Prevalence and impact of endocrine disorders in advanced metastatic cancer patients undergoing cancer-directed therapy: A prospective observational study.

BACKGROUND: Noncommunicable diseases (NCDs) contribute significantly to global morbidity and mortality, with cancer being one of the leading causes. In this prospective observational study, we aimed to investigate the prevalence and impact of endocrine disorders, specifically diabetes and thyroid dysfunction, in patients with advanced metastatic cancer undergoing cancer-directed therapy. METHODS: Over 15 months, we recruited 100 histologically proven advanced metastatic cancer patients from the Department of Medical Oncology Haematology, All India Institute of Medical Sciences, Rishikesh, and conducted institutional-based prospective observational study. All participants over 18 years of age, treatment-naive, and potential candidates for systemic chemotherapy with an expected clinical survival of at least 6 months were included in the study. Patients with prior therapy, secondary neoplasms, and those unable to complete 3 months of palliative chemotherapy were excluded. Patients were assessed for diabetes and thyroid function at presentation, after 3 and 6 months of cancer-directed standard therapy. These data were analyzed, processed, and presented as results. RESULTS: The mean age of participants was 50.45 years, with a near-equal distribution of males and females. At baseline, 10% of the study population had preexisting endocrine disorders (2% hypothyroidism, 8% diabetes). By the end of 6 months, the prevalence increased to 18%, with females being more affected. Notably, the prevalence of new-onset endocrine disorders during cancer-directed therapy was only 3% for diabetes and 4% for thyroid dysfunction. CONCLUSION: Analysis of sociodemographic and cancer-related characteristics showed no significant association with changes in diabetic and thyroid status at 3 and 6 months. However, substance use, particularly smoking, was associated with an increased risk of diabetes development (p < .05). Cancer type and treatment regimen did not show statistically significant correlations with endocrine dysfunction. IMPLICATIONS: Our study highlights the importance of considering endocrine disorders in advanced metastatic cancer patients undergoing therapy. The prevalence of diabetes and thyroid dysfunction increased during cancer-directed therapy, particularly in females. Careful monitoring and timely intervention are essential to improve the quality of life for these patients. Further research is warranted to explore the long-term effects of cancer-directed therapy on endocrine health and develop tailored management strategies for this vulnerable population.

Hyper-Eosinophilic Syndrome with Myocarditis after Inactivated SARSCoV- 2 Vaccination - A Case Study.

INTRODUCTION: COVID-19 vaccine-induced serious adverse reactions are rare. Hypereosinophilia syndrome with myocarditis has not been reported earlier following BBV152 vaccine administration. CASE PRESENTATION: A young man without any co-morbidities presented with persistent periorbital swelling along with itchy swelling over fingers, resting tachycardia, and exertional breathlessness following the first dose of an inactivated SARS-CoV-2 vaccine (BBV152, COVAXIN). On investigation, the patient had elevated blood eosinophils (maximum 21.5% with an absolute eosinophil count of 2767/mm3) and myocarditis (Lake Louise Criteria). He was successfully treated with steroids and supportive treatment. CONCLUSION: This is the first reported case of hyper-eosinophilia syndrome after COVAXIN administration. Prior history of the allergic disease may be a predisposing factor in this case. Hypereosinophilia can present with variable symptoms. In the current case, myocarditis was present with persistent resting tachycardia and dyspnea. Steroid and antiallergic drugs may be successful for the treatment of vaccine-induced hyper-eosinophilia with myocarditis. Increased vigilance is needed for such adverse events.

Association between Mandibular Angle Fracture with Third Molar Positioning and Residual Bone Height.

BACKGROUND: Mandibular angle fracture are frequently associated with presence of third molar. This study aimed at assessing the role of third molar with angle fracture in relation to its positioning and the remaining bone between the apex of third molar and inferior border of mandible. METHODS: A retrospective study of all patients who reported for treatment of mandibular fracture between January 2019 to January 2021 were undertaken. Patient's data and orthopantamogram radiographs were obtained from there medical records. The collected data included presence/absence of mandibular angle fracture, presence/absence of mandibular third molar, angulation and positioning of third molar along with residual bone height. Statistical analysis was done in SPSS version 20 with p-value set at p<0.05 Results: Total of 86 mandibular fracture reported in the study period, of which 34 (39.53%) had angle fracture. Third molar was present in 31 (45.6%) cases and was associated with angle fracture with statistical significance of p<0.026. Mesioangular impaction (86.4%) with class II (57%) ramus relation and position B (72.7%) in occlusal relation were associated with angle fracture in comparison to non-angle fracture group where angulation and occlusal position were statistically significant p<0.001 and p=0.002, respectively. Residual bone height was also found to be less in angle fracture group in comparison to other mandibular fracture group showing statistical significance (p<0.023). CONCLUSIONS: Patient with partially erupted mandibular third molar are more frequently associated with angle fracture and the residual bone height could also be a good predictor for risk of angle fracture.

Calcifying Epithelial Odontogenic Tumor: A Case Report.

Calcifying epithelial odontogenic tumor is a rare benign odontogenic tumor which accounts for approximately 1% of the entire odontogenic tumor. It was firstly described by Pindborg, and thus, is also referred to as the "Pindborg tumor". Histologically, Pindborg tumor consists of three distinct histological compo-nents: sheets of polyhedral epithelial cells, amyloid like deposits, and calcifications. This case report describes a case of Calcifying epithelial odontogenic tumor in 26 years old female patient presented with the swelling in right posterior region of mandible. Taking into account of the aggressive nature of the lesion segmental resection of the mandible followed by reconstruction was planned for treatment. This case report highlights the importance of appropriate clinical, radiographical and histological correlation for the correct diagnosis and treatment of Pindborg tumor.

Xq26 duplications lead to undergrowth or overgrowth via competing pathways including GPC3/GPC4.

The Xq26 locus has importance in human growth with multiple genes and regions playing important roles, which potentially leads to macrosomia or microsomia if disrupted. One region of Xq26.2 comprises the genes GPC3 and GPC4; deletion or duplication of this region has been recently been shown to result in overgrowth, specifically Simpson-Golabi-Behmel syndrome. We describe a male patient with two maternally inherited Xq26 microduplications; the first was 0.8 Mb at Xq26.2 affecting only GPC3 and GPC4, and the second, a distal 0.6 Mb duplication at Xq26.3 affecting seven genes. Rather than having Simpson-Golabi-Behmel syndrome, our patient had microcephaly and undergrowth, with development that was within normal limits at 25 months of age. This finding suggests that the molecular pathway leading to overgrowth secondary to GPC3/GPC4 haploinsufficiency can be overpowered by a disruption to the distal Xq26.3 region. Of the genes in that region, we propose that SLC9A6 is the most likely to play an important role as mutations in this gene lead to Christianson syndrome, in which patients may have microcephaly and weight loss.