Prognostic Heterogeneity Between Oral Tongue and Gingivobuccal Tumours Based on Lymph Node Ratio and Number of Positive Nodes: A Survival Analysis.

Introduction: Lymph node ratio (LNR) and number of pathological positive nodes (pN) have shown better prognostic prediction compared to laterality, size and number of nodes (single or multiple). This study evaluates the prognostic significance of LNR and the number of  pathological positive nodes in predicting the outcomes of node positive oral squamous cell carcinoma(OSCC). It attempts to assess the prognostic heterogeneity between oral tongue and gingivobuccal complex tumours based on the lymph node ratio and the number of pathological positive nodes. Materials and Methods: A retrospective chart review of 498 previously untreated OSCC patients from January 2014 to December 2017 at our tertiary cancer institute was done. Our analysis included 133 oral tongue and 79 gingivobuccal tumours with histopathologically proven lymph node metastasis. The impact of LNR and number of positive nodes on overall survival and disease free survival was studied. Results: Overall survival rate was found to vary significantly based on LNR (> 0.06) and number of positive nodes (> 2). Overall survival reduced significantly in GBC tumours when LNR was more than 0.06(63.37 vs 32.1, p 0.005) but the same trend was not seen with tongue cancers (55.61 vs 41.9, p 0.98). Both the groups shown no difference in DFS based on LNR. Overall survival reduced significantly in both the groups when >2o pathologically positive nodes were present but disease free survival did not vary significantly in both the groups. Conclusion: Lymph node ratio (> 0.06) and number of pathological positive nodes (> 2) provide a better prognostic stratification in node positive oral squamous cell carcinoma. Oral tongue and GBC tumours were found to have a differential impact on overall survival rate on the stratification based on LNR.

Spectroscopic characterization, DFT, antimicrobial activity and molecular docking studies on 4,5-bis[(E)-2-phenylethenyl]-1H,1'H-2,2'-biimidazole.

The newly synthesized imidazole derivative namely, 4,5-bis[(E)-2-phenylethenyl]-1H,1'H-2,2'-biimidazole (KA1), was studied for its molecular geometry, docking studies, spectral analysis and density functional theory (DFT) studies. Experimental vibrational frequencies were compared with scaled ones. The reactivity sites were determined using average localized ionization analysis (ALIE), electron localized function (ELF), localized orbital locator (LOL), reduced density gradient (RDG), Fukui functions and frontier molecular orbital (FMO). Due to the solvent effect, a lower gas phase energy gap was observed. Through utilization of the noncovalent interaction (NCI) method, the hydrogen bond interaction, steric effect and Vander Walls interaction were investigated. Molecular docking simulations were employed to determine the specific atom inside the molecules that exhibits a preference for binding with protein. The parameters for the molecular electrostatic potential (MESP) and global reactivity descriptors were also determined. The thermodynamic characteristics were determined through calculations employing the B3LYP/cc-pVDZ basis set. Antimicrobial activity was carried out using the five different microorganisms like Escherichia coli, Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae and Candida albicans.

Gait analysis in swine, sheep, and goats after neurologic injury: a literature review.

Medical research on neurologic ailments requires representative animal models to validate treatments before they are translated to human clinical trials. Rodents are the predominant animal model used in neurological research despite limited anatomic and physiologic similarities to humans. As a result, functional testing designed to assess locomotor recovery after neurologic impairment is well established in rodent models. Comparatively, larger, more clinically relevant models have not been as well studied. To achieve similar locomotor testing standardization in larger animals, the models must be accessible to a wide array of researchers. Non-human primates are the most relevant animal model for translational research, however ethical and financial barriers limit their accessibility. This review focuses on swine, sheep, and goats as large animal alternatives for transitional studies between rodents and non-human primates. The objective of this review is to compare motor testing and data collection methods used in swine, sheep, and goats to encourage testing standardization in these larger animal models. The PubMed database was analyzed by searching combinations of swine, sheep, and goats, neurologic injuries, and functional assessments. Findings were categorized by animal model, data collection method, and assessment design. Swine and sheep were used in the majority of the studies, while only two studies were found using goats. The functional assessments included open pen analysis, treadmill walking, and guided free walking. Data collection methods included subjective behavioral rating scales and objective tools such as pressure-sensitive mats and image-based analysis software. Overall, swine and sheep were well-suited for a variety of assessment designs, with treadmill walking and guided free walking offering the most consistency across multiple trials. Data collection methods varied, but image-based gait analysis software provided the most robust analysis. Future studies should be conducted to standardize functional testing methods after neurologic impairment in large animals.

Tracheo Esophageal Prosthesis Insertion Under Endoscopic Guidance and Local Anaesthesia- Feasibility and Outcome.

OBJECTIVES: Voice rehabilitation after laryngectomy is by tracheo esophageal puncture (TEP) and prosthesis insertion. Secondary TEP is very difficult due to neck fibrosis. Puncture under local anaesthesia with endoscopy guidance is a feasible option. METHODS: Retrospective review of all laryngectomy patients from March 2009 till March 2019 was done and the methods of voice rehabilitation were assessed. The patients undergoing the procedure were classified according to the timing of insertion and type as primary insertion under general anaesthesia (Group P), secondary insertion under local anaesthesia (Group L), secondary insertion under general anaesthesia (Group G). The speech outcome and the procedure outcome were compared. RESULTS: There were 148 patients who underwent laryngectomy, of which groups P, G, L were 12, 12 and 11. The rate of successful insertion was 100% in primary, 91.6% in secondary in general anaesthesia and 91% in secondary under local anaesthesia. All secondary TEP were done after surgery and radiotherapy. Complications related to the insertion techniques were minimal. Speech outcome were similar on intelligibility rating scale and longevity was not affected by the method. CONCLUSION: TEP in local anaesthesia is feasible and has comparable outcome with TEP in general anaesthesia. Financial burden was very much less in group L compared to the other two groups.

Knowledge acquisition and retention among nurses after an educational intervention on endotracheal cuff pressure.

BACKGROUND: Nurses play a key role in the proper management of endotracheal tube (ETT) cuff pressure, which is important for patients' safety, so it is vital to improve nurses' knowledge on safe cuff management practices. AIMS AND OBJECTIVES: This study aimed to evaluate the effectiveness of an educational intervention related to ETT cuff pressure management on improving and retaining critical care nurses' knowledge. DESIGN: A single group pre-post interventional study was conducted involving 112 registered nurses (RNs) from a 24-bed adult general intensive care unit at a teaching hospital in Malaysia. METHODS: The educational intervention included a theoretical session on endotracheal cuff pressure management and demonstration plus hands-on practice with the conventional cuff pressure monitoring method. Nurses' knowledge was measured using a self-administered questionnaire pre- and post-intervention. Data were analysed using repeated measure analysis of variance and bivariate analysis. RESULTS: In this study, 92% of the total number of RNs in the unit participated. A significant difference in mean knowledge score was noted between the pre- (mean = 8.13; SD = 1.53) and post-intervention phases (3 months [mean = 8.97; SD = 1.57) and 9 months post-intervention [mean = 10.34; SD = 1.08), P < .001), indicating significant knowledge acquisition and retention between the phases. Knowledge gained between the pre- and 9 months post-intervention phases significantly differed according to nurses' educational level. CONCLUSIONS: This study supports existing evidence that ongoing educational interventions are essential to improve nurses' knowledge. However, further exploration is suggested to assess how well this knowledge is translated into clinical practice. RELEVANCE TO CLINICAL PRACTICE: Regular educational programmes with current updates would enhance nurses' knowledge through proper practice and clinical decision-making skills; this, in turn, would help to standardize cuff management practices.