Optical coherence tomography (OCT) is extremely useful in the screening and detection of oral cancers. But various challenges, such as its subjectivity, operator dependence in interpretation, and lack of quantitative outcomes, have been delaying its adoption in clinical decision-making. The objective of this research is to quantify various A-scan features embedded in the OCT signal through advanced signal processing techniques and machine learning algorithms.Ex vivoimaging of biopsied oral tissues (normal mucosa, carcinomain situ(CIS), well-differentiated, and poorly differentiated oral squamous cell carcinoma) was performed using a spectral domain OCT system. Our A-scan dataset consisted of representative 1D signals obtained from different regions of the tissue bed. A set of 12 time- and 8 frequency-domain features were computed on each A-scan, and ten machine learning models were evaluated for binary and multi-label classification. LightGBM achieved the highest performance in both binary (accuracy: 0.8847,F1: 0.8878, AUC: 0.9539) and multi-label classification (accuracy: 0.8248,F1: 0.8201, AUC: 0.964). LightGBM was selected as the final model based on its superior and consistent performance across both classification paradigms. Our proof-of-concept feasibility study demonstrates good accuracy for differentiating oral mucosal tissues, highlighting the biomarker signature of A-scans.

Recent years witnessed an unprecedented growth of unstructured text data in the healthcare domain. Manual analysis and extraction of useful patterns from these large data collections are extremely difficult. Biomedical named entity recognition (BioNER) identifies entities of clinical importance, such as symptoms, treatment, names of drugs, and organisms, from unstructured text documents such as electronic health records and radiology reports. Even though this is the first step for building artificially intelligent applications such as conversational agents and information retrieval, this is difficult and challenging. Recently pre-trained language models gained high popularity in NLP, considering their capacity to manage contexts satisfactorily. This paper proposes an approach that fine-tunes BioBERT, a state-of-the-art pre-trained biomedical language model for extracting named entities for the Oral Medicine and Radiology domain. This work compares various machine learning algorithms on different feature encoding techniques to establish the superior performance of the proposed approach. We assess the proposed approach by employing metrics like precision, recall, and f-measure and found it to be outperforming our chosen baselines.

AIM:The study aims to evaluate and compare the efficacy of Moringa oleifera leaf extract gel (2%) & Retino A cream (0.1%) in reducing the size of lesions in oral leukoplakia.OBJECTIVES:The present study aimed to evaluate the efficacy of two interventions, Moringa oleifera mucoadhesive gel and Retino-A cream, in reducing the size of lesions in patients with oral leukoplakia. Specifically, the objectives were: (1) to assess the efficacy of Moringa oleifera mucoadhesive gel in determining the reduction in lesion size, (2) to assess the efficacy of Retino-A cream in determining the reduction in lesion size, and (3) to compare the efficacy of Moringa oleifera mucoadhesive gel (2%) in determining the change in lesion size in oral leukoplakia patients.METHODS:Clinically diagnosed cases of oral Leukoplakia were included in this study. The sample size is 72. Thirty-six patients had lesion sizes ranging from 2- 4 cm, and 36 patients had lesion sizes ranging from 4.1 - 6 cm that were equally distributed in the case and control groups using the chit system. The case and control groups had 36 patients with an equal size range of lesions. The case and control group participants will be advised topical application of the intervention and Retino-A thrice daily using a sterile cotton bud.RESULTS:M. oleifera gel (2%) was found to be more effective in the reduction in the size of the lesion as compared to Retino-A in the treatment of oral leukoplakia patients.CONCLUSION:This study showed that M. oleifera mucoadhesive gel (2%) is an effective and safe treatment option for oral leukoplakia patients. It demonstrated a significant reduction in lesion size compared to Retino-A cream (0.1%) after 3 months of therapy, without any reported adverse effects. However, long-term follow-up studies are needed to evaluate its long-term effectiveness. The potent antioxidant property of M. oleifera makes it a promising candidate for further studies with concentration variations and in other potentially malignant oral disorders, such as lichen planus and OSMF. The development of chemotherapeutic drugs from M. oleifera for cancer treatment should also be considered. Overall, M. oleifera appears to be a promising natural alternative to synthetic drugs for the treatment of oral leukoplakia.KEY WORDS:Leukoplakia, Oral leukoplakia, premalignant lesion, precancer, potentially malignant disorders.

AIM:The aim of this study is to evaluate and compare the impact strength of conventional acrylic resin, high-impact acrylic resin, high-impact acrylic resin reinforced with silver nanoparticles, and high-impact acrylic resin reinforced with a zirconium oxide powder.MATERIALS AND METHODS:A total of 60 samples were prepared of dimensions 60 mm length × 7 mm width × 4 mm thickness to test impact strength. Machined stainless steel dies of the same dimension were used to form molds for the fabrication of these samples. Of 60 samples, 15 samples were prepared each from conventional acrylic resin (Group A1), high-impact acrylic resin (Group A2), acrylic resin reinforced with silver nanoparticles (Group A3), and acrylic resin reinforced with zirconium oxide powder (Group A4). Izod-Charpy pendulum impact testing machine was used.RESULTS:The impact strength of group A1 was in the range of 2.83-3.30 kJ/m2 (M = 3.12 kJ/m2, SD = 0.16), group A2 was in range of 5.10-5.78 kJ/m2 (M = 5.51 kJ/m2, SD = 0.18), group A3 was in range 3.18-3.56 kJ/m2 (M = 3.37 kJ/m2, SD = 0.11), and group A4 was in range 7.18-7.78 kJ/m2 (M = 7.5 kJ/m2, SD = 0.18). Statistical analysis using one-way ANOVA and t-test revealed significant differences (p < 0.001).CONCLUSION:High-impact acrylic resin reinforced with zirconium oxide powder has the highest impact strength.CLINICAL SIGNIFICANCE:This research sheds light on the usefulness of novel filler materials in clinical prosthodontics.

cortex thinning, a biomarker of general cognitive decline frequently observed in aging. 9ccording to the Global Adult Tobacco Survey (GATS) conducted between 2009-2010 (GATS-1) and 2016-2017 (GATS-2), only 6% (modest) reductions in tobacco use occurred.When the smoker's data is compared, there was only a 23.57% relative reduction IntroductIonTobacco use remains a significant global problem and is responsible for the death of nearly 8.71 million individuals annually, with 1.2 million of those deaths attributed to second-hand smoke exposure. 1,2Furthermore, a significant fraction of tobacco users live in low-middle income countries.According to the World Health Organization (WHO) fact sheet updated in 2018, tobacco accounts for >1 million deaths each year in India. 3 As per recent evidence, tobacco and its smoke contain as many as 950,0 chemicals, of which approximately 83 are well-established International Agency for Research on Cancer-classified carcinogens. 4 Tobacco use is a well-known risk factor for numerous noncommunicable diseases, including (and not limited to) cancer, cardiovascular diseases (like ischemic heart disease, atherosclerosis, and hypertension), cerebrovascular diseases, chronic lung diseases, diabetes, and stroke, as well as adverse reproductive outcomes such as abortions, ectopic pregnancy, infertility, and erectile dysfunction. 5,6 Other health implications of smoking tobacco include cataract formation, early vision loss, and gastrointestinal inflammatory diseases like gastritis. 7Smoking can negatively impact mental health, leading to conditions such as attention-deficit/hyperactivity disorder and memory decline. 8,9Smoking has been associated with accelerated 1,

Lymphangiomas are rare, painless, benign tumors in infancy or early childhood resulting from a congenital malformation of the lymphatic vessels with variable clinical appearance. We report the case of a six-year-old male child who presented with a micronodular surface of the tongue, a burning sensation, difficulties during swallowing and mastication, as well as speech disturbances. Histological examination of the excised tongue specimen showed an angiomatous lesion of the lamina propria that comprised many wide thin-walled spaces. MRI examination revealed an area of disparate T2 signal maximum diameter of 2-3 cm with cystic texture in the middle and frontal left part of the tongue. The lesion was diagnosed as a lymphangioma and was managed through pre-operative embolization and surgery. Tongue lymphangiomas may lead to aesthetic problems, functional issues (like dysphagia, airway obstruction, and speech difficulties), psychological disturbances, poor oral hygiene, and occasional bleeding associated with oral trauma. A major fraction of patients also experience infections, often leading to a significant increase in lesion size. A combination of preoperative embolization and surgical excision could be chosen considering its large size and the age of the patient, and to further eliminate the possibility of recurrence. Early diagnosis and radical treatment are critical in its management.

Understanding the carcinogenesis mechanism of different carcinogenic agents is paramount for implementing preventive and therapeutic strategies for cancer. Hence, an appropriate simulation of the clinical situation in preclinical studies should be the prime mandate for reaching the validated and pragmatic conclusion. In Asian and Southeast Asian countries, one of the most common etiological agents for oral squamous cell carcinoma (OSCC) is the consumption of betel quid (BQ) with and without tobacco. BQ is marketed in the form of a mixture of various ingredients. It is quite conceivable that when BQ is placed or chewed in the oral cavity, all the carcinogenic components released from different agents get mixed and forms an amalgamation of carcinogens. To further add to the complexity, oral microbial flora also becomes part and parcel of this amalgamation. We envisage the interactions of various carcinogens with each other and the salivary components and microbial flora. However, this clinical scenario is not exactly simulated in various in-vitro experimental studies published in the literature. To better understand the oral carcinogenesis mechanism, it becomes imperative to consider the aforementioned fact in mind while studying carcinogens for oral cancer. In the present commentary, we have made an effort to discuss the amalgamation of the carcinogens in the oral cavity and propose the possible preclinical model to study carcinogens associated with OSCC.

Introduction: Cancer stem cells (CSCs) are responsible for initiating the process of carcinogenesis by enabling the self-renewal and self-proliferation of the cancer cells. This study aimed to investigate the presence of epithelial cells with cancer stem cells characteristics (ALDH+) in the early stages of oral precancerous lesions (Oral Leukoplakias) and the frequency of these cells in the different stages of oral squamous cell carcinomas (OSCCs).Materials & methods: The aim of this study was the detection of the immunohistochemical pattern of expression of CSC protein-biomarker ALDH1 & 2 (sc-166362, Santa Cruz Co, Dallas, Texas, USA) in paraffin -embedded samples of 30 cases of leukoplakia of all degrees of dysplasia and 21 cases of oral squamous cell carcinomas (OSCC) of all degrees of differentiation compared to the histologically normal oral epithelium. The samples were retrieved from 2009-2019 from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece. The samples were evaluated through a three-tier scale (positive cells I: 6-35%, II: 36-70%, III: 71-100%). Statistical analysis was performed through SPSS Pearson Chi-square, and the significance level was set at 0.05 (p=0.05).Results: The staining of ALDH1 & 2 was observed mildly in the cell membrane of cells in the stratum spinosum of the normal epithelium and the cell membrane of cells in the stratum basale of the normal epithelium, characteristically at the interface point with the basal membrane. ALDH1 & 2 were expressed significantly more in the OSCC than in the leukoplakia (p-value=0.0001) and the normal epithelium (p-value=0.0001). Mainly, ALDH1 & 2 were expressed significantly more in the severely and moderately dysplastic oral leukoplakia compared to the mildly dysplastic and non-dysplastic leukoplakia (p-value=0.001).Discussion: The characteristic expression of ALDH in potentially malignant oral and OSCC lesions suggests the presence of CSCs and their possible implication in the early stages of oral tumorigenesis, even at the stage of oral leukoplakia.

AIMThis review aims to explore the importance of silk hydrogel and its potential in tissue engineering (TE).BACKGROUNDTissue engineering is a procedure that incorporates cells into the scaffold materials with suitable growth factors to regenerate injured tissue. For tissue formation in TE, the scaffold material plays a key role. Different forms of silk fibroin (SF), such as films, mats, hydrogels, and sponges, can be easily manufactured when SF is disintegrated into an aqueous solution. High precision procedures such as micropatterning and bioprinting of SF-based scaffolds have been used for enhanced fabrication.REVIEW RESULTSIn this narrative review, SF physicochemical and mechanical properties have been presented. We have also discussed SF fabrication techniques like electrospinning, spin coating, freeze-drying, and physiochemical cross-linking. The application of SF-based scaffolds for skeletal, tissue, joint, muscle, epidermal, tissue repair, and tympanic membrane regeneration has also been addressed.CONCLUSIONSF has excellent mechanical properties, tunability, biodegradability, biocompatibility, and bioresorbability.CLINICAL SIGNIFICANCESilk hydrogels are an ideal scaffold matrix material that will significantly impact tissue engineering applications, given the rapid scientific advancements in this field.

AIM The present study aimed at evaluating the efficacy of spirulina 500 mg in reducing the burning sensation and lesion size in oral lichen planus (OLP). MATERIALS AND METHODS A total of 60 subjects who attended the oral medicine specialty clinic with histopathologically confirmed OLP and having symptoms of burning sensation were recruited for the study. They were randomly divided into two groups: group A (30) subjects were prescribed Spirulina 500 mg twice daily along with only a week application of topical triamcinolone acetonide 0.1% thrice daily; group B subjects were prescribed topical triamcinolone acetonide 0.1% alone thrice daily for 8 weeks. Both the groups were followed up posttreatment monthly for three consecutive months. RESULTS Data were recorded, and statistical analysis by using ANOVA one-way test, and Chi-square test were performed, which showed statistically significant p-value (<0.005) for the parameters "burning sensation" and "size of the lesion". When compared between groups, group A showed a favorable outcome of the intervention. CONCLUSION Spirulina 500 mg supplementation twice daily could be effective adjunct therapy with steroids to treat OLP. CLINICAL SIGNIFICANCE This research allowed us to delve into spirulina as one of the treatment modalities for OLP. Further studies are needed as it is a rich source of proteins and vitamins and demonstrates potent anti-inflammatory, immunomodulatory, and antioxidant actions.

Saline nasal irrigation (SNI) is a clinically established treatment that has been used to manage upper respiratory infections and allergies; there is also some indication that it may be effective in the setting of coronavirus disease-2019 (COVID-19). The possible advantages of SNI include the following benefits due to the well-known antiviral impact of sodium chloride (NaCl) and the mechanical cleansing effect arising from the irrigation method. First, there will most likely be a decrease in COVID-19 infection rates; second, illness severity will be lowered; and third, community transmission will be mitigated. Despite the need for more concentrated research into these aspects, public health organizations should emphasize alternate infection mitigation measures such as SNI in light of the ongoing COVID-19 problem, low global vaccine supply, and the rapid introduction of SARS-CoV-2 variants. Keywords: Community transmission, COVID-19, Pandemic, Prevention, Saline, SARS-CoV-2.

Besides conventional vaccinations, viable alternatives are needed to elicit an immune response against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We propose and highlight the value of a homeopathic approach known as the "nosode" for the prevention of coronavirus disease-2019 (COVID-19). Nosode is an extract prepared from disease-affected tissues which is subsequently processed and administered as an antidote for the same medical condition. This concept might be a crucial therapeutic approach for viral infections since infected tissues contain a wide range of important viral antigens that could induce a functional host response via immunological sensitization. Thereby, nosode preparation produced from SARS-CoV-2-affected tissues may provide protection against COVID-19. "SARS-CoV-2 nosode" warrants more scientific investigation as a viable alternative vaccination platform. Keywords: COVID-19, Nosode, SARS-CoV-2, Variolation.

We read with interest the report by Rao et al on COVID-associated mucormycosis, dubbed ‘Black Fungus' in the popular media. 1 Rao V.U. Arakeri G. Madikeri G. et al. COVID-19 associated mucormycosis (CAM) in India: a formidable challenge. Br J Oral Maxillofac Surg. 2021; ([online ahead of print])https://doi.org/10.1016/j.bjoms.2021.06.013 Abstract Full Text Full Text PDF Scopus (0) Google Scholar We take this opportunity to respond to the views presented in their paper.

Sir, The response letter by Arakeri et al was a good read.1Arakeri G, Rao VUS, Mendes RA, et al. COVID-associated mucormycosis (CAM): is the Delta variant a cause? 2022;60:470–473. https://doi.org/10.1016/j.bjoms.2021.08.009.Google Scholar In the original paper, the authors mentioned that mucormycosis has been found to be linked to COVID-19 infections caused by the B.1.617.2 (Delta) variant.2Rao V.U.S. Arakeri G. Madikeri G. et al.COVID-19 associated mucormycosis (CAM) in India: a formidable challenge.Br J Oral Maxillofac Surg. 2022; 60 (S0266-4356(21)00245-X [published online ahead of print, 2021 Jun 29]): e529-533https://doi.org/10.1016/j.bjoms.2021.06.013Abstract Full Text Full Text PDF Scopus (41) Google Scholar The Delta-mucor hypothesis gained importance due to the unusual surge noticed during Indian's second wave; however, its scientific basis still needs to be established.3Panta P. Stone N. COVID-associated mucormycosis (CAM) in India is a multidimensional problem.Br J Oral Maxillofac Surg. 2022; 60: e474-480https://doi.org/10.1016/j.bjoms.2021.08.008Abstract Full Text Full Text PDF Scopus (3) Google Scholar Direct Delta variant-associated immune dysregulation and metabolic dysfunction is a relatively minor mechanism in the absence of other potential contributors (evidenced by the low percentage of mucor cases seen in asymptomatic and untreated COVID patients).4Sen M. Honavar S.G. Bansal R. et al.Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 patients in India - Collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), Report 1.Indian J Ophthalmol. 2021; 69: 1670-1692https://doi.org/10.4103/ijo.IJO_1565_21Crossref PubMed Scopus (253) Google Scholar Such cases form a unique subset and deserve deeper exploration. The SARS-COV-2 virus may tend to infiltrate the pancreatic islets, leading to the genesis of hyperglycaemia and/or diabetes. However, we are unsure if there is any actual evidence that the Delta variant, in particular, has a significant adverse impact compared to other variants. If we show these comparative data on the pancreatic islets through cell-line or animal studies, we can more confidently explain why cases increased during the second wave. More countries are showing mucor cases; however, the numbers in India greatly exceeded all other nations (>45000 cases). This means we should look for India-specific factors, ranging from the geographic distribution of mucor-causing organisms,3Panta P. Stone N. COVID-associated mucormycosis (CAM) in India is a multidimensional problem.Br J Oral Maxillofac Surg. 2022; 60: e474-480https://doi.org/10.1016/j.bjoms.2021.08.008Abstract Full Text Full Text PDF Scopus (3) Google Scholar specific host factors, and even the medical management protocols deployed during that time. If we study the dosing of steroids during the first and second waves (through an analysis of medical prescriptions), our understanding could further improve. Steam inhalation practice (rampant during the pandemic) could have also resulted in heat injury to the nasal epithelium, enabling infection with the ubiquitous mucor organisms. However, very few case reports exist on this topic. Furthermore, a recent pre-print shows a lack of association.5Umang Arora, Megha Priyadarshi, Varidh Katiyar, et al. Novel Risk Factors for Coronavirus Disease-Associated Mucormycosis (CAM): A Case Control Study During the Outbreak in India. Available at SSRN: https://ssrn.com/abstract=3893463 or http://dx.doi.org/10.2139/ssrn.3893463.Google Scholar Another source of mucosal trauma could be repeated 'nasopharyngeal swabbing.' Although it seems unlikely, a pre-print indicates that this could be independently associated with a higher risk of COVID-associated mucormycosis (CAM).5Umang Arora, Megha Priyadarshi, Varidh Katiyar, et al. Novel Risk Factors for Coronavirus Disease-Associated Mucormycosis (CAM): A Case Control Study During the Outbreak in India. Available at SSRN: https://ssrn.com/abstract=3893463 or http://dx.doi.org/10.2139/ssrn.3893463.Google Scholar Prolonged oxygen administration could be another important source of trauma to the protective mucosal barrier.3Panta P. Stone N. COVID-associated mucormycosis (CAM) in India is a multidimensional problem.Br J Oral Maxillofac Surg. 2022; 60: e474-480https://doi.org/10.1016/j.bjoms.2021.08.008Abstract Full Text Full Text PDF Scopus (3) Google Scholar The connection between mask behaviour and mucormycosis also deserves a more committed exploration. Due to financial issues and general difficulty associated with N-95 mask use, many relied on low-cost cloth and surgical masks and frequently reused them. The cloth masks, in particular, could serve as a reservoir of fungal spores.5Umang Arora, Megha Priyadarshi, Varidh Katiyar, et al. Novel Risk Factors for Coronavirus Disease-Associated Mucormycosis (CAM): A Case Control Study During the Outbreak in India. Available at SSRN: https://ssrn.com/abstract=3893463 or http://dx.doi.org/10.2139/ssrn.3893463.Google Scholar Their mesh-like design could entrap and accumulate the free-floating spores that might eventually settle within the nasal passages during air exchange, and germinate once tissue conditions become conducive. A hyperglycaemic and immunosuppressive state induced by diabetes and/or high-dose and prolonged corticosteroid therapy constitute the favourable tissue milieu. Alongside explorations into steroid use, mode of oxygen administration, comorbidities (eg, diabetes, renal disease), immunosuppressant use, future efforts must be strategically planned to address the role of viral variants, mask practices, steam inhalation, nasopharyngeal swabbing, exposure to gardening activities, and indoor/outdoor pollution (environmental fungal contamination). It is noteworthy that different contributors act simultaneously. We have no conflicts of interest. None declared. None declared.