Supriya Bhat

Salivary lactate dehydrogenase levels in oral leukoplakia and oral squamous cell carcinoma: A biochemical and clinicopathological study

BACKGROUND Oral cancer is the third most common form of malignancies in India. In many cases it develops at the site of premalignant lesion. Transformation of normal tissue to premalignant lesion and further to oral cancer results in alteration in glycolytic pathway and hence the lactate dehydrogenase levels. Therefore, a study was carried out to determine the changes in the salivary alterations in lactate dehydrogenase (LD) levels oral leukoplakia (OL) and oral cancer (OC). METHODS Seventy-five patients reporting to department of oral medicine and radiology, were enrolled into the study which includes 25 patients each of oral leukoplakia, 25 of oral cancer and 25 healthy controls (HC). Unstimulated whole saliva measuring 1 mL will be collected from each of these patients by spit method in centrifuged and evaluated for LDH levels using the standard kit method. The data obtained were subjected to statistical analysis using the SPSS software version 17. RESULTS The mean salivary lactate dehydrogenase levels were higher in males in comparison to females in all three study groups OL, OC and HC. The salivary lactate dehydrogenase levels in the controls group, oral leukoplakia group and oral cancer were 79.50 ± 4.67 IU/L, 136.46 ± 3.36 IU/L and 148.77 ± 4.83 IU/L, respectively. There was a significant difference in the mean salivary levels of the above groups. CONCLUSION Salivary lactate dehydrogenase levels are consistently higher in oral precancer and cancer hence it could be future marker.

Salivary ascorbic acid levels in betel quid chewers: A biochemical study.

Background: Quid chewing practice has been a part of our tradition since centuries with little known evidence of oral cancer. However, recent trends show a rise in occurrence of oral cancer often associated with tobacco and arecanut usage. Ascorbic acid is an important salivary antioxidant. Betel leaf which is used in quid is known to contain ascorbic acid. Aim: The aim of our study was to assess the salivary levels of ascorbic acid in traditional quid chewers so as to determine whether the betel leaf has protective antioxidant action. Materials and Methods: Salivary ascorbic acid levels of 60 subjects were estimated using the Dinitrophenyl hydrazine method. Results: The results revealed that quid chewers who used betel leaf had higher salivary ascorbic acid content compared to nonbetel leaf quid chewers. This could possibly be due to the protective antioxidants in the betel leaf.

Goldenhar syndrome: Report of two cases with review of literature

Goldenhar syndrome consists of a varied group of malformations that can involve multiple systems of the body. It is believed to be a variant of hemifacial microsomia with ocular and vertebral involvement. Characteristic findings, such as hypoplasia of one half of the face, epibulbar dermoids, ear tags, and spinal cord defects, warrant the name occulo-auriculo-vertebral dysplasia. The syndrome occurs due to imbalance in cells during the blastogenesis period of embryo formation. It is found to involve the derivatives of first and second branchial arches. The condition is apparent at birth, but the phenotype can vary greatly in its severity depending on the activation and expression of the defective gene. Reported here are detailed clinical and radiographic features of two sporadic cases of Goldenhar syndrome in young males. This work mainly highlights the various theories of etiopathogenesis as well as step-wise management protocol for patients diagnosed with the syndrome.

A rare co-occurrence of facial talon's cusp on fused maxillary permanent central and lateral incisor

Fusion is a developmental anomaly of dental hard tissues characterised by the union of two adjacent teeth. It can be complete or incomplete and commonly seen in deciduous than in the permanent dentition with higher frequency in anterior maxillary regions. Talon’s cusp is an unusual cuspal projection from the lingual aspect of the tooth with normal enamel and dentin and varying degree of pulp tissue. It commonly affects the permanent maxillary lateral incisors followed by central incisors and canines. Talon cusp is mostly found on the lingual aspect of teeth and rarely it projects from the facial aspect. We hereby report a case of fusion of permanent left central and lateral incisor with facial talon cusp which is rarely reported.

Status of serum and salivary ascorbic acid in oral potentially malignant disorders and oral cancer

Background and Aims: The aim of this study was to estimate the detoxification status of serum and saliva by assessing the serum and salivary Vitamin C in oral potentially malignant disorders and oral cancer. Subjects and Methods: A total of 90 subjects, 30 subjects with oral potentially malignant disorders, 30 subjects with oral cancer, and 30 healthy subjects (controls) were included in the study. Serum and saliva were collected and levels of Vitamin C were assessed. Data obtained was analyzed using ANOVA test for the comparison between the groups. Post hoc Tukeys analysis was used for the comparison of the two study groups to the control group. Correlation between the groups was done using Pearsons correlation coefficient test. Results: The mean serum and salivary Vitamin C levels were decreased significantly in potentially malignant disorders and oral cancer when compared to healthy subjects. Conclusions: As significant reduction of Vitamin C is seen in saliva, it can be stated that saliva can be used as a reliable, noninvasive biomarker in diagnosis and management of potentially malignant disorders and oral cancer.

Sialic acid as a biomarker of oral potentially malignant disorders and oral cancer

Background: Carcinogenesis is a multistep process where a healthy cell has initially a precancerous stage and finally an early cancerous stage. The process of carcinogenesis can be divided into three stages of initiation, promotion, and progression. In this process, there is increased turnover, secretion, and/or shedding from malignant cells. Glycoproteins like sialic acid are expressed on the cell surface. In oral potentially malignant disorders (OPMDs) and oral cancer (OC), the sialic acid level is seen to increase due to high cell turnover and shedding of malignant cells which, in turn, results in the release of glycoproteins like sialic acid into circulation. Glycoproteins also form an important constituent of salivary mucins and hence due to the same mechanism, an increase in sialic acid level is also seen in saliva. Objective: The aim is to estimate serum and salivary sialic acid levels in healthy controls, patients with OPMDs and patients with OC. Materials and Methods: In this observational cross-sectional study, serum and salivary sialic acid levels were estimated in thirty healthy controls, thirty patients with OPMDs and thirty patients with OC. Results: Serum and salivary sialic acid levels obtained were subjected to statistical analysis. Post hoc Tukey test was used to compare the serum and salivary sialic acid levels of the two study groups to the control group. ANOVA test was used for the comparison of sialic acid levels between the groups. Pearsons correlation coefficient was used to assess correlation (P < 0.05 was considered statistically significant). The mean serum and salivary sialic acid levels were increased significantly in subjects with OPMDs and OC when compared to healthy controls. Conclusion: This study highlights the high expression of sialic acid on outer cell membranes, due to the significant increase in subjects with OPMDs and OC when compared to healthy controls. A significant increase in sialic acid level is also seen in saliva. Hence, it can be stated that saliva can be used as a reliable, noninvasive tool in diagnosis and management of OPMDs and OC.

Siblings with pierre robin sequence

Pierre Robin anomalad is a syndrome characterized by cleft of the palate, micrognathia of the mandible, and glossoptosis. This syndrome can occur as an individual presentation, or it may be associated with a wide variety of syndromes and anomalies. Such patients are burdened with several problems, some obvious and some less so. The most obvious problems such as the psychological difficulties the patients will have to face due to the appearance and associated problems such as feeding and speech difficulties and serious consequences such as airway obstruction. Here, we report two cases of Pierre Robin sequence seen in the same family in two children of the same parents.

An Intriguing Case of Ectasia of External Jugular Vein Presenting as Intermittent Neck Mass

Ectasia of external jugular vein is a rare entity presenting as an intermittent neck swelling. High index of suspicion is required to diagnose the condition. Ultrasonography with Doppler before, during and after valsalva manoeuvre is the preferred method for diagnosis. The treatment is conservative for asymptomatic patients and surgery is reserved for patients with complications.

Binder's syndrome: Presentation of a rare case

Binder′s syndrome (BS) or Maxillo-nasal dysplasia is a congenital malformation described first by Noyes. The syndrome was not recognized until Binder′s comprehensive report of three unrelated children in 1962. In patients with BS, the mid-face appears flattened, the columella is short and the upper lip slants backward. We hereby present a case with these typical findings of BS in a male patient.

Giant cell fibroma - A Case Report

The Giant cell fibroma (GCF) is a lesion of fibrous connective tissue origin. The giant cell fibroma is a fibrous tumour with distinct clinicopathologic features which sets it apart from the conventional fibroma. The most common site for occurrence of giant cell fibroma is gingiva followed by tongue, buccal mucosa, palate, lip and floor of mouth. It is most commonly seen in the Caucasian population. It represents approximately 2% to 5% of all oral fibrous proliferations submitted for biopsy. GCF usually affects patients in the 2nd and 3rd decades of life with approximately 60% of cases found in the first three decades of life. We hereby present a case of a giant cell fibroma in the left buccal mucosa in a 38 year old female.