Long non­coding RNA LINC00460 contributes as a potential prognostic biomarker through its oncogenic role with ANXA2 in colorectal polyps.

BACKGROUND: Long intergenic non-coding RNA 460 (LINC00460) as a potential oncogene and Annexin A2 (ANXA2) as a promoter in different cancer progression processes was considered. A significant relationship between the LINC00460 and ANXA2 has been recently discovered in colorectal cancer (CRC). Therefore, defining molecular biomarkers accompanied by lesion histopathologic features can be a suggestive prognostic biomarker in precancerous polyps. This study aimed to investigate the elusive expression pattern of ANXA2 and LINC00460 in polyps. MATERIALS AND METHODS: The construction of the co-expression and correlation network of LINC00460 and ANXA2 was plotted. LINC00460 and ANXA2 expression in 40 colon polyps was quantified by reverse transcription-real-time polymerase chain reaction. The receiver operating characteristic (ROC) curve was designed for distinguishing the high-risk precancerous lesion from the low-risk. Further, bioinformatics analysis was applied to find the shared MicroRNA-Interaction-Targets (MITs) between ANXA2 and LINC00460, and the associated pathways. RESULTS: ANXA2 has a high co-expression rank with LINC00460 in the lncHUB database. Overexpression of ANXA2 and LINC00460 was distinguished in advanced adenoma polyps compared to the adjacent normal samples. The estimated AUC for ANXA2 and LINC00460 was 0.88 - 0.85 with 93%-90% sensitivity and 81%-70% specificity. In addition, eight MITs were shared between ANXA2 and LINC00460. Enrichment analysis detected several GO terms and pathways, including HIF-1α associated with cancer development. CONCLUSION: In conclusion, the expression of the ANXA2 and LINC00460 were significantly elevated in pre-cancerous polyps, especially in high-risk adenomas. Collectively, ANXA2 and LINC00460 may be administered as potential prognostic biomarkers in patients with a precancerous large intestine lesion as an alarming issue.

A Systematic Review of Interleukin-17 in Oral Lichen Planus: From Etiopathogenesis to Treatment.

Lichen planus (LP) is a chronic autoimmune disease of skin and mucous membranes. World Health Organization has announced oral lichen planus (OLP) as a premalignant lesion. The exact etiology of OLP remains unknown; however, different mechanisms may be involved in its immunopathogenesis. The upregulation of cytokines, chemokines, and adhesion molecules is consistent with a persistent and erratic immunological response to OLP-mediated antigens generated by oral keratinocytes and innate immune cells. These molecules attract T cells, and mast cells to the disease site and regulate complex interactions among cells that lead to death of keratinocytes, degradation of basement membrane, and chronicity of the disease. It is believed that CD8+ and CD4+ T helper 1 (Th1) cells are the main lymphocytes involved in this process, although recent evidence suggests implication of other T helper subgroups, such as Th23, Th17, and regulatory T cells (Tregs), proposing a more complex cellular immunity process to be involved in its pathogenesis. The emphasis of this research review is on the function of IL-17 in the pathophysiology of OLP and how current discoveries may point to future treatment strategies. This research protocol will follow Preferred Reporting Items for Systematic Reviews (PRISMA 2020) checklist. An electronic search was conducted in PubMed, Scopus, Google Scholar, Embase, and Cochrane databases for articles published from 1960 to June 2022. Based on the eligibility criteria, 21 articles were enrolled. In comparison to healthy controls, the findings of this review demonstrated greater expression of IL-17 and Th-17 in the blood, saliva, and tissues of OLP and LP patients. Additionally, there was a strong link between the relative levels of IL-17 and IL-23 expression. Treatment with monoclonal antibodies against Th-17/Tc-17, IL-12/IL-23, and IL-23 would result in significant long-term improvement of LP symptoms.

Scrutinization of land subsidence rate using a supportive predictive model: Incorporating radar interferometry and ensemble soft-computing.

Land subsidence is a huge challenge that land and water resource managers are still facing. Radar datasets revolutionize the way and give us the ability to provide information about it, thanks to their low cost. But identifying the most important drivers need for the modeling process. Machine learning methods are especially top of mind amid the prediction studies of natural hazards and hit new heights over the last couple of years. Hence, putting an efficient approach like integrated radar-and-ensemble-based method into practice for land subsidence rate simulation is not available yet which is the main aim of this research. In this study, the number of 52 pairs of radar images were used to identify subsidence from 2014 to 2019. Then, using the simulated annealing (SA) algorithm the key variables affecting land subsidence were identified among the topographical parameters, aquifer information, land use, hydroclimatic variables, and geological and soil factors. Afterward, three individual machine learning models (including Support Vector Machine, SVM; Gaussian Process, GP; Bayesian Additive Regression Tree, BART) along with three ensemble learning approaches were considered for land subsidence rate modeling. The results indicated that the subsidence varies between 0 and 59 cm in this period. Comparing the Radar results with the permanent geodynamic station exhibited a very strong correlation between the ground station and the radar images (R2 = 0.99, RMSE = 0.008). Parsing the input data by the SA indicated that key drivers are precipitation, elevation, percentage of fine-grained materials in the saturated zone, groundwater withdrawal, distance to road, groundwater decline, and aquifer thickness. The performance comparison indicated that ensemble models perform better than individual models, and among ensemble models, the nonlinear ensemble approach (i.e., BART model combination) provided better performance (RMSE = 0.061, RSR = 0.42, R2 = 0.83, PBIAS = 2.2). Also, the distribution shape of the probability density function in the non-linear ensemble model is much closer to the observations. Results indicated that the presence of significant fine-grained materials in unconsolidated aquifer systems can clarify the response of the aquifer system to groundwater decline, low recharge, and subsequent land subsidence. Therefore, the interaction between these factors can be very dangerous and intensify subsidence.

Mesenchymal stem cell and endothelial progenitor cells coinjection improves LPS-induced lung injury via Tie2 activation and downregulation of the TLR4/MyD88 pathway.

Sepsis is one of the most important complications of infection with a high mortality rate. Recently, cell therapy has been widely used to reduce the symptoms of sepsis. It has been previously reported that mesenchymal stem cell (MSC) and endothelial progenitor cells (EPC) therapy have beneficial effects in experimental models of sepsis. The effects of coculture of MSC and EPC have not yet been used to treat sepsis. Therefore, the aim of this study was to investigate the therapeutic potential of EPC + MSC coculture on the residual effects of sepsis in a lipopolysaccharide (LPS)-induced mice model. Coinjections of EPC + MSC significantly enhanced the survival rate of LPS-induced mice, decreased concentrations of pro-inflammatory cytokines, and increased the level of anti-inflammatory cytokine. The LPS-induced mice that were treated with EPC + MSC showed a notable reduction in pulmonary edema, hepatic enzymes, and C-reactive protein level compared with the control group. Our results showed that coinjection of EPC + MSC up and downregulates Tie2 and TLR4/MyD88 signaling pathways in LPS-induced mice, respectively. Also, in vitro study showed that viability, adhesion, and migration in coculture cells is significantly decreased after being induced with 10 µg/ml LPS. Our results showed that LPS impaired the functional activity of the cocultured EPC + MSC via upregulation of the TLR4/MyD88 signaling pathway, which may be associated with decreased pTie2/Tie2 expression. In conclusion, coinjection of EPC and MSC modulated the TLR4/MyD88 signaling pathway that leads to reduce the inflammatory response. This study may provide promising results for the introduction of cocultured cells to manage infectious diseases and balance the immune response through immune regulatory function.

Antimicrobial effect of spore-forming probiotics Bacillus laterosporus and Bacillus megaterium against Listeria monocytogenes.

There are several reports on the detection of Listeria monocytogenes in Iran, which has been identified as a major public health problem. In addition, due to drug resistance and strong biofilm formation of this pathogen, new approaches such as using probiotics are needed to combat this bacterium. The aim of this study was to investigate the effect of spore-forming probiotics on the expression of virulence genes hly, plc, inlA, and invasion of L. monocytogenes. Spore-forming probiotics were co-cultured with L. monocytogenes at different time points and following cell count, the expression level of virulence genes of L. monocytogenes was assessed by real-time PCR. To investigate the effect of the isolated strains on the invasiveness of L. monocytogenes at different time points, HT-29 cell line was used. Sporulated probiotics reduced the growth of L. monocytogenes in broth medium at different time periods. The number of L. monocytogenes co-cultured with Bacillus laterosporus decreased by 1, 3, 3, and 6 log at 2, 4, 8 and 24 h after treatment, respectively. In addition, the expression of virulence genes was decreased at different time points and the expression of hly and plcA genes was more affected. The invasion rate of L. monocytogenes on HT-29 cells was decreased by 1 to 6 log at different time points. Both probiotic strains inhibited bacterial growth at different time points; however, more sensitive methods should be established for an accurate assessment.

Aquaporin3 (AQP3) expression in oral epithelium in oral lichen planus.

Lichen Planus is an autoimmune disease of skin and mucous membranes, including oral mucosa and genital organs, with the potential to undergo a malignant transformation. Xerostomia and the salivary gland hypofunction are common manifestations and complications in oral lichen planus (OLP), whose exact cause has not been well defined yet. Aquaporins (AQP) are a family of membrane channel cell proteins which play an important role in the intercellular water permeability. This study for the first time compares the expression of the aquaporin-3 (AQP3) gene in oral tissues of a group of OLP patients and a control group. In this study, 30 OLP patients and 30 healthy individuals were selected. The expression of AQP3 gene was measured using Real-Time PCR method. The expression of the gene in the OLP patients was more than the control group. It could be argued that decreased salivation increases the level of expression of the AQP3 gene in an effort to compensate for this deficiency and prevent the onset of xerostomia (compensatory up-regulation).

Muscarinic cholinergic receptors in minor salivary gland tissues of patients with oral lichen planus: A case-control study.

BACKGROUND: Oral lichen planus (OLP) is a common, chronic immunological and inflammatory condition. Many of the OLP patients complain of xerostomia. The M3 muscarinic cholinergic receptors (MR3) are the main receptors in the salivary glands responsible for water secretion into the saliva. This study aimed to assess the level of M3 muscarinic cholinergic receptors in minor salivary glands of OLP patients. METHODS: This case-control cross-sectional study evaluated 40 OLP patients and 22 controls. All participants completed two questionnaires (xerostomia and xerostomia inventory). Stimulated and unstimulated saliva samples were collected. The saliva flow rate was calculated by dividing the saliva volume (in milliliters) by time (in minutes). Six minor salivary glands were also surgically removed from the lower lip of patients and controls, and weighed using a digital scale with 10-4  g accuracy. They were then frozen at -80°C, and the level of M3 receptors of the glands was determined using the ELISA kit. RESULTS: The unstimulated and stimulated saliva flow rate was significantly lower in OLP patients. The xerostomia inventory score was significantly higher in the OLP group. The level of M3 muscarinic receptors in minor salivary glands of OLP patients was significantly higher than that in controls. CONCLUSIONS: It may be concluded that the reduction in saliva flow significantly increases the number of M3 receptors in an attempt to compensate for this shortage and prevent xerostomia (compensatory upregulation).

Synthesis and evaluation of a novel nanosized anionic linear globular dendrimer G2-ciprofloxacin conjugate against prostate cancer.

Prostate cancer is the second most common cancer in the world and the fifth cause of cancer deaths in men. Ciprofloxacin enables the inhabitation of the development of prostate cancer. In this regard, we plan to improve the anticancer effect of ciprofloxacin using the anionic G2 dendrimer in conjunction with ciprofloxacin. In the current study, we measured the size and the zeta potential as well as LC Mass to prove the fact that the conjugation was synthesized correctly. The anticancer activity among three groups including Ciprofloxacin, Ciprofloxacin -G2 dendrimer, and control was measured in vitro. In vitro studies showed that G2 anionic linear-globular polyethylene-glycol-based dendrimer, which conjugated to ciprofloxacin, was able to significantly improve the treatment efficacy over clinical ciprofloxacin alone with respect to proliferation assay. Maximal inhibitory concentration (IC50) was calculated as 200 µ/mL for ciprofloxacin alone and 30µ/mL for ciprofloxacin-G2 dendrimer. In addition, the growth of DU-145 cancerous cells was inhibited by ciprofloxacin-G2 dendrimer conjugate and the number of apoptotic and necrotic cells was increased significantly as evaluated by an annexin V-fluorescein isothiocyanate assay. Ciprofloxacin -G2 dendrimer conjugate was able to increase Bcl-2/Bax ratio in a large scale as compared with the control group and CBL alone. According to the above results, this compound could be considered as a good candidate for functional cancer treatment with low side effects.

Earth fissure hazard prediction using machine learning models.

Earth fissures are the cracks on the surface of the earth mainly formed in the arid and the semi-arid basins. The excessive withdrawal of groundwater, as well as the other underground natural resources, has been introduced as the significant causing of land subsidence and potentially, the earth fissuring. Fissuring is rapidly turning into the nations' major disasters which are responsible for significant economic, social, and environmental damages with devastating consequences. Modeling the earth fissure hazard is particularly important for identifying the vulnerable groundwater areas for the informed water management, and effectively enforce the groundwater recharge policies toward the sustainable conservation plans to preserve existing groundwater resources. Modeling the formation of earth fissures and ultimately prediction of the hazardous areas has been greatly challenged due to the complexity, and the multidisciplinary involved to predict the earth fissures. This paper aims at proposing novel machine learning models for prediction of earth fissuring hazards. The Simulated annealing feature selection (SAFS) method was applied to identify key features, and the generalized linear model (GLM), multivariate adaptive regression splines (MARS), classification and regression tree (CART), random forest (RF), and support vector machine (SVM) have been used for the first time to build the prediction models. Results indicated that all the models had good accuracy (>86%) and precision (>81%) in the prediction of the earth fissure hazard. The GLM model (as a linear model) had the lowest performance, while the RF model was the best model in the modeling process. Sensitivity analysis indicated that the hazardous class in the study area was mainly related to low elevations with characteristics of high groundwater withdrawal, drop in groundwater level, high well density, high road density, low precipitation, and Quaternary sediments distribution.

Effect of modified tapioca starch on the physicochemical and sensory properties of liquid kashk.

Three forms of modified tapioca starch, i.e. phosphorylated cross-linked tapioca starch (CLTS), octenyl succinic anhydride substituted tapioca starch (OSTS) and hydroxypropylated tapioca starch (HPTS) were studied and used as stabilizers (0.5, 1 and 1.5%) in industrial liquid kashk, and their effects on the physicochemical and sensory properties of products were examined during 60 days of refrigerated storage. When combined with the highest concentration of each stabilizer, the kashk reached its highest acidity, hardness, adhesiveness, viscosity and overall acceptability, while the lowest value of syneresis was obtained. Moreover, the highest values of viscosity was observed after incorporating CLTS into the samples, and other samples with HPTS showed the highest syneresis, hardness, adhesiveness and overall acceptability. During storage, there were significant trends of increase in the values of acidity, syneresis and hardness, whereas the viscosity, pH and adhesiveness decreased significantly. Several sensory attributes such as texture, odour value and overall acceptability were influenced by the type of stabilizer. In general, among the three kinds of modified tapioca starch, the HPTS was the most suitable form at the concentration of 1.5%, and this was most appropriate for the production of industrial liquid kashk with respect to high-quality physicochemical and sensory properties.

Evaluation of Xerostomia and salivary flow rate in Hashimoto's Thyroiditis.

BACKGROUND: One of the most common causes of hypothyroidism is Hashimoto's Thyroiditis (HT). Early detection of dry mouth is critical in preserving and promoting systemic and oral health. In this study we have assessed, for the first time, salivary function and xerostomia in HT patients who have not been involved with Sjögren's syndrome. MATERIAL AND METHODS: HT was diagnosed in 40 patients based on clinical findings and positive anti-thyroid peroxidase antibodies (anti-TPO). Controls, matched by sex, age and body mass index (BMI), and with no history of thyroid disease, were selected. A questionnaire was used for diagnosis of xerostomia. Saliva samples were taken between 8 a.m. and 9 a.m., and at least 2 hours after the last intake of food or drink. The flow rate was calculated in milliliters per minute. RESULTS: Xerostomia was significantly higher in patients with HT. Unstimulated salivary flow rate was significantly lower in the HT group. Stimulated salivary flow rate was lower in HT group, but the difference was not significant. CONCLUSIONS: The patients with HT experienced xerostomia, and their salivary flow rate was diminished. Spitting the saliva then assessing salivary flow rate based on milliliter per minute is non-invasive, fast, and simple for chair-side diagnosis of dry mouth. Autoimmune diseases can be accompanied by salivary gland dysfunction. This may be due to the effect of cytokines in the autoimmune process or because of thyroid hormone dysfunctions.

Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review.

AIM: Many studies have suggested that a lesion originally diagnosed as oral lichen planus (OLP) has different possibilities of undergoing malignant transformation in time, although these findings remain a controversial issue; for example, some studies reported different values of potential malignancy of OLP. INTRODUCTION: World Health Organization (WHO) classifies OLP as a "potentially malignant disorder" with unspecified malignant transformation risk, and suggests that OLP patients should be closely monitored. Numerous studies have attempted to confirm the malignant transformation potential of OLP. REVIEW RESULTS: The Cochrane Controlled Trials Register, Medline and EMBASE databases, PubMed, Google Scholar, Ovid, Up To Date, BMJ Clinical Evidence, MD Consult, and Science Direct were searched for papers published between 1997 and 2015. The medical subject heading search terms were "lichen planus," "oral lichen planus," "erosive oral lichen planus," "dysplasia," "oral precancerous condition," "oral premalignant condition," oral cancer, oral squamous cell carcinoma (OSCC), and atrophic lichen planus. A total of 120 English language abstracts were reviewed, and 50 relevant articles identified. Because of the extensive literature on the association between OLP and SCC, we have divided the data into genetic and non-genetic factors for more accurate assessment. CONCLUSION: In this evidence base, malignant transformation ranges from 0 to 37% with a mean of 4.59%. The highest rate of malignancy was noted in erythematosus and erosive lesions. In this way, follow-up of OLP patients could be carried out more efficiently and appropriately. CLINICAL SIGNIFICANCE: Oral lichen planus is a premalignant lesion. All types of OLP in any site of oral mucosa must be monitored regularly.

Evaluation of the Effects of Dental Implants on Oral Lesions.

OBJECTIVE: To determine whether dental implants impress oral lesions, and to evaluate the nature of their effect on the lesions. MATERIALS AND METHODS: A comprehensive search was done via Google and PubMed for articles (including case reports and literature reviews) containing the keywords 'oral squamous cell carcinoma' (OSCC), 'oral lichen planus' (OLP), 'lichenoid contact reaction' (LCR), 'osseointegrated implants', and 'dental implants' , in the last 10 years (2002-2012). RESULTS: The study included 24 articles involving patients with dental implants, and some oral lesions (e.g. oral lichen planus and oral squamous cell carcinoma) or with a history of lesions. In these publications, there is evidence suggesting the possibility of emergence, exacerbation, recurrence, or even malignant transformation of the oral lesions after implant placement in some cases. CONCLUSION: Based on our review of the literature, implant treatment does not seem to be completely safe under any circumstances, but may have some complications in subjects with certain diseases (e.g. oral lesions, autoimmune diseases, malignancies, allergic reactions, etc.). Therefore prior to treatment, patients should be fully informed of the risks. CLINICAL SIGNIFICANCE: Implant treatment is best done with caution in patients with cancer or mucocutaneous disorders.

Serum and Saliva MMP-3 in Patients with OLP and Oral SCC.

BACKGROUND: Matrix metalloproteinase-3 (MMP-3) plays a key role in development of cancer. The purpose of this study was to assess MMP-3 in the serum and saliva of patients with oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Thirty patients with OLP (8 reticular and 22 erosive forms), and 20 patients with OSCC (6 in low stage and 14 in advanced stage), were enrolled in this study, conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The serum and saliva MMP-3 was assayed by ELISA method. Statistical analysis of the Student's t-test, ANOVA and Pearson correlation coefficient was performed. The mean saliva and serum levels of MMP-3 were significantly higher in patients with OSCC compared with OLP. RESULTS: The serum and saliva MMP-3 concentrations increased from reticular form of OLP to erosive form of OLP, and increased further to low stage of OSCC and advanced stage of OSCC. Serum MMP-3 correlated significantly with unstimulated (r = 0.310, p = 0.038) and stimulated (r = 0.365, p < 0.026) saliva MMP-3. CONCLUSION: Serum and saliva MMP-3 levels appear associated with OLP and OSCC.

Serum and saliva collagenase-3 (MMP-13) in patients with oral lichen planus and oral squamous cell carcinoma.

BACKGROUND: Oral lichen planus (OLP) has been classified as a pre-malignant condition. Matrix metalloproteinase-13 (MMP-13) or collagenase-3 may play a key role in cancer development. The aim of this study was to compare serum and saliva MMP-13 between patients with oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). METHODS: This cross sectional study was performed on 30 patients with OLP (8 reticular and 22 erosive forms) and 20 patients with OSCC (6 in low stage and 14 in advanced stage) who were selected randomly. The study was conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The serum and saliva MMP-13 were assayed by ELISA method. Statistical analysis of the Student's t-test, ANOVA and Pearson correlation coefficient was performed. RESULTS: There were no significant differences in mean saliva and serum levels of MMP-13 between patients with OSCC and OLP and their subgroups. Serum MMP-13 correlated significantly with unstimulated (r = 0.307, p= 0.048), but not with stimulated, saliva MMP-13. CONCLUSION: Serum and saliva MMP-13 levels appear to be statistically similar in OLP and OSCC.

Angiofibrolipoma of the retromolar pad region: case report.

Angiofibrolipoma is a rare histopathological variant of lipoma, characterized by mature adipocytes, blood vessels and dense collagenous tissue. It is seldom seen in the oral and maxillofacial region. Diagnosis of angiofibrolipoma is only possible based on its histopathological features. This report presents the case of a 63-year-old male patient with the complaint of a polyp-like mass, felt from the left retromolar pad region. The mass was found as a small prominent lesion that had grown gradually for 1.5 years. Our differential diagnosis was irritation fibroma and fibrous pyogenic granuloma. This report also includes a comprehensive reference to previously reported data, as found through PubMed and Google Search, which revealed this type of case rarely has been documented.

Oral osteosarcoma: a case report and analysis of previously reported cases.

Osteosarcoma is the most common malignancy of mesenchymal cells after hematopoietic neoplasms. Most originate within bones, but the occurrence of this malignancy in the jaw bones is rare. There is controversy about the characteristics of this tumor in the literature. The aim of this paper was to collect the previous reported data and provide a statistical analysis of them. Additionally, we have reported a case of mandibular osteosarcoma.

Unstimulated whole saliva 25-hydroxycholecalciferol in patients with xerostomia in menopausal women.

BACKGROUND AND AIM: The aim of this study was to compare unstimulated whole saliva 25-hydroxycholecalciferol (25(OH)D) in menopausal women with and without oral dryness (OD) feeling, and evaluate the relationship between saliva 25(OH)D and severity of OD feeling. METHODS: A case-control study was carried out on 70 selected menopausal women aged 41-77 years with or without OD feeling (35 as case and 35 as control) conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. Unstimulated saliva samples were obtained by expectoration. Xerostomia inventory (XI) score was used as an index of OD feeling severity. The saliva 25(OH)D concentration was measured by ELISA. Statistical analysis of Student's t test and Spearman correlation was used. RESULTS: The mean saliva 25(OH)D level was significantly higher in the case group (897.1 ± 128.9 pg/ml), compared with control (156.7 ± 43.4 pg/ml; P < 0.05). XI score correlated significantly with saliva 25(OH)D concentration (r = 0.457, P < 0.001). CONCLUSIONS: It seems that the level of salivary 25(OH)D concentration may be higher in menopausal women with OD feeling than in the control group, and there is a positive correlation between OD feeling severity and unstimulated whole saliva 25(OH)D.

p53 as a neoplastic biomarker in patients with erosive and plaque like forms of oral lichen planus.

AIM: Unstimulated whole salivary p53 was assessed in patients suffering from erosive and plaque-like form of oral lichen planus (OLP). MATERIALS AND METHODS: Eighteen patients with erosive form, 17 patients suffering from plaque-like form and 38 noninvolvement subjects were enrolled. The unstimulated whole saliva p53 level was assayed by ELISA. RESULTS: The mean concentration of salivary p53 was significantly higher in patients with plaque-like form compared to both patients with erosive form and the control group. CONCLUSION: We conclude that plaque like form of OLP is important in view of the potential for malignancy and is not safety form. CLINICAL SIGNIFICANCE: It seems that all forms of OLP must be considered accurately, should be followed up with biannual examinations, and if possible, assessment of salivary p53 every year.

A Comparison of the Anti-Anxiety Effects of Oral Ketamine and Fluvoxamine in Children with Separation Anxiety Disorder Manifesting as School Refusal.

Background: Children suffer from a high prevalence of anxiety problems that require prompt treatment. It has been demonstrated that ketamine offers rapid anti-anxiety effects. This study aimed to evaluate ketamine's anti-anxiety impact in the treatment of children with school-refusal separation anxiety disorder. Materials and Methods: In this open-labeled randomized clinical trial, 71 children (6-10 years) diagnosed with school refusal separation anxiety disorder were randomly assigned to two groups; a case group, who received ketamine at a weekly rising dose of 0.1 to 1 mg/kg; the control group treated with Fluvoxamine (25 mg/day), which could increase to 200 mg/day if necessary. The SCARED and CATS questionnaires were used to assess anxiety before treatment, at the 8th and 16th weeks of intervention. The data were analyzed using repeated-measures analysis of covariance. Results: The mean anxiety scores in the eighth week (19.7 ± 16.1) were significantly lower in the ketamine group than before (31.5 ± 10.8). Until the sixteenth week (19.4 ± 14.6), there was no further decrease in scores in the ketamine group, in the fluvoxamine group, pre-treatment scores (36.3 ± 16.5) and eighth week (36.9 ± 16.6) were not significantly different, but scores decreased significantly in a sixteenth week (26.2 ± 12.5). Conclusion: In first eight weeks of treatment, ketamine was more successful than fluvoxamine at reducing anxiety disorder, considering the emergence of this disorder and the lack of major adverse effects of ketamine, it seems to be beneficial in early phases of treatment. Due to the quick onset of ketamine in future trials, their combination therapy is recommended during the initial weeks of treatment.