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Purpose: The purpose of this study was to analyse the independent prognostic significance of perineural invasion (PNI) on local recurrence (LR) in patients with oral squamous cell carcinoma (OSCC) managed primarily with surgery. Subjects and Methods: Clinical and histopathological data of 195 patients with OSCC were analysed retrospectively to identify risk factors associated with PNI and to evaluate its significant correlation with local recurrence, overall survival (OS) and recurrence free survival (RFS). Results: Patients were followed for a mean period of 39.5 ± 1.376 months and median 35 months. PNI was found in 57 patients (29.2%). PNI correlated with tongue subsite (p = 0.001), nodal metastasis (p < 0.000), depth of invasion (DOI) (p = 0.002), stage (p = 0.013) and adjuvant therapy (p < 0.001). Mean time to recurrence with PNI was significantly shorter (p = 0.002).Multivariate analysis did not establish significant relationship between PNI and LR. Kaplan-Meier curve did not show statistical significance with OS (p = 0.085) or RFS (p = 0.110). Conclusion: PNI remains an aggressive factor for nodal metastasis mandating neck management for regional control. Though PNI showed no statistical significance with LR, time to recurrence in PNI positive patients were significantly shorter. Hence, close follow-up regimen becomes necessary.

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To evaluate fracture stability and complications such as infections, need for hardware removal, malunion, and nonunion when using 2.0-mm locking plating system in fixation of mandible fractures and to compare these to those associated with the 2.0-mm non-locking plating system. A prospective clinical study was conducted in a cohort of mandible fracture patients who were randomly assigned to two groups. Patients in the non-locking group were treated with 2.0-mm non-locking plating system, and those in locking group were treated with 2.0-mm locking plating system. Fracture stability, need for maxillomandibular fixation (MMF) and postoperative complications were assessed and compared. A total of 60 patients (30 in each group) were recruited. Significant differences were found between the two groups with respect to postoperative fracture stability (P = 0.001) and need for MMF (P = 0.005). Multivariate analysis revealed that type of fixation was not the only dependent variable which affected fracture stability. There were no significant differences in postoperative complications between the two groups. The 2.0-mm locking plating system provides greater stability and early functional restoration than the 2.0-mm non-locking plating system, with similar rates of postoperative complications. Thus, it can be used as a reliable and effective treatment modality for treating mandibular fractures.

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BACKGROUND: Maternal death review (MDR) is a strategy that helps in identifying gaps in the care of a pregnant mother. OBJECTIVES: The objective is to assess the quality of MDR, causes of maternal mortality, and finding corrective action in 10 high-priority districts of Odisha. MATERIALS AND METHODS: MDR was undertaken by our team in 4-month timeline (August to November 2014). It included the development of tools, desk reviews, training of staffs, and data handling. The maternal deaths were estimated from the Annual Health Survey. It was compared to estimated maternal death of each district to get the under reporting/over reporting districts. A report was generated on MDR process indicators and program indicators after completion of the assessment. RESULTS: Only 129 (52%) of the 247 deaths found suitable for community-based MDR. The proportion of maternal death reported versus estimated was 247 versus 367. Correct diagnoses were reported in 120 cases. The classification of deaths was not mentioned in 74 cases. Maximum deaths (55%) were in 18-25 years of age group (the most common cause being anemia). Majority (50%) of the deaths occurred during the postnatal period and majority (67%) at the health facility. Only 61 (47%) had received antenatal check-ups. Facility-based MDR showed, Type 1 delay (denotes about seeking care) being the most common (53%). Inaccurate and incomplete information available was also found to compound the above problems in addition. CONCLUSIONS: The present study could contribute to a larger extent to address some of the gaps in the MDR process in the Odisha state.