Prosthesis for a Case of Subtotal Orbital Exenteration

Aims and objectives: To rehabilitate a patient with subtotal orbital exenteration defect. Case description: A 32 year old male with history of carcinoma of ethmoid, treated surgically with subtotal orbital exenteration presented with a defect communicating with the pharynx. He was rehabilitated with a prosthetic eye. Conclusion: A two piece cast with a removable part containing the defect made it very easy to fabricate the prosthesis. Patient was happy with the appearance and expressed satisfaction.&nbsp

Cutaneous Adverse Reactions Due to Antineoplastic Agents

Background- Cancer is a leading cause of mortality and morbidity in the world. Traditional as well as the newer targeted antineoplastic agents are associated with a wide array of Cutaneous Adverse Reactions (CARs). Objectives- The aim of our study is to find the prevalence of CARs and frequency of association with the antineoplastic agents at our centre. Methods- An observational study was conducted on 100 patients in Dermatology and oncology department of our centre from April 2022 to April 2023. We excluded patients who were on concurrent radiotherapy, CARs due to internal malignancies, cutaneous symptoms before chemotherapy, receiving immunosuppressive agents for other causes and having other dermatological conditions. Detailed history, examination and consent were taken in all included patients and Skin biopsies for histopathology were done in relevant cases. Results- Among 100 patients total 192 cutaneous adverse reactions were noted in our study affecting skin, hair and nail. In our study, skin was the most commonly affected site (53.13%) followed by hair (29.17%) and nail (17.71%) respectively. Anagen effluvium was the most common adverse effect finding reported in 50 patients (26.04%) followed by xerosis in 32 patients (16.66%). Most common nail changes were nail pigmentation in 20 patients (10.41%). Infusion site reaction was seen in only 10 patients (5.20%). Conclusion-antineoplastic agents lead to various CARs pertaining to skin, hair and nail changes. Proper understanding of these CARs will help in early detection, timely management and proper counselling of cancer patients

The dark side of cartilage: ochronosis unmasked during femoral neck fracture surgery

Alkaptonuria is a rare autosomal recessive disorder caused by a deficiency in homogentisic acid oxidase, leading to the accumulation of homogentisic acid in connective tissues. It is characterized by bluish-black pigmentation of cartilage and other connective tissues, with progressive joint degeneration and early-onset osteoarthritis. Ochronosis typically becomes symptomatic after the age of 30, affecting larger joints and the spine. A 75-year-old female presented with a transcervical femoral neck fracture and a right distal end radius fracture following a fall. During hip surgery, intraoperative findings included blackish discoloration of the femoral head and acetabulum. The patient had a history of stooped posture and calcified intervertebral discs. Further examination revealed ochronotic pigmentation of the sclera and ear cartilage, and a urine test confirmed the diagnosis of ochronosis. Postoperative recovery was uneventful. Ochronosis should be considered in the differential diagnosis of patients with calcified intervertebral discs and early-onset joint degeneration. The condition is typically asymptomatic until joint involvement occurs. Current treatment options are limited, though nitisinone and dietary modifications show some promise. This case highlights the importance of recognizing ochronosis in patients with joint degeneration, particularly when intraoperative findings reveal characteristic pigmentation

Mycosis fungoides in pediatric population : comprehensive review on epidemiology, clinical presentation, and management

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. However, it is rare in pediatric population. Most of the cases of pediatric MF present with hypopigmented patches and/or various other forms, which may often mimic common childhood dermatoses, thereby causing a delay in the diagnosis. There are no established treatment guidelines for pediatric MF. As the progression of childhood MF is extremely rare and it has an indolent course, it is usually diagnosed at an early stage (IA, IB, IIA), and hence phototherapy with a response rate of >80% is a well-established effective treatment in children. However, as recurrences are frequently seen on stopping the therapies, a maintenance regimen and long-term follow-up is equally important. This article reviews the epidemiological factors, clinical presentations, diagnosis, and various treatment modalities used in pediatric MF. We analyzed and compared the data of almost 616 childhood MF cases from various studies undertaken from 1988 to 2021

Cervical spine Injury clearance protocol in Polytrauma patients

Abstract: It is very common in General Hospita

Surgical outcomes of neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy in patients of locally advanced carcinoma of esophagus: A prospective cross-sectional comparative study

Background: Neoadjuvant chemoradiotherapy + radiotherapy (NACT+RT) or neoadjuvant chemotherapy (NACT) has been shown to improve survival in locally advanced esophageal carcinoma (EC). Comparative evaluation of NACT+RT versus NACT is ambiguous. Aims and Objectives: The current study was designed to evaluate the outcomes of NACT+RT versus NACT in locally advanced EC. Materials and Methods: In this prospective cross-sectional study, patients with operable, non-metastatic squamous cell carcinoma, and adenocarcinoma of the mid and lower esophagus (T3–T4a) were treated with NACT (paclitaxel 175 mg/m2 plus carboplatin 5 Area under curve (AUC) every 3 weeks) or NACT+RT (NACT with 45 Gy in 25 fractions over 5 weeks). Response, R0 resections, post-operative complications, and recurrence were comparatively evaluated. Results: Of 40 enrolled patients, 20 received NACT and 20 received NACT+RT. In the NACT arm, 50% of patients had a partial response and 20% had disease progression. In the NACT+RT arm, 10% of patients had disease progression whereas 25% of patients had complete pathological response. Transhiatal esophagectomy was performed in 60% of patients in the NACT arm, whereas in the NACT+RT arm, 80% of patients had three-stage esophagectomy. The average surgery duration was numerically greater for the NACT+RT arm; blood loss was also greater. Pulmonary complications and anastomotic leak rate were higher in NACT+RT arm whereas other complications such as hoarseness of voice, and wound dehiscence were higher in the NACT arm. Conclusion: NACT+RT had better partial and complete response rates and low recurrence rates versus NACT. Post-operative complications were higher in the NACT+RT, especially pulmonary complications and anastomotic leak. Further, large-scale studies are warranted to confirm the efficacy of NACT versus NACT+RT in EC

Photocatalytic degradation of ciprofloxacin·HCl using Aeroxide® P-25 TiO2 photocatalyst: Comparative evaluation of solar and artificial radiation

The photocatalytic degradation of ciprofloxacin (CFX) has been investigated using Aeroxide® P-25 TiO2 photocatalyst in the presence of solar as well as artificial radiation. The effects of different operating parameters like initial concentration of CFX, catalyst loading, pH of solution and effect of co-existing ions on photocatalytic degradation of CFX have been investigated with a view to establish the optimum operating conditions. It is observed that as the initial concentration of CFX increases, the rate of photocatalytic degradation decreases. Optimum catalyst loading is observed at 1 g L-1 for CFX concentration of 100 mg L-1. Over the pH range 3-11, maximum degradation rate occurs at pH 9. The mechanism and intermediates formed during the photocatalytic degradation of CFX are discussed based on UPLC-MS/MS analysis. From kinetic studies, it is found that the photocatalytic degradation obeys pseudo-first order kinetics. The degradation rate constant using solar radiation is about 1.7 times higher than that under artificial radiation

Efficacy of botulinum toxin in masseter muscle hypertrophy for lower face contouring

Background Masseter muscle hypertrophy (MMH) usually presents with cosmetic concerns as it may lead to widening of the lower face. Apart from the traditional surgical approaches, botulinum toxin type A (BTA) injection is a non-invasive treatment option available. There are no standard guidelines for this procedure. Objectives To study the efficacy of botulinumtoxin A in MMH for lower face contouring. Methodology The Cochrane Library, PubMed/MEDLINE, Google-scholar, Science-Direct database, and ResearchGate from inception until September 2021 were searched using the keywords “botulinumtoxin type A,” “masseter muscle hypertrophy,” “lower face contouring,” and “masseter botox.” All available retrospective and prospective studies, case-series, case-reports, and expert reviews were included with an emphasis on efficacy of BTA in MMH and units injected into the muscle, points of placement, adverse events, and the duration of its effect. Reference lists of the resultant articles, as well as relevant reviews, were also searched. Result 40 articles were shortlisted for the review, of which 14 studies with sample-size ≥10 in accordance with the study requirements were summarized in a tabular form for analysis and easy comparison and reference. Conclusion BTA injection is a non-invasive, safe, and effective treatment for MMH. The optimum number of BTA units could not be ascertained due to wide variability in the studies as well as ethnicity of patients and extent or some measurement of MMH. The points of placement of injection should be well within the boundaries of the masseter muscle. The maximum effect of BTA after a single injection session is usually seen in ~3 months, and the duration may last for 6–12 months. Multiple injection sessions may be required to maintain a long-term effect. Injection technique and total number of injection units of neuromodulator must be individualized for each patient

Hansen’s Disease- Lepromatous Type

A 36-year-old male presented with multiple skin-colored nodules involving both the ears and madarosis for last one year. There was no history of any other lesion elsewhere. Examination revealed lesions over the ear, ala of nose and diffusely infiltrated superciliary region (Panel A, B) and a normal sensory and motor system. Slit skin smear from the ear nodules revealed multiple acid-fast bacilli with globi formation and bacillary index of 6+ and morphological index (MI) of 35% (Panel C). He was diagnosed as Hansen’s disease-lepromatous type (LL) which is usually characterized by infiltrative lesions and nodules especially over face and edema of hands and feet.</jats:p