Temporary resolution of hemicrania continua following ipsilateral ear piercing

BackgroundHemicrania continua is an uncommon subtype of trigeminal autonomic cephalgia that exhibits dramatic therapeutic response to indomethacin. Unfortunately, indomethacin is associated with a range of adverse effects, including neuropsychiatric complications, which limits its use in many patients. Although no other effective pharmacologic agents exist, there is emerging evidence for interventional treatments such as occipital nerve and vagus nerve stimulation, which may act by modulating neural activity within the trigeminovascular system.CaseWe present a 30-year-old woman with long-standing refractory hemicrania continua who suffered adverse effects to indomethacin. She experienced temporary, but near-complete, symptom resolution following piercing of the crus of the ear helix ipsilateral to her headache, whereas contralateral piercing produced no benefit.ConclusionsTo our knowledge, this case is the first to describe a therapeutic benefit following ear piercing in a patient with trigeminal autonomic cephalgia. We argue that symptom relief was obtained through a similar mechanism to occipital or vagus nerve stimulation.

“COMPARATIVE STUDY OF EFFICACY OF TOPICAL SILICONE GELAND INTRALESIONAL TRIAMCINOLONE IN TREATMENT OF KELOID”

INTRODUCTION: Keloid is a common wound healing disorder encountered in post surgery, burn and even minor injury such as ear piercing. The greatest morbidity in treatment of keloid is its high chances of recurrence post surgery. It creates a great challenge in the management of keloid. Following any trauma and surgery, the wound healing generally takes place and is completed by 6-12 months. In some patients this process is delayed and extends beyond 1 year and the excess scar formation occurs. AIMS AND OBJECTIVES: There are different modalities for the treatment of keloid. None of these modalities provides 100% efcacy in managing lesions. Different modalities have highly varying efcacy among themselves. So the objective of this study is to compare the efcacy of Intralesional Triamcinolone and topical silicon gel in management of keloid. METHODOLOGY: Sixty patients of keloid attending the outpatient Department of Surgery, Darbhanga Medical College and Hospital, Laheriasarai; Darbhanga, Bihar, constituted the source of data for a period of 2 years from January 2019 to December 2020. This study included two different treatment regimens with 30 patients in each group. RESULTS AND ANALYSIS: the students constituted the maximum number of cases i.e 38.3 % followed by housewife 30.0% ,farmers 18.3%, labouerer 6.7%, others 6.7%. respectively. however the occupation in the prevalence of disease is not signicant (p value >0.05). In majority of patients the duration of lesion was between 1 and 2 years (65 %) followed by <1 years (23.33%). Minimum number of patients were in >2 years (11.67 %) of duration. The range of duration of lesions was 6 months to 2.5 years. SUMMARYAND CONCLUSION: The both modalities of treatment was more effective in treating smaller size and shorter duration of lesion than massive keloids. Thus keloids are more common in female , over the prestrernal region and mostly present in third decade of life. Both Intralesional Triamcinolone and Topical silicon gel are effective in treating keloid with minimal side effective. Relatively better responses was seen with using Intralesional Trimacinolone than silicon gel. But silicon gel had advantage that it can used by patient itself and lesser frequency of hospital visits for administration.

Ear and pubic keloids in an adolescent girl, the experience of a successful treatment

Keloids are frequent connective tissue tumors characterized by a significant proliferation of fibroblasts and collagen with a recurrent and extensive tendency. They can be secondary to a solution of cutaneous continuity: surgical wound; vaccination; burn; hard inflammatory lesion. Sometimes spontaneous, and are more frequently observed in black populations [1-3]. We report the case of a 20 year old women, melanoderma, with no known pathological history who presented to our department with multifocal slightly pruritic tumor lesions evolving for 4 years on the auricle and the pubis. The patient and her companions thought of a mystical disease. The interrogation revealed that these lesions occurred after an ear piercing and folliculitis lesions on the pubic area. The examination revealed a good general condition, firm non sensitive normochromic tumor lesions of variable size with smooth surface, protruding and adherent to the deep plane located on the pubis and bilaterally on the auricle.

Hybrid Carrier Frequency Modulation Based on Rotor Position to Reduce Sideband Vibro-Acoustics in PMSM Used by Electric Vehicles

In the permanent magnet synchronous motor (PMSM) drive system, the unwilling and ear-piercing vibro-acoustics caused by high-frequency sideband harmonics becomes unacceptable in electric vehicle applications. In this paper, a modified space vector pulse width modulation (SVPWM) technique implemented with a hybrid carrier frequency modulation (HCFM) is provided to reduce the sideband current harmonic components and vibro-acoustic responses. The principle and implementation of the proposed HCFM technique are firstly presented in which the fixed carrier frequency is improved with the sawtooth and random signal-based coupling modulation based on the rotor position. The analytical derivations with the power spectral density method are also proposed. For verification, the experiment tests are conducted on a prototype 12/10 PMSM and microcontroller unit. The effectiveness of the HCFM technique can hence be confirmed considering the sideband vibro-acoustics reduction operated more effectively than that in a conventional random PWM. The proposed approach may provide a new route in noise-cancelling and electromagnetic compatibility for the electric drive powertrain.

Hybrid Carrier Frequency Modulation Based on Rotor Position to Reduce Sideband Vibro-acoustics in PMSM Used by Electric Vehicle

In the permanent magnet synchronous motor (PMSM) drive system, the unwilling and ear-piercing vibro-acoustics caused by high-frequency sideband harmonics becomes unacceptable in the electric vehicle application. In this paper, a modified space vector pulse-width modulation (SVPWM) technique implemented with hybrid carrier frequency modulation (HCFM) is provided to reduce the sideband current harmonic components and vibro-acoustic responses. The principle and implementation of the proposed HCFM technique are firstly presented, in which the fixed carrier frequency is improved with the sawtooth and random signal-based coupling modulation based on the rotor position. For verification, the experiment tests are carried out on a prototype 12/10 PMSM and microcontroller unit. The effectiveness of the HCFM technique can hence be confirmed, in which the sideband vibro-acoustics reduction shows more effectively than that in conventional random PWM. The proposed approach may provide a new route in noise-cancelling and electromagnetic compatibility for the electric drive powertrain.

STUDY OF KARNAVEDHANA: ANCIENT AND CONTEMPORARY METHODS

Background - KarnavedhanaSanskara is one of Important Sanskara. The process of ear piercing is known as Karnavedhana mentioned in ayurvedic text. In today’s era goldsmith, physician, beautician and Boharin performs Karnavedhana. Whether these performers are aware of method explained by Acharya Sushruta? To find answer to aforesaid question this observational survey is carried out. Aim -Understanding the different methods of Kar- navedhana i.e. ear piercing. Objectives - To understand different methods, different performers and proper site of Karnavedhana. Material - Ayurvedic literature i.e. Sushruta Samhita; Survey sheet; Research papers; Articles; Journals; Internet. Methods - Type of study – Observational study. Conclusion- There are four Karnavedhana performers in society viz 1. Goldsmith, 2. Physician, 3. Beautician 4. Boharin. Commonly used methods are gold- smith and physician. No above performer has knowledge of scientific method of Karnavedhana explained in Sushruta Samhita. Keywords: Daivkrutachhidra, Karnavedhana, ear piercing, Boharin.

EVALUATION OF ASSOCIATED RISK FACTORS IN CHRONIC SUPPURATIVE OTITIS MEDIA PATIENTS REPORTED IN COMMUNITY HEALTH CENTER, CHENANI

Background: Chronic suppurative otitis media or CSOM is characterized by recurrent or persistent ear discharge, or otorrhoea, for a period of 2 to 6 weeks, through the tympanic membrane perforation. Studies often present a varying incidence of CSOM, but it is the most important cause of deafness in India. Risk factors are mainly associated with low socioeconomic status, crowded atmosphere, low parental education level, poor nutrition, frequent upper respiratory tract infection and chronic diseases. Methods: A retrospective- observational study of 300 patients of CSOM, selected from OPD of the Department of Otorhinolaryngology, CHC, Chenani, Udhampur, Jammu, J&K, was conducted during August 2018 to January 2019. Detailed clinical examination was done and statistical socio-demographic analysis was performed. Associated factors of CSOM were also recorded and a resultant chart was obtained. Results: Our study showed that urban as well as rural poor were equally affected population. Highest incidence found in the range of 11 to 20 years (36.67%), with only 54 (17.67%) cases reported for age group: 41 and above. 55.33% of cases pertained to lower Socio-economic status with major occupational incidence amongst urban labour class (82/300, i.e. 27%). The major contributing factor for CSOM came out to be the crowded living conditions (52.0%) and aseptic and unsupervised handling or ears (49.0%). Conclusions: Congestion and crowded household, bathing in contaminated ponds and canals, unsterile ear piercing, constituted significant risk factors, therefore preventive strategies and awareness program, based upon the above, should be planned to counter the burden of CSOM. Key words: Chronic Suppurative Otitis Media (CSOM), Ear Discharge, Socio-demographic Status