ABSTRACT
Background: Galectin 3 (Gal?3) has diverse functions critical in cancer biology including cell proliferation, apoptosis, evasion of immune responses and angiogenesis. The expression of Gal?3 is heterogeneous in normal and neoplastic tissues. In oral squamous cell carcinoma (OSCC) and oral leukoplakia (OL), both increased and decreased expressions of Gal?3 were elicited in numerous studies. Aims: To evaluate, compare and correlate the immunohistochemical expression of Gal?3 in OSCC, OL and normal oral mucosa. Settings and Design: The study was conducted at the Department of Oral Pathology and Microbiology at PMS College of Dental Science and Research, Vattapara, Thiruvananthapuram. This is a retrospective analytical study. Methods and Material: Clinically diagnosed and histopathologically confirmed cases of OSCC (n = 21), OL (n = 21), and normal oral mucosa (n = 21) were included in the study. Paraffin?embedded tissues were subjected to immunohistochemical analysis for Gal?3 expression. Gal?3 staining expression, staining distribution and cellular localisation were evaluated. All sampled categories were compared using immunohistochemical scoring analysis such as the H?score, labelling index (LI), immunoreactive score (IRS) and staining intensity (SI). Statistical Analysis: The results were statistically analysed using multivariate analysis of variance (MANOVA) within and among the groups. Results and Conclusion: The statistical inferences obtained found that the H?score could be used as a guideline for better differentiation between the groups and among the groups. The P value obtained was < 0.0125 and was found to be significant. The observation in our study shows that the immunohistochemical expression of Gal?3 gradually decreased from normal oral mucosa to OL to OSCC.
ABSTRACT
The aim of this study was to evaluate the knowledge and attitudes about Do Not Resuscitate orders, Advance Directives and Withdrawal or Withholding of life-sustaining therapy among medical professionals. Descriptive, cross-sectional study. The study was conducted in three teaching hospitals, General Hospital Kandy, Teaching Hospital Peradeniya and Teaching Hospital Gampola of Kandy District [Sri Lanka]. 232 medical professionals were randomly selected. Data were collected using a pre-tested self administered questionnaire. The knowledge and attitude was assessed with regard to 'Advance Directives', DNR orders and 'withdrawal/ withholding life sustaining care', by scenario based questions and several close-ended questions. Data were analyzed with SPSS v17.0 and Pearson Chi Square was calculated. The age range of the study population [n=232] was 26-56 years and majority of the participants were male [64.2%]. Most of the medical professionals were Buddhists [88.4%]. Out of the subjects, 66.8% [p<0.001] had heard the term 'DNR', while 26.3% knew the correct meaning and 68.1% [p<0.001] thought it to be ethical to practice it in Sri Lanka. The number of medical professionals feeling that patient, doctor or the family should have the right to decide on end-of-life decisions was 62.9% [p=0.005], 62.9% [p=0.005] and 46.6% [p=0.46] respectively. 20.7% had heard about 'Advance Directives' but only 12.1% knew the correct meaning; 62.5% had heard about 'withdrawal/withholding of life sustaining therapy' [p=0.006] and 65.9% opined that it should be implemented in Sri Lanka [p<0.001]. The knowledge about end-of-life decisions among medical professionals working in three major teaching hospitals of Kandy district is inadequate. The majority of the medical doctors have positive attitude towards end-of-life decisions implementation in Sri Lanka