Smokeless tobacco - a substantial risk for oral potentially malignant disorders in South Asia

Data sources: Medline, the Science Citation Index (SCI) via Web of Science, Scopus, CINAHL, Global Index Medicus, Google Scholar and SLT-related reports of the International Agency for Research on Cancer and the National Cancer Institute of the United States. Study selection: Observational studies on the use of SLT and the risk of developing OPMDs in South Asian Populations. Data extraction and synthesis: Duplicate selection of studies was undertaken with two reviewers undertaking data abstraction and quality assessment independently. Risk and odds ratios were extracted or calculated for studies where possible. Meta odds ratios (mOR) were calculated using a random effects analysis. Results: Fifteen papers reporting 18 studies were included. The majority (12) were from India. All the studies were case-control designs. MOR for any OPMD with the use of any SLT product was 15.5 (95% CI; 9.9–24.2). Risk was higher in women; mOR = 22.2 (95% CI, 9.1–54.1) than men; mOR = 8.7 (95% CI, 2.1–34.8). Betel quid with tobacco carried the highest risk for OPMD, mOR = 16.1 (95% CI, 7.8–33.5). Conclusions: The findings of our study point towards a strong association between some forms of OPMDs and SLT use in South Asia. The risk estimates are high, irrespective of controlling for confounders such as smoking and alcohol or stratification by sex, country or source of controls. There is also an exposure-response relationship between OPMDs and SLT use

Tooth Decay in Alcohol Abusers Compared to Alcohol and Drug Abusers

Alcohol and drug abuse are detrimental to general and oral health. Though we know the effects of these harmful habits on oral mucosa, their independent and combined effect on the dental caries experience is unknown and worthy of investigation. We compared 363 “alcohol only” abusers to 300 “alcohol and drug” abusers to test the hypothesis that various components of their dental caries experience are significantly different due to plausible sociobiological explanations. After controlling for the potential confounders, we observe that the “alcohol and drug” group had a 38% higher risk of having decayed teeth compared to the “alcohol only” group (P < .05). As expected, those who belonged to a higher social class (OR = 1.98; 95%  CI = 1.43–2.75) and drank wine (OR = 1.85; 95%  CI = 1.16–2.96) had a higher risk of having more filled teeth. We conclude that the risk of tooth decay among “alcohol only” abusers is significantly lower compared to “alcohol and drug” abusers

The potential synergistic behaviour of inter- and intra-genus probiotic combinations in the pattern and rate of short chain fatty acids formation during fibre fermentation

This study compared the rate of short chain fatty acid (SCFA) production by different probiotic combinations of Lactobacillus and Bifidobacterium to determine any synergistic effects. Six different fibre fractions were fermented with nine combinations of Lactobacillus rhamnosus (LR), Lactobacillus acidophilus (LA), Bifidobacterium longum (BL) and Bifidobacterium breve (BB) for 0, 6, 24 and 48 h. SCFAs were quantified by gas chromatography. Inter-genus combinations of bacteria produced more SCFA, especially BB + BL + LR, compared to intra-genus that yielded the lowest SCFA production. Acetate was the most abundant, while propionate and butyrate were the most utilised. The SCFA formation was as acetate \u3e propionate \u3e butyrate and the total dietary fibre produced most of the SCFA. Most combinations utilised 60–80% of the fibre; BB + BL + LR digested the fibre completely. The quantity, pattern and the time of release of SCFA depends on the genus, but the combination of pre and probiotics is of great importance for the outcome

Potential of sorghum polyphenols to prevent and treat Alzheimer\u27s disease: A review article

Alzheimer’s disease (AD) is characterized by the excessive deposition of extracellular amyloid-beta peptide (Aβ) and the build-up of intracellular neurofibrillary tangles containing hyperphosphorylated tau proteins. This leads to neuronal damage, cell death and consequently results in memory and learning impairments leading to dementia. Although the exact cause of AD is not yet clear, numerous studies indicate that oxidative stress, inflammation, and mitochondrial dysfunction significantly contribute to its onset and progression. There is no effective therapeutic approach to stop the progression of AD and its associated symptoms. Thus, early intervention, preferably, pre-clinically when the brain is not significantly affected, is a better option for effective treatment. Natural polyphenols (PP) target multiple AD-related pathways such as protecting the brain from Aβ and tau neurotoxicity, ameliorating oxidative damage and mitochondrial dysfunction. Among natural products, the cereal crop sorghum has some unique features. It is one of the major global grain crops but in the developed world, it is primarily used as feed for farm animals. A broad range of PP, including phenolic acids, flavonoids, and condensed tannins are present in sorghum grain including some classes such as proanthocyanidins that are rarely found in others plants. Pigmented varieties of sorghum have the highest polyphenolic content and antioxidant activity which potentially makes their consumption beneficial for human health through different pathways such as oxidative stress reduction and thus the prevention and treatment of neurodegenerative diseases. This review summarizes the potential of sorghum PP to beneficially affect the neuropathology of AD

Derivation and validation of a risk-factor model for detection of oral potentially malignant disorders in populations with high prevalence

Background:Oral and pharyngeal cancers constitute the sixth most common type of cancer globally, with high morbidity and mortality. In many countries, most cases of oral cancer arise from long-standing, pre-existing lesions, yet advanced malignancies prevail. A new approach to early detection is needed. We aimed to validate a model for screening so that only high-risk individuals receive the clinical examination.Methods:A community-based case-control study (n1029) in rural Sri Lanka assessed risk factors and markers for oral potentially malignant disorders (OPMD) by administering a questionnaire followed by an oral examination. We then developed a model based on age, socioeconomic status and habits of betel-quid chewing, alcohol drinking and tobacco smoking, with weightings based on odds ratios from the multiple logistic regression. A total, single score was calculated per individual. Standard receiver-operator characteristic curves were plotted for the total score and presence of OPMD. The model was validated on a new sample of 410 subjects in a different community.Results:A score of 12.0 produced optimal sensitivity (95.5%), specificity (75.9%), false-positive rate (24.0%), false-negative rate (4.5%), positive predictive value (35.9%) and negative predictive value (99.2%).Conclusion:This model is suitable for detection of OPMD and oral cancer in high-risk communities, for example, in Asia, the Pacific and the global diaspora therefrom. A combined risk-factor score of 12.0 was optimal for participation in oral cancer/OPMD screening in Sri Lanka. The model, or local adaptations, should have wide applicability

Gene expression profile of oral squamous cell carcinomas from Sri Lankan betel quid users

Oral squamous cell carcinoma (OSCC) is one of the major health problems in Sri Lanka and the disease is associated with the habit of Betel Quid (BQ) chewing. Using 35k oligo microarrays, we analyzed the gene expression profile of 15 Sri Lankan patients diagnosed with OSCCs and pair-wised normal controls and correlated the findings with the clinicopathological data. Following the recording of the scanned array images and data analysis, results for selected candidate genes were verified using QRT-PCR. Upon analysis, a total of 263 genes [71 (27%) of unknown functions previously not reported in OSCCs and 192 (73%) of known functions] were found as differentially expressed between tumors and controls. For the genes with known functions, 66 (34%; such as COL4A1, MMP1, MMP3, PLAU, SPARC and KRT19) were previously reported in OSCC and for the remaining 126 (66%; such as CD47, APOL3, RRAGC, BPIL1 and AZGP1) this is the first report in OSCCs. Hierarchical clustering of the differentially expressed 263 genes grouped the samples into several clusters with the larger one being dominated by tumors of stage 3 and 4. Two cases (a verrucous SCC and an advanced SCC), did not cluster with any of the other samples. We found two main biological pathways (cell communication and integrin-mediated cell adhesion) and 5 gene ontology categories (transcription regulator activity, structural molecule activity, intracellular signaling, cytoskeleton and signal transduction) of relevance to the OSCCs examined. Results from the QRT-PCR verified the results from the microarray experiment. This study provides valuable information on gene expression profile of OSCCs of habitual users of BQ from Sri Lanka. Of particular interest were the list of genes of known and unknown functions and the two biological pathways that we suggest as candidate genes in oral cancers associated with BQ chewing in Southeast Asia, in particular Sri Lanka. The suggested candidate genes might be used as molecular biomarkers in the early detection of the alarming problem of OSCCs in Southeast Asia in association with BQ use. These findings provide valuable information that might help in the selection of possible biomarkers that can be used in early detection of the alarming problem of oral cancer in Southeast Asia.publishedVersio

Criteria for Construction Project Success: A Literature Review

AbstractExecution of construction projects in an efficient and effective way is a core competency of project-based organizations. Evaluation of project success plays a key role in improving project management competency. Project success is an elusive topic and goes beyond project management success and traditional criteria. The lack of an agreed definition and a set of criteria for construction project success have long been the reasons for failing to evaluate success. The main possible causes for such disagreement would be the abstract nature of the concept itself and studies including different industry projects and different participants’ viewpoints with different priorities. Therefore, the objective of this paper is to define construction project success and to develop a framework with a practical set of measurement criteria to evaluate the same.This study has followed the Systematic Review Approach recommended by Tranfield et al. (2003). The recommended check-list by Saunders et al. (2007) was used to ensure the criticality of the review. A definition for Construction Project Success and ten criteria – subjective and objective have been identified. The criteria are Time, Cost, Quality, Safety, Client’s Satisfaction, Employees’ Satisfaction, Cash-flow Management, Profitability, Environment Performance and Learning and Development. The paper stresses the need for a long-term perspective rather than having a short-term perspective of Construction Project Success. Further, it has disentangled complications in literature over some criteria such as Quality and Satisfaction. Employee Satisfaction and Learning & Development have been completely overlooked as a result of short term perspective. Criteria should facilitate measuring project success during the execution stage as well as at the end of the project. It is recommended that, through the studies of relationships between critical success factors and success criteria a stronger model to ensure project success could be established. Proposed framework will be tested in Sri Lankan context in future and findings would be added to the project management body of knowledge. Proposed framework will be instrumental for filling the existing empirical gaps.Keywords: Construction Industry, Project Management, Success Criteria, Project Success, Success Measurement

Gottron’s Carcinoid Papillomatosis: Case Report

Introduction. Gottron’s papillomatosis is a rare benign type of dermatosis with pseudoepitheliomatous hyperplasia of the epidermis, first described as an independent disease by the German dermatologist H.A. Gottron. Invasive epidermal growth and hyperkeratosis reveal no signs of malignancy. Chronic venous insufficiency and lymphedema can be associated with various secondary skin lesions: the formation of ulcers, hyperkeratosis and skin papillomatosis, as well as infectious complications. Skin papillomatosis may be a manifestation of paraneoplastic syndrome, which requires a careful differential diagnosis. Timely treatment of complications in a patient with concomitant somatic pathology performed by a multidisciplinary team of specialists is necessary to improve the prognosis. Considering the relative rarity of Gottron’s papillomatosis and the lack of awareness among practicing physicians regarding the differential diagnosis of this disease, we present this clinical analysis.Description of a clinical case. Patient L., 42 years old (body mass index — 76.5 kg/m2) with chronic lymphovenous insufficiency, lymphedema, erysipelas of the right lower limb associated with unspecified skin papillomatosis, was urgently hospitalized in a health care institution “City Clinical Hospital No. 3” of Grodno (Republic of Belarus), consulted by a multidisciplinary team of clinicians including a therapist, a cardiologist, a dermatologist, an endocrinologist, an infectious disease specialist, and a surgeon. Taking into account the clinical status of the patient and the retrospective analysis of archival records of previous examinations performed on the patient in the health care institution “Grodno University Clinic”, the type of dermatosis was determined as Gottron’s papillomatosis of both lower extremities. In terms of the clinical diagnosis of the patient, complex therapy was initiated in a hospital setting, which was then continued at the outpatient stage.Conclusion. Adequate long-term treatment of morbid obesity and chronic lymphovenous insufficiency is necessary to prevent serious complications. According to the academic literature, timely diagnosis of such a rare dermatosis as Gottron’s papillomatosis, as well as the prescription of adequate therapy determine the possibility of regression in the early stages of the disease