The establishment of a biobank and effective utilization of the biological resources comes with lot of challenges which require operating processes and effective governance structure with public awareness. As biobank is an evolving field of data driven health-care research, guided strategies in line with the national and international statutory body regulations is important. A trustworthy governance is paramount in developing a sustainable way of establishing, maintaining and successful functioning of a biobank. This paper highlights the structure of biobank governance, challenges and processes of effective integration of governance strategies.

Objectives: The hypothesized existence of cancer stem cells (CSC) and its markers aldehyde dehydrogenase 1 (ALDH1), CD44, SOX2 and OCT4 in oral dysplastic tissues provides the potential for a more reliable assessment of malignant transformation of oral epithelial dysplasia (OED). Thus, the present study is intended to evaluate the immunohistochemical expression of four different CSC markers ALDH1, CD44, SOX2 and OCT4 in different grades of OED and to investigate the co-expression of these putative stem cell markers in OED. Subjects and Methods: A total of 35 samples of varying grades of OED which included 7 mild, 11 moderate and 17 severe dysplasia samples and 10 samples of normal oral mucosa without dysplasia were used. Four sections each from all 45 samples were stained with ALDH1, CD44, SOX2 and OCT4, respectively, by immunohistochemistry. The acquired data were analyzed and evaluated using the Chi-square test and unpaired t-test and the P < 0.05 was taken significant. Results: ALDH1 and SOX2 expression percentages showed statistically significant differences among study groups (P < 0.05). Statistical comparison of percentage expression of CD44 and OCT4 between OED and normal was nonsignificant (P > 0.05). Co-expression of all four markers was found in 15 cases of OED with none of the normal cases showing co-expression. Conclusion: The expression of CSC markers in OED and normal mucosa differs significantly with co-expression of all four markers located only in dysplastic tissues. Until now, no single protein marker has been able to unequivocally identify the CSCs. Thus, a panel of putative CSC markers will help in identifying the patients with high risk for malignant transformation in OED.

Background: Chewing of areca nut is associated with various oral and systemic ill effects. The deleterious oral effects of areca nut have been widely documented to range from reactive lesions, periodontal health compromise to oral pre-cancer and cancerous states and have been described widely in the literature. The reported systemic effects of areca nut chewing are relatively less documented but reported in literature. Areca nut chewing may predispose to cardiovascular disease due to a systemic inflammatory response from the elevated levels of circulating inflammatory mediators. High-sensitivity C-reactive protein (hsCRP) is a systemic inflammatory biomarker to assess the risk of cardiovascular disease. Materials and Methods: This cross-sectional, observational study was conducted among areca nut chewers (n = 50) and non-chewers (n = 50). Areca nut chewers were considered as chewers/cases. Blood samples were collected from the participants and hsCRP levels were studied. The data were analysed using SPSS software, version 21 for statistical significance. Chi-square test was used to compare categorical variables. Mann–Whitney U test was done to analyse continuous variables. The level of statistical significance was set at P value < 0.05. Results: hsCRP mean was higher among the chewers (2.3 ± 3.7) compared to non-chewers (0.9 ± 1.3). The difference in hsCRP levels between the study group was statistically significant (P = 0.002). Conclusion: This study demonstrates the link between areca nut and cardiovascular disease using hsCRP as biomarker.

Background: Survivin, a member of the inhibitor of apoptosis proteins family, is not detectable in most differentiated normal adult tissues but is expressed in a wide range of cancer tissues. Survivin expression in cancer has been associated with poor prognosis, cancer progression, and drug resistance, and the expression levels correlate with more aggressive disease and a poor clinical outcome. Objective: To evaluate and compare the immunoexpression of survivin in the normal oral epithelium (NOE), oral epithelial dysplasia (OED), and different grades of oral squamous cell carcinoma (OSCC). Methodology: The patterns of survivin immunoexpression and immunoreactivity were assessed in previously diagnosed, paraffin-embedded sections of 10 tissues of NOE and 15 tissues each of OED and the three grades of OSCC (well-, moderately-, and poorly-differentiated). The pattern of survivin expression was recorded as cytoplasmic, nuclear, or both. Survivin immunoreactivity was assessed semi-quantitatively as the immunoreactive score (IRS). Analysis of variance and Tukey-HSD tests were employed for statistical analysis. Results: No immunoreactivity for survivin was evident in the NOE tissues. In the OED tissues, the immunoexpression pattern of survivin was predominantly nuclear in the basal cells, and in the OSCC tissues, cytoplasmic and nuclear. IRS was highest among the moderately- differentiated OSCC, followed by poorly- and well-differentiated OSCC and OED, with a statistically significant difference in the IRS scores between the normal and the study groups. Conclusion: Survivin protein expression may be an important early event in oral carcinogenesis and may predict unfavorable prognosis in OSCC.

Background: Acetaldehyde, a natural by-product of combustion and photo-oxidation, has been detected at low levels in cigarette smoke. Various literature studies have shown increased salivary acetaldehyde production among smokers and heavy drinkers. Aim: The present investigation was performed to estimate the salivary and serum acetaldehyde levels in pan masala chewers (with or without tobacco), betel quid chewers and tobacco smokers. Methodology: Blood and Saliva samples were collected from 40 participants. The study participants were categorized into 4 groups of 10 individuals each. Subjects with no habits, betel quid chewing habit, pan masala chewing habit with or without tobacco and tobacco smoking habit. All the samples were centrifuged and subjected to gas chromatography (GC) analysis as per standard protocols provided by the manufacturer. Results and Discussion: No statistically significant difference in either serum or salivary acetaldehyde levels between Pan Masala chewers (with or without tobacco) and smokers was noted. However, higher mean serum and salivary acetaldehyde levels than the normal subjects and betel quid chewers was observed. It may be speculated that natural acetaldehyde, may not be released in estimated quantity of acetaldehyde by head space GC. Nevertheless, it is possible that addition of acetaldehyde as flavoring agents or preservatives for improving acceptability of the product can be a possible cause for these observations. Conclusion: Owing to various socio, economic and political reasons, implementation of the ban remains to be a formidable challenge. With these observations, we believe that absolute ban of all pan masala product is the ideal solution for minimizing the oral cancer burden in India.

Introduction: Lipids play an important role in the maintenance of cell integrity. Various tobacco-associated products are known to induce the generation of free radicals and reactive oxygen species, responsible for the high rate of oxidation/peroxidation of polyunsaturated fatty acids. These further release peroxide radicals, causing increased utilization of lipids leading to hypolipidemia. Aim: The aim of this study was to evaluate and compare the lipid profile pattern of patients with oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma (OSCC) with healthy controls. Material and Methods: The study included 90 subjects with 30 OPMDs, 30 OSCC and 30 healthy controls. Fasting blood samples were collected from subjects and were analysed for serum lipids, including the following: i) Total cholesterol (TC) ii) High-density lipoproteins (HDL) iii) Low-density lipoproteins (LDL) iv) Very low-density lipoproteins (VLDL) v) Triglycerides (TG) vi) CHO/HDL ratio by using semi auto analyser. Statistical Analysis Used: The statistical tests used were the independent t-test, ANOVA test. A P value of <0.05 and <0.01 was considered statistically significant. Results: A statistically significant decrease in serum TC, LDL and CHO/HDL ratio was observed among OPMD and OSCC groups than controls, whereas a significant decrease in serum VLDL and TG (p value <0.01) in poorly differentiated OSCC was seen. Conclusion: The study shows an association between lipid variations and OPMD and OSCC. Low levels of lipids could be due to the rapidly dividing cells in premalignancies and malignancies utilizing them for new membrane biogenesis. Thus, lower lipid status may be a useful indicator for initial changes happening in neoplastic cells.

Background: The application of traditional medicinal plants and their products for treatment has been an integral part of our culture and continues to play a key role as many infectious microorganisms are resistant to synthetic drugs. Tinospora cordifolia and Ocimum tenuiflorum herbs have shown medicinal properties and have gained importance in modern research. Aims: This study assessed the antimicrobial activities of Tinospora cordifolia and Ocimum tenuiflorum against Streptococcus mutans and Candida albicans to conventional medications such as chlorhexidine and nystatin. Methodology: The S. mutans and C. albicans were grown and maintained on Columbia agar plates and yeast malt extract agar respectively. An ethanolic extract was made and subjected to rotary evaporation to remove the ethanol. The antimicrobial activity of plant extracts was determined using the Kirby-Bauer disc diffusion method. The standard drugs, 10 μg/disc nystatin and 0.12% chlorhexidine, were used as a positive control. The zone of inhibition was measured after 24 hours. Results: At a concentration of 3 mgs., the zone of inhibition of 25.6 mm was found with T. cordifolia, followed by 15.8 mm with O. tenuiflorum against S. mutans, and 0.12% chlorhexidine, at 21.7 ± 0.43 mm. A zone of inhibition of 23 mm and 22.9 mm was observed in both T. cordifolia and O. tenuiflorum against C. albicans, respectively. Positive control of nystatin showed 26.1 ± 0.46 mm. Conclusion: Tinospora cordifolia has better antimicrobial activity against S. mutans compared to Ocimum tenuiflorum. Whereas at higher concentrations, both extracts were effective against C. albicans.

Background: Nanog is a key transcription factor regulating pluripotency in mammalian early embryos and pluripotent stem cells. Nanog plays a central role in pluripotency and forms autoregulatory loops to maintain ESC (embryonic stem cell) identity. Oral squamous cell carcinoma (OSCC) is an extensively studied malignancy that occurs due to accumulated genetic and epigenetic changes. Hence, the current study was done to evaluate role of Nanog in OSCC. Objective: The present study was done to evaluate Nanog role in OSCC. Materials and Methods: Thirty normal subjects and 30 patients of oral squamous cell carcinoma (OSCC) were included in study. The cases were staged clinically based on tumour node metastasis (TNM) staging and graded histopathologically using modified Broder's grading system. Thirty tissue sections of OSCC were subjected to immunohistochemistry (IHC) with Nanog antibody. Random fields were chosen and 300 cells were counted in five areas and mean percentage of immunopositive cells were calculated. The results were analysed using ANOVA test. Results: The results demonstrated a statistically significant difference between normal subjects and in patients with OSCC with respect to mean of IHC score (P = 0.0001*). High mean values for Nanog in tissue with OSCC in both histopathological (P = 0.0001*) and clinical grading (P = 0.0276*) with statistically significant result were observed. Conclusion: The increased expression of Nanog in patients with OSCC was statistically significant, suggesting its role as diagnostic biomarker. Statistically significant result with respect to clinical staging and histopathological grading of Nanog expression in patients with OSCC suggests its role as prognostic biomarker also.

Background: Mast cells (MCs) are immune cells of the myeloid lineage and are present in connective tissues throughout the body. Mastocytosis regulates many physiologic processes and affects the pathogenesis of allergic conditions, anaphylactic reactions, autoimmune disorders and leukemias. Toluidine blue is commonly employed as a special stain for MCs that uniformly imparts blue color to both immature and mature cells. Csaba stain that distinguishes mature from immature MCs has not been widely explored. However, its use in differentiating mature and immature cells has not been reported in the literature. The identification of mature and immature MCs may provide a major clue for the diagnosis of any unrecognized systemic pathologies. Objectives:

• To evaluate the staining efficacy of Csaba stain, toluidine blue and Leishman's stains in the identification of MCs
• To compare the effectiveness of Csaba stain, toluidine blue and Leishman's stains to identify MCs in inflammatory pathologic lesions.

Materials and Methods: Fifty sections of inflammatory lesions were subjected to Csaba stain, toluidine blue and Leishman's stains each for studying MCs. The staining efficacy of the three stains was compared for parameters such as homogeneity, specificity, staining intensity, granular staining property and differentiation between mature and immature cells. Results: The Csaba, toluidine blue and Leishman's stains showed statistically insignificant P = 0.50, 0.95, 0.29, 0.48 for homogeneity, specificity, staining intensity and granular staining property respectively, but Csaba stain showed statistically significant P = 0.0001* in differentiating mature from immature cells. Conclusion: Csaba stain is more effective in differentiating mature from immature MCs compared to the other special stains.

Introduction: The determination of gender by dental pulp Barr bodies seems to be efficient tool especially in case of natural calamities where bodies are mutilated, charred, and unidentified. Different techniques are used for Barr bodies two of which are histopathological and cytological methods. Aims and Objectives: The objective of the study is to check the reliability of human dental pulp for identification of gender using Barr bodies. Material and Methods: The study sample consisted of 60 extracted teeth from 20 male and 40 female patients aged 12–25 years. Inclusion criteria included non-carious freshly extracted teeth, Teeth were extracted and the pulp was obtained using a carborundum disc at 30,000 revolutions per minute (RPM). The teeth were categorized into two groups. Group 1 and Group II include 20 females and 10 males each. In group I, rapid manual tissue processing technique was done and in Group II pulp tissue slides were prepared by cytopathological technique. The slides obtained were stained with H&E and Barr bodies were visualized. Statistical Analysis: On comparison of Barr bodies on males and females in dental pulp, the mean number of Barr body count in females was more than males. Accuracy and count were much more appreciated in histopathological technique than cytological procedure. Conclusion: The mean Barr body count was more in females than in male samples. In histopathological technique Barr bodies were more analyzed and appreciated than in cytopathological technique on checking the efficacy and evaluating its diagnostic significance of dental pulp for identification of gender.

Introduction: Oral lichen planus (OLP) is a chronic inflammatory disease with cell-mediated immune dysregulation. The aetiology of OLP has been studied extensively for decades. Viruses like Hepatitis C Virus (HCV), human papillomavirus (HPV), herpes simplex virus (HSV), and stress have been hypothesized to play a role in the pathogenesis and malignant transformation of OLP. HPV has been proved to be an etiological agent in oropharyngeal cancers and non-tobacco-associated leukoplakia. The role of human papillomavirus in the pathogenesis of OLP has to be studied extensively. Aim: This study aims to detect the presence of HPV 16 and HPV 18 DNA in the biopsy samples of OLP and also to determine the role played by the virus in the pathogenesis and malignant transformation of OLP. Materials and Methods: Biopsy samples comprising 30 OLP tissues were collected. The DNA was extracted by the cetyltrimethylammonium bromide method. Polymerase chain reaction was performed by using general primers to amplify the HPV E6 gene. Results: Twelve out of 30 (40%) OLP cases were positive for HPV DNA. A significant relation was found between HPV, site (buccal mucosa) and the type (reticular) of the lesion (P = 0.007). However, the difference between the percentage of HPV positive males and females was statistically insignificant (P = 0.852). Conclusion: This study confirmed the presence of high-risk HPV 16 and HPV 18 DNA in OLP. The study showed a significantly higher expression of HPV in erosive OLP when compared to reticular OLP, suggesting a possible role of HPV in the malignant transformation of OLP.

Introduction: The worldwide annual incidence of carcinomas of the sinonasal tract is 0.5 to 1.0 patients per 100,000 per year. P63 plays a role in epithelial development and is used as a marker for basal and myoepithelial cells. Expression of p16 occurs as a result of functional inactivation of the retinoblastoma protein (pRb) by the human papilloma virus (HPV) E7 protein. Aims: This study aims to study the histological spectrum of benign and malignant sinonasal mass lesions and to study the immunohistochemical expression of p63 in different type of sinonasal mass lesions. It also aims to ascertain the incidence of high-risk HPV in primary sinonasal mass lesions with p16 immunohistochemistry and delineate the histological spectrum of HPV-related sinonasal lesions. Materials and Methods: This cross-sectional study was conducted on 80 cases from June 2018 to June 2020 at a tertiary care hospital. Clinical history including demographic parameters were collected in the study proforma. The gross findings of the specimens noted and histopathological examination by H&E staining done. Immunohistochemistry staining for p63 and p16 expression was performed on all cases. Results: Most common age group affected was 41–60 years with male:female ratio of 1.67:1. Nonneoplastic lesions (38.7%) comprised majority of the cases followed by benign neoplastic lesions (31.3%) and malignant neoplastic lesions (30%). Among the malignant neoplastic lesions, p63 showed positive expression in 75% (p = 0.005) and p16 showed positive expression in 41.7% (p = 0.023). Among benign and nonneoplastic lesions, p63 showed positivity in 21.4% (p = 0.000) and p16 showed positivity in 44.6% (p = 0.040). Conclusion: We analyzed p63 and p16 expression in varied lineages like carcinomas, papillomas, and neuroectodermal differentiation arising from the sinonasal tract and also in relation to other clinicopathological parameters. This study revealed p63 expression was associated more with the squamous cell carcinomas and nasopharyngeal carcinomas. Sinonasal tract malignancies are also associated with HPV infections that are identifiable by p16 immunostaining and, thus, could provide new prospects in identifying any definite biological and clinical characteristics associated with HPV as well as advancement in the targeted therapies for this patient population.

Background: The oral cavity is a unique environment where systemic maladies may be amplified by the oral mucosa. Oral diseases are usually local, but may also be the sign of systemic disease. Oral lesions are mostly one of the first indications of a systemic problem. Lichen planus (LP) is an inflammatory disease that involves the skin and mucous membrane. It is one of the most common oral diseases that manifest itself in the oral cavity. The exact cause of oral lichen planus (OLP) is unknown, but the immunologic system plays a leading role in the pathogenesis. It is well documented that OLP represents a cell-mediated immune response. Materials and Methods: The study population was drawn from the patients attending the outpatient Department of General Medicine and Department of Oral Medicine and Radiology with a total of 1000 subjects, out of which 500 subjects were clinically diagnosed with hypothyroidism and 500 subjects were without the history of hypothyroidism. The data collected was compiled and analysed to obtain the result. A Chi-square test was used to compare the categorical variables and the analysis was carried out on SPSS 16.0 version. Results: The study revealed an increased prevalence of OLP in hypothyroidism. Cases clearly had a predilection of 2.37 times more tendency to develop OLP as compared to the control. Conclusion: To conclude, it seems that OLP was more prevalent in hypothyroid individuals, especially in females in the third and fourth decades of life.

Introduction: The study indicated that XPD and XPG gene polymorphism is associated with the development of oral potentially malignant disorders (OPMDs) and oral squamous cell carcinoma. Xeroderma pigmentosa (XP) is a part of the complex DNA repair system. Xeroderma pigmentosum group G (XPG) and xeroderma pigmentosum group D (XPD) gene function in the nucleotide excision repair (NER) pathway. XPG and/or XPD gene alterations can cause defective DNA repair efficiency which ultimately leads to genomic instability and carcinogenesis. Thus, this study helps in early detection of OPMDs among individuals who have not yet developed any oral lesions and also helps in the management of oral squamous cell carcinoma as if XP gene polymorphism is known. Aims and Objectives: The aim of the study was to evaluate the expression of XPD and XPG gene polymorphism in oral squamous cell carcinoma cases. The study also had the objective to evaluate and compare the expression of XPG and XPD gene polymorphism in oral squamous cell carcinoma (OSCC) cases, tobacco chewers without any oral lesions, and normal healthy individuals without any habit. Materials and Method: A total of 150 subjects were included in the study and genotyped for the expression of XPD (AC) and XPG (GC) gene polymorphism using polymerase chain reaction (PCR) and agarose gel electrophoresis method. Results: XPD genotype for the study shows that most of the cases of OSCC show heterozygous (AC) genotype (64%), whereas in tobacco chewers without any oral lesions wild (AA) genotype (54%) is more common than other types. XPG genotype for the study shows that wild (GG) type is the most dominant genotype both in OSCC cases (78%) and tobacco chewers without any oral lesion (56%). Conclusion: The study shows the association of XPD and XPG gene polymorphism with the risk of developing OPMDs and oral cancer.

Introduction: Immunohistochemistry (IHC) has not always been an easy field for the research beginners like postgraduates, research fellows and scientists. Meaningful interpretation of IHC positivity needs expertise. This could be made easier for beginners by developing a conceptual framework of markers. The literature review revealed a lack of qualitative evidence on the hitherto IHC studies on oral diseases about the overall expression of IHC markers and its comparison with pathology and normal tissues. Aim: This scoping review aimed to examine the literature and classify the various immunohistochemistry markers of oral diseases based on the tissue, cell and site of expression. Materials and Methods: The review was in accordance with Preferred Reporting Items for scoping reviews (PRISMA -ScR). Electronic databases such as PubMed and Cochrane were searched for relevant articles till 2021. Results: We included 43 articles. We found five different possibilities of the site of expression of a marker in a cell. They are the nucleus, cytoplasm, cell membrane, extracellular matrix or any of the above combinations. Based on the tissue of expression, we also mapped the markers expressed in oral diseases to their tissue of origin as ectoderm, endoderm, mesoderm and markers with multiple tissues of expression. Based on our results, we derived two classifications that give an overview of the expression of IHC markers in oral diseases. Conclusion: This scoping review derived new insight into the classification of IHC markers based on cell lineage, tissue and site of expression. This would enable a beginner to better understand a marker with its application and the interpretation of the staining in research. This could also serve as a beginner's guide for any researcher to thrive and explore the IHC world.

Background: Waterpipe tobacco smoking (WTS) is an issue all over the world, although it is particularly prevalent in the Middle East, and Southeast Asia. The genotoxic effects of smoking were reported to be associated with nucleus abnormalities such as micronuclei (MN), karyorrhexis (KR), karyolysis, pyknosis, binucleates, broken eggs, condensed chromatin in exfoliated buccal mucosal cells, and was believed to be associated with apoptosis of cells and was not correlated to the exposure time. Aim: The aim of this study was to evaluate and compare the cytotoxic and genotoxic effects of cigarette and WTS on buccal mucosa. Materials and Methods: The pertinent search was done through the computerized literature on MEDLINE, EMBASE, and PUBMED databases, which included case-control, clinical and observational studies regarding the mutagenic effects of cigarettes and WTS in oral tissues. The retraction of data in this study was undertaken from May 2010 to May 2022. A total of 60 articles from the search data were retrieved. This investigation was registered with the research center of Riyadh Elm University for institution review board approval (IRB) and obtained the IRB number “FRP/2021/448/733/707 and the systematic review registration number with respect to PROSPERO is 345417. Results: After the removal of duplicates, 32 were evaluated for the inclusion and exclusion criteria. Out of 32 articles, twenty studies were evaluated for cytogenetic abnormalities in buccal mucosal cells of waterpipe tobacco smokers (WTS) and cigarette smokers, and 12 were excluded. The mean MN levels in the oral tissues of WTS were more (1.94 ± 0.39) than in non-smokers (1.68 ± 0.35). Conclusion: Therefore, we conclude that the MN count can be employed as a biomarker and preliminary signal for the identification of changes in oral mucosa among smokers, which develop towards cancer formation.

Peripheral nerve sheath tumors (PNSTs) are defined as type of sarcomas that develops in cells which forms a protective sheath (covering) around the peripheral nerve, i.e., the cells of myelin sheath. Nerve tumors are of neuroectodermal in origin as it was composed of small rounded ectodermal cells that affect exclusively soft tissues. PNSTs are most common neoplasm with classic clinicopathological features, but they are diagnostically challenging. They consist of wide spectrum of tumors ranging from benign tumors to malignant nerve sheath tumors and its prevalent in oral tissues. Diagnosis of PNSTs are quite hectic but made possible by histopathology and immunohistological markers.

Mucormycosis is a fungal infection which has been regrouped under emerging infectious disease. In this COVID-19 pandemic, the incidence of mucormycosis has been reported in many parts of India. Systemic condition that weakens one's immune systems like uncontrolled diabetes, chemotherapy or chronic long-term illness poses a grave threat for this fungal infection. Patients with oral cancer and precancer remain at significant risk for developing severe infections regardless of significant developments in therapy. Few studies have reported that this opportunistic fungal pathogen may be cultured from the oral cavity. Our findings disprove the oral carriage of filamentous fungi (Zygomycetes) among the group of patients with oral squamous cell carcinoma, oral potentially malignant disorders who are susceptible to immunological deficits and healthy subjects. This finding strongly supports that the oral niche of healthy as well as the patients with oral lesions do not harbour this filamentous fungi.

The world today is in the midst of its second wave of the coronavirus disease 2019 (Covid-19), which started as an outbreak first reported in December 2019, Wuhan City, the capital of Hubei Province in China. Then soon enough, it was declared as a public health emergency of international concern on January 30, 2020 by WHO and a pandemic on March 11, 2020. While initially greater emphasis was laid on the elderly and people with co-morbidities such as diabetes mellitus, hypertension, obesity, and immune-compromised states as being at high risk of contracting the Covid-19 disease and/or dying of it, but by now, it is clear that being male is also a factor. Data and studies from different countries across the globe involving China, the United States of America, and European nations such as Italy have showed that although there is no difference based on sex in the number of cases testing positive for the virus, more men died from the virus, and the case-fatality ratio is greater among men than women. Women are infected by the virus as frequently as men but men are more likely to contract severe forms of disease and succumb to it. The reason behind this sex-biased mortality seen in Covid-19 cannot be explained by a single genetic or social factor. The present short communication aims at enumerating the possible reasons behind this gender-biased pandemic.

Forensic science corresponds to the employment of science to the law or legal matters. One of the major concerns of legal system is to deduce the recognition of an item or individual, involved in crime for which forensic expert plays a pivotal role. Forensic odontology, a budding branch in dentistry, involves the application of dentistry to the legal system. The dental characteristics are considered as one of the primary characteristics of identification as per Interpol DVI guidelines. Thus, establishing the identity of unknown human remains through dental features is considered as one of the core domains of forensic odontology. However, its reliability and its acceptability in the court of law are only secondary to the application of DNA technologies. Also, the acceptability of bite-mark analysis and its evidentiary role is debatable. However, the bite marks may also be a source of salivary DNA, to establish the linking of the perpetrator to the victim. The recent advancements in the DNA technologies and the use of teeth and saliva as sources of DNA are the added advantages in the application of DNA as person identifiers especially in badly mutilated, decomposed and charred bodies and in linking the perpetrator to the crime. With this background, we present here a review on the application of forensic genetics from a forensic odontology point of view.

The Adenomatoid Odontogenic Tumour (AOT) is more than 100 years old, known by different names and the term AOT was coined in 1969 by Philipsen and Birn. AOT frequently occurs in intra-osseous location in gnathic skeleton and rarely seen in peripheral forms. These are rare odontogenic tumours, accounting for 2.2--7.1% of all odontogenic tumours, whereas the central or intraosseous variant of AOT in follicular and extra-follicular presentation, accounts for 95.6% of all AOTs. The peripheral variant presents as a gingival mass, which may cause slight saucerization of alveolar bone or might not affect the bone at all. These peripheral variants constitute 4.4% or less, of all AOTs of the gnathic skeleton. Here, we present a rare case of a peripheral variant of AOT in a 35-years-old female, 1.5 to 2 cm in dimension seen on the labial gingiva in right canine-premolar area. The lesion showed marked bone loss in 13 and 14 teeth region, causing mobility of 13. Histopathology showed a well encapsulated tumour mass with metaplastic bone in the capsule. A conventional AOT with ductal and rosette pattern was seen with tumour droplets and amyloid like material. The case clinically presented a moderately aggressive behaviour.

Mucosal malignant melanoma arising from the head and neck region is a rare entity, and it is more aggressive than cutaneous melanoma. Furthermore, the complexity of the oral cavity makes surgical excision more difficult. Oral malignant melanoma is a rare tumour of melanocytic origin, accounting for 20–30% of malignant melanomas at the mucosal surface and 16% intra-orally. Hard palate and maxillary gingiva are the most common involved sites. The age of reported patients ranges from 20 years to 80 years. Hence, we do hereby present a case of malignant melanoma of mandibular gingiva with review of the literature in a 42-year-old female patient.

Primary bone lymphomas account for 3-5% of extranodal non-Hodgkin lymphomas in adults and are typically present in the axial skeleton and weight-bearing bones. We present a unique case of primary bone diffuse large B-cell lymphoma (DLBCL) of the nasal bone and palate. We discuss the pathologic and radiologic findings and review the current literature and clinical management to highlight how this unusual clinical entity should be considered in differential diagnoses of head and neck bone masses.

An aneurysmal bone cyst (ABC) is a non-neoplastic, rapidly expanding pathologic bone lesion that mostly affects the mandible and is most commonly found in the first to third decade of life. The most of the ABC cases are locally aggressive osteolytic lesion with a high recurrence rate. As a result, we present a swelling with pus discharge at the maxillary alveolus in a 68-year-old female who was diagnosed with ABC after a computed tomography scan and histological analysis. The conservative surgical excision was performed without considerable bleeding, and no recurrence was observed even after a five-year follow-up period.

A 24-year-old male patient presented with the principal complaint of deposits on his teeth and gingival pigmentation. After examination, he was diagnosed with chronic generalized gingivitis. He was further referred for pre-procedural routine blood investigations. Bleeding time, clotting time, and his random blood sugar values were normal. CBC report revealed the presence of erythrocytosis with microcytic hypochromic red blood cells. Following this peripheral smear was taken which reveals the presence of polychromatophils, target cells and a few spherocytes. Haemoglobin electrophoresis by high-performance liquid chromatography (HPLC) was performed which disclosed 90.8% of HbE, suggestive of homozygous haemoglobinopathy. He had no other associated systemic findings, and there was no relevant family history. The patient was informed about his condition and stated to have pre-marital and pre-natal genetic counselling in the future. The patient being a carrier of the thalassaemic trait happened to know his condition incidentally, which could prevent future complications.

Desmoplastic ameloblastoma (DA) is an epithelial odontogenic tumor and a rare variant of ameloblastoma. It was first described by Eversole in 1984. In the World Health Organization (WHO) classification of odontogenic tumors (2005), DA has been considered as a distinct entity from conventional/multicystic ameloblastoma. DA differs strikingly in its clinical, radiological, and histopathological presentation when compared to other variants of ameloblastoma. We report here an extremely rare “Hybrid DA” in a 50-year-old female patient with painless hard swelling involving right posterior mandible with detailed clinical history, an unusual radiographic and histopathological presentation. Histopathology revealed odontogenic epithelium in the form of follicles, ameloblastoma with cystic degeneration, and squamous metaplasia at places and elsewhere there were odosntogenic islands compressed by dense fibrocellular stroma suggestive of desmoplasia along with osseous tissue formation. Also review of the literature and possible explanation of etiopathogenesis of cystic change and osseous tissue formation in DA are discussed.

Background: Salivary gland tumors are histologically the most heterogeneous group of tumors. Traditional diagnostics and grading of these tumors often fail to provide any insight into patient's clinical course. Cathepsin-D is a lysosomal acid protease secreted in increased levels in several malignancies. However, its role in salivary gland tumors has not been studied extensively. The present study aims to assess the expression of cathepsin-D in malignant and benign salivary gland tumors and to compare its expression in these tumors. Materials and Methods: A total of 40 salivary gland tumors which included 10 cases each of adenoid cystic carcinoma, mucoepidermoid carcinoma, pleomorphic adenoma and Warthin's tumor were evaluated immunohistochemically for cathepsin-D expression. Intergroup comparison of cathepsin-D expression was done between the benign and malignant groups using the Mann–Whitney U-test. Intragroup comparison was also done using Kruskal–Wallis test. Results: A statistically significant difference in the expression of cathepsin-D was observed between the benign and malignant groups. The malignant group showed a considerably higher cathepsin-D expression (mean value 6.284 ± 4.377) when compared to the benign group (mean value 2.281 ± 2.459). The differences in the immunopositivity between the malignant and benign groups were found to be highly significant (P = 0.004). Conclusions: Increased expression of cathepsin-D is observed in the malignant salivary gland neoplasms. This may prove to be a useful marker for the aggressive biologic behavior as well as invasive potential of salivary gland neoplasms.

Background: The oral mucous membrane is particularly sensitive to certain types of systemic disorders such as anemia, vitamin deficiencies, infectious diseases, hormonal disturbances and can be objectively reproduced through definite measurements using cytomorphometry. Objectives: The objective of the study is to evaluate the quantitative and qualitative changes in cytological buccal smears of obese individuals with type II diabetes (Group 1 = 20), obese individuals without type II diabetes (Group 2 = 20), individuals with type II diabetes without obesity (Group 3 = 20) by comparing with controls (individuals without obesity and without type II diabetes) (Group 4 = 20). Materials and Methods: Buccal mucosal cells were scraped from study participants and were subjected to morphometric analysis (Magnus Pro software). Clinical history, hemoglobin A1c, heights and weights of participants were measured and consequently, their body mass index was calculated. Quantitative parameters (nuclear area, cytoplasmic area, nucleo-cytoplasmic ratio) and qualitative parameters (micronuclei [MN], nuclear budding, nuclear disintegration, apoptosis, necrosis) were assessed among the groups. The data were statistically interpreted using SPSS software version 20.0. Results: There is an increase in nuclear diameter and nuclear: cytoplasmic ratio of Groups 1 and 3 relative to Group 2. The qualitative assessment revealed MN and nuclear disintegration in Group 1 and 3 individuals. In addition, other qualitative changes such as nuclear budding and apoptotic bodies were evident in patients with type II diabetes. Conclusion: The aforementioned qualitative and quantitative parameters facilitate early diagnosis and identification of individuals at risk of developing new age systemic illnesses such as diabetes and obesity.

Context: Candida isolates might exaggerate the development and advancement of oral lichen planus (OLP) alone or together with other factors. There is a differing pathogenic potential of various Candida species. Since Candida species isolated from OLP and oral lichenoid lesions (OLL) have shown to be resistant to commonly used antifungal agents, identification of Candida species may play a pivotal role in its successful clinical management. Aim: The aim of the study was to evaluate and compare the prevalence and phenotypic variations of Candida species in patients of OLP and OLL with healthy controls. Subjects and Methods: This prospective microbiological study was conducted in the institution using indirect microscopic examination. The sample comprised of 40 clinicohistopathologically diagnosed cases of the study group (OLP and OLL) and 40 cases of control group (healthy individuals). Statistical Analysis Used: The data collected was statistically analyzed using the Chi-square test and Fisher's exact test with the SPSS 20.00 software. Results: The prevalence of Candida albicans was higher in the control group (28.10%) as compared to the study group (24.60%) and this difference was statistically significant. An increased frequency of non C. albicans species was seen in the study group, in decreasing order of Candida glabrata (40.70%), Candida tropicalis (22.20%), Candida krusei (22.20%) and Candida guilliermondii (3.70%), as compared to the control group. Conclusion: Non C. albicans species were the predominant pathogens associated with the study (OLP + OLL) group. It is important to identify the infecting strains of Candida because isolates of Candida species differ widely, both in their ability to cause infection and also in their susceptibility of resistance to antifungal agents. Thus, phenotypic speciation of Candida is emerging as a necessary trend to highlight the need of administering appropriate antifungal therapy.

Objective: Plasma cells can just represent a part of host inflammatory response or form the cornerstone of diagnosis such as IgG4-related disease (IgG4RD) and plasma cell dyscrasias and sometimes create a diagnostic dilemma. The study aims to discuss a series of plasma cell lesions which we encountered in the oral cavity, discuss the diagnostic conundrum of plasma cell lesions. We also propose a working classification for their interpretation. Materials and Methods: All plasma cell lesions affecting the oral and maxillofacial region were retrieved from the archives of the Department of Oral and Maxillofacial Pathology. The cases were analyzed on the basis of histomorphology and immunohistochemical markers along with clinical, imaging and laboratory findings. Results: Thirteen (0.64%) of 2026 oral lesions were diagnosed with plasma cell lesions. Out of 13 cases, 9 were plasma cell gingivitis, 2 IgG4-RD, 1 plasma cell myeloma and 1 plasmablastic lymphoma. Representative case from each category is discussed along with one case of well-differentiated squamous cell carcinoma (WDSCC) masquerading as plasma cell dyscrasias. Conclusion: We discuss the practical difficulties faced during the diagnosis of these oral plasma cell entities along with a working classification and propose an efficient diagnostic scheme for the correct characterization of these lesions.

Background: Glutathione S-transferase M1 (GSTM1) and Glutathione S-transferase T1 (GSTT1) null genotypes have been considered risk factors for many cancers. Numerous studies have been conducted to evaluate the association of null genotype of GSTM1 and GSTT1 with increased susceptibility to oral cancers, and these have produced inconsistent and inconclusive results. In the present study, the possible association of oral cancer(OC) with GSTM1 and GSTT1 null genotypes was explored by a meta analysis. Materials and Methods: A meta-analysis was conducted on published original studies retrieved from the literature using a bibliographic search from two electronic databases: MEDLINE (National library of medicine, USA) and EMBASE. The pooled odds ratio and presence of publication bias in those studies were evaluated. Results: A total of 49 studies concerning oral cancer (OC) were identified for GSTM1 null genotype. Similarly, 36 studies were identified for GSTT1 null genotype. The pooled OR was 1.551(95% confidence interval [CI]: 1.355–1.774) for the GSTM1 null genotype, while for GSTT1 null genotype, the pooled OR was 1.377 (95% CI: 1.155–1.642). No evidence of publication bias was detected among the included studies. Conclusion: The results suggest that the Glutathione S-transferase M1 and Glutathione S-transferase T1 null genotypes significantly enhances the risk of developing oral cancer by a substantial percentage.

Background: The excess reactive oxygen species or free radicals reaction leads to oxidative injury to the biological components such as cells and tissues, which would result in the initiation and progression of carcinogenesis. The magnitude of oxidative damage depends primarily on the balance between free radicals (pro-oxidants) and antioxidant system activity. Aim: To assess antioxidant status by evaluating the reduced glutathione (GSH) levels in various biological samples of patients with oral squamous cell carcinoma (OSCC) using available literature. Materials and Methods: An electronic literature search was carried out in PubMed (MeSH), Science Direct, Scopus and Cross Reference by using specific keywords. Results: The systematic electronic search identified 704 articles. After studying the articles' titles and abstracts, 657 articles were excluded for the following reasons; duplicated articles, animal studies, studies of low quality and not relevant to the research question. The remaining 47 articles were selected for full-text assessment. After eliminating the articles that did not match the objectives, the present qualitative synthesis finally included 27 articles for evaluation. The ten studies, which showed coherent data, were included in quantitative analysis. The GSH levels in OSCC groups are significantly decreased (P < 0.001) in plasma and erythrocyte samples compared to healthy controls. Conclusion: The selected studies showed significantly lower levels of GSH in various biological samples of OSCC. Hence, future studies are required to validate the expression of GSH as a prognostic biomarker in oral cancer.

Context: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome (SARS-CoV-2), has become an emergency global public health issue. Disease pattern of COVID-19 ranges from mild to life-threatening pneumonia with associated bacterial and fungal coinfections. Due to associated comorbidities (e.g., diabetes mellitus and chronic obstructive pulmonary disease) and immunocompromised conditions (e.g., corticosteroid therapy), these patients are prone to develop severe opportunistic infections. Aims: The aim of this study was to investigate the incidence of fungal coinfection of hospitalized patients with COVID-19 infection (SARS-CoV-2) in RIMS, Raichur. Materials and Methods: Our study included 94 patients with invasive fungal infection who presented with either COVID-19 infection or had recovered from COVID-19 infection. Tissue samples from suspected sites were received in formalin for histopathological examination, and these were stained stains with hematoxylin and eosin and with periodic acid–Schiff/Gomori's methenamine silver wherever required. Results: A total of 94 biopsies were received with clinical suspicion of mucormycosis. Out of these, 52 (55.3%) were positive for mucormycosis and 42 (44.7%) were negative. Out of 52 positive cases, 46 (88.4%) were males and 6 (11.6%) were females. The highest number of cases was seen in age group of 51–60 years (26.92%). Out of the 52 positive cases, KOH mount was positive for fungal elements in 8 cases and negative for fungal elements in 29 cases. Conclusions: Uncontrolled diabetes and overzealous use of steroids are two of the main factors aggravating the incidence of mucormycosis in COVID-19 patients. Early surgical intervention, histopathological confirmation and rapid and judicious intravenous antifungal treatment should be initiated for better patient outcomes.

Background: Oral submucous fibrosis (OSMF) in recent times has been recognized as a potentially malignant disorder (PMD) with an increased risk of developing oral squamous cell carcinoma with malignant transformation rates that vary from 0.6% to 36%. Alpha-L-fucosidase (AFU) is a lysosomal enzyme that is involved in maintaining the homeostasis of fucose metabolism. In benign and malignant tumors, the cells modulate their surface by increasing fucosylation leading to uncontrolled growth. Aims and objectives: This study was designed to estimate the levels of salivary and serum AFU in patients with OSMF and healthy controls and also to evaluate the clinical utility of salivary AFU levels over serum. Materials and Methods: Saliva and blood samples were collected from twenty participants in both the groups (OSMF and healthy controls). Serum and salivary alpha-L-fucosidase levels were measured by enzyme-linked immunosorbent assay. The data were subjected to appropriate statistical analysis. Results: We found a significant increase in alpha-L-fucosidase level in OSMF compared with healthy subjects. Pearson's correlation showed salivary alpha-L-fucosidase level to have superior sensitivity in detecting OSMF compared with serum alpha-L-fucosidase. Conclusion: The outcome of this study suggests that salivary alpha-L-fucosidase can be utilized as a biomarker in early detection of oral precancer and cancer.

Context: Jaw bones can be afflicted by to a diverse group of lesions ranging from developmental, reactive/inflammatory, cystic lesions to tumors and tumor-like lesions Objectives: The objective of this study is to determine the relative frequency, demographic and pathologic profiles of patients with intraosseous jaw lesions from Thailand. Subjects and Methods: Biopsy records from 1995 to 2019 were reviewed. Age, gender and location of the lesions were collected from the biopsy records. Data were analyzed by appropriate statistics using the IBM SPSS software version 22.0. Results: From 23,344 accessioned cases, 7382 cases (31.62%) were encountered within the jaw bones. Age of the participants ranged from 1 to 96 years with the mean ± standard deviation = 36.05 ± 17.80 years. Pediatric participants (aged ≤16 years) comprised 13.80% of all the participants, whereas the geriatric ones (aged ≥65 years) accounted for 7.55%. The male-to-female ratio was 0.89:1. The majority of lesions were observed in the mandible. The most prevalent intra-osseous jaw lesion was radicular cyst followed by dentigerous cyst and ameloblastoma. The most common malignant tumor was osteosarcoma followed by ameloblastic carcinoma and lymphoma. Among the pediatric participants, dentigerous cyst was the most prevalent jaw lesion, while that in the geriatric participants was radicular cyst. Conclusions: This is the largest study on intra-osseous jaw lesions encompassing several pathological entities ever conducted from Thailand. It thus provides an invaluable database for clinicians to formulate a differential diagnosis as well as for the pathologists to render the final diagnosis. The results of this study are in accordance with previous studies in general.

Context: Oral candidiasis is the most common opportunistic infection affecting the oral mucosa. Most commonly, the lesions are caused by Candida albicans and other organisms isolated are Candida glabrata, Candida krusei, Candida parapsilosis and Candida dubliniensis. As an opportunistic infection, it is seen affecting the young, old and debilitating people. This infection is seen to be enervative, exhausting and crippling; a few routinely employed antifungal agents are used in our study. Aims: We aimed to compare the clinical and mycological effectiveness of topical fluconazole and clotrimazole in the treatment of oral candidiasis. Settings and Design: A total of 40 subjects were taken and randomly divided into two groups of 20 each. Group 1 included patients treated with topical clotrimazole and Group 2 included patients treated with topical fluconazole. Subjects and Methods: Patients were graded according to severity, and swab was taken for species identification and colony count. Patients were treated with clotrimazole and fluconazole according to their group they were also assessed post treatment for clinical signs and colony count changes. Statistical Analysis Used: Data were analyzed using the statistical package SPSS 22.0 (SPSS Inc., Chicago, IL, USA), and the level of significance was set at P < 0.05. Descriptive statistics was performed to assess the mean and standard deviation of the respective groups. Results: The clinical resolution rate of 80% and 100% was noted in the clotrimazole and fluconazole groups, respectively. The mycological cure rate of 82.52% and 86.38% was noted in the clotrimazole and fluconazole groups, respectively. Statistically significant results were obtained in clinical resolution rates and no significant results were obtained when mycological cure rates were compared. Conclusions: We conclude that the clinical cure rate of fluconazole is slightly better than clotrimazole while mycological cure rate was approximately similar.

Aim: This study aims to assess whether preoperative platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) can predict occult metastasis in oral squamous cell carcinoma (OSCC). Materials and Methods: Thirty-five OSCC cases were analyzed for clinicopathological and hematological data. Cases without metastasis (pN0) were checked for micrometastasis immunohistochemically using Desmoglein 3 (DSG3) and Cytokeratin (CK). Mean PLR and NLR were compared and analyzed between the study groups. Results: Metastatic deposits were detected in 9 out of 26 pN0 cases (34.6%) accounting for 11 out of 62 (17%) lymph nodes subjected to immunohistochemistry. The mean PLR was higher in OSCC cases with or without occult metastasis in comparison to controls (P < 0.001). No significant difference was found in the mean PLR and NLR between OSCC cases with and without occult metastasis. Furthermore, we found DSG3+ sinus histiocytes within the lymph nodes in majority of cases which is least reported in literature. Conclusion: A significant percentage of cases showed occult metastasis in this study which led to upstaging of tumor. Although PLR was elevated in OSCC cases, it did not have a positive correlation with the presence of occult metastasis but was able to successfully distinguish OSCC patients from healthy individuals.

Background: The efficiency of probiotics in prevention and also treatment of oral infections including dental caries, periodontitis, halitosis is found to be appealing in the recent literature. Their antagonistic role in oral infections is mainly through formation of biofilm which needs documentation. Though the emergence and practice of oral probiotics is visualized for the past two decades, the consumption and knowledge level is found to be less among the community. Stronger source to spread scientific evidence to the community would be health professionals. Aim: The current study is aimed at assessing the level of awareness of probiotics among dental practitioners of Puducherry thereby aid and assist in the beneficial practice of the same in the community. Methods: The knowledge level was assessed through a cross sectional survey using closed ended questionnaire. Involves practicing dentists of Puducherry (n-173). A prevalidated questionnaire with 17 closed ended and one open ended question was employed as the research tool . Results: The results revealed an acceptable knowledge in 77.4% and a greater level of knowledge in 20.8% of dentists. More number of studies are expected to fulfill the lacunae in the field of safety of usage and long term effects of probiotics. Conclusion: Responses of the current study which was focused on dental practitioners revealed that the knowledge level is well above the acceptable level. There is no profound difference in the awareness level noticed among BDS and MDS practitioners..

Background: The intestine plays an important role in the digestion and absorption of ingested food and the elimination of undigested food, microbes, and microbial products. The functional reliability of the intestinal mucosal epithelial cells depends on the organised regulation of the epithelial cells, mucus layer, the intercellular tight junction, host innate and acquired immune response. The mucus layer of the gastrointestinal tract is the first line of innate host defense, essentially because of the secretory products of intestinal cells. Aim: Present study was conducted to evaluate the effect of arecoline on the gastrointestinal system due to systemic absorption of the drug during the induction period of oral submucous fibrosis (OSMF) in Wistar rats. Methods: Oral submucous fibrosis was induced by submucosal injection of arecoline in the buccal mucosa. Arecoline hydrochloride at a dosage of 10 mg/kg was injected into the submucosa of right buccal mucosa in experimental animals over a period of 3 months on every alternate day. After which, right buccal mucosa, gastrointestinal tract organs like stomach, large intestine, small intestine and liver were dissected, subjected to histopathological evaluation of the healthy and experimental Wistar rats were subjected to histopathological evaluation. Results: On histological evaluation, OSMF was seen to affect Wistar rats showed significant changes in oral mucosa, decrease number of goblet cells in the small intestine as well in the large intestine and deranged hepatocytes. These marked changes indicated a definite effect on the gastro intestinal system by arecoline. Conclusion: The study has highlighted the effect of arecoline due to systemic absorption during the induction process of OSMF in Wistar rats.

Background: Assessment of apoptotic cells and mitotic figures using light microscopy is an easy and viable alternative to assess tumour behaviour. Aims: To evaluate apoptotic index (AI), mitotic index (MI) and apoptotic to mitotic index ratio (AI: MI) in different grades of oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC) in haematoxylin and eosin-stained (H&E) sections. Settings and Design: The study included 45 cases each of OED and OSCC cases which were further subgrouped into groups of 15 each based on their grades. AI, MI and AI/MI were assessed and compared with 15 cases of normal mucosa. Methods and Material: Apoptotic cells and mitotic figures were counted using a binocular light microscope equipped with an oculometer grid (20 × 20 squares) on the eyepiece. Cells were counted in 15 grid fields under oil immersion lenses (×100) in a stepladder fashion. AI/MI ratio was calculated. Statistical Analysis: The results obtained were statistically analysed using Analysis of variance and Tukey Honestly Significant Difference tests with SPSS 20 software at a 0.05 significance level. Results: AI increased with increasing grades of dysplasia and decreased with increasing grades of OSCC. MI increased with increasing grades of OED and OSCC. AI/MI increased with increasing grades of OED but decreased with increasing grades of OSCC. Conclusion: In the light of the current observations, AI, MI and AI: MI can be considered as valuable parameters to assess the biological behaviour of OED and OSCC.

Background: Smokeless tobacco, as well as areca-nut both, causes cancerous and precancerous lesions of the oral cavity. The traditional value of India, as well as West Bengal do not allow females for smoking, but there is no such disapproval for using smokeless tobacco or areca nut. Geographically and socio-culturally, the Northern part of West Bengal differs from its Southern part. Aims: This study aimed to assess the prevalence of different chewing habits, habit products, and habit-related different oral lesions among females in two socio-culturally different areas of West Bengal. Methods: A total of 222 women from areas of North Bengal and 173 women from areas of South Bengal aged 15 years and above were selected. A face-to-face interview was conducted using a structured questionnaire. An oral cavity examination was done to rule out any oral mucosal alterations caused by cancer-causing habits. Statistical Analysis: Chi-square test or Fischer's exact tests were used to compare unpaired proportions as appropriate. Results: In areas of the northern part of Bengal, 42.34% of females were chewers, and in areas of the southern part of Bengal 18.50% of females were chewers. Younger female chewers were more from areas of the northern part of Bengal. Women, residing in different areas of the northern part of Bengal had more habit-related oral lesions, compared to the southern part of Bengal. Conclusion: Special attention should be given to increasing awareness regarding chewing habit-related health hazards among females, especially in areas of North Bengal.

Background: Reactive oral lesions pose diagnostic difficulties as they mimic each other clinically. A definitive diagnosis is made based on the histopathological presentation of this group of lesion. Stromal microenvironment is the key to the sequence of the stages of these lesions. Stringent quantification of each component of the stroma is important to understand the pathogenesis. The aim is to evaluate inflammation, angiogenesis, and fibrosis in the reactive group of lesions through quantitative analysis. Materials and Methods: Blocks of irritation fibroma, inflammatory fibrous hyperplasia, pyogenic granuloma, and normal mucosa were retrieved from the archives and Hematoxylin and Eosin (H&E) and Masson Trichrome staining were done. The severity of inflammation, epithelial thickness, collagen proportionate area, integrated density of collagen, Mean Vascular Area (MVA), Mean Vascular Perimeter (MVP), and Mean blood vessel percentage area (MBVPA) were analysed quantitatively using Image J software version 1.8. The pattern of rete ridges at the epithelium-connective tissue interface was analysed qualitatively. Results: Inflammatory fibrous hyperplasia presented with severe inflammation (60%). Mean Vascular Percentage Area (MVPA) and Mean Vascular Perimeter (MVP) were increased in pyogenic granuloma. The mean collagen proportionate area and the integrated density of collagen were found to be more in irritation fibroma (64.47%, 2519638.01 ± 810471.58 μm²). The epithelial thickness was highest in inflammatory fibrous hyperplasia (62.71 ± 18.86 μm). Conclusion: Reactive oral lesions are histologically distinct, yet they exhibit considerable overlap depending on the stage of the lesion. A morphometric quantitative exploration of the individual pathogenic components may aid in specific diagnosis.

Objectives: Central giant cell granuloma (CGCG) is a fairly common lesion involving the jaw bones. CGCG can show relatively innocuous biological behaviour or it may show clinicoradiological features suggestive of aggressive biological behaviour. To date, there are no histological parameters which can be used to predict the behaviour of these lesions. This study was conducted to assess the utility of parameters of angiogenesis, i.e., total vascular area (TVA), mean vascular area (MVA) and microvessel density (MVD), and density of myofibroblasts in aggressive and non-aggressive CGCGs. Materials and Methods: The study was undertaken as a retrospective study. A total of 20 previously diagnosed cases (10 non-aggressive and 10 aggressive) of CGCGs were included in the study. The sections were subjected to immunohistochemistry using the markers CD34 and α-SMA. For the assessment of vascular parameters, image J software was used. The density of myofibroblasts was determined in each case ranging from score-1 to 4, using the criteria given by Sridhara et al. The correlation between mean values of vascular parameters and density of myofibroblasts with aggressiveness of CGCG was assessed using Mann–Whitney U test. Results: The result of Mann–Whitney U test suggested that the differences between the values of TVA (P < 0.001), MVA (P < 0.003) and density of myofibroblasts, i.e., SMA mean (P < 0.001) and SMA score (P < 0.001), in two groups are statistically significant. The formula for the assessment of aggressiveness was obtained using discriminant analysis. Conclusions: Angiogenesis and density of myofibroblasts significantly differ in aggressive and non-aggressive cases of CGCGs. The aggressiveness of CGCG case can be predicted using the obtained formula by entering the values of vascular parameters and myofibroblasts.

Background: The aerosols generated during dental treatments contain bacteria and other microorganisms that penetrate the body through the respiratory system of dental surgeons and cause infectious diseases. Several studies have been done to reduce these hazards. The aim of the present study is to evaluate the effects of the plant extract essential oil (EO) vapors of Neem, Clove, Cinnamon bark, Thyme, Lemon Grass, and Eucalyptus on the bacterial count in bioaerosols near dental units. Materials and Methods: Sampling was taken on nutrient blood agar plates by placing them open near dental units using passive air sampling method, before commencement of treatment for 1 h, during treatments for 2 h, and after introducing EO vapors for 2 h. The collected samples were taken for incubation at 37°C for 48 h. The colonies formed were counted in colony-forming units per cubic meter and taken for statistical analysis. Results: After comparing the obtained results, it was found that there was a significant reduction (P < 0.05) in the bacterial count for about 43% near the dental units after the introduction of the EO vapours. Conclusion: It is concluded that natural extracts like EOs can reduce bacterial contamination near dental units in the vapourized state, thereby reducing the health hazards in Dental Health Professionals.

Background: Oral cancer is considered as the sixth-most common malignant neoplasm in the world and the most common type is squamous cell carcinoma (SCC). Akt is a serine/threonine-protein kinase, that acts in the regulation of different signaling downstream pathways, including; proliferation, growth, cell metabolism, angiogenesis and survival. The objective of the present study was to show the expression of p-Akt and its prognostic effect in oral SCC (OSCC). Materials and Methods: A total of 72 cases of OSCC were included in this study; the expression of the Akt gene was done on 4 μm tumor sections using immunohistochemical staining of Akt antibody. Results: Histopathological examination showed that: (43) were GIII, (13) cases were GII, and (16) cases were GI. The positivity of immunohistochemical staining were appear as brown stain. Results showed increase expression of p-Akt in most cases of oral SCC and mean expression about (54.86 ± 31.58), and the expression of p-Akt was increased with the progression of the histological grade of the tumor. Conclusion: High expression of p-Akt and its relation with the progression of tumor grade and invasion of tumor may indicate the relationship between p-Akt expression and aggressiveness and progression of the tumor.

Background: There is a scarcity of literature on the presence of additional unexpected pathologies at the surgical margins of oral squamous cell carcinoma (OSCC). It is quite possible that such pathologies might get overlooked because of primary focus on the malignancy at the surgical margins. With this view in mind, a retrospective observational study has been designed to re-visit the surgical margins of OSCC for the possible presence of unexpected pathologies. Methods: Haematoxylin and eosin-stained sections of 96 cases (four surgical margins in each case) of OSCC were carefully examined under a compound microscope by two oral pathologists for the presence of any additional pathology. Results: Out of 96 specimens of OSCC, 76 (79.2%) cases showed the presence of accidental pathologies. The surgical margins of 20 (20.8%) cases showed no evidence of any pathology, whereas the margins of 23 (23.95%) cases were associated with more than one pathology. The most commonly observed accidental pathology was oral submucous fibrosis (40.625%), followed by leukoedema (16.675%), retention cysts (10.42%), and calcifications (7.3%). The mucous extravasation phenomenon (6.25%), minor salivary gland (MSG) inflammation (6.25%), and lichen planus (5.21%) were also observed in the surgical margins of OSCC. Conclusion: A significant number of accidental pathologies exist at the surgical margins of OSCC. This effect could be because of over-emphasis on the tumour status at the surgical margins, which leads to over-looking of minor pathologies.

Context: Hematoxylin–eosin (H&E) stain has stood the test of time as the standard stain for histologic examination of human tissues. Haematoxylin is a natural dye, on the contrary, its counterstain eosin is a synthetic dye which belongs to the xanthene group. Synthetic dyes are hazardous to human and animal health. With the increasing awareness of a green earth, it is advisable to use environment-friendly and biodegradable materials. Therefore, an attempt was made to develop as biofriendly substitute in the form of food colour as a counterstain for haematoxylin. Aim: To assess the staining ability of food colouring agents in routine staining and to compare its staining efficacy with Eosin. Settings and Design: Two food colours were obtained and stain was prepared by using 70% ethyl alcohol as counterstain for haematoxylin. Different tissue structures such as epithelium, keratin, collagen fibers, muscles, salivary glands, adipocytes, blood vessels, RBCs were observed and evaluated. Methods and Material: Group A –10 slides stained with green food colour, Group B – 10 slides stained with tomato red food colour and Group C – 10 slides stained with conventional H and E. The stained sections were assessed and graded for nuclear staining, cytoplasmic staining, clarity, uniformity and crispness of staining. Statistical Analysis Used: The non-parametric Kruskal–Wallis and Mann–Whitney U tests were performed for statistical analysis. Results: There was no statistically significant difference between the three study groups with respect to all the parameters except crispness of staining. The crispness of Tomato Red and H and E was better compared to green food colour. Conclusions: Food colouring agents can be used as a safe, biofriendly and inexpensive substitute to eosin in conventional soft tissue staining.

Background: Dental caries is characterized by an interplay between environmental and genetic factors. Aim: The aim of this study was to analyse the transmissibilities of high caries risk chromosomal loci at 5q 12.1-13.3 and low caries risk chromosomal loci at 13q31.1 and Streptococcus mutans (S. mutans) in family units. Materials: This prospective cohort study was performed on 56 families grouped into four: (a) Group I: 18 families of children with caries affected primary teeth; (b) Group II: 21 families of children with caries in permanent teeth; (c) Group III: 6 families of children with no caries in primary teeth and (d) Group IV: 12 families of children with no caries in permanent teeth. Blood, saliva and plaque samples were collected from consenting study participants. Isolated DNAs were subjected to polymerase chain reactions using suitable primers. Data collected was analysed with ANOVA and Chi-squared test. Results: Wide expression of chromosome loci 5q12.1-13.3 was obtained in both blood and saliva samples. For chromosome loci 13q31.1, no expression was found in saliva samples, hence indicating its local absence. For the GtfB expression, transmissibility was common for a single band expressing S. mutans. Conclusion: This study reflects upon newer findings in the field of genetic research on dental caries.