Evaluating the Efficacy of Adjuvant Radiotherapy in the Management of Advanced Oral Cancer Cases.

Background: Because of its high rates of morbidity and death, especially in its late stages, oral cancer poses a serious threat to world health. Even with improvements in surgical and chemotherapeutic techniques, advanced oral cancer is still difficult to treat and frequently has unfavorable results. Methods: Information on demographics, tumor features, treatment options, and results were gathered from medical records. Patients were categorized according to whether they underwent surgery alone or adjuvant radiation treatment after initial surgical resection. For the survival analysis, Kaplan-Meier curves and Cox proportional hazards models were employed. Results: There were 150 patients in all, 75 in each group, who took part in the trial. Comparing adjuvant radiation to surgery alone resulted in considerably better overall survival (P < 0.001) and disease-free survival (P < 0.001). However, problems connected to the adjuvant radiation group affected a portion of the patient population. Conclusion: In conclusion, patients with advanced oral cancer can improve their overall and disease-free survival with adjuvant radiation, a successful therapeutic option. To maximize results, nevertheless, cautious patient selection and effective management of treatment-related problems are crucial. To improve treatment algorithms and investigate cutting-edge therapeutic techniques for this difficult condition, further research is necessary.

Assessment of the Impact of HPV Infection on the Incidence and Prognosis of Oral Cancers.

Objectives: The purpose of this research was to evaluate, in a tertiary care context, the effects of human papillomavirus (HPV) infection on the incidence and prognosis of oral malignancies. Methods: At a tertiary care hospital, 100 patients who received an oral cancer diagnosis between 2020 and 2022 were the subject of a retrospective analysis. Medical records were used to gather clinicopathological data, and histopathological specimens' molecular analyses were used to ascertain the HPV infection status. To assess the variations in overall and disease-free survival between HPV-positive [HPV+] and HPV-negative [HPV-] patients, survival analysis was done. Results: Of the oral malignancies that tested positive for HPV, 25% were caused by strains HPV-16 and HPV-18. Patients who tested positive for HPV had unique clinicopathological characteristics, such as a decreased prevalence of lymph node involvement, nonkeratinizing histology, and younger age at diagnosis. When compared to HPV- patients, HPV+ patients had substantially better overall survival (P = 0.032) and disease-free survival (P = 0.047) according to survival analysis. Conclusion: The incidence and prognosis of oral malignancies are significantly impacted by HPV infection, as demonstrated by current data. When compared to HPV- cancers, HPV+ tumors have different clinicopathological characteristics and improved survival rates. These findings have implications for therapy selection and prognostication, and they highlight the significance of HPV testing in the therapeutic management of oral malignancies. To understand the underlying molecular pathways and provide tailored therapeutics for oral malignancies that are HPV+, more research is required.

Copper leaching from ultrasonically treated milled waste printed circuit boards: investigation of parameters optimization and kinetics.

Waste printed circuit boards (WPCBs) encompass abundant metals (gold, silver, and copper), along with other harmful materials including brominated epoxy resins, plastics, and heavy metals (lead, mercury, and cadmium). Direct burning and landfilling of WPCBs may cause severe health issues and impair the environment. Therefore, sustainable treatment of WPCBs is necessary to recover valuable metals and remove hazardous materials before disposal. The present work investigates the separation of copper-rich metallic fractions from the WPCBs by the combination of hammer milling and ultrasonic irradiation. Initially, discarded mobile phone PCBs are pre-processed and shortened into 1 × 1 cm2. Downscaled WPCBs are fed into the hammer mill to obtain the fine ground powder. The Powdered WPCBs are further processed through ultrasonic treatment to acquire metal-rich fraction. XRD, SEM-EDS, and ICP/AAS analysis revealed that the current technique can efficiently separate the metal-rich fraction without using toxic solvents. Results show the enhancement of copper fraction from 42.73 to 87 wt. % after ultrasonic treatment of WPCBs ground powder. Further, nitric acid leaching has been implemented to metal-rich fractions, and the parameters have been optimized for copper leaching with the assistance of response surface methodology (RSM) of the design of experiments (DOE). Quantitative dissolution (98.96%) of copper occurred using 3.5 M nitric acid within 3 h at 30 °C with 50 GPL pulp density and 500 rpm agitation speed. Finally, the kinetics of the leaching process were studied to conform the kinetics model. Moreover, the activation energy for diffusion (19.075 kJ/mole) and reaction kinetics model (13.29 kJ/mole) has also been calculated. The low energy consumption due to room temperature pre-treatment and effective leaching ensures the industrial feasibility of the proposed process.

Evaluating Pedicled Pectoralis Major Myocutaneous Flap Reconstructions for Oral Malignancy and the Influence of Laterally Based Rotational Advancement Flap on Donor Site Integrity and Nipple Position in Male Patients.

Oral cancer poses a significant health burden, particularly in the male population of India. This study focuses on evaluating the outcomes of 48 pedicled Pectoralis major myocutaneous (PMMC) flap reconstructions in male patients with oral malignancy. Given the challenges associated with microvascular flap reconstructions, especially in advanced cancer cases, older patients, and resource-constrained settings, the PMMC flap still serves as a valuable alternative. The study introduces a novel approach by incorporating a laterally based rotational advancement flap (LBRA) to address donor site integrity and decrease the nipple-areolar complex (NAC) displacement. Traditionally, PMMC flap designs tend to cause inward shifting of the NAC during chest donor site closure, impacting the aesthetic outcome. Surgical techniques involved wide local resection, neck dissection, and PMMC flap reconstruction. The Flap design included a horizontal orientation with adjustments based on defect location. Additionally, a laterally based rotational flap from the chest aided in donor site closure. Results demonstrate the versatility and reliability of PMMC flap reconstructions, with no total flap necrosis or major complications observed in the 48 cases. The LBRA technique effectively mitigated NAC displacement. The study contributes to the existing literature by providing insights into the advantages of PMMC flap reconstructions and introducing a technique to optimize donor site closure and decrease the medial shifting of the nipple. The adaptability, reliable vascular supply, and simplified learning curve make the PMMC flap a preferred choice in resource-constrained settings with high patient demand. In conclusion, this research underscores the continued relevance and effectiveness of the PMMC flap in head and neck reconstruction, offering satisfactory cosmetic and functional results. The introduction of the LBRA technique adds a nuanced dimension to improve outcomes, particularly in male patients with oral malignancy.

Evaluation of the Blunt Pancreatic Injury, a Long-Term Tertiary Care Center Study: An Original Research.

Introduction: Pancreatic trauma is uncommon and challenging to diagnose. Contrarily, severe injuries to the kidney, spleen, and liver are frequent and typically easy to detect with imaging methods. Pancreas injuries can cause a significant amount of morbidity and mortality. Reviewing the institution's experience with this rather infrequent injury was the goal of this study. Materials and Method: The patients' records were collected from the data records at the tertiary care center for patients who had pancreatic damage and were followed up for a year. The American Association for the Surgery of Trauma pancreatic damage grade scores were assigned to each patient using the radiologic and surgical findings. Clinical examination and CT results were predominantly used to make the diagnosis in patients who underwent non-operative treatment. The data are presented as descriptive statistics. Results: Only 2.2% of the total cases that presented to the trauma center were finalized as pancreatic injuries. Trauma to the abdomen was seen in nearly half the cases brought. Most of the subjects in pancreatic injuries were in grade 3. Mortality was noted maximum for the grade 3 and 4 cases. Conclusions: While high-grade pancreatic injury almost always requires an operational intervention, low-grade pancreatic injury with an intact main pancreatic duct may be effectively handled non-operatively. When possible, distal pancreatectomy with spleen preservation is the ideal procedure for distal pancreatic trans-action. A patient who is hemodynamically stable with complex pancreaticoduodenal damage, which is related to a high death rate, should undergo Whipple resection.

Evaluation of the Clinicoradiological Profile in Cases of Allergic Bronchopulmonary Aspergillosis: An Original Research.

Introduction: A complicated hypersensitive reaction to inhaled fungal antigens results in allergic bronchopulmonary aspergillosis (ABPA), an immunologic pulmonary disease. ABPA complicates nearly 2% of instances of persistent asthma as well as nearly 10% of chronic cases of steroid-dependent asthma, and it occurs most frequently in immunocompetent patients. The purpose of the current research was to analyze the radiological and clinical features of the participants as well as the serological association of ABPA. Materials and Methods: From April 2020 to April 2021, a retrospective investigation was conducted. The study included patients based on the International Society for Human and Animal Mycology's criteria for ABPA confirmation. Analysis was done on the demographic information and pathological and radiological test results of the patients. The patients' pre-bronchodilator and post-bronchodilator spirometry was compared, and asthmatic control was estimated. Results: A total of 50 patients were investigated at in this study. Demographic findings indicated young subjects and aa female predominance. Cough was the most prevalent symptom in 84% of patients. Asthma of the bronchi was a risk factor for all of the patients. The mean serum immunoglobulin E level and the mean absolute eosinophil count were 533 cells/L and 2269 UI/mL, respectively. Spirometry results from the study's participants indicated an obstructive pattern in about 80% of cases. The most typical radiological abnormality observed was bronchiectasis, followed by parenchymal opacities. Conclusion: In conclusion, when treating asthma that is challenging to control, the diagnosis of ABPA must be taken into account. Delay in diagnosis might result in declining lung function, worsening asthma control, possibly irreversible alterations, greater treatment costs, and declined quality of life.

Antelope space-use and behavior indicate multilevel responses to varying anthropogenic influences in a highly human-dominated landscape.

A primary means of conserving a species or a habitat in a human-dominated landscape is through promoting coexistence with humans while minimizing conflict. For this, we should understand how wildlife is impacted by direct and indirect human activities. Such information is rare in areas with high human densities. To investigate how animals respond to altered ecological conditions in human-dominated landscapes, we focused on a wild herbivore of conservation concern in the Krishnasaar Conservation Area (KrCA) in Nepal. Here, blackbuck Antilope cervicapra, a generalist grazer, lives in refugia located with a growing human population. We studied the impacts of humans on habitat use and behavior of blackbuck. We laid 250 × 250 m grid cells in the entire KrCA and carried out indirect sign surveys with three replications for habitat use assessment. We observed herds of blackbuck for 89 h in different habitat types using scan sampling methods. Our habitat-use survey showed that habitats under intensive human use were hardly used by blackbuck, even when high-quality forage was available. Habitat openness was the major predictor of habitat use inside the core area, where levels of human activities were low. We also found a positive correlation between habitat use by blackbuck and livestock. Blackbuck were substantially more vigilant when they were in forest than in grassland, again indicating an influence of risk. Overall, blackbuck appear to be sensitive to the risk associated with both natural and anthropogenic factors. Our findings have direct implications for managing human-wildlife interactions in this landscape, specifically regarding strategies for livestock grazing in habitats highly used by blackbuck and concerning predictions of how changing land use will impact the long-term persistence of blackbuck. Our work suggests that wild herbivores may be able to persist in landscapes with high human densities so long as there are refuges where human activities are relatively low.

Is Gelfoam Necessary for Middle Ear Surgery: A Comparative Study of the Results of Tympanoplasty With and Without Gelfoam in the Middle Ear.

Absorbable gelatin sponge (Gelfoam) has been used for many years in middle ear surgeries. It not only provides support to the graft and ossicular reconstruction materials but also helps in haemostasis and aeration of the middle ear. Although gelfoam is generally well tolerated but fibrosis and granulations in the mesotympanum have been attributed to its usage in some studies. This study was conducted to compare the results of middle ear surgeries with and without gel foam in terms of both objective and subjective improvements of symptoms. To study the outcome of tympanoplasty with and without gel foam in the middle war by measuring following attributes (for measuring outcomes) at an intervals of 6 weeks, 12 weeks and 6 months after surgery. (a) Graft take up rate as evaluated by otoscopy. (b) Pre and post-operative hearing levels as measured on Pure Tone Audiogram. (c) Subjective improvement in symptoms of ear discharge, heaviness in ears, hearing loss and tinnitus. Study design-prospective clinical study. patients undergoing tympanoplasty type 1 between August 2018 to July 2019 were included in the study. Group A (n = 36) consisted of patients who underwent tympanoplasty with gel foam in the middle ear and Group B (n = 36) consisted of patients who underwent tympanoplasty without any gel foam inside the middle ear. The uptake of graft after tympanoplasty was almost similar in the patients using gelfoam (89%) and those without gelfoam (84%) at the end of 6 months. The improvement in the subjective symptoms of ear discharge and hearing loss at 6 weeks following the surgery was better in patients without gelfoam whereas, at the end of 6 months the improvement in these symptoms was similar in both the groups. The improvement in hearing 6 months following tympanoplasty as assessed by pure tone audiometry and was found to be the same in both the groups. Tympanoplasty can be performed safely without using any gelfoam in the ear. This not only makes patients comfortable early but also avoids any gelfoam induced fibrosis or granulations in the middle ear.

The Effectiveness of the Bilobed Pectoralis Major Myocutaneous Flap at a Tertiary Care Hospital: A Retrospective Analytical Study.

BACKGROUND: Cosmetic defects after the major orofacial disease corrections may have an effect on the overall well-being of the patient. Head-and-neck cosmetic surgeries after a major episode of oral cancer impact the functional ability of the individual in several ways. In general, two types of flap are used in reconstructive surgery: microvascular free flaps and regional pedicle flaps. In socioeconomically poor countries like India, bilobed pectoralis major myocutaneous (PMMC) flap has been seen as a mainstay in facial reconstructive surgeries. MATERIALS AND METHODS: The present study was conducted on 100 individuals with oral neoplasm who underwent resective surgery had a soft-tissue defect. All the complications that arose after reconstructive surgery were noted. Simple proportions were recorded. RESULTS: Majority of the individuals had the buccal mucosa as the common site of oral neoplasm, and the tumor nodes and metastases staging was I + II. One individual sustained total flap necrosis. Wound infection and dehiscence were the most common complications. CONCLUSIONS: PMMC is best proven for flap reconstruction in oral neoplasm cases. It is established to be effective with good acceptability and very few complications. Due to these reasons, in spite of the known advances in facial reconstructive surgeries, this technique is widely followed in developing countries.

A Qualitative Study of the Impact of COVID 19, on Health Care Providers for Cancer Patients: An Original Research.

INTRODUCTION: In the challenging times of the COVID-19, the care of individuals with the debilitating diseases such as cancers has been an additional burden to the medical team. We aim to find out about the obstacles for the clinical care of the patients in the COVID, the questions frequently asked by cancer patients, and the medical care and support teams' general experience in taking care of cancer patients during the times of the pandemic. MATERIALS AND METHODS: We conducted a Qualtrics survey that was developed by Cancer and Aging Research Group among 275 health care providers to cancer patients during. There were twenty questions in the survey. Of these 20, three open-ended questions were included that inquired about the barriers to the clinical care of cancer patients during COVID-19; the questions asked to the health care team by cancer patients or the attendants; health care teams general experience in the situations of the COVID-19. Two different reviewers performed the quality analysis for the open-ended questions after they were assigned a code. SPSS ver-23 was used for the descriptive statistics. RESULTS: Medical services organizational difficulties and addressing necessities and support were generally reported. Hindrances to the medical health teams included the included administrative difficulties, access of the patient to the support and basic resources, uncertainties for patients' psychological and physical well-being, and teleconsultation challenges. The most common concern of the patients was the safety and the need for the treatment. Medical health care teams were seen to worry for the mental and the physical health of cancer patient. There was also reported concern for the medical team's own safety, obstruction in multi-level establishments; also the health team was seen feeling positive leadership and communications. CONCLUSION: The medical health provider teams felt a need for thorough support at the organizational level for cancer patients. Medical teams were expected to comprehend the short-term and long-term impact of the COVID-19 on cancer patients. It was accepted that there has been an increased workload and mental stress among the providers. Appreciating the experiences of the medical teams during the pandemic may help in the future guidance in the care of cancer patients.

Impact of atrazine concentration on bioavailability and apparent isotope fractionation in Gram-negative Rhizobium sp. CX-Z.

Compound-specific stable isotope analysis of micropollutants has become an established method for the qualitative and quantitative assessment of biodegradation in the field. However, many of environmental factors may have an influence on the observed isotope fractionation. Herein, we investigate the impact of substrate concentration on the observed enrichment factor derived from Rayleigh plot of batch laboratory experiments conducted to measure the atrazine carbon isotope fractionation of Rhizobium sp. CX-Z subjected to the different initial concentration level of atrazine. The Rayleigh plot (changes in bulk concentration vs. isotopic composition) derived from batch experiments shown divergence from the linear relation towards the end of degradation, confirming bioavailability of atrazine changed along with the decay of substrate concentration, consequently, influenced the isotope fractionation and lowered the observed enrichment factor. When microbial degradation is coupled to a mass transfer step limiting the bioavailability of substrate, the observed enrichment factor displays a dependence on initial atrazine concentration. Observed enrichment factors (ε) (absolute value) derived from the low concentration (i.e. 9.5 µM) are below 3.5‰ to the value of -5.4‰ determined at high bioavailability (membrane-free cells). The observed enrichment factor depended significantly on the atrazine concentration, indicating the concentration level and the bioavailability of a substrate in realistic environments should be considered during the assessment of microbial degradation or in situ bioremediation based on compound-specific stable isotope analysis (CSIA) method.

Isotope fractionation in atrazine degradation reveals rate-limiting, energy-dependent transport across the cell membrane of gram-negative rhizobium sp. CX-Z.

In the biological mass transfer of organic contaminants like atrazine, the cellular membrane limits bioavailability of pesticides. We aimed to illustrate the roles of cellular membrane physiology and substrate uptake (e.g., passive diffusion and energy-dependent transport) on the limitations of bioavailability in atrazine biodegradation by Gram-negative strain Rhizobium sp. CX-Z. Compound-specific stable isotope analysis revealed energy-dependent transport across cellular membrane led to bioavailability limitations in atrazine biotransformation. Carbon isotope fractionation (ε(C) = -1.8 ±â€¯0.3‰) was observed and significantly smaller in atrazine biodegradation by Rhizobium sp. CX-Z than that expected in acid hydrolysis (ε(C) = -4.8 ±â€¯0.4‰) and hydrolysis by the pure enzyme TrzN (ε(C) = -5.0 ±â€¯0.2‰). However, isotope fractionation was restored in membrane-free cells of Rhizobium sp. CX-Z (ε(C) = -5.4 ±â€¯0.2‰) where no cellular membrane limits substrate uptake. When respiratory chain was inhibited by rotenone, the pseudo-first order kinetic rate constants (0.08 ±â€¯0.03 h-1, 0.09 ±â€¯0.03 h-1) was observed to be statistically less than in the control group (0.23 ±â€¯0.02 h-1, 0.33 ±â€¯0.02 h-1), demonstrating that energy-dependent transport dominated atrazine transfer across the cellular membrane. Therefore, our results revealed energy-dependent transport across cellular membrane existing in Gram-negative strain Rhizobium sp. CX-Z determines bioavailability of atrazine in biotransformation process even at high concentration.

Surgical management of pelvic bone sarcoma with internal hemipelvectomy: Oncologic and Functional outcomes.

INTRODUCTION: The management of pelvic sarcoma is challenging and goals of surgery are adequate oncologic local control, maintenance of optimum function with good quality of life. METHODS: We have evaluated the results of internal hemipelvecotmy including age, type of resection, reconstruction, radiotherapy or chemotherapy. From 2010 to 2016, 23 patients with pelvic bone tumors (13 with Ewing's sarcoma, 9 with Osteosarcoma, 1 with chondrosarcoma) were treated by surgical resection. RESULTS: The mean follow-up was 18 months (0.5-5) years. In 12 patients reconstruction was performed and 11 were without reconstruction. A total of 3 patients (13%) had an infection develop at a mean follow up of 1 month. Surgical debridement's and antibiotics in three patients led to complete recovery. One patient had sciatic nerve injury.One patient had injury to femoral vein; was treated with femoral vein reconstruction. Two patients (9%) developed a local recurrence and were treated with best supportive treatment. Distal pulmonary metastases were seen in four patients and treated with supportive treatment. Five-year disease-specific survival rates of all patients were 83%. The mean functional MSTS score was 18(14-24). CONCLUSIONS: Proper selection of patients, preopertive planning and wide surgical margins with reconstruction provides good functional outcomes following internal hemipelvectomy. The surgical site infection and flap necrosis tend to be minor complication and can be managed leading to optimal outcomes and justifies the need for this complex surgery. The oncological and functional outcome after internal hemipelvectomy suggests that it's an effective method for treatment of patients with pelvic sarcomas.

Surgical Management of Primary Spindle Cell Sarcoma of Prostate.

Primary spindle cell sarcoma of prostate is an extremely rare malignancy and very few cases of it have been reported Ozturk and Sivrikoz, 2013; Hansel and Epstein, 2006. We searched the literature through MEDLINE database using PubMed and Scopus for the articles published between January 1988 and September 2016. Our search was limited to the following keywords: "spindle cell sarcoma," "prostate," and "surgical management." Most of the papers focused on histopathology of the tumor, and very few discussed surgical management. We present a case of localized primary spindle cell sarcoma of the prostate operated at our institute with the difficulties we faced and their management.