Tobacco cessation center in a dental college: An 8 year institution-based study.

Background: Oral cancer is a major health concern in the Indian subcontinent, where it ranks among the top three types of cancer in the country. Tobacco and its products have been implicated as a major etiologic factor behind cancers. It is believed that tobacco is an epidemic in itself taking the death toll to 7 million globally. In India alone, mortality because of tobacco is more than 1.3 million. Dentists are the first to notice any change in the oral cavity or come across any suspicious looking oral lesion and therefore are instrumental in primary prevention and care. Methods: The present study data are of the patients enrolled in a Tobacco Cessation Center(TCC) at a Dental College in Meerut in Meerut from May 2012 (since its inception) to March 2020. The following methods of counseling were carried out: group counseling, interactive sessions, audio-visual aids, and individual counseling sessions. Self-training for oral cavity examination was also given after every group counseling session. Behavioral counseling and pharmacological intervention were given as per Fagerström Test for Nicotine Dependence (FTND) score. At the end of 1 year, patients who quit were graded into 0, 1, and 2, with 0 for those who failed to quit, 1 for those who did completely quit, and 2 for those who reduced their habit by more than 50%. Results: The quit rate achieved was 57.6% (complete responders -43.2% and partial responders 14.4%). The relapse reported was 1.8%. Conclusion: A Tobacco cessation Center set up in a Dental College could be of great help in the primary prevention of oral cancer and can bring a drastic increase in quit rates. Proper counseling skills once nurtured in young under-graduates can boost the tobacco-free India campaign.

Touch imprint smear: A prerequisite to obtain better quality and "true" tumor RNA in breast tissues.

BACKGROUND: RNA is the primary genetic material required for various molecular studies. RNA derived from breast tissue has low quality and quantity compared to that extracted from other tissues. Therefore, optimization of techniques for breast tissue RNA extraction is a challenging but essential requirement. METHODS: RNA was extracted from 60 samples of breast cancer after dividing them into 2 groups. Each tissue was divided into 2 halves for RNA extraction and histopathology respectively. In group 2 RNA was extracted after taking touch imprints whereas group1 was not subjected to any such procedure. Concentration and purity of RNA was assessed by using spectrophotometer and 1% agarose gel followed by RT-PCR for 18 S rRNA and CCND1 gene. RESULTS: Based on microscopic observations of imprints, group 2 samples were further subdivided into 2 subgroups. Group 2 A (n = 30) showing tumor in imprint smears were found to yield best concentration of pure RNA (1846.50 ng/µl and 1.92) as compared to group 2B (n = 15) with no malignancy in imprints (102.61 ng/µl and 1.53). The correlation of imprint smears with their corresponding H&E-stained slides further leads to grouping of each group in 2 groups. RT-PCR analyses showed better melting peaks and high relative expression of CCND1 in group 2 A. CONCLUSION: Touch imprints may provide valuable information regarding presence or absence of tumor in tissue samples being used for extraction of genetic material. This approach can be used as easy, cheap and fast strategy to resolve the doubts associated with RNA being truly representative of the tumor.

A not so worthless attempt to develop primary culture from breast FNAC/CNB samples!

Breast cancer is the second leading death-causing cancer in women. Since a longtime, continuous breast cancer cell lines have been used for drug discovery based research. However, these cell lines may not represent the characteristics of original as they are believed to undergo changes due to repeated passaging. Primary cultures directly obtained from the tumor are gaining more attention worldwide as these are believed to mimic the disease process more accurately than that of continuous cell lines. The major problem with the usage of primary culture is to get the sufficient number of cells for the experiments. Here, in this study we attempted to develop primary culture both from FNAC and core needle biopsy (CNB) samples of the breast cancer patients. Overall, we believe that it is not so difficult to establish primary cultures of breast cancer cells from clinical FNAC/CNB samples. However, the starting population in FNAC samples is less which can be a hindrance in getting an adequate number of cells to reach a monolayer. CNB samples may be better quantitatively and stepwise troubleshooting of problems faced can help in the successful establishment of monolayer and primary cultures that can be propagated. We believe, our experience might be helpful for those who are struggling with the development of the short-term primary culture of breast cancer from the small-sized tissue samples.

Do Different Stemness Markers Identify Different Pools of Cancer Stem Cells in Malignancies: A Study on ER+ and ER-Breast Cancer Cell Lines.

In view of popularity of cancer stem cell (CSC) model all events in evolution of cancer are being explained in that context. Breast cancer is first solid tumor in which CSCs were identified. We aimed to compare stemness profile of two major subtypes [Estrogen receptor positive (ER+) and negative (ER-)] breast cancer using different sets of markers. Expression of CD44/CD24, CK/Vimentin, E-Cadherin/Fibronectin and percentage of side population (SP) was studied in ER+ (T47D) and ER- (MDA-MB-231) cell lines by flow cytometry. Breast CSCs (BCSCs) were sorted using CD44+/CD24-/low expression and SP analysis and cultured. BCSCs were then compared with Non-CSCs (NCSCs) for response to drugs (Paclitaxel and Cisplatin), Ki67 and ER expression. Results showed higher expression of stemness markers (CD44+/CD24-/low, CK+/Vimentin+ and E-Cadherin-/FibrinectinF+) in MDA-MB-231 cells. Percentage SP representing BCSCs was found to be significantly more in later (3.20 ± 0.002 cf. T47D 1.25% ± 0.0007). BCSCs were found to be more resistant to drugs as compared to NCSCs in both cell lines. ER expression was weak in BCSCs sorted from T47D as compared to NCSCs. Ki67 was expressed in both BCSCs and NCSCs. Differences in expression of stemness markers help to explain aggressive behavior, higher recurrence rate and metastatic potential of MDA-MB-231 cells. However, no correlation amongst different markers used suggests that they may be identifying varied populations of cells in tumor hierarchy. A weak ER expression in BCSCs may be strategy used by BCSCs to escape effect of hormone therapy in ER+ breast cancers.

Radiological analysis of the sella turcica and its correlations with body mass index in a North Indian population.

OBJECTIVES: The sella turcica is an important component situated in the mid-third of the cranial fossa. Knowledge about its normal morphologies and dimensions may play a crucial role in diagnosing underlying pathologies. The present study aimed to analyze the principal morphological shapes of the sella turcica, measure its linear dimensions, and determine whether any correlations exist between its dimensions and body mass index (BMI) in subjects in a North Indian population. METHODS: The study was conducted on 100 subjects (50 men; 50 women) who underwent cone-beam computed tomography scans at our Oral Medicine and Radiology Department. The subjects had an age range of 20-60 years. The morphology of the sella turcica was examined according to age and various measurements were taken to determine its size. Possible correlations between the dimensions of the sella turcica and BMI were evaluated by statistical analysis. RESULTS: In the present study, 69% of the subjects had a normal morphology. No uniform increases in length, width, and depth of the sella turcica were observed with aging. When Pearson correlation coefficients were calculated, no strong correlations were found between the dimensions of the sella turcica and BMI. A mild correlation was seen between the length and width of the sella turcica. CONCLUSION: No significant correlations were found between the dimensions of the sella turcica and BMI in the present study. These findings may have arisen through the small sample size, and thus further studies with larger groups of subjects are warranted.

Parosteal osteosarcoma of mandible: A rare case report.

With the exception of multiple myelomas, osteosarcoma is the most frequently occurring primary malignant bone tumor with an overall incidence of 1:100,000/year. It has greatest predilection for the metaphyses, most frequently femur and tibia. However, osteosarcomas affecting the craniofacial bones are infrequent. Two main types: intramedullary and juxtacortical varieties are seen. Juxtacortical variety is further subdivided into periosteal and parosteal variants. Due to its rarity, only 13 cases of parosteal osteosarcoma have been reported till date. A 35-year-old male patient with affected postirradiated mandible is being reported as the 14th case of this kind with its unique benign presentation and less aggressive nature.

Knockdown of PINCH-1 protein sensitizes the estrogen positive breast cancer cells to chemotherapy induced apoptosis.

INTRODUCTION: PINCH-1 is a ubiquitously expressed protein belonging to the focal adhesion protein group which has a role in cell survival, spreading, adhesion and migration. It has been implicated in pathogenesis of several cancers. In the present study we aimed to investigate the role of this protein in estrogen positive and negative breast cancer subtypes. MATERIALS AND METHODS: PINCH-1 expression was studied in two estrogen positive(T47D and MCF-7) and one estrogen negative cell lines before and after treatment with six drugs (Cyclophosphamide, Celecoxib, Doxorubicin, Paclitaxel, Etoposide and Tamoxifen). Then the protein was knocked down using siRNA against PINCH-1 and change in percentage of apoptotic cells was analysed by flow cytometry. RESULTS: We observed increased but differential expression of PINCH-1 in the three breast cancer cell lines with a higher expression in estrogen positive cell lines. Knocking down of PINCH-1 led to a significant (p-value<0.05) enhancement in apoptosis in T47D cells in response to 4/6 (cyclophosphamide, celecoxib, paclitaxel, doxorubicin) drugs. Though an increase in apoptosis was observed in MCF-7 cells also, it was not found to be significant.The MDA-MB-231 cells however, did not show significant apoptosis upon PINCH-1 knockdown. CONCLUSION: The results suggest that PINCH-1 may be playing an important role in etiopathogenesis of both subtypes breast cancer. However, enhanced apoptosis observed only in estrogen positive and not in estrogen negative cells upon PINCH-1 knockdown point towards participation of some other protein with redundant functions in the later subtype which needs to be investigated.

Increased advanced glycation end product specific fluorescence in repeatedly heated used cooking oil.

Repeated heating of cooking oils is known to cause their degradation and generation of toxins. Dietary Advanced glycation end products (dAGEs) are formed when the foods are cooked in dry heat at very high temperatures. dAGEs are believed to contribute significantly to total pool of AGEs in body. In this study, cooking oil samples used for frying snacks were collected from 102 shops. AGEs were extracted using Aqueous-TCA-chloroform method. Fluorescent AGE levels were determined using a fluorescence spectrophotometer and compared with AGEs in corresponding fresh oil samples collected from same shops. Palm oil was most commonly (62.5%) used for cooking. Most of the samples were subjected to several rounds of heating (1-6). AGE specific fluorescence (ASF) in used oil (range = 8.5-745.11) samples was found to be significantly higher in 88/102 as compared to the corresponding fresh oil samples. Treatment with inhibitors like lime concentrate and vitamin C decreased ASF (10/14 and 10/11 samples respectively) of the used oils. The results suggest that cooking oil subjected to repeated heating can contribute to increase in fluorescent AGEs in diet. Simple practices like liberal use of common household substances like lime concentrate may help to reduce these in fried food.

Incidence of Oral Lichen Planus in Perimenopausal Women: A Cross-sectional Study in Western Uttar Pradesh Population.

BACKGROUND: Hormonal fluctuations during menopause lead to endocrine changes in women, especially in their sex steroid hormone production. Studies have documented the role of estrogen and progesterone (Pg) on autoimmune disorders such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Lichen planus (LP), an autoimmune disorder, seen frequently in perimenopausal women, may also get affected by sex steroid hormones, but no direct relationship has been established yet. AIM: The aim of this study is to find the incidence of oral LP (OLP) in perimenopausal women and evaluate the factors associated with it. MATERIALS AND METHODS: This cross-sectional study was conducted over a period of 1 year. All the perimenopausal women (44.69 ± 3.79 years) who came to the dental outpatient department were evaluated for the presence of LP and various factors associated with it. Depression Anxiety Stress Scale-21 questionnaire was used for psychometric evaluation of perimenopausal women. RESULTS: According to our study, incidence of LP in postmenopausal women was 10.91%, which is higher than incidence of LP in general population, i.e., 0.5% to 2.0%. Incidence of LP increased with the severity of depression in perimenopausal women (P = 0.000). CONCLUSION: The incidence of OLP is higher in perimenopausal women than in general population and increases significantly with increase in the severity of depression. LP in perimenopausal women can be mediated by declined level of estrogen and Pg directly or indirectly through causing depression that can trigger LP.

Roles of serum uric acid, prolactin levels, and psychosocial factors in oral lichen planus.

Free radicals play important roles in the mechanisms underlying lichen planus (LP). Uric acid (UA) is an important anti-oxidant in plasma. Prolactin (PRL) is an immunomodulatory hormone that may promote LP, as has been documented in other autoimmune disorders, such as systemic lupus erythematosus, rheumatoid arthritis, and psoriasis. PRL has multiple immune-stimulatory effects and promotes the development of such autoimmune disorders. Prolactin and uric acid may serve as biomarkers of disease activity in lichen planus. The aim of the present study was to evaluate the roles of depression, stress, and anxiety in LP, as well as serum levels of UA and PRL as potential biomarkers of disease activity and compare these findings with those of the control group. Thirty-nine patients clinically diagnosed with oral LP (study group) and 39 age- and sex-matched controls (control group) were selected in this study. Serum UA and PRL levels were measured. The Depression Anxiety Stress Scale-21 was used for psychometric evaluation of LP patients and controls. Serum UA level was found to be significantly higher in the control group as well as during the remission phase of disease in the study. There was no significant difference in serum PRL levels between cases and controls. Depression and stress scores were higher in the study group.

Physiochemical and cytotoxicity study of TPGS stabilized nanoemulsion designed by ultrasonication method.

The main aim of the present work was to prepare TPGS stabilized D-α-Tocopherol, lemon oil, tween-80, and water nanoemulsion by low cost and highly effective sonication method. The prepared nanoemulsion showed good stability for 60days at variable temperature conditions i.e. 4, 25 and 37°C. The tolerance of the prepared nanoemulsion to salt (50mM-500mM) and pH (pH 2-pH 7.4) was also studied. The morphology and droplet size of pure and quinine loaded nanoemulsion was characterized with transmission electron microscopy. The prepared formulation was transparent and the obtained average particle size ranged between 25nm and 35nm. The nanoemulsion was found to be non toxic. The cell viability study of pure nanoemulsion carried out on Hep G2 cells revealed that the cell viability was 100%. The formulation further exhibited high quinine loading and release capacity with cumulative release up to 76±2% and 65±2% at pH 7.4 and pH 5.5 respectively. The interaction between quinine and vitamins (riboflavin, thiamine and biotin) was also carried out (aqueous medium). The study revealed that riboflavin had strong interaction with quinine and vitamins vis-à-vis thiamine and biotin.

Exactive Tie-Back - An Accurate Active Tieback.

Active tiebacks using elastomeric modules are preferred for space closure in most cases. Elastomeric ring should be stretched by equal amount on both sides for equalforce delivery and to avoid unwanted complication like shift in mid-line, asymmetric space closure. Elastic tiebacks were originally described using an elastomeric module, stretched to twice its normal size but in clinical situations, stretch of elastomeric rings are diffcult to measure intraorally. This paper introduces a manually fabricated guiding system that will allow the clinician to accurately activate active tie-back bilaterally without fear of over/under stretching the module to twice its original size. With the help of straight length 0.021" 0.025" SS wire and cold cure acrylic a guiding stent is fabricated. Guiding loops were made with 0.009" ligature wire around this stent, which can be placed along with active tieback. This "Exactive tieback" with the help ofguiding loop template is easy to fabricate and use. It is an accurate, effective, and predictable method for placement of symmetrical active tie-backs."

Facial asymmetry in young adults with condylar hyperplasia-unusual changes in the facial bones.

Facial asymmetry can be caused by various pathological conditions, condylar hyperplasia (CH) is one of such condition, characterized by unilateral or bilateral mandibular condylar overgrowth, causing facial asymmetry, mandibular deviation, malocclusion and functional impairment. Advanced imaging and scintigraphic methods, helps the clinicians in diagnosing and monitoring its macroscopic aspects. Here we report three interesting and illustrative cases of facial asymmetry with unilateral CH discussing the unusual changes in the facial bones.

Dentinogenic ghost cell tumor - a neoplastic variety of calcifying odontogenic cyst: case presentation and review.

CONTEXT: The calcifying odontogenic cyst (COC), also referred to as calcifying ghost cell odontogenic cyst (CGCOC) is a heterogeneous lesion existing either as cystic or solid variant. Due to the fact that all CGCOC lesions are not cystic, and the biological behavior is often not consistent with a cyst, there has always been a controversy as to whether COC is a cyst or a tumor. The dentinogenic ghost-cell tumor (DGCT), a solid variant of the COC, is an uncommon odontogenic neoplasm occurring predominantly in later life. Case report is followed by a concise review and disambiguation of controversial terminologies regarding nomenclature of COC. CASE REPORT: We report a case of 33-year-old female patient who presented with an insidious, steadily increasing swelling on the left side of her face since 8 months. Patient reported slight difficulty in eating because of reduced intraoral space and an obvious concern with facial disfigurement. There was no contributory dental or medical history. Intraorally, a hard, well defined, bicortical swelling was noted in left maxillary region with slight mobility of the associated teeth and normal appearing overlying mucosa. A provisional diagnosis of adenomatoid odontogenic tumor was made, and orthopantomogram, paranasal sinus radiograph and computed tomograpy scan of the face were acquired. A radiographic diagnosis of COC was made, which was subsequently confirmed on histopathology postenucleation of the tumor mass. COC has been seen to be of extensive diversity in its clinical and histopathological features as well as in its biological behavior. CONCLUSION: The present case of 33-year-old female was diagnosed as DGCT, a tumorous form of COC, due to its characteristic histological features; numerous ghost cells and dentinoid material.

Inflammatory linear verrucous epidermal nevus and regional odontodysplasia: A rare sorority.

Epidermal nevi are hamartomatous lesion and its association with other developmental defects particularly of the central nervous system, eye and skeletal system are well recognized. We report a rare case of inflammatory linear verrucous epidermal nevus syndrome along with regional odontodysplasia; and to the best of our knowledge this is the second case reported in the literature.

Clinical correlative study on early detection of oral cancer and precancerous lesions by modified oral brush biopsy and cytology followed by histopathology.

BACKGROUND: Oral cancer accounts for 5% of all malignant tumors and 60% of these lesions are well advanced at the time of diagnosis. The early diagnosis could prevent a large number of deaths due to this disease. AIMS: This study aims to evaluate and compare the clinical usefulness of exfoliative cytology, modified brush biopsy (without computer assisted analysis), and biopsy in early detection of oral premalignant and malignant lesions. MATERIALS AND METHODS: Modified oral brush biopsy (using baby toothbrush) and exfoliative cytology was performed on 225 clinically diagnosed oral precancerous lesions (suspected) selected from among 1099 lesions in 877 patients. Scalpel or punch biopsy was performed based on clinic-cytological evidence (test result and/or clinical judgment) on only 117 lesions. All the specimens were analyzed manually in a double-blinded fashion. STATISTICAL ANALYSIS USED: RESULTS were analyzed using Statistical package for Social Sciences version 12 (SPSS Inc., Chicago, IL, USA) and subjected to Fischer exact test. RESULTS: Of 117 lesions that underwent all the three tests, modified oral brush biopsy showed a reasonably higher specificity (68.42%) and sensitivity (81.69%) when compared with specificity (86.48%) and sensitivity (48.57%) of cytology. CONCLUSION: The results demonstrate that modified oral brush biopsy has higher efficacy than routine cytology and can be used as a potentially practical oral cancer screening tool in resource challenged settings. However, clinical judgment is of prime importance. Immediate biopsy is mandatory in highly suspicious lesions proposed under the diagnostic criteria of "clinically diagnosed carcinoma in situ".

Limbal dermoid in Nager acrofacial dysostosis: a rare case report.

Nager syndrome, also called preaxial acrofacial dysostosis, comprises two groups of defects involving the limbs and craniofacial region, respectively. This syndrome is rare and only 70 cases have been reported in the literature. The exact cause of this syndrome is unknown, but there is indication that it is genetically based. Ocular manifestations of this syndrome include widely separated downward slanting eyes, absence of eyelashes, ptosis of upper eyelids and colobomas on the inner aspect of lower eyelids. We report limbal dermoid in a patient with Nager syndrome. We did not find such an association of "Limbal dermoid in Nager acrofacial dysostosis syndrome" on PubMed using Nager acrofacial dysostosis, limbal dermoid and ocular manifestations as the keywords.

Cowden syndrome- Clinico-radiological illustration of a rare case.

Cowden syndrome (CS) or multiple hamartoma syndrome is an infrequent genodermatoses, which is inherited as an autosomal dominant trait resulting from the mutation in the Phosphatase and Tensin homolog gene on the arm 10q and is principally characterized by multiple hamartomas with an increased risk of development of malignancies. Facial and oral signs are remarkable in the form of multiple papules and trichilemmomas on the face. We report one such rare case of CS in a 19-year-old patient who was diagnosed on the basis of her oral mucosal lesions and was further investigated and diagnosed with other hamartomas. The present case report signifies the responsibility of the oral physician in the early diagnosis of this progressive pathological syndrome as it leaves its footmark in the oral cavity in the form of oral mucosal lesions.