Namita Mishra

INTRODUCTION
Community Health Workers (CHW), increase access and help navigate the complex healthcare system
Florida ranks in the bottom 20% in social, economic, physical environment, behavioral, and health outcomes (1).
Public health and medical advances have not reached the health goals in all parts of society (2)
Shortage of health professionals (including CHWs) (1,4), and social determinants of health (3) exacerbated health disparities (US, Florida)
Being familiar and trusted members (5), mobilizing CHWs to marginalized communities increases health access (IOM, 2003)
The rising CHW cadre (US, 41% between 2000 to 2005) (6), their critical roles, and responsibilities warrant effective training for CHWs
CHWs as certified, skilled, experienced cadre via effective and cost-effective training (7), could retool the health system and improve health outcomes
LHWs served in health and social services (1960s). Today, CHWs in community organizations, health departments, churches, schools, and hospitals promote health education and various health interventions
AIMS
Summarize evidence of training program development, implementation, and evaluation to explore Gaps in CHWs’ knowledge, skills, competencies, and training needs
Explore areas for additional training to enhance CHWs’ effectiveness.
Enhance healthcare delivery through appropriate training interventions

Introduction: Salivary gland tumors are difficult to differentiate based solely on clinical presentation or cytological findings due to their overlapping pictures. Often inadequate samples from cytology pose a challenge in preoperative diagnosis. Histopathology is considered the gold standard in diagnosing these tumors. The purpose of this study was to determine clinical, radiological, and cytological findings of these tumors and to assess the accuracy of these results with that of histopathological diagnosis. Materials and methods: Prospectively 52 patients with salivary gland swellings were enrolled between 2007-2009. Cases with inflammatory swelling were excluded from the study. Demographic, clinical history, preoperatively ultrasonography, cytology, and histopathological data were collected and analyzed. Results: Most cases (65.38%) had parotid gland involvement. Benign tumors were common (80.76%) with pleomorphic adenoma as the most common one. Malignant tumors comprised 19.23%. Mucoepidermoid carcinoma and adenoid cystic carcinoma were common malignant tumors. Local swelling was the most common clinical presentation, and no facial nerve involvement was reported. The hard palate was the most common minor salivary gland affected predominantly by benign tumors. The diagnostic accuracy of fine-needle aspiration cytology was 96.15%, followed by clinical and radiological diagnostic accuracy of 92.31% and 86.54%, respectively. Using McNemar's test, a significant agreement was found between clinical and histological diagnosis (p=0.1336) and between FNAC and histological diagnosis (p=0.4975). Conclusion: Fine needle aspiration cytology is a highly accurate, sensitive, and specific screening technique. It is safe and reliable, though minimally invasive. Ultrasonography-guided cytology along with clinical, and radiological findings could enhance the pre-operative diagnostic accuracy in distinguishing salivary glandtumors.

 Background: Salivary gland tumors are difficult to differentiate based solely on clinical presentation or cytological findings due to their overlapping pictures. Often inadequate samples from cytology pose a challenge in preoperative diagnosis. Histopathology is considered the gold standard in diagnosing these tumors. The purpose of this study was to determine clinical, radiological, and cytological findings of these tumors and to assess the accuracy of these results with that of histopathological diagnosis.

Methods: Prospectively 52 patients with salivary gland swellings were enrolled between 2007-2009. Cases with inflammatory swelling were excluded from the study. Demographic, clinical history, preoperatively ultrasonography, cytology, and histopathological data were collected and analyzed.

Results: Most cases (65.38%) had parotid gland involvement. Benign tumors were common (80.76%) with pleomorphic adenoma as the most common one. Malignant tumors comprised 19.23%. Mucoepidermoid carcinoma and adenoid cystic carcinoma were common malignant tumors. Local swelling was the most common clinical presentation, and no facial nerve involvement was reported. The hard palate was the most common minor salivary gland affected predominantly by benign tumors. The diagnostic accuracy of fine-needle aspiration cytology was 96.15%, followed by clinical and radiological diagnostic accuracy of 92.31% and 86.54%, respectively. Using McNemar's test, a significant agreement was found between clinical and histological diagnosis (p=0.1336) and between FNAC and histological diagnosis (p=0.4975).

Conclusions: Fine needle aspiration cytology is a highly accurate, sensitive, and specific screening technique. It is safe and reliable, though minimally invasive. Ultrasonography-guided cytology along with clinical, and radiological findings could enhance the pre-operative diagnostic accuracy in distinguishing salivary gland tumors.