Detection of ABO Blood Groups From Dentin and Pulp by Using the Absorption-Elution Technique: A Forensic Cross-Sectional Study Among the Population of the Al Jouf Province, Saudi Arabia.

Background and objective Human teeth have a significant forensic importance. As they are the hardest of all human tissues, they are not just chemically stable but also their characteristics are maintained for a long time after death even in the most harsh environmental conditions. Despite the advances made in DNA analysis, fingerprinting, etc., ABO blood grouping still plays a significant role in the forensic practice in the field of personal identification, paternity disputes, and several other scenarios including the identification of mass disaster victims. The term blood groups refers to inherited antigens on the surface of red blood cells (RBCs) detected by specific antibodies. Since tooth pulp contains numerous blood vessels, blood group antigens are most certainly bound to be present in tooth pulp. Various studies have shown that blood group antigens in the pulp and dentin are preserved as long as up to two years after the demise of an individual. Absorption-elution technique has been proven to be the most sensitive, reliable, and consistent method to determine the ABO blood group from both the pulp and dentine. This study aimed to ascertain the ABO blood group from both the hard (dentin) as well as the soft tissue (pulp) of the tooth by using the absorption-elution (AE) technique and also to determine if there are any variations in identifying the blood groups from the teeth based on age and gender. Material and methods After obtaining due consent, we included patients of both genders aged between 16-60 years visiting the outpatient department (OPD) clinics at the College of Dentistry for periodontal or orthodontic extractions. One patient's blood type was determined by using the slide agglutination technique before any capillary blood extraction was performed; this patient served as a control. For this investigation, we used the pulp and powdered dentin samples taken from the dental extractions to test for the presence of ABO and Rhesus (Rh) factor antigens by using the AE method. The study samples were compared with the control for blood group determination. Statistical analysis was carried out using the chi-square test with Monte Carlo (MC) simulation to check for any correlation of blood grouping with age and gender. Results The dentin and pulp were shown to have positive blood group antigens for the ABO and Rh factors. While neither pulp nor dentin performed significantly differently in identifying the blood group antigens, pulp showed marginally higher accuracy. There was no discernible difference regarding gender or age in the dentin or pulp of any of the 45 samples studied. Conclusions For determining an individual's blood type and Rh factor, both the hard (dentin) and soft (pulp) tissues of a tooth are valid sources. This is particularly helpful in forensic medicine cases where teeth are the only remains that can be viably used to find out a person's identity.

Assessment of Role of Platelet Indices in the Occurrence of Retinopathy of Prematurity.

PURPOSE: Platelets have a major role in the regulation of angiogenesis. Platelets have proangiogenic factors like vascular endothelial growth factor, which causes neovascularization of immature retina. However, there is no conclusive evidence to show that platelet indices have a role in retinopathy of prematurity (ROP). This study is aimed at assessing the role of platelet indices in the occurrence and need for treatment of ROP. METHODS: This prospective cohort study included the screening of preterm babies (<37 weeks of gestation with birth weight <2000 g). The samples of platelet indices (mean platelet volume [MPV], platelet count [PLT], plateletcrit [PCT], and platelet distribution width [PDW]) collected within 1st week of life were obtained from the electronic medical records and correlated to ROP status. Statistical analysis was done using SPSS version 22, and the Chi-square test and odds ratio were used for analysis. RESULTS: A total of 300 preterm babies were screened, of whom, 55 (18.3%) babies had ROP changes. The association of the presence of ROP changes and platelet indices was not statistically significant (P value being MPV [0.22], PLT [0.58], PCT [0.98], and PDW [0.17]). Similarly, the requirement of treatment for ROP (Type I ROP) could not be correlated with abnormal platelet indices (odds ratio at 95% confidence interval - MPV [6 (0.44-81.44)], PLT [1.7 (0.25-11.37)], PCT [3 (0.44-20.90)], and PDW [0.32 (0.33-3.05)]). CONCLUSION: Abnormal platelet indices did not show any significant risk with the occurrence or need for treatment of ROP.

An Ultrastructural Study on the Effect of High Temperatures on Teeth and Restorative Materials That Aids in the Identification of Human Remains.

INTRODUCTION: In most disasters, teeth are the only means of positive identification of an otherwise unrecognizable body, as there has been tremendous increase in the use of dental restorations that have different resistance to prolonged high temperature which is an important aid in identifying burned victims. Application of SEM/EDS in forensics was found useful in areas where there is a need for good imaging with high magnification combined with elemental analysis. The objective of this study was to analyze incineration effects on teeth and restorative materials using SEM/EDS. Materials and Method. 128 extracted teeth were collected, 96 were restored with silver amalgam, composite, and GIC of 32 each, and crown preparation was done in 32 teeth for which metal ceramic crowns were prepared. These teeth were subjected to 4 different temperatures (500°C, 700°C, 900°C, and 1100°C) for 20 minutes, and they were analyzed macroscopically and by using SEM for the changes subsequent to their exposure to such high temperatures. RESULTS: All the restorations which were very difficult to identify by naked eye were identified with the help of SEM/EDS. CONCLUSION: Elemental analysis of the specific restorative material proves to be an essential tool for the forensic odontologist.

Deletion of Nrip1 delays skin aging by reducing adipose-derived mesenchymal stem cells (ADMSCs) senescence, and maintaining ADMSCs quiescence.

Our previous studies found that deletion of nuclear receptor interacting protein 1 (Nrip1) extended longevity in female mice and delayed cell senescence. The current study investigates the role of NRIP1 in regulating functions of adipose-derived mesenchymal stem cells (ADMSCs) and explores the mechanisms of NRIP1 in skin aging. We first verified the skin aging phenotypes in young (6 months) and old (20 months) C57BL/6J (B6) mice and found deletion of Nrip1 can delay skin aging phenotypes, including reduced thickness of dermis and subcutaneous white adipose tissue (sWAT), as well as the accumulation of senescent cells in sWAT. In ADMSCs isolated from sWAT, we found that deletion of Nrip1 could decrease cell proliferation, prevent cell apoptosis, and suppress adipogenesis. Interestingly, deletion of Nrip1 also reduced cell senescence and maintain cell quiescence of ADMSCs. Moreover, the expressions of genes associated with senescence (p21, and p53), inflammation (p65, IL6, and IL1a), and growth factor (mTOR, Igf1) were reduced in Nrip1 knockout ADMSCs, as well as in siNrip1-treated ADMSCs. Suppression of Nrip1 by siNrip1 also decreased the expressions of mTOR, p-mTOR, p65, and p-p65 in ADMSCs. Reduced expressions of p65 and p-p65 were also confirmed in the skin of Nrip1 knockout mice. These findings suggest that NRIP1 plays an important role in delaying skin aging by reducing ADMSCs senescence and maintaining ADMSCs quiescence.

Frequency and Characteristics of Mesiodens in Indian School Children: A Retrospective Radiographic Study

Abstract Objective: To determine the frequency and characteristics of mesiodens in Indian school children. Material and Methods: 1232 radiographs of patients attending the Department of Oral Medicine and Radiology of the age group of 4-15 years studied for the present retrospective study. The intraoral periapical radiographs and occlusal radiographs of the premaxilla were examined to determine the presence of mesiodens. The data regarding the presence of mesiodens, number, position, location on the arch, shape and associated complications were recorded. Results: Eleven patients had 14 mesiodens, with a frequency of 0.8%. The ratio of boys to girls was 1.2:1. Maximum mesiodens observed in the age group of 7-9 years. Most of the mesiodens were conical in shape and found on the palatal side. Fifty percent of the mesiodens were unerupted. The majority of patients (57.1%) had vertically positioned mesiodens. Midline diastema was the most common complication due to mesiodens (66.7%). Conclusion: Routine check-up during the primary dentition and mixed dentition stages helps for early detection of mesiodens and thus preventing complications. Early identification is useful for planning comprehensive management, initiating proper consultation and referral for evaluation and treatment.

Ameloblastic fibrosarcoma - A rarity?

Ameloblastic fibrosarcoma (AFS) is a rare malignant odontogenic tumour classified by the WHO (1992) as an odontogenic sarcoma and defined as "a neoplasm with a similar structure to ameloblastic fibroma (AF) but in which the ectomesenchymal component shows the features of a sarcoma." The first report of AFS was published by Heath in 1887. AFS and related lesions are less frequently diagnosed than odontogenic carcinomas. Approximately two-thirds of AFSs seem to arise de novo, but others have developed in recurrent AF, in which the ectomesenchymal cells retain their embryonic appearance and develop malignant characteristics. We report a rare case of an aggressive odontogenic neoplasm, the incisional biopsy of which showed the features of AF, while the excisional biopsy revealed the features of malignancy, suggestive of AFS. The purpose of this report is to discuss the diagnostic difficulties, whether AFS is truly an extremely rare tumour as reported earlier and, lastly, should the treatment protocols of AFs be revised, as 44% of AFSs arise from recurrent AFs.

Analysis of prenatal and postnatal risk factors of retinopathy of prematurity in a tertiary care hospital in South India.

CONTEXT: Recent advances in neonatology have influenced the incidence and severity of ROP in a dichotomous fashion. AIMS: To determine the incidence of ROP and to analyse its risk factors. SETTINGS AND DESIGN: Prospective clinical case series. MATERIALS AND METHODS: 282 preterm infants with birthweight < 1500 g and/or gestational age ≤ 32 weeks and also those with gestational age > 32 weeks, with birthweight between 1500-2000 g, who were at risk for ROP were selected. Weight gain proportion was measured as weight at 6 weeks minus birthweight divided by birthweight. STATISTICAL ANALYSIS: Univariate and multivariate logistic regression. RESULTS: Incidence of any ROP was 21.6% while severe ROP was 6.7%. Prenatal factors like multiple gestation (P = 0.510) and antenatal steroids (P = 0.104) were not significantly associated with ROP. On multivariate analysis, postnatal factors like weight at birth < 1250 g (P = 0.01) and gestational age between 31-32 weeks (P = 0.02) were independent risk factors for any ROP, while intraventricular hemorrhage (P = 0.03) was the only independent risk factor for severe ROP. Mean birthweight of infants with severe ROP was 1056 µ 207 g (P = 0.004), which was significantly low. After logistic regression, the mean weight gain proportion at 6 weeks, of those neonates with severe ROP was 30%. CONCLUSIONS: Low birthweight and prematurity were the most important risk factors for developing any ROP, while intraventricular hemorrhage was the independent risk factor for developing severe ROP. The mean postnatal weight gain at 6 weeks was not statistically significant in neonates with severe ROP.

Eye donation - awareness and willingness among attendants of patients at various clinics in Melaka, Malaysia.

AIM: Corneal blindness accounts for 3.42% of blindness in Malaysia; the rate of eye donation is low. The aim of the study was to assess the awareness about eye donation and willingness to donate eyes among attendants of patients at various clinics in Melaka, Malaysia. MATERIALS AND METHODS: This observational study was conducted on attendants who accompanied patients (n = 400) visiting various outpatient departments of the General Hospital and two peripheral clinics in Melaka between August and October 2007. The participants answered a questionnaire (Malay and English versions) which included demographic profile, awareness of eye donation, knowledge regarding facts of eye donation, and willingness to donate eyes. Univariate and multivariate logistic regression was performed at 5% level of significance. RESULTS: Awareness of eye donation was observed in 276 (69%) participants. Multivariate analysis showed that awareness was more among females when compared to males (P = 0.009). Of the 276 participants who were aware of eye donation, only 34.42% were willing to donate eyes. Willingness was more among the Indian race (P = 0.02) and males (P = 0.02). Educational status did not influence the willingness to donate eyes. CONCLUSIONS: Although majority of participants were aware of eye donation, willingness to donate eyes was poor.

The clinical behavior of mixed ductal/lobular carcinoma of the breast: a clinicopathologic analysis.

BACKGROUND: To date, the clinical presentation and prognosis of mixed ductal/lobular mammary carcinomas has not been well studied, and little is known about the outcome of this entity. Thus, best management practices remain undetermined due to a dearth of knowledge on this topic. METHODS: In this paper, we present a clinicopathologic analysis of patients at our institution with this entity and compare them to age-matched controls with purely invasive ductal carcinoma (IDC) and historical data from patients with purely lobular carcinoma and also stain-available tumor specimens for E-cadherin. We have obtained 100 cases of ductal and 50 cases of mixed ductal/lobular breast carcinoma. RESULTS: Clinically, the behavior of mixed ductal/lobular tumors seemed to demonstrate some important differences from their ductal counterparts, particularly a lower rate of metastatic spread but with a much higher rate of second primary breast cancers. CONCLUSIONS: Our data suggests that mixed ductal/lobular carcinomas are a distinct clinicopathologic entity incorporating some features of both lobular and ductal carcinomas and representing a pleomorphic variant of IDC.

Descriptive study on ocular survival, visual outcome and prognostic factors in open globe injuries.

A prospective observational study was done to assess ocular survival, visual outcome and prognostic factors of open globe injury. Eighty eyes of penetrating trauma between 2004 and 2006 were categorized according to the ocular trauma classification system. Primary repair was done and outcomes were assessed at one, three and six months. The final vision was categorized as per World Health Organization classification of visual impairment. Factors at presentation were evaluated for prognostic value towards visual outcome. Sixty-nine eyes with minimum one month follow-up were included for analysis. Statistical analysis was done using Univariate and Multivariate analysis. We found Grade IV visual acuity (< 5/200) at presentation (64%) as the most important factor contributing to poor visual outcome. Statistically insignificant factors were time since injury, cataract, and presence of intraocular foreign body. Ocular survival was 97%. We concluded that initial visual acuity, hyphema, zone and length of injury, retinal detachment and vitreous hemorrhage are statistically significant factors affecting outcome in open globe injuries.

Tumor suppressor function of Rab25 in triple-negative breast cancer.

Rab proteins are a group of ubiquitously expressed proteins that are responsible for intracellular transport of vesicles. Recent evidence has shown that certain Rab proteins are involved in the pathogenesis of cancer. We have recently shown that Rab25 is lost in a large fraction of breast cancer samples, particularly those derived from hormonally insensitive tumors. We have further investigated the role of Rab25 by re-expressing Rab25 in tumorigenic cell lines and measuring the impact on tumor formation as well as on various molecular pathways through PCR array analysis. In vivo tumor growth of cell lines with re-expressed Rab25 was markedly suppressed. Our data suggest that Rab25 acts through multiple pathways to enhance apoptosis and to suppress angiogenesis and invasion by modulating VEGF-A and VEGFR-1 expression. These findings suggest that Rab25 represents a novel class of cellular modulators that can influence both tumor initiation and the progression of the established tumors, thus ultimately affecting the biology of the malignant disease.

Bilateral macular hole secondary to remote lightning strike.

We report a case of a 16-year-old girl, who was struck by lightning, and experienced blurred vision in the right eye (RE) immediately following the episode. She reported for ophthalmic evaluation two months later. Examination revealed relative afferent pupillary defect in the RE. Posterior subcapsular cataract was noted in both eyes. Fundus examination revealed macular holes and multiple areas of RPE hyperpigmentation in the periphery in both eyes. Fundus fluorescein angiography showed increased choroidal transmission with early fluorescence and late fading in the foveal region and retinal pigment epithelium (RPE) stippling in the periphery in both eyes. This is the first case report of such nature in India to the best of our knowledge.

Recurrent Respiratory Papillomatosis (RRP)-Juvenile Onset.

In this article, we describe the treatment of long standing juvenile-onset recurrent respiratory papillomatosis (JORRP) with eventual transformation to carcinoma in a patient who lived to the age of 73. Treatment modalities consisted of bronchoscopy and local excision initially. Later, YAG and CO2 laser debulking were used. Radiotherapy, chemotherapy with carboplatin (300 mg/m2) and 5-FU (600 mg/m2), oral methotrexate (5-7.5 mg/week), pegylated Interferon, indole-3-carbamide, and intralesional cidofovir were also utilized in the treatment of this patient. Except for methotrexate, each of the treatment regimens used in this patient, initially decreased growth of the papillomas and improved symptoms experienced by the patient. Interestingly, we found that this patient's long standing JORRP initially responded to a chemotherapy regimen of 4 cycles of carboplatin (300 mg/m2) and 5-FU (600 mg/m2) as well. Ultimately, the disease became resistant to all forms of treatment and progressed. The patient eventually succumbed to the disease after an approximate 77 year course.