Wednesday, May 6, 2020
Earth from Space Free Essays
NOVA ââ¬Å"Earth From Spaceâ⬠1. They describe at least three teleconnections in the film. The movie talks about sandstorms in the Sahara Desert transforming the rainforest across the globe. We will write a custom essay sample on Earth from Space or any similar topic only for you Order Now Also explained are the waterfalls under the sea in Antarctica, leading to a feeding frenzy in the ocean by the equator. Finally, they talked about streaming water off the coast of Africa causing a disastrous weather storm in the United States. This happens because all of the activity in the ocean, sun and atmosphere are bound together. When an action occurs to one of them, a reaction occurs within another. Itââ¬â¢s almost like a butterfly effect that occurs between the three. 2. We can learn and visually see all these different parts of the Earth by using satellites. I. Geosphere (Solid Earth) The Geosphere is made up of mostly rock. Beneath the surface of Earth, forces inside are a crucial source for the basic materials that nurture life. Volcanoes and earthquakes are examples of reactions to disturbances that initially took place under the Earthââ¬â¢s surface. Although destructive, the natural forces behind these events also provide the materials we and other living organisms need to survive. Through satellites we can see that the Earthââ¬â¢s crust is constantly moving. II. Cryosphere (Ice sheets, glaciers, sea ice) The Cryosphere can be observed from space using satellites. The reason the Cryosphere doesnââ¬â¢t receive much heat from the sun is because the sun strikes these regions at an oblique angle and any heat that does reach the cryosphere is reflected back into space by the sheets of ice covering it. III. Atmosphere (Gases, clouds, weather) As water vapor evaporates from the ocean it works its way up into the atmosphere and eventually creates clouds, who size depends on how much water vapor was evaporated. The heat that water vapors carried before they became clouds is eventually what triggers storms to occur. If there is enough heat influencing the clouds it will cause the clouds to shoot upward and the rotation of the Earth is what makes them spin. If the clouds turn into a vortex, hurricanes are formed. IV. Biosphere (Life on Earth) Life on Earth is affected by all the other parts of the Earth including internally and externally. The catastrophic storms that are caused by the atmosphere effect life on Earth more and more every year. Mother Nature is so unpredictable and it is very hard, even with all of earth-observing technologies humans have created, to prepare for Earthââ¬â¢s catastrophic events. It is even harder for other organisms to survive that do not have the same knowledge about technology as humans do. When hurricanes, tsunamis, and earthquakes do occur, it is instincts that ultimately help different species survive. V. Hydrosphere (Oceans, lakes, rivers) The hydrosphere plays a big part in the water cycle. Energy from the sun causes evaporation from all wet surfaces on the earth. Because the earth is two thirds water, the oceans are important for homeostasis on the planet Earth. The water helps the atmosphere function properly and vice versa. Without one there would be no other. The ocean and lakes are also the homes to millions of organisms. Some believe the ocean is even where the first walks of life were formed. Ocean circulation greatly affects climate and weather. . One NASAââ¬â¢s newest satellites named Polar Orbiting Suomi, after a meteorologist, is an electronic eye in space that measure the impact of the sunââ¬â¢s energy all around the Earth. This satellite can see much more of the electromagnetic spectrum then the human eye can. One of this satellitesââ¬â¢ key instruments in called Cloud and Earthââ¬â¢s Radiant Energy System. It helps detect the ultraviolet and infrared par ts of the spectrum that we canââ¬â¢t see. This instrument helps detect anything on Earth that gives off heat. Aqua is a satellite that uses another earth- observing technology that monitors the interaction between heat and water. Aqua uses infrared to analyze the temperature of water. Using the infrared, Aqua can see how much water vapor is evaporating from the ocean into the atmosphere. TRIM is a satellite equipped with a radar and imager that operate in the micro wave range of the electromagnetic spectrum. These radio waves are higher in energy and shorter in wavelength than others. The instruments on this satellite bounce micro waves off raindrops in the clouds allowing scientist to build a three imensional structure of the internal structure of a hurricane. 4. Scale I. The temporal resolution specifies the revisiting frequency of a satellite sensor for a specific location. A low temporal resolution can last greater than 16 days whereas a high temporal resolution will last only up to 3 days. II. Using satellite remote sensing we can view the earthââ¬â¢s surface as frequently as we woul d like too. As long as the satellites are working efficiently there should be no problem. III. The spatial resolution specifies the pixel size of satellite images covering the earth surface. IV. The level of detail does depend on what the satellites are observing. The different spatial, temporal and spectral resolutions are the limiting factor for the utilization of the data they find. Unfortunately, because of technical constraints, satellite systems can only offer the following relationship between spatial and spectral resolution. Ether a high spatial resolution is associated with a low spectral resolution and vice versa. That means that a system with a high spectral resolution can only offer a medium or low spatial resolution. Therefore, it is either necessary to find compromises between the different resolutions according to the individual application or to utilize alternative methods of data acquisition. 5. I found the most striking thing in this movie to be, how easily events like hurricanes, volcanoes, and tsunamis could be created. A little bit too much moisture in the atmosphere or a little disturbance in the Earth could eventually lead to a disastrous, possibly life threatening event. This movie made me grateful to live in an area that is not as highly affected by natural disasters and sympathetic towards those that do. How to cite Earth from Space, Essay examples
Sunday, May 3, 2020
Data Analytics and Visualisation System â⬠Free Samples to Students
Question: Discuss about the Data Analytics and Visualisation System. Answer: Introduction The cost of medical malpractice in the US is very high and exceeds $ 50 billion. Due to this, there is a upward pressure on the health care costs coupled with a higher premium for insurance related to medical malpractice. One of the known health insurance provider in US is the UnitedHealth Group which aims for a better understanding of the claims raised on account of medical malpractice. In order to achieve this objective, claims data for 200 random claimants has been provided which comprises of information related to the claim amount, severity, gender, hiring of private attorney or not, age, marital status presence/absence of insurance coupled with speciality. The given report aims to present the findings of the statistical analysis of the data provided in wake of the specific questions that my manager Edmond Kendrick has raised in the email. Through the requisite statistical analysis, the report would aim to answer the queries raised in relation to the claims data. An overall summary of the claim payment amount has been indicated in Appendix 1. The average or mean claim payment amount has come out to be $ 73,457.49. Also, it is estimated that 50% of provided sample claim amount is lesser than or equal to $72,571.38. Further, the claim value of $ 5,400 seems to have the highest frequency in the sample data. The dispersion of the claim amount values in the sample data seem to be quite high considering that the lowest value of claim amount is $ 1,547 while the highest value of claim amount is $ 228,724. 80. Also, the standard deviation of the claim amount from the mean or average claim value stands at $ 32,178.50. Additionally, it is noticeable that the distribution of the claim amount is not symmetric considering the fact that there are certain claim amounts which are unusually large and hence considered outliers in the provided sample data. With a likelihood of 95%, it can be stated that the average age of the claimants for the population would lie between 42 years and 47 years. The requisite computation for the same is highlighted. With a likelihood of 95%, it can be stated that the mean proportion of claimants with No Insurance for the population would lie between 5.03% and 12.97%. The requisite computation for the same is highlighted. Based on the given claim sample data, it would be appropriate to conclude with 95% confidence that the average claim amount paid by the industry has dropped below $ 77,500. The requisite computation for the same is highlighted. Using the claim severity data presented, it can be stated with 95% likelihood that the study indicating that 75% of the patients fall either in MILD or MEDIUM severity condition continues to be valid for the current year as well. The computation for the same is illustrated. Considering the gender trends in the provided claims data concerning the severity of the claims, it can be inferred that there no significant difference in proportion of male and female patients in the category of "MILD or MEDIUM claims. The relevant computation for the same is illustrated. Also, the given sample data does suggest that the payment amount does tend to depend on the fact whether the claimant is represented by a private attorney or not. This is apparent from the fact that the average claim amount of claimants represented by private attorneys tends to be higher than the corresponding claim amount of claimants not represented by private attorneys. The relevant computation for the same is illustrated. The given data provided on claims does not lend support to the assertion that private attorneys tend to have higher representation for SEVERE claims as compared to MEDIUM claims. Hence, the statement is not valid. The relevant calculations to support the above conclusion are illustrated. The given claims data does not lend support to the assertion that SEVERE claims tend to be higher for Orthopedic surgeon in comparison to other specialists. Infact, the results derived in Appendix 4A tend to highlight that the difference between the SEVERE claims proportion for the two does not show any significant difference and hence can be assumed to be same. The given claims data does not lend support to the assertion that average claim amount for SEVERE claims tend to be higher for Orthopedic surgeon in comparison to other specialists. Infact, the results derived in Appendix 4B tend to highlight that the difference between the SEVERE claims average amount for the two does not show any significant difference and hence can be assumed to be same. Conclusion Based on the above analysis, useful conclusions can be drawn about the claims data. It may be concluded that the average age of the claimants tends to lie between 42 and 47 years. Also, most of these claimants tend to have insurance since only a very small proportion (about 5-12%) does not have insurance. The average claim amount has now dropped below $ 77,500. Further, it can also be concluded that 75% of the claims belong to the MILD or MEDIUM category and hence only 25% of the claims fall in the SEVERE category. Also, there are no gender specific differences between the proportions of MILD or MEDIUM category claims. Besides, it may be also concluded that the average claim amount tends to be higher when a private attorney represents the claimant. However, no significant difference is observed between the representation proportion of MEDIUM and SEVERE claims with regards to private attorney. Also, the assertions regards higher proportion and average claim amount for orthopaedic rela ted SEVERE claims in comparison with other specialists has been found incorrect as no evidence is present for the same.
Friday, March 27, 2020
Macbeth Tragism Essays - Characters In Macbeth,
Macbeth Tragism Macbeth's vaulting ambition, though it is what brings him to his height of power, it is also what leads him to his downfall. Vaulting Ambition is Macbeth's only flaw; it disables him to achieve his utmost goals and forces him to face his fate. Without this ambition, though, Macbeth never would have been able to achieve his power as King of Scotland or have been able to carry out his evil deeds. In these instances, ambition helped Macbeth do what he wanted to do. But, consequently, Macbeth's ambition has another face and is what leads him to his tragic downfall. Had he not been so enveloped with becoming King and remaining powerful, he would not have continued to kill innocent people in order to keep his position. It was because of these killings and his overbearing attitude that caused him to be overthrown and killed himself. Macbeth, at the beginning of the play seems to be a very noble person. He is characterized as being very loyal and honorable. He fights in the battle against Norway which proves his loyalty, then he is appointed Thane of Cawdor which proves that he is honorable in the eyes of royalty. However, as soon as the witches spark ambition in him, he is no longer trustworthy and becomes evil and deceiving. Even before he reaches his home, thoughts of murder creep into his head and he is overcome with the desire to be powerful. The prince of Cumberland: that is a step on which I must not fall down, or else oerleap, for in my way it lies. Stars, hide your fires, let not light see my black and deep desires, the eye wink at the hand. Yet let that be, which the eye fears when it is done to see (Shakespeare 21). At this point in the play, Macbeth's ambition starts to come into view. The seed has been planted, and there is no turning back. Macbeth becomes bloodthirsty and powerstricken forcing himself further and further into a web of ambition from which he is unable to detatch himself. Macbeth's ambition is what allowed him to become powerful. Without ambition, it is impossible to achieve goals. Therefore, ambition is what allowed Macbeth to overcome his obstacles and come closer to his final goals. As soon as he developed the trait of vaulting ambition, Macbeth is able to make his life fall into place exactly the way he wants it to. He first murders Duncan so that he will become king. Macbeth's ambition is directly the cause of this tragic incident. This murder is in cold evil blood by Macbeth's own hand; at this point he starts seeking his future on his own and will overcome any obstacles in his way. Then, Macbeth ventures on even farther to protect his crown. He proceeds in his evil plans by killing Banquo. This is the climax of the play as well as the height of Macbeth's vualting ambition. Macbeth, up to this point, is almost drunk with his own power and ambition. He does not even hesitate to make rash decisions. He is obsessed with reigning as king, but does not realize that what he is doing to make himself more powerful is actually leading him to a tragic and fatal downfall."Ruthless seeking after power by Macbeth, urged on by his wife, is the tragic flaw that causes his downfall" (Shakespeare, Themes 162). First of all, he resorts to spying on Macduff and makes the rash decision to seize his castle. "Seize upon Fife, give to th'edge o'th'sword His wife, his babes, and all infortunate souls that trace him in his line" (Shakespeare 107). This causes Macbeth to seem tyrannical and results in more people turning against him. He is only interested in himself and his power, but does not even take into consideration that his actions are causing him to be less powerful. Macbeth, while trying to stay powerful, also becomes paranoid. He never feels like he is at his height of power, and therefore feels like others were out to take his power away from him. Macbeth, then goes to whatever lengths he can to stay powerful. He murders numerous people which causes King Edward of England to organize troops to overthrow him. Anything that happens to Macbeth is traced back to his vaulting ambition. This ambition is to be blamed for his great power, as well as his downfall. Macbeths entire character is an example of this quote by Shakespeare: "The heavens themselves, the planets and
Friday, March 6, 2020
Flexi Timings for Employees in an IT Organization
Flexi Timings for Employees in an IT Organization Free Online Research Papers Objective Now days every organization is looking out for new ways and efficient and effective workforce planning mechanisms which can help them increase their productivity, make proper utilization of the resources (especially human resources) and provide complete employee satisfaction. Flexi-Time working is being accepted by more and more number of organizations now days because it is highly effective in providing complete employee satisfaction and helps the organizations to increase its productivity. There are many reasons why organisations should consider a more flexible approach to working patterns and leave arrangements. The benefits can be wide-ranging and long-lasting as well as providing short term solutions. As a business case will demonstrate, investing in employee well-being makes good business sense, not only in terms of improving performance, raising morale and reducing stress, but also improving attraction, recruitment and retention performance. ââ¬Å"Companies that allow their staff to work flexibly reap handsome dividends. It is a case of a little going a long way.â⬠ââ¬Å"Work organisation and flexible working practices that benefit both the employer and the individual, will characterize the high performance work place of the future.â⬠Efficiency, Effectiveness and retaining the employees for longer period can be got through Flexi working approach. The purpose of this article is to report findings from a study taken up on an IT organization (Navaraga Corporation held at Hyderabad) which gave up flexible working to its employees by using web collaborations tools and to examine the impact on the work and employees. Navaraga Corporation held at Hyderabad had been actively promoting this approach for several years and have measured the benefits across a wide range of criteria over a significant time period. Methodology Navaraga Corporation, has introduced a policy for flexible working since the time it started operations in hyderabad. The types of flexible plans are: a) Being available in core hours at office and remaining time can be considered flexi time b) Geographically dispersed work teams working from their location. c) Individuals taken up as special cases and would be considered working from home for a limited period ââ¬â like employees who have small children etc. d) During unexpected incidents like bandââ¬â¢s, curfews etc also flexi working from home had been considered. Let us look into this flexible plans in detail: a) Being available in core hours at office and remaining time can be considered flexi time: Here the employees can work (eg between 10 am and 4 pm), at office and whilst the rest of the working day is ââ¬Å"flexitimeâ⬠, in which staff can choose to work from anywhere subject to achieving total daily, weekly working hours and should complete the tasks assigned in time. Multiple time options followed by employees were: ? Begin work between 7.00 ââ¬â 10.00 or 16.00 ââ¬â 22.00 hours (flexitime can work from anywhere) ? Must be available at office between 10.00 ââ¬â 14.00 (core working hours) for discussions and meetings on the work. Here there should be an understanding between the employee and their team leader about the arrangement of the time and work items and the employee should be clear about the expectations of his team leader. Their rationale is that as long as an employeeââ¬â¢s productivity does not suffer, they have no issues about the number of hours he/she spends in office. They believe that more than observing work patterns, it is important to evaluate output. Similarly they appreciate the need of every employee to balance his/her work and personal life. They believe that it impacts the overall level of motivation, productivity and even influences the engagement levels of the organization. c) Individuals taken up as special cases would be considered working from home for a limited period ââ¬â like employees who have small children etc.: Navaraga Corporation offers its employees the option to have flexibility in its standard working arrangements. These include family reasons, health reasons, and pursuit of academic/professional courses, which require part time working and are relevant to the company. The policy can be in the form of reduction in the standard working hours to a minimum of 4 hours a day or 20 hours a week. However, the option of allowing employees to avail flexi working hours will largely be determined by their needs of a particular role and at all times, the person must have connectivity. Research Papers on Flexi Timings for Employees in an IT OrganizationNever Been Kicked Out of a Place This NiceOpen Architechture a white paperThe Project Managment Office SystemBionic Assembly System: A New Concept of SelfAnalysis of Ebay Expanding into AsiaTwilight of the UAWResearch Process Part OneIncorporating Risk and Uncertainty Factor in CapitalMarketing of Lifeboy Soap A Unilever ProductInfluences of Socio-Economic Status of Married Males
Wednesday, February 19, 2020
Perfect learning environment and functioning of school tribunal Essay
Perfect learning environment and functioning of school tribunal - Essay Example At the same time it is the process by which an individual acquires and develops knowledge, understanding, skills, interests, and attitudes that are necessary to meet life situations. The effect of learning can be witnessed in the behaviour of an individual at various instances. Human has been able to progress just because of his capacity to make profit out of his and otherââ¬â¢s experiences. His customs, manners, etc are the product of his learning. ââ¬Å"Learning is the cognitive process of acquiring skills and knowledgeâ⬠(Learning, n. d). It causes behavioural changes in onesââ¬â¢ life because of the constant interaction with the environment and the extra knowledge acquired about the environment. It is a continuous process which starts from the birth and ends only at the time of death of a person. It is a complex process which depends on many individual characteristics like socioeconomic background, attitude, philosophy of life, intelligence, physical and mental health, the environment in which learning occurs, genetic traits etc. Because of the dependability of various factors, it is difficult to have two persons with same learning abilities. School is a place where the teaching and learning process formally begins in oneââ¬â¢s life. It is not necessary that all the schools provide same type of learning environment to the students. ... What makes the prefect learning environment? ââ¬Å"Curriculum, instruction and assessment are the major means for effective learning. In the curriculum area, educators must place emphasis on intuition, feeling, sensing, and imagination, in addition to the traditional skills of analysis, reason, and sequential problem solvingâ⬠(Learning styles, 2008). It is impossible for a teacher to teach everything related to a specific topic. On the other hand if the teacher was able to develop interest among the students about that particular topic, the students will do the rest part of the learning process by themselves. In other words, developing positive feeling, imagination, intuition etc can make the learning process easy. Curriculum plays an important role in preparing proper learning environment. As mentioned earlier, learning is a complex task and hence it is necessary to control the parameters which affects the learning judiciously. For example, it is difficult to stimulate learnin g in a noisy environment. Learning is a process which requires the combined efforts of the teachers and the students. The transfer of learning takes place from the teacher to the students only if the teacher was able to deliver his/her lecture in an appropriate manner. In order to help the teacher to deliver the lessons in an organized manner, students required to observe strict silence in the class. In other words, discipline is the primary requirement for preparing a proper learning environment. If the teacher keeps on delivering the lectures and the students keep on doing something else, learning will never take place. The students should follow the teacher with utmost care in order to learn the topics properly.
Tuesday, February 4, 2020
Construction law Essay Example | Topics and Well Written Essays - 1500 words
Construction law - Essay Example 2. This paper will look into the value for money delivered by PFI methods in order to determine if PFI is preferable in comparison to public funding. Synopsis of PFI 3. The PFI method relies on delivering infrastructure and / or services for the general public through the utilisation of private funds and resources. The provision is kept in line using public sector specifications so the public sector can be seen as exerting sizable influence on the overall process. Typically the private sectorââ¬â¢s involvement is largely directed to financial support for public projects as per the PFI approach. However, the private sector can also be involved in the operation and maintenance of services that might have been built using PFI or other previous methods3. The basic contention behind PFI is to allow the private sector greater involvement in public spending projects so that the burden on the public sector is eased. Moreover, the involvement of the private sector ensures that public secto r projects are competitive enough while delivering optimal value for money goods and services. Advantages and Disadvantages of PFI Successful PFI Implementations 4. Advocates of PFI argue that projects implemented under the PFI arrangement show greater promise than conventionally public sector funded projects. Research indicates that conventional public infrastructure provision arrangements provided on time and on budget projects around 30% and 27% respectively. In contrast, PFI arrangements provided an increase of 76% and 78% for on time and on budget project handovers4. These statistics clearly highlight that PFI has the capacity to deliver better both in terms of budget variances and schedule variances. The inherent nature of the private sector makes it competitive since the public sector has little or no other competition for infrastructure and service delivery. It is often common that the public sector tends to see negative budget and negative schedule variances on projects sin ce no other benchmarks are possible. However, the private sector thrives on competition and escalating negative budgetary and negative scheduling variances indicate a failing business strategy. The need to remain relevant to the market ensures that private businesses are more efficient in terms of resource and time utilisation when compared to the public sector. 5. Similarly, other research into PFI arrangements showed that optimised deals were attained in every case studied. Moreover, research findings indicated that value for money in PFI projects was achieved 80% of the time5. Another notable aspect of PFI initiatives is the decrease in costs since private financers are looking for ways to reduce costs. Research indicates that public infrastructure provision becomes between 7% and 23% cheaper when PFI methods are applied6. Other research placed cost reduction at 11%7. It could be reasoned that cheaper infrastructure and service provision would lead to a lower quality. However, it must be noted from the research above that value for money is achieved in 80% of PFI projects which tends to dispel this method of reasoning. 6. Critics of the PFI approach contend that private involvement tends to make infrastructure and service provision too competitive such that value addition is minimised. However, such claims hold little ground in light
Monday, January 27, 2020
Oral Erythroplakia Case Study
Oral Erythroplakia Case Study ABSTRACT- Oral Erythroplakia is considered a rare potentially malignant lesion of the oral mucosa. Oral Erythroplakia is a clinical term to describe any erythematous area on a mucous membrane that cannot be attributed to any other pathology. Oral Erythroplakia are very few, only the true, velvety, red homogeneous oral Erythroplakia has been clearly defined while the terminology for mixed red and white lesions is complex, ill-defined and confusing. Oral Erythroplakia is predominantly seen in the middle aged and elderly. The most common affected areas are the soft palate, the floor of the mouth and the buccal mucosa. A specific type of Oral Erythroplakia occurs in Chutta smokers in India. Lesions of Oral Erythroplakia are typically less than 1.5 cm in diameter. Keywords Biopsy, Erythroplakia, Laser, INTRODUCTION- The word erythroplakia means red patch, and is derived from the Greek words à µÃ Ãâ¦Ã ¸Ã à ¿Ãâ red and Ãâ¬Ã »ÃŽà ¬Ã ¾ plate The World Health Organization defines oral erythroplakia as follows: ââ¬Å"Any lesion of the oral mucosa that presents as bright red velvety plaques which cannot be characterized clinically or pathologically as any other recognizable conditionâ⬠It has been reported that prevalence of Oral Erythroplakia varies between 0.02%1 and 0.2%2 (adapted from Reichart et al.)3 Clinically, it can be flat or depressed and sometimes it can be found together with leukoplakia (erythroleukoplakia); it pre-dominantly occurs in the floor of the mouth, the soft palate, the ventral tongue and the tonsillar fauces. There are usually no symptoms. However, some patients may complain of a burning sensation and or sore. Heavy alcohol consumption and tobacco use are known to be important aetiological factors. The main purpose of identifying oral premalignant lesions is to prevent malignant transformation by initiating adequate intervention. It is widely approved that the oral premalignant lesions erythroplakia, show a significant tendency to malignant transformation. The differential diagnosis includes: erythematous candidiasis, early squamous cell carcinoma, local irritation, mucositis, lichen planus, lupus erythematosous, drug reaction and median rh omboid glossitis.4 Surgical excision is the treatment of choice though more studies are needed.The treatment5 modalities include change of lifestyle factors such as tobacco and alcohol intake,medication with retinoids or antimycotics,surgical excision,cryosurgery,laser evaporation or laser excision.Laser surgery has become a reliable treatment6 option for oral cancer as well as for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. The use of lasers in tumor surgery has several advantages: remote application, precise cutting, hemostasis, low cicatrization, reduced postoperative pain and swelling, can be combined with endoscopic, microscopic and robotic surgery. Here we report a case of erythroplakia in soft palate region treated with diode laser. CASE REPORT- A, 63 years old, male patient (Fig 1), came to the department of oral and maxillofacial surgery, with the chief complain of red patches at the hard and soft palate region. Patient gave the history of pan, tobacco chewing and smoking since 20 yrs. Medical history was negative for any findings and all the vitals were under the normal limit. No significant findings were noticed on extra oral examination. (Fig-1). On intraoral examination, multiple red patches were seen at the mucosal surface of the palate. All those patches were less than 1.5 cm in diameter. (Fig- 2). On palpation it was soft and velvety on touch. A provisional diagnosis of Erythroplakia, with differential diagnosis Lichen planus , Erythematous candidiasis ,Early squamous cell carcinoma were made. All necessary blood investigation done, and were found under normal limit. To establish a definitive diagnosis, a biopsy was performed using a local anaesthesia. The biopsy specimen was taken from hard and soft palate, and sen t for histopathological examination (Fig 3) which confirmed the final diagnosis of Erythroplakia. The red appearance is due to the thin atrophic epithelium with prominent subepithelial vascularity and inflammation. Almost all erythroplakic lesions contain dysplastic cells. The histopathology may be mild or moderate epithelial dysplasia, severe dysplasia or carcinoma in-situ. Carcinoma in-situ is characterized by a complete disorganization of cells throughout all layers of the epithelium, with no keratin pearls. Laser ablation was planned as the treatment modality under local anaesthesia. (Fig-4) Diode laser was used at 2.5watts (Fig 5). Post operative instructions given and patient was recalled after 24 hours. Patient came for follow-up, reported with slight pain. Healing was uneventful. After that patient was asked to report at weekly interval. Healing was satisfactory after 3 weeks.(Fig 6) DISCUSSION- Erythroplakia and speckled leukoplakia are uncommon lesions of the mouth. Erythroplakia of the oral cavity is a specific disease entity which must be differentiated from other specific or nonspecific inflammatory oral lesions, although this can only be done in most cases by biopsy. The term erythroplakia of the oral cavity as used in this report and as accepted by most authors describes the clinical appearance of a red patch of the mucous membrane which does not represent some specific or nonspecific inflammatory lesion. However, in most cases the clinician cannot distinguish with certainty the true erythroplakia as discussed here and the more innocuous inflammatory lesions, thus mandating biopsy. Most, and probably all, cases of true clinical erythroplakia represent some epithelial atypia, ranging from mild epithelial dysplasia to invasive carcinoma.7 Furthermore; there is no correlation between the clinical appearance of erythroplakia and the histologic findings. Erythroplakia is t he leukoplakia like term used to describe clinically red and well demarcated macules of the oral mucosa which cannot be attributed to inflammatory or traumatic factors, and which have a much higher propensity for progression to carcinoma than leukoplakia8. The histopathological9 feature of erythroplakia includes a marked epithelial atrophy associated with epithelial dysplasia. A relative reduction in keratin production and increase in vascularity accounts for the clinical color of the lesion. Cellular infiltration and capillary distention were remarkable. Nowadays laser surgery has become a reliable treatment6 option for precancerous lesions. Widely used lasers in oral and maxillofacial tumor surgery are the CO2 laser, diode laser, the Er:YAG laser, the Nd:YAG laser and the KTM laser. In our case we use diode laser in erythroplakia. Laser has many distinctive advantages, such as the ability to cut, coagulate, ablate or vaporize target tissue elements, enabling dry-field surgery thro ugh the sealing of small blood vessels (haemostasis) disinfection of the tissue, reduced post-operative edema (through the sealing of small lymphatic vessels) decreased amount of scarring. It contributes to faster and more effective treatment resulting in improved treatment outcome and increased patient comfort and satisfaction. CONCLUSION- Oral cancer is one of the 4 major non communicable diseases leading to Death10. Soft tissue health in the oral cavity is essential for overall dental and medical health and a successful maintenance of any restoration. The clinical and pathological features of the lesions analyzed in our study support the data in other published studies. Although their prevalence is low, histopathological features ranging from epithelial dysplasia to invasive carcinoma. This justifies placing these lesions among the oral lesions with the highest malignant potential. Additionally, regardless of histopathology and therapy, periodic monitoring of these patients and cessation of risk factors are essential measures.
Subscribe to:
Posts (Atom)