Objectives: Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology which is known as a premalignant disease. A complete cure has not been found for this condition. Mycophenolate mofetil (MMF) is a new drug that seems to be effective in improving OLP lesions. But there are no studies on the efficacy of mucoadhesive form of MMF in ulcerative OLP. Therefore, this study was performed to determine the therapeutic effect of MMF mucoadhesive on OLP lesions. Material and methods: Twenty-seven patients with OLP, were enrolled in two groups. All the patients were instructed to place the MMF 2% mucoadhesive on the lesion twice daily for 4 weeks. Lesion size was measured by a sterile digital caulis (mm) and the severity of burning sensation and pain by visual analogue scale (VAS; cm) at baseline and weekly follow-ups. Results: There was no significant difference in burning sensation and lesion size at Weeks 1, 2, and 3 in both groups. In Group A, at Week 4, there was significant reduction in pain and burning sensation and lesion size on both sides (p = .048, .012). The difference in lesion size on control sides was not significant. In Group B, at Week 4, there was significant reduction in pain and burning sensation and lesion size (p = .004). No side effects were reported by the patients. Conclusions: Based on the results, 2% MMF mucoadhesive was effective in decreasing burning sensation and pain severity and ulcer size of ulcerative OLP and the effect was time-dependent.
Background. Lichen planus is considered a potentially malignant condition with an unknown etiology. This study aimed to determine the carcinoembryonic antigen (CEA) and IgG serum levels in different oral lichenoid lesions before and after treatment with local corticosteroids. Methods. Two groups of 23 individuals, including oral ulcerative lichenoid lesions patients and healthy ones, were evaluated. Toluidine blue staining and biopsy examinations were carried out while visual analog scale (VAS) was used to evaluate symptoms. By applying corticosteroids, CEA and IgG serum levels were determined before and three weeks after intervention and at the end of the study (9 weeks) with ELISA and turbidimetry methods, respectively. Results. Before the intervention, there was no significant difference in CEA serum levels between the control and case groups (P=0.19). Moreover, the CEA serum levels indicated no significant difference before and after treatment in the case group (P=0.30). While IgG serum level was significantly higher before the intervention (P=0.01), it decreased significantly in the case group after treatment (P=0.02). In addition, pain intensity reduced significantly in the case group (P=0.05). According to statistics, 8.2% out of 21.7% of patients with positive staining results exhibited dysplasia signs. Conclusion. However, neither CEA nor IgG serum levels were different in patients diagnosed with or without dysplasia and positive or negative staining results (P>0.05). IgG serum levels and pain severity effectively decreased in the oral ulcerative lichenoid lesions patients treated with local corticosteroids. Therefore, this treatment can be considered an effective and low-complication treatment modality for lichenoid lesions.
Context: Evaluating the prevalence of Staphylococcus aureus nasal carriage and methicillin-resistant Staphylococcus aureus (MRSA) that are sources of nosocomial infection among medical students. Evidence Acquisition: Electronic databases were searched by preferred subject headings and free-text keywords. After omitting duplicates, retrieved articles were screened by two independent reviewers in a three-step process based on inclusion criteria. Then, reviewers critically appraised the selected studies by JBI checklists and extracted the required data. Finally, the pooled prevalence rates of S. aureus nasal carriage and MRSA were meta-analyzed by Stata V.16 software. The heterogeneity of included studies was calculated by I2 and chi-square. Subgroup analysis was carried out according to study designs, as well as the continent origin of clinical and preclinical students. Results: Of 858 retrieved studies, 15 were included in the meta-analysis. The results showed that the pooled prevalence of nasal S. aureus carriage was 28% [prevalence rate: 0.028, 95% CI: 0.21 - 0.34, P < 0.001, I2: 96.40%, chi2: 360.98 (df = 14)]. The prevalence of S. aureus among clinical students was 33% (pooled prevalence rate: 0.33, 95% CI: 0.18 - 0.47) whereas, in preclinical students, it was 25% (pooled prevalence rate: 0.25, 95% CI: 0.23 - 0.28). Also, in a subgroup analysis of continents, Australia (Oceania) had the highest prevalence rate. According to an evaluation of publication bias, the distribution of studies was very high. Moreover, pooled MRSA prevalence among medical students was 2% (prevalence rate: 0.02 95% CI: 0.01 - 0.03, P < 0.001). Conclusions: In this meta-analysis, S. aureus and MRSA prevalence rates among medical students were estimated at 28% and 2%, respectively. More attention should be given to the prevention of MRSA colonization and screening strategies among medical students across the world.
Chloroform is used widely in endodontic treatments for solving gutta-percha points, but it can have-destructive effects if it comes in to contact with oral mucosa. This article presents a case of necrotic-ulcer of palatal and buccal mucosa due to injudicious use of chloroform in endodontic treatment, which-has caused severe destruction in maxilla. A conservative treatment method of repeated curettage and irrigation was used and although the lesion healed completely, it had major effects on the patient’s quality of life including loss of two teeth. It is important that dentist be aware of the devastating effects of imprudent application of various chemicals used in dentistry. The conservative treatment used for this case can be helpful option for similar cases.
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