Antibacterial effect of two mineral trioxide aggregate (MTA) preparations against Enterococcus faecalis and Streptococcus sanguis in vitro

The antibacterial effects of gray-colored MTA (GMTA) and white-colored MTA (WMTA) against Enterococcus faecalis and Streptococcus sanguis were assessed in vitro using the tube dilution test. Broth tubes were prepared and divided into experimental and control groups. Aliquots of each of the tested microorganisms were taken from a stock culture and added to each experimental and positive control group. All groups were incubated at 37 degrees C and evaluated for turbidity at 0, 1, 24, 48, and 72-hour time periods. A direct correlation was found between GMTA and WMTA concentrations and their antibacterial effect. Tubes containing GMTA in concentrations of 50, 25, and 12.5 mg/ml did not show E. faecalis growth at any of the time periods tested whereas tubes containing WMTA showed E. faecalis growth at all concentrations and time periods tested. Statistically significant differences were found between tubes containing GMTA in concentrations of 50, 25 and 12.5 mg/ml and tubes containing similar concentrations of WMTA (p < 0.001). Tubes containing GMTA in concentrations of 50, 25, 12.5, 6.25, and 3.12 mg/ml and tubes containing WMTA in concentrations of 50, 25, and 12.5 mg/ml did not show S. sanguis growth at any of the time periods tested. Statistically significant differences were found between tubes containing GMTA in concentrations 6.25 and 3.12 mg/ml and tubes containing similar concentrations of WMTA (p < 0.001). It appears that the susceptibility of E. faecalis and S. sanguis to MTA differed and that GMTA requires lower concentrations than WMTA to exert the same antibacterial effect against each of the microorganisms tested.     

Plant-borne human contamination by fascioliasis

Contamination by fasciolids takes place through ingestion of metacercariae attached to vegetables. Experimental studies were performed with plant-made foods suggesting a role in human contamination in Iran and on the usefulness of potassium permanganate as a preventive tool for killing metacercariae attached to vegetables used in salads in Egypt. In the foods assayed, although viability decreases with time, a high percentage of the metacercariae were still alive 2 and 4 weeks after preparation. Infection of laboratory animals proved that metacercariae kept their infectivity. The 5-minute tests of potassium permanganate effects showed that metacercarial viability was not affected even at the very high doses of 300, 600, and 1,200 mg/L. Careful, subsequent washing of leaves and vegetables with water is therefore needed after its application. A review on similar studies performed with metacercariae belonging to fasciolid and other trematode species affecting humans is included.     

Prevalence of Helicobacter pylori infection in children (south of Iran)

The prevalence of Helicobacter pylori in children ranges from 10% to more than 80%. High prevalence occurs in developing countries, and after colonization it takes an extended period to be eradicated by the immune system. To evaluate the prevalence and age distribution of H. pylori infection in children in Shiraz (a city in the south of Iran), we collected 593 stool samples from children selected randomly from 5 age groups. Infection was determined based on antigen immunoassay in stool using the enzyme-linked immunosorbent assay method. The prevalence rates were 82%, 98%, 88%, 89%, and 57% in age groups of 9 months, and 2, 6, 10, and 15 years, respectively. There were no significant differences between the prevalence of H. pylori infection in the first 4 age groups (P > 0.05), but there was a significant decrease in the 15-year-old group (P < 0.05). The prevalence of H. pylori infection in the south of Iran is very high. The infection begins at infancy and remains high until late childhood.     

The management of abuse: 2. Child abuse

The role of the GDP and the dental team in the recognition and management of child abuse is discussed. Information on the current legislation and protocols for referral are provided. CLINICAL RELEVANCE: This paper discusses child abuse and offers information and practical advice for the dental team.     

Diagnosis of human fasciolosis in the Gilan province of Northern Iran: application of cathepsin L-ELISA

Fasciolosis, or liver fluke disease, caused by parasites of the genus Fasciola is emerging as an important disease in man, particularly in countries such as Bolivia, Peru and Egypt. Several outbreaks of this disease recently occurred in the Gilan province of Northern Iran and in 1999 alone over 10000 individuals were infected. Our laboratory recently developed an enzyme linked immunosorbant assay (ELISA) test for diagnosing human fasciolosis in an endemic area of northern Bolivia. The assay was based on the detection of serum antibodies reactive with antigens secreted by the parasite. In the present report we examined the sensitivity and specificity of this ELISA to diagnose 176 patients residing in the Gilan province of Northern Iran. These individuals presented at health clinics with clinical symptoms of fasciolosis and were subsequently positively diagnosed by fecal analysis. The ELISA employed total molecules secreted by the parasites (excretory/secretory, ES, products) and a protease, termed cathepsin L1 (CL1), which was purified from this preparation, as antigen. In addition, the specificity of the assay was investigated using serum from Iranian individuals that were infected with hydatidosis, toxocariasis, amoebiasis, malaria and kalaazar. Using this assay, both CL1 and ES exhibited a sensitivity of 100% (all 176 patients tested positive) and a specificity of 100% and 98.9%, respectively. In conclusion, our standardized diagnostic ELISA for human fasciolosis based on the detection of IgG responses to parasite ES and CL1 would be a valuable tool to diagnosis human fasciolosis in Iran and could be employed in a large survey to determine the prevalence of the disease throughout this region.     

Arthrocentesis versus glucocorticosteroid injection for internal derangement of temporomandibular joint

Oral and Maxillofacial Surgery - It is necessary to clarify that temporomandibular joint disorders (TMDs) are one of the most misdiagnosed and mistreated maladies in the medical practice. It is an...     

Perceived Barriers to Following Dietary Recommendations in Hypertensive Patients

Objective: Hypertension (HTN) is one of the most important public health problems in the world. Lifestyle modification including dietary changes such as following the Dietary to Stop Hypertension (DASH) plan is the first step to control HTN. The aim of the present study was to identify perceived barriers to following dietary recommendations in hypertensive patients in Zanjan, Iran.

Materials and Methods: In this cross-sectional study, 200 outpatients (161 women, 39 men) with essential HTN (systolic blood pressure [SBP] ≥ 140 mmHg and diastolic blood pressure [DBP] ≥ 90 mmHg) were recruited from August to November 2012. A 29-item structured questionnaire was designed to assess perceived barriers to follow dietary recommendations. Validity and reliability were assessed by content validity index, content validity ratio, and Chronbach's alpha, respectively. An exploratory factor analysis with a principal component analysis extraction method and varimax rotation was performed to extract the underlying factors.

Results: Mean age and body mass index (BMI) of participants were 46.9 ± 5.5 years and 30.6 ± 3.6 kg/m², respectively. The exploratory factor analysis extracted 6 interpretable factors with eigenvalue > 1. In order of importance, they were social and environmental barriers (eigenvalue = 2.489), social gathering (eigenvalue = 2.379), compliance with recommended diet and preference of other family members (eigenvalue = 2.127), palatability of the recommended diet (eigenvalue = 1.972), emotional statues and psychological factors (eigenvalue = 1.921), and cost (eigenvalue = 1.845). Mentioned factors explained 44% of the total variance.

Conclusion: Patients with HTN in our study perceived some barriers to following the recommended diet. In nutritional counseling, considering these barriers may be effective in improving the dietary adherence level in hypertensive patients.     

Association between social capital,health-related quality of life,and mental health: a structural-equation modeling approach

AimTo explore the association(s) between demographic factors, socioeconomic status (SES), social capital, health-related quality of life (HRQoL), and mental health among residents of Tehran, Iran.MethodsThe pooled data (n = 31 519) were extracted from a population-based survey Urban Health Equity Assessment and Response Tool-2 (Urban HEART-2) conducted in Tehran in 2011. Mental health, social capital, and HRQoL were assessed using the 28-item General Health Questionnaire (GHQ-28), social capital questionnaire, and Short-Form Health Survey (SF-12), respectively. The study used a multistage sampling method. Social capital, HRQoL, and SES were considered as latent variables. The association between these latent variables, demographic factors, and mental health was determined by structural-equation modeling (SEM).ResultsThe mean age and mental health score were 44.48 ± 15.87 years and 23.33 ± 11.10 (range, 0-84), respectively. The prevalence of mental disorders was 41.76% (95% confidence interval 41.21-42.30). The SEM model showed that age was directly associated with social capital (P = 0.016) and mental health (P = 0.001). Sex was indirectly related to mental health through social capital (P = 0.018). SES, HRQoL, and social capital were associated both directly and indirectly with mental health status.ConclusionThis study suggests that changes in social capital and SES can lead to positive changes in mental health status and that individual and contextual determinants influence HRQoL and mental health.Mental health is defined by World Health Organization (WHO) as “a state of well-being in which every individual realizes his/her own potential, can cope with the normal pressures of life, can work productively, and is able to make a contribution to his/her community” (1,2). Mental health and associated disorders have received increasing attention worldwide, largely due to their impact on socio-economic and overall health status of patients (3). Mental health problems remain a global concern, and account for a large fraction of diseases (4,5).The overall prevalence of mental disorders in Iran between 2000 and 2008 ranged from 12.5% to 38.9% and was similar in urban (20.9%) and rural areas (21.3%) (6). Anxiety and depression were more prevalent than somatization and social dysfunction (7). The provinces with the highest prevalence of mental problems were Chaharmahal with 38.3% and Golestan with 37.3% (8).Mental health is usually determined by a complex interaction of sociocultural, psychological, environmental, and demographic factors (9). The prevalence of mental health disorders is significantly associated with age, marital status, educational level, employment, and health-related to quality of life (HRQoL) (10). HRQoL incorporates physical and socio-emotional functioning and is used to measure individual''s perception of health status, welfare, and well-being in a society (11). A frequently used psychometrical tool for the assessment of HRQoL is Short-Form Health Survey (SF-12). Its two main components are physical component summary (PCS) and mental component summary (MCS), both of which are associated with mental health (12). Previous studies have confirmed a bidirectional association between physical health and depression (as one of the main dimensions of mental health) (13). However, it is not clear whether there is a causal relationship between them (13,14).The suggested mechanisms by which depression could lead to physical disability and decreased HRQoL are poor health behaviors, increased risk of physical disease, and characteristics of depression (eg, decreased pain threshold) (15). On the other hand, physical disability can lead to depression and deterioration of mental health due to restriction of social activities and loss of social capital (15). Ultimately, this bilateral association between depression and poor physical health can lead to increasing health risks (14).Mental disorders such as depression and anxiety are also influenced by socioeconomic status (SES) (16). SES is commonly conceptualized as an individual or group’s relative social standing or class (16,17). The main predictors of SES are education level, income, and occupation (15,17,18). The correlations between SES and mental health have been explained by various mechanisms. It has been found that negative impact of low SES on mental health (19) can be reduced by the mediating effect of social capital and physical health (4,18).Social capital has been defined as individual’s social networks and social interactions, shared norms, values, and understandings that facilitate collective action within or among groups. It can act as a protective factor, promoting mental health status by reducing socioeconomic inequalities (4,20) and play an important role in reducing the prevalence of mental disorders (4). Previous studies have found that social ties and support significantly improve mental health (9). Nonetheless, the association between social capital, mental health, quality of life, and SES is not consistently reported (21,22). This population-based study aims to explore the association between demographic factors, SES, social capital, HRQoL, and mental health among Tehran residents using structural-equation modeling (SEM).