Anupam Sarma

Trimodality treatment (neoadjuvant chemoradiotherapy followed by surgery) improves survival in esophageal squamous cell carcinoma (ESCC). However, patient compliance remains a challenge, particularly in high-burden areas like North-East India. To evaluate the compliance rate for trimodality treatment. To evaluate the reasons for non-compliance and to estimate the overall survival of the study patients. This retrospective study involved 113 patients with locally advanced, resectable ESCC treated at a tertiary care center from January 2021 to December 2022. Compliance with trimodality therapy was assessed. Reasons for non-compliance were categorized based on medical records and telephone interviews. Overall survival (OS) was analyzed using the Kaplan-Meier method and Cox regression. Compliance was calculated as the percentage of patients completing trimodality treatment. Reasons for non-compliance were identified through electronic medical records and phone interviews and shown in a pie chart. Kaplan-Meier and log-rank tests were used to assess survival, while Cox regression identified related factors. SPSS (version 29) and Excel were used for analysis, with significance set at p < 0.05. Only 48 patients (44.03%) completed the planned trimodality treatment. The main reason for non-compliance (66%) was subjective symptom relief after chemoradiotherapy, possibly due to inadequate counseling. Financial issues, disease progression, poor health, and inoperability were other factors. Patients completing treatment showed significantly better survival (1-year OS 83.3% vs. 50.8%; 3-year OS 54.3% vs. 20.3%; p<0.001). Cox regression revealed that incomplete treatment was associated with a 3.2-times higher risk of death. Other factors such as age, gender, comorbidities, and nodal status did not significantly affect survival. Compliance with trimodality treatment significantly improves survival in ESCC. Improving patient counselling, financial support, and follow-up may help increase compliance and outcomes in high-burden regions.

Purpose: Early detection through breast self-examination (BSE) provides a cost-effective method to mitigate the significant burden of breast cancer incidence and mortality in developing countries. This study aimed to examine the awareness of breast cancer symptoms and their involvement in practicing breast self-examinations. Method: A total of five hundred eighteen (n = 518) women aged 15–90 years participated in the study. The structured questionnaire included demographic characteristics, knowledge and perceptions about BSE, as well as awareness of risk factors, symptoms, and signs of breast cancer. A study conducted among 518 rural women in Assam, aged 15–90 years, evaluated their awareness and preventive behaviors related to breast cancer and breast self-examination (BSE). Result: Education significantly influenced knowledge and practice, awareness, belief in BSE's importance, and confidence in consulting doctors increased with higher education. For example, 27.7% of post-graduates practiced BSE, compared to none among illiterate participants. Logistic regression revealed that knowing about BSE and awareness of WHO-recommended BSE protocol significantly increased the likelihood of performing BSE, by 20.9% and 91.5%, respectively. Hosmer–Lemeshow test (p = 0.231) confirmed the model fit. Most participants agreed on the need for breast cancer education (96.5%) and were willing to seek medical advice (89.2%), though these were not strongly tied to education level. Conclusion: This study emphasizes the vital role of education in promoting awareness about breast cancer and practices related to BSE. Addressing the educational gaps and barriers identified in this study can improve early detection and help reduce breast cancer mortality.

Acute leukemia is characterized by the swift proliferation of immature white blood cells (WBC) in the blood and bone marrow. It is categorized into acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), depending on whether the cell-line origin is lymphoid or myeloid, respectively. Deep learning (DL) and artificial intelligence (AI) are revolutionizing medical sciences by assisting clinicians with rapid illness identification, reducing workload, and enhancing diagnostic accuracy. This paper proposes a DL-based novel BSNEU-net framework to detect acute leukemia. It comprises 4 Union Blocks (UB) and incorporates block feature map distortion (BFMD) with switchable normalization (SN) in each UB. The UB employs union convolution to extract more discriminant features. The BFMD is adapted to acquire more generalized patterns to minimize overfitting, whereas SN layers are appended to improve the model’s convergence and generalization capabilities. The uniform utilization of batch normalization across convolution layers is sensitive to the mini-batch dimension changes, which is effectively remedied by incorporating an SN layer. Here, a new dataset comprising 2400 blood smear images of ALL, AML, and healthy cases is proposed, as DL methodologies necessitate a sizeable and well-annotated dataset to combat overfitting issues. Further, a heterogeneous dataset comprising 2700 smear images is created by combining four publicly accessible benchmark datasets of ALL, AML, and healthy cases. The BSNEU-net model achieved excellent performance with 99.37% accuracy on the novel dataset and 99.44% accuracy on the heterogeneous dataset. The comparative analysis signifies the superiority of the proposed methodology with comparing schemes.

BACKGROUND To screen asymptomatic rural women for High Risk HPV DNA by CareHPV ® test and cytological screening by Papanicolaou (PAP) test. METHOD A total of Four hundred eighty (n=480) sexually active, non pregnant women in the age group of 20-70 years were included in this study. Two cervical scrap samples were collected from enrolled eligible women, one scrap sample was used for HPV testing (CareHPV®) and second for Papanicolaou (PAP) testing. Statistical analysis for testing outcome with demographic characteristics was analyzed using 95% confidence intervals (95% CI) for different variables. P-values<.05 values were considered statistically significant. RESULTS Among tobacco chewing group of women compared to non-tobacco chewing women positivity rate for high risk HPV (p-0.001) and PAP test (p-0.007) was found to be statistically significant. Alcoholic beverage consuming women group has shown 28 times higher risk of high risk HPV infection (OR-28.3; p-0.0001) compared to non-alcoholic women. Irregular menstruation was found to be significant risk factor for PAP positivity (OR-14.33; p-0.001). High risk HPV infection (p-0.02) and PAP positivity (p-0.0001) was significantly higher in cloth sanitary pad user compared to commercial sanitary pad user. We also found that >3 numbers of childbirth as a significant risk factor for hr-HPV infection (p-0.0122). CONCLUSION We conclude that among rural women of Kamrup, North-East India alcohol consumption, tobacco chewing, cloth sanitary pad reuse, >3 child birth were significantly associated with increased risk of hr-HPV infection and PAP positivity.

Background In our study, we examined the 5-year survival of OSCC patients with HPV positive or negative status along with p16 protein expression. Method A total of 72 biopsy tissue specimens from histologically confirmed oral squamous cell carcinoma (OSCC) patients were collected. HPV detection and genotyping were performed using HPV E6/E7 and HPV-type specific multiplex primer for nested-PCR. Immunohistochemistry evaluation of pl6 was conducted. SPSS statistical software (ver 20) was used for data analysis. Results High risk-HPV (hr-HPV) DNA positivity was found in 27.7% (n=20) of OSCC patients. Stage III OSCC patients were 7.80 times more likely to survive 5 years than stage IV patients (OR-7.80 CI-95%; P-0.03). Among the hr-HPV positive OSCC patients, we found that the median survival time for the 1st year (95%), 3 years (78.5%), and 5 years (38.5%) was significantly higher than that of the hr-HPV negative [1st year (78.6%), 3 years (45.2%) and 5 years (38.5%)] OSCC patients (P-0.03 The survival of male patients with hr-HPV positive OSCC is 9.75 times greater than the survival of patients with HPV negative OSCC (OR-9.75; CI-95%; P-0.05). The p16 expression level (low to overexpression) group and negative P16 expression group of OSCC patients have not demonstrated a significant association with 5-year survival. Conclusion We conclude that in OSCC cases of North-East India, the presence of hr-HPV in OSCC cases could be a good predictor of 5-year survival rate. Expression of p16 does not appear to have any significant association with 5-year survival.

BACKGROUND: Acute leukemia is a heterogenous disease having diverse phenotypes. Immunophenotyping by flowcytometry is essential for diagnosis of myeloid and lymphoid subtypes. Aberrant phenotype incidence is controversial and dissimilar results have