Reply to the letter regarding “Chronic mechanical irritation and oral squamous cell carcinoma: A systematic review and meta-analysis”

Dear Editor, We thank Dr. Jian Xie for the valuable inputs on our paper titled ‘Chronic mechanical irritation and oral squamous cell carcinoma: A systematic review and meta-analysis [1].’ The first concern of Dr. Xie was that we had included two studies that were based on the same population. We re-examined these papers, one was published in 2010 [2] and the other in 2017 [3] by the same group of authors. Given the significant time difference between the two papers, we did not want to presume they were from the same sample population. There is no clear evidence that they are from the same sample population. Read more in PDF.

Letter regarding “Chronic mechanical irritation and oral squamous cell carcinoma: A systematic review and meta-analysis”

Dear Editor: We have read with a great interest the article by Gupta et al. [1] who performed a meta-analysis exploring the association between chronic mechanical irritation and oral squamous cell carcinoma. The conclusion of the meta-analysis is that chronic oral mucosa irritation has a significant association with oral squamous cell carcinoma, and the nature of association could be that of a potential co-factor (dependent risk factor) rather than an independent risk factor. Read more in PDF.

Chronic mechanical irritation and oral squamous cell carcinoma: A systematic review and meta-analysis

The objective of the present article was to qualitatively and quantitatively review the association between chronic mechanical irritation and oral squamous cell carcinoma. PubMed, SCOPUS, and Web of Science databases were searched using the keyword combinations ‘chronic trauma and oral squamous cell carcinoma; chronic irritation and oral squamous cell carcinoma; chronic irritation and oral cancer; chronic trauma and oral cancer.’ Duplicates and irrelevant articles were excluded after the title and abstract screening. The full texts of the remaining articles were assessed using selection criteria. A total of 375 (PubMed-126; SCOPUS-152; WOS-97) articles were screened, and 343 duplicates and irrelevant articles were excluded. Only 9 of the remaining 32 articles met the selection criteria and were included in the qualitative analysis. Buccal mucosa and tongue, being highly prone to chronic irritation through the dental prosthesis, were the common sites for oral squamous cell carcinoma. Edentulous subjects with ill-fitting dentures were at a high risk of developing chronic irritation associated-oral squamous cell carcinoma. According to the Joanna Briggs Institute of risk assessment, eight of the nine included studies had a low risk of bias. The quantitative analysis showed a significant association (p<0.00001) between the chronic oral mucosal irritation and oral squamous cell carcinoma with an overall risk ratio of 2.56 at a confidence interval of 1.96 to 3.35. Chronic oral mucosa irritation has a significant association with oral squamous cell carcinoma, and the nature of association could be that of a potential co-factor (dependent risk factor) rather than an independent risk factor.

Complete relief of vasospasm – Effect of nicardipine coating during direct clipping for the patient with symptomatic vasospasm of subarachnoid hemorrhage

Background: Some patients come to the hospital presenting with ischemic neurological deficits due to postsubarachnoid hemorrhage (SAH) cerebral vasospasm. In such a situation, neurosurgeons tend to avoid direct clipping, since mechanical irritation to the vessels could worsen the vasospasm and exacerbate ischemic symptoms. The optimal timing of direct clipping in patients with evidence of vasospasm is undetermined. Herein, we present the case of a patient who underwent direct clipping in the presence of severe symptomatic and post-SAH angiographic vasospasm. During surgery, we coated the severely spastic artery with nicardipine. Case Description: A 49-year-old woman was admitted to our hospital with the diagnosis of ruptured intracranial aneurysm and severe vasospasm. On the admission day, we performed direct clipping together with direct application of nicardipine to the spastic artery. Postoperative immediate cerebral angiography showed complete disappearance of the vasospasm. Conclusion: Direct clipping should not be contraindicated during the vasospasm period in patients with a ruptured aneurysm, and direct application of nicardipine on the spastic artery would completely relieve vasospasm.

Cytogenetic analysis of genetic damage in young individuals exposed to Chronic Mechanical Irritation in the lateral border of the tongue due to sharp teeth – A novel study.

Background. Chronic inflammation is estimated to contribute to approximately 25% of human cancers. Inflammation can be induced by chronic mechanical irritation which can lead to oral pre-cancer and oral cancer. Though many studies have been conducted to identify the genetic damage in oral cancer or dysplastic stages, no study has been completed so far on early detection of genetic damage in healthy individuals presenting with sharp teeth in contact with the lateral border of the tongue. Objective. The study is aimed at analyzing the genetic damage (micronuclei) in healthy individuals with sharp teeth in contact with the lateral border of the tongue causing chronic mechanical irritation. Methods. The study group comprised of 75 clinically healthy individuals with sharp teeth in contact with the lateral border of the tongue and 25 clinically healthy individuals with normal teeth in contact with the lateral border of the tongue as a control group. Brush samples of epithelial cells were collected, then spread over clean glass slide and fixed in 100% alcohol, stained with rapid PAP and analyzed under the light microscope. The exfoliated cells were examined to detect micronuclei. Results. Micronuclei frequency was found to be increased in the study group where sharp teeth were in contact with the lateral border of the tongue of healthy individuals without deleterious habits such as usage of tobacco in smoking/smokeless form, areca nut chewing or alcohol consumption. Conclusions. Cytogenetic analysis is a simple and scantly invasive technique allowing clinicians the early detection of DNA damage in patients with sharp teeth and subsequently preventing carcinogenesis by proper treatment and follow-up.

HUBUNGAN CAIRAN INFUS DAN LOKASI PEMASANGAN INFUS DENGAN KEJADIAN FLEBITIS DI RUMAH SAKIT DKT BANDAR LAMPUNG

ABSTRACT: CORELATION BETWEEN INFUSION FLUID USE AND LOCATION OF INFUSION WITH PHLEBITIS OCCURRENCE IN DKT HOSPITAL BANDAR LAMPUNG 2020 Background:Phlebitis is venous inflammation caused by either chemical or mechanical irritation. The incidence of phlebitis in 2019 DKT Hospital is 1.8% cases while the indicator limit for phlebitis is 1.5%.Purpose:Determine the corelation between infusion fluid use and location of infusion with phlebitis occurrence in DKT Hospital Bandar Lampung 2020Methods:The type of research is a quantitative study with a case control approach. The study population is 55 patients with phlebitis as a sample cases and 55 patients without phlebitis as control patients. Dats Analysis using univariate analysis and bivariate.Results :It shows the relation between the type of infusion fluid (pv =0,000; OR=8.5) and location of infusion (pv=0.002; OR=3.5) with phlebitis occurrence in DKT Hospital Bandar Lampung.Conclusion:From the results of the study it was suggested perfecting the SOP and disseminating information on hypertonic infusion fluid and monitoring it regularly and continuously Keywords: Phlebitis, type of fluid, location of infusion INTISARI:HUBUNGAN CAIRAN INFUS DAN LOKASI PEMASANGAN INFUS DENGAN KEJADIAN FLEBITIS DI RUMAH SAKIT DKT BANDAR LAMPUNG TAHUN 2020Latar Belakang:Flebitisadalah inflamasi vena yang disebabkan baik iritasi kimia atau mekanik. Angka kejadian flebitis di RS DKT Tahun 2019 adalah 1,8% kasus flebitis sedangkan batas indikator flebitis adalah 1,5%.Tujuan: Untuk mengetahui hubungan antara penggunaan cairan infus dan lokasi pemasangan infus dengan kejadian flebitis di RS DKT Bandar Lampung Tahun 2020.Metode:Jenis penelitian adalah kuantitatif dengan pendekatan case control. Populasi penelitian ini adalah 55 pasien flebitis sebagai sampel kasus dan 55 pasien yang tidak flebitis sebagai pasien kontrol.Analisis menggunakan analisis univariat, bivariat (chi square).Hasil: Hasil penelitian menunjukkan ada hubungan jenis cairan infus (pv=0,000; OR=8,5) dan lokasi pemasangan infus (pv=0,002; OR=3,5)dengan kejadian flebitis di Rumah Sakit DKT Bandar Lampung tahun 2020.Kesimpulan: Dari hasil penelitian disarankan bahwa Rumah Sakit DKT untuk menyempurnakan SPO dan sosialisasi tentang pemberian cairan infus hipertonis dan monitoring secara berkala dan berkesinambungan. Kata kunci: Kejadian flebitis, jenis cairan infus dan lokasi pemasangan infus