A novel compound heterozygous of ß-thalassemia with HbG-Coushatta: case report of Iran.

A 30-year-old male couple from Ardabil city, Iran, were admitted for premarital screening. An abnormal band in HbS/D regions with high levels of HbF and HbA 2 led us to suspect the possibility of a compound heterozygous state of ß-thalassemia in our affected proband. Therefore, beta globin chain sequencing of proband discovered a heterozygote combination of the Hb G-Coushatta [b22 (B4) Glu>Ala, HBB: c.68A>C) with HBB: IVS-II-1 (G>A) mutation as a compound heterozygote.

A Successful Non-surgical Management of a Type II Dens Invaginatus with Antimicrobial Photodynamic Therapy: A Case Report.

Endodontic therapy of dens invaginatus (DI) anomalies is challenging due to difficult access, inadequate cleaning and shaping, and incomplete disinfection of its complicated root canal system. The present case report describes the treatment of tooth #10 with tooth discomfort, intermittent pus discharge, and localized swelling. Sinus tract, mobility, and probing grade 1 were observed. The tooth was tender on palpation and percussion with negative responses to pulp sensibility tests. Radiographic assessments revealed an atypical structure of pulpal anatomy, probably dens invaginatus, associated with a large periapical lesion and severe root curvature. Cone-beam computed tomography confirmed the presence of DI type II. Finally, the diagnosis of pulp necrosis with chronic apical abscess of tooth #10 was made. Combining antimicrobial photodynamic therapy as an adjunctive treatment with different irrigation techniques were effective in nonsurgical endodontic management of the complicated DI type II in a maxillary lateral incisor with a large periradicular lesion and severe root curvature. Six-month and one-year recall radiographic images revealed asymptomatic tooth and progressive osseous healing.

Developing an optimized groundwater exploitation prediction model based on the Harris hawk optimization algorithm for conjunctive use of surface water and groundwater resources.

Due to the lack of surface water and groundwater resources, especially in the agricultural parts, the simultaneous and sustainable use of water resources to supply water demands is essential. In this study, a conjunctive use optimization model is developed to minimize the shortage of water demand. This model is implemented for the Mahabad study area in northwestern Iran to improve the conditions of surface water and groundwater resources and the reclamation of Urmia Lake. For this purpose, the current research is accomplished in three parts. At first, the Mahabad aquifer is numerically simulated to investigate the aquifer conditions. In the second part, the optimized model of conjunctive use obtained by the Harris hawk optimization (HHO) algorithm is investigated over a 20-year period in the study area. In the last part of this research, seven scenarios are developed to predict the optimized groundwater exploitation (OGE) using the results of HHO, meteorological data, and some input information on the dam reservoir. Then, the OGE values are predicted using the artificial neural network (ANN) and ANN-HHO machine learning models for the scenarios. The results showed that the scenario that includes all input variables and the ANN-HHO model outperformed other models. Furthermore, the HHO algorithm provides suitable allocation of the surface water and groundwater resources in optimized conjunctive use and also improves the performance of ANN in predicting the OGE values. The findings of this study also show that groundwater resources can be more applied to supply water demand, and in contrast, surface water resources can be used for supplying downstream environmental demands and reclamation of Urmia Lake.

A hybrid approach based on simulation, optimization, and estimation of conjunctive use of surface water and groundwater resources.

Due to limited groundwater resources in arid and semi-arid areas, conjunctive use of surface water and groundwater is becoming increasingly important. In view of this, there are needs to improve the methods for conjunctive use of surface and groundwater. Using numerical models, optimization algorithms, and machine learning, we created a new comprehensive methodological structure for optimal allocation of surface and groundwater resources and optimal extraction of groundwater. The surface and groundwater system was simulated by MODFLOW to reflect groundwater transport and aquifer conditions. The important Marvdasht aquifer in the south of Iran was used as an experimental study area to test the methodology. In this context, we developed an optimal conjunctive exploitation model for dry and wet years using two new evolutionary algorithms, i.e., whale optimization algorithm (WOA) and firefly algorithm (FA). These were used in combination with the group method of data handling (GMDH) and least squares support vector machine (LS-SVM) to estimate sustainable groundwater withdrawal. The results show that the FA is more efficient in calculating optimal conjunctive water supply so that about 61% of water needs were met in the worst scenario for surface water resources, while it was 52% using the WOA. By applying the optimal conjunctive model during the simulation period, the groundwater level increased by about 0.4 and 0.55 m using the WOA and FA, respectively. The results of Taylor's diagram, box plot diagram, and rock diagram with error evaluation criteria, i.e., root mean square error (RMSE), mean absolute error (MAE), and Nash-Sutcliffe efficiency (NSE), showed that the GMDH (RMSE = 6.04 MCM, MAE = 3.89 MCM, and NSE = 0.99) was slightly better than LS-SVM (RMSE = 6.36 MCM, MAE = 4.50 MCM, and NSE = 0.98) to estimate optimal groundwater use. The results show that machine learning models are cost- and time-effective solutions to estimate optimal exploitation of groundwater resources in complex combined surface and groundwater supply problems. The methodology can be used to better estimate sustainable exploitation of groundwater resources by water resources managers.

Articaine (4%) with epinephrine (1:100,000 or 1:200,000) in inferior alveolar nerve block: Effects on the vital signs and onset, and duration of anesthesia.

BACKGROUND: This prospective, randomized, double-blind, clinical study was conducted to compare the effects of 4% articaine with 1:100,000 epinephrine (A100) and 4% articaine with 1:200,000 epinephrine (A200) on the vital signs and onset and duration of anesthesia in an inferior alveolar nerve block (IANB). METHODS: In the first appointment, an IANB was performed by injecting A100 or A200 in 1 side of the mouth (right or left) randomly in patients referred for extraction of both their first mandibular molars. In the second appointment, the protocol was repeated and the other anesthetic solution was injected in the side that had not received the block in the previous session. Systolic and diastolic blood pressures (SBP and DBP) and pulse rate were measured during and 5 min after the injection. The onset and duration of anesthesia were also evaluated. Data were analyzed using t-test and Mann-Whitney U-test, and p-value was set at 0.05. RESULTS: SBP and pulse rate changes were slightly more with A100; however, DBP changes were more with A200, although the differences were not significant (P > 0.05). There were no statistically significant differences in the parameters evaluated in this study. The onset and duration of anesthesia, and the changes in SBP, DBP, and pulse rate during and 5 min after the injection were the same in both the groups. CONCLUSIONS: For an IANB, A200 and A100 were equally efficient and successful in producing the block. Epinephrine concentration did not influence the effects of 4% articaine.

Platelet-Rich Plasma in Treatment of Zoledronic Acid-Induced Bisphosphonate-related Osteonecrosis of the Jaws.

BACKGROUND: Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a well-known challenging entity warranting management. Platelet-Rich Plasma (PRP) plays an important role in bone biology by enhancing bone repair and regeneration. OBJECTIVES: The aim of this animal study was to evaluate the effects of PRP on zoledronic acid-induced BRONJ. MATERIALS AND METHODS: Seven rats were given 0.04 mg Zoledronic acid intravenously once a week for five weeks. Two weeks later, the animals underwent extraction of their first lower molars, bilaterally. After clinical confirmation of the osteonecrosis, PRP was injected randomly into one of the extraction sockets of each rat. Three weeks later, all rats were sacrificed in order to obtain histological sections. The analysis of epithelialization was performed by McNamar's test, and the analysis of osteogenesis and angiogenesis was performed by the Wilcoxon Sign Rank test. P value was set at 0.05. RESULTS: We found no significant differences between the two groups regarding the amount of epithelialization, angiogenesis or sequestrum formation (P > 0.05), but a significant difference was seen between the two groups regarding the amount of existing vital bone (P < 0.05). CONCLUSIONS: Our study demonstrates positive results (preservation or regeneration of bone) using PRP in treatment of BRONJ. Although PRP may enhance osseous regeneration, long-term follow-ups are required to confirm its benefits.

Human herpesvirus-6 viral load and antibody titer in serum samples of patients with multiple sclerosis.

BACKGROUND: Despite the number of cases with definite diagnosis of multiple sclerosis (MS) being on increase, the role of human herpesvirus-6 (HHV-6) infection as a trigger for MS disease still is deliberated. Based on antibody detection and quantitative HHV-6 polymerase chain reaction assay, this study was achieved to find out the possible association between infection with HHV-6 and clinical progression of MS disease. METHODS: A total of 108 serum samples were obtained from 30 MS patients followed prospectively for a 6-month period. These samples were analyzed for the presence of HHV-6 DNA by nested polymerase chain reaction enzyme-linked immunosorbent assay and for anti-HHV-6 IgG titer. Activation of the disease was determined by either magnetic resonance imaging or by clinical status of the patients. Control groups were also included. RESULTS: The average antibody index for the MS patients in the first sample collection was higher than both control groups (p = 0.001). HHV-6 DNA was detected in the serum samples of 10 of 30 MS patients. The mean HHV-6 viral load in patients with relapsing-remitting multiple sclerosis (RRMS) with and without relapse was 973 and 714, respectively. Seven patients showed an exacerbation during the study period. Of those, four patients had HHV-6 DNA in their collected samples. The prevalence of HHV-6 DNA was significantly higher in patients with MS as compared with control groups (p = 0.001). CONCLUSIONS: The results indicate that HHV-6 is implicated somehow in MS disease. Over time, rising HHV-6 IgG antibody titers together with an exacerbation and detection of HHV-6 DNA in serum samples of some MS patients suggests possible association between the reactivation of the virus and disease progression.