Background: Third molar (M3) agenesis and impaction are associated with evolution, changed dietary habits, and human jaw growth. The aim of the study was to radiographically evaluate the prevalence of M3s agenesis, impacted M3s with different impaction patterns, and the approximation of Inferior Dental Canal (IDC) with impacted mandibular M3s roots among the Sriganganagar population.Methods: The study included 700 randomly selected subjects from OPD with an age range of 25-45 years. Digital OPGs were taken for all subjects using Kodak 8000C digital OPG machine. The M3 impaction patterns were evaluated using Winter's classification.Results: The prevalence of subjects with at least one M3 agenesis was found to be 34.1% and with 95% confidence interval was 30.6% to 37.6%. The overall M3s agenesis was 16.8% with more prevalence in the males. The patients with agenesis of one M3, two M3s, three M3s, and four M3s were 14.4%, 11.3%, 3.7% and 4.7%, respectively. M3 agenesis was more in the upper jaw and on the left side. The total impacted M3s were 21.11% with more prevalence in mixed diet subjects. Mesioangular was most common impaction pattern, and notching was most prevalent IDC relationship with impacted mandibular M3s roots.Conclusion: This study highlighted the evolutionary increasing M3 agenesis and the importance of diagnostic OPG for seeing the status of M3s in jaws.

The overwhelming majority of patients eligible for HER2-targeted therapy in our institution are unable to receive it because of financial constraints and limited access to health insurance. There is a higher fraction of patients with the triple negative phenotype compared to the Western population.

Thyroid gland and thyroid cartilage infiltration in multiple myeloma (MM) are rare. Here, we discuss a patient who presented with hoarseness of voice and was found to have a hypodense lesion in right lobe of thyroid involving thyroid and cricoid cartilage. Fine-needle aspiration cytology with immunohistochemistry revealed extramedullary plasmacytoma of thyroid. MM was ruled out initially by serum protein electrophoresis, immunofixation, and bone marrow biopsy. Later, lytic lesions were found in multiple bones on radiation planning scan and he was finally diagnosed as case of MM with thyroid involvement. Treatment strategies of MM and thyroid plasmacytoma are also discussed briefly.

Digital panoramic radiographs are considered better than conventional panoramic radiographs in locating ZACD. Further, the presence of ZACD might be valuable for age estimations, to some extent. Further studies are required to investigate the pneumatization of articular eminence before puberty.

Malaria is a significant problem in adult solid tumor patients, leading to multiple complications and therapy delays.

5554 Background: Etoposide (E), cyclophosphamide (C) and tamoxifen (T) have been used as single agents in relapsed epithelial ovarian cancer (EOC) patients. We tested a low dose, continuous, daily, oral metronomic regimen that combined these 3 agents. Methods: This single centre prospective study included patients of relapsed EOC with exposure to at least 2 prior lines of chemotherapy (CT) and at least partial as the best response to most recent regimen. Study regimen comprised daily oral administration of E (50 mg/m2) and C (50 mg/m2) for 21 of a 28 day cycle plus T (20 mg/m2, twice per day) continuously. The primary endpoint was serological (CA-125) progression-free survival (PFS) as per Rustin Criteria and secondary endpoints were radiological (RECIST) PFS, overall survival (OS), duration of response (DOR), response rates and toxicity. The data cut-off date was 15 Jan 2013. Results: 26 patients with a median age of 48 years were accrued, of whom 21 had received 2 prior lines of CT and 5 had received 3 lines. 25 patients who were evaluable for analysis received a median of 6 (1-19) cycles of metronomic regimen. The median delivered relative dose intensities of E, C and T were 0.71, 0.71 and 0.97 respectively. 13 (52%) patients needed dose reduction after a median of 3 (1-9) cycles. Most common grade 3 or 4 toxicities included anemia, neutropenia, febrile neutropenia, nausea, vomiting and diarrhea in 44%, 36%, 12%, 16%, 16% and 12% patients respectively. 19 (76%) patients had serological CR or PR with a median time to response (TTR) and DOR of 1.8 (0.83-2.96) and 7.0 (95% CI, 5.8-8.2) months respectively. 11 (45.8%) of the 24 evaluable patients achieved radiological CR or PR with median TTR and DOR of 3.7 (1.8-7.2) and 5.5 (95% CI, 3.9-7.2) months respectively. 17, 18 and 7 patients have respectively experienced serological progression, radiological progression and death at the time of analysis. The median serological PFS, radiological PFS and OS are 7.9 (95% CI 7.2-8.6), 7.97 (95% CI, 5.95-9.98) and 22.3 (95% CI, 17.4-27.3) months, respectively. Conclusions: The oral metronomic combination of E, C and T has substantial and durable activity in relapsed EOC and is worthy of further evaluation in a larger randomized study.

It can be concluded that the number of ZACDs is surprisingly more in diagnosed TMD patients. This strengthens the need for thorough preoperative imaging evaluation of ZACDs in such patients. Further longitudinal studies are required to find out the long-term effect of ZACDs on symptomatic as well as non-symptomatic TMD subjects. This may prove helpful to appreciate that whether ZACDs have any role in the development TMDs and vice versa. As with many TMD studies, caution should be exercised in interpreting these results until further studies have been carried out on this topic. Ideally, some prospective randomised evaluations with "hard" evidence of the diagnosis with MRI support.

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