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Ann Afr Med. 2018 Oct-Dec;17(4):210-214. doi: 10.4103/aam.aam_69_17.

Quantitative analysis of AgNOR counts and pap stain in exfoliative cytology specimens of oral mucosa in bidi smokers and nonsmokers.

Author information

Department of Oral Medicine and Radiology, RR Dental College, Udaipur, Rajasthan, India.
Department of Conservative Dentistry and Endodontics, IDS Sehora, Jammu and Kashmir, India.
Department of Oral Pathology and Microbiology, SB Patil Dental College and Hospital, Bider, Karnataka, India.
Department of Oral Pathology and Microbiology, Rishiraj College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India.
Department of Prosthodontics, Institute of Dental Sciences, Bhubaneswar, Odisha, India.
Department of Oral Medicine and Radiology, Institute of Dental Sciences, Bhubaneswar, Odisha, India.
Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bhubaneswar, Odisha, India.
Private Practitioner, Lajpat Nagar, New Delhi, India.


in English, French


Bidi smoking is a serious health hazard which is common throughout South Asia and parts of the Middle East. It has been strongly implicated to various benign and malignant lesions of oral cavity and oropharynx. These tobacco-filled leaves deliver more than three times the amount of nicotine, carbon monoxide, and tar as cigarettes which exert injurious effects on cells reflected in terms of accelerated proliferative activity in normal oral mucosal cells.


This study aimed to compare the exfoliated cells from the oral mucosa of bidi smokers and nonsmokers, with emphasis on proliferative activity.

Materials and Methods:

Exfoliative smears were obtained from the oral mucosa of forty participants (twenty nonsmokers and twenty smokers) with age group ranging from 30-80 years, in and around Barwala (Haryana). The cytologic smears were evaluated using Papanicolaou (PAP) stain and AgNOR in order to evaluate the presence of cytological alterations suggestive of inflammation, dysplasia, keratinization, and proliferative activity of epithelial cells. Only PAP Class I and Class II smears were observed.


Comparison of the mean number of AgNORs showed a significant difference between nonsmokers and smokers. Inflammatory alterations were found in 70% of smokers and 55% of nonsmokers. A significant difference in proliferative activity was observed between smokers and nonsmokers classified as PAP Class II.


A significant difference of AgNORs/nucleus was observed between bidi smokers and nonsmokers.


AgNOR; bidi smokers; exfoliative smears; smokers

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