<p class="abstract">The incidence of primary hyperparathyroidism in India is 2.5/1000 individuals. Primary hyperparathyroidism can be caused by a non-cancerous parathyroid adenoma, hyperplasia or rarely by parathyroid carcinoma. Most of these patients have few or no symptoms. Correct diagnosis can be reached by clinical settings, biochemical and radiological tests and final confirmation by histopathology of the specimen.</p>
Background: Oral cancer accounts for 30% of all types of cancer in India. Surgery is the mainstay of treatment but due to the recent outbreak of COVID-19, there is a partial or complete disruption of health services in the country. The initial delay in the treatment was due to cancellations of planned surgeries as per government regulations and reduction in public transportation. In the latter half of the initial relaxation of the lockdown, we formulated our institutional protocol for the surgical treatment of oral cancer patients. On admission, all patients were kept in isolated wards followed by RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction) testing on the same day. RT-PCR negative patients are subjected to HRCT Thorax (High-resolution Computer Tomography). This ensured the safety of health care workers, patients, and patient attendees. Keeping this in mind, we did an observational study on the role of HRCT in the pre-operative screening of asymptomatic oral cancer patients. Materials and methods: Retrospective analysis of prospectively collected data of 150 patients was done. HRCT reporting was done by two experienced senior radiologists of the Department of Radiology at our hospital. Results: The number of patients under the CO-RADS 1 category was 121 and CO-RADS 2 category was 29, according to CO-RADS classification. The results of RT-PCR and HRCT were compared and there was a 100% positive correlation between RT-PCR and HRCT Thorax. Conclusion: Our study supported the use of HRCT Thorax as a diagnostic tool in pre-operative screening of oral cancer patients for COVID 19, particularly in RT-PCR negative cases.
The COVID 19 pandemic limited the clinical practice of Surgical Oncologists all over the world to performing emergency procedures and surgeries. During this initial period of two to three weeks we realised that further delay in the treatment of curable oral cancers would have serious adverse prognostic implications. So we started the process to formulate our own institutional guidelines to screen and test all preoperative asymptomatic oral cancer patients for COVID 19. All preoperative oral cancer patients were tested for Reverse Transcriptase Polymerase Chain Reaction (RT PCR) and a negative COVID RT PCR report was followed by HRCT Chest. We share our prospectively collected data of Oral Cancer Surgery patients from 14th April to 31st May 2020 with details of sub site, stage, operative procedure and type of reconstruction offered. Our institutional protocol to test all preoperative patients by the highly sensitive HRCT Chest combined with the gold standard RT PCR assay ensured the safety of our patients, attendants and the hospital staff.
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