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INTRODUCTION: Oral Mucositis (OM) is a serious complication of chemotherapy that results in painful debilitating inflammation that sometimes ends in interruption of treatment. AIM: The study evaluated the effect of quercetin (a natural flavonoid) on preventing and treating chemotherapy induced OM in patients with blood malignancies. Materials and Methods: This double-blind, placebo controlled randomized trial was carried out on 20 adult patients who underwent high dose chemotherapy for blood malignancies. Patients were divided into two groups (10 patients in the intervention group and 10 patients in the control group). Patients in the intervention group were administered 250 mg quercetin capsules twice daily for four weeks. RESULTS: Nine out of 20 patients developed OM (three in the intervention group and six in the control group). The incidence of OM was lower in the intervention group although it was not statistically significant (p=0.189). The mean severity of OM was higher in the intervention group (2.6 vs 2). Healing time, age, gender, type of malignancy, drug type and duration of OM were not different in two groups. CONCLUSION: The incidence of mucositis was lower in the quercetin group, but mucositis was more severe in the intervention group, which may be due to lower oral health status in the intervention group.
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INTRODUCTION: Oral Lichen Planus (OLP) is a chronic mucocutaneous disease with an immunological etiology. This study was conducted to evaluate the effect of cedar honey in the treatment of erosive- atrophic OLP. MATERIALS AND METHODS: Thirty patients with a confirmed clinical and histopathologic diagnosis of OLP participated in this randomized clinical trial in Mashhad Dental School. Patients were randomly allocated into one of two groups. Both groups received standard OLP treatment (dexamethasone mouthwash 0.5 mg three times daily and fluconazole capsule 100 mg daily). The intervention group received cedar honey (20 ml three times daily, via a swish and swallow technique) in addition to standard treatment. The patients were followed for 4 weeks. The pain and severity of the lesions were recorded at the initial visit and follow ups. All recorded data were analyzed using the chi-square test, T-test, and analysis of variance (ANOVA) using SPSS version 11.5. A p-value less than 0.05 was considered significant. RESULTS: Both groups had a marked reduction in pain, size of erosive area, and atrophic lesions, particularly in the first follow-up period, but there was no significant difference between the two groups (P>0.05). Honey was effective in the healing of ulcerative lesions (average recovery in the experimental group was 69% while the average relief of ulcerative lesion in the control group was 50%), but the difference was not significant (P=0.896). CONCLUSION: No significant difference was found in the treatment of atrophic and erosive lesions of OLP through use of honey as an alternative treatment. However, this approach may be effective in managing ulcerative lesions of OLP; although more research with a larger sample size is necessary.
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BACKGROUND: Acute kidney injury (AKI) is commonly occurred in intensive care unit (ICU) patients. The aim of the study was a comparison of RIFLE (Risk of renal injury/Injury to the kidney/Failure of kidney function/Loss of kidney function/End stage disease) classification with other scoring systems in the evaluation of AKI in ICUs. MATERIALS AND METHODS: We performed a retrospective study on 409 ICU patients who were admitted during the 5 years period. RESULTS: At the 1(st) day of admission and time of discharge, the total and non-renal Acute Physiology and Chronic Health Evaluation II and sequential organ failure assessment scores were compared to max RIFLE criteria. In this assessment, there was concordance among the results (P < 0.05). CONCLUSION: The RIFLE classification can be used for detection of AKI in ICU patients.
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OBJECTIVE(S): Lupus nephritis (LN) is the main cause of mortality and disability in systemic lupus erythematosus (SLE) patients. Therefore, utilizing a reliable and non-invasive method for serial measurements of renal function seems to be necessary. The aim of this study was to evaluate the role of urinary lipocalin-2 as a biomarker of renal involvement in SLE patients. MATERIALS AND METHODS: Fifty two lupus patients in this cross sectional study were divided into two groups: patients with and without nephritis. For each group, urinary lipocalin-2, values were measured and reported according to urinary lipocalin-2/creatinine. Urinary lipocalin-2/creatinine sensitivity and specificity for identifying biopsy-proven nephritis were calculated, and a receiver operating characteristic (ROC) curve was constructed. Results : The mean urinary lipocalin-2/creatinine value of patients with biopsy-proven LN was 2.99 ± 4.1 ng/mg, and in non-LN patients was 1.16 ± 1.27 ng/mg. Urinary lipocalin-2/creatinine levels in LN patients were significantly higher than those in non-LN patients (P- Value = 0.03). In LN patients, urinary lipocalin-2/creatinine significantly correlated with proteinuria (r = 0.68; P = 0.0001). Using a cutoff value of 0.896 ng/mg, urinary lipocalin-2/creatinine had a sensitivity of 89.7% and a specificity of 39.1% for identifying SLE patients with biopsy-proven LN. The area under the ROC curve was 0.664 ± 0.076 with a 95% confidence interval of 0.52-0.81 (P=0.04). Analysis of variance showed that urinary lipocalin-2/creatinine is the same in different classes of LN (P-value=0.28). CONCLUSION: An important clinical conclusion is that measurement of urinary Lipocalin-2 may result in earlier diagnosis of LN.
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BACKGROUND: Fas (Apo-1/CD95) and its specific ligand (FasL) are key elements in apoptosis. They have been studied in different malignancies but there are few published studies about the soluble forms of these markers (i.e. sFas/sFasL) in gastric cancer. We have compared the serum levels of sFas/sFasL in gastric adenocarcinoma patients and cases with pre-neoplastic lesions as potential markers for early diagnosis, and investigated their relation with clinicopathological characteristics. METHODS: Fifty-nine newly-diagnosed cases of gastric adenocarcinoma who had undergone gastrectomy, along with 62 endoscopically- and histologically-confirmed non-cancer individuals were enrolled in this study. sFas/sFasL serum levels were detected by Enzyme Linked Immunosurbent Assay. RESULTS: Mean serum sFas level was significantly higher in gastric cancer patients than in control group (305.97 +/- 63.71 (pg/ml) vs. 92.98 +/- 4.95 (pg/ml), P < 0.001); while the mean serum level of sFasL was lower in patients with gastric adenocarcinoma (0.138 +/- 0.04 (pg/ml) vs. 0.150 +/- 0.02 (pg/ml), P < 0.001). Mean serum levels of sFas/sFasL were significantly different in both intestinal/diffuse and cardiac/non-cardiac subtypes when compared to the control group (P < 0.001). There was an increase in the serum level of sFas from the first steps of pre-neoplastic lesions to gastric adenocarcinoma (P < 0.001). Patients who had no lymph node involvement (N0) showed significantly higher serum levels of sFas compared to others (P = 0.044). CONCLUSIONS: Production of sFas may play a critical role in the carcinogenesis of intestinal-type gastric cancer. sFas serum level may serve as a non-invasive tool for early diagnosis of gastric cancer.
