Natural history of trigeminal neuralgia-A hospital-based retrospective study.

OBJECTIVE: The objective of this study was to assess the natural history of trigeminal neuralgia (TN) and pretrigeminal neuralgia (PTN) in a hospital-based sample using a retrospective and descriptive study design. METHODS: This study followed a retrospective study design, which yielded a sample size of 216 patients who were reclassified as per the new classification and diagnostic grading for practice and research proposed by the American Academy of Neurology. Based on an in-depth analysis of patient history and the treatments administered, a possible state of PTN prior to TN development was determined. RESULTS: TN shows a female predilection with predominantly unilateral involvement. A total of 45.83% of patients had left-side involvement with V3 primarily affected. Additionally, 11.11% of patients did not have any clinically apparent trigger zone, while 68.05% had a single trigger zone. Twenty-one patients were found to have suspected PTN prior to TN. The time interval between PTN onset and TN development ranged from 6 months to 6 years. The PTN pain varied, and the clinical overlap between the site of PTN and the site of future TN was 100%. CONCLUSION: An in-depth patient history can serve as a reliable modality for TN diagnosis. PTN should be considered as a differential diagnosis for pain of orofacial origin because of its overlapping features with other painful conditions.

GLUT-1 Expression: An Aid in Complementing the WHO Oral Epithelial Dysplasia Grading System.

AIM AND OBJECTIVES: The clinicopathologic parameters alone are not sufficient to precisely predict if oral potentially malignant disorders (OPMDs) remain unchanged, i.e., without any malignant changes, regress, or advance to oral squamous cell carcinomas (OSCC). Few of the OPMDs, with or without epithelial dysplasia, may transform to frank OSCC. Discovering various molecular markers that can predict OSCC transformation is essential to develop effective therapeutic strategies. GLUT-1 is one of the hypoxia as well as metabolic indicator markers that have been used to study the metabolic activity of the cells. Hence, given by the World Health Organization (WHO), GLUT-1 expression was studied in various grades of dysplasia to see whether it complements the WHO grading system (mild, moderate, and severe). MATERIALS AND METHODS: The study was carried out on paraffin-embedded tissues of 10 normal oral mucosa and 30 OPMD cases. OPMD cases were classified into hyperkeratosis, mild dysplasia, moderate dysplasia, and severe dysplasia groups. Immunohistochemistry was carried out to evaluate the expression of GLUT-1 antigen. RESULTS: According to the WHO grading system of dysplasia, 11 (36.66%) cases were classified as hyperkeratosis, 9 (30%) cases were classified as mild dysplasia, 6 (20%) cases as moderate dysplasia, and 4 (13.33%) cases as severe dysplasia. There was a significant increase in GLUT-1 expression from normal to mild, moderate, and severe dysplasia (p value = 0.00). CONCLUSION: The expression of GLUT-1 marker complements the WHO grading system of oral epithelial dysplasia. CLINICAL SIGNIFICANCE: GLUT-1 expression can be used to complement the WHO grading system to grade epithelial dysplasia.

Oral Potentially Malignant Disorders: Etiology, Pathogenesis, and Transformation Into Oral Cancer.

Among oral diseases, oral cancer is a critical health issue due to its life-threatening potential. Globocan, in its 2020 report, estimated ∼0.37 million new cases of oral cancer, with the majority of them coming from the Asian continent. The WHO has anticipated a rise in the incidences of oral cancer in the coming decades. Various factors, such as genetic, epigenetic, microbial, habitual, and lifestyle factors, are closely associated with oral cancer occurrence and progression. Oral lesions, inherited genetic mutations (dyskeratosis congenital syndrome), and viral infections (HPV) are early signs of oral cancer. Lesions with dysplastic features have been categorized under oral potentially malignant disorders (OPMDs), such as oral leukoplakia, erythroplakia, oral submucous fibrosis (OSMF), and proliferative verrucous leukoplakia, are assumed to have a high risk of malignancy. The incidence and prevalence of OPMDs are recorded as being high in South-Asian countries. Early detection, prevention, and treatment of OPMDs are needed to prevent its malignant transformation into oral cancer. Many advanced diagnostic techniques are used to predict their progression and to assess the risk of malignant transformation. This communication provides insight into the importance of early detection and prevention of OPMDs.

Evaluation of Candidiasis in Upper-Aerodigestive Squamous Cell Carcinoma Patients-A Clinico-Mycological Aspect.

Candida is a commensal yeast. It can be infective when the host's defense mechanism is weakened, as in the case of squamous cell carcinoma patients. We aimed to evaluate the prevalence and clinical mycological manifestation of candidiasis in 150 cancer cases comprised of preoperative and post-operative (with or without radiotherapy) upper aerodigestive squamous cell carcinoma. A total of 150 patients suffering from squamous cell carcinoma of the Upper Aero-Digestive Tract (UADT) were divided into preoperative (n = 48), post-operative without radiotherapy (n = 29) and post-operative with radiotherapy (n = 73). Samples were collected using cotton swabs and cultured. Candida species were identified according to color pigmentation on Candida Differential Agar (CDA) plate. The clinico-mycological association of patients was evaluated by the chi-square test, and 98 out of 150 patients showed the presence of various Candida species. The major species isolated was Candida albicans (53%), followed by Candida tropicalis (16%). There was a significant statistical difference between patients who showed mycological associations and patients who did not have any such association (p = 0.0008). The prevalence of oral candidiasis was found to be 65.33% among total cases of upper aero-digestive squamous cell carcinoma. Chronic erythematous cases of candidiasis were mainly seen in preoperative squamous cell carcinoma cases, whereas the acute erythematous type of candidiasis was mainly seen in post-operative cases who received radiotherapy. The clinicomycological assessment can help to correlate the signs and symptoms with the presence of candidiasis in upper aerodigestive squamous cell carcinoma patients. Meticulous testing and examination can help in the early detection of candidiasis. Future studies are needed to develop advance scientific preventive strategies for high-risk cases.

Comparative Study using Papanicolaou Stain and Silver-stained Nucleolar Organizer Region Counts in Exfoliative Smear of Oral Mucosa in Bidi Smokers and Nonsmokers.

AIM: The aim of this study is to compare the proliferative activity of exfoliated cells in bidi smoker's and nonsmoker's oral mucosa. MATERIALS AND METHODS: The oral mucosal exfoliate smears were prepared from 40 individuals (20 nonsmokers and 20 smokers) with the age group ranging from 25 to 70 years, in and around Akola (Maharashtra). The Papanicolaou (PAP) stain and silver-stained nucleolar organizer region (AgNOR) were used to prepare cytogenic smear to evaluate the presence of cytological alterations, suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. The present study involves PAP Class I and Class II smears. The obtained data were tabulated and statistically analyzed using statistical software IBM SPSS IBM Corp., Statistics for Windows, Version 20.0. Armonk, NY, USA: IBM Corp., and using t-test. RESULTS: There was a significant difference in mean number of AgNORs/nucleus between nonsmokers (0.947 ± 0.2533) and smokers (3.021 ± 0.2256). There were 90% inflammatory changes observed in smokers whereas nonsmokers showed only 75% changes. PAP Class II changes, i.e., significant proliferative activity, were found between smokers and nonsmokers mucosa. CONCLUSION: A significant difference of AgNORs/nucleus was found between nonsmokers and smokers.

Heritability and correlation of lip print, palm print, fingerprint pattern and blood group in twin population.

BACKGROUND: Twins are similar in many ways owing to the genetical and environmental factors. However, still, there are certain things that are not similar among them, and this is the challenge for personal identification among the twins. OBJECTIVES: Our present study aimed to know and assess the similarities and differences present between the monozygotic (identical) and dizygotic (fraternal) twins in relation to lip prints, palm prints, fingerprints and blood group and to evaluate their heritability among parents and their offspring. MATERIALS AND METHODS: The study group comprised 30 twins and their parents - 15 identical and 15 nonidentical twins. The age of twins ranged from 15 years to 40 years. Lip print, palm print, fingerprint and blood group were statistically analyzed. RESULTS: All the data were subjected to statistical analysis. The identical twins showed more percentage of similarities in comparison to the non identical twins. The inheritance pattern was significant for twins in case of their lip prints while palm prints and finger prints showed no such significance in inheritance pattern whereas there was significant association seen in case of blood groups of identical twins and their parents. CONCLUSION: Lip prints, palm prints, fingerprints and blood groups are the important parameters in forensic science for individual identification. Many studies have been done till now in individual but very few studies done in twin population. To the best of knowledge, ours is the first study of its kind with multiple parameters and its heritability in twins. We have observed that heritability in twins with relation to lip print was statistically significant and all the parameters can be used independently to identify the twins.

Non-Infiltrating Angiolipoma of Floor of Mouth-A Rare Case Report and Literature Review.

Angiolipoma, a subtype of lipoma is a benign tumour in which adipose tissue and vascular component are intermingled. The tumour occurs commonly in the trunk and extremities and very rarely seen in maxillofacial region. Here we report a case of Non-Infiltrating Angiolipoma (NIAL) in floor of mouth which is the second case to be reported in literature to the best of our knowledge. We have reviewed all NIAL cases involving the oral cavity from 2008 to 2016 and found 12 cases of NIAL and assessment was made according to age, sex, site and size of lesion for better understanding of the lesion and its nature.

Evaluation of myeloid cells (tumor-associated tissue eosinophils and mast cells) infiltration in different grades of oral squamous cell carcinoma.

BACKGROUND: The multifunctional involvement and infiltration of myeloid cells (tumor-associated tissue eosinophils [TATE] and mast cells) can provide a unique opportunity to define relevant effectors functions that may represent novel, therapeutic options for modulation of tumor onset/growth. AIM: Our study aimed to evaluate infiltration of myeloid cells (TATE and Mast cells) infiltration in different grades (WHO grading) of oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Total 30 cases of OSCC were selected for this study. Hematoxylin and eosin stain and toluidine blue special stain, to evaluate TATE and the mast cells infiltration, were used. Three-year follow-up of OSCC cases was done. RESULT: Among 30 cases, 63.33% cases of OSCC showed TATE-positive and 36.66% cases showed TATE-negative. Regarding mast cells infiltration, 66.66% OSCC cases showed mast cells positive and 33.33% cases did not show significant mast cells infiltration. We found significant association of TATE and mast cells infiltration in OSCC cases. These myeloid cells infiltration significantly associated with age of patients but did not show any significant association with gender, site, and habit of cases. When we compared these cells infiltration with clinical stages and different histological grades of tumor, we found their infiltration is decreasing, from Stages 1 to Stage 3 of tumor and from well to poorly differentiated carcinoma. We have also found the less infiltration of these myeloid in recurrence cases of OSCC. CONCLUSION: As the infiltration of TATE and mast cells are correlated, along with evaluation of TATE, we should also evaluate the presence of mast cells infiltration in OSCC. The assessment of myeloid cells could become, in the future, useful for therapeutic approaches in this subset of the patient.

High Flow AV Malformation (A-V Shunt) of Mandible: A Rare Life Threatening Entity.

Intraosseous Arteriovenous Malformations (AVMs) in the head and neck region are very rare and potentially life threatening entities due to massive hemorrhage. These are the results of an embryonic abnormality of the vascular system. Depending on the blood flow and clinical presentations they are of different types like slow flow and high flow AVM. Here we present a case of high flow AVM involving mandible with a chief complain of gingival bleeding in a four year old girl child.

Cancellous osteoma of maxilla: A rare case report.

Osteoma is a slow growing benign tumor result from either cancellous or compact bone proliferation. Osteoma of the jaws may arise from the surface of the bone as a sessile mass located either peripherally or endosteally. This paper presents a rare case report of peripheral cancellous osteoma, involving the buccal cortical plate and alveolar process of the right maxilla of a 37-year-old female patient.