A comprehensive appraisal on status and management of remediation of DBPs by TiO2 based-photocatalysts: Insights of technology, performance and energy efficiency.

Disinfection has been acknowledged as an inevitable technique in water treatment. However, an inadvertent consequence of generation of carcinogenic and mutagenic disinfection byproducts (DBPs) is associated with the reaction of disinfectants and natural organic matter (NOM) present in water. More than 700 DBPs have been identified in drinking water. The conventional processes carried out in WTPs do not optimally ensure NOM elimination, which evokes the need for the incorporation of other processes. In this context, several physicochemical and advanced oxidation processes (AOP), such as adsorption, membrane techniques, photocatalysis, etc., have been studied for the removal of NOM from water. Photocatalysis using semiconductors has been one of the most proficient technologies, which utilizes light energy for the degradation of recalcitrant organics. The present study aims to provide a comprehensive appraisal on the performance of titanium dioxide (TiO2) based photocatalysts in the remediation of DBPs concerning the efficacy and energy requirements of the system. Furthermore, the effect of process parameters, such as pH, catalyst dose, light intensity, etc. on the efficacy of the process was also studied. It was observed that conventional P25-TiO2 powders were efficient in the degradation of dissolved organic carbon (DOC) (up to 90%). However, low photocatalytic activity under visible light activation is one of its significant downsides. Several modifications on the catalyst surface in many studies exhibited advantages, such as high humic acid (HA) degradation under visible light. Furthermore, doped TiO2 catalysts have shown high total organic carbon (TOC) degradation. The photocatalytic systems have achieved a better decrease in trihalomethane formation potential (THMFP) when compared to haloacetic acid formation potential (HAAFP). The energy requirements of the photocatalytic systems are determined by electrical energy per order (EE/O), which has been observed to be lesser for doped TiO2 and engineered TiO2 catalysts when compared with P25-TiO2 powders. Carbon, iron, silver, etc., based catalysts can be a promising alternative to TiO2-based photocatalysts for the degradation of NOM, although further research is required in this direction. The present review provides critical highlights on the uses, opportunities, and challenges of TiO2-based photocatalytic techniques for the management of DBPs and their precursors pertaining to an emerging area of water treatment.

Development of a schwarzite-based moving bed 3D printed water treatment system for nanoplastic remediation.

The impact of micro and nanoplastic debris on our aquatic ecosystem is among the most prominent environmental challenges we face today. In addition, nanoplastics create significant concern for environmentalists because of their toxicity and difficulty in separation and removal. Here we report the development of a 3D printed moving bed water filter (M-3DPWF), which can perform as an efficient nanoplastic scavenger. The enhanced separation of the nanoplastics happens due to the creation of a charged filter material that traps the more surface charged nanoparticles selectively. Synthetic contaminated water from polycarbonate waste has been tested with the filter, and enhanced nanoplastic removal has been achieved. The proposed filtration mechanism of surface-charge based water cleaning is further validated using density function theory (semi-empirical) based simulation. The filter has also shown good structural and mechanical stability in both static and dynamic water conditions. The field suitability of the novel treatment system has also been confirmed using water from various sources, such as sea, river, and pond. Our results suggest that the newly developed water filter can be used for the removal of floating nanoparticles in water as a robust advanced treatment system.

Histopathological Significance and Prognostic Impact of Tumor Budding in Colorectal Cancer

Background: Colorectal cancer (CRC) is a heterogeneous disease with a complex etiology. New prognostic factors need to be investigated. Our present focus is on histopathological significance and prognostic impact of tumor budding in CRC. Material and Methods: A total of 60 treatment-naive consecutive patients undergoing surgical resection of CRCs during the period of January 2011 to December 2013 were included in the study. Details of each related to their demographic and tumor profile were recorded. Hematoxylin and Eosin (H and E) and pan-cytokeratin details of each "case" immunohistochemically stained sections were examined for tumor budding assessment along with clinical features. Results: The most frequent site of involvement was the rectosigmoid and sigmoid colon (31.6%). The majority of the cases were moderately differentiated (75%), showed tumor invasion into the pericolic/subserosal fat (66.6%) and stage III (38.3%). Nodal involvement was present in 47%. Correlations between tumor budding and nodal involvement (p-value 0.039) and AJCC stage (p-value 0.021) were found to be statistically significant. Conclusion: Tumor budding is a promising and powerful predictor of lymph nodal metastasis and a higher stage of tumor and can be used as a marker for high-risk CRC. Routine H and E staining aided by cytokeratin immunostaining allows reproducible grading of tumor budding in CRC cases.

Indian Council of Medical Research Consensus Document for the Management of Non-Hodgkin's Lymphoma (High Grade).

This consensus document is based on the guidelines related to the management of Non Hodgkin's Lymphoma (High grade) in the Indian population as proposed by the core expert committee. Accurate diagnosis in hematolymphoid neoplasm requires a combination of detailed history,clinical examination, and various investigations including routine laboratory tests, good quality histology section (of tumor and also bone marrow aspirate/biopsy), immunostaining, cytogenetic and molecular studies and radiology investigations. The staging system used for adult high grade lymphomas is based on the Ann Arbor system and includes various parameters like clinical, haematology, biochemistry, serology and radiology. Response should be evaluated with radiological evaluation after 3-4 cycles and at the end of treatment based on criteria including and excluding PET. Treatment of high grade lymphomas is based on histologic subtype, extent of disease, and age of the patient. Autologous stem cell transplantation after high dose chemotherapy is effective in the treatment of relapsed NHL. Newer RT techniques like 3 dimensional conformal radiation therapy (3D-CRT) and intensity modulated radiation therapy (IMRT) can significantly reduce radiation doses to surrounding normal tissues in lymphoma patients. Patients should be followed up every 3 to 4 months for the first 2 years, followed by 6 monthly for the next 3 years and then annually.

Histopathological Significance and Prognostic Impact of Tumor Budding in Colorectal Cancer.

BACKGROUND: Colorectal cancer (CRC) is a heterogeneous disease with complex etiology. New prognostic factors for this group of disease need to be investigated. This study evaluated the histopathological significance and prognostic impact of tumor budding in CRC. DESIGN: A total of 60 treatment naive consecutive patients undergoing surgical resection for CRC during the period of January 2011 to December 2013 were included in the study. Details of each patient related to their demographic and tumor profile were recorded. Pan Cytokeratin immunohistochemistry was applied on chosen sections and tumor budding was assessed. RESULTS: The most frequent site of involvement was rectosigmoid and sigmoid colon (31.6%). The majority of the cases were moderately differentiated (75%) in morphology, and showed tumor invasion into the pericolic/subserosal fat (66.6%), and were stage III (38.3%). Nodal involvement was present in 50% cases. Correlations between tumor budding and nodal involvement (p-value 0.039) and AJCC stage (p-value 0.021) were found to be statistically significant. CONCLUSION: Tumor budding may be a promising and powerful predictor of lymphnodal metastasis and a higher stage of tumor and can be used as a marker for assessing the aggressiveness of CRC. Routine hemotoxylin-eosin staining supported by cytokeratin immunostain can aid in the grading of tumor budding in CRC.

Impact on Radiological and Pathological Response with Neoadjuvant Chemoradiation and Its Effect on Survival in Squamous Cell Carcinoma of Thoracic Esophagus.

BACKGROUND: Neoadjuvant chemoradiation (NCRT) has been shown to improve survival in patients with locally advanced esophageal squamous cell carcinoma (SCC). The aim of the present study was to evaluate the role of 18-FDG PET-CT in predicting pathological response to NCRT. MATERIAL AND METHODS: We assessed 70 patients of esophageal SCC who underwent NCRT and were evaluated with baseline and post chemoradiation 18F-FDG PET-CT scan. Receiver operating characteristic (ROC) curve was generated by analyzing the sensitivity and specificity of different cut-off points for defining a positive test and their ability to predict pathological complete response. Univariate and multivariate analysis were performed using log-rank and Cox proportional hazards models, and survival curves were estimated using the Kaplan-Meier method. RESULTS: Radiological and pathological complete response was achieved in 44.3 % (n = 31) and 34.3 % (n = 24) patients, respectively. Using ROC curves, post-treatment standardized uptake value (SUV) max [3.25, area under curve (AUC) 0.752] and % change in SUVmax cut-off value (72.32 %, AUC 0.705) was used to predict pathological response. Significant associations between pathological response in primary tumor and post chemotherapy/radiotherapy SUVmax values (p = 0.016), % change in SUVmax (p = 0.006), radiological response in primary (p = 0.006), and grade of dysphagia at presentation (p = 0.041) were observed. Mean overall survival and relapse free survival was 83 and 58 %, respectively at 34 months. CONCLUSION: 18F-FDG PET-CT can be used to predict pathological response to NCRT in locally advanced SCC.

MicroRNAs for Detection of Pancreatic Neoplasia: Biomarker Discovery by Next-generation Sequencing and Validation in 2 Independent Cohorts.

OBJECTIVE: The aim of our study was to analyze the miRNome of pancreatic ductal adenocarcinoma (PDAC) and its preneoplastic lesion intraductal papillary mucinous neoplasm (IPMN), to find new microRNA (miRNA)-based biomarkers for early detection of pancreatic neoplasia. OBJECTIVE: Effective early detection methods for PDAC are needed. miRNAs are good biomarker candidates. METHODS: Pancreatic tissues (n = 165) were obtained from patients with PDAC, IPMN, or from control individuals (C), from Hospital Clínic of Barcelona. Biomarker discovery was done using next-generation sequencing in a discovery set of 18 surgical samples (11 PDAC, 4 IPMN, 3 C). MiRNA validation was carried out by quantitative reverse transcriptase PCR in 2 different set of samples. Set 1-52 surgical samples (24 PDAC, 7 IPMN, 6 chronic pancreatitis, 15 C), and set 2-95 endoscopic ultrasound-guided fine-needle aspirations (60 PDAC, 9 IPMN, 26 C). RESULTS: In all, 607 and 396 miRNAs were significantly deregulated in PDAC and IPMN versus C. Of them, 40 miRNAs commonly overexpressed in both PDAC and IPMN were selected for further validation. Among them, significant up-regulation of 31 and 30 miRNAs was confirmed by quantitative reverse transcriptase PCR in samples from set 1 and set 2, respectively. CONCLUSIONS: miRNome analysis shows that PDAC and IPMN have differential miRNA profiles with respect to C, with a large number of deregulated miRNAs shared by both neoplastic lesions. Indeed, we have identified and validated 30 miRNAs whose expression is significantly increased in PDAC and IPMN lesions. The feasibility of detecting these miRNAs in endoscopic ultrasound-guided fine-needle aspiration samples makes them good biomarker candidates for early detection of pancreatic cancer.

Eight Year Survival Analysis of Patients with Triple Negative Breast Cancer in India.

BACKGROUND: Triple-negative breast cancer (TNBC) often presents as an interval cancer with short survival upon metastasis and thus represents an important clinical challenge. The present study investigated the clinicopathologic characteristics and long term survival outcome of early and locally advanced TNBC. MATERIALS AND METHODS: Medical records were reviewed retrospectively for 148 consecutive confirmed cases of TNBC treated in a single unit at our centre. Demographic profile, tumor type, histopathology details, treatment and follow-up information was recorded and immunohistochemistry was performed. RESULTS: Age group >50 years was associated with tumors of clinical stage 3 (53.8%), pathological stage 3 (46.2%), pathological grade 3 (45.7%), presence of extracapsular extension (ECE, 48.5%) and lymphovascular invasion (LVI, 64.9%). Locally advanced breast cancers (LABCs) were characterized by pathological stage 3 (96.2%), presence of ECE (100%) and absence of LVI (46.7%) as compared to early breast cancers (EBCs) which had higher incidence of lower stage tumors (100%), absence of ECE (82%) and presence of LVI (91.9%; p-value <0.001. Better relapse free survival was observed in patients with no axillary involvement (69%; p-value <0.001) and absence of ECE (64%; p-value <0.001). Improved overall survival was seen in patients with EBC (90%; p-value 0.008), clear axilla (86%; p-value <0.001), absence of ECE (87%; p-value <0.001) and negative lymph nodes (90%; p-value 0.006). CONCLUSIONS: TNBCs are aggressive tumors which show poor long term survival. Patients with TNBC benefit from chemotherapy, thus better and less toxic treatment options are needed. Identification of newer targets and development of targeted therapies are the need of the hour.

Salvage Transoral Robotic Surgery for Recurrent or Residual Head and Neck Squamous Cell Carcinoma: A Single Institution Experience.

BACKGROUND: The present study was conducted to evaluate the technical feasibility, safety and adequacy of surgical margins with salvage transoral robotic surgery (TORS) for recurrent or residual head and neck squamous cell carcinoma patients. MATERIALS AND METHODS: Thirty patients who underwent salvage TORS using the 'DaVinci' robot were enrolled in the study and data related to their surgical time, complications and functional outcome were recorded. RESULTS: The feasibility of salvage TORS in our study was observed to be 100%. Positive margins were encountered in only 6.7% of patients. Mean blood loss was 23.3 ml with no patient requiring blood transfusion. Postoperative complications in the form of primary haemorrhage requiring active surgical intervention occurred in 13.3%. Oral feeding could be started as early as the 3rd postoperative day in a few patients, with nasogastric tubes being removed on the 12th postoperative day. Long term gastrostomy tube dependency was seen in 10% cases. Median survival of patients was 19 months. CONCLUSIONS: Salvage TORS is a safe, effective and feasible option in the management of treatment failure cases. It offers an alternative surgical approach with unexpected benefits in terms of tracheostomy tube use, Ryle's tube and gastrostomy dependence.

Lifestyle and Sporadic Colorectal Cancer in India.

BACKGROUND: The study evaluated the patient, lifestyle and tumor profile in patients undergoing upfront surgery for sporadic colorectal cancer (CRC) in Indian population. MATERIALS AND METHODS: One hundred consecutive patients were included. Details related to their demographic profile, habits, signs and symptoms, tumor profile, further treatment and follow up were recorded. RESULTS: The majority of the patients had colonic cancer (68%), advanced tumor stage 3 and 4 (46%), moderately differentiated tumors (70%) with absence of lymphatic invasion (60%) and metastasis (90%). Correlations between tumor location and abdominal pain (p-value 0.002), bleeding per rectum (p-value <0.001), difficulty in micturition (p-value 0.012) and constipation (p-value 0.007) were found to be statistically significant. Abdominal pain was more frequently reported in patients with metastasis (p-value 0.031). Loss of weight statistically correlated with absence of lymphatic invasion (p-value 0.047). Associations between tumor stage and alcohol intake (p-value 0.050) and non vegetarian diet (p-value 0.006); lymphatic invasion and intake of spicy food (p-value 0.040) and non vegetarian diet (p-value 0.001) and metastasis and alcohol intake (p-value 0.041) were also observed. Age and tumor grade were also correlated (p-value 0.020). CONCLUSIONS: Minimizing the adverse lifestyle factors can help in reducing the overall incidence of CRC in the Indian population.

Neuroendocrine Carcinoma of Gall Bladder: A Series of 19 Cases with Review of Literature.

BACKGROUND: Neuroendocrine neoplasms of the gall bladder (GB) are rare tumors classified as grade 1 and 2 neuroendocrine tumor (NET), neuroendocrine carcinoma (large cell or small cell type), and mixed adeno-neuroendocrine carcinoma (MANEC). Primary neuroendocrine carcinomas (NEC) of GB are rare with grave prognosis not withstanding radical surgical treatment. Chemotherapy forms the primary management due to the advanced stage at presentation, as complete surgical resection is generally not possible. The overall median survival is 4-6 months despite aggressive management. Only 73 cases of small cell carcinoma (SCC) and 10 cases of large cell neuroendocrine carcinoma (LCNEC) have been reported in English literature till now. We present a series of 19 cases of NEC of GB with their pathological and clinical features and response to treatment. OBJECTIVE: The objective of this study was to evaluate NECs of the GB for their clinical behavior, prognosis, and treatment outcome in terms of survival and to segregate NECs into further subcategories, that is 20-50 % and >50 %, based on MIB-1 index. METHODS: We retrospectively searched the clinical and pathological database over 2.5 years (January 2012 to June 2014) through existing electronic hospital medical records to collect cases of NEC arising in GB. A total of 447 cases of gall bladder pathologies were analyzed, of which 19 cases were diagnosed as NEC. All relevant investigations were documented and response to treatment/therapy was evaluated clinically and radiologically. Tumor specimen was obtained by fine-needle aspiration cytology and/or biopsy and classified using the latest World Health Organisation (WHO) classification (2010) via cytopathologic, histopathologic, and immunohistochemical visage. RESULTS: Nineteen patients diagnosed as NEC of GB were evaluated in the study, with 16 having SCC, 2 having LCNEC, and 1 with MANEC. All patients presented in advanced clinical stage III or IV, along with distant metastasis and showed progressive disease during therapy. Ki67 index was between 20 and 50 % in 5 cases and >50 % in 8 cases. Follow-up was available in 14 cases with a median survival of 3 months, and 2 of these patients capitulated to their illness, before commencement of treatment. The remaining 5 cases were lost to follow-up. Out of these, 2 had deranged liver function test and no chemotherapy could be administered, and the other 3 refused treatment. CONCLUSIONS: NECs are aggressive with generally poor prognosis, characterized by insidious onset and advanced clinical stage of presentation. A radical approach to treatment with chemotherapy is the best form of palliation. Role of radiotherapy remains undefined due to paucity of data.

Immunohistochemical Profile of Breast Cancer Patients at a Tertiary Care Hospital in New Delhi, India.

BACKGROUND: To assess the immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor-2 (HER2) neu receptor in breast cancer and their associations with various clinicopathological characteristics. MATERIALS AND METHODS: This is a retrospective analysis of women who presented with primary, unilateral breast cancer in the Department of Medical Oncology at Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India during the period from January 2008 to December 2011. Data were retrieved from the medical records of the hospital including both early and locally advanced cancer cases. ER, PgR and HER2neu expression in these patients was assessed and triple negative patients were identified. Associations of triple negative and non-triple negative groups with clinicopathological characteristics were also evaluated. RESULTS: A total of 1,284 women (mean age 52.1 years, 41.9% premenopausal) were included in the analysis. Hormone receptor positivity (ER and/or PgR) was seen in 63.4% patients, while 23.8% of tumors were triple negative. Only 23.0% were HER2 positive. Around 10.0% of tumors were both ER and HER2 positive. ER and PgR positivity was significantly associated with negative HER2 status (p-value<0.0001). Younger age, premenopausal status, higher tumor grade, lymph node negativity, advanced cancer stage, and type of tumor were strongly associated with triple negativity. Significantly, a smaller proportion of women had ductal carcinoma in situ in the triple negative group compared with the non-triple negative group (35.6% versus 60.8%, p-value<0.01). CONCLUSIONS: The present analysis is one of the largest studies from India. The majority of the Indian breast cancer patients seen in our hospital present with ER and PgR positive tumors. The triple negative patients tended to be younger, premenopausal, and were associated with higher tumor grades, negative lymph nodes status and lower frequency of ductal carcinoma in situ.

Post-trial access to treatment for patients participating in clinical trials.

Clinical trials are the mainstay for bringing out newer and better drugs to serve the mankind. By virtue of participating in a clinical trial, a patient receives access to the newer drugs/therapies, but nothing is generally being offered to them once their participation in the study comes to an end. Though the issue of post-trial access to treatment by patients participating in a clinical trial is debatable, there is no compelling justification either for or against it. We examined a case study in order to evaluate the applicability of post-trial access to treatment for patients participating in clinical trials. The provision of post-trial access to treatment should also keep into consideration the compassionate use of drugs on humanitarian grounds, especially in cases of trial drugs that have offered significant benefit to the trial patients and whose termination would lead to deterioration in patient's overall condition. In the present era of personalized medicine, the incorporation of genetic testing into clinical practice further authenticates the rationale of compassionate use of drugs and post-trial access to treatment.

Immunoscoring of epidermal growth factor receptor expression in recurrent cases of oral squamous cell carcinoma.

BACKGROUND: Oral squamous cell carcinoma (OSCC) is a genetic disease with high prevalence and poor survival. Evaluation of recurrent tumor for a valid biomarker may serve as a predictive system for analyzing prognostic course of this disease. This study was designed to evaluate and compare the immunoscoring of epidermal growth factor receptor (EGFR) expression in recurrent cases with their matched regional/locoregional recurrence and non-recurrent cases of OSCC. METHODOLOGY: A total of 64 cases of OSCC were studied and immunostained with polyclonal EGFR antibody. Of these, 33 cases recurred at the end of 5 years of follow-up. For positive evaluation of EGFR staining, immunscoring was performed by adding the extent score and intensity score. RESULTS: We observed significant increase in EGFR immunoscore in recurrent cases of OSCC (P-value 0.001). Immunoscoring of EGFR expression is an independent prognostic and/or predictive parameter for recurrence in OSCC (Odds Ratio: 6.52). CONCLUSION: Immunoscore using EGFR can be incorporated into traditional classification, thus providing an essential prognostic and potentially predictive tool.

Transoral robotic surgery in management of oropharyngeal cancers: a preliminary experience at a tertiary cancer centre in India.

BACKGROUND: The aim of this observational prospective study was to determine the technical feasibility, safety and adequacy of surgical margins for transoral robotic surgery (TORS) in oropharyngeal cancers. METHODS: From March 2013 to May 2014, 60 patients with oropharyngeal lesions underwent TORS with or without neck dissection using the 'DaVinci' robot. Patients were observed and data recorded on surgical time, blood loss, complications and functional outcome of patients. RESULTS: All 60 patients underwent TORS, with neck dissection performed in 45 of the patients. A positive margin was seen in two patients (3.3 %). Intent to treatment was radical in 42 patients and salvage in 18 patients. None of the patients required tracheostomy, and one patient (1.66 %) died postoperatively. Postoperative complications in the form of primary haemorrhage required active intervention in three patients. Average estimated blood loss was 26.5 ± 31.1 ml. Postoperatively, all patients had adequate swallowing and speech function with nasal twang reported in three patients on long-term follow up. Patients started tolerating oral feeds within a week of procedure (mean 3.96 days), with the nasogastric tube removed on the ninth postoperative day (mean 9.19 days). No long-term gastrostomy tube dependency was reported. CONCLUSION: TORS is a safe, feasible, minimally invasive procedure in patients with oropharyngeal cancers. It has the least morbidity and offers benefits in terms of avoidance of tracheostomy tube, prolonged Ryle's tube and gastrostomy dependency.

Expression of epidermal growth factor receptor, p53, Bcl2, vascular endothelial growth factor, cyclooxygenase-2, cyclin D1, human epidermal receptor-2 and Ki-67: Association with clinicopathological profiles and outcomes in gallbladder carcinoma.

BACKGROUND: The present study observed the expression levels of epidermal growth factor receptor (EGFR), p53, Bcl2, vascular endothelial growth factor (VEGF), cyclooxygenase-2 (cox-2), cyclin D1, human epidermal receptor-2 (HER-2) and Ki-67 in gallbladder carcinoma (GBC) and their association with clinicopathological profiles and disease outcomes. MATERIALS AND METHODS: Fifty consecutive samples of cholecystectomy/biopsies from GB bed (archived formalin fixed paraffin embedded tissue blocks of different stages of GBC) were included, and patient details related to their demographic profile, investigations, tumor profile, treatment, and follow-up were recorded. Immunohistochemistry was performed to study the expression levels. RESULTS: Overexpression of EGFR, p53, Bcl2, VEGF, cox-2, cyclin D1 and HER-2 was observed as 74%, 44%, 8%, 34%, 66%, 64%, and 4%, respectively. Association of Bcl2 overexpression in mucinous morphology (40%, P = 0.045), cox-2 overexpression in early stage (I/II) tumors (87.5%, P = 0.028) and VEGF overexpression in alive patients (47.1%, P = 0.044) was observed. Co-expression of EGFR and p53 were statistically significant (P = 0.033). Ki-67 labeling index was significantly higher in patients in age group <40 years (P = 0.027), and poorly differentiated tumors (P = 0.023). Advanced disease and poorly differentiated tumors showed a significantly poor median survival (P < 0.05). CONCLUSION: EGFR, cox-2 and cyclin D1 were largely overexpressed. Advanced tumor stages and poorly differentiated tumors are predictors of poor survival.

Role of apolipoprotein AI gene polymorphism (G-75A and C+83T) in essential hypertension in Indian population.

Hypertension is becoming a public health emergency worldwide. It has been seen that both genetics and gene-environment interactions are major determinants of lipoprotein abnormalities and hypertension. This study elucidates the effect of apolipoprotein AI gene polymorphism (G-75A and C+83T) in 50 cases of essential hypertension and equal number of age & sex matched control subjects in the Indian population. Higher instances of obesity and more adverse biochemical profiles were found in hypertensives [GA (74%) and CT (56%) most commonly observed genotypes]. Presence of A and T alleles and GA (-75 bp) and CT (+83 bp) heterozygosity in apolipoprotein AI gene play an important role in essential hypertension (GA genotype had an odds ratio of 4.27 (1.69-10.96) of developing essential hypertension). The odds ratio for the GA genotype was 3.74 (95%CI, 0.83-9.0) in the presence of confounding factors including total proteins, albumin, amylase, cholesterol, triglycerides, LDL, VLDL and body mass index. It indicates one of the potential areas where population studies may be taken up for identifying the genetic basis of essential hypertension.

Squamous cell carcinoma of the superior gingivobuccal sulcus: an 11-year institutional experience of 203 cases.

OBJECTIVE: The report presents an 11-year Institutional experience of 203 cases with superior gingivobuccal sulcus tumours receiving surgical intervention at a comprehensive tertiary cancer care centre. METHODS: A retrospective chart review of patients with a confirmed diagnosis of squamous cell carcinoma of superior gingivobuccal sulcus was done and data related to patient demographic profile; details of surgical procedure, follow-up and survival were collected. RESULTS: Infratemporal fossa clearance was performed in 56 patients. The 10-year overall survival and disease-free survival was observed to be 39 and 52%, respectively, with a median follow-up of 15 months. The overall survival was 40 and 36%, respectively, in cases with and without infratemporal fossa clearance. Similarly, the disease-free survival was found to be 58 and 49%, respectively, in cases with and without infratemporal fossa clearance. CONCLUSION: Patients with higher stage tumours who underwent infratemporal fossa clearance showed better overall and disease-free survival than those who did not undergo infratemporal fossa clearance.