Background:Resection of eyelid malignancies leads to complex reconstructive problems due to the functional and aesthetic importance of an eyelid. Hence, a large number of such cases are referred to plastic surgery facilities. Eyelid malignancies are of varied histological types and the western and Asian data have considerable variations in case distribution and presentation. This study is an attempt to characterise these tumours in the Indian population.Materials and Methods:The present study is a retrospective analysis of 85 consecutive cases of eyelid malignancies that reported to a tertiary health care facility in central India over a 15-year period starting from January 1996 up to December 2009. The cases were analysed for their age of presentation, sex distribution, tumour location, delay in seeking treatment, recurrence rate and variations with respect to the pathological subtype.Observations:Mean age of presentation for all the malignancies was 59 years. The median age of presentation was 65 years for basal call carcinoma (BCC), 58 years for sebaceous gland carcinoma (SGC), 55 years for squamous cell carcinoma (SCC) and 45 years for malignant melanoma. There was slight female preponderance as 56.28% of the patients were females. The most common location of the tumour was lower lid (58.2%) for all the malignancies. BCC was the most common malignancy (48.2%) followed by SGC (31.2%) and SCC (13.7%). Mean duration of symptoms was 9 months (range 3-21 months). The most common presenting complaint was mass with ulceration across all histological subtypes. Other associated complaints included itching, discharge from eye, pain and ptosis. The mean size of tumour at diagnosis was 2.34 ± 0.4 cm for BCC, 2.19 ± 0.6 cm for SGC and 1.99 ± 0.7 cm for SCC. The mean rate of growth of BCC was 1.39 cm/year. The corresponding values for SGC and SCC were 3.63 and 4.89 cm/year, respectively. The rate of follow-up was 89% at 3 months, 71% at 6 months, 62% at 1 year and 31% at 5 years. Recurrence rate was 1.9% for BCC and 12.7% for SGC. Surgical methods used included wedge excision and primary closure, excision and skin grafting, and tarso-conjunctival flap.Conclusions:We recommend that the surgeons treating eyelid malignancies in India should have a high index of suspicion for SGC. A wider margin of 10 mm is recommended for SGC excision as opposed to 5 mm for BCC.
In the developing world, the incidence of electrical injuries has increased in the past few years. This study attempts to identify the causative and demographic risk factors that can help in formulating a targeted prevention program. The study was conducted prospectively and retrospectively from 2004 to 2009. Eighty-four consecutive patients with electrical burn injuries were analyzed for their demographic profile, age, sex, occupation, rural-urban distribution, mode of injury, and place of injury. The patients were asked to fill out a questionnaire regarding their awareness about electrical burn injuries, and the results were tabulated. The age of presentation ranged from 3 to 61 years. The most frequently affected age group was the second decade of life (33.3%). Of 84 patients studied, 71 were male and 13 female. Fifty-nine patients were from the urban area, while 25 were from the surrounding rural area. Students including children and adolescents were the most common affected single group (22.5%). Contact with live wire or contact with an object that was in contact with a live wire (secondary contact) accounted for 43 of 84 cases (51%). Home was the most common location where injury occurred (51.2%). Twenty-one of 59 cases (35.6%) reported from the urban area and 3 of 25 cases (12%) from the rural area had specific knowledge about prevention of electrical burn injury. Forty-one patients (69.4%) from the urban area and 22 (88%) from the rural area believed that adequate information regarding electrical burn injury was not available. Thirty-six patients (61%) from the urban area and 24 (96%) from the rural area believed that they would have behaved differently if the information had been available. The authors recommend that prevention programs should be modified to cater to the specific needs of the younger age groups and the rural population.
The anatomy of the Indian population is distinct in that the palpebral fissure in men is less than that in women. It appears that changes in the eye become more pronounced after 45 years, including an increase in palpebral fissure, intercanthal distance, and height of the upper lid, along with a decrease in interpupillary distance.
Anthropometric analysis suggests differences between the Indian female nose and the North American white nose. Thus, a single aesthetic ideal is inadequate. Noses of Indian women are smaller and wider, with a less projected and rounded tip than the noses of white women. This study established the nasal anthropometric norms for nasal parameters, which will serve as a guide for cosmetic and reconstructive surgery in Indian women.
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