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Simhachalam Naidu, C. H.
- Efficacy of Computerized Tomography (CT) in Identification of Clinically Un-detectable Lymph Nodes in Patients with Oral Squamous Cell Carcinoma - an Observational Study
Authors
1 A.V. Super Specialty Dental Hospital, Near Amberpet Masjid, Amberpet, Hyderabad, Andhra Pradesh, IN
Source
Indian Journal of Public Health Research & Development, Vol 3, No 3 (2012), Pagination: 110-114Abstract
Background: The most common malignant tumour of head and neck region is Oral squamous cell carcinoma and is the third most common malignancy in India. The most common mode of metastasis is through the cervical lymph nodes. Detection of tumours is mostly done clinically by direct visual examination. The complexity in predicting the presence of metastatic disease in clinically negative necks has lead to wide spread use of elective neck dissection. This present study is intended to evaluate the status of clinically not detectable lymph nodes using.
Computerized Tomography: (CT) which might help in determining the prognosis and treatment plan and also to compare the accuracy between the clinical examination and CT.
Methods: Forty patients who have been histopathologically diagnosed as Oral squamous cell carcinoma were included in the study The patients were subjected to clinical as well as CT examination. The findings of both examinations were correlated with pathological findings from the neck dissection.
Results: Number of True positives detected by clinical examination (CE) versus CT is 7 and 13 respectively (p=0.17). Number of True negatives detected by CE versus CT is 18 and 18 respectively (p=1). Number of False positives detected by CE versus CT is 5 and 5 respectively (p=1). Number of False negatives detected by CE versus CT is 10 and 4 respectively (p=0.1).Sensitivity for CE versus CT is 41.1% and 68.4% respectively (p=0). Specificity for CE versus CT is 78.2% and 78.2% respectively (p=1). Positive Predictive Value for CE versus CT is 58.3% and 72.2% respectively (p=0.001). Negative Predictive Value for CE versus CT is 64.2% and 75% respectively (p=0.001). Accuracy of CE versus CT is 62.5% and 77.5% respectively (p=0.001).
Conclusion: The present result indicates that CT is an important image tool for detection of clinically occult lymph nodes of head and neck in patients with oral squamous cell carcinoma and statistically significant over the clinical examination regarding the sensitivity, true predictive value, false predictive value and over all accuracy.
Keywords
CT, Cervical Lymphnodes, Oral Squamous Cell Carcinoma, Clinical Examination
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- Comprehensive Knowledge on Dental Management of HIV/AIDS: a Survey on Private Sector Oral Health Care Providers in Andhra Pradesh
Authors
1 Association for Rural and Urban Needy (ARUN) Plot # 37-112/4; Sri Colony; Neredmet X Road; R.K.Puram; Secunderabad-500056 Andhra Pradesh, IN
2 Eco Foundation for Research and Training (EFFORT) 2-56/4; Pakabanda Bazar; Khammam; Andhra Pradesh, IN
3 Narayana Super Specialty Dental Hospital Opposite Little Chums School; Sahara Road; Mansoorabad; L.B.Nagar; Hyderabad-68 Andhra Pradesh, IN
4 A.V. Super Specialty Dental Hospital Near Amberpet Masjid; Amberpet; Hyderabad; Andhra Pradesh, IN
Source
Indian Journal of Public Health Research & Development, Vol 3, No 3 (2012), Pagination: 115-119Abstract
Background: In India capacity building and training in HIV/AIDS has been focused on doctors, nurses, and counsellors. Oral healthcare providers namely, dentists, dental assistants and nursing assistants have been marginalized. Dentists form the first source of healthcare contact to many HIV/ AIDS patients for complaints of oral lesions, with absolutely no knowledge of their patients HIV status. As there is a lack of data on oral health care providers and HIV /AIDS in India, ARUN took the initiative to address this issue and collect data that can prove invaluable in designing future programs and policies.
Methodology: The sampling technique used for the assessment is simple random sampling. The survey was carried out in dental colleges and private clinics and trust hospitals both in the rural and urban settings. A total of 75 dental health care providers from 5 dental colleges and 12 private clinics participated in the survey. The tool was a self administered questionnaire. MS Excel was used for recording the findings. Data analysis was done using SPSS software.
Results: None of the oral health care providers are referring the patients to HIV testing centres in government hospitals.67% are referring the patients for HIV testing to labs in private sector.32% of the dentists are referring patients for HIV testing based on the clinical manifestations, 23% as a routine, 8% based on risk behaviour, and 37% of dentists are not at all referring for HIV testing. Only 20% oral health care providers were aware of oral manifestations of HIV/AIDS, 56% of them are not sterilizing the instruments after each use, 61% of them are disinfecting the impressions before sending to the dental laboratory, only 61% dentists are following Universal safety precautions, 94% are not aware of PEP.
Conclusion: Approximately 10776 patients seeking oral health care in 20 private dental colleges and hospitals can be presented with potential HIV infection and approximately 2000 dentists need to be trained every year. Involving dentists would help in early detection and reducing the HIV epidemic.
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