Mouth Research Articles

Cancer survival in sub-Saharan Africa (SURVCAN-3): a population-based study

The Cancer Survival in Africa, Asia, and South America project (SURVCAN-3) of the International Agency for Research on Cancer aims to fill gaps in the availability of population-level cancer survival estimates from countries in these regions. Here, we analysed survival for 18 cancers using data from member registries of the African Cancer Registry Network across 11 countries in sub-Saharan Africa. We included data on patients diagnosed with 18 cancer types between Jan 1, 2005, and Dec 31, 2014, from 13 population-based cancer registries in Cotonou (Benin), Abidjan (CÔte d'Ivoire), Addis Ababa (Ethiopia), Eldoret and Nairobi (Kenya), Bamako (Mali), Mauritius, Namibia, Seychelles, Eastern Cape (South Africa), Kampala (Uganda), and Bulawayo and Harare (Zimbabwe). Patients were followed up until Dec 31, 2018. Patient-level data including cancer topography and morphology, age and date at diagnosis, vital status, and date of death (if applicable) were collected. The follow-up (survival) time was measured from the date of incidence until the date of last contact, the date of death, or until the end of the study, whichever occurred first. We estimated the 1-year, 3-year, and 5-year survival (observed, net, and age-standardised net survival) by sex, cancer type, registry, country, and human development index (HDI). 1-year and 3-year survival data were available for all registries and all cancer sites, whereas availability of 5-year survival data was slightly more variable; thus to provide medium-term survival prospects, we have focused on 3-year survival in the Results section. 10 500 individuals from 13 population-based cancer registries in 11 countries were included in the survival analyses. 9177 (87·4%) of 10 500 cases were morphologically verified. Survival from cancers with a high burden and amenable to prevention was poor: the 3-year age-standardised net survival was 52·3% (95% CI 49·4-55·0) for cervical cancer, 18·1% (11·5-25·9) for liver cancer, and 32·4% (27·5-37·3) for lung cancer. Less than half of the included patients were alive 3 years after a cancer diagnosis for eight cancer types (oral cavity, oesophagus, stomach, larynx, lung, liver, non-Hodgkin lymphoma, and leukaemia). There were differences in survival for some cancers by sex: survival was longer for females with stomach or lung cancer than males with stomach or lung cancer, and longer for males with non-Hodgkin lymphomas than females with non-Hodgkin lymphomas. Survival did not differ by country-level HDI for cancers of the oral cavity, oesophagus, liver, thyroid, and for Hodgkin lymphoma. For cancers for which population-level prevention strategies exist, and with relatively poor prognosis, these estimates highlight the urgent need to upscale population-level prevention activities in sub-Saharan Africa. These data are vital for providing the knowledge base for advocacy to improve access to prevention, diagnosis, and care for patients with cancers in sub-Saharan Africa. Vital Strategies, the Martin-Luther-University Halle-Wittenberg, and the International Agency for Research on Cancer. For the French and Portuguese translations of the abstract see Supplementary Materials section.

Epidemiology of Adenosquamous Carcinomas.

Adenosquamous carcinomas (ASCs) are a very rare histology containing cancer cells with both glandular-like (adeno) and squamous cell histologies, comprising typically a fraction of a percent of all solid tumors. The bulk of the literature on ASCs is comprised of case reports and small series, with the general finding that ASCs tend to have worse outcomes than either of their parent histologies. However, there is a lack of pan site-comparative studies in the literature that compare ASC clinicodemographic and survival outcomes with those of conventional adenocarcinomas (ACs) and squamous cell carcinomas (SCCs). In this study, we summarize these outcomes in eight primary sites, comprising 92.7% of all ASC cases diagnosed from 1975 to 2020 in the Surveillance, Epidemiology, and End Results (SEER) database. Lung ASCs comprise 51.5% of all ASC cases, accounting for 1.1% of all lung cancer cases, followed by uterine/cervical cancers at 29.7% of all ASC cases, translating into 1.8% of all cancers in this site. In descending order, the remaining 20% of ASCs arise in pancreatic, oral cavity, biliary, esophageal, colorectal, and gastric sites, comprising between 0.1% and 0.7% of all cancers in these sites. Apart from pancreatic and oral cavity cancers, ASC tumors tended to favor higher rates of regional or distant disease at presentation with poor tumor differentiation compared to either AC or SCC histologies. After multivariable analysis, adjusting for age, sex, detection stage, grade differentiation, surgery, chemotherapy, and radiotherapy, except for oral cavity cancers, ASCs tended to have worse overall survivals compared to ACs (hazard ratios: 1.1 - 1.6) and SCC (1.0 - 1.3), with colorectal ASCs having the worse overall survival compared to colorectal ACs, with a hazard ratio of 1.4 (95% confidence interval: 1.3 - 1.6). Overall, these results suggest that ASC outcomes are site specific, and in general, tend to have worse outcomes than nonvariant ACs and SCCs even after correction for common clinical and epidemiological factors. These cancers have a poorly understood but unique tumor biology that warrants further characterization.

Dental odyssey: a comprehensive literature review on global strategies, behavioral programs, and creative approaches for ages 6-12 years

Introduction: Oral and dental hygiene serves as an indicator of a condition free from diseases, debris, and health issues in the oral cavity, affecting individuals of all age groups. Health education through various global learning systems, behavioural programmes, and creative approaches has proven effective in enhancing children's understanding of the importance of maintaining oral and dental cleanliness. Objective: Objective: This research aims to review relevant journals contributing to the development of insights, behaviours, and understanding regarding children's oral and dental health across crucial age ranges. Methods: Using a literature review method, we filtered articles from Google Scholar, PubMed, Garuda (Digital Reference Library), and Science Direct published within the last six years. Searches in both Indonesian and English languages yielded ten articles that, after a selection process, provided diverse results regarding the implementation of learning models to enhance children's understanding of their oral and dental hygiene. Result: From the ten articles, it can be concluded that the application of education on oral and dental hygiene through various learning systems can effectively improve children's knowledge. Conclusion: the oral hygiene of elementary school children from various countries. Variations in research designs were found, and there is low awareness among children regarding dental health in Indonesia. Educational programmes, such as "Brush Day & Night," and collaborations between FDI and Unilever have proven effective in improving children's toothbrushing habits. The use of music and the snake ladder game was also considered appropriate for developing awareness and behaviours related to dental hygiene.

A REVIEW ON FAST DISSOLVING FILM

Orally fast dissolving films (OFDFs) have been introduced in the market recently as they provide convenience and ease of use over other dosage forms such as orally disintegrating tablets. This technology evolved over the past few years from the confection and oral care markets in the form of breath strips and became a novel and widely accepted form by consumers, so OFDFs are gaining the interest of large number of pharmaceutical industries. Orally fast dissolving film is the type of drug delivery system which when placed in the oral cavity, disintegrate or dissolve within few seconds without the intake of water. OFDFs are very similar to postage stamp in their shape, size and thickness. These films have a potential to deliver the drug systemically through intragastric, sublingual or buccal route of administration and also has been used for local action. This type of technology offer a convenient way of dosing medication, not to special population groups like pediatric, geriatric, bedridden patients, mentally ill patients, but also to the general population. The present review provides an account of various formulation considerations, method of preparation and quality control of the OFDFs.

Early childhood caries and its impact on general health: Narrative review

Objective: To analyze publications about the impact that early childhood caries has on the general health of this group of patients. Materials and methods: A narrative review was conducted that included articles published from 2017 to 2023 in the following electronic databases: PubMed, Scielo and Google Scholar. Results: Of the 21 articles selected for the narrative review, it was found that the most frequent problems were: the presence of dental pain, followed by difficulty eating and drinking hot and cold beverages, and finally difficulty sleeping. Conclusion: Early childhood caries is considered a worldwide health problem that affects children under 6 years of age, causing problems both in the oral cavity and in general health, generating phonetic and psychological risks, among others that affect the quality of life of the child and his or her parents or caregivers.

Dosimetric and NTCP analyses for selecting parotid gland cancer patients for proton therapy.

To perform a dosimetric and a normal tissue complication probability (NTCP) comparison between intensity modulated proton therapy and photon volumetric modulated arc therapy in a cohort of patients with parotid gland cancers in a post-operative or radical setting. From May 2011 to September 2021, 37 parotid gland cancers patients treated at two institutions were eligible. Inclusion criteria were as follows: patients aged ⩾ 18 years, diagnosis of parotid gland cancers candidate for postoperative radiotherapy or definitive radiotherapy, presence of written informed consent for the use of anonymous data for research purposes. Organs at risk (OARs) were retrospectively contoured. Target coverage goal was defined as D95 > 98%. Six NTCP models were selected. NTCP profiles were calculated for each patient using an internally-developed Python script in RayStation TPS. Average differences in NTCP between photon and proton plans were tested for significance with a two-sided Wilcoxon signed-rank test. Seventy-four plans were generated. A lower Dmean to the majority of organs at risk (inner ear, cochlea, oral cavity, pharyngeal constrictor muscles, contralateral parotid and submandibular gland) was obtained with intensity modulated proton therapy vs volumetric modulated arc therapy with statistical significance (p < .05). Ten (27%) patients had a difference in NTCP (photon vs proton plans) greater than 10% for hearing loss and tinnitus: among them, seven qualified for both endpoints, two patients for hearing loss only, and one for tinnitus. In the current study, nearly one-third of patients resulted eligible for proton therapy and they were the most likely to benefit in terms of prevention of hearing loss and tinnitus.

Evaluation of Salivary Parameters and Oral Health Status in Periodontally Healthy Subjects and Chronic Periodontitis Subjects

Abstract Introduction: Periodontal disease is a chronic disease of the oral cavity that consists of a group of inflammatory disorders affecting the supporting structures of the dentition. Saliva can be used to predict the early onset of periodontitis. Several investigations have been carried out to evaluate the salivary chemical compounds that lead to the destruction and/or protection of periodontal tissues. The present study aimed to assess and compare salivary parameters and oral health status in periodontally healthy and chronic generalised periodontitis patients. Materials and Methods: This is an in vivo study designed to compare salivary parameters (albumin, urea, total proteins, amylase, glucose and pH) of unstimulated saliva and oral health status of periodontally healthy subjects (n = 65) and chronic generalised periodontitis subjects (n = 65). Human whole unstimulated saliva was collected by spitting method with the subject seated in an upright position after refraining from oral intake for 2 h before saliva collection. Approximately 5 mL of saliva was collected and stored in graduated saliva-collecting vials and refrigerated at 4°C for 1 h. The samples were centrifuged at 2800 rpm for 10 min, and the supernatant was separated from the substrate and stored at 20°C. Next, the sample was defrosted at room temperature and centrifuged at 3000 rpm. The supernatant was separated again to determine the concentrations of glucose, amylase, urea, total protein and albumin using the respective kits and analysed using an automated analyser. Salivary pH was estimated electrometrically with the help of a pH meter. Results: A significant association was found between salivary parameters (amylase and albumin total proteins) and clinical parameters (plaque index [PI], gingival index) [GI], probing depth and calculus index in generalised chronic periodontitis subjects when compared to periodontally healthy subjects. Conclusion: The increase in salivary parameters (amylase, total proteins and albumin) was statistically significant except for salivary glucose and urea (statistically non-significant) in generalised chronic periodontitis subjects compared to the healthy subjects. As the clinical parameters (probing depth, loss of attachment, PI, GI, calculus index and decay missing filled teeth) in periodontitis subjects increased, the salivary parameters also increased, suggesting a linear relationship between the generalised chronic periodontitis and salivary parameters (total proteins, albumin and amylase).

Multimodal inhibitory effect of matcha on Porphyromonas gingivalis.

Periodontitis, a multifactorial inflammatory disease of the oral cavity, results in alveolar bone destruction, and is a major cause of tooth loss of humans. In addition, emerging evidence has demonstrated associations between periodontitis and a wide range of other chronic inflammation-driven disorders, including diabetes mellitus, preterm birth, cardiovascular disease, aspiration pneumonia, rheumatoid arthritis, cognitive disorder, and cancer. In the present study, we report that matcha, a product of Camellia sinensis, hampers Porphyromonas gingivalis, a major periodontal pathobiont, in not only a series of in vitro experiments but also a pilot intervention clinical trial of patients with periodontitis, in which matcha mouthwash statistically significantly reduced the P. gingivalis number in saliva, as compared to the pre-intervention level. Taken together, we suggest that matcha may have clinical applicability for prevention and treatment of periodontitis.

Treatment of mucocutaneous leishmaniasis - A systematic review.

Mucocutaneous leishmaniasis is a severe infectious disease, predominantly endemic in Central and South America and is characterized by granulomatous, destructive mucosal lesions in the oral, nasal, and pharyngeal cavities. It is caused by protozoa of the genus Leishmania spp. transmitted to humans by sandflies. Mucocutaneous leishmaniasis occurs after untreated or inadequately treated cutaneous leishmaniasis and is more common in immunocompromised patients. The aim of this systematic review is to summarize all reported treatment options for mucocutaneous leishmaniasis. This review is based on all English, German, French, Spanish and Portuguese articles published in the databases "PubMed" and "Lilacs" from 1995 to 2020. Most of the medical literature is limited to case reports, small case series, retrospective studies, and a few randomized controlled trials. Various treatment options include pentavalent antimonates such as meglumine antimonate or sodium stibogluconate, amphotericin B (liposomal, deoxycholate, lipid complex, colloidal dispersion), miltefosine, and pentamidine. Other therapeutic options include itraconazole, fluconazole, ketoconazole, aminosidine sulfate, and azithromycin. The choice of drug depends primarily on its availability in the endemic area and the patient's comorbidities.

Successful definitive radiation treatment of refractory canine oral papillomatosis.

This case report describes a three-year-old male intact border collie diagnosed with canine papillomavirus type 1 (CPV-1+) oral papillomas resistant to standard-of-care. With time, he developed lesions consistent with squamous cell carcinoma. Malignant tumors were incompletely excised and treated with definitive external beam radiation therapy (45Gy, 3Gy × 15 daily). The remaining oral cavity received 27Gy (1.8Gy x 15 daily) to treat the disseminated oral papillomatosis. A temporary treatment delay of 2weeks was instituted due to grade 3 mucositis. The patient remained in complete remission after 10 months from radiotherapy. No tumor recurrences were noted by the owners after >1 year from treatment.

INDEX-BASED ASSESSMENT ALGORITHM FOR ORAL HYGIENE IN WEARERS OF FIXED DENTAL BRIDGES

Introduction: The study focuses on the importance of maintaining oral hygiene, especially in wearers of fixed dental bridge. The impact of inadequate oral hygiene care on the development of dental diseases and the necessity for developing effective methods for its assessment are examined. Research objective: The aim of this study is to refine the fluorescent diagnostic method in orthopedic dentistry and to develop an index for assessing the hygienic status of natural teeth and fixed dental prostheses through an in vivo experiment. This method is intended to improve the diagnosis of oral conditions in wearers of fixed prostheses, ultimately enhancing the quality of their orthopedic treatment. Materials and methods: The study is based on the application of fluorescent diagnostics using Rhodamine B dye, which, when exposed to ultraviolet light, allows for the detection of dental deposits. The technique involves treating the surfaces of teeth and prostheses with a special solution that enhances the visibility of dental plaque under ultraviolet illumination. Research results: The experimental results demonstrated the high efficiency of the fluorescent method in detecting dental deposits both on the enamel of natural teeth and on the ceramic surface of fixed dentures. The digital analysis method allows for obtaining specific graphical indicators of the biofilm area, enhancing the relevance of an individual approach. Conclusions: Conclusions: The experimental study confirmed the high efficiency of the refined fluorescent method for assessing the hygienic status of the oral cavity, applicable to both natural teeth and fixed orthopedic constructions. This technique enables accurate assessment of hygiene status, facilitating effective prevention of dental diseases and optimization of treatment procedures. The method is convenient to use, and the software is accessible for clinicians. Further observations on the outcomes of this technique in patients with various orthopedic profiles are planned to expand its applicability.

Comparison of physical and acceptability tests of extra oral suction in rsgm ugm prof. Soedomo

The spread of COVID-19 through aerosols and droplets occurs during dental treatment. Dentists use high-volume suction (HVS) and saliva ejectors to suction saliva, blood, and water from the oral cavity. Since the pandemic, prototyping, production, and use of extraoral suction (EOS) have increased. EOS comprises HEPA (High-Efficiency Particulate Air), plasma ions, and ultraviolet (UV) filters. This study was used to see the effectiveness of the use of EOS through a comparison of physical and acceptability tests on the use of EOS at UGM Prof. Sodeomo Dental Hospital using three EOS brands, Coxo™, Eighteeth™ Vacstation, and Eostra™. Physical Test is used to assess the ability of a tool when used—Acceptability Test to assess user acceptance of EOS based on usage experience. The study was conducted at the UGM Prof. Soedomo Hospital (Professional Education Clinic, Resident Education Clinic, General Service Unit, and Specialistic Service Unit) in 2021 with 90 respondents who were EOS users. The EOS with the most incredible suction power, noise figure, and electrical power was Eostra™, while based on user experience, the EOS that was more accepted and more comfortable for users to use was Coxo™. EOS reduces aerosol exposure during dental treatment, and based on this study, EOS that had good capacity was not necessarily comfortable to use by users; this was because each brand had advantages and disadvantages, so the selection of EOS was adjusted to the capacity of the operator and the practice site.

ORAL MANIFESTATIONS IN PATIENTS WITH DIABETES MELLITUS. REVIEW LITERATURE

Background: Diabetes mellitus causes a number of complications in various regions of the body including the oral cavity, the type and degree of which depends on the duration of the disease, its severity, and the age of the patient. Objective: The aim of this literature review was to summarize Oral manifestations in patients with diabetes mellitus. Methods: Search strategy was applied with the aim of identifying as many relevant publications as possible. Data Sources four electronic databases were searched: PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials. The key words used for the search were Diabetes mellitus, Oral complications in Diabetes, Oral manifestations, Periodontal disease, Xerostomia. Of the 146 studies identified, a total of 67 articles that met the inclusion criteria for this systematic review were included. Results: The results of a systematic review showed that oral manifestations and complications in patients with diabetes mellitus are one of the main complications of diabetes mellitus. There is more evidence that chronic oral complications in patients with diabetes negatively affect blood glucose control. Oral complications include many complications that patients with diabetes suffer from, including caries teeth, painful gingival swelling, periodontal disease and mobility of teeth, oral infections, salivary gland dysfunction, taste dysfunction, tongue abnormalities, bad breath and lichen planus. Knowledge of the characteristic clinical changes in oral tissues caused by diabetes mellitus helps medical professionals diagnose and treat diabetes. Conclusion: Prevention and treatment of complications with aspects of the oral cavity, especially periodontal disease, are important in patients with diabetes because of their possible adverse effects on glycemic control. Restoring sugar metabolism by correcting insulin deficiency can control diabetes mellitus. Promoting for healthy oral cavity for patients with diabetes mellitus is of paramount importance

Quantitative analysis of the effects of essential oil mouthrinses on clinical plaque microbiome: a parallel-group, randomized trial.

The rich diversity of microorganisms in the oral cavity plays an important role in the maintenance of oral health and development of detrimental oral health conditions. Beyond commonly used qualitative microbiome metrics, such as relative proportions or diversity, both the species-level identification and quantification of bacteria are key to understanding clinical disease associations. This study reports the first-time application of an absolute quantitative microbiome analysis using spiked DNA standards and shotgun metagenome sequencing to assess the efficacy and safety of product intervention on dental plaque microbiome. In this parallel-group, randomized clinical trial, essential oil mouthrinses, including LISTERINE® Cool Mint Antiseptic (LCM), an alcohol-containing prototype mouthrinse (ACPM), and an alcohol-free prototype mouthrinse (AFPM), were compared against a hydroalcohol control rinse on clinical parameters and the oral microbiome of subjects with moderate gingivitis. To enable a sensitive and clinically meaningful measure of bacterial abundances, species were categorized according to their associations with oral conditions based on published literature and quantified using known amounts of spiked DNA standards. Multivariate analysis showed that both LCM and ACPM shifted the dysbiotic microbiome composition of subjects with gingivitis to a healthier state after 4 weeks of twice-daily use, resembling the composition of subjects with clinically healthy oral conditions recruited for observational reference comparison at baseline. The essential oil-containing mouthrinses evaluated in this study showed statistically significant reductions in clinical gingivitis and plaque measurements when compared to the hydroalcohol control rinse after 6 weeks of use. By establishing a novel quantitative method for microbiome analysis, this study sheds light on the mechanisms of LCM mouthrinse efficacy on oral microbial ecology, demonstrating that repeated usage non-selectively resets a gingivitis-like oral microbiome toward that of a healthy oral cavity. The trial was registered on ClinicalTrials.gov on 10/06/2021. The registration number is NCT04921371.

Risk of Head and Neck Cancer in Patients with Psoriasis: A Nationwide Population-based Study.

An association between psoriasis and cancer risk has been suggested in prior studies, but few have focused on head and neck cancers. Using the Korean National Health Insurance Service database, the relevance between psoriasis and head and neck cancer risks was investigated in a cross-sectional study of 3,869,264 individuals over 20 years of age, who received general health examination in 2009 and were followed until 2020. Head and neck cancer incidence rates were compared between individuals with and without psoriasis, and contributing factors were analysed. The head and neck cancer risk was significantly increased in the psoriasis group compared with the non-psoriasis group (hazard ratio [HR] 1.36; 95% confidence interval [CI] 1.07-1.74; p = 0.01) after adjusting for age, sex, body mass index, income, smoking, alcohol, exercise, diabetes mellitus, hypertension and dyslipidaemia. The risk was especially elevated for nasopharyngeal (HR 2.04; 95% CI 1.12-3.70; p = 0.02) and salivary gland cancer (HR 1.96; 95% CI 1.08-3.56; p = 0.03). Alcohol consumption significantly influenced the risk, particularly for oropharyngeal and oral cavity cancer. Our study provides insights into the potential risks of head and neck cancer in patients with psoriasis, which could aid in refining patient management strategies.

“Ǫuantum Jump” and Their Effects on the Photo Whitening Technique

Recent research on tooth whitening aims to optimize whitening while minimizing its side effects, such as tooth hypersensitivity and damage to the soft and hard tissues of the oral cavity. Various research with methodology using colorimetric and spectrophotometric tests shows that the technique applying violet light, with a wavelength of 408 nm, produced better results than other sources normally used in tooth whitening. Scientific findings prove the results that simultaneously applying dental whitening in the office with transparent/colorless gels and violet LEDs allows the light to interact directly with the pigments, increasing the oxidation effect with the peroxide itself. So, there is a double effect: the photochemical action with the oxidation molecule with the peroxides promoting the optimization of the traditional use of chemical agents. This short communication aims to highlight the advantage of using violet light and provide more physical and chemical information about this whitening process. This is a new technique, without producing heat, roughness or sensitivity, with comfort and safety for the patient and professional. We can conclude that new studies become relevant for the evolution of this technique.

Curcumin and its Analogues in Oral Squamous Cell Carcinoma: State-of-the-art and Therapeutic Potential.

Oral Squamous Cell Carcinoma (OSCC) is the most common cancer arising from squamous epithelium in the oral cavity and is characterized by high aggressiveness and metastatic potential, which together with a late diagnosis results in a 5-year survival rate of only 50% of patients. The therapeutic options for OSCC management are limited and largely influenced by the cancer stage. While radical surgery can be curative in early stage of disease, most cases require adjuvant therapies, including chemotherapy and radiotherapy which, however, often achieve poor curative rates and are associated with important negative effects. Therefore, there is an urgent need to discover new alternative treatment strategies to improve patients' outcomes. Several medicinal herbs are being studied for their preventive or therapeutic effect in several diseases, including cancer. In particular, the Indian spice curcumin, largely used in oriental countries, has been studied as a chemopreventive or adjuvant agent for different malignancies. Indeed, curcumin is characterized by important biological properties, including antioxidant, anti-inflammatory, and anticancer effects, which could also be exploited in OSCC. However, due to its limited bioavailability and poor aqueous solubility, this review is focused on studies designing new synthetic analogues and developing novel types of curcumin delivery systems to improve its pharmacokinetic and biological properties. Thus, this review analyses the potential therapeutic role of curcumin in OSCC by providing an overview of current in vitro and in vivo studies demonstrating the beneficial effects of curcumin and its analogues in OSCC.

Hallmarks of Periodontitis.

Periodontitis is a complex polymicrobial disease of the oral cavity that affects tooth-supporting tissues. It is caused by multiple factors, such as pathogenic bacteria, genetic predisposition, and host immune response factors. The pathogenesis of periodontal disease involves the complex interrelations among bacterial toxins, several populations of cells, and host cell-secreted inflammatory mediators. Generally, periodontitis is characterized by the formation of intricate and varied biofilms of microbes on the tooth surface, commonly known as dental plaque. Activation of defense cells is characterized by releasing inflammatory mediators, such as proteases, acidic metabolites, cytokines, interleukins, and chemokines, which destroy tissue and ultimately cause bone resorption. The individual periodontal condition has a significant impact on systemic homeostasis, and its disruption can cause the development of some metabolic disorders. This review article summarizes the latest studies on the pathogenesis of periodontitis and describes the role of inflammatory mediators and genetic polymorphism in individuals, as well as relationships with some metabolic conditions. The information is collected from PubMed, Scopus, ScienceDirect, SpringerLink, and clinicaltrials.gov.

Histopathological spectrum of gastrointestinal lesions - In a tertiary care centre

Gastrointestinal (GI) pathology is one of the largest sub- specialities in pathology. Histopathological evaluation of GI lesions is the gold standard for providing essential diagnostic and prognostic information to the clinicians for the best timely management of each patient. : This is an unicenter retrospective and prospective study of 510 patients with GI lesions over a period of 2 years from July 2021 to June 2023. Biopsies and resected specimens of gastrointestinal tract were fixed in 10% formalin. Those specimens were then processed in automatic tissue processor. Routine Haematoxylin and Eosin stain and special stains, including immunohistochemical stains were done, whenever indicated. Then slides were examined and data generated from observation and was used for statistical analysis. Out of total 2462 histopathological specimens received in 2 years, over 21% of specimens were GIT lesions of them 510 were GI specimens. Gall bladder was the most common specimen received [34.3%] followed by appendix specimens [18.6%] and gastric biopsies [13.9%]. Non neoplastic GI lesions [89.3%] were the most common followed by neoplastic lesions [10.7%]. Males outnumbered female patients having M: F ratio1.3:1. The peak incidence of non neoplastic lesions are found in the age group of 21-40 years and that for neoplastic lesions found in the age group of 50-70 yrs. Chronic cholecystitis was the most common GI pathology [34.3%] followed by appendicitis [18.1%]. Adenocarcinoma was the most common histopathological malignancy [52.7%] followed by squamous cell carcinoma [47.2%]. Most common lesion in the oesophagus and oral cavity was squamous cell carcinoma whereas adenocarcinoma was most common in colo-rectum. This study enables the overview of the spectrum of histopathological lesion encountered in the surgical pathology department and also reiterates that the histopathological evaluation is a valuable diagnostic tool for definitive and early diagnosis of GI lesions which has an impact on management of neoplastic lesions.

Testing the disintegration and texture-related palatability predictions for orodispersible tablets using an instrumental tool coupled with multivariate analysis: Focus on process variables and analysis settings

Orodispersible tablets (ODTs) represent a growing category of dosage forms intended to increase the treatment acceptability for special groups of patients. ODTs are designed to rapidly disintegrate in the oral cavity and to be administered without water. In addition, ODTs are easy to manufacture using standard excipients and pharmaceutical equipment.This study adds to previously published research that developed an instrumental tool to predict oral disintegration and texture-related palatability of ODTs with different formulations. The current study aimed to challenge the predictive capacity of the models under variable process conditions. The studied process parameters with potential impact on the pharmaceutical properties, texture profiles, and palatability were the compression pressure, punch shape and diameter. Subsequently, for all the placebo and drug-loaded ODTs, the in vivo disintegration time and texture-related palatability were determined with healthy volunteers.Previously developed regression models were applied to predict the formulation's disintegration time and texture-related palatability characteristics of ODTs obtained under different experimental conditions. The influence of process variables on the predictive performance of the models was estimated by calculating the residuals as the difference between the predicted and observed values for the investigated response. Increasing the speed of the analyser`s probe from 0.01 mm/s to 0.02 mm/s led to an improved differentiation of the texture profiles. The in vivo disintegration time and texture-related palatability scores were only influenced by the mechanical resistance and the tablet shape. Lower score was observed for the larger diameter tablets (10 mm). Overall, the prediction of the disintegration time at 0.02 mm/s was more accurate, except for stronger tablets. The best prediction of texture-related palatability was achieved for the 10 mm tablets, tested at 0.01 mm/s speed.The same model achieved good predictions of the oral disintegration time for all API-loaded formulations, which confirmed the ability of the texture analysis to capture process-related variability. Drug loading decreased the predictive capacity of the texture-related palatability because of the taste effect.