Introduction: The study's purpose was to compare the maxillary ALL-on-four, ALL-on-five, and ALL-on-six designs in terms of stress distribution in the bone and various components of the prosthesis design.Materials and Methods: This finite element analysis study was carried out descriptively in 2024 at the Faculty of Dentistry in Isfahan. An edentulous maxillary model and three implant-based fixed prostheses were designed. Design 1 (ALL on four): two vertical anterior implants in the position of the lateral teeth and two posterior implants with an angle of 30 degrees in the position of the second premolars. Design 2(ALL on five): one vertical implant in the position of the central tooth, two vertical implants in the position of the lateral teeth, and two posterior implants with an angle of 30 degrees in the position of the second premolars. Design 3 (ALL on six): two vertical implants in the position of the central teeth, two vertical implants in the position of the canine teeth, and two short vertical implants in the position of the first molars. A force of 100 Newtons was applied to the left end of the superstructure, and then the maximum stress in the bone and corresponding prosthetic structures were compared.Results: The ALL-on-Six design caused the least stress in the bone and prosthetic structures, and the ALL-on-Four design caused the most stress.Conclusion: Among the designs evaluated, the ALL-on-six demonstrated the most favorable biomechanical performance. The ALL-on-four design exhibited the highest stress levels within bone and prosthetic components. While the ALL-on-five design presented intermediate stress levels compared to the other two models.

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer in the PEDIATRIC population. With modern treatments, the chance of the complete recovery is nearly 100%. The most important prognostic factors are appropriate treatment protocol and determination of patient risk factors based on clinical, morphological, immunological and cytological characteristics. In this study we reviewed frequency of these factors, like as age, gender, the primary white blood cell number, sub- group on the base of FAB classification, immunophenotype and the clinical progress.Methods: In this retrospective study, we reviewed 877 PEDIATRIC patients with the diagnosis of ALL between the years of 1994 and 2004. In these patients the age, gender, primary WBC count, sub-group based on the FAB classification, immunophenotype and the clinical progress in 177 patient with acute lymphoblastic leukemia at Imam Khomeini Hospital between the years of 1994 to 2004 were determined.Results: Of these patients, 1.6% was younger than one year, 24.8% more than ten years old and 73.6% were between the ages of one and ten years, 63.8% were male. WBC counts were above 50,000/ul in 28.8% of the patients. FAB classifications included L1 in 80.2%, L2 in 17.5% and L3 in 2.3% of the patients. Immunophenotypes included pre-B cell in 63.8%, early pre-B cell in 23.1%, T cell in 12.3% and mature B cell in 0.8% of the patients. Marker CD10+ was detected in 88.1% of the B cell cases. In this study group, 74% of the patients recovered, 16.3% died and 16.5% relapsed.Conclusions: The prevalence of FAB-L1 and pre-B cell cases in this study is greater than a previous study, while the prevalence of FAB-L2 and early pre-B cell cases is less than that of the previous study.

Background: The scoring systems are helpful to monitor the PICU performance. One of the most important scoring systems is PRISM-III scoring system. Today PRISM score is used to evaluate the quality and quantity of the performance. The goal of this study was to show the prognosis of the patients admitted to Mofid PEDIATRIC intensive care unit (PICU) according to PRISM-III and PIM scoring systems.Materials and Methods: This study was a prospective descriptive one. Sampling method was sequentional and the sample size was 121 patients whom admitted to Mofid Hospital's PICU between Dec 2005 till May 2006. Results of PRISM-III scoring system were recorded in prepared sheets. Then, information transferred to computer for SPSS analysis. We used several statistical tests such as Chi square, t-test, Correlation and Regression, ANOVA, and Post-Hoc test.Results: Our study showed that 54% of patients were male and 46% were female and the most causes of admission to PICU were respiratory distress and central nervous system diseases, respectively. Sepsis was the main cause of death in PICU. The mortality rate was 33%. The mean PRISM-III score was 7.57 and this score had 80% of sensitivity and 75% of specificity to predict the mortality.Conclusion: According to ROC analysis the PRISM-III score has good predictive value in assessing the probability of mortality in Mofid's PICU and increase in PRISM-III score corresponds to the higher incidence of mortality.

Cytomegalovirus (CMV) is the leading cause of viral-associated congenital infections. Moreover, it can also be acquired. Between 50 to 80 percent of the world’, s population is seropositive for CMV and most clinical disease occurs in individuals previously infected with CMV. Rarely, serious CMV infection has occurred in individuals with healthy immune system. In contrast to immunocompetent patients, higher morbidity and mortality of CMV end organ disease is considered in immunocompromised patients. According to available evidence, gastrointestinal (GI) disease has lower prevalence in case of CMV-induced organ involvement, especiALLy in PEDIATRIC non-transplant acute leukemia. In this report, we present a 12-year-old girl, known case of acute lymphoblastic leukemia (ALL) receiving maintenance chemotherapy with manifestations of gastroenteritis and significant weight loss. Initial laboratory data, demonstrated mild pancytopenia especiALLy lymphopenia and thrombocytopenia. After excluding more common etiologies, colonoscopy with multiple biopsies were taken which was indicative of CMV-colitis. Intravenous (IV) ganciclovir for 3 weeks and oral valganciclovir for about 9 months were initiated. Follow-up courses for CMV surveillance included blood qualitative CMV polymerase chain reaction (PCR) and colonoscopy with biopsy which were negative for CMV but tissue qualitative CMV PCR was positive for CMV in about 7 months after initiation of treatment. Oral treatment was decided to be continued. To sum up, plenty of guidelines have been developed in stem cell transplantation and human immunodeficiency virus (HIV) patients but nontransplant leukemic setting, is a neglected area in the field of CMV infection management.

Background and Importance: Tuberous sclerosis, also known as Bourneville’, s disease is a rare autosomal dominant disease affecting multiple systems. In this case report, we emphasize the importance of clinical criteria instead of genetic analysis in diagnosing tuberous sclerosis and the need for rigorous follow-up of patientsto prevent complications. Case Presentation: Here we present a case of a 10-year-old boy presenting with intractable seizure and hypo-pigmented patches on his face and back of trunk. In neuroimaging evaluation, subependymal giant cell astrocytoma was diagnosed. Further, hisabdominal ultrasound showed multiple hamartomatous lesions in the liver and bilateral kidney. His cardiology and dental evaluation were normal. The dermatologist diagnosed a shagreen patch on the back of his trunk. Based on the latest clinical diagnostic criteria, he was diagnosed with a case of tuberous sclerosis and has been on the rigorous follow-up ever since. Conclusion: Since tuberous sclerosis is a multisystem disease, early diagnosis is necessary to prevent acute symptoms and prevent long-term complications. Here we emphasize the need to use clinical criteria instead of genetic study for early diagnosis of tuberous sclerosis.

Background: Hyperglycemia is a common complication during treatment for acute lymphoblastic leukemia (ALL) and can be associated with multiple adverse outcomes. In this study, we investigated the effect of chemotherapy-induced hyperglycemia on response to treatment in PEDIATRIC ALL patients. Material and methods: 192 ALL patients from 2009 to 2017 were divided into the case (glucose value ≥ 200 mg/dl) and control (no hyperglycemia) groups. The two groups were compared in terms of length of hospital stay, nosocomial infection, delay in chemotherapy and remission, and survival rate. Results: Of the 192 patients, 44 (22. 91%) met previously defined criteria of hyperglycemia. The mean (±SEM) length of hospital stay in the case and control groups was 30. 23 (±0. 71) and 27. 49 (±0. 42) days, respectively (P = 0. 002). In the case group, 23 patients (52. 28%) and in the control group 47 patients (31. 75%) had delayed chemotherapy (P = 0. 01). In the case group 23 people (52. 27%), and in the control group 48 people (32. 43%) developed nosocomial infections (P = 0. 02). Everyone in the case group had a remission before a month, in the control also only 2 (1. 3%) didn’t experience remission in a month. The rate of one-year survival in the case and control group were 88. 64% and 84. 09%, and three-year survival was 86. 48% and 83. 1%, respectively. Conclusion: hyperglycemia in PEDIATRICs with ALL is associated with increased length of hospital stay, delayed chemotherapy, and nosocomial infection, however, there was no significant difference between the two groups in terms of remission and survival.