Journal of Kermanshah University of Medical Sciences
Volume:25 Issue: 3, Sep 2021

 Gingivitis and periodontitis cause the inflammation of the soft tissue around the teeth and destroy the supporting structures of the teeth. This is highly prevalent during pregnancy and lactation.

 The present study aimed to investigate the periodontal status in pregnant and lactating women in Ilam province, Iran in 2018 - 2019.

 This descriptive-analytical study was conducted on 100 pregnant and lactating women who were selected via cluster and stratified sampling. Data were collected using a demographic questionnaire and the community periodontal index of treatment needs (CPITN). Data analysis was performed in SPSS version 24 using independent t-test, chi-square, and one-way ANOVA at the significance level of 0.05.

 The mean age of the pregnant and lactating women was 25.62 ± 5.52 and 29.08 ± 6.83 years, respectively. In total, 30% of the pregnant women had a healthy gingival, 18% had bleeding, 36% had a mass, and 16% had CPITN. As for the lactating women, 44% had a healthy gingival, 32% had bleeding, 20% had a mass, and 4% had an envelope. CPITN index II and III were significantly higher in the pregnant women compared to the lactating women. Among the pregnant women, there were 49 housewives and only one employee, while 50 of the lactating women were housewives.

 According to the results, the sample population had an unfavorable periodontal status, and the pregnant women needed more oral health education.

 Bisphenol A (BPA) is an endocrine-disrupting agent with a weak estrogenic effect. BPA causes testicular damage by reducing the activity of antioxidant enzymes. Bromelain (BROM) is a natural compound derived from pineapple, which is widely used as a dietary supplement with antioxidant properties.

 The present study aimed to investigate the possible therapeutic effects of BROM on the testicular damage induced by BPA administration.

 This study was conducted on 40 adult male mice, which were divided into four groups of control (daily treatment with olive oil), BPA (600 mg/kg), BROM (70 mg/kg), and BPA + BROM. The treatments were administered orally for 35 consecutive days. Following that, the animals were euthanized by cervical dislocation, their testes were dissected, and morphometric evaluations (length, width, and thickness of testis) were performed. The epididymal tail was cut to release the sperms for sperm parameter assessment (count and motility). Afterwards, the testes were fixed in buffered formalin for histological examinations (number, diameter, and wall thickness of seminiferous tubules and the counts of spermatogenic, Sertoli, and Leydig cells).

 All the indices of testicular morphology decreased significantly (P < 0.05) following BPA administration compared to the controls. In addition, the sperm parameters and Leydig and Sertoli cell counts indicated significant decremental effects on the animals administered with BPA compared to the controls (P < 0.05). After the administration of BROM in the BPA + BROM group, all the testicular morphometric indices increased significantly (P < 0.05) compared to the animals administered with BPA alone. These indices were the morphometric values of the testes, sperm parameters, cell counts, and seminiferous morphometric properties.

 According to the results, BROM could reduce the debilitative effects of BPA on the testes of the mice and protect the reproductive health of the animals against BPA-induced toxicity.

 The chronicity of multiple sclerosis (MS) plays a key role in 25% of suicides. Therefore, it is essential to assess the other influential factors in this regard.

 The present study aimed to investigate the prevalence of suicidal thoughts and suicide attempts in patients with MS and the correlated factors.

 This cross-sectional study was conducted on 203 MS patients referred to the MS Society of Kermanshah, Iran during August-October 2015. Data were collected using a checklist of demographics and patient records, Ifudu comorbidity index, 100-meter walk test, and Beck’s depression and suicidal thoughts scales. Data analysis was performed using binary logistic regression analysis.

 In total, 30% of the patients had suicidal thoughts, and 8.4% had suicide attempts. After adjustment for demographics, the obtained results indicated that illiterate patients (P < 0.05) and those with a higher depression grade (P < 0.001) were at a higher risk of suicidal thoughts. Illiteracy, older age at the first diagnosis, and being a housewife or unemployed (P < 0.05) significantly decreased the likelihood of suicide attempts, while comorbidities, suicidal thoughts, and depression (P < 0.05) significantly increased the likelihood of suicide attempts.

 Since MS patients are highly prone to suicidal thoughts and even suicide attempts, providing training and preventive psychological interventions are recommended for high-risk cases, such as illiterate patients with challenging jobs, young patients, and patients with comorbidities and depression.

 Unnecessary prescription, diagnosis, and medical services are increasing various health problems in the world. According to the World Health Organization (WHO), over-prescription and unnecessary services are the measures that cause significant damages rather than benefits.

 The present study aimed to evaluate the perspective of Urmia medical system members regarding the frequency and causes of unnecessary medical services and their control and prevention strategies in Urmia, Iran.

 This descriptive-analytical, cross-sectional research was performed on 102 specialist physicians selected from the Urmia Medical Association, and the selected individuals participated in the survey online. Outcome measures included the percentage of unnecessary medical care and common causes of overtreatment. Data were collected using Johns Hopkins University Unnecessary medical services checklist. Data analysis was performed in SPSS version 22 using descriptive statistics (frequency and mean) and chi-square.

 In total, 41% of the participants (n = 43) were family physicians, and 59% (n = 59) were specialists of other medical fields. In terms of gender, 53% were male, and the others were female. The main causes of unnecessary medical services at a national level included pressure from patients (66.7%; n = 68), fear of medical malpractice (54.9%; n = 56), pressure from colleagues (23.5%; n = 24), and achieving a high rank in a performance appraisal (40.2%; n = 41). According to the participants, the development of more guidelines and instructions (47.1%; n = 48) and training residents on the appropriate use of diagnostic criteria (50%; n = 51) could be effective approaches to preventing unnecessary medical services. In addition, significant differences were observed between the perspective of the family physicians and the specialists in terms of the fear of malpractice (P = 0.002), lack of medical history (P = 0.17), pressure from patients (P = 0.25), training of residents on the use of diagnostic criteria (P = 0.001), and easier access to medical files (P = 0.001).

 From the physicians’ perspective, overtreatment is highly common in Iran. In order to solve this problem, efforts should be dedicated to areas such as medical file availability, diminishing the fear of malpractice, and more training of residents. Moreover, it is recommended that patients’ awareness be raised regarding the damages caused by unnecessary prescriptions so that they would not request frequent visits.

 Mangled extremity injuries in civilian settings are challenging conditions for the accident and emergency units of low-resource settings where salvage therapies may not be feasible or affordable for the patients.

Case Report: 

We have described a successful case of initial conservative limb salvage management for a mangled distal left lower limb in a four-year-old male who sustained the injury when a vehicle ran over his extremity as he played by the road. The treatment approach was in contrast to the radical completion of amputation with its attendant revisions, which are associated with similar injuries with the mangled extremity severity scores of ≥ 7.

 The benefits and challenges of the limb salvage intervention were discussed based on the literature in this regard, and a recommendation was proposed while considering an initial conservative limb salvage approach in well-resuscitated children presenting early with a mangled extremity injury.
 

 The unprecedented rise in antibiotic-resistant bacterial infections is a challenging dilemma, urging the development of novel and effective antibiotics for the treatment of such infections. Anti-virulence therapy is a promising solution in this regard. Unlike antibiotics, these drugs could lower the selective evolutionary pressure on a bacterial population and target the virulence factor rather than the growth pathways, thereby targeting and repressing the propagation of antibiotic resistance and virulence genes in bacteria. The present study aimed to investigate anti-virulence therapy against bacterial infections, as well as the mechanisms of action and challenges.

This literature review aimed to discuss the issues of antibiotic resistance developed in bacterial infections, the difficulties in antibiotic treatment, the mechanisms involved in anti-virulence therapy, and the approved anti-virulence drug therapeutics.

We outlined the success in overcoming antibiotic resistance by using anti-virulence therapy as an alternate treatment option, while also discussing the drawbacks associated with their use and safety against bacterial infections.

According to the results, anti-virulence therapy combined with antibiotic treatment is effective in the treatment of several bacterial infections.

Probiotic products with valuable nutritional and therapeutic properties have attracted great attention in the fields of industry, nutrition, and medicine.

The present study aimed to investigate the survival of Lactobacillus plantarum probiotic bacteria in capsulated and non-capsulated forms in malt products during storage. We also evaluated the pH, brix, sugar content, and organoleptic properties of the three products, a control malt (non-probiotic extract), an extract containing the probiotic bacteria without capsules, and an extract containing encapsulated probiotic bacteria.

The probiotic strain of L. plantarum was inoculated into a barley malt extract in free and encapsulated forms. Bacterial microencapsulation was performed using the extrusion technique with sodium alginate. In addition, bacterial viability was determined using the mixed culture method in MRS agar medium at the temperature of 37°C for 48 hours. Data analysis was performed using one-way analysis of variance (ANOVA) in the Minitab 16 software.

The count of L. plantarum in the non-capsulated form did not change significantly although it increased in the capsulated form. No significant changes were observed in the sugar content, pH, and brix during the storage of the three products. Moreover, the sensory acceptance of malt with capsulated bacteria was higher compared to the other samples.

According to the results, the probiotic strain of L. plantarum in the free and microencapsulated forms was maintained in the barley malt extract for two months of storage at the temperature of 4°C. Therefore, it seems that barley malt extract may be a favorable environment for the preservation of probiotic L. plantarum.