Background: In the subclinical hypothyroidism, T4 or T3 levels are normal and thyroid-stimulating hormone (TSH) is slightly high. Selenium deficiency can lead to thyroid dysfunction. The present study aims to investigate the effect of selenium supplementation on the thyroid hormone and anti-thyroid peroxidase antibody (anti-TPO AB) levels. Materials and Methods: In this double-blinded, randomized, placebo-controlled clinical trial, 42 patients with subclinical hypothyroidism were randomly assigned to receive 200 μg selenium or placebo for 8 weeks. In the both groups, the serum TSH and anti-TPO antibody levels were measured and assessed before and after the intervention. Results: After the interventions, the mean serum TSH reduction in the intervention and placebo groups was −10.98 ± 33.31 and −3.20 ± 38.36, respectively, which were not statistically significant. However, the mean serum anti-TPO Ab concentration increased in the intervention and placebo groups (109.81 ± 51.49% vs. 173.17 ± 96.26%), between which the difference was not statistically significant (P >0.05) despite a slight increase in the mean anti-TPO level in the intervention group. Conclusion: The results of the current study indicated that selenium supplementation has no significant effect on serum anti-TPO Ab and TSH levels in the patients with subclinical hypothyroidism. Studies with larger sample size and with different doses of selenium are needed to reach more precise results.

Paraquat is a highly toxic compound and a widely used herbicide that causes serious morbidity and mortality. The most well-known route of poisoning is oral ingestion, whereas parenteral injection of paraquat is individually uncommon. We present a case who injected paraquat in his neck in an attempt to commit suicide. His general condition got worsened gradually over 3 days. He received early hemodialysis in 4 h after self-injection and then supportive treatment in intensive care unit. Early hemodialysis helped him survive, but during hospitalization, some rare complications occurred, and unfortunately, he died after 3 months. Despite the high-risk route of poisoning, the patient survived for 3 months. Our patient was protected from renal and hepatic damage may be because of early hemodialysis but suffered from central nervous system and pulmonary damage.

Background: Dental ceramics exhibit good optical and esthetic properties due to their translucency. Feldspathic ceramic is the most widely used veneering ceramic with brittleness, which accounts for most of its failure. Hence, this study was done to evaluate and compare the flexural strength of feldspathic ceramic reinforced with zirconia-silica nanofibers in the ratio of 2.5, 5, and 7.5 wt% with conventional feldspathic ceramic. Materials and Methods: According to ISO 6872, a master die was prepared from which resin bars were fabricated with 4.0 mm in width × 1.2 mm thickness × 25.0 mm length, Zirconia-silica nanofibers were produced by sol-gel electrospinning go around with calcination and blended with feldspathic ceramic through ball milling method. The samples were prepared with 0, 2.5, 5, 7.5 wt% nanofibers reinforced ceramic. The flexural strength of the samples was evaluated using three-point bending test. Results: The flexural strength values of zirconia-silica nanofibers reinforced ceramic groups were higher than control group. There was a gradual increase in the flexural strength values of felspathic ceramic groups with increase in wt% of nanofibers. Conclusion: The flexural strength of feldspathic ceramic samples reinforced with zirconia-silica nanofibers by 5 and 7.5 wt% were statistically significant compared to control, whereas the flexural strength of 2.5 wt% was statistically insignificant compared to the control group.

Retropubic midurethral sling (MUS) is safe and effective surgery used for the treatment of stress urinary incontinence in women. Bladder neck perforation is a rare intraoperative complication. If this complication missed in intraoperative cystoscopy may have serious morbidity. A 52-year-old woman underwent a retropubic MUS. She presented with early and unusual symptoms such as suprapubic and labial cellulitis and urine leakage through the suprapubic incision 1 week after surgery which was due to a missed bladder neck perforation during surgery. In cystoscopy after MUS revealed mesh traversing the bladder neck and it was removed. The missed bladder perforation may have early and unusual symptoms and cystoscopy must be done more carefully and obsessively in patients with risk factors.

Background: Postoperative complications of open heart surgery require extensive care, especially by the patient. One of the important strategies in this regard is self-care education and one of the well-known patterns is Orem self-care model. This study aimed to investigating the effect of Orem-based self-care program on sleep quality, daily activities, and lower extremity edema in patients undergoing coronary artery bypass graft surgery. Materials and Methods: This clinical trial study was performed on 74 patients with coronary artery bypass graft surgery in Kashani Hospital in Shahrekord. The patients were randomly assigned to intervention and control groups. Data were collected using need assessment form according to the Orem model, quality of life and activity daily living questionnaire and measurement of edema by the meters. Data were analyzed using descriptive and analytical statistics with SPSS software. Results: The sleep quality score in the intervention group immediately after the intervention and 2 months after, was significantly lower in the intervention group than in the control group (P = 0.001). In the intervention group immediately after the intervention and 2 months after, the daily activity score was significantly higher than the control group (P < 0.05) 2 months after intervention, edema score in intervention group was significantly lower than the control group (P = 0.006). Conclusions: Results of the recent study showed that the implementation of the Orem-based self-care program can reduce the postoperative complications and the use of nursing patterns, such as Orem, to enhance self-care ability in patients who require long-term care can be very effective.