The Role of Salivary Lactate Levels in assessing the Severity of Septic Shock.

Background: Sepsis is a major worldwide cause of morbidity and mortality. Hence, rapid and reliable diagnosis is essential. Emergency departments use a standard measure of sepsis, based upon an elevated Lactate level in blood. Saliva is more readily available and easier to obtain than blood samples, and is increasingly being studied as a new source of diagnostic information. Aim: This study aimed to evaluate whether analysis of Lactate levels in saliva can substitute for that of Lactate levels in blood. Methods/Materials: We processed saliva samples and serum samples from septic shock and non-septic shock patients. We found out Lactate levels in both the group. We plotted the concentration of Lactate in non-septic and septic patients and compared lactate levels in saliva to its levels in blood.Statistical analysis: Results were statistically analyzed by independent sample t test and A Spearman rho correlation. Results: We found increased serum and salivary Lactate levels in all cases of sepsis compared to the control group. Notably, the increase in Lactate levels was higher in serum as compared to saliva in septic patients, suggesting saliva may not serve as a better indicator of sepsis compared to blood. Salivary lactate was more in septic shock patients compared to non-septic shock patients. Conclusions: To our knowledge, this is the first study to compare lactic acid levels in serum and saliva in cases of sepsis. The increase in serum lactate in patients with sepsis is evident when compared to increase in salivary lactate, so serum lactate level would be easier for physicians to differentiate septic patients from non-septic patients. Salivary lactate may not serve as better indicator in septic shock patients.

Assessment of fragile histidine triad expression in ameloblastoma, odontogenic keratocyst and dentigerous cyst.

BACKGROUND: FHIT (Fragile histidine triad) a member of tumor suppressor family, has been extensively studied in many solid tumors including head and neck squamous cell carcinoma. Among all head and neck cyst and tumors odontogenic lesions account approximately 3%-9%. The molecular pathogenesis of these lesions is less explored. Defects in cell cycle regulators and tumor suppressor genes could result in the development of odontogenic cyst and tumors. Hence, we aimed to determine the significant role of a tumor suppressor gene FHIT in most commonly occurring odontogenic lesions mainly ameloblastoma, odontogenic keratocyst and dentigerous cyst. SUBJECTS AND METHODS: Immunohistochemical analysis of FHIT was done in ameloblastoma, odontogenic keratocyst, dentigerous cyst and dental follicle. Interpretation of the stained slides were done using standard scoring criteria by two pathologist. The results were subjected for statistical analysis. RESULTS: Expression of FHIT varied among the groups, with highest negative expression in ameloblastoma 44.4% followed by odontogenic keratocyst 14% and 100%positive expression was seen in dentigerous cyst. The expression levels between the groups were statistically insignificant. CONCLUSION: The varied expression or negative expression of FHIT could be considered as an indicator for aggressive behavior and transformation of preneoplastic/cystic epithelium.

Diagnostic and surgical aspects of central hemangioma of mandible: a surgical approach for the reconstruction of mandible.

Intraosseous vascular lesions are rare lesions, accounting for 0.5-1% of all intraosseous tumors. They were found to be affecting the second decade of life, more frequent in women. The frequency found affecting the vertebral column and skull; the mandible is a quite rare location. At present, according to the World Health Organization, these lesions are now considered as benign vasoformative neoplasms of endothelial origin. However, the origin of the central hemangioma is debatable. Some authors state it as a true neoplasm, few state it is a hamartoma. On examination, the patient may or may not show any symptoms, some present discomfort, blood discharge, bluish discoloration, mobility of the teeth. The radiographic finding is a multilocular radiolucenies with classic honeycombs or soap bubble appearance. Differential diagnosis includes odontogenic lesions like ameloblastoma, cystic lesions such as residual cyst, central giant cell tumor, fibrous dysplasia. The wide surgical excision along with the reconstruction is choice of treatment of hemangioma. We present a case report of a 24-year-old female diagnosed with intraosseous mandibular hemangioma and surgical reconstruction of mandible with rib graft.

Do tobacco stimulate the production of nitric oxide by up regulation of inducible nitric oxide synthesis in cancer: Immunohistochemical determination of inducible nitric oxide synthesis in oral squamous cell carcinoma--a comparative study in tobacco habituers and non-habituers.

BACKGROUND: Oral cancer accounts for 6% of all cancers. The most prevalent form of oral cancer is oral squamous cell carcinoma (OSCC), which accounts for 90% of the oral cancer cases. The major risk factor for development of OSCC is the use of tobacco in various forms. NO has been studied widely over the years due to its role in various physiological and pathophysiological processes, including its complex role in carcinogenesis. MATERIALS AND METHODS: A total of 20 cases of OSCC in tobacco habituers and tobacco non-habituers were retrieved respectively from the archival biopsy specimens. Immunohistochemistry was done to assess the inducible nitric oxide synthase (iNOS) protein. RESULTS: This study was performed to assess the correlation between tobacco and nitric oxide in OSCC in order to know the association of these two in the process of carcinogenesis. The results showed the enhanced expression of iNOS in tobacco habituers in comparison with tobacco non-habituers. Though the increased expression of iNOS is found, significant difference is not obtained with scores, but significant difference was found with intensity of staining. CONCLUSIONS: The results of the present study indicate the enhanced expression in OSCC of tobacco habituers when compared to OSCC of tobacco non-habituers indicating the effect of tobacco on nitric oxide. Carcinogenic chemical compounds in Tobacco induce nitric oxide production by iNOS, by its tumor-promoting effects which may enhance the process of carcinogenesis.

Cytokeratin 14 and cytokeratin 18 expressions in reduced enamel epithelium and dentigerous cyst: Possible role in oncofetal transformation and histogenesis- of follicular type of adenomatoid odontogenic tumor.

INTRODUCTION: Odontogenic cysts and tumors arise from the structures and remnants associated with tooth development. Cysts and tumors derived from the odontogenic tissues constitute an unusually diverse group of lesions. This diversity reflects the complex development of the dental structures, since all these lesions originate through some alteration from the normal pattern of odontogenesis. Cytokeratin (CK) 14 is the typical intermediary filament of odontogenic epithelium, CK 18 is the major components of the intermediate filaments of simple or single layered epithelial tissue; it is not expressed in stratified squamous epithelium. The present study was undertaken to understand the expression pattern of these cytokeratins in dentigerous cyst, dental follicular tissue, adenomatoid odontogenic tumor (AOT) and unicystic ameloblastoma. MATERIALS AND METHODS: The present study consists of 60 specimens consisting of 20 samples of Dentigerous cyst, 20 samples of Reduced enamel epithelium/dental follicles, 10 samples of Follicular type of AOT, 10 samples of unicystic ameloblastoma. The sections of these specimens were stained for CK 14 and CK 18. The number of cells positive for CK 14 and CK 18 was counted per 100 cells. The cells were counted in four randomly selected high-power fields and the mean was calculated. Scoring of cytokeratin 14 expressions was done using Remmele score. RESULTS: The highest expression of cytokeratin 14 was noted in AOT, least was seen in dental follicle/Reduced enamel epithelium (REE). CK18 was negative in all the cases included in the present study. CONCLUSION: In the present study, the expression of CK14 was noted in AOT, Dentigerous cyst (DC), Unicystic Ameloblastoma (UCA) and Dental follicle/REE. The expressions between these lesions were compared. These expression pattern may provide an insight to the histogenesis of AOT.