مجله دانشگاه علوم پزشکی اردبیل
پیاپی 88 (تابستان 1402)

Premature Ovarian Insufficiency (POI) refers to the loss of ovarian function before the age of 40. This condition can be attributed to various factors including X chromosome abnormalities, autoimmune disorders, and chemotherapy drugs. Hormone therapy is a commonly used treatment for POI, but due to side effects and low fertility rates, alternative treatment options are needed. In recent years, stem cell transplantation has emerged as a promising treatment approach, offering hope for improving and restoring ovarian function. Stem cells possess the unique ability of self-renewal and regeneration, making them potentially effective in addressing ovarian failure and subsequent infertility. Different types of stem cells have been investigated for the treatment of POI, including mesenchymal stem cells (MSCs), stem cells from extraembryonic tissues, induced pluripotent stem cells (iPSCs), and ovarian stem cells. This article aims to provide an overview of the causes and treatment options for Premature Ovarian Insufficiency, with a particular focus on stem cell therapy as suggested by previous studies. Corresponding Author: Hossein Kalarestaghy, Department of Anatomical Sciences, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.

Background &

File fracture is one of the main concerns in root canal therapy, which can affect endodontic treatment outcomes. The present study aimed to assess the fracture rate of the Smart Tract X3 as a new file system, in comparison with the commonly used rotary file system, during the preparation of simulated severely curved root canals.

A total of 180 resin blocks with simulated severely curved canals were randomly assigned to three equal groups (n=60) including Smart Tract X3, ProTaper Universal and Neoniti. Each set of files was used for cleaning and shaping of five canals, in total, 12 sets of files were used to prepare 60 channels in each group. All files were prepared according to the manufacturer’s instructions. The number (%) of fractures, location, length and distance of fractured segments from the apex of the block were recorded.

Overall 60 files of Smart tractX3 and ProTaper universal (5 files in a set) and 36 files of the Neoniti (3 files in a set) were used. The fracture rate did not show a statistically significant difference in between-groups comparison. All fractures occurred at the apical third of the canal with the mean length of fractured segments and the distance of fractured segments from the apex of the block 2.228±0.216 mm and 0.845±0.186 mm, respectively.

There was no significant statistical difference among Smart Tract X3, ProTaper Universal, and Neoniti files regarding the incidence of fracture during the preparation of five severely curved canals.

Tooth decay directly and indirectly affects the national economy of some countries. These diseases reduce the number and productivity of the workforce. Medical expenses eat up savings and investments. All these factors reduce the earning power of individuals and households and affect the national economy, so an important part of the social and economic consequences of dental caries is the impact on savings at the household level and national income or gross domestic product at the national level.

The present study was descriptive, analytical and cross-sectional. The study sample was 260 6-year-old children and 260 adults who were referred to dental centers in 1401, and were randomly selected. The patients with tooth decay received services from the health and treatment centers of Ardabil city.

The total cost of dental services related to tooth decay in 6-year-old children of Ardabil city was equal to 22543323 rials for one tooth, of which 94.23% of these costs are related to direct medical costs, 2.2% to indirect medical costs and 3.57% is related to non-medical indirect costs. The total cost of dental services related to tooth decay in the adult population of Ardabil city was estimated as 3,227,897 rials for one tooth, of which 95.93% of costs are direct medical costs, 2.43% of costs are direct non-medical costs, and 1.65% of costs are indirect costs.

Considering the high prevalence of tooth decay in 6-year-old children and adults in Ardabil city, its treatment imposes a significant part of the costs on Ardabil households, and the limited supply of dental services in the public health sector and the lack of insurance support in paying the costs have caused that families often pay for private services out of their own pockets.

Background &

Futile or fruitless life-saving interventions are in conflict with the four principles of medical ethics, which are not only ineffective for the patients, but also have a high burden on society. Therefore, this study aimed to determine the causes of unsuccessful life-saving treatment and interventions from the point of view of care providers in the neurology and neurosurgery departments of Tehran University of Medical Sciences hospitals.

The present study is a descriptive cross-sectional study that was conducted on 64 doctors and 72 nurses working in hospitals affiliated to the Tehran University of Medical Sciences in 2018. A 25-item researcher-made questionnaire was used to collect data. SPSS-24 software and descriptive statistics tests were used to analyze data.

The average age of doctors and nurses was 34.25±5.1 and 35.12±8.2 years, respectively. From the point of view of physicians and nurses, the most important reason for the ineffective provision of life-saving services was the lack of legal, moral and Islamic permission and guidelines to cut off life support devices and the lack of resuscitation in patients facing death (end stages of life).

The results of this study showed that, from the point of view of nurses, the most common reasons for providing futile care and cure are the moral and humane obligation of the treatment and care team to provide ineffective life-saving interventions, and from the point of view of the physician, the lack of legal, ethical and religious permission and instructions to cut off life support devices in patients has resulted in death. Some of the causes of unnecessary care were presented in this study, and some of these causes cannot be solved without solving theoretical problems and practical expert studies. Developing guidelines to define futile treatment, especially in end-of-life care, and providing solutions to control and manage treatment and unsuccessful life-saving interventions seems necessary.

Background &

Early warning scores are commonly used by hospital care teams to assess patients and diagnose early signs of their deterioration and initiate further treatment. Due to the existing studies and the lack of sufficient evidence for burned patients, we decided to investigate the value of initial NEWS and MEWS in predicting mortality in burned patients.

After obtaining permission from the Ethics Committee of TUMS, patients who were candidates for hospitalization in the burn wards of Sina Hospital from July to March 1998 were included. All demographic information including age, sex, APACHE Type of discharge, comorbidities, percentage of burns, initial hospitalization in the burn ward, type and time of initiation and duration of antibiotic use, amount of serum and NEWS and MEWS scores for all patients were enrolled immediately after admission to the ward as well as before discharge from the ward. Data were analyzed after registration in SPSS software version 23.

In this study, 80 cases of burned patients were studied with a mean age of 37.94±18.85 years. The initial NEWS and MEWS indices have a good ability to diagnose burned patients (Area=0.79 and 0.78, p<0.001). The best cut- point based on the Youden index, for the initial NEWS and MEWS indices were obtained at 4.50 and 1.50, respectively.

In this study, for the first time, NEWS and MEWS were examined in predicting mortality in burned patients and it was found that these criteria can predict the prognosis of burned patients.

Background &

There is a tendency to increase the risk of dementia in patients with periodontitis, but the opposite, the role of Alzheimer's disease on periodontal disease is still unclear, so in this study, the effect of experimental Alzheimer's disease on periodontal inflammatory cells, collagen fibers and neovascularization was investigated in male rats.

In this experimental study, 16 Wistar male rats (230-250 grams) were randomly divided into 2 groups; control (saline) and streptozotocin 3 mg/kg (bilateral ICV injection, with a volume of 10 μl, in both groups). After 4 weeks of treatment, two groups were tested with the Morris water maze. Then the rats were killed by deep anesthesia and sampling from the papilla around the two central incisor teeth was done. Samples were fixed and the paraffin block was prepared, serial 5-micron slices were made with a microtome. After hematoxylin & eosin staining, the number of inflammatory cells (PMNs, eosinophils, and mast cells), angiogenesis, and fibroblasts were counted using a microscope (400×). Data were analyzed using SPSS 21 software and an independent T-test.

The results showed that Alzheimer's disease causes an increase in periodontal inflammatory cells, collagen fibers and new vessels in the gums of mice, and the difference between these changes between the experimental and control groups was significant in all parameters (p<0.00).

According to these findings, Alzheimer's disease causes or aggravates inflammation and increases the rate of periodontal diseases in rat and may have the same effect in humans.

Background &

Dental anxiety is an effective factor in reducing children's dental visits. It is necessary to identify the factors involved in causing dental anxiety to promote public health. The purpose of this study was to evaluate the relationship between dental fear and anxiety in 5-10 -year -old children with dental caries and a history of trauma in Ardabil dental clinics in 2022.

247 children (139 girls and 108 boys) were examined in terms of demographic information, history of oral and dental trauma, and socio-economic status through a questionnaire. The dmft/DMFT index was determined using the clinical examination to check the oral health condition. Dental fear and anxiety were measured using two standard scales, FIS and CFSS-DS. Chi-square test was used for data analysis .

According to the FIS index, the prevalence of dental anxiety was 11.4% and according to the CFSS-DS questionnaire, it was 18.2%. Children aged 5-7 years showed more anxiety (p=0.043). Children who had a dental visit showed higher levels of anxiety based on the CFSS-DS index (p=0.002). According to the FIS index, children without a dental visit history had a higher frequency in the "very upset" group (p=0.009). Severe dental caries in permanent teeth (DMFT) were associated with a higher level of anxiety (p=0.028). No statistically significant relationship was found between gender, number of siblings, child's position in the family, parent’s education, family income level, history of trauma and dmft with dental anxiety.

The results of the present study showed that age, history of dental visits and decay of permanent teeth are effective factors on children's dental anxiety.

Background &

The causes of Alzheimer's disease are currently unknown. Genetic and environmental factors can be effective in creating of this disease. In recent studies, one of the genes and its polymorphisms that was known to affect Alzheimer is SHARPIN. This study aimed to investigate the presence of rs34674752 polymorphism in the SHARPIN gene and its relation with Alzheimer's disease in the population of Iranian patients.

This study was performed on 50 people with Alzheimer's disease and 50 healthy controls. After blood sampling and DNA extraction, genotyping was done by Tetra ARMS PCR. The data was statistically analyzed.

Results showed that the frequency of GG, GT and TT genotypes of rs34674752 polymorphism in control and patient groups was 100%, 0% and 0%, respectively. Both control and patient groups were in Hardy Weinberg equilibrium. There was no significant correlation between people's genotype and the possibility of Alzheimer's disease, and among the demographic factors, only the relationship between age group and the disease was significant (p=0.029).

According to the results of this study, there was no statistically significant association between the rs34674752 polymorphism in the SHARPIN gene and Alzheimer's disease in the studied Iranian population. To confirm the present study results, the investigation of populations with different societies and a larger quantity of samples are recommended.