Overall and Event Free Survival of Childhood Cancer - Report From a Hospital-based Cancer Registry in Northern India, 2013-21

Objectives: Using data from a hospital-based cancer registry (HBCR) in the private sector in Northern India, we provide overall survival (OS) and event-free survival (EFS) for childhood cancer patients. Methods: All newly diagnosed childhood (age <18 years) cancer patients in our HBCR registered between March 1, 2013 till July 31, 2021 were eligible. 3-year and 5-year OS (death was an event), EFSc (death, progression/relapse was an event), and EFSa (death, progression/relapse, abandonment of treatment was an event) were calculated using the Kaplan-Meier method. Regression analysis was done to see their association with demographic, diagnostic and treatment variables. Results: 705 newly diagnosed children (36.2% female) with cancer were registered. Common cancers were leukemias (26%), CNS tumors (20%) and bone tumors (16%). 202 (28.6%) had experienced an event at median follow up of 1.95 years (range 0-8.14 years), which included 23 (3.3%) who abandoned treatment. The 3- year OS, EFSc, EFSa were 70.8%, 64.4% and 63.6%, respectively. Correspondingly, 5-year OS, EFSc, EFSa were 66%, 58.6% and 57.5%, respectively. There was no significant difference by age group, gender, nationality, and if cancer directed treatment initiated elsewhere. The OS, EFSa and EFSc by the main and the extended International Childhood Cancer Classification categories varied significantly (P<0.001). Conclusion: We add more recent registry-based OS data on childhood cancer in India and present the first estimates on EFS.

Immunization of Children with Cancer in India Treated with Chemotherapy – Consensus Guideline from the Pediatric Hematology-Oncology Chapter and the Advisory Committee on Vaccination and Immunization Practices of the Indian Academy of Pediatrics

Justification: Children with cancer need to be immunized against the common vaccine-preventable diseases after completion andsometimes during ongoing treatment of cancer. However, the immunization schedule for these children needs to be altered due todisease and treatment related immune-suppression. Consequently, there are many guidelines/practice statements from around theworld to address this issue, however, there is no such comprehensive guideline from India catering to the need of Indian children withcancer. Process: A guideline was drafted after reviewing the available literature. The draft guideline was discussed and modified in ameeting attended by pediatric oncologists from the PHO chapter and vaccine experts from the ACVIP of the IAP. Subsequently, themodified draft was reviewed and recommendations were finalized.Objective: To review the current evidence and generate a nationallyrelevant guideline for immunization of children receiving chemotherapy for cancer. Recommendations: Live vaccines arecontraindicated during and up to 6 months after end of chemotherapy. Non-live vaccines are also best given after 6 months from the endof treatment for durable immunity. Annual inactivated influenza vaccine is the only vaccine recommended for all children duringchemotherapy whereas hepatitis B vaccine is recommended only for previously unimmunised children with risk of transfusion associatedtransmission of infection. Post-treatment re-immunization/catch-up schedule largely depends on the pre-chemotherapy immunizationstatus. Sibling immunization should continue uninterrupted except for oral polio vaccine which needs to be substituted by the injectablevaccine. Inactivated influenza vaccine is recommended and varicella vaccine is encouraged for all contacts including siblings

Minimum Effective Volume Of A Combination Of Bupivacaine And Lignocaine For Supraclavicular Brachial Plexus Block Using Ultrasound Guided Technique

Background: To determine the effective volume of a combination of bupivacaine and lignocaine for supraclavicular achial plexus block using ultrasonography (USG). Methods: This study is an intervention study to determine the minimum effective volume of a drug combination. The principle statistical method applied in this study is Staircase Up-down method as described by Dixon and Massey.([i]) Results: By using the log transformation of the data of required volume and outcome as successful or unsuccessful we have calculated EV 50 = 11ml and EV 90 = 14ml. Conclusion: Minimum Effective Volume in 90% individuals (MEV 90) for a combination of 0.25% bupivacaine and 1% lignocaine for ultrasound guided achial plexus block via supraclavicular approach is 14ml.

Evaluation of governmental oral health-care infrastructure in the state of Haryana.

Health system should be organized to meet the needs of entire population of the nation. Oral diseases are the most common of the chronic diseases, but there are few efficient dental care systems to cope with these problems. The present cross-sectional study was conducted among 135 dental care units of various primary health centers, community health centers, and general hospitals existing in the state to evaluate the government oral health-care infrastructure in Haryana. Data regarding provision of water and electricity supply, dental workforce and their qualification, number and type of instruments in the dental operatory unit, etc., were collected on a structured format. There is a shortfall in infrastructure and significant problem with the adequacy of working facilities. This can prove to be a big hurdle in the provision of adequate oral health care to people with greatest health-care needs. A great deal of effort is required to harmonize the oral health-care delivery system.

Non-syndromic oligodontia in permanent dentition: a rare case report / Oligodontia não sindrômica nad entição permanente: relato de caso raro

Tooth agenesis is one of the most common congenital anomalies seen in humans. Although absence of one or more teeth is common, absence of multiple teeth is rare. Oligodontia is a rare developmental anomaly, involving agenesis of six or more permanent teeth, excluding the third molars. The reported prevalence of oligodontia in permanent dentition is 0.14%. Oligodontia can be presented as an isolated condition or as a part of a syndrome. Discussion: The present case report highlights a unique case of non-syndromic oligodontia, with agenesis of four permanent incisors, left permanent canine and right second premolar in the mandibular arch and its management with a novel fixed functional prosthetic appliance. Conclusion: Prosthetic rehabilitation is an urgent need for these kind of patients so that they do not suffer from masticatory and esthetic problems which can eventually lower the self esteem of individuals...

A agenesia dentária é uma das anomalias congênitas mais comuns em humanos. Embora a ausência de um ou mais dentes seja comum, a ausência de vários dentes é rara. A oligodontia é uma anomalia de desenvolvimento rara, envolvendo agenesia de seis ou mais dentes permanentes, excluindo os terceiros molares. A prevalência de oligodontia na dentição permanente é de 0,14%. A oligodontia pode apresentar-se como uma condição isolada ou como parte de uma síndrome. Discussão: O presente relato destaca um caso único de oligodontia não sindrômica, com agenesia de quatro incisivos permanentes, canino permanente esquerdo e segundo pré-molar direito no arco inferior, e seu manejo com um novo aparelho de prótese fixa funcional. Conclusão: A reabilitação protética é uma necessidade urgente para este tipo de paciente para que ele não sofra de problemas de mastigação e estética, os quais podem eventualmente reduzir a autoestima do indivíduo...

Disaster management: Role of dental professionals.

Natural or manmade catastrophic events place great manpower demands on communities and their health care and public health systems. This calls for ever preparedness on the part of the health care workers. Dentists are not perceived as much of help in case of any disaster event. Although the first responders are primarily looked upon for in case of any disaster response; if called upon dentists can be a source of vital support in medical surge events. Dentists and dental auxiliaries can augment the existing medical professionals, in responding to a declared medical emergency. Dentists are exposed to information in many general medical areas during their pre-doctoral education that can be useful in disaster response situations. Dentists have the clinical skills and medical knowledge that are invaluable assets in a mass casualty event. Dentists can be given the opportunity with additional targeted training to become more effective responders to natural disasters and other catastrophic events. Inculcating disaster training in the undergraduate and post graduate curriculum will better prepare the dentist for any surge event. The present article explores the various duties which dental professionals can play in a major public health disaster.

Stromal response in different histological grades of oral squamous cell carcinoma: A histochemical study.

Objectives: The aim of the study is to evaluate the connective tissue changes in different grades of Oral Squamous Cell Carcinoma (OSCC's) and the influence of these changes in predicting the biological behavior of these tumors. Materials and Methods: A total of 39 cases of OSCC's and 6 sections of controls were examined using seven connective tissue special histochemical stains. Results: Staining intensity of collagen, reticulin, acid mucins, fibrin, glycoproteins, sulfated mucins, elastic fibers around the tumor islands and within the connective tissue was observed. Conclusions: Tumor cells which grow progressively in the host stroma have the capacity to pre-empt and subvert the response of host, which is essential for their growth and spread. Clinical Relevance: The reactive changes in the tumor stroma may alter the biological aggressiveness of oral cancer, and by incorporating this concept into a prognostic system, we may help to reflect the biologic diversity of oral cancer and predict its clinical outcomes.

Assessment of prevalence of dental caries among 5 and 12-year-old schoolchildren in Chandigarh (U.T. ), India / Avaliação da prevalência de cárie dental em crianças com idades entre 5 e 12 anos em Chandigarh (U.T. ), Índia

Objectives: To assess the prevalence of dental caries among 5 and 12-year-old schoolchildren in Chandigarhand to explore and suggest suitable preventive programmes for the prevention of dental caries in this population.Materials and methods: Twenty out of 101 schools were randomly selected for the study. A totalof 1113 subjects were examined from May 2008 to September 2009. Data regarding dental caries experienceusing dmft index for 5-year-old and DMFT index for 12-year-old school children were collected on astructured format. Results: Among the 5-year-old children examined, 46.8% (271) were females and 53.2%(308) were males. Considering the 12-year-old age group, 46.6 % (249) were females and 53.4% (285) weremales. Regarding the 5-year-old age group, 48.3% (579) of subjects were affected with dental caries, andin the 12-year-old age group, the amount was 30.52% (534). The prevalence of dental caries was more in5 years age group. Conclusion: In the present study, it was observed that 51.7% of the 5-year-old subjectswere caries free and the mean DMFT was 0.53 at 12 years of age. Hence, it may be concluded that W.H.O.global oral health goals for 5 and 12 year olds are achieved in Chandigarh. Still, as public health people, wehave to aim at achieving ‘0’ (zero) DMFT for all school going children.

Objetivos: Avaliar a prevalência de cárie dentária em crianças com idade entre 5 e 12 anos em Chandigarh,e explorar e sugerir programas para a prevenção da cárie dentária nesta população. Materiais e métodos:Vinte de 101 escolas foram selecionadas aleatoriamente para o estudo. Um total de 1.113 indivíduos foramexaminados entre maio de 2008 e setembro de 2009. Os dados referentes à experiência de cárie foram coletadosem um formato estruturado pelo índice cpo-d para 5 anos e índice CPO-D para crianças de 12 de idade.Resultados: Dentre as crianças de 5 anos examinadas, 46.8% (271) eram do gênero feminino e 53.2% (308)eram do gênero masculino. No grupo de 12 anos, 46.6% (249) eram do gênero feminino e 53.4% (285) eramdo gênero masculino. No grupo de 5 anos de idade, 48.3% (579) dos sujeitos foram afetados por cáries; já nogrupo de 12 anos de idade, o percentual foi de 30.52% (534). A prevalência de cárie foi maior no grupo de5 anos. Conclusão: No presente estudo, observou-se que 51.7% das crianças de 5 anos eram livres de cáriee a média de CPO-D foi de 0.53 para o grupo de 12 anos. Desse modo, foi possível concluir que as metas daOMS para saúde bucal para crianças de 5 e 12 anos de idade foram atingidas em Chandigarh. Porém, nacondição de pessoas de saúde pública temos que atingir o objetivo de CPOD “zero” para todas as criançasem idade escolar.

Value of ultrasound in understanding laryngeal anatomy: Pictorial review

The purpose of our study was to understand the normal Sonographic anatomy of human larynx. High- frequency Sonography was used to assess the normal landmarks and to understand the normal appearances of various laryngeal structures assessable to ultrasound mainly thyroid, cricoid and arytenoids cartilages and assessment of both true and false vocal cords, and outlining relationship with other structures in axial, sagittal/parasagittal and coronal planes

Epidural hematoma with ossification: Two case reports

We report two case of ossified epidural hematoma [EDH]. First case a 30 years male who had head injury 4 years back following a road traffic accident. Initial computed tomography [CT] showed EDH otherwise his hospital stay was uneventful. 3 years later he presented with seizure. Sequential CT scan shows hyperdense layer along the margins of the hematoma which increased in thickness. Second case a 26 years male presented with assault, CT scan showed depressed fracture of left frontal bone with resolving EDH and a thin hyperdense inner margin

Dental lasers: a review of safety essentials

The laser technology offers a wide range of uses in dentistry with certain advantages to the general dental practitioner like bloodless surgery, minimal post-operative pain, reduction of operative time and high patient acceptance. Patient acceptance has also been demonstrated in various studies. Apart of these major advantages, safety regarding the use of lasers cannot be neglected and has become an important concern in this modern era of dentistry, as application of this technology is growing day by day. Potential hazards can be encountered while using lasers like ocular hazards, tissue injury, inhaling the vapor emitted by the laser procedure, fire and explosion hazards etc. The safe use of lasers includes all the individuals who might be exposed either deliberately or accidently while using lasers and effective measures that can be undertaken by clinicians and health professionals to minimize the injuries caused due to laser accidents. The present article serves to explore the risks involved in the use of lasers in dentistry and suggest some of the laser safety protocols/measures that can be established in the dental office for prevention of laser injuries.

Wound healing Agents from Medicinal Plants：A Review

This paper presents a review of plants identified from various ethno botanical surveys and folklore medicinal survey with Wound healing activity. Wound is defined as the disruption of the cellular and anatomic continuity of a tissue. Wound may be produced by physical, chemical, thermal, microbial or immunological insult to the tissues. The process of wound healing consists of integrated cellular and biochemical events leading to re-establishment of structural and functional integrity with regain of strength in injured tissues.This review discuss about Wound healing potential of plants, its botanicalname, Common name, family, part used and references, which are helpful for researcher to development new Wound healing formulations for human use.