Aims:The aim of this study was to compare the efficacy of two mouth washes namely Chlorhexidine 0.2% and 5% green tea mouth rinse when used as pre-procedural rinses in reducing the number of CFU in aerosol generated during ultrasonic scaling. Methodology: 70 subjects were recruited in this study (43 males, 27 females: age range 18-65 years with presence of minimum 20 permanent functional teeth, less than 5 mm mean probing depth and plaque and gingival score between 1-3. Subjects were randomly divided into two groups, group 1 and group 2. Each group comprised of 35 patients. A split mouth design technique was used for collecting the aerosol samples on blood agar Anjum et al.; JAMMR, 31 (7): 1-9, 2019; Article no.JAMMR.53094 2 plates. For every patient, there was a control side and test side of mouth. Ultrasonic scaling was done on control side without pre procedural rinsing and vice versa. Group 1 used 0.2% Chlorhexidine while group 2 rinsed with 5% green tea mouthwash. The blood agar plates were then transported to Microbiology lab and incubated for counting the colony forming units (CFU). Results: Significant reduction of CFU occurred with pre procedural rinsing with both mouthwashes as compared to non-rinsing before ultrasonic scaling and 0.2% Chlorhexidine found to be superior to 5% green tea in reducing bacterial load in aerosol samples Conclusion: Pre procedural mouth rinsing with effective mouthwashes significantly reduces aerosol contamination and should be used before all dental procedures that results in formation of aerosols and splatters along with some other infection control protocol to minimize the risks of cross infection in clinical settings. Original Research Article

Aims:The aim of this study is to determine association between lymph node metastasis and various clinico-pathological parameters in order to predict their future prognosis of cancer patients. Study Design: Cross sectional study design. Place and Duration of Study: Ziauddin Hospital, North Nazimabad campus, Karachi. Methodology: November 2018 to September 2019. Results: The present study enrolled 140 OSCC patients visiting Ziauddin University of which 30 (21.4%) were females and 110 (78.6%) were male patients. The mean age of patients was 46.99 ± 12.26. The buccal mucosa was the most common site observed 93 (66.4%). The mean size of tumour was 4.05 ± 2.261 mm, mean thickness was 1.70 ±1.32 mm. It was found that lymph node metastasis was not present in 66 (47.1%) of OSCC cases, 22 (15.7%) cases were found N1, 9(6.4%) N2a, 27(19.3%) N2b, 3 (2.1%) and 13(9.3%) N3. Abidi et al.; JAMMR, 32(2): 46-53, 2020; Article no.JAMMR.54793 47 Significant association was found between age and lymph node metastasis: (P 0.02); however, gender showed no significant association. (P 0.149). Thickness of tumor, site of tumor, peri-neural invasion, lympho-vascular invasion and bone penetration showed significant association with lymph node metastasis with (P 0.040, 0.021, 0.016, 0.00 and 0.001) respectively. Conclusion: Our study showed significant association of lymph node involvement with tumour staging, tumour thickness, lymphovascular involvement, perineural invasion and bone penetration. Our suggestion is to incorporate these clinic-pathological variables while determining the treatment and prognosis of Oral squamous cell Carcinoma (OSCC). Given the very high incidence and prevalence of Oral Cancer in our country and the region further multi-centered researches should be carried out and with larger sample sizes. Early diagnosis and restrictions on smokeless tobacco products can limit the occurrence and progression of OSCC. Original Research Article

Inherited defect in DNA repair capability is the fundamental problem causing mutations to be passed on to new generation of cells leading to cancer. The NBS1/Nibrin/p95 belongs to the family of the DNA double-strand break repair complex (hMre11 complex) which is a transcript of the mutated NBS gene, located on human chromosome 8q21 The protein complex containing nibrin binds to the edges of the DNA double-stranded break causing defective repair process. Nibrin also activates various signaling cascades such as; phosphatidylinositide 3-kinases PI3-kinase/Akt triggering the oncogenic process. Aims: The purpose of this research was to aid in the diagnosis of oral cancer and dysplastic lesions in Karachi population. Study Design: This cross-sectional study was conducted at a tertiary care hospital. All samples were recruited for the study after obtaining written informed consent from patients and seeking ethical approval from Ethic Review Committee Ziauddin University (Reference Code: 0330618FAOM), Karachi Pakistan. Place and Duration of Study: Ziauddin hospital north Nazimabad Karachi, November 2018 to September 2019. Methodology: Expression of Nibrin (NBS1) was evaluated by Immunohistochemistry on dysplasia and OSCC biopsies by H-Score method. The tumor was graded by broder system. Immunohistochemical analysis for nibrin was performed on the tumor block. Mean, frequency, percentages were calculated for quantitative variables, chi square was used for qualitative variables. A value <0.05 was considered as significant. Results: 92% OSCC cases were positive for Nibrin while 80% of oral dysplasia revealed Nibrin expression. This accounts for significant statistical association of Nibrin with OSCC (0.012*) and dysplasia (0.001*). Unfortunately, apart from moderaterly histological differentiation (0.012) none of these clinicopathological parameters showed statistical significance. Conclusion: We conclude that a Nibrin protein showed overexpression among 92% of OSCC patients out of total 100 cases and in 80% out of 30 cases of dysplasia so the association of histological grading with expression of Nibrin was significant and expression of Nibrin intensity with histological grading was significant as well. Our study suggests that this expression of Nibrin may be used as a diagnostic marker for potential OSCC patients.

Aims: The present study aimed to evaluate the expression of cyclin D1 in oral squamous cell carcinoma and to find association of expression of cyclin D1 with different histological grades of oral squamous cell carcinoma. Study Design:  It is a cross sectional study. Place and Duration of Study: Oral squamous cell carcinoma samples were collected histopathology laboratory of Ziauddin Hospital, North Nazimabad Karachi. Immunohistochemistry was performed in multiple disciplinary research laboratory of Ziauddin University, Karachi. The duration of study was from January 2021 to January 2022. Methodology: The present study included taking biopsy samples from oral squamous cell carcinoma patients. Patients with history of other oral cavity tumors, patients with history of any other treatment of oral cancer were excluded from the study. Immunohistochemistry was performed on a total of 150 samples using anti cyclin D1 antibodies. Results: A total of 150 samples were part of study. Expression of cyclin D1 was found to be present in 77.3% of cases where as 22.7% of cases did not show expression of cyclin D1. A statistically significant association was shown between different grades of oral squamous cell carcinoma and intensity scoring (p value 0.004). Association between labelling index score for cyclin D1 and different grades of oral squamous cell carcinoma showed statistically significant p value (0.003). Association of total scores of cyclin D1 with different grades of oral squamous cell carcinoma was also found to be statistically significant (p value 0.003). Conclusion: The present study shows that oncogenic effects on cyclin D1 by mutations caused by oral squamous cell carcinoma can be detected by immunohistochemistry in the form of its overexpression. The association between overexpression of cyclin D1 and different histological grades can be utilize in predicting the oncogenic behavior of oral squamous cell carcinoma.

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