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CTRI Number  CTRI/2024/02/062193 [Registered on: 01/02/2024] Trial Registered Prospectively
Last Modified On: 30/01/2024
Post Graduate Thesis  Yes 
Type of Trial  Observational 
Type of Study   Cross Sectional Study 
Study Design  Other 
Public Title of Study   To Compare the Crystallization Patterns in Blood Samples of Oral Submucous Fibrosis, Oral Cancer and Healthy Individuals  
Scientific Title of Study   Comparative Evaluation Of Crystallization Patterns In Oral Submucous Fibrosis, Oral Squamous Cell Carcinoma and Healthy Individuals- A Prospective Serological Study 
Trial Acronym  nil  
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  MRUDULA KATARNI 
Designation  Post Graduate Student 
Affiliation  MGM DENTAL COLLEGE AND HOSPITAL NAVI MUMBAI 
Address  Room no. 505, 5th floor, MGM DENTAL COLLEGE AND HOSPITAL , Junction between NH4 and Sion Panvel Hwy, Kamothe, NAVI MUMBAI
Room no. 505, 5th floor, MGM DENTAL COLLEGE AND HOSPITAL , Junction between NH4 and Sion Panvel Hwy, Kamothe, NAVI MUMBAI
Raigarh
MAHARASHTRA
410209
India 
Phone  09970634440  
Fax    
Email  drmrudulakatarni@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  DR KAMLESH DEKATE 
Designation  ASSOCIATE PROFESSOR 
Affiliation  MGM DENTAL COLLEGE AND HOSPITAL NAVI MUMBAI 
Address  Room no. 505, 5th floor, MGM DENTAL COLLEGE AND HOSPITAL , Junction between NH4 and Sion Panvel Hwy, Kamothe, NAVI MUMBAI
Room no. 505, 5th floor, MGM DENTAL COLLEGE AND HOSPITAL , Junction between NH4 and Sion Panvel Hwy, Kamothe, NAVI MUMBAI
Raigarh
MAHARASHTRA
410209
India 
Phone  9223290372  
Fax    
Email  dr.kamleshdekate@gmail.com  
 
Details of Contact Person
Public Query
 
Name  DR KAMLESH DEKATE 
Designation  ASSOCIATE PROFESSOR 
Affiliation  MGM DENTAL COLLEGE AND HOSPITAL NAVI MUMBAI 
Address  Room no. 505, 5th floor, MGM DENTAL COLLEGE AND HOSPITAL , Junction between NH4 and Sion Panvel Hwy, Kamothe, NAVI MUMBAI
Room no. 505, 5th floor, MGM DENTAL COLLEGE AND HOSPITAL , Junction between NH4 and Sion Panvel Hwy, Kamothe, NAVI MUMBAI
Raigarh
MAHARASHTRA
410209
India 
Phone  9223290372  
Fax    
Email  dr.kamleshdekate@gmail.com  
 
Source of Monetary or Material Support  
MGM Dental College and Hospital, Junction of NH4 and Sion-Panvel HWy, Sector 18, Navi Mumbai, Maharashtra 410209 
 
Primary Sponsor  
Name  MGM Dental college and hospital  
Address  Junction of NH4 and Sion-Panvel Hwy, Sector 18, Navi Mumbai, Maharashtra 410209 
Type of Sponsor  Research institution and hospital 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Mrudula Katarni  MGM Dental College and Hospital, Navi Mumbai  room no 505, 5th floor , MGM Dental college and Hospital, junction of NH4 and Sion-Panvel Hwy, Sector 18, Navi Mumbai
Raigarh
MAHARASHTRA 
9970634440

drmrudulakatarni@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
INSTITUTIONAL ETHICS COMMITTEE MAHATMA GANDHI MISSIONS DENTAL COLLEGE & HOSPITAL  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: C00-C14||Malignant neoplasms of lip, oral cavity and pharynx, (2) ICD-10 Condition: K135||Oral submucous fibrosis,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Intervention  nil  NIL 
 
Inclusion Criteria  
Age From  15.00 Year(s)
Age To  70.00 Year(s)
Gender  Both 
Details  Group I- Clinically diagnosed cases of Oral submucous fibrosis
Group II- Clinicopathologically diagnosed cases of Oral Squamous Cell Carcinoma
Group III- Healthy individuals advised for blood investigations for routine dental surgical procedures without any known medical history
 
 
ExclusionCriteria 
Details  Group I-
1.Patients undergoing treatment for OSMF
2.Patient with history of scleroderma, amyloidosis, generalized fibromatosis.
3. Patients with systemic conditions like heart diseases, diabetes mellitus, thyrotoxicosis, liver diseases, pregnancy, oestrogen therapy, etc.
4.Patients those who are not willing to participate.
Group II
1. Recurrent cases of oral squamous cell carcinoma
2. Patients undergoing /undergone treatment of OSCC.
3. Patients with systemic conditions like heart diseases, diabetes mellitus, thyrotoxicosis, liver diseases, pregnancy, oestrogen therapy, etc
4. Patients diagnosed other than OSCC after histopathological examination.
5. Patients those who are not willing to participate.
Group III
1. Patients those who are not willing to participate 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
To Evaluate and Compare the Crystallization Patterns in Oral Submucous Fibrosis, Oral Squamous Cell Carcinoma and Healthy Individuals  Blood samples will be collected at the time of patient presentation from Oral Submucous Fibrosis Oral Squamous Cell Carcinoma patients and healthy individuals. The crystallization patterns will be observed 24 hours after the sample collection and crystallization patterns of oral submucous fibrosis and oral squamous cell carcinoma will be compared with the crystallization patterns of healthy individuals 
 
Secondary Outcome  
Outcome  TimePoints 
To compare the crystallization patterns in different clinical stages in Oral Submucous Fibrosis Cases.  After taking a patients informed consent detailed case history will be taken for study group & blood samples will be collected 
 
Target Sample Size   Total Sample Size="114"
Sample Size from India="114" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   14/02/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

Oral submucous fibrosis (OSMF) is a chronic impairing disease of oral and oropharyngeal mucosa which was historically described by Pindborg and Sirsat in 1966 as “an insidious chronic disease affecting any part of the oral cavity and sometimes pharynx. Although occasionally preceded by and/or associated with vesicle formation, it is always associated with juxta-epithelial inflammatory reaction followed by fibroblastic changes in the lamina propria, with epithelial atrophy leading to stiffness of the oral mucosa causing trismus and difficulty in eating.” The oral manifestations include symptoms like burning sensation, blanching and leathery texture of the oral mucosa, submucosal fibrous bands, gradual reduction of mouth opening, reduced movement and depapillation of the tongue, and shrunken uvula It is mostly related with the areca nut chewing habit, which is consumed in different types of formulations by 10–20% of the World’s populationAccording to world Health Organization OSMF affected more than 5 million people all around the world. In Indian population the prevalence rate has changed from 0.03% to 6.4% in last four decades . Oral submucous fibrosis is one of the most common oral potentially malignant disorders, with nearly 4% rate of transformation into oral squamous cell carcinoma. To judge the severity of the disease, various researchers proposed several classifications based on clinical and histological features, based on various aspects of OSMF. Squamous cell carcinoma is defined as “a malignant epithelial neoplasm exhibiting squamous differentiation as characterized by the formation of keratin and/or the presence of intercellular bridges”. Studies suggest that in India, that many oral cancers are diagnosed in advanced stages due to insufficient approach toward disease leading to 60 to 80% of mortality rate. There is difference in clinical presentations of Oral submucous fibrosis and Oral squamous cell carcinoma and most of the oral cancers are asymptomatic in preliminary stages. There is greater probability of misdiagnosis when OSMF undergoing malignant transformation . Also lack of awareness amongst general practitioners causes failure to refer the patients for investigations, leading to diagnostic delay. Hence, early diagnosis and treatment of carcinoma is the key in improving the survival rates. In presence of various confounding factors like overlapping of clinical features, difficulty in assessment of OSMF patients of advanced stages and post operative healing complications, makes it challenging for the screening and staging of OSMF patients. As this disease carries high risk of malignant transformation, the early screening and clinical staging of OSMF is necessary for the risk assessment of the carcinomatous changes. Therefore, the efficacy of minimally invasive screening techniques should be tested. Some of these includes cytological, biochemical, histopathological, and optical diagnostic methods. In addition to these methods, Biocrystallization test is one such physical test that utilizes the phenomenon of morphogenetic forces. In this salt of cupric chloride is used to test quality of the substance without interacting with the test substance itself, resulting in slow crystallization. These slow growing crystals takes the form of different patterns, that can be studied for determining the quality of the test substance. Pfeiffer and Steiner introduced this sensitive crystallization technique in 1938 which is blood-based qualitative method. They conducted an experiment by adding cupric chloride (CuCl2) solution to diluted hemolyzed human blood of cancer patients . This colloidal solutions mixture gave rise to organic and inorganic salts that created various crystallization patterns due to different rates and amplitudes of molecular movements during evaporation . Thus, it was stated that hemolyzed blood containing colloidal proteins contributed to crystallization patterns. In other way, the concept of biocrystallization was based on the oxidative stress which is induced by the internal metabolic conditions. These crystallization forms appear to be “Transverse bar Formations” , “Muddle Formations” and “Hollow Glans Formations” patterns as peculiar findings in premalignancy and malignancy. To observe the changes in blood samples during routine hematological practice at early stage of carcinogenesis or even at the premalignant phase, such kind of diagnostic approach is need of hour in research. Pfeiffer crystallization method is simple, economical, dependable, less time-consuming and a minimally invasive method for early detection of cancer. This makes it more suitable for mass screening for premalignant and malignant lesions. In addition, this technique will help in early detection of cancer transforming lesion, that would ultimately help in enhancing the prognosis and increase the patient survival rate for individuals with an elevated risk or genetic predisposition. This shall potentially reduce the burden of cancer on patients and their families. Moreover, the healthcare systems can reach people from both rural and urban areas for early screening programs, that will in turn benefit the society to build up a healthy population, especially in developing countries. Hence, it can be used in correlation with the clinical and histopathological grading for the precancerous lesions where biopsy is infrequently recommended. Therefore, the current study aims to compare the patterns of crystallization and to further confirm the efficacy of crystallization test as a screening modality in Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma.


 
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