Iranian Journal of Medical Sciences
Volume:39 Issue: 5, Sep 2014

Amebloblastoma as the most common epithelial odontogenic neoplasm may occur in two forms of central and peripheral. This report presents a case of a 41-year-old Iranian female with a six-month complaint from a painless mass in the right posterior portion of the mandible. The case was diagnosed as an exophytic epulis-like peripheral component with characteristics of peripheral ameloblastoma and an intrabony component like solid ameloblastoma. Two probable hypotheses considered for this case is also discussed.

Among oral lesions, we encounter a series of malignant epithelial lesions that go through clinical and histopathologic processes in order to be diagnosed. Identifying these processes along with the etiology knowledge of these lesions is very important in prevention and early treatments. Dysplasia is the step preceding the formation of squamous cell carcinoma in lesions which have the potential to undergo dysplasia. Identification of etiological factors, clinical and histopathologic methods has been the topic of many articles. This article, reviews various articles presenting oral cavity dysplasia, new clinical methods of identifying lesions, and the immunohistochemic research which proposes various markers for providing more precise identification of such lesions. This article also briefly analyzes new treatment methods such as tissue engineering.

There are many reports on the association between anthracosis and tuberculosis. This study focuses on bronchial anthracosis and associated diseases in the province of South Khorasan-Iran. This case-series study is performed on patients referred to the Vali-e-Asre Hospital (South Khorasan-Iran) for bronchoscopic evaluations during the period of 2009-2012. Written informed consents were obtained prior to bronchoscopic evaluations. The criterion for diagnosis of bronchial anthracosis was black pigmentation on direct observation of bronchus. Bronchial anthracosis was classified into simple (without deformity) or complicated (with deformity). Pulmonary tuberculosis (TB) was diagnosed either by acid fast staining and culture of liquid samples, or histopathology examination of biopsy. Spirometry was performed to determine the obstructive or restrictive pattern. Among 279 patients who underwent bronchoscopic evaluations, 89 patients, including 34 males (38.2%) and 55 (61.79%) females, were diagnosed with anthracosis. Simple and complicated anthracosis were observed in 42 (48.2%) and 47 (52.8%) cases respectively. Mean age of patients was 72.23±9.65 years. There were 43 (48.3%) cases of tuberculosis (28 cases with complicated and 15 cases with simple anthracosis) (P=0.021). Chest X-ray showed consolidation/infiltration, reticular/fibrotic, and mass/nodule/hilar prominence in 57 (64%), 26 (29.21%) and 6 (6.74%) cases, respectively. Bronchitis was reported in 42 (%59.15) out of 79 patients whose biopsy samples were taken. Spirometric patterns were obstructive, restrictive, upper airway obstruction, and normal in 45 (50.56%), 32 (35.95%), 2 (2.24%), and 10 (11.23%) patients respectively. Tuberculosis is the most frequent disease associated with anthracosis in South Khorasan province. Consequently, patients with anthracosis must be carefully evaluated for tuberculosis.

By decreasing oxidative stress and whereby decreasing insulin resistance, it may be possible to decrease complications of Diabetes Mellitus (DM). Green tea and sour tea contain phytochemicals which have anti-oxidative function. The aim of this study is to compare the effect of sour and green tea consumption on insulin resistance and oxidative stress in DM. This study is a randomized clinical trial in which 100 type 2 diabetes patients were randomly assigned into sour tea group (ST) and green tea group (GT). The patients were instructed to drink 150ml sour tea and green tea infusion, respectively, three times a day for 4 weeks. Fasting blood sugar (FBS), fructosamine, lipid profiles, fasting blood insulin (FBI), homeostasis model assessment of insulin resistance (HOMA-IR); beta cell function (b%), insulin sensitivity (S%) and malondialdehyde (MDA) were monitored. HDL-c significantly increased in both groups. The median of FBI in GT showed significant decrease (8.5 to 6.6 μIU/mL) unlike the ST which showed significant increase (8.2 to 16.3 μIU/mL). The median of HOMA-IR after the intervention in GT showed lower levels than the ST (1.1 vs. 1.6, P=0.004). The median of b% only in ST showed significant increase from 38.2% at the baseline to 47.7% after the intervention. The mean of S% only in ST showed significant decrease after the intervention. This study shows that the use of 150 ml infusion of green tea or sour tea, three times a day for four weeks, has positive effect on insulin resistance and certain lipoproteins in type 2 DM.

The present clinical trial study aims at investigating the effect of daily energy intake in 6 isocaloric meals in comparison with the current meal pattern (3 meals and 2 small snacks per day) on type 2 diabetes risk markers in diabetes during 3-month period. Eighty four type 2 diabetes patients were randomly divided into 6 isocaloric meal diet or a balanced diet (3 meals and 2 snacks previous meal pattern). The planned reduced calorie diets for both groups were identical except for the meal pattern. Blood samples were analyzed before and after the investigation for fasting blood sugar (FBS), two-hour post-prandial glucose (2hPP), insulin, hemoglobin A1c (HbA1c), total cholesterol, triglyceride, HDL-C, LDL-C, and molondialdehyde (MDA) concentrations. HbA1c (P=0.00) and body mass index (BMI) (P=0.04) values decreased significantly in the 6 isocaloric meal pattern compared with the controls. There were no significant differences in fasting serum glucose (P=0.09), insulin (P=0.65), total cholesterol (P=0.32), LDL-C (P=0.43), HDL-C (P=0.40) cholesterol, triglyceride (P=0.40), MDA (P=0.13) and 2hPP serum glucose (P=0.30) concentrations between the 6 isocaloric meal and tradition meal pattern. Six isocaloric meal pattern in comparison with the current meal pattern led to weight loss and improved glycemic control. Serum lipid profile and MDA did not change significantly.

Pathophysiology and treatment of obstructive defecation syndrome (ODS) remains to be defined clearly. Rectal hidden intussusceptions and voluminous hemorrhoids may be the cause. Where conservative treatment is not effective, ODS can be treated by STARR or Delorme operation. In some patients treatment of advance hemorrhoidal disease may resolve the syndrome. 81 females out of 183 ODS patients were selected for the treatment by Delorme, STARR or 30 mAmp electrotherapy. The number of patients treated by STARR, Delorme and Electrotherapy were 34, 31 and 16, with mean postoperative pain ranking of 2.5, 3.7 and 1.5 and mean hospital stay of 2.3, and 3.2 and 1 day respectively. Mean ODS score, preoperatively compared with one-year post operation, improved from 14.5 to 5.1 (P=0.005) in STARR, 13.8 to 4.3 (P=0.006) in Delorme and 14.2 to 12.8 (P=0.725) in electrotherapy groups. The mean severity score (SS) changed from 14.2, 15.18 and 13.90 preoperatively to 3.8, 4.12 and 11.34 postoperatively in all groups respectively. The mean resting pressures decreased from 82 to 65 in STARR (P=0.006), from 87 to 63 in Delorme (P=0.005) and from 79 to 74 mmHg (P=0.797) in electrotherapy groups. Postoperative defecography showed significant reduction in the intussusception parameter in STARR and Delorme (82.4% and 88% respectively; P<0.0001), but unchanged in electrotherapy group. STARR and Delorme are effective modalities for the treatment of patients with ODS, while STARR is simpler, less invasive and less painful. Although, electrotherapy eradicates the voluminous hemorrhoids but is ineffective in the treatment of ODS.

The ability of tumour suppressor protein p53 (P53) to regulate cell cycle processes can be modulated by hepatitis B virus (HBV). While preliminary evidences indicates the involvement of protein-x of HBV (HBx) in altering p53 DNA binding, no further data have been accumulated for the significance of serum p53 in chronic hepatitis B virus infected patients. 72 non-cirrhotic and 19 cirrhotic patients infected by HBV were enrolled for the analysis in this study. Enzyme linked immunosorbent assay (ELISA) was performed to study the concentrations of serum p53 protein. The tertiary structures of HBx and P53 were docked by Z-dock and Hex servers for in-silico protein-protein interaction analysis. There was a significant association between the serum p53 and cirrhosis (OR=1.81 95% CI: 1.017-3.2, P=0.044). Cirrhotic patients had higher level of serum p53 compare with chronic infection of HBV (1.98±1.22 vs. 1.29±0.72 U/ml, P=0.05). No evidence of correlation was seen between the different variables such as age, gender, log viral load, serum alkaline phosphatase (ALP) and alanine aminotransferase (ALT) with serum p53. Tertiary model shows that the amino acid residues from Arg110 to Lys132 of the N-terminal of P53 which is critical for ubiquitination, are bonded to a region in N- terminal of HBx amino acid residues from Arg19 to Ser33. There is an increase in serum p53 in HBV-related cirrhosis patients. In this case, HBx might be responsible for such higher concentration of p53 through HBx-p53 protein-protein interaction, as is shown by molecular modeling approach.

Photodynamic therapy (PDT) is a promising therapeutic modality for the treatment of cancer and other diseases. In this study, the epidermoid carcinoma cell line A431 and the normal fibroblasts were used to investigate whether gold nanoparticles (GNPs) can induce an increase in cell death during PDT using 5-aminolevulinic acid (5-ALA) as a photosensitizer. Human fibroblast and A431 cells were grown in 96-well plates. The effect of GNPs on the efficacy of 5-ALA-mediated PDT (5-ALA-PDT) was evaluated by comparing the effect of 5-ALA with GNPs to the effect of 5-ALA alone. Cell viability was determined by the methyl- tetrazolium assay. Dark toxicity experiments showed that 5-ALA at concentrations 0.5, 1 and 2 mM had no significant effect on cell viability of both cell lines. However, treatment of cells with 5-ALA (0.5 to 2 mM) and light dose of 25 Jcm-2 led to 5-10% and 31-42% decrease in cell viability of fibroblast and A431 cells respectively. The data also shows that GNPs in both the absence and the presence of light, results in a dose-dependent decrease in cell viability of both cell lines. However, the sensitivity of cancer cells to GNPs at concentrations more than 24 μg/ml was approximately 2.5- to 4-fold greater than healthy cells. Furthermore, data indicates that 5-ALA in combination with GNPs results in a synergistic reduction in viability of A431 cells. In summary, the findings of this study suggest that concomitant treatment with 5-ALA and GNPs may be useful in enhancing the effect of 5-ALA-PDT.

Hyperthyroidism is associated with liver oxidative stress causing liver dysfunction in many hyperthyroid patients. The hepatoprotective effect of Satureja Khuzestanica Essential Oil (SKEO), as herbal origin antioxidant and anti-inflammatory agent on the hyperthyroidism induced hepatotoxicity and oxidative stress is investigated. Adult male sprague dawley rats were divided into categories of; control (group C), hyperthyroid (group H), hyperthyroid with olive oil (group H+O), hyperthyroid with vitamin E (group H+E), hyperthyroid with SKEO (group H+S), combination of hyperthyroid with vitamin E and SKEO (group H+S+E). Hepatoprotective and antioxidant properties of SKEO with or without vitamin E in hyperthyroid rats were then investigated. Serum Aspartate Transaminase (AST) and Alanine Transaminase (ALT) activities reduced significantly in H+O, H+E, H+S and H+S+E groups in comparison with hyperthyroid rats. Enzymes activities returned to normal in H+S+E group. Hepatic Malondialdehyde (MDA) was reduced in H+E, H+S and H+S+E groups in comparison with hyperthyroid rats. The most significant MDA reduction was in the H+S+E group. Glutathione Peroxidase (GPx) and Glutathione Reductase (GR) activities increased in H+E, H+S and H+S+E groups in comparison with group H. The largest increment in GPx and GR activities were in the H+S+E group. Glutathione level did not change in any group in comparison with the control group. Administration of SKEO has hepatoprotective effect in hyperthyroid rats and is more effective when used in combination with vitamin E.

Some studies have already addressed the effects of occupational organic solvent exposure on the visually evoked potentials (VEPs). Visual system is an important target for Sulphur Mustard (SM) toxicity. A number of Iranian victims of Sulphur Mustard (SM) agent were apprehensive about the delay effect of SM on their vision and a possible delay effect of SM on their visual cortex. This investigation was performed on 34 individuals with a history of chemical exposure and a control group of 15 normal people. The Toennies electro-diagnosis device was used and its signals were saved as the latencies. The mean of N75, N140 and P100 of victims of chemical warfare (VCWs) and control group indicated no significant results (P>0.05). The VCWs did not show any visual symptoms and there was no clear deficit in their VEPs.

Dengue usually presents itself with subclinical or mild infection to full blown dengue fever (DF) to dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). In Kolkata, dengue started in 1824 followed by five epidemics that occurred in 1836, 1906, 1911, 1923 and 2005. The aim of this investigation is to study the clinicohematological correlation of all patients with respect to their gender that were admitted to “Kali Pada Chowdhury Medical College and Hospital” during 2012 epidemic. Amongst a total of 1237 dengue patients (either dengue Nonstructural protein1 antigen or dengue Immunoglobulin M positive) that were admitted to the hospital, 11 patients died within 48 hours of admission; hence they have been excluded from the study. DHF patients were divided into males and females. During admission, proper history, physical examinations with necessary hematological investigations were performed and repeated again after 24-48 hours. After collection of all the reports, correlations of the collected data were carried out. 170 and 1056 patients were diagnosed with DF and DHF respectively; significant symptoms and signs were headache, backache/myalgia, nausea/vomiting, loose motion and anorexia hepatomegaly. Hemoglobin level was low in females, leucopenia observed in 79.52% patients and thrombocytopenia seen in 57.58% and 86.13% patients during and 24-48 hours after admission respectively. 96 and 97 DHF patients showed evidences of ascites and plural effusion respectively. In 2012 epidemic, 86.13% patients suffered from DHF, headache, backache, nausea/vomiting, loose motion and anorexia were predominant symptoms. Significant number of patients had leucopenia; only few showed evidence of plasma leakage.

Vitamin D3 has a role in many autoimmune diseases and appears to play a function in controlling Rheumatoid Arthritis (RA). The aim of this study is to evaluate the relationship between serum level of vitamin D and RA disease activity score. The serum level of vitamin D in 75 RA patients referred to the rheumatology clinic of Rasoul-Akram hospital was measured. Patients were classified into low, moderate and high RA activity groups based on the DAS-28 criteria (Disease Activity Score in 28 joints) and the mean values of serum vitamin D were compared between the three groups.The mean serum levels of vitamin D in high activity group (17.057±7.7 mg/ml) was significantly less than moderate (30.5±11.3 mg/ml) and low (36.7±19.5 mg/ml) activity groups (P<0.001). The outcome of this study shows that serum level of vitamin D is inversely correlated with the activity of RA.

Amebloblastoma as the most common epithelial odontogenic neoplasm may occur in two forms of central and peripheral. This report presents a case of a 41-year-old Iranian female with a six-month complaint from a painless mass in the right posterior portion of the mandible. The case was diagnosed as an exophytic epulis-like peripheral component with characteristics of peripheral ameloblastoma and an intrabony component like solid ameloblastoma. Two probable hypotheses considered for this case is also discussed.

Percutaneous pulmonary balloon valvuloplasty (PBV) remains the treatment of choice for pulmonary stenosis (PS). This procedure is effective, safe and gives excellent results. Pulmonary artery (PA) dissection is a rare complication of PBV. This report is a case of an asymptomatic 17-year-old male with a history of PBV due to severe PS dating back to fifteen years ago. During recent echocardiography, an intimal flap was detected in the main PA and entry site was clearly seen by contrast study.

Moyamoya disease is a rare vaso-occlusive illness with an unknown etiology characterized by stenosis of the internal carotid arteries with spontaneous development of a collateral vascular network.A 15-month-old girl was referred to the emergency ward of Imam Reza Hospital due to decreased level of consciousness, focal seizures and fever during the previous 24 hours with an impression of encephalitis. Physical examination revealed left side hemiparesis; however brain CT-Scan did not show any significant lesions. Initial therapy with vancomycin, ceftriaxone and acyclovir was administered. CSF analysis did not show any abnormality and the blood as well as CSF cultures results were negative. Brain MRI showed hyperintensity at right frontal and parietal regions, suggesting vascular lesion. Magnetic resonance angiography (MRA) showed bilaterally multiple torsions in vessels at the basal ganglia consistent with moyamoya vessels.In all children exhibiting encephalitis, vascular events such as moyamoya disease should be considered. Brain MRI is a critical tool for this purpose. Common causes of encephalitis such as herpes simplex should also be ruled out.