ABSTRACT
Background: Oral submucous fibrosis (OSMF) is a potentially malignant disorder (PMD) known to transform into oral cancer. One of the important hallmarks of malignant transformation is the uncontrolled growth rate, commonly reflected as increased cell proliferation which can be significantly detected by proliferative markers such as a high Ki?67 index. Aim: The aim of this study is to evaluate the degree and pattern of expression of Ki67 in OSMF, oral squamous cell carcinoma (OSCC) and in normal mucosal (NOM) patients and to correlate the Ki67 expression with clinical and histological grading of OSMF and OSCC patient. Materials and Methods: A prospective cross?sectional study was conducted over a duration of two years. An immunohistochemical study was performed for Ki76 expression on 35 cases of OSMF, 10 cases of OSCC and 10 normal mucosal patients. Statistical Analysis: Data were analysed using SPSS version 21. Chi?squared test was used to analyse the differences between the intensity levels in OSMF, OSCC and NOM. Results: Expression of Ki67 was significantly higher in OSMF than that of NOM samples but less than that of OSCC samples. Expression of Ki67 increased with increasing grade of clinical and histological stages. Conclusion: The study demonstrated a high incidence of Ki67 overexpression in OSMF and OSCC and showed a correlation between clinical and histological grading of OSMF and OSCC. Identification of high?risk oral PMDs and intervention at premalignant stages could constitute one of the key steps in reducing the mortality, morbidity and cost of treatment associated with malignant transformation of these diseases
ABSTRACT
Background: Extended Spectrum Beta Lactamases(ESBLs) are rapidly evolving group of β-lactamaseenzymes that are of particular concern to clinicians andepidemiologists. Most ESBLs have been evolved bygenetic mutation from blaTEM and blaSHV genes, andare well described in Klebsiella pneumoniae. Aim andObjective: To investigate the ESBL genotypes in K.pneumoniae isolates from Respiratory Tract Infections(RTIs). Material and Methods: Clinical isolates of K.pneumoniae were obtained from RTI -sputum samples.Antimicrobial susceptibility was determined by KirbyBauer disc diffusion method. ESBL was detectedphenotypically and multiplex Polymerase ChainReaction (PCR) specific for blaTEM, blaSHV andblaCTX-M genes was performed to identify genotypes.Results: During the 19 months period, a total of 212 ofK. pneumoniae were found from RTIs. Of these 212isolates, 60 isolates (28.3%) were ESBL producers byphenotypic method. Of these 212 isolates, 96 wererandomly selected for multiplex PCR for blaTEM,blaSHV and blaCTX-M genes. The findings ofmultiplex PCR showed that 24 isolates (25%)possessed blaTEM gene and only 4 isolates (4.1%)possessed each blaSHV and blaCTX-M gene alone.Isolates having both blaTEM+blaSHV genes were 20(20.8%), and both blaTEM+blaCTX-M genes were 12(12.5%); and isolate possessing all threeblaTEM+blaSHV+blaCTX-M genes were 20 (20.8%).The overall prevalence of blaTEM, blaSHV andblaCTX-M genes in this study was 79.1%, 45.8% and37.5% respectively. Imipenem was most effectiveantibiotic. Conclusion: Spread of ESBL producing K.pneumoniae is a major concern, as it causes limitationsto optimal treatment. Multiplex PCR can be used as arapid method to identify ESBL genotypes in K.pneumoniae. It will prove valuable for surveillance andestablishing the treatment line against drug resistantorganisms, thus saving precious time and resources. Inour study blaTEM genotype was most prevalent.