naser valaei

Several classifications have been proposed for gingival recession defects. Correct diagnosis of the type of gingival recession is necessary for proper treatment planning and assessment of the prognosis. Considering the existing uncertainty regarding the reliability of different classification systems available for gingival recession and their shortcomings, this study sought to assess the reproducibility and reliability of accuracy of three available classifications (Cairo, Mahajan and Miller’s classification systems) for gingival recession.

This descriptive study was conducted on 32 patients presenting to the Department of Periodontics, who were selected using convenience sampling. The screening process entailed two sessions and those with a minimum of one site of gingival recession disclosing the cementoenamel junction (CEJ) of the tooth with no adjacent tooth loss at the site of recession were enrolled. Each patient was separately evaluated by three calibrated examiners twice with a minimum of one-week interval. Grading of the gingival recession defects was determined using the Cairo, Mahajan and Miller’s classification systems for gingival recession. The gradings of each examiner were separately recorded by a blinded examiner. A total of 120 single recession defects were examined and data were analyzed using intra-class correlation coefficient (ICC) and Spearman’s test. Level of agreement was evaluated according to Landis and Koch.

The results showed that the reliability of all the three methods was almost perfect (P<0.05), and no significant difference was noted in reliability of the Cairo, Mahajan and Miller’s classifications for gingival recession (P=0.7).

Based on the results of the study, the highest intra- and inter-observer agreement in the use of the three classifications belonged to the Cairo classification; however, all the three classifications showed high reliability

 One of the important points in composite restorations is the bond strength, which, if reduced, can cause treatment failure and decay recurrence. One of the reasons for reducing the bond strength can be the use of homeostasis in restorations. Therefore, in this study, the effect of aluminum chloride hemostasis on the shear strength of three-step and two-step bonds was investigated.

 This experimental study was performed on forty human premolar teeth in four groups as follows:A: Aluminum chloride + Three-step bond + Composite. B: Aluminum chloride + two-step bond + Composite. C: Three-step bond + Composite. D: Two-step bond + composite. Then the shear strength of the bond was measured in MPa and compared in four groups with Kruskal Wallis test.

In the three-step, non-homeostasis bonding group, the shear bond strength was 53/8± 47/3 MPa and with the homeostasis it was 45/4±31/1 MPa, but this difference was not significant in these groups.  (p < 0.8) In the two-step, non-homeostasis bonding group, the strength was 83.8 ± 35 MPa and with homeostasis was 56/7±27/9 MPa and the test showed that the hemostasis reduced the strength of bond.( p<0.1)

The hemostasis substance does not seem to have an effect on the shear strength of the three-step bond, but it decreases the shear strength of the two-step bond.

Due to the growing trend of the elderly population, attempts to solve their problems, including their mental health problems appear to be necessary. One of the most significant and widespread anxieties among the elderly is fear of death.The present study aimed to evaluate the effectiveness of Logotherapy on the death anxiety among the elderly.This study is quasi-experimental with pretest-posttest control group. The study sample included all elderly women in the Elderly Day Centers in Kermanshah.To select sample, an elderly care center were randomly selected and among 93 elderly women members in the center, 50 patients who met the inclusion criteria were selected and randomly assigned to experimental and control groups.The experimental group received the Logotherapy protocol for ten weekly sessions of one hour.Data collection instruments included Collett-Lester the Fear of Death questionnaires (1969).The result of analysis of covariance shows that the Logotherapy significantly reduced the death anxiety in the experimental group.Therefore, it is suggested to psychologists working in the field of elderly to take advantage of this treatment to reduce the anxiety of death in the elderly.

The free-living amoeba called amphizoic amoebae, have the ability to live in natural environmental resources, including water, soil, dust and body tissues of humans and animals. Unlike other free-living amoebae, Neagleria fowleri could cause fatal disease called Primary Amoebic Meningoencephalitis in immunocompetent humans and animals. The disease affects the meninges membrane of brain and in a short time the affected people will die.
This paper presents an overview of the free-living amoeba pathogens using keywords, N. fowleri, brain-eating amoeba, primary amoebic meningoencephalitis, treatment, prevention and control methods in Google scholar search engines, Medline, PubMed and Relevant books. Finally, 27 articles selected in both Persian and English were fully studied.
Conclusions and Recommendations: Due to fulminant progress of the disease caused by N. fowleri and many reports regarding its death worldwide and also reported case of the brain-eating amoeba in Iran and identification of different species of amoebae including N. australiensis and N. gruberi in Tehran water resources and dust hospital in Tehran and the hot springs of Ardabil province awareness regarding N. fowleri distribution in environment, its identification criteria, pathogenesis process and recognizing the symptoms of the disease is essential and necessary. It should be noted that in addition to people with healthy immune system, the amoebae could attack people with impaired immunity. For these purposes, awareness and attention of people at risk is necessary by installing warning signs along the springs and water sources.

Facial wrinkles develop over the natural aging process. The demand to treat these wrinkles is increasing. Several treatment options are available.. We aimed to investigate the effect of fat injection and its combination with platelet-rich plasma (PRP) on facial wrinkles..Patients and We recruited 28 patients who were candidates for the treatment of facial wrinkles in this study. Wrinkles were recorded in five areas using standard digital photographs. These areas include nasolabial fold (NL), mouth corners (MC), perioral line (PL), chin (Ch), and marionette line (Mar). Patients were randomly allocated to two groups of 14. The first group received fat injection and the second one received Fat-PRP injection. For this purpose, 15 to 20 mL of fat was harvested from the thigh or abdomen; PRP was driven from blood, centrifuged, and mixed with fat before injection. Patients were followed up at the third and sixth months posttreatment. Wrinkles were evaluated with Wrinkle Assessment Scale (WAS) Index and level of satisfaction was determined on a scale of five.. In comparison to their initial condition, both groups showed improvement in wrinkles. NL wrinkles were reduced significantly in the second group compared to the first group (P < 0.001). The two groups were not different in reduction of MC, PL, and Ch wrinkles (P > 0.05). At the third-month follow-up, Mar wrinkles were more significantly improved in the first group (P < 0.02); however, the results were the same in both groups for Mar wrinkles at the sixth month follow-up. Patients of the first and second groups were more satisfied at the third and the sixth month, respectively; however, this difference did not reach a significant level (P > 0.05).. Although PRP preparation of fat was found to be superior to fat in the treatment of facial wrinkles in some areas, further studies are required to better delineate this difference..

Abstract Congenital hypothyroidism (CH) is a preventable mental retardation cause that can be diagnosed in early days of infancy and it can be treated on time.CH screening can decrease social-economic burden of the disease. The aim of this study was to determine the prevalence of permanent CH and increase transient TSH in newborns in Mazandaran. This was a review from official statistical records of Mazandaran University of Medical Sciences to control the non-transitional diseases. Screening was performed using heel prick blood collecting in the 3rdto fifth days after birth in 139,111 neonates who were born from June 2006 to June 2010 in Mazandaran. The blood sample was taken on a special filter sheet and TSH >5 mu/L was recalled. TSH>10 and T4<6.5 was diagnosed CH by venous blood sampling and treatment was done.However, in TSH ≥20 treatment began immediately. The data was analyzed using SPSS 16. 139,111 newborns were screened. 71,301(51.2%) were male and 67,810 were (48.3%) female. Also, 8,438(6%) were recalled. Prevalence of permanent CH was 0.45 in 1000 newborns (1/2272) and transient TSH was 0.62 in 1000 newborns (1/1612). Prevalence of CH in Mazandaran is more than most countries. Thus, CH screening is necessary to be continued andsearch for CH high prevalence causes in Mazandaran is needed.

Abstract Dental caries are one of the major clinical problems. Bacterial treatment is an alternative technique for pathogen microorganism replacement. The most common bacterial treatment technique is using probiotic bacteria. The aim of this study was to evaluate short-term consumption of probiotic yogurt on salivary Streptococcus mutans and Lactobacillus in adult. A crossover, double blind, randomized clinical trial was performed on 32 healthy adults having Streptococci mutans and 28 healthy adults having Lactobacillus. The samples were randomly divided into two groups for each microorganism. A control group consuming conventional yoghurt and a sample group consuming probiotic yoghurt containing Lactobacillus acidophilus and Bifidobacteria for 3 weeks. 0.7 ml unstimulated saliva was collected from each participant directly into graduated test tubes 1 day prior and after each intervention. Mitis Salivarius Agar and MRS were respectively the selective media for Streptococcus mutans and Lactobacillus. Periods 1 and 3 were run-in and washout periods of 1 and 2 weeks respectively. The data were analyzed with Wilcoxon and chi-square tests. The decrease in Streptococcus mutans colony count in the sample group was not significant (p<0.7). However, Lactobacillus colony count showed a significant decrease (p<0.01) in the sample group. It seems that short-term consumption of probiotic yogurt cannot change Streptococcus mutans populations, but significantly reduces the level of salivary Lactobacilli.

In order to communicate effectively with their students all teachers need verbal and non-verbal communication skills. The aim of this study was to evaluate these skills in the faculty members of the Shahed Dental School in 2010.

Cross-sectional survey was done by asking the students to fill up a questionnaire regarding their opinions about the communication skills of their teachers, based on five-item Likert scale(very poor, poor, fair, good, very good).. The reliability of the questionnaire was tested in a pilot study on 10 students for one week by test-retest method and a reliability of 85/0 was obtained.

Seven hundred and fifty-five students were included in the study 68.2% were females. Their opinion was as follows: 13.6% rated their teachers to be very good as regards communication skills, 34.3% as good, 45.4% as fair, and 6.6% as poor. For 48% of students, communication skills of their teachers were acceptable and for 52 percent these skills were poor.

It seems that interventional programs are needed to improve communication between the faculty members and their students.

Long delays in getting a paper published in a medical journal may affect motivation for research. The aim of this study was to evaluate the duration of the research, and the average interval between the completion of a research project and the publication of the research article in dental research journals.

In this cross sectional study, all eligible articles were collected and adjusted based on the reported intervals according to the month of publication. In this study, delay was defined as the interval between receipt of the paper and final modification >6 months, final modification and final approval >3 months and the time between final approval and publication >3 months. Name of the journal, authors, type of design, quality of materials (type and time of source, number of sources in English, Farsi, whether books or articles) and the project sponsor, were assessed to determine if any of these factors were associated with delay.

In this study, 7 journals and 509 articles were evaluated. 14.6% of the papers were delayed. Delay between receipt and final modification was noted in 31.2%, between final modification and final approval was observed in 3.3% and between final approval and publication in 11.2%. In 54.3 percent of papers, this data was not available. At all stages, type of journal had a significant role especially in the time between approval and publication.

Significant delays have been observed between receipt of papers and their publication in dental journals.

Coronary artery disease, (CAD) is an important risk for morbidity and mortality. Because of controversial reports about relation between high-sensitivity C-reactive protein (hs-CRP) level and the severity of coronary artery stenosis, this study was done in Taleghani Hospital. In this case-control study 85 patients with CAD undergoing coronary angiography were studied. Angiography findings were based on severity of disease according to the Gensini score: <10 was classified as mild, 10 to 50 as moderate and >50 as severe. Blood samples (1mL) were collected from each patient. After centrifugation in laboratory the level of hs-CRP were measured, and classified in three levels: <1mg/L, 1 to 3 and >3mg/L respectively as mild, moderate and significant elevation of hs-CRP. Correlation of these levels with the severity of CAD was analyzed with chi-square test. Out of 85 subjects, 64.7% were males; mean age 55.7±7.06 years. In 28.2% the hs-CRP level were <1 mg/L, in 27.1% between 1 and 3 mg/L and in 44.7% >3mg/L. Findings revealed significant elevation of hs-CRP level in patients with moderate and severe coronary artery stenosis (p<0.01). Findings of this study demonstrated correlation between serum hs-CRP level and severity of coronary artery stenosis.

Diastolic heart failure comprises 50 percent of cases of heart failure. The implications of increased levels of cardiac troponin I (CTnI) on congestive heart failure with preserved systolic function (AHF PEF) have been poorly evaluated. We hypothesized that its level might be elevated in AHF PEF so this evaluation was done in patients referred to Taleghani hospital with heart failure. In this cross-sectional study, patients with symptoms of acute heart failure according to Framingham criteria, with preserved systolic function & diastolic dysfunction in echocardiography were included. Measurement of CTnI in serum was performed with CTnI assay kit (Rapid test-SD-CTnI; China) at admission & 6 hours later in blood samples. CTnI >0.01 ng/ml was interpreted as positive. Study was done on 60 patient with AHF PEF; mean age was 72±7 year (35 women, 5men) without acute and old MI, Rheumatic heart disease (RHD), cor pulmonale and with PPH and LVEF<45%. CTnI level was positive in 4 patients (6.7%) which was not significant. (p<0.05). According to our results there is no acceptable relation between CTnI level & AHF PEF in Iranian patients. We recommend another biomarker or CTnI kit for further evaluation.

According to increasing prevalence of myocardial infarction (MI) and importance of detecting inflammatory markers, and also controversies in this topic, this trial was performed in Taleghani hospital to define the role of TNF-alpha in patients with myocardial infarction during 2010-2011. This case-control study was done on patient with definite diagnosis of myocardial infarction admitted in the hospital (case group, n=20) and persons with no cardiac problems referred to this hospital for check up (control group, n=20). Serum levels of TNF-alpha were checked by ELISA method and the two groups were compared by T-test. Participants were divided to two groups of more and less than 9.5pg/mL and analyzed by exact Fisher test. Mean serum level of TNF-alpha in the control group was 9.5±0.7pg/ml and in the case group 12.8±2pg/ml (P<0.001). 12 (60 percent) subjects of control group and all (100 percent) patients of case group had TNF-alpha mare than 9.5pg/mL (P<0.001). it seems that serum level of TNF-alpha in patients with myocardial infarction is higher than controls. Regarding important role of inflammation in the development of atherosclerosis, cohort or experimental studies are recommended to evaluate role of this marker in predicting ischemic heart diseases. Keywords:ELISA, TNF-alpha, MI.

Topical NSAIDs have been shown to be effective in treatment of recurrent aphtous stomititis. Therefore, the purpose of the study was to compare the effect of Triamecinolone asetonide and diclofenac in patients with recurrent aphtous stomititis referred to Shahed dental school in 2011. In this clinical trial Study 25 patients were divided in two groups (12 persons in control-triamcilonone group and 13 persons in case- diclofenac group). All patients were asked to apply the drug 3 times daily and the effect of therapy was assessed in 0, 2 and 6 days after start of the therapy. Pain level, disease period and ulcer size were compared with in each group and also between case and control groups. Patients in both groups were matched according to the personal and disease specifications. Pain level in day 6 in diclofenac group was 1/6±2/6 and in triamcinolone group was 1/5±2/8 (p<0/9). Ulcer size and treatment results were similar in both groups (p<0/7). It seems that both drugs have similar effects. However, considering the corticosteroid side effects, we recommend topical diclofenac therapy in patients with recurrent aphtous stomititis. Moreover, additional research is suggested to compare the effectiveness of the two drug.

Concerns about the known consequences of non adherence to standard treatment protocols by physicians in patients suffering from ACS and the lack of any dependable statistics as regards the degree of adherence in Iran and also the existence of different statistics on the subject in different countries led the present researchers to conduct an investigation to determine the extent of adherence to ACC/ AHA guidelines among cardiologists in patients with ACS. A cross sectional study was done in Shahid Modarres hospital in 2010. All patients suspected with ACS were investigated and those with definite diagnosis during angiography were included in the research. Their treatment protocols were investigated and the level of adherence to AHA guidelines was determined such that a ≥75% conformity with the guidelines was classified as complete adherence; 50% to 75% as relative adherence and <50% was classified as non adherence. K2 test was used in the analysis of data. Eighty-five patients with definite diagnosis of ACS were chosen out of 100 suspected patients. Complete adherence to the AHA protocol was noted in 47.1%, relative adherence in 32.9% and non adherence in 20%. In other words the level of adherence was unacceptable in 52.9%. No elements of individual characteristics and risk factors had any effect on the level of adherence (p<0.7). The high level of non adherence of the ACC/AHA guidelines in treatment of patients suffering from ACS is a cause of great concern. It is strongly recommended that a scientific investigation be carried out as the cause of this non adherence on the part of the cardiologists along with an investigation into the outcome of these patients.

Different factors affect sexual function and satisfaction. Some studies showed no relationship between type of delivery and sexual function and satisfaction, but others showed association of vaginal or cesarean delivery with sexual function and satisfaction. This study aimed to determine the sexual function and satisfaction in women with vaginal delivery and cesarean referring to Health Center of Shahid Beheshti University of Medical Sciences in 2008. In this cross-sectioned study, 180 women (90 vaginal deliveries and 90 cesarean deliveries) were selected with multiple sampling. Data collection was performed by questionnaires including socio-demographic characteristics, history of obstetric and sexual function and sexual satisfaction. The questionnaire was completed by interview in private place. Data were analyzed via descriptive and chi square test using SPSS software. There was no signification difference in sexual function including desire, arousal, orgasm and resolution, and sexual satisfaction after delivery between two groups. ‍ We did not find significant difference between women with vaginal delivery and women with cesarean delivery. Therefore it seems that various physical and mental factors affect sexual function.

Myofascial pain syndrome of upper trapezius muscle is common; reports about successful treatment with dry needling and physical therapy have been published. This study was performed with the objective of comparing the efficacy of these two treatment modalities in relieving the symptoms in patients with myofascial pain in the trapezius referred to the Physical Medicine and Rehabilitation Center at the Shohadaye Tajrish Hospital from Apr 2009 to March 2010.

It was a randomized controlled trial performed on 28 patients. After matching age, sex, duration of symptoms, pain severity, pain pressure threshold of trigger point and quality of life measures, subjects were randomly put in to subgroups of case (dry needling) or control (physical therapy). One week and one month after receiving treatment, outcomes and intra and inter group changes in pain severity, pain pressure threshold of trigger point and quality of life measures were evaluated and compared.

28 subjects in two 14 patients groups took part in this study. After one month of both physical therapy and dry needling, there was a decrease in resting, night and activity pain levels, (p<0.05). Pain pressure threshold of trigger point, scores of physical functioning, role limitation due to physical problems, social functioning and bodily pain were improved (p<0.05). Results were similar in the two groups, (p<0.4).

It seems that both physical therapy modalities and dry needling have equal effect in decreasing myofascial pain of upper trapezius muscle.

EMG needling is not a painless procedure. In recent studies it has been shown that a form of lidocaine has the efficacy which is similar to EMLA, for prevention of pain associated with EMG needling. The aim of this study was to evaluate the efficacy of Lidocaine H ointment in alleviating the pain caused by EMG needling. This study was performed on patients referred to Shohadaye Tajrish Hospital for EDx study in APR 2009- APR 2010. A double blinded, placebo controlled study was performed in 47 adult patients (94 lower limbs) to compare the pain of EMG needling into the tibialis anterior muscle after application of lidocaine-H ointment or placebo. Pain scores were obtained by using visual analog scale (VAS). Experimental and placebo groups were compared with Mann-U-Whitney and Chi-square tests. The study was performed on 47 patients, 38.3% male & 61.7% female, mean age being 45.5 ± 16.4years. Median VAS score was 4.66 ± 2.14 vs. 6.11 ± 2.07, (P<0.05). 51.1% of patients in experimental group as compared to 21.3% in controls reported mild pain (VAS < 4), (P<0/01). It seems that lidocaine-H ointment has beneficial effects in prevention of the pain associated with EMG needling.

There is evidence of a possible etiological role of human papillomaviruses (HPVs) in the development of colorectal cancer. Loss of p53 tumor suppressor gene function has been found in many malignancies and it can occur in a variety of ways, including gene mutation and interaction with the E6 protein of oncogenic HPVs. The objective of this study was to determine the prevalence of HPV infection and p53 overexprssion in colorectal cancer (CRC) tissue samples and its association with tumor histopathologic characteristics.60 tissue sections from patients with CRC were investigated by immunocytochemistry techniques for aberrant expression of p53 using the streptavidin-biotin-peroxidase method with monoclonal antibodies. The HPV status was also analyzed using type-specific primers for HPV16/18 by polymerase chain reaction (PCR).Overall, 21 (35%) of 60 patients were found positive for HPV DNA; HPV 18 was detected in 19 (32%) and HPV16 in 11 (18%) of 60 samples. An abnormal expression of tumor-suppressor protein p53 was observed in 29 (48%) samples. p53 overexpression was observed in 15 (71%) of 21 HPV-positive and in 14 (36%) of 39 HPV-negative patients (p=0.009). Similar significant difference was found in p53 overexpression in HPV18-positive patients (p=0.007) but not in those positive for HPV 16 (p=0.261). HPV DNA presentation was not significantly associated with histopathologic characteristics including tumor stage (p=0.509), grade (p=0.668), peri-neural invasion (p=0.265) and lympho-vascular invasion (p=0.275).p53 inactivation caused by HPV infection may play a role in the pathogenesis of colorectal cancer. There is no association between HPV infection and histopathologic characteristics.

Oxaliplatin (OX) significantly enhanced the antitumor activity of 5-FU in patients with advanced colorectal cancer and recently some phase II trials have evaluated the feasibility and efficacy of oxaliplatin in neoadjuvant setting for treatment of locally advanced rectal cancer. On the other hand various studies have demonstrated that the overexpression of thymidylate synthase (TS) can induce resistance to 5-FU in colorectal carcinoma. The aim of this study was to assess the value of TS expression as a predictive factor in the efficacy of neoadjuvant chemoradiation with and without oxaliplatin in rectal cancer.This study was performed in 61 patients (that ultimately 50 patients had including criteria) with locally advanced rectal adenocarcinoma that inferior margin of the tumor had to be located no farther than 6 cm from the anal verge. Preoperative radiotherapy was delivered to the pelvis with CO 60 to 50/4 Gy. All patients received simultaneous chemotherapy: 5-fluorouracil (5-FU), 300 mg/square meter i.v. 24 h infusion during radiotherapy on days 1-5 every week. Thirty patients received oxaliplatin 50-60 mg /square meter weekly during radiotherapy.TS expression was assessed by immunohistochemical staining technique in pretreatment specimen, and the patients were categorized into TS (+) and TS (-) groups. A total of 23 of 50 tumors showed TS positive status at biopsy (46 %). Overall 36 patients (72%) achieved pathologic response (40% complete and 32% partial) that was significantly better in the TS (-) group than in the TS (+) group (85.1 vs 56.5%, p=0.024) and in the OX (+) group than in the OX (-) group (86.6 vs 50%, p=0.005). Among TS (-) patients there was no difference in pathologic response (88.2 vs 80%, p=0.561) or sphincter preservation (76.4 vs 80%, p= 0.831) as a result of whether oxaliplatin therapy was carried out or not. But among the TS (+) patients there was a significant gain in pathologic response (84.6 vs 20 %, p=0.002) and sphincter preservation (84.6 vs 40 %, p= 0.026) in favor of oxaliplatin group. Our study indicate that oxaliplatin can improves poor outcome of TS positive rectal cancer and TS expression may be used for selecting patients for oxaliplatin containing neoadjuvant chemoradiation protocols that can have major role in the tumor down staging and preservation of sphincter and ultimately better quality of life.

Injection is one of the dental procedures which has the most negative reflection in dentistry and reducing its pain is one of the most serious problems in pediatric dentistry. Since the application of topical anesthetics is in contrast and doubts and there was no study done in Iran for it, this research was done to determine the effect of Benzocaine 18% on reducing pain during injection in children referred to dental faculty of Azad University, 2004. Methods & Materials: In this sequential randomized double blind clinical trial, the kids were in need of bilateral posterior infiltration of Maxilla for Cl I restoration. Child cooperation was classified within level 3 or 4 and they could not have any systemic disease or abcess & fistula in that area. The gels used were Benzocaine 18% and Fluoride (with the same color and flavor).Randomly one of the gels was applied for 2 minutes and after 10 minutes rest, the procedure was repeated contralaterally with the other gel. For measuring the pain CPS & VAS were used and the child was asked about the preference gel. Data of CPS & VAS were statistically analyzed by Mann Whitney and Chi Square, of preference by sign test. The relation between VAS & CPS was measured by Spearman. The study was performed on 6-12 year old kids (50 samples). Two of them were ignored due to instability in responses. In VAS, score of placebo gel was 551 and Benzocaine was 530.In CPS score of placebo gel was 519 and Benzocaine was 562 which were not significant by Mann Whitney. Amount of pain of “not & low” in 2 groups were similar and depending of “not & low” and “medium & severe” was insignificant by Chi square. As the preference, results show 3 cases (13%) preferred placebo and 9 cases (40%) Benzocaine which was insignificant by Sign test. Relation between VAS & CPS in control group was 0.21(21%) and in case group was 0.17(17%) which was poor depending on Spearman test. Benzocaine 18% did not reduce children’s pain during injection so it can be eliminated. Other investigations are necessary to specify replacement of other methods so that the best way to reduce the pain of injection will be known.

To evaluate the efficacy of adjuvant subtenon carboplatin in the management of intraocular retinoblastoma.

This study was conducted as a randomized, double-masked clinical trial. A diagnosis of intraocular retinoblastoma was made based on clinical examination, ultrasonography and orbital CT-scanning. The greatest basal dimension of the tumors was estimated in disc diameter (DD) by indirect ophthalmoscopy. Tumor thickness was determined by ultrasonography. Each eye was assigned to one of 10 blocks based on tumor stage (Reese-Ellsworth classification) and randomly received systemic chemotherapy alone (control group) or systemic chemotherapy plus 20mg subtenon carboplatin (case group). Indirect laser photocoagulation or cryotherapy was performed as additional treatment.

The study included 35 tumors in 17 eyes of 14 patients (19 tumors in 8 eyes in the control group and 16 tumors in 9 eyes in the case group). There was 57.22% and 61.73% decrease in tumor thickness in the control and case groups, respectively. This difference was not statistically significant (P=0.12). The decrease in greatest basal tumor dimension in the control group (47.32%) was not significantly different from that in the case group (38.80%). One eye (12.5%) in the control group and 3 eyes (33.3%) in the case group were enucleated.

Adjuvant subtenon carboplatin does not seem to increase the efficacy of systemic chemotherapy in the treatment of intraocular retinoblastoma.

History and Human hydati d disease has been world widely spread and its frequency, clinical presentation, diagnostic methods, treatment and recurrence rate were reported variously. For determining the frequency, surgical results, and recurrence rate, this study was performed in Kashan area. A cross-sectional study on patients with hydatid disease was caried out. Age,sex,living side, clinical loboratory, imaging finding, anatomic location. and operation procedure, were all considered.At the end of the investigation for recurrency, chest X-rey pA Ultra sonography of abdomen and indirect hemagglotination test IHT was performed. From 135cases (62.2%) were female,FM/M:1.6/1 the incidence pick was in (2-30). 58. % living in rural area 68% of cyst was in abdomen (liver) and 30% pulmonary, caught and then sputum was the most frequent symptom in pulmonary hydatid disease, abdominal pain and fever in liver hydatid disease was more frequent. Casoni test in 85.3% pre-operation was positive and indirect hemagglotination test IHT serology after 5years 90% was positive Diagnosis of liver cyst was confirmed by ultra sonography in 98% in lung with chest X ray and CT scan 88.9 and 100% respectively.The most common procedure in liver was cystectomy and omentoplasy, in lung was systectomy. We did not use any scolocidall agent and had 4 patients recurrence in liver 3% but no any patient had pulmonary Recurrent. indirect hemagglotination test IHT after 5 years operation in 88.4 was positive It seams that after perfect surgery no scolocidal drug administration is necessary and indirect hemagglotination test IHT is an excellent sero diagnostic means

Identifying various scorpion species and manifestation of their bites are of high importance in medicine. Considering the variety of scorpion species and insufficiency of current methods for prevention, control and treatment of their bites, this study was carried out to evaluate the situation of scorpion bite in Iran. In a review method, after searching key words on the relevant Internet sites and in domestic journals, 47 related articles were selected and reviewed. Approach to scorpion bite as one of the main health problems in Iran is changing. Having clear information and exact programming are needed to decrease number of bites and control their complications. In this regard, information provided by this study can help authorities as well as other researchers of this field.

Hip fracture and dislocation is a common orthopedic complication. However, multiple fractures and dislocations is a rare event that was not found in the literature. A 28-year man referred to our unit with multiple trauma. He had the following fractures: femoral neck, subtrocantric, posterior edge of acetabulum, posterior hip dislocation as well as impaction fracture of femoral neck. He underwent an emergency operation and all fractures were fixated with cephalomedullary nails. In a 4-month follow up, he seems to be fine.

Dental calculus has a major role in the development of periodontal disease, so this study was designed to assess the frequency of dental calculus and its precipitating factors and the correlation between them in patients referring to Department of Oral Disease, Shahid Beheshti Dental School in 2002. Methods & Materials: 100 patients without missing in lower incisors and having teeth necessary for Sillness - Loe plaque Index were selected. This descriptive - analytical (cross sectional) study was accomplished by means of interview and observation (examination and laboratory tests). After filling out a data form, the height of calculi on lingual surfaces of lower incisors were measured by using a graded periodontal probe, and the calculus score (c.s) and Sillness - Loe plaque index were calculated for each patient. Then a saliva sample was taken and sent to the laboratory to measure the concentration of calcium. All the data collected by interviewing, examination, and laboratory results were recorded in questionnaires and finally analyzed by SPSS statistical software. The research showed that the frequency of dental calculus was 75%, and the mean calculus score was 30.21±22.9. The mean saliva calcium concentration was 4.96±1.43 mg/dl. Meanwhile, there was a correlation between dental calculus and saliva calcium (2=0.96, P<0.0001). This study revealed that 69.2% of patients with very heavy calculus were male 57.7% of them did not have academic education 80.7% had poor oral hygiene and 69.2% of them had crowding in site of dental calculus. Also 38.5% of them were cigarette smokers (O.R=17.7). The frequency of dental calculus and calculus scores in dental patients are high. It's mandatory to determine and remove calculus contributing factors to achieve an optimum level of oral hygiene and decrease periodontal problems.