Acute dacryocystitis, or inflammation of the lacrimal sac with lacrimal abscess, is almost always secondary to nasolacrimal duct obstruction. The standard practice for the treatment is incision and drainage because of concerns about the risks of exacerbation and spread of infection. Here we tried to evaluate primary EnDCR as a treatment for acute dacryocystitis with abscess formation.

Background: Oral submucous fibrosis (OSMF) is a common premalignant condition caused by chewing arecanut, betel quid and gutkha with tobacco. Its medical treatment is not yet fully standardized, although the optimal doses of its medical treatment is in the form of triamcinolone acetonide combined with hyaluronidase or intralesional placental extract. Objectives:We compared the efficacy of intralesional triamcinolone acetonide combined with hyaluronidase in group A vs placental extract in group B. Design:Comparative case series analysis series study with random allocation of 60 patients equally into two groups. (60) were randomly allocated into two groups A and B. Group A (n = 30) patients received combination of triamcinolone acetonide (10 mg/ml) + hyaluronidase (1,500 IU) at weekly intervals for 8 weeks. Group B (n = 30) patients received 2 ml of placentrex injection intralesionally at weekly interval for 8 weeks. Treatment outcome was evaluated on the basis of improvement in trismus, oral mucosal pattern and reduction in burning sensation. Materials and methods: Patients of OSMFResults: Trismus improvements in group A with combination of triamcinolone acetonide + hyaluronidase were significantly better to that in group B where placentrex was used. No significant difference in results in the two groups were observed as far as improvement in oral mucosal pattern and burning sensation were compared in the two groups.Conclusion: Combination of triamcinolone acetonide and hyaluronidase intralesionally is more effective than placental extract intralesionally in treatment of OSMF. But placental extract injections are cost-effective. No side effects were seen in both study groups.

Background: Ingestion of formic acid, accidentally or with suicidal intention is a common problem among the workers in rubber plantations in Sullia. The diluted form of formic acid is used in coagulation of rubber latex. Sullia, a small town in South India, is well known for its rubber plantations. Easy accessibility to formic acid makes it susceptible to be used for committing suicide in this region. Also accidental ingestion are very common in these workers. Aim:To study a case report of accidental formic acid poisoning and its management. Intervention:The patient was managed successfully by medical line of treatment. No gastric lavage or antidote was used in treatment and no vomiting induced. Nasogastric tube feeding was done and electrolyte imbalance was corrected. Conclusion:Easy availability of formic acid should be curtailed by enforcing statutory limitations in its distribution and the complication of formic acid poisoning should be educated to these rubber workers. Patients with hematemesis or melena, after successful treatment, should be followed up with serial esophagogastroduodenoscopy for diagnosis and early treatment of strictures.

Background: Schwannomas are solitary, encapsulated tumor usually attached to, or surrounded by a nerve and are not associated with von Recklinghausen's disease and rarely show malignant degeneration. Setting:Case report: A 68-year-old female presented with pain at the left side of the tongue since 1 month. Also a firm to soft 7 × 5 cm sublingual swelling of long-standing duration was seen. FNAC was inconclusive and contrast CT showed a sublingual swelling with mild-contrast enhancement.Intervention: Sublingual excision of the tumor was done under general anesthesia and the tumor enucleated. No complications were seen and the recovery was uneventful. Histopathological report came as benign schwannoma and immunoreactive to S-100 protein. Conclusion:Most of the intraoral schwannomas are managed by complete surgical excision and recurrence are not reported. Malignant transformation is not seen in any of the intraoral schwannomas but definite preoperative diagnosis is necessary to avoid wide excision when the tumors can be easily enucleated without recurrence.

Background/objectives: Plummer-Vinson syndrome also known as sideropenic dysphagia is a disease characterized by chronic iron-deficiency anemia, dysphagia and esophageal web. It commonly affects white female in the 4th to 7th decade. Most of the dysphagia and iron deficiency can be treated by iron supplementation and rarely web dilatation is needed. Setting:Case report: A 36-year-old female with dysphagia of 10 months and iron-deficiency anemia with a small upper esophageal web seen on upper GI endoscopy and barium swallow.Intervention: Conservative line of management with blood transfusion and dilatation of the web with cuffed endotracheal tube.Results: A good symptomatic and radiological improvement was seen after blood transfusion and web dilatation with cuffed endotracheal tube.Conclusion: Cuffed endotracheal tube dilatation is a better way of managing upper esophageal webs with minimal complications under general anesthesia.