bluuebunny/crossref_metadata_2025 huggingface dataset:
Seizure in geriatric population – An unheeded integer
Authors: Narayanan Namitha , Selvaraj Shivamalarvizhi , Mohamedkalifa Abdulmuthalif , Gaur Archana , Kaliappan Ariyanachi , Reddy Kotha Sugunakar , Geetha Jeganathan , Sakthivadivel Varatharajan
Published: April 2023

ABSTRACT

Background:

Epilepsy is one of the most prevalent neurological conditions among the elderly. Age-related epileptogenic disorders as well as the ageing itself pose a risk for seizures in the elderly. The lack of witnesses, non-specific symptoms, and transient symptoms make the diagnosis challenging in the elderly.

Aim:

This study aimed to assess the various presentation and aetiology for the seizure disorder in the elderly population.

Materials and Methods:

A total of 125 elderly patients ≥60 years with new onset seizure were included in the study. Demographic data, co-morbidities, and clinical presentation of seizure were elicited. Hemogram, liver and renal function tests, random blood sugar, electrolytes, and serum calcium were analysed. Computed tomography (CT), magnetic resonance imaging (MRI) brain, and electroencephalogram (EEG) were performed.

Results:

Seizure was seen predominantly in the males with age group of 60–70 years. Generalized tonic-clonic seizure was the commonest presentation, followed by focal seizures. The leading causes of seizures were cerebral vascular accidents, metabolic conditions, and alcohol. CT brain was abnormal in 49%, and 73% of the patients showed abnormality in MRI brain. EEG was abnormal in 17.3% of patients. Temporal lobe infarction was the commonest, trailed by parieto-temporal and frontal lobe involvement.

Conclusion:

Seizures in the elderly have varied clinical signs and aetiology. An awareness about these atypical presentation and aetiology is essential for the early diagnosis and management to prevent morbidity.
Unintentional domestic injuries among elderly in rural areas of Mandya: A community-based cross-sectional study in Southern Karnataka
Authors: Shashikantha S K , Huchchannavar Raghavendra , Jindal Har Ashish
Published: April 2023

ABSTRACT

Background:

As the proportion of elderly in the population increases, they also become vulnerable to various types of intentional or unintentional injuries. Domestic accidents including falls among the elderly have been identified as a leading cause of injury-related morbidity and mortality in India and elsewhere.

Aim:

This study aims to assess the burden and pattern of domestic accidents in a rural part of Southern India.

Methods and Setting:

A community-based cross-sectional study among the elderly (≥60 years) was carried out in rural areas of Southern Karnataka. A semi-structured interview schedule was used to get the information on domestic accidents. Inferential statistical tests like the Chi-square test and logistic regression analysis were used.

Results:

A total of 500 persons aged ≥60 years with a mean age of 69.09 ± 7.42 years (Range 60–92 years) were included. One-third of the subjects have had an incidence of domestic accidents in the past 1 year contributing to a 35% prevalence of domestic accidents. A higher prevalence of domestic accidents was seen in those subjects who were ill (47.9%). Overall prevalence of falls was 21.4% (P = 0.007). One-fifth of the subjects with domestic accidents had a residual illness.

Conclusion and Contribution:

One-third of our subjects gave a history of one or the other form of domestic accidents in the previous 1 year. Our study highlights the problem of unintentional domestic injuries among the most vulnerable group of the elderly and calls for a continuous assessment of the burden and nature of injuries.
Study on acute respiratory infection in children aged 1 year to 5 years-A hospital-based cross-sectional study
Authors: Vinod Anuna , Kaimal Resmi S.
Published: April 2023

ABSTRACT

Background:

Acute respiratory infections (ARIs) are the single greatest cause of death among children throughout the world. They are responsible every year for the deaths of 4.3 million children under 5 years of age worldwide. Community- or hospital-based surveys for finding out the prevalence and various factors associated with ARI are very few, especially in urban areas. Also, surveys to study the use of vaccines in preventing ARIs are scarce. Hence, we studied ARI in children aged 1 year to 5 years in a tertiary care hospital in Kerala. The aim was to determine the frequency of ARIs in the last 1 year in children aged 1 year to 5 years, attending the immunization clinic at Lourdes Hospital, Kochi, and assess the selected epidemiological, socio-demographic, nutritional and immunization factors associated with ARIs in the study group.

Methods:

Children attending the immunization clinic at a tertiary care hospital, Kochi, in the age group of 1 year to 5 years were selected. A brief introduction was given to the mother/caregiver of the child regarding the purpose of the study and was asked to fill out the questionnaire. Informed consent was taken. For the study, ARI is defined as the presence of one or more of the following: cough, running nose, blocked nose, sore throat, difficulty breathing, or ear problems; with or without fever. Results were analyzed.

Results:

Mother was the caregiver in 67% of the cases. When the caregiver was the mother, ARI is found to be less. Among those mothers who had no formal education, 100% of their children got ARI. Children whose caregivers were 30 years and older had lesser ARI. The proportion of children with ARIs was more with a history of respiratory infection among family members (parents/siblings) compared to those with no such history. The occurrence of ARI was more frequent in rural compared to urban areas. There is a significant proportion of ARI in non-exclusively breastfed infants, bottle feeding, and early initiation of complementary feeding. Children with a history of exposure to cigarette smoke had an increased occurrence of ARI. Similar results followed for exposure to biomass fuel and exposure to cold and rain. Children who were not immunized to vaccines-pneumococcal, Hib, measles, vitamin A, showed a higher occurrence of ARI compared to immunization.

Conclusion:

The studies regarding factors influencing ARI are relatively rare in an urban setting, thus this calls for more studies in urban areas. Health education can change the healthcare-seeking behavior and attitude of parents for preventing ARI-related deaths. Family physicians can play a significant role by educating caregivers of children and giving timely services. Promoting and ensuring exclusive breastfeeding practices, timely weaning after 6 months, and avoidance of bottle feeds can dramatically decrease the episodes of ARI.
Epidemio-toxicological profile of fatal poisoning cases autopsied at a tertiary care centre of North India
Authors: Kumar Rajesh , Sheikh Nishat Ahmed , Bashar Mohammad Abu , Vasudeva Abhimanyu , Kumar Adarsh , Yadav Abhishek , Gupta Sudhir K.
Published: April 2023

ABSTRACT

Background:

Poisoning is an important health hazard and one of the leading causes of morbidity and mortality worldwide including in India. The study was conducted to understand the magnitude, pattern, and gender differentials of all poisoning fatalities in relation to the manner of death autopsied at a tertiary care center.

Methods:

A retrospective study of all fatal poisoning cases autopsied at the department of Forensic Medicine & Toxicology of a tertiary care institute in Northern India for the period 1st January 1998 to 31st December 2017 was conducted, and a profile of the victims of fatal poisoning was prepared. Data were analyzed with descriptive and inferential statistics.

Results:

The study included a total of 1099 cases of fatal poisoning autopsied at the department of Forensic medicine & Toxicology. Suicidal poisoning was reported in 90.2% of cases and accidental poisoning was seen in 8.9% of cases. Males were predominantly affected (63.8%). The majority of the victims were in the 3rd decade (40.0%) of life. The age of the victims ranged from 2 to 82 years with a mean age of 38.4 years. Agrochemical compounds were implicated in 44.4% of the total fatalities.

Conclusion:

Males in the 2nd to 4th decades of life were more prone to self-poisoning with Agrochemical compounds in the region of North India. Accidental poisoning deaths were uncommon and poisoning was not a preferred method of homicide in this region. Our approach to the study reveals that quantitative chemical (toxicological) analysis is required to further strengthen and improve the databases of the epidemiology of poisoning in this region.
Correlation of dental caries status with BMI in school children of age 3-16 years- An institutional study
Authors: Talluri Devaki , Panga Gnana Sarita Kumari , Shaik Parveen S. , Pavani Nijampatnam P. M. , Yaddanapalli Suresh C. , Bommireddy Vikram Simha , Bhavani Vasamsetti D.
Published: April 2023

ABSTRACT

Aim:

The study investigates the correlation of dental caries status with body mass index (BMI) in school children of age 3 to 16 years.

Background:

Obesity is a rising global health epidemic. Dental caries has been the predominant disorder in modern society. Obesity and dental caries are major health problems with multifactorial characteristics and similar risk factors, such as diet, lack of physical activity, unhealthy eating pattern, not enough sleep, and high amount of stress etc. Various studies have documented diverse outcomes linked to BMI and dental caries.

Material and Methods:

A cross-sectional study was implemented on 756 participants. Among the study participants, 475 (62.8%) were boys and 281 (37.2%) were girls. The decayed, missing and filled teeth (DMFT) index has been used to assess the prevalence of dental caries. Information of the study participant’s height and weight was reported using a standardized measuring scale and weighing machine; after that, the BMI was measured. SPSS version 22 was used to analyze the data.

Results:

The mean DMFT of the study participants in normal-weight children was 2.3. There was a positive correlation between the dental caries status and BMI, with a significant value of 0.27.

Conclusion:

Diet counselling and regular dental check-ups should be prescribed to prevent dental caries from occurring and monitor children’s healthy weight. Balanced nutrition needs to be provided to children by school authorities and parents.
Regional assessment of medical care provision system by principal component analysis
Authors: Ohashi Kazuki , Abe Arisa , Fujiwara Kensuke , Nishimoto Naoki , Ogasawara Katsuhiko
Published: April 2023

ABSTRACT

Introduction:

The Japanese government has promoted policies ensuring standardized medical care across the secondary medical care areas (SMCAs); however, these efforts have not been evaluated, making the current conditions unclear. Multidimensional indicators could identify these differences; thus, this study examined the regional characteristics of the medical care provision system for 21 SMCAs in Hokkaido, Japan, and the changes from 1998 to 2018.

Materials and Methods:

This study evaluated the characteristics of SMCAs by principal component analysis using multidimensional data related to the medical care provision system. Factor loadings and principal component scores were calculated, with the characteristics of each SMCA visually expressed using scatter plots. Additionally, data from 1998 to 2018 were analyzed to clarify the changes in SMCAs’ characteristics.

Results:

The primary and secondary principal components were Medical Resources and Geographical Factors, respectively. The Medical Resources components included the number of hospitals, clinics, and doctors, and an area’s population of older adults, accounting for 65.28% of the total variance. The Geographical Factors components included the number of districts without doctors and the population and a land area of these districts, accounting for 23.20% of the variance. The accumulated proportion of variance was 88.47%. From 1998 to 2018, the area with the highest increase in Medical Resources was Sapporo, with numerous initial medical resources (−9.283 to −10.919).

Discussion:

Principal component analysis summarized multidimensional indicators and evaluated SMCAs in this regional assessment. This study categorized SMCAs into four quadrants based on Medical Resources and Geographical Factors. Additionally, the difference in principal component scores between 1998 and 2018 emphasized the expanding gap in the medical care provision system among the 21 SMCAs.
Comparing knowledge and opinions of medical and dental students in the field of pediatric anesthesia
Authors: Fathi Amirhossein , Rahnama Sara , Alesaeidi Sogol , Mousavi Elnaz , Bagherboum Nazila , GHolami Mahnaz , Fotovat Farnoush
Published: April 2023

ABSTRACT

Background and Purpose:

Dental treatment under general anesthesia (GA) is one of the common treatment methods today for dental treatment in children, so dentists’ point of view in this field is very important. Therefore, the purpose of this study was evaluation the awareness and attitude of pediatric dentists and final-year dental students about dental treatment for children under GA.

Methods:

To conduct this study, 150 people, including 75 general dentists (GD) and 75 final-year dental students (FYDS), were randomly selected in Tehran. In this study, a researcher-made questionnaire containing 15 questions (7 awareness questions and 8 attitude questions) was used to evaluate the awareness and attitude of the participants. After extracting the raw results, statistical analysis of the results was done using SPSS-Ver. 22 software.

Results:

60% of the participants (90 people) were men and the remaining 40% (60 people) were women. The results showed that the level of awareness of male dentists was significantly higher than that of female dentists (P = 0.015). In addition, although the awareness level of FYDS was lower than GD, this difference was not statistically significant (P = 0.130). The average level of awareness among different age groups had a significant difference (P = 0.009), so the age group of 36-45 years compared to the younger age groups (25-35 years) and the older age groups (36-45 and 55 -46 years), had a higher level of awareness.

Conclusion:

According to the findings, it can be concluded that it is necessary to use appropriate educational methods to improve the level of awareness and attitude of children’s dentists.
Correlation between screen time and psychosomatic symptoms in children during COVID-19 pandemic-related lockdown
Authors: Pasi Rachna , Babu Thirunavukkarasu A. , Jamir Limalemla , Ravi Kumar S.
Published: April 2023

ABSTRACT

Background:

This study was planned to estimate the effect of lockdown on psychosomatic problems and sleep of children and their association with screen the time during the lockdown.

Methods:

A cross-sectional study was conducted among 1–12-year-old children at a tertiary care hospital in South India. A pre-validated questionnaire with 20 related questions was disseminated through pediatric OPD, telemedicine service, and social media to eligible parents.

Results:

A total of 278 children aged 1–12 years with a mean (SD) age of 6.92 (3.01) years were studied. Most under 5-year-oldchildren had screen time of ≤2 hours/day, whereas 58.16% of children between 5 and 12 years spent >4 hours/day (P < 0.000). A significant proportion of participants aged 5–12 years had vision problems (P = 0.019), whereas under 5-year-old children had significant associated behavioral changes (P = 0.016) and sleep problems (P = 0.043).

Conclusion:

Behavioral and sleep problems were significantly high and correlated with an increase in screen time among under 5-year-old children. Vision problems were more in 5–12-year-old children.
Attitude towards patients with psychiatric illness among undergraduate medical students at Government Medical College: A cross-sectional study
Authors: Patel Amar Deep , Pal Alok , Rahat Faraz , Yadav Richa , Tiwari Paritosh , Alam Zaryab
Published: April 2023

ABSTRACT

Background:

People with mental illnesses commonly experience stigma, discrimination, and prejudice from the general public and medical professionals around the world. Numerous research has looked into the unfavourable perceptions that medical students have of those who suffer from mental illness.

Objective:

The objective was to study the attitude of undergraduate medical students towards patients with psychiatric illnesses.

Materials and Methods:

A cross-sectional study was carried out among undergraduate medical students who were exposed (n = 69) to 2-week psychiatry posting and attended lectures and those who were not exposed (n = 163) to psychiatry training using self-reported Attitude Scale for Mental Illness (ASMI) questionnaire via Google form distributed among medical students.

Results:

The findings indicate there is no change in attitude toward the patient with psychiatric illness after exposure to psychiatry training among medical students. However, urban residence and female gender were the factors found to be influencing students’ attitudes towards patients with psychiatric illnesses.

Conclusions:

There was no change in attitude towards patients with psychiatric illness after psychiatry exposure. Students belonging to urban domicile and female students showed more sympathetic attitudes toward those with mental illnesses.
Study of thyroid disorders in vitiligo
Authors: Khiangte Lalchamliani , Lalrindik C.
Published: April 2023

ABSTRACT

Background and Aims:

Vitiligo, an acquired sometimes familial depigmentary disorder of the skin and hair that results from selective destruction of melanocytes or pigment cells. It is the single most important non-neo plastic disease that involves both the immune system and melanocytes which are subsequently destroyed and the affected area turns pale and becomes white. The prevalence of the disease is between 1% and 2% in general population.

Methods:

It is a prospective, randomized, and controlled study. Over 90 vitiligo patients attending Dermatology OPD and vitiligo clinic are enrolled in the study. About 35 apparently healthy, age and sex matched individuals are selected to serve as control. A prescribed proforma containing all the demographic data, relevant questionnaire were recorded for each and every case with brief clinical history suggestive of any thyroid disease as well as those referred by the clinicians. P value <0.05 is considered significant. The Quantitative Determination of Thyroglobulin (Tg) Autoantibodies in Human Serum or Plasma by a Microplate Enzyme Immunoassay.

Results:

Vitiligo group, thirty four (37.78%) patients have clinical hypothyroidism while 9 (10%) patients have clinical hyperthyroidism. This difference in the distribution is statistically significant (P < 0.05) with a Chi-square value of 10.08. The data are entered, analyzed and computed with SPSS version 15 software and well-known statistical test like Chi-square, students’ ‘t’ test have been advocated wherever found applicable. P value <0.05 is considered significant.

Conclusion:

There is increased incidence of autoimmune thyroid diseases among vitiligo patients. The reason being vitiligo usually precedes the onset of thyroid dysfunction.
Assessment of Knowledge, Attitudes and Practices Regarding Chronic Kidney Disease in at-Risk Individuals
Authors: Sharma Gaurav Shekhar , Lata Hem , Kumari Ranjeeta , Pai Venkatesh S , Kandari Sharon , Huda Farhanul , Walia Prateek , Kant Ravi
Published: April 2023

Background:

Chronic kidney disease (CKD) is a global health problem, with a worldwide prevalence of around 9.1 per cent (as of 2017). In India, its prevalence was found to be around 17.2%. There are several risk factors of CKD, out of which the presence of underlying longstanding uncontrolled diabetes mellitus (DM) and hypertension are common. Certain previous studies have tried to assess the level of knowledge, attitudes and practices of such a ‘high risk’ group for developing CKD but there is a paucity of literature on it. Hence, this study was undertaken to assess these domains in individuals at risk for developing CKD.

Patients and Methods:

It is an observational cross-sectional study conducted from October 2020 to December 2021 at a tertiary care teaching and referral hospital in India. A total of 215 patients who were at risk of developing CKD, were enrolled and were given a CKD Screening Index questionnaire to fill and scoring was done for all three components-knowledge, attitudes and practices.

Results:

The mean age was found to be 49.21 ± 13.49 years with a male: female ratio of 1.4:1. Nearly three-a fourth of the patients were having DM while one-fourth of the participants had a previous history of hypertension. The mean scores on the knowledge, attitude and practices scales were found to be 11.80 ± 5.31, 50.18 ± 8.23 and 30.83 ± 7.53 respectively. The study results revealed that the majority of patients had ‘low’ levels of knowledge scores but ‘average’ levels of attitude and practice scores. A significant correlation was found amongst knowledge and attitude scores (r = 0.226, P = 0.001), knowledge and practice scores (r = 0.153, P = 0.025) and practice and attitude scores (r = 0.295, P = 0.000) of our patients.

Conclusion:

There is a need of improving awareness at least amongst the population at risk of getting CKD. Improving knowledge would help in inculcating positive attitudes and healthier practices amongst these, thus delaying the onset of this disease.
Mandibular metastasis of follicular thyroid carcinoma
Authors: Jawanda Manveen Kaur , Gupta Sonia , Gupta Priya , Narula Ravi
Published: April 2023

Metastasis is one of the major complications of malignant tumors that leads to morbidity and mortality. Metastatic tumors to the oral cavity are very rare, and true incidence is still unknown. However, they are of great clinical significance as they can represent as the first and the only manifestation of dissemination in most of the cases. The most common sources of metastasis in the oral cavity are the breast, kidney, lung, prostate and Gastrointestinal tract (GIT). Thyroid carcinoma though is the most common type of endocrinal malignancy but rarely metastasizes to the oral region. Follicular thyroid carcinoma (FTC) is the second most common type of thyroid cancer after papillary thyroid carcinoma. It affects the jawbones more often than the soft tissues. To our knowledge, till present, literature has reported 44 cases of metastatic FTC to jawbones with mandibular predominance. With the increasing incidence of these tumors during the past few years, it has become of great concern to diagnose them at an early stage so that further complications can be eradicated. Here, we present a rare case of metastatic FTC occurring in the mandible of a 55 year old male along with a systematic review of the literature.
COVID-19 Associated Mucormycosis (CAM)
Authors: Vijapur Manjunath M. , Kattimani Vasanth , Varsha VK , Girish HC , Kamat Mamata , Ram Bhargav
Published: April 2023

Background:

Opportunistic fungal infections like Mucormycosis in Coronavirus Disease 2019 (COVID-19) patients have posed a great challenge to health care professionals, especially in developing countries like India. Hence, there is a need to understand the biological behaviour of COVID-19 associated Mucormycosis (CAM) to establish standard treatment Protocols and to reduce mortality.

Aims:

This study aims is to assess the type of Mucormycosis among COVID-19 patients in study population and compare the findings with clinical, radiological and haematological parameters along with treatment and surgical management.

Methods and Material:

This retrospective, observational study included 60 cases of CAM reported to the Department of Oral and Maxillofacial Surgery at the tertiary care centre, Karnataka Institute of Medical Sciences, Hubli. Data about various parameters were tabulated and analysed statistically.

Statistical Analysis Used:

Bivariate analysis was done using the Chi-Square test to assess the relationship between the type of Mucormycosis and other variables. Spearman's Correlation test was used to assess the correlation between types of Mucormycosis with the other variables. Linear regression analysis was performed to assess the response variable related to the type of Mucormycosis.

Results:

About 50% of subjects presented with “Rhino orbital” type of Mucormycosis. Palatal discoloration and palatal erosion was the most common oral manifestation among “only Sinus” and “Rhino orbital” types of Mucormycosis (P = 0.00). Significant association (P = 0.29) was found between the type of Diabetes mellitus and Mucormycosis.

Conclusions:

The study indicates that DM is the most commonly associated comorbidity in CAM patients. Hence, a thorough understanding of the underlying comorbidity and its close monitoring during and after COVID-19 infection is mandatory for successful treatment outcomes.
Primary amelanotic malignant melanoma of parotid and submandibular salivary gland
Authors: Sultana Mehebuba , Chatterjee Rudra Prasad , Kundu Sanchita , Mahmud SK Abdul
Published: April 2023

Primary amelanotic malignant melanomas (AMMs) of the parotid and submandibular salivary glands are extremely rare with only a few reported cases due to its low incidence and misdiagnosis. Malignant melanoma (MM) has a high predilection for the head-and-neck region and majority of the cases in the parotid gland reported as association with metastasis in and around the gland from a cutaneous primary tumor. Immunohistochemistry is solely needed for confirmation of diagnosis and MMs give positive reactivity for melan-A, HMB-45, and S–100. Prognosis for AMM in the mucosal or salivary gland regions is much poorer than cutaneous regions because of anatomic considerations and its delayed diagnosis. The treatment of choice is radical surgery and parotidectomy along with radiotherapy and chemotherapy.
A study on genetic and mutans streptococcal transmissibility of dental caries
Authors: Chatterjee Shailja , Damle Satyawan G. , Iyer Nageshwar
Published: April 2023

Background:

Dental caries is characterized by an interplay between environmental and genetic factors.

Aim:

The aim of this study was to analyse the transmissibilities of high caries risk chromosomal loci at 5q 12.1-13.3 and low caries risk chromosomal loci at 13q31.1 and Streptococcus mutans (S. mutans) in family units.

Materials:

This prospective cohort study was performed on 56 families grouped into four: (a) Group I: 18 families of children with caries affected primary teeth; (b) Group II: 21 families of children with caries in permanent teeth; (c) Group III: 6 families of children with no caries in primary teeth and (d) Group IV: 12 families of children with no caries in permanent teeth. Blood, saliva and plaque samples were collected from consenting study participants. Isolated DNAs were subjected to polymerase chain reactions using suitable primers. Data collected was analysed with ANOVA and Chi-squared test.

Results:

Wide expression of chromosome loci 5q12.1-13.3 was obtained in both blood and saliva samples. For chromosome loci 13q31.1, no expression was found in saliva samples, hence indicating its local absence. For the GtfB expression, transmissibility was common for a single band expressing S. mutans.

Conclusion:

This study reflects upon newer findings in the field of genetic research on dental caries.
Comparison of Demirjian and Cameriere methods and development of modified Cameriere and Demirjian formula more efficient for North Indian population
Authors: Gupta Shalini , Verma Anoop Kumar , Patil Ranjit , Singh Uma S. , Kumar Navneet , Bhattacharya Sandeep
Published: April 2023

Introduction:

Accurate age estimation is of utmost importance in several branches of life, be it disaster victim identification (DVI), sports, fashion, education, and many more. Several studies/formulas have been proposed over the years from various parts of the world and amongst them, Cameriere's method of age estimation is now being accepted globally, and the related work is still one of the most thought about.

Aim:

The aim of this study was to access the relationship between dental age (DA) and chronological age using Cameriere and Demirjian age estimation method in the north Indian population and develop a population-specific regression formula and validate it in the north Indian population.

Materials and Methods:

Orthopantomograms (OPG) of 762 children of north India with age groups between 7 and 16 years were collected. Seven left permanent mandibular teeth were analyzed using both Cameriere and Demirjian's age estimation method. The resultant data were subjected to statistical analysis.

Results:

The mean differences between CAge and DAge with age were 1.21 (males), 0.14 (males) and 1.72 (females), 0.28 (females) respectively, which shows significant disparity, wherein Demirjian follows overestimation and Cameriere follows the underestimation trend. Therefore, we modified these methods using the linear regression model.

Conclusion:

The modified Demirjian and Cameriere formula after validation shows a better fit in the north Indian state of the Uttar Pradesh population.
The association of fingerprint patterns with oral potentially malignant disorders and oral cancer
Authors: Dodia Vaishali S , Odedra Sima P , Shah Khushali Himanshu , Monpara Pooja C , Vyas Priya M , Pillai Jayasankar P
Published: April 2023

Background:

Dermatoglyphics play an important role in the identification of a person as well as identifying a person with a genetic abnormality. Hence, the present study was conducted with an aim to explore the association between the fingerprint patterns and oral potentially malignant disorders, oral squamous cell carcinoma (OSCC), individuals with habit and without lesion and the control group.

Materials and Methods:

A cross-sectional study comprising of 100 individuals divided into 5 groups with 20 individuals in each group based on their habit and the presence of oral lesions. Group 1 included individuals with oral leukoplakia (OL), Group 2 included individuals with oral submucous fibrosis (OSMF), Group 3 included individuals who had OSCC, Group 4 individuals had tobacco habits but without lesion and Group 5 comprised of control individuals. The fingerprints of all the study subjects were recorded using a standard ink method. They were analyzed qualitatively and quantitively.

Results:

The present study showed a predominance of that loop patterns in all the groups. The frequency of the whorled pattern was higher in subjects with OSMF as compared to OL and OSCC. The arch pattern was comparatively lesser in subjects with OL than OSMF subjects. The right-left comparison of the fingerprint patterns in all the five groups, except Group 4, showed a significant association and correlation. The Group 4 individuals were showing the least correlation between sides.

Conclusion:

The study concluded that dermatoglyphics can be used as a potential marker to identify the subjects with risk for potentially malignant oral disorders and oral cancers.
Utility of serum homocysteine in oral squamous cell carcinoma patients as a potential biomarker
Authors: Palaskar Sangeeta , Joshi Kalpana , Mukkanwar Rutuja , Pawar Rasika , Kulkarni Gayatri , Pawar Saurabhachandra
Published: April 2023

Background:

In India, Oral cancer is one of the most common cancers. Despite advances in treatments, prognosis for oral cancer has remained poor with a five-year survival rate of 40–50%. Therefore, it is necessary to develop effective diagnostic methods for early diagnosis and better prognosis. Homocysteine (Hcy) has been reported as a 'tumour marker' in various cancers such as breast cancer, colorectal cancer, lung cancer, cervical cancer.

Aim:

To study the levels of serum Hcy in oral squamous cell carcinoma (OSCC) patients.

Objectives:

To assess the clinical utility of serum Hcy as a potential tumour marker for OSCC cases.

Methodology:

Serum Hcy levels were studied and compared between patients with OSCC and healthy individuals.

Results:

Serum Hcy levels were higher in patients having OSCC.

Conclusion:

Serum Hcy levels could be utilized as a biological marker in the diagnosis and the prognosis of OSCC patients.
Assessment of sexual dimorphism in Maharashtrian young adults using maxillary intercanine, interpremolar, and intermolar widths
Authors: Wankhede Mukesh P. , Tamgdge Avinash , Anjali A. K. , Vidhale Rutuja G. , Pereira Treville , Lalai Megha N.
Published: April 2023

Introduction:

Sexual dimorphism practically involves differences in size and appearance of the same species which does not involve the difference in sexual organs. A significant variation also occurs with the tooth size, shape, etc., which plays a critical role in sex determination. Forensic investigations are used in defining the number of missing people whose skeletal remains are unknown. Depending on the available bones and their state, a variety of methods with varying degrees of reliability are available for identifying unknown remains.

Materials and Methods:

Fifty male and 50 female patients in the age group 20–30 years were randomly selected after taking a detailed history. All maxillary impressions were made with alginate and poured into a dental stone. These casts were measured for intercanine width, interpremolar width, and intermolar width using a digital vernier caliper, and findings were correlated with sexual dimorphism.

Results:

Intercanine width between the tips of right and left maxillary canine was measured in males and females at 36.08 ± 2.04 mm (Range: 30.05–41.64 mm) and in females, the mean intercanine width was 34.31 ± 1.75 mm (Range: 28.35–39.01 mm), respectively. Interpremolar width between the distal pits of right and left first premolars was measured in males and females at 38.97 ± 2.10 mm (Range: 33.94–45.21 mm) and in females, the mean interpremolar width was 36.92 ± 1.87 mm (Range: 31.34 mm), respectively. Intermolar width between the central fossae of right and left first molars was measured in males and females at 50.43 ± 2.25 mm (Range: 44.16–56.84 mm) and in females, the mean intermolar width was 47.90 ± 2.06 mm (Range: 42.66–54.63 mm), respectively.

Conclusion:

In males, the mean value of the combination of intercanine, interpremolar, and intermolar widths was 125.47 ± 5.61 mm (Range: 108.15–141.86 mm) and in females, it was 119.12 ± 5.05 mm (Range: 103.25–134.36 mm). Mean values of all combinations were larger in males than in females. Thereby, maxillary arch widths contribute to accuracy in determining the gender of the individual.
Exploring a safer alternative to eosin in soft tissue staining
Authors: Sarode Surabhi A. , Pradeep GL , Prakash Nilima , Mahajan Aarti , Mangle Nikita
Published: April 2023

Context:

Hematoxylin–eosin (H&E) stain has stood the test of time as the standard stain for histologic examination of human tissues. Haematoxylin is a natural dye, on the contrary, its counterstain eosin is a synthetic dye which belongs to the xanthene group. Synthetic dyes are hazardous to human and animal health. With the increasing awareness of a green earth, it is advisable to use environment-friendly and biodegradable materials. Therefore, an attempt was made to develop as biofriendly substitute in the form of food colour as a counterstain for haematoxylin.

Aim:

To assess the staining ability of food colouring agents in routine staining and to compare its staining efficacy with Eosin.

Settings and Design:

Two food colours were obtained and stain was prepared by using 70% ethyl alcohol as counterstain for haematoxylin. Different tissue structures such as epithelium, keratin, collagen fibers, muscles, salivary glands, adipocytes, blood vessels, RBCs were observed and evaluated.

Methods and Material:

Group A –10 slides stained with green food colour, Group B – 10 slides stained with

tomato red

food colour and Group C – 10 slides stained with conventional H and E. The stained sections were assessed and graded for nuclear staining, cytoplasmic staining, clarity, uniformity and crispness of staining.

Statistical Analysis Used:

The non-parametric Kruskal–Wallis and Mann–Whitney U tests were performed for statistical analysis.

Results:

There was no statistically significant difference between the three study groups with respect to all the parameters except crispness of staining. The crispness of Tomato Red and H and E was better compared to green food colour.

Conclusions:

Food colouring agents can be used as a safe, biofriendly and inexpensive substitute to eosin in conventional soft tissue staining.
Correlation of serum trace elements (Fe, Cu, and Zn) in the blood samples of Indian patients with leukoplakia, oral squamous cell carcinoma, and normal subjects
Authors: Sourabh Abhishek , Shreedhar Balasundari , Khare Abhishek , Haideri Safia , Kalim Shadab , Srivastava Ankita
Published: April 2023

Context:

Trace elements (iron, copper, and zinc), leukoplakia, and oral squamous cell carcinoma.

Aims:

To study and correlate serum trace element (iron, copper, and zinc) levels in leukoplakia, oral squamous cell carcinoma, and normal subjects.

Settings and Design:

The present study comprised a total of 80 patients, which included 30 patients of leukoplakia, 30 patients of oral squamous cell carcinoma, and the normal control group comprising 20 healthy individuals who were not having any relevant medical, dental, and habit history.

Subjects and Methods:

Peripheral blood samples of a volume of 10 ml each will be collected by anti-cubical vein puncture from control groups and from patients suffering from leukoplakia and oral squamous cell carcinoma. The blood will be collected in a plain red top vein puncture tube without additives or anti-coagulants and allowed to stand undisturbed to clot at room temperature, and serum will be separated from the cells by centrifugation at 4°C at a speed of 3000 rev/min, the separated sera will be kept at –20°C until analysis is performed.

Estimation of Serum Iron, Zinc, and Copper Levels:

The estimation of serum zinc (Zn) and copper (Cu) levels is performed by atomic absorption spectrometry (AAS). In the present study, the estimation of copper and zinc levels was conducted by using an atomic absorption spectrophotometer (model no: AA-6300 SHIMADZU, Japan). Serum iron estimation is performed using the kit RANDOX (siedel, 1984).

Statistical Analysis Used:

Statistical analysis is performed by the paired and Scheffe tests.

Results:

From the results, it was concluded that there was a decrease in serum iron and zinc levels and copper had increased serum levels.

Conclusions:

It was concluded that evaluation of serum trace elements can be a cost-effective and non-invasive alternative for screening, diagnosis, and monitoring of pre-malignant lesions such as leukoplakia and malignant lesions such as oral squamous cell carcinoma. Thus, these parameters can be used as biomarkers that provide important tools in formulating an adequate diagnosis, treatment plan, and prognosis for oral squamous cell carcinoma.
Cartilaginous choristoma of tongue - A case report and review
Authors: Sakrikar Aditee , Agrawal Umesh , Pimpale Gaurao , Agrawal Pooja
Published: April 2023

Choristoma (aberrant rest or heterotopic tissue) is defined as a histologically normal tissue proliferation, which is not normally found in the anatomic site of proliferation. Choristoma with a proliferation of chondroid tissue is known as cartilaginous choristoma. Clinically, they present as a painless firm nodule and may produce local dysfunction. They occur most frequently in the tongue and less commonly in other sites, such as buccal mucosa, soft palate and gingiva. We report a 35 years female patient with pedunculated globular growth over the left lateral border of the tongue, resembling papilloma but histopathological analysis of the excised specimen revealed to be cartilaginous choristoma.
Assessment of the anti-oxidant reduced glutathione in oral squamous cell carcinoma – Systematic review and meta-analysis
Authors: Mohideen Khadijah , Sudhakar Uma , Jeddy Nadeem , Sankari S. Leena , Radhika T. , Vani N.
Published: April 2023

Background:

The excess reactive oxygen species or free radicals reaction leads to oxidative injury to the biological components such as cells and tissues, which would result in the initiation and progression of carcinogenesis. The magnitude of oxidative damage depends primarily on the balance between free radicals (pro-oxidants) and antioxidant system activity.

Aim:

To assess antioxidant status by evaluating the reduced glutathione (GSH) levels in various biological samples of patients with oral squamous cell carcinoma (OSCC) using available literature.

Materials and Methods:

An electronic literature search was carried out in PubMed (MeSH), Science Direct, Scopus and Cross Reference by using specific keywords.

Results:

The systematic electronic search identified 704 articles. After studying the articles' titles and abstracts, 657 articles were excluded for the following reasons; duplicated articles, animal studies, studies of low quality and not relevant to the research question. The remaining 47 articles were selected for full-text assessment. After eliminating the articles that did not match the objectives, the present qualitative synthesis finally included 27 articles for evaluation. The ten studies, which showed coherent data, were included in quantitative analysis. The GSH levels in OSCC groups are significantly decreased (P < 0.001) in plasma and erythrocyte samples compared to healthy controls.

Conclusion:

The selected studies showed significantly lower levels of GSH in various biological samples of OSCC. Hence, future studies are required to validate the expression of GSH as a prognostic biomarker in oral cancer.
Non-Hodgkin lymphoma of a palate
Authors: Milani Cintia M. , Stadler Claudia F. , Silva Larissa L. Gomes da , Milani Paulo A.P.
Published: April 2023

Non-Hodgkin lymphoma (NHL) is a haematolymphoid neoplasm that can affect nodal and extra-nodal sites. It is a rare disease in the oral cavity, accounting for only 2% of all extra-nodal lymphomas. Its aetiology is multi-factorial, being strongly associated with viral infections. The average age group most affected is 66 years old, with a slight predilection for males. The most common histological sub-type in the oral cavity is diffuse large B-cell lymphoma, with Waldeyer's ring being the most affected site in the nodal form, and extranodally, it may involve the tongue, hard/soft palate, maxilla, and mandible. It presents as a nodular lesion with a smooth or ulcerated surface. The initial treatment approach is chemotherapy, but this may vary according to the stage of lymphoma. The aim of this study was to report a case of NHL in the palate of a 54-year-old female patient, with extensive tissue destruction.
Circulating biomarkers in oral cancer
Authors: Prakash Nilima , Pradeep GL
Published: April 2023

Oral squamous cell carcinoma (OSCC) is among the most common malignancies and a leading cause of death in developing countries. Late diagnosis and regional and/or distant metastasis worsen the prognosis of this condition. Despite the advances in diagnostic modalities and management strategies, there is little improvement in the 5-year survival rate. A deeper insight into the molecular events of various tumours has enabled the use of minimally invasive methods for monitoring disease progression, prognostication and treatment monitoring. Although studies in OSCC are preliminary, the use of liquid biopsies has opened new frontiers for the development of biomarkers that can serve as alternatives to conventional biopsies and imaging methods. Circulating biomarkers in blood allow for the real-time monitoring of tumour and therapeutic responses. This review aims to outline the promises and challenges of circulating biomarkers in OSCC with special emphasis on circulating tumour cells, circulating tumor DNA, and exosomes.
Elucidating the immunohistochemistry of Nanog
Authors: Afroze Syeda Neelam , Rao Guttikonda Venkateswar , Suri Surekha
Published: April 2023

Background:

Nanog is a key transcription factor regulating pluripotency in mammalian early embryos and pluripotent stem cells. Nanog plays a central role in pluripotency and forms autoregulatory loops to maintain ESC (embryonic stem cell) identity. Oral squamous cell carcinoma (OSCC) is an extensively studied malignancy that occurs due to accumulated genetic and epigenetic changes. Hence, the current study was done to evaluate role of Nanog in OSCC.

Objective:

The present study was done to evaluate Nanog role in OSCC.

Materials and Methods:

Thirty normal subjects and 30 patients of oral squamous cell carcinoma (OSCC) were included in study. The cases were staged clinically based on tumour node metastasis (TNM) staging and graded histopathologically using modified Broder's grading system. Thirty tissue sections of OSCC were subjected to immunohistochemistry (IHC) with Nanog antibody. Random fields were chosen and 300 cells were counted in five areas and mean percentage of immunopositive cells were calculated. The results were analysed using ANOVA test.

Results:

The results demonstrated a statistically significant difference between normal subjects and in patients with OSCC with respect to mean of IHC score (P = 0.0001*). High mean values for Nanog in tissue with OSCC in both histopathological (P = 0.0001*) and clinical grading (P = 0.0276*) with statistically significant result were observed.

Conclusion:

The increased expression of Nanog in patients with OSCC was statistically significant, suggesting its role as diagnostic biomarker. Statistically significant result with respect to clinical staging and histopathological grading of Nanog expression in patients with OSCC suggests its role as prognostic biomarker also.
Malignancy mimics- diagnostic perplexities for oral and maxillofacial pathologists
Authors: Kaur Harpreet , Mishra Deepika , Roychoudhury Ajoy , Kakkar Aanchal , Mridha Asit Ranjan , Sharma Mehar Chand
Published: April 2023

Objective:

In pathology practice, one frequently encounters benign lesions which superficially resemble malignancy clinically and histopathologically. The diagnostic pitfalls can be avoided if the approach exemplified in the present study is followed. We expect that familiarity of these cases will be helpful for pathologists at the beginning of their career.

Methods:

Clinical case records of all the pathological specimens reported in our laboratory from January 2018 to September 2019 were queried. Cases displaying pseudotumor features were reviewed along with the special stains were performed and immunohistochemistry (IHC) studies. A working classification of pseudotumors presenting in the oral cavity was proposed.

Results:

Immunoglobulin G4-related disease, nodular fasciitis, fibrolipoma, odontogenic keratocyst with giant cell granuloma, juvenile ossifying fibroma with central giant cell granuloma and tumor-induced osteomalacia were the most common diagnoses where the tissue specimens resembled malignancies on routine clinicoradiological evaluation and light microscopy of tissue specimens. Their differential diagnosis and the pathological diagnostic dilemmas are explained. We have also highlighted the importance of correlating clinical, radiological and microscopic details with the findings deduced from advanced pathological aids to establish the final diagnosis.

Conclusions:

Pathologists should be aware of the conditions where the diagnosis of malignancy needs stricter evaluation to rule out malignant mimics. In such scenarios, correlation of light microscopy findings with clinical and radiological details cannot be overemphasized. Advanced pathological aids such as IHC, where necessary are often indispensable for reaching the accurate diagnosis in these cases.