Irosha Perera

The oral cavity is the second most diverse microbial ecosystem providing residency to AMP producers which play a significant role in shaping the community structure and preserving the delicate equilibrium between the host and the residential microbial flora. The integration of AMPs in the microbial membranes can disrupt the membrane structure, eventually causing cellular death. On the other hand, the permeabilization of the membrane allows for AMP leakage into the cytoplasm, where it can bind to nucleic acids and cellular components to disrupt the normal functioning of the microbial metabolism. Production of bacteriocins among oral bacteria has been commonly found in of the genera Streptococcus, Lactobacillus, Fusobacterium, and Prevotella. Furthermore, many of these have probiotic potential. Bacteriocins have been explored as alternatives to antibiotics for combating cariogenic species. For instance, the lantibiotic nisin has shown effectiveness in vitro against mono-species biofilms of Streptococcus mutans. Among the late colonizers studied, Porphyromonas gingivalis, Prevotella intermedia, Treponema denticola, and Aggregatibacter actinomycetemcomitans were particularly sensitive to nisin. Furthermore, when cultured in the presence of nisin, multispecies biofilms showed a reduction in biomass and thickness. Through further advancements and collaborations between researchers, healthcare professionals, and industry partners, we can harness the power of these naturally occurring molecules to develop innovative therapies that effectively combat infections and enhance human health.

Sri Lanka is a famous tourist destination thus; ensuring food safety has garnered importance in public health. Chinese style fried rice are popular among consumers and the majority of them belong to the low-income category. Hence, the aim of this descriptive cross-sectional study was to detect food hygienic quality of Chinese style fried rice available in hotels, restaurants and take away outlets in the Colombo city.. Using systematic random and cluster sampling technique 25 eating houses were selected in the Colombo city limits in which prepared and available for sale. Two hundred Chinese style fried rice samples were collected comprising 35%of vegetable, 29 % of chicken, 18% of seafood, 9% egg, 5%of beef and 3.5% of mixed variety respectively. Aerobic Plate Count was carried out using USFDA Manual of Food Quality Control 1992. Detection and enumeration of coliforms, faecal coliforms and E.coli were carried out using SLS516:part3:1982 standard. In the present study Aerobic Plate counts of 39.50% samples were > 105 cfu/g. Furthermore, 24.50% of the total fried rice samples (200) tested contained ≥ 1.100 Coliforms/g of rice followed by 16% contained ≥ 1.100 Faecal Coliforms/g of rice. Alarmingly, E.coli was detected in 39.0 % of the fried rice samples tested and the highest percentages of varieties contaminated were egg, vegetable and mixed. The services of PHIs who render their services on food safety are strongly recommended to improve the microbial quality of ready-to-eat food available for sale in food establishments of the Colombo city.

The oral cavity hosts the second most diverse microbial community. All inflammatory diseases of the oral cavity typically have a polymicrobial origin. Modern epidemiological and metagenomic evidence shows significant associations between potential periodontal pathogens, periodontitis, and oral cancer. Notably, Fusobacterium nucleatum and Porphyromonas gingivalis have been shown to promote carcinogenesis in mechanistic studies. Probiotics aim to modulate the normal inhabitants of a healthy oral biofilm, preventing the elevation of pathogenic microorganisms (pathobiont). Besides competing for attachment sites and host-derived nutrients, these probiotic strains may also produce bacteriocins to combat pathobiont. Importantly, probiotic strains can modulate the host’s innate immune mechanisms and produce anti-inflammatory substances. However, the precise mechanisms by which probiotics help re-establishing a healthy oral biofilm remain under explored. There is inconsistency in the findings regarding the ability of probiotics to reverse dysbiotic microbiomes in oral cancer patients, although there are promising individual cases of success. Inter-individual variations are a significant factor contributing to these discrepancies. Since the prognosis for oral diseases depends on the specific microbiota and immune responses of each patient, the outcomes of probiotic therapy will also vary among individuals. Personalized treatment has been successful in traditional oral healthcare, and probiotic therapy should follow this trend, given the undeniable inter individual variation in the oral microbiome. Expanding combination therapies to include various probiotic bacterial strains and species could enhance our ability to address the diverse microbiomes in individuals, with a focus on prevention and control of oral squamous cell carcinomas (OSCC).

Periodontal disease is the most common chronic inflammatory condition with a polymicrobial origin, particularly among the elderly. Numerous risk factors can independently or synergistically contribute to immune suppression and inflammation in the periodontium. This leads to microbial dysbiosis in the periodontal pockets and the supra gingival biofilm, resulting in the elevation of patho bionts or opportunistic pathogens that are considered potential contributors to periodontal disease. The progression from gingivitis to chronic periodontitis typically follows an ecological succession, starting with the facultative anaerobes of the yellow complex and advancing to the strict anaerobes of the red complex of periodontal pathogens. Additionally, there has been an observed increase in sulfate-reducing bacteria (SRB) within the oral cavities, which are part of the human oral microbiome. SRB is a diverse group of naturally occurring microorganisms known for their capability of dissimilatory sulfate reduction to hydrogen sulfide (H2S). Methanogenic archaea are a minority within the SRB group, known for their hydrogenotrophic metabolism and cooperative growth alongside other species in the periodontal pockets. However, these methanogenic archaea are not typically recognized as contributors to the development of periodontal disease. Investigating the role of methanogenic archaea in the context of periodontal disease enhances our understanding of the dynamics within the supragingival biofilm associated with chronic periodontitis.

Fibroepithelial polyps are inflammatory hyperplastic lesions characterized by para-keratinized stratified squamous epithelium. They develop in response to chronic irritation and display arcading patterns with a mixed infiltrate of inflammatory cells, predominantly lymphocytes, along with plasma cells. 12 species of Candida were identified in the FEP tissues of a group of Sri Lankan male patients with oral risk habits. Among these, C. albicans was the most prevalent, with an average relative abundance of 29.56%. The other species detected included Candida tropicalis (2.59%), Candida parapsilosis (1.56%), Candida niveriensis (0.91%), Candida salmanticensis (0.74%), Candida blattae (0.13%), Candida doubliniensis (0.10%), Candida etchellsii (0.12%), Candida metapsilosis (0.10%), Candida vanderwaltii (0.34%), Candida santamariae (0.11%), and Candida albicans_nov_92.15% (0.002%) as shown.

Head and neck cancers (HNC) are devastating, thus imposing a negative impact on the appearance of an individual as well as vital activities such as eating, swallowing, speaking, and breathing. Therefore, HNC patients undergo distress, while their caregivers become overburdened. Religion and spirituality can be helpful for patients and their caregivers from diverse cultural backgrounds to cope with cancer. Though well established in palliative care, religion and spirituality are rarely incorporated into usual early oncological care. Despite the availability of heterogeneous literature examining the influence of religion and spirituality on cancer patients, there is notably limited research on this topic across the HNC trajectory. Therefore, this scoping review attempts to answer “What is the influence of religion or spirituality on HNC patients and their caregivers in different contexts?” and will map the evidence on the influence of religion and spirituality on HNC patients and their caregivers in different contexts including geographical areas, cultures, health care systems, and different study settings. This scoping review was formulated using the guidelines of Joanna Briggs Institute (JBI) manual for evidence synthesis: scoping reviews and will be reported confirming to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR checklist). A comprehensive search strategy will include Embase, CINAHL, Scopus, and APA PsycINFO. The OPENGREU.EU and Google Scholar will be used as gray literature sources complimented by manual searches. Our eligibility criteria follow the population, concept, and context (PCC) framework. Patients aged ≥ 18 years diagnosed with HNC and their informal, nonpaid caregivers aged > 18 years will be included. The data will be extracted using piloted data extraction form on sociodemographic, disease-related, and treatment-related factors and outcomes, and the data will be analyzed through descriptive statistics and thematic analysis. The results will be narratively synthesized. This review will aim to explore existing literature and summarize the findings of studies that examine the influence of religion and spirituality among HNC patients and their caregivers and vice versa over a range of physical, psychological, and social outcomes including quality of life. We also aim to identify existing research gaps. The findings of this review would generate evidence to better inform health care providers in countries and cultures in the management of patients diagnosed with HNC in usual oncological care with due consideration to caregivers.

The aim of this study was to discover the host factors and the relative abundance of Candida species associated with oral squamous-cell carcinoma (OSCC). DNA was extracted from 52 tissue biopsies (cases: 25 OSCC; controls and sequenced for the fungal internal transcribed spacer 2 region using Illumina™ 2 x300bp chemistry. Merged reads were classified to species level using a BLASTN-algorithm with UNITE’s named species sequences as reference. Candida albicans was flourished in OSCC tissues, followed by Candida tropicalis, Candida parapsilosis, Candida doubliniensis, Candida etchellsii, Candida metapsilosis, Candida santamariae and Candida albicans_nov_92.15%. The older age, low socio-economic status, poor oral hygiene status, periodontal disease status, oral risk habits, nutritional deficiencies, and OSCC status appeared as host factors that accounted for elevated C. albicans occurrence (61.2% of average relative abundance) in all OSCC tissues (100%) of a group of male patients. Powered matched case-control studies, controlling confounders to apply multivariate logistic regression are much recommended to find out the reliability of results of the present study.

Introduction: Oral cancer represents the most prevalent malignancy among Sri Lankan males. This aggressive disease is associated with significant psychological distress, driven by disfigurement and impairments of vital functions. While the detrimental impact of psychological distress on patients with oral cancer is well documented, its prevalence and associated determinants remain underexplored in the Sri Lankan context. This study aims to evaluate the prevalence and identify the factors associated with psychological distress in a selected cohort of patients with oral cancer in Sri Lanka. Methods: A hospital-based cross-sectional study was conducted among 355 patients with oral cancer to determine the prevalence of psychological distress. Additionally, a nested case-control study comprising 140 patients per group was carried out to evaluate the factors associated with psychological distress. Multivariate logistic regression analysis was performed to identify significant associated factors of psychological distress. Results: The prevalence of psychological distress among patients with oral cancer was 31.0% (95% CI=27.8–35.3%). Being worry (“Other people worry about me more than I do”; AOR=5, 95% CI=2.8–6.9) and anger (“I feel very angry about what has happened to me”; AOR=12.1, 95% CI=6.8–15.4)—emerged as significant independent factors that were associated with increased risk of psychological distress among patients with oral cancer. Conclusion: Approximately one-third of patients with oral cancer in the selected tertiary care hospitals were found to experience psychological distress, highlighting its high prevalence in this population. The identification of key factors associated with psychological distress provides valuable insights for the development of targeted intervention strategies aimed at mitigating psychological morbidity among patients with oral cancer.

Objectives: The aim of this study was to compare selected patient-related factors and clinical characteristics of surgically removed mandibular third molars among a cohort of Sri Lankan patients. We hypothesized that age and gender of patients could be significantly associated with their medical conditions, life-style-related risk habits and clinical characteristics of surgically removed mandibular third molars. Materials and Methods: A descriptive cross-sectional study was conducted with a sample of 715 patients who underwent mandibular third molar surgeries at the Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. Frequency distributions were presented as descriptive statistics with group comparisons made using chi-square and Fisher’s exact test of statistical significance. Results: There was a significant female preponderance, especially aged ≤ 40 years, among patients who underwent surgical removal of mandibular third molars, of whom 81.1% were impacted. Medical conditions were dominated by hypertension. Smoking was the most prevalent risk habit. These risk habits were significantly higher among patients aged >40 years compared to their younger counterparts (p=0.001). Moreover, beyond 40 years, patients had significantly higher vertical angulation according to Winter’s classification (p=0.002), non-impacted status and Class-1 ramus classification by Pell & Gregory Classification (p=0.001) compared to the younger cohort. Conclusions: There was a significant association between age, gender and life-style-related risk habits, impaction status, angulation and ramus relationship. Therefore, patient-related factors could be useful in ensuring optimal treatment outcomes in surgical removal of mandibular third molars. Studies conducted in other countries would be able to generate more conclusive evidence in this regard.