bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge about Attention Deficit Hyperactivity Disorder among Primary School Teachers in Riyadh, Saudi Arabia
Authors: Abouammoh Noura , Younis Afnan , Alwatban Layan , Alkhalil Marwah , Alharbi Rawan , AlHalabi Reham , Alzahrani Shahad , Alrwais Shikah
Published: September 2024

Context:

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders affecting children. As ADHD symptoms affect the learning process of children at schools, teachers have an important role in identifying children who may have ADHD.

Aim:

This study aims to estimate knowledge level of primary school teachers in Riyadh about ADHD and to correlate the level of knowledge to demographic characteristics.

Settings and Design:

A cross-sectional study including 448 male and female teachers from 20 primary schools.

Materials and Methods:

Schools were sampled using multistage random sampling technique. The Knowledge of Attention Deficit Disorder Scale questionnaire was used for data collection. Data collection continued for 1 month starting from January 30, 2020.

Statistical Analysis Used:

Association between main outcome and different demographic variables was tested using analysis of variance test for more than two groups, categorical variables and t-test for nominal binary variables using SPSS.

Results:

The mean of the overall knowledge about ADHD was 43.1%. The mean of ADHD general knowledge, diagnosis, and treatment was 32.3%, 61%, and 36%, respectively. Regarding general knowledge about ADHD, teachers between 22 and 30 years of age and males scored significantly higher than the other groups. Regarding teachers' knowledge about ADHD treatment, statistically significant higher scores were found male teachers. Previous experience with ADHD child had significantly higher scores than those who did not have experience in all three knowledge categories.

Conclusions:

Knowledge about ADHD has a positive correlation to previous experience with ADHD which proves the importance of implementing a training program to help the teachers identify students with ADHD leading to earlier diagnosis and better outcomes.
Anxiety, Depression, Disease Disability, and Health-Related Quality of Life in Rheumatoid Arthritis Patients during the Coronavirus Disease 2019 Pandemic
Authors: Alaujan Shiekha S. , Almalag Haya M. , Alshehri Shahad M. , Alkendi Jumanah M. , Almansour Mohamad A. , Alanizy Layla N. , Omair Mohammed
Published: September 2024

Purpose:

The coronavirus disease 2019 (COVID-19) pandemic has posed a threat to global health, including mental health. This study aimed to examine the impact of the pandemic on psychological health and to identify the factors associated with anxiety in patients with rheumatoid arthritis (RA) in Saudi Arabia.

Materials and Methods:

A cross-sectional observational study was conducted between September and November 2020, at the rheumatology clinics of two tertiary care hospitals. Eligible participants were adults with a confirmed diagnosis of RA. Data collected included socio-demographics, contact history, commitment to COVID-19 precautionary measures, medication-taking behavior, the hospital anxiety and depression scale (HADS), the European Quality of Life (QoL) measure (EQ-5D-3L), and the health assessment questionnaire disability index (HAQ-DI).

Results:

Of the 252 invited eligible patients, 204 agreed to participate. The majority were aged 41–50 years (28.2%), female (86.5%), and nonsmokers (96%), had at least one comorbidity (38.8%), had missed medications (8.8%), and had psychiatric illnesses or were on psychiatric medication for the past 3 months (15.4%). Borderline-abnormal anxiety levels were reported in 32.8% of patients. The mean standard deviation score for HADS depression was 3 (3), that for the EQ-5D-3L index was 0.587 (0.378), and that for the HAQ-DI was 0.947 (0.887). After adjusting for age, sex, presence of psychiatric illnesses or psychiatric medication use and noncompliance with medication, higher levels of anxiety were significantly associated with a higher level of depression, RA disability index, and pain intensity (p-value< 0.05). In contrast, higher health-related QoL was significantly associated with lower levels of anxiety (p-value< 0.001).

Conclusion:

During the mid-phase of the pandemic in Saudi Arabia, almost one-third of RA patients reported the presence of anxiety symptoms. Higher anxiety levels were found to be associated with depression, health-related QoL, and disease disability in RA patients.
Prevalence, Risk Factors, and Outcome of Diabetic Patients Infected with COVID-19 in Saudi Arabia
Authors: AlOtair Hadil Abdulkader , Sheshah Eman , AlJuaid Mohammed M. , AlShaikh Mashael K. , AlNajjar Farrah K. , AlAshgar Lolwah M. , Alzeer Faisal A.
Published: September 2024

Background:

Recent global studies including those coming from Saudi Arabia highlighted the apparent increase in the prevalence and severity of COVID-19 in diabetic patients. Hence, this study was conducted to report the prevalence, clinical outcomes, and risk factors among a cohort of diabetic patients with COVID-19 infection in Saudi Arabia.

Research Design and Methods:

A retrospective observational case–control study of COVID-19 patients admitted at two major hospitals in Saudi Arabia between April 2020 and July 2020. Electronic charts were retrospectively reviewed, comparing diabetic and nondiabetic patients' demographic, clinical variables, and outcome measures.

Results:

A total of 564 patients with polymerase chain reaction-confirmed COVID-19 infection were enrolled in the study. Their mean age was 52.3 ± 14.4 years and 254 patients (45%) had diabetes mellitus (DM). Diabetic patients were significantly older compared to patients without DM (P < 0.001) and more likely to have hypertension (P < 0.001), heart failure (P = 0.011), chronic kidney disease (P = 0.002), ischemic heart disease (P = 0.005), and higher D-Dimer level (P = 0.011). Patients with DM had significantly higher risk of acute kidney injury (26.4% vs. 14.8%, P = 0.001) and higher rate of inhospital mortality (25.2% vs. 15.8%, P = 0.006) compared to nondiabetics. The most important independent risk factors in diabetic patients were HbA1c and the average capillary glucose check during admission (P < 0.001).

Conclusion:

Diabetes is highly prevalent among COVID-19 patients admitted to hospitals in Saudi Arabia. The inhospital mortality rate is increased among diabetic patients of older age group with high HbA1c levels, poor glycemic control during hospitalization, and had multiple comorbid conditions compared to nondiabetics. Early identification of at-risk patients with DM and optimal blood glucose control are extremely important for better clinical outcomes.
The Relationship Between Coronavirus Disease-2019-Positive Patients and Plasma Interleukins and Transforming Growth Factor-β Levels
Authors: Vatansever H. Seda , Sayan Murat , Ozgul-Onal Melike , Akhan Sila , Ozel Selcan , Sanlidag Tamer
Published: September 2024

Objective:

The aim of this study is to reveal the relationship between the cytokine plasma levels and symptoms of coronavirus disease-2019 (COVID-19)-positive patients, which is characterized by serious respiratory syndromes.

Materials and Methods:

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)-positive patients were evaluated in four groups. Group 1 patients had no symptoms. Group 2 patients were mildly symptomatic. Group 3 patients had multiple symptoms. Group 4 patients had all symptoms of acute respiratory distress syndrome. Analysis of interleukin (IL)-17A, transforming growth factor-β1 (TGF-β1), and IL-6 concentrations in plasma samples taken from patients were examined by enzyme-linked immunosorbent assay method.

Results:

IL-17A levels were increased in parallel with the clinical condition in all patients. TGF-β1 was only observed in patients in Groups 3 and 4, and IL-6 was only observed in Group 4 patients.

Conclusion:

It is known that many cytokines are involved in the development of different viral infections and viral invasion always triggers an inflammatory response. The profile of inflammatory markers may be used to classify COVID-19 patients. In conclusion of this study, it is suggested that the level of cytokines which is changed according to the patient's clinical status should be used to evaluate the response of SARS-CoV-2 treatment. IL-17A, TGF-β1, and IL-6 concentrations in plasma levels could be good prognostic indicators of COVID-19.
Patients' Attitudes Toward Alternative Medicine as a Treatment for Musculoskeletal Conditions
Authors: AlSaleh Khalid , Alkhenizan Zeyad , Aldossari Abdulelah , Alammari Ali , Dakhil Abdulaziz Bin , AlZakri Abdulmajeed
Published: September 2024

Introduction:

Despite rapid progress in providing advanced medical care, patients still seek traditional and alternative medicine (AM) therapies for their musculoskeletal complaints.

Materials and Methods:

A survey of adult patients attending the outpatient orthopedic clinics of a Tertiary Care Institution in Riyadh, Saudi Arabia, was performed. The survey was designed to delineate the patients' demographics, current musculoskeletal complaints, previous history of seeking an alternative treatment modality, and their opinions regarding these AM therapies.

Results:

One hundred and ninety-six patients agreed to fill the questionnaire. Fifty-four (27.6%) admitted to having had AM in the past. Wet cupping and traditional manual therapy were the most popular AM modalities undertaken, follow closely by herbal treatment and cautery. Age and educational level were found to be associated with the use of AM (P < 0.05). Most participants would never consider using AM, their rationale because it was perceived to be either unsafe or ineffective.

Conclusion:

AM use for musculoskeletal ailments is still prevalent. It is provision by the untrained and unlicensed individual is a concern. Better access to healthcare, advances in education, and a younger population may decrease its prevalence in the future.
Medical Education at the Time of COVID-19
Authors: Alrumaihi Nouf , AlSheikh Mona Hmoud , Zaini Rania G. , Alamri Abdulaziz , Patel Ayyub , Alassiri Ali , Ageely Hussein M. , Abdulghani Hamza , Alamro Ahmad , Alrumayyan Ahmad , Neel Khalid Fouda , Soliman Mona M
Published: September 2024

Background:

The coronavirus disease-2019 (COVID-19) pandemic has disrupted medical education worldwide. This study investigates how Saudi medical colleges face the pandemic and proceed with teaching and assessment plans. The study also highlights the best practices employed by Saudi medical colleges during the time of COVID-19 crisis and proposes a contingency plan in the event of future outbreaks necessitating similar containment measures.

Methods:

This cross-sectional study was conducted among medical colleges in Saudi Arabia between June and August 2020. A convenience sampling method was applied. An online questionnaire was designed. The questionnaire consisted of six main parts: basic demographic data, curriculum, teaching and learning, learning management systems (LMS), assessment, and lessons learned. The questions targeting the educational process focused on what was happening before and what was done during the pandemic. Data were collected using Google Forms. The data was analyzed using SPSS.

Results:

A variety of teaching modalities were used before the pandemic, including class lectures (95.46%), problem-based learning (70%), case-based learning (47.25%), team-based learning (43.67%), videos/online interaction (24.58%), and flipped classroom (18.13%). During the pandemic, 97.87% of the participants used video lectures. During the pandemic, PBL and tutorial usage were reduced to 40.09% and 48.44% compared to 71.59% and 64.91% before the pandemic, respectively. Most faculty members (65.39%) reported no problems (nor did they encounter any obstacles) during online classes. Fully 96.18% of participants used Blackboard LMS during the pandemic. During the COVID-19 pandemic, 50.83% of participants reported utilizing continuous assessment, and 50.35% reported that the summative (final) assessment they performed was an online assessment. Most participants reported (85.68%) use online multiple-choice questions, followed by students' projects (34.84%), online SAQs (25.53%), and online objective structured clinical examinations (21.47%) if the pandemic were to continue.

Conclusions:

This study's value lies in the large sample of faculty and nationwide distribution of responses. Study results enable an understanding of early heuristic responses to online education, which may be used as a guide for mitigation efforts and to identify success stories, obstacles, key issues, and solutions.
The Global Shortage of Essential Drugs during the COVID-19 Pandemic
Authors: Salahuddin Mohammed , Manzar Dilshad , Unissa Aleem , Pandi-Perumal Seithikurippu R. , BaHammam Ahmed S.
Published: September 2024

Background:

Implications from accumulated bodies of commentaries and media/social-media reports highlight the drug shortage during the COVID-19 pandemic. In this special report, the relation between drug shortage and response measures is discussed in the light of a preliminary data construct.

Materials and Methods:

Media reports and social media posts on public and national drug regulatory bodies' websites were searched between March 1, 2020, and August 11, 2020. The search's key terms were shortage, nonavailability, essential medicine, essential drug, imported medicine, imported drug, COVID-19, current pandemic, and corona. A qualitative and quantitative summary of drug-shortage response pages and trends of drug-shortage reports are presented.

Results:

In the developed countries, the drug regulatory bodies released drug-shortage response pages; such pages were not made available in the developing countries. There were reports of drug shortages from both the developing and developed countries. There were reports of drug shortage from as early as March 2020 when the lockdown was first implemented and continued until July 2020. The reported drug shortages varied from that of simple essential medicines to those needed in critical care.

Conclusions:

The study findings highlighted the spread (across the developing and developed countries), time trend of drug-shortage reports (started from the 1st week of the first round of lockdown and continued throughout the study duration), and nontermination of drug-shortage reports even after availability of drug-shortage response page.
Knowledge, Beliefs, and Practice toward Seasonal Influenza Vaccine among Adults with Chronic Conditions in Riyadh
Authors: Binkhamis Khalifa M. , Alshammari Taif A. , Alnahdi Maha M. , Alghunaim Lamia A. , Alyahya Lama A. , Arnous Nouran K. , Alkeridy Walid A.
Published: September 2024

Aims:

The present study aimed to assess the knowledge, beliefs, practices, and associated factors (educational level, gender, age, and socioeconomic status) that influence the decision to receive the influenza vaccine and determine whether health-care recommendations affect its acceptance among adults with chronic conditions in Riyadh from 2020 to 2021.

Settings and Design:

This analytical cross-sectional study was conducted using a convenience sampling technique in Riyadh, Saudi Arabia.

Materials and Methods:

An electronic questionnaire was distributed through social media, shopping centers, home care unit patients, and outpatient clinics at King Khalid University Hospital in Riyadh, Saudi Arabia.

Statistical Analysis Used:

Descriptive statistics (frequencies and percentages) were used to describe quantitative and categorical variables. Bivariate statistical analysis was performed using the Chi-square test. Statistical significance was set at P < 0.05.

Results:

The total number of participants was 518, and 66.4% of those who had received the vaccine (n = 211) had high knowledge. Of the 210 male participants, 68.1% had received the vaccine, and of the 308 female participants, 56.8% had received the vaccine. The main motives for vaccine uptake were worry about contracting influenza (48.1%) and health-care professionals’ recommendations (44.6%).

Conclusions:

Influenza vaccination in adults with chronic diseases in Riyadh is suboptimal. Physician recommendations are the main motivator, whereas the fear of side effects is the main barrier. Educational campaigns should be conducted to promote knowledge and address misconceptions, fears, and false beliefs about the influenza vaccine, along with increasing physicians’ recommendations.
Awareness of the Causes and Management of Endodontic Mishaps among Dental Students at King Saud University and Riyadh Al-Elm
Authors: Alkahtany Mazen , Almadi Khalid , Alotaibi Abdulaziz Ghassab , Alzahrani Yazeed , Fatani Bader , Alabdullatif Almaha , Alaiban Haifa
Published: September 2024

Background:

Nonsurgical root canal treatment is an inseparable and essential element of thorough dental health care. Any errors that occur through any phase of endodontic treatment can affect the success of treatment.

Objective:

The aim of this study is to evaluate and assess dental Student's knowledge, awareness, and practice regarding the endodontic mishap.

Materials and Methods:

This study was carried out in Saudi Arabia, Riyadh, King Saud University, Dental hospital, and Riyadh Al-elm dental hospital. A well-structured questionnaire consisting of 24 questions were sent to 465 dental students from both colleges male and female from 3rd, 4th, and 5th academic year using Google form.

Results:

In general, 260 students (55.9%) reported at least one endodontic procedural error. Access cavity errors were reported by 158 students (34%). The total number of instrumentation errors was 243, which were performed by 187 students (40.2%). A total of 284 obturation errors were reported by 220 students (47.3%), and among the whole sample, the average knowledge of the student regarding endodontic mishaps was only 34%, which mean that 66% of the student does not know the causes and management of the endodontic procedural errors.

Conclusion:

As health-care providers, it is our responsibility to treat our patient with highest quality, and update our knowledge constantly, and according to our results, the average knowledge of the student regarding endodontic mishaps was only 34%, this shows that dental students have inferior knowledge about the causes and management of the endodontic errors, thus measures should be taken by the educational program and the student them self to improve their knowledge regarding endodontic mishaps.
Anxiety among Otolaryngology Residents during the Coronavirus Disease of 2019 Pandemic in Saudi Arabia
Authors: Alsayahi Hessah Saad , Alturki Abdulaziz Yousef , Almansour Nouf Mohammed , Alqahtani Zuhour Abdullah , Alassaf Hatim Ibrahim , Alabdulsalam Arwa Mohammad , Alfahhad Aseel Abdulkarim , Altameem Roba Mohsin , Alotaibi Fahad Z.
Published: September 2024

Background:

Otolaryngologists are among the health professionals most commonly working on the front lines against coronavirus disease of 2019 (COVID-19). They are at high risk of exposure, as well as physical and psychological stress. Nevertheless, the psychological influence of working during the pandemic still needs to be explored.

Objective:

This study aims to assess the anxiety symptoms among otolaryngology residents in Saudi Arabia during the novel coronavirus (COVID-19) pandemic.

Materials and Methods:

A cross-sectional qualitative study was carried out via a survey sent to otolaryngology residents in Saudi Arabia. The questionnaire collected demographic data and included questions using the 7-item Generalized Anxiety Disorder (GAD-7) scale to evaluate the residents' anxiety toward working during the pandemic. Data analysis was conducted using R v 3.6.2.

Results:

Ninety-three otolaryngology residents completed the online questionnaire with a response rate of 42.5%. Of them, 30.1% had been in contact with confirmed COVID-19 patients. More than two-thirds of the respondents (68.8%) suffered from anxiety based on the GAD-7 scale; in the results, 45.2% had mild anxiety, 12.9% had moderate anxiety, and 10.8% had severe anxiety. Almost 24% of the respondents suffered from anxiety with a score of 10 or greater on the GAD-7 used as a cutoff point. Anxiety was more prevalent in married residents compared with single ones (18.9% vs. 5.45%, P = 0.002). In addition, it was prevalent in 40% of smokers compared with 5.13% of nonsmokers (P = 0.001).

Conclusion:

Anxiety levels among otolaryngology residents were high during the COVID-19 pandemic.
Bibliometric Analysis of Coronavirus Disease 2019 Medical Research Production from Saudi Arabia
Authors: Jamal Amr A. , BinKheder Samar , Aldekhyyel Raniah N. , Almulhem Jwaher , Tharkar Shabana , Batis Afaf Ali , Hneiny Layal
Published: September 2024

In response to the coronavirus disease 2019 (COVID-19) pandemic and as an attempt to fill the knowledge gap related to this topic, extensive research in this area has been published. The Kingdom of Saudi Arabia, as one of the countries affected by the pandemic, has contributed to the growing body of scientific literature related to COVID-19. To measure research contribution produced by Saudi Arabian affiliated researchers, we conducted a bibliometric analysis of COVID-19 research across two databases: the Web of Science and Scopus. Analysis was conducted on February 2, 2021 and included all relevant COVID-19-related publications (n = 1510). The majority of publications were research articles with the average number of citations per publication of 4.8, an authorship collaboration dimension of 5.49 authors per publication, collaboration index of 6.0, and 5.6 mean total citations per year. Further analysis showed that 89.5% of publications were multi-authored reflecting the importance of substantial efforts made toward research collaboration.
Saudi Knowledge and Awareness of Drinking Tea as Natural Fighter Against COVID-19
Authors: Shamlan Ghalia
Published: September 2024

Objective:

Stressful period as COVID-19 pandemic and quarantine affect human health indirectly by weakening the immune system which lead to increase the risk of having viral infection. Tea in all its kind considered as a strong antioxidant that helps to enhance the immune system and body defense against COVID-19 infection. The aim of this study is to assess the knowledge of participants toward the benefits of drinking tea during COVID-19 pandemic.

Methodology:

A cross-sectional study including 2368 participants who answered a structured survey. The survey had some information about basic demographic characteristics including age, education, gender, physical examination level, and place of residence. The second part of the survey will be measuring knowledge about drinking different kind of tea to booster immunity against COVID-19.

Results:

Both gender have participate in this study with a ratio of 2:1 female more than male both within the age group of 30–50 years and 76.4% have higher educational level, 78.2% married and majority 55.8% and 30.4% from central and western areas of Saudi, respectively. The majority 69% consider drinking tea is part of their daily habit and mostly 44.3% drinking black tea, with 15% increase of tea consumption during the quarantine and that consumption increased to more than five cups a day by 2.2%. Regarding the source of knowledge about immune boosting benefits of tea majority specified their source is self-developed, family tradition and media during the quarantine period. The association between body mass index (BMI) and drinking tea showed strong significance among normal overweight groups and statistical significance of increase consumption related to high BMI categories.

Conclusion:

Saudi traditional tea drinking habit and knowledge of health benefits of such a routine have helped them during the threatening time as COVID-19 pandemic and stressing time of quarantine.
Attitudes of Saudis Toward Social Media use During Emergencies and Disasters
Authors: Al Shebani Mashal Mnahi , Khan Anas A.
Published: September 2024

Introduction:

Social media is the most commonly used method of communication during emergency and disaster events. The prompt contribution of social media in emergency management has lately captured the imagination of governmental organizations and researchers. This study explores the attitudes of Saudis toward social media use during emergency and disaster events.

Materials and Methods:

A cross-sectional study was conducted via an electronic questionnaire sent to all Saudis across all regions of Saudi Arabia. Data were collected using a valid self-administered questionnaire. The questionnaire solicited demographic details of survey participants and their attitudes toward social media, particularly regarding emergency and disaster events.

Results:

A total of 385 respondents were included in this study. Respondents reported that they used TV news channels (89%), followed by local radio (82%), online news (61%), and social media (43%). Most respondents used WhatsApp (61.0% always and 20.0% frequently). Significant differences in the general use of social media among participants from different age groups (P < 0.001), gender (P < 0.012), and education levels (P < 0.0001) were noted. About 35% of respondents used social media for information during emergencies and disasters. Of the participants who used social media in this context, 86% sought information regarding weather conditions or warnings/advisories. A majority of the participants indicated that the information extant on social media during emergencies and disasters is available more quickly and is more accessible when compared with other channels (86.4%, 77.6%). A majority of the participants exhibited a positive attitude toward the future use of social media for information on emergencies and disasters (81.8%, mean = 4.16). Approximately 57.7% of participants stated that they were unaware of Facebook Safety Checks, and 35% of them were unaware of Twitter Alerts.

Conclusion:

This study revealed that the attitudes of Saudis toward the use of social media either for general use or during emergencies were similar to those in other studies.
Malnutrition in Cancer Patients Receiving Chemotherapy in a Single Oncology Center
Authors: Alsaleh Khaled , Almomen Firas A , Altaweel Abdullah , Barasain Omar , Alqublan Abdullah , Binsalamah Abdulrahman , Almashham Abdulrahman
Published: September 2024

Background:

Cancer patients face a high risk of developing malnutrition due to cancer itself and as an adverse effect of receiving chemotherapy rounds.

Objectives:

The aim of this study is to estimate the prevalence of malnourishment in cancer patients receiving chemotherapy in an oncology center in Riyadh, to identify the biometric characteristics that are associated with changes due to receiving chemotherapy, and to identify possible associated risk factors affecting nutritional status.

Methodology:

A cross-sectional study was conducted at an oncology center in Riyadh, Saudi Arabia, in 2018. The scored patient-generated subjective global assessment (PG-SGA), which is a global tool used to assess the nutritional status in cancer patients, was distributed among 126 patients, with 116 (92.1%) patients responding, and of which 110 (87.3%) were ultimately selected for participation. We assessed the associated risk factors of malnutrition, and inquired about cancer type, location, age, current residence, and social support. Past laboratory results (albumin, hemoglobin, mean corpuscular volume, and creatinine) were obtained from the patients' records.

Results:

Fifty-seven of the participants (51.8%) were malnourished according to the PG-SGA scoring system (Class B and C PG-SGA), and the other 53 participants (48.2%) were well-nourished (Class A PG-SGA). Out of the 57 malnourished patients, 39 (68.42%) were moderately malnourished (Class B PG-SGA), and 18 (31.58%) were severely malnourished (Class C PG-SGA).

Conclusion:

There is a statistically significant correlation between chemotherapy, cancer, and malnourishment. Intervention is required to improve the detection of the condition and increase both awareness and nutritional status of the affected patients.
Plastination - A method for preservation of oral hard and soft tissue biopsy specimen v/s the conventional method of preservation with formalin
Authors: Shetty Urvashi A. , Dinakar Chethana , D’Cruz Audrey M. , Shetty Pushparaja , Prabhu Vishnudas
Published: September 2024

Context:

Plastination is one of the most advanced method for preserving perishable biological specimen as well as tissue samples as for a longer period of time using polymers.

Aims:

To evaluate the changes in dimension of hard and soft tissue specimens after plastination procedure and compare it with the conventional method of preservation in formalin.

Settings and Design:

Institution-based retrospective study.

Methods and Material:

The study included 20 formalin-fixed soft tissue and 10 formalin-fixed hard tissue specimens. All the specimens were plastinated which involved four basic steps of fixation, dehydration and defatting, impregnation with polymer and curing of polymer followed by finishing and storage. The specimens were analysed for shrinkage and dimensional changes and changes in colour and consistency between formalin-fixed specimen and plastinated soft tissue and hard tissue specimen.

Statistical Analysis Used:

Descriptive statistics were used.

Results:

After plastination, soft tissues showed average shrinkage of 3.49%with a range of 0.80–7.90% in comparison to the original size. In case of teeth and hard tissue specimen, there was no evidence of dimensional changes or shrinkage before and after plastination. Changes in colour and consistency of the soft tissue specimens were also noted before plastination and after plastination.

Conclusions:

Although the plastinated specimens in the current study showed minimal shrinkage rate, they have proved to be an excellent alternative to formalin-fixed specimens as they are easy to handle and maintain, non-infectious, non-toxic, user-friendly.
Expression of immune checkpoint protein in oral squamous cell carcinoma and its clinicopathological correlation: A tertiary care center cross-sectional study
Authors: Ratnakar Sonal , Kumar Madhu , Maurya Malti K. , Qayoom Sumaira , Sagar Mala , Babu Suresh , Kumar Vijay
Published: September 2024

Background:

Recent evidence suggests that oral squamous cell carcinoma (OSCC) patients who exhibit the immunohistochemical expression of immune checkpoint protein programmed cell death ligand 1 (PD-L1) are more likely to have a poor clinical outcome and may serve as an independent prognostic marker.

Aims and Objectives:

This study aimed to assess the immunohistochemical expression of immune checkpoint protein PD-L1 in OSCC and its clinicopathological correlation.

Materials and Methods:

OSCC cases were included in the study. This was a tertiary care center cross-sectional one-year duration study. Histomorphological diagnosis and immunohistochemical expression of PD-L1 were performed after taking ethical clearance. The statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 21.0 statistical analysis software.

Results:

A total of 106 cases of OSCC were included in the study. Histologically, the majority of cases (58.5%) were graded as well differentiated, followed by moderately differentiated (58.5%) and poorly differentiated (4.7%), respectively. In PD-L1 immunohistochemical expression, score 1+ was accorded to 37 (34.9%), 2+ was accorded to 31 (29.2%), and score 3+ was accorded to 33 (31.1%) cases. Tumor size, pattern, depth of invasion lymphovascular invasion (LVI), and perineural invasion (PNI) were found to be significantly associated with PD-L1 immunohistochemical scores.

Conclusions:

We concluded that the immunohistochemical expression of immune checkpoint protein PD-L1 positivity in tumor cells was seen in the majority of the cases (60.37%) in our patient. This suggests that the PD-1 or PD-L1 pathway plays a significant role in tumor immune evasion in OSCC.
Comparative analysis of cheiloscopy, pulpal tissue and fingerprint for gender identification
Authors: Nayak Anjali , Nayak Meghanand T. , Solanki Jitender , Mathur Hemant , Srivastava Apurva , Gupta Apoorva
Published: September 2024

Background:

The most important step in identifying an unknown person is determining one’s gender and as a dentist, the oral tissues are potential sources of information in this aspect. A study was carried out to assess and evaluate the accuracy of cheiloscopy, pulp tissue, and fingerprints in determining gender.

Material and Methods:

A study comprising of 160 individuals (80 males and 80 females) was conducted. After obtaining informed written consent and recording their bio-data; lip prints, and fingerprints were recorded. The patients’ extracted tooth was collected, their pulp extirpated, for assessment of the Barr body.

Results:

We found that every lip pattern was unique and hence can be used to identify an unknown individual. The occurrence of the Barr body was determined, and all female samples were found to be positive for the existence of the Barr body. In fingerprint patterns, a significant difference was noted between both sexes with ulnar loops and whorl patterns only. A highly significant difference was observed in the fingerprint ridge density between genders.

Conclusions:

We conclude that the Barr body in pulpal tissue can be considered as the best possible technique for gender determination within the dental tissues. Lip prints did not show any differences in genders and had no role to play in gender determination. Fingerprint ridge density can also be used to determine gender.
Understanding the approach to interpretation and challenges in measurement of pathological depth of invasion in oral squamous cell carcinoma: A cross-sectional survey of oral and maxillofacial pathologists in India
Authors: Rath Rachna , Smitha T , Bhatta Archana , Nagar Saurabh R. , Mishra Sudhasmruti , Sharma Gaurav
Published: September 2024

Objectives:

To understand the approach to interpretation along with challenges encountered in assessing pathological depth of invasion (pDOI) in oral squamous cell carcinoma (OSCC) as per 8th Edition of TNM-AJCC staging among oral and maxillofacial pathologists in India.

Method and Materials:

A cross-sectional web-based survey was conducted (May 2021–October 2021) with a pre-validated 21-item questionnaire. Responses were stored in a Microsoft Excel worksheet and analysed by descriptive statistics using SPSS v 25.0.

Results:

About 69.7% of the 267 respondents correctly defined pDOI while 13.1% measured the same from tumour surface. Among those not reporting pDOI, one-third of respondents (36.6%) lacked requisite awareness about 8th edition staging while more than half of them (55.4%) lacked proper tools to measure. The vst majority of the oral pathologists found pDOI measurement practically challenging (85.8%), mostly with difficulty in obtaining adjacent normal mucosa (77.9%). Selection of reference points of adjacent normal mucosa was divided between deepest point of rete ridge (43.1%), the closest rete ridge (28.8%) and the tip of highest submucosal papilla (15%).

Conclusion:

Underreporting of pDOI was observed owing to inherent challenges in measurement, thus ostensibly substituted with tumour thickness. Elaboration on reference points of adjacent normal mucosa is awaited.
Angiofibroma of the mandible: Rare sight for juvenile tumor
Authors: Khan Mohammad I. , Khare Abhisheik , Ali Iqbal , Nasir Abdullah
Published: September 2024

Angiofibroma also called juvenile nasopharyngeal angiofibroma are tumors of adolescence and the commonest site is the nasopharynx. Extra nasopharyngeal sites include upper respiratory and digestive tracts, oral cavity, tonsils, larynx, trachea, and esophagus. Intraosseous angiofibroma is the rarest of a rare entity.
Evaluation of extracellular matrix changes among oral submucous fibrosis and oral squamous cell carcinoma patients of Malwa region of Punjab using special histochemical stains: An insight into cancerous transformation
Authors: Gandhi Piyush , Singh Harkanwal P. , Thippeswamy Halappa S. , Sodhi Surinder P. S. , Kaur Mandeep , Laskar Neha
Published: September 2024

Background:

To assess extracellular matrix changes among oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC) patients using special histochemical stains.

Materials and Methods:

Twenty biopsy specimens of OSMF and 30 biopsy specimens of OSCC were included in the present study. Among 20 OSMF specimens, 10 were of early OSMF and the remaining 10 were of advanced OSMF. Out of 30 OSCC specimens, 10 cases each were of well-differentiated OSCC, moderately differentiated OSCC and poorly differentiated OSCC. Three sections, each 4 μm thick, were obtained from all specimens. One section was stained with routine H&E staining, whereas the other section was stained with Masson’s trichrome (MT) stain for collagen and Verhoeff–Van Gieson (VVG) for elastic fibres. Evaluation of all specimens was performed under the light microscope. The arrangement of collagen fibres and elastic fibres was compared between the OSMF group and OSCC group, in between different grades of OSMF and in between different grades of OSCC. The results were evaluated using SPSS software.

Results:

Early OSMF cases were associated with fibrosis in the superficial lamina propria, whereas advanced OSMF had fibrosis involving deeper muscle fibres. In all early OSMF cases, elastic fibres were arranged in thin bundles, whereas in advanced OSMF cases, elastic fibres were in thick bundles. In well- and moderately differentiated OSCCs, the collagen fibres were arranged in thick bundles and in poorly-differentiated OSCCs, the collagen fibres appeared to be fragmented. The elastic fibres in well-differentiated OSCC and moderately-differentiated OSCC were thickly arranged, and poorly-differentiated OSCC showed thin fibres and 70% of cases showed the absence of elastic fibres.

Conclusion:

Changes observed in both collagen and elastic fibres in the extracellular matrix (ECM) can be taken as a study model to further understand the progression of OSMF to OSCC using histochemical stains.
Immunohistochemical expression of E-Cadherin and Cyclin D1 in different grades of oral squamous cell carcinoma
Authors: Dar Mohammad S. , Abbas Rezhat , Shah Zeenat , Latoo Suheel H. , Gowhar Owais
Published: September 2024

Background:

Oral squamous cell carcinoma (OSCC) is the most common oral malignancy, representing up to 80–90% of all malignant neoplasms of the oral cavity. It results from the multistep accumulation of heterogeneous genetic changes. Important risk factors for OSCC include the use of tobacco or betel quid chewing, alcohol consumption, human papillomavirus and poor nutrition. E-Cadherin as a tumour suppressor gene sets a threshold for Wnt/β-catenin signalling. When expression of E-Cadherin is lost, potentiation of Wnt signalling pathway occurs leading to loss of cell–cell adhesion. The cyclin D1 gene (CCND1) located on chromosome 11q13 encodes a nuclear protein that is the regulatory subunit of Cdk-4 and Cdk-6. Cyclin D1 plays a major role in cell cycle transition from G1 to S phase by contributing to inactivation of the retinoblastoma gene product, and overexpression of CCND1 has been reported in 35–40% cases of OSCC.

Aim:

Considering this, we decided to evaluate and compare the expression of CE-Cadherin and Cyclin D1 in different grades of OSCC.

Materials and Methods:

A retrospective study was carried out on 60 formalin-fixed paraffin embedded tissue blocks comprising of 20 cases of well-differentiated OSCC, 20 cases of moderately differentiated OSCC and 20 cases of poorly differentiated OSCC. Diagnosed (using H and E), with oral mucosa taken as control.

Results:

There was downregulation of E-Cadherin and overexpression of Cyclin D1 in increasing grades of OSCC and the difference was statistically significant. E-Cadherin was localised to membranous and shifted to cytoplasm as the grade worsened. Cyclin D1 was localised to nuclei of cells and the expression was seen more at the peripheral portions of tumour islands depicting the proliferative activity of tumour front.

Conclusion:

The study revealed a good prognostic role of both E-Cadherin and Cyclin D1 in OSCC. The markers can be used for prognostic as well as therapeutic purposes.
Role of dry ice in decoverslipping of microscopic slides: A new insight
Authors: Sabarinath B , Protyusha GB , Sivapathasundharam B , Dhanarathna S
Published: September 2024

Background:

The process of decoverslipping is often required in a laboratory to review or examine an older slide which tends to fade over time, making it almost impossible to use it for research or study purposes. The sections then need to be re-stained which can only be done after removing the coverslip. The traditional method of decoverslipping using xylene is a time-consuming process. Various methods have been used in the past; however, none were found to be completely effective. Dry ice, the solid form of carbon dioxide, is an easily available, cheap cooling agent with a low freezing temperature (−78.5°C) which was evaluated for its efficacy in decoverslipping process, as an alternative to xylene.

Materials and Method:

64 faded haematoxylin and eosin (H&E)–stained histopathology slides were randomly selected and segregated, according to duration of year, into eight major groups. Each group was further divided into four subgroups according to the time that the slides were subjected for decoverslipping. The slides were placed on dry ice and the time was set. Once the coverslip was removed, the slides were placed in xylene to remove any residual mountant. The tissue sections were evaluated for physical disfigurement followed by re-staining with H&E to check for any change in tissue morphology.

Result:

The mean time taken for removal of coverslip using dry ice was 35 seconds.

Conclusion:

This technique is easy, fast, and effective, with no tissue loss or compromise in staining quality, thereby preventing xylene toxicity and its effect on the environment.
A massive dentinogenic ghost cell tumor that crossed the midline: A rare case report
Authors: Sangamithra S , Sukumaran Gheena , Ramani Pratibha , Ramasubramanian Abilasha , Krishnan Reshma Poothakulath
Published: September 2024

Dentinogenic ghost cell tumor (DGCT) is a rare tumor of odontogenic origin. A locally invasive lesion can be described by the presence of ameloblast-like epithelial islands, ghost cells, and dentinoid material. It is one of the few lesions with a predilection for the Asian population. The available literature has revealed that only 131 cases to date have been reported and published from 1968 to 2022. The following is a case report of a 25-year-old male with a tumor in the left lower back teeth region for the past 1 month. Orthopantomogram (OPG) reveals a well-defined unilocular radiolucency extending anteroposteriorly and crossing the midline. Histopathology revealed basal ameloblast-like cells and central stellate reticulum-like cells with the characteristic presence of ghost cells. The diagnosis was made based on the clinical, radiographical, and histopathological correlation and was confirmed using immunohistochemical analysis as a DGCT.
Role of immunohistochemistry in diagnosing round-cell tumours affecting the oral and maxillofacial regions
Authors: Kaur Harpreet , Mishra Deepika , Kakkar Aanchal , Roychoudhury Ajoy
Published: September 2024

Background:

One of the most challenging spectra of lesions in the oral and maxillofacial region (OMFR) are round-cell tumours (RCTs). They show a considerable degree of overlap in microscopy and immunophenotypes. The main aim of this study is to analyse the spectrum of RCTs encountered in the oral and maxillofacial regions. We emphasise the role of immunohistochemistry (IHC) which in conjunction with histological, clinical, and imaging findings is necessary for their correct characterisation. The secondary objectives are to discuss differential diagnosis, workflow, and diagnostic algorithm for round-cell lesions affecting the OMFR.

Methods:

Formalin-fixed, paraffin-embedded sections of RCTs were retrieved from the archives of the Department of Oral Pathology (January 2018 to March 2020). These cases were analysed by three pathologists independently by evaluating haematoxylin and eosin-stained sections, and immunohistochemical markers employed to characterise these lesions.

Results:

Under the spectrum of RCTs, 11 cases (0.53%) were diagnosed with a predominance of non-Hodgkin lymphoma (55%) followed by Ewing sarcoma (18%). The remaining were Langerhans cell histiocytosis (9%), neuroendocrine carcinoma (9%), and sinonasal undifferentiated carcinoma (9%). Except for one case, in all cases, the final diagnosis was established with the use of adjunctive IHC.

Conclusion:

RCTs can pose a diagnostic challenge for inexperienced oral pathologists. Thorough knowledge of the differentials of RCT occurring in oral and maxillofacial is helpful. An algorithm-based diagnostic approach incorporating the clinical, imaging, and histomorphological findings and immunohistochemical evaluation can help in minimizing diagnostic confusion and errors.
Expression of anti - Apoptotic survivin in odontogenic keratocyst, adenomatoid odontogenic tumor and ameloblastoma
Authors: Latha H. Aparna , Prakash A. Ravi , Kanth M. Rajini , Reddy A. Vikram Simha , Sreenath G. , Vidya Karanam S.
Published: September 2024

Background:

The process of odontogenesis is complex involving epithelial–mesenchymal interactions, along with the molecular signalling pathways triggering the initiating process. The triggering factors and cells precisely involved in the pathogenesis of odontogenic cysts and tumors are unknown. There is a vast array of biomarkers used to stain different sites, thereby helpful in diagnosing and evaluating the prognosis of these cysts and tumors. In the following study, Anti Apoptotic survivin expression patterns were assessed quantitatively in 48 samples (12 each) of Reduced Enamel Epithelium, Adenomatoid Odontogenic Tumor, Odontogenic Keratocyst and Ameloblastoma.

Aim:

The Aim of this study is to assess the anti-apoptotic survivin expression in Reduced Enamel Epithelium, Adenomatoid odontogenic tumour, Odontogenic Keratocyst and Ameloblastoma.

Materials and Methods:

The present study is carried out with 12 samples in each group. Routine hematoxylin and eosin staining was performed for confirmatory diagnosis. Later Immunohistochemistry was performed using survivin antibody. Survivin protein expression was analyzed using the parameters like location, intensity, percentage of cells positivity with survivin protein and extent of staining. With the help of Olympus BX 43 microscope, with ProgRes microscope camera, the 48 slides obtained were examined. The region of interest was selected in each slide and number of cells positively stained was counted. Data was analyzed using SPSS software version 23. Descriptive for scale data, results were analysed by using ANOVA with Chi-square test for intergroup comparison.

Results:

The results showed significant P value <0.05. Expression of survivin was highest in Ameloblastoma, followed by Odontogenic keratocyst, Adenomatoid odontogenic tumor, and Reduced Enamel Epithelium.

Conclusion:

Survivin was involved in the inhibition of apoptosis as well as the detailed understanding of the biological behaviour of odontogenic cysts and tumours, thereby increasing therapeutic approaches.