Sonographic Correlation of Fetal Foot Length as a Reliable Parameter for Estimation of Gestational Age in 2ND and 3RD Trimester

Objective: To sonographic correlation fetal foot length as a reliable parameter for estimation of gestational age in 2nd and 3rd trimester. Study Design: An analytical cross-sectional prospective study was performed. Settings: The study was performed in Meer Children and family clinic, Tajpora Lahore. Period: An analytical cross-sectional study was conducted from 15 October, 2021 to 15 January, 2021. Material & Methods: The present study is conducted in the in the Meer Children and Family Clinic Tajpura Lahore .In pregnant women attending the OPD during 2nd and 3rd trimester for routine checkups. The present study done in 60 normal pregnant women who were sure about their last menstrual period, have regular menstrual cycle, not experienced any vaginal bleeding. Ultrasonographic fetal foot length measurements was done without previous knowledge of gestational age and then the gestational age confirmed by biparietal diameter, abdominal circumference and head circumference . Results: The present study is conducted in 63 pragnent women between 15 to 35 weeks  of gestational age attending the OPD for 2nd and 3rd trimester routine checkups the  in the Meer Children and Family Clinic Tajpura Lahore . Sonographically we calculated foot length from 15 to 35 weeks of gestation. In our study to Early  age at which fetal foot length could be seen and measured sonographically was found to be 15 weeks of  gestation age. In 27 weeks of gestational age and mean foot length 83.67 with std. deviation 5.718 and std. Error Mean -720 and the mean value of foot length by gestational age is 93.33 with std. deviation and std. error mean 338.740 and 42.677 respectivly.  Along with foot length bipraietal diameter(BPD),Abdominal circumference(AC),head circumference(HC) also measured for comparison. Conclusion: In the normal growing fetus the fetal foot length increases with increasing gestational age. Fetal foot length is a good parameter for gestational age especially in cases of femur achondroplasia, dolichocephaly or brachycephaly and in cases who are not sure about their L.M.P. Fetal foot length is  used as an investigational implement  to measured  of gestational age in the late second and third trimesters of pregnancy. Fetal foot length was especially useful when other parameters did not correctly estimate gestational age, e.g., in cases of short-limb dwarfism hydrocephalus or anencephaly. Keywords: Gestational age, Fetal foot length, Ultrasonographically age estimation DOI: 10.7176/JHMN/93-04 Publication date:September 30th 202

To assess the aggressiveness of oral squamous cell carcinoma in the young population

Introduction: Squamous cell carcinoma of the oral cavity has a high prevalence not only worldwide but also in Asian countries. It has been estimated that the mortality from the tumor has remained almost 56% and cancer presenting at a younger age tends to be more aggressive and advance at the time of presentation. Objectives: To assess the pattern of recurrence and disease-free survival in two age groups. Materials and methods: This is a retrospective, cohort study of patients diagnosed with oral squamous cell carcinoma admitted between 2008 to 2018. Two groups were made with 40 years as a cut off mean. Various etiological factors, staging, treatment, site of the tumor, and recurrence and mortality were assessed. Results: Patients who underwent treatment for the cancer of which 124 patients were of less than 40 years and 327 were of age above 40 years. The ratio between males to females in Age40 was 3:1 respectively. The most common site of the tumor is cheek in origin. Patients in Age 40 years recurrence of tumor is (n=120, 37%) with CI of 95% (P=0.653) and the overall mortality in Age40 (n=168, 51%) of patients have a mortality with CI of 95% (P=0.811). Conclusion: Overall the study suggests that mortality of the tumor is almost the same with a slight difference in recurrence of the disease. Cheek is the most common site of presentation

Selective neck dissection for node-positive oral cavity squamous cell carcinoma: A retrospective cohort study

Introduction: Selective neck dissection in clinically node-negative neck is considered the standard of care for oral squamous cell carcinomas (SCCs). Controversy still prevails in node-positive disease regarding the extent of neck dissection. In our part of the world, comprehensive neck dissection is mostly considered to be the minimal optimal treatment for palpable neck disease.Objective: To compare regional control and disease-specific survival between clinically node-positive and node-negative patients undergoing selective neck dissection for oral SCC.Methods: This was a retrospective cohort study conducted in the department of ENT, Head and Neck surgery at a tertiary care hospital. All patients with biopsy-proven oral and lip SCC, with or without nodal disease, who underwent selective neck dissection between April 2006 and July 2015 were included in the study. Results: During the study period, 111 patients with oral SCC underwent selective neck dissection, of whom 71 (62%) were clinically node-negative and 40 (38%) patients had clinically positive nodes in the neck. The mean follow-up was 16.62 months (standard deviation [SD]: 17.03). The overall regional control rates were 95 versus 96% for clinical negative versus positive nodes, respectively ( p = 0.589). The disease-specific survival was 84.5% in the node negative group versus 82.5% in the node-positive group ( p = 0.703). Conclusion: Selective neck dissection in node-positive neck oral SCC has similar regional control rates when compared with node-negative neck SCC. The difference in disease-specific survival between the two groups is also not significant

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population