Cytomorphometric analysis of buccal mucosal cells in iron deficiency anemia: A cross-sectional study.

Background: Worldwide, at any given moment, more individuals have iron deficiency anemia (IDA) than any other health problems. Very few studies have been conducted to evaluate changes in oral mucosa in IDA. The present study is undertaken for cytomorphometric analysis of buccal mucosal cells in IDA. Nuclear diameter (ND), cell diameter (CD), nuclear area (NA), cell area (CA), and nuclear-cytoplasmic ratio (N/C) are measured and compared in buccal mucosal cells of IDA patients and controls. Aims: To evaluate cytomorphometric changes in epithelial cells of oral mucosa in IDA and to compare these changes with the controls. Settings and Design: A cross-sectional study. Methods and Materials: Forty cases of IDA and forty cases of control group were selected for the study. IDA cases were diagnosed with decreased Hb level, MCV, MCH, MCHC and confirmed by decreased serum iron and increased total iron-binding capacity levels. Cytomorphometric analysis of buccal mucosa was performed to study CA, CD, NA, ND, and N/C ratio. Statistical Analysis Used: Statistical analysis was done using t- test in SPSS software version 4. Result: Results of our study showed increased cell area, cell diameter, nuclear area, nuclear diameter, and nuclear-cytoplasmic ratio in anemic group as compared to controls. Conclusion: The study suggests that individuals with IDA regardless of clinically visible oral lesions show cytological changes in oral mucosal epithelium. Knowledge of quantitative alterations in oral epithelial cells of IDA patients is important as these alterations are similar to those seen in precancerous and radiation-induced changes. Cytomorphometry is an efficient tool to understand the extent of cellular changes that occur in oral epithelial cells in IDA.

Detection of Helicobacter pylori in oral squamous cell carcinoma using modified Giemsa stain: A new diagnostic approach.

Context: Oral squamous cell carcinoma (OSCC) is the sixth most common cancer worldwide. It is mainly known to be caused by tobacco in various forms and also due to viral, fungal infection and poor oral hygiene, etc. Poor oral hygiene leads to colonization of pathogenic bacteria including Helicobacter pylori. It seems that the presence of H. pylori might be a risk factor for developing oral cancer. The successful attempt was made to detect H. pylori in diagnosed specimens of OSCC using Warthin-starry and Giemsa stains in our department. The modified Giemsa stain is the method of choice because it is sensitive, cheap, easy to perform, faster, and reproducible. Aim: The aim of this study is to detect H. pylori in various grades of OSCC using modified Giemsa stain. Subjects and Methods: Thirty cases of various grades of OSCC were selected from the archives of the department. Five-micrometer-thick paraffin-embedded tissue sections of these cases were taken and stained with modified Giemsa and were studied under ×100 magnification. Results: All the tissue sections studied were positive for H. pylori bacteria. Conclusions: Our study showed a significant presence of H. pylori in histological sections of OSCC, and it seems likely that the presence of H. pylori might be a risk factor for the developing oral lesions such as oral cancer. Early detection and eradication of H. pylori in the oral cavity, especially in high-risk patients, might prevent its harmful consequences.

Assessment of apoptotic index in various grades of oral epithelial dysplasia: A cross-sectional study.

CONTEXT: : Oral cancer is a major health problem worldwide. In cancer, the equilibrium between cell proliferation and apoptosis is disturbed. The defect in the apoptotic pathway allows cells to proliferate with genetic abnormalities. Thus, the apoptotic index (AI) can be used to assess the significance of apoptosis as a proliferative marker in oral epithelial dysplasia. AIMS: To assess the apoptotic index in various grades of epithelial dysplasia. OBJECTIVES: 1) To calculate the apoptotic index in various grades of oral epithelial dysplasia, 2) To compare the apoptotic index between various grades of oral epithelial dysplasia, 3) To predict the biologic behavior of oral epithelial dysplasia based on an apoptotic index. SETTINGS AND DESIGN: Cross-sectional tissue analyzing study. METHODS AND MATERIALS: This study constituted 30 cases, previously diagnosed with various grades of oral epithelial dysplasia (OED). AI was calculated as the number of apoptotic bodies/cells expressed as a percentage of the total number of cells counted in each case. STATISTICAL ANALYSIS USED: Statistical analysis was carried out using ANOVA test. RESULTS: A statistically significant difference was observed between mild dysplasia and severe dysplasia where P = 0.002. The mean AI was increased progressively with increasing grades of OED. CONCLUSIONS: This study demonstrated the clinical significance of apoptosis in assessing disease progression in Oral Potentially Malignant Disorder (OPMD) which may be used as a prognostic indicator in OED. This would, in turn, help in knowing the prognosis of the disease and to develop targeted drug therapy.

Effect of Temperature and Tissue Type on the Development of the Forensic Fly Chrysomya megacephala (Diptera: Calliphoridae).

Chrysomya megacephala Fabricius is one of the most common myiasis-causing and carrion-feeding fly species in the tropics. This species has a worldwide distribution due to globalization and therefore is of critical importance to the public health sector and forensic investigations. Development studies carried worldwide show that Ch. megacephala reared at similar temperatures may require different amounts of time to complete their cycle of growth. The present study determined for the first time the life-history information of this species in Sri Lanka. Chrysomya megacephala colonies were reared on three different food sources (bovine muscle, swine muscle, and swine liver) considering the most common forensic entomology rearing mediums and the capability of Ch. megacephala to cause myiasis in cattle. Furthermore, colonies were reared at four temperature regimes representing several specific development conditions of this blowfly: 1) 20°C representing the estimation of the lower developmental threshold for this species in Sri Lanka; 2) 25 and 27°C representing typical room/environmental temperatures in Sri Lanka; and 3) 38°C as this is the typical living animal temperature, representing myiasis conditions. Results show that temperature significantly affected larval length and width over time; however, tissue type was not a significant factor. The fastest development was recorded at 38°C for immature feeding on bovine muscle (162.15 h), followed by those fed swine liver (184.15 h) and swine muscle (208.00 h). The calculated minimum temperature threshold for Ch. megacephala was 13°C. Data generated will be crucial for future forensic investigations involving living or deceased individuals colonized by this species.

Myiasis incidences reported in and around central province of Sri Lanka.

BACKGROUND: Myiasis, or the invasion of living tissues of humans and other mammals by dipterous larvae, is considered the world's fourth most common travel-associated skin disease after cutaneous larval migrants, pyodermas, and pruritic arthropod-reactive dermatitis. METHOD: The present study recorded the cause, anatomical position, and severity of the wounds of myiasis patients admitted to 11 hospitals located in the central region of Sri Lanka from February 2016 to July 2017. RESULTS: Altogether, 28 myiasis incidences were noted within the study period. Of the total identified myiasis patients, nine were female while the remainder were male. The greatest number of patients was recorded from the Mawanella Base Hospital and Peradeniya Teaching Hospital (seven patients each). The ages of recorded patients ranged between 30 and 92 years with the average being 59.4 years. The greatest number of myiasis cases was diagnosed in wounds located in lower limbs (24). In addition, scalp, urogenital, and umbilical infestations were recorded. Eighteen out of the total patients had diabetes mellitus, and two patients suffered from filarial lymphedema. Psychiatric illnesses were a predisposing factor of larval infestation of six patients including the recorded scalp and two urogenital myiasis patients. Of the 28 myiasis cases, 27 were caused by the old world screwworm, Chrysomya bezziana Villeneuve (Diptera: Calliphoridae), and one by the blowfly, Chrysomya megacephala Fabricius (Diptera: Calliphoridae). CONCLUSION: The awareness of patients with ulcers about this disease helps to decrease further risk of being infected by fly larvae.

Temperature and Tissue Type Impact Development of Lucilia cuprina (Diptera: Calliphoridae) in Sri Lanka.

Lucilia cuprina (Wiedemann; Diptera: Calliphoridae) is a facultative ecto-parasitic fly, distributed throughout the temperate and subtropical regions of the world. This blow fly species is of medical, veterinary, and forensic importance due to it being used in maggot debridement therapy (MDT), a causative agent of myiasis, and a decomposer of vertebrate carrion. The current study examined the combined effects of temperature and tissue type on the development of L. cuprina. Specimens were reared on three tissue types; swine muscle, swine liver, and bovine muscle at 20°C, 25°C, 27°C, and 38°C. The optimum condition for L. cuprina development was for immatures reared on bovine muscle (287.4 h) followed by those reared on swine muscle (288.0 h) and swine liver (288.4 h) at 27°C. The minimum temperature threshold of L. cuprina was deduced to be 14°C. No significant differences in larval width and length over time were determined for the tissue type.

Cd34 and Mast Cell Analysis in Normal Oral Mucosa and Different Grades of Oral Squamous Cell Carcinoma: A Comparative Study.

BACKGROUND: Oral Squamous Cell Carcinoma (OSCC) remains a serious health problem worldwide. Prognosis of OSCC is poor and long term survival rate still remains below 50%. Angiogenesis or neovascularisation plays an important role in tumour progression and metastasis. Mast cells have been implicated in promoting tumour angiogenesis, especially of digestive tract, little is known in OSCC. AIM & OBJECTIVE: To study the correlation between blood vessel density (BVD) and mast cell density (MCD) in different grades of OSCC. METHODS: Thirty eight paraffin blocks of different grades of OSCC were retrieved from the department and sections were stained with CD34 followed by counterstaining with toluidine blue. The slides were then analysed using Leica Software (Version 4.5). RESULTS: Mean BVD and MCD were found to be increased in OSCC as compared to normal mucosa. Increase in BVD with co-current increase in MCD was also observed in different grades of OSCC. CONCLUSION: From our study, it was concluded that, mast cells play a major role in promoting tumour angiogenesis. But, as the grade of the tumour increases, other angiogenic factors may play a more significant role than mast cells in tumour progression.

Keratoameloblastoma a rare entity: a case report.

Ameloblastoma is the second most common odontogenic tumour of oral cavity; which has several different histological variants such as follicular, plexiform, acanthomatous, granular cell, desmoplastic, basal cell, clear cell, hemangiomatous, mucous cell differentiation and keratoameloblastoma. It is common in posterior mandible and has high male predilection in the ratio of 3:1. This report presents a case of keratoameloblastoma in 65-year-old female patient in the anterior mandible region with literature review on clinical features, histopathological findings, radiological appearance and treatment options.

Hospital-based study of endometrial cancer survival in Mumbai, India.

BACKGROUND: Endometrial cancer is common in western women, and the rates are very high; however in India, the rates are as low as 4.3 per 100,000 (Delhi). OBJECTIVE: To estimate the survival of endometrial cancer patients based on age, education, family history, tobacco habit, number of pregnancies, clinical extent of disease and treatment received. MATERIALS AND METHODS: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India, between 1999-2002. 310 cases treated in TMH were considered as eligible entrants for the study. Five-year survival rates were estimated using actuarial and loss-adjusted (LAR) methods. RESULTS: The proportions of patients dying above 50 years of age, non-residents and illiterates was higher than their counterparts. 54.8% of patients had some form of treatment before attending TMH. There were only 4.2% tobacco-chewers and only 6.1% had a family history of cancer. There were 25.8% who had 3-5 pregnancies (not living children) and 38.1% did not remember the pregnancy history. The 5-year overall survival rate was 92%. The five-year rates indicated better prognosis for those aged less than 50 years (97%), non-tobacco-chewers (94%), with no family history of cancer (93%), with localized disease (93%) and those treated with surgery either alone or as a combination treatment (95%). CONCLUSIONS: The present study showed that endometrial cancer patients with localized disease at diagnosis have a good outcome in India. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies now available.