This document summarizes a case report of a rare case of bilateral squamous cell carcinoma of the temporal bones in a 30-year-old male patient who presented with extensive late-stage disease. Imaging showed large lesions destroying bone structure in the right temporal bone and a smaller lesion in the left. Biopsy confirmed squamous cell carcinoma in both ears. The right-sided tumor was deemed unresectable and the patient received palliative radiotherapy, with a poor prognosis. Bilateral temporal bone cancer is exceptionally rare and this represents one of the few reported cases.
Traditionally, obtaining tissue diagnosis from the Temporomandibular Joint (TMJ) has required invasive open techniques. In this case-series, the authors demonstrate a minimally invasive technique using arthroscopy to diagnose and treat Pigmented Villonodular Synovitis (PVNS) and pseudogout of the TMJ, followed by a review of the literature.
Chondroblastic osteosarcoma of the left zygomatic bone rare case report and ...Prashant Munde
Chondroblastic osteosarcoma (COS), a subgroup of intramedullary
osteosarcoma (OS), is the most common osteosarcoma that occurs in
adolescents and early adulthood. The COS has similar clinical and radiological
features to those of conventional OS. We present a case of 20‑year‑old male
patient with the chief complaint of pain and swelling in the left zygomatic region.
The computed tomography (CT) and three‑dimensional (3D) CT face showed
erosion, calcific foci, sunray type of spicules suggestive of OS. On fine‑needle
aspiration cytology (FNAC) examination, initial diagnosis was malignant
chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma,
COS on incisional biopsy and finally COS on excisional biopsy. The patient
underwent radical resection of left zygomatic arch, followed by chemotherapy.
Although clinically unsuspected in this unusual site, histopathology along with
immunohistochemistry (IHC) results confirmed the COS. Because zygomatic
location of COS is very rare, this report aimed to discuss clinical, radiographic,
histopathologic, IHC findings and diagnostic pitfalls of COS in light of the
literature.
The Central Giant Cell Lesion is very interesting pathologically, as it is one of the few disease processes that we can alter minimize with something other than surgery. I have been fortunate to treat a number of cases, both with direct excision as well as with steroids and calcitonin. I hope that this presentation is useful to you.
Traditionally, obtaining tissue diagnosis from the Temporomandibular Joint (TMJ) has required invasive open techniques. In this case-series, the authors demonstrate a minimally invasive technique using arthroscopy to diagnose and treat Pigmented Villonodular Synovitis (PVNS) and pseudogout of the TMJ, followed by a review of the literature.
Chondroblastic osteosarcoma of the left zygomatic bone rare case report and ...Prashant Munde
Chondroblastic osteosarcoma (COS), a subgroup of intramedullary
osteosarcoma (OS), is the most common osteosarcoma that occurs in
adolescents and early adulthood. The COS has similar clinical and radiological
features to those of conventional OS. We present a case of 20‑year‑old male
patient with the chief complaint of pain and swelling in the left zygomatic region.
The computed tomography (CT) and three‑dimensional (3D) CT face showed
erosion, calcific foci, sunray type of spicules suggestive of OS. On fine‑needle
aspiration cytology (FNAC) examination, initial diagnosis was malignant
chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma,
COS on incisional biopsy and finally COS on excisional biopsy. The patient
underwent radical resection of left zygomatic arch, followed by chemotherapy.
Although clinically unsuspected in this unusual site, histopathology along with
immunohistochemistry (IHC) results confirmed the COS. Because zygomatic
location of COS is very rare, this report aimed to discuss clinical, radiographic,
histopathologic, IHC findings and diagnostic pitfalls of COS in light of the
literature.
The Central Giant Cell Lesion is very interesting pathologically, as it is one of the few disease processes that we can alter minimize with something other than surgery. I have been fortunate to treat a number of cases, both with direct excision as well as with steroids and calcitonin. I hope that this presentation is useful to you.
Ossifying fibroma vs fibrous dysplasia of the jaw/rotary endodontic courses b...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Austin Head & Neck Oncology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Head & Neck Oncology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of head & neck oncology. Austin Head & Neck Oncology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Head & Neck Oncology.
Austin Head & Neck Oncology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Austin Head & Neck Oncology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Head & Neck Oncology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of head & neck oncology. Austin Head & Neck Oncology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Head & Neck Oncology.
Austin Head & Neck Oncology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Ossifying fibroma vs fibrous dysplasia of the jaw/rotary endodontic courses b...Indian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
Austin Head & Neck Oncology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Head & Neck Oncology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of head & neck oncology. Austin Head & Neck Oncology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Head & Neck Oncology.
Austin Head & Neck Oncology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Austin Head & Neck Oncology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Head & Neck Oncology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of head & neck oncology. Austin Head & Neck Oncology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Head & Neck Oncology.
Austin Head & Neck Oncology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Skull Metastasis From Papillary Thyroid Carcinoma : Case Report and Literatur...komalicarol
Although papillary thyroid carcinoma is a relatively common form of malignancy, metastatic spread to the skull
is exceptional. Here, we report a case of papillary thyroid carcinoma revealed by frontal skull metastasis.
Skull Metastasis from Papillary Thyroid Carcinoma: Case Report and Literature...semualkaira
Although papillary thyroid carcinoma is a relatively common form of malignancy, metastatic spread to the skull
is exceptional. Here, we report a case of papillary thyroid carcinoma revealed by frontal skull metastasis.
An Unusual Case of Secondary in Sphenoid Sinus from Carcinoma Prostate by George MV in Experiments in Rhinology & Otolaryngology
https://crimsonpublishers.com/ero/fulltext/ERO.000518.php
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine, Al-Azhar University. Ameloblastoma is benign slow-growing but locally invasive neoplasm of odontogenic origin. In 2005, the WHO has classified ameloblastomas into multi cystic, unicystic and peripheral subtypes. The clinical picture, radiographic findings and differential diagnosis are presented. Treatment of ameloblastomas is primarily surgical. There has been some debate regarding the most appropriate method for removing. These range from conservative to radical modes. Some authors advocate conservative approach and thought that ameloblastoma are essentially benign in nature and should be treated as such. However, this conservative approach result in recurrence rates of 55% to 90%of the cases. Currently, the standard of care for ameloblastoma includes en bloc resection with 1-2 combine margin and immediate bone reconstruction. Despite the medical nature of a surgical resection, it may actually involve less morbidity than extensive hard and soft tissue resection with associated extensive morbidity that may be warranted in case of recurrence following inadequate primary treatment.
Journal of Pathology & Microbiology is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Pathology & Microbiology.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Pathology & Microbiology. Journal of Pathology & Microbiology accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of pathology & microbiology.
Journal of Pathology & Microbiology strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Background: Perforated tympanic membrane and middle ear infection are among common complications treated by tympanoplasty. This study was aimed to compare the effects of underlay and overlay tympanoplasty on the improvement of hearing and tympanic membrane landmarks and post-operative complications as well.
This study was performed Department of Otor hinolaryngology, Jubilee Mission Medical College, thrissur, Kerala for a period of 2 years commencing from December 2012 to November 2014. To review our experience with deep neck space infections and to study changing trends. The objectives were to study clinical presentation, etiology, associated systemic diseases, bacteriology, radiology, management and outcome of deep neck space infections.40 Patients coming from both urban and rural areas irrespective of age and sex admitted in department of ENT with deep neck space infections which was confirmed either clinically or radiologically. Superficial skin abscesses and abscesses due to infections of external neck injuries were excluded from the study \r\n.
Objectives: To determine the potential of“Black Bone” MRI as an alternative to CT in the maturation parameters of the palatine suture and identify the optimal time to perform orthodontic palatal expansion. Methods: two patients from 10.3 and 25.9 years underwent “Black Bone” MRI “, T1 and T2 weighted spin echo imaging were obtained in the axial plane in addition to routine cranial RMI. “Black Bone” datasets weresubsequently compared to T2 wheighted RMI for the visualisation medial palatine sutures by using a similarbased method to evaluate suture fusion stages. Results: Patient palatine sutures were consistently identified on “Black Bone” MRI as áreas with different signal intensity according to the maturation stage, from complete separation of the halves to total fusion, as also found in the T2 weighted protocol.“Black Bone” MRI can be considered as an alternative o CTBC to assess the maturation of medial palatine suture for orthodontic purposes. Conclusions “Black Bone” MRI has considerable clinical potential as a nonionising alternative to CT in the assessement of the medial palatine suture.
The Mastoid Compartment of Middle Ear Cleft-A Clinic Pathological Study in Patients with Chronic Otitis Media-Mucosal Type by George MV in Experiments in Rhinology & Otolaryngology
https://crimsonpublishers.com/ero/fulltext/ERO.000525.php
The Utility of the Bird’s Eye View in Rhinoplasty by Anil R Shah in Experiments in Rhinology & Otolaryngology
Objectives: To examine the utility of the bird’s eye view in its use of preoperative rhinoplasty photographic analysis. The nose is a 3 dimensional object and therefore it stands to reason that viewing the nose from an additional angle would both assist in analyzing the deviation of the nose as well as in patient education.
Invasive Fungal Sinusitis: Management of the
Orbit, a Multi Institutional Study and Review of
Literature by Abhishek Kumar Ramadhin in Experiments in Rhinology & Otolaryngology
https://crimsonpublishers.com/ero/fulltext/ERO.000522.php
Metastatic Atypical Fibroxanthoma: Case Report of an Uncommon Pathology in the Head and Neck by Luis Boccalatte in Experiments in Rhinology & Otolaryngology
Atypical fibroxanthoma (AFX) is an uncommon skin neoplasm developed mainly in the head and neck region in older senior patients. Prolonged sun exposure, actinic damaged, history of previous neoplasms and immunosuppressant are considered the most important risks factors. Subcutaneous extension of these tumors is related to a more aggressive biology.
https://crimsonpublishers.com/ero/fulltext/ERO.000521.php
The Role of the Nasal Inspiratory Flow Peak, the Clinical and of the Visual Analogue Scale in the Evaluation of Allergic Rhinitis by Ana Carolina Gonçalves Ribeiro de Carvalho in Experiments in Rhinology & Otolaryngology
https://crimsonpublishers.com/ero/fulltext/ERO.000519.php
Premalignant Lesions of Oral Cavity - A Clinicopathological Study by Mohit Srivastava in Experiments in Rhinology & Otolaryngology
We conducted a study on a total of 360 patients to find out the incidence of premalignant disorders in the oral cavity who attended the ENT opd of Saraswathi Institute of Medical Sciences, Hapur. The study design was cross sectional in nature. Out of all the 360 patients who were suspected to have premalignant disorders of oral cavity were subjected to biopsy and 87 of them were found to be premalignant. Incidence was found to be 24.53% in males and 23.6% in females. Buccal mucosa was most common site of involvement.
https://crimsonpublishers.com/ero/fulltext/ERO.000515.php
A Rare Case of Nasal Inferior Meatus Polyps by George MV in Experiments in Rhinology & Otolaryngology
This is a case report of a patient with a sided nasal inferior meatus polyposis. A 34-year-old female patient rested with history of discharge coming from right side of nose of 6 months duration. On examination, there was minimal discharge in the floor of the nose. On endoscopy, there was a swelling under the inferior turbinate. CT PNS showed an enlarged inferior turbinate of the same side and bilateral concha bullosa, and mild maxillary sinusitis. The patient had undergone an endoscopic excision biopsy of the swelling and the histopathological report was Inflammatory Nasal polyps.
https://crimsonpublishers.com/ero/fulltext/ERO.000514.php
Management Outcomes of Post-Thyroidectomy Bilateral Recurrent Laryngeal Nerve Paralysis at National Hospital Abuja by Olusesi Abiodun Daud in Experiments in Rhinology & Otolaryngology
Bilateral recurrent laryngeal paralysis is an uncommon complication of total or subtotal thyroidectomy, observed in approximately 0.4 per cent of cases. This paralysis could be temporary or permanent. An audit of 5 cases referred to the ENT Department of National Hospital Abuja, between January 2010 and July 2017 is presented. All cases were referred already on tracheostomy tubes and were females aged 11 to 59 years. 4 of the cases had external arytenoidectomy, bilateral in 2 cases, and unilateral in 2 cases. 4 out of the 5 cases were successfully decannulated. The preferred approach to cases of post-thyroidectomy bilateral recurrent laryngeal nerve paralysis referred to ENT Specialists in resource-poor economy like ours is not very clear from existing literature and we discuss our adopted protocol for management of such cases in this case series.
https://crimsonpublishers.com/ero/fulltext/ERO.000511.php
Evaluation of Radiotherapy Effect on Auditory System in Patients with Head and Neck Tumors by Seyedeh Mahtab Ashja Arvan in Experiments in Rhinology & Otolaryngology
Radiotherapy in patients with head and neck tumors may result in damage of different organs such as eyes and ears. However, there is no consensus regarding the level of damage, especially its effect on hearing threshold. This study has been designed to determine the effect of radiotherapy on auditory system of patients with head and neck tumors.
https://crimsonpublishers.com/ero/fulltext/ERO.000509.php
Post-Thyroidectomy Laryngeal Diplegia in Mali: What Therapeutic Challenge? by Kone Fatogoma Issa in Experiments in Rhinology & Otolaryngology
Post-thyroidectomy laryngeal diplegia is the most common and most feared complication [1]. It occurs following a recurrent nerve lesion in 26 to 59% of cases [1,2]. Tracheotomy was considered until 1922 as the only reference treatment [3,4]. Therapeutic approaches have evolved over time, ranging from convention altranslaryngeal or extralaryngeal therapy to endoscopic laser approaches [5]. These endoscopic methods emphasized endoscopicary tenoidectomy and posterior transverse cordotomy [4,6]. Laser transverse posterior cordotomy has proved its efficacy, illustrated by the work of Denis and Kashima and Laccoureye & Merite Drancy [4,7].
Regeneration of Traumatic Tympanic Membrane Perforations by Zhengcai-Lou in Experiments in Rhinology & Otolaryngology
Traumatic tympanic membrane perforations (TTMPs) are commonly encountered by otologists. They can be caused by a physical blow to the ear (such as a collision or slap), blast, barotrauma (pneumatization of the mastoid cells) or insertion of sharp objects (such as cotton swabs, bobby pins and sticks) [1- 3]. Among these, collision is more often the cause in males, while perforation induced by insertion of a cotton swab is approximately twice as common in females [2].
https://crimsonpublishers.com/ero/fulltext/ERO.000506.php
Microbial Flora in Chronic Rhinosinusitis with and without Nasalpolyps by José Gameirodos Santos in Experiments in Rhinology & Otolaryngology
The most common microbial agents in the etiology of chronic rhinosinusitis are defined in the literature as Staphylococcus aureus, Staphylococcus coagulase-negative and Streptococcus spp. In healthy individuals these same microorganisms are also the most frequent (mainly Staphylococcus coagulase negative) ascolonizing flora agents. We often encounter a poly microbial colonization of the nose and sinuses. The contribution of the different pathogens for the disease remains sun certain. The aim of this study is to compare the microbial flora found in patients with chronic rhinosinusitis with and without nasal polyps.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
2. How to cite this article: Asok K S, Titas K, Nirmalya R. An Unusual Presentation of Squamous Cell Carcinoma of Bilateral Temporal Bones. Exp Rhinol
Otolaryngol. 1(2). ERO.000510. 2018. DOI: 10.31031/ERO.2018.01.000510
Experiments in Rhinology & Otolaryngology
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Exp Rhinol Otolaryngol
Figure 3: HRCT Temporal bone.
The patient was admitted and started on intravenous
antiobiotics and analgesics. A high resolution CT scan of both
temporal bones was ordered, which revealed a large heterogenous
soft tissue density behind right pinna, measuring about 37mm x
23mm in the maximum cross sectional diameter, which extended
to involve the right parotid. Soft tissue densities were also noted
in bilateral ear canals. There was a large post operative cavity on
the right mastoid region. Bilateral inner ear structures were normal
(Figure 3). To know the extent of soft tissue involvement, a contrast
MRI of both temporal bone region along with neck was ordered.
T2 weighted FSE & STIR images showed large heterogenous lesion
with complete bony destruction of right middle ear, involving right
ear canal, pinna, right parotid and extending to middle & posterior
cranial fossa, with involvement of the neurovascular planes. Focal
enhancing lesion was also seen in left ear confined to petrous bone,
about 28mm x 24mm x 26mm in size. These pointed towards a
neoplastic lesion (Figure 4).
Figure 4: Contrast MRI.
Biopsy was taken from both the ears under general anaesthesia
and the ears were packed with gauze packing to control the
significant amount of bleeding. Histopathological studies revealed
welldifferentiatedinfiltratingkeratinisingsquamouscellcarcinoma
of both the ears, with the tumour cells arranged in solid nests and
sheets with peritumoral chronic inflammatory cell infiltration
(Figure 5).
Figure 5: H & E, 40X.
Sincethetumoursonbothsidesdidnothaveanyinterconnection
beween them, both were diagnosed as primaries. Using the
University of Pittsburgh staging system for temporal bone tumours,
the lesions on both the sides were independently staged. The right
side was staged to Stage IV (T4N0M0) while the left side was staged
to Stage II (T2N0M0).
Since such a large tumour required multimodality treatment,
a tumour board was constituted. The lesion was deemed
unresectable, so the patient was put up for palliative radiotherapy
in a dosage of 30 Gy over 10 fractions. During the course of his
treatment, he developed intractable pain, and his analgesics were
stepped up gradually and ultimately, he had to be started on opioid
analgesics (morphine tablets). Eye care for prevention of exposure
keratitis was prescribed. Since prognosis was grave, the patient’s
relatives were counselled about providing the best supportive care.
At the last follow up, patient had completed his course of palliative
chemotherapy but his general condition was extremely poor. He is
alive as of January 2018.
Discussion
Squamous carcinoma of the temporal bone is a rare but
3. How to cite this article: Asok K S, Titas K, Nirmalya R. An Unusual Presentation of Squamous Cell Carcinoma of Bilateral Temporal Bones. Exp Rhinol
Otolaryngol. 1(2). ERO.000510. 2018. DOI: 10.31031/ERO.2018.01.000510
3/3
Exp Rhinol OtolaryngolExperiments in Rhinology & Otolaryngology
aggressive tumour, usually having a poor prognosis. Survival rate
decreases with increasing stage of the disease [7]. The main staging
system used today, despite being flawed, is the revised Pittsburgh
classification system [8,9]. Surgical resection of the tumour, with
adjuvant radiotherapy for advanced stage disease appears to be the
treatment of choice with the extent of surgery being a subject of
debate [4,10]. Prasad et al. [11], in their meta-analysis on temporal
bone carcinoma treatment, found that survival rates in case of
advanced stage disease stayed poor, despite the extent of primary
surgery.
Pensak et al. [12] considered that invasion of any of the
following structures: cavernous sinus, carotid artery, infratemporal
fossa, paraspinous musculature make a tumour unresectable. In the
present case, the tumour was deemed unresectable due to spread to
the infratemporal fossa and also had extensive involvement of the
neurovascular planes. Since the patient already had very advanced
disease in the right ear, there was no obvious benefit for operating
on the left ear, and so surgery was not contemplated for the left ear
although it was Stage II.
References
1. Kuhel WI, Hume CR, Selesnick SH (1996) Cancer of the external auditory
canal and temporal bone. Otolaryngol Clin North Am 29(5): 827-852.
2. Moffat D, Wagstaff SA (2003) Squamous cell carcinoma of the temporal
bone. Curr Opin Otolaryngol Head Neck Surg 11(2): 107-111.
3. Beyea JA, Moberly AC (2015) Squamous cell carcinoma of the temporal
bone. Otolaryngol Clin North Am 48(2): 281-292.
4. Kinney SE, Wood BG (1987) Malignancies of the external ear canal and
temporal bone: surgical techniques and results. Laryngoscope 97(2):
158-164.
5. Bibas AG, Gleeson MJ (2006) Bilateral Squamous Cell Carcinoma of the
Temporal Bones. Skull Base 16(4): 213-218.
6. Vamvakidis T, Sengas J, Xenellis J (2010) Bilateral carcinoma of the
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