Clinical and laboratory characteristics of Juvenile Idiopathic Arthritis in Northeast Iran

Background: Juvenile Idiopathic Arthritis (JIA) is a chronic rheumatic disorder commonly affecting children younger than 16. The incidence and prevalence of JIA can vary greatly depending on ethnicity, genetic background, and socioeconomic status within different populations. Epidemiological studies play an essential role in planning successful treatment for chronic diseases like JIA and providing appropriate care measures in specific geographic regions.Methods: In this cross-sectional study, 149 children were referred to the pediatric rheumatology department of Akbar Hospital in Mashhad from 2016 to 2019. Data was collected from all children within the first six months of disease onset, including the number of affected joints, demographic characteristics, systemic symptoms, extra-articular manifestations, and medication regimens.Results: The most prevalent subtype of JIA is Oligoarticular, followed by Systemic JIA at 25.5%. Among children with enthesitis-related arthritis, more girls than boys were affected. Additionally, the most frequently affected joints in children were those of the lower limb. 5.4% of the total, had involvement of lumbosacral and sacroiliac joints. Serositis was observed in 2% of the patients. Uveitis was detected in 4 out of 154 patients (2.6%); 3 of these cases were chronic anterior uveitis, while one was acute anterior uveitis. 3 children (2%) were reported to have Macrophage Activation Syndrome (MAS).Conclusion: Diagnosing juvenile idiopathic arthritis and other rheumatic diseases in children can often be delayed due to physicians’ lacking adequate clinical knowledge. To properly manage this chronic childhood illness, it is crucial to identify its symptoms and clinical course. This study represents the most comprehensive research conducted on children with JIA in the Northeast of Iran

Evaluation of the diagnostic value of a Modified Liquid-Based Cytology using OralCDx Brush in early detection of oral potentially malignant lesions and oral cancer

Objectives: To determine diagnostic value of modified Liquid Based Brush Biopsy technique. Study design: 26 oral premalignant and malignant lesions in 25 patients (12 females; 54.23±19.77 years and 13 males; 53.77±15.43 years) underwent Modified (Liquid Based) Brush Biopsy and scalpel biopsy simultaneously from the same area. Results: There were 16 positive and 10 negative brush biopsy results, with no inadequate readings. Histological findings were compatible with oral leukoplakia(n=5)with dysplasia, Oral lichen planus and lichenoid reaction(n=7) (with or without dysplasia)oral squamous cell carcinoma(n=11),verrucous carcinoma(n=1) and granular cell tumors( n=2). Sensitivity, specificity, positive predictive value, negative predictive value, positive diagnostic likelihood ratio(LR+) and negative diagnostic likelihood ratio(LR-) were 88.8%,100%,100% , 80%, infinity and 0.11 respectively(no false positive results). Conclusion: It is the first attempt to do LBC (liquid based cytology) with a specialized oral brush. Our results show that modified technique is a useful tool for screening of oral premalignant and malignant lesions

ПРИМЕНЕНИЕ ВОЗОБНОВЛЯЕМЫХ ИСТОЧНИКОВ ЭНЕРГИИ В РОССИЙСКОЙ ФЕДЕРАЦИИ

Objectives: Multifocal epithelial hyperplasia (MEH) is benign, asymptomatic oral disease with viral etiology. The frequency of this disease varies widely from one geographic region to another, and can vary, from 0.002 to 35% depending on the population studied. Study design: Here we report the clinicopathological features of twelve cases of MEH referred to Oral Medicine Department of Mashhad Dental School for the first time in Iran. Records of patients with the diagnosis of MEH in our department during 7 years were analyzed and data were extracted. Results: Most of the patients were younger than 20-year-old (66%), and females were predominantly affected (7:12). The mean age of onset was 12.72±10.14 years and the mean duration was 52.54 ± 78.51 months. Patients had multiple, well circumscribed, soft, non tender, flattened papules, with a color similar to the adjacent mucosa, in different areas of the oral cavity but the most affected site was buccal mucosa. Familial history of such lesions was negative in all patients. Only three cases showed spontaneous regression. Conclusion: In spite of rare nature of this disease in Asia, it seems that it is not the case in Khorasan Province, southeast Iran

Evaluation the efficacy of educational booklet of oral diseases on the patients’ knowledge referred to Mashhad Dental School in 2016, Iran

Background: Due to the high prevalence of oral diseases and lack of knowledge, giving the proper education is needed to familiarize patients with oral diseases. Objective: This study aimed to determine the efficacy of using an educational booklet on patients` knowledge. Methods: This interventional study was conducted from spring to winter 2016 on fifty patients referred to Mashhad Dental School. An educational booklet of oral diseases describes various domains of oral diseases in six different groups. Also a questionnaire containing 18 questions of oral diseases that was prepared and used in two stages, prior to the intervention and after the intervention. The patients were divided into control (n=25) and intervention (n=25) groups. Initially, a pre-test questionnaire was given to both groups. The intervention group received the educational booklet. After one month, the post-test questionnaire was taken from both groups. Chi-square, Mann-Whitney, Fisher and independent t-test were used for statistical analysis. Findings: The difference between mean score changes was significant in both groups respectively 1.6±0.12 and 5.4±1.5 (P<0.001). The intervention significantly increased the knowledge score for all domains in the intervention group compared to the control group (P<0.001). The booklet had the most significant effect on the awareness of cancer and the least influence on pain. Conclusion: It seems that the educational booklet significantly could enhance the level of patients’ knowledge about oral diseases

Wegener Granulomatosis with Oral Involvement as Primary Manifestation: A Case Study

Introduction: Wegener Granulomatosis is a rare multisystemic disease with an unknown cause, characterized by necrotic granulomatous lesions in respiratory tract, systemic vasculitis in small arteries and veins and necrotizing glomerulonephritis. Wegener can affect any organ including kidneys, eyes or other organs but classically affects upper and lower respiratory tract. One of the rare but important signs of this disease is oral involvement, generally occurring in 6-13% of patients, however, oral involvement as the primary manifestation of disease, occurs in only 5-6% of cases. The most common oral manifestation is strawberry gingivitis. Patients: Our patient was a 35 year-old man with gingival bleeding during brushing which began approximately 45 days before referring to the department of oral and maxillofacial diseases, Mashhad Dental School. In intraoral examination, his gingiva had a papillomatous appearance and was purple in color (strawberry appearance). Due to the presence of strawberry appearance in absence of plaque, primary diagnosis of Wegener granulomatosis was established and the patient was referred for histopathological evaluation. In laboratory tests, C-ANCA was positive and P-ANCA was negative. Finally, diagnosis of Wegener granulomatosis was confirmed and his treatment was started. Rheumatologic condition of patient's lungs was evaluated by chest X-ray and CT-scan and blood tests, biochemistry tests and urine analysis were performed for the patient. He did not have pulmonary or renal involvement. In our study, the patient was followed up after 1, 2 and 11 months from the first visit. Discussion: Up to now, few reports have been published on Wegener disease with oral involvement and in most of these articles, Wegener was diagnosed after respiratory symptoms and kidney or other organs involvement. Only in few studies was Wegener diagnosis confirmed on the basis of oral symptoms and gingival involvement. Immediate and aggressive administration of immunotherapy treatments are required due to the fatal nature of the disease as the survival rate of patients with untreated WG is low and 90% of these patients die within 1 year after respiratory or kidney involvement

Role of MAML1 in targeted therapy against the esophageal cancer stem cells

Abstract Background Esophageal cancer is the sixth-leading cause of cancer-related deaths worldwide. Cancer stem cells (CSCs) are the main reason for tumor relapse in esophageal squamous cell carcinoma (ESCC). The NOTCH pathway is important in preservation of CSCs, therefore it is possible to target such cells by targeting MAML1 as the main component of the NOTCH transcription machinery. Methods In present study we isolated the CD44+ ESCC CSCs and designed a MAML1-targeted therapy to inhibit the NOTCH signaling pathway. CSCs were isolated using magnetic cell sorting utilizing the CD44 cell surface marker. Several stem cell markers were analyzed in the levels of protein and mRNA expression. The isolated CSCs were characterized in vivo in NUDE mice. Biological role of MAML1 was assessed in isolated CD44+ CSCs. A drug resistance assay was also performed to assess the role of MAML1 in CD44+ CSCs with 5FU resistance. Results The CD44+ CSCs had ability to form tumors in NUDE mice. MAML1 silencing caused a significant decrease (p = 0.019) and ectopic expression caused a significant increase in migration of CD44+ CSCs (p = 0.012). Moreover, MAML1 silencing and ectopic expression significantly increased and decreased 5FU resistance, respectively (p < 0.05). MAML1 silencing significantly increased the number of cells in G1 phase (p = 0.008), and its ectopic expression significantly increased the number of CD44+ CSCS in S phase (p = 0.037). Conclusions MAML1 may be utilized for targeted therapy with a low side effect to eliminate the CD44+ CSCs through inhibition of canonical NOTCH pathway in ESCC patients

Efficacy of an herbal compound in decreasing steatosis and transaminase activities in non-alcoholic fatty liver disease: Efficacy of an herbal compound in decreasing steatosis and transaminase activities in non-alcoholic fatty liver disease

Hepatoprotective effects of many herbal agents have been reported in animal studies and clinical trials. In this study, five hepatoprotective plants with potent antioxidant, anti-inflammatory, and hypolipidemic effects were chosen to prepare a polyherbal compound for managing NAFLD. Sixty patients with NAFLD were randomly divided into treatment and control groups (2:1 ratio). Both group were advised to take healthy diet and exercise. The treatment group also received herbal capsules containing 400 mg of the mixture of&nbsp;Anethum graveolens,&nbsp;Citrus aurantium,&nbsp;Cynara scolymus, Portulaca oleracea, and&nbsp;Silybum marianum&nbsp;(2 capsules, thrice daily, for two months). The liver ultrasound and biochemical markers including the serum lipids, liver enzymes, and glucose were evaluated before starting the study and at the end of the treatment. Thirty patients in the treatment group and sixteen patients in the control group completed the study. The herbal compound significantly decreased the serum level of alanine transaminase (ALT), aspartate transaminase (AST), and total cholesterol. Treatment with the herbal compound significantly improved the grade of the fatty liver, but no significant change was found in the control group. In conclusion, the formulated herbal compound appeared to be effective in biochemical improvement and decreasing the grade of the fatty liver in the patients with NAFLD

Effect of vitamin D supplementation on chronic liver disease: systematic literature review

Introduction: It is long known that vitamin D deficiency was common in patients with liver disease, but little is known on the therapeutic effects of vitamin D, especially in patients with chronic liver disease. In this study, we aimed to systematically review the literatures and study the evidences in which the effects of vitamin D supplementation had been investigated on the severity of chronic liver disease or liver cirrhosis.Methods: A systematic literature search was performed by using the following key terms “vitamin D supplementation” and “chronic liver disease” in the PubMed, Scopus and Google scholar to find relevant articles. After collecting the eligible documents, data were extracted and described based on the purpose of this review.Result: Of total 196 articles found, only 7 relevant documents with 518 studied patients were included. The results of this study showed that the levels of 25(OH) D were considerably lower in patients with chronic liver disease. Findings showed that vitamin D supplementation can rise up the mean serum level of 25(OH) D in patients with severe vitamin D deficiency, especially patients with liver cirrhosis.Conclusion:The results of this review showed that vitamin D deficiency is associated with the severity of liver disease and may have prognostic value in the assessment of liver disease. Also, it was shown that vitamin D supplementation may be helpful for the treatment of liver disease at least in certain groups of patients