Background and Aim: Dental anxiety is a major problem among patients and dentists leading to treatment disruption. The aim of this study was to determine dental fear and anxiety level among dental and medical students of Babol University of Medical Sciences.Materials and Methods: This cross-sectional descriptive-analytical study was carried out on 412 medical and dental students, Babol University of Medical Sciences using standardized questionnaires of DAS (Dental Anxiety Scale) and DFS (Dental Fear Scale).DAS and DFS scores along with information about age, sex, course of study, year of university entrance and history of dental office admission were analyzed by SPSS software, ANOVA and t tests.Results: Out of 296 (71.8%) medical students and 116 (28.2%) dental, 261 (63.3%) were males and 151 (36.7%) were females. The means of DAS and DFS scores were 8.03±3.73 and 34.13±16.75, respectively. Dental anxiety was reported among 54 (13.3%) students. The mean of dental anxiety score (DAS) in females and males were 8.59±3.99 and 7.03±2.95, respectively (P=0.000) and 8.2±3.82 and 7.61±3.46 (P=0.135) in medical and dental students, respectively. The mean of dental fear score in females and males were 35±17.94 and 31.99±15.29 (P=0.112), respectively. Injection and needle were reported as the most prevalent fear reasons.Conclusion: Dental fear and anxiety are not prevalent among students and not influenced by course of study and history of dental office admission, however; they are affected by sex and university grade.

Introduction: HER2 over-expression has been identified in a variety of malignant tumors including bladder transitional carcinoma. In some researches HER2 was detected in 10%-50% of muscle invasive bladder cancers. In this study we evaluated the correlation between HER2 over-expression and pathological characteristics as well as its impact on the disease free survival (DFS) of patients with non-metastatic bladder transitional carcinoma.Objective: Study of Her2/neu Protein over Expression Frequency and Its Relationship with Grade, Stage in Patients with Non Metatstatic Transitional Cell Carcinoma and Disease Free Survival.Materials and Methods: In this retrospective cohort study, paraffin-embedded specimens from 50 patients with non-metastatic bladder transitional cell carcinoma, referred to Omid hospital from 2003 to 2007, were examined immunohistochemically for HER-2/neu over-expression. The specimens were also reviewed for tumor grade. The patients with superficial tumors underwent TURBT and a full course of intravesical BCG therapy and cases with muscle invasive tumor received cisplatin based chemoradiation. Results: There were 27 (54%) high grade and 23 low grade tumors. The specimens stained for HER-2 over-expression as follow: 11 as Zero, 11 as 1+, 13 as 2+ and 15 as 3+. The T stages of Tis, T1, T2 and T3 were detected in 14, 19, 10, and 7 cases respectively. The frequency of strong positive HER-2 tumors (3+) was significantly higher among patients with muscle invasive tumors compared to those with superficial lesions (58.8% vs. 15.2%, p<0.001). There was also a relatively significant association between strong positive HER-2 expression and high grade tumors (43.5% vs. 18.5% p=0.055). The Median follow up time was 14 months (range, 4-52 months) during which 17 cases (34%) experienced recurrence (12 local, 3 bones & 2 lungs). For all patients 3-year DFS was 62.7%±7.4% which was significantly better for cases with superficial tumors than patients with muscle invasive tumors (78.1% vs. 19.5%, p=0.005). In patients with strong positive HER-2 expression tumors, DFS was significantly lower compared to the other cases (3-year DFS: 19.4% vs. 80%, p<0.001). No significant difference in DFS was found between high grade and low grade tumors (3-DFS: 53.9% vs. 70%, p=0.20). Conclusion: In This study, strong HER-2 over-expression (3+) was significantly associated with higher T stages as well as high grade tumors. In addition to T stage, strong HER-2 over-expression was a significant predictor of lower disease free survival.

Background: In the large breast tumors or locally-advanced breast cancers, breast conserving surgery (BCS) after neoadjuvant chemotherapy (NACT) had an acceptable local control, but greater risk of recurrence. Adding boost dose radiation to whole breast radiotherapy is involved with a reduced risk of recurrence. Boost radiotherapy can be delivered in 3 methods, including (1) external beam radiotherapy (EBRT), (2) intraoperative radiotherapy with electron (IOERT), and (3) intraoperative radiotherapy with low-kV X-ray (IOXRT). Objectives: This study compared the outcomes of these 3 methods with each other. Methods: Within 60 months, 217 unselected breast cancer patients in Cancer Research Center of Shahid Beheshti were under treatment with BCS after NACT. They received boost dose radiation in 3 groups; 115 patients in the EBRT group, 39 patients IOXRT group, and 63 patients in the IOERT group. All of them received WBRT after surgery. Results: The patients had large tumors or stage 3 breast cancer. Local recurrences were 1 (2. 5%) in IOXRT, 2 (3. 2%) in IOERT, and 1 (0. 9%) in EBRT groups. Systemic recurrences were 4 (10. 3%) in IOXRT, 10 (15. 9%) in IOERT, and 16 (13. 9%) in EBRT groups. Deaths were 3 (7. 7%) in IOXRT, 2 (3. 2%) in IOERT, and 10 (6. 9%) in EBRT groups. Patients with any events were 4 (10. 3%) in IOXRT, 11 (17. 5%) in IOERT, and 33 (15. 2%) in the EBRT group. Death due to distant metastases was lower in IOERT group, but it was not significant. No significant difference was observed in disease-free survival (DFS) among 3 groups. IOXRT group had non-significant, lower events, and better DFS. Especially, in non-PCR (non-pathologic complete response) patients, multivariate COX analysis showed better outcome (DFS) in IOXRT group (HR = 0. 50), although it was not significant (P = 0. 53). Conclusions: Intraoperative radiotherapy (IORT or IOXRT) as tumor bed boost during BCS after NACT had at least non-inferiority compared with EBRT. In non-PCR patient, IOXRT group had non-significant better outcomes (DFS).

Introduction: Recently, there is a growing interest in the role of nitrate and nitrites in protecting against oral and gastrointestinal diseases. In human, ingested nitrate absorbs into the blood and concentrates in the salivary glands rapidly changes to nitrite. Nitrite may then be acidified through encounter with the plaque micro flora. The acidification of nitrite produces a mixture of nitrogen oxides as well as nitrous acid. Nitrous acid will spontaneously decompose to produce nitric oxide (NO). NO participates in the nonspecific defense mechanisms of the oral cavity to prevent bacteria from overgrowing. The aim of the study was to determine the correlation of nitric oxide with dental caries in children in mixed dentition period.Methods and Materials: 3 ten-member groups of children aged 6–12 years old were selected according to decayed and filled surfaces (DFS); with DFS < 1, 1< DFS < 5, and 5 < DFS > 10. A 2ml sample of saliva of each child was taken and transferred to laboratory, where by using the chromatograph unit, NO concentration was measured. Data was analyzed by ANOVA and t-tests.Results: Based on the laboratory findings, NO concentration in DFS < 1 group showed significant difference with other groups; but there was no significant difference of the NO concentration in groups with 5 < DFS < 10 and DFS > 10.Conclusion: The NO levels were higher in high DFS groups. NO production might be a host defense mechanism when dental caries increases.

Background: About one-third of total breast cancer cases occur in women over 65 years of age. Elderly breast cancer management is a major oncology challenge across the globe. Unlike radical treatment of younger women’ s mammary tumors, the method used for treatment in elderly breast cancer depends on patient life expectancy. The present study aims to determine the clinical and pathological characteristics of elderly breast cancer in Iranian patients and to identify modal treatment differences compared to developed countries. Methods: A total of 239 cases of breast cancer patients over 65 years who had been referred to the Cancer Institute of Iran between 2000 and 2014 were studied and their demographic, pathologic, surgical, and adjuvant therapy data were recorded. In addition, the two parameters of recurrence and disease-free survival (DFS) were analyzed statistically. Results: The mean age of patients was 71. 8± 6. 15 and invasive ductal carcinoma (IDC) was the most commonly occurring tumor among these case. In terms of tumor size, 52. 5% of cases were T2, and in terms of axillary lymph node involvement, 53. 2% were N1. Stage II had the highest measured rate and metastasis had occurred in 16% of patients, when analyzed during follow up. 74. 2% of patients were positive for hormone receptors and 33. 1% for HER-2. In terms of treatment, 64. 6% of patients underwent modified radical mastectomy (MRM), 76. 8% chemotherapy, 75. 1% radiotherapy, and 54% hormone therapy. In 54-month follow-ups, local and systemic recurrence occurred in 27 patients, most of which occurred during the first 4 years; 79 patients died of cancer during the same period. Conclusion: Our results showed that patients’ tumor stage was higher than similar studies, and despite the radical regimen strategies in Iran, the risk of recurrence and mortality was higher. Therefore, it is suggested that the study be repeated in other major treatment centers in Iran. We suggest that the treatment of elderly breast cancer be carried out with the help of a multidisciplinary team, and to develop national guidelines for these patients.

This study presents an innovative approach to eliminating the pharmaceutical pollutant diclofenac sodium (DFS) by combining nanofiltration membrane technology with an electrochemical oxidation process. The nanofiltration membrane was prepared by phase inversion, and modified with cetyltrimethylammonium chloride (CTAC) to improve surface properties and pore structure. The concentrate from the nanofiltration treatment has been utilized as the input feed for the electrochemical section, employing Ti/SnO2-α-Fe2O3 electrodes. The PES/CTAC membrane exhibits a more uniform and stable pore structure, leading to increased permeability and antifouling properties. Additionally, the inclusion of CTAC through the surface adsorption mechanism improved the DFS rejection performance, achieving a maximum rejection rate of 65.2% for the membrane with a composition of 0.1 wt% CTAC. The obtained results show that the titanium electrode coated with SnO2 and α-Fe2O3 nanoparticles removed the DFS pollutant by 56%. In total, both membrane and electrochemical process removed 80.5% of the primary Diclofenac pollutant. According to the low energy consumption of this process (EEC=0.014144 US$/m3) and other results, the combination of the PES/CTAC membrane and Ti/SnO2-α-Fe2O3 electrode is an efficient method for diclofenac sodium pollutant removal.

BACKGROUND AND OBJECTIVE: Dental caries is the most common dental disease in children. Alkaline phosphatase (ALP) activity and inorganic phosphorus concentration in saliva may be related to the susceptibility to dental caries.METHODS: In this case-control study, one hundred children in the age group of 4 – 6 years were divided into 3 groups: group one, 30 caries– free children with DFS <1, group two, 33 children with 5< DFS £10 and group three, 37 children with DFS> 10. The unstimulated mixed salivary sample was collected from each child. After centrifuge, supernatants were separated and measurements of salivary ALP activity and inorganic phosphorus concentration were performed by using colorimetric techniques. Data were analyzed by SPSS software and student t-test. FINDINGS: Mean of DFS in groups 1, 2 and 3 were 0.36, 7.12 and 16.32, respectively. Mean values of ALP activity in group 2 (16.9 IU/L) and group 3 (18.3 IU/L) were significantly higher than group 1 (5.4 IU/L) (p<0.05). In addition, mean values of inorganic phosphorus in group 2 (31.1mg/dl) and group 3 (29.3mg/dl) were significantly higher than group 1 (16.2mg/dl) (p< 0.05).CONCLUSION: Our results revealed that ALP activity and inorganic phosphorus concentration had a direct relationship with the increase in caries rates. But this relationship was not seen between moderate and severe caries.