Background: Oral cancer accounts for 30% of all types of cancer in India. Surgery is the mainstay of treatment but due to the recent outbreak of COVID-19, there is a partial or complete disruption of health services in the country. The initial delay in the treatment was due to cancellations of planned surgeries as per government regulations and reduction in public transportation. In the latter half of the initial relaxation of the lockdown, we formulated our institutional protocol for the surgical treatment of oral cancer patients. On admission, all patients were kept in isolated wards followed by RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction) testing on the same day. RT-PCR negative patients are subjected to HRCT Thorax (High-resolution Computer Tomography). This ensured the safety of health care workers, patients, and patient attendees. Keeping this in mind, we did an observational study on the role of HRCT in the pre-operative screening of asymptomatic oral cancer patients. Materials and methods: Retrospective analysis of prospectively collected data of 150 patients was done. HRCT reporting was done by two experienced senior radiologists of the Department of Radiology at our hospital. Results: The number of patients under the CO-RADS 1 category was 121 and CO-RADS 2 category was 29, according to CO-RADS classification. The results of RT-PCR and HRCT were compared and there was a 100% positive correlation between RT-PCR and HRCT Thorax. Conclusion: Our study supported the use of HRCT Thorax as a diagnostic tool in pre-operative screening of oral cancer patients for COVID 19, particularly in RT-PCR negative cases.
One of India's biggest challenges is to improve its global standing by increasing healthcare access and outcomes for children with cancer, with inferior overall survivorship compared with its Western counterparts. In conjunction with the government's efforts, private enterprise is crucial in delivering optimal cancer care consistently to its vast and diverse pediatric population, despite existing limitations. This article describes the successful implementation of a value-based, collaborative clinical and research framework by a philanthropic foundation in a rural Northern Indian city to establish and run a local childhood cancer service. It is proof of concept that substantial change could be brought about at grass roots level through resourceful partnerships and reduce prevailing imbalance in pediatric oncology service provision.
Suspected growth in the region of base of tongue, pharynx, and larynx need direct/indirect laryngoscopy for establishing Diagnosis and for Staging of the disease. The Covid 19 Pandemic has severely affected these modes of examination because they are Aerosol Generating Procedures and carry very high risk of transmission of the Virus. The Department of Head And Neck Oncosurgery at KCHRC is one of the busiest department at our Institute with an average annual footfall of around 20,000 new patients. The main objective of our study is to know the role of Image Guided Biopsy/FNAC for primary diagnosis in Head and Neck Cancers. Retrospective analysis of prospectively collected data of 35 patients was done from April to September 2020. Histopathological records along with patient’s clinical records were reviewed. Of the 35 patients, 23 patients underwent CT Guided biopsies, 11 patients had CT Guided FNA and one patient had USG guided biopsy. In 23 patients (CT Guided Biopsy), the biopsy was taken from tongue in 16 patients, Larynx in two patient, Pyriform sinus(PFS), posterior pharyngeal wall, RMT (retromolar trigone), lower GBS and Tonsil sites had one patient each. Of the 11 CT Guided FNAC patients, the site of FNA was from PFS in 7 patients, Tongue in 2 patients RMT and soft palate had one patient each. One patient had undergone USG Guided biopsy for PFS lesion. Out of 35 patients, tissue specimen taken was adequate in 33 patients and inadequate in two patients. The results were supported both histologically and clinically. The histological confirmation was found in 88.6% cases (31/35), squamous cell carcinoma was found in 74.3% cases (26/35), no malignancy in 8.5% cases(3/35), no specific lesion in 5.7% cases(2/35), no definitive diagnosis in 2.8% cases(1/35) and in inadequate in 8.5% cases(3/35). Repeat biopsy in one patient revealed no malignancy. There were no post procedure complications noted. Image guided biopsy/FNAC is a safe, reliable minimally invasive technique and can be used for primary diagnosis of Head and Neck cancers without the risk of Aerosol generation in the current Covid -19 Pandemic.
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