Background: The amino amide type, lidocaine, lignocaine with the brand name Xylocaine, which was discovered in 1946 and went on sale in 1948, is a local anesthetic agent. Lidocaine is the most widely used medication in dentistry. The aim of this study was to provide an updated review regarding lidocaine as a local anesthesia in dentistry. Methods: The appropriate documents for this review were achieved by searching databases such as; Web of Science, Scopus, and PUBMED. From their inception to 14 May 2024 based on the relevant and in-depth search, current, high-quality manuscripts were selected. Results: It is well known that before dental operation, lidocaine may be given to the patient. Unlike general anesthesia, lidocaine does not cause the feeling of being asleep condition in a patient. A recent publication confirmed that by attention to microbial contamination, multi-dose vials could be used in clinics for economic reasons. Based on the nation, gender, age, weight, and medical condition of the patients the maximum recommended dose of lidocaine could be varied. Regarding allergic reactions in a dental office, dentists should quickly manage anaphylaxis and associated events. In addition, the publication confirmed that bupivacaine may be superior to lidocaine with epinephrine and mepivacaine with regard to time and amount of analgesic consumption. Conclusion: A protected and consistent pain supervision procedure in the field of dentistry could be mentioned as local analgesia. The use of modern techniques could make the process more enjoyable for both the dentist and the patient.
Osteoid osteoma (OO) is a benign osteoblastic bone tumor, most frequently affecting young male patients. It is commonly seen in the 2nd & 3rd decades, more often between 5-30 years.It involves the appendicular skeleton & the spine more often, rarely the flat bones & unheard in the membranous bones. Many forms of treatment are available but the classical method of treatment is surgical excision. We at Avicenna Military Hospital report such a case of osteoid osteoma of tibia in a 43 year old female treated with surgical excision. Patient was pain free with no signs of recurrence after two years.
Gardnerella vaginalis is a facultative anaerobic gram-negative bacterium that can be sexually transmitted and usually causes genital infections such as vaginitis. This microorganism is an opportunistic pathogen and in addition to genital infections, it can also cause invasive infections. We searched various English articles published between January 1980 and October 2021 in the database Medline, EMBASE, Web of Science, Google Scholar, PubMed, Scopus, Research Gate. Data were extracted based on the characteristics and quality of the study. We studied 20 case report articles of bacteremia and sepsis caused by Gardnerella vaginalis from different parts of the body. Cases included men and women with different clinical conditions in different age groups. This factor may not be considered because the microbiological diagnosis of Gardnerella vaginalis is difficult and is not detected by routine culture media. Most of the cases reported in these articles were treatable. In conclusion, physicians should consider the association of this bacterium with invasive infections such as bacteremia and sepsis. The use of specific culture media and new microbiological methods can quickly identify this microorganism and show its role in invasive and systemic infections more clearly.
With significant mortality among malignancies, Ewing's family of tumors stands out as one of the most malignant cancers in young patients. This study aims to investigate clinicopathological characteristics and the impact of demographic and treatment types on survival. This retrospective-analytical study was conducted using the census method at Shahid Sadoughi Hospital in Yazd. The study included all patients with Ewing's family of tumors referred to these hospitals from 2011 to 2018. Demographic and disease characteristics were collected from the registry and analyzed using SPSS v.17. Fifty patients were enrolled in the study, with a mean age of 19.14±15.92 years. The lower extremity (30%) and abdominopelvic (24%) were the most common sites of the primary tumor, respectively. The mean tumor size was 5.76 ± 3.92 cm, and metastasis occurred in 16% of patients. Among them, 42% underwent combination therapy (chemotherapy/radiotherapy/ surgery), and 40% underwent chemotherapy + surgery. The disease relapsed in 62% of patients, and the most common site of recurrence was the chest wall (38%). The mean overall survival was 87.82 ± 11.54 months. Tumor location was associated with overall survival. Gender, age group, tumor size, and treatment type did not affect overall survival (P> 0.05). The mean survival until disease recurrence was 57.74 ± 7.74 months. It was concluded that recurrence is common in Ewing sarcomas, with the chest wall being the most common site of recurrence. Overall survival is linked to tumor location.
Respiratory syncytial virus (RSV) is a viral infectious disease that has detrimentally affected the quality of life in children younger than 2 years of age since it was discovered in 1956. It is the major cause of lower respiratory tract illness in young children. So effectively does RSV spread that essentially all persons have experienced RSV infection within the first few years of life. RSV is estimated to cause up to 75% of all infant bronchiolitis and 40% of all pediatric pneumonia. RSV can manifest in different ways, causing a myriad of symptoms which are as follows: (1) cough; (2) shortness of breath; (3) fever; (4) wheezing; (5) decrease in appetite; and (6) runny nose. Data collection methods for this study consisted of the utilization of primary methods such as interviewing. Interviews conducted in either Spanish or English were utilized for data collection, accommodating the local Hispanic population. Seemingly, a weak negative correlation exists between early identification of RSV and oxygen requirements upon inpatient admittance and a weak positive correlation exists between early identification of RSV and length of hospital stay. This study concludes the need for additional research among the Hispanic population due to lack of information in parenting capacity to identify RSV symptoms.
Temperature rise in the pulp chamber is a severe stress that can cause irreversible damage to the pulp. The objective of this study was to compare the temperature rise under primary teeth dentin induced by Light Emitting Diode (LED1) with different light curing modes. Thirty dentin discs of 0.5- and 2-mm thickness were prepared from human primary molars. Resin composite placed in an acrylic cavity was cured using a high-powered LED (Foshan JERRY Medical Apparatus CO., LTD, Foshan, China) for 20s. The different modes tested in this study were standard mode, ramp mode, and pulse mode (n=5). Temperature was recorded using a k-type thermocouple in direct contact with the dentin disc. Temperature change data were subjected to analysis of variance (ANOVA) and Tukey's test. The highest temperature rise was observed under 0.5 mm thick dentin disc with standard mode (4.7 ± 0.42), whereas the lowest values were recorded with pulse mode under 2 mm thick dentin (2.5 ± 0.23). Pulse mode produced significant lower temperature rise compared to standard mode in both dentin thicknesses (P < 0.05). Ramp mode gave significantly lower values compared to standard mode in 0.5 mm group (P < 0.05). For standard and ramp modes, temperature rise decreased with the increase of the dentin thickness (P < 0.05). Maximum temperature rise induced by high-powered LED was not critical for pulpal health. Temperature rise related to dentin thickness and curing modes. Pulse mode gave the lowest values.
Abstract: Herein, we propose a hypothesis for the low level of vitamin D as a sign of untimely relocation of humans during history. This improper displacement made the human species prone to infectious and noninfectious diseases during the life journey. The low level of vitamin D is a sign that needs to be addressed as a marker of an unsafe journey in a lifetime, not the cause for associated diseases, and the replacement of vitamin D is the least performed in this regard.
Mycobacterium tuberculosis (TB) is a worldwide danger to human health, with the potential to spread to all parts of the body, including the heart. Tuberculous endocarditis (TBE) is a rare form of tuberculosis that is often associated with miliary TB and the replacement of an infected prosthetic or native valve. Despite advances in the diagnosis of tuberculosis, extrapulmonary tuberculosis remains a challenge due to its difficulty in diagnosis. In most cases, TBE is only detected post-mortem. In order to better manage TBE in the future, there is a need to accelerate and develop more accurate diagnostic methods. This review paper looks at the literature on TBE from 1970 to 2021. The diagnosis of TBE is complicated by the fact that the symptoms can vary greatly depending on the individual, and the disease can remain asymptomatic for long periods of time. The most common symptoms of TBE include fever, fatigue, joint pain, and an irregular heartbeat. Other symptoms can include chest pain, shortness of breath, and swelling of the extremities. Diagnosis is often made through a combination of physical examination, laboratory tests, and imaging. Treatment usually involves a combination of antibiotics and surgery. In some cases, valve replacement may be necessary. It is important to note that the prognosis of TBE is variable and depends on the individual's overall health, the stage of the disease, and the type of treatment received. Better management of TBE in the future requires acceleration and evolution of diagnostic methods. In this study, we review the literature on TBE from 1970 to 2021.
Migraine headaches are amongst the most prevalent neurological disorders. Dementia on the other hand, is classified as a neurodegenerative disease with symptoms of slow progressive memory loss and cognitive decline. Identifying the preliminary signs and symptoms of such neurological diseases are crucial in preventing the onset of such disease. In this review article, we analyzed several studies signifying and or contradicting the claim of migraine headaches as a preliminary symptom of dementia. This can ultimately aid in focusing specific treatments to reduce the risk of patients developing dementia. Databases including Google Scholar, PubMed, and NCBI were searched by using keywords including migraine, dementia, association, symptom, etc. This study analyzed articles that were sought through various databases. Several studies signified a positive correlation between the two diseases. Studies that contradicted this claim, were vastly outnumbered by studies that depicted the claim to be true. It was eminent that preventing and treating migraine headaches in patients with a high-risk profile of dementia should be considered and studied more extensively.
Abstract. A significant cause of morbidity and mortality was ranked as ventilator associated pneumonia (VAP). Therefore studies based on evidence-based pharmacotherapy could help in preventing multiple drug resistance and microorganism colonization. Experts suggested an 8 or 14-21 days course of vigilant antibiotics. Therefore, to reduce toxicity and cost, this systematic review aims to investigate updated antibiotic regimens for VAP. Web of Science, PubMed and Google Scholar were searched. New-onset pneumonia that developing more than 48 hours after endotracheal intubation was defined as VAP. Regarding pulmonary recurrent or excess mortality an 8 days course antibiotic therapy showed appropriate. For treatment of resistant pathogens with high minimum inhibitory concentrations, aerosolized antimicrobilas suggested more effective. Monitoring fever, prolcalcitonin values, C-reactive protein and PaO2/FiO(2) should also be considered. In addition report indicated that serum prolcalcitonin reduces the exposure of antibiotics. A study of 100 VAP patients reported that mortality rates were significantly associated with a change in antibiotic therapy. Published result associated with 12 studies included 3571 patients with VAP, confirmed no statistical difference in all‐cause mortality between monotherapy and combination therapy, clinical cure, length of stay in ICU or adverse events. Studies comparing tigecycline versus imipenem‐cilastatin for clinical cure in the clinically evaluable population showed statistically significant increase in clinical cure for imipenem‐cilastatin. There was no statistical difference in all‐cause mortality between carbapenem and non‐carbapenem therapies or adverse events, but carbapenems were associated with a statistically significant increase in the clinical cure. Treatment strategy in VAP should be considered based on pathogen reports. Vigilant attention to patient clinical status recommended to be advantageous for considering limited spectrum antibiotics.
With the prevalence of one-third of intracranial brain tumors, meningioma prognosis is affected by the size, location, ability to access the tumor through surgery, and the degree of histological malignancy. We intended to investigate patients' prognosis and clinical features with central nervous system meningioma.Records of all patients with central nervous system and spinal cord meningiomas between 2006-2016 in Yazd Shahid Sadoughi, Shahid Rahnemoun, Mortaz, Goodarz, and Mojibian hospitals were studied. Using SPSS version 17, survival, age, type of treatment, grade, size, and tumor location were investigated in this retrospective cross-sectional study. Of the 175 patients (66 (37.7%) male, 109 (62.3%) female) with an average survival time of 78.5 months, tumors recurred in 12 (10.7%) patients. Among them, 63 (47%) were between 18-54, and 72 (53%) were between 55-87 years. Syncytial was the most common histological subtype, and a significant relationship between age and tumor subtype was found (p-value = 0.03). Primary symptoms of headache and nausea/vomiting were in most of them (51, 57%). The most and the most minor expected location was the brain lobes (14 cases) and the spinal cord (2 patients). There was no significant relationship between meningioma subtype-symptoms, survival-gender/ tumor subtype, recurrence-gender/ age, or tumor subtype. Also, a significant relationship between age and survival was found (p-value = 0.05). An increase in the prevalence of meningioma in recent years has been due to improvements in imaging techniques and the population's aging. Overall, there was a significant relationship between age and meningioma prevalence.
Introduction: Burn is the fourth cause of trauma worldwide (1-3) and as a major health challenges, it is one of the most common health related accidents in different societies (4). Burn is one of the important causes of injury in Iran and it is responsible for 6 percent of deaths in Iran, among all deaths caused by accidents (5). Method: Data was obtained by reviewing the hospital documents of patients attending to Velayat Burn Hospital of Rasht from March 2019 till 2020, regarding the possible factors affecting death among burn patients. Data were then entered in SPSS 26 and the variants were analysed by one sample t test and chi-square (p<0.05). Results: There were 231 females (58.5%) and 326 males (41.5%) in our patients. The most common cause of burn was flame (49.4%). The most common area of burn was the upper limp (59.5%). The average percent of burn in patients was 23.41±19.17 %. Most of the patients (45.8%) were admitted between 5 to 10 days and most burns were in the winter (28.7%). The average blood glucose in patients was 113 mg/dl, average pH was 4.4, average BUN[1] was 19.6 mg/dl and average creatinine was 1.2±0.7 mg/dl. A significant relationship was found between self-immolation and neuropsychiatric diseases. Most common cause of death in patients was respiratory failure (54.1%). Inhalation burn injury was seen in 40 patients (7.2%) and self-immolation was 11 (1.97%) of patients. In the case of place of burn 459 patients were in home, 61 in work and 37 patients in other places. In all the patients, 47 (8.43%) were expired and 510 (91.75%) were rescued. Conclusion: According to current results, the most common cause of burn was flame and most common area was the upper limb. Most of the burns were in winter and a significant relationship exists between self-immolation and neuropsychiatric diseases. Most common cause of death in patients was respiratory failure. Lower pH and higher BUN had a significant relationship with death. Therefore, focusing on burn by hot liquids should be a priority in any of the high risk groups and prevention of burn and education of true usage of incendiary and hot devices and safety precautions, should be noted more than ever.
Melatonin (N-Acetyl-5-Methoxytryptamine) is a neuro-hormone produced in the pineal gland. It is found in animals, plants and fungi. Its biological properties contribute to the circadian rhythm, reproductive physiology and antioxidant activity. Melatonin is known to help reduce the effects of the jet lag by cultivating the necessary re-set of the body's circadian rhythm. Natural production of melatonin in humans depends on the amount of light as well as age; in fact, natural melatonin production declines with age. The present study was conducted to evaluate melatonin expression in yeast species. One hundred and thirty yeast species were screened and analyzed for melatonin production. It was found that Cryptococcus uzbekistanensis produced 46 ppm of melatonin in the optimized condition. The Box-Behnken methodology was used to identify significant factors in terms of the carbon source, temperature, growth incubation, and tryptophan concentration for optimization of melatonin production. The Response Surface Methodology (RSM) was applied to optimize the levels of these factors. In the presence of 3 ppm of tryptophan in the growth media, a growth incubation time of 72 hours, glucose as carbohydrate, and a temperature of 308 Kelvin, Cryptococcus uzbekistanensis produced the maximum concentration of melatonin. This is among few instances that a microorganism is found to produce melatonin and thus the results can be utilized for industrial production of melatonin.
Thyroid nodules are often discovered incidentally in the clinical practice. Even though definite preoperative diagnosis of follicular thyroid lesions prevents unnecessary thyroid surgeries, fine needle aspiration (FNA) cannot definitely differentiate benign or malignant follicular lesions of the thyroid. Several proliferative markers including minichromosome maintenance proteins (MCM) have been evaluated for diagnosis of follicular lesion. In this study, the immunohistochemical expression of MCM2 in follicular adenoma and carcinoma of thyroid was investigated to determine whether it can distinguish between them and if there is a difference between follicular carcinomas diagnosed with capsular/vascular invasion. The correlation between intensity of MCM2 expression in follicular adenoma and carcinoma was evaluated. Thirty cases of follicular carcinoma and thirty cases of follicular adenoma were obtained from pathology department in Yazd, Iran from 2005 to 2015. We subdivided the follicular carcinomas into three groups on the basis of vascular and capsular invasion. The data were analyzed using SPSS v. 16 and p-value<0.05 was considered meaningful. In this study, the average intensity of MCM2 expression was 73.16% in adenoma and 70.31% in carcinoma which was equally distributed in the invasion area of carcinoma and subcapsular area of adenoma. There is no meaningful relationship between marker expression of MCM2 and gender nor age. MCM2 expression in the thyroid follicular carcinoma is not significantly more than the MCM2 expression in follicular adenoma. MCM2 cannot be used for cytology diagnosis before surgical operations nor for confirming or ruling out histopathologic suspicious cases.
This study’s aim was to determine the effect of music therapy on symptoms and functions in patients with fibromyalgia syndrome (FMS). Women diagnosed with FMS for at least 6 months included in the study. 16 patients were in the music treatment group and 51 patients were in the control group. Patients in music treatment group were given a music CD which includes nature sounds recommended by the Turkish Psychological Association. The patients were evaluated with Fibromyalgia Impact Questionnaire (FIQ) before and after the treatment. The FIQ-function (p<0.001), FIQ-overall impact (p=0.001) and FIQ-symptoms (p<0.001) subscales improved after music treatment. All FIQ scores were similar in controls before and after treatment. FIQ total score (p=0.001), symptoms score (p=0.006), overall impact score (p=0.008) and function score (p=0.010) were lower in the music group after treatment. In conclusion, this study supports a potential benefit of music in the treatment of FMS and FMS-associated symptoms.
The affiliation of multiple sclerosis (MS) with other immune system and inflammatory illnesses like transverse myelitis (TM) has been a theme of interest. Even though, previous investigations tried to elucidate the relationship between these two illnesses, it remained unclear because of restricted and incompatible information in this subject. In this review, we researched the etiology, pathophysiology, epidemiology and treatments of MS and TM according to accessible articles in valid databases. We figured out multiple sclerosis (MS) can be associated with transverse myelitis (TM) in a number of aspects and longitudinal expanse of brain and spinal cord lesions found by MRI, presence of DRB1*1501 allele, and etc. However, further research is fundamental to perceive the remarkable relationship between multiple sclerosis and transverse myelitis in field of neurodegenerative diseases. An appraisal of research studies published in various bibliographic databases including PubMed, Medscape, and Google scholar were used. A total of 57 articles were sought and reviewed. Results were classified into 6 specific subtitles including prevalence and incidence rates, complications, common cerebrospinal fluid (CSF) agents and factors, prognosis and diagnosis, treatment, and finally risk factors. Research articles were reviewed and analyzed for information regarding each subject. In this study, we aimed to review articles that detected links between TM and MS and those that described different aspects of these correlations. It was observed that in various aspects MS and TM had strong as well as weak correlations. On the other hand, we discussed that the lack of common appropriate treatment caused the inability to restrict symptoms on patients in either disease. Further trials on candidate therapies may result in new reliable treatments with acceptable adverse effects.
Parkinson's disease (PD) is one of the most common neurodegenerative disorders. Recently, deep brain stimulation (DBS) was proposed as a potential therapeutic approach for PD patients. This procedure has side effects that can be divide into three categories: stimulation-related, surgery-related, and hardware-related side effects. Stimulation-related complications are also divided into motors such as paresthesia and dysarthria, while non-motor contains cognitive decline and depression. The most important complication related to surgery is intracerebral hemorrhage (ICH). Side effects related to hardware consist mainly of erosion and infections. Choosing the appropriate patient for DBS implantation has a critical role in reducing side effects. Also, adaptive or closed-loop DBS stimulates the brain by adjusting the parameters in response to feedback from the body and produce electrical flow in appropriate time. In addition, new directional leads provide the ability to shape and steer the current to avoid stimulation of unwanted regions. Moreover, using magnetic resonance imaging (MRI) instead of microelectrode recording (MER) allows surgery under general anesthesia and reduces the risk of ICH. Also, interleaving stimulation (ILS) can be a second option for those patients for whom conventional programming does not effective. Choosing the right trajectory and keeping a distance from the vascular areas during lead placement also reduces the risk of hemorrhage.
This review article focused on a statistical analysis of the obesity population’s viral infection rate and compared the effects from different viral respiratory infections, such as abnormal immune responses and hyperglycemia in the population with obesity. Obesity has become more prevalent in developed countries while still less in developing countries. People with obesity have higher adipose fat accumulation underneath the organ membrane and in-between tissues, which can lead to abnormal organ function and respiratory difficulties. Respiratory problems can exist in people with obesity that usually related to hypertension and dyslipidemia. Meanwhile, obesity downregulates many immune and metabolic responses in the body. Viruses like H1N1, SARS-CoV, and SARS-CoV-2 have pathological damages in the lung shared in common, in which a higher severity was observed in people with obesity. The review was done by an online article search from PubMed, Google Scholar, and NEMJ database to allocate potential case studies and review articles of our keyword criteria. The initial article search layout 206 articles related to obesity, respiratory, and virus in human studies carried out from 2000 to 2020. Further analysis has shown that 15 articles pointed out a clear relationship between obesity and viral infection. Influenza, MERS, and SARS coronaviruses reported a significantly higher infection rate in the population with obesity condition. However, there were inconsistent results regarding the relationship between obesity and pneumonia, in which pneumonia was observed in most viral respiratory infections. Comparing pathological evidence from obesity and SARS viral infections, both share in common on hyperglycemia and increase of ACE engagement, whether it is to increase blood pressure or increase virus entry. Obesity condition itself makes consequent treatments even more difficult. In suggestion, there is a need to conduct further extensive clinical studies on the people with obesity that are COVID-19 positive.
Malignant lymphoma is a well-recognized occurrence in Sjögren syndrome; however, progression to acute lymphoblastic leukemia is extremely uncommon. Here we present a patient with Sjögren syndrome complicated with acute lymphoblastic leukemia. A 41-year-old male, who was diagnosed as primary Sjögren syndrome 3 months ago was admitted to our hospital due to hematuria and weakness. The complete blood count showed bicytopenia. Bone marrow biopsy and aspiration cytology confirmed the diagnosis of acute lymphoblastic leukemia. He received combination chemotherapy with prednisolone, doxorubicin, cyclophosphamide, vincristine and intra-thecal methotrexate. Sjögren syndrome and other autoimmune diseases may build a portion of a continuum of lymphoproliferative disorders which have joined with B-cell neoplasms.
Coronavirus SARS-CoV-2 is a leading cause of public health emergencies, particularly, has only few literatures have summarized its clinical and radiologic pattern, however the treatment strategies are confined, whilst it is not just medical, economic and social but also has documented emphasis. Furthermore, the former Chinese guideline has highlighted that convalescent plasma (CP) therapy was a promising treatment for alarming Covid-19. CP is a pattern of passive immunization. Usually, CP was notoriously used to enhance the survival speed in a diverse outbreak such as SARS, MERS, influenza, Ebola virus disease, etc. It predominantly acts by neutralizing antibodies that significantly bind to the specific antigens of SARS-CoV therein protecting the susceptibility of individuals, moreover, urgently needed to reduce the immediate health hazard in this Covid-19 pandemic scenario. On the other hand, CP therapy is predominantly efficacious at the initial stage of disease ultimately confirmed by various research literature. This short review highlights on the use, historical context and its benefits in treatment of Covid-19.
