ABSTRACT
PURPOSE: Oral submucous fibrosis (OSMF) is a high-risk precancerous condition that predominantly affects Indian youngsters due to the habit of gutkha chewing. Candida may play a role in the etiopathogenesis of premalignant and malignant lesions. The aim of this study is to compare the incidence, intensity, and species of Candida found in OSMF patients and healthy individuals. METHODS: This study included 20 OSMF patients and 20 healthy controls. A detailed history of each patient was recorded along with a clinical examination. Samples were collected with the oral rinse technique and cultured on Sabouraud's agar medium. The isolated yeast species were counted and identified based on Gram staining, a germ tube test, chlamydospore formation and a sugar assimilation test. RESULTA: In total, 40 percent of OSMF patients and 15 percent of healthy controls yielded Candida organisms on culture. C. albicans was the predominant species isolated, but C. krusei and C. tropicalis were also identified. Gender, gutkha habit and clinical staging had no influence on the candidal carriage in OSMF patients. CONCLUSION: The incidence and intensity of Candida (primarily C. albicans) was greater in OSMF patients than in healthy controls, but these findings were within the normal limit (3-47 percent). Therefore, Candida may not be an etiologic factor in malignant transformation. However, controversy still exists over whether the chewing of betel quid in cases of OSMF has an inhibitory effect or promotes the adherence and invasion of Candida.
OBJETIVO: Fibrose submucosa oral (FSO) é uma condição pré-maligna de alto risco que predominantemente afeta jovens da Índia devido ao hábito de mascar 'gutkha'. Candida pode ter um papel importante na etiopatogenia de lesões pré-malignas e malignas. O objetivo deste estudo foi comparar a incidência, intensidade e Candida spp encontradas em pacientes com FSO e em indivíduos saudáveis. METODOLOGIA: Este estudo incluiu 20 pacientes com FSO e 20 controles saudáveis. Obteve-se de cada sujeito uma história detalhada e exame clínico. As amostras foram coletadas com uma técnica de enxágue bucal e cultivadas em meio Agar Sabouraud. As espécies isoladas foram contadas e identificadas com base em coloração Gram, teste de tubo de ensaio e teste de assimilação de açúcar. RESULTADOS: No total, 40 por cento dos pacientes com FSO e 15 por cento dos controles saudáveis apresentaram resultado positivo de cultura para Candida. C. albicans foi a espécie predominante isolada, mas C. krusei e C. tropicalis também foram identificados. O sexo, hábito de mascar 'gutkha' e estadiamento clínico não influenciaram a presença de fungos nos pacientes com FSO. CONCLUSÃO: A incidência e intensidade de Candida (primariamente C. albicans) foi maior nos pacientes com FSO que nos sujeitos controle, mas estes achados estavam dentro dos limites normais (3-47 por cento). Portanto, Candida pode não ser um fator etiológico na transformação maligna. Entretanto, ainda há controvérsias se o hábito de mascar 'betel' em casos de FSO teria um efeito inibidor ou promoveria a aderência e invasão de Candida.
Subject(s)
Humans , Candida/isolation & purification , Oral Submucous Fibrosis , Piper betleABSTRACT
Phaeohyphomycosis, caused by heterogeneous group of phaeoid fungi causes both subcutaneous and systemic infections. The disease is more of a histopathological than a clinical entity. We present a case of phaeohyphomycosis in a 29-year-old male who presented with the complaint of painful swelling of the right eye of 1-year duration. Computed tomography (CT) scan showed an abnormal hyper dense enhancing soft tissue in the extra coronal aspect of the right orbit along the superolateral and superomedial aspect. A provisional clinical diagnosis of lymphoma or fungal infection was entertained. Histopathology revealed granulomas with numerous multinucleated giant cells and fungal hyphae within and in between the giant cells. Per-iodic acid Schiff (PAS stain) was used to confirm the presence of hyphae. Based on the clinical, CT and histopathological features, a diagnosis of Phaeohyphomycosis was given.
Subject(s)
Adult , Ascomycota/classification , Dermatomycoses/diagnosis , Ethmoid Sinus/pathology , Humans , Male , Orbit/pathology , Silver Nitrate/metabolism , Soft Tissue Infections/diagnosis , Tomography, X-Ray ComputedABSTRACT
AIM: Detection of cancer at the early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, noninvasive methods like analysis of saliva may provide a cost-effective approach for screening a large population. Thus, this study aimed to estimate salivary levels of sialic acid, total protein, and total sugar in the oral cancer patients and in healthy control group to evaluate their role in diagnosis and prognosis of oral cancer. STUDY DESIGN: Unstimulated whole saliva samples were collected from 30 healthy controls (Group I) and 30 squamous cell carcinoma patients (group II). Estimations of salivary levels of sialic acid, total protein, and total sugar were performed. This was correlated histopathologically with the grades of carcinoma. STATISTICAL ANALYSIS AND RESULTS: The Student's ' t ' test and multivariate regression analysis were performed. The results showed that salivary levels of total protein, total sugar, protein-bound sialic acid, and free sialic acid were significantly higher in oral cancer patients compared to those of normal healthy controls ( P values in all the results were less than 0.001). The salivary free sialic acid levels were found to be significantly higher in well-differentiated squamous cell carcinoma than in moderately differentiated carcinoma ( P < 0.001). However, protein-bound sialic acid, total proteins, and total sugars did not show any statistical significance between well and moderately differentiated carcinomas. CONCLUSION: Biochemical analysis of saliva can be used in early detection of cancer and is best correlated with histopathological degree of squamous cell carcinoma.