ABSTRACT
Schwannoma in larynx is a rare presentaion. Laryngeal schwannomas are characterstically slow growing benign tumour usually arising from false cord and aryepiglottic fold with globus sensation being the most common presentation. Seldom it can present as stridor which need immediate intervention for survival of the patient. We present a case of 53 year female who presented with stridor at emergency and emergency tracheostomy was done. This patient had a history of dysphagia to solid food, hoarseness of voice and symptoms of aspirations. 70 degree rigid endoscopy and CEMRI of neck was performed to see the extent of the laryngeal lesion causing stridor. Tumor was excised completely by external transcervical approach. Histopathological reports suggested this tumor as schwannoma. Large obstructive laryngeal schwannoma though a unusual presentation but with immediate tracheostomy, proper diagnostic work up and precise surgical approach can give excellent recovery and post operative outcome for the patient.
ABSTRACT
Self-esteem is one of the most important psychological aspect of cosmetic surgery, in our case aesthetic rhinoplasty surgery. Self-esteem can be described as one's attitude towards ownself. Our aim is to assess the self-esteem pre-operatively in patients seeking aesthetic rhinoplasty with respect to those seeking functional rhinoplasty and also compare the post-operative improvement in the self-esteem in those patients. This is a Prospective comparative study in a Tertiary care centre. A total of 48 patients who were planned to undergo rhinoplasty over a period of 1 year in a tertiary care centre, A total of 48 patients (24 requiring aesthetic rhinoplasty and the rest functional rhinoplasty),grouped according to their primary objective, were asked to fill up Rosenberg's self-esteem scale pre-operatively and 6 months post-operatively. Independent t test was used for data analysis. The mean value of self-esteem in aesthetic rhinoplasty group was significantly lower as compared to functional rhinoplasty and there was also significant improvement of self-esteem score post -operatively in the aesthetic rhinoplasty group. Age,gender, marital status, socio-economic status and educational backgrounds were analyzed and there was no significant differences in these factors on comparison between the two groups. Our study showed that self-esteem is an important parameter in cosmetic surgery as patients opting for aesthetic rhinoplasty had lower self-esteem score pre-operatively and there was significant improvement of these scores post-operatively.
ABSTRACT
Capillary hemangioma involving external auditory canal, middle ear and mastoid cavity is a very rare entity. Due to infrequent incidence but multiple overlapping clinical and radiological features amongst some common middle ear pathologies this benign vascular tumour often can be misdiagnosed. Histopathological report helps us to get definitive diagnosis. 40 years old female presented with diminished hearing and mass in right ear cavity for last 3 years. The otoscopic examination of right ear showed a pinkish polypoidal mass at the external auditory canal and tympanic membrane could not be visualized. Patient had a history of cortical mastoidectomy 2 years back for the similar problem. HRCT temporal bone revealed a single cavity with soft tissue density content in right mastoid cavity which was extending into right middle ear and external ear. Contrast Enhanced MRI showed a long polypoidal heterogeneously but strong enhancing T2 and STIR hyperintense lesion within mastoid antrum extending into middle ear cavity and external auditory canal forming an aural polyp. Excision of the mass was done by canal wall down mastoidectomy and also type IIIc tympanoplasty performed in same sitting. There is no recurrence noted after 6 months of follow up and hearing improvement noticed. Capillary haemangioma of mastoid antrum extending to middle ear and external auditory canal requires surgical excision as preferred treatment modality, pre-operative imaging guide us to choose the preferred surgical approaches.
ABSTRACT
This paper investigates the history of drugs sold as "patent medicines" in India in the early twentieth century. The paper investigates their legitimacy as patenting of medicines was forbidden by the Indian Patents and Designs Act, 1911 (IPDA). The paper argues that the instrument of letters patents functioning as the prerogative of the Crown that gave monopolistic rights to grantees to sell any compound without having to disclose its constituents was the reason behind this seemingly conflicting historical relationship between the law and the market. Colonial law-making left sufficient space within the ambit of the IPDA for letters patents to have their ill effects. The colonial state made attempts to address this as a public health issue by incorporating concerns related to this class of medicines within regulations addressed to the drugs market in the 1930s. The currency of patent medicines in the market was further added to by Indian indigenous entrepreneurs fueled by cultural nationalism of Swadeshi ideology in Bengal in the early twentieth century. However, even such indigenous responses or attempts at hybridization of manufacturing and selling practices related to patent medicines were mostly informed by upper-caste/ upper-class interests and not so much by those of consumers of these medicines.
