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Search Results: 1 - 10 of 219840 matches for " Raghav C. Dwivedi "
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A Unique Case of Pneumatised Styloid Process with Cholesteatoma
Mostayn Alam,Raghav C. Dwivedi,Faruque Riffat,Daniel Scoffings,David Moffat,Piyush Jani
Case Reports in Otolaryngology , 2013, DOI: 10.1155/2013/964725
Abstract: Pneumatisation of styloid process is a very rare finding and has never been reported previously. We present a unique case of a pneumatised styloid process with a cholesteatoma arising within the cavity. We describe the clinical features, associated radiological findings, and management of this lesion. 1. Introduction Styloid process develops from the dorsal part of the second branchial arch (Reichert cartilage) at around fourth week of intrauterine life [1, 2]. Its base becomes embedded in the petromastoid region of the temporal bone thereby making it a part of temporal bone. The pneumatisation of temporal bones starts late in fetal life and continues until the adult life [3]. Pneumatisation process is variable and in cases where there are well pneumatised temporal bones, accessory air cells may occur and communicate with the middle ear mastoid air cells [3, 4]. Therefore theoretically pneumatisation can be seen in some portions of the skull base as well [3]. Extensive pneumatisation of skull base and atlas vertebrae [3] has been described in the literature; however, pneumatisation of the styloid process has not been reported before. We present a unique case of pneumatised styloid process with a cholesteatoma arising within it. 2. Case A 43-year-old female presented to our otolaryngology department with an 11-month history of recurrent, right-sided otalgia and foul-smelling otorrhoea. The condition had been misdiagnosed as recurrent otitis externa. Patient denied any history of hearing impairment, vertigo, tinnitus, facial nerve palsy, or a history of head trauma. Clinical examination revealed squamous debris and purulent material in a grossly eroded floor of bony meatus with the lower half of the tympanic membrane hanging in the breeze. The facial nerve function was normal and there were no other neuro-otologic signs. Examination of contralateral ear and rest of the ENT examination were unremarkable. CT scan of the temporal bone demonstrated an extensively pneumatised styloid process containing a soft tissue mass (Figures 1(a) and 1(b)). Further MRI imaging showed a hyperintense material in the pneumatised right styloid process on T2 weighted imaging (Figure 2(a)), of intermediate signal intensity on fat suppressed T1 weighted imaging (Figure 2(b)) and marked hyperintensity on PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) diffusion weighted imaging (Figure 2(c)). These signal characteristics are typical of cholesteatomas. In addition there was erosion of the hypotympanum. No intracranial involvement was seen.
Chronic Cough, Reflux, Postnasal Drip Syndrome, and the Otolaryngologist
Deborah C. Sylvester,Petros D. Karkos,Casey Vaughan,James Johnston,Raghav C. Dwivedi,Helen Atkinson,Shah Kortequee
International Journal of Otolaryngology , 2012, DOI: 10.1155/2012/564852
Abstract: Objectives. Chronic cough is a multifactorial symptom that requires multidisciplinary approach. Over the last years, general practitioners refer increasingly more chronic cough patients directly to the otolaryngologist. The aim of this paper is to highlight the issues in diagnosis and management of chronic cough patients from the otolaryngologist perspective. Design. Literature review. Results. Gastroesophageal reflux and postnasal drip syndrome remain one of the most common causes of chronic cough. Better diagnostic modalities, noninvasive tests, and high technology radiological and endoscopic innovations have made diagnosis of these difficult-to-treat patients relatively easier. Multidisciplinary assessment has also meant that at least some of these cases can be dealt with confidently in one stop clinics. Conclusions. As the number of referrals of chronic cough patients to an Ear Nose Throat Clinic increases, the otolaryngologist plays a pivotal role in managing these difficult cases.
Chronic Cough, Reflux, Postnasal Drip Syndrome, and the Otolaryngologist
Deborah C. Sylvester,Petros D. Karkos,Casey Vaughan,James Johnston,Raghav C. Dwivedi,Helen Atkinson,Shah Kortequee
International Journal of Otolaryngology , 2012, DOI: 10.1155/2012/564852
Abstract: Objectives. Chronic cough is a multifactorial symptom that requires multidisciplinary approach. Over the last years, general practitioners refer increasingly more chronic cough patients directly to the otolaryngologist. The aim of this paper is to highlight the issues in diagnosis and management of chronic cough patients from the otolaryngologist perspective. Design. Literature review. Results. Gastroesophageal reflux and postnasal drip syndrome remain one of the most common causes of chronic cough. Better diagnostic modalities, noninvasive tests, and high technology radiological and endoscopic innovations have made diagnosis of these difficult-to-treat patients relatively easier. Multidisciplinary assessment has also meant that at least some of these cases can be dealt with confidently in one stop clinics. Conclusions. As the number of referrals of chronic cough patients to an Ear Nose Throat Clinic increases, the otolaryngologist plays a pivotal role in managing these difficult cases. 1. Introduction Chronic cough is a persistent and frustrating symptom for many adults and children and a frequent reason for primary or secondary care visits or referrals. This condition generates significant healthcare and economic cost and is associated with a spectrum of disorders across multiple medical specialties and can provide significant challenges for the involved physician or surgeon. Chronic cough is associated with deterioration in the quality of patients’ lives. Associated symptoms and negative outcomes with this condition include loss of sleep, exhaustion, irritability, urinary incontinence, cough syncope, social disability, and inability to perform daily activities. Many patients experience chronic cough secondary to another medical condition, such as COPD, asthma, rhinosinusitis, Gastroesophageal reflux syndrome (GERD), postnasal drip syndrome (PNDS), or unknown etiology. GERD is thought to be the most common cause of chronic cough in a nonsmoker nonasthmatic individual. Thorough assessment of a patient with a chronic cough relies on a multidisciplinary approach. The otolaryngologist should be familiar with the diagnostic algorithm of chronic cough patients and should work closely with the gastroenterologist and the pulmonologist, ideally in “cough clinics,” to confidently diagnose and treat these patients. 1.1. Reflux and Chronic Cough Chronic nonspecific cough, defined as a nonproductive cough in the absence of identifiable respiratory disease or known cause [1] persisting for more than three to eight weeks [2], poses a significant burden to healthcare
Cancer stem cells: An enigma in head and neck cancer
Kazi Rehan,Sayed Suhail,Dwivedi Raghav
Journal of Cancer Research and Therapeutics , 2010,
Abstract:
Perspective on robotic surgery and its role in head and neck cancers
Kazi Rehan,Garg Anubha,Dwivedi Raghav
Journal of Cancer Research and Therapeutics , 2010,
Abstract:
Mucosal melanoma of nasal cavity and paranasal sinus
Dwivedi Raghav,Dwivedi Ravi,Kazi Rehan,Kumar Sumit
Journal of Cancer Research and Therapeutics , 2008,
Abstract: Mucosal melanoma of the nasal cavity and paranasal sinuses is seldom encountered in routine ENT practice. These tumors have poor prognosis owing to higher rates of locoregional recurrence and distant metastasis. Various treatment modalities have been employed over time but the ideal treatment approach still remains an open issue. This article presents some commonly accepted guidelines in treating these rare mucosal neoplasms.
Non-Hodgkin′s lymphoma of the sino-nasal tract in children
Zagolski Olaf,Dwivedi Raghav,Subramanian Somasundaram,Kazi Rehan
Journal of Cancer Research and Therapeutics , 2010,
Abstract: Childhood head and neck cancers are relatively uncommon. Of all head and neck cancers occurring in children, non-Hodgkin′s lymphoma (NHL) is the most common, others being rhabdomyosarcoma and nasopharyngeal carcinoma. In the head and neck region, sinuses are the second commonest primary site of NHL after neck lymph nodes. These can be of several different types depending on the predominant cell type and histologic appearance, the most common histological variant being diffuse large B-cell lymphoma. In an attempt to simplify the classification and to develop a universally acceptable classification and staging, they have been classified and staged numerous times over the last three decades, adding more confusion to the topic. Clinical presentations vary according to the histological type. The low grade lymphomas present with a nasal cavity or para-nasal sinus mass associated with obstructive symptoms and/or lymphadenopathy, while high grade lymphomas present with aggressive signs and symptoms including non-healing ulcer, epistaxis, septal perforation and bony destruction. The primary treatment consists of chemotherapy and / or radiation therapy, which is able to achieve remission in two-third of the patients, however, prognosis remains poor with cumulative five-year survival rates at about 30% for all the types of sino-nasal NHLs. Newer targeted therapy (monoclonal antibodies) and combination therapies (including stem cells) are currently being tested in order to improve survival rates in these patients. This article aims at providing an overview of clinico-epidemiologic characteristics, staging system currently in use, management, prognosis and possibilities of future research in the field of childhood sinonasal NHLs.
Nonlinear shock structure in a weakly ionised magnetoplasma
C. B. Dwivedi,S. C. Tripathy
Annales Geophysicae (ANGEO) , 2003,
Abstract: The formation of a neutral induced weak nonlinear shock structure in a weakly ionised magnetoplasma has been analytically investigated. Using the reductive perturbation method, basic dynamical equations of a three-component (electron, ion and neutral) plasma have been reduced to a well-known Burger equation which can support a weak shock solution. Its stationary and initial value solutions have been derived to describe the characteristics of the weak shock profile. Asymptotic behaviour of the Burger solution results in a saw-tooth structure which has a practical implication to predict the nonlinear steepened structure of the nighttime irregularity in the lower portion of the Earth's ionosphere. Accordingly, it is suggested that the observation of saw-tooth shape of nighttime irregularity at 92 km could be attributed to the nonlinear saturation of the NILF mode instability as proposed by Dwivedi and Das in 1992. However, exact experimental verification of this suggestion requires more data on nighttime irregularity in the mesosphere and lower thermosphere (80-95 km) for a wide range of scale sizes extending up to about 1 km and above.
Effect of electron inertial delay on Debye sheath formation
Deka, U.;Dwivedi, C.B.;
Brazilian Journal of Physics , 2010, DOI: 10.1590/S0103-97332010000300014
Abstract: present contribution deals with the role of weak but finite electron inertia on the sheath formation condition. as reported earlier this becomes effective when the ions' drift velocity exceeds the phase velocity of the acoustic wave fluctuations. such situation has natural existence near the sheath edge. keeping this in mind we have revisited the problem of usual bohm sheath condition. analytical and numerical analysis have been performed to re- derive the local condition for plasma sheath formation. it is found that the weak but finite electron inertia reduces the threshold value of ion mach number that may be, at least in principle, of qualitative value to define the sheath edge boundary. consideration of finite but weak equilibrium electron flow at the defined sheath edge shrinks the width of non- neutral space charge layer over which major potential drop and charge imbalance occurs. detailed numerical analysis and results of quantitative and qualitative importance are included in the text.
On conformal transformation of certain Finsler spaces
S. C. Rastogi,A. K. Dwivedi
Tamkang Journal of Mathematics , 2007, DOI: 10.5556/j.tkjm.38.2007.277-289
Abstract: $;$
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