Regional Institute of Medical Sciences

To explore the stakeholders' perspectives on barriers and facilitators influencing childhood cancer care delivery in India.

A nationwide survey was conducted across 26 states and 4 Union Territories, involving childhood cancer physicians from tertiary and secondary hospitals, state nodal officers (SNOs) for the National Programme for Control of Non-Communicable Diseases (NP-NCD), and representatives from Civil Society Organizations (CSOs) and Non-Governmental Organizations (NGOs). A hub-and-spoke sampling model was employed, with designated tertiary hospitals coordinating data collection from secondary hospitals. An online survey tool assessed perceived challenges and facilitators in childhood cancer care. Data collection occurred from July to September 2021, and descriptive statistics were used for analysis.

Responses were received from 137 tertiary hospitals (100%), 92 secondary hospitals (91%), 16 SNOs (53.3%), and 9 CSO/NGO representatives (23.1%). Key barriers to diagnosis and treatment included shortage of human resources, beds, and equipment, along with advanced-stage presentation and inadequate back-referrals from tertiary to secondary hospitals. Treatment abandonment and denial were highlighted as major concerns. SNOs and CSOs identified financial constraints, limited insurance coverage, and reliance on traditional healers as additional challenges. Facilitators included strengthening referral networks, expanding diagnostic capabilities, ensuring free treatment and medications, and improving infrastructure and workforce capacity.

Resource constraints, late-stage presentation, treatment abandonment, and financial challenges are the significant barriers to childhood cancer care in India. Addressing these through improved referral systems, expanded diagnostic services, financial support mechanisms, and policy-level interventions are needed to enhance childhood cancer care outcomes and quality of life.

Introduction Peripheral pulmonary lesions (PPLs) pose a significant diagnostic challenge for the clinician as they are not visualized within the bronchial tree during flexible bronchoscopy. Radial endobronchial ultrasound (EBUS) is a minimally invasive bronchoscopic technique that expands the view of the bronchoscopist beyond the lumen of the airway, offering a promising diagnostic modality for PPLs. Objectives To assess the types of different peripheral pulmonary lesions diagnosed by radial endobronchial ultrasound-guided biopsy, and also to assess the agreement between the findings of radiological imaging and radial EBUS-guided biopsy in determining benign and malignant peripheral pulmonary lesions. Methodology This was a cross-sectional study performed on 40 patients aged ≥18 years with radiological evidence of PPLs who attended the respiratory medicine outpatient department (OPD) of the Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, from April 2023 to March 2025. Results This study determined the diagnostic yield of radial EBUS to be 77.5%. Among the malignant lesions diagnosed, adenocarcinoma (15 patients, 37.5%) was the most common histopathological type followed by squamous cell carcinoma (eight patients, 20%) and small cell carcinoma (one patient, 2.5%) while benign lesions included pulmonary tuberculosis (five patients, 12.5%) and pulmonary aspergillosis (two patients, 5%). Substantial agreement (Kappa=0.674, p<0.001) was found between CT diagnosis and radial EBUS transbronchial lung biopsy (TBLB) findings in classifying lesions as benign or malignant. Conclusion In this study, radial EBUS-guided TBLB was found to be a safe and effective diagnostic modality for PPLs, offering high diagnostic yield and strong concordance with imaging findings, reinforcing its value in clinical decision-making.

The recontouring of disfigured maxillofacial and dental parts in prosthodontics is a process that goes beyond physical alteration, significantly enhancing patients' psychological well-being. This paper comprehensively analyzes the techniques, materials, and clinical approaches used in the cosmetic recontouring of disfigured parts, such as teeth, gingival tissues, maxillofacial, and somatic (missing body parts like fingers, hands, or prosthetic legs) prostheses. It elaborates on the clinical and laboratory steps involved in the fabrication of auricular prostheses using room temperature vulcanizing (RTV) silicone as a maxillofacial material, which gives a life-like appearance. It helps regain the overall aesthetics of the patient. The prosthesis was well retained through the use of silicone adhesives and the available undercut present at the ear defect site. The prognosis was good in terms of retention, stability, support of the prosthesis, and comfort for the patient, even after six months of follow-up. Additionally, it gives insights into higher-quality, affordable, and readily available advanced recontour prosthesis materials and modern techniques employed. Recontouring of maxillofacial, somatic, and dental structures is not just a professional duty but a moral imperative, ensuring that the patient's needs and well-being are at the forefront of every decision.