Tobacco use and its impact on survival in young patients with oral cancer

Background: Tobacco is a major risk factor associaetd with developing oral factor. Recent studies have shown that the age of onset, especially in Asia, is reducing. This study was to determine if tobacco exposure correlated with prognosis in oral squamous cell carcinoms (OSCC) based on age at diagnosis. Methods: Six hundred and forty three patients of OSCC treated in our institution were divided into four groups, younger patients (?45 years) with or without tobacco exposure and older patients (>45 years) with or without tobacco exposure, and compared with respect to prognostically relevant variables, disease?free survival (DFS) and overall survival (OS). Survival analysis was performed. Results: The percentage of those with tobacco exposure was comparable in both age groups. Tobacco correlated with known pathological determinants in OSCC; however, perineural invasion, lymphovascular invasion, and extranodal extension were significantly more common in the young. On survival analysis, tobacco exposure impacted OS (P = 0.04) and DFS (P = 0.03) in patients ?45 years, and not in older patients >45 years. On multivariate analysis, tobacco exposure in the young was significantly associated with recurrence (P = 0.03, hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.07�94) but not survival. Conclusion: Younger patients with a history of tobacco use have a significantly higher risk of recurrence and mortality due to OSCC, but this difference could not be attributed to any of the known prognostic determinants in OSCC. Younger patients also had more adverse pathological features. Whether this occurs because of altered disease biology or pathways of carcinogenesis in the young wi

A STUDY ON IMPACT OF ORGANIZATION CLIMATE TOWARDS EMPLOYEE PERFORMANCE

A study on impact of organization climate towards employee Performance with special reference to TNPL paper unit-1, karurThis exploration aims to examine theimpact of organization climate towards employee Performance with special reference to TNPL paper unit-1, karur. A quantitative approach is espoused for this study by collecting primary data through a questionnaire distributed to workers working in different brigades of the organization. The sample size was 113. The tools used in this disquisition are chance analysis, Chi- Square, annova. The findings of the study reveal aimpact of organization climate towards employee Performance with special reference to TNPL paper unit-1, karur

Digit ratio (2D:4D) and performance in non-elite male badminton players

Background: The second to fourth digit ratio (2D:4D ratio) is derived by dividing the length of the index finger (2D) by the length of the ring finger (4D). It has been considered as an index of how much the fetus is exposed to testosterone in utero. Research has suggested that high levels of testosterone are associated with low 2D:4D ratio. The relationship between 2D:4D ratio and physical performance is still an unexplored field in badminton players. Aims and Objectives: This study intends to assess the digit ratio 2D:4D in non-elite male badminton players in comparison to their sedentary controls. Materials and Methods: The study included 30 male badminton players in the age group of 19–23 years who were practicing badminton for more than 3 years and 30 age, body mass index-matched sedentary controls. The second and fourth finger measurements were taken from scanned printouts using Vernier calipers. Results: The 2D:4D ratio was significantly lower in the left hand of badminton players when compared to their controls (P = 0.0001). There was no significant difference in 2D:4D ratios of the right hand and 2D:4D (? r–l) between badminton players and controls. Conclusion: There was significant difference in the ratio of 2nd–4th digit between badminton players and controls in the left hand but not in the right hand. The reason for no difference in 2D:4D ratio and controls in the right hand could be due to the fact that badminton is a moderate intensity sport, and also, the study participants were non-elite players.

Effect of dexamethasone implant on intraocular cytokines in diabetic macular edema

Purpose: Our primary aim was to evaluate intraocular cytokines (IC) before and after dexamethasone in diabetic macular edema (DME). Our secondary aim was to study the early and late effects of single dexamethasone implant in DME. Methods: This before and after comparative study was conducted at the Department of Ophthalmology and Centre for Nanosciences at a quaternary referral center in Kerala, India, from September 2016 to September 2018. Patients underwent complete ophthalmological examination and cytokine analysis before and after dexamethasone implant. Levels of cytokines at baseline and repeat sample were studied. Results: Twenty?seven eyes (21 patients) were divided into two groups depending on time from baseline to second injection. Group 1 included patients with <3 months between the two samples – 12 (44.4%). Group 2 included patients with >3 months between the two samples –15 (55.6%). Best corrected visual acuity (BCVA) and central macular thickness (CMT) improved significantly post?dexamethasone in group 1, but not in group 2. Interleukin (IL)?4, IL?6, IL?10, vascular endothelial growth factor (VEGF), IL?1?, interferon?gamma inducible protein?10 (IP?10), monocyte chemoattractant protein?1 (MCP?1), and IL?2 decreased post?injection in group 1. But cytokines increased post?dexamethasone in group 2, except IL?10. When compared to baseline, IL?6 reduced to half in group 1 (P?value 0.814) and it tripled in group 2 ( P?value 0.009). The level of VEGF in the first and second samples was not different in either group. Conclusion: Our study suggests that dexamethasone acts more on IC than VEGF in DME. This is significant in the first 3 months with a rebound effect on IL?6 after 3 months. Our study also suggests that repeat injection of DEX in DME should be done at 3 months to prevent deterioration of visual acuity (VA) and worsening of CMT.

Premature coronary artery disease, risk factors, clinical presentation, angiography and interventions: Hospital based registry

Background & aims: Premature coronary artery disease (CAD) is endemic in India. We performed a study to identify risk factors, clinical presentation, angiographic findings and interventions in premature CAD. Methods: Successive patients who underwent percutaneous intervention (PCI) were enrolled from January 2018 to June 2021. Premature CAD was defined as women 45-59 y and men 40-54 y and very premature as women <45 y and men <40 y. Descriptive statistics are presented. Univariate odds ratio (OR) and 95% confidence intervals (95%CI) were calculated to identify differences in various groups. Results: 4672 patients (women 936, men 3736) were enrolled. Premature CAD was in 1238 (26.5%; women 31.9%; men 25.1%) and very premature in 212 (4.5%; women 6.5%, men 4.0%). In premature and very premature vs non-premature CAD, OR (95%CI) for high cholesterol _x0001_200 mg/dl [women 1.52(1.03 e2.25) and 1.59(0.79e3.20); men 1.73(1.38e2.17) and 1.92(1.22e3.03)], non-HDL cholesterol _x0001_130 mg/dl [women 1.84(1.35e2.52) and 1.32(0.72e2.42); men 1.69(1.43e1.90) and 1.67(1.17e2.34)], LDL cholesterol [men 1.10(0.95e1.25) and 1.04(0.77e1.41)], and tobacco [women 1.40(0.84e2.35) and 2.14(0.95e4.82); men 1.63(1.34e1.98) and 1.27(0.81e1.97)] were higher while hypertension, diabetes and chronic kidney disease were more in non-premature(p < 0.05). Presentation as STEMI was marginally more in women with premature [1.13(0.85e1.51)] and very premature [1.29(0.75e2.22)] CAD and was significantly higher in men [1.35(1.16e1.56) and 1.79(1.29e2.49)]. Location and extent of CAD were not different. Conclusions: In India, a third of CAD patients presenting for coronary intervention have premature disease. Important risk factors are high total and non-HDL cholesterol and tobacco (men) with greater presentation as STEMI. Extent and type of CAD are similar to non-premature CAD indicating severe disease.

An Exploration of Pulmonary Fitness of Construction Workers in Delhi NCR in Light of the Building and Other Construction Workers Act, 1996

Workers in the construction sector are exposed to high concentrations of particulate matter at their workplace. This increases their susceptibility to various respiratory diseases, particularly chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS). The study reports comparative pulmonary fitness and hematological parameters of the migrant workers in the construction sector versus other sectors in Delhi. Parameters such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1 ), the ratio of FEV1 to FVC, and peak expiratory flow were measured in both groups using a spirometer. We observed significant differences (P < 0.05) in FEV1 and FVC between both groups. The study thus confirms that workers exposed to poor air quality at the construction site are susceptible to respiratory diseases, particularly ARDS. All of this reflects the poor enforcement of the adequate safety measures well enlisted in social legislations such as the Building and Other Construction Workers Act.

Clinical and histopathological profile of primary caruncular lesions

Purpose: To provide a retrospective analysis of lesions of the caruncle which have been very rarely reported in the literature. Methods: A retrospective review of all the caruncular lesions between January 2000 and January 2020 was done at a single tertiary eye care hospital. The lesions were classified as benign and malignant lesions. Clinicopathological correlation was done for the excised lesions. Results: A total of 87 caruncular lesions were included in the study. Males (59%) were affected more than females (41%). The mean age at presentation was 44 ± 20 years. The mean duration of complaint was 36 ± 62 months. A total of 36 patients underwent surgical excision whereas the rest opted for conservative management. Recurrence was noted in five patients. Fifteen different types of lesions were identified histopathologically. Benign lesions (78%) were far more common than malignant ones (22%). Epithelial inclusion cyst was the most common benign lesion and sebaceous gland carcinoma was the most common malignant lesion. Correct clinicopathological correlation was seen in 52.7% of the cases. Caruncular tuberculosis, oncocytoma, and basosquamous cell carcinoma were some of the rare lesions. Conclusion: Caruncular lesions are uncommon and very diverse, which makes clinical diagnosis challenging. Epithelial inclusion cyst and sebaceous gland carcinoma were the most common benign and malignant lesions respectively. Correct clinicopathological correlation was seen in more than half of the cases

Combined treatment modality including topical 20% fluorescein dye in the management of phthiriasis palpebrarum � A case series

Purpose: To study the clinical presentations and outcomes of phthiriasis palpebrarum (PP) managed with combined treatment modality comprising of 20% fluorescein dye, mechanical removal of the ectoparasites, and topical application of antibiotic eye ointment with paraffin base. Methods: This is a prospective interventional noncomparative hospital?based series of 13 patients of PP. All the patients underwent local application of 20% fluorescein dye over the eyelashes and eyebrows of both the eyes followed by the mechanical removal of all the ectoparasites and trimming of the eyelashes from the base followed by application of ophthalmic ointment. Results: Mean age of the patients was 28 � 22 years (range 3� Years). Out of the total of 13 patients, 11 patients (85%) were having bilateral involvement. The mean duration of symptoms in 11 patients (rest 2 were accidental findings) was 4 � 3 weeks (range 1� weeks). Three patients (23%) had a history of sexual contact with possible parasite?infested partners. Four patients (31%) had additional parasites in the pubic area or torso. All the patients were completely parasite free at the end of 1 month. There was no infestation of the treating medical personnel from the patient. The average follow?up was 8 � 5 months (range 3� months). Conclusion: Itching and irritation of the eyes were the most common presentations of PP. Combined treatment modality comprising of 20% fluorescein dye, mechanical removal of ectoparasites, and topical application of antibiotic eye ointment with paraffin base is effective in the management of PP

The effect of direct cell injury inflicted by cryotherapy on eyelid sebaceous gland carcinoma cells: An ex-vivo experimental study

Purpose: To evaluate the effect of direct cell injury of cryotherapy on eyelid sebaceous gland carcinoma cells by an ex vivo cryotherapy experiment. Methods: It was a prospective interventional case series. Six patients with biopsy?proven nodular sebaceous gland carcinoma were included. After excision of the mass, a thin slice of the mass resembling the thickness of the conjunctiva was shaved off and was oriented over the broad end of a tissue forceps. Cryotherapy was applied to both its anterior and posterior aspects by the triple freeze?thaw technique. The mass was then labeled and sent separately for histopathological evaluation by fixation and staining. Results: A total of six patients with a mean age of 58.2 ± 15.5 years were included. There were four females and two males. The mean duration of the lesion was 21.6 ± 17.51 months. All patients had involvement of the upper eyelid. The patients were clinically staged as T2b (n=2), T1a (n=2), T2c (n=1), and T3a (n=1) respectively. There was no regional lymphadenopathy or metastasis in any of the cases. The experimental cryo?tissue containing the cryo?treated lesion revealed the presence of viable tumor cells (>50%) in all six specimens. Conclusion: The direct cell injury caused by cryotherapy may not be sufficient to kill all the residual sebaceous gland carcinoma cells on the tumor bed.

Clinical profile, imaging features and short term visual outcomes of Indian optic neuritis patients with and without seromarkers for myelin oligodendrocyte glycoprotein and neuromyelitis optica

Purpose: To analyze clinical profile, imaging features, and short?term visual outcomes of optic neuritis patients in Indian population with and without seromarkers for myelin oligodendrocyte glycoprotein (MOG)/neuromyelitis optica (NMO). Methods: Electronic medical records of 203 optic neuritis patients who presented between June 2018 and December 2019 to the Neuro?ophthalmology services of a tertiary care center in India were retrospectively analyzed. Results: Of 203 patients, 57 patients (28.08%) were positive for MOG?antibody and 20 patients (9.85%) were positive for NMO antibody. 114 patients (56.16%) were double?negative (negative for both antibodies) and 12 patients (5.91%) were diagnosed as multiple sclerosis (MS). None of the patients had both antibodies. Mean age of presentation was 31.29 ± 1.035 years. There was female preponderance in NMO?optic neuritis (NMO?ON) and MS?optic neuritis (MS?ON) groups (1:5). Mean vision on presentation was worse (logMAR 1.570 ± 0.863) in NMO?ON group. The mean visual acuity showed statistically significant recovery (logMAR 0.338 ± 0.639) in the final follow?up in MOG?optic neuritis (MOG?ON) group. Multivariate logistic regression analysis revealed poor visual outcome in patients presenting with retrobulbar neuritis, optic disc pallor, bilateral sequential optic nerve involvement, and with positive NMO antibody. Optic neuritis patients presenting with disc edema associated with pain and positive for MOG antibody were found to have a better visual outcome. Conclusion: In this Indian optic neuritis cohort, the prevalence of MOG?ON was higher than NMO?ON. MOG?ON had a better visual outcome than NMO?ON. The incidence of MS?ON was less compared to the western literature. A significant number of patients (114 patients, 56.16%) were double negative for both seromarkers and yet had presented with optic neuritis with no clinical or imaging features suggestive of MS/MOG associated disease (MOG AD)/NMO spectrum disorder (NMO SD).

The spectrum and clinicopathological correlation of eyelid lesions: Twenty years’ experience at a tertiary eye care center in South India

Purpose: To study the epidemiological pattern and diagnostic accuracy of histopathologically proven eyelid lesions over a period of two decades. Methods: A retrospective study of all histopathologically proven eyelid lesions from April 1996 to March 2016 was conducted. The lesions were broadly categorized as benign or malignant. Inflammatory and infectious lesions were included under the benign category. The percentage and diagnostic accuracy of each lesion was calculated. Results: There were a total of 994 (M = 551, F = 443) cases. The mean age of the patients was 43.5 ± 19.9 years. There were 809 (81.4%) benign and 185 (18.6%) malignant lesions. Benign lesions were commonly seen in the fourth decade, while the malignant ones in the late fifth decade. The upper lid was the most common site in both groups (n = 481, 48.4%). The commonest benign lesion was chalazion (n = 484, 59.8%). Dermal nevus (n = 94, 11.6%) was the most common benign neoplasm, while Molluscum contagiosum (n = 25, 3.09%) was the most common infectious lesion. Sebaceous gland carcinoma (SGC) (n = 103, 55.7%) was the leading malignant lesion followed by basal cell carcinoma (n = 39, 21.1%). Eleven malignant cases were misdiagnosed as benign (5.9%). Chalazion (99.1%) and SGC (65%) had the highest diagnostic accuracy, while Molluscum (40%) and squamous cell carcinoma (40%) were the most misdiagnosed lesions in the respective groups. Conclusion: Benign eyelid lesions are far more common than malignant ones. Atypical and rare presentations may lead to misdiagnosis. Knowledge of epidemiological patterns and clinical features can help in achieving higher diagnostic accuracy.

Monday Blues - Rare Cause of Hypoglycemia in a Child with Leukemia

Hypoglycemia in a child with acute lymphoblastic leukemia (ALL) often makes the clinician think of sepsis or metabolic disturbances due to relative adrenal insufficiency with steroid withdrawal. We report a rare scenario of drug-induced hypoglycemia in a child on treatment for ALL. Recurrent symptomatic episodes of hypoglycemia in a 4-year-girl on treatment for high-risk ALL were analyzed and it was surprising to note that the episodes were noted on early hours on Monday and Sunday nights. Detailed evaluation for the etiology and the workup was not contributory. With the background of drug history for ALL maintenance and occurrence of episodes on Mondays, possibility of drug-induced hypoglycemia secondary to cotrimoxazole was considered. Dose alteration for trimethoprim-sulfamethoxazole was considered stopping the drug is not feasible. Malnutrition was attributed as the coexisting risk factor in our child

Studies on the development of cassava based reconstituted dry starch sago with modified starch as binder and characterization of its physico-functional properties

Aim: The present study was conducted to investigate the status and diversity of plant species used for rearing of Eri silkworm and their traditional management in the homegardens of Mishing tribe.Methodology: A total of 45 homegardens from three villages were surveyed randomly which were primarily associated with rearing of Eri silkworm. Vegetation was studied using quadrat method. The data on traditional knowledge associated with the management of plants species for rearing of Eri silkworm were collected using semi structured questionnaires. Results: The average size of studied homegardens was 0.35 ha. A total of 243 plant species were recorded from the studied homegardens of which six species were used as food plants for rearing of Eri silkworm and 10 species were used in construction of mountage. Trees related to Eri culture contributed to 37.47% of the total importance value index (IVI) in the studied homegardens. Heteropanax fragrans (Roxb.) Seem and Ricinus communis L. were the primary food plants of Eri silkworm and were found to be dominant in the homegardens. Activities such as land preparation, sowing, pruning, weeding and watering are carried out for the management of Eri silkworm food plant species and were found to vary for different species. Interpretation: There is an urgent need to document the indigenous knowledge and traditional practices associated with the management of host and food plants used in the rearing of Eri silkworm in the present day context as it is a part of their cultural heritage and should be reoriented through integration of modern farming technique.

Prevalence of teenage pregnancy in 2015–2016 and its obstetric outcomes compared to nonteenage pregnancy at Hospital Tuanku Ja’afar Seremban (HTJS), Negeri Sembilan, Malaysia: A retrospective case-control study based on the national obstetric registry

@#Objective: To determine the prevalence of teenage pregnancy and compare its obstetric and perinatal outcomes with those of non-teenage pregnancy. Method: This retrospective hospital-based case-control study was conducted in the Department of Obstetrics and Gynaecology in Hospital Tuanku Ja’afar Seremban. The study made use of the Malaysian National Obstetric Registry (NOR) records of teenage pregnant women aged 11–19 at Hospital Tuanku Ja’afar Seremban over a 12-month period between May 2015 and May 2016 (n=164). Socio-demographic profiles, obstetric outcomes, and perinatal outcomes were detailed for each pregnant woman. The results were compared to a control group of 169 pregnant women aged 20–30 who also delivered in hospital Tuanku Ja’afar Seremban during the same period. The aim of this study was to assess the obstetric outcomes of teenage pregnancy and to compare them with those of the control group. A chi-squared test was used to identify the statistical significance of the relationship between teenage pregnancy rates and obstetric outcomes. Results with p <0.05 was considered statistically significant. Results: The prevalence of teenage pregnancy was 2.8%. The mean age of the teenage group was 17.9; that of the control group was 26.4. Teenage mothers had a significantly higher risk of anemia (p<0.05), episiotomy (p<0.001), preterm labor (p<0.001), and delivering low-birthweight babies (p<0.001). There were no significant differences between the two groups in mode of delivery, antenatal complications, birth outcomes, APGAR scores at 5th minute, or neonatal complications. Conclusion: The prevalence of teenage pregnancy in this study is relatively low but is associated with an increased risk of some perinatal complications. The primary care physician’s role is pivotal in educating adolescents on sexual health, providing continual care in hospitals, and empowering teenagers in their reproductive health decisions.

Dynamic smile reanimation in facial nerve palsy

Objectives@#Long-term facial paralysis results in degeneration of the distal nerve segment and atrophy of the supplied muscles. Options for these patients include free muscle transfer, temporalis myoplasty, and botulinum toxin injections for smile reanimation. In this study we aimed to evaluate the subjective and objective outcomes of these procedures. @*Materials and Methods@#In our study, we retrospectively analyzed smile symmetry in patients with facial palsy (n=8) who underwent facial reanimation procedures. @*Results@#Subjective analysis showed high satisfaction in seven out of eight patients. Objective analysis showed statistically significant improvement postoperatively in both vertical and horizontal smile symmetry at rest and during maximum smile (P<0.001). @*Conclusion@#Choosing the ideal procedure for the patients is the most critical aspect for facial reanimation. Though free muscle transfer is considered gold standard procedure, temporalis myoplasty also gives satisfactory results. Residual synkinesis which can lead to disturbing aesthetic deformity can be effectively treated with botulinum toxin.

Super continuum generation in water doped with Homeopathic medicines

We have carried out systematic studies to investigate the effect on supercontinuumgeneration in water using 40 fs laser pulses when doped with Homeopathic medicines. We perform these studies using five series of medications with different levels of dilution (10-30 to 10-100000). We measure supercontinuum spectra that span from 400-1050nm. We monitor the area under the curve in the range 450-750 nm for each sample at a fixed incident laser energy. Our observations indicate that the yield of supercontinuum generation, in water containing Homeopathic medicine is significantly different from that obtained in water containing plain ethanol. The measurement for different dilutions shows up to 7 times standard deviation variation in the yield of supercontinuum generationEven though linear absorption in the UV-visible region does not show any significant difference for different Homeopathic medicines, the supercontinuum yield which depends on the effective nonlinear refractive index changes with different samples. (AU)

Sensitivity and specificity of frozen section diagnosis in orbital and adnexal malignancies

Purpose: To analyze the diagnostic accuracy of frozen section in orbital and adnexal malignancies. Methods: A total of 55 cases between January 2006 and December 2011 for which intraoperative frozen section was performed for various orbital and adnexal lesions were included in the study. The frozen section diagnosis was compared with the permanent section diagnosis. Margin clearance was also compared between the two. Data were analysed using SPSS version 14. Odds ratio and cross-tabulation was used to perform the analysis. Results: The mean age at presentation was 51.46 � 20 years. Eyelid was the most common site of involvement. Out of 55 cases, diagnosis was deferred in four cases (7.27%) on frozen section. Among 51 cases, 44 (86%) cases were concordant, whereas 7 (13%) cases were discordant. The sensitivity and specificity of frozen section compared to permanent section for diagnosis of malignancy was found to be 87.2% and 87.5%, respectively. The sensitivity and specificity of frozen section for diagnoses of basal cell carcinoma was found to be 100%, while it was 83.3% and 100% respectively for sebaceous gland carcinoma and 87.5% and 94.9% respectively for squamous cell carcinoma. Conclusion: Frozen section had high sensitivity and specificity when compared with permanent section for all three parameters studied. It is an important intraoperative tool that is increasingly being used in histopathological examination of ophthalmic lesions. However, it should not be used as a substitute for the permanent section and critical decisions based on it are best avoided.

Sympathetic ophthalmia with incidental finding of chicken pox supported by histopathology and immunohistochemistry

Sympathetic ophthalmia (SO) is a rare bilateral diffuse granulomatous panuveitis that occurs in few days to several years after penetrating injury. This intraocular inflammation can occur in any age group without a sex predilection. Pathology and immunohistochemistry-supported evidence is important to know the disease in a better way. We present a case of a 24-year-old female with clinical diagnosis of SO with an atypical past history of chicken pox in that eye and residual corneal opacity.