Ophthalmology

The story is the thing - The Birth of Indian Journal of Ophthalmology Case Reports Santosh G Honavar Indian Journal of Ophthalmology - Case Reports 2021 1(1):1-1

Diamonds are forever… and so are case reports Carol L Shields, Jerry A Shields Indian Journal of Ophthalmology - Case Reports 2021 1(1):2-3

Verrucous carcinoma: A rare variant of eyelid squamous cell carcinoma Tarjani V Dave, Sasi Pyda Indian Journal of Ophthalmology - Case Reports 2021 1(1):4-4

Periocular cutaneous leishmaniasis Md Shahid Alam, Sanhita Chatterjee Indian Journal of Ophthalmology - Case Reports 2021 1(1):5-5

Beware of the bruise: Eyelid and periocular cutaneous angiosarcoma Tarjani V Dave, Richa D Wagh, Dilip K Mishra Indian Journal of Ophthalmology - Case Reports 2021 1(1):6-6

Congenital keratopellis R Balamurugan, Parul Chawla Gupta, Sameer Sethi, Savleen Kaur, Jagat Ram Indian Journal of Ophthalmology - Case Reports 2021 1(1):7-7

Pre-Descemet's corneal dystrophy Alka Sonkeshri, Deepshikha Agrawal, Samrat Chatterjee, Sharad N Gomase Indian Journal of Ophthalmology - Case Reports 2021 1(1):8-8

An interesting case of corneal burn following electrocution Shweta Patro, Anushri Agrawal, KS Siddharthan Indian Journal of Ophthalmology - Case Reports 2021 1(1):9-9

Intracameral fungal bridge Mohamed Ibrahime Asif, Suman Lata, Shristi, Rahul Kumar Bafna, Rajesh Sinha Indian Journal of Ophthalmology - Case Reports 2021 1(1):10-10

Complete Schwalbe's ring in Axenfeld-Rieger anomaly Sagarika Snehi, Gaurav Gupta, Deepika Dhingra, Sushmita Kaushik Indian Journal of Ophthalmology - Case Reports 2021 1(1):11-11

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

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Social Psychiatry

Substance abuse in the elderly: A hidden behemoth Subhash Das, Siddharth Sarkar Indian Journal of Social Psychiatry 2020 36(4):267-269

Of mice and men.....The unforgettable narrative of how social factors shape substance use, addiction, and recovery Debasish Basu Indian Journal of Social Psychiatry 2020 36(4):270-276 The currently predominant model to explain addiction is the brain disease model of addiction, which emphasizes drug-induced brain changes at the individual level, producing an uncontrollable, chronic relapsing disease. It tacitly de-emphasizes the complex sociocultural, contextual, and other environmental determinants of substance use and addiction. In this oration, I challenge these assumptions with a hop-and-stop tour of five countries: Canada, the USA, India, Vietnam, and Iceland. The journey covers five narratives: isolation, pain, frustration, and then the positive narrative of recovery, and finally the narrative of hope. The socially enriched rats in the “Rat Park” in a laboratory in Canada consumed much less morphine than the isolated, caged rats. People dying of opioid overdose in the worst-ever opioid epidemic in the USA might be using opioids as an escape from broadly defined “pain,” where pain is an emblem of deeper societal isolation and suffering. In Punjab, India, frustrated youths due to complex socio-political-economic reasons are falling easy prey to the profiteering drug mafia. On the positive side of the narratives, most of the Vietnam war veterans who had been using heroin heavily while in Vietnam quit after returning to the comfort of their home, family, and friends, thus providing the narrative of recovery. Finally, the Icelandic Model, a series of pro-social policy measures at the government level targeting the children, the parents, the school, and the environment in Iceland, where teenage substance abuse had been peaking alarmingly in the mid-1990s, demonstrated the preventive prowess of these measures. All in all, this journey teaches us vital lessons not to forget the social psychiatry of addiction. It also teaches us that it would be a wise investment to improve the social determinants of health, including mental health and addiction.

The role of "Attributions" in social psychology and their relevance in psychosocial health: A narrative review Debanjan Banerjee, Chehak Gidwani, TS Sathyanarayana Rao Indian Journal of Social Psychiatry 2020 36(4):277-283 Assigning motives or reasons to situations and actions have been the basic premise of human existence. Attributing cause to an action makes it logical and easier to comprehend. In social psychology, attribution is the process through which individuals explain the causes of behavior and events. Various theories and models have been proposed to explain this concept, starting from the early works of Fritz Heider in the early 20th century and further advances by Harold Kelley and Bernard Weiner. Attributional concepts can be used in a wide arena of behavioral science ranging from mental health stigma-related interventions to consumerism, corporate and jury psychology, and finally, attributional bias in psychosis and learned helplessness in depression. Attribution theories are viewed as the relevant concepts in the exploration and explanation of a wide repertoire of psychopathologies, especially for culture bound syndromes. Research into the translational use of attributional theories has declined in the recent years, the models being criticized for being mechanistic and reductionistic in approach. Nevertheless, the role of “attributions” in social psychology remains equally important today to explore the various facets of human behavior and reactions. The article explores the relevance of attributions in the fields of psychosocial health. It discusses various theoretical perspectives and frameworks premised on attributional models and narrates the understanding as well as the applications of the relevant theories in the realms of stigma research and consumerism. The criticism and implications in mental health are highlighted thereafter.

Care of transgender individuals in India: A clinical perspective Shiva Prakash Srinivasan, Sruti Chandrasekaran Indian Journal of Social Psychiatry 2020 36(4):284-288 India is making rapid strides in recent times in recognizing and providing legal supports to the transgender community. An increasing number of individuals are seeking medical assistance for gender-affirming medical interventions. Many medical and surgical practitioners working with transgender clients in the Indian subcontinent face clinical and social challenges. In this article, we highlight some of the common challenges experienced by healthcare professionals and the solutions adopted in providing care for transgender clients.

Social media disorder among Indian undergraduate medical students and its association with depression: An institution-based mixed-method study Rajib Saha, Manisha Sarkar Indian Journal of Social Psychiatry 2020 36(4):289-295 Background: Social media disorder (SMD) is the current entity in this decade that leads to different screen-related health problems. Despite of tremendous academic pressure, how social media affects the future doctors, is yet unknown. Aims: The aim is to determine the prevalence of SMD among the undergraduate medical students of a tertiary care hospital in West Bengal and to determine its predictors. Settings and Design: A cross sectional analytical mixed-method study was conducted at a tertiary care center of Bankura. Methodology: During April–June 2019, 216 undergraduate medical students were selected through two-stage sampling method. Data were collected using semi-structured questionnaire, 9-item SMD scale, and Beck's Depression Inventory Scale. Statistical Analysis Used: Data were analyzed using SPSS (version 16) initially through bivariate analysis using Chi-square test and later logistic regression was used to determine the actual predictor(s). Results: The prevalence of SMD was found to be 11.6%. All of the students were found to be social media users and among them the prevalence of screen-related sleep disturbance, headache, eye problem, musculoskeletal problems, and overweight or obesity was 35.6%, 36.1%, 28.7%, 31.5%, and 50.9%, respectively. However, no significant relationship was obtained between SMD and above health problems. Through logistic regression model, it was found that the students with depression were 6.7 times more prone to develop SMD. Conclusions: Depression being a risk-factor for SMD needs to be addressed as priority by providing appropriate counseling and/or professional consultation.

Taking therapy beyond clinics – An evaluation of family therapy training program with lay counselors Janardhana Navaneetham, Tania Roy Indian Journal of Social Psychiatry 2020 36(4):296-302 Background: Families have been accommodating the changes to suit the present situation. Indian families even though structurally moving toward nuclear families, still carry on the values of the joint families of connectedness, interfamily influences, extended family influences on decision-making, etc., Subjects and Methods: The study aims at understanding the effectiveness of family training with lay counselors. An interview schedule was prepared to collect sociodemographic profile, knowledge about family therapy (FT), and confidence of practicing FT. The participants were enrolled for training based on ‘first come first serve’; those who completed postgraduation and PG diploma were included for the training program, and most of them were involved in the helping profession either as part of the training or service. This study was of a quasi-experimental design with assessments at two timelines – pre-post training sessions. Results: Most of them expressed that they had previously worked with families with child abuse, academic difficulties in children, marital issues, domestic violence, etc. A test of Wilcoxon's signed-rank test showed the change in the knowledge and confidence level of the trainees. Nearly 48.1% and 46.3% of the participants felt they have high and moderate skills in identifying cases that require family interventions, respectively, 70.4% said that the sessions were high in clarity, while 25.9% reported moderate clarity. Almost 68.5% expressed no difficulty in understanding sessions. This article attempts to share their experience of conducting the dissemination of systemic family intervention for the people in the service sector. It was found that the participants appreciated the training programs and were able to see the benefit of including systemic approach in their family intervention. Conclusion: This article attempts to share the experience of conducting the dissemination of systemic family intervention for the people in the service sector. It was found that the participants appreciated the training programs and were able to see the benefit of including systemic approach in their family intervention.

Impact of social-emotional learning intervention on emotional intelligence of adolescents Shruthi Kothari, Mareena Susan Wesley Indian Journal of Social Psychiatry 2020 36(4):303-309 Adolescents face a variety of challenges, some of which include social, emotional, cognitive, and interpersonal. In order to help them with their emotions, adolescents should be taught a variety of skills to regulate and handle emotions better. With this intent in mind, a social-emotional learning (SEL) intervention module was developed by the researchers. This module covered aspects related to self-awareness, social awareness, responsibility, empathy and decision-making. These components also form the basis for emotional intelligence (EI) which is defined as the ability to perceive, understand, and regulate emotions of oneself and others. The present study aimed to understand if there arises any difference in scores of EI post the SEL intervention. Second, the gender differences with respect to EI were also be analyzed. The EI Scale (2014) was administered to 80 students between the age group of 13–14 years, from a CBSE school in Chennai. These adolescents were selected through the convenience sampling, and the four subscales were also analyzed. The findings from the study revealed a significant difference in scores from pretest to posttest (t = −4.66, P < 0.05). With respect to gender, no significant difference was found. On the subscales, two of four subscales showed significant difference in understanding emotions (Z = −4.63, P < 0.05) and handling emotions (Z = −4.023, P < 0.05).

The influence of social environment on children of a commercial sex worker V Deepa, MY Manjula Indian Journal of Social Psychiatry 2020 36(4):310-316 The case study aims to understand the influence of social environment on the course of life of children of a commercial sex worker. The participants of the study were two sons of a commercial sex worker who grew up in different environments. The older sibling who is 19 years of age (case 1) lives with his mother, whereas the younger sibling who is 17 years of age (case 2) lives in a hostel distant from everyday influence of a brothel. The study adopts multiple case study design and in-depth interviews were conducted to gather data. The obtained data were subjected to thematic analysis. Each case was analyzed individually, and then cross comparison of the themes derived was carried out. The themes derived on analyzing case 1 were social categorization, mercenary activity, substance aficionado, complacency in life, and compliance with life while the themes derived on analyzing case 2 were disgust toward commercial sex work, feeling of precariousness, antipathy toward home environment, irrational thoughts and anticipation of a better future. The only overlapping issue that emerged in both cases was being protective about their mother. It was concluded that environmental variance contributes to the difference in experience and perception of the situation and society.

Medical students and marijuana, attitudes and beliefs: A comparative study Gurappa Puttanna Gururaj, Ruth Sneha Chandrakumar Indian Journal of Social Psychiatry 2020 36(4):317-320 Background and Objectives: Various studies indicating that cannabis is associated with various psychiatric disorders despite which is a controversy existing regarding the legalisation of cannabis by all the promoters and consumers of the substance. Our objective was to find out the knowledge and awareness among the 1st year and final year medical students toward the effects and experiences with the consumption of cannabis. Methodology: It was a cross-sectional study done on first and final year medical students between July 2019 and August 2019 in Sri Devaraj Urs higher education and research center, who are assessed using a structured and validated instrument, Marijuana Effect Expectancy Questionnaire-Brief (MEEQ-B) questionnaire. Results: Both the first-year and final-year medical students in our study had poor awareness and inadequate knowledge about the various adverse effects of cannabis, especially on all the six parameters of the MEEQ questionnaire. Conclusion: Extensive and elaborative teaching regarding substance use, especially of cannabis and its implication must be updated in the curriculum of both UG teaching and PG teaching in other specialities as well.

Psychological aspects of infertility: A comparative study Nigesh Kalorath, Tilottama Mukherjee Indian Journal of Social Psychiatry 2020 36(4):321-326 Introduction: Psychosocial aspects of infertility in couples are of much relevance. This paper attempts to compare psychological factors that may play a role in couples with and without infertility. The main objectives are to examine the differences concerning marital quality, attachment styles, and defense styles of infertile and fertile couples. Methods: A total of 60 individuals (30 infertile couples and 30 matched fertile couples) were assessed through administering the personal information schedule, Marital Quality Scale, Attachment Style Questionnaire, and Defense Style Questionnaire-40. General Health Questionnaire-28 was administered in the fertile couples to rule out psychiatric morbidity. Results: Statistical analyses revealed that infertile couples differed from fertile couples on marital quality dimensions of understanding, satisfaction, trust, role functioning, despair, and rejection. On the attachment style, component of preoccupation with relationships and the use of immature defenses such as acting out and displacement. Conclusions: This research identified several psychological dimensions related to fertility. Understanding these factors may be helpful for the couples, their family members, and practitioners, with regard to the psychological and social needs related to infertility.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

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Dental Sciences

Knowledge, attitude, and practices of parents on the importance of their Children's oral health in Greater Noida, India Sukhdeep Singh, Neha Awasthi, Dhirja Goel, Deepak Khandelwal, Priyanka Sachdeva, Rakshana Bakhtawar Indian Journal of Dental Sciences 2021 13(1):1-5 Background: Parents and family members are considered the primary source for knowledge about child rearing and health habits for children. Young children's oral health maintenance and outcomes are influenced by their parent's knowledge and beliefs, which affect oral hygiene and healthy eating habits. Parental perception has a long-term influence in determining a child's oral health status. Aim: The aim of this study is to assess the oral health-related knowledge, attitude, and practices (KAP) of parents with children aged 3–5 years. Materials and Methods: A total of 500 parents of children aged 3 to 5 years were included in the study. A self-administered questionnaire, written both in English and local language (Hindi), validated through pre-tested survey, was given to the parents to assess the oral health related KAP. The results were calculated on the basis of frequency and percentages using the SPSS software. Results: Males comprised 49.8% and females comprised 50.2% of the respondents of questionnaire. Majority of fathers and mothers of the study population agreed for the importance of primary teeth. Almost all the participants in this study agreed that a child's teeth should be brushed/cleaned. A little less than half of study population considered 1 year as the suitable age for the child's first dental visit. A higher proportion of females as compared to males felt that night time bottle/breastfeeding leads to caries. Conclusion: Parental attitude, knowledge, and practices are responsible for their child's oral health. No statistical significance was seen between mothers and fathers on perception of their child's oral health care.

The role of decalcified freeze-dried bone allografts in the healing of postoperative osseous defects resulting from cyst enucleation: A pilot study Tejashvini Joshi, Neha Vyas, Nitu Shah, Saket Thaker, Nesha Sanghvi Indian Journal of Dental Sciences 2021 13(1):6-11 Background: We performed this pilot study to evaluate the osteoinductive potential of decalcified freeze-dried bone allografts (DFDBA) in the healing of postsurgical osseous defects after cyst enucleation through radiographic bone density monitoring over a 6-month period. Materials and Methods: Patients aged between 18 and 70 years of either gender with noninfected odontogenic or nonodontogenic cystic jaw lesions measuring 1–5 cm in size were enrolled and randomly assigned to study group or control group. The study group patients were filled with DFDBA graft in bony defects resulting from the enucleation of the cysts, whereas no filling material was used in the control group. Sutures were removed on the 7th postoperative day and healing was assessed. Further follow-up visits were done at 1, 3, and 6 months. Bone densities were recorded with grayscale histogram using Adobe Photoshop (version CS 5.1) and compared across all follow-ups. Results: A total of 20 patients were enrolled in the study. Both the groups were balanced in terms of the baseline (preoperative) characteristics. There was a significant increase in bone density in the study group as compared to the control group at months 1, 3, and 6 after the surgery. There was an overall percentage increase in bone density (postoperative density as reference) at months 1, 3, and 6 in the study and control groups. However, the increase was significantly greater in the study group as compared to the control group at month 3 and month 6, whereas there was no difference between both the groups at month 1. Conclusion: Our findings suggest the osteoinductive potential of DFDBA in the healing of osseous defects resulting from the enucleation of cysts.

Epidemiological and clinicopathological analysis of oral leukoplakia in Patna Madhuresh Kumar, Manisha Singh, S Suwasini Indian Journal of Dental Sciences 2021 13(1):12-17 Background: The early detection of oral potentially malignant disorder can reduce the transformation risk to oral squamous cell carcinoma, thereby reducing cancer morbidity and mortality. Aim: To obtain epidemiological information of oral leukoplakia (OL) and distribution of this disease in Patna. Subjects and Methods: Data were collected and analyzed for prevalence of OL among gender, age group, various oral sites, habits, and clinical and histopathological basis. Results: The overall prevalence shows high incidence of homogenous leukoplakia along with mild dysplasia in middle age male persons. Conclusion: Appropriate steps should be taken for early intervention, as it is the key to effective prevention.

Evaluation and comparison of smear layer removal potency of three different irrigation regimes – A stereomicroscopic and scanning electron microscopic study Megha C Patel, Roshni A Bhatt, Kaushal R Joshi, Lilavanti L Vaghela Indian Journal of Dental Sciences 2021 13(1):18-23 Background: Irrigation plays a pivotal role in pulp therapy owing to its flushing action and removal of the smear layer which if present prevents penetration of medicaments and sealers into the dentinal tubules. Aim: This study aims to evaluate and compare the smear layer removal potency of three commercial Irrigating agents. Materials and Methods: Single rooted 30 teeth were selected, decoronated, and randomly divided into three groups according to the irrigation regime to be used (Group I − 5% sodium hypochlorite [NaOCl] + ethylenediaminetetraacetic acid [EDTA], Group II – Chloraxid Gel + EDTA, Group III – Tween Kleen + 3% NaOCl). After recommended biomechanical preparation and irrigation, teeth were stained with 1% methylene blue dye for 24 h and sectioned in 2 halves. Stereomicroscopy was used to assess dye penetration and scanning electron microscope (SEM) analysis was done to detect dentinal surface changes. Data were analyzed using one-way ANOVA test and Tukey honestly significant difference test by statistical software SPSS version 20.0. Results: The highest dye penetration exhibiting smear layer removal for the apical third was seen in Group II (44.78) and for the middle third in Group I (64.73) which was statistically significant. SEM analysis showed maximum dentinal tubules visibility and patency in Group I and minimum in Group III. Conclusion: Newer irrigating materials (1-hydroxyethylidene-1, 1-bisphosphonate) exhibited weak potency for smear layer removal. The sequential use of gold standard NaOCl + EDTA gave satisfactory results, however, in apical third NaOCl Gel + EDTA was found to be more effective. Therefore, it can be prudent to use NaOCl Gels as a safer alternative to conventional means.

Comparing original and universal screwdrivers in terms of torque loss in the abutment screw Vasilios Alevizakos, Nadine Achilles, Björn Rahlf, Philipp Jehn, Marcus Schiller Indian Journal of Dental Sciences 2021 13(1):24-29 Objective: The aim of this study was to examine whether tightening or loosening the abutment screw results in torque loss and whether there is a difference in this respect between original screwdrivers and universal screwdrivers. Materials and Methods: For the purpose of the study, two groups were formed, with the original screwdriver used in group 1 and the universal screwdriver used in group 2. One Straumann implant and one BEGO implant were each inserted into a stationary torque transducer. The next step was to screw 13 abutments into each implant with 13 original abutment screws, using the screwdriver assigned to the group with the torque specified by the manufacturer. To establish whether the torque transmitted to the abutment screw via the screwdriver is also transmitted to the implant rather than causing deformation of the screw head or being transmitted to the surrounding area, the actual torque transmitted from the screw to the implant was measured and recorded electronically during the experiment. Results: There was no loss of torque in the transmission of the tightening torque to the Straumann implant with either screwdriver (P > 0.05). There was a loss of torque in the transmission of the tightening torque to the BEGO implant when using the universal screwdriver but not with the original screwdriver (P < 0.01). Relative to the previously applied tightening torque, a loss of torque when loosening the screw was found with both screwdrivers, both Straumann (P > 0.05) and BEGO (P < 0.05). Conclusion: Using universal screwdrivers can result in loss of torque. The loosening torque is thus decreased, which in turn increases the likelihood of complications such as screw loosening.

Prevalence of oral submucous fibrosis among habitual gutkha and areca nut chewer in Bihar population: A community-based research Rashi Chauhan, Amit Kumar Singh, Kriti Singh, Khushboo Rani, Kumar Anand, Aparajita Tiwari Indian Journal of Dental Sciences 2021 13(1):30-33 Background: The aim of the study was to determine the prevalence and severity of oral submucous fibrosis (OSMF) among habitual gutkha, areca nut, and pan chewers of Bihar population. Materials and Methods: The study was conducted of 3000 adult patients aged over 15 years who visited the Department of Oral Medicine and Radiology, Buddha Institute of Dental Sciences and Hospital. They were subjected to a thorough oral examination, and the bindings were recorded in the prescribed WHO Pro forma. Results: Our study revealed that the prevalence of OSMF was 1.6%. The prevalence among males was 2.60% and among females was 0.16%. All the 243 cases (100%) were associated with areca nut habits. Conclusion: Educating the population about the deleterious effects of the practice of tobacco and related habits on the body in general and the oral cavity. It is hoped that this study would serve as a reference for further epidemiological studies on the abovementioned lesion in this region.

The bridge connecting sella turcica and palatally impacted canine Isha Aggarwal, Ashwin Pradhan, Sanjay Mittal, Mandeep Kaur Bhullar, Aman Sachdeva, Merry Setia Indian Journal of Dental Sciences 2021 13(1):34-39 Introduction: The calcification of sella trucica bridge might be positively associated with canine impaction, the reason being that sella turcica, dental epithelial progenitor cells along with maxilla, palatal, and frontonasal development share a common embryological origin (neural crest cells). Therefore their assessment might provide useful clinical information in predicting palatal canine impaction. Aim: To evaluate the calcification of sella turcica bridging in patients with palatally impacted canine. Materials and method: A total of 21 pretreatment lateral cephalograms of patients with palatally impacted canine and 29 patients with normally erupted canine were selected for the study. Lateral cephalograms of the patients were acquired and landmark were identified and marked. Various Sella values (sella length/interclinoid distance, sella depth, sella diameter) were measured. The values obtained were then subjected to statistical analysis. Result: Suggested that patients with a palatally impacted canine showed smaller interclinoid distance. The frequency of sella bridging was significantly higher in subjects with canine impaction than in controls (P <0.001). Conclusion: Sella bridging is frequently found in palatally impacted canines. The smaller intercliniod distance could be an indicative factor for diagnosis of palatal canine impaction.

Accidental displacement of third molar root into the lingual pouch: A case report and review of treatment approaches Mudit Agarwal, R Muthunagai, Amit Agarwal, Himanshu Aeran Indian Journal of Dental Sciences 2021 13(1):40-42 Third molar surgery is the most common procedure performed by oral and maxillofacial surgeons. A thorough understanding of the complications associated with this procedure will enable the practitioner to identify and counsel high-risk patients, appropriately manage more common complications, and be cognizant of less common sequelae and the most effective methods of management. We present a case of displaced third molar root into the lingual pouch (submandibular space) and ways to prevent and manage this rare complication. In this article, we have compared different surgical approaches for the removal of displaced root from the submandibular space.

Ectopic nasal tooth associated with cleft lip and palate Subhransu Basu, Sudipto Sahu, Abhinaba Bose, Sucharu Ghosh Indian Journal of Dental Sciences 2021 13(1):43-45 Ectopic nasal tooth is a rare phenomenon with only 0.1%–1% incidence rate. They are more frequently found coupled with cleft lip and palate. Here, we present a case of intranasal tooth in a 12-year-old male child with operated cleft lip and palate. The condition was diagnosed only on the basis of intraoral periapical radiograph and was extracted using gauge-holding forceps at a rural health-care center. We discuss the possible etiology, clinical findings, diagnosis, and treatment modalities of this condition. The purpose of this paper is to highlight that this rare condition can be managed with minimum available equipment in a rural setup.

Misdiagnosis or missed diagnosis? Cone-beam computed tomography-aided multidisciplinary management of maxillary central incisor with palatogingival groove R Kurinji Amalavathy, KM Vidya, Sonali Nabil Sarooshi, Hrudi Sundar Sahoo Indian Journal of Dental Sciences 2021 13(1):46-49 Palatogingival groove is a developmental anomaly that is most often seen on maxillary incisors, with a predilection for lateral incisors. It begins in the central groove and can extend to varying lengths and depths into the root. This groove can communicate with the pulp internally and periodontium externally, thereby establishing a milieu for the development of complex endodontic-periodontic lesion. In this article, we report multidisciplinary management of a maxillary central incisor, which was mistaken to be a vertical root fracture instead of a palatogingival groove. We also discuss the significance of early recognition of this lesion, differential diagnosis, and it's interdisciplinary management with the aid of cone-beam computed tomography.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

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Tropical Pathology

Histopathologic analysis of endometrial biopsies in a Northern Nigerian Teaching Hospital Murtala Abubakar, Balarabe Kabir, Almustapha Aliyu Liman, Sani Muhammed Shehu, Bilkisu Lawal Kankia, Anisa Yahya, Zainab Adamu Ali Annals of Tropical Pathology 2020 11(2):101-106 Background: Endometrial biopsy is a reliable means of evaluating the physiologic and pathologic states of the endometrium. The aim of this study was to examine the histopathological pattern of endometrial biopsies as seen in Zaria, Nigeria and to compare the results with similar studies elsewhere. Method: A retrospective analysis was carried out based on the records of the Department of Pathology, Ahmadu Bello University Teaching Hospital, Shika, Zaria between January 2014 and December 2018. The neoplastic lesions were classified according to 2014 World Health Organization classification for endometrial neoplasms. Results: A total of 1518 endometrial tissue samples were analysed. Pregnancy related conditions (41.76%) and functional endometrial changes (27.24%) were the most common morphologic diagnostic category seen. Endometrial hyperplasia (7.13%) was the most common pathologic lesion diagnosed. Of the malignant endometrial tumours, endometrial carcinoma is the most common with 29 cases (58% of all malignant endometrial lesions). One Hundred and Nine cases (7.2%) of the total cases reviewed were found to be inadequate for histopathologic evaluation. Conclusion: Retained product of conception was the most common morphologic entity seen in endometrial biopsy in Zaria. The proportion of endometrial samples that are inadequate for histopathologic evaluation is high. There is a need, therefore, for retraining of staff and standardization of biopsy procedures.

Seroprevalence and factors associated with risk of human brucellosis among febrile patients attending health-care facilities in Bauchi, North-Eastern Nigeria Hafiz Halilu, Fatima J Giwa, Saad A Ahmed, Mu'awiyyah B Sufiyan, Amina I Mohammed Annals of Tropical Pathology 2020 11(2):107-112 Background: Brucellosis is a neglected underdiagnosed zoonotic disease of worldwide distribution with varying symptoms similar to those occurring in other febrile illnesses. A recent screening survey conducted among butchers in Bauchi state reported a high prevalence of human brucellosis; however, its burden among patients with other febrile illnesses is unknown. We determine the seroprevalence and factors associated with risk of brucellosis among febrile patients attending health-care facilities (HCFs) in Bauchi metropolis, North-Eastern Nigeria. Methodology: We conducted a hospital-based descriptive cross-sectional study of 382 participants using a multistage sampling technique. Brucella antibodies were detected using Rose Bengal plate test, and a questionnaire was used to identify risk factors associated with human brucellosis. Data analyses were conducted using Epi Info version 7.0. Bivariate and multivariate analyses were conducted at P = 0.05. Results: Fifty-seven (14.9%) of the 382 febrile patients tested had Brucella antibodies. Males: female ratio was 1.1:1, and the mean age was 29.9 (standard deviation ± 12.03). Age, sex, occupational status, keeping animals, having ever milked an animal, handling animals during birth, and consuming unpasteurized milk or meat were found to be significantly associated with brucellosis on bivariate analysis. Conclusions: Up to 14.9% of the febrile patients attending HCFs in Bauchi metropolis had Brucella antibodies. Age, occupational status, consuming unpasteurized milk or meat, handling animals during birth, and lack of awareness on zoonosis remained independent predictors for brucellosis. Therefore, conducting routine serological screening tests for Brucella antibodies in all febrile patients presenting to HCFs will assist in its diagnosis and proper management.

Breast lesions in a district hospital: Demographic and histopathologic characteristics Kevin Nwabueze Ezike, Solomon Raphael, Ijeoma Ahunna Okwudire-Ejeh, Damian Ikechukwu Okonkwo Annals of Tropical Pathology 2020 11(2):113-118 Background and Aim: Breast cancer is increasingly the most common malignancy among Nigerian women. This study documents the demographic and histopathologic characteristics of breast lesions in a district hospital over a 5-year period. Patients and Methods: Data were collated from patients' request forms and duplicate copies of histology reports of all cases seen under the study period. Results: Breast lesions represented 13% of all histologically diagnosed lesions during the period of the study. Almost 98.6% of these breast specimens were received from females, with a female-to-male ratio of 58.9:1.0. The overall age range of the patients seen was from 10 to 96 years, with a mean of 33.3 ± 13.1 years at the time of presentation. There were 37 (4.4%) nonneoplastic breast lesions, 547 (65.3%) benign breast neoplasms (BBNs), and 254 (30.3%) malignant breast neoplasms (MBNs). The peak age incidence of MBNs was seen in the fifth decade (33.1%). The most common BBN was fibroadenoma (54.5%), followed by fibrocystic change (29.3%). The most common MBN was invasive ductal carcinoma (84.3%), followed by lobular and mucinous carcinoma, each accounting for 4.3%. About 77.1% of the breast carcinomas were Grade II. Conclusion: Breast lesions are common in our setting, strikingly more common in females, predominantly benign in nature with fibroadenoma which peaks in the 20–29 years age group being the most common variety. Invasive ductal carcinoma is the most common malignancy, affecting more women in their 40s with one of every three cases seen in women before their 40th birthday.

Indications and diagnostic utility of bone marrow aspiration cytology: A 12-year experience at a tertiary health center in Gombe, Northeastern Nigeria Saleh Yuguda, Ahmed Iya Girei, Kasim Mohammed Pindiga, Rufai Abdu Dachi, Aliyu Ibrahim Lawan, Yusuf Mohammed Abdullahi Annals of Tropical Pathology 2020 11(2):119-122 Background: Bone marrow aspiration (BMA) cytology is very important in the diagnosis and management of a wide range of both hematological and nonhematological disorders. It has several indications ranging from the evaluation of cytopenias to staging and assessment of remission in the course of management. Aim: The aim of the study was to determine the indications and diagnostic utility of BMA cytology at the Federal Teaching Hospital, Gombe, Gombe State, Nigeria. Methodology: A retrospective review of BMA cytology records performed at the department of Haematology and Blood Transfusion of the Federal Teaching Hospital, Gombe, over a 12-year period from January 1, 2006, to December 31, 2017. Results: A total of 596 BMAs were performed over the study period. The age ranges were from 2 months to 88 years, with a median age of 36 years. Majority of the patients were males (61%). The most common indication for the bone marrow examination was for the evaluation of recurrent anemia 32.2%, followed by presumptive diagnosis of leukemia 27.7%. Normal marrow finding constituted 4.7%, while the diagnosis was inconclusive in 4.2% of the cases. The most frequently diagnosed diseases are the nutritional deficiency anemia together accounting for about one-third of the cases (megaloblastic anemia 20.3%, combined deficiency anemia 9.9%, and iron deficiency anemia 2.5%) and leukemia. Conclusion: Anemia and leukemia are the most common indication for BMA, and nutritional deficiency anemia is the major BMA diagnosis in Gombe, Northeastern Nigeria.

Adherence to glivec (imatinib mesylate) therapy amongst patients with chronic myeloid leukaemia in Nigeria Charles Erhinyodavwe Origbo, Rahman A Bolarinwa, Anthony A Oyekunle, Temitope O Afolabi, Benedict Nwogoh, Muheez A Durosinmi Annals of Tropical Pathology 2020 11(2):123-127 Background: Adherence to Imatinib (Glivec®) is of critical importance in achieving optimal treatment outcomes in patients with chronic myeloid leukemia (CML). Objective: This study aims to investigate adherence to therapy and factors that could influence patient adherence to Glivec®. Methods: This is a prospective cohort study conducted at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife. Seventy consenting newly diagnosed CML patients in the chronic phase were counseled on adherence to therapy and administered 400 mg/day dose of Glivec. Six months after commencement, they were evaluated for adherence using two structured self-administered questionnaires. The first one to evaluate adherence (Morisky Medication Adherence Scale) and the other was administered to identify factors known to influence adherence to therapy. Data were analyzed using SPSS version 21.0 Statistical package (2012, IBM Corp, Armonk, NY, USA.). Results: The study participants had a mean age of 38.4 ± 12.7 years. The male-to-female (male:female) ratio was 1.7:1. Thirty-three (47.1%) of the patients were classified as adherent. Family support was significantly associated with adherence (P = 0.012). The distance of >200 km away from the point of drug collection, OAUTHC, Ile-Ife was significantly associated with nonadherence to Glivec therapy (P = 0.008). Conclusion: This study found that adherence in patients on Glivec® therapy was <50%. Distance of >200 km and family support were significant determinants of adherence in this study.

Overexpression of human epidermal growth factor receptor 2 protein in urothelial carcinoma of the urinary bladder in Ibadan: A single-institutional experience Ebenezer O Fatunla, Mustapha A Ajani, Francis A Onakpoma, Augustine O Takure, Clement A Okolo Annals of Tropical Pathology 2020 11(2):128-132 Background: Overexpression of human epidermal growth factor receptor 2 (HER-2) protein has been shown to have both prognostic and therapeutic values in several malignancies including urothelial carcinoma of urinary bladder (UCB). Aims: This study aimed to determine HER-2 protein overexpression and evaluate its correlation with clinico-pathological parameters in UCB. Materials and Methods: This was a descriptive-analytical study involving the immunohistochemical review of all histologically diagnosed urinary bladder malignancy in the Department of Pathology, University College Hospital, Ibadan, between January 2002 and December 2016. Urinary bladder malignancies whose tissue blocks could not be found and/or demographic data were not available were excluded. Immunohistochemistry analysis was done using rabbit anti-HER-2 antibody (Biocare) and American Society of Clinical Oncology/College of American Pathologists guidelines established for breast cancer were used for HER-2 status scoring. The statistical analysis was carried out usingthe Statistical Package for the Social Sciences, version 22 (SPSS Inc, Chicago, Illinois, USA). Results: HER-2 overexpression was found in four (6.3%) cases. All the HER-2-positive cases were males. One (2.9%) of the 35 high-grade UCB showed positive HER-2 overexpression, whereas three (10.7%) of the 28 low-grade tumor were positive for HER-2 protein overexpression.There was no statistically significant association between HER-2 protein overexpression and histological grades of UCB and muscle invasion by the tumor. Conclusion: Our study demonstrated the low percentage of HER-2 overexpression in UCB with no significant association with tumor grades and muscle invasion. Larger samples involving multiple centers can provide more robust information and further evaluate HER-2 overexpression in urothelial carcinoma in our environment.

Antimicrobial activity of garlic (Allium sativum ) on selected uropathogens from cases of urinary tract infection Okunye Olufemi Lionel, Idowu Philip Adegboyega, Adeleke O Ezekiel, Babalola Caroline Olufunke Annals of Tropical Pathology 2020 11(2):133-138 Introduction: The etiologic agents of urinary tract infection (UTI) occur among both the Gram-positive and Gram-negative bacteria including those that exhibit resistance to commonly used standard antibiotics. Both the male and female individuals can be prone to developing UTI. Garlic (Allium sativum) has been associated with antibacterial activity, though with scanty reports on uropathogens. This study was, therefore, carried out to determine the antibacterial efficacy of aqueous and methanol extracts of garlic (A. sativum)in vitro against six uropathogens (Escherichia coli , Staphylococcus saprophyticus, Pseudomonas aeruginosa, Proteus spp., Klebsiella spp., and Serratia marcescens ) and a reference strain, E. coli ATCC-25922 . Materials and Methods: The bacterial isolates were collected from the Routine Microbiology Laboratory, University College Hospital, Ibadan, and were authenticated by Gram staining and some conventional biochemical tests. The isolates were then subjected to antimicrobial susceptibility testing against both the aqueous and methanol extracts of garlic. Phytochemical screening was also carried out on the plant. Results: Both aqueous and methanol extracts had maximum zones of growth inhibitions of 22 mm at 200 mg/mL and 25 mm at 200 mg/mL against E. coli, followed by P. aeruginosa with zones of growth inhibitions of 21 mm and 25 mm at the same concentration. Proteus spp., exhibited the lowest zones of growth inhibition of 16mm at 200mg/mL.and 10mm at 25mg/mL to methanol and aqueous extracts respectively. The minimum inhibitory concentrations MICs and MBCs of the aqueous and ethanol extracts of garlic varied for each organism. Escherichia coli had the MICs' of 100mg/mL and MBC of 220mg/mL while the MIC and MBC of the aqueous extract on the Proteus spp. are 100mg/mL and 320mg/mL respectively. The MBCs recorded were relatively higher in comparison to the MIC values. Conclusion: These findings showed that garlic could be of therapeutic use in the management of bacterial mediated UTI.

Analysis of argyrophilic nucleolar organizer region score and epithelial dysplasia in common odontogenic cysts seen in a university teaching hospital Oluseyi Folake Ajayi, Oladunni M Ogundana, Moses T Kolade, Onatolu Odukoya Annals of Tropical Pathology 2020 11(2):139-145 Aim: Carcinomatous transformation in odontogenic cysts (OC) lining may be more common than is generally appreciated. Thus, the aim of this study is to predict the potential for neoplastic transformation in the epithelial lining of OC using argyrophilic nucleolar organizer region (AgNOR) scores and degree of epithelial dysplasia. Subjects and Methods: A retrospective clinicopathological study was undertaken on OC histologically diagnosed over a 40-year period in a university teaching hospital in Southwestern Nigeria. Paraffin blocks of selected cases were retrieved and sectioned for hematoxylin and eosin and AgNOR stain. Evaluation of epithelial dysplasia was done using the WHO 2005 protocol. Estimation of atypical features and AgNOR scoring were done using modified and established protocols. Epi info and GraphPad InStat software packages were employed to manage the ensuing data. Results: The commonly observed OC was odontogenic keratocyst (OKC), which accounted for 44.5%, radicular cyst (RC) (24.2%), calcifying odontogenic cyst (COC) (12.7%), and dentigerous cyst (DC) (11.5%). Nuclear pleomorphism was the most common atypical feature and was present in 50% each of DC and COC, 42% of OKC, and 36% of RC. Drop-shaped rete pegs were rarely observed. A significant association was observed between the presence of moderate dysplasia and histologic type of OC (P = 0.022). Mean AgNOR scores per 100 cells was OKC (137.38 ± 35.82), RC (132.04 ± 34.22), COC and DC (119.00 ± 10.93) and (96.91 ± 38.88) respectively. This was not statistically significant (P = 0.218). Conclusions: As moderate epithelial dysplasia was more significantly associated with OKC than other cysts, it is concluded that the potential for malignant transformation is higher in OKC than other histologically categorized types of cysts.

Evaluation of lipid profile pattern among apparently healthy students of Niger Delta University Benedicta Erere Kasia, Victoria Y Nyondia, Promise O Oseajeh, Prohp The Prophet Annals of Tropical Pathology 2020 11(2):146-150 Background: Dyslipidemia constitutes a high risk of cardiovascular disease. Aim: This study was designed to evaluate the lipid profile pattern of apparently healthy students of Niger Delta University to detect any possible abnormality. Setting and Design: This was a cross-sectional descriptive study. Materials and Methods: A total of 102 apparently healthy students were studied. A convenient sampling technique was employed for willing participants. The studied group constituted 55 males and 47 females aged within 20–40 years. Relevant demographic data were obtained by a one-on-one interview with the participants. A blood specimen was collected for measurements of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) by standard assay methods. The data obtained were analyzed using SPSS 22.0, and the student t -test was performed at P < 0.05 for comparison of means. Results: The mean plasma TC and LDL-c values for males were significantly lower than females values of 3.865 ± 0.675 mmol/L versus 4.251 ± 0.851 mmol/L and 2.38 ± 0.49 versus 2.64 ± 0.64 with P = 0.012 and 0.023, respectively. Similarly, the mean plasma HDL-c and TGs for males were lower than female values of 1.126 ± 0.190 mmol/L versus 1.194 ± 0.224 mmol/L and 0.77 ± 0.20 versus 0.82 ± 0.27 with P = 0.099 and 0.27, respectively which were not statistically significant. The age group of 24–27 years constituted the highest mean values and the age group of 28–40 years constituted the least mean values for all the studied parameters. These values, however, did not differ statistically. Most of the participants had significantly within low-normal reference range values. Conclusion: These findings revealed within normal lipid profiles for most subjects.

Peritrabecular clefting in differentiating ossifying fibroma from fibrous dysplasia of the jaws Adetokunbo B Olawuyi, Olajumoke A Effiom, Sunday Omilabu, Onatolu Odukoya Annals of Tropical Pathology 2020 11(2):151-156 Context: Fibrous dysplasia (FD) and ossifying fibroma (OF) are the most prevalent fibro-osseous lesions in Nigerians and present with overlapping clinical, radiological, and microscopic features, resulting in diagnostic challenges for the pathologist and surgeon. Aims: The objectives of this study were to differentiate between FD and OF using clinical features, radiographic features, growth rate, and microscopic method to evaluate the prevalence of peritrabecular clefting. Settings and Design: Random sampling was used to select the sample size of 30 for each lesion from cases diagnosed from 1994 to 2014 in the oral biopsy service of Lagos University Teaching Hospital. Subjects and Methods: Hematoxylin and Eosin sections were prepared from retrieved blocks of FD and OF which had been blinded. Each section was divided into four quadrants, largest vertical and horizontal dimensions of cleft surrounding five trabeculae in each quadrant were measured with ocular grid and multiplied to project an estimation of area of each cleft. Data retrieved on clinical and radiographic information were statistically compared to differentiate between the lesions. Statistical Analysis Used: Statistical Package for the Social Sciences for Windows (version 16.0, Chicago, IL, USA) was used. Results: In the study, 77% of FD had clefts, none was seen in OF. This difference was statistically significant P = 0.001. Ill-defined radiographic borders occurred in 60% of FD, well-defined borders occurred in 81% of OF. In lesions with mixed radiolucency and radiopacity, an association was established between border definition and type of lesion. P = 0.02122. Conclusions: Peritrabecular clefting was observed in 77% of FD, while this feature was not observed in OF and could therefore serve as a reliable parameter to differentiate the lesions.

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Colorectal Surgery

Is Laparoscopic Hartmann's Reversal a Safe Option? A Systematic Review and Meta-Analysis Joseph C Kong, Glen R Guerra, Swetha Prabhakaran, Satish K Warrier, Alexander G Heriot World Journal of Colorectal Surgery 2020 9(4):57-63 Background: Hartmann's reversal is a major operation to restore colorectal continuity. Traditionally, an open Hartmann's reversal (OHR) has been performed but there is a trend toward performing laparoscopic Hartmann's reversal (LHR). With the increasing number of publications comparing these two, it is important to ascertain whether the benefits of LHR outweigh the risks. Objective: To compare LHR and OHR with respect to morbidity and mortality rates. Design: A systematic review and meta-analysis. Setting: The study was conducted at the Peter MacCallum Cancer Centre in Melbourne, Australia. Patients and Methods: A detailed systematic search was performed through PubMed, SCOPUS, TRIP, EMBASE, and ClinicalKey from 1990 to October 26, 2016. A review was undertaken in accordance with PRISMA guidelines. Main Outcome Measures: The primary outcome measure was 30-day morbidity. Secondary outcome measures included estimated intraoperative blood loss, conversion from laparoscopic to open approach, length of hospital stay, and 30-day mortality. Sample Size: Eighteen eligible studies were identified, comprising a total of 7824 patients: 1586 in the laparoscopic group and 6238 in the open group. Results: There was no statistical difference in mean operative time between the two groups. Overall morbidity was lower in the LHR group (16.8% vs 23.7%, P < 0.0001). Subgroup-analysis showed a higher risk of sepsis (6.5% vs 3.2%; P < 0.0001), wound infection (22.5% vs 12.6%; P < 0.0001), and ileus (13.4% vs 5.5%; P = 0.001) in the OHR group. Conclusion: LHR was associated with a lower morbidity rate and shorter hospital stay with an equivalent operative time. There is a moderate rate of conversion and appropriate case selection is important. Limitations: An absence of prospective or randomized trials comparing the two approaches for Hartmann's reversal, contributing to selection bias in our study. It was difficult to combine patient characteristics data due to the heterogeneity in the reported parameters. Conflict of Interest: None.

Nigam's Modified Roeder's Knot in Cutting Seton in High Fistula-in-ano Prevents Rethreading and Reapplication of Seton VK Nigam, Siddharth Nigam World Journal of Colorectal Surgery 2020 9(4):64-67 Background: Fistula-in-ano is known for its recurrence and other complications after surgery, especially in high fistulae cases. Use of a cutting seton is an accepted mode of treatment for high fistula-in-ano cases. Nigam's modified Roeder's knot (NMRK) makes the cutting seton adjustable. The aim of our study is to investigate the results of NMRK application in cutting seton in relation to reapplication, rethreading, postoperative inconvenience to the patient, and postoperative complications. Objectives: To determine whether the NMRK in cutting seton reduces the chances of seton reapplication and postoperative complications in high fistula-in-ano. Design: Squire---Quality Improvement Study. Setting: Patients admitted in various hospitals in Gurugram, Haryana, India. Materials, Methods, and Main Outcome Measures: Eighty high fistula-in-ano patients underwent fistulactomies using the NMRK in both the cutting and adjustable setons between January 2001 and January 2019. Informed consent was obtained from each patient. The patients were evaluated for seton reapplication, inconvenience, recurrence, fecal incontinence, and other postoperative complications. Sample Size: Eighty high fistula-in-ano patients underwent fistulactomies using the NMRK in both the cutting and adjustable setons Results: In our series, no patient suffered fecal incontinence. Three patients (3.75%) had gas incontinence, which gradually stopped within 2 weeks. Most of the setons took 4&#8211; 6 weeks to drop. The healing time was 6&#8211; 8 weeks for majority of the patients. Two patients (2.50%) developed recurrence after surgery. No patient required readmission or anesthesia for seton reapplication. Conclusion: If the cutting seton with the NMRK is retightened every week, then the drop time of the seton and the total healing time decrease, resulting in reduced incidence of inconvenience, pain, fecal incontinence, and recurrence. Rethreading or reapplication of seton is not required. Limitations: Our study includes only uncomplicated high fistula-in-ano cases. It also excludes complex fistulae, watercan perineum, and fistulae with inflammatory bowel disease or cancer. Conflict of Interest: None. Keywords: Cutting seton, fecal incontinence, fistula-in-ano, Nigam's modified Roeder's knot, recurrence

Spontaneous Rectal Perforation with Transanal Evisceration Maria Sebastian Fuertes, Sonia Martinez Alcaide World Journal of Colorectal Surgery 2020 9(4):68-69 We present the case of an 83-year-old woman that visited the emergency room of our hospital for correcting the transanal small bowel evisceration after a defecatory effort, without any history of rectal trauma. Emergency laparotomy was indicated, with the intraoperative finding of perforation in the anterior superior rectum, with a defect of approximately 3 cm. Due to the absence of fecaloid peritonitis, it was decided to perform a primary closure with double sutures. The patient evolved favorably.

Perforated Toxic Megacolon: The Dreaded Complication in IBD Kanmani Murugesu, Premanandan N Sivadasan, Michael Arvind, Wilson Liew Wei Xin World Journal of Colorectal Surgery 2020 9(4):70-72 Toxic megacolon is a dreaded complication of inflammatory bowel disease. Unfortunately, it is usually diagnosed late and, in cases of perforation, has a high mortality rate and is associated with a poor prognosis. We present a case of perforated toxic megacolon in a young woman with undiagnosed ulcerative colitis, highlighting the clinical course and outcome of this condition along with the need for prompt detection and intervention. It was difficult to manage this case in a district hospital because of the limited subspecialty support and resources.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

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Functional Foods

New discovery of anti-ulcerative colitis active ingredients of Nostoc commune: p-Hydroxy benzaldehyde Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Xiaotian Xu, Chengqiong Wei, Yingying Yang, Meng Liu, Ailin Luo, Hengzhi Song, Yuhui Wang, Xiaoqun Duan

Microbial shifts of faecal microbiota using enteral nutrition in vitro Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Nikol Modrackova, Ivana Copova, Adam Stovicek, Marie Makovska, Dagmar Schierova, Jakub Mrazek, Monika Sabolova, Eva Vlkova, Ondrej Hradsky, Jiri Bronsky, Jiri Nevoral, Vera Neuzil-Bunesova

Consumption of fresh Centella asiatica improves short term alertness and contentedness in healthy females Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Oluranti Mopelola Lawal, Fatima Wakel, Matthijs Dekker

Salidroside from Rhodiola rosea L. attenuates diabetic nephropathy in STZ induced diabetic rats via anti-oxidative stress, anti-inflammation, and inhibiting TGF-β1/Smad pathway Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Shan Shan Qi, Meng Li Shao, Sun Ze, Hong Xing Zheng

Potential compound from herbal food of Rhizoma Polygonati for treatment of COVID-19 analyzed by network pharmacology: Viral and cancer signaling mechanisms Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Chenglin Mu, Yifan Sheng, Qian Wang, Amr Amin, Xugang Li, Yingqiu Xie

HPP and SGQR peptides from silkworm pupae protein hydrolysates regulated biosynthesis of cholesterol in HepG2 cell line Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Suling Sun, Wei Wang, Nan Wang, Yu Zhang, Zuoyi Zhu, Xue Li, Junhong Wang, Qihe Chen, Faizan Ahmed Sadiq, Hua Yang, Qianhui Qi, Guohua Zhang

Effects of chitooligosaccharides on the rebalance of gut microorganisms and their metabolites in patients with nonalcoholic fatty liver disease Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Xiaoguo Ji, Mai Chen, Mengyao Zhao, Yudong Song, Yong Lin, Hao Yin, Liming Zhao

Effect of dietary supplementation with oat β-glucan for 3 months in subjects with type 2 diabetes: A randomized, double-blind, controlled clinical trial Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): José Luis Pino, Verónica Mujica, Miguel Arredondo

Smilax china L. polyphenols alleviates obesity and inflammation by modulating gut microbiota in high fat/high sucrose diet-fed C57BL/6J mice Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Xin Li, Licong Yang, Meng Xu, Gaoxiang Qiao, ChangJiang Li, Lezhen Lin, Guodong Zheng

Antidiabetic activity of a Flavonoid-Rich extract from flowers of Wisteria sinensis in type 2 diabetic mice via activation of the IRS-1/PI3K/Akt/GLUT4 pathway Publication date: February 2021 Source: Journal of Functional Foods, Volume 77 Author(s): Yun Huang, Tongxi Zhou, Yirui Zhang, Huiqi Huang, Yuanren Ma, Chaoqun Wu, Qiang Wang, Qinxiong Lin, Xinzhou Yang, Kejian Pang

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Oral Oncology

select article Brain metastasis in head and neck squamous cell carcinoma after immune check point inhibitors treatment
CorrespondenceNo access
Brain metastasis in head and neck squamous cell carcinoma after immune check point inhibitors treatment
Luigi Lorini, Marco Merlano, Lisa Licitra, Marco Ravanelli, Paolo Bossi
In Press, Corrected Proof, Available online 31 December 2020
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select article Back to basics: Hematoxylin and eosin staining is the principal tool for histopathological risk assessment of oral cancer
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Back to basics: Hematoxylin and eosin staining is the principal tool for histopathological risk assessment of oral cancer
Alhadi Almangush, Antti A. Mäkitie, Ilmo Leivo
In Press, Corrected Proof, Available online 29 December 2020
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select article Role of Pembrolizumab in recurrent or metastatic head and neck carcinoma
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Role of Pembrolizumab in recurrent or metastatic head and neck carcinoma
Raul Pellini, Flaminia Campo, Domenico Sergi, Federico Cappuzzo
In Press, Corrected Proof, Available online 29 December 2020
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select article Palatine tonsil adenoid cystic carcinoma
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Palatine tonsil adenoid cystic carcinoma
Dmitry Tretiakow, Edward Mollin, Andrzej Skorek
In Press, Corrected Proof, Available online 26 December 2020
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select article Submucosal oral squamous cell carcinoma of the tongue
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Submucosal oral squamous cell carcinoma of the tongue
Niccolò Lombardi, Elena M. Varoni, Laura Moneghini, Giovanni Lodi
In Press, Corrected Proof, Available online 24 December 2020
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select article Retiform hemangioendothelioma of the mandible: A case report
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Retiform hemangioendothelioma of the mandible: A case report
Junjian Jiang, Xiaoguang Li, Fengshuo Zhu, Yue He
In Press, Corrected Proof, Available online 17 December 2020
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select article In situ melanoma of oral cavity: Diagnosis and treatment of a rare entity
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In situ melanoma of oral cavity: Diagnosis and treatment of a rare entity
Diovana de Melo Cardoso, Daniela Brito Bastos, Daniela Micheline dos Santos, Sebastião Conrado-Neto, ... Daniel Galera Bernabé
In Press, Corrected Proof, Available online 17 December 2020
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Abstract
Abstract
Oral melanoma is an extremely aggressive and rare tumor. Commonly, oral melanomas are diagnosed as invasive tumors, which considerably reduces the chances of cure. In situ oral melanomas being exceedingly rare, which makes its clinicopathological and prognostic characteristics poorly known. Herein, we report a case of 67-year-old non-white woman with a large black patch on the maxillary alveolar mucosa. A biopsy was made and microscopical analysis revealed moderate atypical junctional melanocytic. Tumor cells were positive for S100 (Polyclonal), Melan-A (Clone A103) and Melanosome (HMB-45). The diagnosis of in situ oral melanoma was made and the patient was treated surgically with partial maxillectomy and rehabilitated with obturator prosthesis. Although extremely rare in situ melanomas should be considered in the differential diagnosis of non-invasive pigmented lesions of the oral mucosa.

select article Synchronous primary neoplasia in patients with p16 positive oropharyngeal carcinoma: Does the 2nd cancer really matters?
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Synchronous primary neoplasia in patients with p16 positive oropharyngeal carcinoma: Does the 2nd cancer really matters?
Pirabu Sakthivel, Sarath Raveendran, Smriti Panda, Chirom Amit Singh
In Press, Corrected Proof, Available online 13 December 2020
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select article Maxillo-facial reconstruction following cancer ablation during COVID-19 pandemic in southern Italy
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Maxillo-facial reconstruction following cancer ablation during COVID-19 pandemic in southern Italy
Raffaele Rauso, Fabrizio Chirico, Francesco Federico, Giovanni Francesco Nicoletti, ... Gianpaolo Tartaro
In Press, Corrected Proof, Available online 9 December 2020
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Abstract
Abstract
In COVID-19 pandemic era, one major concern is related to ensure optimal management to oncologic patients, even though a context of radical uncertainty. The aim of our effort is to guarantee high-quality and timely care, minimizing COVID-19 infection risk, according to our head and neck (HN) reconstructive mission, still more challenging because of the criticality of the period. Thus, our reconstructive decision algorithm is changed. Microvascular free flaps, reported to be the gold standard for surgical reconstruction, represent extremely specialized procedures necessitating an extended resource allocation not affordable in the adversities of the period. Therefore, we are obliged to define a paradigm shift in our approach, based on free-style reconstructive surgery principles of propeller flap concept. According to our experience, we believe that this viable and feasible surgical technique could represent a reconstructive landmark in this pandemic era, since any guideline is missing, besides HN reconstructive surgery is most likely heading towards a new reconstructive approach.

select article Reply to "Keynote 48: Is it really for everyone?"
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Reply to "Keynote 48: Is it really for everyone?"
Jonathan D. Schoenfeld, Geoffrey Fell, Robert I. Haddad, Lorenzo Trippa
In Press, Corrected Proof, Available online 1 December 2020
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select article Medicinal treatment of oral submucous fibrosis: Why is research not still translated into actual practice?
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Medicinal treatment of oral submucous fibrosis: Why is research not still translated into actual practice?
Gargi S. Sarode, Sachin C. Sarode, Shankargouda Patil
In Press, Corrected Proof, Available online 24 November 2020
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select article Treating sinonasal crusting and infection after palatal and sinonasal cancer resection with topical antibiotic irrigations
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Treating sinonasal crusting and infection after palatal and sinonasal cancer resection with topical antibiotic irrigations
Madeline Goosmann, Steven Chang, John Craig
In Press, Corrected Proof, Available online 23 November 2020
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select article Two distinct TP53 mutations in HNSCC primary tumor: Only one circulates in the blood
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Two distinct TP53 mutations in HNSCC primary tumor: Only one circulates in the blood
Federica Ganci, Matteo Allegretti, Valentina Manciocco, Francesco Fiorentino, ... Giovanni Blandino
In Press, Corrected Proof, Available online 21 November 2020
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select article Tracheostomy stomal seeding following oral cavity resection
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Tracheostomy stomal seeding following oral cavity resection
J.M. Hintze, C. Fitzgerald, B. Lang, J. O'Shea, ... P. Lennon
In Press, Corrected Proof, Available online 21 November 2020
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Abstract
Abstract
Background
Tracheal stoma recurrence following oral cavity surgery is exceedingly rare. Although several different mechanisms for this have been described, the pathogenesis still remains uncertain.

Methods
We present the case of a gentleman who presented 6-months following oral cavity SCC resection with a large fungating mass at his previous tracheostomy site, and also review the reported literature on this rare phenomenon.

Results
Four weeks after diagnosis of his recurrence he underwent a total laryngectomy, wide-local skin excision and reconstruction with a pectoralis major pedicled flap. He recovered well initially following his operation, however unfortunately contracted nosocomial SARS-Cov2 and succumbed from respiratory complications during his post-operative recovery.

Conclusion
Stomal recurrence after temporary tracheostomy for oral cavity malignancies are very rare. Previously reported management of these can vary from surgical to palliative treatment. Methods to prevent these include delaying tracheostomy until after surgical resection, packing the pharynx during resection and adjuvant radiotherapy.

select article Maxillary bone metastasis, as an early sign of breast cancer; an unusual & rare site of metastasis from the common cancer
CorrespondenceAbstract only
Maxillary bone metastasis, as an early sign of breast cancer; an unusual & rare site of metastasis from the common cancer
Irappa Madabhavi, Malay Sarkar, Chidanand Chavan, Mansi Trivedi
In Press, Corrected Proof, Available online 20 November 2020
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Abstract
Abstract
Oral cavity metastases are considered rare and represent approximately 1% of all oral malignancies. Due to their rarity and atypical clinical and radiographic appearance, metastatic lesions are considered a diagnostic challenge. In this article we present a rare, unusual & exceptional case of left maxillary mass which on further evaluation leading to diagnosis of left breast carcinoma with metastasis to isolated left maxillary bone. Sixty five year old postmenopausal woman of low socioeconomic status with good performance status presented with a 3 months history of progressive pain and swelling in the left maxillary region. Fine Needle Aspiration Cytology (FNAC) from the maxillary mass shows invasive ductal carcinoma. On further clinical, radiographic, and histopathological examination findings from the breast lesion confirmed the diagnosis of hormone receptor positive metastatic breast carcinoma. In view of painful metastatic maxillary lesion with breast disease she was managed with a palliative radiotherapy to the maxillary lesion and palliative chemotherapy with Doxorubicin-Cyclophosphamide and bhisphosphonate-Zolendronic acid. Patient responded very well to palliative radiotherapy and chemotherapy, in view of hormone receptor positive breast cancer, now she is on Tab. Anastrazole 1 mg once a day along with monthly Zolendronic acid injection since last 13 months without any symptoms of disease evolution. A high index of clinical thought of metastatic cancer to maxilla is necessary when evaluating patients who complain of maxillary pain and swelling without a history of pain or swelling in the head and neck & non-head and neck region. To the best of our knowledge, this is the first reported case of a metastatic isolated solitary maxillary bone metastasis presenting as an early sign of breast cancer.

select article Optimising elective neck dissection for early oral cancers
CorrespondenceNo access
Optimising elective neck dissection for early oral cancers
Deep Chakrabarti, Naseem Akhtar, Sumaira Qayoom, Shiv Rajan, ... Arun Chaturvedi
In Press, Corrected Proof, Available online 14 November 2020
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select article Mammary analog secretory carcinoma of the thyroid gland: A rare cancer harboring <em>TRK</em> fusion
CorrespondenceAbstract only
Mammary analog secretory carcinoma of the thyroid gland: A rare cancer harboring TRK fusion
Nai-si Huang, Yi-ming Cao, Zhong-wu Lu, Qing Guan, ... Qing-hai Ji
In Press, Corrected Proof, Available online 12 November 2020
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Abstract
Abstract
Mammary analog secretory carcinoma (MASC), or secretory carcinoma of the thyroid is an extremely rare disease harboring ETV6–NTRK3 gene fusion with TRK activation. Here we report the twelfth case of MASC of the thyroid worldwide. A 36-year-old female was diagnosed with poor-differentiated thyroid carcinoma (PDTC). Pathology consultant and immunochemical workups showed the tumor cells were negative for TTF1, TG, PAX8, positive for S100, Vimentin, GATA-3, and focally positive for mammaglobin. Fluorescence in situ hybridization (FISH) assay using a dual-color break-apart probe showed ETV6 translocation t(12p13) (ETV6) was present and established the diagnosis of MASC. Next-generation sequencing (NGS) of a 47-gene panel identified exon 1–5 of ETV6 gene were fused with exons 15–19 of NTRK3 gene. The patient experienced three loco-regional recurrences within 12 months and eventually developed inoperable local disease as well as bilateral lung metastasis. She is currently receiving anti-TRK treatment with a follow-up time of 33 months. A literature review of MASC in the thyroid was also conducted.

select article TERT promoter mutation in patients with second primary of tongue squamous cell carcinoma
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TERT promoter mutation in patients with second primary of tongue squamous cell carcinoma
Evren Erkul, Ismail Yilmaz
In Press, Corrected Proof, Available online 12 November 2020
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Abstract
Abstract
It is well known that head and neck squamous cell carcinomas are characterized by genetic alterations, genomic instability and different immune defects and Telomerase reverse transcriptase promoter mutations have been found with high rates in patients with tongue squamous cell carcinomas. We presented a non-smoker, no alcohol consuming woman who had a second primary tongue SCC after four and a half years later of her first tongue SCC with TERT promoter mutation. The primary tumor and its recurrences in woman with tongue SCC who have never smoked and had no alcohol consumption may need to be differing from other tongue carcinomas. TERT promoter mutations may have a relation in etiopathogenesis of tumor and mutations need to be on mind in future studies.

select article BRAFV600E mutation in oral melanocytic nevus and oral mucosal melanoma
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BRAFV600E mutation in oral melanocytic nevus and oral mucosal melanoma
Taynara Asevedo Campos de Resende, Bruno Augusto Benevenuto de Andrade, Vanessa Fátima Bernardes, Bruna Pizziolo Coura, ... Ricardo Santiago Gomez
In Press, Corrected Proof, Available online 12 November 2020
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select article Amelanotic melanoma presenting as a tongue tumor
CorrespondenceNo access
Amelanotic melanoma presenting as a tongue tumor
Ana Kober Leite, Marco Aurélio V. Kulcsar, Danielli Matsuura, Leandro Luongo Matos, Luiz Paulo Kowalski
In Press, Corrected Proof, Available online 11 November 2020
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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Telephone consultation 11855 int 1193,

Medical and Paediatric Oncology

Oncoradiology preparedness in the COVID-19 pandemic: Perspective from a tertiary oncology referral center from Eastern India Argha Chatterjee, Bivas K Biswas, Anisha Gehani, Jayanta Das, Saugata Sen, Sumit Mukhopadhyay, Aditi Chandra, Priya Ghosh, Bharat Gupta, Dayanand Lingegowda Indian Journal of Medical and Paediatric Oncology 2020 41(6):789-798 At the time of writing this article, more than 18 million people worldwide have been infected by the severe acute respiratory syndrome-associated coronavirus-2 and about 700,000 people have died from coronavirus disease 2019 (COVID-19). In India, about 190,000 people have been infected and nearly 39,000 people have succumbed to this infection. Infection among health-care workers has emerged as one of the key problems in facing this pandemic. The purpose of this article is to describe the measures taken by the department of oncoradiology at our institution to control the infection and minimize staff exposure during the current lockdown period with reduced patient load and in the post-lockdown period with increased demand for radiology services. The key focus of this article is the continued delivery of cancer imaging services with practical precautions and optimized resources. We have also discussed algorithms and protocols unique to the practice of oncoradiology in the time of the COVID-19 pandemic.

Clinical research in hematology-oncology in India during the COVID-19 era Nishant Jindal, Pankaj Malhotra, Amol N Patil, Deepesh P Lad Indian Journal of Medical and Paediatric Oncology 2020 41(6):799-800

Immunotherapy in rare cancers Venkata Pradeep Babu Koyyala, Padmaj Kulkarni Indian Journal of Medical and Paediatric Oncology 2020 41(6):801-803

Multidisciplinary joint clinics: Talent wins games, but teamwork wins championships Rima Sanjay Pathak, TS Shylasree, Jyoti Bajpai Indian Journal of Medical and Paediatric Oncology 2020 41(6):804-808 Cancer is among the leading causes of deaths worldwide. The treatments of cancer across most sites involve using surgery, systemic therapy, and radiation therapy. The treatment protocols are complex and require careful planning at the beginning of the therapy and coordination between the treating teams, the patient, and the caregivers to ensure compliance and avoid unnecessary treatment delays. This commentary provides an insight into the role the multidisciplinary joint clinics play in providing personalized cancer care. While such joint clinics are advantageous, they are not devoid of drawbacks and these are also enumerated. In this era, when communication platforms are increasingly digitized, we have highlighted the need for virtual tumor boards. The commentary aims to motivate the development of multidisciplinary joint clinics for ensuring holistic cancer care across the country.

Gastrointestinal stromal tumor – An overview Anant Ramaswamy, Vikram Chaudhari, Prabhat Bhargava, Manish Bhandare, Rajiv Kumar, Shailesh V Shrikhande, Vikas Ostwal Indian Journal of Medical and Paediatric Oncology 2020 41(6):809-818 Gastrointestinal stromal tumors (GISTs) are rare tumors but are most common mesenchymal tumors of the digestive tract. They are commonly seen in the stomach (60%) and small intestine (30%). GISTs are likely derived from the interstitial cells of Cajal or their stem cell precursors. They are best characterized by computerized tomography and have a specific staining pattern on immunohistochemistry, i.e., C-Kit and DOG-1. The treatment of GIST is based on the risk assessment for relapse, and patients with localized GIST require resection with or without adjuvant imatinib mesylate (IM). Advanced unresectable tumors are usually treated with IM, with a number of further options available for patients post progression on IM. There is an increasing emphasis on identifying C-Kit and platelet-derived growth factor receptor alpha mutations in all patients with GIST, as these are driver mutations with current and future therapeutic implications.

Efficacy of antiemetic regimens for prevention and treatment of chemotherapy-induced nausea and vomiting in patients of breast cancer receiving highly emetogenic chemotherapy Soumya Vij, Dilip Chander Dhasmana, Suman Bala, Sanjiv Kumar Verma Indian Journal of Medical and Paediatric Oncology 2020 41(6):819-824 Background: Chemotherapy is fraught with serious and troublesome adverse effects, of which nausea and vomiting appears earliest and is the most disturbing. Therefore, this study was planned to investigate the antiemetic drug regimens used for chemotherapy-induced nausea vomiting (CINV) in patients with breast cancer receiving highly emetogenic chemotherapy (HEC). Subjects and Methods: An observational follow-up study was conducted to assess the efficacy of antiemetic regimens in breast cancer patients receiving HEC. A total of 71 newly diagnosed patients with breast cancer were included in the study. Patients were assessed for nausea by the visual analog scale, and a history of emetic episodes and need for rescue medication were recorded at 0 h, 6 h, 24 h, 48 h, and 120 h post-chemotherapy till three cycles. Results: The patients were prescribed a combination of ondansetron and dexamethasone (n = 23, n = 17, and n = 13 in first, second, and third cycle, respectively) or a combination of aprepitant, ondansetron, and dexamethasone (n = 48, n = 54 and n = 56 in the first, second, and third cycle, respectively). The intensity of nausea was higher for the patients who were prescribed ondansetron and dexamethasone regimen as compared to patients prescribed aprepitant additionally. Complete response, i.e., no emesis and no rescue medication, was higher in triple-drug regimen (52% vs. 0.4%, 63% vs. 17.6%, and 69% vs. 23% in three cycles, respectively). Conclusion: The control of CINV was better with a combination of aprepitant, ondansetron, and dexamethasone as compared to a regimen without aprepitant.

Patient-reported shoulder morbidity and fatigue among breast cancer survivors: An insight from a tertiary care cancer hospital Abhishek Basu, Janmenjoy Mondal, Bhukya Swetha, Shinjini Chakrabarty, Debjit Ghosh, Subhendu Gangopadhyay, Bidyut Mandal Indian Journal of Medical and Paediatric Oncology 2020 41(6):825-831 Context: Breast cancer is the most common cancer in Indian women with an annual mortality of around 87,000. Treatment for breast carcinoma may lead to swelling of the ipsilateral arm, shoulder stiffness, arm pain, and cancer-related fatigue. Very few centers in India have reported the arm and shoulder morbidity treated in their hospitals. Aims: The aim was to evaluate the predictive factors of arm and shoulder morbidity and fatigue among breast cancer survivors. Settings and Design: This was a retrospective analysis based on a prospectively maintained database. Materials and Methods: Early and locally advanced cases of breast cancer patients were screened for the study during 2015–2018. Eligible participants were invited to fill up the predetermined questionnaire, and their demographic and treatment-related information was accrued from a file archive. Follow-up period was estimated from the date of tissue diagnosis to last contact/time of interview. Results: Shoulder stiffness was the most common complaint followed by arm numbness. Obesity and diabetes played a crucial role in most of the morbidities and fatigue. The median fatigue score was 34, and the median time of appearance of lymphedema was 13 months. Modified radical mastectomy and radiotherapy to axilla were statistically significantly (P = 0.04 and 0.01, respectively) associated with greater shoulder stiffness and arm swelling. Conclusions: Obesity, diabetes, type of surgery, the extent of axillary dissection, and radiation plan are the major predictive factors of arm and shoulder morbidity. Further prospective validation is necessary for future breast cancer survivorship programs.

Does neoadjuvant chemotherapy increase the survival in patients with locally advanced gastric cancer patients? – A real-world evidence Murugesan Janarthinakani, Selvaraj Kalaiselvi, Rajamani Priyadarshini, Seshachalam Arun, K Shashidhar, R Krishnakumar, N Manjunath, Sirigeri Roopa, SG Raman Indian Journal of Medical and Paediatric Oncology 2020 41(6):832-840 Background: In locally advanced gastric cancer (LAGC), perioperative chemotherapy has shown to improve the survival to a larger extent compared to surgery alone. In India, the treatment followed for gastric carcinoma widely varies based on the type of health-care provider and treatment access. There is a paucity of data on the role of neoadjuvant chemotherapy on survival among LAGC patients in the Indian context. Aim: The aim of this study was to compare the disease-free survival (DFS) and overall survival (OS) between neoadjuvant and adjuvant chemotherapies among LAGC patients. Subjects and Methods: This was a retrospective cohort study involving clinical record review of LAGC patients enrolled between 2015 and 2017 from four tertiary cancer centers in South India. The date for the following events, namely diagnosis, recurrence, death, and last day of visit, was extracted in a mobile-based open-access tool. The median duration of OS and DFS between the neoadjuvant and adjuvant groups was compared using Kaplan–Meier survival curves. Results: Of the 137 patients, 70 (51%) had received neoadjuvant chemotherapy followed by surgery and 67 (49%) had adjuvant chemotherapy following the surgery. The mean (standard deviation) age of participants was 55.4 (11.4) years. Seventy-eight percent of the patients were diagnosed at Stage 3 or 4. Regional lymph nodes were involved in 83.9%. The median duration of follow-up was 15 months. The OS in the neoadjuvant and adjuvant groups was 18.6 months and 8.3 months, respectively. Nonregional lymph node involvement and adjacent organ involvement had independently increased the risk of death. Conclusion: Among LAGC patients, the neoadjuvant chemotherapy indicated a better median and DFS compared to the adjuvant group. However, these findings were statistically not significant. The current study has contributed an important finding to the existing evidences of clinical practice in an Indian setting. Further large-scale studies are required to validate the promising trend of using neoadjuvant chemotherapy in LAGC.

Treating acute myeloid leukemia among children with down syndrome Rajan Kapoor, Karthik Ram Mohan, Shuvendu Roy, Suman Kumar Pramanik, Sanjeev Khera, AK Simalti Indian Journal of Medical and Paediatric Oncology 2020 41(6):841-845 Background: Down Syndrome (DS) children with acute myeloid leukemia (AML) have unique differences in clinical features, epidemiologic nature, and biologic patterns of disease compared with AML in children without DS. Aims and Objective: AML in DS children should be considered distinct disorder from AML in Non DS population and treatment needs to be customized for this population. In this retrospective study spanning from 2014 to 2019 we present our experience of managing leukemia in children with DS. Materials and Methods: From 2014 and 2019, 72 children aged below 18 years were managed at our institute with acute myeloid leukemia (AML). Out of these 72 children with AML, 7 children were with DS which was confirmed by karyotyping. Majority of these children had M7 while M2 and M4 subtypes were seen in one child each. On conventional karyotyping in addition to trisomy 21 additional cytogenetic abnormalities were seen in 4 patients. Two children had trisomy 8. One child had deletion of 11 chromosomes and one had translocation between 8 and 21 chromosomes. Results: All 7 children were administered intensive chemotherapy with curative intent after informed parental consent. All 7 children achieved complete remission. Four out of 7 children had complications related to severe neutropenia. Conclusion: All patients of DS with AML should be offered chemotherapy with curative intent. Endeavour should be to give less aggressive chemotherapy protocol to bring down treatment related mortality.

Daratumumab plus carfilzomib: An optimistic approach in relapsed/refractory multiple myeloma AP Dubey, Sameer Khatri, Sachin Maggo, Nilabh K Singh, Durgesh Sharma Indian Journal of Medical and Paediatric Oncology 2020 41(6):846-849 Background: Although with the introduction of novel agents, clinical outcomes have significantly improved in patients of multiple myeloma (MM); however, nearly all relapse, requiring subsequent treatment. Patients who have been heavily treated for relapsed/refractory MM (RRMM) have limited options and poor survival outcomes. Carfilzomib plus daratumumab combination have been evaluated in a phase 1b study in patients of RRMM progressing after 1–3 lines of therapies including bortezomib and an immune-modulatory drug. However, data are lacking evaluating the efficacy of this combination in RRMM patients who have progressed or have suboptimal response on either of these drugs (carfilzomib or daratumumab). Methods: Prospective analysis of data of 19 RRMM patients who progressed after multiple lines of therapy (including bortezomib and lenalidomide/pomalidomide) and had suboptimal response/stable/progressive disease after receiving carfilzomib or daratumumab based combination as last therapy. All patients received combination of carfilzomib plus daratumumab along with dexamethasone (DKd) after prior consent. Daratumumab (16 mg/kg IV) was administered weekly (days 1, 8, 15, and 22) during cycles 1 and 2, every 2 weeks (days 1 and 15) during cycles 3–6, and every 4 weeks thereafter. Carfilzomib was administered weekly on days 1, 8, and 15 of each 28-day cycle. Patients received an initial carfilzomib dose of 20 mg/m2 on day 1,2; 27 mg/m2 on day 8, 9, 15, 16 of cycle 1, which increased to 70 mg/m2 on day 1, 8, 15 from cycle 2 onwards if deemed tolerable. Dexamethasone was given as fixed-dose of 40 mg weekly. Results: Eighteen of 19 patients (including 3 high risk cytogenetics) to DKd (CR-4, very good partial response-10, partial response-02). After median follow-up of 16 months, progression-free survival (PFS) was 95%. Median PFS was not reached. Three patients who were transplant eligible received high-dose chemotherapy followed by autologous stem-cell transplantation and achieved minimal residual disease negativity. The most frequent all grade side effects were hematological, which included neutropenia 30%, anemia 70%, and thrombocytopenia 42%. Most frequent non hematological side effects were nausea 40%, vomiting, cough, respiratory tract infections, asthenia, and loss of appetite. Conclusion: Carfilzomib plus daratumumab based combination in RRMM patients has shown promising results in phase Ib study, where patients with prior exposure to either of these drugs were excluded. Our data show similar or better response of this combination in patients who had progressive disease/stable disease/minimal response to either of carfilzomib or daratumumab. This combination can be a better option in heavily treated RRMM (with prior exposure to either of carfilzomib or daratumumab) producing deeper and durable responses. A larger study may be required to prove this benefit.

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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,

Telephone consultation 11855 int 1193,