Penbactam for Helicobacter pylori eradication: A randomised comparison of quadruple and triple treatment schedules in an Iranian population

Background & study aims: Selection of the best drug regimens for eradication of Helicobacter pylori infection especially in patients at risk of peptic ulcer relapses and the development of complications is challenging. This study assessed and compared the efficacy of the two common PPI based triple therapies to a quadruple therapy including PPI, metronidazole, amoxicillin and a bismuth compound in Iranian population. Patients & Methods: Three hundred and thirty patients with peptic ulcer and H. pylori infection were included in the study. Patients were randomly assigned to one of the three treatment protocols all given twice daily: (a) A 14-day quadruple therapy (OMAB group) comprising omeprazole 20. mg, metronicazole 500. mg, amoxicillin 1. g, and bismuth subcitrate 240. mg; (b) A 14-day triple regimen (OCP group) comprising omeprazole 20. mg plus clarithromycine 500. mg and penbactam 750. mg and (c) A 14-day triple regimen (OCA group) comprising omeprazole 20. mg plus clarithromycine 500. mg and amoxicillin 1. g. Cure was defined as a negative urea breath test at least six weeks after treatment. Results: The per-protocol eradication rates achieved with both OCP regimen (87.0%) and OCA treatment (90.8%) were significantly higher than the OMAB treatment protocol (56.0%); however, no significant difference emerged in eradication rates between the two triple treatment schedules. No significant differences between the groups were found in most side-effects. Conclusion: Two-week quadruple therapy showed a lower eradication rate compared to common triple treatment schedules when used as first-line eradication treatment for H. pylori infection in Iranian population. © 2012 Arab Journal of Gastroenterology

The Effect of Intracanal Irrigants on Push out Bond Strength of CEM, Root MTA and Angelus MTA Cements to the Dentin Wall

Background and Objective: To reduce microbial contamination in cases such as perforation treatment, it is necessary to use irrigants after cement placement. The aim of the present study is to investigate the effect of intracanal irrigants on the push out bond strength of CEM, Root MTA and Angelus MTA cements to the dentin wall. Methods: In this laboratory research, 150 cross-section samples from the mid-root region of single canal teeth without caries with a thickness of 1 mm, which were randomly divided into 3 groups of 50 and filled with CEM cement, Root MTA or Angelus MTA, were examined. After the cements were set, the samples of each group were divided into 5 subgroups of 10; 4 subgroups were cleaned with sodium hypochlorite, EDTA, normal saline, 2% chlorhexidine for 30 minutes, and one subgroup was not cleaned as a control group. Then, the push out bond strength of cement with the dentin wall (MPa) and the failure pattern of the samples were evaluated. Findings: Different cleaning methods did not show any significant effect on the bond strength of CEM, Root MTA and Angelus MTA cements. In the cleaning method with saline, the bond strength of Angelus MTA (6.3±1.98) was higher than Root MTA (2.1±3.61) (p=0.004). In the cleaning method with 2% chlorhexidine, the bond strength of Angelus MTA cement (8.72±3.13) was higher compared to CEM (3.87±1.35) and Root MTA (4.66±1.76) (respectively p<0.001 and p=0.001). The most common type of failure in the Angelus MTA group was of the adhesive type, and in the CEM cement and Root MTA groups, it was of the mixed type. Conclusion: The results of the study showed that different cleaning methods have no effect on the push-out bond strength of the examined cements

Comparison of the Expression Level of P53 and Proliferating Cell Nuclear Antigen (PCNA) Genes in the Inflamed and Non-Inflamed Dentigerous Cysts

Abstract: Background & Aims: The role of P53 and proliferating cell nuclear antigen (PCNA) genes in inflamed and non-inflamed odontogenic cysts is related to cell proliferation but it is unclear. The aim of this study was immunohistochemical evaluation of P53 and PCNA expression in inflamed and non-inflamed dentigerous cysts. Methods: In the present study, 23 dentigerous cysts (12 inflamed and 11 non-inflamed) were surveyed. Three microns slices were got from paraffined blocks and stained with P53 and PCNA antibodies by immunohistochemistry. Slides were seen by oral pathologist with optical microscope (Olympus BX41) in ×400 magnification and scored by Allred scoring. Data were analyzed by Mann-Whitney test via SPSS software. Results: Percent of stained cells in inflamed compared non-inflamed dentigerous cyst did not show any significant difference for expression level of P53 and PCNA in basal and suprabasal layers (P> 0.05). Conclusion: It seems that inflammation does not affect on expression level of P53 and PCNA in dentigerous cyst. Keywords: P53, Proliferating cell nuclear antigen (PCNA), Dentigerous cyst, Inflammatio

The Prevalence of Odontogenic Cysts and Tumors in Babol, North of Iran

BACKGROUND AND OBJECTIVE: Odontogenic cysts and tumors exclusively develop in the jaws from odontogenesis tissues. Given the importance of the early diagnosis and proper treatment, the present study aimed to determine the prevalence of these lesions in a population from the North of Iran during a 22-year survey. METHODS: This cross-sectional study was conducted by investigating the records in the archives of Shahid Beheshti Hospital of Babol affiliated with the Department of Pathology of School of Dentistry from 1990 to 2012. The demographic features of the subjects including age, gender, anatomic pathology and clinical and pathological lesions were collected in the form of data which were recorded and evaluated. FINDINGS: Out of a total of 8956 samples with oral lesion dysfunctions, 317 cases of odontogenic cysts and 53 cases of odontogenic tumors were discovered which belonged to 205 men (55.4%) and 165 women (44.6%). The mean age of these patients was 15.15 &plusmn; 28.75 years (ranging from 2 to 79 years). Among the cysts, radicular cyst accounted for the highest prevalence (67.8%) while ameloblastoma was the most frequent odontogenic tumor (82.6%). Moreover, the lesions most commonly developed in the maxillary anterior and the posterior mandibular region, respectively. CONCLUSION:&nbsp;According to the results of this study, the incidence of odontogenic tumors is lower compared to the incidence of odontogenic cysts in the north of Ira

Subclavian artery-esophageal fistula after placement of a self-expanding metal stent in a patient with esophagogastric anastomosis stenosis

Background: There have been reports on stent-related vascular erosions about patients with benign or malignant stenosis of the esophagus who received endoscopic stent insertion for palliative intention for oral intake. Case presentation: A 61-year-old woman with esophageal cancer located in the middle part of esophagus was treated with esophagectomy. Two years following the surgery, malignant stenosis recurred in the esophagogastric anastomosis. A non-covered self-expanding metal stent (10 cm length with a diameter of 18 mm at expanded state) was inserted. Three months later, a massive hematemesis with subsequent hemorrhagic shock developed from the proximal end of the stent which resulted in the final diagnosis of arterioesophageal fistula on the left subclavian artery. An endovascular repair using a stent graft for the left subclavian artery via the right common iliac artery was performed and the patient remained well until discharge. Conclusion: Increase in the treatment of esophageal strictures by stent insertion increases the risk of stent-related vascular fistula. These complications should be considered in any patients with massive upper gastrointestinal bleeding

The Effect of Intracanal Irrigants on Push out Bond Strength of CEM, Root MTA and Angelus MTA Cements to the Dentin Wall

Background and Objective: To reduce microbial contamination in cases such as perforation treatment, it is necessary to use irrigants after cement placement. The aim of the present study is to investigate the effect of intracanal irrigants on the push out bond strength of CEM, Root MTA and Angelus MTA cements to the dentin wall. Methods: In this laboratory research, 150 cross-section samples from the mid-root region of single canal teeth without caries with a thickness of 1 mm, which were randomly divided into 3 groups of 50 and filled with CEM cement, Root MTA or Angelus MTA, were examined. After the cements were set, the samples of each group were divided into 5 subgroups of 10; 4 subgroups were cleaned with sodium hypochlorite, EDTA, normal saline, 2% chlorhexidine for 30 minutes, and one subgroup was not cleaned as a control group. Then, the push out bond strength of cement with the dentin wall (MPa) and the failure pattern of the samples were evaluated. Findings: Different cleaning methods did not show any significant effect on the bond strength of CEM, Root MTA and Angelus MTA cements. In the cleaning method with saline, the bond strength of Angelus MTA (6.3±1.98) was higher than Root MTA (2.1±3.61) (p=0.004). In the cleaning method with 2% chlorhexidine, the bond strength of Angelus MTA cement (8.72±3.13) was higher compared to CEM (3.87±1.35) and Root MTA (4.66±1.76) (respectively p<0.001 and p=0.001). The most common type of failure in the Angelus MTA group was of the adhesive type, and in the CEM cement and Root MTA groups, it was of the mixed type. Conclusion: The results of the study showed that different cleaning methods have no effect on the push-out bond strength of the examined cements

Education, consultation, guidance, students, advisor, teacher

Introduction: Student counseling and supervision play an important role to overcome learning problems and to achieve educational goals. The present study is intended to investigate viewpoints of students regarding educational guidance and advice studying at Babol University of Medical Sciences. Methods: In this descriptive cross-sectional survey, viewpoints of 480 students were collected by a questionnaire. The validity and reliability of the questionnaire had been approved before. Data were analyzed using SPSS version 17 software. Chi- square and ANOVA tests were administered. Results: 61.2% of all participants were female and 38.8% were males with mean age of 21.3±4.0. 37.2% of these students lacked sufficient knowledge and information on how to request from their advisors for help and guidance. Half of students (50.3%) reported attendance of advisors and holding routine consultation is inappropriate. Advisors made more educational files for females compare to males (P=0.001). No difference observed regarding educational disciplines of the advisors regarding students were dissatisfied with help and guidance received from paramedics and dentistry students in most fields (87.3% and 81.5% respectively). Conclusion: It seems that either student has no sufficient information about tasks of advisors and/or advisors may not do their tasks properly. It is recommended the students to be acquainted with advisors’ tasks upon their entrance into the university. Training classes for new academics would be helpful

Diagnostic Value of Serum and Saliva Matrix Metalloproteinase13 (MMP13) in Oral Squamous Cell Carcinoma

BACKGROUND AND OBJECTIVE: Matrix metalloproteinases (MMPs) are a group of enzymes responsible for extracellular matrix breakdown. Increased activity of type 13 is involved in invasion of oral squamous cell carcinoma. This study was performed to compare the level of matrix metalloproteinase13 (MMP13) in saliva and serum of patients with oral squamous cell carcinoma and healthy controls. METHODS: In this experimental in vitro study, 24 saliva and 24 serum samples were collected from patients with primary oral squamous cell carcinoma after histopathologic confirmation, whereas 21 saliva samples and 21 serum samples were collected from healthy subjects with mucosal health confirmation. Clinical examination was done for MMP-13 levels in saliva and serum, and the results were compared by ELISA. FINDINGS: MMP-13 levels in serum (7.47±2.36) and saliva (8.42±2.69) of patients with oral squamous cell carcinoma compared to healthy subjects increased respectively by 5.39±1.90 and 6.72±2.11 (P= 0.002 and P= 0.025, respectively). The levels of MMP13 in saliva and serum to determine the existence of oral squamous cell carcinoma has a "good" diagnostic value, with sensitivity and specificity of 88% and 86% respectively for serum, and 88% and 71% respectively for saliva. CONCLUSION: According to the results of this study, the levels of MMP13 in saliva and serum of patients with oral squamous cell carcinoma was higher than in healthy individuals and this biomarker had good diagnostic value in the diagnosis of oral squamous cell carcinoma

Prevalence of Co-infection by Human Papillomavirus, Epstein-Barr Virus and Merkel Cell Polyomavirus in Iranian Oral Cavity Cancer and Pre-malignant Lesions

Human papillomavirus (HPV) is recognized as the most important risk factor in oral cavity cancer and premalignant lesions; however, the etiological association of concomitant infection with other oncogenic viruses as a co-factor has not been definitively proven. The present study aimed to determine the prevalence of coinfection with HPV, Epstein�Barr virus (EBV) and Merkel Cell PolyomaVirus (MCPyV) in oral cavity lesions in Iranian patients. One hundred and fourteen oral cavity samples, including 33 oral squamous cell carcinoma, 28 oral lichen planus, 16 oral epithelial dysplasia and 37 oral irritation fibromas were analyzed for the HPV, EBV and MCPyV infection by quantitative real-time PCR. According to histological features 32.5 and 28.9 of cases were oral irritation fibroma and oral squamous cell carcinoma, respectively. Infection with at least two viruses was detected in 21.1 of patients. In this group, co-infection with HPV/EBV was identified in 37.5 of cases, HPV/MCPyV in 29.2, EBV/MCPyV in 12.5, and HPV/EBV/MCPyV in 20.8. There was no statistically significant difference between multiple infections and anatomical locations of cancer. The prevalence of triple viral infection (HPV/EBV/MCPyV) in well differentiated tumors was higher than EBV or MCPyV single infection. This study revealed that co-infection of HPV, EBV and MCPyV can be detected in both malignant and non-malignant oral cavity tissues, and co-infection with all three viruses in well differentiated tumors can be shown as a synergistic hypothesis of the pathogenic role of these viruses in oral malignant transformation. © The Author(s). Publisher: Babol University of Medical Sciences This work is published as an open access article distributed under the terms of the Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by-nc/4). Non-commercial uses of the work are permitted, provided the original work is properly cited