Gingivo-buccal oral squamous cell carcinoma (OSCC-GB), an anatomical and clinical subtype of head and neck squamous cell carcinoma (HNSCC), is prevalent in regions where tobacco-chewing is common. Exome sequencing (n=50) and recurrence testing (n=60) reveals that some significantly and frequently altered genes are specific to OSCC-GB (USP9X, MLL4, ARID2, UNC13C and TRPM3), while some others are shared with HNSCC (for example, TP53, FAT1, CASP8, HRAS and NOTCH1). We also find new genes with recurrent amplifications (for example, DROSHA, YAP1) or homozygous deletions (for example, DDX3X) in OSCC-GB. We find a high proportion of C>G transversions among tobacco users with high numbers of mutations. Many pathways that are enriched for genomic alterations are specific to OSCC-GB. Our work reveals molecular subtypes with distinctive mutational profiles such as patients predominantly harbouring mutations in CASP8 with or without mutations in FAT1. Mean duration of disease-free survival is significantly elevated in some molecular subgroups. These findings open new avenues for biological characterization and exploration of therapies.
Relative to their current health, RA patients assigned low preference values to many glucocorticoid adverse events, particularly those associated with chronic fracture outcomes. Results varied with the preference measure used, indicating that methodological attributes of preference determinations must be considered in clinical decision making.
Among the patients undergoing haemodialysis, complication of muscle cramps, commonly occurs in calf muscles, feet, toes and thigh. Stretching exercises are the best measure to reduce or prevent cramps from occurring during haemodialysis among chronic renal failure patients. In this study to evaluate the effectiveness of intra dialytic stretching exercise on pain due to muscle cramps among haemodialysis patient, randomised controlled clinical trial design was adopted; 162 patients, undergoing dialysis at Pradyumna Bal Memorial Hospital, Bhubaneswar were selected by consecutive sampling technique and according to randomisation table, divided into (1) control group (n=81) receiving only standard institutional protocol with 0.9% normal saline, at the onset of muscle cramps, during haemodialysis and (2) experimental group (n=81) receiving passive intradialytic stretching exercises, at the onset of pain, during haemodialysis for 15 minutes, once per sitting and the same was repeated for 3 such sittings. Pre-test pain score and post-test pain score at the end of each sitting, for both the group was recorded. Statistical ndings (independent t-test) revealed that in day 3 post-test mean score of pain due to muscle cramp in experimental group and control group were 1.74 & 4.15 respectively with difference of pre-test and post-test score in experimental group and control group were 7.04 & 4.87 respectively which was found to be statistically signi cant (p<0.05). After intra dialytic stretching exercise, a signi cant level of reduction in pain due to muscle cramps was noticed among patients undergoing haemodialysis. Participants felt comfortable and also expressed high level of satisfaction towards administration of stretching exercise.
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