Advancing head and neck cancer following the coronavirus disease 2019 pandemic.

OBJECTIVE: Delay in the diagnosis of head and neck cancer can result in significant excess morbidity and mortality. How the pandemic has affected patient presentation in Scotland is unknown. METHOD: This retrospective cohort study compared all presentations of head and neck cancer between June and October of 2019 with the same period following the peak of the pandemic in 2020 in West Scotland, a region populated by 2.5 million people. RESULTS: A total of 528 patients met our inclusion criteria. Compared with 2019, patients in 2020 were more likely to present with a higher American Joint Committee on Cancer stage (odds ratio, 1.67 (95 per cent confidence interval = 1.20 to 2.31); p = 0.002), a longer preceding symptom duration (odds ratio, 2.03 (95 per cent confidence interval = 1.44 to 2.87; p < 0.001) and to have an emergency presentation (odds ratio, 2.53, (95 per cent confidence interval = 1.15 to 5.55; p = 0.017). CONCLUSION: Patients are presenting later with more advanced head and neck cancer following the coronavirus disease 2019 pandemic.

Risk factors for outbreaks caused by variant strain of Newcastle disease on environmentally controlled broiler chicken farms in Lahore, Pakistan.

Newcastle disease (ND) is a frequently reported disease in poultry among both vaccinated and non-vaccinated flocks in Pakistan. During 2011-2012 poultry industry in Punjab, mainly in Lahore region, faced fatal outbreaks of ND caused by a variant strain. An analytical study was conducted during outbreak period in Lahore region. A total of 114 environmentally controlled farms were selected with the help of convenient sampling method. A questionnaire was designed about the potential risk factors associated with the spread of ND outbreak. The bivariate relationships between ND status and independent variables were investigated by applying the Chi-square and Fisher's exact test. Multivariable logistic model was used to estimate the effect of each studied variable on the outcome by adjusting the other variables in the model. The variables which showed an association with ND outbreaks at commercial poultry farms were improper method for dead birds disposal (OR=4.96; 95% CI 1.63-15.12), use of same feed transporting vehicle at multiple poultry farms (OR=4.92; 95% CI 1.58-15.33), farm to farm distance of less than 1 km (OR=9.32; 95% CI(1.19-73.12), number of sheds at one farm (OR=2.31; 95% CI 0.93-5.69), labor type (OR=2.72; 95% CI 0.83-8.88) and biosecurity (OR= 4.47; 95% CI 0.56-35.66).

Carcinoma of gall bladder.

A study of 118 newly diagnosed patients with gallbladder disease during a two year period showed that the frequency of gallbladder cancer was 8.4% and cholelithiasis played a significant role in its etiology. No remarkable differences were observed in the clinical and biochemical findings between the benign and malignant disease of gallbladder.

Composition of gall stones-microchemical analysis.

The composition of gall stones removed surgically from 31 patients was determined by microchemical analysis. Twenty six had mixed infective, 2 cholesterol and 3 pigment stones. All the stones consisted of combination of various constituents in varying amount. Bilirubin was detected in the centre and peripheral layers of all, protein was found in the centre of 84.6% and cholesterol in the centre of 54% and the peripheral layers of all the gall stones. The findings in this study suggest that infection is the most likely cause of biliary lithogenesis.

Clinical and biochemical study of 114 cases of cholelithiasis.

During a period of 16 months 114 patients with cholelithiasis were studied. The diagnosis was confirmed by cholecystogram in 41 cases, by surgery in 28 and both surgery and the x-ray in 45 cases. There were 100 females and 14 males and their average age was 43.2 years. The average number of pregnancies in females was 6.5. Clinically the jaundice was observed in 9% and the gall bladder was palpable in 47% of cases. Cholelithiasis appeared to be related to increased parity but not to the body weight.

Gall-stone composition and biochemical alterations in the serum of patients with cholelithiasis.

The levels of cholesterol, calcium and bilirubin were determined in the serum and gall stones in 47 cases with cholelithiasis. The mixed stones were observed in 87.5%, high cholesterol stone in 8.5% and high bilirubin stones in 4.2%. Serum and stone cholesterol levels were inversely proportional and the bilirubin levels were directly proportional to each other.

Aminoacid imbalance ratio in liver disease.

Amino acid imbalance ratio was determined in apparently healthy Pakistanis and patients with hepatitis and cirrhosis of the liver. The ratio was normal in 75% of the patients with actue viral hepatitis but in only 5% with cirrhosis of the liver. The ratio was abnormal in 25% cases of acute viral hepatitis possibly due to aminoaciduria. The abnormal ratio in cirrhosis of the liver indicated the functional capacity for albumin synthesis and correlated well with serum albumin concentration.

Aminoacid imbalance ratio in liver disease.

Amino acid imbalance ratio was determined in apparently healthy Pakistanis and patients with hepatitis and cirrhosis of the liver. The ratio was normal in 75% of the patients with acute viral hepatitis but in only 5% with cirrhosis of the liver. The ratio was abnormal in 25% cases of acute viral hepatitis possibly due to aminoaciduria. The abnormal ratio in cirrhosis of the liver indicated the functional capacity for albumin synthesis and correlated well with serum albumin concentration.