Pattern of referral and management of oro-dental problems in patients with cancer: a retrospective study

Background: General dentistry care is of paramount importance in maintaining oral hygiene of cancer patients. Methods: The data of patients registered at the dental wing in a tertiary care cancer center for one year period (2013) was used for the present analysis. All the cases were retrospectively analyzed for the pattern of referral, diagnosis of different oro-dental conditions, and different interventions done for the various oro-dental conditions.Results: A total of 798 patients were referred from various oncology wings for management of oro-dental problems, 50.1% patients were referred from head and neck oncology, 31% were from radiation department, 6.2% patients were from medical oncology and palliative care department each, 4% patients were from gynecologic oncology, and 2.5% patients were from screening wing. Acute gingivitis (62%) in pre treatment and mucositis (28%) in post treatment were major symptoms and signs for referral. 47% patients were managed with tooth extraction, grinding was done on 23%, scaling were done on 12.5%, desensitization was done on 8.7% patients, filling was done on 2.5% patients, prosthesis fitting in 2.5% patients, root canal treatment in 2.2% patients, and post surgical obturator fittings in 0.75% patients. Conclusion: Majority of cancer patients were referred for oro-dental care from head and neck oncology department with head and neck cancers and extraction of tooth pre radiotherapy and chemotherapy remains an important part of oro-dental care in cancer patients.

Knowledge of yoga among cancer patients and their attendants: a survey in a tertiary cancer centre in North East India

Yoga is an ancient Indian science that has evolved over thousands of years. Yoga deals with the physical, mental, moral and spiritual well-being of an individual.1 We have conducted an electronic survey amongst the cancer patients and attendants of our hospital about their knowledge of yoga. It’s a survey of 62 participants from 15/06/2021 to 18/06/2021 (before international yoga day on 21/06/21), 46.8% of the participants are male and 53.2% are female in the survey. The age of the participants ranges from 9 to 69 years. We have designed a set of ten questions, first six questions are designed to know their knowledge about the beneficial effects of the yoga, next two questions are about the misconceptions, cautions and guidance needs while performing yoga and the last two questions about the possibility of the practical application of it in their life. In our survey, we find that 93.5% of the participants think yoga reduces stress, 96.8% think yoga reduces fatigue, 95.2% opine yoga improves sleep, 93.5% feel yoga improves posture-related dysfunctions in cancer patients. Regarding chances of recurrence in cancer patients, 75.8% of patients think it has a negative impact on recurrence, 40.3% of participants have an opinion that yoga can cure cancer (no study till now proves that yoga cures cancer), and 90.3% feels that unguided yoga can cause injuries. At last, 93.5% patients feel yoga improve quality of life in cancer patients and 93.5% want to implement yoga in their daily life. From our survey, it seems participants have a fair idea of the benefits of yoga in cancer

Ultrasound evaluation of biopsy proven malignant breast mass

Background: Breast cancer is the most common malignancy in female worldwide. Ultrasound (US) is a safe and easily available modality for evaluation of breasts in females of all age groups. It can detect characteristic features of breast malignancy with high degree of accuracy. This study was undertaken with the aims to evaluate the ultrasonographic features of malignant breast mass, to identify the most commonly encountered gray scale ultrasound findings and to study the role of Doppler ultrasound in those cases.Methods: The study was conducted in Dr B. Borooah Cancer Institute, Guwahati from January 2018 to January 2019. Gray scale ultrasound including Doppler study was done in all the female patients coming with palpable breast lump or with nipple discharge and images were archived. The archived images of a total number of 108 patients with biopsy report positive for malignancy were retrospectively studied and the ultrasound findings were evaluated.Results: Most common gray scale ultrasound features for malignant breast masses were hypoechoic mass, taller than wide, irregular shape, having spiculated margins, neither posterior acoustic enhancement nor shadowing, presence of intralesional microcalcifications and surrounding echogenic halo. Hypervascularity, noticeable difference in waveform pattern between central and peripheral vessels, high resistance flow pattern with absent or reversal of diastolic flow were the common Doppler findings.Conclusions: Combination of Doppler with gray scale ultrasound has emerged as a very important technique in diagnosing malignant breast mass with high accuracy

Oral premedication for pediatric anaesthesia: a comparison between midazolam and clonidine

Background:In children any anticipated surgery is associated with profound psychological stress to the patients. To allay this stress and anxiety, wide variety of pharmacological interventions are used.Methods: A prospective observational study was carried out between July’2005 and June’2006 in a tertiary care hospital in Assam. The study included children undergoing surgery under general anaesthesia in age group 2-10 years. Sixty children were divided into two groups, in one group patients received oral midazolam and other group received oral clonidine as pre-medicant.Results: In the midazolam group 23 (76.67%) children had no apprehension after parental separation and at induction (P˂0.001), sedation score at induction was significant higher in midazolam group versus clonidine group (93.33% versus 66.6%, P<0.01), clonidine resulted in a more stable pulse and blood pressure peri-operatively (P<0.05).Conclusion: Oral midazolam has better efficacy in terms of preoperative sedation and oral clonidine had stable hemodynamic profile and better analgesia in the clonidine group

Profiles of gall bladder cancer reported in the hospital cancer registry of a Regional Cancer Center in the North-East India

Background: The incidence of gall bladder cancer (GBC) is very high in this part of the world and there is little information on the descriptive epidemiology of GBC from our population.Methods: A retrospective study on the data set of hospital cancer registry was analyzed. The data set consisted of patient information registered during the period of January 2011 to December 2012. The cases included for the present study were histologically confirmed and radiologically diagnosed cases of GBC. All the cases were retrospectively analyzed for gender, age, urban-rural residences, religion of patients and their educational levels. Descriptive statistics was calculated and Chi square test was done to see the significance differences among categories.Results: A total of 837 cases of GBC were registered, F:M was 2.33, median age in females and males was 54 and 50 years respectively, majority of cases in both the genders were seen in 50-59 years of age, 81.1% patients were from rural areas and 18.8% from urban areas, Chi square on comparison with other cancers showed p<0.05, and there was no major religious and educational pattern of GBC seen in our population.Conclusion: In our population females are at high risk especially past 40 years of age and rural population with its varied environmental, lifestyles and infective agents should be investigated for possible risk factor in the causation of GBC.

Correlation between ABO blood groups and various cancers in the north eastern region of India: a retrospective observational study

Background: Numerous studies have documented the association of the ABO blood groups with the occurrence of cancers. Aim was to find out an association of ABO blood groups and various cancers in the North Eastern region of India.Methods: The study was a retrospective observational study that included 1000 cases and 1000 controls. The data included the ABO blood typing of the selected cancer sites which were head and neck, esophagus, stomach, breast, cervix, and ovary. Patients who attended blood bank of regional cancer center with requisition for blood transfusion from 2014 to 2016 were included. The control group was healthy blood donors. Chi square test was used to assess the difference among the compared groups. Risk was calculated by regression analysis. P value <0.05 was considered as statistically significant at 95% confidence interval.Results: Out of 1000 cases and 1000 controls, O blood group were seen in 377 (37.7%) and 395 (39.5%) cases and control, respectively. Significant reduced odds ratio (OR) in non O blood groups for head and neck, esophagus, stomach, and breast was observed. In case of carcinoma cervix, OR for B group was 1.5 (P=0.05), and for blood group A OR=2.2 (P=0.02) was seen in carcinoma ovary.Conclusions: In the studied population, patients with O blood group are at an increased risk of developing head and neck, esophagus, stomach, and breast cancers

Pattern of regional metastasis in papillary thyroid cancer: our experience of 86 cases

Background: Papillary thyroid cancer (PTC) have a high propensity for regional metastasis which ranges from 30- 80%. The objective of the study is to assess the pattern of lymph node metastasis and to plan the extent of neck dissection accordingly. Though central neck dissection (CND) is routinely done in PTC but the indication of extent of  neck dissection is still controversial.Methods: The medical records of   86 patients with PTC  who underwent total thyroidectomy (TT) and neck dissection at Dr. B. Borooah Cancer Institute(BBCI) from January 2010 to  December 2014 were retrospectively reviewed.Results: Out of 86 patients 22 were males and 64 were females. The median age of presentation was 40.0 years. 43 out of 86 patients (50%) had cervical lymph node metastasis. Ipsilateral nodal metastasis was found in 37 patients (43.0%) and contralateral metastasis was found in only 6 patients (7.0%).Tumors with size more than 3cm had ipsilateral nodal metastasis in 21(56.7%) patients which is statistically significant (p 0.03).A strong association was found between level VI and the ipsilateral group of lymph nodes involving level II,III,IV and V.Conclusions: Majority of patients present with multiple level nodal metastasis, with the central compartment commonly involved. In view of the high incidence of metastatic lymph nodes in levels II, III, IV and level VI ,our study  supports the recommendation  for posterolateral  and anterior  neck dissection in patients with clinically positive neck  nodes and tumor with aggressive criteria

Coexistent squamous cell carcinoma and tuberculosis in the cervix: a rare case report

Tuberculosis may coexist with malignancy. But coexistence of tuberculosis and cancer in cervix is extremely rare. We present a rare case of coexistent squamous cell carcinona and tuberculosis of uterine cervix in a 35 years old lady who presented with chief complaints of white discharge and bleeding per vagina since 1 year. Histopathological findings of carcinomatous nests along with epithelioid granuloma, langhans type of giant cells and positive acid fast bacilli in the tissue section give authenticity to our diagnosis. Tuberculosis complicating malignancy may occur in regions with high prevalence of this disease. Hence, proper diagnosis of tuberculosis in a patient with cancer assumes importance as it may add to the surveillance of the patient........................................................Cite this article as:Sharma M, Ahmed S, Sharma J, Kataki AC, Sarma A. Coexistent squamous cell carcinoma and tuberculosis in the cervix: a rare case report. Int J Cancer Ther Oncol 2014; 2(3):020314. DOI: 10.14319/ijcto.0203.1

Value of urinary microalbumin test in cancer patients with borderline serum creatinine level

Background: Micralbuminuria (MA) is an early sign of incipient renal damage and cancer patients are at the risk of developing kidney diseases due to the use of nephrtoxic chemotherapeutic agents.Methods: A pilot study of urinary microalbumin on 41 patients with borderline serum creatinine was carried out at regional cancer centre of North-East India during the period from June to August 2014. The patients whose serum creatinine levels were between 1.2 mg/dl to 1.3 mg/dl were considered as borderline for the present study. The assays were performed with a dimension Rxl max random access biochemistry analyzer.Results: Out of 41 cases, 22 (53.6%) had MA, M:F = 1.75, 65 years 2 (9.0%) patients were detected with urinary microalbumin. Chi square test showed P = 0.695 (Fisher’s exact P value).  Conclusion: Testing of urinary microalbumin can be done in cancer patients with borderline serum creatinine level in order to identify patients at risk of developing kidney disease.

Rosai-Dorfman disease in a child with involvement of extra-nodal wrist joint

Rosai-Dorfman Disease (RDD) is a benign condition primarily affecting the lymph nodes. The term sinus histiocytosis with massive lymphadenopathy was first used. There may be extra-nodal presentation of RDD with or without constitutional symptoms. A 10-year-old boy presented with massive bilateral cervical lymphadenopathy which mimicked the diagnosis of lymphoma. We describe here a case of RDD in a child with extra-nodal bone involvement of the wrist joint, its diagnosis by histopathological examination supported by immunohistochemistry and consequent initial management