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Background and Aim: For decades, using fluoride has been introduced to prevent the development and progression of primary carious lesions. Increased surface microhardness of primary caries is among the essential factors in preventing lesion progression and cavity formation. The present study aimed to compare the microhardness changes of primary caries treated with 3 products, containing fluoride (varnish, toothpaste, & mouthwash) in dental teeth.
Methods & Materials: In this study, 45 extracted human deciduous molars were used. Using a diamond-winning disc, enamel blocks with a dimension of 1 x 4 x 4 mm were prepared from the buccal surface of the teeth, i.e., healthy and without structural defects; they were mounted in acrylic self-adhesive. Initial microhardness test (Vicker’s test) with a force of 300 gr and Dwell time for 15 seconds was applied on samples. Next, artificial caries with the standard solution were created in all samples and the microhardness of samples was recorded at this stage. The study samples were randomly divided into 3 groups of 15, treated with fluoride varnish, mouthwash, and toothpaste. Then, the microhardness of samples was re-measured. The mean surface microhardness was compared between the study groups by Independent Samples t-test and Bonferroni test. All analyses were performed using SPSS at the significance level of P<0.05.
Ethical Considerations: This study was approved by the Ethics Committee of the Arak University of Medical Science (Code: IR.ARAKMU.REC.1397.264).
Results: Increase in surface microhardness of primary caries in fluoride varnish group was statistically significant; in GC MI paste plus toothpaste and Oral B mouthwash was non-significant. The research samples treated by fluoride varnish had a higher surface microhardness, compared to toothpaste and mouthwash.
Conclusion: According to the present research results, fluoride varnish was superior to fluoride mouthwash and toothpaste in improving the microhardness of primary dental caries.

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Introduction: One of the most common problems in newborns is apnea of prematurity. Given the importance of preventing apnea in very premature infants, the present study was designed and conducted to investigate the preventive effect of caffeine on reducing the frequency of apnea events in very premature infants.
Methods: This randomized, double-blind, controlled clinical trial was conducted on premature infants hospitalized in the neonatal intensive care unit of Shahid Motahari Hospital in Urmia. Infants were randomly divided into two intervention and control groups. The intervention group received intravenous caffeine at an initial dose of 20 mg/kg and a maintenance dose of 5 mg/kg for 14 days. In contrast, the control group received an equal volume of normal saline intravenously for the same period. Apnea events, cyanosis attacks, and bradycardia were recorded by the researchers in a standard checklist.
Results: Of the 50 infants in each group, 2% of the caffeine and 4% of the control group required prolonged oxygen therapy, respectively. Also, 6% of the caffeine group and 4% of the control group experienced intraventricular hemorrhage. In addition, 4% of the caffeine group and 2% of the control group required surgery to close the patent ductus arteriosus, and 14% of the caffeine group and 18% of the control group experienced apneic events. However, there was no statistically significant difference between the two groups regarding the incidence of apneic events (P = 0.58). Ultimately, 20% of the caffeine group and 14% of the control group died.
Conclusions: Although the findings of the present study were not statistically significant, they indicate a decrease in the frequency of apnea events in the group of premature infants receiving caffeine compared to the control group.

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Background: Some intracranial surgeries must be performed while the patient is awake. Awake craniotomy is an intracranial surgical procedure in which the patient is kept in a state of relative consciousness while the surgery is performed. The aim of this study was to present a case of intracranial surgery to remove a tumor in the right frontal cortex by awake craniotomy.
Case: In this report, anesthesia in craniotomy surgery with full wakefulness was investigated in a 22-year-old man. This patient, who was the first to perform a craniotomy with the fully awake method (from the beginning to the end of the operation) at Arak University of Medical Sciences and Valiasr Hospital in Arak, after preparing the patient and interviewing before the operation, Cranial nerve blocks related to the skin and head muscles (scalp block) were performed in the desired locations, and after providing mild sedation, surgical excision was given. The lesion was examined while awake and the surgery was performed while fully awake from the beginning to the end, and the patient's brain tumor was removed safely. A combination of local and regional anesthesia and light intravenous anesthesia was used in the patient. Two types of local anesthetics, lidocaine 1.5% and bupivacaine 2.5%, were used for anesthesia, as well as intravenous sedatives and anesthetics such as propofol, remifentanil, and dexmedetomidine were used to relieve the patients. Throughout the operation, the patient was awake and breathing spontaneously, and the function of the brain nerves during the operation could be evaluated. Finally, the patient's surgery was performed without any complications and in completely favorable conditions, and the patient was transferred to the intensive care unit in a good general condition, awake and fully alert.
Conclusion: Although maintaining analgesia and hemodynamic and ventilation stability in fully awake craniotomy conditions is considered a challenge, but due to the necessity of performing this procedure due to the need to check the function of cranial nerves during the operation and to prevent any neurological and functional damage, using By carefully performing the desired nerve block in the scalp and prescribing a small amount of sedative medicine(propofol,remifentanil,dexmedetomidine), we were able to create a condition where the operation can be successfully performed while fully awake. In this method, the possible complications of surgery are prevented and a satisfactory analgesia is achieved for the patient. In this recent experience, both surgical complications are prevented and the patient and surgeon are satisfied during the operation. Performing this technique was satisfactory for our patient.