Quality of life among head and neck cancer treated patients in South India: A cross-sectional study

Oral health related quality of life in head and neck cancer survivors within the first year following treatment: a cross-sectional study in Karachi, Pakistan

After completing treatment for head and neck cancer (HNC), patients often face oral complications like oral pain, limited mouth opening and dry mouth which significantly reduce their oral health related quality of life (OHRQoL). These issues impact their overall well-being, social activities and long-term survival. The primary objective of this study was to evaluate OHRQoL and its association with sociodemographic characteristics, oral hygiene practices and oral clinical parameters such as oral hygiene status and oral mucositis grade in patients who have completed treatment for head and neck cancer. This cross-sectional study involved 79 HNC-treated patients within first year after completion of cancer treatment attending ENT and dental clinics at outpatient department (OPD) setting in Karachi. Data was collected electronically using structured questionnaire comprising of EORTC QLQ H&N - 35 to measure OHRQoL, patients were also examined for oral hygiene status using oral hygiene index- simplified (OHI-s) and oral mucositis grade using WHO oral mucositis scale. Multiple linear regression was used to test OHRQoL associations with the sociodemographic and different clinical factors. The result showed an overall mean score for oral health related quality of life (OHRQoL) of 25.02 ± 15.86 (95% CI 21.46-28.57), with difficulty in mouth opening 53.16 ± 18.88 and dry mouth 45.14 ± 24.48 being predominant concerns for decline in the OHRQoL in the population. Male predilection was observed among participants n = 60 (75.9%), majority of the participants n = 41 (51.9%) were below 52 years of age. n = 63 (80%) participants received radiotherapy alongside surgery and chemotherapy. Most of participants n = 66 (83.5%) experienced moderate to severe oral mucositis with poor oral hygiene status n = 56 (71%). Significant associations were found between OHRQoL and BMI, OH status, marital status, monthly income, gender and fluoride toothpaste (p < 0.05). These findings suggest that Quality of Life (QoL) among HNC treated patients is negatively impacted by their poor oral health, post cancer treatment. Therefore, it is important to evaluate and modify the current treatment modalities and involve multidisciplinary teams, to improve their OHRQoL thereby enhancing overall QoL.

A state-of-art-review on emerging contaminants: Environmental chemistry, health effect, and modern treatment methods

Pollution problems are increasingly becoming e a priority issue from both scientific and technological points of view. The dispersion and frequency of pollutants in the environment are on the rise, leading to the emergence have been increasing, including of a new class of contaminants that not only impact the environment but also pose risks to people's health. Therefore, developing new methods for identifying and quantifying these pollutants classified as emerging contaminants is imperative. These methods enable regulatory actions that effectively minimize their adverse effects to take steps to regulate and reduce their impact. On the other hand, these new contaminants represent a challenge for current technologies to be adapted to control and remove emerging contaminants and involve innovative, eco-friendly, and sustainable remediation technologies. There is a vast amount of information collected in this review on emerging pollutants, comparing the identification and quantification methods, the technologies applied for their control and remediation, and the policies and regulations necessary for their operation and application. In addition, This review will deal with different aspects of emerging contaminants, their origin, nature, detection, and treatment concerning water and wastewater.

Evaluation of recurrence, mortality and treatment complications of oral squamous cell carcinoma in public health centers in Shiraz during 2010 to 2020

INTRODUCTION

Oral Squamous cell Carcinoma (OSCC) is the most common oral cancer and is treated with surgery, radiotherapy and chemotherapy. Various complications of treatment include xerostomia, mucositis, and trismus, which affect patients' quality of life. The aim of this study is to evaluate the mortality, recurrence rate and prevalence of oral complications in treated patients.

METHOD AND MATERIALS

This cross-sectional study reviewed 326 cases of patients with OSCC who were referred to public health centers in Shiraz (Khalili Hospital and Dental School) from 2010 to 2020. All patients were contacted, and the survivors were called and examined by an oral physician. A medical record was created for them, including demographic information, location of the lesion, type of treatment, history of recurrence, metastasis and oral complications.

RESULTS

53.5% of patients were male and 46.5% were female. The mean age of patients was 58.68 years. Mortality and recurrence rate was respectively 49.8% and 17.8%. The most common location of the lesion was tongue (64%). Surgery was done for all patients. 97.4% of patients complained of xerostomia, 46.2% of mucositis and 44.3% of trismus.

CONCLUSION

The most common complications of treatment are xerostomia, mucositis, and trismus, respectively. Frequent and regular follow-ups and supportive therapies reduce these complications and improve patients' quality of life.

Resection and Rehabilitation for COVID-19 Associated Rhino-Maxillary Mucormycosis: A Case Report

Often, patients with rhino-maxillary mucormycosis present with osteomyelitis and necrosis affecting the involved bone. Therefore, curative treatment involves a combination of antifungal therapy and surgical removal of the necrotic bone. In this case report, a 50-year-old female presented with pain in the right side of her face and was diagnosed with rhino-maxillary mucormycosis involving the right maxillary sinus, posterior maxilla, orbital floor, and zygomatic bone. To address the condition, a total maxillectomy of the right maxilla was performed. The post-surgical defect was packed using cotton leno-weave fabric, impregnated with soft paraffin and containing 0.5% chlorhexidine acetate dressing, which was changed every 3^rd day. After a six-month follow-up, satisfactory healing was observed. For, rehabilitation, a simple cast partial denture was used.

The effects of myofascial induction therapy in survivors of head and neck cancer: a randomized, controlled clinical trial

PURPOSE

We aim to evaluate the effects of myofascial induction therapy (MIT) on the sequelae suffered by the survivors of HNC (sHNC).

METHODS

We enrolled 46 sHNC in a randomized controlled trial (RCT), of whom 20 received a MIT protocol and 23 were placed on a waitlist while receiving the recommended treatment for 6 weeks. The MIT protocol included a total of 18 sessions, 3 days a week on alternate days for 6 weeks. Maximal mouth opening, the presence of temporomandibular dysfunction, cervical endurance, active range of motion (AROM), shoulder AROM, handgrip strength, and perceived physical fitness were assessed.

RESULTS

Maximal mouth opening, temporomandibular dysfunction, cervical endurance, and AROM, affected shoulder abduction and unaffected shoulder flexion and external rotation significantly improved (p < .05) after an MIT protocol, but only cervical AROM and affected shoulder abduction changes were clinically meaningful. No statistically significant changes were observed in the other shoulder AROM, handgrip strength, or physical fitness perception (p > .05).

CONCLUSION

A 6-week MIT protocol improves mouth opening, TMD, cervical function (endurance and AROM), affected shoulder abduction and unaffected shoulder flexion, and external rotation AROM in the sHNC. However, no changes were observed in most of the shoulder AROM, muscular strength, or perceived physical fitness. Future studies should perform longer follow-up designs, increase the sample size, and include multimodal treatments to address these sequelae in the sHNC.