Comparison of Aesthetic and Functional Outcomes of Microvascular Reconstruction with Other Forms of Reconstruction in Oral Cavity Malignancies

BACKGROUND Surgical resection is the main stay treatment in oral cancer. Different techniques were used by the surgeons for reconstruction of the normal anatomy. With these, a study was conducted to evaluate the outcome and quality of life in terms of conventional forms of reconstruction and functional outcome in both genders for oral cavity reconstruction. METHODS It was a hospital based non randomized study, conducted in the department of surgical oncology, Vydehi Institute of Medical Sciences and research centre, Bangalore from January 2017 to June 2018. Individuals aged 20 – 70 years with confirmed oral carcinoma were included; poor vascular supply of donor area, distant metastasis proved by chest X ray or abdominal ultrasound were excluded. Pre-structured proforma was used to collect the baseline data. ANOVA tests were used. P <0.05 was considered statistically significant. RESULTS Majority (27.7 %) were in the age group 51 to 60 years and the male to female ratio was 0.56. Statistically, there was no significant association between gender and type of flaps. 60 % had carcinoma of left buccal mucosa and 40 % had right side carcinoma, statistically there was no significant difference. The mean number of nodes was 20.85 ± 9.52. Statistically, there was no significant association between type of flaps and number of lymph nodes. CONCLUSIONS PMMC flap reconstruction is reliable and an affordable procedure with high success rate in achieving treatment goals. However, studies on large sample size for long term is required. KEYWORDS Oral Carcinoma, Microvascular Techniques, Local Flaps, Regional Flaps

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Palonosetron for the prevention of chemotherapy induced nausea and vomiting: a comparative study in a tertiary care hospital from India

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20194216 ◽

2019 ◽

Vol 8 (10) ◽

pp. 2197

Author(s):

Shubhatara Swamy ◽

Vijaya Rajendran ◽

Durga Prasan ◽

Pratibha Nadig

Keyword(s):

Tertiary Care ◽

Nausea And Vomiting ◽

Research Centre ◽

Care Hospital ◽

Serious Adverse Events ◽

Female Ratio ◽

First Line Therapy ◽

Significant Difference ◽

Group A ◽

Group B

Background: Despite advances in symptom management, chemotherapy-induced nausea and vomiting (CINV) remains one of the most dreadful consequences of cancer therapy.Methods: The study was carried out at Medical Oncology Department, Vydehi Institute of Medical Sciences and Research Centre, Bangalore. Hundred and forty-four cancer patients of either sex, aged 18-65 years with adequate blood counts requiring moderately emetogenic chemotherapy (MEC) as per Hesketh classification were included. The patients were prospectively divided into two groups before the initial cycle of chemotherapy. Patients in Group A (n=71) received ondansetron, and dexamethasone along with aprepitant capsules, Whereas, Group B (n=73) received palonosetron, and dexamethasone along with placebo capsules, 30 minutes before chemotherapy. Thereafter the patients were administered with the drugs and observed for nausea and vomiting. The efficiency of both regimens was assessed by adopting validated functional living index emesis (FLIE) questionnaire. Analysis of the data was done using the SPSS 21.0 software.Results: The mean age of the patients was 40.5 years and the male to female ratio was 1:2.4. In all the patients, no changes were detected in the ECG readings after MEC. The nausea and vomiting score were comparable in both groups. No significant difference (p>0.05) was noticed between group A and group B in both mm and in FLIE points. No serious adverse events were found relating to antiemetic treatment.Conclusions: Palonosetron in combination with corticosteroids was non inferior to ondansetron in combination with aprepitant and corticosteroids in controlling acute and delayed stages of CINV in patients requiring MEC. Thus, it can be recommended as first-line therapy for patients treated with MEC.

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A comparative study of the effect of piroxicam versus diclofenac on wound healing in clean abdominal wounds

International Surgery Journal ◽

10.18203/2349-2902.isj20180827 ◽

2018 ◽

Vol 5 (3) ◽

pp. 1041 ◽

Cited By ~ 2

Author(s):

Chandrashekar Reddy J. Madinur ◽

Prashant Tubachi ◽

A. S. Godhi ◽

A. S. Godhi

Keyword(s):

Wound Healing ◽

Controlled Trial ◽

Research Centre ◽

Female Ratio ◽

Factors Affecting ◽

Significant Difference ◽

Group A ◽

One Year ◽

Group B ◽

The Individual

Background: The primary function of the skin is to serve as a protective barrier against the environment. The process of wound healing constitutes an array of interrelated and concomitant events. Understanding these processes and various factors affecting these processes continue to expand. The present study was undertaken to compare and evaluate the effect of piroxicam versus diclofenac on wound healing in clean abdominal wounds.Methods: The present one year randomized controlled trial was conducted on all the patients undergoing appendicectomies for uncomplicated appendicitis and uncomplicated inguinal hernia repairs in the Department of Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum during the period of one year. Based on the thumb rule a total of 60 patients divided into two groups of 30 each were studied. Based on the computer-generated randomization patients were allocated to two groups that is group A (Inj. Piroxicam) and Group B (Inj. Diclofenac).Results: In the present study, males outnumbered females with male to female ratio between of 1.72 to 2:1. The mean age in group A was30.9±7.86 years and in group B it was 30.3±7.97 years. Both the groups that is Group A and B were graded under grade I (Good wound healing) from the POD 3 onwards. Overall the individual score and total scores had no influence of the final grading (outcome) of the wound.Conclusions: Overall, better results were seen on wound healing in patients who received Inj piroxicam with significantly less post-operative redness and edema. However, this did not have significant difference in the final outcome of the grading of the wound.

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Clinicopathological study of oral Carcinoma

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v20i1.22012 ◽

2015 ◽

Vol 20 (1) ◽

pp. 15-19

Author(s):

Md Aktar Kamal ◽

Md Yousuf ◽

Md Yusuf Haider ◽

Kamrul Hasan Tarafder

Keyword(s):

Oral Cavity ◽

Buccal Mucosa ◽

Malignant Tumour ◽

Neck Surgery ◽

Cross Sectional Study ◽

Oral Carcinoma ◽

College Hospital ◽

Cross Sectional ◽

Surgical Specimen ◽

Female Ratio

Background: Oral carcinoma is the 6th most common carcinoma worldwide. The 5 year survival rate for oral carcinoma is only 50%. Patients of oral carcinoma are at high risk from secondary neoplasm. Over 90% of all primary malignant tumour of the oral cavity is squamous cell carcinoma. Aim: To find out the difference of clinical presentation and pathological aspects of oral cancer. Methods: In this cross sectional study 30 patients with carcinoma oral cavity from the department of otolaryngology and Head neck surgery, Bangabandhu Sheik Mujib medical University, Dhaka Medical College hospital and National Institute of cancer research & hospital, Mohakhali, Dhaka were included , period from march 2009 to September 2009. The patients were examined after admission into Hospital pre-operatively and in the post-operative period. The surgical specimen were sent for Histopathology. Results: Majority of the patients were at 6th decade where female outnumbered the male with male female ratio is 5:4. Out of 30 patients majority of the patients complains of soreness/ irritation and ulceration in the oral cavity followed by difficulty in mastication, foul breath, pain in the lesion, dysphagia, spitting of blood and excessive salivation. About the site of the lesion maximum patients having the lesion in buccal mucosa(30%) then anterior 2/3rd of tongue (23.33%), retromolar area (13.33%) in decreasing frequency. Conclusion: Oral carcinoma usually a disease of middle age and elderly people. Irritation or soreness is the commonest symptom. Most affected sites are buccal mucosa and anterior 2/ 3rd of tongue. DOI: http://dx.doi.org/10.3329/bjo.v20i1.22012 Bangladesh J Otorhinolaryngol; April 2014; 20(1): 15-19

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Female Versus Male Oral Cavity Cancer: is There a Difference?

10.21203/rs.3.rs-53503/v1 ◽

2020 ◽

Author(s):

Yi-Chieh Lee ◽

Huei-Tzu Chien ◽

Chi-Kuang Young ◽

Shy-Chyi Chin ◽

Andrea Iandelli ◽

...

Keyword(s):

Risk Factors ◽

Oral Cancer ◽

Oral Cavity ◽

Treatment Outcomes ◽

Tongue Cancer ◽

Female Group ◽

Female Ratio ◽

Female Patients ◽

Significant Difference ◽

Male Patients

Abstract Objectives: Oral cavity squamous cell carcinoma (OSCC) is a leading cause of death in Taiwan, and most of the patients are male. Little is known about the differences in risk factors, cancer characteristics and treatment outcomes in female patients. The study aim is to investigate the clinicopathological and outcome differences between gender in patients affected by oral cancer in Taiwan.Methods: This is a retrospective study based on data obtained between 1995 and 2019. A total of 2,046 patients were recruited for analysis. Cancer characteristics, risk factors and treatment outcomes in patients with oral cancer between genders were collected. Results: Female patients represented the 6.7% of the entire cohort of study. Females were diagnosed at an older age and at an earlier local stage compared to male patients (p < 0.001). The female patients were less exposed to cigarette, alcohol, and betel-nut (BQ) (all p-values < 0.001). Tongue (55.1%) was the most frequent subsite involved in the female group, while buccal (38.4%) and tongue (35.3%) were more likely (p < 0.001) to be associated with male gender. In tongue cancer subgroup, female patients presented less frequently extra-nodal extension compared with male patients (p = 0.040). During the follow-up period, there was no significant difference in recurrence and overall deaths between genders.Conclusion:In Taiwan, the male to female ratio in OSCC is 14:1. The tumor subsite distribution, environment exposure and stage distribution are different between females and male. There are no differences in term of survival between female and male OSCC patients.

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Laser Versus Pneumatic Lithotripsy With Semi-Rigid Ureteroscope; A Comparative Randomized Study

Journal of lasers in medical sciences ◽

10.15171/jlms.2019.29 ◽

2019 ◽

Vol 10 (3) ◽

pp. 185-188

Author(s):

Seyed Mohammadreza Rabani ◽

Seyedhossein Rabani ◽

Najmeh Rashidi

Keyword(s):

Randomized Study ◽

Laser Lithotripsy ◽

Ureteral Stones ◽

Female Ratio ◽

Pneumatic Lithotripsy ◽

Extracorporeal Shock Wave ◽

Academic Center ◽

Significant Difference ◽

Group 2 ◽

Group 1

Introduction: Ureteral stones are among the most common disorders in the urologic field. Miniaturization of endoscopic devices in urology and extracorporeal shock wave lithotripsy (ESWL) has revolutionized the management of ureteral stones. The aim of this study was to compare the efficacy and results of laser versus pneumatic lithotripsy (PL) with semi-rigid ureteroscope in a randomized prospective clinical trial in removing stones. Methods: 117 adult patients underwent transurethral lithotripsy (TUL) in a single academic center and by a single surgeon. The patients were randomized in 2 groups: In group 1, 58 patients with ureteral stones underwent ureteroscopy and stone fragmentation was done by Ho: YAG laser lithotripsy (LL) and in group 2, 59 patients underwent PL (Swiss LithoClast) by using the same ureteroscope. Results: Mean age was 41.77 years and 41.1years in group one and 2 respectively (P=0.79), there was no significant difference in male to female ratio and mean stone in both groups. The success rate for stone clearance was 79.31% and 77.96% in group 1 and 2 respectively (P=0.52). No difference between complications was seen in both groups, but the duration of operations was different (significantly lower in group 2). Conclusion: In both techniques, acceptable results were achieved. We have found a significant statistical difference in duration of operation between our results (P=0.001) and similar studies, while this was shorter in the pneumatic group in our study, it was longer in other similar ones. This might be a result of more experience in working with PL in our center.

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Effects of Neoadjuvant Chemio-Radiation Therapy on the Anal Sphincter Function in Patients with Low Rectal Cancers

Creative Surgery and Oncology ◽

10.24060/2076-3093-2020-10-3-190-197 ◽

2020 ◽

Vol 10 (3) ◽

pp. 190-197

Author(s):

A. B. Baichorov ◽

A. O. Rasulov

Keyword(s):

Anal Sphincter ◽

Neoadjuvant Chemoradiotherapy ◽

Functional Results ◽

Neoadjuvant Chemoradiation ◽

Chemoradiation Therapy ◽

Preoperative Treatment ◽

Neoadjuvant Chemoradiation Therapy ◽

Reconstruction Methods ◽

Anterior Rectal Resection ◽

Significant Difference

The aim of the study was to compare functional results prior to and following neoadjuvant chemoradiation therapy.Materials and methods. An analysis of the functional results of a prospective clinical study was carried out. The study included 90 patients who underwent low anterior rectal resection for cancer of the lower or middle ampullar rectum with T1-4aN0-2M0 using various reconstruction methods.Results and discussion. Group A included 22 patients with J-shaped reservoirs; group B — 30 patients with side-to-end anastomoses; group C — 38 patients with end-to-end anastomoses. Out of the total study group (n = 90), 43 patients underwent neoadjuvant chemoradiotherapy vs. 47 patients without any preoperative treatment. No statistically significant difference was observed in the frequency of applied reconstructive techniques (р = 0.725) and the incidence of postoperative complications (p = 0.103) in the groups with and without neoadjuvant chemoradiotherapy. The baseline scores of the Wexner scale and the results of anorectal manometry in the comparison groups were comparable (p > 0.05). However, upon completion of neoadjuvant chemoradiotherapy and during the period from the moment of surgery up to 12 months after the closure of preventive intestinal stomas, the functional results were less satisfactory in the group of patients having received neoadjuvant chemoradiotherapy (n = 43) with regard to the comparison group (n = 47). Nevertheless, a statistically significant difference in the results was observed from the end of neoadjuvant chemoradiotherapy up to 3 months after closure of the stoma (p <0.05).Conclusions. Neoadjuvant chemoradiation therapy has a negative effect on the function of the anal sphincter, thus requiring concomitant therapy and physiotherapy both at the stages of neoadjuvant chemoradiotherapy and at long intervals after the main surgical stage.

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EVALUATION OF CLINICAL AND PARACLINICAL FEATURES IN PATIENTS WITH CARCINOMA OF ORAL CAVITY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.5.9 ◽

2016 ◽

pp. 56-60

Author(s):

Van Minh Nguyen ◽

Hong Loi Nguyen ◽

Thi Kim Anh Dang

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Oral Cavity ◽

Tumor Size ◽

Regional Lymph Node ◽

Regional Lymph Node Metastasis ◽

Female Ratio ◽

Histopathological Grade ◽

Node Metastasis ◽

Metastasis Rate

Background: To evaluate the clinical, hystopathologycal features and correlation between lymph node metastasis and hystopathologycal grade in patients with carcinoma of the oral cavity. Materials and Methods: From July 2015 to July 2016, 32 patients with carcinoma of the oral cavity at Hue Central Hospital Results: The most common age group from 51 to 60 years and the male/female ratio was 1.9/1. Tumor were usually observed around the the tongue (40.6%) and oral floor (34.4%). Most of the tumor size is larger than 2 cm diameters (> 80%). The regional lymph node metastasis rate was 43.8% and there was a positive correlation between lymph node metastasis and tumor size (p <0.05). Squamous-cell carcinoma was mainly type of histopathology. Difference between the rate of lymph node metastasis in patient groups with different histopathological grade show no statistical significance (p> 0.05). Conclusion: the greater tumor, the higher regional lymph node metastasis. There is no relationship between the lymph node metastasis rate and histopathological grade of oral carcinoma. Key words: : carcinoma of oral cavity, tumor size, lymph node metastasis, histopathology

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The tipping point in oral cavity reconstruction: A multi-institutional survey of choice between flap and non-flap reconstruction

Oral Oncology ◽

10.1016/j.oraloncology.2021.105267 ◽

2021 ◽

pp. 105267

Author(s):

Kenneth E. Akakpo ◽

Mark A. Varvares ◽

Jeremy D. Richmon ◽

Caitlin McMullen ◽

Andrew J. Holcomb ◽

...

Keyword(s):

Oral Cavity ◽

Tipping Point ◽

Flap Reconstruction ◽

Oral Cavity Reconstruction

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Intracameral Bevacizumab Versus Sub-Tenon’s Mitomycin C as Adjuncts to Trabeculectomy: 3-Year Results of a Prospective Randomized Study

Journal of Clinical Medicine ◽

10.3390/jcm10102054 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2054

Author(s):

Gerasimos Kopsinis ◽

Dimitrios Tsoukanas ◽

Dimitra Kopsini ◽

Theodoros Filippopoulos

Keyword(s):

Mitomycin C ◽

Primary Outcome ◽

Randomized Study ◽

Primary Outcome Measure ◽

Complication Rates ◽

Filtration Surgery ◽

Significant Difference ◽

Exfoliative Glaucoma

Conjunctival wound healing determines success after filtration surgery and the quest for better antifibrotic agents remains active. This study compares intracameral bevacizumab to sub-Tenon’s mitomycin C (MMC) in trabeculectomy. Primary open-angle or exfoliative glaucoma patients were randomized to either bevacizumab (n = 50 eyes) or MMC (n = 50 eyes). The primary outcome measure was complete success, defined as Intraocular Pressure (IOP) > 5 mmHg and ≤ 21 mmHg with a minimum 20% reduction from baseline without medications. Average IOP and glaucoma medications decreased significantly in both groups at all follow-up points compared to baseline (p < 0.001), without significant difference between groups at 3 years (IOP: bevacizumab group from 29 ± 9.4 to 15 ± 3.4 mmHg, MMC group from 28.3 ± 8.7 to 15.4 ± 3.8 mmHg, p = 0.60; Medications: bevacizumab group from 3.5 ± 0.9 to 0.5 ± 1, MMC group from 3.6 ± 0.7 to 0.6 ± 1.1, p = 0.70). Complete success, although similar between groups at 3 years (66% vs. 64%), was significantly higher for bevacizumab at months 6 and 12 (96% vs. 82%, p = 0.03; 88% vs. 72%, p = 0.04, respectively) with fewer patients requiring medications at months 6, 9 and 12 (4% vs. 18%, p = 0.03; 6% vs. 20%, p = 0.04; 8% vs. 24%, p = 0.03, respectively). Complication rates were similar between groups. In conclusion, intracameral bevacizumab appears to provide similar long-term efficacy and safety results as sub-Tenon’s MMC after trabeculectomy.

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The effect of clamped and unclamped umbilical cord samples on blood gas analysis

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-021-06076-w ◽

2021 ◽

Author(s):

Elisabetta Colciago ◽

Simona Fumagalli ◽

Elena Ciarmoli ◽

Laura Antolini ◽

Antonella Nespoli ◽

...

Keyword(s):

Blood Gas Analysis ◽

Cross Sectional Study ◽

Gas Analysis ◽

Blood Collection ◽

Large Sample Size ◽

Blood Gas ◽

Delayed Cord Clamping ◽

Cross Sectional ◽

High Risk Women ◽

Significant Difference

Abstract Purpose Delayed cord clamping for at least 60 s is recommended to improve neonatal outcomes. The aim of this study is to evaluate whether there are differences in cord BGA between samples collected after double clamping the cord or without clamping the cord, when blood collection occurs within 60 s from birth in both groups. Methods A cross-sectional study was carried out, collecting data from 6884 high-risk women who were divided into two groups based on the method of cord sampling (clamped vs unclamped). Results There were significant decrease in pH and BE values into unclamped group compared with the clamped group. This difference remained significant when considering pathological blood gas analysis parameters, with a higher percentage of pathological pH or BE values in the unclamped group. Conclusion Samples from the unclamped cord alter the acid–base parameters compared to collection from the clamped cord; however, this difference does not appear to be of clinical relevance. Findings could be due to the large sample size, which allowed to achieve a high power and to investigate very small numerical changes between groups, leading to a statistically significant difference in pH and BE between samples even when we could not appreciate any clinical relevant difference of pH or BE between groups. When blood gas analysis is indicated, the priority should be given to the timing of blood collection to allow reliable results, to assess newborns status at birth and intervene when needed.

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