Objective: Our study was undertaken to observe the effect of Terminalia arjuna on total platelet count, lipid profile, clinical parameters in patients of coronary artery disease (CAD) and their usefulness in the same patient group. Materials and Methods: One hundred patients having CAD were selected and randomised to study group (to receive Arjuna Chhal Powder) and control group (not receiving any medication). After the therapy of 1 month with Arjuna Chhal Powder, patients of both study and control groups evaluated for body weight, blood pressure, pulse rate, total platelet count and lipid profile. Observations were analysed with use of appropriate statistical test. Results: We observed 0.22% decrease in body weight in study group although insignificant. The systolic blood pressure decreased by 10.28% and diastolic blood pressure by 4.8% in the study group which was statistically significant in comparison to control group. The pulse rate has shown a decrement of 4.85% of baseline and total platelet count decreased by 10.81% with statistically significant difference. Lipid profile improved with 10.2% reduction in total cholesterol level, 17.9% reduction in serum triglyceride level, 9.59% reduction in serum low-density lipoprotein (LDL) level, 16% reduction in serum very LDL level and 10.48% increase in serum high-density lipoprotein level, all being statistically significant. Conclusions: T. arjuna bark extract can significantly reduce blood pressure and favourably modify lipid profile. It might also have antioxidant properties and may be beneficial for cardiac as well as overall health.

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Backgrounds and Aims: Stomach cancer (SC) is the fourth most common cancer and the second leading cause of death due to cancer in the world. The aim of this study was to investigate the provincial distribution as well as age-specific incidence of SC in both genders across Iran. Materials and Methods: This ecological study was conducted according to re-analysis of medical records aggregated to provinces from National Registry of Cancer and Disease Control and Prevention report of the Ministry of Health and Medical Education for SC in 2008. For each province, the average annual age-standardised rate (ASR) for the incidence of SC was calculated. Results: Our findings showed that in Iran, adenocarcinoma, not otherwise specified, was the most common histological type of SC in both genders (59% in males and 56% in females), while intestinal type of adenocarcinoma had the lowest prevalence (14% in males and 12% in females). In age groups above 45 years, there was a steady upward trend, and the highest ASR in both genders was related to 80–84 years of age with 292.14 and 112/100,000 in males and females, respectively. Conclusion: The assessment of geographical distribution showed that there is a wide geographical variation in the incidence of SC across the 31 provinces of Iran, and the ASR of SC in South-East and North-West parts of Iran was higher than any other areas. Thus, development access to screening services and carryout of prevention programs should be considered for high-risk groups in these areas.

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Background: Brain tumours (BTs) constitute approximately 88% of all central nervous system tumours. The present study aimed to determine the age-standardised rate (ASR) of BTs in Iran. Methods: A comprehensive search was conducted on all studies of BTs incidence using Medline/PubMed, Scopus, Embase, Google Scholar and Web of Sciences as international databases and Scientific Information Database, MagIran, IranMedex and IranDoc as Iranian databases until April 2018. This systematic review was done based on the preferred reporting items for systematic reviews and meta-analyses. Results: The primary search yielded 312 relevant studies. A total of 17 studies were included after more detailed retrieval. The results of the random-effect model were demonstrated the ASR of BTs was 4.16 (95% confidence interval [CI], 3.20–5.12) for males and 3.40 (95% CI, 2.67–4.13) for females. Conclusion: The incidence of BTs is lower in Iran compared to other parts of the world. The incidence of nervous system cancers is increasing base on region, geographical, and economic conditions in Iran. Hence, training programmes can be considered to reduce the risk factors, complications of nervous system cancers and early diagnosis of nervous tumors.

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Background and Aim: Headache is the most common clinical syndrome of pain, and it is estimated that more than half of the patients are visited by physicians due to headache. Stachys lavandulifolia is one of the medicinal herbs which are traditionally used to treat headache. Therefore, the present study aimed to investigate the therapeutic effect of this herb on pain relief among patients with migraine. Methods: In this study, 50 patients with migraine were assigned randomly by block randomisation to intervention and control groups. In addition to routine treatment, two grams of hot herbal tea was given to the intervention group twice a day and every time while control group took routine herbs and placebo. Pain intensity was measured using visual analogue scale 1 and 2 months after the beginning of treatment. The data were analysed by t-tests and repeated measures using SPSS software (Version 18.0, SPSS Inc., Chicago, USA). Results: The mean score of pain intensity was similar at baseline and after intervention reached to 4.21 ± 1.42 and 6.33 ± 1.55 for intervention and control groups, respectively. Based on the results of repeated measures, the mean score of pain intensity decreased in both groups, but the decreasing trend has more speed in intervention group. Moreover, the mean score of pain intensity decreased more 1 and 2 months after taking the medicinal herbs in intervention group compared to control group (P < 0.001). The mean score of decrease in pain intensity was statistically significant between two groups (4.21 ± 1.89 vs. 1.92 ± 1.41, P < 0.001). Conclusion: Mountain tea can be used as an auxiliary drug in the treatment of migraine patients due to its strong analgesic resources and the lack of significant side effects.

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Background: Microorganism transmission is an important route for the outbreak of microbial pathogens in outdoor and indoor environments. Objectives: In this study, we performed air sampling and analysis of various bio-aerosol particles (bacteria and fungi) by a passive method in order to measure the level of contaminant particles. Materials and Methods: Air sampling was done in five hospitals in Iran, which included Imam Ali Hospital (IAH), Taleghani Hospital (TH), Imam Khomeini Hospital (IKH), Farabi Hospital (FH) and Imam Reza Hospital (IRH). In each hospital, units such as surgery, intensive care unit, angiography, emergency, oncology, nursing station, pathology laboratory, microbiological laboratory, operating room, isolation room (infectious section), delivery room and outdoor environment were investigated. Results: The total counts for viable bacteria and fungi in the sampled air from the hospitals were as follows: IAH (bacteria 0–>100 colony-forming unit [CFU]/m³;fungi 0–14 CFU/m³), FH (bacteria 1–18 CFU/m³; fungi 0–7 CFU/m³), IRH (bacteria 0–14 CFU/m³; fungi 4–>100 CFU/m³), TH (bacteria 4–>250 CFU/m³; fungi 0–43 CFU/m³) and IKH (bacteria 11–1766 CFU/m³; fungi 0–25 CFU/m³). Conclusions: Results showed that microbial counts following the air sampling are strongly dependent on the environment. However, a low number of air microorganisms do not mean a clean and healthy environment.

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Background: Viral hepatitis is a type of liver disease caused by viral infection and is the leading cause of liver cancer and liver cirrhosis. Adequate information, positive attitude and good practice are essential factors to reduce the risk of this disease. This study aimed to evaluate the knowledge, attitude and practice (KAP) regarding viral hepatitis amongst university students in Klang Valley, Malaysia. Methods: A cross-sectional study was conducted on 120 students to represent the population of medical and non-medical science students. A questionnaire was used to collect the data regarding demographic information and KAP of students on viral hepatitis. The Statistical Package for the Social Sciences software was used to analyse the data. Results: The mean total scores of KAP regarding viral hepatitis were significantly higher in medical as compared to non-medical science-based participants with the P < 0.001 for each comparison. A total number of sources of information were also significantly correlated with a higher total score of KAP regarding viral hepatitis (P < 0.001 each). Conclusion: The finding of this study is crucial as it can be the benchmark for assessing the KAP of society regarding viral hepatitis.

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Introduction: Pain on injection of anaesthetics is significant for patients' dissatisfaction. The present study aimed to compare the efficacy of granisetron, dexmedetomidine and lidocaine on the reduction of etomidate injection pain. Materials and Methods: A clinical trial was performed on 132 patients aged 18–50 years undergoing elective surgery under general anaesthesia. Two cannulas were inserted into the veins on the dorsum of both hands, and arterial drainage of both was occluded. The patients were randomised into three groups and injected with 6 mg granisetron, 40 mg lidocaine and 5 mcg dexmedetomidine, respectively, into one arm, while injecting normal saline into the other arm. Two minutes later, the tourniquet was released in each group, and 2 mg etomidate was injected into each arm. Participants were asked to rate their pain using the visual analogue scale for each arm on injection, as well as 5 min after injection. Results: A significant difference was found in pain scores of etomidate injection in the three groups of dexmedetomidine, lidocaine and granisetron. Moreover, the pain reduction effect was lower both immediately and at 5 min after injection in dexmedetomidine group than other groups (P = 0.03). In addition, the mean of pain score was lower in lidocaine group than granisetron group (P = 0.01). Nevertheless, the trend of haemodynamic parameters was not significant and different among studied groups (P > 0.05). Conclusion: Dexmedetomidine seems to have been more efficient than the others in reducing etomidate injection pain. However, the adverse effect of the three interventions was not different, and the haemodynamic parameters were stable during anaesthesia.

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The meta-analysis of case–control and cohort studies was conducted to obtain the association between breech presentation and the risk of autism spectrum disorder (ASD) among children. The search for relevant studies in major electronic databases was performed including; Web of Science, PubMed and Scopus up to May 2018. The odds ratio (ORs) with 95% confidence intervals (CI) was extracted from eligible studies. The pooled estimate of OR was not indicated a significant association between breech presentation and risk of ASD among children (OR = 1.15, 95% CI = 0.93–1.37), but this association was significant in the unadjusted analysis (OR = 1.32, 95% CI = 1.05–1.58). Our findings were not showed that breech presentation is associated with increased risk of ASD among children.

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Objective: Testicular cancer (TC), although it is one of the most unusual cancers, seems to be increasing. There is no accurate information on the incidence of this cancer in Iran. The present study is conducted to evaluate the incidence rates of TC in Iran. Methods: A systematic search was conducted on all published studies of TC incidence using Medline/PubMed, Scopus, Embase, Web of Science, Google Scholar and four Iranian databases (Scientific Information Database, MagIran, IranMedex and IranDoc) until June 2018. This systematic review was done according to the preferred reporting items for systematic reviews and meta-analyses. Result: The database searching yielded 132 potentially relevant studies. A total of 11 studies were included in the study. The results of the random-effects model were demonstrated that the age-standardised rate (ASR) of TC was 1.13, 95% confidence interval (0.97–1.29) among Iranian males. Conclusion: ASR for TC in Iran is lower than the world average; however, it has a higher incidence than other Asian countries.

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Aim and Objectives: The aim of this study is to check the accuracy of two different electronic apex locators (EALs): Canal Pro and Root ZX – in locating simulated horizontal root fractures (HRFs). Materials and Methods: Forty-five recently extracted, single-rooted, human permanent teeth were selected for the study. Endodontic access cavity was prepared, and canal patency was checked using no. 10-K file. Horizontal fractures were simulated using 0.2-mm thick diamond disk in coronal, middle and/or apical third of root by operator one, until half of the canal was exposed circumferentially. Using both the apex locators, all the fractures were detected by the second operator to confirm the accuracy of EALs. The actual length of the fractures was then measured under ×2.5 magnification, and results were subjected to statistical analysis. Results: Results were analysed using the one-way analysis of variance and Tukey's post hoc test, and the differences between all the test samples were analysed. All the measurements were compared to the actual values separately. A statistically significant difference was determined at 95% confidence level (P ≤ 0.05). Conclusion: Investigated both the EAL are capable of detecting simulated HRF and that the Canal Pro showed a higher accuracy rate.

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Background: The purpose of the present study was to assess foetal heart rate (FHR) pattern after complete cord occlusion by radiofrequency ablation (RFA) for selective reduction in the complicated monochorionic twin pregnancies. Materials and Methods: A prospective cohort study was done at an Iranian Hospital in 2016–2017 on 85 pregnant women candidate for selective reduction by RFA. Umbilical vein was cauterised two times (power 100 Watt) for 2 min. Cease of blood flow was confirmed by colour Doppler and FHR was recorded. Then, the pattern of FHR after cord blood occlusion was assessed and recorded with certain intervals until cardiac asystole. Results: Of all 85 participants who entered the study, 59 cases with normal heart echocardiography were eligible. After about 4-min post-RFA, FHR steeply dropped to <80 beats/min. In 10 min, FHR deceased to about 60 beats/min, and in 20 min, it reached to 40 beats/min. At the 15^th min after RFA, the majority of foetuses and at 85^th min, all the foetuses showed cardiac asystole. Conclusion: We found that about 4 min after complete cord occlusion by RFA, FHR steeply decreased to problematic ranges. Our results indicated that in similar conditions such as foetal hypoxia and time for rescuing of foetus was too limited. Moreover, it is supposed that such a pattern of heart rate in preterm foetuses may be presented in terms, so tight monitoring of FHR trend, presence of an expert surgery team and advanced hospital facilities seems necessary.

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There is a contradict findings on the effect of placenta abruption on the risk of intrauterine growth restriction (IUGR). Therefore, the objective of present meta-analysis was to identify all the eligible studies to assess the effect of placenta abruption on the risk of IUGR. The major electronic databases, including PubMed, Scopus and Web of Science, were searched to identify relevant published studies. The literature search included 551 articles until January 2018 with 35,201 participants. In the end, a total of seven references were remained for this meta-analysis. Two independent authors reviewed the retrieved the studies and extracted data. I² statistics was used to assess of heterogeneity. The random effects model was conducted to assess pooled effects size. the results of study showed that placenta abruption has a significant effect on the risk of IUGR based on odds ratio results (2.06; 95% confidence interval: 1.57, 2.55). The result reported of the measure of effect was homogeneous (I² = 0.0%). we presented based on reports in epidemiological studies that placenta abruption is a risk factor for IUGR.

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Introduction: Diabetes is due to defect in Beta cell of islets of Langerhans, that is seen in pancreas. This defect is responsible for disturbance in blood glucose level. Other factors which are also responsible includes diet, hereditary, immunological factor, lack of exercise etc., The damage to nerves in DM has been assumed to be a result of the interaction of metabolic defects complicated by vasa nervorum abnormalities. Nerve conduction velocity, are standard measurement used to confirm the presence or absence of diabetic neuropathy. In Nerve conduction velocity study common nerves that are studied are common peroneal nerve, tibial nerve and sural nerve. Materials and Methods: The study was planned in Physiology Department in close collaboration with Department of Medicine (Diabetic Section), S.p.mc. Bikaner. A total of 100 subjects for study from diabetic centre, were selected. Institutional ethical clearance was taken before commencement of study from ethical committee of our institution. Results: In present study, maximum number of patients were non-smokers in both study and control groups (87% and 91% respectively) and this difference was found statistically insignificant (P > 0.05). We observed that the patients were vegetarian in both study and control groups and this difference was found statistically insignificant (P > 0.05). The mean peroneal nerve in study group was 42.26 ± 1.95 m/s and in control group it was 52.05 ± 4.78 m/s and the difference was found statistically highly significant (P < 0.001) and mean value of tibial nerve in study group was 41.71 ± 2.29 m/s and in control group it was 49.84 ± 2.67 m/s and the difference was found statistically highly significant (P < 0.001). Conclusion: In our study, we concluded that nerve conduction velocities decreases in tibial and common peroneal nerve in diabetic patients as compared to control. Nerve conduction velocities also decrease with increasing age, increased HbA1C >6.5%.

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Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most significant enzyme defect in India with an incidence ranging from 2% to 27.9% in different communities. Prolonged neonatal jaundice and haemolytic crisis are known to occur in children with G6PD deficiency. Hence, screening of a population for G6PD deficiency is paramount. A Novel water soluble tetrazolium-8 (WST-8) Formazan Method has been used in this study for in-field mass-screening of G6PD in the region of Himachal Pradesh, India. Materials and Methods: In this prospective study, 5652 neonates were screened to assay G6PD activity using WST8/1-methoxy phenazine methosulphate method within the first 48 h of life. Orange colour at the end of the procedure indicated normal G6PD activity while pink or colourless appearance indicated G6PD deficiency. Results: After the screening of 5652 neonates, the prevalence of G6PD deficiency was 12.4%. 45 newborns (6%) had a severe G6PD deficiency. Males were more affected than females (70:30). Furthermore, males had higher prevalence of deficiency than females (64% [n = 29] and 16% [n = 16]). Conclusions: G6PD deficiency assessment by the method used for population screening in the study was easy to do and quite simple. Following this, the high prevalence of this deficiency was noted in Himachal Pradesh. This study highlights the need to do neonatal screening of G6PD deficiency in population so that untowards complications like haemolytic crisis, complications due to neonatal jaundice can be avoided.

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Background: Iodine is one of the essential micronutrients for synthesise and secrete adequate amounts of thyroid gland hormones. Its deficiency is the most important threatening causes for human health. The aim of this study was to evaluate iodine concentration in marketed edible salt samples in Qom city and to compare with existing standards and offering solutions necessary to fix the probably problems. Materials and Methods: A cross-sectional, descriptive study was carried out on 60 samples of 20 brands of marketed edible salt in Qom during 2017. Iodine concentration was evaluated by the British Pharmacopoeia titration method. Results: According to the national standard of Iran during this study, iodine concentration in 51.67% of salt samples was in acceptable limits and 48.33% of samples were out of acceptable ranges. None of the tested samples had iodine content more than the standard limit. Conclusions: To improve salt fortification status and removing iodine deficiency in society, the following actions should be considered: enforcing producers to follow national and international standards, continuous monitoring the producers, necessary legal actions against offending manufacturers and appropriate measures by health ministry and relevant authorities.

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Context: Dermatoglyphics is the scientific study of the epidermal ridges and their configurations on the surfaces of the palms, fingers, soles of the feet and the toes. Aims: The aim of the study was to determine whether there exists any sexual dimorphism in A-B ridge count (ABRC) and ATD angle. Settings and Design: This was a cross-sectional study. Materials and Methods: Four hundred individuals (200 males and 200 females) were studied. Age range was 18–30 years. Palm prints were captured using a Deskjet scanner. Dermatoglyphic parameters were measured manually. Statistical Analysis Used: Statistical analysis was done using descriptive statistics and Student's t-test. Results: The mean values of ABRC in males were 42.08 ± 3.84 (right palm) and 41.94 ± 4.39 (left palm), while the ABRCs in females were 42.46 ± 4.40 (right palm) and 41.97 ± 3.46 (left palm). The mean ATD angles in males were 43.07 ± 4.99 (right palm) and 43.99 ± 4.77 (left palm), while the mean ATD angles in females were 43.91 ± 5.11 (right palms) and 44.05 ± 5.12 (left palms). There was no statistically significant difference between the mean values of both parameters in both sexes and in both palms. Conclusion: There was no sexual dimorphism in the values of ABRC and ATD angles, and therefore, these parameters cannot be used to infer gender in our environment.

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Introduction: Diabetes Mellitus (DM) is a chronic disorder of the metabolism of glucose, lipids and proteins caused by a defect in insulin action or secretion. This metabolic disorder is responsible for chronic complications that affect macro and microcirculation.The manifestations of microvascular complications are more frequently found in the eyes, kidneys, and nerves, and those of macrovascular disease, in heart, brain, and leg arteries. Chronic metabolic disorder diabetes mellitus is fast growing global problem with huge social, health and economic consequences. Materials and Methods: The study was planned in Physiology Department in close collaboration with Department of Medicine (Diabetic Section), Sardar Patel Medical College, Bikaner & Associated Group of Hospital. A total of 100 subjects for study from diabetic centre, were selected. Institutional ethical clearance was taken before commencement of study from ethical committee of Sardar Patel Medical College, Bikaner & Associated Group of Hospital, Bikaner. Control and subject were similar in sex and age. Results: We observed that Mean age in study group was 52.66 ± 10.86 while in control group mean age was 32.06 ± 14.08 and this difference was found statistically highly significant (P < 0.001). We observed that the mean FBS in study group was 101.63 ± 25.20 mg% wwhile in control group it was 97.52 ± 19.53 mg% and the difference was found statistically insignificant (P > 0.05). The mean median nerve in study group was 51.68 ± 4.01 m/s and in control group it was 57.64 ± 4.52 m/s and the difference was found statistically highly significant (P < 0.001) and mean value of ulnar nerve in study group was 53.56 ± 3.53 m/s and in control group it was 60.73 ± 5.99 m/s and the difference was found statistically highly significant (P < 0.001). Conclusion: In our study, we concluded that nerve conduction velocities decreases in median, ulnar diabetic patients as compared to control. Nerve conduction velocities also decrease with increasing age, increased duration of disease, increased BMI.

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Background: A medical emergency is an unwanted, unexpected reaction or complication, and few studies that assessed the knowledge and competency about emergencies in the dental clinics in Nigeria have been focussed on dentists and interns. This study, therefore, seeks to assess knowledge and self-assessed preparedness on medical emergencies amongst undergraduate dental students at two dental schools in Lagos State. Methodology: This was a descriptive study at two dental schools in Lagos State. The participants were selected consecutively from the class using the class register of the final-year undergraduate students of the two dental schools in Lagos for the 2017/2018 academic year as the sampling frame. Data were collected using a pre-tested structured close-ended self-administered questionnaire. Data entry and analysis were done using SPSS version 20, and P < 0.05 was considered statistically significant. Results: The age of the respondents ranged from 20 to 29 years with a mean age of 23.60 ± 2.1. Ninety-three per cent of students adequately assessed the patient's medical history, but only 64.9% regularly used a medical pro forma to obtain the health history of the patients. Forty (72%) respondents believed that they had good medical emergency preparedness while 17 (28%) assessed themselves as having poor skills. However, 38.6% of the students had poor knowledge about medical emergencies while 50% had fair knowledge. Only 10.5% of the students had good knowledge. Conclusion: Although many of the dental students indicate that they had good emergency preparedness, an assessment of their knowledge showed that only 10.5% of the students had good knowledge about handling medical emergencies. This highlights the need for a review of curriculum as well as a modification in delivery style to a practical, hands-on teaching and emergency scenarios simulations to enhance the students' skills and self-confidence in managing emergencies in a dental setting.

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Background: This study was conducted to evaluate the uterine artery Doppler velocimetry (UADV) during peak uterine contraction in order to predict preterm labour in Iranian women with a normal cervical length. Materials and Methods: This cohort study was conducted at Shariati Hospital within an interval of 1 year between January 2016 and January 2017. One hundred women within gestational age <24 weeks and preterm uterus contraction were enrolled. UADV during peak uterine contraction was evaluated by a perinatologist. Their flow velocity waveforms were recorded (during three consecutive uterine contractions), and the mean for uterine artery doppler pulsatility index (PI) was documented. Results: One hundred cases with the mean age of 31 ± 4.8 years were enrolled in this study. From this selection, eight (8%) cases delivered during the first 48 h of admission and 13 (13%) during the first 7 days. The mean gestational age and the PI were significantly different between cases who delivered during the first 48 h and those who failed to do so. The correlation coefficient between PI and gestational age was r = 0.2, P = 0.02. For women who delivered within the first 7 days, the mean velocity and the PI were considered as significant variables for predicting preterm birth. At last, similar to the first group, for those women who delivered within the first 14 days, the PI was the only predicting factor for preterm birth. Conclusion: This study concludes that the mean PI of uterine artery during peak contractions can be considered as a strong predictor of delivery in preterm labour in women with normal cervical length.

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Aim: The aim of the present systematic review was to assess the effect of cryopreservation on the human periodontal ligament (PDL) stem cells and their ability for periodontal regeneration. Materials and Methods: An electronic search without time restrictions was conducted up to August 2017 in indexed databases using the combination of different keywords including cryopreservation, cryofixation, vitrification and human periodontal ligament stem cells. The exclusion criteria included reviews, commentaries, letters to the editor, interviews and updates. The relevant articles were included and data extraction was processed. Results: Dimethyl sulphoxide was used as a cryoprotectant in all the studies which yielded good results. The magnetic freezing proves to be better than the normal freezer. The cryopreserved cells showed no significant difference for viability, proliferation, and regenerative capacities as compared to the fresh human PDL stem cells (PDLSCs), in vitro as well as in vivo. Conclusion: Cryopreservation of the human PDLSCs would serve as an opportunity for future regenerative therapy for the periodontium.

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