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Diabetes Mellitus (DM) is the sixth leading cause of mortality and morbidity in the world. Early diagnosis and periodic monitoring are mandatory to prevent complications. The custom of noninvasive exfoliative cytology diagnostic technique is the need of the hour in diabetes, where the invasive methods lose viability. The purpose of this meta-analysis is to analyze the cytomorphometric changes in the exfoliated cells of the oral mucosa, as an adjunct to the diagnosis of type II diabetes. A thorough search was made by using PubMed, Google Scholar, and Cochrane Library databases. Original research articles, that evaluated cytomorphometric parameters (nuclear area, cytoplasmic area, cytoplasmic nuclear ratio) in type II diabetes patients were included in this review. Risk of bias was analysed for each study using Joanna Briggs Institute and Review Manager was used for meta-analysis. All nine subgroups included for qualitative and quantitative data synthesis revealed that there was a significant increase in nuclear area and a decrease in cytoplasmic nuclear ratio in diabetic patients as compared to non-diabetics. Random-effects model also confirmed cytologically altered (nuclear area and cytoplasmic nuclear ratio) parameters to have a significantly increased risk of association with diabetes. Furthermore, these morphometry parameters were also associated with glycemic control and there was no gender disparity among them. Mounting evidence authenticate that cytomorphometric analysis of oral mucosal cells using exfoliative cytology might be aid as an adjunct non-invasive diagnostic tool for type II diabetes. [ABSTRACT FROM AUTHOR]

Introduction : Cytological diagnosis of sarcomas requires detailed cytomorphological assessment and integration of immunocytochemistry and/or molecular testing. The role of exfoliative cytology, as compared to aspiration cytology, is less understood. This case series describes well-differentiated/dedifferentiated liposarcomas in effusions, with cytomorphological features, ancillary test results and clinical outcomes detailed. Methods : A computerized search of the department pathology archives was performed for sarcomatous effusions with histological diagnosis or clinical history of well-differentiated/dedifferentiated liposarcoma. Clinical progress, cytology slides, immunocytochemistry and molecular test results were reviewed. Results : Six patients were identified. In 5 patients with clinical follow up, 4 (80%) were deceased within 5 months of malignant effusion. One patient was alive with 12 years disease-free survival after radical resection with adjuvant radiotherapy. Three patients showed dedifferentiation on histology, and high-grade (dedifferentiated) tumor cells were present in effusion cytology of 2 patients. Two showed well-differentiated components only on biopsy, but high-grade (dedifferentiated) tumor cells were identified in cytology. The high-grade tumor cells displayed marked nuclear irregularity, enlargement, size variation, with macronucleoli and multinucleation. Well-differentiated lipomatous components were demonstrated in 4 patients (66.7%), comprising of multivacuolated lipoblasts and atypical lipocytes. CDK4 and MDM2 immunoreactivity in all 3 cases with cell blocks, and CDK4 and MDM2 amplification in one were successfully demonstrated. Conclusion : Lipomatous and dedifferentiated components can be sampled and cytomorphologically identified on effusion fluids of liposarcomas, with sufficient cellularity for immunocytochemistry and molecular testing. Although generally associated with poor prognosis, long disease-free survival with sarcomatous effusion is possible with radical surgery and adjuvant treatment. [ABSTRACT FROM AUTHOR]

Menopause is a phase of physiological alteration in women that leads to changes in both systemic and oral health. Buccal smears were collected from 28 premenopausal women and 28 early postmenopausal women who visited the outpatient Department of Oral medicine and radiology of our college. The Oral changes were observed and the patients were asked about complaints of their menstrual history, dry mouth, systemic conditions, signs of inflammation, focal infections, ulceration, white and red lesions, and periodontal diseases. The results were obtained by correlating the changes observed in premenopausal and early postmenopausal women by the influence of hormones on oral health using oral exfoliative cytology. The results of the study were then correlated with various other similar studies and revealed that there is a high chance that the early postmenopausal women are more prone to oral discomfort than the premenopausal women. The data obtained from this study will be used to plan preventive health care programs (creating awareness about oral hygiene maintenance, measures to improve salivary parameters) for the menopausal and early postmenopausal women to improve their oral health related quality of life. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to assess cytological alterations of the squamous epithelium of the alveolar ridge mucosal surface under the acrylate prosthesis in T2D patients. Methods and Results: The subjects of interest were patients in whom the total acrylate prosthesis had been applied 3-5 years or more prior to the examination. The subjects were divided into two groups: 30 adult subjects with T2D (T2D group) and 30 adult subjects without T2D (control group). Both groups were over 49 years of age. Cytological smears were obtained by cytobrush from the mucosal surface of the gingival crest underlying the acrylate prosthesis. The following parameters were assessed: type of cells (basal, intermediate, superficial, superficial without nucleus, and parakeratotic), proportions of the types of cells, cytoplasmic diameter, nuclear diameter, and nucleus-to-cytoplasm ratio. An independent sample t-test was used to compare the two study groups. The percentage of superficial cells was significantly lower in the T2D group than in the control group (P=0.001). The T2D group tended to have a higher rate of parakeratotic cells (13.0±11.12 vs. 8.07±7.92, P=0.052). Superficial cells in the T2D group had a significantly lower mean cytoplasmic diameter than the control group (32.7947±8.61929 µ vs. 36.6383±4.32228 µ, P=0.03). Additionally, the nucleus-to-cytoplasm ratio of intermediate and superficial cells in the T2D group was significantly higher than in the control group (0.2407±0.07206 vs. 0.2000±o.03291, P=0.007 and 0.2573±0.06330 vs. 0.2280±0.03178, P=0.027). Conclusion: The results of our study show that total acrylate prostheses in diabetic patients are responsible for the disrupted maturation of squamous epithelial cells. This is reflected in smaller superficial cells, increased parakeratosis, and the higher nucleus-to-cytoplasm ratio of intermediate and superficial cells.

This narrative review delves into cervical health during pregnancy, specifically focusing on the frequency and associated risk factors of abnormal Pap smears conducted in the 1st trimester. Pregnancy is a transformative journey for women, characterized by profound physiological changes, yet the performance and implications of Pap smears during this crucial period remain underexplored in the literature. In pursuit of comprehensive and reliable insights, this review strictly adheres to ethical guidelines, drawing exclusively from published, peer-reviewed sources while upholding the privacy and confidentiality of human subjects involved in the studies. Employing a qualitative data analysis and interpretation approach, the review presents results descriptively and thematically. Through this systematic approach, our review offers a holistic overview of abnormal Pap smears in the 1st trimester of pregnancy while identifying the factors associated with their occurrence. This synthesis of existing knowledge ensures the relevance and reliability of our findings, effectively addressing the research question. Understanding the implications of abnormal Pap smear results during the initial stages of pregnancy is paramount for maternal and fetal wellbeing. As such, this review contributes to bridging the gap in the literature by shedding light on this relatively understudied intersection of cervical health and pregnancy. Doing so provides valuable insights that can guide healthcare professionals in offering informed and appropriate care to pregnant women, ultimately promoting the health and safety of both mothers and their unborn children. [ABSTRACT FROM AUTHOR]

Introduction and aim. Oral squamous cell carcinoma (OSCC) and premalignant disorders (PMDs) are becoming common in India as the use of tobacco in different forms is increasing from a young age, and the prevalence of this disease is becoming more common in middle age. Identifying disease at earlier stages is an important measure for limiting disease incidence and improving patient prognosis. The micronuclei count can be a valid biomarker for screening suspected patients and can be helpful in educating patients about the discontinuation of treatment, diagnosing the disease in its early stages and planning a treatment for a better prognosis. Different stains that are nuclear specific can be used to identify micronuclei. The aim was to establish diagnostic efficacy of various staining techniques in OSCC and potentially malignant disorders on oral brush cytology smears with observation of micronuclei as a valid biomarker for evaluation of the disease. Material and methods. Exfoliative cytology was done with oral brush and smears are obtained from 25 oral squamous cell carcinoma, 25 leukoplakia, 25 lichen planus, 25 oral sub mucous fibrosis patients and 15 samples with no disease. Each smear was stained with five different stains Papanicolaou (PAP), hematoxylin and eosin (H&E), toluidine blue, Leishman and Giemsa (LG) cocktail and Feulgen and observed for staining efficacy of micronuclei and cellular structures. Results. The best stain to observe DNA content as micronuclei is Feulgen which gives clear and crisp details of micronuclei without giving any false count as it is nuclear specific stain. PAP can be the second choice stain. Micronuclei count is definitely increased in OSCC and PMDs compared to samples without disease confirming its use as biomarker. Conclusion. Micronuclei count in oral brush cytology smears is a valid biomarker for evaluation of premalignant disorders and OSCC and can be used for detection of disease in individuals and for screening purposes of large populations at risk. Feulgen stain is best to study DNA content as micronuclei, on the other hand PAP can be used in large sampling investigations where there is lack of armamentarium. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the estrous cycle length of the Algerian Arbia goat in Northern Algeria. For this, eighteen (18) Arbia goats, aged between 2 and 6 years, were used in our work that took place in the experimental farm of the Saad Dahlab University (Blida, Algeria). Blood samples were taken from each goat twice a week (at a 2 or 3-day interval) for 3 months. The serum progesterone concentration was determined by Radio-Immuno-Assay. Smears of the vaginal mucosa were taken at the same time as the blood samples. The predominance of superficial cells on the smear of the vaginal mucosa as well as a serum progesterone level less than 1 ng/mL expressed the return to estrous which was considered the beginning of a new cycle. A negative correlation was observed between the percentage of superficial cells (SC) and serum progesterone (P4) levels in all goats. Our results showed a significant difference (P<0.05) between the means of different cycle lengths obtained among the females. In addition, normal cycles had an average of 20.11±1.85 days (17-25 days) representing 59.6% of cycles. Besides, a large number of short cycles (<17 days) with an average of 14.41±1.51 days were found representing 25.5% of recorded cycles. The number of long cycles (>25 days; with an average of 32.14±5.58 days), represented 14.9% of recorded cycles. Following these results, it can be concluded that the local goat in Northern Algeria had different types of cycles (normal, short, and long) with a large percentage of normal cycles. [ABSTRACT FROM AUTHOR]

Background: The aim was to diagnose Candida in the oral cavity of subjects with type 2 diabetes mellitus (T2DM) using a genotyping technique and compare the results with those from conventional diagnosis by Papanicolaou (Pap) staining. Methods: Palatal mucosa smears were performed on 18 dental care patients diagnosed with T2DM and grade I, II, and III prosthetic stomatitis who met the inclusion criteria; 18 healthy control subjects were also included in the study. Hemoglobin A1c (HbA1c) levels were determined from total blood. Using exfoliative cytology, the Pap staining technique was used to diagnose candidiasis. Exfoliative cytology was also used for molecular diagnosis; DNA was obtained for Candida genotyping, and RNA was used for gene expression studies. Results: Clinical patterns indicated that all subjects were positive for Candida; however, Pap analysis revealed only three positive subjects, whereas end-point polymerase chain reaction (PCR) analysis revealed 15 subjects with some type of Candida. The most common Candida species found were Candida guilliermondii (38.8%), Candida krusei (33.3%), Candida tropicalis, and Candida lusitaniae (22.2%). Interestingly, the coexpression of different species of Candida was found in various patients. In all patients, HbA1c levels were increased. Gene expression analysis showed a significant decrease (p ≤ 0.05) in TLR2 expression in positive subjects, whereas TLR4 expression did not differ significantly among patients. Conclusions: The end-point PCR technique showed better sensitivity for the diagnosis of Candida when compared with the diagnosis by Pap staining. T2DM subjects showed an increased presence of C. guilliermondii that was correlated with decreased TLR2 expression. [ABSTRACT FROM AUTHOR]

The oral cavity can be explored as an area to identify the impacts of aging. Exfoliative cytology is a painless, rapid, and effective method for collecting intact cells from various epithelial layers for microscopic examination. Therefore, the current study's objective was to determine the average cell size using morphometric analysis and radiovisiography (RVG) to estimate an individual's age utilizing buccal smears and the pulp/tooth ratio. A software program was utilized to determine the cell size using exfoliative cytology, and the pulp and tooth area was measured using RVG of mandibular canine with the help of an image analysis software. Appropriate statistical tests were performed using IBM SPSS statistical software for Windows (version 25). The patient's chronological age, pulp area, and the associated pulp-tooth area ratio values were determined, along with Karl Pearson's correlation coefficient. It was discovered by using a paired t-test to compare chronological age to the age deduced from cell size and pulp-tooth area ratio. According to the current study, age estimation could be done based on average cell size, pulp size, and pulp-tooth area ratio for forensic odontology. Studies with bigger sample sizes and diverse population would help achieve definitive conclusions about the reliability of this particular method. [ABSTRACT FROM AUTHOR]

Bullous pemphigoid (BP) is a common immune-mediated blistering disorder with predominant skin involvement and occasionally oral manifestations. Vesiculobullous lesions of the oral mucosa present with similar clinical features, and hence arriving at a clinical diagnosis is aided by a valuable chairside investigation, exfoliative cytology. Cytology done in the present case ruled out pemphigus because of the absence of Tzanck cells in the smear. Biopsy and direct immunofluorescence further confirmed the diagnosis of BP. Treatment initiated with systemic steroids and immunomodulators, along with oral topical application of triamcinolone acetonide resulted in complete remission in 2 months. This case report highlights the role of cytology in the diagnosis of vesiculobullous lesions and management protocol for BP patients presenting with simultaneous skin and oral lesions. [ABSTRACT FROM AUTHOR]

Objective: To estimate the efficacy of the Leishman Giemsa cocktail stain, Giemsa stain, and Papanicolaou for the screening of potentially malignant lesions by exfoliative cytology. Study Design: Comparative study. Setting: Department of Oral Pathology, Isra Dental College, Faculty of Dentistry and Allied Sciences Hyderabad, Pakistan. Period: 1st February 2022 to 31st January 2023. Methods: A total of 90 participants were enrolled in the study, 30 subjects of normal healthy individuals were categorized in Group-I and 60 patients with diagnosed potentially malignant lesions (Oral submucous Fibrosis, Oral Lichen Planus, and Leukoplakia) were categorized in Group II. Participants were advised to rinse their mouth with water and the sample was taken by moving a brush clockwise and anti-clockwise over mucosa and the surface of the lesion. Three smears were prepared from each sample, one was fixed with biofix spray and stained with Papanicolaou stain, and other two smears were air-dried and stained with Leishman Giemsa and Giemsa stain. Stained slides were observed under a microscope and the slides were interpreted. Results: In Group-I Leishman Giemsa cocktail stain was highly significant compared to Papanicolaou and Giemsa stain, the mean value of the Leishman Giemsa cytoplasmic stain was 1.16, Papanicolaou was 1.0 and Giemsa was 0.52. Whereas in group II, the mean score of cytoplasmic staining of the Leishman Giemsa cocktail was 1.16, Papanicolaou was 1.10 and Giemsa was 0.67. There was no significant difference found in the mean score of cytoplasmic staining of Group-I and Group II respectively. Conclusion: According to current research study results, the Leishman Giemsa cocktail stain is a better staining technique for the screening of potentially malignant lesions along with the Papanicolaou stain. [ABSTRACT FROM AUTHOR]

Background: Age estimation plays a crucial role in identifying an unknown individual in the event of any mass disaster or crime. One of the important noninvasive procedures that may have an impact on determining an individual's age is exfoliative cytology. Aim and Objective: Exfoliated buccal mucosa cells were used in the study to determine the participant's age by assessing the changes in nuclear diameter (ND), nuclear–cytoplasmic (N: C) ratio, and cell diameter (CD). Materials and Methods: With the help of a moistened wooden spatula and a light scraping motion, buccal smears were taken from 100 healthy and normal individuals across various age groups. The samples were then preserved with 95% ethanol and stained using ultrafast Papanicolaou stain. Cell and nuclear diameter were measured for each of these cells using the ImageJ software, and N: C was calculated from the two parameters. The N: C was calculated from CD and ND for each subject. One-way ANOVA tests were used for statistical analysis. Results: A significant difference in the diameter of cell and nucleus with the individual's age (P < 0.05) was noticed. The N: C ratio reduces with increasing age but is not consistent. Conclusion: Buccal smears show age-related alterations that could be utilized as an effective tool for age estimation.

Background: Age estimation plays a crucial role in identifying an unknown individual in the event of any mass disaster or crime. One of the important noninvasive procedures that may have an impact on determining an individual's age is exfoliative cytology. Aim and Objective: Exfoliated buccal mucosa cells were used in the study to determine the participant's age by assessing the changes in nuclear diameter (ND), nuclear-cytoplasmic (N: C) ratio, and cell diameter (CD). Materials and Methods: With the help of a moistened wooden spatula and a light scraping motion, buccal smears were taken from 100 healthy and normal individuals across various age groups. The samples were then preserved with 95% ethanol and stained using ultrafast Papanicolaou stain. Cell and nuclear diameter were measured for each of these cells using the ImageJ software, and N: C was calculated from the two parameters. The N: C was calculated from CD and ND for each subject. One-way ANOVA tests were used for statistical analysis. Results: A significant difference in the diameter of cell and nucleus with the individual's age (P < 0.05) was noticed. The N: C ratio reduces with increasing age but is not consistent. Conclusion: Buccal smears show age-related alterations that could be utilized as an effective tool for age estimation. [ABSTRACT FROM AUTHOR]

Background: Smoking is currently the most preventable cause of diseases and death worldwide and is one of the causative risk factors for developing cancer in different organs. Hence, it is necessary to detect potentially malignant lesions at their incipient stage. Oral cancers commonly affects floor of the mouth, soft palate, lateral border of the tongue and other areas of the mouth. Aim and Objective: The present study was the Cytomorphometric Changes In The Buccal Mucosal Cell In Smokers In Central Indian Populations. Material and Methods:A comparative study conducted among smokers of Central India population, was performed on 200 males under the age group of 20-60 years. The subjects were chosen randomly from IPD and OPD patients of Medicine Department of Index Medical College and Hospital, Indore. Results: There was significant difference observed between non smoking and smoking for cells with binucleation pyknosis, perinuclear halo, cytoplasmic granules, karyolsis, karyorrhexis, and micronuclei, in buccal mucosal cells but non significance difference was found for cytoplasmic vacuoles between nonsmoking and smokers. similar study of non-smoking populations. Conclusion: The present study indicates that almost all cytomorphological findings were high in smokers than non-smokers. Early detection of oral cancers becomes complex as they are mostly innocuous and asymptomatic during their initial stages, Cytomorphometric analysis can be used regularly to detect these cell alterations. Currently, use of exfoliative cytology has increased as an adjunct to screening of precancerous lesions and malignancies of the oral cavity. [ABSTRACT FROM AUTHOR]

Abstract Background Screening and early diagnosis of oral squamous cell carcinoma (OSCC) are directly associated with increased survival rate and improved prognosis. Noninvasive diagnostic tools have been implemented in the early detection as toluidine blue staining, optical imaging, and oral cytology. This study aimed to assess and compare the presence of micronuclei (MN) in oral exfoliative cytology of healthy controls, subjects exposed to high-risk factors for oral cancer, subjects with oral potentially malignant lesions (OPMLs), and those with malignant oral lesions. Subjects and methods A total number of 92 subjects were divided into 46 healthy controls with no oral mucosal lesions (23 with no evidence of cancer risk factors and 23 with cancer risk factors), 23 with OPMLs and 23 with oral malignant lesions. All the 92 participants were subjected to cytological sampling for detection of MN. The final diagnosis of the oral lesions was confirmed by the histopathological picture and compared to the cytological results. Results The results showed that the diagnostic accuracy of MN was higher in OPMLs group (95.2%). The sensitivity of MN test in malignant group was much lower (52.2%); however, all the cytological criteria of malignancy were markedly detected as compared to the OPMLs group. Conclusions Conventional oral cytology supported by MN is highly beneficial as adjunctive tool in the screening for early detection of dysplastic oral lesions.

The most significant accomplishment of dentists is the early detection of oral dysplasia or the rapid diagnosis of potentially malignant lesions. An additional test that assists in the diagnosis of numerous oral illnesses is exfoliative cytology. This study was conducted among dental professionals in the city of Bhubaneswar to assess their exfoliative cytology knowledge, attitudes, and practices. Fifty-eight dental interns participated in a cross-sectional, descriptive, Web-based questionnaire study. The findings reveal that while some interns were knowledgeable about some components of exfoliative cytology in oral cancer (OC) screening, they lacked a thorough understanding of other crucial elements. To enhance early diagnosis and lessen the prevalence of OC, it is critical that dental practitioners increase their understanding of and use of exfoliative cytology. To address the misconcepts found in the study, it draws attention to the necessity of patient education and public awareness campaigns. The study recommends more awareness and education among dental practitioners and emphasizes the need of tackling OC through preventive measures and appropriate diagnostic techniques such as exfoliative cytology. [ABSTRACT FROM AUTHOR]

Background: Screening and early diagnosis of oral squamous cell carcinoma (OSCC) are directly associated with increased survival rate and improved prognosis. Noninvasive diagnostic tools have been implemented in the early detection as toluidine blue staining, optical imaging, and oral cytology. This study aimed to assess and compare the presence of micronuclei (MN) in oral exfoliative cytology of healthy controls, subjects exposed to high-risk factors for oral cancer, subjects with oral potentially malignant lesions (OPMLs), and those with malignant oral lesions. Subjects and methods: A total number of 92 subjects were divided into 46 healthy controls with no oral mucosal lesions (23 with no evidence of cancer risk factors and 23 with cancer risk factors), 23 with OPMLs and 23 with oral malignant lesions. All the 92 participants were subjected to cytological sampling for detection of MN. The final diagnosis of the oral lesions was confirmed by the histopathological picture and compared to the cytological results. Results: The results showed that the diagnostic accuracy of MN was higher in OPMLs group (95.2%). The sensitivity of MN test in malignant group was much lower (52.2%); however, all the cytological criteria of malignancy were markedly detected as compared to the OPMLs group. Conclusions: Conventional oral cytology supported by MN is highly beneficial as adjunctive tool in the screening for early detection of dysplastic oral lesions. [ABSTRACT FROM AUTHOR]

Aim: To document a case of lobomycosis and to discuss its epidemiology & diagnosis. Case Report: A 53-year-old male presented with a history of nasal congestion, nasal discharge, and epistaxis following Covid 19 infection. On physical examination, there was necrotic slough in the nasal vestibule near the inferior turbinate. Scrapings and punch biopsy were taken from the lesion. Hematoxylin-eosin-stained sections showed necrotic and mucoid areas with mixed inflammatory cell infiltration and numerous budding yeasts 3-7µm diameter in singles, and small clusters with single narrow based budding as well as multiple budding including sequential budding forming "chains of yeasts". A diagnosis of Lobomycosis was made. Yeasts of lobomycosis are often confused with other yeasts such as P. brasiliensis, Candida spp., B. dermatitidis, and Cryptococci, but characteristic 'sequential budding' with a 'chain of yeasts" aid in the final diagnosis. Demonstration of yeasts with characteristic chains either in tissue sections or in potassium hydroxide (KOH) preparation of scraped material, exudate, or exfoliative cytology is the mainstay in the diagnosis as the organisms are uncultivable in vitro in culture medium. [ABSTRACT FROM AUTHOR]

Background: Neoplasms of the vermiform appendix are rare. They comprise a heterogeneous group of entities requiring different kinds of treatment. Methods: This review is based on publications retrieved by a selective literature search in the PubMed, Embase, and Cochrane databases. Results: 0.5% of all tumors of the gastrointestinal tract arise in the appendix. Their treatment depends on their histopathological classification and tumor stage. The mucosal epithelium gives rise to adenomas, sessile serrated lesions, adenocarcinomas, goblet-cell adenocarcinomas, and mucinous neoplasms. Neuroendocrine neoplasms originate in neuroectodermal tissue. Adenomas of the appendix can usually be definitively treated by appendectomy. Mucinous neoplasms, depending on their tumor stage, may require additional cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemoperfusion (HIPEC). Adenocarcinomas and goblet-cell adenocarcinomas can metastasize via the lymphatic vessels and the bloodstream and should therefore be treated by oncological right hemicolectomy. Approximately 80% of neuroendocrine tumors are less than 1 cm in diameter when diagnosed and can therefore be adequately treated by appendectomy; right hemicolectomy is recommended if the patient has risk factors for metastasis via the lymphatic vessels. Systemic chemotherapy has not been shown to be beneficial for appendiceal neoplasms in prospective, randomized trials; it is recommended for adenocarcinomas and goblet-cell adenocarcinomas of stage III or higher, in analogy to the treatment of colorectal carcinoma. [ABSTRACT FROM AUTHOR]

Background: Tobacco-induced mucosal changes have been identified in exfoliated cells. The morphology of the exfoliated cells depends on the nature of the changes taking place in the epithelial layer; conversely, alteration in cytological pattern may be attributed to the changes occurring in the epithelial layer. Applying this possibility, exfoliative cytological techniques have been applied to examine the effect of tobacco on the oral mucosa. Aims and Objectives: The study was conducted to study the alterations in the cellular diameter of buccal mucosal cells. Materials and Methods: In a case controlled study, 240 participants were divided into four groups according to their habit of consumption of tobacco leaves, tobacco with areca nut, participants with oral lesions, and participants without any such habit. The groups were, further, subdivided according to their age. Desquamated cells from the buccal mucosa of were collected and smeared on a slide. The cells were stained with Papanicolou (rapid kit). Fifty cells per slide were studied and photomicrographs were obtained at ×40 magnification. The cellular diameter was obtained using the Leica 1000 software. Results: The mean cell diameter was found to be highest in the group of normal subjects (49.51±7.31 micron), followed by the group of tobacco users (43.52±1.92 micron) and Gutkha users (39.05±3.57 micron). The mean cell diameter was minimum (24.97±3.13 micron) in the group of oral lesion patients. According to the ANOVA test, the difference in cell diameter among various groups is found to be highly significant (P

Objective: To assess differences based on gender in nuclear area (NA), cytoplasmic area (CA), and nuclear‐cytoplasmic ratio (N:C ratio) values for clinically normal buccal smears in apparently healthy subjects of a South Indian population, thereby providing definitive baseline cytomorphometric measurements for the South Indian population. Methods: Buccal smears were collected from 60 healthy subjects (30 males and 30 females) of a South Indian population above 18 years in age. Values of the NA and CA were measured, and the N:C ratio calculated, using ImageJ software. Statistical analysis of the data with independent t tests and 95% confidence intervals was done using SPSS version 21 (significance set at P < 0.05). Results: The results showed that there were significant differences in the NA, CA, and N:C values between males and females irrespective of age (P = 0.01). Conclusion: Definitive gender‐specific baseline cytomorphometric data can be established using exfoliative cytology for the South Indian population, and this may be helpful in deciphering the occurrence of oral pre‐malignant diseases and oral squamous cell carcinoma in this population, as the incidence of these conditions varies with gender and different ethnic groups. [ABSTRACT FROM AUTHOR]

Background: Ionizing radiation can cause chromosomal aberrations and micronuclei (MN) formation in the cell cytoplasm, and a research study was conducted to assess the genotoxic effects of panoramic radiation. Methods: Cytological smears were prepared from the buccal mucosa of 60 patients between the age group of 10–40 years before and 10 days after exposure to panoramic radiation and were stained with Giemsa. The sections were studied for the frequency of MN before and after exposure to radiation. Results: There was a statistically significant increase in the cells containing MN (MCF) and total MN count after exposure to the radiation in comparison to before exposure. There was no correlation of MN and MCF with age and gender. Conclusion: This data suggests that there is a need to use panoramic radiographs cautiously, only when it is highly necessary. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is a dominant metabolic disorder in the current fast paced culture; its prevalence is escalating worldwide and among all age groups. Guidelines recommend universal screening for diabetes; however, the uptake of these tests in individuals suggests challenges owing to invasive nature of blood collection. Thus, there arises the need for a noninvasive investigation for diabetes screening with a minimum paraphilia and for all medical settings. Materials and Methods: We have thus conducted a systematic review and meta analysis according to Preferred Reporting Items for Systematic Reviews and Meta Analysis guidelines, to quantify the association between diabetes and effectiveness of periodic acid--Schiff staining of exfoliative cytology as a screening method. MEDLINE, EMBASE, Cochrane, Scopus, Web of science, CINAHL, and Google Scholar were searched systematically for publications dated till July 20, 2022. Six studies (case--control cross sectional) were selected and evaluated in depth. The statistical evaluation was done with a forest plot with odds ratio and weightage examined. Results: It was proved that exfoliative cytology with periodic acid--Schiff (PAS) staining can be used as a screening test for diabetic status evaluation. The findings suggest that the aforesaid noninvasive test is a conclusive screening practice for diabetics. Conclusion: This systematic review and meta analysis suggest that PAS staining in exfoliative cytology can be used as a noninvasive screening in diabetic individuals to assess the current level of blood glucose. Given the increased risk of diabetes worldwide, higher quality prospective evidence is suggested in larger sample sizes with other metabolic disorders, ethnicity, and oral disorders to further evaluate the plausibility of the results. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the cytomorphometric changes in the buccal mucosal smears and to correlate the cytomorphometric findings and glycosylated hemoglobin (HbA1c) in type 1 diabetic (T1D) patients. In addition, DNA repair proficiency in peripheral lymphocytes of T1D patients was evaluated. Smears from the clinically normal buccal mucosa of 46 healthy subjects as controls and randomly selected 45 T1D patients, were stained using the Papanicolaou method, and the mean values (μm2) of nuclear area (NA), cytoplasmic area (CA), and cytoplasmic: nucleus ratio (CNR) were obtained for each patient. DNA damage in diabetics and control subjects was tested on peripheral blood samples using an in vitro mutagen sensitivity assay. Statistical analysis included Student's t-test, one-way ANOVA, and Pearson's correlation test to correlate cytomorphometric changes with HbA1c levels in both T1D and healthy control groups. The mean NA and CA values were higher in T1D while the mean CNR was found to be higher in the healthy control group. Statistical significance between the two groups was found only for the mean NA (P < 0.001) and mean CNR values (P < 0.001). A significant correlation was seen between HbA1c and CNR in both the T1D group (P = 0.015) and the healthy control group (P = 0.02). Significant differences were noted between the T1D and control subjects with regard to the frequency of damaged cells and DNA repair proficiency (P < 0.05). Significant cytomorphometric alterations were detected in the buccal mucosal cells of diabetic patients, which may aid in the early detection of diabetes or predict the risk for future disease complications among T1D patients.

Background: Tobacco-induced mucosal changes have been identified in exfoliated cells. The morphology of the exfoliated cells depends on the nature of the changes taking place in the epithelial layer; conversely, alteration in cytological pattern may be attributed to the changes occurring in the epithelial layer. Applying this possibility, exfoliative cytological techniques have been applied to examine the effect of tobacco on the oral mucosa. Aims and Objectives: The study was conducted to study the alterations in the cellular diameter of buccal mucosal cells. Materials and Methods: In a case controlled study, 240 participants were divided into four groups according to their habit of consumption of tobacco leaves, tobacco with areca nut, participants with oral lesions, and participants without any such habit. The groups were, further, subdivided according to their age. Desquamated cells from the buccal mucosa of were collected and smeared on a slide. The cells were stained with Papanicolou (rapid kit). Fifty cells per slide were studied and photomicrographs were obtained at ×40 magnification. The cellular diameter was obtained using the Leica 1000 software. Results: The mean cell diameter was found to be highest in the group of normal subjects (49.51±7.31 micron), followed by the group of tobacco users (43.52±1.92 micron) and Gutkha users (39.05±3.57 micron). The mean cell diameter was minimum (24.97±3.13 micron) in the group of oral lesion patients. According to the ANOVA test, the difference in cell diameter among various groups is found to be highly significant (P<0.0001). Conclusion: Tobacco used in any form can induce changes in the buccal mucosa. In our study, mean cellular diameter decreased from normal-cells to cells affected by oral lesions. [ABSTRACT FROM AUTHOR]

Entamoeba gingivalis is thought to be parasitic in the periodontal pocket. However, its behavior as an infectious organism in the oral region is still not well known. The authors report here two cases of mandibular osteomyelitis suspected of involvement of E. gingivalis infection. In these two cases, although rapid and prominent bone resorption was observed on radiographs, clinical findings such as trismus and inferior alveolar nerve dysesthesia as seen in normal mandibular osteomyelitis were not observed. For that reason, gingival cancer was also suspected, and exfoliative cytology of the periodontal pocket was performed, and E. gingivalis was detected from both specimens. Administration of conventional antibacterial agents for suppurative inflammation did not respond to the lesions. In these cases, after the removal of teeth and sequestrum that had been desorbing due to marked bone resorption of the lesion, rapid bone regeneration was observed at the site of bone resorption. After removing the source of infection with E. gingivalis, antibiotic therapy was also effective, and good healing was confirmed in both cases. [ABSTRACT FROM AUTHOR]

Introduction: Potentially malignant disorders (PMDS) such as leukoplakia, lichen planus, and oral sub-mucous fibrosis these disorders associated with tobacco habits either chewing or smoking. Exfoliative cytology is a simple, noninvasive diagnostic technique and it can be used in the early stage of PMDS. There are different methods for assessing cellular alterations including cytoplasm and nuclear area. The examination of the cytological smear can be done using a light microscope and phase contrast microscope. Aim: Cytomorphometric analysis of cell and nuclear diameter using light and phase contrast microscope in potentially malignant disorders. Materials and Methodology: Individuals with a history of burning sensation, restricted mouth opening, and a non-scrapable white patch were included. A buccal smear was taken and stained with hematoxylin and eosin stain and a Papainicolous stain was done. Each smear of 50 cells was selected for quantitative assessment for the nuclear and cytoplasm areas. Results: Males were more in leukoplakia, the mean age was 35.0 ± 7.1. Comparison between light and phase contrast microscope in both nuclear and cytoplasmic areas showed statistically significant. Conclusion: Oral cytomorphometric analysis will improve diagnostic reliability. This method can be one of the adjuvants it will help to detect as well as follow-up the potentially malignant disorders. [ABSTRACT FROM AUTHOR]

Background: White Sponge Nevus (WSN) is a rare benign disorder associated with mutations in genes coding for cytokeratin 4 (KRT4) and 13 (KRT13) characterized by dyskeratotic hyperplasia of mucous membranes. This study was aimed at examining different approaches (cytology, pathology and genetic analysis) to WSN diagnosis. Methods: A series of four patients with asymptomatic white diffuse oral lesions were evaluated and, before performing an incisional biopsy for pathology, an oral brush Thin Prep was collected for exfoliative liquid-based cytology (LBC). DNA for genetic analysis was also obtained from patients and both their parents, using buccal swabs. Results: Pathology and cytology showed similar results, leading to the same diagnosis of hyperkeratotic epithelium with acanthosis and spongiosis, without atypia, demonstrating the efficiency of LBC for the differential diagnosis. Sequencing analysis revealed at least 6 rare variants in the KRT4 and KRT13 genes in each patient, contributed in part by both unaffected parents. Conclusions: Thin Prep for oral exfoliative cytology and genetic analysis are sufficient for an accurate diagnosis of WSN. The combination of cytological and genetic analyses could substitute the histologic exam, providing a non-invasive alternative for incisional biopsy. [ABSTRACT FROM AUTHOR]

Numerous tools and techniques such as vital stain, autofluorescence, exfoliative cytology, histomorphometry, etc. were explored in the detection of dysplasia, but have variable sensitivity and specificity. The present study evaluated the effect of toluidine blue in increasing the accuracy of histomorphometry analysis in detection of the dysplasia in OPMDs on exfoliative cytology. An experimental, observational, cross-sectional research was performed on patients attending dental hospitals and in oral health check-up camps suspected of having OPMDs. Cytology smear was collected using the standard protocol before and after the application of a toluidine blue stain over the lesion. Two pathologists performed the dysplasia grading and histomorphometry analysis. Chi-square and t-tests were carried out (p<0.05). The study observed a positive correlation between toluidine blue positivity and dysplasia in OPMDs. The toluidine blue stain sensitivity, specificity, Positive Predictive Value, and Negative predictive value were 39.53%, 97.56, 97.14, and 43.58% respectively. Toluidine blue before the cytology smear does not improve the diagnostic accuracy of cytomorphometry. Further, there was no significant variation in cellular and nuclear morphometry parameters as compared to normal mucosa. Toluidine blue stain does not improve the efficacy of cytomorphometry in discriminating dysplasia on cytosmears. However, toluidine blue stain can assist clinicians in identifying potential areas of having a suspicion of dysplasia for scalpel biopsy. [ABSTRACT FROM AUTHOR]

This investigation was conducted to study the effect of progestin and prostaglandin-based estrous synchronization protocol on estrus parameters, hormonal profile and vaginal cytology in Surti goats. Ten non-pregnant Surti goats were selected and subjected to estrus synchronization with intra-vaginal progesterone sponges (60 mg Medroxyprogesterone acetate, MAP) for 11 days followed by PGF2α injection (125 μg Cloprostenol). Whole blood was collected on day 0 (before treatment), day 5, 11 (after treatment), at proestrus, estrus and diestrus for analyzing progesterone as well as estrogen hormone concentration. The vaginal exfoliative cytology was studied at proestrus, estrus and diestrus. Estrus parameters such as induction rate was 100%, time of onset of estrus from PG injection was 29.70 ± 1.06 h and duration was 30.74 ± 0.19 h. Significantly higher population of parabasal cells and superficial cells were observed during proestrus, intermediate cells in diestrus and cornified cells during estrus. At estrus, level of progesterone was lowest and estrogen was highest. Combination of progestin and prostaglandin-based protocol is successful in synchronization of estrous cycle with 100% estrus induction rate in Surti goats. Further in addition to other signs, vaginal exfoliative cytology can also be used for determining different phases of estrous cycle. [ABSTRACT FROM AUTHOR]

Irritation and biofilm adhesion are complaints associated with ocular prosthesis use. This study aimed to evaluate the effects of prosthesis repolishing on several conditions of anophthalmic volunteers. Participants were divided into two groups: intervention (IG, n = 10) and nonintervention (NIG, n = 6) groups. The anophthalmic cavity, contralateral eye, and prosthesis surface were evaluated at initial, day 15, and day 30 after repolishing. Microbiological analysis (colony-forming units), exfoliative cytology (conjunctiva inflammatory cells), sensory analysis (quantitative mechanical sensory test), tear production (Schirmer's test), and conjunctival inflammation (clinical evaluation) were performed. Nonparametric tests were used to compare groups in the initial period and to analyze periods for the IG (p < 0.05). More microorganisms were formed in the anophthalmic socket and prosthesis than in the contralateral eye in the initial period. For IG, the anophthalmic cavity exhibited more microorganisms and inflammatory clinical signs in the initial period than at 15 and 30 after repolishing. The prosthesis showed greater accumulations of total bacteria and Candida albicans in the initial period than at 15 and 30 days after repolishing. The anophthalmic cavity had more palpebral inflammation than the contralateral eye. In conclusion, repolishing reduced the number of microorganisms and inflammatory signs over time. [ABSTRACT FROM AUTHOR]

Background: Exfoliative cytology is the technique of microscopic examination of shed or desquamated cells from the epithelial surface of mucous membrane. Papanicolaou stain (PAP) is the common stain used for these cytological smears. Conventional PAP (cPAP) stain has undergone many modifications, of these ultrafast PAP (UFPAP) is a popular stain used as it shortens the staining time and quality. UFPAP was discovered as a fusion of Romanowsky and PAP. Aim and Objectives: To evaluate and estimate the quality of UFPAP and c PAP stains in oral cytology smears of normal mucosa (NM), oral squamous cell carcinoma (OSCC), and oral potentially malignant disorders (OPMDs). Materials and Methods: 50 samples/smears were collected from outpatients from the Government Dental College and Hospital, Hyderabad. Samples include 10 cases of NM, 20 cases each of OPMDs (leukoplakia) and OSCC. Two cytological smears of representative areas were obtained and each smear is stained by the cPAP and UFPAP stains, respectively. Results and Observation: The quality index is obtained for the comparison of UFPAP and cPAP stains by using four parameters like - nuclear details, over all staining, background staining, and cell morphology. QI for all parameters of UFPAP staining was good compared to cPAP and percentage of UFPAP for NM, OPMDs and OSCC was 92.7%, 88.1%, 66.3% respectively. Conclusion: The study concludes that UFPAP staining is used for diagnosis in a regular oral cytology smears to offer immediate diagnosis of OPMDs and OSCCs.

Objectives: The present study focusses on cytomorphological evaluation of the scrapings and cytological appearance of a spectrum of lesions of the oral cavity, Morphometric nuclear and cytoplasmic parameters were used to distinguish between benign, premalignant and malignant lesions. Material and Methods: The samples were obtained by scraping the lesion firmly till tiny pin point bleeding points were seen to ensure adequate sampling. Adequate sampling was defined as 50 cells consisting of transepithelial cytology specimen (superficial, intermediate and basal cells). Results: A total of 80 patients were evaluated with predominance in males and mean age of presentation was 45.05± 12.8 years. Cytomorphomteric analysis revealed an increasing trend in nuclear parameters as the spectrum of oral lesion moved from benign to malignant category while a decline was observed in cellular parameters. A significant p value of

The present study was undertaken to assess the mucosal changes in individuals who are using tobacco with betel leaf and those who are using tobacco without betel leaf with respect to the duration and also to assess the changes of cell diameter (CD) and nuclear diameter (ND) of exfoliated cells from the buccal mucosa/ mucosal lesions in those with the above-mentioned habits. [ABSTRACT FROM AUTHOR]

Vaginal lavage cytology is commonly used in rodents to determine oestrous cyclicity and is a requirement for regulatory reproductive toxicity studies. While rats are the preferred species for these studies, where scientifically justified, the mouse is an alternative species. The current study sought to evaluate the utility of day 21 vaginal lavage cytology in the CD-1 mouse for assessment of changes in the murine oestrous cycle. It compared the vaginal lavage technique, using either fresh or fixed and stained cytology smears, with the histological evaluation of the vagina on day 21 of a murine study and examined the results in the context of interpreting data from reproductive toxicity studies conducted in mice. On day 21, concordance between methanol-fixed, Wright-Giemsa-stained vaginal lavage cytology slides and histological examination of the vagina was recorded in 17/24 animals (70.83%). The results also show that vaginal lavage cytology in mice yields variable data with the stages of the oestrous cycle being less clearly discernible. Compared with vaginal lavage cytology, terminal histological examination of the vagina was found to be the most accurate method for determining stage of oestrous. Routine assessment of oestrous cyclicity in mice by vaginal lavage cytology is of questionable value and has animal welfare implications. [ABSTRACT FROM AUTHOR]

Cigarette smoke is a well-known main risk factor for cancer related early death. Exposure to cigarette smoke by both active and passive smokers increases the incidence of infections and causes atypical changes. This study aimed at examining the cytomorphological features of buccal mucosal smears of active, passive cigarette smokers and non-smokers. About 290 subjects were recruited for this study, of which 220 were active cigarette smokers, 20 were passive cigarette smokers and 50 were nonsmokers. Sterile Ayre's spatulas were used to collect buccal mucosa samples from each subject and smeared immediately on 3 clean frosted slides, which were fixed immediately with 95% Methanol for at least 30 minutes before they were stained using Papanicolaou, Giemsa and Heamatoxylin & Eosin techniques respectively. Stained smears were viewed with the microscope to examine their cytomorphological features. Cytological features such as pleomorphism, hyperchromatism, micronuclei, fungal infection and increased nuclei-cytoplasmic ratio were observed in increased severity in the buccal mucosa smears of active cigarette smokers when compared with the Passive cigarette smokers and the non-smokers. Oral exfoliative cytology is a noninvasive, low-cost test that should be advocated in cigarette smokers for early detection of any precancerous diagnosis. [ABSTRACT FROM AUTHOR]

Duchenne muscular dystrophy (DMD) is a rare genetic disorder in which patients progressive muscle deterioration and low life expectancy. Since DMD has no cure, treatment slows the deterioration process using corticosteroids and other medications, including oral bisphosphonates (BP). These drugs can lead to toxicities in both soft and hard tissues. The objective of this study was to present cytological changes in DMD patients, comparing to young, healthy individuals. Cytological smears were obtained from buccal mucosa from nine DMD patients and five healthy patients. The Papanicolaou technique was used to stain the slides. Images were captured using a photomicroscope, and 50 clearly defined cells were selected. The size and ratio between the nucleus and cytoplasmic areas (NA/CA) diameter were measured using a computer program. All the DMD patients presented a statistical difference (p < 0.0001) in the size of the cytoplasm (0.60 ± 0.33 μm) and the NA/CA ratio (0.17 ± 0.07 μm) was seen when compared to the control group (cytoplasm 0.60 ± 0.15 µm and nucleus 0.14 ± 0.05 µm). Furthermore, in one DMD in use of BP who presented Medication-Related Osteonecrosis of the Jaw (MRONJ), presented higher differences in the cytoplasmic (1.20 ± 0.65 µm) and nuclear (0.20 ± 0.12 µm) sizes (p < 0.0001) compared with all others DMD patients. These results suggest that the drugs used or the systemic condition of individuals with DMD may contribute to these changes. [ABSTRACT FROM AUTHOR]

The use of sharpness aware minimization (SAM) as an optimizer that achieves high performance for convolutional neural networks (CNNs) is attracting attention in various fields of deep learning. We used deep learning to perform classification diagnosis in oral exfoliative cytology and to analyze performance, using SAM as an optimization algorithm to improve classification accuracy. The whole image of the oral exfoliation cytology slide was cut into tiles and labeled by an oral pathologist. CNN was VGG16, and stochastic gradient descent (SGD) and SAM were used as optimizers. Each was analyzed with and without a learning rate scheduler in 300 epochs. The performance metrics used were accuracy, precision, recall, specificity, F1 score, AUC, and statistical and effect size. All optimizers performed better with the rate scheduler. In particular, the SAM effect size had high accuracy (11.2) and AUC (11.0). SAM had the best performance of all models with a learning rate scheduler. (AUC = 0.9328) SAM tended to suppress overfitting compared to SGD. In oral exfoliation cytology classification, CNNs using SAM rate scheduler showed the highest classification performance. These results suggest that SAM can play an important role in primary screening of the oral cytological diagnostic environment. [ABSTRACT FROM AUTHOR]

The Kymi Odyssey Honorary Ceremony was held in Kymi, Greece to celebrate the life and career of Dr. George N. Papanicolaou, the founder of exfoliative cytology and developer of the Pap test. The ceremony took place in the newly renovated Papanicolaou homestead, which will become the future G.N. Papanicolaou Museum. Various artifacts related to Dr. Papanicolaou were donated for the museum, including handwritten letters, photographs, scientific manuscripts, and dedicated postage stamps. The ceremony was attended by international cytologists and local authorities, and the future museum is set to open in mid-August 2024. [Extracted from the article]

Context: Areca nut (AN) is a potent cytotoxic and genotoxic agent. Oxidative stress-induced by chewing of AN can cause DNA damage leading to nuclear anomalies such as micronuclei (MN) and also alters antioxidant defense mechanisms, leading to genomic instabilities and the development of oral cancer.Aims: The aim of this study is to study the correlation between the levels of glutathione reductase (GR) and superoxide dismutase (SOD) in exfoliated buccal mucosal cells and the genotoxicity levels (MN count) in chronic AN chewers.Materials and Methods: The present study was conducted with the approval of the Research Ethics Board in 60 individuals; 40 cases (Group I-20 raw AN chewers, Group II-20 dried areca with tobacco chewers), and 20 controls as Group III in the age group of 18-68 years who attended the outpatient department of our college. Estimation of SOD and GR and MN assessment was done using buccal exfoliated cells.Statistical Analysis Used: Statistical analysis was performed using the Student's t-test and one-way ANOVA.Results: Antioxidant levels were found to be significantly reduced in both Group I and Group II in comparison to the control group. Group II showed significantly reduced level of GR in comparison to Group I. The MN count was significantly increased in Group II in comparison to Group I. The MN counts showed an inverse correlation to the activities of the antioxidant enzymes. Greater activities of antioxidant enzymes correlated with decreased MN counts.Conclusions: Detection of MN in AN chewers with or without tobacco can be a useful biomarker for clinical screening procedures that may be used as a risk marker for oral cancer. It is important to increase the awareness programs to educate the public about the deleterious effects of AN chewing, emphasize on early intervention of AN chewing habit and thus prevent the development of oral cancer. [ABSTRACT FROM AUTHOR]

Background: Allergies, including food allergies, are a considerable clinical and public-health problem. The introduced preventive measures and differential diagnostics, including oral food challenges, are the gold standard for determining further treatment planning. Case presentation: We present a case of an 18-year-old girl with a cow's milk allergy who underwent an oral food challenge (double blind oral food challenge). Such a challenge may be confounded by inducing a response from other systems and organs, which provides theoretical grounds for the use of other methods of assessing the body's response to food allergens (response demonstrated by the upper respiratory tract). Based on this idea, in order to assess the degree of mucosal response, we used optical rhinometry as an objective method for nasal patency evaluation, as well as identification of tryptase level in nasal lavage fluid and exfoliative cytology of nasal mucosa. The results of these tests confirmed positive reaction of the nasal mucosa in the course of the oral allergen challenge. Conclusions: The observed increase in the nasal mucosal reactivity that accompanies oral food challenges may suggest a potential for using food allergens in nasal allergen provocation testing in order to diagnose food allergies. [ABSTRACT FROM AUTHOR]

Objective: To advance studies on the effect of a new pharmaceutical formulation for the treatment of oral fungal infections, we evaluated the safety and tolerability of orabase ointment containing cinnamaldehyde for use on the oral mucosa. Material and methods: A clinical trial (phase I) was carried out on 35 individuals with healthy oral mucosa divided into three groups: ointments at 200 µg/mL, n = 12; 300 µg/mL, n = 11; and 400 µg/mL, n = 12. Product safety was assessed using three parameters: (a) clinical evolution as recorded by trained examiners; (b) evolution of the inflammatory process as registered by an exfoliative cytology exam and analyzed by trained pathologists; (c) mucosal swab to count Candida spp. colony-forming units (CFU). These parameters were analyzed both beforehand and at 15 days of treatment. Results: The three ointment concentrations evaluated did not trigger inflammatory processes. The mycological analyses revealed a reduction of at least 99% in the number of Candida spp. CFU. In the exfoliative cytology analyses, the cells were found to be healthy. Participants reported a pleasant taste, yet 17% reported a slight burning sensation when applying the product. Conclusions: The ointment is safe and tolerable for use on healthy oral mucosa. Trial registration: Registration number: RBR-7zwzs3. Clinical relevance: The ointment proved to be safe and tolerable for use on oral mucosa, encouraging studies to evaluate its clinical efficacy in patients with oral candidiasis, and contributing to a new therapeutic proposal for the treatment of fungal infections caused by Candida spp. [ABSTRACT FROM AUTHOR]

Background: Exfoliative cytology is the technique of microscopic examination of shed or desquamated cells from the epithelial surface of mucous membrane. Papanicolaou stain (PAP) is the common stain used for these cytological smears. Conventional PAP (cPAP) stain has undergone many modifications, of these ultrafast PAP (UFPAP) is a popular stain used as it shortens the staining time and quality. UFPAP was discovered as a fusion of Romanowsky and PAP. Aim and Objectives: To evaluate and estimate the quality of UFPAP and c PAP stains in oral cytology smears of normal mucosa (NM), oral squamous cell carcinoma (OSCC), and oral potentially malignant disorders (OPMDs). Materials and Methods: 50 samples/smears were collected from outpatients from the Government Dental College and Hospital, Hyderabad. Samples include 10 cases of NM, 20 cases each of OPMDs (leukoplakia) and OSCC. Two cytological smears of representative areas were obtained and each smear is stained by the cPAP and UFPAP stains, respectively. Results and Observation: The quality index is obtained for the comparison of UFPAP and cPAP stains by using four parameters like - nuclear details, over all staining, background staining, and cell morphology. QI for all parameters of UFPAP staining was good compared to cPAP and percentage of UFPAP for NM, OPMDs and OSCC was 92.7%, 88.1%, 66.3% respectively. Conclusion: The study concludes that UFPAP staining is used for diagnosis in a regular oral cytology smears to offer immediate diagnosis of OPMDs and OSCCs. [ABSTRACT FROM AUTHOR]

Background: The five-year survival rate of oral cancer remains 50% or less despite the treatment advances. An effective screening test is necessary for early detection of oral cancer. Aim: To assess the efficacy and diagnostic accuracy of centrifuged liquid-based cytology in comparison to conventional exfoliative cytology in normal oral mucosa and oral squamous cell carcinoma. Materials & Methods: The study population comprised of 40 individuals, equally divided into two groups: healthy individuals and previous histopathologically proven oral squamous cell carcinoma cases. Exfoliative cytology was done and the samples were processed by conventional cytology as well as by centrifuged liquid-based cytology and stained with Papanicolaou stain. Seven cytological parameters were analysed to assess the quality of slides prepared. A cytological diagnosis of the case group was also made and was compared with histopathological diagnosis to evaluate the diagnostic accuracy. Results: The present study revealed statistically significant superior results in all the cytological parameters evaluated by centrifuged liquid-based cytology compared to conventional exfoliative cytology (P ≤0.05). There was an ‘almost perfect agreement’ found between centrifuged liquid-based cytology diagnosis and histopathology (k=0.89) while only a ‘substantial agreement’ was found between conventional exfoliative cytology with histopathology (k=0.79). Conclusion: The present study summarizes that centrifuged liquid based cytology is more effective than conventional oral exfoliative cytology in screening oral cancer. Further studies with larger sample size in different oral lesions are necessary to validate the use of this cytology technique. [ABSTRACT FROM AUTHOR]

Objectives: The present study focusses on cytomorphological evaluation of the scrapings and cytological appearance of a spectrum of lesions of the oral cavity, Morphometric nuclear and cytoplasmic parameters were used to distinguish between benign, premalignant and malignant lesions. Material and Methods: The samples were obtained by scraping the lesion firmly till tiny pin point bleeding points were seen to ensure adequate sampling. Adequate sampling was defined as 50 cells consisting of transepithelial cytology specimen (superficial, intermediate and basal cells). Results: A total of 80 patients were evaluated with predominance in males and mean age of presentation was 45.05± 12.8 years. Cytomorphomteric analysis revealed an increasing trend in nuclear parameters as the spectrum of oral lesion moved from benign to malignant category while a decline was observed in cellular parameters. A significant p value of <0.0001 was found between cytomorphometrical parameters and histopathological subtypes. Sensitivity and specificity of conventional exfoliative cytology in conjunction with cytomorphometry was 100% and 94.74% respectively. Negative predictive value and positive predictive value of cytology for malignant lesions was 100% and 93.75% respectively. Diagnostic accuracy of cytology in predicting malignancy taking histopathology as gold standard was 97.0. Conclusion: Grading and scoring of oral cytosmears according to morphology showed a positive correlation with histopathological diagnosis. In addition, cytomorphometry increases the diagnostic accuracy of oral conventional exfoliative cytology and hence is seen to have an impact on early detection of cellular alterations and prompt treatment. Therefore, it is a sensitive and useful adjunct to monitor the cellular transformation. [ABSTRACT FROM AUTHOR]

Objectives: The value of consultation in pathology has been well documented in surgical pathology, but there are few comprehensive studies of consultation cases in cytopathology. Here we report our experience with cytopathology consultation cases at a large academic center.Methods: A review of consultation cases at our institution was performed by searching our laboratory information system. The contributing institution's diagnosis was compared with that rendered by the reviewing cytopathologist to assess major and/or minor diagnostic discrepancies.Results: In total, 928 cases were reviewed with the following distribution: fine-needle aspiration (FNA, 79.4%), exfoliative nongynecologic cytology (18.3%), and cases with both FNA and nongynecologic cytology (2.3%). There were 379 (40.8%) true consults and 549 (59.2%) confirming consults. A total of 586 (63.1%) cases were in agreement with the outside pathologist, 78 (8.4%) cases had major discrepancies, and 264 (28.4%) cases had minor discrepancies. Major discrepancies were most common for pancreas (38.5%), lymph node (11.5%), and soft tissue sites (9.0%).Conclusions: Of the cases, 8.4% had major diagnostic discrepancies between the original diagnosis and the consultation diagnosis, which is consistent with reported values in surgical pathology consultation studies. The findings support the importance of second-opinion consultation in cytopathology to guide patient care. [ABSTRACT FROM AUTHOR]

• Ureteral cancer with tumor size ≥2 cm demonstrated inferior urothelial RFS. • Tumor size ≥2 cm was a significant prognostic factor of poor urothelial RFS. • The optimal tumor size cutoff value for endpoints was 2 cm. • Ureteral cancer patients shall select surgical treatment following the EAU guideline. To evaluate the classification and prognostic effects of a 2 cm tumor size in patients with ureteral cancer (UC) undergoing segmental ureterectomy (SU). A total of 75 patients with UC who underwent SU in our hospital between April 2013 and April 2023 were included in this study. The study population was grouped based on tumor size, which was defined as the maximum diameter of the pathological specimens, resulting in 30 patients (40.0%) with tumor size <2 cm and 45 patients (60.0%) with tumor size ≥2 cm. The clinicopathological variables, perioperative parameters, and oncological outcomes were compared between the 2 groups. The endpoints were recurrence-free survival (RFS), and cancer-specific survival (CSS). A tumor ≥2 cm was related to a higher positive rate of urine exfoliative cytology (P = 0.049) and fewer preoperative ureteroscopies (P = 0.033) than tumors <2 cm. After a follow-up of 6.3 to 128.7 months (median 40.2 months), 23 cases (30.7%) experienced recurrence and 11 patients (14.7%) succumbed to UC in the end. Compared to those with tumor size <2 cm, patients with tumor size ≥2 cm experienced more urothelial recurrence (P = 0.032). Kaplan–Meier analysis demonstrated that patients with tumor size ≥2 cm displayed inferior urothelial RFS than those with tumor size <2 cm (P = 0.026). Multivariate Cox analysis identified tumor size ≥2 cm, and pathological stage ≥T2 were significant prognostic factors of poor urothelial RFS (all P < 0.05). Tumor size ≥2 cm was associated with a high rate of urothelial recurrence and served as an independent prognostic factor of adverse urothelial RFS in SU-treated patients with UC. Patients are advised to select surgical treatments for UC following the EAU guidelines. [ABSTRACT FROM AUTHOR]

[Display omitted] • Significance: Addressing global oral cancer burden; India has highest prevalence, urgent prevention/detection need. • Nuclear Morphometric Analysis (NMA): Evaluating NMPs in buccal mucosa cells for innovative oral cancer screening. • Smoking and Dysplasia: Strong correlations between NMPs and smoking exposure, dysplasia severity links. • Cut-off Values: Establishing NMP cut-off values using ROC analysis for precise dysplasia severity classification. • Future Implications: NMA's potential in telepathology and AI integration for efficient patient-centered oral cancer screening. Oral cancer poses a significant global health burden, with India having the highest prevalence. Effective detection is crucial in effective prevention. This study aimed to evaluate nuclear morphometric parameters (NMPs) in buccal mucosa cells of smokers, correlate NMPs with dysplasia, establish cut off values for grading dysplasia, and investigate the relationship between NMPs and smoking. After obtaining ethical approval and informed consent, patients were recruited from the outpatient department of our institution. A target sample size of 250 was calculated. The data included smoking exposure quantified in pack-years, nuclear morphometric analysis (NMA) of buccal mucosa cells obtained through oral cytology using Image J, and the severity of dysplasia of the slides assessed by pathologists. Statistical analysis assessed the impact of dysplasia and the association between nuclear characteristics and smoking exposure. Receiver operating characteristic (ROC) plots determined the potential of these parameters to distinguish dysplasia levels. Significant differences in NMPs were observed among different smoking groups. Dysplasia severity had a significant correlation with NMPs, and strong correlations were found between NMPs and lifetime smoking exposure. ROC analysis established cut off values for NMPs with good sensitivity and specificity for classifying dysplasia severity. This study highlights the potential of NMA as a tool for oral cancer screening. NMPs can distinguish dysplasia severity and correlate with tobacco (smoking). The efficiency of NMA in a non-invasive oral cytology offers promise for patient-centered screening Additionally, the findings suggest future applications in telepathology and the potential for AI integration in automated screening after conducting multicentric large-scale studies. [ABSTRACT FROM AUTHOR]