Histological risk score and its role in predicting recurrence in early-stage oral squamous cell carcinomas

Context: Oral squamous cell carcinoma (OSCC) comprises more than 90% of oral cancers and is the most common carcinoma affecting the oral cavity. Early stage T1/T2 OSCC have a heterogeneous prognosis and a significant number of patients develop loco regional recurrence (LRR) and have reduced disease free survival (DFS) with increased disease related mortality. Aims and Objectives: To assess the impact of the three parameters used in Brandwein-Gensler risk model along with lympho-vascular invasion (LVI), depth of invasion (DOI) and lymph node metastases in predicting LRR in early stage OSCC. Materials and Methods: This was a retrospective study on early stage T1/2 OSCC patients over a period of 2 years who received treatment by surgical resection and had follow-up data. LRR was assessed based on recurrence of OSCC at the initial site or in regional lymph nodes. Results: Out of 1135 OSCC cases during our study period a total of 207 cases befitted our inclusion criteria. Recurrence was noted in 113 (54.6%) cases. Univariate analysis identified LVI (P < 0.00001), DOI (P < 0.00001), nodal involvement (P < 0.00001), worst pattern of invasion (WPOI) (P < 0.00001), lymphocytic host response (LHR) (P = 0.004), perineural invasion (PNI) (P = 0.012) as strong statistically significant risk factors for LRR. Conclusion: Adequate assessment of simple parameters on routine H and E by incorporating Brandwein-Gensler histological risk scoring model at the initial presentation can help prognosticate and predict LRR and select patients for post-surgical adjuvant therapy.

Caregiver Burden and self-efficacy: A Hospital- based Comparison between General and Special Ward Patients

India has one of the largest health-care systems in the world, and caregivers play an important role in assisting the patients in seeking services, supporting the patient during treatment and also in recovery, as there is a culturally determined emphasis on kinship

Gross Morphology of the Hip Articulation of Buffalo Calves (Bubalus Bubalis).

Back ground: The vulnerability of the buffalo to the luxation of the hip articulation previous to and during parturition encouraged the investigation in this species. The literature reviewed did not reveal complete anatomical descriptions of the coxofemoral articulation of buffalo. Hence the study was undertaken. Purpose: to study the different anatomical aspects of the hip joint which are specific to buffaloes. Methods and Results: A total number of fifteen hip joints of buffalo calves procured from the local slaughter house and department of VeterinaryAnatomy were studied in the Department of Veterinary Anatomy,College of Veterinary Science, Tirupati irrespective of breed, sex and nutritional status. The gross morphology of joints and relations were studied. The round ligament of buffalo was stronger compared to cattle. A thick fibrous stratum of articular capsule was present. A few arched and semi-circular fibers were seen in the articular capsule but zona orbicularis was absent. The best developed periarticular ligament in the buffalo hip was the iliofemoral ligament. It was a thick cord of connective tissue extending from a nodule below and behind the ischiatic spine and spreaded over the capsula articularis and finally attached to the trochanter major and trochanteric ridge. The pubocapsular ligament was located on the ventral surface of the joint capsule and blended with it. Compared to the most of other quadripeds the periarticular ligaments were well developed in buffalo. The iliofemoral ligamentwasmostly helpful in preventing the hip fromexcessive extension and adduction. The relative development of the periarticular ligaments in the biped and quadrupedswere probably in accordance with comparative weight that this articulation must support. Potential implications: An understanding of the basic anatomy of the hip helps in understanding pathology and can greatly assist the surgeon in appropriately diagnosing and treating the problems.

A case of melanoma in xeroderma pigmentosum.

Xeroderma pigmentosum (XP) was first described in 1874 by Hebra and Kaposi. [1] It is a rare autosomal recessive disorder characterized by photosensitivity, pigmentary changes, premature skin aging, and malignant tumor development due to cellular hypersensitivity to ultraviolet radiation resulting from a defect in DNA repair. The basic defect in XP is in nucleotide excision repair (NER), leading to deficient repair of damaged DNA. A 12-year-old boy presented with a large growth over the right side of the forehead. The lesion was first noticed before two years as a 2 x 2 cm 2 mass. It was slowly growing and attained the present size of 10 x 8 x 7 cm 3 . The surface showed ulceration with areas of hemorrhage and blackish pigmentation. Also, the patient had hyperpigmented macules over the skin since early childhood. The macules appeared initially over the face and later developed over the other areas of the body. The macules were more over the sun exposed areas. He also had photophobia and both eyes showed corneal opacities. Histopathological examination of the excised growth showed features consistent with melanoma. This case is being presented because of its rare association with xeroderma pigmentosum patients in India.

Homocystinuria due to cystathionine beta synthase deficiency.

A two year-old male child presented with cutis marmorata congenita universalis, brittle hair, mild mental retardation, and finger spasms. Biochemical findings include increased levels of homocysteine in the blood-106.62 micromol/L (normal levels: 5.90-16 micromol/L). Biochemical tests such as the silver nitroprusside and nitroprusside tests were positive suggesting homocystinuria. The patient was treated with oral pyridoxine therapy for three months. The child responded well to this therapy and the muscle spasms as well as skin manifestations such as cutis marmorata subsided. The treatment is being continued; the case is reported here because of its rarity. Homocysteinuria arising due to cystathionine beta-synthase (CBS) deficiency is an autosomal recessive disorder of methionine metabolism that produces increased levels of urinary homocysteine and methionine It manifests itself in vascular, central nervous system, cutaneous, and connective tissue disturbances and phenotypically resembles Marfan's syndrome. Skin manifestations include malar flush, thin hair, and cutis reticulata / marmorata.

Risk profile of pregnant mothers in the coastal area of Udupi Taluk, India

A demographic and obstetric profile of pregnant mothers attending the Rural Maternity and Child Welfare homes was carried out through a cross- sectional study. In 613 registered pregnant mothers, the prevalence of risk factors related to age of the mother, parity, weight, haemoglobin level and Rh negative blood group, bad obstetric history and pregnancy related diseases were analysed. Prevalence of teenage pregnancy and primigravida accounted for 7 and 34.7 percent respectively. Nearly 17 percent of mothers had weight less than 40 kg and 28 percent of mothers were found to be anaemic [HB less than 8 gm%]. Twenty percent of the mothers did not have even a single risk factor whereas 33.8 percent of mothers had at least one risk factor and 20 percent had multiple risk factors of 3 or more. Previous bad obstetric history, pregnancy related diseases and Rh negative blood group accounted for 9.2, 3.9 and 2.7 percent respectively

Entamoeba histolytica and other parasitic infections in south Kanara district, Karnataka.

Single stool specimens collected from 1,020 apparently healthy people of the South Kanara District, were processed for intestinal parasites using three parasitological methods viz. (a) Direct smear in physiological saline and D'Antoni's iodine, (b) Zinc sulfate concentration method and (c) by culture in modified Boek and Drbolhav medium. Of these 781 (76.51 per cent) were found to be infected with parasites. The prevalence of various intestinal parasites was: Ascaris lumbricoides (48.33 per cent), Necator americanus (46.86 per cent), Trichuris trichiura (42.75 per cent), Entamoeba coli (23.24 per cent), Entamoeba histolytica (7.94 per cent), Enterobius vermicularis (2.84 per cent), Giardia intestinalis (2.45 per cent), Iodamoeba buitschlii (1.57 per cent), Entamoeba hartmanni (1.37 per cent), Trichomonas hominis (0.88 per cent), Strongyloides stercoralis (0.68 per cent), Hymenolepis nana (0.49 per cent), Chilomastis mesnili (0.10 per cent) and Endolimax nana (0.10 per cent). High incidence of parasitic infections was recorded in females and age group of 6-14 years.

Late inflammatory swelling by carrageenan in rat's subcutaneous neck tissue.

When injected subcutaneously in the dorsum of neck in albino rats, carrageenan produced inflammatory swelling which reached peak after about 16 hr. The occurrence of the peak inflammatory swelling was delayed but not significantly reduced in severity by aspirin or indomethacin which were administered repeatedly. Phenylbutazone significantly reduced and dexamethasone almost completely inhibited it. In rat hind paw model, subplantar carrageenan injection produced peak inflammatory swelling after about 4 hr which was significantly reduced by all anti-inflammatory drugs mentioned above. It is interesting that an inflammagen when injected at different sites in the same species elicits responses which differ in the time course and drug responses.

Some aspects of pharmacological profile of sodium curcuminate.

Rapid i.v. injection of sodium curcuminate (NaC) produced transient hypotension and bradycardia in anaesthetized dogs and cats which were not blocked by bilateral vagotomy, atropine, mepyramine or propranolol. In open-chest anaesthetized cats, decrease in blood pressure and heart rate was accompanied by simultaneous transient reductions in left ventricular systolic pressure, maximal rate of rise of left ventricular pressure and a concomitant increase in left ventricular end-diastolic pressure. It was concluded that the transient hypotensive effect of NaC is due to its myocardial depressant action. NaC exhibited negative inotropic and chronotropic effect on isolated perfused rabbit heart, an antispasmodic effect on smooth muscle of dog s intestine in vivo and of vas deferens of guinea-pig in vitro but no effect on the rectus abdominis muscle of frog or its response to cholinergic stimulation.