Browsing by Author "Tripathi, Richik"

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    An Analysis of Xpert Test for Diagnosing Maxillofacial Tuberculosis
    (Springer, 2023) Tripathi, Richik; Singh, Nidhi; Agrawal, Rahul; Chandra, Akhilesh; Bera, Rathindra; Asodariya, Mital R.
    Background: Maxillofacial tuberculosis is a diagnostic challenge for surgeons. The aim of this study was to present a detailed analysis of Xpert test in diagnosing maxillofacial tuberculosis and to analyse the accuracy of Xpert test results for various tissues of maxillofacial region. Materials and Methods: In this cross-sectional study, patients were selected randomly from outpatient department. The patients who had clinical picture and differential diagnosis highly suggestive of maxillofacial tuberculosis were included. Patients were divided into three different groups depending upon the site of involvement. The samples collected from the patients were further subdivided depending upon the type of specimen. Patients were screened first by routine tests, and the negative cases were followed by Xpert test for tuberculosis. Results: A total of 54 patients were enrolled in the study, 13 patients were found to be positive for maxillofacial tuberculosis on routine screening tests for tuberculosis, and 41 tested negative on routine test and were evaluated further through Xpert test. Specimens from bone (n12), soft tissue and skin biopsy (n15) and aspirates from lymph nodes (n14) were obtained and tested. Twenty-one samples were found to be positive, and 20 were negative upon Xpert testing. There was a statistically significant difference seen between the test groups (p < 0.01) with higher frequency of negative results in routine test. The p value for various specimens containing pus, biopsies and aspirates was 0.045, 0.023 and 0.067, respectively. Conclusion: Xpert test is more accurate when compared to routine test for diagnosing maxillofacial tuberculosis. Although accuracy of Xpert test is better for pus and biopsy samples in the specimens from bone and soft tissue, it gives poor accuracy for aspirated cells. The aspirates from lymph nodes were more susceptible for false negative test. � 2021, The Association of Oral and Maxillofacial Surgeons of India.
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    Comparative Evaluation of Nasolabial Flap, Buccal Fat Pad and Platysma Myocutaneous Flap for Reconstruction of Oral Sub Mucous Fibrosis Defects
    (Springer, 2023) Singh, Akhilesh Kumar; Bera, Rathindra Nath; Neville, J.F.; Tripathi, Richik; Sharma, Naresh Kumar; Kumar, Jananni Anand; Hirani, Mehul Shashikant; Chauhan, Nishtha
    Moderately advanced (stage III) and advanced (stage IV a & b) OSMF requires surgical intervention for management A number of options are available for reconstruction of post OSMF oral cavity defects. In our study we retrospectively compared buccal fat pad, nasolabial flap and platysma flap for reconstruction of the buccal mucosal defects. Patient records were obtained from the medical records section of the Institute and divided into three groups; group A (buccal fat pad), group B (nasolabial group) and group C (platysma flap). Maximal mouth opening and intercommisural distance were the primary outcomes. Kruskal Wallis test was used to test the mean difference between three groups. Mann�Whitney test was used for intergroup comparisons. Wilcoxon signed rank test was used to evaluate the mean difference in outcomes at each follow up interval. A p value of < 0.05 was considered as statistically significant at 95% confidence interval. After 1�year follow up patients in platysma group had significantly better mouth opening (39.84 � 1.65�mm) compared to both buccal fat pad (36.69 � 3.41�mm) and nasolabial groups (37.94 � 0.43�mm). Inter commisural distance was significantly better in patients reconstructed with platysma flap (59.21 � 0.99�mm) compared to both buccal fat pad (54.11 � 1�mm) and nasolabial flap (56.84 � 1.48�mm). Platysma flap lead to significantly better maximal mouth opening compared to both nasolabial and buccal fat pad. Both buccal fat pad and nasolabial lead to comparable mouth opening. Inter commissural distance is maximum with platysma flap followed by nasolabial flap and buccal fat pad. � 2023, Association of Otolaryngologists of India.
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    Correction to: Influence of Site, Size, Depth of Invasion and Histologic Grading on the Occurrence of Cervical Level IIb Metastasis and Extranodal Extension in Clinically N0 Neck of Patients with OSCC: A Single Center Retrospective Analysis (Journal of Maxillofacial and Oral Surgery, (2022), 10.1007/s12663-022-01776-5)
    (Springer, 2022) Bera, Rathindra Nath; Singh, Akhilesh Kumar; Tripathi, Richik; Sharma, Naresh Kumar
    In the original publication of the article, in the subheading, extranodal extension, a sentence has been published incorrectly as However; DOI > 5 mm and size of the metastatic nodes were the predictors. size of lymph nodes and DOI > 5 mm were the prime predictors and this needs to be corrected as follows: " DOI > 5 mm and size of metastatic nodes were the prime predictors for ECS." The original article has been updated with this correction. � 2022, The Association of Oral and Maxillofacial Surgeons of India.
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    Implant survival in patients with neuropsychiatric, neurocognitive, and neurodegenerative disorders: A meta-analysis
    (Wolters Kluwer Medknow Publications, 2021) Bera, Rathindra Nath; Tripathi, Richik; Bhattacharjee, Bappaditya; Singh, Akhilesh Kumar; Kanojia, Shweta; Kumar, Vikram
    Neurologic disorders impede oral hygiene measures and routine clinical follow-up, along with the various drugs used may jeopardise oral health and the peri-implant tissue health. A total of 7 studies were considered eligible for the current systematic review. The overall estimated effect was categorized as significant where P < 0.05. Funnel plot was used to assess the publication bias within the studies. Difference in means was used as principal summary measure. P value <0.05 was considered as statistically significant. 1069 implants survived in test group and 4677 implants survived in control group (odds ratio: 2.58, 95% CI: 1.93-3.43) indicating significant success in patient without any disorders or taking medications for these disorders. Subgroup analysis was done to check the implant survival rate in patients taking selective serotonin reuptake inhibitors (SSRI) compared with SSRI non-users. Subgroup analysis showed that SSRI non-users had higher implant survival rate than patients taking SSRI (odds ratio: 2.45, 95% CI: 1.82-3.31). Serotonin significantly inhibits bone mineralization and osteoblast differentiation. The presence of any form of neuropsychiatric or neuromuscular disorders precludes proper oral hygiene and may contribute towards implant failure. � 2021 National Journal of Maxillofacial Surgery.
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    Influence of Site, Size, Depth of Invasion and Histologic Grading on the Occurrence of Cervical Level IIb Metastasis and Extranodal Extension in Clinically N0 Neck of Patients with OSCC: A Single Center Retrospective Analysis
    (Springer, 2022) Bera, Rathindra Nath; Singh, Akhilesh Kumar; Tripathi, Richik; Sharma, Naresh Kumar
    Background: Depth of Invasion ? 4�mm, T stage and primary site with more than 20% chances for occult metastasis are currently the accepted indications for elective neck dissection. Nodal metastasis decreases survival by 50%. ENE further reduces the prognosis. Dissection of level IIb lymph nodes in clinically N0 neck does not improve survival. Methods: A total of 320 patients were evaluated. Binary and multiple logistic regression and chi-square test were used for data analysis. ROC curve with Youden�s J index was used to set up a cutoff value for DOI. The predictor variables were site, size, grading and depth of invasion of primary tumor. Incidence of level IIb metastasis and ENE were the outcomes. Results: The study revealed a significant association and risk stratification between primary tumor characteristics with the occurrence of ENE. The cutoff value for DOI predicting ENE was 12.5�mm. Tumors of the oral tongue were an independent risk factor for level IIb metastasis. Discussion: Size of primary tumor, DOI, tumors of the mandibular alveolus and poor grading are independent risk factors for ENE. Isolated metastasis to level IIb rarely occurs in the absence of concomitant level IIa metastasis. Size, DOI and grading were significantly associated with level IIb metastasis. However, only tumors of the oral tongue were independent risk factor. � 2022, The Association of Oral and Maxillofacial Surgeons of India.
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    Survival Outcomes and Factors Affecting Survival in Resectable Locally Advanced Oral Squamous Cell Carcinoma
    (Springer, 2023) Bera, Rathindra Nath; Tripathi, Richik
    Management of locally advanced OSCC include primary surgery followed by adjuvant radiotherapy or chemo radiation, concurrent chemo radiation, induction chemotherapy followed by surgery or non surgical methods. In resectable disease the role of induction chemotherapy is questionable and surgery remains the first choice. In this study we aimed at evaluating the survival and factors effecting survival in locally advanced oral cancer. retrospective review of patient records was made. Kaplan Meir method was used to evaluate OS and DFS rate and log rank test was used to compare the survival amongst groups. Cox regression analysis (univariate and multivariate) was used to evaluate the hazard ratio to find out the possible factors influencing risk of death and disease. The 3�year OS of the entire cohort was 56.80% and 3�year DFS was 52.4%. ECS, surgical margin, PNI, LVI and LN size were independent risk factors for poor overall and disease free survival. We identified ECS, positive margin, LVI, PNI and LN size as independent risk factors effecting survival. These factors justify the use of adjuvant radiotherapy or chemo radiation according to the already available guidelines. � 2022, Association of Otolaryngologists of India.