Clinicopathological Evaluation of Odontogenic Tumours in Pakistan - A Seven Years Retrospective Study

Naz, Iram,Mahmood, Muhammad Khurram,Akhtar, Farhan,Nagi, Abdul Hannan Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.7

Background: The purpose of the study was to analyse the clinicopathological spectrum of benign and malignant odontogenic tumours (OT) in Pakistan. Materials and Methods: This retrospective study was carried out at the Armed Forces Institute of Pathology (AFIP) Rawalpindi. Seven years archival records of histologically diagnosed odontogenic tumours, both benign and malignant, were collected and the lesions re-diagnosed histologically in accordance with the WHO classification of head and neck tumours (2005). Clinical as well as histological data were analysed and frequency of each type of OT was calculated using computer software programme SPSS (version 17). Mean tumour size was calculated and Chi-square test was applied to find associations of age, gender and site with each histological type of tumour. Results: Only 1.7% of the odontogenic tumours diagnosed in this said period were malignant while the remaining 98.3% were benign. Amongst benign lesions, ameloblastoma was the most common (61.3%) type while primary intraosseous squamous cell carcinoma (1.7%) was the only reported malignant tumour. Mean age of the affected patients was $31.7{\pm}16.7$ years with posterior mandible as the commonest site involved. Conclusions: Our study revealed ameloblastoma and primary intraosseous squamous cell carcinoma as the commonest diagnosed benign and malignant tumours respectively. There was a significant difference in age and site of origin of different types of OT at the time of their presentation. However, all the tumours showed male predominance.

Expression of Bcl-2 in Primary and Recurrent Odontogenic Keratocysts in Comparison with Other Odontogenic Lesions

Naz, Iram,Mahmood, Muhammad Khurram,Nagi, Abdul Hannan Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.15

Purpose: To determine the biological behaviour of common odontogenic cystic lesions by analysing and comparing bcl-2 expression amongst them. Materials and Methods: Our study covered 90 formalin fixed paraffin embedded tissue samples: 26 primary cases each of radicular cysts (RC), dentigerous cysts (DC) and odontogenic keratocysts (OKC) and 12 of recurrent OKCs. Bcl-2 expression was analysed immunohistochemically and data analysis was accomplished using SPSS version 17.0. Means were taken for age while for gender and site of the lesions frequencies and percentages were determined. The Chi-square test was applied to evaluate any statistically significant difference of bcl-2 expression in these lesions and p value of ${\leq}0.05$ was taken as significant. Results: All the recurrent OKCs showed a strong positivity for bcl-2 that was absent in all of its primary cases (p value<0.05). Although variation in expression of bcl-2 was not found to be statistically significant between RC and DC, however, it became significant when all primary cases of these common odontogenic lesions were compared. Conclusions: Recurrent OKC showed comparatively a more aggressive behaviour than their primary counterparts and also from RC and DC. Bcl-2 proved to be a valuable adjunct in determining aggressive biological behaviour of odontogenic lesions.

Frequency of Delayed Diagnosis of Oral Squamous Cell Carcinoma in Pakistan

Naseer, Rabia,Naz, Iram,Mahmood, Muhammad Khurram Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.11

Objectives: To determine the frequency of delayed diagnosis of oral squamous cell carcinoma in our setup; highlighting factors responsible for any delay and their possible relevance to demographic and diagnostic features. Methods: This cross sectional study of six months duration was conducted in the Oral and Maxillofacial Surgery Department of the Armed Forces Institute of Dentistry, Rawalpindi, Pakistan. A total of 246 patients, both male and female, having a biopsy proven definitive diagnosis of OSCC were included using a consecutive sampling technique. Delay in diagnosis was assessed from the stated period of time from when the patient first noticed symptoms of disease until a definitive diagnosis was made. We concluded delayed diagnosis if this was more than 40 days. Results: The ages of patients ranged from 27 to 60 years with a mean of $46.7{\pm}10.2$ years and a marked male predominance (3.7:1). Delayed diagnosis was observed in 91.5% of cases. However, statistically no significant differences were found with age, gender, marital, education status, household income and time of biopsy. Conclusion: Our primary finding of delayed diagnosis with no prior contact with any health care professional clearly reflects a need of taking urgent measures to avoid serious impacts on morbidity and mortality associated with OSCC.

Utility of a modified components separation for abdominal wall reconstruction in the liver and kidney transplant population

Cara K Black,Elizabeth G Zolper,Elliot T Walters,Jessica Wang,Jesus Martinez,Andrew Tran,Iram Naz,Vikas Kotha,Paul J Kim,Sarah R Sher,Karen K. Evans 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.5

Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was 61.0±8.3 years old, with a mean body mass index of 28.4±4.8 kg/m2, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of 28.7±22.8 months. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

Utility of a modified components separation for abdominal wall reconstruction in the liver and kidney transplant population

Black, Cara K,Zolper, Elizabeth G,Walters, Elliot T,Wang, Jessica,Martinez, Jesus,Tran, Andrew,Naz, Iram,Kotha, Vikas,Kim, Paul J,Sher, Sarah R,Evans, Karen K Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.5

Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was $61.0{\pm}8.3years\;old$, with a mean body mass index of $28.4{\pm}4.8kg/m^2$, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of $28.7{\pm}22.8months$. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.