Razi International Medical Journal

Management of Immature Permanent Necrotic Teeth Treated by Regenerative Endodontic: A Systematic Review

2025-12-23T21:37:15+00:00

Background: Regenerative endodontics is an evolving field of dentistry that focuses on biological restoration and tissue regeneration rather than traditional apexification techniques. This approach utilizes biological materials, growth factors, and scaffolds to stimulate natural healing, enabling root dentin thickening and lengthening. Regenerative endodontic procedures (REPs) aim to replace damaged structures, relieve symptoms, promote bone healing, and enhance root maturation. The success of REPs relies on three key components: stem cells, signaling molecules, and an appropriate scaffold to support cell growth and differentiation.

Methods: This systematic review evaluates the management of immature permanent necrotic teeth treated with regenerative endodontic procedures. A comprehensive literature search was conducted in PubMed and Google Scholar databases for studies published between 2015 and 2024, following PRISMA guidelines. Case series and case reports were included based on predefined eligibility criteria. Data extraction focused on patient demographics, etiology, radiographic findings, treatment protocols, and clinical outcomes.

Results: The findings indicate that regenerative endodontic treatment is highly effective, with a success rate of 82.6%, demonstrating significant healing of pre-apical radiolucency and root maturation. The most commonly used irrigation protocol involved NaOCl, saline, and EDTA, while Triple Antibiotic Paste (TAP) was the preferred intracanal medicament. MTA was the most frequently used capping material, and Platelet-Rich Fibrin (PRF) and Blood Clot (BC) were the most commonly utilized scaffolds. Despite the high success rate, a small percentage of cases were only partially successful or failed, emphasizing the need for further research to refine treatment protocols and improve long-term outcomes.

Conclusion: This review highlights the importance of regenerative endodontic techniques in promoting root development and periapical healing, offering a biologically driven approach to managing immature necrotic teeth. Further studies are required to optimize treatment strategies and enhance clinical predictability.

Strengthening Equitable Global Health Scholarship: Reflections on the Role of the Razi International Medical Journal

2025-12-23T21:32:07+00:00

Depression, anxiety, and stress among type-2 diabetic patients in Afghanistan: A cross-sectional survey study

2025-12-23T21:51:57+00:00

Background: Diabetic patients are prone to increased depression, anxiety, and stress. The main objective of this study was to assess the prevalence and associated factors of depression, anxiety, and stress among diabetic patients in Herat province of Afghanistan.

Methods: This cross-sectional study was conducted in 2024 among 353 adult diabetic patients in Herat province of Afghanistan. To assess depression, anxiety, and stress, the Persian version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used. Data were analyzed by using descriptive statistics, Chi-square tests, and multiple regression analysis. A two-tailed p-value below 0.05 was considered statistically significant.

Results: Among the 353 diabetic patients, 95.2% were aged ³50 years, 61.8% were females, 62.0% were living in urban areas, 64.6% were illiterate, 75.1% had low economic status, and 62.9% were overweight/obese. Severe/extremely severe depression, anxiety, and stress were present in 73.9%, 84.1%, and 80.5% of the diabetic patients. The statistically significant predictors of depression were being female, having low economic status, and having had a bad event in the past month. The statistically significant predictors of anxiety were being female and having low economic status. The statistically significant predictors of stress were being female, being a widow/divorced, having low economic status, and having had a bad event in the past months. Being a female diabetic patient was a strong predictor for all three conditions of depression (adjusted odds ratio [AOR] = 11.01, p-value <0.001), anxiety (AOR = 4.53, p-value = 0.005), and stress (AOR = 6.77, p-value <0.001).

Conclusion: Depression and anxiety are highly prevalent among diabetic patients in Herat province of Afghanistan.

Assessment of knowledge, attitudes, and practices concerning skincare agents among the inhabitants in Anuradhapura District, North Central Province, Sri Lanka

2023-09-09T13:50:19+00:00

Background: Skincare formulations have turned out to be one of the most frequently used products in the day-to-day life of people in this modern society. The present study sought the knowledge, attitudes, and practices on the usage of skincare products among the inhabitants in Anuradhapura district, North Central Province, Sri Lanka.

Method: A pre-validated questionnaire was used in this community-based descriptive cross-sectional study to collect information from randomly selected 404 participants. The data were analyzed by SPSS statistical package (version 20). Chi-squared test was used to determine the statistical association between the socio-demographic data and the usage of skincare products.

Results: Among the study population, 221 (54.7%) were identified as regular skincare product users. A statistically significant association was observed between some of the demographic data; ie. gender (p=<0.001), age groups (p=<0.001), marital status (p=0.013), and level of education (p=<0.001) with the usage of skincare products. Interestingly, 79.64% of the respondents who used skincare products preferred herbal formulations. The consumer awareness of the products they use was quite satisfactory as 95.09%, 69.23, and 77.37% of the regular users were cautious about manufacturing/expiry date, ingredients/composition, and possible side effects respectively. Moreover, 88.59% of the skincare product users had the habit of reading the safety precautions/warnings on the label. The quality of the products was the primary criterion for the purchasing of a particular product.

Conclusion: This study revealed that consumers in Anuradhapura district were quite rational and were aware during the selection of skincare products. Also, it pointed out the consumer preferences for herbal-based skincare formulations over synthetic counterparts.

Determinants of Unintended Pregnancy and Unmet Need for Contraception among Reproductive-Age Women in Nigeria

2025-01-06T11:58:27+00:00

Background: Globally, a quarter of unintended pregnancies end in unsafe abortions which is one of the leading causes of maternal mortality. This study aimed to investigate the determinants of unintended pregnancy and the unmet need for contraception among reproductive-age women in Nigeria.
Methods: Data were obtained from the 2018 Nigerian Demographic and Health Survey. A total of 20,655 women of reproductive age were included. Unmet need for contraception was the main outcome variable. Bivariate and multiple logistic regressions were carried out to predict the determinants. SPSS version 27.0 was used for data analysis. Statistical significance was set at p < 0.05.
Results: The respondents’ mean age was 29.7±7.1years, 36.7% had their first child before 18years, and 93.9% were married. 18.5% desired no more children and only 17.5% were currently using contraceptives. 11.8% admitted to having unintended pregnancy and 74.2% reported no unmet need for contraception. Respondents who were 18years and above at first birth were 14.7% less likely to have unintended pregnancy compared with those who were below 18years at their first birth (OR=0.853, CI=0.764–0.952). Respondents who had ever terminated a pregnancy were 1.3 times more likely to have an unintended pregnancy than those who had never terminated a pregnancy (OR=1.251, CI=1.101–1.422).
Conclusion: Many women reported unmet contraceptive needs, with some admitting to having unintended pregnancies. Addressing this is vital for reducing unintended pregnancies, which will contribute to improved health status for mothers and their babies and facilitate the attainment of maternal and child health-related sustainable development goals.

A Comparative Analysis of Hand Hygiene Knowledge, Attitudes, and Practice Among Female Medical and Non-medical Students in Peshawar: A Cross-sectional Study

2025-05-10T18:11:41+00:00

Background: Hand hygiene is a fundamental component of infection prevention, control, and patient care. However, it is often perceived as merely a personal hygiene practice, as its wider implications for disease prevention and public health are not comprehended. Hand hygiene is not implemented in an optimal way, both by health professionals and the population. The study aimed to assess and compare the hand hygiene knowledge, attitudes, and practices of medical and non-medical students in Peshawar, Pakistan.

Methods: A cross-sectional study was conducted, and data was collected from female medical and non-medical students in Peshawar by means of a validated questionnaire using convenience sampling and snowball sampling techniques. SPSS version 20 was used for data analysis.

Results: The overall level of knowledge, attitudes, and practices of hand hygiene in both groups was good. More medical students associated damaged skin, jewelry, and artificial fingernails with germ colonization, believed in the adequacy of hand washing after environmental exposure, prioritized hand hygiene, and consistently washed their hands after handling garbage and bowel movements. On the other hand, more non-medical students believed that hand washing cleans both hands and food, recognized the protective role of hand cream, washed hands only when visibly dirty, and considered hand washing after coughing, sneezing, or blowing the nose and drying hands after washing necessary.

Conclusion: The findings suggest that it is imperative to make targeted interventions, create awareness, and educate the public regarding hand hygiene to effectively improve its compliance. Moreover, additional research is necessary to establish the extent of KAP concerning hand hygiene.

Beyond the Five-Year survival threshold in Peritoneal Dialysis: Public Health insights from the Moroccan experience in a Low- and Middle-Income country context

2025-07-21T23:43:58+00:00

Background: Long-term survival on peritoneal dialysis (PD) remains uncommon globally and is even more challenging in low- and middle-income countries (LMICs), where resource constraints and health system factors influence dialysis outcomes. This study compared clinical, biological, and outcome differences between Moroccan patients who achieved ≥5 years of PD survival and those who did not.

Methods: We conducted a retrospective descriptive and analytical study from June 2006 to January 2024 including 175 PD patients. Participants were categorized into long-term survivors (≥5 years, n=61) and non-survivors (<5 years, n=114). Demographic characteristics, comorbidities, laboratory parameters, and technique-related complications were assessed. Survival and mortality determinants were analyzed using linear and logistic regression models.

Results: Female sex was significantly associated with longer PD survival (p=0.019). Non-survivors presented higher baseline urea, creatinine, and vitamin D levels, and lower bicarbonate, albumin, residual kidney function (RKF), and weekly creatinine clearance (WCC). Infectious complications—including peritonitis and catheter infections—were more frequent among non-survivors. Among long-term survivors, RKF, Kt/V, and albumin decreased over time, while hemoglobin and vitamin D improved. Cardiovascular events were the leading cause of death across both groups. Low ultrafiltration, hypoalbuminemia, and recurrent peritonitis were major predictors of mortality.

Conclusion: Although uncommon, long-term PD survival is achievable in Morocco. Better preservation of RKF, higher serum albumin, and fewer infectious complications contribute to prolonged survival. Strengthening early identification and management of these modifiable factors may improve outcomes in PD programs. Enhancing PD management strategies, infection control practices, and nutritional support could significantly reduce mortality and ease the burden on health systems in LMICs where access to renal replacement therapies remains limited.

Artificial Intelligence and Mental Health Care in Afghanistan: Opportunities, Constraints, and Ethical Considerations

2025-12-24T21:37:06+00:00