Shiraz Emedical Journal
Volume:24 Issue: 5, May 2023

 The incorporation of oral health promotion into general healthcare has been proposed by the World Health Organization. General practitioners (GPs) could play a vital role in the promotion of oral healthcare.

 This study was designed to evaluate the awareness of oral and maxillofacial medicine specialty and its scope of practice among Iranian GPs.

 The present cross-sectional study was conducted in Yazd, Iran. A total of 95 GPs randomly filled out a close-ended questionnaire. Responses to the questionnaire were analyzed using descriptive and analytical statistics. The self-administered questionnaire comprised 35 items and covered the demographical details and characteristics of participants, in addition to their awareness of oral and maxillofacial medicine and its scope of practice. Finally, awareness scores were classified as weak, intermediate, and good. The data were analyzed using a t-test and Pearson correlation. A P-value ≤ 0.05 was considered statistically significant for all statistical analyses.

 Only 24.2% of GPs had enough awareness. The mean score of total awareness about oral diseases was 11.82 ± 3. The mean scores of total awareness for the oral manifestations of systemic diseases, medical considerations in dentistry, and oral lesions were 3.59 ± 1.17, 3.96 ± 1.62, and 4.27 ± 1.65, respectively.

 According to this study, the awareness of GPs playing a key role regarding oral medicine and oral manifestations of systemic diseases was weak. It is recommended to revise the medical curriculum to incorporate related courses about common oral diseases into the medical curriculum. The aim will only be achieved by improving the coordination between dentists and GPs.

Oncocytic cysts of the larynx are benign, uncommon, and slow-growing lesions that usually occur in elderly people, especially in those with a history of smoking and chronic irritation. These lesions cause various clinical symptoms depending on their location and size, requiring physicians to consider a wide range of symptoms.

Here we present two men who were referred to us because of prolonged voice hoarseness.

Medical assessments led us to the diagnosis of oncocytic cysts in the false and true vocal cords. Both patients were followed up after removing their laryngeal cysts and have had no clinical complaints since then.

Congenital atrioventricular heart block (CAVB) is a relatively rare condition that can lead to long-term complications. Early diagnosis and management of CAVB is currently the ideal goal, particularly in high-risk pregnancies.

The Fetal Heart Center at Kurdistan University serves as the primary referral center for pregnant mothers residing in the western region of Iran. Fifteen fetuses with CAVB were admitted between November 2007 and August 2022. They were referred for one or more of the following reasons: fetal bradycardia or arrhythmia, abnormal ultrasound findings, and previous maternal or fetal risk factors. After obtaining a complete medical history, we conducted fetal echocardiography and ordered testing for maternal Lo/Ra autoantibodies. Our therapeutic approach was based on the type of atrioventricular block (AVB), serum titer of Lo/Ra antibodies, and specific risk factors associated with each type of AVB. Consequently, we used a combination of different medications, including dexamethasone, Hydroxychloroquine (HCQ), IVIG, beta-agonists, and inotropes.

We admitted 15 fetuses with CAVB, including seven females (47%) and eight males (53%). Most of our cases had positive tests for Lo and Ra autoantibodies, with varying degrees of AVB. A previous fetal death wascommon in our case series, accounting for 47% of cases. Moderate and high antibody titers were present in 80% of our cases. Mild bradycardia was a relatively common finding in our cases of first and second-degree atrioventricular block (AVB), occurring in 33% of patients. All of the above-mentioned findings, commonly referred to as major risk factors, were used for either early evaluation or therapeutic goals. No cases with first-degree AVB developed a higher grade of AVB after our therapeutic approach. One fetus with second-degree AVB developed CCHB, and another with mixed second/third-degree AVB reverted to second-degree AVB with the use of appropriate medications.

Our therapeutic approach for the current cases yielded satisfactory results. Subsequently, we attempted to develop a rudimentary approach for early managing and treating fetuses with various types of CAVB.We are looking forward to future multicenter studies.

Gallery Walk (GW) is a student-centered educational method emphasizing team-based learning. In this approach, students actively participate in the learning process while the instructor is a facilitator.

This study was conducted to compare the effectiveness of the GW method to the lecture method in teaching the topic of general anesthesia care during the induction phase.

This study employed a quasi-experimental design with a pre-test-post-test approach involving 60 nurse anesthesia students at Jundishapur University of Medical Sciences in Ahvaz, Iran, in 2022. The data were collected through 30 four-choice questions assessing the knowledge of nurse anesthetists in the main stages of general anesthesia induction. After randomly assigning students into two homogeneous groups, an intervention group (GW) and a control group (lecture), the study investigated the effects of the two educational methods on learning outcomes and retention of general anesthesia care during the induction phase. This was done by comparing the mean scores of the students on three tests.

There was a significant difference between the two groups in terms of themeanscores of the immediate posttest (GW: 22.3 ± 0.47, lecture: 20.8 ± 1.01) compared to the pretest (GW: 15.13 ± 0.87, lecture: 14.73 ± 1) (P < 0.001). Additionally, there was a significant difference in themeanscores of the one-month posttest (GW: 23.37 ± 0.61, lecture: 17.33 ± 1.12) (P< 0.001) between the two groups. No significant difference was observed between the two groups regarding themeanscores on the immediate posttest (P = 0.186). Unlike the lecture group, there was no significant difference between the mean scores of immediate and delayed (one-month) posttests in the GW group (P = 0.16).

The GW method not only enhances knowledge but also proves to be significantly more effective than the lecture method in retaining knowledge of general anesthesia care during the induction phase. Therefore, GW is recommended as an effective educational method for topics that require long-term retention.

Context: 

Considering the importance of bread as a staple food in many countries around the world, including Iran, This study aimed to assess the nutritional values (i.e., protein content, fat content, carbohydrates, vitamins, minerals, and antioxidant activity) of quinoa-wheat bread compared to simple wheat bread.

Evidence Acquisition: 

A search was conducted in electronic databases, including PubMed, Scopus, and Web of Science, as well as Google Scholar search engine. After screening the title and full-text of the articles, data were extracted by two independent researchers; a third researcher interfered in case of disagreement. Keywords, including “Chenopodium quinoa”, “Quinoa”, and “bread”, were obtained from the MeSh database and the manuscripts of related articles. All papers written in English language, which were published before March 2022, were selected for this review.

Among 159 initially extracted articles, 38 were selected by screening the titles and removing duplicates and irrelevant papers. Eleven articles were finally included in this review. Overall, the results showed significantly higher protein, fat, and fiber content in quinoa-wheat bread compared to simple wheat bread.

Based on the results, the addition of quinoa flour could promote the health benefits of bread by increasing the protein, lipid, fiber, and micronutrient contents. It is suggested to optimize the nutritional value of the Iranian’s staple food by adding quinoa flour to wheat bread.

Cholesteatomas are benign destructive lesions of the temporal bone that may lead to life-threatening complications.

This study described the clinical and surgical characteristics of chronic otitis media patients with acquired middle ear cholesteatoma.

Among 1790 patients with chronic otitis media detected during almost 10 years, 449 suffered from cholesteatoma. The clinical features and surgical data were investigated.

Among the chronic otitis media patients, 449 (25.0%) cases had cholesteatoma with a mean age of 32.2 ± 16.1 SD years, and 62.8% were male. The most common symptom was otorrhoea (53%), followed by hearing impairment (37.9%). Erosion of the facial nerve canal was observed in 33.1% of patients, dural plate erosion in 4.8% of cases, and labyrinthine fistula in 10.3% of patients. Moreover, ossicular chain erosion was observed with the highest frequency in incus (40%), followed by malleus (33%) and stapes (26%). Amongst the surgically treated patients, 59.3% underwent mastoidectomy with canal wall preservation, 29.7% underwent modified radical mastoidectomy, and radical mastoidectomy was performed in 11% of patients.

Cholesteatoma was seen in about a quarter of patients with chronic otitis media. Based on our findings, cholesteatoma can be associated with serious complications such as facial nerve canal erosion (33.1%), dural plate erosion (4.8%), and labyrinthine fistula (10.3%). Regarding the functional importance of the hearing system and the high prevalence of disease complications, middle ear cholesteatoma needs long-term follow-up.

Non-adherence to medication is a significant health problem that affects disease control and increases hospitalization and mortality. One method of evaluating patients’ medication adherence is utilizing standard questionnaires, such as the Morisky Medication Adherence Scale (MMAS).

This study evaluated the reliability of the Persian-translated version of the MMAS among asthma patients.

After the English to Persian translation, back-translation was done, examining the word appropriateness to Iranian culture. A panel of experts in related fields evaluated the questionnaire. The final questionnaire was assessed in 62 asthma patients.

The participants’ mean age was 49.62 ± 11.39 years (range: 30 - 72), and the mean duration of asthma was 9.05 ± 6.79 years (range: 1 - 35). The reliability of the questionnaire for four items was 0.637 (95% confidence interval: 0.465 - 0.765; P < 0.001). A significant percentage (29.03%) of the subjectshadlowdrugadherence, andonly 30.6% hadhigh adherence. Therewasnosignificant correlation between drug adherence and asthma duration (P = 0.441).

This study shows that drug adherence is linked to asthma control and the quality of life in asthma patients. The Persian translation of the 4-item MMAS is valid to assess adherence to treatment in asthma patients.

 It is necessary to study high-risk behaviors among intravenous drug users, as well as the effectiveness of the syringe-needle program to help health officials adopt appropriate health policies in order to promote public health services. Therefore, it is necessary to gather and present up-to-date evidence on the effectiveness of these interventions.

 The study aimed to evaluate a harm-reducing program using a self-report tool before and after implementing an interventional program, consisting of training on low-risk injection methods, sterilization methods for injection devices, reducing the risks of drug abuse and sexual behaviors, HIV and hepatitis B counseling and testing, apportioning sterile syringes, needles, cotton, alcohol, and condoms, offering methadone maintenance treatment, collecting and discarding contaminated needles, and referral of patients to specialized medical centers. These procedures were performed in two drop-in centers (DIC) in Hamadan. Participants were recruited by the census, including 188 volunteers from the DICs. Descriptive statistics for quantitative variables were mean and standard deviation. Absolute and relative frequencies were used for ranked and categorized variables. Analytical analysis for high-risk behaviors before and after the intervention was performed using the tests related to paired data and, if necessary, regression models (P ≤ 0.05). STATA version 12 was used to analyze the data.

 A total of 188 people participated in this study, of whom 112 (59.6%) were male, and 76 (40.4%) were female. The mean ± standard deviation of the age of the participants was 47.72 ± 10.88. The results showed that the proportions of non-injecting drug users (P = 0.03), injecting drug users (P = 0.008), and co-injection users (P < 0.001) were significantly different compared before admission to the DICs and two months after discharge (P = 0.03).

 Programs of DICs, especially educational programs and distributing syringes and needles, play a significant role in reducing high-risk behaviors, at least in the short term. As a result, this practice may help reduce the incidence of HIV and other diseases transmitted through joint injections among drug users.