Prognostic value of lymph node ratio in surgically treated cases of vulvar cancer: a tertiary care centre experience

( Pabashi Poddar ),( Shilpa Patel ),( Ruchi Arora ),( Chetana Parekh ),( Pariseema Dave ),( Sangeetha Amin ) 대한산부인과학회 2020 Obstetrics & Gynecology Science Vol.63 No.2

Objective This study aimed to study the patterns of recurrence in surgically treated cases of vulvar cancer (VC) and determine the factors associated with recurrence, with a special emphasis on lymph node ratio (LNR). Methods This retrospective study examined VC patients primarily treated with surgery at our institute from January 2005 to December 2015. Demographic data, clinical characteristics, surgicohistopathological data, adjuvant treatment, follow up, and recurrence site and treatment were studied. Results Among the 111 cases treated, a recurrence rate of 18.9% was noted. Recurrence was most commonly local (61.9%). On univariate and multivariable analyses of clinicopathological parameters, an LNR >20 had the highest hazard ratio for recurrence. Conclusion LNR may provide useful prognostic information in VC patients with positive inguinal lymph node status.

Study of neoadjuvant chemotherapy in advanced malignant ovarian germ cell tumors at a tertiary center in western India

Abhilash Vasanth,Shilpa M Patel,Ruchi Arora,Chetana D Parekh,Pariseema Dave,Bijal M Patel,Priyanka Vemanamandhi 대한부인종양학회 2024 Journal of Gynecologic Oncology Vol.35 No.2

Objective: To study clinical characters and outcomes in patients of malignant ovarian germcell tumor (MOGCT) undergoing surger y following neoadjuvant chemotherapy (NACT). Methods: Retrospective study of patients undergoing surger y following NACT for MOGCT atour institute. Platinum based chemotherapy was given in all patients in NACT. Results: Between March 2013 and Februar y 2023, 30 patients had surger y after NACT. Patient’s median age was 22 years (range, 12 to 35 years) and median follow up 42months(range, 6 to 132 months). Majority had endodermal sinus tumor (n=12), dysgerminoma (n=9)and mixed GCT (n=7). All had either International Federation of Gynecology and Obstetrics(FIGO) stage 3 (n=19) or FIGO stage 4 disease (n=11). Complete response to NACT seen in5 patients and 23 patients had partial response. Fertility sparing surger y in 18 patients andcomplete surger y in 12 patients. Suboptimal surger y was seen in 4 patients. Currently, 20of 30 patients are alive and disease free, 3 lost for follow up and 7 patients had progressionafter adjuvant therapy. Five patients had mortality—4 with progression and 1 with bleomycintoxicity. Fifteen of 17 eligible patients have resumed menstruation and one had successfulpregnancy. Prognostic factors noted in study are stage, optimal surger y and viable tumor inhistopathology. Dysgerminoma had better outcome than other histology. Conclusion: NACT may be a reasonable option in patients with extensive unresectable diseaseor in whom fertility sparing is not possible or in the poor general condition. Fertility sparingsurger y can be attempted post neoadjuvant chemotherapy without adversely affecting prognosis.

Adenosine Deaminase - a Novel Diagnostic and Prognostic Biomarker for Oral Squamous Cell Carcinoma

Kelgandre, Deepak Chandrakant,Pathak, Jigna,Patel, Shilpa,Ingale, Pramod,Swain, Niharika Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.4

Background: The number of patients with oral cancer in India is increasing gradually (especially in younger people). Although the diagnostic modalities and therapeutic management of oral cancer are improving, the treatment outcome and prognosis of oral cancer remain poor. The absence of definite early warning symptoms for most head and neck cancers suggests that sensitive and specific biomarkers are likely to be important in screening for high-risk patients. Aims: To analyze serum adenosine deaminase (ADA) levels in oral squamous cell carcinoma (OSCC) cases who reported to our institute. Materials and Methods: A prospective study was performed on 100 histopathologically proven cases of OSCC (study group) and 100 normal healthy individuals (control group). Independent sample and one sample t-tests and one way ANOVA followed by Tuckey's POST HOC test were conducted for analysis. Results: Statistically significant increase in serum ADA levels was observed in OSCC cases compared to the control group. Also serum ADA level increased significantly with the histopathological grade. Conclusions: Serum ADA levels in OSCC may be a useful diagnostic and prognostic biomarkers in clinical practice and our findings suggest that a large-scale study is warranted to confirm clinical utility as a prognostic and diagnostic biomarker.

Effect of Dental Practicality Index training using an online video on decision-making and confidence level in treatment planning by dental undergraduates

See Zhai Wei,Lee Ming Sern,Parolia Abhishek,Kanagasingam Shalini,Gunjal Shilpa,Patel Shanon 대한치과보존학회 2024 Restorative Dentistry & Endodontics Vol.49 No.1

Objectives The purpose of this study was to evaluate the effect of Dental Practicality Index (DPI) training using an online video on the treatment planning decisions and confidence level of dental undergraduates (DUs). Materials and Methods Ninety-four DUs were shown 15 clinical case scenarios and asked to decide on treatment plans based on 4 treatment options. The most appropriate treatment plan had been decided by a consensus panel of experienced dentists. DUs then underwent DPI training using an online video. In a post-DPI-training test, DUs were shown the same clinical case scenarios and asked to assign the best treatment option. After 6 weeks, DUs were retested to assess their knowledge retention. In all 3 tests, DUs completed the confidence level scale questionnaire. Data were analyzed using the related-samples Wilcoxon signed rank test and the independent-samples Mann-Whitney U test with the level of significance set at p < 0.05. Results DPI training significantly improved the mean scores of the DUs from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training. Conclusions Training DUs using DPI with an online video improved their decision-making and confidence level in treatment planning. Objectives The purpose of this study was to evaluate the effect of Dental Practicality Index (DPI) training using an online video on the treatment planning decisions and confidence level of dental undergraduates (DUs). Materials and Methods Ninety-four DUs were shown 15 clinical case scenarios and asked to decide on treatment plans based on 4 treatment options. The most appropriate treatment plan had been decided by a consensus panel of experienced dentists. DUs then underwent DPI training using an online video. In a post-DPI-training test, DUs were shown the same clinical case scenarios and asked to assign the best treatment option. After 6 weeks, DUs were retested to assess their knowledge retention. In all 3 tests, DUs completed the confidence level scale questionnaire. Data were analyzed using the related-samples Wilcoxon signed rank test and the independent-samples Mann-Whitney U test with the level of significance set at p < 0.05. Results DPI training significantly improved the mean scores of the DUs from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training. Conclusions Training DUs using DPI with an online video improved their decision-making and confidence level in treatment planning.

Impact of Universal Suicide Risk Screening in a Pediatric Emergency Department: A Discrete Event Simulation Approach

Kenneth W. McKinley,Kelly N. Z. Rickard,Finza Latif,Theresa Wavra,Julie Berg,Sephora Morrison,James M. Chamberlain,Shilpa J. Patel 대한의료정보학회 2022 Healthcare Informatics Research Vol.28 No.1

Objectives: The aim of this study was to use discrete event simulation (DES) to model the impact of two universal suiciderisk screening scenarios (emergency department [ED] and hospital-wide) on mean length of stay (LOS), wait times, andoverflow of our secure patient care unit for patients being evaluated for a behavioral health complaint (BHC) in the ED of alarge, academic children’s hospital. Methods: We developed a conceptual model of BHC patient flow through the ED, incorporatinganticipated system changes with both universal suicide risk screening scenarios. Retrospective site-specific patienttracking data from 2017 were used to generate model parameters and validate model output metrics with a random 50/50split for derivation and validation data. Results: The model predicted small increases (less than 1 hour) in LOS and waittimes for our BHC patients in both universal screening scenarios. However, the days per year in which the ED experiencedsecure unit overflow increased (existing system: 52.9 days; 95% CI, 51.5–54.3 days; ED: 94.4 days; 95% CI, 92.6–96.2 days;and hospital-wide: 276.9 days; 95% CI, 274.8–279.0 days). Conclusions: The DES model predicted that implementation of eitheruniversal suicide risk screening scenario would not severely impact LOS or wait times for BHC patients in our ED. However,universal screening would greatly stress our existing ED capacity to care for BHC patients in secure, dedicated patientareas by creating more overflow.