[Correlation of Bcl-2 and COX-2 expression in oral lichen planus]

Lichen planus is a common immune-mediated disease that is associated with an increased risk of malignant transformation in the oral cavity. Synchronous up-regulation of COX-2 and down-regulation of Bcl-2 have been demonstrated in some malignancies. The aim of this study was to assess the correlation between COX-2 and Bcl-2 expression and their role in dysplastic changes of oral lichen planus [OLP]. This study was performed on 47 paraffin blocks with the diagnosis of OLP and 16 blocks with the diagnosis of focal fibrous hyperplasia [control group]. Immunohistochemical staining was performed using antibodies against COX-2 and Bcl-2. Spearman's rank correlation coefficient and Mann-Whitney test were used for data analysis. A significant correlation was observed between the intensity of sub-epithelial inflammation and the severity of basal cell layer degeneration [P=0.048]. Significant up-regulation of Bcl-2 and COX-2 was detected in sub-epithelial inflammatory infiltration [P<0.001, P=0,003]. The amount and intensity of Bcl-2 and COX-2 expression were significantly correlated in sub-epithelial lymphocytic infiltration [P=0.013, P=0.019]. Our findings indicated the effective role of Bcl-2 expression in decreasing the apoptosis in the inflammator y infiltrate unlike the epithelium. The significant correlation of the intensity of Bcl-2 expression in the epithelium and the sub-epithelial inflammatory infiltrate with COX-2 expression and also the correlation of the intensity of inflammation with the severity of basal layer hydropic degeneration may imply that these two markers can induce malignant transformation in the affected epithelium in an indirect manner by the continuation of inflammation and activation of carcinogenic mechanisms

Orofacial clefts and risk factors in Tehran, Iran: a case control study

Non-syndromic cleft lip with or without cleft palate [CL/P] or cleft palate only [CPO] are orofacial clefts with multifactorial etiology. These include environmental factors and heterogeneous genetic background. Therefore, studies on different and homogenous populations can be useful in detecting related factors. The aim of the present study was to evaluate the risk factors in patients with non-syndromic cleft in Tehran, Iran. Data from 300 patients and 300 controls were collected between 2005 and 2010. Binary logistic regression analyses were used to calculate relative risk by odds ratio [OR] and%95 confidence interval. Low maternal age [OR=1.06, 95% Cl, 1.011-1.113], low socioeconomic status [OR=0.23, 95% Cl, 0.007-0.074], maternal systemic disease [OR=0.364; 95% Cl, 0.152-0.873] and passive smoking [OR=0.613, 95% Cl, 0.430-0.874] increased the risk for CL/P and CPO. There was a significant difference in iron and folic acid use during pregnancy when the case and control groups were compared. In assessing for orofacial cleft risk, we should consider lack of folic acid supplementation use, maternal age and systemic diseases and passive smoking as risk factors

Esophagitis may not be a major precursor lesion for esophageal squamous cell carcinoma in a high incidence area in north-eastern Iran

Esophageal squamous cell carcinoma [ESCC] is usually detected in advanced stages resulting in a very poor prognosis. Early diagnosis needs identification of clinically releveant precancerous lesions which could become the target of screening and early treatment. Our aim was to check whether esophagitis could serve as a relevant histological precursor of ESCC in Northern Iran. During 2001-2005, all adult patients who were referred to Atrak clinic for upper gastrointestinal endoscopy and biopsy were enrolled. Atrak clinic is a major center for upper gastrointestinal cancer research in eastern Golestan. All subjects had been complaining of upper GI symptoms and were under further investigation to rule out cancer. Biopsies from the endoscopically normal mid-esophagus and also just above the esophago-gastric junction were obtained in all subjects whose esophagus appeared normal during endoscopy and from endoscopically normal appearing mucosa at the proximal vicinity of any detected mass. Microscopic examinations for the verification of the presence or absence of esophagitis was performed by independent histological examination of the samples by two pathologists. All the discrepant diagnoses were resolved in joint diagnostic sessions. During the study period 836 patients were enrolled including 419 non cancer patients [endoscopy clinic controls], 387 cancer patients, and 30 subjects with clinical diagnosis of malignancy referred for histological reconfirmation of diagnosis by repeated biopsy. Mild or marked mid-esophagitis was diagnosed in 39 [9.3%], 47 [12.5%] and 12 [40%] of endoscopy clinic controls, cancer patients and those who were suspicious for upper gastrointestinal malignancies. Our observation does not show evidence for esophagitis to be a predisposing factor for ESCC in Gonbad region In North Eastern Iran

Evaluation of CD31 expression and mast cell count in dysplastic lesions and squamous cell carcinoma of the oral cavity

Squamous cell carcinoma [SCC] is the most common malignancy in the oral cavity. Angiogenesis is essential for development and progression of SCC. Recently, some studies have reported that mast cells play a role in tumor progression, via promoting angiogenesis. The aim of this study was to determine CD31 [an endothelial marker] expression and mast cell count in oral dysplastic lesions and SCC. The CD31 expression and mast cell count were investigated in paraffin-embedded specimens of 10 cases of fibroma [control group], 10 cases of epithelial dysplasia, and 20 cases of SCC. CD31 expression was examined by IHC and mast cell count was evaluated by Giemsa staining. The mean of CD31 expression did not show any significant difference between groups, but in the tumors, peritumoral stroma revealed a significantly higher CD31 expression than intratumoral stroma. A significant difference in the mast cell count was observed between the groups and between peri-and intratumoral stroma of SCCs. The mean of CD31 expression and mast cell count did not show any correlation. Pre-and posttreatment studies and double staining methods are suggested for more definitive results

Prevalence of methicilin resistance staphylococcus aureus in different wards of Imam Hossein Hospital in Tehran, in 2007-2008

Always Staphylococcus aureus is among the most frequent causes of morbidity and mortality worldwide. The unique ability of this organism to develop resistance to virtually any new antibacterial agent reflects the extraordinary capacity of this organism to adapt and survive in a great variety of environments. The purpose of this study is the detection of prevalence of Methicilin Resistance Staphylococcus Aureus [MRSA] in Imam Hossein Hospital, in Tehran. This prevalence helps us to apply the best and correct antibiotic for this pathogen. For this cross sectional study- all samples of admitted patients [with a suspicion of infection], were evaluated from Nov. 2007 to Aug. 2008. Isolated staphylococci- tested for methicilin sensitivity by disc diffusion method [Methicilin disc]. Of 6640 tested samples, 143 [2.1%] revealed to be positive for Staphylococcus aureus of whom 113 [79%] were MRSA. Logistic regression showed a significant association between wards with prevalence of MRSA [p<0.028]. The prevalence was more visible in Orthopedic, Neurologic Wards, and ICU. In this study there was no association between gender, sample type and age of patients with MRSA rate. In our study, prevalence of MRSA infection in Imam Hosein Hospital was 79%. Different Hospitals should identify prevalence of MRSA in different wards and declare causes of more prevalence in some wards then a coordinated program would lead to measures designed to reduce this incidence. The results highlight the need for effective implementation of infection control measures in the hospital. There is a need for the judicious use of antimicrobial agents in the hospital and outside as their indiscriminate use can exert pressure in selecting out MRSA and other multidrug resistant organisms

Evaluation of the height and weight of students aged 7-11 years in Shahrood, 2003-2005

Children's physical growth is of utmost importance and their height and weight measurements are the most valuable factors in order to study and evaluate the quantity and quality of their growth. In Iran, like many other countries, NCHS standard charts are used, however, due to ethnic and geographical variations local charts should be prepared in order to compare children's status of health and growth. During the present cross sectional study, some primary schools were selected randomly and the height and weight of all 7-11 years old students [2224 students] were measured. Those with known disease affecting growth were excluded. Our results indicated that the mean of height and weight of 7 years old girls had been 120.04cm and 21.23kg, respectively, however, these figures increased to 140.49cm and 31.88kg by the age of 11 years. These figures were 119.32cm and 21.5kg and 139.36cm and 31.98kg for 7 and 11 years old boys, respectively. Results revealed that the mean height and weight of children in Shahrood is lower than the international standards. This suggests that nursing education should be improved to provide a higher level of health services. Also parents, teachers and school health care providers need some further training regarding children nourishment, health, vaccination and disorders and disease prevention, as these factors have critical roles in children's physical growth

[Comparing accuracy of Kodak Ektaspeed and Agfa Dentus M2 dental X-ray films in detection of caries]

Approximal caries is detected by clinical examination supplemented by bite wing radiography. In vitro comparison of diagnostic accuracy in detecting approximal caries of two dental X-ray films named as Kodak Ektaspeed and Agfa Dentus M2. In an experimental study, sixty-four unrestored extracted premolar and molar with approximal caries were arranged in a way to simulate a bite wing examination followed by radiography under standardized condition using Dentus M2 [Agfa-Gevaert] and Ektaspeed [Kodak Eastman]. The films were processed automatically. Three observers assessed radiographs using the following rating measures: R[0]=sound R[1]= enamel lesion R[2]= lesion reaching the dentioenamel junction R3= dentinal lesion. True caries depth was determined by histological examination. True caries depth was compared using the values given by observers and further an analysis of kappa was performed. The null hypothesis was rejected when p<0.001. The interobservers agreement on two films was high and revealed no significant disagreement [p<0.001]. Kappa value was 0.52 to 0.62. This value corresponded with moderate to high strength of agreement. There was no significant difference between two films and the standard [p>0.001]. Both films produced similar results in terms of diagnostic accuracy for approximal caries

[Evaluation of quality of life in patients with diabetes mellitus, based on its complications, referred to Emam Hossein Hospital, Shahroud]

Diabetes mellitus is an important and global health problem and is the seventh leading cause of death in the United States. It causes a high mortality and produces many personal, familial, social and financial problems. This study was performed to evaluate quality of life in diabetic patients based on the complications. ????This study was performed on 150 patients with diabetes mellitus selected by unrandomized sampling from patients referred to Shahroud Imam Hossein hospital. Based on the disease complications the sample was divided into 4 groups: without complication, microvascular complication, macrovascular complication and miro-macrovascular complication. Quality of life was assessed in physical, emotional and social aspects with audit of diabetes dependent qoL [ADDQoL] questionnaire. Average age of the sample was 59 years. 79.3% of patients were married, 62.8% were uneducated, 78.7% of patients did not have any educational course about diabetes mellitus. The mean of the total score of the quality of life in without complication group was 60.4 +/- 11.6, in microvascular complication group was 56.4 +/- 10.4, in macrovascular complication group was 61 +/- 7.8 and in micro-macrovascular complication group was 50.1 +/- 11.7. The quality of life of 4 groups was significantly different [ANOVA, P<0.05]. There was not a significant correlation between demographic variables and the quality of life score. The results showed that diabetes mellitus complications have significant and advert effects on the quality of this patient's life. Therefore, rapid diagnosis of the disease and its complication and use of appropriate therapeutic strategies in prevention or decreasing the complication is essential