Ki67 Labelling Index predicts clinical outcome and survival in oral squamous cell carcinoma

Objective: To investigate the Ki 67 expression and its correlation with clinicopathological features and 3 years as well as 5 years survival rate in oral squamous cell carcinoma (OSCC). Methodology: Total 217cases of OSCC primarily treated with surgery with or without radiation were included. All patients were followed up for 3 years and 150 were followed up of 5 years for disease free survival. The immunohistochemistry was carried out on neutral buffered formalin fixed paraffin embedded tissue to evaluate the expression of Ki67. Results: The Ki67 labeling index (LI) was significantly higher with respect to adverse clinicopathological parameters such as histopathological grading (p<0.001), clinical TNM staging (p<0.001) and nodal metastasis (p<0.001). The OSCC patients survived for less than 3 and 5 years were showed significantly higher Ki67 LI as compared to diseases free survived more than 3 and 5 years(p<0.001). The three years survival rate of OSCC patient significantly higher with low Ki67 LI (≤45) 96.2%, followed by moderate Ki67 LI (46 to 60) 60.7% and high Ki67 LI (≥61) 37.7% (p<0.001). The five years survival rate of OSCC patient statistically significantly higher with low Ki67 LI (≤45)93.3%, followed by moderate Ki67 LI (46 to 60) 46.8% and Ki67 LI (≥61) 23.3% (p<0.001). Conclusion: The measurement of cell proliferative activity by using Ki67 antigen expression in individual OSCC might provide unique, predictive information on clinical outcome, prognosis and deciding treatment modalities in OSCC

Undifferentiated Nasopharyngeal Carcinoma with Oral Manifestation: A Case Report

Nazofaringealni karcinom (NPC) rijetka je maligna bolest u većem dijelu svijeta, pa se zato često pogrešno dijagnosticira. Ta se vrsta raka teško pronađe među karcinomima glave i vrata zbog predilekcijskog mjesta, malignih karakteristika rasta, posebnih teškoća u otkrivanju i određivanju stupnja proširenosti te visoke stope neuspjeha u liječenju, iako je osjetljiv na radioterapiju. O toj bolesti malo se zna i obično na godinu oboli jedna osoba u populaciji od 100 tisuća. Uobičajen je u južnoj Kini i sjevernoj Africi, gdje se njegova etiologija povezuje s prehrambenim navikama. Kako bismo bolje razumjeli etiološku patogenezu i mogli prepoznati klinička obilježja te postaviti ranu dijagnozu i prognozu NPC-a, izvještavamo o rijetkom slučaju nazofaringealnog karcinoma u srednjoj Indiji. Pacijentica je bila u dobi od 19 godina i došla je na liječenje zbog tkivne mase u sklopu vrata intraoralno uključene u meko nepce.Nasopharyngeal carcinoma (NPC) is a rare malignancy in most parts of the world and is one of the most confusing, commonly misdiagnosed, and poorly understood diseases. It is unusual among all the head and neck cancers due to its marked geographical predilection, highly malignant tumor growth characteristics, special difficulties in detection and staging and a high rate of treatment failure despite of its radiosensitivity. This carcinoma is rare in most parts of the world with reported incidence of around 1 case per 100,000 population per year. Nasopharyngeal carcinoma is common in Southern China and North Africa, where the etiology is related to dietary habits but it is rare in other parts of the world. Therefore, for better understanding of etiopathogenesis, clinical pathological features, early diagnosis and prognosis of NPC, we report a rare case of a nasopharyngeal carcinoma in Central India, of a 19 year old female patient who presented with a mass in her neck and intraoral involvement of the soft palate

Role of oral foci in systemic diseases: An update

Background: A current research disagreement middles about a theorized connection between chronic oral infections and the progress of adverse systemic health conditions. However, the gap between general and dental medicine is quickly closing, due to significant findings supporting the association between dental infections and systemic conditions such as cardiovascular diseases, type 2 diabetes mellitus, respiratory diseases, stroke, adverse pregnancy outcomes, osteoporosis, renal diseases, and gastrointestinal diseases. Relentless efforts have brought light on numerous advances in illuminating their etiopathological links. However, the majority of data about possible role or interlink between the infection and systemic disease is available in the form of case report or summary. As case reports are not the acceptable to many indexed scientific magazines, many these findings undergo unnoticed to researchers. The currently minimal accessible data provide only an indication of the actuality. Aim: This article highlights the Role of oral foci in systemic diseases. Conclusion: There is need of sincere work efforts on genetic relatedness of organisms, rather than their phenotypes, sophisticated sampling, detection, and analytical techniques to create the associations. To give insight to recent apprises of different systemic diseases as a consequence of primary oral infections and the pathogenesis link. The odontogenic bacteremia is likely to cause systemic and end organ infections, but such infections can easily resist by body defenses. It is important that role of good oral health and the risks associated with poor oral health should told to the individuals. Clinical significance: Dentists and medical practitioners should work together to provide comprehensive health care, thereby reducing the morbidity and mortality associated with oral infections

Herpes zoster oticus: A rare clinical entity

Herpes zoster oticus also known as Ramsay Hunt syndrome is a rare complication of herpes zoster in which reactivation of latent varicella zoster virus infection in the geniculate ganglion causes otalgia, auricular vesicles, and peripheral facial paralysis. Ramsay Hunt syndrome is rare in children and affects both sexes equally. Incidence and clinical severity increases when host immunity is compromised. Because these symptoms do not always present at the onset, this syndrome can be misdiagnosed. Although secondary to Bell′s palsy in terms of the cause of acute atraumatic peripheral facial paralysis, Ramsay Hunt syndrome, with incidence ranged from 0.3 to 18%, has a worse prognosis. Herpes zoster oticus accounts for about 12% cases of facial palsy, which is usually unilateral and complete and full recovery occurs in only about 20% of untreated patients. The most advisable method to treat Ramsay Hunt syndrome is the combination therapy with acyclovir and prednisone but still not promising, and several prerequisites are required for better results. We present a case of 32-year-old man suffering from Ramsay Hunt syndrome with grade V facial palsy treated effectively with rehabilitation program, after the termination of the combination therapy of acyclovir and prednisone

Facial hemihypertrophy and facial hemiatrophy: Report of 2 cases

Facial hemihypertrophy and facial hemiatrophy are rare developmental anomalies. These conditions are characterized by an asymmetric growth of one or more parts of the tissues on one side of the face. The facial asymmetry may be total or partial. The unilateral overgrowth of the mandible seen as the facial asymmetry occurs in case of the congenital mandibular hemihypertrophy, whereas, the facial or mandibular hemiatrophy results in the hallowing or depression on one side of face. The hormonal imbalance, chromosomal abnormalities, trauma, trophic malfunctions of cervical sympathetic nervous system are the factors which are considered to be attributed to the mandibular or facial asymmetry

Oral pregnancy tumor

Pyogenic granuloma is one of the inflammatory hyperplasias seen in the oral cavity. This term is a misnomer because the lesion is unrelated to infection and in reality arises in response to various stimuli such as low-grade local irritation, traumatic injury, or hormonal factors. It predominantly occurs in the second decade of life in young females, possibly because of the vascular effects of female hormones. Clinically, oral pyogenic granuloma is a smooth or lobulated exophytic lesion manifesting as small, red erythematous growth on a pedunculated or sometimes sessile base, which is usually hemorrhagic. Although excisional surgery is the treatment of choice , some other treatment protocols such as the use of Nd:YAG laser, flash lamp pulsed dye laser, cryosurgery, intralesional injection of ethanol or corticosteroids, and sodium tetradecyl sulfate sclerotherapy have been proposed. We present the case of a 25-year-old pregnant woman with large oral pyogenic granuloma

Measurement properties of oral health related patient reported outcome measures in patients with oral cancer: A systematic review using COSMIN checklist.

BACKGROUND:Oral cancer (OC) is one of the common malignant neoplasm resulting in a range of debilitating symptoms. Patient reported outcome measures (PROMs) could provide a valuable insight into the impact of OC on patients' quality of life (QoL). Selecting an adequate instrument among available PROMs for OC has been challenging for clinicians due to lack of information on their psychometric quality. This systematic review provides an extensive overview of methodological quality of all currently available PROMs for OC. METHOD:A systematic search was performed in PubMed, Scopus, Web of Science and CINAHL for relevant literature until 10th January 2019 and data was extracted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the identified studies was assessed per measurement property according to the COnsensus-based Standards for the selection of health Measurements Instruments (COSMIN) checklist. RESULTS:Seven studies were found evaluating 6 health-related QoL PROMs. Among six, there were 1 disease-specific and 5 generic PROMs. Information regarding important measurement properties was often incomplete. The evidence for the quality of measurement properties was found to be variable, none of the instruments performed sufficient on all measurement properties. Considering results of this review, QOL-OC appeared to have adequate COSMIN measurement properties. CONCLUSION:QOL-OC can be implemented in future studies to better understand symptoms and expectations of OC patients and help inform clinicians to formulate treatment strategies as per patients' needs

Oxcarbazepine: Drug of the future in the treatment of trigeminal neuralgia

Background: The aim of the study was to estimate the efficacy of oxcarbazepine in trigeminal neuralgia. Oxcarbazepine is a novel antiepilepfic drug, and its effect on trigeminal neuralgia has not been studied extensively previously. Materials and methods: Fifty-three patients with trigeminal neuralgia (34 men and 19 women) took a mean dose of 600 mg of oxcarbazepine for a period of three weeks. Pain intensity was measured by using visual analog scale. Results: Of the 53 patients, 42 (79%) were completely or well controlled by OXC, and nine (17%) partially but acceptably controlled. Treatment with OXC was therefore satisfactory initially in 51 (96%) of the patients. In seven of these patients, mild transient side effects occurred but did not necessitate cessation of treatment Conclusion: OXC appears to be an effective substitute for carbamazepine in those patients intolerant of this agent, or experiencing significant side effects

Impact of Oral Lichen Planus on Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis

Oral health-related quality of life (OR-QoL) measurement in patients with oral lichen planus (OLP) can provide valuable information for the optimal management of their clinical conditions. The main objective of the present study was to assess the OR-QoL of patients with OLP as measured by the short-form Oral Health Impact profile-14 (OHIP-14) questionnaire. PubMed/MEDLINE, ISI/Web of Science, clinical trial registry, Embase, Scopus, and grey literature (via Google Scholar and Scilit) were searched. Reviewers independently screened titles/abstracts, assessed full-text articles, extracted data, and appraised their quality. Random effect analysis along with subgroup analysis for age, gender, and clinical type was performed. Seventeen studies were included. Mean overall OH-QoL was 15.20, [95% CI 12.176, 18.231]; a higher OHIP-14 score was seen in OLP patients, resulting in poor OH-QoL. The impact of OLP on OH-QoL life was moderate as compared to healthy subjects. However, medical treatment of the disease improved the OH-QoL and thus reduced the impact of OLP on it. OH-QoL among patients with OLP is generally poor. Clinicians and physicians should consider the OH-QoL of these patients as part of patients’ evaluation and modulate the administered treatment based on the OH-QoL response

Evaluation of alteration in serum lipid levels in patients with chronic periodontitis postperiodontal therapy

Aim: There is growing evidence that periodontitis may affect general health. This study was assigned to explore changes in cholesterol levels following nonsurgical periodontal therapy in patients with chronic periodontitis. Materials and methods: Periodontal parameters and lipid profile (total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides and very low-density lipoprotein) were evaluated in 50 subjects suffering from moderate to severe generalized chronic periodontitis. Results: At third month, there was significant reduction in total cholesterol, low density lipoprotein, very low density lipoprotein, triglyceride and increase in high density lipoprotein after nonsurgical periodontal therapy (NSPT). Also, the reduction in bleeding on probing, pocket depth and attachment level were statistically significant in the treatment group. Conclusion: The results of our study showed that periodontal destruction and serum lipid levels are positively correlated and nonsurgical periodontal treatment in chronic periodontitis patients resulted in significant changes in the concentration of total cholesterol, triglycerides, HDL. LDL levels in blood serum