Browsing by Author "Rahul Agrawal"

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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
Chondroblastic Osteosarcoma in an Adolescent: Are Conventional Biopsy Techniques Just Scratching the Surface?
(Springer, 2025) Neeraj Kumar Dhiman; Arjun D. Mahajan; Trupti Jain; Ajit Kumar Vishwakarma; Rahul Agrawal
Osteosarcoma, although the most common malignant bone tumor in long bones, represents only 5–8% of head and neck tumors, making it uncommon for clinicians. Conventional biopsy techniques can complicate diagnosis due to varying tissue representation in surrounding areas. This article discusses a case involving a 19-year-old female who presented with facial swelling and a rapidly growing intraoral mass. Initial panoramic radiography showed localized radio-opacity and root resorption. Incisional biopsies initially suggested diagnoses of ossifying fibroma and fibrous hyperplasia, which did not align with the clinical presentation. Repeat excisional biopsy extending to the periosteum revealed findings consistent with chondroblastic and fibroblastic proliferation, including malignant osteoid and myxomatous stroma, confirming chondroblastic osteosarcoma. The patient subsequently underwent neo-adjuvant chemotherapy followed by surgical resection and radiotherapy. This case underscores the critical importance of timely and accurate diagnosis in osteosarcoma, as delays can significantly impact patient prognosis. The article emphasizes the lessons learned from such experiences in managing this challenging malignancy. © Association of Otolaryngologists of India 2024.
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.
Correlation between fasting blood sugar and cytomorphometric values of diabetic patient's buccal mucosa exfoliative cytology
(Wolters Kluwer Medknow Publications, 2018) Rahul Agrawal; Naresh Kumar; Kanupriya Gupta; Tej Bali Singh
Objectives: Type-2 diabetes mellitus (DM) has considerable prevalence in India. A noninvasive diagnostic tool will be more appropriate in conditions like DM. In this study, we intend to find a difference in cytomophometric values, and glycogen accumulation (if any) in buccal mucosa exfoliated cells of type-2 DM patients when compared to nondiabetic healthy individuals, and establish its diagnostic role. Methodology: In the present study, 36 known DM patients with at least 1-year history (case group) and 36 healthy, age- (5 year interval) -matched patients (control group) were included in the study. Patients with any other systemic disease were excluded from the study. Buccal mucosa exfoliative cytology smears were prepared from all 72 patients and stained with Papanicolaou (PAP) stain. The cytomorphometric analysis was performed to evaluate nuclear area (NA), cytoplasmic area (CA), and cytoplasm to nuclear area ratio (CNR) of cells in the smear. The data were tabulated and statistically analyzed using Chi-square test, Student's t-test, Karl Pearson's correlation coefficient and significance (two tailed) test. Results: Statistically significant difference was found in NA and CNR in exfoliative cytology of DM patient group when compared to control group. Fasting blood sugar of DM patients was significantly correlated with NA and CNR of buccal mucosa exfoliated cells. Conclusion: The cytomorphometric changes in exfoliated buccal mucosa cells of type-2 DM patients can have a diagnostic value which needs to be explored further. © 2016 Journal of Cancer Research and Therapeutics.
Dental care for the deaf pediatric patient
(2012) Rajat K. Singh; Kritika Murawat; Rahul Agrawal
Great strides have been accomplished recently in providing better medical services for handicapped children. As the dentist begins to understand the complexity of each particular form of handicap and its characteristics, he is able to plan more efficiently for satisfactory treatment. Because many dentists do not understand deafness and the unique problems that deaf children exhibit, inadequate dental care for deaf children still ensues. Handicapped persons are at a greater risk for dental disease, for the most part, because of greater neglect or poor oral hygiene and access to routine dental care. Deaf patients in particular often fail to obtain needed care because of communication difficulties experienced in the treatment situation.
Dermatillomania: In patient undergoing orthodontic treatment
(Wolters Kluwer Medknow Publications, 2014) Adit; Avesh Sachan; T.P. Chaturvedi; Rahul Agrawal; Ajit Vikram Parihar
Dermatillomania is a disorder in which a person habitually picks their skin, and this is a form of self-injury. It can involve any part of the body, but usually involves the face, neck, arms and shoulders. Symptoms often follow an event that has caused severe emotional distress. A dermatillomania or compulsive skin picking episode may be a conscious response to anxiety or depression but is frequently done as an unconscious habit. In this case report, a patient undergoing orthodontic treatment was found to be suffering from dermatillomania and was treated using psychological counseling.
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.
Effect of Surface Nanostructuring on Gene Expression for Protein Synthesis, Osteoblast Cells Recruitment and Size of Focal Adhesion: A Review
(Apple Academic Press, 2022) Nancy Raj; Rahul Agrawal; K. Chattopadhyay; R. Bansal; V. Singh
Dental implants provide oral rehabilitation by mimicking bone topography, faster bone formation, and rapid bone healing to enable early loading protocol with better stability. The dental implant surface affects the mechanical stability of the implant affecting cell adhesion and osteogenic cell response. Different techniques have shown biological advantages through increase in surface wettability, surface roughness, and altered surface topography. These have benefitted osseointegration in both healthy as well as a compromised bone through its underlying cellular mechanisms. The effects of nanostructuring are discussed in this chapter in terms of gene expression, biochemical stimuli, biocompatibility, corrosion resistance, cell metabolism, and its differentiation. © 2022 Apple Academic Press, Inc.
Evaluation of efficacy of platelet-rich fibrin membrane and bone graft in coverage of immediate dental implant in esthetic zone: An in vivo study
(Wolters Kluwer Medknow Publications, 2020) Romesh Soni; Aditi Priya; Rahul Agrawal; Atul Bhatnagar; Lakshya Kumar
Objective: This study compared and evaluated the clinical and radiographic results of guided bone regeneration using platelet-rich fibrin (PRF) and collagen membrane as barrier membrane in immediately placed implants with severe buccal bone defect (with respect to marginal bone level, implant stability quotient [ISQ]), and histological analysis of new bone formation. Materials and Methods: Sixteen implants were placed in patients requiring immediate implant placement and having a buccal wall defect and randomly divided into two groups one receiving PRF membranes and other collagen membrane. The sites were grafted with bone-substitute material in both the groups. After 4 months, at the time of second-stage surgery, implant stability is measured by Osstell Mentor, crestal bone level on mesial and distal sides of implant by digital intraoral periapical, buccal defect clinically by probe and histological analysis of biopsied bone. Results: The results were insignificant and comparable in both the groups when comparison was made between the groups. The mean buccal defect, mean values of average ISQ, crestal bone level in both the groups at baseline and after 4 months were compared. No significant difference between both the groups was found after 4 months. Bone quality seemed to be equal in both groups after histological analysis. Within the limits of the study, both the groups had shown similar results in all criteria. Conclusion: Within the limitation of the study, it can be concluded that both the treatment modalities are successful in terms of buccal defect reduction, stability, and increase in crestal bone level. © 2020 National Journal of Maxillofacial Surgery.
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.
Extranodal diffuse large B cell Non-Hodgkin's lymphoma of maxilla: An immunohistochemical study based diagnostic approach
(Elsevier Ltd, 2020) Akhilesh Kumar Singh; Rahul Agrawal; Janani T; Keshav Kumar
Lymphomas are solid cohesive neoplasm, originating from the cells of immune system, having diverse presentation. NHL is the third most common group of malignant tumors. Incidence of NHL in extra-nodal sites is approximately 20–30%. Diffuse large B cell Non-hodgkin's lymphoma (DLBCL) is the most common histological variant of lymphoma. This report discusses a case of Non-Hodgkin's lymphoma in an 80-year male patient with clinical presentation of non-healing painless ulceroproliferative growth, which mimics squamous cell carcinoma. © 2020 Asian AOMS(+) ASOMP(+) JSOP(+) JSOMS(+) JSOM(+) and JAMI
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.
Immunohistochemical expression of Ki-67 and Glypican-3 to distinguish aggressive from nonaggressive benign odontogenic tumors
(Wolters Kluwer Medknow Publications, 2022) T. Chaturvedi; Kanupriya Gupta; Rahul Agrawal; P. Naveen Kumar; Jatin Gupta
Background: The benign neoplasms are normally slow growing, indolent with no invasive potential. However, there exist a few locally aggressive benign odontogenic tumors that have a tendency to invade and deform the surrounding structures. The exact reason for the aggressiveness of these benign neoplasms remained an enigma. Their biology and clinical expression can often be destructive and ominous. An appropriate treatment protocol needs to be followed to combat the high recurrence rate and aggressiveness of these entities. Aggressive and noniaggressive epithelial odontogenic tumors were analyzed immunohistochemically with Ki-67 and glypican 3 (GPC3). Materials and Methods: Fifty-nine cases of tumors were divided into aggressive odontogenic tumors (20 solid ameloblastomas, four unicystic ameloblastoma, and 28 keratocystic odontogenic tumors) and nonaggressive odontogenic tumors (five adenomatoid odontogenic tumors and two calcifying cystic odontogenic itumors). Results: Statistical analysis using Pearson correlation showed Ki-67 to be a better marker for differentiating aggressive from nonaggressive odontogenic tumor as compared to GPC3 (P < 0.001, highly significant), whereas among aggressive tumors, GPC3 turned out to be more useful as compared to Ki-67 (P < 0.001, highly significant). Conclusion: The present study provides an insight into the different biological behavior of odontogenic tumors, which can thus be helpful in determining the therapy strategies for more aggressive odontogenic tumors. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Lobster claw deformity
(Medknow Publications, 2014) Ashish Agrawal; Rahul Agrawal; Rajat Singh; Romi Agrawal; Seema Agrawal
Endogenous erythroid colony (EEC) syndrome comprise of three cardinal features, i.e. ectrodactyly, ectodermal dysplasia and cleft lip. EEC itself has three different forms. Ectrodactyly (absence of one or more digits) can be present with clefting in the proximal portion of hand or foot known as split hand foot malformation (SHFM) or lobster claw deformity. SHFM can be of four types depending upon the different responsible chromosomal loci. SHFM-4 can be present as pure limb malformation (non-syndromic form). In this article, describes a rare case report of lobster claw deformity patient.
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.