Worst pattern of invasion in oral squamous cell carcinoma is an independent prognostic factor.

Introduction: Biologic aggressiveness of OSCC (Oral Cavity Squamous Cell Carcinoma), has intrigued research in various prognosticating histopathological markers over past few decades. DOI (Depth of Invasion) is one such histopathological factor which affects outcomes and was included in the AJCC 8th edition TNM staging. Pattern of Invasion (POI) has been widely reported as an adverse prognostic factor associated with higher locoregional failure and poor prognosis. However, these factors are not utilized for treatment decision making and for outcome assessment. Materials and methods: This is a retrospective analysis of 320 patients with OSCC who underwent treatment, from October 2018-February 2020. Clinic demographic details were extracted from electronic medical records. Univariate and multivariate analysis was done for the parameters. WPOI (Worst Pattern of Invasion) was correlated with all histopathological prognostic factors. Survival analysis was done using Kaplan Meier for WPOI type's I-V. DFS (Disease free Survival) was evaluated for different grades of WPOI. Results: We analyzed the results comparing, early and advanced T (Tumor) stages, cohesive WPOI I-III, non-cohesive WPOI IV-V. Univariate analysis showed a significant association of T-stage (p = 0.001), N (Nodal) -stage (p = 0.002), DOI (p = 0.008), PNI (Peri-neural invasion) (0.001) and Tumor differentiation Grade (p = 0.001). On multivariate analysis, non-cohesive WPOI (IV & V) showed significant association with grade, PNI, DOI (0.002, 0.033 & 0.033 respectively). Non-cohesive WPOI had significantly higher locoregional failures and short DFS. Conclusion: Presence of invasive WPOI is associated with advanced T stage, poor differentiation, PNI, greater depth of invasion, and higher chances of nodal metastasis. WPOI is associated with poor DFS, treatment intensification in early stage disease with WPOI type IV & V may improve survival.

Contamination level, source identification and health risk evaluation of potentially toxic elements (PTEs) in groundwater of an industrial city in eastern India.

The present investigation explores the spatial and seasonal variations in potentially toxic element (PTEs) concentrations and contamination level assessment of groundwater samples in and around the Asansol industrial city, eastern India. The representative samples of groundwater from 24 different locations were analyzed for pH, electrical conductivity (EC), total dissolved solids (TDS), total hardness (TH) and PTEs, e.g., Pb, Cu, Cd, Zn, Fe and Cr for pre-monsoon and post-monsoon. The pH level of examined groundwater samples is under the desirable limit with few exceptions (S5, S11 and S16 in pre-monsoon and S12 in post-monsoon). The recorded values for Pb, Cd, Fe and Cr in many sampling stations found higher than the prescribed limits of Indian standards (IS 10500: 2012) in both the seasons. The mean contamination factor (Cf) for PTEs in the groundwater is in the order of Cr > Fe > Cd > Pb > Cu > Zn and Fe > Cr > Cd > Pb > Cu > Zn, with mean contamination index (Cd) value of 2.83 and 2.72 in pre-monsoon and post-monsoon season, respectively, indicating moderate level of contamination in the examined area. Geospatial depiction of HPI values shows high level of contamination during pre-monsoon (58.3% sampling sites) and post-monsoon (45.8% sampling sites) in majority of sampling sites. Further, application of multivariate statistical analysis ascertains that the PTEs in groundwater are majorly derived from anthropogenic activities such as opencast mining, thermal power plants, iron and steel industries, sponge iron and other metallurgical industries, and leachate from urban and industrial wastes along with limited contribution from geogenic and lithogenic sources. The health risk assessment demonstrates that the non-carcinogenic risk (due to PTEs) in adults is in the sequence of Cr > Cd > Pb > Fe > Cu > Zn, while for children the order is Cr > Pb > Cd > Fe > Cu > Zn for both the seasons. The results also reveal higher chance of occurrence of carcinogenic risk due to Cr (ILCR > 1.0E-04) for children and adults in both the seasons.

Safe Delivery of Surgical Care in Head and Neck Cancer Patients During COVID-19-an Audit of Pattern of Presentation and Treatment Strategies in an Oncology Centre in the Northern India.

Delay in treatment of head and neck cancer leads to stage migration and increased morbidity. Due to the COVID-19, surgical care has been severely affected. We continued our oncology services during the pandemic. We present here the pattern of presentation of head and neck cancer patients to the hospital and strategy to continue services. A retrospective audit of patients registered under Head and Neck Disease Management Group during lockdown, 23rd March to 31st May 2020, was done. Four categories were made new registrations, post-surgical patients, emergency department visits and follow-up presentation. Of the 693 patients assessed, a majority were with oral cavity cancer (80%). Seventy-eight percent of patients presented with stage IV disease. There were 382 new registrations, of which 68% were symptomatic. Of the 69 patients that underwent surgery, 17 patients were on adjuvant treatment. A total of 60 patients presented to emergency department during this period, maximum with complaints of dyspnoea (67%). One hundred eighty-nine patients were follow-up patients of which 43% were symptomatic. Among these, 12 patients were diagnosed with recurrence. Various administrative and clinical policies were formulated to continue cancer care during this time. Surgical services need not be halted during the COVID-19 pandemic. Following scientific rationale and treatment strategies, safe oncosurgical care can be delivered during pandemic.

Co-expression network analysis of protein phosphatase 2A (PP2A) genes with stress-responsive genes in Arabidopsis thaliana reveals 13 key regulators.

Abiotic and biotic stresses adversely affect plant growth and development and eventually result in less yield and threaten food security worldwide. In plants, several studies have been carried out to understand molecular responses to abiotic and biotic stresses. However, the complete circuitry of stress-responsive genes that plants utilise in response to those environmental stresses are still unknown. The protein phosphatase 2A (PP2A) gene has been known to have a crucial role in abiotic and biotic stresses; but how it regulates the stress response in plants is still not known completely. In this study, we constructed gene co-expression networks of PP2A genes with stress-responsive gene datasets from cold, drought, heat, osmotic, genotoxic, salt, and wounding stresses to unveil their relationships with the PP2A under different conditions of stress. The graph analysis identified 13 hub genes and several influential genes based on closeness centrality score (CCS). Our findings also revealed the count of unique genes present in different settings of stresses and subunits. We also formed clusters of influential genes based on the stress, CCS, and co-expression value. Analysis of cis-regulatory elements (CREs), recurring in promoters of these genes was also performed. Our study has led to the identification of 16 conserved CREs.

O to T Flap for Central Forehead Defect Reconstruction.

The reconstruction of central forehead defect is challenging because of the paucity of the adjacent extensible tissue and aesthetic importance of the area. Reconstruction of this region should be done keeping in mind brow symmetry and natural hairline. Camouflaging the final scar lines in wrinkles or hairline should be the final goal. Even small resections in this region can be surprisingly difficult owing to resistance offered by galea to advancement despite significant undermining due to its inelastic composition and position over the skull's natural convexity. Following, we present a case report wherein we describe a technique for the reconstruction of central forehead defects using simple Burrow's triangles.

Sources evaluation, ecological and health risk assessment of potential toxic metals (PTMs) in surface soils of an industrial area, India.

The present study aims to appraise the spatial distribution of potential toxic metals by using geostatistical technique and find their associated ecological and human health risks from surface soils of Durgapur industrial area, India. The results show that the mean metal concentrations are 116.03, 32.96, 154.37, 321.20, 50.08, 29.54 and 2.97 mg/kg for Pb, Cd, Cr, Fe, Cu, Ni and Hg, respectively, and majority of them is found higher than their background and world natural soil concentrations. The GIS contour map of pollution load index values clearly distinguished the studied sampling area is highly to very highly polluted by the toxic metals. Contamination factor (Cf) and geo-accumulation index (Igeo) values of studied metals show a similar sequence of Hg > Cd > Pb > Fe > Cr > Ni > Cu. Calculated enrichment factor (EF) value for Hg (13.29), Cd (5.26) and Pb (1.11) in studied soils was found significantly higher, which suggests that their primary sources are higher industrial activities in the studied area. Computation of potential ecological risk index reveals that the entire study area is under high risk level (1941.60-3367.23), in which Cd (588.52) and Hg (1979.26) possess the maximum ecological risk factor in all the sampling sites. The results of correlation analysis, principle component analysis and cluster analysis explore that industrial discharges, atmospheric disposition and waste disposal are the major sources of soil metal pollution in the studied region. Human health hazard indices are lower than 1 for all metals, indicating low non-carcinogenic risks to children and adults. Carcinogenic risk assessment reveals the existence of cancer risk of Cd (5.5E-03), Cr (8.6E-04) and Ni (3.0E-04) to child and Cd (8.2E-04) and Cr (1.3E-04) to adults in Durgapur.