Expression of CD44 and SALL4 in Leukoplakia and Oral Squamous Cell Carcinoma.

CD44 and SALL4 are markers of stemness and expressed in cancer stem cells (CSCs). Their deregulated expression was seen in various tumors and has been correlated with clinical severity. We evaluated immunohistochemical expression of CD44 and SALL4 in leukoplakia and oral squamous cell carcinoma (OSCC). CD44 was expressed in all the cases of leukoplakia and Its expression correlated with severity of the dysplasia in leukoplakia but varied with differentiation in OSCC. SALL4 did not express in leukoplakia. Its expression was varied in OSCC cases. We opine that CD44 expression is consistent with the progression of dysplasia in leukoplakia and differentiation in OSCC.

Comparative evaluation of immunohistochemical expression of MCM2 and Ki67 in oral epithelial dysplasia and oral squamous cell carcinoma.

Aim and Objectives: The aim and objective of the study were to evaluate the immunohistochemical expression of proliferative markers, Ki67, and MCM2 in oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC), to compare the relationship of their staining patterns, and to look for correlation between them, if any. Materials and Methods: Thirty archival paraffin-embedded tissue blocks of previously diagnosed cases of OED, OSCC each, and 10 normal oral mucosa were used in the study. Immunohistochemical staining for MCM2 and Ki67 markers was done and the slides were individually evaluated for MCM2 and Ki67 expression, with immunopositivity determined on the basis of dark brown staining of the nucleus. The number of positively stained nuclei was counted in 10 representative areas and the data were charted and statistically analyzed. Results: The overall mean expression of both the proteins increased progressively from normal mucosa to OED to OSCC. In normal mucosa, all positively stained nuclei were seen in the basal compartment of the epithelium, while in dysplastic cases, expression was seen toward the surface of squamous epithelium. In OSCC, the frequency of expression of MCM2 and Ki-67 proteins showed an inverse correlation with the degree of tumor differentiation. In well-differentiated cases, the positivity of either marker was restricted to the outermost layer of the tumor cells. In moderately differentiated cases, an expression of Ki-67 was more diffuse in inner layers, whereas the MCM2 antigen was found to be more intense and diffuse in both the inner and outer layers. Whereas in poorly differentiated SCC, positive expression was seen in most of the tumor cells, the mean expression of MCM2 was found to be higher than that of Ki67 in all cases. Conclusion: MCM2, as a proliferation marker, is superior to Ki67 as it indicates the capacity of proliferation and the ability of DNA replication of a cell.

A Digital Radiographic Study of Age Estimation Using Area-specific Formula in Odisha Population.

AIM: The aim of the article was to evaluate the feasibility of pulp/tooth area ratio in three mandibular teeth, namely left canine, left first premolar, and left second premolar (33, 34, and 35), as an indicator of age using digital panoramic radiograph and Kvaal's parameters. The study also aimed at computing an area-specific formula for age estimation in Odisha population. MATERIALS AND METHODS: Observation and analysis of 50 digital orthopantomographs (OPGs) and clinical data of patients were made. These images were saved as high-resolution JPEG files. Using the Adobe Photoshop CS3 (extended) image editing software program (Adobe Systems Inc, San Jose, California, United States), the pulp/tooth area ratio of 33, 34, and 35 was analyzed. These ratios were substituted in Odisha population-specific formula, derived using principal component regression analysis. RESULTS: The mean chronological age was 33.24 years. Principal component regression analysis was used to derive multiple regression formulae for individual teeth as well as a combined formula. R2 (coefficient of determination) for combined three mandibular teeth was highest (0.7769) with a standard error of 4.5969 years and thus was a better predictor of age in the population of Odisha. In terms of an individual tooth, comparison between chronological and predicted age revealed that left second mandibular premolar (35) had highest correlation to actual age. Karl Pearson's correlation coefficient showed correlation between age and the mean of ratios from combined three mandibular teeth was stronger than that of single tooth. CONCLUSION: In the present study, second left mandibular premolar showed highest correlation to actual age when used alone. The use of three teeth in combination increased the correlation. This Odisha-specific formula showed promising results and can be used for forensic applications in this population. CLINICAL SIGNIFICANCE: Using three different teeth for age estimation proved to be a better predictor of age in the Odisha population. Moreover, the obtained formula can act as a standard and be used for anthropological or forensic investigations in the said population.

Can Increased Metabolic Status be a Grading Tool for Oral Squamous Cell Carcinoma? A Glucose Transporter 1 Immunoexpression Study.

BACKGROUND: Glucose transporter-1 (GLUT-1) is a GLUT protein whose expression is upregulated in malignant cells where enhanced uptake of glucose is observed. AIM: The aim of this study is to evaluate the expression of GLUT-1 protein in oral squamous cell carcinoma (OSCC) tissue sections using immunohistochemistry and to describe the relationship between increased metabolic status and the grades of OSCC. MATERIALS AND METHODS: This is cross-sectional study with 76 formalin-fixed paraffin-embedded tissue blocks of OSCC, obtained from the archives of the department. All the cases were scored using Bryne's grading system by three oral pathologists independently. The tissue sections were then stained using immunohistochemistry with anti-GLUT-1 rabbit monoclonal antibody. RESULTS: Staining intensity and localization of positively stained slides were evaluated. Overall, a significant correlation between Bryne's histopathological grading system for OSCC and GLUT-1 immunohistochemical expression was observed. Thus, high GLUT-1 expressions are observed with increasing grades of OSCC. CONCLUSION: This study shows that a significant positive correlation exists between GLUT-1 immunoexpression and histological grading of OSCC. Thus, GLUT-1 expression can be used as a diagnostic adjunct and prognostic marker for OSCC patients.

Comparative Study of Micronuclei Count in Patients with Different Tobacco-related Habits using Exfoliated Buccal Epithelial Cells: A Tool for Assessment of Genotoxicity.

AIM: To study and compare the genotoxic effects of tobacco using micronuclei count in individuals with different tobacco-related habits. MATERIALS AND METHODS: A cross-sectional study was done comprising 200 individuals, divided into four groups. Group I: 50 subjects with history of tobacco chewing, group II: 50 subjects with a history of smoking tobacco, group III: 50 subjects with a history of both tobacco chewing and smoking, and group IV: 50 subjects without any habits as controls (age-matched). The study groups were individually further divided into three subgroups which comprised of subjects with history of substance abuse for less than 5, 5 to 10, and greater than 10 years. Exfoliated cells from the buccal mucosa of the subjects were collected and stained using Giemsa stain. A total of 1,000 cells were examined for each case and micronuclei frequency was scored according to the guidelines given by Tolbert et al. Results: The mean number of micronuclei count was 18.28 ± 10.0 in group I (smokeless tobacco users), 11.38 ± 6.3 in group II (subjects with history of tobacco smoking), 22.44 ± 9.8 in group III (subjects with history of using both smokeless and smokable form of tobacco), and 4.86 ± 2.4 in the control group. The statistical difference was found to be highly significant (p < 0.001). Similarly, based on the duration, highly significant difference was notable in the mean number of micronuclei in subjects who had a history of substance abuse for more than 10 years. CONCLUSION: A significantly higher micronucleus frequency was found in smokeless tobacco users than in smokers and controls. Micronuclei assay in the exfoliated buccal cells is a useful and minimally invasive method for monitoring early genotoxic damage. CLINICAL SIGNIFICANCE: Micronuclei assay can be used to detect genotoxic damage at the earliest and, if intervened at this point, may prevent frank malignancy, morbidity, and mortality.

Awareness of Biomedical Waste Management among Dentists associated with Institutions and Private Practitioners of North India: A Comparative Study.

AIM: The present study aimed to obtain information about knowledge, execution, and attitude toward biomedical waste (BMW) and its management. MATERIALS AND METHODS: In the present study, a self-administered closed-ended questionnaire was designed to conduct a cross-sectional survey. It was distributed among 614 dentists (institution associated or private practitioners) in the cities of North India. The questionnaire comprised 36 questions regarding knowledge, execution, and attitude toward BMW and its management. Frequency distribution and chi-square test along with paired t-test were used to compare the data obtained between the private practitioners and institution-associated dentists. RESULTS: The study showed that 80% private practitioners were aware of the categories of BMW as compared with 100% of institution-associated dentists. However, 41% dentists associated with institution were disposing the chemical waste directly into sewer and a surprising high number of private practitioners were discarding directly without any treatment. Furthermore, regarding the mandatory maintenance of BMW records, 100% institution-associated respondents were aware, whereas only 6.5% private practitioners knew about it. Regarding BMW management not frequently being followed, 78% of private practitioners believed extra burden as the reason. CONCLUSION: Most of the dentists had adequate knowledge regarding BMW policies and its management. Although it was being practiced in mostly all the institutes on a regular basis, the majority of private practitioners were not practicing it due to various reasons, such as financial burden, lack of availability of service, and poor attitude toward its management. CLINICAL SIGNIFICANCE: There is a need to make it compulsory and organize training sessions to educate the dental personnel and to establish the importance of proper management.

Knowledge, Attitudes, and Practices among Health-Care Providers Regarding Zika Virus Infection.

AIMS AND OBJECTIVES: Zika virus (ZIKV) is a mosquito-borne flavivirus that was first identified in Uganda in 1947 in monkeys. The study was designed to assess the knowledge, attitude, and practices regarding ZIKV infection among rural health-care providers in Aligarh district, Uttar Pradesh, India. MATERIALS AND METHODS: A total of 600 health-care providers were selected through stratified random sampling in an interventional survey. A self-structured, closed-ended questionnaire was administered to each participant in two phases to record their demographic, professional characteristics, knowledge, attitude, and practices regarding ZIKV. RESULTS: Out of 600 health-care workers contacted, 585 (97.5%) agreed to participate in the survey. Multivariable linear regression analysis was carried out to assess the association of participant's professional characteristics with their knowledge, attitude, and practices. CONCLUSION: It showed that there was a wide gap between the level of awareness, knowledge, and practice among the different categories of health-care providers about the ZIKV. This study revealed that there was a very high probability of the risk of transmission of ZIKAV through health-care settings and hence health-care personnel must strictly adhere to Universal Precautions to prevent it.

Assessment of Oral Hygiene Knowledge, Practices, and Concepts of Tobacco Usage among Engineering Students in Bhubaneswar, Odisha, India.

AIM: This study aimed to assess oral hygiene-related knowledge and practices among engineering students of Bhubaneswar city and also to evaluate the concepts about the side effects of tobacco usage among those students. MATERIALS AND METHODS: The study was conducted using a self-administered, close-ended questionnaire to assess the oral hygiene knowledge and practices and study the concepts on tobacco usage among 362 engineering students of Bhubaneswar city, Odisha, India. The obtained data were statistically analyzed using Statistical Package for the Social Sciences software version 20.0. RESULTS: This survey found that 26.51% of the students had never visited a dentist. Nearly 43.64% of the participants were cognizant of the fact that improper brushing is the reason of tooth decay. About 47% of the participants consumed alcohol and 32.6% had the habit of chewing tobacco, though 80% were aware that use of smokeless tobacco can impair oral health and cause cancer and use of alcohol has detrimental effect on oral health. CONCLUSION: Knowledge with respect to oral health among engineering students of Bhubaneswar city is adequate regarding using fluoridated toothpaste and flosses. However, an unhealthy snacking habit, overusage of toothbrushes, consumption of alcohol, and practicing tobacco habit show the lack of oral health knowledge in these students. CLINICAL SIGNIFICANCE: Our study provides an idea about the present scenario in terms of oral hygiene and tobacco usage in young individuals. This can form the basis for oral health education and tobacco cessation program. Moreover, as the habit of tobacco usage starts early during college life, adequate knowledge about its ill-effects would prevent deadly diseases, such as potentially malignant disorders and oral cancer.