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      Evaluation of Hematological profile in Oral Submucous Fibrosis: A Cross-sectional Study

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          Abstract

          Aims:

          The purpose of this study was to estimate hemoglobin (Hb) level, red cell indices (RCIs), serum iron level and Vitamin B12 level in patients with oral submucous fibrosis (OSMF) and to analyze the association of these parameters in different stages of OSMF.

          Setting and Design:

          This case–control study comprised of 65 individuals, with 40 OSMF patients and 25 controls. The OSMF patients were graded clinically according to the classification by Arakeri et al. Fasting blood samples were collected from both groups for hematological evaluation.

          Statistical Analysis Used:

          The mean values and standard deviations were calculated by Chi-square test. Normality of various parameters was evaluated by Kolmogorov–Smirnov test. The independent t-test was used to compare more than two means simultaneously. Correlation analysis was done by Karl Pearson's correlation coefficient method.

          Results:

          The OSMF patients were in the age range of 21–67 years, with a mean age of 39.85 ± 10.42 years. The mean value of Hb of the control group was 14.24 ± 1.03 g/dL, whereas that of OSMF group was 11.18 ± 2.06 g/dL ( P < 0.001). The mean value of the serum iron level of the control group was 119.67 ± 42.42 μg/dL, whereas that of the OSMF group was 45.04 ± 10.41 μg/dL ( P < 0.001). The mean value of serum Vitamin B12 levels of the control group was 422.98 ± 112.57 μg/dL, whereas that of the OSMF group was 211.78 ± 45.17 μg/dL ( P < 0.001). The RCIs including packed cell volume, mean corpuscular volume, mean corpuscular Hb (MCH) and MCH concentration were significantly reduced in OSMF cases. Iron deficiency was present in 38 patients among the study group and Vitamin B12 deficiency was present in 22 patients of the study group.

          Conclusion:

          OSMF causes depletion of minerals and trace elements, and its replenishment is required for the healing of tissues and performing daily routine activities.

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          Most cited references40

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          Reactive nitrogen species in the chemical biology of inflammation.

          The preponderance of epidemiological evidence now points to a strong association between chronic inflammation and cancers of several organs, including the gastrointestinal tract, liver, and lungs. The strongest evidence for a mechanistic link here involves the generation of reactive oxygen and nitrogen species by macrophages and neutrophils that respond to cytokines and other signaling processes arising at sites of inflammation. These reactive species cause oxidation, nitration, halogenation, and deamination of biomolecules of all types, including lipids, proteins, carbohydrates, and nucleic acids, with the formation of toxic and mutagenic products. This review, in honor of Bruce Ames, will focus on recent advances in our understanding of the protein and DNA damage caused by reactive nitrogen species produced by macrophages and neutrophils, with emphasis on nitric oxide, nitrous anhydride, peroxynitrite, and nitrogen dioxide radical.
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            Etiology of oral submucous fibrosis with special reference to the role of areca nut chewing.

            Oral submucous fibrosis (OSF) is a high risk precancerous condition, predominantly affecting Indians. Consumption of chilli was hypothesized as an etiologic factor on the basis of ecological observations and a solitary animal experimental study. Subsequent epidemiologic studies that included case-series reports, large cross-sectional surveys, case-control studies, cohort and intervention studies have identified areca nut as the major etiologic agent. Tissue-culture studies involving human fibroblasts, areca nut extracts and areca nut alkaloids supported this etiologic hypothesis by showing fibroblastic proliferation and increased collagen formation. Currently, the role of genetic susceptibility and that of autoimmunity are receiving attention. The influence of nutritional factors, if any, remains unclear.
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              Oral submucous fibrosis. A review.

              Oral submucous fibrosis (OSF) affects an estimated 2.5 million people, mostly in the Indian subcontinent. Limitation of oral opening resulting in difficulty in eating is the main presenting feature. Although nutritional deficiencies and immunological processes may play a part in the pathogenesis, the available epidemiological evidence indicates that chewing betel quid (containing areca nut, tobacco, slaked lime or other species) is an important risk factor for OSF. Genetically determined susceptibility could explain why only a small fraction of those using betel quid develop the disease. In OSF there is an incidence of oral cancer of 7.6 per cent for a median 10-year follow-up period. Risk markers for malignant transformation in OSF include epithelial dysplasia, silver binding nucleolar organizer region counts, and sister-chromatid exchange frequencies; p53 tumour suppressor gene mutations may be involved in these potentially malignant changes.
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                Author and article information

                Journal
                J Oral Maxillofac Pathol
                J Oral Maxillofac Pathol
                JOMFP
                Journal of Oral and Maxillofacial Pathology : JOMFP
                Wolters Kluwer - Medknow (India )
                0973-029X
                1998-393X
                Sep-Dec 2020
                09 January 2021
                : 24
                : 3
                : 575
                Affiliations
                [1 ]Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Piparia, Gujarat, India
                [2 ]Department of Oral Medicine and Radiology, Manubhai Patel Dental College, Hospital and Oral Research Institute, Vadodara, Gujarat, India
                Author notes
                Address for correspondence: Dr. Deepa Jatti Patil, Department of Oral Medicine and Radiology, KM Shah Dental College and Hospital, Sumandeep Vidyapeeth Deemed to be University, Piparia, Vadodara - 391 760, Gujarat, India. E-mail: iafdeepa@ 123456gmail.com
                Article
                JOMFP-24-575
                10.4103/jomfp.JOMFP_65_20
                8083419
                5b879e49-11a2-4760-9775-95ca6f8f1a34
                Copyright: © 2021 Journal of Oral and Maxillofacial Pathology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 12 February 2020
                : 17 August 2020
                : 04 September 2020
                Categories
                Original Article

                Pathology
                chemoprevention,iron deficiency,oral submucous fibrosis,vitamin b12 deficiency
                Pathology
                chemoprevention, iron deficiency, oral submucous fibrosis, vitamin b12 deficiency

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