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Nadia Ashraf
Muhammad Younus
Muhammad Ishfaq
Syed Amjad Shah
Bushra Mehboob
Muhammad Sulaiman


Objectives: To detect early signs of potentially malignant disorders (PMDs) in tobacco users through toluidine blue staining screening and to evaluate the diagnostic efficacy of toluidine blue staining in screening tobacco users for PMDs.
Methodology: This descriptive cross-sectional study was conducted at the Peshawar Dental College with effect from November 5, 2021, to September 25, 2022. A total of 300 tobacco users (either smokers or Naswar dippers) were included in the study, regardless of their age and gender. Whereas, those tobacco users who were both smokers and Naswar dippers were excluded. Every tobacco user was screened out for the presence of oral mucosal changes with a naked-eye oral examination followed by toluidine blue staining screening.
Results: The majority of tobacco users screened out for PMDs were male (92%) with a male-to-female ratio of 11.5:1, and most of them were between the ages of 51 and 70 years. Out of 300 tobacco users, more than half were Naswar dippers (63%). While the screening results showed that out of the total 300 tobacco users, 35 had positively stained, and more than two-thirds of them were Naswar dippers (68.6%),. On histological examination of 35 toluidine blue positive samples, we noted dysplastic changes in 29 (83%) cases, where 16 (55%) individuals showed moderately dysplastic changes and 11 (38%) displayed mildly dysplastic changes.
Conclusion: Tobacco users, especially Naswar dippers, were at high risk for PMDs. In addition, toluidine blue staining emerges as a useful diagnostic tool for the early detection of PMDs.

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Ashraf N, Younus M, Ishfaq M, Shah SA, Mehboob B, Sulaiman M. SCREENING OF TOBACCO USERS FOR POTENTIALLY MALIGNANT DISORDERS USING TOLUIDINE BLUE STAINING. J Postgrad Med Inst [Internet]. 2024 May 8 [cited 2024 Jul. 13];38(2):135-9. Available from:
Original Article


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