Browsing by Author "Akhilesh Chandra"

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Acuity of Dental Undergraduate Students towards Oral Pathology and Microbiology as a Subject and Profession - An Evaluative Study
(Wolters Kluwer Medknow Publications, 2025) Akhilesh Chandra; Trupti Jain; R. Keerthika; Mahesh R. Khairnar; Vineet Chauhan; Rahul Agrawal
Aim and Objectives: Oral Pathology and Microbiology (OPM) is a branch of dentistry; the objectives of it have been underestimated by undergraduate (UG) dental students. Thus, the present study was formulated, which outlines the acuity of UG students toward OPM as subject and career prospects along with its gender‑wise comparison. Material and Methods: An institutional close‑ended questionnaire‑based, cross‑sectional study was conducted among 219 students including BDS IInd year (36), IIIrd year (42), IVth year (93) students and interns (48), aged between 19 and 24 years. The questionnaire comprised 13 questions related to students’ perception of OPM as a subject along with its career practice. Data obtained were analyzed using Chi‑square test (P < 0.05). Statistics and Results: Among all participants, 99 (45%) were males and 120 (55%) were females. On Chi‑square analysis, we found that the majority of interns (87.5%) and 41.7% of Bachelor of Dental Surgery (BDS) IV year opined that the subject was both research‑oriented as well as clinical with a statistically significant difference. Additionally, students from all four years agreed with the affirmation of career opportunities at cancer centres with significant differences and increased propensity for making Oncology Fellowship programs a prerequisite in addition to Master of Dental Surgery (MDS) certification. On gender comparisons, we observed mixed types of results and inconclusive perceptions. Conclusion: The study revealed that students of a higher grade (BDS final year and interns) possess adequate practical knowledge and scope of practice of OPM compared to the lower‑grade (BDS II and III years) UG dental students with a need for workshops and seminars in the future prospectus. © 2025 Indian Journal of Dental Research.
An Analysis of Xpert Test for Diagnosing Maxillofacial Tuberculosis
(Springer, 2023) Richik Tripathi; Nidhi Singh; Rahul Agrawal; Akhilesh Chandra; Rathindra Bera; Mital R. Asodariya
Background: Maxillofacial tuberculosis is a diagnostic challenge for surgeons. The aim of this study was to present a detailed analysis of Xpert test in diagnosing maxillofacial tuberculosis and to analyse the accuracy of Xpert test results for various tissues of maxillofacial region. Materials and Methods: In this cross-sectional study, patients were selected randomly from outpatient department. The patients who had clinical picture and differential diagnosis highly suggestive of maxillofacial tuberculosis were included. Patients were divided into three different groups depending upon the site of involvement. The samples collected from the patients were further subdivided depending upon the type of specimen. Patients were screened first by routine tests, and the negative cases were followed by Xpert test for tuberculosis. Results: A total of 54 patients were enrolled in the study, 13 patients were found to be positive for maxillofacial tuberculosis on routine screening tests for tuberculosis, and 41 tested negative on routine test and were evaluated further through Xpert test. Specimens from bone (n12), soft tissue and skin biopsy (n15) and aspirates from lymph nodes (n14) were obtained and tested. Twenty-one samples were found to be positive, and 20 were negative upon Xpert testing. There was a statistically significant difference seen between the test groups (p < 0.01) with higher frequency of negative results in routine test. The p value for various specimens containing pus, biopsies and aspirates was 0.045, 0.023 and 0.067, respectively. Conclusion: Xpert test is more accurate when compared to routine test for diagnosing maxillofacial tuberculosis. Although accuracy of Xpert test is better for pus and biopsy samples in the specimens from bone and soft tissue, it gives poor accuracy for aspirated cells. The aspirates from lymph nodes were more susceptible for false negative test. © 2021, The Association of Oral and Maxillofacial Surgeons of India.
An enigmatic pathogenetic mechanism of hypoxia inducible factor - 1/2 alpha in the progression of fibrosis of oral submucous fibrosis and its malignant transformation: A systematic review and meta-analysis
(Elsevier Ltd, 2024) Keerthika R; Akhilesh Chandra; Trupti Jain; Neha Singh; Rahul Agrawal
Objective: Oral submucous fibrosis is a frequently reported potentially malignant disorder characterized by fibrosis and a malignant transformation rate of 7–30%. The role of hypoxia-inducible factor-1/2α in malignant transformation mechanisms of oral submucous fibrosis remains uncharted territory owing to a scarcity of studies. Thus the present systematic review and meta-analysis aimed to determine the role of hypoxia-inducible factor-1/2α in the progression of fibrosis of oral submucous fibrosis and its malignant transformation. Material and methods: Using PubMed, Google Scholar, and Cochrane Library databases, full-text articles that investigated hypoxia-inducible factor-1/2α in oral submucous fibrosis were entailed for review. A modified Newcastle-Ottawa scale was employed to evaluate risk of bias in all articles and Review Manager was utilized for meta-analysis. Results: Eighteen and eight qualified articles respectively were included for qualitative and quantitative data synthesis. Progressive upregulation of hypoxia-inducible factor-1/2α in oral submucous fibrosis is associated with fibrosis-induced carcinogenesis. A Random-effects model uncloaked that oral submucous fibrosis cases with significantly increased expression of hypoxia-inducible factor-1α had an increased associated risk of malignant transformation compared with controls (combined odds ratio 523.83, 95% confidence interval 125.74- 2182.28, p < 0.00001). Conclusion: The existing evidence substantiates the notion that hypoxia-inducible factor-1/2α, a fundamental pathogenetic mechanism of progression and malignant transformation of oral submucous fibrosis in the background of fibrosis. © 2024 Elsevier Ltd
Association of Ki-67 antigen and p53 protein at invasive tumor front of oral squamous cell carcinoma
(Wolters Kluwer Medknow Publications, 2014) Ruchita Verma; Anil Singh; Rohit Jaiswal; Akhilesh Chandra; Renuka Verma; Jalaj Tak
Aim: Studies reveal that invasive tumor front may be the best field for quantification of proliferative and apoptotic markers. The current study assessed the expression of Ki-67 antigen and p53 protein at invasive tumor front of oral squamous cell carcinoma (OSCC) and correlated the immunostaining with the histologic grades of malignancy. Materials and Methods: A total of 80 slides sample was prepared for the study, one each from ten normal oral mucosa cases and two each from 30 OSCC cases. The OSCC patients were biopsied along invasive tumor front, and samples were immunohistochemically analyzed for the expression of both Ki-67 antigen and p53 protein. Results: Of the total 30 OSCC cases, the expression of p53 was found positive in 20 cases (66.6%), while Ki-67 expression was found positive in 21 cases (70%). All the cases in the control group were negative. A higher p53 and Ki-67 expression were seen in OSCC group as compared to normal mucosa. On comparing the control group with various grades of OSCC a statistically significant result was obtained. Conclusion: Higher and statistically significant expression was noted for both p53 and Ki-67 antigen. The results emphasize the potential of Ki-67 and p53 as biomarkers of carcinogenesis in OSCC. Ki-67 expression was comparatively higher when compared with p53 except in poorly differentiated squamous cell carcinoma and signifies actively proliferating malignant cells at invasive tumor front.
Clinical evaluation of the role of tulsi and turmeric in the management of oral submucous fibrosis: A pilot, prospective observational study
(Medknow Publications, 2015) Adit Srivastava; Rahul Agarwal; T.P. Chaturvedi; Akhilesh Chandra; O.P. Singh
The aim of the present study was to investigate the clinical efficacy of herbal medicines (1 gm tulsi and 1 gm turmeric mixed in glycerine base) for the treatment of oral submucous fibrosis (OSMF). Forty-one patients in the age group of 17- 56 years without any systemic complications were included in the study. The patients were treated with medicines, which were to be applied 3-4 times a day. Blood samples were collected before and after treatment to screen for any systemic changes due to these medications. Burning sensation and mouth opening were recorded before and after treatment. Patients were followed up on monthly subsequent visits for three months. Changes in the burning sensation on visual analogue scale (VAS) scale and difference in the mouth opening were analyzed statistically. A statistically significant improvement was seen in both burning sensation and mouth opening. Tulsi and turmeric offers a safe and efficacious combination of natural products available for symptomatic treatment of OSMF.
Comparison of haematological and serum lipid profile parameters in oral potentially malignant disorders and oral squamous cell carcinoma
(Wolters Kluwer Medknow Publications, 2025) Akhilesh Chandra; Rahul Agrawal; R. Keerthika; Trupti Jain; Mahesh R. Khairnar; Akhilesh Kumar Singh; R. Maheswari
Introduction: Oral squamous cell carcinoma (OSCC) is sixth most common cancer in Indian subcontinent with a high morbidity and mortality rate. It is frequently preceded by oral potentially malignant disorders (OPMD). Early diagnosis of OSCC might halt the poor prognosis. Therefore, present study was aimed to evaluate the diagnostic significance of preoperative hematological parameters and serum lipid indices in OSCCs and OPMDs. Material and Methods: Study included 75 cases each of OSCC, OPMD, and controls. Mean and standard deviation of various hematological and lipid parameters were evaluated, including: a) RBC metrics: RBC count, hemoglobin (Hb%), hematocrit, MCV, MCH, RDW. b) WBC metrics: WBC count, neutrophils, lymphocytes, monocytes, atypical lymphocytes, immature leukocytes count, NLR. c) Platelet metrics: Platelet count, MPV, PDWSD, PCT, PLCR. d) Lipid metrics: Total Cholesterol, Triglycerides, HDL, LDL, VLDL, Non-HDL. The parameters were statistically analyzed using one-way ANOVA. Result: Mean values of neutrophil count, immature leucocytic cells, NLR, MPV, PDWSD, PLCR, and VLDL were found to be significantly increased (P < 0.00), while, mean values of RBC count, Hb%, atypical lymphocytes, platelet count and HDL were observed to be significantly decreased (P < 0.05) in OPMD and OSCC groups as compared to control. However, the remaining indices were found to be non-significant. Conclusion: Present study findings corroborate the role of hematological and serum lipid profile parameters in the etiology and progression of OPMDs and OSCCs. This highlights their potential as early diagnostic predictive markers to forecast the occurrence of high-risk OPMD and OSCC cases and also guiding personalized treatment strategies. © 2025 National Journal of Maxillofacial Surgery.
Contemporary practice in forensic odontology
(Wolters Kluwer Medknow Publications, 2014) Shalini Gupta; Archana Agnihotri; Akhilesh Chandra; Om Prakash Gupta
Forensic odontology plays a major role in the identification of those individuals who cannot be identified visually or by other means. The unique nature of dental anatomy and placement of custom restorations ensure accuracy when the techniques are correctly employed. It is evident that identification of victims in accidents and natural calamities is of utmost importance and is a challenging task. The teeth may also be used as weapons and under certain circumstances; they may provide information regarding the identity of the biter. Dental professionals play a major role in keeping accurate dental records and providing all necessary information so that legal authorities may recognize malpractices, negligence, fraud child abuse and also, identify an individual. In this article, we will discuss such evolvement of the subject.
Diagnostic utility of cytomorphometric evaluation of exfoliated buccal mucosal cells in age estimation: a systematic review and meta-analysis
(Taylor and Francis Ltd., 2025) R. Keerthika; Akhilesh Chandra; Dinesh Raja; Mahesh R. Khairnar; Rahul Agrawal
Age estimation is a critical aspect of forensic odontology for victim identification. Exfoliative cytology has frequently been investigated for this purpose with variable results, necessitating further exploration. This systematic review and meta-analysis aims to analyze the diagnostic utility of cytomorphometrically evaluated exfoliated buccal cells in living individuals for age estimation. A thorough search was conducted using PubMed, Google Scholar, and Cochrane Library databases. Original research articles that performed exfoliative cytology on healthy individuals and evaluated cytomorphometric parameters were included in this review. The risk of bias was analyzed for each study using the Joanna Briggs Institute criteria, and Review Manager was used for the meta-analysis. Twelve studies, and two subgroups included for qualitative and quantitative data synthesis, revealed a significant decrease in cellular parameters and an increase in nuclear parameters in healthy individuals as age progressed. The random-effects model also confirmed that significantly decreased cellular parameters were associated with an increased risk of advanced age. Mounting evidence confirms that cytomorphometric evaluation of exfoliated buccal cells, specifically cellular parameters, is a useful tool for age estimation. However, it still lacks the credibility to be used as a sole factor for predicting an individual’s age. Therefore, a combination of factors should be considered for age estimation to provide more reliable results. © 2025 The Biological Stain Commission.
Diagnostic Utility of Cytomorphometric Evaluation of Exfoliated Oral Mucosal Cells in Type II Diabetes Mellitus: A Systematic Review and Meta-analysis
(Springer, 2024) R. Keerthika; Akhilesh Chandra; Mahesh Khairnar; Trupti Jain; Neha Singh; Rahul Agrawal
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. © Association of Otolaryngologists of India 2024.
Estimation of gingival crevicular blood glucose level for the screening of diabetes mellitus: A simple yet reliable method
(Elsevier B.V., 2016) Sarita Parihar; Richik Tripathi; Ajit Vikram Parihar; Fahad M. Samadi; Akhilesh Chandra; Neeta Bhavsar
Aim: This study was designed to assess the reliability of blood glucose level estimation in gingival crevicular blood(GCB) for screening diabetes mellitus. Materials and method: 70 patients were included in study. A randomized, double-blind clinical trial was performed. Among these, 39 patients were diabetic (including 4 patients who were diagnosed during the study) and rest 31 patients were non-diabetic. GCB obtained during routine periodontal examination was analyzed by glucometer to know blood glucose level. The same patient underwent for finger stick blood (FSB) glucose level estimation with glucometer and venous blood (VB) glucose level with standardized laboratory method as per American Diabetes Association Guidelines.1 All the three blood glucose levels were compared. Periodontal parameters were also recorded including gingival index (GI) and probing pocket depth (PPD). Results: A strong positive correlation (r) was observed between glucose levels of GCB with FSB and VB with the values of 0.986 and 0.972 in diabetic group and 0.820 and 0.721 in non-diabetic group. As well, the mean values of GI and PPD were more in diabetic group than non-diabetic group with the statistically significant difference (p < 0.005). Conclusion: GCB can be reliably used to measure the blood glucose level as the values were closest to glucose levels estimated by VB. The technique is safe, easy to perform and non-invasive to the patient and can increase the frequency of diagnosing diabetes during routine periodontal therapy. © 2016 Craniofacial Research Foundation.
Evaluation of exfoliative cytology in the diagnosis of oral premalignant and malignant lesions: A cytomorphometric analysis
(Torabinejad Dental Research Center, 2015) Renuka Verma; Anil Singh; Manjunath Badni; Akhilesh Chandra; Shalini Gupta; Ruchita Verma
Background: Many oral squamous cell carcinomas (OSCCs) arise within regions that previously had premalignant lesion. Early diagnosis and prompt treatment of premalignant lesions offers the best hope of improving the prognosis in patients with OSCC. Exfoliative cytology is a simple and non-invasive diagnostic technique that could be used for early detection of oral premalignant and malignant lesions. This study was undertaken to evaluate the quantitative changes in nuclear area (NA), cytoplasmic area (CA) and nuclear-to-cytoplasmic ratio (NA/CA) in cytological buccal smears of oral leukoplakia with dysplasia (OLD) and OSCC patients while comparing with normal healthy mucosa. Materials and Methods: A quantitative study was conducted over 90 subjects including 30 cases each of OLD, OSCC and clinically normal oral mucosa. The smears obtained were stained with Papanicolaou (PAP) stain and cytomorphological assessment of the keratinocytes was carried out. The statistical tools included arithmetic mean, standard deviation, Chi-square test, analysis of variance, Tukey multiple comparison. P < 0.001 was considered as significant. Results: The mean NA of keratinocytes in the normal mucosa was 65.47 ± 4.77 μm 2 while for OLD it was 107.97 ± 5.44 μm 2 and 139.02 ± 8.10 μm 2 for that of OSCC. The differences show a statistically significant increment in NA (P < 0.001). There was significant reduction (P < 0.001) in the CA of keratinocytes from OSCC when compared with those from smears of OLD and normal mucosa with the values of 1535.80 ± 79.38 μm 2 , 1078.51 ± 56.65 μm 2 and 769.70 ± 38.77 μm 2 respectively. The NA/CA ratio in the smears from normal oral mucosa, OLD and OSCC showed a mean value of 0.043 ± 0.004, 0.100 ± 0.008, 0.181 ± 0.015 respectively with a significant difference among the groups (P < 0.001). Conclusion: Evaluation of nuclear and CA of keratinocytes by cytomorphometry can serve as a useful adjunct in the diagnosis and prognosis of a dysplastic lesion which may lead to OSCC.
Evaluation of the effect of nonsurgical periodontal therapy on malondialdehyde and 8-hydroxy deoxyguanosine levels in chronic periodontitis
(Wolters Kluwer Medknow Publications, 2022) Anju Gautam; Neelam Mittal; Surendra Pratap Mishra; Tej Bali Singh; Akhilesh Chandra
Background: Reactive oxygen species released on stimulation by periodontal pathogens cause oxidation of biomolecules and play significant role in periodontal disease pathogenesis. Aim: This study aimed to evaluate the levels of oxidative by-products malondialdehyde (MDA) and 8-hydroxy deoxyguanosine (8-OHdG) as biomarkers in chronic periodontitis patients compared to healthy as well as before and after nonsurgical periodontal therapy. The correlation between biomarkers and clinical attachment level was also evaluated. Settings and Design: A total of 112 subjects were included in this study. The subjects were divided into two groups (Group I included 56 healthy subjects and Group II constituted 56 chronic periodontitis patients) on the basis of clinical periodontal parameters. Materials and Methods: Group I subjects received no treatment and were evaluated once only for clinical and oxidative stress biomarker parameters. Nonsurgical periodontal therapy was carried out in Group II patients and they were evaluated at baseline and 3 months after therapy. Results: Both salivary and serum levels of MDA and 8-OHdG were found to be increased in chronic periodontitis patients as compared to healthy subjects. After nonsurgical periodontal therapy, the levels of MDA and 8-OHdG significantly reduced. Linear correlation between clinical attachment level and oxidative stress parameters was found to be positive and highly significant. Conclusion: It can be concluded that periodontal therapy is effective in improving the oxidative stress condition. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Exotic Keratin Pearl Degradation Mechanism by Giant Cells in Oral Squamous Cell Carcinoma and its Plausible Hypothesis
(Springer, 2024) R. Keerthika; Akhilesh Chandra; Rahul Agrawal
Introduction: Oral squamous cell carcinoma (OSCC) is a formidable malignancy in the Indian subcontinent, characterized by high morbidity and mortality, with a dismal 5-year survival rate of 40–50%. The tumor’s histopathological heterogeneity is well documented, particularly in its differentiation status, which ranges from well-differentiated lesions with prominent keratin pearls to poorly differentiated forms lacking such structures. Objectives: Existing literature has elucidated the role of neutrophils and macrophages in the degradation of keratin pearls, the involvement of multinucleated giant cells (MNGCs) in this process remains cryptic. Case report: This study reports a novel case of a 49-year-old male with moderately differentiated OSCC, characterized by ulcerative growth in the left buccal mucosa. Histopathological analysis revealed neoplastic cell infiltration, keratinization, and abnormal mitoses, alongside the degradation of keratin pearls by large foreign body and Langhans MNGCs. This intricate keratin pearl degradation by MNGCs in OSCC highlights tumor heterogeneity and aggressiveness, offering profound insights into surgical, radiotherapy, and chemotherapy strategies. Surgeons must meticulously consider this process as a marker of aggressive behavior, warranting precise surgical planning and a multidisciplinary approach for optimal outcomes. Conclusion: This case emphasizes the critical role of foreign body and Langhans MNGCs in the degradation of keratin pearls within OSCC, revealing a hitherto unrecognized facet of tumor biology. This discovery holds profound implications for understanding OSCC progression, prognosis, and therapeutic responsiveness, warranting further investigation into the molecular mechanisms underpinning this process. © The Association of Oral and Maxillofacial Surgeons of India 2024.
Exploring the role of angiogenesis in fibrosis and malignant transformation in oral submucous fibrosis: a systematic review and meta-analysis
(Korean Association of Oral and Maxillofacial Surgeons, 2024) R. Keerthika; Akhilesh Chandra; Dinesh Raja; Mahesh Khairnar; Rahul Agrawal
Angiogenesis is a crucial molecular driver of fibrosis in various inflammatory lesions. Oral submucous fibrosis (OSMF) is a chronic inflammatory fibrotic disorder with malignant potential. The angiogenetic pathways in OSMF remain obscure due to limited research, necessitating an in-depth review. This review aimed to illuminate the cryptic pathogenetic mechanisms of angiogenesis in the disease progression/fibrosis of OSMF and its malignant transformation, providing insights for improved treatment. Extensive literature searches were conducted across an array of databases until October 2023. Original research articles on angiogenesis in OSMF were included, and the risk of bias was assessed using the modified Newcastle-Ottawa scale. RevMan ver. 5.4 (Cochrane Collaboration) was used for data analysis. Thirty-four articles were included for qualitative synthesis and seven for quantitative analysis. Findings revealed that angiogenesis was significantly increased in early-stage OSMF but decreased as the disease advanced. It was also associated with the severity of epithelial dysplasia and malignant transformation. A random-effects model confirmed the upregulation of angiogenesis as a significant risk factor in early-stage fibrosis and malignant transformation. The mounting evidence reinforces that angiogenesis plays a crucial role in the progression of early-stage fibrosis of OSMF and its malignant transformation, opening avenues for diagnostic and therapeutic interventions. © 2024 The Korean Association of Oral and Maxillofacial Surgeons.
HIF-1/2α: The Silent Architects of Adenoid Cystic Carcinoma—A Systematic Review and Meta-Analysis
(John Wiley and Sons Inc, 2025) R. Maheswari; Akhilesh Chandra; Rahul Agrawal
Background: Adenoid cystic carcinoma (AdCC) is a rare, aggressive salivary gland malignancy with a poor prognosis due to metastasis and local recurrence. Although hypoxia-inducible factors-1/2α (HIF-1/2α) play crucial roles in AdCC, their pleiotropic effects remain poorly understood. This systematic review and meta-analysis evaluates the impact of HIF-1/2α in AdCC progression. Methods: A comprehensive literature search was conducted across PubMed, Scopus, EMBASE, and Web of Science to identify studies examining HIF-1/2α in AdCC. Study quality was assessed using the modified Newcastle-Ottawa scale, and meta-analyses were performed using IBM SPSS Statistics (Version 29). Results: Sixteen studies met inclusion criteria, with 10 studies encompassing 650 AdCC cases included in the meta-analysis. Positive HIF-1/2α expression was reported in 77.4% of AdCC cases (95% CI: 0.630–0.919, p < 0.001) and was significantly correlated with tumor size (OR: 0.38, 95% CI: 0.16–0.89, p = 0.03), advanced stage (OR: 2.86, 95% CI: 1.74–4.71, p < 0.001), and distant metastasis (OR: 1.82, 95% CI: 1.02–3.25, p = 0.04). Human studies demonstrated significantly increased HIF-1/2α protein and mRNA expression in AdCC cases compared to control groups. Solid-type AdCC exhibited predominantly higher nuclear HIF-1α expression than cribriform and tubular subtypes. Additionally, in cell culture models, the hypoxia-induced upregulation of these factors increased the expression of VEGF (20-fold), BNIP3 (6-fold), and NID1, promoting angiogenesis, epithelial–mesenchymal transition, autophagy, and invasiveness. Conclusion: HIF-1/2α emerge as a pivotal drivers of AdCC progression, serving dual roles as prognostic biomarker and therapeutic target, necessitating further clinical investigation through multicenter validation studies. © 2025 John Wiley & Sons Ltd.
High-resolution AI image dataset for diagnosing oral submucous fibrosis and squamous cell carcinoma
(Nature Research, 2024) Nisha Chaudhary; Arpita Rai; Aakash Madhav Rao; Md Imam Faizan; Jeyaseelan Augustine; Akhilanand Chaurasia; Deepika Mishra; Akhilesh Chandra; Varnit Chauhan; Tanveer Ahmad
Oral cancer is a global health challenge with a difficult histopathological diagnosis. The accurate histopathological interpretation of oral cancer tissue samples remains difficult. However, early diagnosis is very challenging due to a lack of experienced pathologists and inter- observer variability in diagnosis. The application of artificial intelligence (deep learning algorithms) for oral cancer histology images is very promising for rapid diagnosis. However, it requires a quality annotated dataset to build AI models. We present ORCHID (ORal Cancer Histology Image Database), a specialized database generated to advance research in AI-based histology image analytics of oral cancer and precancer. The ORCHID database is an extensive multicenter collection of high-resolution images captured at 1000X effective magnification (100X objective lens), encapsulating various oral cancer and precancer categories, such as oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC). Additionally, it also contains grade-level sub-classifications for OSCC, such as well- differentiated (WD), moderately-differentiated (MD), and poorly-differentiated (PD). The database seeks to aid in developing innovative artificial intelligence-based rapid diagnostics for OSMF and OSCC, along with subtypes. © The Author(s) 2024.
Immunohistochemical analysis of plasmacytoid myoepithelioma of minor salivary glands: A case report with review of literature
(Wolters Kluwer Medknow Publications, 2016) Adit Srivastava; Rahul Agarwal; Shivakumar Ganiga Channaiah; Akhilesh Chandra
Myoepithelioma (ME) is a rare benign neoplasm of salivary gland, which commonly originates from parotid gland. Limited number of cases originating from the minor salivary gland tissue have been reported. MEs have characteristic histopathologic and immunohistochemical features, helping in its definitive diagnosis. Here, we present a case of plasmacytoid ME of the palate with review of literature. To the best of our knowledge, only 19 such cases have been reported in literature till date. © 2017 Journal of Indian Academy of Oral Medicine & Radiology.
Insights of dental postgraduate students and guides toward change in MDS examination pattern: A cross-sectional study
(Wolters Kluwer Medknow Publications, 2022) Shrivardhan Kalghatgi; Mahesh Khairnar; Tanushri Dalvi; Archana Dwivedi; Hrishikesh Saoji; Akhilesh Chandra
Introduction: According to the notification dated May 17, 2018, no. DE-14-MDS-2018/2131 published by the Dental Council of India, basic sciences theory examination (Paper-1) will be conducted before the commencement of II-year MDS academic year instead of III-year MDS end. Hence, this study was conducted to assess the opinions regarding this recent change in the curriculum among I MDS students, II MDS students, and their respective postgraduate (PG) guides. Methodology: The study was conducted on 120 participants from three dental colleges. All the participants were interviewed using a pretested, structured questionnaire. The initial part of questionnaire consisted of demographic information of the study participants followed by ten questions targeted to assess the perception toward change in MDS examination pattern. Statistical analysis was performed using SPSS software v20, and Chi-square test was used for comparison of responses among PG students and PG guides. Results: Questions pertaining to the need of allowed to keep term (ATKT), assumption to improved concentration on specialization subjects, and increase in understanding of the subject have received maximum positive response. Negative responses were more for the questions such as hampering of PG curriculum, effect on dissertation selection process, and rendering quality treatment to the patient. Responses to necessity of ATKT and the assumption to better concentrate on specialization subject later differed significantly among the participants. Conclusion: The present study results revealed an overall positive perception toward the change in MDS curriculum pattern among the study participants. © 2022 National Journal of Maxillofacial Surgery | Published by Wolters Kluwer - Medknow.
Master Regulator: Angiogenesis in the Pathogenetic Mechanism of Oral Submucous Fibrosis
(Springer, 2025) R. Keerthika; Akhilesh Chandra; Rahul Agrawal
[No abstract available]
Mitochondrial Dysfunction in Oral Carcinogenesis: Insights from Exfoliative Cytology
(Springer, 2025) R. Keerthika; Jadhav Sachin Kumar; Akhilesh Chandra; Rahul Agrawal
Background: Oral squamous cell carcinoma (OSCC), a growing global health concern, is often preceded by oral potentially malignant disorders (OPMDs). Emerging evidence suggests mitochondrial dysfunction is crucial in carcinogenesis, affecting malignancy’s aggressiveness. This study uses Janus Green B (JGB) staining to investigate mitochondrial dysfunction in OPMDs and OSCC and examines its relationship with tobacco exposure to better understand its etiopathogenesis. Materials and Methods: Utilizing the exfoliative cytology technique, thirty buccal smears of epithelial cells from normal, OPMD and OSCC samples were collected and subjected to JGB staining. The intensity of staining and the total percentage of positively stained cells were quantified and subsequently correlated with clinicopathological parameters. Results: The mean values of varying grades of staining intensity including mild, moderate, and high as well as the total percentage of positive cells, demonstrated statistically increased significant differences among control, OPMD, and OSCC cases. Additionally, moderate, high-grade staining intensity and the total positive stained cells exhibited significant correlations with tobacco use frequency and duration. A cut-off value of 44.31 and 51.32 of JGB-positive cells was found to categorize the cases into high-risk OPMDs and OSCC transformation. Conclusion: The progressive increase in staining intensity and the number of positive cells from OPMDs to increasing histopathological grades of OSCC highlights mitochondrial dysfunction as a key factor in oral carcinogenesis and a reliable indicator for assessing malignant transformation in OPMDs and aggressive potential in OSCC. Furthermore, the study underscores tobacco as a primary cause of mitochondrial dysfunction in both OPMDs and OSCC. © Association of Otolaryngologists of India 2025.