Correlation of Bony Invasion With Nodal Metastasis, Pattern of Invasion and Survival in Oral Squamous Cell Carcinoma: A Retrospective Analysis of 122 Primary Cases From Oral Cancer Centre of South India

Oral squamous cell carcinoma (OSCC) is considered to be the most common epithelial malignant neoplasm of the oral cavity. Despite advancements in diagnosis and therapeutics the clinical outcome of the disease has not improved much which may be attributed to tumor biology and heterogeneity. Bone invasion by cancer cells is currently staged as a moderately advanced disease. However, many low-grade carcinomas such as verrucous carcinoma and carcinoma cuniculatum show body invasion but less nodal metastases and better overall survival. The present study was orchestrated to analyze if bone invasion in OSCC has any impact on regional nodal metastases and survival

Correlation between Vascularity and Advancing Histological Grades of Oral Submucous Fibrosis with a Plausible Role in Malignisation: Systematic review of a persisting matter of conflict

Objectives: Recent studies showed that as the stage advances there is no significant change in the vascularity as opposed to the conventional concept, thus, the present was designed to quantify the vascularity in histological grades of OSMF and to assess if there is any connection between vasculogenesis and malignisation. Methods: A comprehensive database search was done for published articles on vascularity in oral submucous fibrosis following PRISMA guidelines without date constrains; the search was done till December 2022. The review was registered in Prospero. After screening 607 articles, a total of 13 studies were finally included for systematic evaluation. Results: A total of 607 cases were included, with a definite predilection for the male gender. 11/13 studies evaluated mean vascular density; in more than half, the vascularity decreased as the stage advanced. Similar results were obtained for endothelial cells /square μm, mean vascular area percentage & mean vascular area. Conclusion: The present review supports the prevailing concept that vascularity decreases with advancement of the stage of OSMF, denying systemic absorption of carcinogens into the circulation with resultant longer exposure of compromised epithelium and malignisation. Keywords: Malignisation; Mean Vascular Density; Oral Submucous Fibrosis; OSMF; Vascularity

Development of Decadal (1985–1995–2005) Land Use and Land Cover Database for India

India has experienced significant Land-Use and Land-Cover Change (LULCC) over the past few decades. In this context, careful observation and mapping of LULCC using satellite data of high to medium spatial resolution is crucial for understanding the long-term usage patterns of natural resources and facilitating sustainable management to plan, monitor and evaluate development. The present study utilizes the satellite images to generate national level LULC maps at decadal intervals for 1985, 1995 and 2005 using onscreen visual interpretation techniques with minimum mapping unit of 2.5 hectares. These maps follow the classification scheme of the International Geosphere Biosphere Programme (IGBP) to ensure compatibility with other global/regional LULC datasets for comparison and integration. Our LULC maps with more than 90% overall accuracy highlight the changes prominent at regional level, i.e., loss of forest cover in central and northeast India, increase of cropland area in Western India, growth of peri-urban area, and relative increase in plantations. We also found spatial correlation between the cropping area and precipitation, which in turn confirms the monsoon dependent agriculture system in the country. On comparison with the existing global LULC products (GlobCover and MODIS), it can be concluded that our dataset has captured the maximum cumulative patch diversity frequency indicating the detailed representation that can be attributed to the on-screen visual interpretation technique. Comparisons with global LULC products (GlobCover and MODIS) show that our dataset captures maximum landscape diversity, which is partly attributable to the on-screen visual interpretation techniques. We advocate the utility of this database for national and regional studies on land dynamics and climate change research. The database would be updated to 2015 as a continuing effort of this study

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically