Transitional Epidemiology of Human Papillomavirus Infection in Iran: A Cross-Sectional Study and National Review.

Background: The high prevalence of cervical cancer in developing countries, despite its preventive nature, makes the disease a principal matter of concern for scientific studies. Providing global availability of primary and secondary preventive methods based on the high-risk human papillomavirus (HPV), which is the well-known pathogenesis in most malignant cervical lesions, has become the World Health Organization's (WHO's) critical target for 2030. Considering the demographic diversity and manufacturing of the internal vaccine in Iran, there is need for more study on the cost-effectiveness of these strategies. Materials and Methods: This study intends to assess female HPV prevalence at the time in Iran provinces, especially in the capital province, Khorasan Razavi, in the north to establish a scientific rationale for conducting further studies on arguments for and against national HPV prevention strategies in line with the WHO. In this population-based study, the HPV prevalence was evaluated in 900 cervical samples accumulated between 2012 and 2015. The data were later compared with recently published data in the same province, in the north of Iran. Result: Based on the results of our cross-sectional study, the estimated prevalence of HPV infection in the northern female population was 4.1% in 2015 and significantly increased to 35% in 2021. Conclusion: The hypothesis of the impact of behavioral and cultural changes in addition to population aging on general health indicates the need for national health promotion strategies. Additionally, it emphasizes the critical significance of conducting further investigational studies to obtain the actual and updated prevalence of HPV in Iran.

Seroprevalence of Herpes Simplex Viruses Types 1 and 2 in a Population, Age 15-35 Years, of Mashhad City.

Background: Considering the high prevalence and clinical importance of herpes simplex virus (HSV) infection worldwide, we aimed to evaluate the seroprevalence of HSV-1 and HSV-2 in a population aged between 15 and 35 years in Mashhad, Iran. Methods: This cross-sectional study was conducted on 916 cases composed of 288 (31.4%) men and 628 (68.6%) women. Using ELISA method, the presence of IgM and IgG antibodies against HSV-1 and HSV-2 was assessed. Results: Among the population studied, 681 (74.3%) cases were positive for anti-HSV antibodies, while 235 (25.7%) cases were negative. Moreover, no IgMs were found and all positive subjects had IgG antibodies. Age (p < 0.001), occupation (p < 0.001), education (p = 0.006), smoking (p = 0.029), and BMI (p = 0.004) demonstrated a significant association with HSV-1 and HSV-2 infection. Conclusion: Our study indicates a high seroprevalence of HSV infection; however, there was no cases positive for IgM antibodies, suggesting the high prevalence of latent infection.

Analyzing the relationship between tissue color observed in VELscope examination and histopathological factors in OSCC patients.

OBJECTIVE: Early detection of OSCC is a crucial step towards improving OSCC prognosis. In recent years, novel diagnostic aids such as light-based detection systems have been introduced for early diagnosis. VELscope is one such light-based device which is used to examine tissue fluorescence. Based on different studies, VELscope has a sensitivity of 90% in the diagnosis of oral premalignant and malignant lesions. Tumor depth of invasion and invasive front have recently been proposed as influential factors in OSCC prognosis. Therefore, the aim of this study was to assess the relationship between tissue color seen through this device and tumor depth of invasion. METHODS & MATERIALS: 20 histopathologically approved OSCCs were included in this study. Conventional oral examination was carried out followed by an assessment of the lesion using VELscope. The H&E slides prepared following the final OSCC surgeries were then examined by an oral pathologist to assess tumor depth of invasion (interpreted as low-risk/high-risk), invasivefront (low-risk/high-risk) and perivascular and perineural invasions. Data was transferred to SPSS 16 software. The association between color changes and histopathological factors was analyzed using the fisher's exact and chi-square tests. RESULTS: The mean age of the patients was 51/5+/-16/74, 60% of which were men. Most lesions were exophytic and the most common color seen during VELscope examination was red. 55% and 50% of the OSCCs showed high-risk tumor depths and high-risk invasive fronts respectively. Perivascular and perineural invasion was seen in 55% and 35% of the samples respectively. Statistical analysis showed that 72/2% of the lesions with high tumor depths and 70% with high-risk invasive fronts were seen as red, although these associations were not significant (P>0/05). Tumor depth was significantly correlated with invasive front (P<0/05). CONCLUSION: There was no significant relationship between the type of color seen through VELscope and tumor depth of invasion, however most cases with high-risk depth of invasions were red.

Assessing Heavy Metal Burden Among Cigarette Smokers and Non-smoking Individuals in Iran: Cluster Analysis and Principal Component Analysis.

Smoking is one of the major causes of mortality and numerous diseases, both directly and indirectly. The role of smoking as a significant risk factor is already known in several human diseases such as cardiovascular diseases, lung cancer, and chronic obstructive pulmonary disease. We aimed to compare the toxicity of heavy metal levels in the two groups of cigarette smokers and non-smokers in Birjand during 2018. In this case-control study, 70 smokers were enrolled as the case group and 70 individuals with no history of smoking as control group. The cases were selected from among those who smoked 10 cigarettes per day without a drug use history. Heavy metal concentrations were collected in participants' serum samples. Cluster analysis and principal components analysis were employed to compare heavy metal toxicity between the groups. The duration of smoking and the number of cigarettes consumed per day were 14.36 ± 12.75 years and 11.32 ± 7.23, respectively. The concentration of thallium (Ti), arsenic (As), manganese (Mn), and copper (Cu) was significantly higher in the smoker group than that in the non-smoker group (p < 0.05). Lead (Pb), cadmium (Cd), and cobalt (Co) are among the most important metals accumulated in smokers' blood, and 21.6% of our study's total data was associated with them. Cluster analysis in the smoker group, including A1 (Cd), A2 (Co, Pb), B1 (Ti), B2 (mercury (Hg), As, chromium (Cr), iron (Fe), nickel (Ni), and zinc (Zn)) and C (Mn and Cu). In our study, cluster analysis showed a different grouping of elements in patient and control groups. Lead, cadmium, and cobalt were the most critical metals accumulated in the blood of cigarette smokers.

Evaluation of the salivary glutaredoxin-1 levels in oral lichen planus and oral squamous cell carcinoma.

BACKGROUND: Glutaredoxin-1, as a component of antioxidant system, plays a crucial role in pathogenesis of some cancers and pre-malignant lesions. The aim of this study is to assess salivary levels of glutaredoxin-1 in oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC) patients compared with healthy controls. METHODS & MATERIALS: This cross-sectional study was conducted on 28 OLP patients, 20 OSCC cases, and 40 healthy subjects. Their salivary glutaredoxin-1 was assessed by the enzyme-linked immunosorbent assay (ELISA). RESULTS: Regarding the glutaredoxin-1 level, there was no significant difference between the three studied groups (p=0.073); however, the salivary glutaredoxin-1levels were higher in the healthy subjects than the OLP and OSCC patients. Among OSCC patients, the salivary glutaredoxin-1 levels were significantly higher in the males (p=0.03). According to glutaredoxin-1 levels, the difference between keratotic and non-keratotic OLP lesions were not significant (p=0.98). Furthermore, there was no significant difference between various clinical manifestations and grades of OSCC, (p=0.08, p=0.56, respectively). CONCLUSION: Salivary glutaredoxin-1 levels were lower in OLP and OSCC patients compared to the normal volunteers; therefore the role of glutaredoxin-1 in the pathogenesis of these diseases could be proposed.

Assessment of salivary thioredoxin levels in oral lichen planus and oral squamous cell carcinoma.

OBJECTIVE: Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease, which is considered as a potentially malignant condition and could transformed into oral squamous cell carcinoma (OSCC). Squamous cell carcinmoma is the most common oral cancer. This study aimed to compare salivary thioredoxin levels as an antioxidant protein among patients with OSSC, OLP and healthy subjects. MATERIALS AND METHODS: Twenty-eight patients with OLP, 20 patients with OSCC and 40 healthy people enrolled in this observational study. Saliva samples were collected from all subjects and salivary thioredoxin levels were evaluated by Elisa test. The data were recorded in the check lists and analyzed using SPSS (ver.17). RESULTS: Thioredoxin levels of healthy controls were insignificantly higher than OLP and SCC patients (p = 0.135). There was a statistically remarkable indirect relationship between thioredoxin levels and severity of the lesions determined by Thongprasom criteria among OLP patients. The thioredoxin concentration was significantly higher in the keratotic OLP. Among the OSCC patients, the highest levels of thioredoxin were found among patients aged more than 65 years. Salivary thioredoxin levels based on other variables were not significantly different between the studied groups. CONCLUSION: In this study, there was not any significant difference between salivary thioredoxin levels in the OLP and OSCC patients, though it was unremarkable higher in the healthy group compared to the patients; therefore, the role of thioredoxin in the cellular oxidation-reduction status could be suggested; however, further studies are recommended.

Evaluation of Tissue and Serum Expression Levels of Lactate Dehydrogenase Isoenzymes in Patients with Head and Neck Squamous Cell Carcinoma.

BACKGROUND: Head and Neck Squamous Cell Carcinoma (HNSCC) is a common malignancy that is associated with high morbidity and mortality all over the world. We explored the role of mRNA expression of both subunits of LDH in the early diagnosis of HNSCC. MATERIALS AND METHODS: This was a case-control study on 62 healthy individuals and 62 patients with HNSCC. The expression of LDH in tumors and healthy tissue margins, and in the serum of both HNSCC patients and healthy individuals was evaluated using a quantitative real-time PCR method. Analysis of LDH-A and LDH-B expression and sensitivity-specificity analysis were carried out using SPSS software. RESULTS: mRNA expression levels of LDH-A (4.18±1.29) and LDH-B (2.85±1.07) isoenzymes in tumor tissues were significantly higher than the expressions in the corresponding healthy tissue margins (1.85±0.56 and 1.61±0.56 for LDH-A and LDH-B, respectively). A comparison of LDH-B expression between histological grade I tumor tissue (2.74±0.19) and marginal tissue (1.62±0.90) showed a significant difference (P=0.016). Patients with a positive history of alcohol consumption and cigarette smoking had significantly higher mRNA expression of LDH-A (P=0.024) and LDH-B (P=0.03) in the marginal tissue and blood, respectively. The highest sensitivity and specificity values pertained to the mRNA expression of LDH-A (90.9%) and LDH-B (85.5%) in the blood. CONCLUSION: This is the first study reporting LDH gene expression as a biomarker in blood and tumoral tissue of HNSCC patients. Given the highest sensitivity and specificity values for LDH-A and LDH-B in blood, we recommend the simultaneous evaluation of both LDH isoenzymes in blood samples as a potential diagnostic method.

Effect of Using a Simulation Device for Ostomy Self-care Teaching in Iran: A Pilot, Randomized Clinical Trial.

The appearance of a stoma and the potential for contact with stool may negatively affect postoperative teaching effectiveness, especially for patients with cultural and religious backgrounds that consider stool untouchable. Instruction that involves the use of a physical stoma simulator for practice may help address this problem. PURPOSE: The aim of this pilot study was to determine the effects of simulation in ostomy self-care training on self-efficacy and adjustment. METHODS: A randomized clinical trial was conducted among patients at 2 public medical center surgical units in eastern Iran from April 2015 to December 2015 using consecutive sampling. Patients who spoke Persian, were 18 to 65 years of age, had a temporary or permanent intestinal stoma, and did not have comorbidities that might interfere with self-care teaching were invited to participate and randomly allocated to the simulation (SG) or the control group (CG). Both groups were provided 4 training sessions; the first and fourth session was the same for each group, but in sessions 2 and 3, the SG group used a wearable stoma simulator, whereas the CG group used the demonstration-return method. Demographic and stoma variables were collected, and the Stoma Self-Efficacy Scale (SSES) and Ostomy Adjustment Inventory-23 (OAI-23) were administered at baseline (following surgery), after 4 instructional sessions, and 45 days following the last education session. Descriptive statistics and chi-squared, Fisher's exact, Mann-Whitney U, repeated measure, and least significant difference tests were used to analyze the data. RESULTS: Of the 53 patients enrolled, 46 (23 in each group) completed the study. Mean age for SG and CG patients was 45.91 ± 10.40 and 53.78 ± 9.15, respectively (P = .009). The majority of patients were female (SG: 11 [47.8%]; CG: 14 [60.9%]), married (SG: 20 [87.0%]; CG: 19 [82.6%]), and had a diagnosis of cancer (SG: 20 [87.0%]; CG: 21 [91.3%]). The mean SSES score for stoma self-efficacy was 103.82 ± 15.81 in the SG and 89.91 ± 13.41 in the CG after the fourth session. Results indicated an improvement in self-efficacy in both groups from baseline to final follow-up visit (P <.0001). SSES in the SG was significantly different from baseline to final follow-up visit during the study (F = 3.183, P = .008). Mean OAI-23 scores were 51.04 ± 13.37 in the SG and 50.82 ± 13.84 in the CG at baseline and after the intervention (fourth session) were 60.56 ± 16.41 in the SG and 53.95 ± 13.22 in the CG group. The repeated measure test results indicated significant increases in adjustment scores from baseline to final follow-up visit in both groups (P = .000). CONCLUSION: The results of this pilot study suggest that using simulation to teach ostomy self-care improves self-efficacy after 3 and 9 weeks. Further randomized controlled trials that expand the sample size and demographic should be conducted.

Overexpression of Lactate Dehydrogenase in the Saliva and Tissues of Patients with Head and Neck Squamous Cell Carcinoma.

BACKGROUND: Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy that is associated with high morbidity and mortality. Salivary lactate dehydrogenase (LDH concentration), as an expression of cellular necrosis, may be a special marker of lesions that occur with changes in the integrity of the oral mucosa. This study was performed to determine the accuracy of salivary LDH as a clinical marker for HNSCC detection and to investigate the relationship between salivary LDH levels and tissue tumor detection. METHODS: The case group consisted of 44 HNSCC patients and the control group consisted of 44 healthy subjects. The stage and grade of HNSCC were determined, and the LDH levels in collected saliva samples were measured in all subjects. The expression of LDH in tumors and healthy tissue margins was evaluated via immunohistochemistry. RESULTS: The expression of LDH in the saliva of patients with HNSCC is significantly higher than that in the saliva of the healthy control group. The expression of salivary LDH in patients with oral squamous cell carcinoma (OSCC) is significantly higher than that in the other patients and healthy individuals in the control group. The levels of salivary LDH in patients with SCC of the tongue and lower oral cavity were significantly higher than those in other patients affected with SCC in other parts of the head and neck (P<0.01). CONCLUSION: As this enzyme increases simultaneously in both tumoral tissues and saliva, it can serve as a useful diagnostic marker for the early diagnosis and prediction of HNSCC.

Overexpression of High-Mobility Motor Box 1 in the Blood and Tissues of Patients with Head and Neck Squamous Cell Carcinoma.

INTRODUCTION: Head and neck squamous cell carcinoma (HNSCC) is one of the most common cancers in the world. Extra- and intra-cellular high-mobility motor box 1 (HMGB1) proteins are invovled in the pathogenesis and prognosis of cancer. Regarding this, the present study was conducted with the aim of investigating the expression of HMGB1 protein and mRNA levels in the blood, tumor tissue, and marginal normal tissue of patients with head and neck squamous cell carcinoma (HNSCC) using the quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC). MATERIALS AND METHODS: This study was performed on 88 patients with HNSCC, who referred to the otorhinolaryngology and oral pathology departments, affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, and a group of healthy subjects (i.e., control group) matched in terms of age and gender. RNA was collected from fresh tumor tissues, marginal tissues, and blood, followed by the implementation of quantitative PCR on the specimens. Furthermore, the expression of HMGB1 in tumor and normal margins was evaluated by means of IHC. The data were analyzed in SPSS software. RESULTS: According to the results the expression levels of HMGB1 protein and mRNA were significantly higher in the tumor tissue than in the normal margin tissues (P<0.01). In addition, there was a significant correlation between histologic grading and the expression of HMGB1 protein and mRNA in tissues (P<0.05). Furthermore, the receiver operating characteristic curve of the HMGB1 mRNA in tissue was located closer to the theoretical 100% sensitivity. CONCLUSION: The findings revealed a higher increase in the levels of mRNA and HMGB1 protein in HNSCC, compared to those in the normal margin tissues. In addition, HMGB1 mRNA showed a significant expression in the tissue and blood of the patients with lymph node involvement.

The diagnostic value of the native fluorescence visualization device for early detection of premalignant/malignant lesions of the oral cavity.

PURPOSE: The present study aimed to determine the diagnostic value of a native fluorescence visualization device in the identification of oral malignant/dysplastic lesions. METHODS: This study involved 45 patients who had oral lesions that were suspected to be malignant, potentially malignant, or benign. The patients visited the Oral Medicine Department of the Mashhad Dental School. The sensitivity, specificity, positive and negative predictive values, and likelihood ratio of this device were determined. RESULTS: The histopathological assessment of samples showed 9 cases of oral squamous cell carcinoma and 12 lesions with dysplasia. Ten samples of dysplastic lesions and all malignant lesions appeared dark or red/orange when examined with the native fluorescence visualization device. In 90% of the dysplastic/malignant lesions, the label-free fluorescence results were positive. The sensitivity, specificity, and positive and negative predictive values of this device were 90%, 15%, 40%, and 71%, respectively. CONCLUSIONS: The native fluorescence visualization device can be used in specialized centers as an adjunctive device to increase the sensitivity of a clinical examination, but is not capable of distinguishing benign lesions from malignant and dysplastic ones due to its low specificity.

Accuracy of color Doppler ultrasonography and magnetic resonance imaging in diagnosis of placenta accreta: A survey of 82 cases.

BACKGROUND: Placenta adhesive disorder (PAD) is one of the most common causes of postpartum hemorrhage and peripartum hysterectomy. The main risk factors are placenta previa and prior uterine surgery such as cesarean section. Diagnosis of placenta adhesive disorders can lead to a decrease of maternal mortality and morbidities. OBJECTIVE: The purpose of this study was to compare the accuracy of color Doppler ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of PADs. MATERIALS AND METHODS: In this is cross-sectional study, Eighty-two pregnant women who were high risk for PAD underwent color Doppler ultrasound and MRI after 18 weeks of gestation. The sonographic and MRI findings were compared with the final pathologic or clinical findings. P<0.05 was considered statistically significant. RESULTS: Mean maternal age was 31.42±4.2 years. The average gravidity was third pregnancy. 46% of patients had placenta previa. The history of the previous cesarean section was seen in 79 cases (96%). The diagnosis of placenta adhesive disorder was found in 17 cases (21%). Doppler sonography sensitivity was 87% and MRI sensitivity was 76% (p=0.37). Doppler sonography specificity was 63% and MRI specificity was 83% (p=0.01). CONCLUSION: Women with high-risk factors for PAD should undergo Doppler ultrasonography at first. When results on Doppler sonography are equivocal for PAD, MRI can be performed due to its high specificity.

Classification and Biomarker Genes Selection for Cancer Gene Expression Data Using Random Forest.

BACKGROUND & OBJECTIVE: Microarray and next generation sequencing (NGS) data are the important sources to find helpful molecular patterns. Also, the great number of gene expression data increases the challenge of how to identify the biomarkers associated with cancer. The random forest (RF) is used to effectively analyze the problems of large-p and small-n. Therefore, RF can be used to select and rank the genes for the diagnosis and effective treatment of cancer. METHODS: The microarray gene expression data of colon, leukemia, and prostate cancers were collected from public databases. Primary preprocessing was done on them using limma package, and then, the RF classification method was implemented on datasets separately in R software. Finally, the selected genes in each of the cancers were evaluated and compared with those of previous experimental studies and their functionalities were assessed in molecular cancer processes. RESULT: The RF method extracted very small sets of genes while it retained its predictive performance. About colon cancer data set DIEXF, GUCA2A, CA7, and IGHA1 key genes with the accuracy of 87.39 and precision of 85.45 were selected. The SNCA, USP20, and SNRPA1 genes were selected for prostate cancer with the accuracy of 73.33 and precision of 66.67. Also, key genes of leukemia data set were BAG4, ANKHD1-EIF4EBP3, PLXNC1, and PCDH9 genes, and the accuracy and precision were 100 and 95.24, respectively. CONCLUSION: The current study results showed most of the selected genes involved in the processes and cancerous pathways were previously reported and had an important role in shifting from normal cell to abnormal.

Correlation between serum leptin and bone mineral density in hemodialysis patients.

INTRODUCTION: For diagnosing of specific types of bone lesions in hemodialysis (HD) patients, it is necessary to conduct a bone biopsy as the gold standard method. However, it is an invasive procedure. While different markers have been suggested as alternative methods, none of them has been selected. The frequency of hip fractures is 80 fold in HD patients who have two-fold mortality as compared with general population. OBJECTIVES: Recently, serum leptin has been suggested as a bone density marker. This study tries to confirm this proposal. PATIENTS AND METHODS: In this study about 104 HD patients (53.8% male and 46.2% female) were enrolled. The average age was 38.28±7.89 years. Serum leptin, bone alkaline phosphatase, intact parathyroid hormone (iPTH), 25(OH)D, calcium, phosphorus and bone mineral density (BMD) (at the femoral neck and lumbar spine, as measured by dual-energy x-ray absorptiometry [DXA]) were assessed. RESULTS: Analysis by polynomial regression revealed no correlation between BMD Z-score at two points and serum leptin level. According to the thresholds of 25 ng/mL and 18-24 ng/mL in some studies, we detected 25 ng/mL as the threshold in our patients. Under this threshold, the leptin effect on bone mass was negative, and above the threshold of 25 ng/mL, we found leptin had positive effect on bone mass. CONCLUSION: In this investigation, we found, leptin has a bimodal effect on bone mass. Cortical bones assessment may be a better option for assessment.

The Effects of Ozonated Olive Oil and Clotrimazole Cream for Treatment of Vulvovaginal Candidiasis.

Context • Vulvovaginal candidiasis is the most common infection of the vulvovagina, which manifests with itching, a burning sensation, and leucorrhea. Some infections have been reported to be tolerant to conventional treatments, especially in immunosuppressed patients. New studies have suggested that ozone, which is the allotropic form of oxygen, may have antifungal effects. Objective • The study intended to compare the effects of ozononated olive oil and clotrimazole in the treatment of vulvovaginal candidiasis. Design • Patients were randomly assigned either to an ozone group or to a clotrimazole group in a randomized, controlled trial. Setting • The study took place in the Department of Gynecology of the School of Medicine at Mashhad University of Medical Sciences in Mashhad, Iran. Participants • Participants were 100 female patients who had been referred to the women's gynecology clinic at the Omolbanin and Ghaem Hospitals and who had confirmed vulvovaginal candidiasis. Intervention • Patients in the ozone group were treated with ozonated olive oil or those in the clotrimazole group were treated with clotrimazole for 7 d. Outcome Measures • Patients were evaluated through an interview and a paraclinical examination at baseline and postintervention. The study measured changes in itching, burning, and leucorrhea using a questionnaire that patients completed at the end of the study and determined the presence of an infection with vaginal candidiasis through a culture both before acceptance into the study and after the treatments, if accepted. Results • Ozone and clotrimazole both reduced symptoms significantly and led to a negative culture for vaginal candidiasis (P < .05). No significant differences existed between the 2 groups in their effects on the symptom of itching and leucorrhea and on the results of the culture (P > .05). However, clotrimazole decreased the burning sensation significantly more than did ozone (P < .05). Conclusions • Considering the potential efficacy of ozonated olive oil in the improvement of the clinical and paraclinical aspects of treatment of patients with vulvovaginal candidiasis, the research team suggests that the treatment can be an effective topical treatment for those patients.

Preventing and Therapeutic Effect of Propolis in Radiotherapy Induced Mucositis of Head and Neck Cancers: A Triple-Blind, Randomized, Placebo-Controlled Trial.

BACKGROUND: Mucositis is one of the acute complications of radiotherapy which can ulcerate oral mucosa and cause severe pain and discomfort which can affect oral normal function. Propolis is a natural source of flavenoid which has antiulcer, antibacterial, antifungal, healing and anti-inflammatory effects. Using such an affordable compound without any bad smell or taste that has reasonable price can help the radiotherapy undergoing patients. OBJECTIVES: Our goal is assessing the preventing and therapeutic effect of propolis in radiotherapy induced mucositis in patients with head and neck cancer. PATIENTS AND METHODS: In a randomized triple blind clinical trial, 20 patient were selected randomly to swish and swallow 15 ml of water based extract of propolis mouth wash 3 times a day in the case group (n = 10) and 15 ml placebo mouth wash in control group (n = 10). we use NIC-CTC scale for determining mucositis grading. RESULTS: We use T-test, Man-Whitney, Chi-square, and Friedman as analyzing tests. Case group had significantly (P < 0.05) lower grade of mucositis in all of the follow-ups, but xerostomia is not significantly different in two groups (P > 0.05). CONCLUSIONS: This is a pilot study which shows water based extract of propolis efficiently prevents and heals radiotherapy induced mucositis.

Immunohistochemical expression of p16 protein in oral squamous cell carcinoma and lichen planus.

Epithelial carcinogenesis is a multistep process. Specific genetic events lead to malignant transformation of oral epithelium. Oral squamous cell carcinoma (OSCC) may be preceded by potentially malignant lesions such as oral lichen planus (OLP). The p16 protein functions as a negative regulator of the cell cycle progression. Altered pattern of p16 serves as a biomarker for oral mucosal dysplasia and malignant growth. The purpose of this study was to evaluate p16 expression in OSCC and OLP to determine whether it can be a useful marker for early detection of carcinogenesis. We examined p16 expression in 45 OSCCs (15 grade I, 15 grade II, and 15 grade III), 15 OLPs without dysplasia, and 8 normal mucosal specimens with immunohistochemistry. p16 was interpreted as positive if more than 70% of tumor cells showed brown nuclear and cytoplasmic staining. All of the OSCC and control group samples showed negative immunoreactivity, whereas 26.7% of OLP samples were positive for p16. Our findings suggest that p16 expression could not be used as a helpful marker for detection of development toward malignancy in OLP samples.

Pictorial health warning labels on cigarette packages: an investigation on opinions of male smokers.

BACKGROUND: Health warning labels on cigarette packages are among the most straightforward and important tools to communicate with smokers and various studies have illustrated their efficacy. OBJECTIVES: The current study aimed to investigate the opinions of male smokers in Mashhad city about the efficacy of health warning labels printed on cigarette packages on the smoking status of smokers. PATIENTS AND METHODS: This cross-sectional descriptive study was conducted in 2013 using a questionnaire. The research population included the male smokers of Mashhad. The participants were selected from the customers referring to the newsstands for cigarettes. The obtained data were analyzed employing SPSS software Version 16, and the statistical tests including Kruskal-Wallis, Spearman, and correlation coefficient of Pearson, Chi Square, Mann-Whitney, and Bonferroni correction were used in this regard. RESULTS: In this research, there were 500 participants with the average age of 25 years. The initiation age of smoking was eight years while the maximum age was reported as 45 years. Results of this research about the effect of these labels on decreasing cigarette consumption rate showed that almost half of the participants believed that these labels were ineffective for them (52.2%) and other smokers (53.8%).Furthermore, significant relationship was found between the age and opinion of the smokers about the influence of these labels on reducing their cigarette consumption (P < 0.001). CONCLUSIONS: To promote the effect of printed images on cigarette packages, it is recommended to consider the suitability of labels in the targeted culture. In addition, to be more effective consultation sites to quit smoking should be introduced under the images.

Overcoming Complications Through Pre-patient Surgical Training in Otolaryngology.

Planning a balanced academic and practical surgical curriculum that is parallel to the constant innovations in surgical fields is the cornerstone of surgical education. Current training methods have coinciding benefits and drawbacks. In this study, we compare the efficacy of two learning models: pre-patient training outside the operating room versus step-by-step training on real patients in the operating room. Facial nerve preservation in superficial parotidectomy is the surgical model used in the study. Five otolaryngology residents in the third year of their residency participated in this study. They were divided into two groups: a treatment group which underwent a pre-patient training program by cadaver dissection and a control group which followed a step-by-step training model. At the end of the study, significant differences were apparent between two groups in the ability to find facial nerve trunk, microdissection of facial nerve branches, and the mean duration of total operating time. Pre-patient training programs outside the operating room provide surgical residents the opportunity to learn by trial and error without fear of complications.

The prevalence of Epstein-Barr virus infection in head and neck non-Hodgkin's lymphomas in Khorasan, northeast of Iran.

OBJECTIVES: To investigate the frequency and possible role of Epstein-Barr virus infection in non-Hodgkin's lymphomas of the oral cavity and maxillofacial region in Khorasan (Northeast of Iran). METHODS: The cross-sectional retrospective study assessed the frequency of Epstein-Barr virus infection in non-immunosuppressed non-Hodgkin's lymphoma cases of the oral cavity and maxillofacial region. Formalin-fixed, paraffin-embedded tissue sections from 34 cases of head and neck non-Hodgkin's lymphoma (17 low-grade B-cell lymphoma, 14 diffuse large B-cell lymphoma, and 3 peripheral T cell lymphoma) were selected as a case group, and 10 normal lymph node sections were considered as a control group. Polymerase chain reaction was used to detect the EBV-DNA in tissue specimens. SPSS 16 was used for statistical analysis of the data. RESULTS: EBV-DNA was detected in 26.5% of NHL samples. Among NHLs, Epstein-Barr virus was found to be positive in 50% cases with diffuse large B-cell lymphoma and 11.8% of low grade B-cell lymphomas. Epstein-Barr virus was not detected in any cases of peripheral T-cell lymphoma. CONCLUSION: Although it seems that Epstein-Barr virus appears to be an etiological factor in some subtypes of non-Hodgkin's lymphomas, especially in diffuse large B-cell lymphoma, more researches should be done to investigate the relationship between Epstein-Barr virus infection and head and neck non-Hodgkin's lymphomas.