Ravikiran Ongole

Assessment of Quality of Life in Patients with Chronic Oral Mucosal Diseases: A Questionnaire-Based Study

CONTEXT A validated discipline-specific questionnaire has been developed recently to assess the quality of life (QOL) in patients with chronic oral mucosal diseases. OBJECTIVE Use the Chronic Oral Mucosal Diseases Questionnaire for evaluating a diverse group of patients with chronic oral mucosal disease after therapy. DESIGN Prospective convenience sample. MAIN OUTCOME MEASURE Quality of life. METHODS Seventy patients seen in the Department of Oral Medicine and Radiology with oral lichen planus, recurrent aphthous ulcers, pemphigus, and other chronic oral mucosal diseases were included in the study. Patients completed the questionnaire after undergoing treatment of their oral mucosal disease to assess their QOL. RESULTS Patients older than age 35 years reported significantly lower QOL (p = 0.015) in the domain of social and emotional status. Significant age-related differences in QOL were not observed in other domains. Older individuals also reported a significantly lower overall QOL. Men reported significantly better oral health-related QOL than women did in pain and functional limitation: 16.14 ± 8.94 vs 21.44 ± 7.696, respectively (p = 0.010). Significant differences were not observed between sexes for other domains. Significant differences were observed between the disease groups only for recurrent aphthous ulcers and pemphigus (p = 0.005). Patients with pemphigus had the worst overall QOL (73.6 ± 5.6). CONCLUSION Even after treatment, chronic oral mucosal diseases negatively affect patients’ QOL. Use of the Chronic Oral Mucosal Diseases Questionnaire may allow physicians to more effectively care for their patients with these diseases.

Evaluation of high-performance liquid chromatography laser-induced fluorescence for serum protein profiling for early diagnosis of oral cancer

The present work deals with the evaluation of a high-performance liquid chromatography laser-induced fluorescence (HPLC-LIF) technique developed in our laboratory for early detection of oral cancer from protein profiles of body fluids. The results show that protein profiles of serum samples from a given class of samples, say, normal, premalignant, or malignant, are statistically very close to each other, while profiles of members of any class are significantly different from other classes. The performance of the technique is evaluated by the use of sensitivity and specificity pairs, receiver operating characteristic (ROC) analysis, and Youdens Index. The technique uses protein profile differences in serum samples, registered by the HPLC-LIF technique. The study is carried out using serum samples from volunteers diagnosed as normal or premalignant clinically, and as malignant by histopathology. The specificities and sensitivities of the HPLC-LIF method at an ideal threshold (M-distance = 2) for normal, malignant, and premalignant classes are 100, 69.5, and 61.5%, and 86.5, 87.5, and 87.5% respectively.

Salivary protein markers: a noninvasive protein profile-based method for the early diagnosis of oral premalignancy and malignancy

Abstract. An ultra-sensitive hyphenated technique, high-performance liquid chromatography-laser-induced fluorescence detection protein profiling of saliva, is evaluated for early detection and diagnosis of oral premalignancy and malignancy. Calibration sets of protein profiles of unstimulated whole saliva are collected from clinically/pathologically normal, premalignant, and malignant subjects and used as standards. Three parameters—scores of factors, sum of squared residuals, and Mahalanobis distance—derived from principal component analysis of protein profiles of the standard calibration sets, and blind samples are used for “match/no-match” diagnosis of the blind samples. Analyses of the results show that the method is capable of differentiating normal, premalignant, and malignant conditions with the sensitivity and specificity of 79% and 78%, respectively. The technique provides a fast, highly objective (free from personal judgment and statistically defined), and noninvasive diagnostic method for screening and early detection of oral cancer.

Detection of human papilloma virus in potentially malignant and malignant lesions of the oral cavity and a study of associated risk factors.

Background: Squamous cell carcinoma of the head and neck is the 6 th most frequently occurring cancer worldwide, with over 400,000 cases projected annually. Multiple factors such as tobacco, alcohol, irradiation, virus, and chronic irritants are involved in the development of oral squamous cell carcinomas (OSCCs). The most important risk factors are chronic exposure to tobacco and alcohol. Although the evidence that implicates virus is increasing, particularly (human papillomavirus [HPV]), in the carcinogenesis process, the role of virus is not well established. Aim and Objective: This study is designed to assess the presence of HPV in potentially malignant and malignant lesions of the oral cavity as well as to correlate the presence of HPV with addictive habits and histopathological grading of the disease. Materials and Methods: Biopsy samples of OSCC and potentially malignant lesions were obtained and 3, 5 μm thickness sections were cut using a microtome. The sections were collected using a sterile brush and transferred to an Eppendorf tube. DNA extraction and polymerase chain reaction for the detection of HPV were done. Results and Conclusion: The association between histopathological grading and presence of HPV was assessed using Chi-square test and the values thus obtained were found to be statistically significant. HPV was more predominantly seen in well-differentiated carcinomas and moderately differentiated carcinomas as compared to poorly differentiated carcinomas.

Nurses' knowledge and education about oral care of cancer patients undergoing chemotherapy and radiation therapy

Context: Oral health awareness and oral care are crucial aspects of oncology nursing practice. However very few studies concentrate on the oral care of cancer patients undergoing cancer treatment and nursing practice in the Indian subcontinent. Most of the published studies have been conducted in the Western and European countries. Aim: This study aimed to determine the nurses’ knowledge and education about oral care in cancer patient undergoing chemotherapy and radiation therapy. Setting and design: A cross sectional descriptive survey was conducted among 158 staff nurses working in oncology related areas from 4 different hospitals of Dakshina Kannada district and Udupi district of Karnataka state, India. Statistical Analysis: descriptive and inferential statistics was used by using SPSS 16 version. Results: Majority 81 (51.3%) of the staff nurses had poor knowledge of oral care in cancer patients whereas 87 (55.1%) reported that knowledge acquired through basic education in oral care is not sufficient. Most of the staff nurses 115 (72.8%) did not receive basic education in oral care of cancer patients. There was significant association between knowledge and variables such as designation (.005), years of work experience (.040) and years of experience in cancer wards (.000) at 0.05 levels. Conclusion: Lack of knowledge suggest the need to develop and implement continuing nursing education programs on oral care specifically for patients receiving cancer treatments, for improving knowledge of staff nurses’ in order to render comprehensive care to the patients. This study also recommends the importance of inclusion of cancer patient specific oral care in the curriculum which can enhance competency of the qualified nurses in cancer wards.

Bilaterally occurring mucosal alterations of the oral cavity-a review

Introduction: Lesions of the oral cavity could be unilateral / bilateral and could be the initial manifestation of certain underlying pathology. Oral diagnosticians’ may be the ones who diagnose them in their initial stages. Unilateral lesions have been well documented whereas bilateral soft tissue lesions have been rarely documented in the literature. Hence we classified commonly occurring bilateral oro mucosal soft tissue lesions. Aim: To classify bilaterally occurring oro-mucosal soft tissue lesions bilateral occurrence of lesions could be a normal variant or indicative of pathology. Some of the lesions may or may not be symptomatic and some can even have a malignant potential. It is imperative to know the different types of bilaterally occurring lesions as diagnosing such lesions of the oral mucosa by the clinician is important through an adequate knowledge and thorough examination, followed by investigation for the proper management and better prognosis for the patients.