Department of Oral Pathology and Medicine
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Item Single nucleotide polymorphisms: A paradigm in oral disease research(Dental Journal (Majalah Kedokteran Gigi), 2024) Ummer, H.; Santosh, A.B.R.; Surboyo, M.D.C.; Chitipothu, M.D.; Sivanandham, S.Background: A higher occurrence of oral cancer is observed in South Asian and Southeast Asian countries when compared with other countries in the world. Cancer, a disease with complex pathophysiology, has been linked to chronic inflammation. Inflammation has been considered an important component of tumor initiation and progression. This is supported by the fact that many cancers arise at the sites of chronic inflammation, but the exact mechanism by which inflammation influences cancer is unknown. Purpose: This review article correlates single nucleotide polymorphisms (SNPs), chronic inflammation, and oral cancer. The article emphasizes the critical role that SNPs play in oral cancer susceptibility, progression, and prognosis. This involves discussing the impact of specific SNPs on oral cancer risk and patient outcomes. Review: Gene polymorphism has been documented in the molecular pathogenesis of various cancers, including oral cancer, and SNPs are the most common form of gene polymorphism. Genetic variation has been documented in the molecular pathogenesis of various cancers, including oral cancer, and SNPs are the most common form of gene polymorphism. SNPs have been documented in inflammatory conditions as well as in various diseases. Conclusion: SNPs have phenotypic consequences and therefore can serve as genetic fingerprints. The upregulation or downregulation of genes is able to drive oral carcinogenesis.Item Aggregatibacter actinomycetemcomitans and Filifactor alocis as Associated with Periodontal Attachment Loss in a Cohort of Ghanaian Adolescents(Microorganisms, 2022) Razooqi, Z.; Åberg, C.H.; Kwamin, F.; Claesson, R.; Haubek, D.; Oscarsson, J.; Johansson, A.The aims of the present study were to document the presence of Aggregatibacter actinomyctemcomitans and the emerging oral pathogen Filifactor alocis, as well as to identify genotypes of these bacterial species with enhanced virulence. In addition, these data were analyzed in relation to periodontal pocket depth (PPD) and the progression of PPD from the sampled periodontal sites during a two-year period. Subgingival plaque samples were collected from 172 periodontal pockets of 68 Ghanaian adolescents. PPD at sampling varied from 3–14 mm and the progression from baseline, i.e., two years earlier up to 8 mm. The levels of A. actinomycetemcomitans and F. alocis were determined with quantitative PCR. The highly leukotoxic JP2-genotype of A. actinomycetemcomitans and the ftxA a gene of F. alocis, encoding a putative Repeats-in-Toxin (RTX) protein, were detected with conventional PCR. The prevalence of A. actinomycetemcomitans was 57%, and 14% of the samples contained the JP2 genotype. F. alocis was detected in 92% of the samples and the ftxA gene in 52%. The levels of these bacterial species were significantly associated with enhanced PPD and progression, with a more pronounced impact in sites positive for the JP2 genotype or the ftxA gene. Taken together, the results indicate that the presence of both A. actinomycetemcomitans and Falocis with their RTX proteins are linked to increased PPD and progression of disease.Item The pathologist in Ghana and potential for research(Ghana Medical Journal, 2018-06) Anim, J.T.One of the neglected areas of clinical medical practice in developing countries is the field of Laboratory Medicine. As a result, the important role of the laboratory physician in diagnosis of disease and subsequent management of patients is not much appreciated. Even more worrying is lack of appreciation of the research potential of laboratory medicine, considering that it provides a repository of confirmatory data on many human disorders; data that have been usefully employed for the study of various diseases in developed parts of the world. It is perhaps, the reason that many diseases peculiar to developing countries still remain untamed. My experience in the practice of anatomical pathology in several countries has taught me that the specialty, as with other specialties of laboratory medicine in Ghana needs more attention, with regards to its development to the level where it can meet its clinical functions satisfactorily. When this is ensured, it would also provide the necessary vital contribution to research that has characterised its practice in more advanced countries. More exposure of the specialty to undergraduate medical students must be encouraged in order to attract trainees into the specialty. Along with this exposure must go an increase in infrastructure and the necessary facilities to permit growth of the specialty. Research potential of the specialty must be harnessed and fully supported financially to help in unravelling peculiar disease problems of our locality. To achieve this, I have re-emphasised the need for a special fund to drive scientific research in GhanaItem Carcinoma of the pancreas: A review of autopsy material at the Korle Bu Teaching Hospital for the period 1972-1981.(Ghana Medical Journal, 1988-06) Dankwa, K.E.; Anim, J.T.A retrospective study of autopsies has been carried out and this shows the death rate from pancreatic carcinoma to be 5.8% of all cancer deaths in the Korle Bu Teaching Hospital Mortuary between the period 1972-1981. This relatively high incidence would lend support to findings of other studies which indicate that the disease is more common in US blacks and some parts of Africa. The high case fatality rate as found in our hospital-based cancer registry coupled with the increasing trend in females in recent years indicate that the disease requires a closer study from the point of view of aetiology and natural history in Ghana. The greater preference to the head of the pancreas would obviously pose problems to effective managementItem Necrotising Fasciitis of the Submandibular Region(Ghana Medical Journal, 2006-06) Nyako, E.A.; Nartey, N.O.Two cases of necrotizing fasciitis (NF) complicat-ing different conditions of the maxillofacial re-gion, treated at the Korle Bu Teaching Hospital are reported. These were managed by an early diagno-sis, aggressive surgical exploration, fasciotomies and debridement of necrotic tissue. In addition, frequent irrigation within the fascial planes with eusol and saline solutions plus the administration of broad spectrum antibiotics ensured early con-tainment of the spread of the infection. Our early recognition of the signs and symptoms of NF led to an early intervention resulting in minimal resid-ual skin defects which even though were not skin-grafted healed satisfactorily.Item Towards an Improved Pathology Service in Ghana(Ghana medical journal, 2013-03) Anim, J.T.Pathology service in Ghana is still in its infancy due to inadequate personnel (Pathologists) and a poor perception of the role of the pathologist in health care delivery. The state of affairs in Ghana may be partly blamed on an accident of history, the anomaly resulting from which has been allowed to become the norm. In the days of the colonial administration of the Gold Coast, as a result of non-availability of forensic doctors, hospital pathologists, and in some cases other medical officers, performed medico-legal autopsies for the Coroner. The first health care laboratory in the then Gold Coast was the Accra Laboratory which was established around 1900. It subsequently, underwent improvements, including relocation in the 1920s, to the newly constructed Korle Bu Hospital. Its main function was to undertake research into tropical diseases, but it also carried out routine diagnostic laboratory work, including autopsies, both hospital and medico-legal.Item High salivary levels of JP2 genotype of Aggregatibacter actinomycetemcomitans is associated with clinical attachment loss in Moroccan adolescents(Clinical and Experimental Dental Research, 2019-02) Ennibi, O.K.; Claesson, R.; Reddahi, S.; Kwamin, F.; Haubek, D.; Johansson, A.It has previously been shown that the presence of Aggregatibacter actinomycetemcomitans in subgingival plaque is significantly associated with increased risk for clinical attachment loss. The highly leukotoxic JP2 genotype of this bacterium is frequently detected in adolescents with aggressive forms of periodontitis. The aims of the study were to quantify the levels of JP2 and non‐JP2 genotypes of A. actinomycetemcomitans in saliva of Moroccan adolescents with the JP2 genotype earlier detected in the subgingival plaque. The salivary concentrations of inflammatory proteins were quantified and linked to the clinical parameters and microbial findings. Finally, a mouth rinse with leukotoxin‐neutralizing effect was administrated and its effect on the levels the biomarkers and A. actinomycetemcomitans examined. The study population consisted of 22 adolescents that previously were found to be positive for the JP2 genotype in subgingival plaque. Periodontal registration and sampling of stimulated saliva was performed at baseline. A mouth rinse (active/placebo) was administrated, and saliva sampling repeated after 2 and 4 weeks rinse. The salivary levels of JP2 and non‐JP2 were analyzed by quantitative PCR and inflammatory proteins by ELISA. Both the JP2 and the non‐JP2 genotype were detected in all individuals with significantly higher levels of the non‐JP2. Enhanced levels of the JP2 genotype of A. actinomycetemcomitans was significantly correlated to the presence of attachment loss (≥3 mm). Salivary concentrations of inflammatory biomarkers did not correlate to periodontal condition or levels of A. actinomycetemcomitans. The use of active or placebo leukotoxin‐neutralizing mouth rinse did not significantly interfered with the levels of these biomarkers. Saliva is an excellent source for detection of A. actinomycetemcomitans on individual basis, and high levels of the JP2 genotype were significantly associated with the presence of clinical attachment loss.Item Inequalities in access to education and healthcare(European Journal of Dental Education, 2008-02) Nunn, J.; Freeman, R.; Anderson, E.; Carneiro, L.C.; Carneiro, M.S.A.; Formicola, A.; Frezel, R.et.al.The burden of disease is borne by those who suffer as patients but also by society at large, including health service providers. That burden is felt most severely in parts of the world where there is no infrastructure, or foreseeable prospects of any, to change the status quo without external support. Poverty, disease and inequality pervade all the activities of daily living in low-income regions and are inextricably linked. External interventions may not be the most appropriate way to impact on this positively in all circumstances, but targeted programmes to build social capital, within and by countries, are more likely to be sustainable. By these means, basic oral healthcare, underpinned by the primary healthcare approach, can be delivered to more equitably address needs and demands. Education is fundamental to building knowledge-based economies but is often lacking in such regions even at primary and secondary level. Provision of private education at tertiary level may also introduce its own inequities. Access to distance learning and community-based practice opens opportunities and is more likely to encourage graduates to work in similar areas. Recruitment of faculty from minority groups provides role models for students from similar backgrounds but all faculty staff must be involved in supporting and mentoring students from marginalized groups to ensure their retention. The developed world has to act responsibly in two crucial areas: first, not to exacerbate the shortage of skilled educators and healthcare workers in emerging economies by recruiting their staff; second, they must offer educational opportunities at an economic rate. Governments need to lead on developing initiatives to attract, support and retain a competent workforce. © 2008 Blackwell Munksgaard and The American Dental Education Association.Item Cervical human papillomavirus infection in Accra, Ghana.(2008) Domfeh, A.A.; Wiredu, E.; Adjei, A.; Ayeh-Kumi, P.; Adiku, T.K.; Tettey, Y.; Gyasi, R.; Armah, H.Background: This study was aimed at estimating the human papillomavirus (HPV) prevalence and its determinants among a sample of Ghanaian women. Design: Cross-sectional observational study. Setting: Gynaecology outpatient clinic of the Korle-Bu Teaching Hospital, Accra, Ghana; the largest tertiary care gynaecology outpatient clinic in Ghana. Participants: Convenient sample of 75 consenting women visiting the clinic. Methods: Information was obtained through personal interviews using structured questionnaire, Pap smears obtained, and laboratory testing of cervical exfoliated cells was performed. HPV DNA was detected using a GP5+/6+ polymerase chain reaction assay. These data were analyzed using both univariate and bivariate techniques. Results: The mean age of participants was 33.3 years (standard deviation, 9.2) and the percentage of lifetime monogamy was 21.3%. The crude HPV DNA prevalence was 10.7%. Unlike most populations studied so far, HPV prevalence was high not only among young women, but also in middle and old age. Independent HPV determinants were being illiterate (prevalence odds ratio [POR], 13.9; 95% confidence interval [95%CI], 1.9-100) and reporting more than three lifetime sexual partners (POR, 4.6; 95% CI, 1.0-22.2). Conclusions: The study indicates a high crude prevalence of HPV in a largely polygamous Ghanaian population with a high crude prevalence in older age groups, which may be a distinctive feature of polygamous populations where HPV transmission continues into middle age and cervical cancer incidence is very high.Item Determinants of Oral Diseases in the African and Middle East Region(Advances in dental research, 2015-06) Chidzonga, M.M.; Carneiro, L.C.; Kalyanyama, B.M.; Kwamin, F.; Oginni, F.O.Oral health policies must be developed that emphasize the role of social determinants in health and oral diseases. The aim of this report is to review literature on determinants of oral diseases and apply the concepts to promoting oral health in the African countries in the African and Middle East region (AMER). Structural and proximal determinants of oral diseases are common to those affected by other noncommunicable diseases (NCDs). Oral diseases are also heavily affected by issues of politics, poor health behaviors, underdeveloped health systems, and low oral health literacy. Wide-scale poverty exists in populations in the AMER. Oral health promotion and preventive oral health programs should therefore be integrated with those for general health and use the common risk factor approach (CRFA). Attempts should be made to improve the daily living conditions and reduce the incline of the social gradient. Oral health practitioners should use the CRFA when dealing with determinants of oral diseases and in the design of preventive oral health programs. The detrimental effects of the social determinants of health may be ameliorated by involving both the individual and community. Interventions in health promotion programs in the AMER need more research on the epidemiology of oral diseases and the role played by the social determinants of oral diseases, especially with regard to poverty. The high levels of poverty and low gross domestic product in most countries in the African region make it difficult to fund high-quality, affordable, accessible oral health services.