Papers by Atessa Pakfetrat
Journal of Cancer Research and Therapeutics
Background and Aim: Squamous cell carcinoma (SCC) is the most common type of oral cancer, and it ... more Background and Aim: Squamous cell carcinoma (SCC) is the most common type of oral cancer, and it is important for it to be diagnosed in early stages. Researchers are interested in exploring the possibility of using biomarkers in the diagnosis of SCC in early stages. One of the detectable biomarkers in the serum is glutathione. Glutathione includes two forms: reduced form (or GSH) and oxidized form (or GSSG). The GSH/GSSG ratio tends to decrease in severe oxidative stress. The aim of this study was to assess the serum levels of GSH and GSSG as well as GSH/GSSG as total antioxidant capacity in patients with head and neck SCC (HNSCC) and to subsequently compare them with healthy controls. Materials and Methods: Twenty HNSCC patients as well as twenty healthy controls were included in the study. A blood sample of 5 ml was obtained from both the case and control groups. GSH, GSSG, and total antioxidant capacity were measured spectrophotometrically. Results: No significant difference in the level of GSSG was observed in the patients from the case and control groups (P = 0.796), whereas the level of GSH and GSH/GSSG was significantly lower in the case group (P = 0.002, P = 0.011, respectively). There was no significant relationship between the level of GSH, GSSG, and total antioxidant capacity, on the one hand, and the stage and grade of the tumor, on the other hand. Since the levels of GSH and GSH/GSSG were significantly lower in the case group, GSH/GSSG could be used as a prognostic factor for the early diagnosis of HNSCC.
BackgroundGiven the importance of the role of gene expression in the prognosis and diagnosis of m... more BackgroundGiven the importance of the role of gene expression in the prognosis and diagnosis of malignancies of the head and neck, we examined in this study the gene expressions of cathepsin-B (Cat-B) and caveolin-1 (Cav-1) in oral squamous cell carcinoma (OSCC) and oral lichen planus (OLP) and compared them to controls. We also investigated their relationship to clinicopathological indices.MethodsIn this case-control study, 29 biopsy samples from OLP patients were compared to 29 paraffin blocks of OSCC samples as well as 28 paraffin blocks of normal oral tissue. The mean age of OSCC and OLP patients were 59.24 ± 15.04 and 48.79 ± 14.17 years, respectively. Clinical data were analyzed for their relationship to gene expressions using parametric and nonparametric tests.ResultsThe gene expressions of Cat-B and Cav-1 were significantly higher in OSCC and OLP patients compared to controls (p<0.001). The highest expression were found in OSCC, which was significantly different from OLP ...
Despite persistent attention to early detection and treatment, cancer remains important public he... more Despite persistent attention to early detection and treatment, cancer remains important public health problem and cause of death. Squamous cell carcinoma(SCC) is the most common malignant neoplasm of the oral cavity. Oral SCC is a important public health threat over the world. W e studied to access awareness about oral cancer among patients attending for dental treatment at dental school. W e studied in a cross sectional - descriptive survey 200 persons attending to oral medicine center of Zahedan dental school. The questionnaire consisted of 14 questions about demographic information and signs and symptoms, risk factors of oral cancer. Finally, the achieved information analyzed by SPSS 13 software and statistic test of chi square. Patient's knowledge level about oral cancer were as follow: Among the people, %37 of patients had poor knowledge, %57.5 moderate knowledge and %5.5 good knowledge about oral cancer. The relation between the studied patient's knowledge with educati...
Avicenna Journal of Phytomedicine, 2019
Objective: Burning mouth syndrome (BMS) is a debilitating disorder with few limited treatment mod... more Objective: Burning mouth syndrome (BMS) is a debilitating disorder with few limited treatment modalities. Because of the proven association between BMS symptoms, and depression and anxiety, treatment modalities that alleviate the two latter etiologic factors can be clinically effective. Thus, owing to the antidepressant and potential analgesic effects of crocin (as an active constituent of saffron), the present study was performed to compare the effect of crocin and citalopram (as control) on BMS symptoms and depression/anxiety in patients with BMS. Materials and Methods: The present double-blind randomized clinical trial was carried out on BMS patients. Patients were randomly divided into citalopram (n=21) and crocin (n=26) groups and treated for 11 weeks. BMS symptoms (based on Visual Analysis Scale (VAS)), as well as anxiety and depression (based on Hamilton questionnaire) were evaluated at baseline and during the treatment period. Mann-Whitney, Chi-Square test, Independent t-tes...
Iranian Journal of Otorhinolaryngology, 2015
Introduction: Oral lichen planus (OLP) is a common chronic mucocutaneous disease. Patients with a... more Introduction: Oral lichen planus (OLP) is a common chronic mucocutaneous disease. Patients with atrophic and erosive types of OLP often have symptoms of soreness, and require proper treatment. The main treatment for OLP has been the administration of topical or systemic corticosteroids. The objective of this study was to compare the efficacy of adcortyl cream (triamcinolone acetonide in orabase) with topical pimecrolimus cream for the treatment of erosive OLP. Materials and Methods: Twenty-eight patients with OLP were enrolled in a single blind clinical trial and assigned to either a pimecrolimus 1% cream group or an adcortyl 0.1% cream group. The medication was applied every day for 2 months and patients were assessed every 2 weeks. Results: The mean lesion size and mean pain and burning sensation scores did not differ between the pimecrolimus and adcortyl cream groups. The pimecrolimus cream was well tolerated. No clinical drug-related adverse events were observed. Conclusion: Top...
Journal of Dental Materials and Techniques, 2016
Adenoid cystic carcinoma (AdCC) is a malignant neoplasm, which accounts for 5-10% of all salivary... more Adenoid cystic carcinoma (AdCC) is a malignant neoplasm, which accounts for 5-10% of all salivary gland tumors (1). About 50% of these tumors originate from intraoral minor salivary glands usually in the hard palate (1). Three clinically obvious characteristics of AdCC include slow growth rate, perineural invasion and high incidence of distant metastasis (1). The most commonly-affected sites of distant metastasis are bone, liver and brain, followed by lungs (2). Lymph node metastases are rare; The most common sites involved by hematogenous spread are lungs (2). This is a report about a patient with a rare form of AdCC on buccal mucosa with an unusual metastasis to the frontal region after a two-year follow up.
Addiction & Health, 2020
Background The cigarette compounds are associated with the increase in the incidence of oral canc... more Background The cigarette compounds are associated with the increase in the incidence of oral cancer and precancerous lesions. Salivary antioxidant system plays an important role in anti-carcinogenic capacity of saliva. Cotinine, a nicotine metabolite, has a longer half-life in comparison with nicotine and is a suitable marker for exposure to cigarette smoke. This study aims to measure total antioxidant capacity (TAC) and cotinine level in saliva of smokers and non-smokers and compare salivary cotinine level and TAC in each group. Methods In this cross-sectional study, 32 smokers and 34 non-smokers were recruited by consecutive sampling from Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran. Salivary cotinine and TAC concentrations were determined using the enzyme-linked immunosorbent assay (ELISA) technique. For data analysis, correlation tests of Spearman, Mann-Whitney U, and independent samples t-test were used. Findings A sign...
Frequency distribution of subjects based on knowledge of oral cancer manifestations Oral Cancer
Background: Early intervention improves treatment results in oral cancer. The purpose of present ... more Background: Early intervention improves treatment results in oral cancer. The purpose of present study was to assess the level of awareness and knowledge about oral cancer among patients referred to Mashhad Dental School. Methods: Three hundred and twenty individuals completed a 15 item written questionnaire that focused on oral cancer risk factors, signs and symptoms, epidemiology, and treatment. Statistical analyses were performed with the Kruskal-Wallis and Friedman tests (level of signi¿cance, P=0.05). Results: A total of 89.4% of patients who completed the questionnaire had a poor understanding of oral cancer, particularly with regard to etiology. Additionally, 83.8% were unaware of oral cancer risk factors. Only 8.8% knew the most likely sites for oral cancer. No relation was identi¿ed between knowledge and sex (P=0.01), or age (P=0.052) of the subjects. There was a signi¿cant correlation between the level of education and knowledge score (P<0.001). Medical students and hea...
Cumhuriyet Dental Journal, 2016
Abstract: Objectives : The aim of the study was to assess MR sialography and Ultrasonography as o... more Abstract: Objectives : The aim of the study was to assess MR sialography and Ultrasonography as objective tools to examine salivary glands in patients with xerostomia. Methods : In this Cross-sectional descriptive study,MR sialography using salivary secretion stimulation was performed in 16 patients (with the chief complaint of xerostomia) and 11 healthy volunteers.Visibility of the main duct and ductal branches were evaluated before and after stimulation in axial and oblique sagittal plans, and were classified in to three grades (poor,fair & good). Patients and volunteers were also examined by ultrasonography;their parenchymal homogeneity of the salivary glands was graded from 0 to 5 and their echogenicity was divided to three levels:hypoecho, isoecho and hyperecho. Size of the salivary glands was also measured.Dependent T-test and independent T-test ,Spearman and Chi-square analysis were performed to analyze the results. Results : In this study the results showed no significant d...
Journal of Clinical and Experimental Dentistry, 2020
Background: Pemphigus is an autoimmune blistering disease of the skin and mucous membranes caused... more Background: Pemphigus is an autoimmune blistering disease of the skin and mucous membranes caused by autoantibodies against desmoglein 1 (Dsg1) and desmoglein 3 (Dsg3). Pemphigus vulgaris (PV) is the most common form of pemphigus. The aim of this study was to assess the correlation between the levels of anti-desmoglein 1 and 3 autoantibodies and the severity of PV disease. Material and Methods: Nineteen newly diagnosed patients with pemphigus vulgaris were enrolled in this study. The titers of Dsg in subjects by using enzyme-linked immunosorbent assay (ELISA) were done at diagnosis time-point, 4th and 8th weeks after the initiation of treatment, and the correlation of antibodies with the oral and skin disease severity was evaluated. Results: The severity of cutaneous lesions was significantly correlated with anti-Dsg1 titer in all visits and the severity of mucosal lesions was correlated with the titer of Dsg3 in the third visit (<0.001, 0.001, 0.016 and 0.015 P value, respectively). Conclusions: Anti-Dsg-1 autoantibodies titers seem to be more useful in showing the extent of the disease and activity in pemphigus with mucocutaneous lesions.
International Journal of Cancer Management, 2019
Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth common cancer worldwide. A... more Background: Head and neck squamous cell carcinoma (HNSCC) is the sixth common cancer worldwide. A hallmark of cancer progression is degradation of the extracellular matrix by matrix metalloproteinases (MMPs) that allows cancer cells to invade the surrounding tissue. Objectives: The purpose of this study was to evaluate the levels of MMP-2 and 9 in serum and salivary of HNSCC patients and compare it with a healthy group. Methods: Twenty patients with newly diagnosed HNSCC, who had not received any treatment, referred to Omid and Ghaem hospitals, Mashhad, Iran, and twenty healthy controls were voluntarily included in this study. Salivary and blood samples were collected from both groups and the concentration of MMP-2 and MMP-9 were measured by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed by SPSS using Student t-test or Mann-Whitney with significance level of ≤ 0.05. In cancer patients, the serum level of MMP-9 was significantly higher than that of in the healthy group (P < 0.001). However, salivary MMP-9 was higher in cancer patients, this difference was not significant (P = 0.736). There was no significant difference between the study groups for the levels of serum (P = 0.283) and salivary MMP-2 (P = 0.764). There was a correlation between salivary and serum levels of both markers in cancer patients (P = 0.046 and P = 0.011 for MMP-2 and MMP-9, respectively), on the contrary, there was not a correlation between them in the healthy controls (P = 0.628 and P = 0.064, for MMP-2 and MMP-9, respectively). A direct correlation between the salivary level of MMP-9 and tumor grade was also detected (P = 0.045). Conclusions: The salivary analysis indicates that an altered composition for MMPs in HNSCC, suggesting a potential diagnostic tool for oral cancer. The serum level of MMP-9 appears to be a reliable marker for early diagnosis in HNSCC patients.
Journal of dentistry (Shiraz, Iran), 2016
Lichen planus is a chronic inflammatory disease. Free radicals and reactive oxygen species play im... more Lichen planus is a chronic inflammatory disease. Free radicals and reactive oxygen species play important roles in pathogenesis of oral lichen planus (OLP). Isoprostanes show oxidative stress and are formed by free-radical mediated lipid peroxidation of arachidonic acid and cell membrane phospholipids. This study was conducted to evaluate the plasma level of 8-isoprostane in patients suffering from erosive and non-erosive forms of OLP. In this case-control study, 31 patients with OLP and 30 control subjects were enrolled. Plasma samples were obtained and the level of 8-isoprostane was measured with Sandwich enzyme-linked immunosorbent assay (ELISA) in both groups. The data were analyzed by using two-sample t-test, chi-square and ANOVA tests. The results showed significant increase in the plasma level of 8-isoprostane in OLP group compared with the control group. The results of independent t-test revealed no significant correlation between the plasma level of isoprostane and sex, smok...
Clinical & Investigative Medicine, 2010
Purpose: Recurrent aphthous stomatitis (RAS) is one of the most common ulcers of the oral cavity ... more Purpose: Recurrent aphthous stomatitis (RAS) is one of the most common ulcers of the oral cavity with a reported prevalence of 5- 50%. There is still no definitive treatment for RAS; however, immunosuppressive and immunomodulant agents have been proposed. In this study, we compared the therapeutic effects of 5 mg/d prednisolone with 0.5 mg/d colchicine in the treatment of RAS. Methods: In a double-blind randomized clinical trial, 34 patients with RAS were randomly divided into two groups for treatment with prednisolone or colchicine. All patients took the medication for three months and were assessed at two weeks intervals. The groups were compared for size and number of lesions, severity of pain and burning sensation, duration of pain-free episodes and any side effects of the prescribed medicines. Both colchicine and prednisolone treatments significantly reduced RAS (p < 0.001). No significant differences in size and number of lesions, recurrence and severity of pain and duratio...
Journal of clinical and diagnostic research : JCDR, 2016
Oral Lichen Planus (OLP) is a chronic immunological, mucocutaneous disease with a wide range of c... more Oral Lichen Planus (OLP) is a chronic immunological, mucocutaneous disease with a wide range of clinical appearances. The treatment of oral lichen planus is often difficult and disappointing. We have studied the efficacy of curcumin, a low molecular weight flavonoid with anti-inflammatory and anti-oxidant activities, in the treatment of OLP. In this study, a randomized, double-blind, placebo-controlled trial was conducted with a total of 20 OLP patients. The patients were randomly divided into two groups, each treated with curcumin tablets at a dose of 2000 mg/day or placebo for a period of four weeks. Furthermore, the patients of both groups received routine treatment for OLP (i.e. Mouthwash Dexamethasone 0.5 mg and suspension Nystatin 100,000 Units). The baseline data were recorded for each patient. Patients were evaluated on day 14 and after completing the course of treatment. Pain and burning sensation were measured based on the Visual Analogue Scale, and the Thongprasom Index w...
Evaluación del valor diagnóstico de la Citología en Medio Líquido Modificada usando el cepillo Oral CDx® en la detección precoz de lesiones potencialmente malignas y de cáncer oral
Medicina Oral Patologia Oral Y Cirugia Bucal, 2011
Objetivos. Determinar el valor diagnostico de la tecnica de biopsia con cepillo de base liquida m... more Objetivos. Determinar el valor diagnostico de la tecnica de biopsia con cepillo de base liquida modificada. Diseno del estudio: veintiseis lesiones orales malignas y premalignas presentes en veinticinco pacientes (12 mujeres, 54.23 ± 19.77 anos y 13 hombres; 53.77± 15.43 anos) fueron biopsiadas simultaneamente y en la misma localizacion mediante la tecnica de cepillado Modificada (en Medio Liquido) y con bisturi frio. Resultados: hubo dieciseis resultados positivos y diez negativos, sin interpretaciones inespecificas. Los hallazgos histologicos fueron compatibles con leucoplasia oral (n= 5) con displasia, liquen plano oral y reaccion liquenoide (n=7)(con o sin displasia), carcinoma oral de celulas escamosas (n=11), carcinoma verrugoso (n=1) y tumores de celulas granulares(n=2). La sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo, ratio de probabilidad de diagnostico positivo (LR +), ratio de probabilidad de diagnostico negativo (LR-) fue de 88.8%,100%,100%,80%, infinito y 0.11 respectivamente (no hubo falsos positivos.) Conclusion: Este es el primer intento de llevar a cabo la CML (Citologia en Medio Liquido) con un cepillado oral especializado. Nuestros resultados muestran que la tecnica modificada es una herramienta util para el screening de las lesiones malignas y premalignas.
Iranian Journal of Cancer Prevention, 2015
Background: Mucositis is one of the acute complications of radiotherapy which can ulcerate oral m... more Background: Mucositis is one of the acute complications of radiotherapy which can ulcerate oral mucosa and cause severe pain and discomfort which can affect oral normal function. Propolis is a natural source of flavenoid which has antiulcer, antibacterial, antifungal, healing and anti-inflammatory effects. Using such an affordable compound without any bad smell or taste that has reasonable price can help the radiotherapy undergoing patients. Objectives: Our goal is assessing the preventing and therapeutic effect of propolis in radiotherapy induced mucositis in patients with head and neck cancer. Patients and Methods: In a randomized triple blind clinical trial, 20 patient were selected randomly to swish and swallow 15 ml of water based extract of propolis mouth wash 3 times a day in the case group (n = 10) and 15 ml placebo mouth wash in control group (n = 10). we use NIC-CTC scale for determining mucositis grading. Results: We use T-test, Man-Whitney, Chi-square, and Friedman as analyzing tests. Case group had significantly (P < 0.05) lower grade of mucositis in all of the follow-ups, but xerostomia is not significantly different in two groups (P > 0.05). Conclusions: This is a pilot study which shows water based extract of propolis efficiently prevents and heals radiotherapy induced mucositis.
Objectives: The purpose of this study was to determine the efficacy of oral sucralfate suspension... more Objectives: The purpose of this study was to determine the efficacy of oral sucralfate suspension (1gr/10ml) in the treatment of recurrent aphthous stomatitis (RAS). Materials and Methods: Fifty-five patients with oral aphthae were included in this randomized, double-blind, placebo-controlled clinical trial conducted in the Department of Oral Medicine, School of Dentistry, Mashhad University of Medical Sciences. In the first part of the study, all subjects were instructed to rinse with a 10% suspension of sucralfate or placebo, 4 times a day for 2 weeks. Clinical examination was performed two times a week. The second part consisted of topical use of sucralfate or placebo 2 times a day for 4 weeks, followed by biweekly inspections for 6 months. The size and number of the ulcers along with pain severity were assessed in the course of the pretreatment and treatment phases. Recurrence was evaluated during the follow up period. Pearson, χ 2 , and Fisher's exact tests were used for st...
Lichen planus is a chronic mucocutaneos disease and relatively frequent in adult, which involves ... more Lichen planus is a chronic mucocutaneos disease and relatively frequent in adult, which involves 0.2-2% of population. There are limited studies on frequency and clinical pattern of oral lichen planus in Iran. This study was designed in order to evaluate clinical and epidemiological features of Oral lichen planus (OLP) patients referred to oral Medicine Department of Mashhad dental school during 2000-2005 compared with other populations. In this descriptive study, the patients' data were collected from files of 420 OLP patients who had been referred to oral medicine department of Mashhad dental school and included age, sex, chief compliment, skin involvment, location, type & form of lesions. Data were analysed with SPSS 11.5 statistical software. The mean age of these OLP patients was 41.16 years. 64.9% of cases were female and 35.1% were male. Buccal mucosa was most frequently involved (85.2%). The most prevalent clinical type was reticular form (76.9%). 15.5% of patients had skin involvement. Based on the results of this study, the importance of proper history and clinical examination is of great importance to achieve the best diagnosis and treatment plan for OLP. Considering the variety of epidemiologic findings, we need more extensive epidemiological study of this kind to be more familiar with our OLP patients and to schedule clinical research and treatment plan in our society.
Multiple myeloma is a monoclonal malignant proliferationof plasma cells. The disease is more freq... more Multiple myeloma is a monoclonal malignant proliferationof plasma cells. The disease is more frequent in men, andthe average age of patients at the time of diagnosis of thedisease is about 60 years. Solitary myeloma may be the firstmanifestation of the disseminated form of multiple myeloma,which is characterized by multiple skeletal lesions,general metabolic alterations, impairment of renal functionand eventually death.The findings in regards to the present case suggest that oralmanifestations may be the first sign of multiple myeloma. Thismight highlight the important role that a dentist can have inthe early diagnosis of the disease.Iran J Med Sci 2010; 35(4): 331-334.
Medicina oral, patología oral y cirugía bucal, 2009
In terms of the demographic and clinical characteristics, this is the one of the largest studies ... more In terms of the demographic and clinical characteristics, this is the one of the largest studies on Iranian patients with Oral Lichen Planus (OLP). Data was taken from the medical records of 420 consecutive patients referred to the Oral Medicine Department, and who were subsequently found to have clinical and usual histopathology consistent with features of OLP. Seventy percent of the patients had been referred to the Oral Medicine Department by general dental practitioners. 52.6% were referred due to oral mucosal and/or gingival pain or burning sensation. Reticular OLP was the most common presentation (76.9%); about 18% of patients reported symptoms or signs, or had a known history of OLP, or possible Lichen Planus affecting non-oral epithelia. A malignant transformation rate of 0.07% was observed.
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Papers by Atessa Pakfetrat