CASE REPORT: A patient with a history of surgical resection of an acoustic neuroma presented with involvement of both the left facial nerve and the left trigeminal nerve. She initially consulted for exposure keratitis, but two weeks later presented with an infectious keratitis. After taking the corneal sample, she presented with persistent epithelial defect, which did not respond to medical management. Topical insulin was indicated, and a decrease in the area of the lesion was seen in the following 5 days. A therapeutic contact lens was also placed at that time and finally, two weeks after the initiation of insulin, the epithelial defect completely closed. DISCUSSION: This was a complex case due to the confluence of facial paralysis, neurotrophic keratitis, and infectious keratitis, which finally had a successful outcome. Topical insulin can be an effective adjuvant therapy in cases of neurotrophic ulcers that do not respond to standard therapy.
Facial Nerve Injuries/complications , Insulin/therapeutic use , Keratitis/etiology , Neuroma, Acoustic/surgery , Postoperative Complications/etiology , Trigeminal Nerve Injuries/complications , Administration, Ophthalmic , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Contact Lenses, Hydrophilic , Corneal Ulcer/drug therapy , Corneal Ulcer/etiology , Corneal Ulcer/therapy , Facial Paralysis/etiology , Female , Humans , Insulin/administration & dosage , Keratitis/drug therapy , Keratitis/microbiology , Keratitis/therapy , Middle Aged , Moxifloxacin/therapeutic use , Postoperative Complications/drug therapy , Staphylococcal Infections/drug therapy , Staphylococcal Infections/etiology , Vancomycin/therapeutic use
The aim of this study was to optimize and characterize an extruded snack made with taro flour and mango pulp. A central experimental design composed of the following three variables was used: mango pulp proportion (MPP = 0-10 g/100 g) in taro flour, feed moisture content (FMC = 16-30 g/100 g) and extrusion temperature (zone 4 of extruder) (T = 80-150 °C) using a single-screw extruder with a compression screw ratio of 3:1. Increasing FMC values decreased the torque, pressure, specific mechanical energy (SME), expansion index (EI), water solubility index and pH values and increased the residence time, bulk density (BD), hardness and total colour difference. Increasing T values led to a decrease in the torque, pressure, BD and hardness values, while increasing MPP values only caused a significant increase in the hardness values and ß-carotene content and a decrease in the pressure value. The optimal extrusion conditions were T = 135.81 °C, FMC = 18.84 g/100 g and MPP = 7.97 g/100 g, with a desirability value of 0.772, to obtain a snack with EI = 1.52, BD = 0.66 g/cm3, hardness = 24.48 N, ß-carotene content = 99.1 µg/g and SME = 428.54 J/g. The mango pulp is an available and economical source of ß-carotene for the enrichment of extruded expanded taro snacks.
