Forensic odontology and anthropology play an important role in the identification of humans/victims in mass disasters (accidents and earthquakes) and criminal cases (homicide, rape and suicide) even if less available human remains or samples. Forensic also helps in the identification of age, sex, stature estimation and race identification using photographs, bite marks, lip prints, palatal rugae, radiographs and dental DNA identification if antemortem records are available. Here, we review the available methods of human identification. Cone-beam computed tomography of the skull showed superiority in comparison of both facial skeletal and soft tissue to examine the teeth, occlusion, palatal rugae, soft tissue thickness and other unique features.

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Background: In microscopic assessment of mineralized tissue, decalcification is an important step during tissue processing. The present study was attempted to compare the efficacy of various decalcifying agents and to evaluate the most efficacious decalcifying agent. Aims and Objectives: The aim was to study and compare the time taken for complete decalcification of the specimen by six different chemical agents; to study and compare the effect of various decalcifying agents on cellular and nuclear changes of hard and soft tissues; to study and compare the effect of various decalcifying agents used on the staining intensity with Ehrlich's Hematoxylin and Eosin stain and to determine the ideal decalcification technique. Materials and Methods: The six decalcifying agents, namely 5% nitric acid, 8% formic acid, formalin-nitric acid, 5% trichloroacetic acid, neutral ethylenediaminetetraacetic acid (EDTA) and Perenyi's fluid were used to decalcify 30 human permanent teeth (5 teeth in each solution). The endpoint of decalcification was evaluated by chemical (calcium oxalate test) as well as radiographic methods. The specimens were then subjected to processing, sectioning and staining with hematoxylin and eosin. The stained sections were observed under a light microscope and grading was done. Results: The results in the present study confirmed the fact that the time required for complete decalcification process was least in Perenyi's fluid, 5% trichloroacetic acid and highest in 14% EDTA. Teeth decalcified in 5% trichloroacetic acid, 8% formic acid, formalin-nitric acid and 5% nitric acid were easy to section. Sectioning was most difficult for teeth decalcified in Perenyi's fluid and 14% EDTA. The overall structure details as well as staining characteristics were best in teeth decalcified by 5% trichloroacetic acid and neutral EDTA and worst in teeth decalcified by Perenyi's fluid. Conclusion: Five percent trichloroacetic acid was showing the most efficient result as it balances both tissue integrity and time factor suggesting that it can be used as a stable decalcifying agent for routine histopathological diagnosis.

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Introduction: Oral malignancies account for about 4% in males and 2% in females among all malignant tumors. Tobacco use in the oral cavity can cause potentially malignant disorders such as oral submucous fibrosis (OSMF), leukoplakia and oral squamous cell carcinoma (OSCC). Factors such as lifestyle changes, habits and limited access to health care increase cancer development and morbidity. Aim and objectives: This study aimed at studying and correlating the oral mucosal changes among the tobacco users with the different forms of tobacco used. Materials and Methods: Four thousand and five hundred individuals were examined and patients with habits were categorized as Group A: only chewing, Group B: only smoking and Group C: smoking and chewing. A preformed case sheet with a detailed recording of the patient's habits was used for each individual. The suspected oral lesions were examined with care and a biopsy was taken (if needed) with patient consent. The collected data were compiled and statistical analysis was done. Results: Among the three groups OSMF, chewer's mucositis, smoker's palate and OSCC were more compared to other lesions. Conclusion: OSCC, OSMF and chewer's mucositis were seen more among A and C Group individuals. Smoker's palate was more in Group B. All the lesions showed a strong correlation with increased usage of tobacco. Lesions were more among males compared to females as there were no females with smoking habits in the study. A future study with larger sample size and equal gender distribution in different population among various locations is to be carried out to get accurate details about the lesions associated with tobacco habits and to correlate between the types, frequency and duration of the habit with the tobacco usage.

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Context: Early oral cancer diagnosis is an important factor in reducing cancer-associated mortality and morbidity. Traditional oral cancer screening by Conventional Oral Examination (COE) is limited. A new approach in this regard is the use of “optical biopsy systems” like VELscope. Aims: Hence, this study aimed to determine the diagnostic value of VELscope, an autofluorescence-based handheld device in detection of dysplasia and oral squamous cell carcinoma (OSCC) in general oral potentially malignant disorder. Settings and Design: A prospective, cross-sectional study was conducted at a tertiary hospital in western Maharashtra, India. Materials and Methods: Thirty patients with presence of clinically suspicious oral lesions were included, and for each lesion, both the COE and Autofluorescence Examination by VELscope were carried out at the same appointment by different experts. All lesions were biopsied and histopathological findings were documented and analyzed. Statistical Analysis Used: Sensitivity, specificity, positive predictive value and negative predictive value were estimated to determine the accuracy of VELscope examination analysis outcome. Results: The study included a total of 30 subjects including 19 (63.33%) males and 11 (26.66%) females. Autofluorescence examination by VELscope (AFV) revealed Autofluorescence Loss in 24 (80%) patients, while 6 (20%) patients showed Autofluorescence Retained. Comparison between the “high-risk lesions” (moderate/severe dysplasia and OSCC) and “low-risk lesions” (no/mild dysplasia) showed a 90.47% sensitivity but only 44.44% specificity. Conclusions: The findings of our study indicate that although AFV cannot be a substitute for COE, it can be used as a potential complementary diagnostic aid in surveillance of the high-risk patient population.

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Background: The pandemic outbreak of COVID-19 highlighting the zoonotic cross-over link in the present century has provoked an emergency worldwide. Recent experimental evidence supporting the proposition of ABO blood grouping and its susceptibility in certain blood group individuals has created interest among researchers to explore more. Aim: The aim of this study is to find the susceptibility of “ABO” blood group in COVID-19-positive cases. Objectives: Association of ABO blood group patterns with COVID-19-positive cases. Materials and Methods: A cross-sectional, observational study design was conducted among 728 confirmed positive COVID-19 admitted to the tertiary health care center in Maharashtra from June 01, 2020 to August 31, 2020. The inclusion criteria were COVID-19-positive cases confirmed by positive real-time reverse transcriptase-polymerase chain reaction test of severe acute respiratory syndrome coronavirus 2. We collected the demographic details, associated clinical symptoms and ABO blood groups from all the patients. The data collected were subjected to statistical analysis. Results: The most common blood group affected was B + (35.5%) followed by A + (26.10%), AB + (20.60%) and O + (11.18%) and the least common was AB- (0.96%), O- (1.51%), A- (1.65%) and B- (1.79%). Conclusions: ABO blood grouping can be used as one of the simplest yet efficient markers for COVID-19. Blood group B Rh-positive and A Rh-positive were the most prevalent blood group types in patients with COVID-19.

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Background: It becomes extremely challenging for forensic artists to reconstruct the highly decomposed faces, especially during mass disasters. It would be of great help for the identifying team of experts if there was a method to determine the facial and cephalic dimensions. This study aims to provide a method to generate a simplified method to calculate the facial and cephalic indices of an individual based on the dentition since human dentition remains almost intact in most scenarios. Materials and Methods: The sample consisted of 200 participants with the age range of 18–23 years belonging to Kerala. The cephalic and facial indices were measured using a caliper. The interincisal, intercanine, interpremolar and intermolar widths of maxillary dentition were measured on study models using a digital vernier caliper. The mean cranial and facial index were calculated and were correlated with interdental measurements. Results: It was concluded that dominant head types in Kerala males were dolichocephalic (50.2%) followed by mesocephalic (29.8%). In females, the dominant head types were dolichocephalic (42.7%) followed by mesocephalic (42.2%). In the facial types, majority of individuals were found to be leptoprosopic. A good correlation was found between the intercanine width with facial width and cranial width and a simplified formula were derived to estimate the cranial and facial index for this population. Conclusion: The results of the study suggest that the facial index and cranial index of a particular population can be evaluated from interdental measurements of the maxillary cast, especially the intercanine width.

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Various treatment modalities have been practiced for the suppression of premalignant conditions such as oral submucous fibrosis (OSMF) to prevent their differentiation into malignant lesions. Conventional treatment includes steroids, enzymes like hyaluronidase, trypsin, chymotrypsin and placental extracts which are advocated intralesionally and oral drugs like carotenoids, alpha lipoic acid, lycopene, vitamins, microelements and tea pigments have also been advocated. In this study, a total number of 30 patients with OSMF were taken and randomly divided into two groups with 15 patients each according to Khanna and Andrade group of classification 1995. Group 1 (test group) received the test drug Tretiome 20 mg, whereas Group 2 (control group) received an antioxidant lycopene 20 mg/day for a period of 1 month and the effect of the therapy with the changes in the symptoms was recorded every 1 week, 15 days and 30 days of follow-up. The result of this study showed an improvement in the mouth opening of the patients of test Group with a significant decrease in the burning sensation as compared to the control group (P < 0.05). Xerostomia and headache were the two most commonly seen side effects which were reported in the patients of the test group, of which headache was associated with the withdrawal symptom of habit cessation and xerostomia was taken care by increase in hydration.

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Background: Diabetes is one of the most important causes of mortality worldwide. People having diabetes are vulnerable to infectious diseases and have been clinically recognized; which may be because of their deregulated immune system. Hyperglycemia in diabetes is consequence of chronic resistance to insulin and relative insulin deficiency on target cells. Alpha-amylase, a salivary enzyme is shown to increase in diabetic individuals compared to nondiabetics and can be used as a marker for the diagnosis of diabetes. Aim and Objective: The present study was undertaken to investigate the levels of salivary amylase in type II diabetic patients. Materials and Methods: A total of 80 participants in the age range of 30–60 years, were divided into three groups as Group I: Uncontrolled diabetics (30), Group II: Controlled diabetics (30) and Group III: Age- and sex-matched healthy controls (20) were taken for the study. Unstimulated whole saliva was collected for salivary amylase level estimation and blood samples were from the antecubital vein, after 12 h of overnight fasting of each individual for the estimation of blood glucose levels. Results: The mean random blood sugar and glycated hemoglobin A_1c levels were found to be statistically significant among diabetics and healthy individuals. Salivary amylase levels were much higher in uncontrolled and controlled diabetics compared to healthy individuals showing a significant correlation (P = 0.001) between all groups. However, the salivary amylase levels nonsignificant (P = 0.060) between the controlled diabetics (Group II) and healthy individuals (Group III). Conclusion: Our study confirms the considerable increase in salivary amylase levels in diabetes patients as compared to healthy individuals. Studies with a larger sample size comprising prediabetics, type I diabetics and type II diabetics in all age groups are required to validate these results. Further, if our results are established, salivary amylase can be used as biomarker for the diagnosis of diabetes and also monitoring it.

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The emerging (COVID-19) pandemic is a global health disaster, caused by infection with severe acute respiratory syndrome coronavirus-2. The disease spreads at an alarming rate all over the world and presents a range of disease manifestations including asymptomatic, mild, moderate and severe symptoms irrespective of age groups. Most patients with severe symptoms exhibit underlying comorbidities such as diabetes, hypertension and obesity. Alternatively, there is an existing evidence for an association between oral health and nonoral systemic diseases. Since the oral cavity is a significant pool for many respiratory pathogens, patients with oral infections are more likely to develop pneumonia as a complication. Therefore, we emphasize that the oral hygiene status has a great impact on the recession and progression of oropharyngeal and respiratory diseases.

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Herbal rinses possess different medicinal properties. Numerous studies have reported the usefulness of various herbal oral rinses. Few studies claimed that herbal rinses are superior to synthetic mouth rinses for certain purposes, but there appears to be a lack of sound scientific evidence to prove the efficacy of herbal rinses in controlling oral plaque in cancer patients. This review analyses the various clinical studies on herbal rinses and aims to find the safety and efficacy of red ginseng mouth rinses over other available mouth rinses in carcinoma patients. A thorough electronic search was conducted in various databases and 10 articles were included in the review based on the inclusion and exclusion criteria. The data extracted were tabulated and analyzed. The risk of bias table was drawn. Meta-analysis was not performed due to the heterogeneity of the included studies. Of the 10 clinical trials included in the review, three studies appeared to have low risk of bias. The mean follow-up period was 14 days, ranging from 7 to 21 days. The sample size in each study was reported to be between 10 and 50, except one study with 240 samples. Seven studies have reported a significant difference between the herbal mouth rinse group and the chlorhexidine group. Of all the herbal rinses, mouth rinses with ginger extracts show more efficacy over other herbal rinses and red ginseng appears to be a more safer herbal rinse. Based on the available evidence, herbal mouth rinses are comparable to synthetic mouth rinses in their anti-bacterial properties. The red ginseng with anti-bacterial, anti-inflammatory and anti-cancerous properties may be an alternative mouth rinse in cancer patients. However, further clinical trials with more samples are required for better evidence.

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Background: It has been reported that oral squamous cell carcinoma (OSCC) is associated with the presence of potentially malignant disorders (PMDs) in 15%–48% of cases. Among PMDs, oral leukoplakia (OL) is the most common, with 16%–62% of cases associated with OSCC. Hence, in the present study, we have analyzed demographic data and re-evaluated immunohistochemical (IHC) data of OL cases and aimed to correlate the clinical, histopathological and IHC aspects of OL. Materials and Methods: The data of histopathologically diagnosed cases of OL were retrieved from the archives. These data were further evaluated for age, gender, duration, site, size, side, habits, clinical staging and histopathological grading. IHC re-evaluation of OL tissues was done using epithelial cadherin (E-cadherin), n = 20; human MutL homolog 1 (hMLH1), n = 30; CD1a (n = 30); vimentin (n = 30); Ki-67 (n = 30); heat shock protein-70 (HSP-70), n = 30; p16^INK4, n = 20; and mucin-1 (MUC1), n = 30. All the results and observations were subjected to descriptive statistical analysis. Results: The male: female ratio was 7.5:1; right side and buccal mucosa were more commonly affected. The duration of the lesion ranged from 1 to 30 years. One hundred and twelve patients were habituated to tobacco chewing, while 171 patients came with a combined habit of smoke and smokeless tobacco usage. Clinically, most of the lesions were of stage 2 while histopathologically they were of mild dysplasia. There was a decrease in the immunoexpression of E-cadherin, hMLH1 and CD1a, while there was an increase in the immunoexpression of vimentin, Ki-67, HSP-70, MUC1 and p16^INK4. Conclusion: The study of different biomarkers such as cytoplasmic, membranous and nuclear in OL will help in better understanding and application of a reliable marker for diagnostic and prognostic purpose.

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Introduction: Palatorugoscopy is the term used to study the rugae patterns. The word rugae came from the Greek word seam. Moreover, it relates the crisscrossing or joining or stitching of the parts of two biological structures during fetal differentiation. The aim of this study is to determine the gender difference in rugae pattern with regard to length, number, shape, unification and direction in the population of Sri Ganganagar, Rajasthan. Objective: The objective is to determine the gender difference in rugae pattern with regard to length, number, shape, unification and direction; to investigate the difference in division of rugae in males and females and to compare rugae pattern in males and females of different age group. Materials and Methods: This study included 100 subjects, in which 50 were males (Group A) and other 50 were females (Group B). After the formation of primary cast, all quantitative as well as qualitative characteristics of palatal rugae patterns were recorded. Mainly, two classifications were used in this study, Thomas et al. and Kapali et al. Statistical Analysis: Student t-test was used, and “P” value of <0.05 was considered statistically significant. Results: A statistically significant value was found in left-sided palatal rugae patterns depending upon the size, where we found that primary rugae were more in males. On comparing the angulation of palatal rugae patterns of left-sided rugae, a statistically significant value was found among the negative angulation which was higher in male subjects. Next, while comparing the angulation of palatal rugae of right side, we found a statistically significant value among zero (perpendicular rugae), which was more in male population. On comparing the unification of right-sided rugae patterns, we found that divergent rugae were more in male subjects. Conclusion: Palatal rugae patterns act as individualistic, and are unique patterns, and are helpful in determining the human gender. Further, more studies are required on palatal rugae patterns used in forensics on large population scale.

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Introduction: Candida is most common fungal pathogen in the immunocompromised and medically ill patients. Higher prevalence of Candidaalbicans has been reported in tobacco users and oral squamous cell carcinoma (OSCC) patients which may be due to immunosuppression. Recently, emergence of nonalbicans candida (NAC) species resistant to conventional antifungal treatment has been observed that requires accurate identification of organisms at species level for reduction of progression of suspicious oral lesions toward malignancy. Aims and Objectives: To detect and compare the prevalence of C.albicans and NAC species smokeless tobacco chewers, histopathologically confirmed oral squamous cell carcinoma patients and the normal individuals. Effectiveness of automated Vitek 2 system in comparison to HiCrome agar color media in the identification of the candida species was also evaluated. Methodology: One hundred and fifty patients (90 males, 60 females) aged between 20 and 76 years were divided into three groups: Group I individuals with habit of chewing Gutka, and betel quid/pan masala with or without tobacco, Group II individuals with clinically and histopathologically confirmed oral squamous cell carcinoma and Group III comprised of controls. Salivary samples were cultured on HiCrome agar color media and results were compared with those of Vitek 2 system in the accurate identification of candida species. Data were statistically analyzed and Chi-square test was used to estimate the effectiveness of color and Vitek method in the identification of candida species in all the three groups. P < 0.05 was considered to be statistically significant. Results: HiCrome agar color method identified six candida isolates C.albicans,Candidatropicalis, Candidakrusei and Candidaglabrata isolates in all the three groups, with 0.00 unidentified organisms (P = 0.00001) whereas VITEK 2 system identified five isolates of candida; C.albicans,Candidafamat,Candidaciferri,Candidagulleri,C.tropicalis, unidentified organisms were observed in 26% of subjects. Further confirmation by supplemental tests indicated the presence of two or three organisms of different species/or subspecies with low reactivity biopattern. Higher incidence of opportunistic infections was seen in Group II OSCC patients (P = 0.00001). Conclusion: The results suggested that there is shift toward NAC species, with higher species diversity in OSCC patients followed by gutka, betel quid/pan masala with or without tobacco users. Conventional agar media culture methods of species identification should be used in conjunction with automated Vitek 2 method for better control of candida-associated oral cancer.

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Herpes zoster (HZ) is a viral disease which is primarily caused by the nerve tissue, but its treatment necessitates a multidisciplinary approach. Varicella zoster virus (VZV) is a DNA virus that causes both primary and recurrent infection. HZ, also known as shingles, is a unique condition induced by VZV reactivation. Neuropathic pain, headache, malaise and sleep disruption are all prodromal symptoms in such cases. HZ generates a pruritic, localized and vesicular rash that is usually unilateral. Individuals who are immunocompromised as a result of disease or receiving any treatment are also at increased risk, regardless of their age. HZ and its sequelae set a major strain on patient's caregivers, health-care system and business. Despite recent advances, prevention and treatment of HZ, consequences remain a therapeutic challenge. This is a case report of HZ infection in a 56-year-old female patient who was managed with comprehensive medical treatment.

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Background: Lichen planus is a chronic mucocutaneous disease of unknown etiology with well-established clinical and microscopic features. Oral lichenoid reactions are a family of lesions triggered by contact with specific agents such as metallic restorative materials, resins and drugs. Oral lichenoid reactions share clinical and histological features of oral lichen planus (OLP) but has varied management options. Hence, the discrimination between these two lesions is a major challenge for clinicians as well as pathologists. Aim: Histopathologic categorization of OLP and oral lichenoid reaction by comparing the thickness of basement membrane and the distribution of mast cells using special stains. Materials and Methods: The test group consists of formalin-fixed paraffin-embedded blocks of OLP (n = 15), and oral lichenoid reactions (n = 15) obtained from the archives of the Department of Oral Pathology, Amrita School of Dentistry. Three serial sections of 4 μm thickness were cut from each block. The sections were stained with H & E, periodic acid-Schiff (PAS) and toluidine blue, respectively. Results: A significant increase in the maximum basement membrane thickness (BMT) was noticed in OLP when compared to oral lichenoid reaction. A definite increase was also noticed in the number of mast cells in OLP and oral lichenoid reaction when compared to normal oral mucosa. There was a statistically significant increase in the number of degranulated mast cells in the deeper connective tissue in oral lichenoid reaction when compared to OLP. Conclusion: OLP and oral lichenoid reactions are two different entities showing similar clinical and microscopic presentation. The histochemical analysis of basement membrane and mast cells in these lesions might provide a more authentic method for differentiating these two lesions and might be of utmost value in deciding the treatment options.

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Background: Fibrosis is an uncontrolled healing process, led by persistent differentiation of fibroblast to alpha-smooth muscle actin (αSMA) positive activated fibroblast or myofibroblast. Oral submucous fibrosis (OSMF) is one such condition that is associated with areca nut use. Recently, Programmed Cell Death 4 (PDCD4), a pro-apoptotic marker, has been shown to modulate fibroblast differentiation in various organ fibrosis. The present study aimed to evaluate the role of PDCD4 in the regulation of fibroblast differentiation in OSMF. Materials and Methods: Paraffin-embedded tissue sections from 45 cases of the normal oral mucosa, early OSMF and advanced OSMF were examined for PDCD4 and αSMA expression by immunostaining. Co-expression of PDCD4 and αSMA in fibroblasts was examined using Spearman's correlation test. Results: The stromal fibroblasts showed minimal expression of αSMA in the normal mucosa and early OSMF, while advanced OSMF groups demonstrated a higher frequency of αSMA myofibroblasts. The PDCD4 expression was noted in the normal stromal fibroblasts. However, this expression appeared to progressively reduce with an increasing grade of OSMF. Thus, a negative correlation was noted between stromal PDCD4 and αSMA expression with progressive OSMF. Conclusion: This study demonstrated a putative role for PDCD4 in oral fibrosis consistent with its role in other tissues. The lack of PDCD4 expression with increasing myofibroblast expression in OSMF suggests that targeting its dysregulation may be an attractive translational therapeutic target.

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Mucormycosis also termed as phycomycosis or zygomycosis is less commonly seen in oral cavity. However, it is an invasive, life-threatening and aggressive fungal infection. It mostly targets individuals with altered immunological system and diabetes. In this recent pandemic situation, the individuals affected with coronavirus disease 2019 (COVID-19) are also affected with this fungal infection which commonly involves the maxilla. In this case report, we present a case of a 45-year-old female affected with mucormycosis in post-COVID scenario involving mandible which is quite rare situation. The case report covers clinical findings, radiographic investigations and histopathological details with brief on literature review. Since mucormycosis is aggressive fungal infection, it should be handled with multimodal approach to reduce the systemic damage of an individual, morbidity and mortality.

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Background: Although recurrent aphthous stomatitis (RAS) is the most common oral mucosal disease, the etiology remains poorly understood till date. In addition, RAS lacks definitive therapeutic options, and hence, it becomes even more important to know the etiological factor so as to relieve the symptoms and render treatment effectively. Recently, late bedtime has been shown to be associated with RAS. Due to prolonged duty hours along with lengthy learning and training periods, late bedtime is a frequent observation among health-care professional students. However, this is a less explored field in the previous studies on RAS. Aims: This study aimed to evaluate the role of bedtime in the causation of RAS among health-care professional students. Methods: This present cross-sectional survey was carried out among medical, dental and nursing students studying in our medical campus, using an anonymous, self-administered questionnaire consisting of 18 items. The collected data was statistically analyzed and interpreted. Descriptive analysis and Chi-square tests were employed to assess the association of RAS with various variables. Results: Among a total of 1111 students who participated in the study, 39.8% (n = 442) experienced RAS. Factors such as history of digestive tract disease, family history and stress showed a positive correlation with RAS. Interestingly, both during examination and nonexamination period, RAS was more prevalent among students with bedtime >11pm than in students with bedtime <11 pm. Conclusion: The study indicates that late bedtime is an independent risk factor for RAS and thus clinicians should focus on recommending a healthy lifestyle with adequate sleep to patients with RAS. This would benefit patients with RAS, especially health-care professional students, and could probably contribute to long-term remission in RAS.

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Context: Oral cancer is the 8^th most common cancer in the world. An important feature of carcinogenesis is angiogenesis. Endoglin is a powerful marker of neovascularization in solid malignancies. This study was done to ascertain its role as an indicator of metastasis and prognosis. Aim: This study aimed to evaluate and compare the expression of endoglin (CD105) in metastatic primary tumor, lymph node of the metastasized tumor, nonmetastatic primary tumor and in normal buccal mucosa immunohistochemically. Settings and Design: The total sample size comprised 45 formalin-fixed paraffin-embedded tissue blocks, n = 10 metastasized primary tumor, n = 10 lymph nodes of metastasized primary tumor, n = 20 nonmetastasized oral squamous cell carcinoma and n = 5 normal buccal mucosa were studied. Subjects and Methods: Immunohistochemistry for endoglin was performed and microvessel density (MVD) was determined by hot spot method. Microvessel density was compared between the groups. Statistical Analysis: Statistical analysis was used using one-way ANOVA. P < 0.05 was statistically significant. Results: Endoglin expression in metastatic cases (0.68 + 0.10) was higher than nonmetastatic cases (0.45 + 0.20) and the difference was statistically significant (P = 0.002). Conclusion: This study shows that presence of endoglin determines the metastatic potential of the tumor and its prognosis, thus, could be considered as a potential target of therapy.

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Chronology of tooth eruption is the most preliminary and crucial topic which is covered in the undergraduate syllabus of the dental curriculum. Eruption of permanent and primary teeth follows a particular time sequence. Both maxillary and mandibular arch has similar number of teeth, beginning from central incisors to molars. The pattern of eruption differs slightly between maxillary and mandibular arch. Remembering the years or months in a numerical manner is the usual way by which a student learns the eruption chronology. Eruption clock is a specially designed learning aid, which makes this teaching–learning process a lot easier, effective and practical.

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Background: Amyloidosis is a distressing and infrequent condition caused by accumulation of abnormally folded proteins as aggregates in the extracellular tissue spaces of the body, leading to destruction of organ structure and function. Presentation of Oral Amyloidosis is generally a rare phenomenon, tongue being the most common site to manifest the disease process. Accurate recognition of the amyloid protein and its sub typing is absolutely critical for clinical management and to assess prognosis such as to avoid misdiagnosis and unwanted, potentially harmful treatment. Case Report: We report a case of 84 year old male patient with an enlarged tongue, who presented with burning sensation and a facial violaceous papules with no other known systemic findings. Incisional biopsy revealed amorphous deposits confirmed for amyloid by congo red stain and Immunohistochemistry. Conclusion: The suspicion of Amyloidosis should always be kept in mind whenever a solitary enlargement of the tongue is noticed. Close follow-up and an entire panel of investigations is mandatory, both to manage recurrences and to monitor the possible advancement of the disease into a full blown systemic form.

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Context: Oral and maxillofacial pathology (OMFP) is a subspecialization having a masters course in India. Due to lesser number of oral pathologists in the country, the biopsy material from the head and neck is catered to by the general pathologist. Aim: This survey was conducted to acquire responses from general pathologists and gathering knowledge on their perspective of oral pathology. Methods: Pathologists at various medical institutions and at laboratories all over Karnataka were requested to answer a questionnaire comprising 13 questions pertaining to the need and scope of oral pathology. Results: In total, 37 (57%) general pathologists completed the questionnaire, of whom 97% (36) were aware of the specialty and 30 (81%) perceived a need for it. Eleven (30%) of them referred oral biopsy specimens to oral pathologists. The most common sources of diagnostic difficulty were identified as odontogenic tumors and cysts. Twenty-six (70%) pathologists felt the need for a short-term posting for their postgraduates in oral pathology, while 28 (76%) of them expressed their opinion about considering an oral pathologist as a part of their team when diagnosing complex head and neck pathologies. Twelve (71%) of them mentioned that they sometimes found that head and neck lesions took longer time to diagnose. Conclusion: Although the utilization of OMFP specialists' services in the state is quite low, general pathologists strongly feel the need for OMFP training as head and neck specimens form a considerable proportion of biopsies received by them.

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Basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma characterized by a conglomerate of clinically aggressive course and disparate histopathological features. It is frequently seen in upper aerodigestive tract area. Histopathologically, it is biphasic and composed of two types of tumor cells, namely basaloid and squamous cells. Tumor markers, namely, BerEp4, epithelial membrane antigen and p53 are used in this case to differentiate from similar tumors which impersonate BSCC histologically but differ prognostically. We report a case of BSCC in a 48-year-old female patient, involving the lateral border of the tongue with an exhaustive picture of its histological and immunohistochemical appearance.

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Background: Sepsis is a major worldwide cause of morbidity and mortality. Hence, rapid and reliable diagnosis is essential. Emergency departments use a standard measure of sepsis, based upon an elevated Lactate level in blood. Saliva is more readily available and easier to obtain than blood samples, and is increasingly being studied as a new source of diagnostic information. Aim: This study aimed to evaluate whether analysis of Lactate levels in saliva can substitute for that of Lactate levels in blood. Methods/Materials: We processed saliva samples and serum samples from septic shock and non-septic shock patients. We found out Lactate levels in both the group. We plotted the concentration of Lactate in non-septic and septic patients and compared lactate levels in saliva to its levels in blood. Statistical analysis: Results were statistically analyzed by independent sample t test and A Spearman rho correlation Results: We found increased serum and salivary Lactate levels in all cases of sepsis compared to the control group. Notably, the increase in Lactate levels was higher in serum as compared to saliva in septic patients, suggesting saliva may not serve as a better indicator of sepsis compared to blood. Salivary lactate was more in septic shock patients compared to non-septic shock patients. Conclusions: To our knowledge, this is the first study to compare lactic acid levels in serum and saliva in cases of sepsis. The increase in serum lactate in patients with sepsis is evident when compared to increase in salivary lactate, so serum lactate level would be easier for physicians to differentiate septic patients from non-septic patients. Salivary lactate may not serve as better indicator in septic shock patients.

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Background: Pregnancy is a physiological condition in which the maternal environment undergoes many changes. Serum uric acid (UA) levels have been used for the early diagnosis of preeclampsia, predictor of reduced birth weight and fetal outcome. UA is also expressed in saliva, and collection of saliva sample is a noninvasive method which will be more acceptable by the patients. Aims and Objectives: The present study aimed to estimate and compare serum and salivary UA levels in age-matched healthy nonpregnant and healthy pregnant women at different trimesters longitudinally. Methodology: Forty female participants with age ranging between 20 and 38 years comprised the study population. The study group consisted of 20 healthy nonpregnant women (controls) and an equal number of confirmed cases of healthy pregnant women in the first trimester (cases). The cases were followed in their second and third trimesters for the sample collection. Results: Both serum and salivary UA levels were significantly reduced in the first trimester of pregnancy than the controls. In the second and third trimesters, the values of serum and salivary UA levels gradually increased and gained values similar to that of nonpregnant women. Salivary UA levels showed a highly significant positive correlation with serum levels in both controls and cases. Conclusion: Salivary estimation, being a noninvasive procedure, is easily accepted by the patients and carries minimal risk of exposure to the blood-borne pathogens compared to serum estimation. Our findings warrant the use of saliva instead of blood for UA estimation.

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Background: Oral squamous cell carcinoma (OSCC) can be preceded by the appearance of lesions which have the potential to develop into cancer. Recently, it was suggested that the tumor-associated lymphatic vessels formation plays an active role in tumor progression and metastasis of several human malignancies including OSCC. There is the view that, in an individual lesion, the more severe the dysplasia, the greater the likelihood is of progression to malignancy. Aim: This study is aimed to investigate podoplanin (PDPN) immunoexpression in lymphatic vessels of oral epithelial dysplasia (OED) and to assess the lymphatic vessel density (LVD) in histologic grades of OED. Materials and Methods: The study group comprised thirty histopathologically diagnosed cases of OED with various grades of differentiation and thirty cases of clinically normal oral mucosa. After immunohistochemical staining, cases of OED were immunohistochemically analyzed quantitatively for PDPN (D2-40) LVD. Statistical Analysis: The statistical analysis was done using Kruskal Wallis analysis of variance; pair-wise Tukey's post hoc test was applied to evaluate the significant differences among the mean values in different groups. Results with “P < 0.05” were considered to be statistically significant at 95% of confidence level. Results: PDPN LVD scores increased with increasing grades of dysplasia. Pair-wise comparisons of the PDPN LVD scores and the histopathologic grades of OED were found to be statistically significant (P < 0.05). Conclusions: Increase in PDPN LVD in OED represents a promising tool for more wide spread studies of tumor lymphangiogenesis and its role in progression of dysplastic lesion to human cancer.

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Pleomorphic adenoma is the most common benign salivary gland tumour characterized by great histologic diversity. The presence of extensive squamous metaplasia and numerous keratin pearls is mostly uncommon in the microscopic study and can signify a potential pitfall in the histopathological diagnosis Pleomorphic adenoma can show the presence of squamous metaplasia with keratin pearls as a rare finding and is encountered most often in the parotid gland (84%) and 6% in the minor salivary gland. Here we present a case report of a rare histopathological variant of pleomorphic adenoma with exuberant squamous metaplasia and keratin pearl formation of the minor salivary gland in an unusual location.

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Polymorphous adenocarcinoma (PAC) is an uncommon tumor that affects minor salivary glands mainly. It presents as an indolent malignancy that frequently manifests as an asymptomatic, slow-growing mass within the oral cavity, especially palate and its clinical behavior resembles that of benign neoplasm, often causing delay in the diagnosis. Here, we report a rare case of PAC of palate in a 49-year-old female patient along with a concise review of characteristics of PAC and highlight diagnostic challenges caused by the overlap of clinical and microscopic features between PAC, pleomorphic adenoma and adenoid cystic carcinoma.

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Objectives: To estimate the awareness of hepatitis B virus (HBV) and coverage of hepatitis B vaccination among dental students enrolled in dental colleges located in Andhra Pradesh. Materials and Methods: A cross-sectional study was conducted using a prestructured questionnaire to find out the awareness of HBV and coverage of hepatitis B vaccine among dental students. Results: A total of 2780 dental students were approached to participate in the study but only 2701 (97.1%) students (M = 900, F = 1801) gave response. Out of the total 2701 students, 79.45% were aware of HBV infection and only 51.50% of the participants received hepatitis B vaccine. 20.5% have come across HBV infected patients and 59.5% are unaware of postexposure protocol. Of all, 63.9%, 21.5% and 42% felt the mode of transmission is blood, sexual contact and oral fluids, respectively. 49.12% recommended for awareness programs on risks in HBV; 56.46% suggested mandatory Hepatitis B vaccination programs in dental colleges. Conclusions: Despite the availability and accessibility of a cost-effective hepatitis B vaccine, the vaccination coverage among dental students was low. Health education needs to be improved for all health care students especially for dental students.

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Background: Dental identification plays a major role in mass disaster identification of human remains. Palatal rugae can be used as a substitute for a comparative method of identification. Materials and Methods: The present cross-sectional study was done with 137 pre- and post-orthodontically treated casts of patients, which were divided into 50 cases each of extraction and nonextraction and 37 cases of palatal expansion involving both extraction and nonextraction. Hydrocolloid (alginate) impression of the upper jaw of the patient was taken and then cast in the dental plaster of Paris material. Palatal rugae pattern was classified according to Lysellm, and Thomas and Kotze classification. Two Observers recorded the data, mean of two were taken for analysis. Results: On the right side, there was no significant difference between the extraction and nonextraction groups; however, there was a rise in length in the nonextraction and palatal expansion groups. On the left side, there was little change between the nonextraction and palatal expansion groups, but the extraction group had a modest increase in length. Mean lengths compared within three groups revealed insignificant difference. Conclusion: Palatal rugae pattern can be used in establishing identity in forensic medicine provided antemortem data are available. Orthodontic treatment has an impact on stability of palatal rugae. Most reliable and stable points being third rugae, they could be used as reference points to evaluate tooth movements

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Background: Propolis, a natural antibiotic, which is in high demand in dentistry is a resinous substance. The main ingredient of propolis that is required for antibiotic effect is flavonoids and phenolic acids. Although propolis is a promising option for the control of oral microbes with lower related hazards and a good immunomodulator effect, its composition differs considerably depending on its botanical origin, the site and the season of collection. This original research aims to find the chemical composition and minimum inhibitory concentration (MIC) of propolis procured from different places of Karnataka state. The results would help the dentist and the pharmacist to select the best propolis to use as antibiotics in treating oral disease. Materials and Methods: Propolis sample from 5 different locations of Karnataka was procured from single apiary in Bangalore. Extraction of propolis using two different extracting solvents was carried out. The total phenolic content, total flavonoid content and MIC of each sample were analyzed. Results: Water extract propolis of Sullia and Hubli was highly active against tested organism with the MIC <0.312; alcohol extract of Sullia, Hubli and Chitradurga was moderately active with the MIC between 0.312 and 5 mg/ml. Vijayapura and Bagalkot were least active with the MIC >5 mg/ml at tested concentration. Conclusion: Propolis procured from different locations of Karnataka can be used as an antimicrobial agent with varying concentrations. However, when propolis is procured for therapeutic purpose, then it needs to be tested for its chemical composition before being utilized.

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Background: Mast cells (MCs) are immune cells derived from a multipotent CD34 precursor. The most significant identifying feature of MCs is the presence of metachromatic granules. MCs are increased in oral reactive lesions and are possibly involved in pathogenesis of these lesions. Objectives: 1. To compare the number of MCs between reactive and nonreactive lesions of gingiva using toluidine blue (TB) and mast cell tryptase (MCT) as a specific marker for MCs 2. To compare the staining specificity/efficacy of TB and MCT. Methodology: The study sample comprised 90 tissues which were divided into three groups: Group A comprised 30 cases of pyogenic granuloma (PG), Group B consisted of 30 cases of gingival hyperplasia (GH) and Group C comprised 30 cases of pericoronitis. Staining was done between 1% TB and immunohistochemistry (IHC) marker MCT. Results: A significant increase in number of MCs was observed in PG as compared to GH and pericoronitis. IHC marker MCT proved to be a more specific marker for MCs compared to TB. Conclusion: IHC marker MCT is a specific marker compared to TB. The position of MCs changed from juxtaepithelial in GH to deeper connective tissue in PG which was in correlation with the proliferating tissue that is epithelium in GH and blood vessel in PG.

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Aim: The aim of the study is to evaluate the presence of myofibroblasts quantitatively in oral epithelial dysplasia, oral squamous cell carcinoma (OSCC). Materials and Methods: Formalin-fixed, paraffin-embedded blocks were retrieved from the institutional archives. The sample size is 35 and included 15 cases of oral epithelial dysplasia (n = 15), 15 cases of squamous cell carcinoma (n = 15) and 5 cases of normal oral mucosa which served as the control (n = 5). Histologic sections were subjected to immunohistochemical analysis using alpha-smooth muscle actin, and the mean number of myofibroblasts was evaluated. Results: There were no myofibroblasts in the stroma of normal oral mucosa and oral epithelial dysplasia. Whereas all cases of OSCC showed myofibroblasts (mean ± standard deviation: 21.49 ± 9.76). This difference of myofibroblasts between OSCC and oral epithelial dysplasia was statistically significant with a P < 0.05. There was no statistically significant difference in the mean number of Myofibroblasts(MF) between 3 histologic grades of OSCC. Conclusion: The presence of myofibroblasts in the stroma of OSCC and their absence in normal oral mucosa and epithelial dysplasia reveals that these cells may play a role in cancer cell invasion and progression so the treatment strategies targeting the myofibroblasts and their by products may be beneficial in OSCC patients.

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Background: Salivary gland tumors are rare and clinically represent a diverse group of neoplasms among which mucoepidermoid carcinoma (MEC) is a relatively common salivary gland tumor with varying potential for aggressive behavior. The purpose of the study was aimed at to analyze the relative frequency and correlate with age, sex, anatomical site and histological grade of MEC and compare the findings with epidemiological data from different geographic locations. Materials and Methods: Twenty-five cases diagnosed with MEC during the period June 1985 to June 2004 (19 years) were retrieved from the Department of Pathology, Government Medical College and Hospital, Ambajogai, and clinical data were recorded and reviewed histopathologically. Results: The relative frequency of MEC was 13.15%. Low-grade MEC (44%) was the most common, followed by intermediate-grade MEC (36%) and high-grade MEC (20%). The mean age for occurrence of MEC was 44.28 ± 13.29 years. MEC was predominant in females (60%) than males (40%). Thus, the overall female-male ratio was 1.5:1. Among minor salivary glands, palate (48%) was the most common site, and among major salivary glands, parotid gland (16%) was the common site. Conclusion: Comparing the present data with previous studies on MEC, one may infer that some demographic characteristics and the predominance vary in different geographic regions. Analysis of the distribution and particular features of MEC in a specific population helps in establishment of appropriate treatment.

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A 64-year-old female with complaints of swelling right preauricular region was referred to our tertiary cancer center with fine-needle aspiration cytology (FNAC) report of mucoepidermoid carcinoma and radiological differential of malignant salivary gland neoplasm and sarcoma. On examination, there was a mass over her right parotid region Clinical diagnosis was malignant salivary gland neoplasm. Slide review of FNAC was inconclusive. Biopsy was done. Histopathology showed neoplasm comprising of nests of cells with abundant granular eosinophilic cytoplasm with focal area showing peripherally arranged columnar cells with palisading. On enquiry, the patient gave a history of surgery of right mandible 48 years back. Correlating histopathology and clinical history, a diagnosis of granular cell ameloblastoma was rendered. Radiological evaluation showed a solid-cystic lesion in the right masticator space. Right mandible showed only part of head of mandible consistent with previous surgery. Radical surgery was done. Final report confirmed the biopsy diagnosis.

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Dentin dysplasia is a rare, hereditary disorder affecting the dental hard tissue. It is a congenital, autosomal dominant disease of unknown etiology that affects 1:100,000 populations. It may present as such affecting only the dental hard tissue or as one of the symptoms of underlying diseases such as calcinosis, Ehlers–Danlos syndrome, rhematoid arthitis, Vitaminosis D and Branchioskeletogenital syndrome. This was first described by Ballschmiede as rootless teeth in 1920 and termed as dentin dysplasia by Rushton in the year 1939. It is classified into Type I, II and III, in which Type III affects only the secondary dentition. This article reports a rare case of Type I dentin dysplasia in a 26-year-old male patient, and focus on clinical, radiological, ground section and histopathological aspects. It emphasizes the significance of early diagnosis and intervention for the psychological well-being of the individual.

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Hemodialysis is one of the commonly used renal replacement therapies in treating end-stage renal failure patients. Patients with long-term dialysis may develop frequently complications such as secondary hyperparathyroidism (SHPT), bone diseases, amyloidosis, endocrinal disturbances, cardiovascular complications and infections. Brown tumors (BTs) are erosive giant cell bony lesions that arise in some patients as a result of primary or SHPT. About 2% of all the reported cases showed involvement of facial skeleton, of which the mandible is the favorite site. A complete clinical, biochemical, radiological and histopathological correlation is required for definitive diagnosis. We report here a case of BT in 37-year-old female hemodialysis patient with SHPT.

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Background: Odontogenic tumors show a variety of characteristic features that are dependent on the tumor cell origin and the stage of tumor cell differentiation. Odontogenic cysts arise from the enamel organ or remnants of dental epithelium which influences their pathogenetic model and further clinical behavior of these lesions. Aim: The study aims at assessment of CD 99 immunoexpression in odontogenic keratocyst (OKC) and ameloblastoma (in tooth bearing [anterior to third molar] and nontooth bearing areas [molar ramus area]) to postulate neural influence in their pathogenesis and the clinical behavior. Materials and Methods: Immunohistochemical analysis for CD 99 was performed on paraffin-embedded tissue sections on 50 histopathologically confirmed cases of OKC and ameloblastoma (25 each) arising within the oral cavity and were scored qualitatively, topographically, and according to cellular localization. Statistical Analysis: The resulting data were analyzed using the SPSS software version 20.0. The significance of the parameters was tested by the Pearson's Chi-square test (P ≤ 0.05 as statistically significant). Results: CD99 immunoreactivity was distributed in both tooth bearing and nontooth bearing groups of OKC and ameloblastoma with an increased immunoexpression in basal and suprabasal layers of OKC in nontooth bearing area and in peripheral cells of ameloblastoma in nontooth bearing area confined to the cell membrane. Conclusions: The results point toward the role of CD99 in the pathogenesis and aggressive behavior of such odontogenic lesions and it can be used as a promising therapeutic target.

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Background: Oral squamous cell carcinoma (OSCC) remains as one of the leading causes of death in many of the developing countries including India. Early detection helps in improving the prognosis and survival rates. Over the years, tumor markers continue to play an important role in diagnosing and monitoring cancer progression. The ectopic production human chorionic gonadotropin-β (hCG-β) is one such marker that is seen in various nontrophoblastic cancers and serves as a marker for tumor prognosis. Few immunohistochemical studies have shown the presence of hCG-β in oral cancers too. The present study investigated the immunohistochemical expression, levels of hCG-β in saliva and urine of various grades of OSCC patients and correlated it with their histopathological grading. Materials and Methods: Tissue sections of 50 histologically confirmed OSCC were subjected to immunohistochemical staining by using hCG-β antibody (well differentiated – 21, moderately differentiated – 21 and poorly differentiated – 8). The levels of hCG-β in saliva and urine were estimated in these individuals, by using Beckman Coulter Access 2 automated immunoassay system and comparisons drawn. Results: hCG-β immunopositivity was seen in 8 (38%) of 21 well-differentiated, 11 (52%) of 21 moderately differentiated and 6 (75%) of 8 poorly differentiated OSCC specimens. The levels of hCG-β in both saliva and urine were increased in poorly differentiated (0.40 and 1.19 mIU/ml) than moderately (0.3 and 0.76 mIU/ml) and well-differentiated (0.36 and 0.48 mIU/ml) OSCC patients. Conclusion: Immunohistochemical expression, salivary and urine levels of hCG-β could serve as an independent prognostic indicator in OSCC patients.

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Current times have seen growing use of social medial tools, including microblogging sites like Twitter as an efficient method to disseminate information related to health amongst patients, students as well as health care workers. This article explores the role of this short, effective messaging platform in oral health care, teaching, research and learning. The concepts of “tweeting the meeting” and aggregation of conversations via “hashtags” is advocated for academic conferences, which will extend the conference reach to give the users better access to the instructors and enhance the related outcomes. Tweeting and retweeting the required research content may increase the academic footprint of the conducted research and researchers. In addition, it has served an immense role in the current COVID-19 pandemic by the regular circulation of information to the public and helped governments in policymaking and showcasing the areas of public concern. However, it still has a huge potential yet to be explored, with collective efforts towards strengthening the aspects of authenticity and standardization of the shared content.

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Background: The developmental stages of the teeth in the radiographs are graded on an ordinal scale. The present study was conducted using 123 digital orthopantomograms from individuals in the age group of 5 to 22 years and to analyze and evaluate the inter-observer agreement in grading the developmental stages of second and third molars. Four observers with different levels of practical experience in age estimation participated in the study. The development stages of both the molars in the lower left quadrant (3^rd quadrant) were assigned based on the Demirjian's 10 stage chart. The percentage agreement and Kappa statistics were used to test the agreement between the observers. The data of the observer 1 were used as the standard for the comparison. Results: There was 70.0%–75.6% agreement among the observers in staging second molar and 52%–68.3% for the third molars. There was an excellent agreement (k > 080) between observer 1 and observer 2 and a good agreement (k = 060–0.79) between observer 1 and the other two observers for both the molars. The Fleiss Kappa revealed moderate to a good overall agreement for both the molars (k = 0.51–0.66). The Freidman's test revealed a significant difference in the grading of third molars between all the raters (χ² = 25.02, df 3, P < 0.001) and for the second molar the difference was not significant (χ² = 3.89, df 3, P > 0.05). The stage-wise overall agreement was fair for Stage 3 in the second molar and Stage 9 and Stage 4 in the third molar. Conclusions: In conclusion, proper training in the radiographic interpretation of developmental stages may minimize the errors during the age estimation methods.

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Introduction: Demirjian's method of dental age assessment estimates the overall dental age by scoring based on the stage of tooth formation, using panoramic radiographs. This method was primarily based on data acquired from individuals of French-Canadian origin. It has since been applied and modified for the Indian population. Therefore, the aim of the present study is to assess the reliability of the Indian formula in the population of Bengaluru. Materials and Methods: Dental maturity of 297 subjects between 9 and 17 years was assessed using the India-specific formula of Demirjian et al.'s 8-teeth method and the chronological age of each subject was calculated. Pearson's correlation, Independent student test/Mann–Whitney test and Chi-square test were used for statistical analysis of the results obtained. Results and Discussion: A very strong correlation (P < 0.001) between the chronological and estimated age by Demirjian's method was obtained. The mean absolute error among the total samples was not significant and majority of the error in the estimated age was <1 year in males and females, indicating that the India specific formula gave nearly accurate estimation of the chronological age of the sample subjects. Conclusion: Demirjian's Indian formula is relaible in the population of Bengaluru

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Pigmentation in the head-and-neck lesions is an uncommon feature. The presence of it is fascinating, but its relevance is unknown. Various odontogenic and nonodontogenic lesions show the presence of melanin pigment. Although the presence of melanin is normal in the epithelium and connective tissue, the role of melanin pigmentation in odontogenic cysts is unclear. Apart from maintaining the skin balance, varying other functions of melanin is being researched. However, not much study has been done regarding it in odontogenic lesions. As the literature regarding such cases are scanty, here, we present a case of pigmented dentigerous cyst and an attempt to understand their relationship.

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Ever since the COVID 19 pandemic struck our nation and started to cripple our health care infrastructure around the world, a considerable number of research was directed toward the development of the COVID Vaccine. However, when it finally came into our medical infrastructure, people were skeptical about taking the vaccine because of the considerable confusion on its efficacy and adverse effects. An attempt has been made through this communication to narrate my personal experience; My journey from First Infection to Vaccination finally culminating with COVID Reinfection, lessons learnt!!

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Background of the Study: Although many studies are available validating the role of saliva as an alternative diagnostic tool, no reliable data are available on the duration of time, a salivary sample can be reliably stored at room temperature for estimation. It varies from one analyte to another and has to be researched. Aim: The aim of the study was to determine the effect of 2 h of room temperature storage on salivary glucose concentration. Materials and Methods: Saliva samples obtained by spitting method from thirty healthy volunteers were centrifuged and glucose concentration determined in the supernatant obtained. The test was repeated 2 h later following room temperature storage of the supernatant. Results: The data obtained were analyzed using wilcoxson signed rank test. No significant difference between was observed between the two values. Conclusion: Salivary glucose can reliably estimate on centrifuged samples following 2 h of room temperature storage.

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Myofibroma is a benign tumor of myofibroblasts occurring commonly in infants and children. It can occur as a solitary lesion or as multiple lesions in the soft tissues or intraosseously. The presence of the solitary lesion is common in the soft tissues of the head-and-neck region but rare in jawbones. Histologically, it has a biphasic pattern of presentation and mimics spindle cell tumors. Immunohistochemistry is essential for its confirmatory diagnosis. This article describes a case of this rare lesion presenting as a solitary lesion in the left body of the mandible in a 7-month-old boy baby. The diagnostic and therapeutic challenges have been discussed.

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