Submandibular gland involvement in early stage oral cavity carcinomas: can the gland be left behind?

To determine the frequency of submandibular gland involvement in early oral cavity tumors. Observational study. ENT Department, CMH, Rawalpindi, from January 2008 to December 2011. Data of 110 oral cavity tumors operated over 2008 - 2011 was retrieved from ENT OPD, tumor registry in AFIP and from Head and Neck Oncology Forum Registry. Cases of oral cavity tumors that had undergone elective neck dissections were retrospectively studied for invasion of the submandibular gland, TNM Staging, perineural, perivascular, lymphovascular invasion, site specific frequency of oral cavity tumors and frequency of lymph node metastasis. Tumors of tongue were the most common constituting 42%, squamous cell carcinoma was the histological diagnosis in 90% cases. Sixty eight [61.8%] cases were node negative. Selective neck dissection was done in 55.5% of the cases. Submandibular gland was involved in 2 cases [1.8%]. Submandibular gland metastasis from early oral cavity tumors is rare; any neoplastic involvement of the gland usually occurs via direct spread

Right ventricular infarction incidence and outcome

To determine the incidence and outcome of right ventricular infarction we looked prospectively at 346 consecutive patients admitted with acute myocardial infarction. Right ventricular infarction was diagnosed by combination of electrocardiographic and echocardiographic criteria. There were 48 patients with right ventricular infarction. The incidence of right ventricular infarction in patients with inferior myocardial infarction was 30%. There were 39 males and 9 females. In hospital mortality of patients with right ventricular infarction was significantly more than the mortality of the patients with acute myocardial infarction who did not have right ventricular involvement [23% vs 13%, p<0.001]. Six patients presented with cardiogenic shock all of which died. Most patients had good resting left ventricular ejection fraction [mean 54%, range 39% to 74%]. We conclude that all patients with acute inferior myocardial infarction should be evaluated for right ventricular involvement so that specific haemodynamic and pharmacological management can be started