IntroductionDemographic, behavioural and environmental factors have been associated with increased risk of head and neck cancer (HNC). We will review published reports and explore connections between risk factors and HNC incidence. This protocol aims to provide strategies for a systematic review and meta-analysis of HNC risk factor analysis in India. It also provides guidelines in order to visualise obtained HNC risk factor data in the form of a heat-map highlighting variations across gender, age and geographical location.Methods and analysisWe will identify well-established HNC risk factors and perform a comprehensive systematic review and meta-analysis to quantify each risk factor’s impact on HNC incidence. A systematic search will be performed to identify the studies and published reports of HNC risk factors in India. Meta-analysis will be conducted to estimate the proportional contribution of the most prevalent risk factor in HNC on a city-wide basis in Indian states and territories.Ethics and disseminationThe review protocol draws on publicly available anonymised data without directly involving human participants and therefore requires neither formal human ethical review nor approval by a human research ethics committee. We published an outline of the protocol in the International Prospective Register of Systematic Reviews (PROSPERO) in 2017. The results will provide an updated analysis of HNC risk factor prevalence in India, and we will discuss the applicability of rehabilitation care. We plan to disseminate the findings of this systematic review through publication in a peer-reviewed journal and presentation at relevant conference proceedings.PROSPERO registration numberCRD42017077758.

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Delayed migration of a ductal occluder device into the aorta after transcatheter closure of a patent ductus arteriosus is extremely rare. We present a case of delayed migration of a ductal occluder into the descending aorta 4 months after its deployment in an 11-year-old girl. Successful surgical removal of the device from the descending aorta and triple-ligation of the ductus arteriosus was performed via a left thoracotomy. The patient made an uneventful recovery.