Bulbul Gupta

A Study of Voice Changes in Various Phases of Menstrual Cycle and in Postmenopausal Women

Larynx is responsible for the generation of voice and subsequently impacts on communication, social interaction, personality, and artistic expression. The vocal instrument is comprised of the vibratory body, the respiratory power source, and the oropharyngeal resonating chamber. The lungs are the power supply, the larynx is the vibratory source, and the supraglottal vocal tract (supraglottal pharynx oral cavity, nasal cavity) is the resonator that shapes the sound into words and songs. During the phase of expiration as the diaphragm relaxes and the chest wall recoils, air is pushed through the nearly closed vocal folds. The aerodynamic forces of the air column and myoelastic properties of the vocal folds are responsible for the repeated opening and closing of the glottal tissue that pulses that air column as it flows out. These disruptions in the steady state of tracheal air pressure by glottal activity and vocal fold vibrations result in voice production. Voice is characterized by its frequency intensity and harmonics. The harmonics are hormonally dependent. This is illustrated by changes that occur during male and female puberty. The female voice evolves from childhood to menopause under the varied influences of estrogen, progesterone, and testosterone. These hormones are the dominant factor in determining voice changes throughout life. Female voice has a fundamental frequency one-third lower than that of a child. In males, androgen released at puberty is responsible for the male vocal frequency being an octave lower than that of a child. The females have a reproductive system, which undergoes a regular cyclic change known as the menstrual cycle. Laryngeal changes are evident and fluctuate systematically during the reproductive years with the menstrual cycle. The main objective of this experiment is to provide a solid ground with evidence of changes in voice because of sexual hormones, which will form the base of a multidisciplinary approach to a comprehensive and integrated understanding of premenstrual and menopausal female voice.

Deep neck abscess: a prospective study of 54 cases

Deep neck abscesses (DNAs) continue to be commonly encountered in developing countries like India. This study was conducted to determine the changing trends within our population with respect to presentation, aetiology, location and microbiology of DNAs. Fifty-four patients with DNAs who were managed at the Department of ORL and H&N Surgery in our hospital between May 2002 and December 2002 formed the basis of the study. We observed that the high incidence of DNAs could be attributed to lack of awareness, illiteracy and poverty among patients, along with the poor primary health infrastructure. We also recommend early surgical intervention in these cases to decrease the prevalence of complications.

Duplication cyst of oesophagus: a case report.

Duplication of the oesophagus is the second most common duplication of the gastrointestinal tract. Children with oesophageal duplication cyst usually present with dysphagia or as asymptomatic thoracic mass found o incidental chest x‐ray. We report a case of oesophageal duplication cyst that presented with inspiratory stridor and dyspnoea in a 6 month old boy. Bronchoscopy revealed an external compression on the trachea. Duplication cyst arising from the oesophagus was suggested on CT and MRI. The cyst was surgically excised with resolution of symptoms.

Unusual complication of ingestion of a foreign body

Foreign bodies of the upper aerodigestive tract are common problems dealt with by the otolaryngologist. Among all foreign bodies in the oesophagus, an open safety pin still presents a challenge for the ENT specialists because of its propensity to pierce the oesophagus and surrounding structures. We present an interesting case of a long-standing foreign body i.e. an open safety pin, which, after piercing the hypopharynx, caused fatal common carotid artery rupture.

A Rare Presentation of Pellet Injury in the Neck

Penetrating neck injuries are dangerous and deserve emergency treatment by virtue of the vital structures present underneath. There is a potential risk of unrecognized vascular injury and retained foreign bodies with their associated complications in these wounds. Therefore, an early diagnostic workup to localize the site of injury and an immediate neck exploration are important.

A generalized procedure for minimizing tool changeovers of two parallel and identical CNC machining centres

This paper considers the problems of scheduling N jobs of the same family. Each job is manufactured in a number of operations, in sequence, on two parallel and identical CNC machining centres which are equipped with automatic tool changers. A generalized procedure to minimize tool changeovers has been developed and tested on real industrial problems considering a set of possible constraints. The procedure suggested in this paper results in minimal changeovers. Validity of the heuristics suggested is borne out of the fact that when the same case study is considered as a travelling salesman problem and solved using the Hungarian method, an identical result is attained. The procedure is simple and easy to implement in a CNC environment.

An unusual orbital blow-out fracture: a case report.

The complete dislocation of the orbital contents into the maxillary antrum as a result of trauma is an extremely rare event and requires immediate exploration and repositioning of the globe with reconstruction of the orbital floor. We present the case of a 10-year-old male who sustained trauma to the orbit and was initially suspected to have developed auto-evisceration. He underwent successful exploration and reconstruction of orbital floor with remarkable improvement.