Objectives:We report a case of granulomatous lesion infiltrating the recurrent laryngeal nerve to produce vocal cord palsy, the diagnostic dilemma posed by it and its management.
Materials and methods:Clinical documentation of a 52-yearold man who presented with hoarseness of 3 months duration is presented. The clinical examination revealed immobile left vocal cord and a bulky (Lt) ventricular band with a suspicious ulcer on its posterior aspect. A computed tomographic (CT) scan of the neck and chest revealed a 1 × 1 cm nodular lesion in the tracheoesophageal groove.
Conclusion:Causes for vocal cord palsies are wide ranging and predominantly include malignant infiltration of the vagus or the recurrent laryngeal nerve. The anatomical site of involvement can be clinically and radiologically assessed with ease. Vocal cord palsy due to recurrent laryngeal nerve involvement by a granulomatous lesion is an unreported phenomenon and we believe that this is the first case to be reported in literature.
Summary:An unusual case of recurrent laryngeal nerve granuloma is reported with the diagnostic dilemma that it presented. This was successfully managed by surgical excision and postoperative antituberculosis treatment.
A low cost web solarimetric station tool was developed using an educational solar panel and Arduino microcontroller. Data are shown at Web platform, doing the accessible anywhere anytime, data are also shown at real time. The level of confidence is high due to the proposal was calibrated with specialized equipment to monitoring Irradiance level. The developed web tool performs automatic data acquisition of the open circuit Voltage (V OC ) from the solar panel, as well as temperature level measurement. Low cost microcontroller Arduino is the data acquisition device, it sends V OC measurements obtained from the solar panel, and temperature from a thermocouple. Data are sent by wireless connection into a web data base. After data are obtained, processed and analyzed performing the programmed calculations. Results can be shown in the Web platform as a table or as a graphic, depending on the user requirement, data are updated every fifteen minutes. Historical data are also available on the Web platform with some period of time limitations. Data can be consulted on different Operative System platforms, such as Windows, Android or iOS, it means data can be consulted even in mobile devices. The integration of low cost open source software and hardware tools was successfully done to build an automatic data acquisition system for Irradiance and temperature in-situ of the university campus.
Acute onset of severe pain in cancer patients may be due to multiple causes. Irrespective of the etiology, adequate analgesia has to be provided as quickly as possible. The standard practices of relieving pain by using syringe pumps (syringe drivers) or infusion pumps may not be feasible in resource-scarce developing nations where many cancer patients first present at advanced stages of disease for management. This study compared the efficacy of the subcutaneous and intravenous routes of morphine administration continuously using a simple and economic technique for cancer pain management. Both routes were found to be equally effective in producing good analgesia without side effects. The drip method is a cost-effective way of providing subcutaneous morphine infusion for cancer patients and is applicable for both inpatients and home care.
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