Comparative study of radical neck dissection vs. modified radical neck dissection in metastatic neck gland.

Treatment of metastatic neck gland is an integral part of management of Head and Neck cancers, because this is the single most important prognostic determining factor. Although surgery and radio therapy with or without chemotherapy are the modalities available for treating neck gland, wide surgical excision of the whole regional lymphatic chain enblock is mostly favored. Radical Neck dissection is the operation for such disease, designed in the early part of twentieth century, still has got the validity, but a modification of that (modified radical neck dissection) is becoming popular for last few decades to reduce morbidity. In this study we compared 15 cases of radical neck dissection and equal number of modified radical neck dissection to observe the selection criteria of these two types of operations, their complications and therapeutic success. Neck deformity, shoulder pain and restricted shoulder movement are the major morbidities which are less in modified radical neck dissection. The oncologic efficacy appears as same in both procedures.

Head and neck squamous cell carcinoma (HNSCC) 5 year study at BSMMU.

Head and Neck Squamous Cell Carcinoma (HNSCC) are generally similar in their clinical features, epidemiology and etiology although their natural and clinical history and treatment differ. Despite lot of improvement in diagnostic and management technique, there is little improvement in survival rate over the last few decades. This study was carried-out in a multidisciplinary tertiary level hospital (BSMMU), with a country-wide catchment area to see the burden of HNSCC existing in our country and their clinical pattern. The overall incidence rate of HNSCC in this study was (0.15%) i.e. 150 person in 1,00,000 population. Male incidence (0.19%) was higher than female (0.12%). This study revealed that carcinoma of the larynx (25.22%) and pyriform fossae (20.57%) were the main culprit, whereas buccal carcinoma was the main component (37.70%) in the female series. Highest incidence was found in the 6th decade in both sexes. As the treatment of HNSCC may be time consuming, requires multidisciplinary approach, demands lot of clinical, social and financial consideration, therefore, the best treatment can be offered through a combined board consisting of Surgical, Radiation, Medical oncologists, Histopathologist and Speech therapist as required.

Prevalence of CSOM among rural school going children.

A prospective study was carried out from January 2001 to December 2002 to find the prevalence of CSOM among rural school going children. Altogether 225 students aged 4-13 years from five primary schools and junior high schools of Magura district were interviewed and examined. 28 (12.44%) children were found to have CSOM. Out of these 28 cases, 25 came from lower and 3 from middle income group families. No case of CSOM was found in higher income group family. In this study 73.33% mothers were not aware of CSOM. 60% mothers had no knowledge about treatment and sequelae of CSOM. Only (5.78%) people use cotton bud to clean ear while majority use unhygienic materials like matchstick, cloth with stick and chicken feathers. Treatment seeking pattern was observed in our study. 10.71% cases did not receive any treatment and remaining 89.29% received treatment of which 25% from MBBS doctor or Hospital and 7.14%, 35.71%, 10.71%, 10.71% received it from Kabiraj, Quack, Homeopathy doctor, and salesman of pharmacy respectively.