Browsing by Author "Chaturvedi, Pankaj"

Now showing 1 - 8 of 8
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    Consensus guidelines on management of oral potentially malignant disorders
    (Wolters Kluwer - Medknow, 2022-09) Birur, Praveen N; Patrick, Sanjana; Warnakulasuriya, Saman; Gurushanth, Keerthi; Raghavan, Shubhasini A.; Rath, Goura K; Chaturvedi, Pankaj; Chandru, Vijay; Mathew, Babu; Prabhash, Kumar; Gurudath, Shubha; Mukhia, Nirza; Sunny, Sumsum P.; Mehrotra, Ravi; V, Vivek; Patil, Shankargouda; G, Suresh Kumar; Fasalkar, Shruthi; Rao, Pratima; Kuriakose, Moni A
    Oral cancer is usually preceded by oral potentially malignant disorders (OPMDs) and early detection can downstage the disease. The majority of OPMDs are asymptomatic in early stages and can be detected on routine oral examination. Though only a proportion of OPMDs may transform to oral squamous cell carcinoma (OSCC), they may serve as a surrogate clinical lesion to identify individuals at risk of developing OSCC. Currently, there is a scarcity of scientific evidence on specific interventions and management of OPMDs and there is no consensus regarding their management. A consensus meeting with a panel of experts was convened to frame guidelines for clinical practices and recommendations for management strategies for OPMDs. A review of literature from medical databases was conducted to provide the best possible evidence and provide recommendations in management of OPMDs
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    Frozen section is not cost beneficial for the assessment of margins in oral cancer
    (Indian Cancer Society, 2019-01) Datta, Sourav; Mishra, Aseem; Chaturvedi, Pankaj; Bal, Munita; Nair, Deepa; More, Yogesh; Ingole, Pranav; Sawakare, Sandeep; Agarwal, Jai Prakash; Kane, Shubhada V; Joshi, Poonam; Nair, Sudhir; D'Cruz, Anil
    BACKGROUND: Routine use of frozen section (FS) is a costly procedure and sparsely available in resource poor countries. A proper cost benefit analysis may help to reduce its routine use and would empower surgeons to perform oral cancer surgeries without having FS facility. FS is performed to identify microscopic spread beyond gross disease that cannot be assessed clinically. OBJECTIVE: Our primary aim was to determine the cost benefit analysis of FS in the assessment of margins in oral cavity squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Retrospective study of prospectively collected data of 1311 consecutive patients who were operated between January 2012 and October 2013. The gross and microscopic margin status of each patient was extracted from the patient's chart. The cost estimates were performed to calculate the financial burden of FS as well as expenses incurred on adjuvant treatment resulting from inadequate margins. RESULT: Microscopic spread changed the gross margin status in 5.2% (65/1237) patients. Of this entire cohort of 1237 patients, FS helped 29 (2.3%) patients to achieve tumor free margin, and it changed the adjuvant treatment plan in 9 (0.7%) patients. The cost of FS for each patient was INR 11052. The cost-benefit ratio of FS was 12:1. Gross examination alone could have identified majority of the inadequate margins. CONCLUSION: Frozen section for assessment of margin status bears poor cost-benefit ratio. Meticulous gross examination of the entire surgical specimen is sufficient to identify majority of inadequate margins.
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    High-grade adenocarcinoma, (ductal type) arising in unilateral Warthin tumor of the parotid gland.
    (2011-07) Deodhar, Kedar K; Shah, Milap; Chaturvedi, Pankaj
    Warthin tumor is a well-recognized benign salivary gland neoplasm consisting of an epithelial as well as a lymphoid component. Malignant transformation in Warthin tumor is rare and its reported incidence is up to 1%. The more common types of carcinomas described in Warthin tumor are the squamous and mucoepidermoid types, with high-grade adenocarcinoma being extremely rare. A high-grade adenocarcinoma (ductal type) arising in the Warthin tumor in a 72-year-old man is presented for its rarity and diagnostic difficulties.
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    The Human Papillomavirus Enigma: A Narrative Review of Global Variations in Oropharyngeal Cancer Epidemiology and Prognosis
    (Wolters Kluwer – Medknow, 2024-06) Singhavi, Hitesh Rajendra; Chaturvedi, Pankaj; Nair, Deepa
    Oropharyngeal cancers (OPCs) in Asia account for 42% of the global burden and over 50% of related deaths. Human papillomavirus (HPV) is involved in over 70% of OPC cases in the Western hemisphere, but its role in the Eastern hemisphere is unclear. This study reviews OPC epidemiology, including prevalence, etiological factors (such as smokeless tobacco and HPV), and their interaction. Among the SEAR countries, India had the highest incidence of HPV-related OPCs at 38.4%, while data were unavailable for most African countries, with only a 14% incidence reported. Conversely, the American region exhibited one of the highest HPV positivity rates, reaching up to 65% in different states of the USA, while Brazil reported an incidence of up to 38%. In the European Union, the UK had the highest incidence of HPV-associated OPC, reaching up to 52%. In the Western Pacific region, New Zealand demonstrated the highest incidence at up to 78%. Smokeless tobacco consumption was higher in SEAR countries, which had a relatively lower incidence of HPV infection, suggesting a negative correlation between the two. Based on our literature search, the most common detection methods used globally are immunohistochemistry for p16 and polymerized chain reaction. OPCs are a global health concern, and proper identification and classification are vital. HPV-driven cancers have better survival rates, emphasizing the need for focused research on specific problem areas based on the burden of HPV-positive or HPV-negative cancers.
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    Indian needs stricter implementation.....
    (2007-10-07) Chaturvedi, Pankaj
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    Lamins, laminopathies and disease mechanisms: Possible role for proteasomal degradation of key regulatory proteins.
    (2011-08) Parnaik, Veena K; Chaturvedi, Pankaj; Muralikrishna, B h
    Lamins are major structural proteins of the nucleus and are essential for nuclear integrity and organization of nuclear functions. Mutations in the human lamin genes lead to highly degenerative genetic diseases that affect a number of different tissues such as muscle, adipose or neuronal tissues, or cause premature ageing syndromes. New findings on the role of lamins in cellular signalling pathways, as well as in ubiquitin-mediated proteasomal degradation, have given important insights into possible mechanisms of pathogenesis.
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    Prognostic factors in parotid cancers: Clinicopathological and treatment factors influencing outcomes
    (Indian Cancer Society, 2018-01) Chakrabarti, Swagnik; Nair, Deepa; Malik, Akshat; Qayyumi, Burhanuddin; Nair, Sudhir; Agrawal, Jai Prakash; Chaturvedi, Pankaj
    Background: Parotid cancers are uncommon and have a relatively long natural history. Determination of prognostic factors affecting the outcome is difficult. Materials and Methods: The primary objective was to determine the demographic, clinical, histopathology and treatment-related factors affecting overall survival (OS) in parotid cancers. The secondary objective was to study the impact of these factors on disease-free survival (DFS) and patterns of failure. Data of consecutive patients who underwent parotidectomy for primary parotid malignancy between July 2006 and April 2015 with at least 6 months of posttreatment follow-up were retrospectively retrieved. Patients whose follow-up status was known at the time of analysis were included. One hundred and sixty-five patients met the inclusion criteria. Results: The median follow-up was 38 months. The mean OS and DFS were 141.03 and 124.38 months, respectively. Age > 45 years affected both OS and DFS (P = 0.00 and 0.002 respectively) adversely. Advanced T stage affected adversely OS in univariate (P = 0.00) but not in multivariate analysis (P = 0.91) and DFS in both univariate (P = 0.00) and multivariate analysis (P = 0.005). Nodal positivity adversely affected survival adversely in univariate (P = 0.00 for OS and DFS) and multivariate analysis (P = 0.022 for OS and P = 0.001 for DFS). Resection margin of < 5mm affected OS as compared to a margin of ≥5mm (P = 0.03). Conclusions: Nodal positivity is the single most important factor affecting survival in parotid cancers. A histopathological resection margin of at least 5 mm is desirable. Advanced age along with high grade, advanced T and N stages need to be considered for adjuvant treatment.
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    Swallowing in advanced oral cancers: A prospective observational study
    (Wolters Kluwer - Medknow, 2024-01) Malik, Akshat; Sharin, Florida; Balaji, Arun; Mathur, Yash; Nair, Sudhir; Chaturvedi, Pankaj; Nair, Deepa
    Background: Advanced head and neck cancers are known to cause swallowing dysfunction due to anatomical and post?treatment changes. Literature is sparse on post?surgical and/or multi?modality therapy?associated swallowing function in advanced oral cancers. We conducted this study to longitudinally assess and compare the pre? and post?therapy swallowing dysfunction associated with locally advanced oral cancers. Methods and Material: A prospective observational longitudinal study was conducted at a tertiary cancer center from 2017 to 2018 including treatment?naive cT4a oral cancer patients (AJCC 7th edition). The assessment was done pre?surgery, post?surgery, and post?adjuvant setting as per the scales (Dysphagia score, Penetration aspiration scale, and Yale pharyngeal residue (vallecular and pyriform fossa). Results: Of the 30 patients in the study, 47.4%, 47.4%, 52.6%, and 47.4% experienced deterioration of Dysphagia score, Penetration?Aspiration Scale (PAS), vallecula residue, and pyriform residue scores in the postoperative period. And 52.6%, 47.4%, 68.4%, and 57.9% had inferior dysphagia score, PAS, vallecula, and pyriform residue scores even 6 months after completion of adjuvant therapy. The dysphagia score correlated well with other objective assessment scores at different time points. Conclusion: Swallowing functions are significantly affected by surgery and adjuvant therapy and continue to be affected even 6 months after completion of treatment. Appropriate rehabilitation and intervention must be offered to patients to reduce this problem. Dysphagia scores can predict the swallowing status similar to other objective assessments.