DNA damage in buccal cells in oral PMDs and malignant disorders by comet assay: a comparison with blood leukocytes

Aim: DNA damage associated with Oral Squamous Cell Carcinoma (OSCC) and potentially malignant disorders (PMDs) is produced due to carcinogenic agents or increased oxidative stress. Comet assay can assist in early detection and evaluation of the amount of DNA damage; lymphocytesare the most commonly used cells for performing comet assay. Utilisation of buccal epithelial cells in comet assay can be a minimally invasive and rapid method. The present study compared the efficacy of comet assay in assessing DNA damage in buccal cells over peripheral blood leucocytes (PBLs) in oral potentially malignant and malignant disorders. Methods: The study included fifty five patients each of Leukoplakia, Oral Submucous Fibrosis (OSMF) and OSCC along with fifty five healthy individuals as control. Buccal epithelial cells were collected from all the selected subjects. DNA damage was evaluated bymeasuring the mean tail length (µm). Results: A significantly increased mean tail length (µm) and higher DNA damage were found in OSCC (26.1096 + 1.84355) and there was a progressive stepwise increase in mean tail length from control(8.4982 + 0.93307) to PMD [leukoplakia (14.6105 + 0.71857); OSMF (12.5009 + 1.12694)] to OSCC.The mean tail length in different habit groups was greater than controls, though no significant difference was noted between habit groups. The mean tail length of buccal cells was significantly greater than the mean tail length of PBLs in all study groups and controls. Conclusion: Hence, use of comet assay on buccal epithelial cells can prove to be beneficiary for evaluation of DNA damage

Homology Modeling and Docking Studies of Japanese Encephalitis Virus Proteins Like Envelope Protein and NS1 Protein.

Japanese Encephalitis (JE) is a vector- borne, viral zoonosis that may affect humans. The disease periodically becomes endemic in areas such as northern India, parts of central and southern India. Japanese Encephalitis virus belongs to the mostly vector-borne flaviviriade, which are single stranded RNA viruses. The envelope glycoprotein of JE Viruses contain specific as well as cross relative, neutralizing epitopes. The objective of this research to find out the best ligand molecule each for the two drug targeting protein present in the JEV. This will be done by studying the complete structure of JEV drug targeting proteins and their interaction with their respective ligand. The envelope protein and NS1 protein have been studied. The minimum energies were recorded after the docking studies for all the inhibitors docked with the protein. After comparison of the minimum energies recorded, the ligand with the least minimum docking energy has been considered as the best ligand. The entire study indicates that the inhibitor Mycophenolate with minimum energy -5.00605kj/mol is the most effective against Envelope protein. However in case of NS1 protein, the inhibitor Deoxynojirimycin with the minimum energy of - 6.75932kj/mol is found to be the most effective.

Acute pulmonary embolism during an endoscopic retrograde cholangiopancreatography.

A 76‑year‑old female patient presented for an endoscopic retrograde cholangiopancreatography (ERCP) for the removal of a biliary stent and lithotripsy. During the procedure, an acute drop in the end‑tidal CO2, followed by cardiovascular collapse prompted the initiation of the advanced cardiac life support protocol. Transesophageal echocardiography (TEE) demonstrated direct evidence of pulmonary embolism. The patient was promptly treated with thrombolytic therapy and subsequently discharged home on oral warfarin therapy, with no noted sequelae. Although, there have been case reports of air embolism during an ERCP presenting with cardiovascular collapse, to the best of our knowledge, there are no reported cases of acute pulmonary embolus during this procedure. While the availability of TEE in the operating suites is quite common, quick access and interpretation capabilities in remote locations may not be as common. With the expansion of anesthesia services outside of the operating rooms, it may be prudent to develop rapid response systems that incorporate resources such as TEE and trained personnel to deal with such emergent situations.

Level of glycaemic control in type 2 diabetes mellitus in Bareilly region (India).

Background: Diabetes mellitus has emerged as a major health care problem of India. The real burden of diabetes is due to its associated complications which lead to increased morbidity and mortality. An accurate diagnosis of diabetes and level of glycaemic control in known diabetics is recommended for the treatment and prevention of complication in the population. Aims & Objective: To identify the pattern of glycaemic control in type 2 diabetes mellitus using glycosylated haemoglobin (HbA1C) in Bareilly region, India. Material and Methods: The present cross sectional study was conducted in one of the tertiary care hospital of Bareilly district. The respondents were the 1000 type 2 diabetics of 35 to 60 years of age group. Glycosylated haemoglobin A1C (HbA1C) was done in all subjects by ion exchange chromatography and results were categorized as normal, good, average and poor diabetes control. The statistical analysis was Analysis of variance (ANOVA) using SPSS software. Results: Out of 1000 individuals, 120 had good, 469 had fair and 411 had poor glycaemic control on the basis of their HbA1C status. Age was similar for all 3 groups and was insignificantly related to glycaemic control (p-0.663). Out of 1000 individuals, 703(70.30%) had normal BMI while 297 (29.7%) were overweight. Conclusion: Measurement of glycosylated haemoglobin levels should be used in monitoring the treatment and long term glycaemic control of diabetes in a population and the assessment of body mass index should be done for the need of life style intervention in a population.

Prevalence and severity of periodontal diseases in type 2 diabetes mellitus of Bareilly region (India).

Background: Periodontal disease and diabetes share a two way relationship because of common pathways of disease progression. Aims & Objective: Extensive study on various population worldwide were carried out but there is a limited data for Indian population, Hence, the present study was done to evaluate the prevalence and severity of periodontitis in type 2 diabetes mellitus of Bareilly region of Uttar Pradesh (INDIA). Material and Methods: 1000 individuals of type 2 diabetes mellitus were categorized as good, average and poor glycaemic control on the basis of glycosylated hemoglobinA1C(HbA1C). Periodontal examination was done by recording oral hygiene index simplified, clinical attachment loss and gingival bleeding index. This periodontal result was correlated with glycaemic status and duration of diabetes since diagnosis. Results: Results showed a 91.7% prevalence of periodontitis, predominating with 41.3% cases of moderate periodontitis followed by 26.2% of severe and 24.2% of slight and 8.3% of gingivitis cases. In poor oral hygiene strata; the amount of severe periodontitis cases increased from 0% to 26.2% and up to 73.8%; as the glycaemic control deteriorated from good to average to poor. Similar results were reported for good and fair oral hygiene strata. Conclusion: Results of present study demonstrated that with worsening of glycaemic control, severity of periodontitis significantly increases even when examined for similar oral hygiene status.

Ewing's Sarcoma of the Rhinomaxillary Complex: A case Report with Review of Literature.

Ewing's Sarcoma of bone (ESB) is a rare primary malignant tumor of bone, belonging to Ewing's Sarcoma Family of Tumors (EFT) and are neuro-ectodermal in origin. These tumors are characterized histopathologically as small round blue cell tumors (SRBCT) containing cytoplasmic glycogen, cytogenetically by a (t:11;22) or (q:24;12) translocation and molecularly by the presence of EWS and FLI1 fusion transcripts. ESB is primarily a pediatric tumor, uncommon in the Asian population, affecting the axial skeleton and rarely the jaw bones. ESB poses a diagnostic challenge as it shares many features with other malignant tumors whose managements are substantially different. We present the clinical, radiographic histopathological and immuno histochemical features of ESB involving the left rhinomaxillary complex in a young Indian male. We also discuss the differential diagnosis and current treatment modalities in management of ESB.

Case report on cherubism: non-familial variant / Relato de caso de querubismo: uma variante não familiar

Introduction: Cherubism is a rare, non-neoplastic, self-limiting, fibro-osseous disease, characterized by painless expansion of the maxilla, mandible or both. It usually develops in the first and second year of life. The radiographic appearance presentation is ordinarily bilateral, multilocular appearance in the mandible. To the best of our knowledge, very few cases (less than ten) of non-familial cherubism have been reported in the English literature. Objective: To describe non-familial case of cherubism in a 10-year-old child. Materials and methods: The current case was clinically, radiographically and histopathologically analysed for confirmatory diagnosis. Results: H & E stained section showed vascular and cellular stroma containing numerous multinucleated giant cells. Conclusion: Correlating radiographically and histopathologically the case was finally diagnosed as non-familial variant of cherubism.

Introdução: Querubismo é uma doença rara, não neoplásica, autolimitada, fibro-óssea, caracterizada pela expansão indolor da maxila, mandíbula ou ambas. Ela geralmente se desenvolve no primeiro e no segundo ano de vida. A aparência radiográfica é normalmente bilateral, multilocular e localizada na mandíbula. Para melhor conhecimento, poucos casos (menos de dez) de querubismo não familiar foram relatados na literatura. Objetivo: Descrever um caso de querubismo não familiar em uma criança de 10 anos. Materiais e métodos: Para confirmação do diagnóstico, foram realizadas avaliações clínicas, radiográficas e histológicas deste caso. Resultados: Seção corada de H & E mostrou estroma vascular e celular contendo numerosas células gigantes multinucleadas. Conclusão: Na correlação radiográfica e histológica, ficou confirmado diagnóstico de variante não familiar de querubismo.

Incidental discovery of an unusual right atrial membrane in an adult patient.

We describe presence of an unusual right atrial membrane in a 30-year old female with end stage renal disease, hypertension and peripheral vascular disease. The patient was scheduled for midline sternotomy and pericardiotomy and removal of a migrated vascular stent in the right pulmonary artery. An intraoperative transesophageal echocardiogram (TEE) revealed an unusual membranous structure with fenestrations that stretched across the right atrium with attachments superiorly at the free wall and inferiorly at the inter-atrial septum. There was no evidence of flow obstruction across the tricuspid valve. Some of the considerations for the likely diagnosis of this structure were a prominent Eustachian valve, persistent Chiari network, aneurysmal inter-atrial septum, an inter-atrial septal cyst or Cor triatriatum dexter (CTD).

Coexpression of p53 and Ki 67 and lack of c-erbB2 expression in oral leukoplakias in India

Oral cancer is commonly preceded by premalignant lesions and conditions. The clinician's ability to identify lesions at an increased risk of cancer development is critical for its control. The purpose of this study was to compare the expression of tumor suppressor gene p53, proliferation marker Ki-67, and oncogene c-erbB2 and to evaluate the relevance of their co-expression in the diagnosis of, and prognosis for, oral leukoplakia. In the present study, the expression of biomarkers was studied immunohistochemically in 55 cases of leukoplakia (26 without dysplasia, 29 with dysplasia) and 10 cases of normal epithelia. The Labeling Indices (LI) of p53 and Ki-67 were found to increase significantly with an increase in the grade of dysplasia. A significant correlation was also found between the LI of p53 and that of Ki-67. It was also observed that c-erbB2 expression was only cytoplasmic, indicating incomplete receptor degradation. Hence, it can be concluded from the present study that the increased expression of p53 and Ki-67 with an increase in the grade of dysplasia suggests that their co-expression may be used for the identification of high-risk lesions. Also, c-erbB2 has no pathogenetic role in early carcinogenesis in the studied population, although incomplete receptor degradation, as evidenced by cytoplasmic staining, may indicate an early change.