Journal of Research in Medical Sciences
Volume:9 Issue: 4, Jul & Aug 2004

Prompt L-Pop is a self-etching dentin adhesive, which is recommended to use with both compomers and composite resins. The aims of this investigation were to determine and compare the microleakage, shear bond strength, and shear push out strength of composite and compomer to dentin with application of Prompt L-Pop as adhesive system. After application of Prompt L-Pop on the occlusal dentinal surfaces of 24 intact molar teeth, the specimens were divided into two groups (n=12). Composite resin(Filtec Z250) and compomer (F2000) were used to dentinal surfaces of group 1 and 2 respectively, using a plastic mold. Twenty-four truncated cavities were prepared in 24 horizontal occlusal coronal dentinal wafer. After application of Prompt L-Pop, the specimens divided into two groups (n=12), and the cavities in group 1 and 2 were filled with composite and compomer respectively. After application of Prompt-L-Pop on the surfaces of 20 class V cavities, the cavities were randomly divided into two groups (n=10), and were restored with composite resin and compomer respectively. The bond strength values and microleakage scores of groups were evaluated. Compomer material revealed more but not statistically significant different means (SD) of shear bond strengths (Mpa) and shear push out strength (MPa). There were no significant differences in enamel and also dentinal microleakage scores, between two groups (p>0.05). Improving bonding efficacy and microleakage result of compomer in this study, would be because Prompt LPop is a water based material and therefore chemically more compatible with hydrophilic restorative materials, such as compomers.

Administration of magnesium sulfate has neuroprotective effects and reduces infarct volume in animal models of stroke. Previous small clinical trials have reported beneficial effect of magnesium on the outcome in patients with stroke. This study was a randomized, placebo-controlled, double-blind study, investigated the benefit of magnesium sulfate the administration given intravenously as a neuroprotective. Patients who had cortical infarction in the middle cerebral artery territory (superior or inferior division) with moderate neurologic deficits (Orgogozo scale score greater than 30 and less than 70) and onset less than 24 hours were included. The patients were treated with magnesium sulfate (4gr stat and 1gr/hr) or placebo for 4 days and examined by a blind investigator. NIH Stroke Scale was obtained on admission and fifth day after stroke. Eighteen patients were given treatment and nineteen patients were given placebo who demonstrated significant beneficial effects on the difference between NIH Stroke Scales on the day of admission and day 5 (3.16 ± 0.98 vs. 1.84 ± 1.06; p = 0.000 respectively). Intravenous magnesium sulfate had significant beneficial effect on acute phase of stroke patients and, as a result, may reduce duration of admission.

Early detection of vertebro-basilar insufficiency is of paramount importance. Brain MRI was the only method of diagnosis for many years, but in addition to high cost and delay in report, it may not detect all brain stem lesions. In this study Blink reflex (BR) was evaluated as a complementary test to MRI. Fifty-four patients were studied [27 anterior circulation stroke patients (ACSP) and 27 posterior circulation stroke patients (PCSP)]. MRI was performed within the first week after the onset of stroke. Nineteen age and sex matched healthy people enrolled as controls. BR was performed within the first 24 hours of the onset. Frequency of abnormal blink reflex in ACSP and PCSP was compared with MRI findings. Then abnormal responses in two groups were compared by chi-square test. In both ACSP and PCSP, two patients had normal BR responses, and in 25 patients R1 or R2 components of blink responses were absent or prolonged (92.5%). R1was absent or delayed in 16 PCSP, but it was abnormal in only two ACSP (P < 0.001). Abnormal R2 responses were detected in 22 PCSP and 24 ACSP. BR abnormalities had high correlation with MRI findings in PCSP (92.5%) BR can be performed within the first 24 hours of onset of stroke, and its results is available immediately. This test is easy to perform and comfortable for the patient, has low cost, and is available every where. Therefore we introduced BR as a complementary (but not replacing) test to MRI in early detection of brainstem infarctions. Comparison of BR responses in ACSP and PCSP showed that abnormalities of R1 responses had high accuracy in differentiation between anterior and posterior circulation strokes. We concluded that BR responses not only can detect brainstem infarctions rapidly and readily in its early stages, but also can differentiate ACSP from PCSP with high accuracy.

Prevention of postoperative pain by injecting opioid into the knee joint is believed to support the hypothesis of peripheral opioid receptor activation in inflammation. Main outcomes were reduction of pain intensity and need for supplementary analgesics. The aim of the present study was to evaluate the analgesic effects of intra-articular sufentanil in comparison with morphine, after arthreoscopic procedures of knee joint. In this prospective, double-blind study, 45 patients were randomized in three equal number groups to receive either sufentanil 5 µg (group s), morphine 3 mg (group M) or normal saline 20 cc as placebo (group p), intra-articularly at the end of arthroscopic knee surgery, under general anesthesia, which was same in all three groups. Pain levels at rest were measured by Visual Analog Scale (VAS) at intervals of 1,2,4,8,12,14 hours and during movement of knee at discharge time. Significant difference between the groups (p

The risk for unsuccessful reperfusion after streptokinase therapy may be caused by the antifibrinolytic effect of platelet-derived type 1 plasminogen activator inhibitor (Pal-1) and antistreptokinase antibodies. This study aims to show the relation of pretreatment PAI-1 levels of patients with acute myocardial infarction treated with streptokinase and the outcome of fibrinolysis, emphasizing on reperfusion with and without considering pretreatment antistreptokinase antibodies. Pretreatment PAI-1 and antistreptokinase antibodies levels of 61 patients with acute myocardial infarction, treated with streptokinase, were determined by an enzyme- linked immunosorbent assay kit method. Failure of thrombolysis with streptokinase was present when reperfusion was unsuccessful as assessed by noninvasive reperfusion criteria. Mean pretreatment PAI-1 level of patients was 29.72 ± 4.74 ng/ml. Thrombolysis with streptokinase failed significantly with higher pretreatment PAI-1 levels (p < 0.05) in all patients and patients with negative pretreatment antistreptokinase antibodies. We showed that higher on reperfusion in patients with acute myocardial infarction, with and without considering pretreatment antistreptokinase pretreatment PAI-1 levels were associated with significant failure of streptokinase therapy with the emphasis antibodies (anti-SK). It seems that by estimating PAI-1>25ng/l and antistreptokinase antibodies higher than normal levels in patients before the start of streptokinase therapy, candidates for potentially unsuccessful streptokinase therapy (with failed reperfusion) can be identified in advance and an alternative therapy such as primary angioplasty with better immediate results can be started.

There are many reports about nosocomial infections in ICU patients, their antibiotic resistance and the necessity of combination therapy with two or more different antibiotics. This study was designed to find the predominant pathogens and their antimicrobial resistance in a University hospital intensive care unit. We obtained samples from patients who had no signs and symptoms of infection on admission in ICU but showed infection signs at least after 48 hours. Cultures were obtained and antibiogram tests were done. Thereafter appropriate About 40 percent of ICU patients were infected through their hospitalization. Urinary tract infection (UTI), respiratory, blood, and CNS infections were the most common infections. Gram-negative rods were including E-coli, Kelebsiella, pseudomonas and enterobacters, Gram-positive pathogens (staphylococcus epidermidis and S-aureus) were reported. Most of pathogens had resistance not only to common antibiotics but also to new generation ones. In most cases, empirical therapy had not been scaled down to definitive regimen with optimal activity, although the pathogen had been isolated and its antimicrobial sensitivities were identified. Widespread use of antimicrobial agents without any precaution is responsible for antibiotic resistance. This shows the necessity of prevention of infections with use of proper antibiotics.

The increased left ventricular mass (LVM) is a strong risk factor for cardiac mortality. Although the relationship between diabetes mellitus (DM) and LVM in adults is established, it is not universally accepted in young diabetic patients. We sought to determine LVM in young diabetics, healthy youngs with diabetic parents, and healthy youngs. This is a descriptive case- control study. The non-probability convenience sampling was done to choose 30 young insulin dependent diabetics (group I), 30 healthy young with history of DM in one of his or her parents (group II), and 30 healthy young without history of DM in his or her parents (group III). The LVM of these 3 groups were measured by twodimensional echocardiography and mean of LVM in 3 groups were compared by ANOVA. The mean age of patients was 14.3 ± 2.3 years. ANOVA showed significant difference between LVM in three groups. (F=5.005 p=0.009). According to Scheffe test, the difference between group II and group III was significant while there was no significant difference between group I and other groups. This study showed that offsprings of diabetic patients have significantly higher LVM than normal healthy groups but diabetic patients have mildly increased LVM versus control group. The higher LVM in healthy youngs with diabetic parents must be noted and more studies must be performed on this group who may be benefited from risk factor modification.

Adequate hydration and good urine output improve the efficacy of phototherapy. The aim of this study was to evaluate the effect of intravenous fluid supplementation on decrease of serum bilirubin levels in jaundiced healthy term infants during conventional phototherapy. Sixty healthy breast-fed neonates with non-hemolytic hyperbilirubinemia were assigned randomly to receive either breast milk exclusively (non-supplemented group; n=30) or intravenous fluid in addition to breast milk (supplemented group; n=30) during conventional phototherapy. The mean total serum bilirubin (TSB) levels at the time of enrollment and within 84 hours after phototherapy were not statistically different between two groups. Similarly, the mean rate of decrease in TSB levels during the first 12 h of phototherapy were 0.13±0.06 and 0.10 ± 0.1 mg/dL/h in supplemented and non supplemented groups, respectively (P=0.13). Duration of phototherapy required in supplemented and non-supplemented groups was 58 ± 13.02 and 63.20 ± 13.71 hours, respectively (P=0.13). These data show that administration of extra intravenous fluid in jaundiced healthy, term, breastfed neonates have no beneficial effect on the rate of serum bilirubin reduction during conventional phototherapy.

There is little systematic research about the efficacy of multimedia-based system for learning in medical sciences. The purpose of this study was to evaluate the efficacy of an interactive multimedia courseware package to demonstrate access cavity preparation for undergraduate dental students in preclinical endodontics course and compare with tutorial method of education. This study was performed on 62 undergraduate dental students. The students were randomly assigned in two groups of 31 each. The first group was instructed by interactive system using computer assisted learning (CAL), and the second group was instructed by conventional tutorial sessions in laboratory (Lab). The students’ scientific knowledge and overall scores were compared between two groups. The students’ scientific knowledge and retention showed no significant difference between two groups. In addition, students’ attitudes were not significantly different between two groups. CAL software packages has the same efficacy as conventional method in preclinical endodontics course and can be developed in some branches of dentistry.

A 13 years old boy underwenta surgical operation of craniopharyngioma which followed by postoperative radiation therapy. Eighteen monthes later he was admitted to the neurological ward due to sudden sensory aphasia. Brain CT showed infarction of left hemisphere. Since no other predisposing factor was present, the cause of stroke in this patient can be related to Moyamoya - like disease after radiation.