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   Table of Contents - Current issue
Coverpage
January-June 2020
Volume 3 | Issue 1
Page Nos. 1-50

Online since Wednesday, July 8, 2020

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EDITORIAL  

COVID-19 and Cancer Management p. 1
Anurag Mehta, Abhishek Mohanty, Shalini Agnihotri
DOI:10.4103/jco.jco_18_20  
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REVIEW ARTICLE Top

Predatory publishing: What a researcher should know about Highly accessed article p. 4
Smreti Vasudevan, Anurag Mehta
DOI:10.4103/jco.jco_15_20  
With the emergence of fast modes of communication such as Twitter, Blogs, Instagram, and others, the world is writing and sharing as never before. But what distinguishes an academic publication from all other write-ups is the credibility and future utility of the message conveyed. A stringent peer review mechanism is the guarantee to trustworthiness and usability of the publication for future scientific discourse and research. Circumventing or weakening the peer review process for ulterior considerations marks a predatory journal. These journals may end up circulating scientifically questionable information that may lead astray the scientific community. It is important that a researcher is not duped by predatory calls and he makes an informed decision for his submission. This article attempts to explain in a concise manner the key attributes and modus operandi of predatory journals, the consequence of predatory publishing, and the measures that can be adopted to curb such practices.
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ORIGINAL ARTICLES Top

Comparative evaluation of alteration in salivary pH among gutkha chewers with and without oral submucous fibrosis and healthy subjects: A prospective case-control study p. 8
Prashant Tamgadge, Rashmi Wasekar, Sunita Kulkarni, Ajay Chandran, Sanchit Jain, KV Chalapathi, Abhishek Singh Nayyar
DOI:10.4103/jco.jco_12_20  
Context and Aim: Several studies have shown that during gutkha chewing, many harmful chemicals and metals are leached-out into the saliva altering salivary parameters including the flow rate and pH, whereas the normal range of salivary pH is recorded to be within 5.5–7.9 with the flow rate in a range of 0.33–1.42 mL/min. Due to a scarcity of literature on this aspect of the disease process of patients with oral submucous fibrosis (OSMF), this study intended to assess and compare the pH of saliva among gutkha chewers with and without OSMF and healthy subjects. Materials and Methods: This study was designed as a prospective case-control study comprising 90 individuals within an age range of 15–50 years who were divided into three groups with Group A consisting of 30 patients who were gutkha chewers with OSMF, Group B consisting of 30 individuals who were gutkha chewers but without OSMF, and Group C consisting of 30 healthy subjects who were included as normal controls. Salivary pH was measured using the pH indicator strips (INDIKROM PAPERS, pH: 3.5–6 and pH: 6.5–9). Statistical Analysis Used: The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 16.0 (SPSS, Chicago, Illinois). Comparison of the said parameters was done using chi-square test, analysis of variance (ANOVA), and Tukey’s post hoc test. A value of P < 0.05 was considered statistically significant. Results: The results were not found to be statistically significant when the pH among OSMF (Group A) and individuals with habit but without OSMF (Group B) was compared, though, significant between Groups A and C. Conclusion: From the findings of this study, it could be concluded that “reduced salivary pH could be a significant initial subjective sign of OSMF.” An early diagnosis and management of these changes, thus, can not only help such patients to improve their quality of life (QoL) significantly but also can decrease the chances of the ongoing malignant transformation.
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Dosimetric assessment of heart in cancer esophagus patients treated by chemoradiation: A retrospective analysis p. 17
Ankita Mehta, Piyush Kumar, Jitendra Nigam, NS Silambarasan, S Navitha, Arvind Kumar, Pavan Kumar
DOI:10.4103/jco.jco_6_20  
Context: Radiation-induced cardiac events have not gained much concern in esophageal malignancies. There are several serious cardiac events, which may impact the overall survival rates. Aims: This study was designed to compare the dosimetric parameters of heart in patients with carcinoma esophagus planned by intensity-modulated radiotherapy (IMRT) and 3Dimensional conformal radiotherapy (3DCRT) technique. Materials and Methods: Twenty-two patients with carcinoma esophagus who were treated by the IMRT technique to a dose of 50.4 Gy were retrospectively selected for the study and corresponding virtual 3DCRT plans were generated for study purpose (total = 44 plans). The dosimetric parameters of the resulting plans were compared for planning target volume (PTV) and organs at risk: heart, left ventricle, left anterior descending artery, and lungs. Statistical Analysis Used: Paired t test. Results: The dosimetric parameters of PTV were comparable for D50, Dmean; however, a significant improvement was observed in D95 (P = 0.0005), D90 (P = 0.003), homogeneity index, and conformity index (P < 0.0001 each) with IMRT. A significant reduction in the various dose volumes of the heart (V20, V25, V30, V40, D33, D67, D100), left anterior descending artery (V30, V40), and left ventricle (V30, V40) along with mean dose was seen. The lung dose was nearly comparable in terms of Dmean and V20. Conclusion: IMRT has a better dose homogeneity and conformity compared to 3DCRT. Better cardiac sparing may translate into a decreased incidence of long-term radiation-induced cardiac complications.
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Efficacy of a cashless scheme in rural India to improve outcomes in head and neck cancer patients p. 25
Pallavi Kalbande, Virendra Vyas, Ashok Singh, Jay Phate
DOI:10.4103/jco.jco_3_20  
Purpose: Treatment of head and neck cancer is toxic, costly, and challenging in underserved population of India; adherence to treatment is the key predictor of the outcome. Objective: The aim of this work was to study compliance with radiotherapy (RT) in beneficiaries of a cashless scheme, namely Mahatma Jyotiba Phule Jan Arogya Yojna (MJPJAY), and factors associated. Materials and Methods: Head and neck cancer patients eligible for curative intent RT and beneficiaries of the cashless scheme registered at a rural tertiary cancer center were included in the study. Noncompliance was studied for association with age, sex, stage of disease, primary site, distance to travel, radical surgery, concurrent or neo-adjuvant chemotherapy, poverty level, and education. Results: Of the 228 patients, 128 (56.14%) defaulted to start RT after approval of the package and 55 (24.12%) have completed treatment without a gap. Conclusion: A large number of patients are defaulting even after approval of the cashless package to initiate RT. Patients with early-stage cancer, who are undergoing radical surgery, with lesser distance to travel, with higher education, who are above poverty level are more likely to start treatment. Whereas employed patients, patients with lesser distance to travel, with higher education are more likely to complete their prescribed RT.
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CASE REPORTS Top

Symptomatic bone metastasis revealing an occult malignant paraganglioma of urinary bladder p. 31
Meenakshi Kamboj, Sunil Pasricha, Gurudutt Gupta, Anila Sharma
DOI:10.4103/jco.jco_14_20  
Paragangliomas arising in the urinary bladder are rare, and they pose a diagnostic challenge. They need to be differentiated from the more common urothelial carcinoma and the rare morphological mimics, such as granular cell tumor. Majority of these tumors are benign, and malignant counterpart is extremely rare with a handful of cases described in the world literature. We present a case report of a 23-year-old male presenting with the symptoms related to metastatic bone disease, which was subsequently diagnosed as malignant paraganglioma of urinary bladder.
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Myoepithelial carcinoma with heterologous differentiation presenting as exophytic mass on forearm: A rare case p. 35
Vedita M Bobde, Satish B Helwatkar, Waman K Raut
DOI:10.4103/jco.jco_8_20  
Myoepithelial tumors of soft tissue origin are rarely seen unlike their salivary counterpart. Myoepithelial carcinomas are even rarer, and only 15% show heterologous differentiation. They are usually misdiagnosed as skin malignancies because of their subcutaneous location. No age-group is exempted but malignant counterparts are more common in children. Surgery is the mainstay of treatment, and early diagnosis is desirable to avoid metastatic spread. Heterologous elements, if not represented in biopsy, lead to misdiagnosis. Immunohistochemistry is helpful in difficult to diagnose cases.
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Extracorporeal bone irradiation and reimplantation: Case report and cost–benefit evaluation p. 39
Ashutosh Mukherji, Harika Puligolla, Sachin S Marda, Sunil Dachepalli
DOI:10.4103/jco.jco_24_19  
Extracorporeal irradiation and reimplantation in bone tumors is the technique of surgical removal of the tumor-bearing segment of a bone, removing the tumor, and irradiating that segment of bone separated from the body to a very high dose, and then reimplanting it in its original location. This case report describes a 6-year-old boy with Ewing’s sarcoma post chemotherapy with tumor localized to left upper shaft femur, which was excised and which underwent extracorporeal irradiation. The authors have compared this technique to metallic implants with regard to cost and benefit to patient. The rates of graft failure and implant failure remain similar at 25%–30% at 2–5 years, although the graft does not have any host rejection issues as would the implant. Also, bigger series’ have shown a similar survival rate between the two techniques as well as better functional preservation compared to implants.
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Neuroblastoma presenting as orbital metastasis: Case report and review of literature p. 44
Sucheta Parija, Aparajita Banerjee
DOI:10.4103/jco.jco_18_19  
Neuroblastoma is the third most common extracranial neural malignancy of the childhood, with most cases getting diagnosed before the age of 5 years. Orbital metastasis is present in few number of such cases and ocular manifestation as the first sign of the disease is even rarer, which causes a great diagnostic dilemma. As the prognosis of these patients remains very poor, early diagnosis and aggressive treatment can be lifesaving. The case presented here is a patient of Stage 4 neuroblastoma with orbital manifestation as the first presenting feature, which led to diagnostic delay. The role of ophthalmologist in metastatic neuroblastoma can vary from making a clinical diagnosis and staging of the disease, monitoring ocular complications during active treatment, or as a supportive role in the entire management of the case.
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Chondromyxoid fibroma of the femoral head: A rare case and review of literature p. 47
Mohammed Schezan Iqbal, Debraj Sen, Prasenjeet Singh, Anjan Prabhakara
DOI:10.4103/jco.jco_17_19  
Chondromyxoid fibroma (CMF) is one of the rarest benign cartilaginous tumors, accounting for less than 0.5% of bone tumors and less than 2% of benign bone tumors. Common locations of occurrence include the metaphyseal region of the proximal tibia and distal femur. The diagnosis of CMF rests upon its typical histological appearance like a lobular arrangement of stellate-shaped cells in a chondroid or myxoid background. We present a rare case of CMF in a 19-year-old male involving the head–neck junction of the proximal femur, which was managed by extended curettage and bone cementing, with excellent results on final follow-up.
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