Human otoacariasis: a common outbreak in rubber growing belt of Karnataka.

Background/Objective: Soft tick in the ear is a very common acute painful and distressing condition in the flowering months of October to March. It’s a common condition in the rubber growing belt of Sullia.The mouthparts of the tick grips firmly the skin of the external auditory canal or the tympanic membrane and sucks blood and swells up. Otoscopy and removal of the tick from the ear can be done in outpatients in adults and difficult in a frightened irritable child.Materials and methods: 312 cases of intra-aural ticks presenting to the opd and casualty which included 131 males and 181 females were included in the study.Results: Out of the 312 cases of intra-aural ticks, 170 cases were treated in the outpatient and 140 cases under short general anesthesia with oto-microscopy.Conclusion: Intra-aural tick infestation is an acute painful condition which needs prompt management by an experienced otolaryngologist. Proper visualization and instrumentation is necessary to avoid complications.

Crouzon’s syndrome with adenotonsillitis: conventional surgery in altered anatomy.

Background/Objectives: Crouzon’s syndrome is characterized by premature closure of the cranial sutures, midface hypoplasia, orbital deformities & other associated abnormalities.Children with Crouzon syndrome frequently have obstructive sleep apnea due to the underdevelopment of the midface.Case report: A 12 year old boy of Crouzon’s syndrome with chronic adeno-tonsillitis was managed by adeno-tonsillectomy under general anaesthesia by scalpel cautery method. The boyresponded well to surgery & the mild sleep disorder disappeared within a week uveventfully.Conclusion: Sleep disorders in this condition can be treated by improving the airway by selective procedures like midface advancement, mandibular expansion , adeno-tonsillectomy,uvulo-palatopharyngoplasty, anterior tongue reduction & endoscopic tracheal granuloma excision.

Effects of xanthan-locust bean gum mixtures on the physicochemical properties and oxidative stability of whey protein stabilised oil-in-water emulsions

The effects of xanthan gum (XG)-locust bean gum (LBG) mixtures (0.05, 0.1, 0.15, 0.2 and 0.5 wt%) on the physicochemical properties of whey protein isolate (WPI) stabilized oil-in-water (O/W) emulsions containing 20% v/v menhaden oil was investigated. The apparent viscosity of the emulsions containing XG/LBG mixtures was significantly higher (p < 0.05) than the emulsions containing either XG or LBG alone at higher concentrations of XG/LBG mixtures. Locust bean gum showed the greatest phase separation, followed by XG. Microstructure images showed depletion flocculation at lower biopolymer concentrations, and thus let led to an increase in creaming in stability and apparent viscosity of the emulsions. Addition of 0.15, 0.2 and 0.5 wt% XG/LBG mixtures greatly decreased the creaming of the emulsions. The rate of lipid oxidation for 8-week storage was significantly lower (p <0.05) in emulsions containing XG/LBG mixtures than in emulsions containing either of the biopolymer alone

The second “time-out”: A surgical safety checklist for lengthy robotic surgeries

Robotic surgeries of long duration are associated with both increased risks to patients as well as distinct challenges for care providers. We propose a surgical checklist, to be completed during a second “time-out”, aimed at reducing peri-operative complications and addressing obstacles presented by lengthy robotic surgeries. A review of the literature was performed to identify the most common complications of robotic surgeries with extended operative times. A surgical checklist was developed with the goal of addressing these issues and maximizing patient safety. Extended operative times during robotic surgery increase patient risk for position-related complications and other adverse events. These cases also raise concerns for surgical, anesthesia, and nursing staff which are less common in shorter, non-robotic operations. Key elements of the checklist were designed to coordinate operative staff in verifying patient safety while addressing the unique concerns within each specialty. As robotic surgery is increasingly utilized, operations with long surgical times may become more common due to increased case complexity and surgeons overcoming the learning curve. A standardized surgical checklist, conducted three to four hours after the start of surgery, may enhance perioperative patient safety and quality of care

A Parallel Monte-Carlo Tree Search-Based Metaheuristic For Optimal Fleet Composition Considering Vehicle Routing Using Branch & Bound

In this paper, a Monte-Carlo Tree Search (MCTS)-based metaheuristic is developed that guides a Branch & Bound (B&B) algorithm to find the globally optimal solution to the heterogeneous fleet composition problem while considering vehicle routing. Fleet Size and Mix Vehicle Routing Problem with Time Windows (FSMVRPTW). The metaheuristic and exact algorithms are implemented in a parallel hybrid optimization algorithm where the metaheuristic rapidly finds feasible solutions that provide candidate upper bounds for the B&B algorithm which runs simultaneously. The MCTS additionally provides a candidate fleet composition to initiate the B&B search. Experiments show that the proposed approach results in significant improvements in computation time and convergence to the optimal solution.Comment: Submitted to the IEEE Intelligent Vehicles Symposium 202

Sonneratia ovata (Sonneratiaceae)－A New Distributional Record for India from Andaman and Nicobar Islands

Sonneratia ovata Backer was found from Havelock, Andaman and Nicobar Islands, representing a new addition to the mangrove flora of India. This species lacks petals and is characterized by the finely warty calyx, the lobes of which are red on the inner side and by the adpressed calyx lobes in fruit. Since S. ovata is considered rare as a whole, conservation measures are imperative for managing the mangrove diversity of the Islands with special reference to this species

Budesonide/formoterol combination in COPD: a US perspective

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease of the lung caused primarily by exposure to cigarette smoke. Clinically, it presents with progressive cough, sputum production, dyspnea, reduced exercise capacity, and diminished quality of life. Physiologically, it is characterized by the presence of partially reversible expiratory airflow limitation and hyperinflation. Pathologically, COPD is a multicomponent disease characterized by bronchial submucosal mucous gland hypertrophy, bronchiolar mucosal hyperplasia, increased luminal inflammatory mucus, airway wall inflammation and scarring, and alveolar wall damage and destruction. Management of COPD involves both pharmacological and nonpharmacological approaches. Bronchodilators and inhaled corticosteroids are recommended medications for management of COPD especially in more severe disease. Combination therapies containing these medications are now available for the chronic management of stable COPD. The US Food and Drug Administration, recently, approved the combination of budesonide/formoterol (160/4.5 μg; Symbicort™, AstraZeneca, Sweden) delivered via a pressurized meter dose inhaler for maintenance management of stable COPD. The combination also is delivered via dry powder inhaler (Symbicort™ and Turbuhaler™, AstraZeneca, Sweden) but is not approved for use in the United States. In this review, we evaluate available data of the efficacy and safety of this combination in patients with COPD

Rock Magnetic properties of Proterozoic mafic dykes from the Southern margin of Cuddapah Basin

Seventeen basic dykes of Proterozoic age intruding the Archaean basement from the Southern margin of the Cuddapah Basin were studied from five sites for their magnetic characters. NRM intensity (Jn) of the dykes range between 1793 and 57×10−3 Am−1 while magnetic susceptibility (χ) ranges from 31 to 303×10−6 CGS units. Koenigsberger's ratio (Qn) varies from 1 to 55 for most of the specimens. All the above parameters are indicative of retaining the original magnetization in most of the dykes sampled. Based on the above mentioned rock magnetic properties along with hysterisis studies and low temperature (−196°C) magnetic studies, it is inferred that the main magnetic carrier in these dykes is magnetite in multi domain and mixed domain states. Dykes from Tirupati area seems to be magnetically altered