Dentists' familiarity with tobacco cessation programs in dental settings in Iran

Objectives: The current study assessed Iranian dentists' practice, knowledge, perceived barriers, and attitudes toward helping patients to quit. We hypothesized that Iranian dentists would have limited knowledge and awareness of tobacco cessation methods or of their important role in encouraging patients to quit. We expected the combination of quantitative and qualitative research to yield important insights regarding effective methods of engaging Iranian dentists in tobacco intervention. Methods: From a list of registered dentists following an initial screening, we randomly selected a total of 1,000 dental practices in 10 randomly selected provinces. Following an initial letter describing the study, we mailed a questionnaire. For the qualitative part of the study, we used a convenience purposeful sampling of 16 dentists. Results: Despite repeated contacts, only 35 percent of those contacted returned completed surveys. Key findings not only included generally positive attitudes toward tobacco cessation programs, but also identification of major barriers including concerns about patient resistance, lack of supportive organization, and opportunities for training. Dentists were far more likely to ask patients about smoking than to provide actual cessation support. Female dentists were more likely to ask patients. The qualitative interviews shed further light on barriers to intervention. Conclusions: Interpretation of the findings is limited by the relatively low response rate. However, despite identified barriers to intervention, we are encouraged by dentists' overall knowledge and interest in tobacco cessation services. We plan to use the current findings to inform development of continuing education programs and incorporation of tobacco cessation counseling into dental school curricula in Iran.     

Central auditory processing and word discrimination in patients with multiple sclerosis

Many multiple sclerosis (MS) patients with normal pure tone threshold suffer from difficulties in their hearing especially speech perception in background noise, which is possibly because of incompetence of central auditory processing in this group. Three audiologic tests including gap in noise test (GIN), duration pattern sequence test (DPST) and word discrimination score (WDS) were used for comparing a number of aspects of central auditory processing between patients with MS and normal subjects. Approximate threshold and percent of correct answers in GIN test, percent of correct answers in DPST test and monosyllabic discrimination in WDS test were obtained through cross-sectional non-invasive study conducted on 26 subjects with relapsing-remitting multiple sclerosis who had mean age of 28.9 (SD 4.1) years, and 26 18–40-year-old ones with normal hearing and mean age of 27.7 (SD 5.2). Results of this study demonstrate increased approximate threshold and reduction of percent of correct answers obtained from GIN test in patients with multiple sclerosis (Pv = 0.0001). Furthermore in patients with MS, the average of correct answers in DPST was lower than normal subjects and finally performance of MS subjects in WDS test in quiet environment was correlated with GIN threshold (r = ?/624, Pr = /003). Results of the present study showed that patients with MS had defect in aspects of central auditory processing consisting of temporal resolution, auditory pattern and the memory for auditory task and difficulty in discrimination of speech in noisy environment that are related to the involvement of central nervous system.     

Effect of Picrotoxin on Antinociception in the Formalin Test

Abstract: Subcutaneous injection of diluted formalin (0.25 μl of 0.5%) caused a biphasic pain response in mice. The first phase of pain was observed during the first 5 min., while the second phase occurred 10-30 min. after formalin administration. With the formalin test, it was found that the antinociception produced by the GABA-A antagonist, picrotoxin, and the GABA-B antagonist, phaclofen, was abolished when employed in combination. The opioid antagonist naloxone and antimuscarinic atropine also decreased the picrotoxin response. However, sulpiride, SCH 23390, phenoxybenzamine and propranolol did not alter the picrotoxin response. Administration of naloxone, sulpiride and propranolol showed a pain response. The data indicate that dopaminergic and adrenergic mechanisms may not be involved in the picrotoxin antino-ciceptive effect. However, postsynaptic GABA-A and GABA-B may be involved in the drug effect, and involvement of opioid or cholinergic systems can not be excluded.     

Effects of Lead Exposure on Bromocriptine-Induced Penile Erection in Rats

Abstract: In the present work we have studied the effects of lead exposure on penile erection induced by bromocriptine. Intraperitoneal injection of bromocriptine (2, 3, 4 and 8 mg/kg) induced dose-related penile erection in rats. Maximum response was observed with 4 mg/kg of the drug. Lead exposure (as Pb-acetate in drinking water) for periods of 7, 14, 21 and 28 days decreased the bromocriptine-induced penile erection response. Higher concentrations of lead (0.05%) were shown to cause a more prominent decrease of penile erection. The same procedure for lead administration did not significantly alter penile erection induced by physostigmine (0.1 and 0.3 mg/kg, intraperitoneally). In a series of experiments, blood lead concentrations were measured 7 and 21 days after lead exposure. Significant increases of lead concentrations were found after lead exposure. It is concluded that lead can influence bromocriptine-induced penile erection.     

A submucosal fecal mass as the complication of stapled hemorrhoidopexy: A case report

Despite the early encouraging results and safety profile of hemorrhoidopexy, several serious complications have been reported including rectal perforation, retroperitoneal sepsis, pelvic sepsis and rectovaginal fistulas. The recent article is the report of the case of a 30 year old woman, with a submucosal mass which was palpable in the anterior rectum. She had undergone a stapled hemorrhoidopexy due to a 2nd degree internal prolapsed hemorrhoid three years previously. Operation was planned to identify the nature of the mass and a cylindrical impacted 4 cm × 2 cm fecal mass was excised. The recent finding seems to be the first one being reported in this issue.     

The risk of nerve injury with minimally invasive plate osteosynthesis of distal fibula fractures: an anatomic study

Aim  

The aim of our study was to identify the structures which may be at risk of injury when using a minimally invasive technique for the osteosynthesis of the lateral malleolus and the influence of the size of the implant on the frequency of injury to these structures.     

Upregulation of the ERG11 gene in Candida krusei by azoles

BACKGROUND AND THE PURPOSE OF THE STUDY: Candida species are the agents of local and systemic opportunistic infections and have become a major cause of morbidity and mortality in the last few decades. Azole resistance in Candida krusei (C. krusei) species appears to be the result of gene alterations in relation to the ergosterol biosynthesis pathway, as well as efflux pumps. The main objective of this study was to examine the RNA expression of ERG11 in C. krusei which had been identified to be resistance to azoles. METHODS: The ERG11 mRNA expression was investigated in four Iranian clinical isolates of C. krusei, which were resistant to fluconazole and itraconazole by a semiquantitative RT-PCR. Results: The mRNA expression levels were observed in all four isolates by this technique. Furthermore, it was found that ERG11 expression levels vary among four representative isolates of C. krusei. Although DNA sequencing revealed no significant genetic alteration in the ERG11 gene, one heterozygous polymorphism was observed in two isolates, but not in others. This polymorphism was found in the third base of codon 313 for Thr (ACT>ACC). MAJOR CONCLUSION: Even though such a polymorphism creates a new Ear1 restriction site, no significant effect was found on the resistance of C. krusei to azoles. Results of this investigation are consistent with previous studies and may provide further evidence for the genetic heterogeneity and complexity of the ergosterol biosynthetic pathway or efflux pumps.     

Assessment of atorvastatin effectiveness on serum PSA level in hypercholesterolemic males

The previous large retrospective studies demonstrated that treatment with Statins reduces both the incidence of prostate cancer by 50% and serum Prostate Specific Antigen (PSA) level up to 40%. However the main problem in those studies was the absence of control groups of men with hypercholesterolemia without Statin treatment. We performed a small prospective controlled clinical trial to assess the influence of the treatment with Atorvastatin on serum PSA in men with hypercholesterolemia referred to our educational and treatment center from October 2007 to March 2008. In this study, among the newly diagnosed males with hypercholesterolemia (LDL > 130 mg/dl), 40 patients with LDL more than 190 mg/dl were selected as a case group and were treated with Atorvastatin (20 mg/day). Among the same population and in the same period, another 40 patients with LDL between 130 and 190 mg/dl were selected as first control group and were treated only with low fat diet. Another 40 patients with normal serum cholesterol and without any treatment were selected as second control group. The lipid profile and serum PSA level of patients of all groups were tested at the first and third months after the therapy. After completion of data, the mean serum lipids and PSA level were measured in both visits and compared with each other by paired t-test. Also the mean PSA change in two visits between three groups was compared by ANOVA and Tukey HSD test. There was not any significant difference in mean baseline PSA between hypercholesterolemic and normocholesterolemic patients (P=0.547). In case group, mean PSA and LDL was reduced by 14.1% (P=0.0001) and 30% (P=0.0001) respectively by second visit. In first control group, mean PSA was not changed significantly (P=0.337), whereas mean LDL in this group was reduced by 9.6% (P= 0.0001). Similarly in the second control group mean PSA was not changed significantly (P=0.309) by second visit. In addition, mean change of PSA in case group was compared with first and second control groups that was significantly different (P=0.0001) whereas mean change of PSA between two control groups was not significantly different (P=0.615). The results of this study showed that: 1) Short term treatment with Atorvastatin can reduce serum PSA level, and 2) This reduction is more likely to be due to direct effect and is not related to lowering serum cholesterol levels. Thus, if results of this study are confirmed by large prospective randomized clinical trials with longer follow up period, it will be possible that Atorvastatin could be used in long term as a safe chemoprophylactic agent against prostate cancer in high risk patients.