Palliative care needs of stroke patients at a tertiary care center in South India.

Objectives: Stroke survivors have palliative care needs in multiple domains, which are overlooked. Accurate estimation of these is pivotal in ensuring proper rehabilitation and planning interventions to improve quality of life (QoL). We aimed to assess the palliative care needs of stroke patients in various domains in a structured manner at the neurology service of a tertiary care center in South India. Materials and Methods: Seventy-five consecutive stroke patients presenting to the neurology service were recruited over six months with assessment across various domains including symptom burden, physical domain, activities of daily living (ADL), psychiatric/psychological domain, and QoL at baseline and with follow-up at one month and three months. Results: Despite improvement in the conventional stroke impairment measures among stroke survivors, there were significant unmet needs across various domains; 98% were severely or entirely dependent on ADL at three-month follow-up; and pain and insomnia were the most frequent (33% incidence) troubling symptoms encountered. There were substantial mental health related issues. The QoL measurement tools employed were the stroke impact assessment questionnaire (SIAQ), a novel tool and the World Health Organization Quality Of Life Brief Version (WHO-QOL-BREF). SIAQ scores at one month showed that 19 patients (42.22%) had their QoL severely affected, and 36 patients (80%) showed the same trend at the three-month follow-up. WHO-BREF scores showed that 27 (62%) did not report good QoL, and 32 (73%) were found not to be satisfied with their health at a one-month follow-up. Conclusion: There is a significant burden of unmet palliative care needs among stroke survivors in India across various domains.

Role of Facial Index and Odontometric Parameters in the Establishment of Stature and Gender of Individuals.

BACKGROUND: Dental anthropology is an important aspect of bioarchaeology and forensic anthropology. In forensic anthropological studies, identifying an unknown individual from a mangled and decomposing body is a challenging task. Cranial remains are the only critical clues available for personal identification. Age, sex, and stature are significant parameters in establishing the identity of an unrecognized individual. Stature is the natural height of the individual in an upright position. Stature can be estimated from various parts of the body such as long bones, short bones, and skull. Few studies conducted in specific population have established a correlation for predicting stature from cephalometric and odontometric parameters. Thus, the present study was conducted to determine stature and gender based on cephalometric and odontometric parameters in the population of Tamil Nadu. AIMS: The aim of this study was to investigate the possibility of predicting the stature and gender of an individual based on odontometric measurements, facial height, and bizygomatic width. MATERIALS AND METHODS: A total of seventy individuals in the age group of 18-24 years were selected for the study. The facial height, bizygomatic width and length ,mesiodistal and labiolingual diameter of clinical crown of maxillary central,lateral and canine teeth of both the right and left quadrants were measured. The values were analyzed statistically. Through this analysis, regression equations for estimation of stature from odontometric and facial index were derived. RESULTS: Pearson correlation test was carried out to establish a correlation between the stature and the measured parameters. Regression analysis was carried out to establish stature from the odontometric and facial index of the individual. The regression equations were used to get estimated stature in the same sample of volunteers from which regression equations were obtained. Tabulated results showed a probable correlation between various parameters. CONCLUSION: In our study, a positive correlation between cephalometric measurements, gender, crown length of permanent left central incisor, and combined mesiodistal diameter of permanent maxillary anteriors with stature was found. This can be used as a supplementary method for estimating the stature of unknown human bodies.

Oral medullary plasmacytoma: Rare case reports.

Medullary plasmacytoma (MP) or osseous or solitary bone plasmacytoma is a specializing hematopathology lesion typically present with local symptoms, such as pain, paresthesia and pathologic bone fractures as a result of proliferation of plasma cells. The most often involved sites are active hematopoietic long bones and the vertebrae. The clinical course of disease is identical to spectrum of other plasma cell dyscrasias. The diagnostic criteria include punched-out radiolucencies, monoclonal plasma cells and M protein. This lesion should be considered for the differential diagnosis of bone tumors. It is highly radiosensitive although combination modalities of radiation, surgery and chemotherapy have been used in the treatment. The long-term follow-up is essential. We report two rare cases of oral MP with unusual clinical presentation.

Expression of Osteopontin in Oral Squamous Cell Carcinoma and its Surgical Margins-An Immunohistochemical Study.

INTRODUCTION: Despite the advances in the treatment modalities offered for oral squamous cell carcinoma. The recurrence rate of it still remains quite high. Early detection of recurrence will improve the outcome and the survival of the patient. Osteopontin, a transformation-related phosphorylated protein in epithelial cells has been closely related with tumourigenesis. This study was undertaken to explore the potential of OPN as a tumour marker of recurrence in OSCC. AIM: To analyse the expression of Osteopontin (OPN) in Oral Squamous Cell Carcinoma (OSCC), patient matched tumour free surgical margins and normal oral mucosa and to correlate with local & loco regional recurrence. MATERIALS AND METHODS: Twenty cases each of formalin fixed paraffin embedded blocks of histopathologically diagnosed cases of OSCC, patient matched tumour free surgical margins and normal oral mucosal tissues were obtained from the archives of the Oral Pathology & Microbiology Department, Faculty of Dental Sciences, SRU and Govt. Arignar Anna Memorial Cancer Hospital, Kancheepuram. Immunohistochemical analysis was performed with an antibody to Osteopontin protein. Patients with secondary tumours and those treated with chemotherapy and radiotherapy were excluded from this study. RESULTS: The expression of OPN was elevated in 95% of tumours & 55% of histologically tumour free margin samples. There was negative OPN expression in normal mucosal samples. The result of the study was statistically analysed using Pearson chi-square test and was found to be statistically significant. CONCLUSION: OPN can be used as a diagnostic marker in Oral Squamous Cell Carcinoma. In the tumour free surgical margins, elevated levels of OPN may predict a significantly increased risk of recurrence.

Cartilaginous choristoma of the gingiva: a rare clinical entity.

Choristomas are rare entities which are aggregates of microscopically normal cells or tissues in aberrant locations. They are a "heterotopic" rest of cells, as they appear as a tumor-like mass. Herein we report a case of cartilaginous choristoma in a 54-year-old male who presented with a swelling on right lower gingiva. The histopathological examination revealed features of a well circumscribed mass of mature cartilage in a dense fibrous connective tissue stroma.