], probing depth [PD], keratinized gingiva [KG], and clinical attachment level [CAL] were measured at baseline and 3 months post operatively by means of Williams probe, caliper and stent. Changes in these clinical parameters were calculated in and between groups and analyzed statistically with paired T test. Both treatments resulted in a significant decrease in RH [1.88 +/- 0.93 mm, P<0.000 in SeCTG with collar epithelium; 1.54 +/- 1.11 mm, P<0001 in SeCTG without collar epithelium] and RW [1.62 +/- 1.38 mm, P<0.002 in SeCTG with collar epithelium; 1.22 +/- 1.62 mm, P<0.024 in SeCTG without collar epithelium]. The mean changes in RH, RW, KG, CAL in each group to baseline were significant. However, the amount of these variables were not significant between the two groups. The subepithelial connective tissue graft with epithelial collar offers a more convenient approach for handling and suturing as a root coverage procedure and increasing width of keratinized gingiva in Miller class I recession defects specially in fixed and removable partial dentures for abutment teeth