Dynamics of Kirsten Ras and isoforms of protein kinasis in the progression of oral potentially malignant to malignant lesions

Oral premalignant lesions and oral squamous cell carcinoma are significant health problems influenced by different predisposing factors and genetic alterations .The clinical and histological features alone cannot accurately predict whether potentially premalignant lesions of the oral mucosa will remain stable, regress or progress to malignancy. Methodology included extraction of RNA from paraffin embedded tissue samples, RT-PCR followed by PCR in 53 biopsy specimens of premalignant and malignant lesions. Results of this study indicate that Akt levels show a continuous rise from pre-malignant lesions to grade II. [Akt1: Premalignant lesions 0.06 + 0.01 and in moderately differentiated Grade II OSCC 0.12 + 0.03; Akt2: Premalignant lesions 0.03 +0.00 and moderately differentiated Grade II OSCC 0.13 + 0.03 and Akt3: Premalignant lesions 0.02 +0.00 and moderately differentiated Grade II OSCC 0.06 + 0.01. KRas expression also increases as the grade of the cancer increases [premalignant lesions 0.02 +0.02 and Grade II OSCC 0.17 +0.01]. Blocking these genes at the level of premalignant lesions may help to decrease the chances of progression into oral squamous cell carcinoma

Role of protein kinases and Kirsten Ras pathways in oral squamous cell carcinoma and poorly differentiated oral squamous cell carcinoma in Punjab [Pakistan] population

Oral Squamous Cell Carcinoma [OSCC] develops by accumulation of multiple genetic alterations, influenced by the patient's genetic predisposition as well as by environmental influences, that includes pan, chaalyia, tobacco, alcohol, chronic inflammation, and viral infection. This study was carried out to understand the molecular alterations which contribute to the development of OSCC in Pakistani population. The study was conducted on a sample of 53 patients collected from different hospitals of Lahore. Results of this study indicate that Akt levels shows higher expression with increase in grades. The value of Akt1 in well differentiated grade 1 tissue is of the order of 0.09+0.00, Akt2 is 0.04+0.00 and Akt3 is 0.02+0.00 while in poorly differentiated tissues the values of Akt 1, Akt and Akt3 are 0.22+0.09, 0.13+0.03 and 0.06+0.01 respectively. kRas is an oncogene which is highly elevated in both grades [well differentiated: 0.09+0.02 and poorly differentiated: 0.13+0.02] in all samples of OSCC. In conclusion, our data demonstrated that Akt isoforms and kRas significantly control the cancer transition pathway. It is seen that Akt 1expression rises from 2.5- fold in well differentiated tissues to 3.5-fold in poorly differentiated tissues. The Akt-2 on the other hand shows only 0.5-fold increases from normal tissue in grade 1 tissues, but rises to 4-fold in grade-3 tissue. On the other hand there was no change in Akt-3 as compared to normal in grade I tissues yet, 3-fold increase has been recorded in grade III tissue. The oncogene K-RaS shows consistent increase of the order of 2.5-fold in grade I and 3-fold in grade III. This information combined with histopathological reports can further improve our understanding of the prognosis of oral squamous cell carcinoma

Awareness regarding screening of oral cancers in young dental graduate

Oral cancer is an ideal cancer to identify early by screening. Dentists can play a critical role in the early diagnosis of oral cancers. Because oral and pharyngeal cancers can be recognized at an earliest stage by visual and tactile examination, dentists are one of the most likely groups of health care practitioners who have a key role in counseling patients regarding early detection of oral cancer. Assessment of the level of knowledge, attitudes, and behaviors of dental health care workers regarding oral cancer is thus important and it is vital to train such professionals in oral cancer risk, prevention and control measures, and detection procedures. The aim of this study was thus to investigate the oral cancer awareness of dentist at Lahore dental schools by assessing knowledge and attitude about oral cancer risk factors. This cross-sectional survey was conducted between September to October 2011 by self-administered questionnaires among a random sample of 75 young dentists of dental institutes of Lahore. Questionnaires were then entered in the SPSS and quantitative e qualitative data was analyzed. Though dentists were aware of risk factors associated with oral cancers and understand the importance of screening in early diagnosis as shown by this study but more education was needed in dental schools, postgraduate programs and continuing education programs to enhance dental professionals' knowledge of Oral Cancer risk factors and diagnostic concepts. Such programs should include information about adjunctive diagnostic aids as well

Correlation between salivary glucose level and gingivitis in patients with diabetes

Type 1 Diabetes has been linked with an increased risk of gingivitis and periodontal disease. Patients with periodontal disease and/or diabetes show differences in the profile of constituents in whole saliva. This profile reflects the nature and amplitude of the host response to a periodontal microbial challenge and /or response to diabetes mellitus. To compare gingival health between control group and patients with type I Diabetes and to assess whether there is any association between gingivitis/periodontitis and salivary glucose level. Study was conducted on 90 subjects; 30 control and 60 diabetics. Gingival and periodontal status was assessed for both the groups clinically. Then un-stimulated whole saliva samples from diabetics and control group were collected stored and frozen at -20°C. Saliva samples were then thawed, centrifuged and its supernatant portion was analyzed by Dimension Clinical Chemistry System for Salivary glucose levels. SPSS 17.0 was used for statistical analysis. Results showed that gingivitis was statistically significantly higher among the type I diabetic patients when compared with the control group p < 0.05. It was concluded that gingival health was compromised in diabetic children. It was also concluded that salivary glucose levels were higher in the patients with type I as compared to control group

Dental caries and diabetes mellitus

Diabetes Mellitus has been linked with increased incidence of dental caries. Aim of this study was to compare caries incidence between control group and diabetic patients and to assess whether there is any association between dental caries and salivary glucose level and salivary calcium levels. Study was conducted on 60 subjects; 30 control and 30 diabetics. DFT [Decayed Filled Teeth Score] was assessed for both the groups clinically. Then un-stimulated whole saliva samples from diabetics and control group were collected, stored and frozen at -20C. Saliva samples were then defrosted, centrifuged and their supernatant portion were analyzed by Dimension Clinical Chemistry System for Salivary glucose and calcium levels. SPSS 16.0 was used for statistical analysis. Results showed that DFT score was higher among the diabetic patients [2.49] when compared with the control group [0.53]. It was also concluded that salivary glucose levels were higher and salivary calcium levels were lower in the diabetic patients as compared to control group

Oral cancer knowledge and awareness amongst undergraduate dental students of Lahore - Pakistan

The aim of this study was to investigate the knowledge and awareness of undergraduate dental students regarding risk factors and signs of oral cancer. A self reported questionnaire comprising of eight questions was given to seven hundred and sixty undergraduate dental students in four of the five dental institutes situated in Lahore, Pakistan during the academic year 2010. The results showed i gradient of responses to questions related to oral cancer awareness and knowledge amongst students of 1[st], 2[nd], 3[rd] and final year BDS. Better knowledge and awareness was found amongst 3rd year students as compared to final year students [p<0.05]. This may be due to the fact that oral pathology is taught in third year. The study highlights the need to improve the knowledge of undergraduate dental students regarding prevention and early detection of oral cancer

Assessment of antero-posterior position of lips: E-line- S-line

In cephalometric and photographic analysis, several reference lines have been used to assess anteroposterior position of the upper and lower lips: E-Line and S-Line being the most commonly used reference lines Aim of this study was to find out the antero-posterior position of lips on photograph using E-line and S-line in patients with orthognathic profile and to establish correlation between lip prominence judged by E-Line and S-Line. The study was conducted on 90 subjects, with orthognathic profile as judged in consensus by orthodontist, prosthodontist, Oral Surgeon, Oral Pathologist and General Dentist and confirmed by lateral cephalogram [ANB 0-4°, Wits Value 0,-lmm] with age range of 12-30 years. E-Line and S-Line were drawn on photograph to assess the prominence of upper Lip and lower lip. SPSS 16.0 was used for statistical evaluation. Antero-posterior position of upper and lower lip with reference to E-line was -7.9+3.33 mm -0.4+3.24 mm respectively and Antero-posterior position of upper and lower lip with reference to S-line was 3.72+2.85 mm and 1.18+3.23 mm respectively. Moreover statistically significant correlation was found r-0.509 between Upper lip to E-Line and Upper Lip to S-Line andm r= 0.861 between Lower lip to E-Line and Lower lip to S-Line

Sensitivity and specificity of saliva in estimation of anti-HCV antibodies

This study was done to assess the efficacy of saliva as a screening tool in Hepatitis C infection when collected in a sterile test tube by simple spitting process. Anti Hepatitis C Virus antibodies [Anti-HCV] were detected in salivary samples of patients and healthy controls without using any special salivary collection device. Paired serum and oral fluid collections were obtained from 50 HCV positive cases and twenty five negative individuals. Saliva samples were collected in a sterile disposable plastic test tube by simple spitting of un-stimulated saliva by the study subjects. A modification of the serum HCV ELISA assay was developed to improve test accuracy for an oral fluid substrate. The presence or absence of anti-HCV antibodies in the blood serum was taken as gold standard against which anti-HCV levels in saliva were comparid. Overall sensitivity of saliva to detect Anti HCV antibodies was found to be 94.2% while specificity was 100%. This simple method of oral fluid collection proved to be an effective alternative to special collection saliva can be used as a cost effective screening tool for initial screening of hepatitis C infection in high risk populations

Oral health status in diabetic children

Objectives: diabetes causes numerous oral and salivary changes leading to cariogenic and gingival lesions. The present study was designed to elucidate the role of diabetes mellitus in oral health

Methods: a cross-sectional study including 60 diabetic children [case group] and 30 non diabetic children [control group] of age 3-14 years was conducted. HbA1c and blood glucose level was measured along with the oral health including gingival status and dental caries status was visually assessed. Gingival status was coded for healthy, marginal gingivitis and calculus. Dental caries status [decayed and filled] for both deciduous and permanent dentition was assessed. Data was recorded in a pre-coded oral health proforma, which was then entered and analyzed in SPSS version 10.0. Descriptive analysis such as percentage frequencies and means was performed. Exact Chi-square test was used to analyze any significant changes observed amongst the study population, where level of significance was p < 0.05 with confidence interval 95%

Results: the results show important difference between both groups of children. Dental caries level is significantly higher in diabetic children both in deciduous and permanent dentition than in non-diabetic children [p <0.05]. Gingival health was also observed to be debilitated in diabetic children than non- diabetic children [p < 0.05]

Conclusion: the study highlights that special preventive measures must be adopted to maintain a good oral health of the diabetic children