Detection of species diversity in oral candida colonization and anti-fungal susceptibility among non-oral habit adult diabetic patients.

BACKGROUND AND OBJECTIVES: Patients with diabetes mellitus are prone to secondary infections. In this study we aim to determine the prevalence of one such secondary infection (oral Candida colonization) and evaluate the influence of local and systemic factors on the oral candidal colonization in patients with diabetes mellitus. MATERIALS AND METHODS: Forty non-insulin-dependent diabetic patients and 40 healthy individuals were included in this study. Samples were collected by using the oral rinse method. The candidal species were isolated and identified through phenotypic methods. An in vitro antifungal susceptibility profile was evaluated. Glycemic control, as determined by the glycosylated hemoglobin concentrations (HbA1c) of the study subjects, was correlated with the candidal colonization. RESULTS: Patients with diabetes showed a significantly higher prevalence of candidal colonization. The rate of carriage and density (P = 0.001) was higher. Candida albicans was the most predominantly isolated species, however, C. dubliniensis, C. tropicalis, and C. parapsilosis were also observed. Variable resistance toward the antifungal drugs (amphotericin B and fluconazole) was observed in the Candida isolated from diabetics, but not from healthy patients. Interestingly, a positive correlation was observed between glycemic control and candidal colonization. CONCLUSION: Diabetic patients had a higher candidal carriage rate, with a variety of candidal strains, which significantly varied in their resistance to routinely used anti-fungal agents. Interestingly the higher oral candidal colonization in diabetic patients is related to local and systemic factors, independent of their oral habits.

Amino acid profile of saliva from patients with oral squamous cell carcinoma using high performance liquid chromatography.

Oral cancer is the leading cause of death worldwide and it is the eighth most common cause of cancer death. Cancer cells utilize more glucose and amino acids than their benign counterparts. Diagnosis of disease via the analysis of saliva is potentially valuable, as the collection of fluid is associated with fewer compliance problems than the collection of blood. Hence, the present study was undertaken to evaluate the comprehensive amino acid profiling of saliva by high performance liquid chromatography (HPLC). The study group comprised 16 subjects, of whom eight were classified as having well-differentiated oral squamous (OSCC) cell carcinoma (Group I) and eight were classified as having moderately differentiated oral squamous cell carcinoma (Group II). Eight healthy individuals comprised the control group (Group III). The results showed increased salivary levels of all the amino acids in both groups of OSCC patients (Groups I and II) when compared with healthy controls (Group III). Hence, our study showed higher levels of all amino acids in the saliva of OSCC patients than in the saliva of healthy controls. The increased levels may serve as a "diagnostic and prognostic marker" for oral squamous cell carcinoma and for further detection of metastatic spread.

Micronuclei and other nuclear anomalies in buccal mucosa following exposure to X-ray radiation.

OBJECTIVE: To evaluate DNA damage and cellular death in exfoliated buccal mucosa cells from healthy individuals following dental X-ray exposure, to compare effects of different types of radiographic techniques using the buccal cytome assay and to standardize the staining procedure. STUDY DESIGN: This study comprised 90 patients, categorized into 3 groups subjected to intraoral periapical radiography, conventional orthopantomogram and digital orthopantomogram X-ray exposure. Exfoliated oral mucosa cells were collected immediately before the X-ray and 10 days later and stained using DNA-specific stains and nonspecific DNA stains. RESULTS: The results indicated no statistically significant differences in micronucleated cells before and after dental X-ray exposure. On the other hand, X-ray exposure did increase other nuclear alterations closely related to cytotoxicity, such as karyorrhexis, pyknosis and karyolysis. CONCLUSION: These data indicate that dental radiography may not induce chromosomal damage, but it is able to promote cytotoxicity.

Sino nasal undifferentiated carcinoma: A rare entity.

Malignant neoplasms of the paranasal sinuses and nasal cavity are rare, comprising only 3% of all head and neck malignancies. This includes both primary sinonasal neoplasms and metastatic disease. We present the case of a patient with a maxillary soft tissue swelling, which proved to be a rare malignant tumor of maxillary sinus origin, a sinonasal undifferentiated carcinoma.

Management of mucous membrane pemphigoid with dapsone plus weekly steroid injections in a young patient: a case report / Tratamento de penfigóide membranoso mucoso com dapsona e injeções semanais de esteróide em um paciente jovem: relato de caso

Purpose: Mucous Membrane Pemphigoid (MMP) is an autoimmune subepithelial blistering disorder usually affecting older individuals. This paper describes the pharmacological management of MMP in a young patient. Case description: A 23 year-old woman showed erythematous ulcerative gingiva in the maxillary palatal region and around the retromolar region. A perilesional excisional biopsy was done, and the histologic and immunohistochemical analysis confirmed the clinical diagnosis of MMP as the cause of desquamative gingivitis in this patient. The patient was treated with topical steroids plus daily Dapsone 100 mg and weekly steroid injections (40 mg). The lesions began to resolve after 12 weeks of therapy. Conclusion: This case of MMP in a young female patient was effectively managed with a combination therapy of topical steroids, Dapsone and steroid injections.

Objetivo: O penfigóide membranoso mucoso (PMM) é uma desordem autoimume subeptelial bolhosa que geralmente afeta indivíduos mais velhos. Este relato de caso descreve a abordagem farmacológica do PMM em uma paciente jovem. Descrição do caso: Uma paciente do sexo feminino, com 23 anos de idade, apresentava a gengiva eritematosa e ulcerada na região palatina e na região retromolar. A biópsia excisional total foi realizada e as análises histológica e de imuno-histoquímica confirmaram o diagnóstico clínico de PMM como causa da gengivite descamativa nesta paciente. A paciente foi tratada com esteróides tópicos, Dapsona 100 mg diariamente e injeções de esteróides mensais (40 mg). A resolução das lesões se iniciou após 12 semanas de terapia medicamentosa. Conclusão: Este caso de PMM em uma paciente jovem foi efetivamente tratado com uma terapia combinada de esteróides tópicos, Dapsona e injeções de esteróides.

Glandular odontogenic cyst: report of two cases and review of literature.

Glandular odontogenic cyst (GOC) is an uncommon jaw bone cyst of odontogenic origin described in 1987 by Gardner et al. It is a cyst having an unpredictable and potentially aggressive behaviour. It also has the propensity to grow to a large size and tendency to recur with only 111 cases having been reported thus far. The first case occurred in a 42-year-old female and presented as a localized swelling extending from 19 to 29 regions. There was a history of traumatic injury at the site. There was evidence of bicortical expansion and radiographs revealed a multilocular radiolucency. The second case occurred in a 21-year-old male, as a large swelling in the mandible and radiograph revealed radiolucency in the region. On histopathological examination, these lesions were diagnosed as GOC. It was concluded that, two cases submitted by us correlate with the existing literature that GOC's affect more commonly in the middle age group, having predilection for mandible and that trauma could be a precipitating factor for its occurrence. The increased recurrence rates can be due to its intrinsic biological behavior, multilocularity of the cyst, and incomplete removal of the lining following conservative treatment.

Stromal changes in apparently normal mucosa of smokers and pan chewers: a multi-parametric approach

Aim: To compare and contrast the various changes in the connective tissue among patients with the habits of smoking, pan chewing and controls by using fluorescence spectroscopy, histopathology and transmission electron microscopy. Method: Thirty subjects were categorized into three groups: pan chewers, smokers and controls without any oral lesions. Fluorescence spectroscopy was carried out using FLUOROMAX-2. Excitation spectroscopy was performed at 280 and 320nm respectively and Emission spectroscopy was performed at 340 and 390nm excitation. Subsequently, histopathological evaluation and transmission electron microscopy was done for biopsies taken from test groups and controls. Results: The mean, standard deviation and test of significance of mean values between different groups for intensity-380nm, intensity–420nm and intensity – 460nm at 320 nm excitations, showed that the Mean values in group I and group II were significantly higher than the mean value in group III with a p-value of less than 0.001. Considering the histopathological parameters, the pattern of the sub-epithelial connective tissue, the presence of chronic inflammatory cells and lysis of connective tissue was significant. The ultrastructural analysis revealed the presence of epithelioid, spindle or elongated and stellate shaped fibroblasts in the connective tissue. Conclusion: In this pilot study, we could find variations in emission characteristics of various amino acids which correlated with histopathology and electron microscopy. Our study suggests that there are connective tissue changes in oral mucosa among smokers and pan chewers, though it is apparently normal in clinical presentation. These initial connective tissue changes could determine the progression of altered mucosa to a pre-cancer or cancer, which is further related to other complex interactions. Elaborate studies are required to evaluate the significance of our hypothesis.

Oral signs and salivary parameters as indicators of possible osteoporosis and osteopenia in postmenopausal women: a study of 45 subjects

Aim: To correlate the oral signs, salivary calcium, phosphorus, alkaline phosphatase levels and dental radiographic findings in postmenopausal osteoporotic, osteopenic and non-osteoporotic women. Materials and Methods: Forty-five subjects were selected based on bone mineral density (BMD) analyses and were assigned to 3 groups (n=15): Group 1 - established osteoporotic women; Group II - established osteopenic women; Group III (control) - non-osteoporotic women. Complete oral and radiographic examination, saliva collection and analysis of calcium, phosphorus and alkaline phosphatase were performed. Results: The results were tabulated and analyzed for statistical significance using the Mann-Whitney U-test. There was statistically significant difference (p<0.05) in salivary calcium, phosphorus and alkaline phosphatase levels when osteoporotic and osteopenic women were compared to the controls. Conclusion: Salivary parameters can be used as indicators to aid in the diagnosis of osteoporosis and osteopenia in postmenopausal women.