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Agarwal R, Chaudhary M, Bohra S, Bajaj S. Evaluation of natural killer cell (CD57) as a prognostic marker in oral squamous cell carcinoma: An immunohistochemistry study. J Oral Maxillofac Pathol 2016; 20:173-7. [PMID: 27601804 PMCID: PMC4989542 DOI: 10.4103/0973-029x.185933] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives: Natural killer (NK) cells are important effector lymphocytes. NK cells are considered to represent innate immune system. NK cells target and kill aberrant cells such as virally infected and tumorigenic cells. The purpose of this study was to assess the expression of CD57 in oral squamous cell carcinoma (OSCC) and to correlate the expression of CD57 with 3 years survival in patients with OSCC. Materials and Methods: About 100 histopathologically diagnosed cases of OSCC of various grades were divided into two groups, i.e., Group I (dead patients) and Group II (live patients) from the archives of Department of Oral Pathology and Microbiology. CD57 was detected in these tissues by immunohistochemistry. Result: The results were analyzed using Spearman's correlation coefficient and students unpaired t-test. The mean CD57 labeling index in Group II was significantly higher than that found in Group I (P = 0.000). There was a significant correlation (P = 0.00) in the mean CD57 levels between Groups I and II and prognosis of patient. Conclusion: CD57 could be a good prognostic marker for OSCC patients.
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Affiliation(s)
- Rashmi Agarwal
- Department of Oral and Maxillofacial Pathology, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Patna, Bihar, India
| | - Minal Chaudhary
- Department of Oral and Maxillofacial Pathology and Microbiology, Sharad Pawar Dental College, Wardha, Maharashtra, India
| | - Shruti Bohra
- Department of Oral and Maxillofacial Pathology and Microbiology, Sharad Pawar Dental College, Wardha, Maharashtra, India
| | - Shree Bajaj
- Department of Oral and Maxillofacial Pathology and Microbiology, Sharad Pawar Dental College, Wardha, Maharashtra, India
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Abstract
Melkersson-Rosenthal syndrome (MRS) classically shows a triad of orofacial swelling, fissured tongue and facial palsy, more commonly the oligosymptomatic form. The orofacial swelling is characterised by swollen reddish-brown non-pruritic lips and facial oedema. In one-third to one half of patients, fissured tongue is seen, which also aids in diagnosis. The histological finding of MRS includes non-caseating, sarcoidal granulomas, but their absence does not exclude the diagnosis. All these findings together form a basis for a cautious search for confrontational reasons for the symptom complex of MRS.
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Affiliation(s)
- Shruti Bohra
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College, Wardha, Maharashtra, India
| | - Pratik B Kariya
- Department of Pedodontics and Preventive Dentistry, KM Shah Dental College and Hospital, Vadodara, Gujarat, India
| | - Seema Dinesh Bargale
- Department of Pedodontics and Preventive Dentistry, KM Shah Dental College and Hospital, Vadodara, Gujarat, India
| | - Shital Kiran
- Department of Pedodontics and Preventive Dentistry,Karnavati School of Dentistry, Gandhinagar, Gujarat, India
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Chaudhary M, Bajaj S, Bohra S, Swastika N, Hande A. The domino effect: Role of hypoxia in malignant transformation of oral submucous fibrosis. J Oral Maxillofac Pathol 2015; 19:122-7. [PMID: 26604484 PMCID: PMC4611916 DOI: 10.4103/0973-029x.164519] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 07/30/2015] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Oral submucous fibrosis (OSMF) is a precancerous condition predominantly seen in people of Asian descent. About 7-12% OSMF patients develop oral squamous cell carcinoma (OSCC). Morphological features of OSMF especially fibrosis suggests a possibility of the hypoxic environment in diseased tissues. Oral cancer usually develops from hyperplasia through dysplasia to carcinoma. Neovascularization and increased glycolysis, represent adaptations to a hypoxic microenvironment that are correlated with tumor invasion and metastasis. The adaptation of cells to hypoxia appears to be mediated via hypoxia inducible factor-1α (HIF-1α). HIF-1α is said to be associated with malignant transformation of epithelium in other sites. It appears that HIF-1α plays a significant role in both prostate and cervical carcinogenesis at early stages. We hypothesize that progression of OSMF and malignant transformation in the background of fibrosis mediates via HIF-1α either by up- or down-regulation of various such molecules. Therefore, the main objective of this study was to investigate the relationship between the expression of HIF-1α in OSMF, OSCC and OSCC with OSMF. AIM To investigate the relationship between the expression of HIF-1α in OSMF, OSCC and OSCC with OSMF. MATERIALS AND METHODS The study group consists of histopathologically diagnosed 20 cases of OSCC, oral submucous fibrosis and OSCC with OSMF each. The immunohistochemistry was carried out on neutral buffered formalin-fixed paraffin-embedded tissue sections by using the monoclonal antibody of HIF-1α. RESULTS A rise in the expression of HIF-1α from OSMF to OSCC to OSCC with OSMF is observed.
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Affiliation(s)
- Minal Chaudhary
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Shree Bajaj
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Shruti Bohra
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Nisu Swastika
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
| | - Alka Hande
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Sawangi (Meghe), Wardha, Maharashtra, India
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Hande AH, Mohite DP, Chaudhary MS, Patel M, Agarwal P, Bohra S. Evidence based demonstration of the concept of 'field cancerization' by p53 expression in mirror image biopsies of patients with oral squamous cell carcinoma - an immunohistochemical study. Rom J Morphol Embryol 2015; 56:1027-1033. [PMID: 26662135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The main rationale for treatment failure and death of the patients with oral squamous cell carcinoma (OSCC) is loco-regional recurrence, development of second primary tumor (SPT) and metastasis, which could be well explained by concept of field cancerization. Identification of patients at high risk for development of SPT is an important part of research for cancer management. This study was designed keeping this aspect in mind and utilizing the increased expression of p53 as an indicator of existence of altered fields in mirror image biopsies of OSCC patients. DESIGN Forty clinically diagnosed oral cancer patients were included in the study. Biopsy tissue samples from clinically diagnosed oral cancer patients (Group A) and the mirror image, clinically normal looking mucosa at corresponding contralateral anatomical site (Group B) were studied for histopathological evaluation and p53 immunoexpression. RESULTS Tissue alterations were observed in Groups A and B. There was statistically significant (chi-square value - 126.6, p=0.0001) difference in grades of epithelial dysplasia and p53 immunoexpression in Group B. Spearman's Rank Correlation Coefficient shows non-significant positive correlation between epithelial dysplasia and p53 (r=0.28, p=0.05) in Group B. CONCLUSIONS Evidence of presence of field cancerization, evaluated by histopathological alterations and enhanced p53 expression was observed in mirror image biopsies of OSCC patients. This could predict the altered state of oral mucosa secondary to carcinogen exposure. The realization of a genetically altered field as a cancer risk factor provides a new paradigm. It would be prudent to keep these patients under close observation and to advice them chemotherapeutic regimes.
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Affiliation(s)
- Alka H Hande
- Department of Oral Pathology and Microbiology, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Medical Sciences (DU), Sawangi (Meghe), Wardha, Maharashtra, India;
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Bajaj S, Ghatage D, Bohra S, Bhola N, Chaudhary M. Lesion of Dual Nature - Carcinoma or Sarcoma: A Histopathologic Dilemma. Clin Cancer Investig J 2015. [DOI: 10.4103/2278-0513.149038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Driscoll A, Elsik M, Reid C, Heynen H, Hare D, Abhayaratna W, Prior D, O’Donnell D, Kistler P, Bohra S, Krum H. Prevalence of ICD and/or CRT Device Therapy in HF Patients: Interim Results of an Australian Multicentre Study. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bohra S, Byrne MF, Manning D, Smyth C, Patchett SE, Murray FE. A prospective analysis of inpatient consultations to a gastroenterology service. Ir Med J 2003; 96:263-5. [PMID: 14753578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
The provision of a formal consultation service for inpatients between subspecialists is little studied. We prospectively surveyed the pattern of inpatient consultations from hospital-based generalists and surgeons to the gastroenterology (GI) service for inpatients in a large urban teaching hospital over a 5 month period. There are two GI consultants/attendings and five GI registrars/fellows on the service. A formal consultation is made by the requesting team to the GI service using the hospital computer network. All referrals over a 5 month period were prospectively analysed. 242 consecutive inpatient referrals were sent to the GI service over 5 months. Average age was 56 years, 48.8% males. 32 consultants/attendings from other disciplines sent referrals. Most patients were seen within one working day. Urgent referrals were seen without delay. The commonest reasons for referral were abdominal pain (15.8%), percutaneous endoscopic gastrostomy (PEG) tube insertion (13.6%), diarrhoea (12.8%), abnormal liver blood tests (10%), nausea and vomiting (8.2%), anaemia (6.2%), and melaena (4.9%). Iatrogenic diseases accounted for 6.2% of consultations. Ongoing patient care was assumed by the GI team in 9.5% of referrals. 15.3% required a second consultation visit before discharge. 22.7% of referrals were followed in the GI outpatients' clinic after discharge. 51.2% underwent an endoscopic procedure. 13.6% of referrals were for PEG tube insertion. A quarter of these were considered unsuitable for immediate PEG tube insertion. Subspecialty consultation provides an expert opinion, encourages discussion and learning, and improves patient care. In our experience, the provision of specialist advice and reassurance often speeded up a patient's work-up and expedited discharge. However, evaluating referral patients and subsequently providing ongoing inpatient and outpatient care and provision of endoscopy for these referrals contributes significantly to the workload of the GI service.
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Affiliation(s)
- S Bohra
- Department of Gastroenterology, Beaumont Hospital/Royal College of Surgeons in Ireland, Dublin, Ireland
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Singh V, Khandelwal R, Bohra S, Gupta R, Gupta BS. Evaluation of communication skills of physicians about asthma. J Assoc Physicians India 2002; 50:1266-9. [PMID: 12568212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE Communication skills in medical practice are important. To assess the communication skills of physicians about asthma, we undertook this study. METHODS One thousand four hundred and twenty one physicians attending the annual conference of association of physicians of India volunteered to participate in the study. They were divided into three categories. 'Teachers' group 1, (n = 131), 'Clinicians', group 2, (n = 951) and 'Students' group 3, (n = 339). Questionnaire containing ten most frequently asked questions by asthmatic patients were given to the physicians. A panel of three patients assessed the replies of these question and graded them as 'Convincing', 'Just convincing' and 'Not convincing'. RESULTS Replies of only 2% of physicians were graded as convincing, 15.6% just convincing and 82.4 as not convincing. Among group 1 none gave a convincing reply while replies of 2.2% of group 2 and 2.4% of group 3 were graded as convincing. The difference in results was not significant statistically on comparing the three groups (p > 0.1). CONCLUSIONS Communication skills are the integral part of patient care and management. Our study demonstrated lack of effective communication skills among physicians.
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Affiliation(s)
- V Singh
- Pulmonary Division, Department of Medicine, SMS Medical College, Jaipur
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Abstract
Wegener's granulomatosis is a rare necrotizing vasculitis usually affecting the respiratory tract and kidneys. The aetiology is unknown and it usually occurs in patients over the age of 40. Involvement of the gastrointestinal tract in Wegener's granulomatosis is relatively rare and usually occurs long after the onset of initial symptoms. Acute colitis as a presenting feature of Wegener's granulomatosis is very rare with only a few reports in the literature. We describe a young woman who presented initially to hospital with gastrointestinal features and then developed a severe colitis and severe gastrointestinal haemorrhage. This preceded the development of respiratory tract features with severe pulmonary haemorrhage, haemoptysis and the development of rapidly progressive renal failure and nasal septal perforation. Following treatment with intravenous steroids and cyclophosphamide, gastrointestinal symptoms and signs improved dramatically, as did her pulmonary disease. She still remains dialysis dependent, due to end-stage renal disease secondary to glomerulonephritis.
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Affiliation(s)
- C Steele
- Department of Gastroenterology and Hepatology, Beaumont Hospital, Dublin 9, Ireland
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