Samadara Siriwardena | University Of Peradeniya,Sri Lanka (original) (raw)
Papers by Samadara Siriwardena
Oral Diseases
IntroductionVerruco papillary lesions (VPL) in the oral cavity encompass a spectrum of lesions st... more IntroductionVerruco papillary lesions (VPL) in the oral cavity encompass a spectrum of lesions starting from benign, potentially malignant to entirely malignant tumors. Much of the controversies in these entities occur due to lack of consensus on the disease characteristics and the management. This systematic review was conducted to identify and describe different lesions categorized as VPL in the oral cavity and their association with malignancy.MethodsAn electronic literature search was conducted in MEDLINE (via PubMed), Scopus, LILAC, IMSEAR, and CENTRAL databases, which retrieved a total of 1020 abstracts. These abstracts were managed through Rayyan and Mendeley software, and only 28 studies with high quality were included in the systematic review.ResultsStudies were published from 1992 to 2021. From the extracted data, nine different entities under the umbrella term VPL were identified associated with malignancy. We describe the clinical and histopathological characteristics of...
Background- Prevalence of smoking in Sri Lanka shows a gradual reduction whilst the use of smokel... more Background- Prevalence of smoking in Sri Lanka shows a gradual reduction whilst the use of smokeless tobacco and areca nut shows an increasing trend. At present, to the best of our knowledge only a few well-structured smokeless tobacco (SLT)/areca nut (AN) cessation programmes are conducted in Sri Lanka, which is a gross underachievement considering that betel chewing related oral squamous cell carcinoma being the commonest cancer in Sri Lankan males. As General Dental Practitioners (GDP) do not contribute significantly to SLT/AN cessation activities at present, capacity building programmes on SLT/AN control were carried out. The study evaluated the knowledge, attitude and practices related to SLT/AN control among dental surgeonsMethods: Following an one day capacity building programme/workshop on smokeless tobacco / areca nut control, two self-administered questionnaires were used to assess the improvement of knowledge and change of attitudes among 663 GDPs . Results - 27.1% of the...
Annals of global health
Schistosomiasis is a highly prevalent parasitic disease in Senegal. The early symptoms are hematu... more Schistosomiasis is a highly prevalent parasitic disease in Senegal. The early symptoms are hematuria and dysuria. Children's comprehension of the disease is fundamental to preventing the infection. The aim of this study was to investigate the knowledge attitudes, and practices related to schistosomiasis among schoolchildren in 2 rural villages in Northern Senegal and to evaluate their impact on the disease. A cross-sectional study was conducted. Data about children's knowledge of schistosomiasis, behavior, and preventive measures were collected through a questionnaire. Questionnaire responses from 575 schoolchildren were analyzed. Correct answers about risky behavior for schistosomiasis were associated with early symptoms (P = 0.010). Wearing shoes and washing hands with soap were associated with not having hematuria and dysuria (P = 0.007 and 0.049, respectively). Playing in rivers was associated with the aforementioned symptoms (P < 0.001). Children who had good knowled...
Journal of Otology & Rhinology, 2015
Plasma cell mucositis is a rare idiopathic inflammatory condition showing benign plasma cell prol... more Plasma cell mucositis is a rare idiopathic inflammatory condition showing benign plasma cell proliferation with erythematous mucosa and varying surface appearances affecting oral, upper respiratory and genital mucosae. Final diagnosis should be achieved by clinicopathological correlation following exclusion of other similarly presenting diseases. Different treatment modalities such as steroids, calcinurin inhibitors, cryotherapy, laser and surgical excision have been used but with varying response. Therefore Plasma cell mucositis presents a challenge in both diagnosis and treatment. Here, we report eleven new cases of plasma cell mucositis and discuss their histological variations and management.
Journal of Diagnostic Pathology, 2013
Objective: To grade MEC using the criteria of the Armed forces Institute of Pathology (AFIP), Bra... more Objective: To grade MEC using the criteria of the Armed forces Institute of Pathology (AFIP), Brandwein point based system and Modified Healey qualitative analytic system and correlate the survival data with the grading obtained for each patient. Method: Haematoxylin and eosin stained slides of 34 patients with MEC were used to grade the tumours according to the criteria specified in the three grading systems. Survival period in months and the outcome including if the patient had died due to disease or whether the patient is living with or without disease was obtained by sending a questionnaire to the patients/relatives of the patient. Results: Statistically significant higher recurrence and poor survival rates could be observed in high grade MECs compared to low/intermediate grade tumours when MECs were graded according to AFIP (Recurrence rate-p=0.0036, survival-p=0.0067) and Modified Healey (Recurrence rate-p=0.031, survival-p=0.0067) system. However, no statistically significant differences could be demonstrated when the tumours were graded according to Brandwein classification (p>0.05). Conclusion: The histopathological grade carries a high prognostic significance, when MECs are graded according to AFIP and Modified Healey classifications, while Brandwein system was unsuitable to predict the survival and prognosis of patients.
Otolaryngology–Head and Neck Surgery, 2011
Background: The term "primary intraosseous squamous cell carcinoma" was introduced in 2005 by the... more Background: The term "primary intraosseous squamous cell carcinoma" was introduced in 2005 by the World Health Organization with three subcategories. Squamous cell carcinoma arising from the lining of an odontogenic cyst is one important rare subcategory of such lesions with an incidence of 0.01 to 0.02%. Furthermore, the appearance of such malignancy in an odontogenic tumor such as keratocystic odontogenic tumor is considered extremely rare. Case presentation: In this case report we report a case of a 50-year-old Sri Lankan woman who complained of pain and increase in the size of a swelling at the anterior mandible, which had been present for over 1 year. The increase was significant for 1 month with accompanying numbness of the left half of her lip. Cone beam computed tomography results revealed an irregular radiolucent lesion involving most of her mandible and, except in the anterior part, very little buccolingual expansion was seen that suggested a keratocystic odontogenic tumor. An excision biopsy of the cyst lining confirmed a squamous cell carcinoma arising from a preexisting keratocystic odontogenic tumor. Conclusions: Even though primary intraosseous squamous cell carcinoma arising from a keratocystic odontogenic tumor is considered to be very rare, the present case is comparable to most of the aspects cited in the literature. The current case emphasizes the importance of careful investigation of swellings present in the mandible. Clinicians as well as patients should be aware and detect these changes to avoid being clinically negligent.
AIDS Care, 2007
... because Turkey is a Muslim country with conservative cultural values where premarital sex is ... more ... because Turkey is a Muslim country with conservative cultural values where premarital sex is less ... Negative attitudes towards PLHIV can interfere with the quality of nursing care and can cause ... In this study there was a substantial negative attitude towards AIDS and HIV-positive ...
Journal of Oral Pathology & Medicine, 2022
BACKGROUND Lymph node metastasis in oral squamous cell carcinoma (OSCC) is influenced by clinical... more BACKGROUND Lymph node metastasis in oral squamous cell carcinoma (OSCC) is influenced by clinical and histopathological variables. The aim of this study was to develop a simple model to predict nodal metastasis of OSCC in clinically negative necks (cN0). METHODS Data from patients who underwent surgery for treatment of OSCC of the tongue or buccal mucosa with neck dissection were used for model development and validation. RESULTS Nodal metastasis was significantly associated with gender, age, tumor size, site, POI and DOI on univariate analysis. All the five variables except age was retained at the variable selection step of the model development and were used in the final model because it was not significant at 0.10 significance level after adjusting for other variables. Regression coefficients of the model were used to estimate risks of nodal metastases for each combination of clinicopathological characteristics. A 10-fold cross validation was used to assess the model. The average of the resultant 10 AUCs (along with its 95% confidence interval estimated using bootstrap) was used as the overall validated measure of the model. A risk chart was produced using probability of nodal metastasis predicted by the model for each combination of five characteristics. The model's ability to identify patients with nodal metastases as assessed by the area under the ROC curve (AUC) was 0.752. CONCLUSION The model based on established clinicopathological variables has been internally validated on a large cohort of patients and offers practicability for use in OSCCs of the tongue and buccal mucosa.
Case Reports in Pathology, 2017
Phaeohyphomycosis is a fungal infection caused by Dermatiacae group of fungi, by Cladosporium spp... more Phaeohyphomycosis is a fungal infection caused by Dermatiacae group of fungi, by Cladosporium spp. The term phaeohyphomycosis was introduced by Ajello et al. in 1974 to designate infections by brown pigmented filamentous fungi. Cladosporium oxysporum is a very rare etiological agent in humans. Phaeohyphomycosis of the cervical lymph node in an immunocompetent individual is a very rare clinical entity. To the best of our knowledge we report the first case of phaeohyphomycosis caused by Cladosporium oxysporum in the absence of other systemic manifestations in a 16-year-old male.
Asian Pacific journal of cancer prevention : APJCP, 2021
BACKGROUND Epithelial dysplasia (ED) at oral cancer excision margins is a frequent finding. Dyspl... more BACKGROUND Epithelial dysplasia (ED) at oral cancer excision margins is a frequent finding. Dysplastic epithelium at excision margins may not be similar to dysplasia in Oral potentially malignant disorders (OPMD) as malignant transformation has already taken place. Therefore, management of ED at excision margins should be different to that of OPMD. ED creates a dilemma in relation to further management of cancer patients, since there are no accepted guidelines. Therefore, the objective of this review is to analyze existing literature and to arrive at evidence based recommendations for the management of ED at excision margins. METHODS A comprehensive string was run on PubMed, Medscape and Medline. The final outcome included 113 studies. Finally, the most relevant 10 articles were critically assessed for inclusion and exclusion criteria against various parameters. RESULTS AND CONCLUSIONS Severe and Moderate ED need re-excision in order to improve prognosis. There is not enough soun...
目的 探讨法洛四联症(TOF)合并不同类型的主肺侧支动脉(MAPCA)行手术矫治的适应证、方法及效果.方法 2000年1月至-2004年5月对9例TOF合并MAPCA患者行矫治手术治疗,其中5例... more 目的 探讨法洛四联症(TOF)合并不同类型的主肺侧支动脉(MAPCA)行手术矫治的适应证、方法及效果.方法 2000年1月至-2004年5月对9例TOF合并MAPCA患者行矫治手术治疗,其中5例合并肺动脉闭锁,男性6例、女性3例,年龄3～9岁.手术均在中度低温体外循环下进行,5例先采用介入技术弹簧圈封堵MAPCA,随即行心内矫治手术,采用涤纶补片修复室间隔缺损, 右心室流出道重建;1例心内矫治手术中结扎MAPCA;3例合并Ⅲ或Ⅳ型肺动脉闭锁患者采用一期单源化手术,2例心内修复术,1例室间隔缺损开放.结果术后早期死亡1例,死亡原因为脊髓内出血. 随访3个月～4年,NYHA心功能Ⅰ、Ⅱ级7例,Ⅲ级1例.结论合并MAPCA的TOF患者一经诊断应尽快手术,结合介入技术方法,早期行矫治手术可以得到满意的效果.
Zhonghua wai ke za zhi [Chinese journal of surgery], 2004
OBJECTIVE To summarize the experience in surgical treatment of residual shunt after repair of ven... more OBJECTIVE To summarize the experience in surgical treatment of residual shunt after repair of ventricular septal defect and investigate the position of the residual shunts. METHODS Between January 1979 and May 2003, re-operations on residual shunt after repair of ventricular septal defect were performed in 37 patients with congenital heart disease including ventricular septal defect, tetralogy of Fallot, double outlet right ventricle in 19, 17 and 1 patients, respectively. It accounted for 0.21% (37/18000) of open heart operations performed during these years. The patients included 26 males and 11 females with age from 3 months to 53 years (mean 16 +/- 12 years). The residual shunt was diagnosed by postoperative murmur and echocardiography. Twenty-six cases were repaired with patch and 11 cases were closed directly with mattresses sutures. RESULTS Two patients (2/37, 5%) died within 48 hrs postoperatively. The results in other 35 patients followed up after surgery from 3 months to 1...
Lichen palnus is a mucocutaneous disorder that predominantly affects older patients and less freq... more Lichen palnus is a mucocutaneous disorder that predominantly affects older patients and less frequently the paediatric population. Oral lichen planus (OLP) can cause severe morbidity if undiagnosed and it carries low risk of malignant transformation potential too. Although OLP in children is rare,it should be included in the differential diagnosis of oral mucosal ulcerative disease because it is important to prevent the serious morbidity that may result from disease. This paper describes a case of bullous OLP in a 9 year old child that was diagnosed and successfullymanaged.
Journal of Oral Pathology & Medicine, 2021
BACKGROUND Ameloblastoma is an odontogenic tumour exhibiting locally invasive behaviour and high ... more BACKGROUND Ameloblastoma is an odontogenic tumour exhibiting locally invasive behaviour and high recurrence rate after treatment. Conventional ameloblastoma is reportedly be more aggressive showing infiltrative growth pattern and tendency for recurrence. This is a retrospective study performed to analyse the relationship between clinicopathological characteristics and treatment modalities in the recurrence of ameloblastoma. METHODS 624 cases of ameloblastoma comprising of 519 non-recurrent ameloblastoma and 105 recurrent ameloblastoma from two main diagnostic centres in Malaysia and Sri Lanka were included. The demographic data, clinical characteristics, histopathological data, treatment modality and episodes of recurrence were extracted and analysed. RESULTS The mean age for recurrent ameloblastoma was 37.23 with a peak occurrence in the third decade of life. Recurrent ameloblastoma was marginally female predominant with male to female ratio of 1:1.3. Mandible was the commonest site for recurrence with a predilection for more than two segments of left mandible followed by left posterior mandible. Follicular (58.1%) histopathological variant was the most reported type to recur followed by plexiform (17.1%). 49.5% of recurrent cases were treated with conservative approach. 65.7% of recurrent cases demonstrated a single episode of recurrence. Mixed (follicular and plexiform) histopathological variant showed the longest average years (11.5 years) for single episode of recurrence. Plexiform ameloblastoma treated with conservative approach recurred in the shortest follow up period. Recurrence of ameloblastoma was significantly associated with age group, sub-site of occurrence and histopathological variants (p<0.05). CONCLUSION This study showed that age, sub-site of occurrence, histopathological variants are significant factors responsible for recurrence of ameloblastoma.
Brazilian Journal of Otorhinolaryngology, 2020
BACKGROUND Amyloidosis is the term applied to a diverse group of disorders that share the feature... more BACKGROUND Amyloidosis is the term applied to a diverse group of disorders that share the features of deposition of amorphous, extracellular material at various sites. Amyloid deposits may occur locally or may involve various organs, resulting number of clinical manifestations. Amyloidosis of the head and neck is rare and reflects underlying plasma cell dyscrasia. METHODS A 57-year-old female patient presented with multiple painful oral ulcerative lesions on tongue and bilateral buccal mucosa for 1year and 6 months duration and a 76-year old male patient with small yellowish nodules on mucosal surfaces of the tongue and buccal mucosa. Results both cases histopathologically diagnosed as amyloidosis. Further investigations confirmed multiple myeloma. CONCLUSION unusual oral lesions could be the first sign of systemic diseases such as multiple myeloma that account the significance of the role of the oral and maxillofacial specialists and dental surgeons.
BioMed Research International, 2020
Background. Nodal metastasis is a critical factor in predicting the prognosis of oral squamous ce... more Background. Nodal metastasis is a critical factor in predicting the prognosis of oral squamous cell carcinoma (OSCC). When patients present with a clinically positive neck, the treatment of choice is radical neck dissection. However, management of a clinically negative neck is still a subject of significant controversy. Aim. This study was carried out in order to propose a model to predict regional lymph node metastasis of OSCC using histological parameters such as tumour stage, tumour size, pattern of invasion (POI), differentiation of tumour, and host immune response, together with the expression levels of six biomarkers (periostin, HIF-1α, MMP-9, β-catenin, VEGF-C, and EGFR), and, furthermore, to compare the impact of all these parameters on recurrence and 3 yr and 5 yr survival rates. Materials and Method. Histological materials collected from the archives were used to evaluate histological parameters and immunohistochemical profiles. Standard methods were used for immunohistoch...
Journal of Oral Biology and Craniofacial Research, 2020
Introduction:-Early detection plays a major role to reduce the mortality of oral squamous cell ca... more Introduction:-Early detection plays a major role to reduce the mortality of oral squamous cell carcinoma (OSCC). Many adjunctive techniques have emerged with claims of differentiating high risk oral potentially malignant disorders (OPMDs) from benign lesions. Toluidine blue (TB) test has been established as a diagnostic adjunct in detecting high risk OPMDs and early asymptomatic OSCCs. As majority of OSCC are preceded by OPMDs, recognition of them at an early stage is important in the management of this devastating disease. Methods:-This study was conducted as a multi-center study prospectively for a period of 2 years. Sixty five patients presented with OPMDs were selected and TB test was performed followed by a biopsy for histopathological confirmation. Criterion validity was assessed with histological diagnosis of the incisional biopsy of the OPMD as a gold standard test verses TB test results. Results: The sensitivity of the TB test was 68.3% and the specificity 63.1% with a false positive rate of 36.8% and false negative rate of 31.7%. However, the predictive value of the positive test was 80%. Conclusion:-TB testing might be a potential adjunct diagnostic aid in identifying high risk OPMDs. Further studies with extensive sample size and different demographics are needed to validate our findings.
Ceylon Journal of Science, 2018
Actinic keratosis (AK) is a dermatological condition commonly found among fair-skinned population... more Actinic keratosis (AK) is a dermatological condition commonly found among fair-skinned populations and considered as a potentially malignant disorder usually appearing on sunexposed areas such as the scalp, face and forearms. It is an uncommon disorder among Asians. Therefore, Actinic Keratosis in Asians has not been thoroughly investigated. AK is clinically termed as"Actinic chelitis" when lesions present in the lips. This case report is about a 42-year-old male who presented at the Oral Medicine Clinic of the University Dental Hospital, Peradeniya, with a complaint of burning sensation of the mouth which aggravates with spicy foods for about three months. Been working in a farm from the age of 12 years and exposure to sunlight for about 9 to 10 hours a day, he has had an extreme exposure to sunlight. Examination revealed an erythematous, nonindurated ulceration of the lower lip. Histopathological sections showed ulcerated mucosa covered by orthokeratinized stratified squamous epithelium with regenerative atypia towards the ulcer bed. Degenerative changes of collagen were evident in the upper corium. The patient was educated about the disease and a protective local covering agent was prescribed to apply on the affected area. This case report emphasizes the possibility of acquiring AK among dark-skinned people due to extreme exposure to sunlight and the importance of knowledge about this disease entity for clinicians when diagnosing as it may have been misdiagnosed.
Oral Diseases
IntroductionVerruco papillary lesions (VPL) in the oral cavity encompass a spectrum of lesions st... more IntroductionVerruco papillary lesions (VPL) in the oral cavity encompass a spectrum of lesions starting from benign, potentially malignant to entirely malignant tumors. Much of the controversies in these entities occur due to lack of consensus on the disease characteristics and the management. This systematic review was conducted to identify and describe different lesions categorized as VPL in the oral cavity and their association with malignancy.MethodsAn electronic literature search was conducted in MEDLINE (via PubMed), Scopus, LILAC, IMSEAR, and CENTRAL databases, which retrieved a total of 1020 abstracts. These abstracts were managed through Rayyan and Mendeley software, and only 28 studies with high quality were included in the systematic review.ResultsStudies were published from 1992 to 2021. From the extracted data, nine different entities under the umbrella term VPL were identified associated with malignancy. We describe the clinical and histopathological characteristics of...
Background- Prevalence of smoking in Sri Lanka shows a gradual reduction whilst the use of smokel... more Background- Prevalence of smoking in Sri Lanka shows a gradual reduction whilst the use of smokeless tobacco and areca nut shows an increasing trend. At present, to the best of our knowledge only a few well-structured smokeless tobacco (SLT)/areca nut (AN) cessation programmes are conducted in Sri Lanka, which is a gross underachievement considering that betel chewing related oral squamous cell carcinoma being the commonest cancer in Sri Lankan males. As General Dental Practitioners (GDP) do not contribute significantly to SLT/AN cessation activities at present, capacity building programmes on SLT/AN control were carried out. The study evaluated the knowledge, attitude and practices related to SLT/AN control among dental surgeonsMethods: Following an one day capacity building programme/workshop on smokeless tobacco / areca nut control, two self-administered questionnaires were used to assess the improvement of knowledge and change of attitudes among 663 GDPs . Results - 27.1% of the...
Annals of global health
Schistosomiasis is a highly prevalent parasitic disease in Senegal. The early symptoms are hematu... more Schistosomiasis is a highly prevalent parasitic disease in Senegal. The early symptoms are hematuria and dysuria. Children's comprehension of the disease is fundamental to preventing the infection. The aim of this study was to investigate the knowledge attitudes, and practices related to schistosomiasis among schoolchildren in 2 rural villages in Northern Senegal and to evaluate their impact on the disease. A cross-sectional study was conducted. Data about children's knowledge of schistosomiasis, behavior, and preventive measures were collected through a questionnaire. Questionnaire responses from 575 schoolchildren were analyzed. Correct answers about risky behavior for schistosomiasis were associated with early symptoms (P = 0.010). Wearing shoes and washing hands with soap were associated with not having hematuria and dysuria (P = 0.007 and 0.049, respectively). Playing in rivers was associated with the aforementioned symptoms (P < 0.001). Children who had good knowled...
Journal of Otology & Rhinology, 2015
Plasma cell mucositis is a rare idiopathic inflammatory condition showing benign plasma cell prol... more Plasma cell mucositis is a rare idiopathic inflammatory condition showing benign plasma cell proliferation with erythematous mucosa and varying surface appearances affecting oral, upper respiratory and genital mucosae. Final diagnosis should be achieved by clinicopathological correlation following exclusion of other similarly presenting diseases. Different treatment modalities such as steroids, calcinurin inhibitors, cryotherapy, laser and surgical excision have been used but with varying response. Therefore Plasma cell mucositis presents a challenge in both diagnosis and treatment. Here, we report eleven new cases of plasma cell mucositis and discuss their histological variations and management.
Journal of Diagnostic Pathology, 2013
Objective: To grade MEC using the criteria of the Armed forces Institute of Pathology (AFIP), Bra... more Objective: To grade MEC using the criteria of the Armed forces Institute of Pathology (AFIP), Brandwein point based system and Modified Healey qualitative analytic system and correlate the survival data with the grading obtained for each patient. Method: Haematoxylin and eosin stained slides of 34 patients with MEC were used to grade the tumours according to the criteria specified in the three grading systems. Survival period in months and the outcome including if the patient had died due to disease or whether the patient is living with or without disease was obtained by sending a questionnaire to the patients/relatives of the patient. Results: Statistically significant higher recurrence and poor survival rates could be observed in high grade MECs compared to low/intermediate grade tumours when MECs were graded according to AFIP (Recurrence rate-p=0.0036, survival-p=0.0067) and Modified Healey (Recurrence rate-p=0.031, survival-p=0.0067) system. However, no statistically significant differences could be demonstrated when the tumours were graded according to Brandwein classification (p>0.05). Conclusion: The histopathological grade carries a high prognostic significance, when MECs are graded according to AFIP and Modified Healey classifications, while Brandwein system was unsuitable to predict the survival and prognosis of patients.
Otolaryngology–Head and Neck Surgery, 2011
Background: The term "primary intraosseous squamous cell carcinoma" was introduced in 2005 by the... more Background: The term "primary intraosseous squamous cell carcinoma" was introduced in 2005 by the World Health Organization with three subcategories. Squamous cell carcinoma arising from the lining of an odontogenic cyst is one important rare subcategory of such lesions with an incidence of 0.01 to 0.02%. Furthermore, the appearance of such malignancy in an odontogenic tumor such as keratocystic odontogenic tumor is considered extremely rare. Case presentation: In this case report we report a case of a 50-year-old Sri Lankan woman who complained of pain and increase in the size of a swelling at the anterior mandible, which had been present for over 1 year. The increase was significant for 1 month with accompanying numbness of the left half of her lip. Cone beam computed tomography results revealed an irregular radiolucent lesion involving most of her mandible and, except in the anterior part, very little buccolingual expansion was seen that suggested a keratocystic odontogenic tumor. An excision biopsy of the cyst lining confirmed a squamous cell carcinoma arising from a preexisting keratocystic odontogenic tumor. Conclusions: Even though primary intraosseous squamous cell carcinoma arising from a keratocystic odontogenic tumor is considered to be very rare, the present case is comparable to most of the aspects cited in the literature. The current case emphasizes the importance of careful investigation of swellings present in the mandible. Clinicians as well as patients should be aware and detect these changes to avoid being clinically negligent.
AIDS Care, 2007
... because Turkey is a Muslim country with conservative cultural values where premarital sex is ... more ... because Turkey is a Muslim country with conservative cultural values where premarital sex is less ... Negative attitudes towards PLHIV can interfere with the quality of nursing care and can cause ... In this study there was a substantial negative attitude towards AIDS and HIV-positive ...
Journal of Oral Pathology & Medicine, 2022
BACKGROUND Lymph node metastasis in oral squamous cell carcinoma (OSCC) is influenced by clinical... more BACKGROUND Lymph node metastasis in oral squamous cell carcinoma (OSCC) is influenced by clinical and histopathological variables. The aim of this study was to develop a simple model to predict nodal metastasis of OSCC in clinically negative necks (cN0). METHODS Data from patients who underwent surgery for treatment of OSCC of the tongue or buccal mucosa with neck dissection were used for model development and validation. RESULTS Nodal metastasis was significantly associated with gender, age, tumor size, site, POI and DOI on univariate analysis. All the five variables except age was retained at the variable selection step of the model development and were used in the final model because it was not significant at 0.10 significance level after adjusting for other variables. Regression coefficients of the model were used to estimate risks of nodal metastases for each combination of clinicopathological characteristics. A 10-fold cross validation was used to assess the model. The average of the resultant 10 AUCs (along with its 95% confidence interval estimated using bootstrap) was used as the overall validated measure of the model. A risk chart was produced using probability of nodal metastasis predicted by the model for each combination of five characteristics. The model's ability to identify patients with nodal metastases as assessed by the area under the ROC curve (AUC) was 0.752. CONCLUSION The model based on established clinicopathological variables has been internally validated on a large cohort of patients and offers practicability for use in OSCCs of the tongue and buccal mucosa.
Case Reports in Pathology, 2017
Phaeohyphomycosis is a fungal infection caused by Dermatiacae group of fungi, by Cladosporium spp... more Phaeohyphomycosis is a fungal infection caused by Dermatiacae group of fungi, by Cladosporium spp. The term phaeohyphomycosis was introduced by Ajello et al. in 1974 to designate infections by brown pigmented filamentous fungi. Cladosporium oxysporum is a very rare etiological agent in humans. Phaeohyphomycosis of the cervical lymph node in an immunocompetent individual is a very rare clinical entity. To the best of our knowledge we report the first case of phaeohyphomycosis caused by Cladosporium oxysporum in the absence of other systemic manifestations in a 16-year-old male.
Asian Pacific journal of cancer prevention : APJCP, 2021
BACKGROUND Epithelial dysplasia (ED) at oral cancer excision margins is a frequent finding. Dyspl... more BACKGROUND Epithelial dysplasia (ED) at oral cancer excision margins is a frequent finding. Dysplastic epithelium at excision margins may not be similar to dysplasia in Oral potentially malignant disorders (OPMD) as malignant transformation has already taken place. Therefore, management of ED at excision margins should be different to that of OPMD. ED creates a dilemma in relation to further management of cancer patients, since there are no accepted guidelines. Therefore, the objective of this review is to analyze existing literature and to arrive at evidence based recommendations for the management of ED at excision margins. METHODS A comprehensive string was run on PubMed, Medscape and Medline. The final outcome included 113 studies. Finally, the most relevant 10 articles were critically assessed for inclusion and exclusion criteria against various parameters. RESULTS AND CONCLUSIONS Severe and Moderate ED need re-excision in order to improve prognosis. There is not enough soun...
目的 探讨法洛四联症(TOF)合并不同类型的主肺侧支动脉(MAPCA)行手术矫治的适应证、方法及效果.方法 2000年1月至-2004年5月对9例TOF合并MAPCA患者行矫治手术治疗,其中5例... more 目的 探讨法洛四联症(TOF)合并不同类型的主肺侧支动脉(MAPCA)行手术矫治的适应证、方法及效果.方法 2000年1月至-2004年5月对9例TOF合并MAPCA患者行矫治手术治疗,其中5例合并肺动脉闭锁,男性6例、女性3例,年龄3～9岁.手术均在中度低温体外循环下进行,5例先采用介入技术弹簧圈封堵MAPCA,随即行心内矫治手术,采用涤纶补片修复室间隔缺损, 右心室流出道重建;1例心内矫治手术中结扎MAPCA;3例合并Ⅲ或Ⅳ型肺动脉闭锁患者采用一期单源化手术,2例心内修复术,1例室间隔缺损开放.结果术后早期死亡1例,死亡原因为脊髓内出血. 随访3个月～4年,NYHA心功能Ⅰ、Ⅱ级7例,Ⅲ级1例.结论合并MAPCA的TOF患者一经诊断应尽快手术,结合介入技术方法,早期行矫治手术可以得到满意的效果.
Zhonghua wai ke za zhi [Chinese journal of surgery], 2004
OBJECTIVE To summarize the experience in surgical treatment of residual shunt after repair of ven... more OBJECTIVE To summarize the experience in surgical treatment of residual shunt after repair of ventricular septal defect and investigate the position of the residual shunts. METHODS Between January 1979 and May 2003, re-operations on residual shunt after repair of ventricular septal defect were performed in 37 patients with congenital heart disease including ventricular septal defect, tetralogy of Fallot, double outlet right ventricle in 19, 17 and 1 patients, respectively. It accounted for 0.21% (37/18000) of open heart operations performed during these years. The patients included 26 males and 11 females with age from 3 months to 53 years (mean 16 +/- 12 years). The residual shunt was diagnosed by postoperative murmur and echocardiography. Twenty-six cases were repaired with patch and 11 cases were closed directly with mattresses sutures. RESULTS Two patients (2/37, 5%) died within 48 hrs postoperatively. The results in other 35 patients followed up after surgery from 3 months to 1...
Lichen palnus is a mucocutaneous disorder that predominantly affects older patients and less freq... more Lichen palnus is a mucocutaneous disorder that predominantly affects older patients and less frequently the paediatric population. Oral lichen planus (OLP) can cause severe morbidity if undiagnosed and it carries low risk of malignant transformation potential too. Although OLP in children is rare,it should be included in the differential diagnosis of oral mucosal ulcerative disease because it is important to prevent the serious morbidity that may result from disease. This paper describes a case of bullous OLP in a 9 year old child that was diagnosed and successfullymanaged.
Journal of Oral Pathology & Medicine, 2021
BACKGROUND Ameloblastoma is an odontogenic tumour exhibiting locally invasive behaviour and high ... more BACKGROUND Ameloblastoma is an odontogenic tumour exhibiting locally invasive behaviour and high recurrence rate after treatment. Conventional ameloblastoma is reportedly be more aggressive showing infiltrative growth pattern and tendency for recurrence. This is a retrospective study performed to analyse the relationship between clinicopathological characteristics and treatment modalities in the recurrence of ameloblastoma. METHODS 624 cases of ameloblastoma comprising of 519 non-recurrent ameloblastoma and 105 recurrent ameloblastoma from two main diagnostic centres in Malaysia and Sri Lanka were included. The demographic data, clinical characteristics, histopathological data, treatment modality and episodes of recurrence were extracted and analysed. RESULTS The mean age for recurrent ameloblastoma was 37.23 with a peak occurrence in the third decade of life. Recurrent ameloblastoma was marginally female predominant with male to female ratio of 1:1.3. Mandible was the commonest site for recurrence with a predilection for more than two segments of left mandible followed by left posterior mandible. Follicular (58.1%) histopathological variant was the most reported type to recur followed by plexiform (17.1%). 49.5% of recurrent cases were treated with conservative approach. 65.7% of recurrent cases demonstrated a single episode of recurrence. Mixed (follicular and plexiform) histopathological variant showed the longest average years (11.5 years) for single episode of recurrence. Plexiform ameloblastoma treated with conservative approach recurred in the shortest follow up period. Recurrence of ameloblastoma was significantly associated with age group, sub-site of occurrence and histopathological variants (p<0.05). CONCLUSION This study showed that age, sub-site of occurrence, histopathological variants are significant factors responsible for recurrence of ameloblastoma.
Brazilian Journal of Otorhinolaryngology, 2020
BACKGROUND Amyloidosis is the term applied to a diverse group of disorders that share the feature... more BACKGROUND Amyloidosis is the term applied to a diverse group of disorders that share the features of deposition of amorphous, extracellular material at various sites. Amyloid deposits may occur locally or may involve various organs, resulting number of clinical manifestations. Amyloidosis of the head and neck is rare and reflects underlying plasma cell dyscrasia. METHODS A 57-year-old female patient presented with multiple painful oral ulcerative lesions on tongue and bilateral buccal mucosa for 1year and 6 months duration and a 76-year old male patient with small yellowish nodules on mucosal surfaces of the tongue and buccal mucosa. Results both cases histopathologically diagnosed as amyloidosis. Further investigations confirmed multiple myeloma. CONCLUSION unusual oral lesions could be the first sign of systemic diseases such as multiple myeloma that account the significance of the role of the oral and maxillofacial specialists and dental surgeons.
BioMed Research International, 2020
Background. Nodal metastasis is a critical factor in predicting the prognosis of oral squamous ce... more Background. Nodal metastasis is a critical factor in predicting the prognosis of oral squamous cell carcinoma (OSCC). When patients present with a clinically positive neck, the treatment of choice is radical neck dissection. However, management of a clinically negative neck is still a subject of significant controversy. Aim. This study was carried out in order to propose a model to predict regional lymph node metastasis of OSCC using histological parameters such as tumour stage, tumour size, pattern of invasion (POI), differentiation of tumour, and host immune response, together with the expression levels of six biomarkers (periostin, HIF-1α, MMP-9, β-catenin, VEGF-C, and EGFR), and, furthermore, to compare the impact of all these parameters on recurrence and 3 yr and 5 yr survival rates. Materials and Method. Histological materials collected from the archives were used to evaluate histological parameters and immunohistochemical profiles. Standard methods were used for immunohistoch...
Journal of Oral Biology and Craniofacial Research, 2020
Introduction:-Early detection plays a major role to reduce the mortality of oral squamous cell ca... more Introduction:-Early detection plays a major role to reduce the mortality of oral squamous cell carcinoma (OSCC). Many adjunctive techniques have emerged with claims of differentiating high risk oral potentially malignant disorders (OPMDs) from benign lesions. Toluidine blue (TB) test has been established as a diagnostic adjunct in detecting high risk OPMDs and early asymptomatic OSCCs. As majority of OSCC are preceded by OPMDs, recognition of them at an early stage is important in the management of this devastating disease. Methods:-This study was conducted as a multi-center study prospectively for a period of 2 years. Sixty five patients presented with OPMDs were selected and TB test was performed followed by a biopsy for histopathological confirmation. Criterion validity was assessed with histological diagnosis of the incisional biopsy of the OPMD as a gold standard test verses TB test results. Results: The sensitivity of the TB test was 68.3% and the specificity 63.1% with a false positive rate of 36.8% and false negative rate of 31.7%. However, the predictive value of the positive test was 80%. Conclusion:-TB testing might be a potential adjunct diagnostic aid in identifying high risk OPMDs. Further studies with extensive sample size and different demographics are needed to validate our findings.
Ceylon Journal of Science, 2018
Actinic keratosis (AK) is a dermatological condition commonly found among fair-skinned population... more Actinic keratosis (AK) is a dermatological condition commonly found among fair-skinned populations and considered as a potentially malignant disorder usually appearing on sunexposed areas such as the scalp, face and forearms. It is an uncommon disorder among Asians. Therefore, Actinic Keratosis in Asians has not been thoroughly investigated. AK is clinically termed as"Actinic chelitis" when lesions present in the lips. This case report is about a 42-year-old male who presented at the Oral Medicine Clinic of the University Dental Hospital, Peradeniya, with a complaint of burning sensation of the mouth which aggravates with spicy foods for about three months. Been working in a farm from the age of 12 years and exposure to sunlight for about 9 to 10 hours a day, he has had an extreme exposure to sunlight. Examination revealed an erythematous, nonindurated ulceration of the lower lip. Histopathological sections showed ulcerated mucosa covered by orthokeratinized stratified squamous epithelium with regenerative atypia towards the ulcer bed. Degenerative changes of collagen were evident in the upper corium. The patient was educated about the disease and a protective local covering agent was prescribed to apply on the affected area. This case report emphasizes the possibility of acquiring AK among dark-skinned people due to extreme exposure to sunlight and the importance of knowledge about this disease entity for clinicians when diagnosing as it may have been misdiagnosed.