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Article
Dental Anxiety and it's Relation to Serum Cortisol Level Before

Author: Dunia W. Alfayad دنيا وديع الفياض
Journal: Al- Anbar Medical Journal مجلة الأنبار الطبية ISSN: PISSN: 27066207 / EISSN: 26643154 Year: 2012 Volume: Vol.10 Issue: 1 Pages: 35-40
Publisher: University of Anbar جامعة الانبار

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Abstract

Background: Dental anxiety is still prevalent, despite advances in treatment methods, and it affects the utilization of health does not only decrease the pain threshold, but actually leads to the perception of painless stimuli as painful. services. Cortisol is an important hormone in the body, secreted by the adrenal glands and involved in many functions.Objectives: To evaluate the relation between the level of serum cortisol and increase anxiety in dental patients before minor oral surgery.Materials and Method: Sixty patients were included in this study were attended Alkatana Specialized Dental Center from October/4/2010 till December/1/2010, their age ranged from (16-54 years) 27 patients were females and 33 were males. They were divided into two groups, 30 of them as controls (they didn't need any dental surgery) who match the other 30 patients study group in age, sex and their general health status but they needed minor oral surgery. Blood samples were collected from all patients between 10-11 Am., and about 5 minutes before surgery to the patients of the study group. Serum cortisol level was measured by using radioimmunoassay analysis.Results: A total of 60 patients were enrolled in this study. Regarding the control group 15 were females and 15 were males while for the study group patients12 were females and 18 were males. Serum cortisol level was significantly different between two groups the mean was13.05 ±6.51 for control patients and 23.62 ±10.12 respectively and the Coefficient correlation (r)between serum cortisol level and pulse rate in both groups were 0.16 (p>0.05) for the control patients and 0.58 (p<0.01) for the study group patients. When serum cortisol concentrations in study group were distributed according to the age of the sample, there was a highly significant positive correlation between these variables (r=0.36, p< 0.05). Also pulse rat in study group was found highly positive association with age (r=0.55, p < 0.01).Conclusions: It is concluded that the study group patients exhibited significantly higher levels of serum cortisol and pulse rate than that of the control group. This deference is suggested to be due to phobia from dental surgical work. As recommendation we suggest giving patient 5 mg of diazepam at the night before the operation.

القلق النفسي لدى مرضى الاسنان وعلاقة هرمون الكورتيزول قبل عمليات الاسنان الصغرى

Keywords

dental anxiety --- pain --- cortisol


Article
Determination of the effect of stress on the salivary cortisol level among sample of university students having myofacial pain

Authors: Rana M. Hasan --- Jamal N. Ahmed
Journal: Journal of baghdad college of dentistry مجلة كلية طب الاسنان بغداد ISSN: 16800087 Year: 2013 Volume: 25 Issue: 3 Pages: 87-90
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Psychological stress is considered the major etiological factor precipitating myofacial pain andtemporomandibular disorders.It is known that stress induce various adaptational responses of physiologic systems. Theprocess includes increase in the activity of the hypothalamic -pituitary-adrenal axis which promotes cortisol secretion.Salivary cortisol has been used as a measure of free circulating cortisol levels.The use of salivary biomarkers hasgained increased popularity since collecting samples is non-invasive and painless. The aim of thisstudy was toevaluate the level of cortisol in saliva among sample of university students having myofacial pain, during the finalexam period and whether this finding could have a significant value as a symptomatic psychobiological marker.Materials and Methods: Ninety eight (98) university students were enrolled in this study. Fifty(50) were with myofacialpain (symptomatic) and forty eight (48) were without myofacial pain (asymptomatic) as a control group.Eachstudent with myofacial pain was examined according to Research Diagnostic Criteria for TemporomandibularDisorders. Saliva sample were collected from each subject before final examination and three months later forbiochemical analysis of cortisolusing ELISA test.Results: A highly significant difference in salivary cortisol level between the two periods for both the study and controlgroups, and a non-significant difference between the two groups in before examination period. A negativeassociation has been observed between the level of salivary cortisol and severity of pain and a highly significantimprovement of pain between the final examination periods and three months later.Conclusions: Dental students perceived a higher level of stress prior to the final exam was associated with raisedsalivary cortisol levels which could be considered as a useful non-invasive biomarker for measuring acute stress

Keywords

Stress --- Cortisol --- Myofacial pain


Article
Pre- and Post Exercise Changes of Salivary Cortisol as a Response to Heavily Training among Students of Physical Education College in Karbala University

Author: Ali Mihsen Hussein Al-Yassiri
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2014 Volume: 11 Issue: 4 Pages: 994-999
Publisher: Babylon University جامعة بابل

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Abstract

Background: Cortisol, the principal glucocorticoid in humans, plays a major role in metabolism and immune function. A cute exercise induces a change in plasma cortisol concentrations, which is dependent on the type of exercise. Several studies have investigated the effect of both acute and chronic resistance exercise on adrenocortical function.Objective: This study was designed to determine the level of salivary cortisol as a stress related hormone during pre- and post- exercise in college student- athletes.Materials and Methods: 10 males subjects (college student- athletes) were measured for height, weight, the general features of the participants are: Mean ±SD Age (year) 22 ± 2.79 Weight (Kg) 70.5±8.46, Height (Cm) 175.34±7.12, Three milliliters of un-stimulated total saliva was collected via passive drooling, at the beginning of each testing session (without stimulation, by spitting directly into a plastic tube), 5 min before, 5 min after the end of the match.Results: The results showed a significant increase the salivary cortisol level between post and pre- exercise and there was a strong association between increase salivary cortisol concentration and heavier exercise.Conclusions: During the course of a competitive season collegiate soccer players are exposed to a number of physical and psychological stressors from practice, conditioning, and competition. The ability of players to recover following such activities can ultimately affect the ability of the performance for ensuring physical activity.

Keywords

Cortisol --- Saliva --- Football


Article
Evaluation of the Level of Melatonin, Cortisol and IgA in Saliva of Patients with Oral Lichen Planus Lesions

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Abstract

Back ground: Oral lichen planus is a chronic inflammatory disease that affects the mucous membrane of the mouth.Several researchers suggest that oxidative stress is implicated in the pathogenesis of this disorder. It has beenhypothesized that melatonin is powerful anti-oxidants and can easily cross the cell membrane and is considered afree radical scavenger of Hydroxid, Oxygen and Nitrogen dioxide, cortisol as a stress hormone and theimmunoglobulin A as first line of defense and protection to the mucous membrane of the mouth are interrelatedfactors for the emergence of oral lichen planus. Aim of this study was to evaluate the level of melatonin, Cortisol andIgA in saliva of patients with oral lichen planus lesions in comparison with participants with normal oral mucosa.Materials and methods: In this study seventy five subjects with age 18 and over were included. The subjects weredivided into two groups; control group, this group comprised of 41 subjects with normal oral mucosa and the studygroup, which comprised of 34 subjects with clinically and histopathologically diagnosed oral lichen planus lesion. Thesamples were selected from patients attending College of Dentistry/University of Baghdad and cases that recruitedto the AL-Emmam Ali hospital / in Baghdad /Dermatology Department. Samples collection started from 2/ may 2013to 23/ January 2014.Saliva samples were collected between 10-12 Am. High performance chromatography (HPLC)analyzing technique was used for estimating the salivary melatonin and cortisol level. IgA level was measured byELIZA method.Results: The mean salivary melatonin level in patients with oral lichen planus was 4.786 μg/ml and the mean salivamelatonin level in normal person was 8.759 μg/ml. significant difference (p<0.01) was observed in the salivarymelatonin levels between the study and control group. The mean salivary cortisol level in patients with OLP was 0.730μg / ml and the mean saliva cortisol level in normal persons was 0.165 μg/ml. significant difference (p<0.01) wasobserved in the salivary cortisol levels between the study and control, group. The mean salivary IgA level in patientswith OLP was 221.4 μg/ml and the mean saliva IgA level in normal person was 125.8 μg/ml. There was a highsignificant difference (p<0.01) the study and control groups.Conclusions: The level of salivary melatonin was lower in patients with oral lichen planus, however cortisol and IgAwas higher when comparing the salivary level with that of the control groups

Keywords

lichen planus --- melatonin --- cortisol --- sIgA


Article
The Effect of Smoking on the Some Trace Elements and Cortisol Hormone Concentration in Serum

Author: Ali Saad Elewi علي سعد عليوي
Journal: Al-Mustansiriyah Journal for Pharmaceutical Sciences مجلة المستنصرية للعلوم الصيدلانية ISSN: 18150993 Year: 2012 Volume: 11 Issue: 1 Pages: 32-46
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:The effect of different doses of smoking on the some trace elements (Se,Zn, Pb, Cu) and cortisol hormone concentration have been studied.Four groups of smokers were used in this study to investigate the effect ofsmoking in trace element and cortisol hormone concentration in smokers andcompare the finding with nonsmokers group (control group).Mean values of cortisol hormone concentration in group I (consumed 10-20 cigar per day with 0.4mg nicotine/cigar) were found to be significantlyhigher (p 0.01) in comparison with the value of control group and highsignificantly higher (p 0.001) in group II who consumed 10-20 cigar per daywith 0.8 mg nicotine/cigar, and high significantly higher (p 0.001) in group

الخلاصة:تم أخذ أربع مجامیع من المدخنین لدراسة تأثیر التدخین على مستوى هرمون الكورتزول وبعضالعناصر النادرة ومقارنة النتائج مع مجموعة من غیر المدخنین.20 سیجار ة - لوحظ ارتفاع في مستوى هرمون الكورتزول لدى ألمجموعة الأولى من المدخنین ( 10في الیوم مع نسبه نیكوتین 0,4 مغم/سیجار ة) مقارنة مع مجموعة السیطرة، بینما كان الارتفاع واضح اً20 سیجار ة في الیوم مع نسبة نیكوتین 0,8 - جد اً في ألمجموعة الثانیة ( 17 شخص) من المدخنین ( 10مغم/سیجار ة) وكذلك كان الارتفاع واضح اً جد اً لدى المجموعتین الثالثة ( 14 شخص) والرابعة ( 18شخص) من المدخنین الذین یستهلكون 40 سیجارة أو اكثر في الیوم مع نسبة نیكوتین 0.4 مغم/سیجار ةو 0.8 مغم/سیجارة، على التوالي.كان تركیز عنصر السلینیوم في جمیع مجامیع المدخنین اقل من مجموعه السیطرة, والنقصان فيتركیز عنصر السلینیوم یزداد مع زیادة عدد السجائر ونسبه النیكوتین في ألسیجار ة.لم یلاحظ اختلاف في تركیز عنصر النحاس لدى ألمجموعة الأولى والثانیة بالمقارنة مع مجموعةالسیطرة, بینما كانت هناك زیادة في تركیز عنصر النحاس لدى ألمجموعة الثالثة والرابعة.لم یكن هناك تأثیر للتدخین على تركیز عنصر الزنك لدى جمیع مجامیع المدخنین ,بینما هناكارتفاع واضح في عنصر الرصاص لدى جمیع مجامیع المدخنین والزیادة في تركیز عنصر الرصاصتتناسب طردیا مع عدد السجائر ونسبه النیكوتین في ألسیجار ة.


Article
Effect of transfusion interval rate on clinical manifestations of patients with beta- thalassemia major and their correlation with some biochemical parameters

Author: Wafaa Fawzi. AL-Mosawy
Journal: karbala journal of pharmaceutical sciences مجلة كربلاء للعلوم الصيدلانية ISSN: 70272221 Year: 2017 Issue: 13 Pages: 249-257
Publisher: Kerbala University جامعة كربلاء

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Abstract

Background: Regular blood transfusions is the commonest form of life-long treatment for patients with beta-thalassemia major but multiple transfusions of blood causes iron overload and resulting in multiple progressive organ damage that later involved endocrine system, heart, and liver. Objective: This study is aimed to evaluate some clinical manifestations in the adult patients with beta thalassemia major based on interval rate of the blood transfusion and also investigate correlation between clinical status of patients with some biochemical parameters including the level of ferritin, Hb, prolactin, and cortisol.Methodology: Forty one Iraqi β -thalassemia major (TM) patients (19male and 22 female) are recruited from thalassemia center in Karbala at age of 14-24 years. The frequency of blood transfusion rate, blood groups, spleen status, and HCV infection are recorded from the profile of all patients. The weight and height of patients were measured to calculate body mass index (BMI), while the concentration of Hb, ferritin, cortisol, and prolactin are tested at morning just before blood transfusion session. Patients are grouped according to their transfusion interval rate (TIR) into two groups; short TIR group (˂ 3 weeks), and long TIR group (≥ 3 weeks). Results: The results were non-significant in the distribution of gender and blood groups, spleen status, frequency of HCV infection, Hb, cortisol, and prolactin between the two groups, but age average, ferritin level and BMI of long TIR group are significantly lower than those of short TIR patients. On the other hand, long TIR patients revealed non-significant correlation between all parameters and clinical manifestations except for Hb content which is significantly decreased (r = - 0.451, P = 0.039) in splenectomized patients. However, short TIR group showed that Hb content is significantly decreased in both splenectomized (r = - 0.560, P = 0.01) and underweighted (r = - 0.477, P = 0.033) TM patients. Conclusion: We can concluded that the levels of cortisol and prolactin hormones are neither disturbed in TM patients nor correlated with interval rate of transfusion, but Hb level is the key factor that determine TIR and ferritin level leading to retardation in BMI which may be due to another endocrinopathy particularly those that are closely related with metabolic pathways such as growth hormone and thyroxin.


Article
Serum Cortisol in Type 1 Diabetic females
مصل الكورتيزول في الإناث نوع السكري 1

Authors: Abbas AL-Musawi عباس الموسوي --- Perry H. Saif Ullah --- Ekhlas Abdu Allah Hassan اخلاص عبدالله حسن
Journal: Diyala Journal For Pure Science مجلة ديالى للعلوم الصرفة ISSN: 83732222 25189255 Year: 2012 Volume: 8 Issue: 1 Pages: 97-102
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Diabetes mellitus is regarded as one of the commonest metabolic disorder all over the world. It can cause various endocrine disorders by affecting the secretion, metabolism, clearance or bioavailability of hormones. Aim of study: This study is to answer if type1 diabetes changes cortisol level in female diabetic patients who have different degrees of glycemic control. Subjects, Materials and Methods: This study includes (81) female subjects, age ranged from (15 to 37) years. (20) subjects are apparently healthy chosen as control group and (61) patients with type 1 diabetes mellitus were divided into two groups according to their glycemic control : (16) with poor glycemic control (HbA1c>8%) and (45) with acceptable glycemic control (HbA1c<8%) . In this study Cortisol was quantitatively determined in patients and healthy subjects by Enzyme-Linked Immuno sorbent Assay [ELISA] test using commercially available kits. In addition to that, the duration of disease, fasting plasma glucose (FPG) ,Glycated hemoglobin (HbA1c), and body mass index (BMI) were identified in the patients. RESULTS: In poor glycemic control group, Cortisol level (267.89±16.60 ng/ml,p<0.05) was higher than in acceptable glycemic control group (126.84±4.55 ng/ml,p>0.05) and in nondiabetic patients (123±6.13 ng/ml ,p>0.05). CONCLUSIONS In type 1 female diabetic subjects, adrenal activity is enhanced in patients with poorly controlled patients diabetes and the degree of cortisol secretion is related to the glycemic control

خلفية البحث يعتبر داء السكري من أكثر الأمراض شيوعا في العالم والذي يعزى الى عمليات أيضيه غير طبيعيه. يسبب داء السكري خلل في الغدد الصم وذلك عن طريق تأثيره على إفراز وايض والفعالية البيولوجية للهرمونات .الهدف من الدراسة هذة الدراسة كانت اللأجابة فيما اذا كان مرض السكري من النوع الاول يغير تركيز الكورتيزول للمريضات بدرجة سيطرة مختلفة من المرض .العينات ، المواد وطرائق العمل : هذه الدراسةِ تَضمّنتْ (81) امرأة ًبمدى العُمرِ بين (15-37) سَنَه ، (20)امرأة صحيحة كمجموعةضابطة و(61) مصابة بداء السكري"النوع الاول" ، مجموعه المرضى قسّمت إلى مجموعتين وفقا لدرجةالسيطرة على السكري(16) مصابة ذات سيطرة ضعيفة (خضاب الدم المعسل<8%) .(45) مصابة ذات سيطرة جيدة (خضاب الدم المعسل>8%) . في هذه الدراسة تم تعين مستويات هرمون الكورتيزول وكان التقييم بواسطة فحص (ELISA) عن طريق العدد المختبرية التجارية المتوفرة. وقيمت أيضا فترة الإصابة بالمرض ,سكر بلازما الدم الصائم ,خضاب الدم المعسل((HbA1c.,دالة كتلة الجسم (BMI في مصل الدم.النتائج : يوجد اختلاف معنوي في مستوى الكورتيزول لمجموعة المصابات ذات السيطرة الضعيفة(267.89±16.60 ng/ml,p<0.05) عند مقارنتهم مع مجموعه المصابات ذات السيطرة المقبولة(126.84±4.55 ng/ml,p>0.05) ومجموعة الأصحاء(123±6.13 ng/ml ,p>0.05)..الأستتناج:في النساء المصابات بمرض السكري من النوع الأول زيادة فعالية القشرة الكظرية تكون في مجموعة المصابات ذات السيطرة الضعيفة وزيادة درجة إفراز الكورتيزول تكون متعلقة بدرجة السيطرة على المرض


Article
Heat-Intolerance Syndrome subsequent Foot-and-Mouth Disease in Cattle; ThiQar –Iraq
متزامنة عدم تحمل الحرارة المرافقة للإصابة بالحمى القلاعية في الأبقار: ذي قار العراق

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Abstract

The investigation on Heat-Intolerance Syndrome following foot and mouth disease (FMD) infection in cattle in ThiQar–Iraq, used 3ABC FMD ELISA kit, and Radio- immunoassay (RIA) to detect the cortisol level. From 105 there were 65(62%) infected cattle with FMD, which was high at 5- less 8 years old, while the cortrisol level showed three levels; normal (13-21 nmol⁄L), high and low levels were; 6(5.6%), 44(42%) and 55(52%) subsequently. More over the combined result of ELISA and RIA had divided cattle into six groups. First group of 40(38%) cattle infected with FMD and had low level of cortisol, this group containing 21(20%) with clinical signs of heat intolerance. Second group contain 22(21%) FMD infected cattle with high level of cortisol. Third group of 3(2.8%) FMD Infected cattle but normal cortisol level. Fourth group included 3(2.8%) not infected by FMD with normal cortisol level. Fifth group contain 22(21%) not infected with FMD but had high level of cortisol may related to stress. Sixth group consisted 15 (14%) cattle not infected with FMD and had low level of cortisol due to un known cause. Clinical signs of heat intolerance that showed in 21 head of cattle in the first group were: panting, overgrowth of hair coat, emaciation and seeking for shad. The diseased cow known locally as ”Mahrorah” meaning heat-intolerance.

عدت هذه الدراسة للتحري عن متزامنة عدم تحمل الحرارة بعد الإصابة بمرض الحمى القلاعية في الأبقار في محافظة ذي قار , وذلك باستخدام عدة الاليزا (3ABC FMD ELISA kit ) وفحص هرمون الكورتيزول بالتحليل الاستشعاعي الممنع لمصل الدم من خلال فحص (105) رأسا من الأبقار وجد 65(62%) مصابا بالحمى القلاعية وكانت الإصابة في أوجها بعمر من 5-اقل من 8 سنوات بينما كان مستوى هرمون الكورتيزول الطبيعي 13-21 مل مول وظهر في الأبقار بمستويات من الأعلى إلى الأقل على التوالي: 6(5و6%) و 44(42%) و 55(52%) علاوة على ذلك إن ربط علاقة نتائج الكشف بالا ليزا مع مستوى الكورتيزول وزعت الأبقار إلى ستة مجاميع:المجموعة الاولى من 40(38%) أبقار مصابة بالحمى القلاعية وتحمل مستوى واطئ من هرمون الكورتيزول وقد اشتملت هذه المجموعة على 22(21%) رأسا يعاني من علامات سريرية لعدم تحمل الحرارة ∙ والمجموعة الثانية من 22(21%) أبقار مصابة بالحمى القلاعية وتحمل مستوى عال من الكورتيزول∙ والمجموعة الثالثة من 3(2,8%) أبقار مصابة بالحمى القلاعية ولكنها تحمل مستوى طبيعي للكورتيزول , والمجموعة الرابعة شملت 3(2,8%) أبقار غير مصابة بالحمى القلاعية وكذلك ذات كورتيزول بمستوى طبيعي , والمجموعة الخامسة تألفت من 22(21%) أبقار غير مصابة بالحمى القلاعية ولكنها تحمل مستويات عالية من الكورتيزول ربما بسببالإجهاد, والمجموعة السادسة كانت من 15(14%) أبقار غير مصابة بالحمى القلاعية مع ذلك تحمل مستوى واطئ للكورتيزول لأسباب غير معرفة∙ وتميزت العلامات السريرية لعدم تحمل الحرارة في 21 رأسا من الأبقار ضمن المجموعة الاولي باللهاث وزيادة نمو شعر الجسم والهزال والبحث عن الظل وعرفت البقرة المصابة بالمرض بين القرويين في تلك المناطق بالمحرورة وتعني عدم تحمل الحرارة .

Keywords

Heat-Intolerance --- FMD --- Cattle --- ABC- ELISA --- RIA --- cortisol --- ThiQar --- Iraq


Article
Influence of dental extraction on patient’s stress and anxiety levels by assessing the salivary cortisol concentration at different time points during the extraction procedure

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Abstract

The aim of our study was to analyze the stress and anxiety in patients undergoingroutine dental extraction, by the assessment of cortisol in saliva, which can beconsidered as one of the major hormones that is released during stressful events.After obtaining the ethical approval and the patients were consented for their rolein this study, we examined 26 patients (13 males, and 13 females).The age rangedfrom 29-42 with mean age of 36.2. We collected three salivary samples from eachpatient after asking him to chew on a cotton roll to stimulate salivary secretion. Thefirst sample was obtained 10 minutes prior to local anesthetic injection, the secondsample collected 6-8 minutes after the local anesthetic injection, and third sampleacquired 10-15 minutes post-extraction. The samples were assessed and analyzedusing ELISA immunoassay (competitive inhibition enzyme immunoassay technique).Statistical analysis was performed using SPSS statistical software (version19).ANOVA and t-test were applied to obtain the significance and correlationbetween the examined samples.Significant difference was shown among the three samples (P-Value =0.002).The mean value in the third sample (post-extraction salivary sample) wasconsiderably high when compared to the other samples (Mean ± SD = 0.184± 0.184,0.307 ± 0.121 and 0.357 ± 0.141) respectively, which positively correlates with thepatient’s level of stress. Cortisol concentration in μg/dl in percentages between eachsample and the percentages, 50%, were0.105 μg/dl, 0.295 μg/dl and 0.410 μg/dl, (75%) were0.348 μg/dl, 0.410 μg/dl and 0.443 μg/dl and (90%), 0.443 μg/dl, 0.468 μg/dland 0.518 μg/dl.Our study revealed that salivary cortisol is within its highest levels after extractionin 15 minutes.


Article
Acute stress, salivary cortisol and calcium ions, in patients undergoing dental extraction procedure

Author: Dr. Hani Radhi B.D.S. M.Sc. * د. هاني راضي
Journal: MUSTANSIRIA DENTAL JOURNAL مجلة المستنصرية لطب الاسنان ISSN: 18138500 Year: 2014 Volume: 11 Issue: 1 Pages: 111-121
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Stress is well approved to be co-related to the dental extraction procedure, andlinked to the increase in cortisol levels in patients undergoing dental treatments. Boneaffected vastly by exposure to cortisol and that is mainly due to scavenging ofminerals (calcium and phosphorus) from the bone by cortisol to be consumed as a fueland energy source in the process of gluconeogenesis; hence, alter the density of boneand can cause substantial deterioration in bone quality and quantity. Cortisol can beinfluential on the function of both the osteoblasts and the osteoclasts and that willdemonstrate significant changes on bone as well. This research investigated therelation between the levels of cortisol and calcium ions with the degree of stressbefore and after routine dental extraction.Fifty two participants were included in this study, all met the inclusion andexclusion criteria designated for the research; they were subdivided into 2 groups, firstgroup was admitted to salivary cortisol evaluation, and salivary calcium ions wereachieved for the second group.The collected data represent a significant increase in both salivary cortisol andsalivary calcium ions in the post – dental extraction group when compared to the preextractiongroup. The evaluated salivary cortisol with mean of 4.589± 0.819 mmol/Lfor pre- extraction while, in the post-extraction the mean was 5.364 ± 1.017 mmol/Lwith a significant changes. The salivary calcium ions mean were 5.66 ±0.985mmol/L, while for the post-extraction mean was 6.380± 1.161 mmol/L with asignificant changes .The findings of this research gave an insight that stress plays an essential role inaltering both salivary calcium ions and cortisol levels in the post-extraction period, asboth increased significantly.

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