مجله پزشکی دانشگاه علوم پزشکی تبریز
سال چهل و چهارم شماره 5 (پیاپی 161، آذر و دی 1401)

Oral health is one of the most important issues for people and physicians, and it is very important to identify the factors that contribute to the damage to oral health. One of the factors that is always emphasized in harming oral health is drug addiction. 

Methods:

This study is a systematic review and meta-analysis. We searched the electronic databases, including PubMed, Scopus, ProQuest, Google Scholar, and ISI for Persian and English articles and compared oral health indicators in patients with substance abuse with healthy subjects. The quality of the selected studies was measured by the Newcastle-Ottawa Scale. Heterogeneity of studies was performed using the Q test and I-square index. In case of heterogeneity of studies, a random effect model was used to combine the results. Publication bias was performed by funnel curves and Egger’s and Begg’s tests.

Substance abuse had a significant effect on (std dif in means 1/657[1.873-1/442], P<0/001) and it has a strong positive and significant effect on plaque index (OR. 1/42; 95% CI 1/18-1/7), P= 0/0002.

Conclusion:

 The mean DMFT was higher in people with drug abuse than in healthy people. Periodontal problems are also more common in people with drug abuse than in healthy people. Hence, the oral health status of these people needs more attention.

Practical Implications:

Responsible organizations and social dentists should pay more attention to oral and dental health of substance abusers.

Road Traffic Accidents (RTAs) are one of the essential causes of mortality;therefore, it is crucial to investigate the influencing factors. Studies indicate that drivers with attention deficit disorder have weaker driving performance than others. Therefore, it is vital to evaluate their driving performance in various circumstances, given their distinctive driving patterns.

In this methodological study, a total of 62 individuals in both genders, aged 18 to 59, 31 with Attention Deficit Hyperactivity Disorder (ADHD) and 31 in a control group were randomly referred to the Sahand driving simulator or take the tests of Vienna Test System (VTS),after a definitive diagnosis by a psychiatrist . This study protocol aims to compare the driving performance of ADHD drivers with that of control group drivers. In addition, a joint investigation of driving simulator assessments and the Vienna Test System (VTS) including Reaction time (RT) and Adaptive Tachistoscopic Traffic Perception Test (ATAVT) will be performed.

Glial cells release different gliotransmitters and response to neurotransmitters released from neurons. These cells especially astrocytes, having different transporters, play an important role in synaptic space homeostasis and synaptic plasticity. In this study, the role of hippocampal glial glutamate transporter (EAAT2) in baseline synaptic response and short term synaptic plasticity were investigated.

In this experimental study, ceftriaxone, EAAT2 activator (0.5mmol/0.5μl), was microinjected intrahippcampally for activation of hippocampal glial glutamate transporter in male wistar rats. Baseline synaptic response and short term synaptic plasticity were evaluated by field potential recording. fEPSP was recorded from CA1 following Schaffer collaterals stimulation. After Input/Output curve construction, short term synaptic plasticity was induced by paired pulse stimulations.

Activation of EAAT2 by ceftriaxone microinjection in CA1 did not have any effect on baseline synaptic response (P> 0.05, Two Way ANOVA). There was no significant difference in Paired Pulse Index at 20, 80, and 200 ms inter-pulse interval between ceftriaxone treated and control group (P> 0.05, Two Way ANOVA).

The results suggest that hippocampal glial glutamate transporter activation does not have effect on baseline synaptic response and short term synaptic plasticity in CA1 area of the hippocampus.

Considering the role of glial cells in regulating the excitability of the nervous system as well as synaptic plasticity, correcting these features of the nervous system by manipulating glial cells can help the treatment or prevention of neurological diseases. In this study, the role of glial cells in the homeostasis of the glutamate in the synaptic space of the hippocampus was evaluated, through the stimulation of its uptake, on the basic synaptic activity and short-term synaptic plasticity.

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders starting at an early age with symptoms of attention deficit hyperactivity disorder and impulsivity. This study aimed to investigate the molecular alterations of the DRD4 gene, which have been linked to ADHD in previous studies with respect to the dose of methylphenidate.

The study population included all ADHD patients needing drug therapy aged 5-18 years referred to Bozorgmehr psychiatric clinic in Tabriz in 2017 for one year. After diagnosis, symptoms severity was assessed using the Conners Scale for ADHD Assessment. Then, 4 ml of blood was collected from each individual and DNA was extracted using salting out method. After performing polymerase chain reaction (PCR), the products were separated using specific restriction enzymes and then polymorphisms of Ex3 VNTR and rs3758653 of DRD4 gene were analyzed in 2% agarose gel. The last dose to achieve the therapeutic response was recorded in mg/kg. Then, we investigated the relationship between the doses of drug used to achieve the therapeutic response and the existence of the mentioned polymorphisms.

There was no significant relationship between treatment response and type of polymorphism. Also, there was no significant relationship between the average dose of drug and the polymorphisms of three replicates, four replicates, six replicates, and more than six replicates in EX3VNTR in DRD4 gene. In addition, we witnessed no statistically significant relationship between the mean drug dose and CC, TC, and TT genotypes in DRD4rs3758653.

There was no significant relationship between treatment response and type of polymorphism. There was no significant relationship between the average dose of drug and the polymorphisms of three replicate, four replicates, six replicates and more than six replicates in EX3VNTR in DRD4 gene. Between mean drug dose and CC, TC and TT genotypes in DRD4rs3758653, there was no statistically significant relationship.

Determining the reduction of ADHD symptoms by taking methylphenidate and evaluating the relationship between presence or absence of DRD4 polymorphisms and the dosage of drug to achieve a better response to treatment can collect enough evidence to determine the dose of methylphenidate according to the molecular analysis of DRD4 gene in patients with ADHD. This can reduce doctor visits, save time, and decrease the drug side effects.

COVID-19 disease is the cause of daily morbidity and mortality worldwide due to its high transmissibility and pathogenicity. To date, intravenous immunoglobulin (IVIg) injection has been used as one of the various treatments for this disease. This study aimed to determine the effect of IVIg injection on the treatment of patients with Coronavirus-induced cytokine storm.

A total of 174 patients with COVID-19 were included in this study based on their clinical characteristics and laboratory findings and were divided into two groups of IVIg recipients and non-recipients according to the treatment they received. Statistical analysis was performed using SPSS version 22.0. A p-value less than 0.05 was considered statistically significant.

IVIg was used to treat merely 20 patients and Kaletra and hemoperfusion drugs were used more among IVIg recipient patients (P=0.003 and P=0.001, respectively). COVID-19-positive PCR tests were significantly more frequent among IVIg recipients (P=0.026). The polymorphonuclear neutrophil (PMN) count (P=0.007) and sodium level (P=0.007) were significantly higher in the IVIg recipient group on the first admission day. Moreover, INR levels in the IVIg recipient group were significantly lower on the seventh admission day (P=0.020). The median of total intensive care unit (ICU) duration of hospitalization among IVIg recipients was significantly higher (P=0.001).

It seems that the use of IVIg in COVID-19 patients should be further investigated.

IVIg injection could decrease mortality and slightly increase the survival rate among COVID-19 patients.

Children's meningitis is associated with many complications and deaths. Therefore, it is critical to develop reliable and available methods to predict these complications, diagnose them in a timely manner, and prevent the progression of complications. This study aimed to investigate the findings of computed tomography (CT) scan in patients with meningitis and evaluate its association with prognosis.

In this cross-sectional analytical study, we investigated the clinical files of 100 patients with meningitis (preferably bacterial meningitis) in Tabriz Children's Hospital, Iran between 2013-2017. The results of CT scan and disease complications were recorded and analyzed by statistical software.

Common symptoms identified in the patients included fever (88%), nausea and vomiting (36%), headache (27%), and convulsions (25%). Also, the results of CT scan included cerebral effusion (16%), hydrocephalus (7%), diffuse cerebral edema (7%), and cerebral atrophy (4%). Statistical analysis indicated a statistically significant association between the complications of meningitis (learning disorder, epilepsy, and hearing disorder) and the results of CT scan (cerebral effusion, diffuse cerebral edema, and hydrocephalus).

CT scan can be used as an early diagnostic and prognostic method in children with meningitis.

Meningitis is associated with many complications and deaths, and the lack of diagnostic methods and accurate prognosis is one of the important challenges in this field. Therefore, identifying and introducing accurate and cheap methods for predicting these complications and taking early measures to prevent the development of complications and treatment can be beneficial. The results of the present study showed that CT scan can be used as an early diagnostic and prognostic method in children with meningitis.

Premature birth, in addition to causing health problems in infants, increases stress in the mother and reduces attachment between mother and baby. Therefore, the present study was conducted to determine the effect of guided visualization on stress and attachment of mothers of preterm infants in the neonatal intensive care unit (NICU).

This quasi-experimental study was performed on 35 mothers with premature infants admitted to the NICU of Mahdieh Hospital of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mothers were selected by available sampling method and randomly assigned into intervention and control groups. For mothers in the intervention group, the intervention was performed from the first to the fifth day of birth through training and sending guided imagery files. On the day of admission and discharge, the parental stress questionnaire and the postpartum attachment questionnaire were completed by the mother. SPSS software (version 20) was used to analyze the data.

The mean total score of maternal attachment on the fifth day of the intervention was significantly higher in the intervention group (P<0.001). Also, the mean total score of mothers' attachment status on the day of discharge was significantly higher in the intervention group (P<0.001).

Implementation of guided visualization program reduced stress in mothers with premature infants admitted to the NICU, and consequently increased the level of attachment.

Mothers are the primary caregivers of infants, and promoting maternal health has an effect on infants. In addition to reducing stress in preterm infants, this study can help improve the quality of infant care and increase attachment and parenting. The present study offers a completely cost-effective way to reduce the costs of long-term hospitalization and improve the quality of nursing.

Mothers with autistic children suffer a lot of psychological and physical pressures that can affect their quality of life, emotional states, and judgment about medical services. This study aimed to evaluate the quality of life, anxiety, and satisfaction with rehabilitation services for mothers of children with autism spectrum disorders and of non-autistic children in Ahvaz-Iran.

In this cross-sectional descriptive-analytical study, 128 mothers with autistic children and 30 mothers with non-autistic children needing rehabilitation interventions were selected from Ahvaz rehabilitation centers. All participants were asked to complete Quality of Life (WHOQOL-BREIF) questionnaire, 14-item Perceived Stress Scale as well as Satisfaction Questionnaire. Data analysis was performed using a multivariate three-way ANOVA test.

It was found that mothers of autistic children had a significantly lower quality of life score than those without autistic children (P<0.001). However, the two groups had no significant difference in anxiety score (P=0.114) and satisfaction (P=0.079). Factors such as age, education, and occupation of mothers significantly affected the results (P<0.05). Moreover, mothers whose autistic children received rehabilitation services under one month had lower quality of life (P=0.003) and a higher level of anxiety (P=0.025) than those who received rehabilitation over six months.

Middle-aged housewives with autistic children had the lowest mean quality of life score among all mothers studied. Mothers with a university education reported a lower level of satisfaction compared to mothers without a university education, indicating a higher level of expectations for their rehabilitation outcome.

Research findings can be applied in managing rehabilitation services for autistic children and their families.