Quality of life and shoulder function among oral cancer patients treated with selective neck dissection: A cross-sectional study

BACKGROUND

There is no doubt about the oncologic effectiveness of neck dissections (NDs). But the quality of life (QoL) of patients with oral cancer and the morbidity associated with ND like shoulder dysfunction remain uncertain. The present study aimed to assess the postoperative ND-related QoL and shoulder function of oral cancer patients who underwent selective neck dissection (SND).

METHODS

A cross-sectional study was conducted by using a self-administered, ND-related QoL questionnaire and arm abduction test (AAT) in 128 patients who had undergone only SND (up to Level IV) for oral cancer.

RESULTS

Out of the 128 patients, 94 (73.8%) patients had better QoL, and 34 (26.2%) patients had worse QoL. Fifty-one (39.84%) participants were able to abduct up to or more than 150° but less than 180° (Score 3) followed by 31 (24.22%) participants who could abduct up to or more than 90° but not less than 150° (Score 2). Strong positive correlations ( r = 1.000) were observed between the ND QoL scores and the AAT scores. It was found to be statistically significant ( P = 0.000).

CONCLUSION

SND, being a more conservative approach sparing the spinal accessory nerve, could still limit the QoL and could affect the shoulder function to a certain extent.

Fluoride content in various types of tea used by tea stalls in Salem district - An in vitro cross sectional study

Background

Tea leaves are natural rich source of fluoride and are known as fluorine absorbants. It is consumed on large scale in India and thus needs to be monitored for its daily fluoride consumption by customers. Tea manufacturers should mention fluoride concentrations on the packages to avoid overdose through unknown consumption by consumers.

Objectives

To detect the levels of fluoride in tea at different periods of boiling and to compare the fluoride levels in various brands of tea at different periods of boiling.

Methodology

A survey was conducted in 25 tea stalls of Salem on the type of tea and time of boiling black tea. The five most common brands of tea will bought for the study. The stainless-steel vessel will be used in the methodology for boiling tea. Mettur water will be used for the preparation of black tea and 1 g of tea leaves to 100 ml of hot (~95°C) deionized water (1% w/v tea infusion) and allowed the mixture to stand for 5 min in a glass beaker. After 5 min, the infusions were filtered and again left standing until they are cooled to room temperature. All fluoride measurements will be completed within 4 h of the preparation of the infusion. About 2 min and 4 min boiling will be followed. The fluoride present in each brand of tea will be calculated from black tea prepared using 2-(parasulfophenylazo)-1,8-dihydroxy-3,6-naphthalene-disulfonate (SPADNS) calorimetric method.

Results

The distribution of mean score of fluoride level in tea powders available in tea shops of Salem when boiled in distilled water was (559.00 ± 112.12). The mean score of fluoride level in tea powders available in tea shops of Salem boiled in Mettur water was (689.05 ± 116.34). To test the significance of difference between the average fluoride in tea powders available in tea shops of Salem when boiled in distilled water and Mettur water, the independent t-test was used. the P value is <0.05, and hence, it is found that there is significant difference between the average fluoride in tea powders available in tea shops of Salem boiled in distilled water and Mettur water.

Conclusion

Thus, the study showed tea consists of significant amount of fluoride concentration that is consumed on daily basis. The study also evaluated fluoride concentration in tea preparations using different water. The study shows necessity for regulations of mentioning fluoride concentration on tea packs.

Insights into Knowledge, Attitude and Perception about Dental Ergonomics and Work-Related Musculo Skeletal Disorders (MSD) among Dental Professionals at Chengalpet District, Tamil Nadu, India: A cross-sectional study

Introduction: Despite all modern technological advances, dentistry is a profession still being affected by various musculoskeletal disorders, because of their prolonged working hours and difficult postures. Hence, this study was undertaken to assess the basic knowledge, attitude and practice of dental ergonomics during routine dental procedures among dental professionals and the second aim of the study focused on knowledge, attitude and practice of dental ergonomics by gender. Methods: A cross-sectional study was conducted among 203 dental professionals from January 2021 to February 2021. A structured questionnaire consisting of 15 questions was administered. Descriptive analysis of demographic variables was done and knowledge, attitude and perception scores were performed using the chi-square test. Results: Among the 203 participants, a considerable majority of the participants which is about 75.9% (male: 71.1% and female: 79.6%) reported that they have awareness of dental ergonomics. There were no statistically significant differences between males and females regarding knowledge score of p=1.280. About 46.4% of participants (male: 54.3 % and female: 43.9%), complained of neck pain followed by 44.3% (male 41.3% and female 45.2%) complained of back pain. About 58.6% reported that the pain was caused strictly because of improper posture and non-ergonomically designed equipment. The difference between the gender variations was statistically significant regarding perception about dental ergonomics (p=0.001*) Conclusion: Dental professionals have considerable awareness of ergonomics in dental practice. The current study highlights the situation of ergonomics in dental practice in the form of knowledge, attitude, and practices.

Application of Health Behavioral Models in Smoking Cessation - A Systematic Review

Background

Smoking is a significant risk factor for morbidity and mortality. Health education by health promotion is such a gauge to control tobacco epidemic at both national and multinational levels.

Objectives

The objectives of the study were to systematically review the literature to identify models for health behavior change and evaluate evidence for their effectiveness in smoking cessation.

Methods

A systematic review of the literature identified four peer-reviewed studies describing two smoking cessation behavioral interventional models (transtheoretical model [TTM] and health belief model [HBM]) between 2008 and 2018. Electronic databases MEDLINE (PubMed) and Google Scholar and Trip database were carried out. There were two randomized controlled trials and two nonrandomized controlled interventional studies. There was a high degree of homogeneity of design, definition of smoking and smoking abstinence, and implementation, followed by comparison of studies. All included studies have evaluated outcome by stage of changes (component of TTM model) and therefore show the reduction of smoking rate. All studies did not have blinding of study participants, leading to a higher risk of bias in the outcome.

Results

There was a statistically significant difference between TTM-based interventional group and control group in smoking cessation rate. While comparing HBM- and TTM-based behavioral counseling, there was no statistically significant difference in smoking cessation rate.

Conclusion

Both HBM- and TTM-based trainings were found to have positive effects on both smoking cessation and progression between the stages.

Anneroth’s Histopathological Grading System in Non Metastatic and Metastatic Oral Squamous Cell Carcinoma- A Pilot Study

Introduction: Prognostic evaluation of Oral Squamous Cell Carcinoma (OSCC) is mainly based on [Tumour (T), Nodes (N), and Metastases (M)] staging. To predict the biological and clinical behaviour of a tumour, histological grading systems plays an important role. Modified Anneroth’s grading system includes three parameters each for histologic features and tumour-host relationship. Aim: To compare and analyse the histological features of tumour center and periphery of non metastatic and metastatic OSCC according to Anneroth’s histopathological classification and its association with regional lymph node metastasis. Materials and Methods: A retrospective pilot study was conducted on 20 histopathologically proven cases of OSCC collected from the Department of Oral Pathology and Oral Microbiology, Vinayaka Mission’s Sankarachariyar Dental College, Salem, Tamil Nadu, India. The OSCC cases those reported from March 2018 to June 2020 were included in the study. Among 20 cases, 10 non metastatic and 10 metastatic cases, were retrieved from archival blocks. Scores for the morphology and tumour-host relationship of non metastatic and metastatic tumours was assessed and graded by Anneroth’s grading system; then compared with the Broder's histopathological grading system. The histopathological scoring of lymph node was based on TNM staging. Chi-square test and Spearman’s correlation coefficient analysis was done. Results: Anneroth’s grading system showed a significant difference in pattern of invasion in tumour periphery of metastatic OSCC (p-value=0.01). Compared to Broder’s, Anneroth’s classification showed a highly significant corelation with lymph node metastasis (p-value=0.001). Conclusion: Hence, Anneroth’s histopathological grading system can be used to predict the biological changes in metastatic and non metastatic OSCC and its increased possibility of regional lymph node metastasis.

Survivin Expression in Metastatic and Nonmetastatic Oral Squamous Cell Carcinoma: A Comparative Study

Aim:

Survivin is a multifunctional protein chiefly involved in apoptosis and cell cycle regulation. Increased expression of survivin in tumors and fetal tissue determines its antiapoptotic activity. The aim of the study is to identify the immunoexpression of survivin in metastatic and nonmetastatic oral squamous cell carcinoma (OSCC) and also to evaluate and compare the expression of survivin in metastatic and nonmetastatic OSCC of buccal mucosa.

Materials and Methods:

In total, 40 histopathologically proven cases of OSCC, including 20 metastatic and 20 nonmetastatic cases, are selected. Among the 20 metastatic and nonmetastatic cases, 10 well-differentiated and 10 moderately differentiated squamous cell carcinoma cases were included and were subjected to immunohistochemical staining for survivin expression. The results were analyzed by SPSS version 11.5 using chi-square test.

Results:

The expression of survivin in metastatic and nonmetastatic tumors is 15%–70% and 15%–60%, respectively. When comparing the cases of moderately differentiated squamous cell carcinoma in metastatic and nonmetastatic tumors, 70% cases show moderate staining intensity.

Conclusion:

The survivin expression was comparatively high in metastatic OSCC. Also based on the aforementioned results, survivin expression was high in increasing grades of OSCC.

Remineralizing potential of CPP-ACP in white spot lesions - A systematic review

Objective

The aim of this systematic review was to assess the long term remineralizing potential of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) only in paste form compared with fluoride varnish, and or placebo in both naturally occurring and post-orthodontic white spot lesions in vivo.

Data Sources

The literature search covered the electronic databases: PubMed and Google scholar from 2005-2016. Only articles published in English were included. Randomized control trials in which CPP-ACP delivered by paste form were included. All studies which met inclusion criteria underwent two independent reviews.

Study Selection

Two ninety five articles were identified from the search after excluding duplications. Abstracts of forty one articles were reviewed independently. Twenty nine articles were excluded after reading abstract. Full text articles were retrieved for fifteen relevant studies. After reviewing articles independently, three articles were excluded after full text reading. Finally twelve studies were selected based on the eligibility criteria. The remineralizing effect of CPP-ACP were compared with placebo and fluoridated toothpaste and fluoride varnish in randomized control trial.

Conclusion

A high level evidence of remineralizing potential of CPP-ACP on naturally occurring white spot lesion and WSL post orthodontic treatment was found in comparison with placebo/fluoridated toothpaste and fluoride varnish without any statistically significant difference. Well-designed RCTs are, therefore, required to improve the level of evidence in this area.

Oral health-related quality of life in patients treated for oral malignancy at Kanchipuram district, India: A cross-sectional study

BACKGROUND

The modern-day onco-surgical therapy is now concerned on the overall Quality of Life after treatment of the patient. There is need to evaluate final outcome following the different combination of treatment modalities available to make better therapeutic treatment decisions.

AIM

The aim of this study was to assess Oral health related quality of life (OHRQoL) in patients with oral malignancies who had undergone various treatments.

SETTINGS AND DESIGN

A Cross sectional study was conducted among 90 patients between October 2016 to January 2017 in private hospitals, kanchipuram, India.

MATERIALS AND METHODS

Participants were grouped based on the treatment they had undergone into Group I - Surgery alone, Group II - Surgery and Radiotherapy, Group III- Surgery, chemotherapy and radiotherapy and assessed for OHRQoL using the shorter version of Oral health impact profile -14 (OHIP-14) questionnaire.

STATISTICAL ANALYSIS

Descriptive analysis of socio demographic variables and OHIP 14 was performed using Chi-square test and one way ANOVA.

RESULTS

Among the 90 participants, 43.3% belonged to upper lower class and 38.3% to lower class. Buccal mucosa (58.9%) was found to be the most frequent site. Among the clinical staging, Stage II (33.33%) oral cancer was more prevalent. No statistically significant differences in the OHIP mean score for Groups, I, II, III. Among the domains functional limitation was significantly different in the three groups.

CONCLUSION

Patients with oral malignancies who had been treated surgically alone had better Quality of life when compared to the combined treatment modalities.