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Aims:The aim of this study is to determine association between lymph node metastasis and various clinico-pathological parameters in order to predict their future prognosis of cancer patients. Study Design: Cross sectional study design. Place and Duration of Study: Ziauddin Hospital, North Nazimabad campus, Karachi. Methodology: November 2018 to September 2019. Results: The present study enrolled 140 OSCC patients visiting Ziauddin University of which 30 (21.4%) were females and 110 (78.6%) were male patients. The mean age of patients was 46.99 ± 12.26. The buccal mucosa was the most common site observed 93 (66.4%). The mean size of tumour was 4.05 ± 2.261 mm, mean thickness was 1.70 ±1.32 mm. It was found that lymph node metastasis was not present in 66 (47.1%) of OSCC cases, 22 (15.7%) cases were found N1, 9(6.4%) N2a, 27(19.3%) N2b, 3 (2.1%) and 13(9.3%) N3. Abidi et al.; JAMMR, 32(2): 46-53, 2020; Article no.JAMMR.54793 47 Significant association was found between age and lymph node metastasis: (P 0.02); however, gender showed no significant association. (P 0.149). Thickness of tumor, site of tumor, peri-neural invasion, lympho-vascular invasion and bone penetration showed significant association with lymph node metastasis with (P 0.040, 0.021, 0.016, 0.00 and 0.001) respectively. Conclusion: Our study showed significant association of lymph node involvement with tumour staging, tumour thickness, lymphovascular involvement, perineural invasion and bone penetration. Our suggestion is to incorporate these clinic-pathological variables while determining the treatment and prognosis of Oral squamous cell Carcinoma (OSCC). Given the very high incidence and prevalence of Oral Cancer in our country and the region further multi-centered researches should be carried out and with larger sample sizes. Early diagnosis and restrictions on smokeless tobacco products can limit the occurrence and progression of OSCC. Original Research Article

Objective: To compare nicotine dependence and intention to quit among different types of smokers. Method: The comparative cross-sectional study was conducted from November 2018 to October 2019 in Karachi after approval from the ethics review committee of the Jinnah Sindh Medical University, and comprised conventional, electronic and dual cigarette users. Data was collected using a structured questionnaire regarding socio-demographics, usage characteristics, and intention to quit. The validated Hooked on Nicotine Checklist was also used. Data was analysed using SPSS 22. Results: Of the 246 subjects, 82(33%) were conventional cigarette users with a mean age of 27.41±8.7 years, 82(33.3%) were electronic cigarette users having mean age of 30.37±9.16 years, and 82(33.3%) were dual cigarette users with a mean age of 28.89±9.07 years. The use of electronic cigarette was more in people with higher age (p=0.01), married (p=0.001) and having higher income (p=0.05). Compared to conventional cigarette users, electronic cigarette users showed lower odds of high nicotine dependence (odds ratio: 0.38, 95% confidence interval: 0.18-0.80). No significant difference was observed in intention to quit among different types of cigarette users (p>0.05). Conclusion: Electronic cigarettes users were comparatively less nicotine-dependent compared to the users of other types of cigarettes. Electronic cigarettes should only be recommended to conventional users with the intention to quit. Key Words: Cigarette, Electronic, Nicotine dependence, Quit intention.

To determine the association of dental anxiety and mental health among undergraduate students of health-care profession with delays in seeking dental treatment. METHODS: This cross-sectional study was performed on 400 undergraduate students attending Ziauddin College of Dentistry, Karachi, Pakistan. The sample was selected through non-probability convenience sampling from age group between 18-24 years old. A validated structured questionnaire was used to measure dental anxiety through modified dental anxiety scale, anxiety induced consumption patterns and dental treatment avoidance. Data was analyzed through SPSS version-22. RESULTS: Out of 400 students, 296 (74%) were females and 104 (26%) were males; 223 (55.8%) were ≤20 years old. About 52.2% (n=209) consumed fizzy drinks and 49.5% (n=198) used to brush their teeth once daily. Thirty-five percent (n=139) never visited the dentist for checkup and 38.2% (n=153) reported low dental fear. High, moderate & low level of anxiety was observed in 22 (14.1%), 86 (55.1%) & 48 (30.8%) students with deferral in dental treatment as compared to 15 (6.2%), 124 (50.8%) 105 (43.0%) students with no deferral in dental treatment respectively (p<0.05). Majority of females (64.7%) as compared to males (35.3%) had delayed treatment due to dental phobia (p<0.01). Moderate & mild depression was observed in six (3.9%) & 25 (16%) students with deferral in dental treatment as compared to 15 (6.2%) & 34 (13.9%) students with no deferral in dental treatment respectively. CONCLUSION: A significant association was noted between dental anxiety and negative dental-health seeking behaviors, while stress had no significant association with deferral.