Expression of p53, p63, podoplanin and Ki-67 in recurring versus non-recurring oral leukoplakia.

Oral leukoplakia (OL), a potentially malignant disorder, recurs in 40% of cases after surgical removal. Recurrence is a risk factor for malignant transformation. We aimed to examine the prognostic significance of four biomarkers related to cell proliferation: p53, p63, podoplanin (PDPN) and Ki-67 in predicting recurrence. Formalin-fixed-paraffin-embedded specimens from excised OL (n = 73, 33 recurrent; 40 non-recurrent) were collected in a prospective study. Immunohistochemistry was used to visualise expression of p53, p63, PDPN and Ki-67. Image analysis software was used for quantification of p53-, p63- and Ki-67-expressing cells, while PDPN was analysed visually. The expression of all four proteins were higher in recurrent compared with non-recurrent OL, only expression of p53 was statistically significant. In uni- and multivariable Cox regression analyses of individual markers, expression of p63 was significantly associated with higher recurrence risk (p = 0.047). OL with a combined high expression of both p53 and p63 had a significantly higher risk to recur [Log Rank, p = 0.036; multivariate Cox, HR: 2.48 (1.13-5.44; p = 0.024)]. Combination of p53 and p63 expression may be used as a prognostic biomarker for recurrence of OL.

Combined loss of expression of involucrin and cytokeratin 13 is associated with poor prognosis in squamous cell carcinoma of mobile tongue.

BACKGROUND: This study aimed to evaluate the prognostic significance of expression levels of involucrin (IVL), cytokeratin (CK)-10 and -13 at different intratumor sites (tumor center and invading area) of oral tongue squamous cell carcinoma (OTSCC). METHODS: IVL, CK13 and CK10 expression levels were examined in a multicenter cohort of 146 OTSCCs using immunohistochemistry. External mRNA datasets were used for expression analysis and/or to validate survival associations. RESULTS: External transcriptomic datasets showed downregulation of IVL and KRT13 in oral malignancies including OTSCC as compared to normal controls. The combined loss of IVL and CK13 expression at the invading core but not at the center core was significantly associated with poor differentiation and reduced 5-year overall survival. Multivariate Cox analysis confirmed the loss of CK13 and IVL expression to be an independent prognostic factor. Transcriptomic dataset corroborated immunohistochemistry results. CONCLUSIONS: Combined expression levlels of IVL and CK13 might be useful as prognostic biomarkers in OTSCC.

Diagnostic Accuracy of Color Doppler and Calcium Scoring versus Dual-Energy Computed Tomography Angiography in the Assessment of Peripheral Arterial Diseases of Lower Limb.

OBJECTIVES: Peripheral arterial disease (PAD) leads to narrowing and hardening of arteries which leads to increased risk of lower extremity amputation. Hence, the accuracy of non-invasive diagnostic methods such as calcium scoring and color Doppler needs to be assessed in comparison to the gold standard dual-energy computed tomography (DECT) angiography. This study aims to evaluate the accuracy of color Doppler and calcium scoring when compared to DECT angiography in the assessment of PAD of the lower limb. It is a cross- sectional retrospective study. MATERIAL AND METHODS: The study included 55 patients aged between 40 and 70 years. All the patients with symptoms suggestive of PAD underwent color Doppler study of lower limb arterial system. Afterward, the patient underwent CT angiography. The first plain images were taken for calcium scoring following which contrast was given and further images were taken. RESULTS: As compared to CT angiography assessment, Doppler assessment was 88.1% sensitive but only 69.2% specific with diagnostic accuracy of 83.6%. For angiographically detected atheromatous changes, color Doppler had sensitivity and specificity of 86.2% and 76.9%. The derived cutoff value >149.1 of calcium score in lower limb arteries was in 100% agreement with CT angiography detected PAD, whereas, for atheromatous changes, total calcium score at a cutoff value of >842.2 had sensitivity and specificity of 75.9% and 80.8%. CONCLUSION: Calcium scoring as compared to color Doppler has a higher diagnostic efficacy for the detection of DECT angiography confirmed PAD, whereas calcium score lacks adequate sensitivity at projected cutoff in the evaluation of atheromatous changes.

Effect of home-based newborn care on neonatal and infant mortality: a cluster randomised trial in India.

BACKGROUND: Home-based newborn care has been found to reduce neonatal mortality in rural areas. Study evaluated effectiveness of home-based care delivered by specially recruited newborn care workers- Shishu Rakshak (SR) and existing workers- anganwadi workers (AWW) in reducing neonatal and infant mortality rates. METHODS: This three-arm, community-based, cluster randomised trial was conducted in five districts in India. Intervention package consisted of pregnancy surveillance, health education, care at birth, care of normal/low birthweight neonates, identification and treatment of sick neonates and young infants using oral and injectable antibiotics and community mobilisation. The package was similar in both intervention arms-SR and AWW; difference being healthcare provider. The control arm received routine health services from the existing health system. Primary outcomes were neonatal and young infant mortality rates at 'endline' period (2008-2009) assessed by an independent team from January to April 2010 in the study clusters. FINDINGS: A total of 6623, 6852 and 5898 births occurred in the SR, AWW and control arms, respectively, during the endline period; the proportion of facility births were 69.0%, 64.4% and 70.6% in the three arms. Baseline mortality rates were comparable in three arms. During the endline period, the risk of neonatal mortality was 25% lower in the SR arm (adjusted OR 0.75, 95% CI 0.57 to 0.99); the risks of early neonatal mortality, young infant mortality and infant mortality were also lower by 32%, 27%, and 33%, respectively. The risks of neonatal, early neonatal, young infant, infant mortality in the AWW arm were not different from that of the control arm. INTERPRETATION: Home-based care is effective in reducing neonatal and infant mortality rates, when delivered by a dedicated worker, even in settings with high rates of facility births. TRIAL REGISTRATION NUMBER: The study was registered with Clinical Trial Registry of India (CTRI/2011/12/002181).

Diagnostic accuracy of dual energy CT in the assessment of traumatic bone marrow edema of lower limb and its correlation with MRI.

BACKGROUND: Bone marrow edema is assumed to be caused as a result of trabecular microfractures that are detected by MRI. As MRI is not widely available in countries like India, this study aims to encourage the use of DECT in detection of bone edema as evidence with comparable efficiency to MRI. AIM: To assess the diagnostic accuracy of dual-energy CT in detecting bone marrow edema in patients of trauma of lower limb and correlate it with MRI. SETTING AND DESIGN: It is a cross-sectional study. MATERIALS AND METHODS: The study included 40 patients of age 15-70 years irrespective of sex. All the patients of lower extremity trauma underwent DECT and MRI evaluation after clinical evaluation. All the images were postprocessed on a work station and were further evaluated by a radiologist. RESULTS: Mean attenuation at fractured site observed by Dual energy CT was found to be significantly higher as compared to that at adjacent site (170.75 ± 33.99 vs. 19.73 ± 22.50 HU). The sensitivity and specificity of dual energy CT as compared to MRI in detecting bone marrow edema were 94.1% and 91.3%, respectively. Of the 40 cases enrolled in the study, agreement of MRI and Dual energy CT was observed in 37 (92.5%). CONCLUSION: Dual energy CT can be an effective alternative to MRI in the detection of bone marrow edema in patients of lower limb trauma. Dual energy CT can also be used in patients in whom MRI is contraindicated.

Helicobacter pylori was not detected in oral squamous cell carcinomas from cohorts of Norwegian and Nepalese patients.

Helicobacter pylori (HP) infection is an established causative agent for gastric cancer. Although the oral cavity is a part of the gastrointestinal system, the presence and possible causative role of HP in oral squamous cell carcinoma (OSCC) is a subject of controversy. Therefore, the current study aimed to investigate HP infection in two cohorts of OSCC patients with different demographic characteristics, lifestyles and habitual risk factors. A total of 242 formalin-fixed paraffin-embedded OSCC specimens from two different patient cohorts (Norway, n = 171 and Nepal, n = 71) were used to examine HP using immunohistochemistry (IHC) and quantitative polymerase chain reaction (qPCR). Two different HP specific genes (23S rRNA and ureA) were used for TaqMan-based qPCR, and for subsequent verification using HP specific RIDAGENE HP kit and SYBR Green based qPCR. All of the OSCC specimens from both cohorts were found to be negative for HP infection with IHC and qPCR, although the positive control specimens tested positive. Our findings suggest that HP is absent in the examined OSCC cohorts, irrespective of race, lifestyle and habitual risk factors. This indicates that, in contrast to gastric cancer, HP is an unlikely contributing factor for OSCC pathogenesis.

Loss of S100A14 expression at the tumor-invading front correlates with poor differentiation and worse prognosis in oral squamous cell carcinoma.

BACKGROUND: We previously showed a tumor-suppressive function of S100A14 in oral squamous cell carcinoma (OSCC). This study aimed to examine the prognostic significance and differentiation-related function of S100A14 in OSCC. METHODS: S100A14 expression was examined in 170 OSCCs from Norwegian and Nepalese populations using immunohistochemistry. Pro-differentiation function was investigated by overexpressing and silencing S100A14 expression in OSCC-derived cells. External transcriptomic datasets were used to validate association between S100A14 and differentiation markers in OSCC. RESULT: Loss of S100A14 expression at the invading tumor fronts significantly correlated with poor differentiation and reduced 10-years survival of OSCC-patients. Multivariate Cox analysis identified S100A14 to be an independent prognostic factor. Modulation of S100A14 expression in OSCC-derived cells positively correlated with the expression of differentiation markers. Analysis of external datasets supported the pro-differentiation function of S100A14. CONCLUSION: These results indicate that S100A14 is a pro-differentiation protein and its expression might be useful as a prognostic marker in OSCC.

Crossed Fused Renal Ectopia with Single Ureter and Single Renal Vein: A Rare Case.

Crossed fused renal ectopia with a single ureter and single renal vein is a rare congenital anomaly in which both the fused kidneys lie on one side of the body. We present an unusual case of crossed fused renal ectopia with a single ureter, single renal vein, and a calculus in a 22-year-old man who presented with lower abdominal pain, burning micturition, and a right-side abdominal lump present for three months. On abdominal ultrasound and non-contrast computed tomography (CT), the left kidney was not visualized in the left renal fossa. However, we noted it on the right side, fused to the lower pole of the right kidney with a calculus within the pelvis leading to mild hydronephrosis. After intravenous administration of non-ionic contrast medium, we saw a single ureter draining both the moieties into the urinary bladder on the right side. A three-dimensional volume rendering technique revealed a single renal vein draining the renal parenchyma into the inferior vena cava. Cross fused renal ectopia is an uncommon congenital anomaly which remains asymptomatic throughout life and undetected in the absence of renal pathologies. Multi-detector computed tomography (MDCT) is an excellent tool for denoting anatomical details of this anomaly; the information provided by MDCT is crucial for surgeons, nephrologists, and radiologists alike in facilitating proper management of the condition.

Oral cancer awareness of the general public in Gorakhpur city, India.

OBJECTIVES: Global cancer statistical data show that India has one of the highest incidence rates of oral cancer worldwide. Early detection is extremely important as it results in lower morbidity and death rates. The present study was undertaken to assess awareness of oral cancer and knowledge of its early signs and risk factors in the general public of the semi-urban Gorakhpur area of Uttar Pradesh (India). It was also intended to educate the same population for early detection by increasing their ability to recognize signs and risk factors. METHOD: A questionnaire-based household survey was conducted over a period of one month in different parts of Gorakhpur district, a region where tobacco use is apparently very high. A total of 2,093 persons participated in the survey. The collected data were analyzed using SPSS software to assess and associate oral cancer awareness with the prevalence, and abstract risk factors, as well as other confounding variables. RESULTS: The general awareness, knowledge of signs and risk factors of oral cancer were found to be proportionate to the literacy level with the highest rate of awareness being among high school and graduates and lowest among illiterates. It was also observed that on most of these dimensions the younger age groups (<30 years) were significantly more knowledgeable. CONCLUSION: Overall, the awareness of oral cancer in the high-risk population of Gorakhpur was not satisfactory, pointing to a need for further dissemination of information on this issue and its associated risks. This is especially important for the youngsters, as this may possibly help them keep away from the deleterious habit of tobacco indulgence in any form. If necessary risk factor cessation counselling should be provided.

Unilateral segmental odontomaxillary hypoplasia: an unusual case report.

Facial asymmetry is not an uncommon occurrence in day to day dental practice. It can be caused by various etiologic factors ranging from facial trauma to serious hereditary conditions. Here, we report a rare case of non-syndromic facial asymmetry in a young female, who was born with this condition but was not aware of the progression of asymmetry. No relevant family history was recognized. She was also deficient in both deciduous and permanent teeth in the corresponding region of maxilla. Hence, the cause of this asymmetry was believed to be a segmental odontomaxillary hypoplasia of left maxilla accompanied by agenesis of left maxillary premolars and molars and disuse atrophy of corresponding facial musculature. This report briefly discussed the comparative features of segmental odontomaxillary hypoplasia, hemimaxillofacial dysplasia, and segmental odontomaxillary dysplasia and justified the differences between segmental odontomaxillary hypoplasia and the other two conditions.

Soil dehydrogenase, phosphomonoesterase and arginine deaminase activities in an insecticide treated groundnut (Arachis hypogaea L.) field.

Chlorpyrifos (O,O-diethyl O-3,5,6-trichloro-2 pyridyl phosphorothioate) 20 EC and Quinalphos (O,O-diethyl O-quinoxalin-2-yl phosphorothioate) 25 EC, were applied in groundnut (Arachis hypogaea L.) field as seed treatment at 25 ml/kg and soil treatment at 4 l/ha in 1998 and 1999. The residues of these insecticides were monitored during the entire crop season and their effect on the soil enzymes dehydrogenase, phosphomonoesterase and arginine deaminase were studied. Ninety nine percent of chlorpyrifos residues were dissipated within 60 days from seed treated soil and 98% dissipation was observed in soil treated field for the same days. Its half lives in seed treated soil were 8 days and 7 days and in soil treated field were 9.2 days in and 7.5 days in 1998 and 1999 respectively. Dissipation of quinalphos in comparison to chlorpyrifos was slow both in seed treated and soil treated field. Eighty seven percentage to 92% dissipation of quinalphos residues were observed from seed treated soil and 98% residues were dissipated from soil treated field within 75 days. Its half lives in seed treated soil were 20 days and 18 days and in soil treated field, its half lives were 13 days and 17 days 1998 and 1999 respectively. Inhibition in dehydrogenase activity followed by recovery was observed both in seed and soil treatments with chlorpyrifos. An inhibition of 17.2% was estimated after 60 days of seed treatment in comparison to control. Dehydrogenase activity was significantly reduced to 63% after 15 days of quinalphos seed treatment in comparison to control in 1998. Similar trends were observed in 1999. A significant inhibition in dehydrogenase activity was observed after soil treatment both in 1998 and 1999. Phosphomonoesterase activities were significantly inhibited upto 25.2% as compared to the control, on the 15th day of chlorpyrifos seed treatment in 1998 and similarly, after one day of treatment in 1999. Quinalphos inhibited the phosphomonoesterase activity till the end of the experimental period in the soil treated fields, whereas recovered within 30-60 days of treatment in the seed treated fields. Arginine deaminase activity was significantly stimulated within one day after chlorpyrifos seed and soil treatments in both years. The activity was almost threefold higher on the 30th and the 15th day of soil treatment in 1998 and 1999, respectively. A temporary inhibition of arginine deaminase activity was observed after quinalphos treatment. It was observed that in most of cases insecticides have temporary inhibitory effect on soil enzymes. However, inhibition was smaller in seed treated soil than in direct soil treatment.

Total bacterial and fungal population after chlorpyrifos and quinalphos treatments in groundnut (Arachis hypogaea L.) soil.

Short-term inhibitory effect on the total bacterial population was observed after chlorpyrifos and quinalphos applications in the groundnut fields, which recovered within 60 days after seed treatment and by 45 days of soil treatment. The fungal population was significantly enhanced after chlorpyrifos treatment whereas quinalphos inhibited the fungal population during the initial days of treatment but no effect was observed after 60 days of treatment. The residues of chlorpyrifos and quinalphos in the treated soil were not persistent and their half-lives ranged from 7.0 to 9.2 days and 13.2 to 20.6 days, respectively.