22 research outputs found

    Assessment of salivary and serum antioxidant status in patients with recurrent aphthous stomatitis

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    Objective: The aim of this study was to determine the possible association of oxidant/antioxidant status and recurrent aphthous stomatitis (RAS). Study design: The study consis ted of thirty-one patients with RAS and thirty-two healthy controls from whom saliva and blood samples were collected. Superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and catalase (CAT) were measured in erythrocytes and total antioxidant status (TAS) was measured in plasma and saliva. Results: Erythrocyte SOD activity was significantly lower in RAS patients in comparison to healthy controls (P=0.012). No significant differences were found in erythrocyte GSHPx, CAT activities, and salivary and plasma TAS between RAS patients and control subjects (p>0.1). Conclusion: Changes in SOD activity may be important in the inflammatory reactions observed in RAS, but other tested defense systems such as CAT and GSHPx do not seem to play a primary role in the aetiopathogenesis of RAS. Moreover, the antioxidant system in saliva and plasma is not as affected as in erythrocytes in RAS patients, and therefore it may not be considered an appropriate indicator of the body?s total antioxidant status

    Clinical decision support system, a potential solution for diagnostic accuracy improvement in oral squamous cell carcinoma: A systematic review

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    BACKGROUND AND AIM: Oral squamous cell carcinoma (OSCC) is a rapidly progressive disease and despite the progress in the treatment of cancer, remains a life-threatening illness with a poor prognosis. Diagnostic techniques of the oral cavity are not painful, non-invasive, simple and inexpensive methods. Clinical decision support systems (CDSSs) are the most important diagnostic technologies used to help health professionals to analyze patients’ data and make decisions. This paper, by studying CDSS applications in the process of providing care for the cancer patients, has looked into the CDSS potentials in OSCC diagnosis. METHODS: We retrieved relevant articles indexed in MEDLINE/PubMed database using high-quality keywords. First, the title and then the abstract of the related articles were reviewed in the step of screening. Only research articles which had designed clinical decision support system in different stages of providing care for the cancer patient were retained in this study according to the input criteria. RESULTS: Various studies have been conducted about the important roles of CDSS in health processes related to different types of cancer. According to the aim of studies, we categorized them into several groups including treatment, diagnosis, risk assessment, screening, and survival estimation. CONCLUSION: Successful experiences in the field of CDSS applications in different types of cancer have indicated that machine learning methods have a high potential to manage the data and diagnostic improvement in OSCC intelligently and accurately. KEYWORDS: Squamous Cell Carcinoma; Clinical Decision Support System; Neoplasm; Dental Informatic

    Post-discharge health assessment in survivors of coronavirus disease: a time-point analysis of a prospective cohort study

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    © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.PURPOSE: The objective of this study was to quantitatively evaluate psychological and quality of life-related complications at three months following discharge in hospitalized coronavirus disease 2019 (COVID-19) patients during the pandemic in Iran. METHODS: In this time-point analysis of prospective cohort study data, adult patients hospitalized with symptoms suggestive of COVID-19 were enrolled. Patients were stratifed in analyses based on severity. The primary outcomes consisted of psychological problems and pulmonary function tests (PFTs) in the three months following discharge, with Health-related quality of life (HRQoL) as the secondary outcome. Exploratory predictors were determined for both primary and secondary outcomes. Results 283 out of 900 (30%) eligible patients were accessible for the follow-up assessment and included in the study. The mean age was 53.65±13.43 years, with 68% experiencing a severe disease course. At the time of the fnal follow-up, participants still reported persistent symptoms, among which fatigue, shortness of breath, and cough were the most common. Based on the regression-adjusted analysis, lower levels of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio was associated with higher levels of depression (standardized ß=- 0.161 (SE=0.042), P=0.017) and stress levels (standardized ß=- 0.110 (SE=0.047), P=0.015). Furthermore, higher levels of anti-SARS-CoV-2 immunoglobulinM (IgM) were associated with signifcantly lower levels of depression (standardized ß=- 0.139 (SE=0.135), P=0.031). CONCLUSIONS: There is an association between lung damage during COVID-19 and the reduction of pulmonary function for up to three months from acute infection in hospitalized patients. Varying degrees of anxiety, depression, stress, and low HRQoL frequently occur in patients with COVID-19. More severe lung damage and lower COVID-19 antibodies were associated with lower levels of psychological health.Isfahan University of Medical Sciences, IR.MUI.MED.REC.1399.517, Ramin SamiPeer ReviewedPostprint (published version

    Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

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    Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

    Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

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    Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

    Discrimination, stigma and negative attitudes - in health care

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    Comparison of the Efficacy of Topical Triamcinolone in Orabase and Curcumin in Orabase in Oral Graft-versus-Host Disease

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    Objectives: Graft-versus-host disease (GVHD) is among the most frequent complications of allogeneic hematopoietic stem cell transplantation (HSCT). GVHD has several clinical manifestations in the oral cavity, including painful desquamative erythema, ulcerative mucosal lesions, and lichenoid lesions. The patients presenting with oral GVHD complain of oral sensitivity, pain, dysgeusia, and xerostomia. The treatment of oral GVHD includes a proper systemic therapy combined with a good oral hygiene and the use of local and topical steroids. Corticosteroids and immunosuppressants are used for the treatment of chronic oral GVHD; however, they are associated with different complications. Evidence shows that curcumin has anti-inflammatory and antioxidative properties. The treatment of lichen planus and oral mucositis with curcumin has been successful. This study aimed to compare the efficacy of topical curcumin in Orabase and triamcinolone in Orabase in the patients affected by oral GVHD. Materials and Methods: Twenty-six patients presenting with oral GVHD were randomly divided into two groups of 13 using block randomization. The control group used triamcinolone in Orabase, and the case group received curcumin in Orabase. Results: The two groups were not significantly different in terms of the alleviated severity of the lesions at the end of the treatment (P=0.052). The comparison of the pain score via the visual analog scale (VAS) at the onset of the treatment and at days 14 and 28 (completion of the treatment) showed no significant difference between the two groups (P>0.05). Conclusions: Curcumin has comparable efficacy to that of triamcinolone and may be prescribed for the patients presenting with oral GVHD

    Effect of low level laser on the number of candida albicans colonies in vitro study: A new finding

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    Objective: Candida albicans is a commensal organism that causes a wide variety of diseases in human. A high recurrence rate has been reported for vaginal and oral candidiasis, in spite of the best available treatments. The purpose of this study was to compare the effects of low-level laser irradiation and nystatin on the growth of candida albicans. Methods: Candida albicans with concentration of 104 and 106 viable cells per milliliter was prepared and incubated. Subjects were divided into four groups: control, laser for 30 seconds, laser for 60 seconds and nystatin. The control group was cultured without intervention. The second group was irradiated with laser 940 nm for 30s and the third group for 60s and then cultivation was taken from each group. Nystatin was added to the fourth group and then samples of the mixtures were obtained at 30 and 60 seconds after addition, were plated. Finally the number of colonies (CFU/mL) were counted and compared. Results: The effectiveness of laser at a concentration of 104, significantly increased the number of colonies in the irradiated group, so that the number of colonies at 30s was more than the number of colonies at 60s. Also the number of colonies was more in the concentration 106 and 60s. Nystatin left 0 CFU/mL colonies in the plated samples of all the suspensions. Conclusion: Laser therapy leads to increased growth of candida in media. No significant difference was observed in different laser group

    Management of the essential data element in the differential diagnosis of oral medicine: An effective step in promoting oral health

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    BACKGROUND: Oral soft tissue diseases include a broad spectrum, and the wide array of patient data elements need to be processed in their diagnosis. One of the biggest and most basic challenges is the analysis of this huge amount of complex patient data in an increasing number of complicated clinical decisions. This study seeks to identify the necessary steps for collecting and management of these data elements through establishing a consensus-based framework. METHODS: This research was conducted as a descriptive, cross-sectional study from April 2016 to January 2017, which has been performed in several steps: literature review, developing the initial draft (v. 0), submitting the draft to experts, validating by an expert panel, applying expert opinions and creating version v.i, performing Delphi rounds, and creating the final framework. RESULTS: The administrative data category with 17 and the historical data category with 23 data elements were utilized in recording data elements in the diagnosis of all of the different oral diseases. In the paraclinical indicator and clinical indicator categories, the necessary data elements were considered with respect to the 6 main axes of oral soft tissue diseases, according to Burket's Oral Medicine: ulcerative, vesicular, and bullous lesions; red and white lesions of the oral mucosa; pigmented lesions of the oral mucosa; benign lesions of the oral cavity and the jaws; oral and oropharyngeal cancer; and salivary gland diseases. CONCLUSIONS: The study achieved a consensus-based framework for the essential data element in the differential diagnosis of oral medicine using a comprehensive search with rich keywords in databases and reference texts, providing an environment for discussion and exchange of ideas among experts and the careful use of the Delphi decision technique

    Checklist development for assessing the dental students\' clinical skills in oral and maxillofacial medicine course and comparison with global rating

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    Background and Aims: The objective of this study was the development of a checklist for assessment of students’ clinical skills in the clinical oral medicine. The second aim was the assessment of stake holders’ satisfaction of this checklist in comparison to the routine global rating method. Materials and Methods: The checklist was developed in an expert panel sessions and the validity and reliability of checklist were assessed by CVI and test-retest method, respectively. All students (n=66) were assessed in 2 groups, one with developed checklist and another with global rating. At the end of the session, the satisfaction’s level of staff and students were analysized using Wilcoxon and Mann-Whitney test and the mean scores of students were analysized using Paired T test. Results: Content validity index (CV I) of checklist was 0.88. Reliability of checklist confirmed with high correlation coefficient (0.9). Staffs’ satisfaction had no significant difference between the two methods (Wilcoxon P=0.06). The mean score of students who assessed by checklist was higher than global rating with no significant differences (P=0.06). Conclusion: Regarding the higher students’ satisfaction from checklist and more attention to component of assessment and more objectivity of this method and also higher score in checklist, it seems that the use of a checklist is more proper method for assessing the students’ clinical skills
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