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Objective: The purpose of this study was to assess how oral and maxillofacial surgeons used various diagnostic tools for oral cancer. Materials and Methods: A cross-sectional methodology was used, and a standardized questionnaire was given to oral and maxillofacial surgeons randomly chosen sample. The questionnaire gathered information on demographics and the use of diagnostic tools. Data analysis methods included Chi-square testing and descriptive statistics. Results: The study included 200 oral and maxillofacial surgeons in total. The most often used diagnostic tool (95%) was visual inspection, followed by toluidine blue staining (48%) and brush biopsy (32%). Less frequently used were newer methods like optical coherence tomography (12.5%) and autofluorescence imaging (15%). No significant correlations between demographic factors and patterns of use of diagnostic tools were found by Chi-square tests. Conclusion: The results show that oral and maxillofacial surgeons frequently use brush biopsy, toluidine blue staining, and ocular evaluation. However, there is a need for more widespread adoption of cutting-edge technologies. By removing obstacles and offering training opportunities, one can increase the use of diagnostic tools, improving patient outcomes and the diagnosis of oral cancer. [ABSTRACT FROM AUTHOR]

Background: Endometrial stromal tumors (ESTs) are rare subset of mesenchymal uterine neoplasms. There are heterogeneous morphological, immunohistochemical, and genetic features. Approximately 50% of ESTs occur in perimenopausal women. In 2020, WHO sub-categorized ESTs into four groups: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LGESS), high-grade endometrial stromal sarcoma (HGESS), and undifferentiated uterine sarcoma (UUS). Objective: To review the morphological spectrum of endometrial stromal tumors. Method: This retrospective study reviewed the histomorphological features of 15 endometrial stromal tumors with respect to atypia, necrosis, mitosis, collagen bands, whorling around vessels, myometrial invasion, and inflammatory cells. Immunohistochemistry markers (CD10, SMA, and ER) along with special stains (Masson's trichrome, toluidine blue) were also studied. Results: The age of the patients ranged from 32 to 60 years. Three patients were postmenopausal. The most common presenting symptom was vaginal bleeding. Five patients were operated with a clinical diagnosis of uterine fibroid. One patient presented with prolapse with no other complaint. All the 15 patients had total abdominal hysterectomy and salpingo-oophorectomy. One case showed necrosis, eight cases showed collagen bands, all the 15 cases showed whorling around vessels, one case showed vascular emboli, and seven cases showed inflammatory cells. In low-grade cases, one case showed focal atypia and one case showed focal coagulative necrosis indicating infarction. Thirteen cases were LGESS, and one case of ESN and HGESS. All cases were positive for ER and CD10. Conclusion: Endometrial stromal tumors demonstrate extensive permeation of the myometrium as irregular islands with frequent vascular invasion, whorling around vessels, collagen bands, and inflammatory cells. All these features should be observed thoroughly on microscopy by pathologists to clearly differentiate the low-grade and high-grade endometrial stromal tumors, and to understand the overlapping gray areas morphologically as it affects the prognosis of the patient. [ABSTRACT FROM AUTHOR]

Background: Diagnostic adjuncts such as toluidine blue have been investigated as screening tools that improve visual examination of potentially malignant disorders (PMD) and oral cancer. Acetic acid has been reported to be of value in the early detection of cervical cancers. This study assessed the utility of 5% acetic acid as a diagnostic adjunct in oral PMD and compared the accuracy of acetic acid with toluidine blue in the detection of dysplastic PMD and high-risk lesions. Materials and Methods: This cross-sectional study was conducted at a dental hospital in a rural setting. Thirty-one patients with oral PMD formed the study group. Five percent acetic acid was applied to the lesions, followed by toluidine blue application and biopsy. Sensitivity, specificity, and positive and negative predictive values were computed considering true positives as stain uptake in dysplastic and high-risk PMD. Results: The sensitivity, specificity, and positive and negative predictive values of acetic acid for identifying dysplastic or malignant lesions were 100%, 13.3%, 51.2%, and 100%, respectively, and that for toluidine blue were 75%, 100%, 100%, and 78.9%, respectively. The corresponding values for identifying high-risk PMD (lesions with moderate and severe dysplasia) using acetic acid were 100%, 9.1%, 25.9%, and 100%, respectively, and for toluidine blue were 85.7%, 81.8%, 60%, and 94.7%, respectively. Conclusion: The utility of acetic acid in detecting dysplasia and high-risk PMD is severely limited due to its poor specificity. Compared with acetic acid, toluidine blue is a superior screening tool. [ABSTRACT FROM AUTHOR]

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

Aims: To compare the delivery of irrigant to the apical third of the root canals using an ingeniously designed continuous irrigation and intracanal aspiration system to standard irrigation techniques. Methods: Sixty-six freshly extracted single-rooted mandibular second premolars of similar dimensions with a single straight canal, confirmed radiographically, were selected and divided into three groups (n = 22) based on irrigation techniques employed: (i) manual dynamic activation, (ii) passive ultrasonic activation, and (iii) the system designed by the authors. Standard oval-shaped access cavities were prepared and the working length was determined radiographically. Instrumentation with ProTaper F2 rotary files was followed by irrigation with 2.5% NaOCl and saline using a 2.5 ml syringe and needle for Groups 1 and 2, and the irrigant delivery system for Group 3. A prefinal rinse with EDTA and a final rinse with saline was also carried out. Apical delivery of irrigant was evaluated by flooding the root canals with 1% toluidine blue dye for 30 seconds. The specimens were decoronated and split vertically and labiolingually and visualized under a stereomicroscope (×5 magnification) and photographed. The images were analyzed using ImageJ software to measure the unstained apical region. One-way ANOVA with Tukey's post hoc test was used to statistically analyze the results (P < 0.05). Results: The ingeniously devised irrigation delivery and intracanal aspiration system showed a significantly higher apical delivery of irrigant as compared to the other methods studied (P < 0.001). Conclusions: The proposed simple root canal irrigating device can be made with materials readily available. Comparing the same to standard techniques showed better irrigant delivery to the apical region. With further studies planned to evaluate smear layer removal and canal disinfection, we hope that this can serve as an efficient, cost-effective novel device that can be easily incorporated into clinical practice. [ABSTRACT FROM AUTHOR]

Background: Mast cells (MCs) are immune cells of the myeloid lineage and are present in connective tissues throughout the body. Mastocytosis regulates many physiologic processes and affects the pathogenesis of allergic conditions, anaphylactic reactions, autoimmune disorders and leukemias. Toluidine blue is commonly employed as a special stain for MCs that uniformly imparts blue color to both immature and mature cells. Csaba stain that distinguishes mature from immature MCs has not been widely explored. However, its use in differentiating mature and immature cells has not been reported in the literature. The identification of mature and immature MCs may provide a major clue for the diagnosis of any unrecognized systemic pathologies. Objectives: To evaluate the staining efficacy of Csaba stain, toluidine blue and Leishman's stains in the identification of MCs To compare the effectiveness of Csaba stain, toluidine blue and Leishman's stains to identify MCs in inflammatory pathologic lesions. Materials and Methods: Fifty sections of inflammatory lesions were subjected to Csaba stain, toluidine blue and Leishman's stains each for studying MCs. The staining efficacy of the three stains was compared for parameters such as homogeneity, specificity, staining intensity, granular staining property and differentiation between mature and immature cells. Results: The Csaba, toluidine blue and Leishman's stains showed statistically insignificant P = 0.50, 0.95, 0.29, 0.48 for homogeneity, specificity, staining intensity and granular staining property respectively, but Csaba stain showed statistically significant P = 0.0001* in differentiating mature from immature cells. Conclusion: Csaba stain is more effective in differentiating mature from immature MCs compared to the other special stains. [ABSTRACT FROM AUTHOR]

Introduction: This in-vitro study comprises Antimicrobial and Confocal Microscopic analysis of the efficacy of Triple Antibiotic and Toluidine Blue (TBO) loaded chitosan nanoparticles (chnp) activated with photodynamic therapy (PDT) against Enterococcus faecalis (Ef). Methodology: 105 single-rooted extracted teeth were decoronated, cleaned and shaped, and incubated with Ef. The roots were randomly divided into three groups: Group I-Control, Group II-Triple Antibiotic Paste (TAP), Group III: Triple antibiotic-loaded chitosan nanoparticles (tachnp), and Group IV: Tachnp and TBO loaded chnp activated with PDT. Ten specimens from all the groups were subjected to antimicrobial analysis and five specimens were observed under the confocal microscope after 24 h and 7 days. Group IV was additionally analyzed after 24 h and 7 days of laser activation. Results: Group IV C showed the least colony-forming units followed by Group IVB, Group IIIB, Group IVA, and Group IIIA. Group II showed more colony-forming units. On intergroup comparison of mean colony count in control and experimental groups at 24 h and 7 days using one-way ANOVA F test was highly significant P < 0.001. The confocal microscopic images of IV C showed the increased intensity of fluorescent red indicating dead bacteria. Conclusion: Within the limitations of this study, TAP loaded chitosan nanoparticles activated with PDT showed a significant reduction in colony count. [ABSTRACT FROM AUTHOR]

Background: Periapical granuloma and periapical cysts develop as a sequela of inflammation of dental pulp, usually a consequence of an infected root canal. Mast cells (MCs) have most frequently been implicated in the pathophysiology of periapical lesions such as periapical granulomas and cysts. Aims: The present study was undertaken to emphasize the presence and quantification of MCs in periapical lesions (granulomas and cysts) using toluidine blue stain, with an aim to elucidate their role in the pathogenesis of these lesions. Materials and Methods: The study comprised a total of 55 previously diagnosed cases (30 cases of radicular cyst and 25 cases of periapical granuloma) selected from the departmental archives. The MCs were quantified in all the sections in the three zones, namely the epithelial, subepithelial, and deeper connective tissue zones. The results were sent for statistical analysis. Statistical Analysis: Wilcoxon paired t-test and Mann–Whitney U test were applied for intra- and intergroup comparison MCs in different zones of periapical granulomas and radicular cyst, respectively. Results: A statistically significant difference was observed between the two lesions in all the three zones, i.e., epithelial, subepithelial, and in deeper connective tissue zone with P = 0.001. Conclusion: Although MCs were present in all the three zones of both periapical cysts and granuloma, they were predominantly observed in radicular cysts than in periapical granuloma. This suggests a significant role of MC in initiation, development, and progression of these periapical lesions. [ABSTRACT FROM AUTHOR]

Background: Chemiluminescence is the production of light as a result of a chemical reaction. Oral potentially malignant disorders (OPMDs) include both precancerous lesions and conditions that carry an increased risk of cancer. There are different etiological and risk factors for OPMDs such as smoking, alcohol consumption, infections such as viral and fungal, sun exposure and certain other genetic factors. The most common etiological factor for OPMDs is tobacco usage. Chemiluminescence is a light-based detection system and is very useful for detecting OPMDs for early intervention. Because it is a non-invasive procedure, it can be used to evaluate dysplastic changes in various OPMDs at their initial stage for timely intervention. Vital staining has also been used as a chair-side marker for delineating normal and dysplastic oral mucosal tissues.Aim: To compare the efficacy of chemiluminescence with Lugol's iodine to that with toluidine blue in diagnosing dysplastic changes in tobacco associated oral lesions.Methodology: A total of 84 patients with clinically suspicious oral mucosal lesions and OPMDs with tobacco habit history were included and randomly assigned to either of the diagnostic study groups (Group A: chemiluminescence with Lugol's iodine or Group B: chemiluminescence with toluidine blue). All these patients were subjected to a histopathological examination (reference standard).Results: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) were 91.7%, 66.7%, 84.6%, 80%, and 0.792 for chemiluminescence with Lugol's iodine group (P = 0.001) respectively whereas for chemiluminescence with toluidine blue, the sensitivity, specificity, PPV, NPV and ROC were 100%, 60%, 93.3%, 100% and 0.800 (P = 0.002), respectively.Conclusion: The combination of chemiluminescence with toluidine blue had a better diagnostic efficiency in detecting dysplasia in tobacco-associated oral lesions when compared to the group of chemiluminescence with Lugol's iodine. [ABSTRACT FROM AUTHOR]

Background: Chemiluminescence is the production of light as a result of a chemical reaction. Oral potentially malignant disorders (OPMDs) include both precancerous lesions and conditions that carry an increased risk of cancer. There are different etiological and risk factors for OPMDs such as smoking, alcohol consumption, infections such as viral and fungal, sun exposure and certain other genetic factors. The most common etiological factor for OPMDs is tobacco usage. Chemiluminescence is a light‑based detection system and is very useful for detecting OPMDs for early intervention. Because it is a non‑invasive procedure, it can be used to evaluate dysplastic changes in various OPMDs at their initial stage for timely intervention. Vital staining has also been used as a chair‑side marker for delineating normal and dysplastic oral mucosal tissues. Aim: To compare the efficacy of chemiluminescence with Lugol’s iodine to that with toluidine blue in diagnosing dysplastic changes in tobacco associated oral lesions. Methodology: A total of 84 patients with clinically suspicious oral mucosal lesions and OPMDs with tobacco habit history were included and randomly assigned to either of the diagnostic study groups (Group A: chemiluminescence with Lugol’s iodine or Group B: chemiluminescence with toluidine blue). All these patients were subjected to a histopathological examination (reference standard). Results: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and receiver operating characteristics (ROC) were 91.7%, 66.7%, 84.6%, 80%, and 0.792 for chemiluminescence with Lugol’s iodine group (P = 0.001) respectively whereas for chemiluminescence with toluidine blue, the sensitivity, specificity, PPV, NPV and ROC were 100%, 60%, 93.3%, 100% and 0.800 (P = 0.002), respectively. Conclusion: The combination of chemiluminescence with toluidine blue had a better diagnostic efficiency in detecting dysplasia in tobacco‑associated oral lesions when compared to the group of chemiluminescence with Lugol’s iodine. [ABSTRACT FROM AUTHOR]

Introduction: The early detection of the cancer will dramatically improve the prognosis. There are many diagnostic aids that can be employed for screening. Hence, in our study, we aim to evaluate the efficiency of dyes in detection of cancer cells. Materials and Methods: We piloted a prospective clinical study among 30 subjects to detect the efficiency of two dyes--Lugol's iodine and toluidine blue. They were grouped equally for potentially malignant and malignant lesions. The areas were analyzed for the diagnostic accuracy of the dyes using the histopathological examination and compared using chi square test deliberating P < 0.05 as significant. Results: We observed that both the dyes showed a diagnostic accuracy of over 90% when used alone or in combination. Both the dyes had greater sensitivity while specificity was 20%. Conclusion: The combination of these two dyes can be used as an efficient screening aid for the identification of the cancer cells. [ABSTRACT FROM AUTHOR]

Introduction: Human placental extract gel contains extract of human placenta and total nitrogen not more than 0.25% w/w. It is natural vitamins, peptides, nucleotides and amino acid gel. It enhances wound healing significantly; increases collagen synthesis and improves tensile strength of healing tissue. It brings about maximum increases in the percent of DNA, total protein and epithelialisation. It also has anti-inflammatory and analgesic effects. Aim and Objective: Clinical and histological evaluation of depigmented gingival epithelium on application of human placental extract gel. Material and Method: 10 healthy patients in the age group of 18-35 yrs. who were indicated for depigmentation procedure were selected for the study. Depigmentation was done with scalpel technique on maxillary and mandibular anterior region. In group A human placental extract gel was applied on the wound and non-eugenol pack was placed whereas group B was covered with non-eugenol pack only. Wound Healing index and Visual Analogue Score was assessed after 7 and 15 days. Epithelisation of wound was assessed by using toluidine blue after 7 days of surgery. Result: Application of human placental extract gel showed a statistically significant improvement clinically and histologically. Conclusion: Application of human placental extract can be a successful approach to protect the raw wound area of depigmented gingiva with better patient comfort and faster healing. Introduction: In today's era, increased aesthetic concerns have increased the number of patients receiving gingival depigmentation surgeries to create an aesthetically pleasing appearance of gingiva. Human placental extract gel contains extract of human placenta and total nitrogen not more than 0.25% w/w. It is natural vitamins, peptides, nucleotides and amino acid gel. It enhances wound healing significantly; increases collagen synthesis and improves tensile strength of healing tissue. It brings about maximum increases in the percent of DNA, total protein and epithelialisation. It also has anti-inflammatory and analgesic effects. Aim and Objective: Clinical and histological evaluation of depigmented gingival epithelium on application of human placental extract gel. Material and Method: 10 healthy patients in the age group of 18-35 yrs. who were indicated for depigmentation procedure were selected for the study. Depigmentation was done with scalpel technique on maxillary and mandibular anterior region. In group A human placental extract gel was applied on the wound and non-eugenol pack was placed whereas group B was covered with non-eugenol pack only. Wound Healing index and Visual Analogue Score was assessed after 7 and 15 days. Epithelisation of wound was assessed by using toluidine blue after 7 days of surgery. Result: Application of human placental extract gel showed a statistically significant improvement clinically and histologically. Conclusion: Application of human placental extract can be a successful approach to protect the raw wound area of depigmented gingiva with better patient comfort and faster healing. [ABSTRACT FROM AUTHOR]

Introduction: The use of microwave in the field of diagnostic pathology has gained a huge response in recent times. Use of domestic microwave ovens in the same is being widely studied. Unveiling the use of the microwave in improving the staining quality of tissue sections in the field of pathology can aid in precise diagnosis of complex conditions. Aim: The main aim of this study was to study the efficiency of microwave staining to reproduce the tissue architecture compared to that of conventional staining techniques. Materials and Methods: Thirty different tissue blocks (including 10 mucocele tissue blocks) were used to prepare 30 pairs of slides for three different stains, namely hematoxylin and eosin, Van Gieson's, 0.1% toluidine blue and periodic acid–Schiff and 10 pairs of slides for mucicarmine stain. From each pair of slides, one slide was stained routinely, and the other was stained inside a microwave. Two pathologists evaluated the stained slides, and the results so obtained were analyzed statistically. Results: Microwave staining considerably cut down the staining time from hours to seconds. Microwave staining showed no loss of cellular and nuclear details, uniform staining characteristics, and was of excellent quality. Conclusion: The microwave stained slide showed no significant difference in terms of cell outline clarity, cytoplasmic staining, nuclear outline, nuclear staining, nuclear chromatin, and staining intensity compared to that of routine staining method, and a significant difference was observed in the total staining time consumed by all the stains that were used. [ABSTRACT FROM AUTHOR]

Background: Fractal analysis is, a noninvasive method, used to determine the intricate characteristics of the matter. Oral leukoplakia (OL), a potential malignant disorder, has definite propensity to turn in to malignancy. In such lesions, fractal dimension analysis (FDA) could be helpful in the early detection of malignant transformation. Objectives: To determine the efficacy of fractal dimension analysis in detecting malignancy potential of oral leukoplakia. Materials and Methods: After ethical clearance, we enrolled 121 patients in our study. Lesions were photographed before and after toluidine staining. Image J software was used to analyze fractal dimensions (FDs) of digital image and results were compared with biopsy. Results: Fractal dimension value is significantly higher in leukoplakia with dysplastic changes. FD values increase as age of patients increases. FD value in leukoplakia with different tobacco products showed more positive correlation with surti/khaini abusers. Conclusion: Fractal dimension analysis is a useful method in determination of complication in OL cases and can be used as an effective, noninvasive screening tool at primary healthcare centers for early intervention. [ABSTRACT FROM AUTHOR]

Background and Aims: Recurrent Pregnancy loss (RPL) is a heterogeneous disease. The role of maternal factor is clear but the relationship between the paternal factors remains uncertain. It has been shown that increase the level of Reactive Oxygen Species (ROS) and decrease the antioxidant levels in men can lead to RPL. New researches show treatment with antioxidant can improved sperm parameter. The aim of the present study was to assess the effect of vitamin E plus Zinc therapy on sperm parameters and chromatin quality in couples with RPL. Methods: In this clinical trial study, 60 RPL patients were selected from RPL clinic. Standard sperm parameters were analyzed and then male partners were intake vitamin E and Zinc in antioxidant therapy plan for 90 days. After that, sperm parameters were analyzed again. Sperm chromatin assay was reviewed before and after vitamin E and Zinc therapy by cytochemical assay including aniline blue (AB), chromomycin A3 (CMA3), toluidine blue (TB). To assess DNA fragmentation index, TUNEL test was used. Data were analyzed and compared before and after treatment. Results: data analysis showed all sperm parameters significantly improved after treatment (P < 0.001). The number of AB+ and TB+ sperms were decreased significantly after vitamin E and Zinc therapy (P = 0.0001). Decrease in DNA fragmentation in post treatment group in comparison to pre-treatment was statistically significant. Conclusion: Supplemental of vitamin E plus Zinc may improve sperm parameters chromatin quality and decrease sperm DNA fragmentation in RPL patients. [ABSTRACT FROM AUTHOR]

Male factor infertility has been diagnosed as the cause of infertility in about 20% of infertile couples. Sperm analysis is the most common method for diagnosing infertility in a laboratory. However, approximately 15% of infertile men have a normal sperm analysis. Therefore, the result of a routine sperm analysis often cannot be a definitive diagnosis for male factor infertility. Also, approximately 8% of infertile men with normal sperm parameters have high levels of abnormal sperm DNA. This indicates the role of the integrity of sperm DNA in male infertility. Here, we review the current tests available to evaluate the sperm DNA integrity along with their benefits and limitations. [ABSTRACT FROM AUTHOR]

Introduction: Oral leukoplakia, oral submucous fibrosis, and oral lichen planus are the precancerous or potentially malignant lesions and conditions whereas oral squamous cell carcinoma (OSCC) is a cancerous or malignant lesion of the oral cavity. They have characteristic clinical and histopathological features. These diseases not only originate from epithelium but also associated with chronic inflammation juxta-epithellialy. Mast cells present in the connective tissue stroma and release pro-inflammatory and mitogenic cytokines. These functions of mast cells contribute and enhance the pathogenesis translation of diseases. Aim: The study was done to histologically evaluate the number of mast cells in oral epithelial dysplasia and OSCC and compare it with normal oral mucosa (NOM). Materials and Methods: Forty-five cases each of oral dysplasia, OSCC and ten cases of NOM were studied for mast cell number using toluidine blue. Results: There was a highly significant increase of mast cells in oral epithelial dysplasia on comparison with OSCC whereas there was only a significant increase in mast cells in OSCC on comparison with NOM. Conclusion: The literature has proven that mast cells can be an indicator of increased angiogenesis and hence can help in the prediction of carcinogenesis, its progression, and also the prognosis of the malignant lesions. [ABSTRACT FROM AUTHOR]

Objectives: One percent toluidine blue being the most effective adjunct is often used to detect dysplasia. Not much attention has been given to the effect of toluidine blue in enhancement of cytological smears. The present study assessed the smears before and after application of toluidine blue in smokers against non-smokers using three different stains [Papanicolaou (PAP), Hematoxylin and Eosin (H and E), and Giemsa]. Study Design: Twenty-five individuals from each group participated in the study. The oral cytosmears were obtained before and after application of toluidine blue and assessed for clumping of squamous cells, cellular and nuclear pleomorphism, micronuclei, binucleation, bacterial colony units, and keratin flakes. Results: In smokers, the maximum enhancement in cytological smears post-toluidine blue application was shown by Giemsa stain than PAP and H and E stains. Among the individual parameters, nuclear pleomorphism exhibited greatest significant difference between smokers and non-smokers. Conclusion: Toluidine blue enhanced the staining characteristics both in terms of sensitivity and specificity and thereby was found to be synergistic in assessment of cytosmears. The cellular alterations noticed in the smears of smokers with clinically normal buccal mucosa can be used as a means of education tool in counselling for smoking cessation. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: Angiogenesis is a complex event facilitated by angiogenic factors released from neoplastic and host immune cells. Among host immune cells, mast cells (MCs) may have greater significance in tumor progression through angiogenesis. The objectives of the study were to evaluate and correlate mast cell density (MCD) and microvessel density (MVD) in normal gingival tissue, leukoplakia with and without dysplasia and oral squamous cell carcinoma (OSCC) cases. Materials and Methods: Among eighty selected cases, twenty were of normal gingiva, twenty each of leukoplakia without and with dysplasia and twenty of OSCC. The slides were stained with CD34 and counterstained with 0.1% toluidine blue, followed by quantification of MCD and MVD per high-power field (x40) using Image-Pro Express software. Statistical Analysis: Chi-square test and correlation coefficient were used for statistical analysis. Observation and Results: A statistically significant difference in the values of MVD and MCD between normal gingival tissue, leukoplakia with and without dysplasia and OSCC (P = 0.000) was observed. MVD and MCD showed a positive correlation between the study groups. Conclusion: MVD and MCD increased significantly in cases of OSCC as compared to leukoplakia with and without dysplasia and normal gingival tissue. It was concluded that MCs may play a significant role in angiogenesis by releasing pro-angiogenic and angiogenic factors which may in turn favor the progression of premalignant lesion to a malignant one. [ABSTRACT FROM AUTHOR]

Introduction: Angiogenesis is a complex event mediated by angiogenic factors released from cancer cells and immune cells. It has been reported to be associated with progression, aggressiveness and metastases of various malignant tumors including oral squamous cell carcinoma (OSCC). Similarly, mast cells have also been reported to play a role in tumor progression and metastases by promoting angiogenesis. Objectives: The present study was conducted to compare microvessel density (MVD) and mast cell density (MCD) in different histological grades of OSCC in comparison with normal oral mucosa (NM). Materials and Methods: Comparison of MVD by CD34 and MCD by toluidine blue among different histological grades of OSCC and in NM as controls. Statistical Analysis: The results were analysed using 't" test, ANOVA and Pearson's correlation co-efficient. Results: The mean MVD was higher in different grades as compared to normal mucosa. Intergroup comparison of increase in MVD between different grades of OSCC was not found to be highly statistically significant. Pearson's correlation between MVD and MCD revealed a linear increase in MVD as the MCD increased, suggestive of a positive correlation. Conclusion: There was significant correlation found between MVD and MCD which was in agreement that mast cells promote tumor progression through upregulation of angiogenesis. [ABSTRACT FROM AUTHOR]

Background: (1) To study and correlate the mast cell numbers in benign prostatic hyperplasia (BPH) and prostate carcinoma lesions. (2) To compare mast cell numbers of intratumoral and peritumoral regions in prostate adenocarcinomas. (3) To ascertain a relationship between the number of mast cells and age, prostate-specific antigen (PSA) levels, and Gleason Grade. Subjects and Methods: One-hundred cases of prostate lesions, consisting of 75 cases of BPH and 25 cases of prostatic adenocarcinoma, received in the form of transurethral resection of prostate chips in the Department of Pathology, were included in the study. After histopathological diagnosis, the paraffin sections were stained with toluidine blue. Results: The mean value of mast cell count per mm2 in benign and malignant lesion was 37.05 and 92.20, respectively. The difference in mean mast cell count in BPH and prostatic adenocarcinoma was found to be statistically significant (P = 0.001). The correlation between mast cell count and Gleason Grade was found to be statistically significant (P: Grades I-III - 0.043; 0.002; 0.012). However, no correlation was found between mast cell count with age and PSA levels. Conclusion: In this study, an increase in the number of mast cells was observed in patients with prostate cancer than in benign lesions. This suggests a stimulating role of mast cells in the progression of cancer. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Oral cancer is one of the most common cancers in India. It's also associated with poor survival rate. Early diagnosis is the only way of reducing the high morbidity and mortality associated with it. However, most often there is delay in its diagnosis. Several adjuncts have been developed to aid in the diagnosis of cancer in its pre-cancerous and early stage. Chemiluminescence is one of the newly developed adjuncts, which is still in its infancy. This article reviews chemiluminescence technique and its applications in oral cancer diagnosis. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to quantify the number of mast cells in focal reactive hyperplastic lesions of the oral cavity and to compare these two number of mast cells in normal gingival tissues and to correlate their presence with the state of connective tissue changes in reactive lesions and probably suggest a role for mast cells in these lesions. Materials and Methods: Patient records were retrieved during a 10 year period from 2001 to 2010. Data of all reactive hyperplasias namely focal fibrous hyperplasia, pyogenic granuloma (PG), peripheral ossifying fibroma (POF) and peripheral giant cell granuloma (PGCG) were reviewed and 10 cases seen in the gingiva were selected for each category and stained with 1% toluidine blue for mast cells. Statistical analysis was applied to see the significant differences between the groups and with the normal gingival tissue. One-way ANOVA-F and unpaired t-test was applied and significant differences were seen between the groups at 5% level of significance. Results: In this study, mast cell count was maximum in POF and fibrous hyperplasia (FH) followed by cases of PG and PGCG. Conclusion: The number of mast cells was more numerous in POF and FH suggesting that mast cell activation is a characteristic feature of chronic inflammation, a condition that may lead to fibrosis as a result of increased collagen synthesis by fibroblasts. [ABSTRACT FROM AUTHOR]

Objective: Neo-vascularization is vital for an expansion and metastasis of a tumor and is influenced by a number of mediators. Mast cells are believed to release many pro-angiogenic mediators that may help in tumor expansion and invasion. This study describes the role of mast cells and angiogenesis in oral squamous cell carcinoma (OSCC). Study Design: It was a prospective study in which 37 biopsies of well-differentiated OSCC were obtained. Micro-vessels were stained with cluster of differentiation (CD)-34 and mast cells were counted using the Toluidine blue stain. Results: When compared to normal oral mucosal tissue, it was seen that micro-vessel density and mast cell density indeed increases significantly in squamous cell carcinoma; however, they are not correlated to each other. Conclusion: This study reports that angiogenesis does increase in OSCC and mast cells also invade the peri-tumor tissue, but they are not directly correlated. [ABSTRACT FROM AUTHOR]

Background/Aim: Chronic diarrhea is defined as a decrease in fecal consistency lasting for four or more weeks. Prevalence of this complication in the general population is 5%. Mast cells that play an important role in the regulation of gastrointestinal visceral sensitivity and vascular permeability may be involved in functional chronic diarrhea. In this study we tried to evaluate mast cells density in colonic mucosa of patients with chronic diarrhea. Patients and Methods: 50 patients with chronic diarrhea and 50 persons as control group were investigated. All specimens were immunohistochemically stained for mast cell tryptase (MCT) with monoclonal mouse anti-human MCT as well as toluidine blue. Mean number of mucosal mast cells were counted in 10 high power microscopic fields of patients and control groups. Results: In patients group (age range, 15-78 years; 26 females), the number of mast cells per high power field in the immunohistochemistry staining was 21.3 ± 4.8 compared to 14.2 ± 3.4 in the control group (age range, 18-78 years; 24 females) [P < 0.001]. Also number of mast cells in toluidine blue staining was 10.3 ± 3.6 per high power field in cases and 7.1 ± 2.4 in the control group (P < 0.001). Conclusion: Elevated number of colonic mast cells exist in patients with chronic diarrhea. Further research should be considered on application of these findings for new therapeutic opportunities. [ABSTRACT FROM AUTHOR]

Background: Enterococcus faecalis has been widely used as a valuable microbiological pathogen for in vitro studies due to its ability to successfully colonize the root canal in a biofilm-like style, invade dentinal tubules, and resist endodontic treatment procedures. The aim of this study was to compare the bactericidal efficacy of photodynamic therapy (PDT), 2% chlorhexidine, 2.5% NaOCl, and combination of PDT and 2.5% NaOCl against E. faecalis. Materials and Methods: Sixty single-rooted teeth had their canals contaminated with E. faecalis in brain heart infusion broth and were incubated for 48 hours. The canals were then subjected to 2% chlorhexidine, 2.5% NaOCl, PDT (red light emitting diode 625 nm+ Toludine Blue) and PDT + 2.5% NaOCl. Controls consisted of no treatment (positive control) and without inoculation of bacterium (negative control). Following treatment, the canal contents were sampled with sterile paper points. The samples were dispersed in transport medium, serially diluted, and cultured on blood agar to determine the number of colony forming units (CFU). Data were analyzed by Mann-Whitney U test at 5% significance level. The significance level for all analyses was set at P <.05. Results: Combination of PDT and 2.5% NaOCl achieved maximum reduction in recovered viable bacteria, no viable bacteria was observed after treatment of PDT + 2.5% NaOCl. Conclusion: Combination of PDT and 2.5% NaOCl simultaneously is effective in the elimination of E. faecalis from dentinal tubules under the conditions of this study. [ABSTRACT FROM AUTHOR]

Context: Carcinoma in an early stage of development is hard to detect clinically because the lesion may not be palpable and color of the lesional tissue is not necessarily different from the color of the surrounding mucosa. In order to improve the efficacy of the diagnosis, techniques are being developed to complement clinical examination and to facilitate the identification of initial carcinomas. Aims: To find out the efficacy of chemiluminescent illumination (ViziLite™) for the diagnosis in precancer and cancer patients and compare this result to toluidine blue staining and oral exfoliative cytology. Materials and Methods: This study was done in 3 groups. Each group consists of 10 cases. Group I consists of normal appearing mucosa. Group II and III consist of clinically diagnosed precancer and clinically suggestive of cancer respectively. Chemiluminescent illumination, toluidine blue supravital staining, oral exfoliative cytology and biopsy were performed in all cases. Statistical analysis used: SPSS version 10.05 was used to calculate positive and negative predictive values. Results: In Group I, all 10 patients showed negative result to ViziLite™. 8 patients showed positivity and 2 patients showed negativity to ViziLite™ test in Group II. 9 patients were positive and one patient was negative for ViziLite™. Conclusions: Chemiluminescent illumination test was sensitive for precancerous and cancerous lesions, which presented as keratotic lesions and red-white lesions. It showed negative result to erosive lesions. Toluidine blue staining test was reliable in precancerous and cancerous lesions, which present as erosive and red-white lesions. It showed negative result to keratotic lesions. Oral exfoliative cytology has diagnostic value in cancer patients than in precancer patients. These results indicate that chemiluminescent illumination test is relatively reliable and accurate than toluidine blue staining test and useful chair side diagnostic test. [ABSTRACT FROM AUTHOR]

Toluidine blue is a basic thiazine metachromatic dye with high affinity for acidic tissue components, thereby staining tissues rich in DNAand RNA. It has found wide applications both as vital staining in living tissues and as a special stain owing to its metachromatic property. Toluidine blue has been used in vivo to identify dysplasia and carcinoma of the oral cavity. Use of toluidine blue in tissue sections is done with the aim to highlight components, such as mast cells granules, mucins, and cartilage. This article provides an overview on chemistry, technique, and the various applications of toluidine blue. [ABSTRACT FROM AUTHOR]

Oral cancers form a significant portion of the cancer burden seen in our country. Typically, they tend to be preceded by a premalignant state for a long time. This article discusses the various types of premalignant disorders commonly seen in daily practice. Also, it is important to screen patients for these conditions so as to detect malignant changes early. Previously, the screening of patients for oral cancer and precancerous lesions has relied mainly on conventional oral examination. Nowadays, many newer techniques are available to potentially assist in the screening of healthy patients for evidence of oral cancer. This article attempts to review the current literature for screening methods and adjuncts such as toluidine blue, brush cytology, tissue chemiluminescence and autofluorescence. [ABSTRACT FROM AUTHOR]

Angiolipoma is a variant of lipoma with a prominent vascular component. It is the most common tumor of the forearm followed by trunk and extremities of young individuals. It's occurrence in head and neck region is rare. In this report, we present clinical and histopathologic features of non-infiltrating angiolipoma occurring on the upper lip in a 9-year-old female. Toluidine blue stain is used to demonstrate increased mast cell density around blood vessels, speculating its role in vasculogenesis. [ABSTRACT FROM AUTHOR]

Recent attention has been directed toward the role of mast cells in the pathogenesis of oral lichen planus. Mast cells are responsible for trafficking inflammatory cells into the connective tissue that in turn helps in progression and maintenance of chronicity of oral lichen planus (OLP). OLP is a T-cell-mediated chronic inflammatory oral mucosal disease of unknown etiology, and lesions contain few B-cells or plasma cells and minimal deposits of immunoglobulin or complement. Hence, OLP is ideally positioned for the study of human T-cell-mediated inflammation and autoimmunity. This study was done to evaluate the mast cell count using toluidine blue stain in OLP and compares it with oral lichenoid reaction (OLR), and to propose the possible role of mast cells in the pathogenesis of OLP and OLR. Ten cases each of OLP and OLR and five cases of normal buccal mucosa were taken from the archives of Department of Oral Pathology. The samples were stained with toluidine blue using standard toluidine blue method by Wolman 1971. An increase in mast cell count was observed in OLP and OLR in comparison to normal oral mucosa. However, no significant differences in mast cell count were noted between OLP and OLR. [ABSTRACT FROM AUTHOR]

Background and Objectives: In vivo stains are prompt resources, which have emerged, in the recent years, to aid as clinical diagnostic tools in detecting early premalignant and malignant lesions. The aim of the study was to determine the diagnostic efficiency of toluidine blue with Lugol's iodine in oral premalignancies and malignancies and to evaluate the reliability of in vivo staining with toluidine blue and Lugol's iodine in the lesions at risk of malignancy. Materials and Methods: The study group comprised 30 subjects with clinically suspicious premalignant lesions and 30 subjects with clinically suspicious malignant lesions. All the lesions were stained consecutively with toluidine blue and Lugol's iodine and the dye retention were recorded with photographs. Depending on the retention of the dyes, the biopsy site was determined. The biopsy specimens were sent for histological confirmation and results were statistically analyzed. Results: The overall diagnostic accuracy of Lugol's iodine when used consecutively with toluidine blue stain in distinguishing premalignant lesions and malignant lesions was 90%. As the degree of differentiation of malignant lesions progressed toward more severity, they failed to show the retention of Lugol's iodine and the result was highly significant statistically, with a P value <0.001. Interpretation and Conclusion: Lugol's iodine when used with toluidine blue helped in delineating the inflammatory lesions and was the mean source in determining clinically the degrees of differentiation of malignant lesions as the poorly differentiated malignant lesions without glycogen content failed to show Lugol's iodine retention. Toluidine blue with Lugol's iodine can be used as a pretherapeutic assessment of the biologic aggressiveness of the disease. [ABSTRACT FROM AUTHOR]

Background: Frozen section (FS) diagnosis is one of the promising applications of digital pathology (DP). However, the implementation of an appropriate and economically viable DP solution for FS in routine practice is challenging. The objective of this study was to establish the non-inferiority of whole-slide imaging (WSI) versus optical microscopy (OM) for FS diagnosis using a low cost and portable DP system. Materials and Methods: A validation study to investigate the technical performance and diagnostic accuracy of WSI versus OM for FS diagnosis was performed using 60 FS cases[120 slides i.e, 60 hematoxylin and eosin (H & E) and 60 toluidine blue (TOLB)]. The diagnostic concordance, inter- and intra-observer agreement for FS diagnosis by WSI versus OM were recorded. Results: The first time successful scanning rate was 89.1% (107/120). Mean scanning time per slide for H and E and TOLB slide was 1:47 min (range; 0:22–3: 21 min) and 1:46 min (range; 0:21–3: 20 min), respectively. Mean storage space per slide for H and E and TOLB slide was 0.83 GB (range: 0.12–1.73 GB) and 0.71 GB (range: 0.11–1.66 GB), respectively. Considering major discrepancies, the overall diagnostic concordance for OM and WSI, when compared with the reference standard, was 95.42% and 95.83%, respectively. There was almost perfect intra as well as inter-observer agreement (k ≥ 0.8) among 4 pathologists between WSI and OM for FS diagnosis. Mean turnaround time (TAT) of 14:58 min was observed using WSI for FS diagnosis, which was within the College of American Pathologists recommended range for FS reporting. The image quality was average to best quality in most of the cases. Conclusion: WSI was noninferior to OM for FS diagnosis across various specimen types. This portable WSI system can be safely adopted for routine FS diagnosis and provides an economically viable alternative to high-end scanners. [ABSTRACT FROM AUTHOR]

Background: Malaria is a commonest mosquito-borne infectious disease worldwide. Early identification and management of malaria prevents complications and mortality. Identification of the malaria mainly relies on detection of the parasite on blood smears. The present study was conducted to compare Toluidine blue method with Leishman method for detection of malaria parasite and also to study the efficacy and advantages of using Toluidine blue method. Materials and Methods: In 540 consecutive patients with clinical suspicion of malaria, peripheral smears were prepared. Smears were processed for both conventional Leishman method and Toluidine blue method simultaneously. The significance of Toluidine blue method over Leishman method was analyzed using Chi-square (χ2) test. Results: Out of 540 smears, 28.3% (153/540) were positive for malaria parasite on conventional Leishman method, while the smear positivity was more by Toluidine blue method to 33.3% (180/540) [P value < 0.01]. The remaining 66.67% (360/540) were negative by both Toluidine blue method and conventional Leishman method. Conclusion: The Toluidine blue method is simple, rapid, inexpensive, and easily available. The implementation of Toluidine blue method clearly improves microscopic detection of malaria parasite and can be a useful contribution to routine hematology even at rural health sectors. [ABSTRACT FROM AUTHOR]

Context: Early detection of oral cancer is of paramount importance in determining the prognosis of oral cancer. Literature suggests that several diagnostic modalities have been proposed to aid a clinician in early detection of oral cancer without much conclusive evidence. Aims: The present study aims to compare toluidine blue and chemiluminescence screening methods in early detection of carcinoma in North Indian population and also to evaluate these methods with histopathological diagnosis. Methods: In this prospective study, 42 patients with clinically visible premalignant lesions were included. Demographic data were collected, and suspicious lesions were examined by chemiluminescence light (Vizilite) and followed by local application of toluidine blue (Mashberg's recommendation). Findings were recorded for each lesion under standard incandescent light as positive or negative. Biopsy and histopathological analysis of the tissues were performed. Statistical Analysis: Sensitivity, specificity and positive and negative predictive values for the chemiluminescence technique and toluidine blue were calculated for diagnostic tests. Results and Conclusions: In the present study, toluidine blue test was found to be moderately sensitive (63.33%) whereas chemiluminescence test (Vizilite) was found to be highly sensitive (90%); however, the test has limited specificity (50%). Thus, the study concluded that both toluidine blue and Vizilite can be used as an adjunct to simple, conventional visual examination and in screening procedure for oral potentially malignant disorders. [ABSTRACT FROM AUTHOR]