1
|
Lokhande M, Kannusamy S, Oak A, Cheulkar S, Chavan S, Mishra V, Gode P, Thakadiyil AS, Mendhe S, Kadam S, Balasubramaniam G, Chaturvedi P, Dikshit R. A hospital-based study of survival in oral cancer patients of Tata Memorial Hospital, Mumbai. Ecancermedicalscience 2024; 18:1669. [PMID: 38439812 PMCID: PMC10911663 DOI: 10.3332/ecancer.2024.1669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Indexed: 03/06/2024] Open
Abstract
Introduction Oral cancer represents a significant global public health concern, with the death rate for lip and oral cavity malignancies experiencing a 1.40-fold increase worldwide in the past three decades. This retrospective study aimed to comprehensively understand overall survival (OS) and the influence of sociodemographic and clinical factors on patients diagnosed with oral cavity cancer. Materials and methods The study focused on oral cancer patients enrolled in 2016 and treated at Tata Memorial Hospital, Mumbai, with a follow-up period extending to 5 years until 2021. Utilising the Kaplan-Meier technique and log-rank test, we examined OS and variations based on sociodemographic factors, while the Cox proportional hazard model allowed us to investigate the simultaneous impact of multiple factors on OS. Results A total of 1,895 eligible participants were included. The overall 5-year survival rate was 65%. After adjusting for age, gender, education, primary site, tumour grade, TNM staging, treatment intention, status and modality, we found in our study oral cancer patients aged more than 60 years (HR = 1.37, 95% CI: 1.01-1.85, p-value 0.03), patients who had poorly differentiated carcinoma (HR = 2.44, 95% CI: 1.56-3.81, p-value < 0.001), belonged to stage IV as per TNM staging (HR = 2.44, 95% CI: 1.65-3.61, p-value < 0.001), patient who have received partial treatment (HR = 2.44, 95% CI: 1.65-3.61, p-value < 0.001) and only chemotherapy (HR = 3.56, 95% CI: 2.43-5.23, p-value < 0.001) found to have a higher hazard of dying while literate (HR = 0.73, 95% CI: 0.56-0.95, p-value 0.02) are protective. Limitations The retrospective nature of the study posed constraints in exploring additional variable associations. Implication Overall early detection, appropriate treatment, and regular follow-up are critical for improving the survival rate of patients with oral cavity cancer. Conclusion This research proposes that improving the socioeconomic status and promoting proactive treatment-seeking behaviour is crucial for enhancing the survival of oral cancer patients. Cancer hospitals, in collaboration with the wider public healthcare system in India, which includes clinicians and policymakers, should consider these suggestions to enhance cancer treatment and control in low-middle-income countries.
Collapse
Affiliation(s)
- Monika Lokhande
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
- https://orcid.org/0009-0005-2587-7188
| | - Sivaranjini Kannusamy
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Amey Oak
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
- https://orcid.org/0009-0004-1893-4191
| | - Sandhya Cheulkar
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Shalmali Chavan
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Varsha Mishra
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Pragati Gode
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Aijimol S Thakadiyil
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Saket Mendhe
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | - Supriya Kadam
- Homi Bhabha National Institute, Mumbai 400094, India
- Division of Cancer Care, Hospital Cancer Registries and Survival Studies, Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai 400094, India
| | | | | | | |
Collapse
|
2
|
Ravel V, Jayaseelan V, Rengaraj S, Lakshminarayanan S, Kannusamy S, Susindhran B. Adherence to medical nutrition therapy and it's challenges among antenatal women with gestational diabetes mellitus in South India- A sequential explanatory mixed-method study. J Educ Health Promot 2023; 12:28. [PMID: 37034861 PMCID: PMC10079207 DOI: 10.4103/jehp.jehp_930_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/08/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND Globally, one in ten pregnant women have diabetes; out of which, 90% contribute to gestational diabetes mellitus (GDM). Medical Nutrition Therapy (MNT) is the cornerstone for GDM treatment yet adherence to MNT among the masses is not adequately monitored as part of the routine antenatal services. The study aimed to estimate the proportion of adherence to MNT and determine the factors related toadherence among antenatal women with GDM. This study also explores the facilitators, barriers, and possible suggestions for improving adherence. MATERIALS AND METHODS This facility-based sequential explanatory mixed-method study was conducted among 341 antenatal women with GDM at, Puducherry. The study was conducted in 2021. Dietary adherence was evaluated using Perceived Dietary Adherence Questionnaire and based on the scores obtained they were selected for in-depth interviews to explore the facilitators and barriers. Collected data wereanalysed by Chi-square test using STATA version 16. RESULTS Out of 341 participants, the proportion of participants adherent to MNT was 135 (39.6%) with 95% CI of 34%-44%. Thepredictors for poor adherence were unemployment (PR: 0.65; 95%CI: 0.48-0.88) and good adherence was antenatal women in the 2nd trimester (PR: 1.541; 95%CI: 1.18-2.025). Barrierstonon-adherence were financial crisis, lack of awareness ofthe need for MNT, and joint family pressure. CONCLUSIONS About two-thirds of antenatal women with GDM are non-adherent to MNT. Unemployment and period of gestation were found to be theirdeterminants. Appropriate action has to be implemented for improving the adherence rate.
Collapse
Affiliation(s)
- Vanessa Ravel
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
| | | | | | | | | | - Balaji Susindhran
- Department of Preventive and Social Medicine, JIPMER, Puducherry, India
| |
Collapse
|
3
|
Krishnamoorthy Y, Kannusamy S, Ganesh K, Thulasingam M, Lakshminarayanan S, Kar SS. Development and Validation of Scale Assessing the Preparedness of Objective Structured Clinical Examination in Undergraduate Competency based Medical Education. Indian J Community Med 2022; 47:522-526. [PMID: 36742952 PMCID: PMC9891036 DOI: 10.4103/ijcm.ijcm_1392_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/28/2022] [Indexed: 02/07/2023] Open
Abstract
Background Formative assessments methods such as objective structured clinical examination (OSCE) are reliable and valid assessment tools employed under the competency-based medical education (CBME) curriculum. However, there was no uniform scale to assess the attributes of OSCE for any of the medical subjects. Hence, this study was done to develop and validate a scale to assess the attributes of OSCE and make sure that the intended objectives of the OSCE are achieved. Methods The scale was developed using literature review and expert opinion. It consisted of 10 questions and response to these items was based on a 5-point Likert scale ranging from "strongly agree" to "strongly disagree." The final version was administered among 30 students undertaking survey community diagnosis (CD) posting during their third semester. Exploratory and confirmatory factor analysis was performed to validate the scale. Results Two-factor structures were obtained with eigenvalues of 4.32 and 1.90. Factor 1 consisted of seven items (positively faced questions) accounting for 42.84% of the variance, whereas Factor 2 had the remaining three items (negatively faced questions) explaining 19.36% of the variance. Thus, together, the two factors explained 62.20% of the variance. Goodness-of-fit indices revealed good Comparative fit index (CFI) s of 0.90, Tucker Lewis index (TLI) of 0.87, and acceptable Standardized Root Mean Square Residua (SRMR) of 0.13. The reliability coefficient (Cronbach's alpha) for the scale was 0.81. Conclusion This study develops and validates a scale that can be used universally for assessing the attributes of OSCE across all disciplines and in medical education institutes in India.
Collapse
Affiliation(s)
- Yuvaraj Krishnamoorthy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, Tamil Nadu, India
| | - Sivaranjini Kannusamy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, Tamil Nadu, India
| | - Karthika Ganesh
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, Tamil Nadu, India
| | - Mahalakshmy Thulasingam
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, Tamil Nadu, India
| | - Subitha Lakshminarayanan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, Tamil Nadu, India
| | - Sitanshu S Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, Tamil Nadu, India
| |
Collapse
|
4
|
Krishnamoorthy Y, Kannusamy S, Sarveswaran G, Majella MG, Sarkar S, Narayanan V. Factors related to vaccine hesitancy during the implementation of Measles-Rubella campaign 2017 in rural Puducherry-A mixed-method study. J Family Med Prim Care 2019; 8:3962-3970. [PMID: 31879644 PMCID: PMC6924217 DOI: 10.4103/jfmpc.jfmpc_790_19] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 09/22/2019] [Accepted: 10/21/2019] [Indexed: 11/29/2022] Open
Abstract
Background: Measles is one the leading cause of morbidity, mortality, and disability among under-five children worldwide with India contributing to half of the burden. Hence, Measles-Rubella (MR) campaign was launched to vaccinate all the children between 9 months and 15 years. The current study was done to find the prevalence and factors related to vaccine hesitancy in the MR campaign 2017 in rural Puducherry. Methods: This was a mixed-method study conducted with a quantitative part involving cross-sectional survey done among parents of children aged between 9 months and 15 years to determine the proportion of MR vaccine hesitancy and qualitative part involved in-depth interviews to explore the barriers and facilitating factors for the MR vaccine hesitancy. Results: Among 461 participants, the prevalence of vaccine hesitancy for the MR campaign was 14.1% (95%CI: 11–17.6%). In adjusted analysis, only mother's age (aPR–2.27) was the significant predictor of vaccine hesitancy. In qualitative analysis, major facilitating factor for campaign was the role played by the doctors in spreading awareness regarding the importance of vaccine and trust by parents on doctors. Major hindering factors were inadequate knowledge regarding campaign, rumors spread about the safety of vaccine, sudden planning, and under preparedness at health system level. Conclusion: The current study found that almost one-fifth of the parents were hesitant to give vaccination to children. Social media rumors, lack of knowledge among parents, and inadequate time in planning were major reasons for vaccine hesitancy. Hence, countries should undertake training and education of healthcare workers to empower them to address the vaccine hesitancy.
Collapse
Affiliation(s)
- Yuvaraj Krishnamoorthy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sivaranjini Kannusamy
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Gokul Sarveswaran
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Marie Gilbert Majella
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Sonali Sarkar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Vishwanath Narayanan
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| |
Collapse
|