Therapeutic and Analgesic Efficacy of Laser in Conjunction With Pharmaceutical Therapy for Trigeminal Neuralgia

Introduction: Trigeminal neuralgia (TN) is the most common neuralgia in the head and neck region and a common cause of orofacial pain. It is routinely treated with carbamazepine. Laser, acupuncture and radiofrequency are among other treatment modalities for this condition. This study sought to assess the efficacy of laser therapy in conjunction with carbamazepine for treatment of TN.Methods: A total of 30 patients who met the inclusion criteria were divided into 2 groups of cases and controls (n = 15) by double blind randomized controlled clinical trial. All patients received 100 mg carbamazepine at baseline and another 100 mg after 2 days for pain control. In the case group, low level laser therapy (LLLT) was also performed in addition to pharmaceutical therapy. Sham laser was used in the control group instead of LLLT. Treatment was continued for 9 sessions (3 days a week). The intensity of pain was measured and compared in the 2 groups using visual analog scale (VAS) in 3 period. The qualitative variables among the groups were compared using the repeated measures analysis of variance (ANOVA).Results: The severity of pain was lower at the end of treatment in the case compared to the control group so this difference was statistically significant (P = 0.003). The severity of pain decreased in both groups over time. Significant difference was noted in this regard between the 2 groups either (P = 0.003). At the end of treatment pain intensity dropped in the intervention group from 6/8 to 1/2 and control group from 6/6 to 2/7.Conclusion: Laser therapy did add to the value of pharmaceutical therapy for treatment of TN. Both groups experienced significant improvement over time. So it is better to used laser complementary therapy to reduce side effects and the medicine dosage

Treatment of Symptomatic Geographic Tongue with Triamcinolone Acetonide Alone and in Combination with Retinoic Acid: A Randomized Clinical Trial

Objectives: Geographic tongue or migratory glossitis is an inflammatory disorder with unknown etiology. Considering the accompanied burning pain, taste dysfunction, and lack of definite cure, it is important to treat this condition symptomatically. The objective of the current study was to compare the efficacy of a combination of 0.05% retinoic acid and 0.1% triamcinolone acetonide with that of triamcinolone acetonide alone for treatment of symptomatic geographic tongue. Materials and Methods: This randomized controlled double-blind clinical trial was performed on 28 patients with symptomatic geographic tongue, who were referred to two dental clinics. Participants were randomly divided into two groups and treated with triamcinolone alone or retinoic acid plus triamcinolone for 10 days. Patients were assessed for the level of pain, burning sensation and size of lesion at the beginning and at the end of the study. Participants were followed up for two months after cessation of treatment (at the end of each month). SPSS 11 was applied to compare the two therapeutic modalities. Results: Twenty-eight participants with a mean age of 40 years were evaluated including Seven (25%) males and 21(75%) females. There was a positive family history of geographic tongue in 21 patients. Despite the diminished pain and burning sensation as well as smaller size of lesions following treatment (P 0.05). No side effect was reported.  Conclusion: The combination of triamcinolone and retinoic acid was not more effective than triamcinolone alone for symptomatic treatment of geographic tongue

Trend in laryngeal cancer, mortality and survival rate in Iran

Objective Among the noncommunicable disease, cancer is one of the highest load and charge that lead to disability and death. The goal of this study was to determine the important epidemiologic factors that effect on survival rate of patients with laryngeal cancer. Methods From 307 cases, 136 (2009–2012) that their follow-up was possible by phone or postal address were included in the study. Data collections were performed from the questionnaire. The data were analyzed by SPSS version 20. The Kaplan–Meier survival curves were utilized and, moreover, the corresponding influential factors were examined by using the Cox regression test. Results The most widely used method for the treatment was a combination of three methods of surgery, radiation therapy, and chemotherapy. The overall 5-year survival rate was 47.28%. The age and regular follow up had a statistically significant relationship with the survival rate (P = 0.02, 0.03). Conclusion The survival rate was lower in older patients. Patient and professional delays were high, which need more attention for improving the quality of life

Association of Transforming Growth Factor-Beta Gene Polymorphisms in Recurrent Aphthous Stomatitis

This study has been conducted to evaluate the allele, genotype and haplotype frequencies of the polymorphic gene coding TGF-β in recurrent aphthous stomatitis (RAS). TGF-β gene typing was done by polymerase chain reaction with sequence-specific primers (PCR-SSP) assay. Allele frequencies were estimated by direct gene counting. C allele at codon 25 was significantly increased, while G allele at this position was significantly decreased in patients compared to the controls. A significantly higher frequency of CG genotype at codon 25 was found in control group. CC genotype and TT genotype at codon 10 of the gene was significantly decreased, while CT genotype at the same position was significantly increased in patients, indicating that CT heterozygosity at codon 10 TGF-β is associated with greater risk of RAS. CG and TG haplotypes were significantly decreased while CC and TC haplotypes were significantly increased in patients compared with controls. This study indicates the TGF-β single nucleotide polymorphisms could play a role in RAS pathogenesis. Thereby certain SNPs of TGF-β gene have an association with RAS pathogenesis

Interleukin-2, Interferon-gamma Gene Polymorphisms in Recurrent Aphthous Stomatitis

Recurrent aphthous stomatitis (RAS) is the most common oral ulcerative inflammatory disease with unknown etiology. IL-2 and IFN-γ are secreted by Th1 cells and the elevated levels of them have been reported in RAS. Single nucleotide polymorphisms (SNPs) of IL-2 and IFN-γ genes could alter the cytokine production. The aim of this study was to investigate frequencies of IL-2 and IFN-γ alleles and genotypes in a group of patients with minor-RAS (MiRAS). PCR-SSP method used to type genomic DNA of 64 Iranian patients with MiRAS for IL-2 gene (G –330 T) and (G +166 T) and IFN-γ gene at position UTR5644 (A/T). Frequency of each allele and genotype was compared with control group. IL-2 +166 G allele was significantly lower among patients which was reflected in significantly decreased of GG genotype at this position, while IL-2 +166 T allele was significantly higher among patients, IL-2 GT genotype was also significantly higher in RAS patients. No significant differences were found regarding IL-2 –330 G/T allele frequencies, while IL-2 GT genotype at this position was significantly higher among patients and IL-2 –330 TT genotype was significantly lower among RAS patients. Although no significant differences were found in IFN-γ allele frequencies at UTR5644 (A/T), AT genotype at this position was significantly overrepresented among patients compared with controls. Results of this study suggest that certain SNPs of IL-2 and IFN-γ genes have association with predisposition of individuals to RAS. More studies in different ethnic groups are needed to confirm results of this study

Effect of sodium bicarbonate against Candida albicans in denture stomatitis: An in vitro study

Background and Aims: The aim of this study was to investigate the effects of sodium bicarbonate against candida albicans, the main infectious factor of denture stomatitis, and to compare it with other common anti-candida medications. Materials and Methods: Three concentrations of Candida albicans (105, 106, 107 CFU/mL) were prepared. Experimental substances were 5% sodium bicarbonate, nystatin, chlorhexidine, and sterile saline (as control). Each of them was added separately to the same amounts of Candida albicans of different concentrations, and sampled at the intervals of 1, 2, 3 and 4 min. Then, the samples were cultured and incubated. The number of formed colonies was counted for each plate. The data were analyzed, using ANOVA and Tukey test. Results: Sodium bicarbonate showed a noticeable anti-candida effect on the concentrations of 105 and 106 CFU/mL, with almost similar anti-candida effect as nystatin and chlorehexidine(P=0.29, P=0.32). Nystatin was the most effective medication on the concentration of 107 CFU/mL of candida (P=0.03, P=0.01). Sodium bicarbonate and chlorhexidine were less effective in this concentration with no statistically significant difference (P=1.00). Conclusion: Sodium bicarbonate showed a significant anti-candida effect at low and medium concentrations of Candida albicans, but nystatin was more effective in the higher concentrations

Evaluation of antioxidant efficacy of Purslane extract in Patients with Recurrent Aphthous Stomatitis: a randomized, placebo-controlled, triple-blinded, clinical trial

und: This herbal medicine is considered a rich source of antioxidants with anti-inflammatory effects. The purpose of this study was to evaluate the effectiveness of purslane in treatment of recurrent aphthous stomatitis (RAS) and also it &#835;s effect on antioxidant level. Materials and methods: 50 patients were selected for this randomized triple-blind placebo-controlled trial. All subjects were randomly divided in to two groups, one group received purslane (n=25) and another group, placebo (n=25) for 3 month. Superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and total antioxidant status (TAS) was measured in plasma at baseline and after 3 month of treatment. Also pain intensity based on the visual analogue scale (VAS), the mean interval between lesion, number of lesions and the mean duration of complete healing at baseline and in month 1, 2 and 3 were recorded. Statistical analysis was performed by using Mann-Whitney and T-test. Results: A significant decrease in pain intensity in VAS scores was seen after treatment in intervention group (p<0.001). The mean duration of complete healing showed significant differences (P<0.001) between the two groups. The mean interval between lesions also showed significant differences (P<0.001) among the intervention group (33.12 days) compared with the placebo group (17.88 days). No significant differences were found regarding the number of lesions, level of erythrocyte GSHPx, TAS and SOD. No serious side-effects occurred in either of groups. Conclusions: According to this study, purslane is clinically effective in treatment of RAS (number of lesions, pain intensity and duration of healing) although it is unable to change the level of antioxidants