Introduction: Recurrent aphthous ulcers are one of the most frequent painful conditions affecting the oral mucosa in young adults. Psychosocial stress has been recognized as a contributing factor to the causation of recurrent aphthous ulcers. Aim: To assess the occurrence rate of recurrent aphthous ulcers and their correlation with levels of psychosocial stress among dental students. Materials and Methods: The present cross-sectional study included 383 undergraduate and postgraduate students of a dental college. Google Forms was used for collecting the responses from the participants. In this survey, a questionnaire was used. Two parts were developed for data collection. Part one covered demographic details as well as some prerequisite information on recurrent aphthous ulcers. Psychological stress was evaluated through the second part of the questionnaire using the Perceived Stress Scale (PSS-10). Results: Among the 383 participants, 80.9% (n=310) had moderate stress, 11.2% (n=43) had high stress and 30 participants had no to minimal stress according to the PSS-10 scale. Conclusion: Recurrent oral ulcers are prevalent among dental students, with stress emerging as a major associative factor. Early identification of stress-related triggers and incorporation of stress-management strategies may play a vital role in tackling their stress levels.

ABSTRACT:Glandular odontogenic cyst (GOC) is a very rare and aggressive odontogenic cyst predominantly occurring in the anterior mandibular region. This lesion shows high recurrence and resembles lateral periodontal cyst and mucoepidermoid carcinoma of the jaws; therefore, in-depth diagnosis and long-term follow-up are mandatory in these patients. We describe clinical and histopathologic findings of five cases of GOC diagnosed at our institution. Careful microscopic examination and long-term follow-up of the patient are mandatory, considering their unpredictable behavior and tendency for recurrence.

Recent years have documented an upsurge in the number of Oral Squamous Cell Carcinoma (OSCC) cases in the young community, which is of grave concern. This study was envisaged to evaluate the demographic profile and clinico-pathologic characteristics of young OSCC patients (≤ 40 years of age) and understand the influence of risk factors. Clinical records of 118 young patients diagnosed with OSCC in the last decade (2013–2023), were extracted from the documents of Oral and Maxillofacial Pathology Department and details like age, gender, habits, lymph node status and histopathologic grading were tabulated and analyzed statistically. Out of 556 cases of malignancies reported in the oral cavity, 77.7

Molluscum contagiosum is a poxvirus-mediated, highly contagious infection predominantly affecting the face, trunk, and extremities of children and young adults. Although typically characterized by flesh-colored papules with central umbilication, atypical presentations, particularly in immunosuppressed and HIV-infected individuals pose diagnostic challenges. This retrospective study, spanning from January 2013 to January 2016, examined 19 cases of molluscum contagiosum, emphasizing unusual clinical and histopathological features. Three atypical cases were identified, including a 24-year-old female with a subcutaneous lump on the left areola, a 34-year-old male with genital lesions resembling lichen nitidus, and a 17-year-old male with a cystic scalp swelling. Histopathological examination confirmed molluscum contagiosum in all cases, revealing characteristic eosinophilic inclusions within squamous cells. Notably, the study expands the understanding of atypical presentations, such as lesions on the areola and cystic forms, which are infrequently reported in the literature. Despite the absence of immunosuppression or HIV infection in the atypical cases, the study highlights the need for clinicians to consider molluscum contagiosum in diverse clinical scenarios. The accurate diagnosis, often requiring biopsy or cytology, underscores the importance of histopathological evaluation in guiding appropriate treatment strategies, including surgical excision or topical antiviral agents. Overall, this case reports contributes valuable insights into the varied manifestations of molluscum contagiosum, emphasizing the necessity for vigilance in recognizing atypical presentations.

The main objective of the current systematic review was to compile and evaluate the data on opportunistic maxillofacial mycotic infections in COVID-19 patients during the treatment and post-recovery period of SARS-CoV-2 infection. Comorbidities like diabetes, corticosteroid use, and mortality among COVID-19-associated patients presenting with oral and maxillofacial fungal infections were also assessed. The review was conducted in accordance with Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. A comprehensive search was carried out in the archives of Web of Science, Pubmed/Medline, Scopus, Google Scholar, Lilacs, and Livivo in combination with Boolean operators till 24th June 2022, and cross-sectional studies, case series, and case reports deliberating on maxillofacial mycoses in COVID-19 were included. The included studies were meted to the risk of bias using the Joana Briggs Institute Appraisal tools for prevalence studies, case series, and case reports. In a two-stage collection, 20 studies were included: 9 observational (3269 patients), 5 case-series (42 patients), and 6 case reports (8 patients) from 7 countries. Mucormycosis was the most commonly reported maxillofacial fungal infection (96.7%/3162 cases), followed by candidiasis (3.2%/105 cases) associated with COVID-19. Although aspergillosis was observed in only one case and one patient, a mixed mycotic infection demonstrating both aspergillus and mucor fungal elements was identified in one patient. Comorbidities like diabetes mellitus, indiscriminate corticosteroid use and immunosuppression leads to invasive maxillofacial fungal infections in COVID-19, which may prove to be fatal.

BACKGROUND:Since the introduction, hematoxylin and eosin (H and E) have been a gold standard stain for routine histopathological diagnosis of biopsied specimens. Xylene, despite its hazardous toxic effects, is the most commonly used deparaffinizing agent and forms an imperative part of this staining procedure. In the pursuit to eliminate the use of xylene, various substitutes became available, some with as many if not more hazards. AIM:This study aimed to evaluate Reetha ( Sapindus mukorossi ) extract as a biosafe surrogate for xylene to deparaffinize the sections during the H and E staining procedure and compare it with xylene deparaffinized H and E stained sections. MATERIALS AND METHODS:Two sections each from thirty paraffin blocks of different oral lesions including odontogenic cysts and tumors, salivary gland tumors, reactive lesions, epithelial, and connective tissue tumors, and premalignant lesions were prepared. One section was stained with the conventional H and E method using xylene as a deparaffinizing agent and the other section with xylene-free H and E method with Reetha extract. STATISTICAL ANALYSIS USED:The test of significance was calculated ( P value significant at ≤0.05) using the Wilcoxon matched pairs signed rank test. RESULTS AND CONCLUSION:The result was productive as Reetha extract was found to be an effectual replacement for xylene as a deparaffinizing agent, which has the added advantage that it is non-biohazardous, cheaper, and a rapid deparaffinizing agent.

Background:The morphological features of keratinisation can impact histopathological diagnosis. Routine haematoxylin and eosin (H&E) stain has its limitations in moderately differentiated cases of oral squamous cell carcinoma (OSCC). Aims:The aim of this study was to evaluate and compare the characteristics of staining and identification of keratin by routine H&E stain, Alcian Blue-Periodic Acid Schiff (AB-PAS), Ayoub-Shklar, and Modified Papanicolaou (PAP) stain in OSCC cases. Material and Methods:Overall, 30 cases of OSCC were included in experimental groups, and 20 cases of well-differentiated squamous cell carcinoma (WDSCC) and ten cases of moderately differentiated squamous cell carcinoma (MDSCC) and ten cases of normal keratinised oral mucosa (NKOM) were included in the control group. Histopathologicaly diagnosed cases of OSCC were selected, and tissue sections from each were prepared. Fisher's exact test was used for the statistical analysis. Results and Conclusions:We observed that the staining intensity was greater in Ayoub-Shklar in WDSCC and in MDSCC followed by modified PAP and AB-PAS-stained sections and the staining specificity was greater in modified PAP in WDSCC and in MDSCC followed by AB-PAS and Ayoub-Shklar in stained sections. We conclude that special stains like AB-PAS, Ayoub-Shklar, and modified PAP stain can prove to be a simple solution to detect the presence and pattern of keratin histologically. The efficacy of distinct identification of keratin pearls and individual cell keratinisation in OSCC-modified PAP stain is better. It can be used as alternative stain to H&E for histological grading of OSCC based on keratinisation.

It is exceptionally unusual to see oral malignant melanoma, which is highly aggressive with dismal prognosis. A 61-year-old female patient presented with hyperpigmented and hemorrhagic areas in the anterior mandible. Microscopically, positive Immunohistochemistry staining with monoclonal antibody Human Melanoma Black (HMB45) and S100 protein, confirmed the diagnosis as malignant melanoma.

Background: Onodi cells are a type of posterior ethmoid cells which extend superior and lateral to the sphenoid sinus. As these cells have a close relationship with the optic nerve and the internal carotid artery, it becomes important to be aware about their presence preoperatively to prevent injury to these vital structures. Aim of the study was to identify the presence of the Onodi cell with computed tomography (CT) scan and to determine its prevalence and gender distribution of these cells in a north Indian population. Methods: CT scan of nose and paranasal sinuses of 300 adult patients were studied retrospectively to determine the prevalence of Onodi cells. Results: The overall prevalence of Onodi cells was found to be 20.33%. Of this, 24 (57%) were present in males and 17 (43%) in females. Out of 61 Onodi cells, 30 (49.2%) were right-sided, 10 (16.4%) left-sided, 13 (21.3%) central and 8 (13.1%) were bilateral. Conclusions: The presence of Onodi cell in every fifth person makes it important to have a knowledge of their presence preoperatively to prevent adverse surgical complications.

Amidst worldwide reports of adverse oral lesions subsequent to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination, the current systematic review planned to determine the prevalence of adverse oral events in adult individuals (≥18 years) after SARS-CoV-2 vaccination, emphasizing upon the type and dose of vaccine, time of onset, and underlying pathophysiology. The registered protocol (PROSPERO CRD42023421307), conforming with PRISMA guidelines, included an all-inclusive literature search through online databases, consisting of Scopus, PubMed/MEDLINE, Web of Science, Lilacs, Livivo, and PROSPERO, completed on 2 May 2023, followed by assessment of risk of bias by Joana Briggs Institute Evaluation Checklist. Due to the paucity of literature, case reports and case series were included. Self-reported lesions were excluded. Qualitative synthesis employing Microsoft Excel software 2019 revealed low prevalence (43 subjects) from 26 case reports and two case series. There were multiple erosive oral ulcers on gingiva, palate, burning pain in the mouth, xerostomia, tongue fissuring and glossitis, palatal petechiae, diffuse erythematous lesions and loss of smell (16.2%), primary herpetic gingivostomatitis (21%), oral lichen planus (16.2%), Stevens-Johnson syndrome (6.9%), Bell's palsy in four cases where two cases were Guillain-Barré syndrome (9.3%), erythema multiforme (11.6%), pemphigus (4.6%), idiopathic thrombocytopenic purpura (6.9%), unilateral hypoglossal nerve palsy (4.6%), and trigeminal neuralgia (2.3%). Maximum cases (22 subjects) presented oral lesions after Pfizer (BNT162b2) SARS-CoV-2 vaccine. No association was found between the vaccine type and dose with oral side effects. Dentists must be aware of the oral adverse effects after coronavirus disease 2019 vaccination to better understand the pathogenesis and the risk factors associated with such reactions.

Background: Fluoridated dentifrices have been used for the prevention of dental caries since ages. However, to avoid the risk of fluorosis, the use of newer nonfluoridated options in dentifrices has shown a great interest in reducing Streptococcus mutans (SM) in early childhood caries (ECC). Aim: The study aimed to evaluate the antimicrobial efficacy of active oxygen (AO)-based dentifrice with amine fluoride (AF)-, sodium monofluorophosphate (SMP)-, herbal (HB)-, and tricalcium phosphate (TCP)-based dentifrices on SM count in children with ECC. Materials and Methods: Two hundred and fifty children aged 3–6 years with def ≥4 were selected and randomly divided into five groups of 50 each, based on the type of dentifrices used; Group I: AO-based, Group II: TCP, Group III: SMP, Group IV: AF, and Group V: HB dentifrice, and were asked to brush twice daily for 15 days. The saliva samples were collected at baseline, and after 15 days, cultured for SM colonies count. Results: Difference in colony-forming units (CFU)/ml between baseline and 15 days was highly significant in all the five groups (P < 0.001). Significant difference was observed in SM count after 15 days between Groups I and IV (P = 0.017), while nonsignificant differences were seen when compared with Groups II, III, and V (P = 0.975, 0.137, and 0.992). Conclusions: All the dentifrices were efficacious in reducing SM count in children with ECC. Although AO dentifrice showed superior results when compared to SMP, TCP, and HB, it did not prove to be superior to AF.

OBJECTIVE:Invasive front malignancy grading system in oral squamous cell carcinoma (OSCC) introduced by Bryne et al. is reported to be of prognostic significance in a number of studies conducted in Western countries. The aim of this study was to evaluate the prognostic significance of the modified Bryne's malignancy grading system and to compare it with the World Health Organization (WHO) grading system in the Indian population. METHODS:The records of 50 patients diagnosed with primary OSCC were evaluated. Only large surgically resected specimens that had deep invasive fronts in the cut sections were selected. All hematoxylin and eosin-stained slides were analyzed by two grading systems: the WHO grading system and the Bryne's malignancy grading of the deep invasive fronts of OSCCs. RESULTS:Histopathologic grading in the invasive sites had highly significant prognostic value and had significant correlation with overall survival rate. The Kaplan-Meier survival curves showed that five years following therapy, the proportion of cases surviving with Bryne's scores lower or equal to 12 was 60.6% compared to only 17.6% for those with scores greater than 12. The drop in the survival curve of the patients with Bryne's scores greater than 12 was much steeper toward the end of the two years (nearly 16 months). In WHO Grades I and II, the survival rate was 48.9% and in Grade III, it was Nil. CONCLUSION:The histologically invasive areas may be the only prognostic indicator for the clinical behavior of OSCC and can be used to predict overall survival in patients.

: Musculoskeletal disorder (MSD) are a group of conditions that affect the muscles, bones, tendons, ligaments, and other supporting structures in the body. The purpose of this study is to determine the risk factors associated with MSD, to evaluate the occurrence of MSD and to ascertain if they are also aware of the measures to prevent and manage these conditions.A questionnaire based study was done including the dental students who were working in clinics, this comprising of third year, final year as well as interns of our institute via social networks. The variables taken into consideration were demographic details presence and absence of pain, average working hours per day, break between attending patients, best practices followed by subject to minimize MSD.: Among 270 dental students, 202 responses were collected, with response rate of (74.81%). The most common site affected by MSD was the lower back reported in 26.3% subjects, while other regions affected in descending order were, neck (16.8%), more than one region (15.3%) followed by Upper back (14.9%), no pain(10.8%), Shoulders (9.6%) and elbow (6.3%).Statistical analysis among the different variables showed how awareness regarding measures like stretching exercises and physical activities positively influences work performance and act as a catalyst in reducing MSD. : Occurrence of musculoskeletal disorders among dental students is significantly high due to lack of awareness regarding maintaining proper posture, implementing regular breaks and physical exercises. MSD in dentistry can be diminished through following proper posture, taking adequate breaks between the patients and maintaining good physical health.

BACKGROUND: Pancytopenia generally suggests the likelihood of bone marrow failure syndromes or leukemias. However, other easily treatable entities can also cause pancytopenia. To know the underlying cause of pancytopenia is essential for definite management and prognosis. AIM: The aim of this study is to study the prevalence, clinico-hematological profile, and etiology of pancytopenia in hospitalized children of 1 month to 18 years of age. METHODS: Descriptive study conducted in a tertiary care center included children of age 1 month to 18 years hospitalized with pancytopenia. Sociodemographic data, presenting complaints, and detailed history were noted. Detailed clinical examination and relevant investigations were done. RESULTS: The prevalence of pancytopenia was 2%. Majority of the patients were >10 years of age. Female: Male ratio was 1.15:1. The most common presentation was progressive pallor, followed by fever, icterus, and bleeding manifestations. The most common clinical examination finding was pallor, followed by splenomegaly, hepatomegaly, icterus, and lymphadenopathy. Macrocytic blood picture was most common, followed by microcytic, atypical cells, and normocytic picture. Mean serum ferritin (ng/ml) was 374.77 ± 1662.64. Mean serum B12 (pg/ml) was 117.72 ± 64.71. In bone marrow aspirate examination, megaloblastic erythropoiesis was most common, followed by normoblastic erythropoiesis, dual deficiency, malignant cells of lymphoid series, hypocellular marrow, and malignant cells of myeloid series. Megaloblastic anemia was the most common etiology, followed by dimorphic anemia amid acute leukemia. CONCLUSION: The study showed that megaloblastic anemia and infections (tuberculosis, dengue fever, and enteric fever) both of which are eminently treatable, cause nearly 65% of pancytopenia cases in pediatric patients.

Background:Currently, oral cancer in India ranks among the top three types of cancer affecting mainly the elderly population. However, recent years have witnessed a marked increase in the younger people less than 45 years of age being affected by oral squamous cell carcinoma (OSCC). Thus, its early detection and treatment are of utmost importance and this responsibility lies with the healthcare providers. Therefore, we planned this study to assess the knowledge, attitude and practices of oral cancer among undergraduate dental and medical students. The objective was to suggest strategies to improve awareness on oral cancer.Methods:A pretested questionnaire comprising nineteen questions were distributed among 193 undergraduate dental and 218 undergraduate medical students of our university. Fundamental questions were included in the clinical examination, risk factors and need for information lectures on oral cancer. Chi-square and ANOVA tests were used to analyse the data.Results:The response rate of the study was good with 91.7% (177/193) of the dental and 88% (191/218) of the medical undergraduates participating in the survey. Though dental students had sufficient knowledge regarding the prevention and detection of oral cancer, however, medical students were less aware of the investigative methods of oral cancer.Conclusion:Though the mean knowledge of the dental students was good, they were not confident of diagnosing the early clinical symptoms of oral cancer. Practices on detection of oral cancer have to be reinforced among medical students so that they can contribute to its prevention.

The occurrence of clear cell histologic sub-type of oral squamous cell carcinoma in the oral cavity is a distinct and exceedingly rare entity exhibiting aggressive behavior. To date, only 10 cases have been published in the literature. We describe 2 extremely rare cases, both presenting with swelling and ulcerated nodule-like proliferative growth in the mandible. Microscopically, sheets and lobules of neoplastic squamous epithelial cells showing clear cell differentiation were appreciated in both patients. Periodic acid-Schiff and mucicarmine revealed negative staining. Immunohistochemical (IHC) analysis for antibody for renal cell tumor marker CD 10 was immune-negative. The malignant clear cells in both cases showed intense positive reactions with IHC markers pan-cytokeratin and epithelial membrane antigen, confirming the diagnosis as a clear cell variant of oral squamous cell carcinoma (CCOSCC). The first patient was unwilling for treatment and eventually died within 2 months of the diagnosis. In the second patient, right hemi-mandibulectomy with level 1A and 1B lymph nodes was performed. Adjuvant chemotherapy with low-dose methotrexate was initiated. Follow-up after 2 months of surgery was uneventful. Current rare reports emphasize the significance of prompt and extensive diagnostic work-up of clear cell neoplasms, as the CCOSCC may be fatal.

Intraorally, cysticercosis is regarded as uncommon and a diagnostic challenge. Here, we report a diagnostic conundrum of an unusual case of innocuous appearing lesion on the tongue presenting as moderately tender swelling finally diagnosed as lingual cysticercosis, based on USG (Ultrasound), CT (Computed Tomography) findings and characteristic histopathologic features.

Objective The aim was to study the epidemiology, clinical profile, and outcomes of children with coronavirus disease-2019 (COVID-19) admitted in our hospital. Methods This prospective study was conducted at the tertiary care dedicated hospital of COVID-19 in North India between April 1, 2021 and June 30, 2021. A total of 36 children less than or equal to 18 years of age who tested positive for SARS-CoV-2 by RT-PCR from nasopharyngeal swab were enrolled. The details pertaining to age, sex, clinical symptoms, severity of the disease, radiography abnormalities, and laboratory investigations were recorded. The outcomes were mortality, discharged patients, and complications. Results The mean age was 8.5 years, with 72.22% males. Majority (47.22%) had a history of household contacts. The mean duration of symptoms after admission was 3.03 ± 5.34 days. The chief clinical symptoms were fever (91.67%), cough (38.89%), and upper respiratory infection (33.33%). Radiographic findings were abnormal in 12 (33.33%) patients. D-dimer was deranged in 17 (89.47%) patients. C-reactive protein was positive in all patients. The mean duration for RT-PCR to become positive was 3 ± 5.53 days from the day of admission. Severity wise, 72.22% had mild infection, 8.33% had moderate, and 19.44% had severe disease. The most common complications seen were pneumonia (19.44%), shock (13.89%), and disseminated intravascular coagulation (5.56%). The mean duration taken to being asymptomatic after symptoms was 5.12 ± 3.5 days. A total of three deaths were reported, and rest of them were discharged. The mean days of discharge were 8.76 ± 8.4 days. Conclusion In COVID-19, respiratory involvement is primary with mild presentation commonly. Children portray good recovery with low mortality.

We report two extremely rare cases of metastatic clear-cell carcinomas, which metastasized from and to the oral cavity and both presented clinically in the oral cavity. First case was a primary lesion in the oral cavity, which showed distant metastatic deposits in liver, kidney, bone and brain. Histopathologically, lobules of pleomorphic clear cells were evident descending from the overlying mucosa, raising the suspicion of renal cell carcinoma. Immunohistochemical staining for CD10 was negative and the case was diagnosed as clear-cell type of oral squamous cell carcinoma which had disseminated to distant organs. In the second case, dysplastic clear granular cells were seen invading the bone. Immunohistochemical staining for CD10 showed focal mild positivity, confirming the diagnosis as clear-cell renal carcinoma which had metastasized to the oral cavity. Metastatic tumours must be considered in the differential diagnosis of rapidly growing ulcero proliferative lesions in the oral cavity.

BACKGROUND:Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) impair quality of life (QOL), accelerate the decline in lung function and often require hospitalisation, and thus, leading to increased healthcare burden. By identifying factors that may be associated with AE-COPD and managing them rationally, not only the hospital admissions could be avoided but progression of the disease may also be slowed. Objective. The aim of the present study was to determine the factors associated with hospital admissions among adults with AE-COPD.METHODS:Seventy-three patients admitted with AE-COPD were administered a structured questionnaire during their hospital stay. Data on body mass index (BMI), smoking, symptoms, co-morbidities course of the disease, spirometry management and outcomes during the hospitalisation were obtained. Factors associated with hospital admissions were analysed.RESULTS:The hospitalisation due to AE-COPD was significantly associated with the reduced forced expiratory volume in one second (FEV1), and peak expiratory flow rates, increasing sputum purulence, number of hospitalisations during previous year for COPD and presence of co-morbidities.CONCLUSIONS:The study shows that both disease and healthcare-related factors are predictors for hospitalisation. Identification of risk factors and appropriate management may reduce hospitalisation due to AE-COPD.