Uncommon culprits: Foreign body grass fragments in buccal mucosa presenting as recurrent buccal abscess in a pediatric patient - a case report.

Foreign body ingestion is a common occurrence in the pediatric population, often involving the gastrointestinal tract. However, the presence of foreign bodies in the oral cavity, particularly within the buccal mucosa, is relatively rare. This case report describes an unusual presentation of a foreign body embedded in the buccal mucosa and discusses the diagnostic and management challenges associated with such cases. A 10-month-old female child with no significant previous medical history presented with recurrent buccal abscess. Following the removal of the foreign body (grass fragments), the child experienced a complete recovery.

Biomarker responses in the Coilia dussumieri exposed to petroleum hydrocarbons contamination in urbanized estuaries along the west coast of India.

The estuaries of Maharashtra are under continuous pressure due to uncontrolled dumping of persistent toxic organic pollutants into these regions and their impact on the marine environment. In this study, total petroleum hydrocarbons (TPHs) in water, sediments, fish, and biomarker responses in the Coilia dussumieri exposed to TPHs were determined in seven urbanized tropical estuaries along the west coast of India during the winter and summer. The results of the cluster analysis highlighted that the concentration of TPHs in the water, sediment, and fish in the study area was spatially varied, with the highest concentration in the northern area of Maharashtra (NM) estuaries than in the southern region of Maharashtra (SM) estuaries during both seasons. The enrichment of TPHs in water and sediment in the middle part of most estuaries highlights the addition of anthropogenic organic matter. A higher concentration of TPHs in the muscle tissue of Coilia dussumieri observed in NM during the winter season, indicates the energetic intake and storage of large quantities of TPHs in their muscle tissue. The biochemical results showed decreased levels of total protein (PRT) under exposure to TPHs, under oxidative stress and reversing correlations was observed between catalase (CAT) and lipid peroxidation (LPO) activities with the respective TPHs. Similarly, reduced activity of the CAT antioxidant and increased glutathione-S-transferase (GST) under exposure to TPHs were more likely to occur under hydrocarbon stress. However, current results indicate that Coilia dussumieri actively produces oxidative stress and antioxidant reaction that can be used as biomarkers of pollution in the study area.

Hypersensitivity reaction to intravenous ondansetron: A case report.

Ondansteron is widely used as prophylaxis for postoperative nausea and vomiting and is associated with various side effects. We present a case of hypersensitivity reaction in the form of itching and rashes in a 6-year-old female patient with a single dose of intravenous ondansetron.

Diagnostic and therapeutic dilemma in orofacial pain: A rare case of bilateral Eagle syndrome.

Eagle's syndrome is a collection of symptoms due to abnormal and/or elongated styloid process. This can irritate the various neurovascular structures that lie in its close proximity, mainly the glossopharyngeal nerve, leading to odynophagia, dysphagia, foreign body sensation, cervicofacial pain, and headache. It is a diagnosis of exclusion and needs high degree of clinical suspicion. It is a rare condition with no reported incidence in the Bhutanese population so far. In this article, we present a case of elongated styloid process that was causing persistent and troublesome orofacial pain in a patient, which was not relieved by medication. The patient underwent trans-oral styloidectomy, which helped cure his symptoms.

Outcomes of an Ear Camp Conducted in Bhutan by Thai Rural ENT Foundation-A Descriptive Study.

BACKGROUND: The Thai Rural ENT foundation has been conducting ear camps in Bhutan for many years to address the shortage of ENT specialists in the kingdom where patients are examined and treated for various ear illnesses. However, there has been no study conducted to assess the outcomes of such camps. This is the first study of its kind to be carried out in Bhutan. OBJECTIVE: To study the spectrum of ear cases seen during the mobile ear camp, the intervention done and treatment outcomes. MATERIALS AND METHODS: The study enrolled patients with ear disorders who presented to the mobile ear camp at Monggar Regional Referral Hospital, Bhutan, from January 6, 2020, to January 8, 2020. The following data were recorded: demographic details, preoperative clinical symptoms and otoscopic findings, preoperative audiogram, treatment or surgery done, postoperative middle ear and mastoid infection, wound infection, graft condition, any complications, and postoperative audiogram of operated cases. Patients who underwent surgery were followed up at 1 day, 6 weeks, and 2 months postoperatively. RESULTS: Two hundred ten patients presented with otologic conditions and 43 underwent surgeries. Otitis media was the commonest disease detected, and tympanoplasty was the commonest surgery performed. The tympanic membrane closure rate was 92.1%, and the rate of hearing improvement was 63.2%. CONCLUSION: The ear camp had beneficial effect and showed good results.

Multivariate assessment of outflow water quality in highly urbanized creek system: implication of natural and anthropogenic processes.

Nutrient source and transport study in tropical creeks adjacent to megacities are sparse on a regional and global scale. High-frequency chemical data collected during 2017-2018 in the Thane creek system, the largest micro-tidal urbanized creek in Asia, were analysed to assess the chemical water quality, with its linkage to different hydrological stages (southwest monsoon, post- and pre-monsoon) and ongoing anthropogenic activities. Cluster analysis indicates typical zonation between creek outflow and nearshore waters with distinctive physicochemical properties. The creek outflow upholds substantial amounts of nutrient and suspended sediment due to turbid water movement from the ephemeral mudflats and anthropogenic dredging. The year-round hyper-turbid condition in the bottom water triggers the addition of disproportionate nutrients (9% dissolved inorganic nitrogen (DIN) and 14% reactive phosphorous (PO43-) in the outflow region. The DIN and PO43- removal up to 10 and 35%, respectively, occurs in the nearshore region; sedimentation, which acts as a sinking interface for nitrogen and phosphorous, also causes shifting in their limiting conditions. The hyper-turbid condition causes removal of dissolved silicate (DSi) by 5% in the entire region. Ammonium (NH4+) is mainly sourced from the sewage in outflow waters and efficiently mineralized. Chemical indexing of water highlights that the bottom water column remained un-supportive to the balanced ecology. The findings of this study have implications for other tropical creek-estuary concerning management strategies against inadequate flushing. The stalled nutrient export affected balance ecology in tropical Thane creek, which need attention in order to accurately understand the impact on adjacent marine environment and to form effective mitigation policies.

Prevalence of Internet Addiction and Associated Psychological Co-morbidities among College Students in Bhutan.

INTRODUCTION: Globally 3.5 billion people have access to internet and most of them are young adults and adolescents. In South Asia, Bhutan has the highest proportion of population with internet access at 37% in 2016. Many studies in Asia have reported significantly high level of internet addiction among college going students. In this light, this study was designed to estimate the prevalence of internet addiction and other co-morbidities. METHODS: This cross sectional study included 823 first year and final year students aged 18-24 from six colleges in Bhutan. A self-administered questionnaire consisting of three parts was utilized for data collection. The data was entered and validated in Epidata and analyzed using STATA/IC 14. RESULTS: The prevalence of moderate and severe internet addiction was 282 (34.3%) and 10 (1%) respectively. Positive correlations between internet addiction and psychological well-being (r= 0.331 95% CI: 0.269, 0.390), between Internet Addiction score and years of internet usage (r=0.104 95% CI: 0.036, 0.171), age and years of using internet (r= 0.8 95% CI: 0.012, 0.148) were observed. The commonest mode of internet use was martphone 714 (86.8%). The use of computer laboratory (aPR 0.80, 95%CI: 0.66, 0.96) and internet use for news and educational purposes (aPR 0.76, 95%CI: 0.64, 0.9) showed protective effects. CONCLUSIONS: The prevalence of internet addiction is high among the college going students in Bhutan. This warrants timely interventions to address the problems of internet addiction.

Effect of physico-chemical regimes and tropical cyclones on seasonal distribution of chlorophyll-a in the Chilika Lagoon, east coast of India.

A comprehensive analysis on spatiotemporal variation in physico-chemical variables and their control on chlorophyll-a during 2013-14 was carried out in the Chilika Lagoon. Spatiotemporal variation in physico-chemical regimes significantly controlled the phytoplankton biomass of the lagoon. Further, precipitation-induced river/terrestrial freshwater influx and marine influence controlled the physico-chemical regimes of the Chilika Lagoon, such as nutrients (NH4+, NO3-, NO2-, PO43- and Si(OH)4), temperature, salinity, total suspended matter and dissolved oxygen. This study revealed significant effects of tropical cyclones Phailin (2013) and Hudhud (2014) on physico-chemical regimes and in turn the phytoplankton biomass of the lagoon. Although both cyclones Phailin (2013) and Hudhud (2014) were intense, Phailin (2013) had a greater impact on the Chilika Lagoon due to the proximity of its landfall. Heavy precipitation caused an influx of nutrient-rich freshwater, both during each cyclone's passage, through rainfall, and after, through increased river flow and terrestrial run-off. The increase in nutrients, carried by the run-off, promoted phytoplankton growth, albeit in lag phase. In general, phytoplankton growth was controlled by nitrogenous nutrients. However, the addition of SiO4 through terrigenous run-off fuelled preferential growth of diatoms. The salinity pattern (which can be considered a proxy for fresh and marine water influx) indicated injection of freshwater nutrients into the northern, southern and central sectors of the lagoon through riverine/terrestrial freshwater run-off; marine influx was restricted to the mouth of the lagoon. Present and past magnitudes of salinity and chlorophyll-a were also compared to better understand the pattern of variability. A significant change in salinity pattern was noticed after the opening of an artificial inlet, because of the resulting higher influx of marine water. The overall phytoplankton biomass (using chlorophyll-a concentration as a proxy) remained consistent in the lagoon pre- and post-restoration. Due to the wide range of salinity and temperature tolerance, diatoms remained dominant in both pre- and post-restoration periods, but the overall phytoplankton diversity increased after the artificial inlet was dredged.