Objective:A recent trend in diagnosis of oral cancer in young age is observed, however its impact on various clinicopathological parameters needs to be explored. The aim of the current study was to compare and analyze impact of age at diagnosis with clinicopathological parameters of oral squamous cell carcinoma patients.Methods:In this cross sectional study conducted at Department of Oncology Ziauddin Hospital Karachi, we included histologically confirmed cases of oral squamous cell carcinoma. The patients were categorized as young age group (40yrs and younger) and old age group (41 yrs and above). A total of 115 patients diagnosed between 2013 and 2016 were enrolled in the study. The variables considered were age at diagnosis, sex, site of lesion, positive family history, tumor grade, stage, uric acid level and survival.Results:A statistically significant difference was observed between two age groups in overall survival, uric acid level and positive family history of cancer. No significant difference was observed in tumor location, grade and stage.Conclusion:Majority of oral cancer patients present at an advanced stage irrespective of age at diagnosis but young age has an overall improved survival. Moreover, a positive family history of cancer in young age group mandates further exploration of possible role of genetic polymorphisms which might be responsible for early onset of the disease.

Background & Objective: The high-throughput analysis of circulating microRNAs (miRNAs) is an active area of biomarker research. The oral cancer remains a common cancer among Pakistani males that continues to present at an advance stage, thus exhibiting poor survival. MiRNA 21 (miR-21) is the most consistently over-expressed miRNA in different types of tumor tissues. However, information regarding expression of miR-21 in plasma remains to be resolved. Therefore, present study was designed to investigate if miR-21 was expressed in plasma of patients with oral cancer, and further explore its diagnostic and prognostic potential. Methods: Present study was conducted at Ziauddin University and Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN). Histologically confirmed cases of oral squamous cell carcinoma were recruited from Oncology Department of Ziauddin Hospital between 2013 and 2017. Controls were carefully selected after considering age, gender and socioeconomic condition. MiRNA was extracted and immediately reverse transcribed to cDNA. MiR-21 expression was evaluated using probes specifically designed for Real time quantitative polymerase chain reaction. Results: A significant over expression of miRNA 21 was observed in histologically confirmed cases as compared to controls. The increased expression of miRNA 21 was also reported to be associated with tumor size, metastasis and local invasion (p<0.05). Conclusion: The expression of circulating miR-21 in plasma samples of oral cancer patients makes it a promising diagnostic and prognostic marker. doi: https://doi.org/10.12669/pjms.35.5.331 How to cite this:Mahmood N, Hanif M, Ahmed A, Jamal Q, Mushtaq S, Khan A, et al. Circulating miR-21 as a prognostic and predictive biomarker in oral squamous cell carcinoma. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.331 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MicroRNA-21, an oncomiR, plays a pivotal role in carcinogenesis and is upregulated in many cancers including oral squamous cell carcinoma (OSCC). Use of smokeless tobacco (ST) products and cigarettes smoking in causation of OSCC is well established. This study sought to reconnoiter miR-21 expression in relation to smoking and chewing habits among subjects with oral cancer. Methods After gaining approval from IRB of Ziauddin University, analysis of miR-21 expression was conducted in 100 biopsy proven OSCC cases and 100 controls. All participants gave informed written consent after which venous blood sample was collected. qRT-PCR (Quantitative real-time Polymerase chain reaction) was performed to check miR-21 expression. SPSS Version 24 was used for analyzing the data. Results Consumption of ST was reported by 85 % and 63% were smoking cigarettes. miR-21 expression was significantly higher among smokers and those addicted to ST products, p<0.001. Subjects addicted to gutka chewing and those using more than one chewable product showed significant upregulation of miR-21, p<0.05. Amount of ST product use and smoking cigarettes was found to be positively correlated with miR-21expression. Conclusion Our study provides the evidence that use of ST products and cigarette smoking trigger miR-21 which in turn potentiate carcinogenesis in OSCC.

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Background: The risk of transmission of novel SARS CoronaVirus-2 among health care workers can be reduced using personal protective equipment. It is critical to follow guidelines for appropriate use of protective gear to avoid its wastage. This study aimed to evaluate frontline healthcare workers’ understanding of effective donning and doffing of protective equipment in the wake of recent emergence of corona virus disease.Physical impacts due to its prolonged usage were also identified. Material and Methods: A cross sectional survey was conducted targeting frontline health care workers from June till July 2021. Data was analyzed using SPSS version 24. Descriptive analysis was performed for qualitative variables.Chi-square test was utilized to determine association between qualitative variables and p <0.05 was considered to be statistically significant. Results: A total of 204 responses were received. Surgical masks (53.9%), gloves (51.5%), gowns (46.1%) and N95 respirator (40.7%) were most frequently used. Physicians had better knowledge on correct utilization of protective equipment as compared to non-physicians, p<0.001.Only 55.9% and 47.1% participants knew correct donning and doffing sequence respectively.The most prevalent mistakes while doffingwere touching front of mask and potentially contaminated surfaces followed by incorrect doffing sequence.Mostrespondentsmentioned scarcity of protective gear. Around 53% participants did not attend any training session on utilization of personal protective equipment. Prolonged exposure to masks and gloves led to acne, facial marks and itching. Frequent practice of hand hygiene was linked with skin dryness and cracking, p<0.001. Conclusion: We observed lack of expertise in donning and doffing technique. Mostly mistakes occurred during doffing, so interactive workshops are required to train health care workers.Most common dermatological manifestationsdue to use of masks and gloves included acne, facial markings, and itching. Adverse effects of prolonged use of PPE can be avoided by having shorter duration of working hours and giving rest during the shifts. Keywords: COVID-19; personal protective equipment; skin manifestation; pandemics.