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Introduction: The oncological safety of a submental flap is thought to be controversial. The objective of our study was to validate our previous study regarding the oncological safety of submental flaps in oral cavity reconstruction. Materials and Methods: An electronic database was searched from 2015 to 2021 for all head and neck tumour patients, where reconstruction was performed using a submental flap. Results: Eighty-eight oral cavity squamous cell carcinoma patients, amongst whom 71 were males (81.8%), with a mean age of 55.3 years (range: 25-79 years), were retrieved from the database. The sites of involvement were 37 buccal mucosa, 27 lower alveolus and 24 tongue. The mean follow-up was 33.5 months. The submental flap reconstruction was done for 88 patients; 3 had complete loss of flap, 17 had incomplete loss/partial necrosis, and 68 patients had uneventful recovery of the flap. We had 16 patients with local recurrence. Of these, 4 (4.5%) patients had clear margins and no lymphadenopathy at the level I at the final histopathology report. Conclusion: This study provides validation of the oncological safety of the submental flap and establishes that nodal positivity at level 1 alone does not contribute to recurrence at the primary site.

This study examines the challenges Pakistani farmers face in adopting global good agricultural practices (GGAP) and highlights the limitations in infrastructure and cost-based clauses. A questionnaire based on GGAP’s fruit and vegetable module version 5.0 was developed and validated by the Department of Environmental Sciences, Government College University, Faisalabad. This was a survey-based study of 15 farmers divided into 5 groups according to their annual farm turnover. The findings of the study indicated that, although the basic paperwork requirements of GGAP were implementable, clauses related to capital investment and technical record-keeping were not. Results showed that 90-100% of farmers considered risk assessments, training, and documentation on their farms. However, 42-56% of clauses related to record-keeping, installation, visual presentation, and infrastructure development, and 24-37% of clauses related to external testing, health, safety, and hygiene were declared not implementable. The study revealed a need for adapting GGAP standards to Pakistan's unique agricultural conditions, suggesting the development of localized standards for more practical implementation. The study’s findings highlight crucial insights for policymakers and stakeholders in the agriculture sector and suggest the need for target strategies to overcome implementation barriers and optimize the adaptation of Global GAP in Pakistan that would help to increase exports of agricultural commodities.

Introduction Squamous cell carcinoma (SCC) of the maxillary alveolus is a relatively rare disease. There is lack of data on this subsite as compared with other sites. The factors that affect survival in cases of maxillary alveolar SCC are tumor stage, local and cervical metastases, histological grading, and the margin status.

Objective: To analyse the clinicopathological characteristics of sinonasal malignancies in the light of the updates regarding head and neck tumours. Method: The retrospective study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data of patients diagnosed with primary malignant tumours of the sinonasal tract between 2015 and 2020. Slides related to biopsies and resection specimens were retrieved from the institutional database and reviewed by two pathologists. Follow-up data was also obtained. Data was analysed using SPSS 20. Results: Of the 245 samples, 144(58.7%) were epithelial tumours, 46(18.7%) neuroectodermal tumours, 41(16.7%) hematolymphoid tumours and 14(5.7%) were malignant soft tissue tumours. A heavy reliance was placed on immunohistochemical stains to diagnose poorly-differentiated tumuors. Survival was dismal, especially with early and frequent spread to the brain (33.3% in cases of Sinonasal Undifferentiated Carcinoma). Conclusion: A wide array of sinonasal malignancies was seen. Updated knowledge of the malignancies prevalent in the region is imperative for timely diagnosis and treatment. Key Words: Sinonasal tract, Squamous cell carcinoma, Sinonasal undifferentiated carcinoma, NUT c, Survival, Pakistani.

Artificial intelligence is changing the game for cybersecurity, analyzing enormous amount of risky data, increasing response times and enlarging the abilities of under-resourced security tasks. While security as IT percentage grows at a fast pace, the cost of security beaches grows at a more rapid pace. The malware targeting Android is growing. Android systems holds more than 70 percent of the market share.This paper presents a simple APK analysis approach with the help of neural networks to identify malicious and benign application. The selected methodology is efficient in detecting malwares with an accuracy of 98.42% and false positive rate of 0.0121

Objective:The objective of this study was to identify the characteristic features of patients with distant metastasis as the only manifestation of well-differentiated thyroid cancers and to analyze the treatment outcomesMethods:A retrospective review of all patients with well-differentiated thyroid cancers and distant metastasis as the sole initial presentation was carried out. Data regarding age, gender, tumor histology, site, symptoms, and treatment outcomes were collected.Results:There were 10 patients who presented with distant metastasis as the only presentation. The mean age was 56.1 years. Eight (80%) patients had osseous metastasis, one (10%) had pulmonary and one (10%) had both. Follicular thyroid carcinoma was more common and seen in six (60%) patients. Seven (77.8%) out of nine patients had demised within five years of initial presentation.Conclusion:Distant metastases without a neck lump as the initial presentation of well-differentiated thyroid cancers are extremely rare. No specific guidelines are available to manage such patients due to lack of relevant data in the literature.

Mammary Analogue Secretory Carcinoma (MASC) is a rare pathology of the salivary gland, most commonly involving the parotid gland. The objective of this study was to identify the characteristic features of MASC and its treatment outcomes. A retrospective review of 12 patients with histological diagnosis of MASC, who were managed between 2010 to 2019, was carried out at the Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore. Their mean age was 34 (±16) years. There were 9 (75%) male and 3 (25%) female patients. Painless slow growing swelling was the most common presenting symptom. All the patients had undergone surgical excision with or without neck dissection, followed by adjuvant treatment. Of these, six patients had T2 tumours, while four had cervical lymph node metastasis. The mean follow-up period was 23 (±21) months. Local recurrence was seen in one patient. MASC is considered a low-grade tumour with good prognosis which can be treated with curative intent of surgery followed by radiotherapy effectively. Keywords: Mammary analogue secretory carcinoma, Parotid gland, Salivary tumour.

Humanity has faced several foes over the centuries, a formidable one amongst them is the current pandemic of COVID-19. The symptoms of COVID-19 are more or less related to the nose and throat. Therefore, patients more often present to Ear Nose Throat (ENT) clinics with symptoms including cough, sore throat, fever and shortness of breath. In the management of head and neck pathologies, as the airway is a direct source of infection, the impact of COVID-19 holds special significance. This review has attempted to explain the various aspects of the disease itself, its diagnosis, the use of personal protective equipment (PPE) to provide an overview of the evolving recommendations in head and neck patients, the future outlook and the limitations faced in developing countries specifically for ENT patients.