Craniofacial trauma is often associated with orbital and ocular injuries. We report a case of a 21-year-old male with motor vehicular accident, orbital roof blow-in fracture, cerebrospinal fluid (CSF) leak, and left sided globe luxation with corneal abrasion and complete conjunctival denuding. The patient was managed by a multispeciality team and the eyeball was protected by amniotic membrane graft (AMG) biological dressing with novel use of inverted sterile metallic bowl as mechanical protection till the patient stabilized. During surgery, eyeball was reposited and ocular surface was reconstructed using amniotic membrane and symblepharon ring. Surgical correction and plating of the facial fractures and dural repair with autologus tensor fascia lata was done. Post surgery ocular surface was intact, ocular motility was well preserved and the globe was prephthisical. Traumatic eyeball luxation is a rare, but dramatic presentation which may occur in a blow in fracture when the intra orbital volume reduces and expels the eye ball out of the socket. This may be associated with extra ocular muscle rupture or optic nerve avulsion. The visual prognosis is nil in majority cases. However, the management is targeted towards globe preservation in view of psychological benefit and ease of cosmetic or prosthetic rehabilitation. Knowing the mechanism of luxation helps to plan the management. A stepwise approach for globe salvage is recommended. Team efforts to take care of various morbidities with special steps to safeguard the eye help to optimize outcomes.
This paper seeks to share what Bondage-Domination-Sado-Masochism/Kink might offer to feminist understandings of sexuality, gender and power. It has been written by members of the Kinky Collective, a group that seeks to raise awareness about BDSM in India. The paper addresses four key themes. The first theme relates to the subversion of gender and sexual norms in kink from a feminist lens. It challenges popular notions of BDSM which seem to reflect heteropatriarchy, evoking images of, typically, a cisman dominating a ciswoman, making her submit to his desires. The paper argues that this assumption invisibilises male submissiveness with female dominants as well as queer/same sex kink. Even if a seemingly 'mainstream' submissive role is chosen by a woman, it has the capacity to be feminist as roles and dynamics are intentional, discussed, negotiated and consented to by all involved unlike in 'real life' where power dynamics are rarely acknowledged. Since kink is solidly in the area of playfulness and experimentation, it also makes for a safe space for gender transgressive persons. The second theme addressed by the paper related to Kink, Feminism and Desire. It argues that kink enables a paradigm shift from consent for harm reduction to consent for enabling pleasure and the exploration of desires. It offers another paradigm shift, away from false consciousness to one that brings to focus on the unconscious. In this third theme of the unconscious, the paper challenges the false binary of sexual fantasies being 'OK' vs. 'not OK'. The unconscious allows for a link between the personal and political such that our politics is less judgmental. Being in that space where our desires seem to collide with our politics might help challenge the overly rational framework of feminism and help us move perhaps from a politics of certainty to a politics of doubt. The fourth theme of the paper relates to the question of Power in Kink. It argues that kink challenges binary notions of powerful and powerfulness because submission is powerful and that it is precisely because the submissive submits that the Dominant can dominate. Using these four subthemes, we argue that kink can contribute to feminist thought and praxis in India.
Nasal deformity, a common occurrence in unilateral and bilateral cleft lip and cleft palate patients, is a formidable challenge for the cleft surgeon. The underlying abnormal anatomy, aggravated by tissue scarring and loss of facial planes after primary procedures, makes secondary rhinoplasty a difficult procedure for even the most experienced. Over the past years, numerous techniques for secondary cleft rhinoplasty have been described in literature. Regardless of the technique adopted, the fundamental goal of cleft rhinoplasty is to achieve a nose that would be esthetically accepted in society as well as functionally accepted by the patient. The correction of nasal deformity can be performed with a closed or an open technique. This article highlights the open technique used for secondary rhinoplasty for a challenging case of unilateral cleft lip nasal deformity in an adult patient.
Panoramic radiographs of male patient revealed the presence of bilateral impacted fourth molars in mandibular region. The supernumerary teeth were distomolars and had normal tooth morphology with regard to their crowns and roots but were slightly smaller than the existing third molars. Their crowns were three tuberculate and they all had single roots. Supernumerary teeth are often located in the anterior maxilla, mandible, and to a lesser frequency posterior of the maxillary and mandibular region. They are classified as distomolar when they are located in posterior to their location. Their presence may or may not give rise to a variety of clinical problems. Detection of supernumerary teeth is usually achieved by clinical and radiographic examination. Their management should form part of a comprehensive treatment plan. A fourth molar tooth is a very rare entity in modern humans although prevalent in early humans. This article presents a case report in a non-syndromic patient with bilateral impacted mandibular distomolar; aberrations associated with supernumerary teeth and also a note on their incidence and prevalence.
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