Non-invasive Assessment of Interleukin 6 and its Clinico-pathologic correlation in patients with Oral Squamous cell carcinoma.

Background: Interleukin-6 (IL-6) is a pro inflammatory cytokine that promotes inflammation, development and progression of cancer. Quantitative assessment of IL6 in saliva will help in the early diagnosis of oral cancer. Whole saliva as an alternative laboratory tool to blood comprises a non-invasive, easy, rapid to collect, easy to handle and cost-effective sample convenient both for patient and the health personnel during screening of larger population. Hence the study aimed to estimate the concentration of salivary IL6 and clinically correlate these levels in patients with oral Squamous cell carcinoma. Methods: A total of 72 subjects aged between 31-60 yrs were included in the study. Group I: Thirty six histological proven cases of oral Squamous cell carcinoma. Group 2: Thirty-six healthy controls. Unstimulated whole saliva sample was collected and the samples were analysed for interleukin-6 using ELISA kits. Data was analyzed using SPSS software version 22. Results: The study showed a statistically significant elevation ofinterleukin-6 in saliva of patients with oral cancer 214.29�.64 pg/mL as compared to the healthy control group 17.11�83 pg/mL with a p value of 0.001. The Salivary IL6 levels did not show any correlation with gender of patients both in OSCC and control subjects. The median Salivary IL6 levels were significantly higher in stage (I-II) compared to stage(III -IV). Conclusion: Estimation of IL6 in saliva can be considered as a non invasive alternative laboratory tool to blood for oral cancer for screening among high risk subjects.

Usefulness of salivary sialic acid as a tumor marker in tobacco chewers with oral cancer

Aim:This study aims to assess the usefulness of salivary sialic acid (SA) as a tumor marker in the detection of oral squamous cell carcinoma (OSCC) among tobacco chewers. Materials and Methods:After the approval of study protocol by the Institutional Ethics Committee and informed voluntary consent, salivary samples were collected from 96 participants in each group of tobacco chewers with OSCC, tobacco chewers without precancerous or cancerous lesion, and healthy controls. Salivary protein-bound SA (PBSA) and salivary-free SA (FSA) were measured by Yao et al.'s method of acid ninhydrin reaction, and the data were subjected to appropriate statistical analysis. Results: The salivary PBSA and FSA levels in the Groups 1, 2, and 3 participants were 31.17 ± 7.6 mg/dL and 63.45 ± 9.8 mg/dL, 25.45 ± 16.61 mg/dL and 33.18 ± 11.38 mg/dL, and 22.73 ± 3.01 mg/dL and 21.62 ± 8.86 mg/dL, respectively. Salivary FSA levels were significantly increased among the tobacco chewers with OSCC patients (Group 1) and tobacco chewers with no premalignant lesions of the oral cavity (Group 2) compared to the healthy controls (Group 3) with P < 0.05 being statistically significant. Salivary FSA levels were significantly increased in Group 1 as compared with Group 2. The salivary PBSA was high among Group 1 as compared to the control Group 3; there was however no significant difference in the levels of salivary PBSA between Group 1 and Group 2. There was no significant difference in the PBSA levels between OSCC patients of Group 1 and the tobacco chewers without precancerous or cancerous lesion in the oral cavity of Group 2. Conclusion: Salivary PBSA and FSA are significantly raised in both tobacco chewers with OSCC and in tobacco chewers with no precancerous or cancerous lesions in the oral cavity. SA should therefore be used cautiously while considering it as a marker for the early detection of oral cancer. Tobacco can be a crucial confounding factor when SA is used as a biomarker in OSCC since their levels are elevated to some extent even in tobacco chewers without any clinically obvious precancerous or cancerous lesions in the oral cavity

Nicotinic acetylcholine receptor gene polymorphism is not associated with tobacco-related oral squamous cell carcinoma

CONTEXT: Tobacco use is a major public health challenge in India with 275 million adults consuming different tobacco products. Despite innumerable laws, the overall picture of the current system is not clear and the menace of tobacco persists. What does it take to stop this menace? The present study made an attempt to throw some light on the prevailing discrepancy in the current system. AIMS: The aim of the study was to explore the knowledge and attitude of people involved in growth and sales of tobacco. MATERIALS AND METHODS: This qualitative research was aimed at farmers growing tobacco in Mysore district and vendors selling tobacco in Bangalore. Snowball sampling technique was used to select the farmers. Simple random sampling technique was used to shortlist vendors selling tobacco products in Bangalore. Data were collected using semistructured questionnaire through interviews which were recorded using an audio recorder. RESULTS: Inductive analysis was conducted for the present study and the responses were divided into three categories, that is, awareness of laws, compliance to laws, and opinion regarding banning tobacco. Ninety percent of the growers and all the tobacco vendors (100%) were aware of the laws governing them; however, the compliance was poor in both the populations (32% and 20%, respectively). CONCLUSIONS: Implementation of law is an area that needs to be strengthened. Violations of these laws are not adequately reported; this matter should be dealt with. It was seen that the system which creates the laws itself promotes the growth and thereby the distribution of the tobacco products.

Successful treatment of Zenker's diverticulum by endoscopic staple-assisted diverticulotomy in a 75-year Saudi female

Zenker's diverticulum [hypopharyngeal pouch] is a rare medical entity caused by herniation of esophageal mucosa and submucosa through an anatomical defect between the layers of the inferior constrictor muscle. It is believed that this occurs mainly due to incoordination between the stages of swallowing and timely opening of the cricopharyngeus. It usually affects the elderly and patients usually present with dysphagia, regurgitation of food, halitosis and aspiration. We describe one case of Zenker's diverticulum in a 75-year Saudi female whom we successfully managed in Ear Nose Throat [ENT] department, North West Armed Forces Hospital, Tabuk, Saudi Arabia by endoscopic staple-assisted diverticulotomy resulting in successful division of the intervening septum between the diverticulum and the esophagus. This technique was well-tolerated by the patient with early return to oral feeding and shorter hospital stay. Endoscopic staple-assisted diverticulotomy is a relatively safer technique of dealing with this problem as compared to the traditional open procedure causing more morbidity, and we advocate its use to reduce patient morbidity in selected cases

Differences in detection rates for serious neonatal diseases before and after institution of newborn rounds by paediatricians in a private sector hospital

Perinatal and infant mortality are two major contributors to child mortality in developing world. It is widely recognised that synergistic efforts by paediatric and obstetric healthcare providers result in improvement of neonatal and infant survival. Close working relationship between the 2 disciplines with attendance of all high risk births by paediatric healthcare providers and routine examination of all neonates is required for this purpose. Objectives were to compare 2 continuums of 100 neonatal cases for detection of serious neonatal disease. One set of neonates being examined by neonatal/paediatric service and other without this service in place. One hundred Neonatal Exam sheets were selected randomly from records of 2007-2008 and compared with 100 Neonatal Exam Sheets of 2006-2007. Records were analysed for detection of serious neonatal conditions at 24 hours age. Data was analysed using MS EXCEL. Odds ratio was calculated for each disease with Haldane correction. Odds ratio was significantly higher for detection of serious neonatal diseases in 2007-2008 group when neonatal service was actively involved in newborn examinations of all neonates. Highest odds ratios were obtained for detection of Heart Murmur and neonatal sepsis. Newborn Examination within 24-48 hours of birth by trained neonatal healthcare provider is paramount for adequate detection of serious neonatal diseases. Such services should be instituted in all obstetric units for better neonatal outcome

Acephate-induced alterations in acetylcholine and acetyl-cholinesterase of different brain regions of albino rat.

Acephate (O,S-dimethyl acetyl phosphoramidothioate) is a racemic organophosphorus insecticide, and is effective against a wide range of insects and their larvae. The present study investigated the effect of acute sublethal dose of acephate on acetylcholine (ACh) levels and acetylcholinesterase (AChE) activity in different regions of rat brain, viz., cerebral cortex, hippocampus, cerebellum, and medulla oblongata. The LD50 of acephate (1080mg/kg) was evaluated by probit analysis method. Albino rats were divided into 4 groups with group I serving as control, while II, III and IV groups were given single, double, and multiple doses of acephate (1/5 LD50, i.e., 216mg/kg) orally, respectively. After a pre-determined time period, the rats were sacrificed by cervical dislocation, and the brain tissue was isolated in cold conditions to carry out estimations of ACh content and AChE activity. In contrast to increased AChE inhibition, ACh levels were elevated in all brain regions in a dose-dependent manner.

Extensive deep neck space abscess due to B-Haemolytic group G Streptococci-A case report.

Beta haemolytic phenotype of group G streptococci was isolated from the pus obtained from a patient with extensive deep neck space abscess. Patient was immunocompetent and made complete recovery after surgical drainage and administration of amoxycillin with clavulanic acid, amikacin and metronidazole. To our knowledge, this is the first report of deep neck space abscess due to group G streptococci.