Stability assessment of selected chrysanthemum (Dendranthema grandiflora Tzvelev) hybrids over the years through AMMI and GGE biplot in the mid hills of North-Western Himalayas.

Dendranthema grandiflora is an important cut flower with high economic importance in the floriculture industry. Identification of stable and high yielding genotypes of Dendranthema grandiflora, hence becomes paramount for ensuring its year-round production. In this context, the genotype by environment interaction effects on 22 chrysanthemum hybrids across six test environments were investigated. The experiment was conducted using Randomized Complete Block Design with three replications for 6 years and data on various agro-morphological and yield-contributing traits were evaluated. Our analysis revealed significant mean sum of squares due to environmental, genotypic and genotype by environment interaction variations for all examined traits. A 2D GGE biplot constructed using first two principal components computed as 59.2% and 23.3% of the differences in genotype by environment interaction for flower yield per plant. The GGE biplot identified two top-performing genotypes, G2 and G5, while the AMMI model highlighted genotypes G17, G15, G6, G5, and G2 as the best performers. Genotype G17 ranked highest for multiple traits, while G2 displayed high mean flower yield as well as stability across all environments. According to AEC line, genotypes G2 and G5 exhibited exceptional stability, whereas genotypes G4, G18 and G19 demonstrated lower stability but maintained high average flower yields. Hence, our findings provide valuable insights into chrysanthemum hybrids that were not only best performing but also hold promise to meet the growers demand of the cut flower industry and can be recommended for large scale commercial cultivation.

Assessment of radiosensitivity and enhancing key steviol glycosides in Stevia rebaudiana Bertoni through gamma radiation.

PURPOSE: Stevia rebaudiana Bertoni is a perennial herb, widely used as a natural sweetener around the globe. The key compounds responsible for its sweetness includes stevioside and rebaudioside-A. In order to improve these steviol glycosides, the present study was initiated to study the effect of induced mutagenesis on growth parameters, steviol glycosides and nuclear DNA content in Stevia rebaudiana Bertoni using ten doses of gamma-rays (5-100 kR). MATERIALS AND METHODS: Healthy seeds of 'Madhuguna' variety of Stevia rebaudiana Bertoni developed and maintained at stevia breeding farm, Agrotechnology division, CSIR-Institute of Himalayan Bioresource Technology, Palampur (HP), India were irradiated with ten doses of gamma rays (600 seeds each/dose) ranging from 5 kR to 100 kR (i.e., 5, 10, 15, 20, 30, 40, 50, 60, 80 and 100 kR) using Co60 gamma irradiation chamber at CCS Haryana Agricultural University, Hisar, (Haryana), India. RESULTS: Significant variations were recorded for all the seedling traits studied while major impact was noticed on the seedling after reaching the cotyledonary stage and doses above 40 kR showed absolute mortality of the seedlings. Based on probit analysis, the optimum LD50 dose lies in the range of 20-23 kR. Glycosidic profiling of 296 mutants using high-performance liquid chromatography showed decreased total steviol glycoside content with increased radiation dose. Doses 5 kR and 10 kR, were found to be effective in increasing the overall glycosidic content. A total of 72 promising mutants were also screened for increased rebaudioside-A stevioside ratio. Comparison of nuclear DNA content using flow cytometry revealed a similar decrease in the total nuclear DNA content with increase in dosage of gamma rays. The average genome size at 5, 10, 15, 20 and 30 kR treatments were 2.72, 2.69, 2.68, 2.70 and 2.66 pg as compared to 2.72 pg in control. CONCLUSIONS: Mild dose of gamma rays (5 and 10 kR) in stevia were found to be effective in improving the mean steviol glycoside content and may be used in future stevia mutation programmes.

Deciphering induced variability, character association and multivariate analysis utilizing gamma rays and ethyl methanesulfonate in bread wheat (Triticum aestivum L.) genotypes with differential grain texture.

PURPOSE: Sustainable wheat production and higher genetic gains can be realized by broadening the genetic base and improving the well adapted varieties. In the present study, a multi-year experiment involving induced mutagenesis was conducted to create genetic variation, assess trait associations and genetic divergence in four wheat varieties with differential grain texture treated with six doses of gamma rays and ethyl methane sulfonate using ten agro-morphological traits. MATERIALS AND METHODS: Healthy selfed seeds of four bread wheat varieties with differential texture were irradiated using six doses ranging from 175 Gy-300 Gy of gamma rays (Co60: BARC, Mumbai) and six concentrations of ethyl methanesulfonate (0.3-1.3%) (Sigma-Aldrich, Bangalore, India) to evaluate variability, character association and degree of genetic diversity induced among the mutagenic treatments of wheat varieties with differential grain texture. RESULTS: Significant inter-population differences were observed for almost all the traits. The sample mean of twelve mutant populations in each of the cultivar exhibited superior quantitative phenotypic traits and increased values of the genetic parameters. Based on association and variability studies, plant height, spike length, grain filling period, biological yield per plant and harvest index can be used as early generation criteria for maximum genetic improvement. Multivariate studies indicated the contribution of various traits towards divergence and indicated the efficiency of mutagens in generating variability. Gamma-irradiation dosages between 200-250 Gy and 0.5-1.1% EMS for soft-textured varieties, whereas doses between 225-275 Gy and 0.5-0.9% EMS were found to be most potent for semi-hard-textured varieties. CONCLUSIONS: Assessment of mutagen sensitivity showed that semi-hard wheat varieties were responsive to both mutagens, particularly EMS and generated higher variability and divergence than the soft textured varieties. Hence, gamma rays were proved to be more effective in generating higher variability than ethyl methanesulfonate. A total of 117 putative mutants were identified with desirable agro-morphological attributes. Among these, mutants with higher inter-cluster distance can be used as parents in hybridization programs and serve as important genetic resources in future wheat improvement programs.

Mutagenic sensitivity, effectiveness and efficiency of gamma rays and ethyl methane sulfonate on soft and semi-hard bread wheat (Triticum aestivum L.) varieties in the north-western Himalayan climate.

PURPOSE: The North-western Himalayan region requires unique varietal traits for the cultivation and quality of grain produced. Wheat varieties released for this zone in the past remained very popular among the farmers. However, with the passage of time certain traits such as the appearance of pathogenic rust races and grain softness have become threat to the fecundity of these genotypes and needs immediate improvement in this region. Mutation breeding facilitates improving one or two traits of a popular cultivar and to generate variability for most of plant traits upon which selection can be imposed. The purpose of this study is to evaluate the mutagenic sensitivity, effectiveness and efficiency of physical and chemical mutagens in four bread wheat varieties with differential grain texture. MATERIALS AND METHODS: Four bread wheat varieties; HS 490, HPW 89, HPW 360 and HPW 251 were irradiated using six doses of gamma rays (γ-rays) ranging from 175 to 300 Gy; Co60 source (BARC, Mumbai, India) and six doses of ethyl methane sulfonate (EMS) ranging from 0.3 to 1.3%; EMS (Sigma-Aldrich, Bangalore, India) to assess their mutation sensitivity, effectiveness, efficiency and spectrum of induced macro-mutations in M1 and M2 generation. RESULTS: Based on mutagen sensitivity tests, both gamma rays and ethyl methane sulfonate had similar effects as the doses/concentrations increased in all four varieties. Ethyl methane sulfonate had a discernible effect on seed germination and growth parameters as compared to gamma irradiated treatments. Pollens viability studies confirmed the differential effects of both mutagens on germination and plant survivability. The LD50 and LC50 values varied between 290-315 Gy for gamma rays and 0.90-1.35% for EMS under controlled laboratory conditions, however, the range substantially differs for gamma rays (240-290 Gy) and for EMS (0.50-1.1%) under field conditions, irrespective of the variety treated. The frequency of chlorophyll mutations was low and showed a linear correlation with the doses/concentrations of the mutagen. A total of 117 putative mutants with desirable agro-morphological characteristics were also isolated. Mutagenic effectiveness and efficiency results showed that gamma irradiation doses of 250-300 Gy and ethyl methane sulfonate of 0.7-1.3% were most potent for an effective mutation breeding programme in wheat crop. CONCLUSIONS: It was found that semi-hard textured varieties showed higher sensitivity to chemical mutagens as compared to soft-textured varieties. Gamma irradiation dose of 250-300 Gy and ethyl methane sulfonate concentration of 0.7-1.3% were found to be most effective and efficient across four bread wheat varieties and can be used in large scale mutagenesis programmes.

Genome sequencing of SARS-CoV-2 omicron variants in Delhi reveals alterations in immunogenic regions in spike glycoprotein.

The SARS-CoV-2 omicron variants keep accumulating a large number of mutations in the spike (S) protein, which contributes to greater transmissibility and a rapid rise to dominance within populations. The identification of mutations and their affinity to the cellular angiotensin-converting enzyme-2 (ACE-2) receptor and immune evasion in the Delhi NCR region was under-acknowledged. The study identifies some mutations (Y505 reversion, G339H, and R346T/N) in genomes from Delhi, India, and their probable implications for altering the immune response and binding affinity for ACE-2. The spike mutations have influenced the neutralizing activity of antibodies against the omicron variant, which shows partial immune escape. However, researchers are currently exploring various mitigation strategies to tackle the potential decline in efficacy or effectiveness against existing and future variants of SARS-CoV-2. These strategies include modifying vaccines to target specific variants, such as the omicron variant, developing multivalent vaccine formulations, and exploring alternative delivery methods. To address this, it is also necessary to understand the impact of these mutations from a different perspective, especially in terms of alterations in antigenic determinants. In this study, we have done whole genome sequencing (WGS) of SARS-CoV-2 in COVID-19 samples from Delhi, NCR, and analyzed the spike's mutation with an emphasis on antigenic alterations. The impact of mutation in terms of epitope formation, loss/gain of efficiency, and interaction of epitopes with antibodies has been studied. Some of the mutations or variant genomes seem to be the progenitors of the upcoming variants in India. Our analyses suggested that weakening interactions with antibodies may lead to immune resistance in the circulating genomes.

Portable Gas Spring with Rachet and Pinion System as a Third Arm for Holding Endoscope in Two Handed Endoscopic ENT Surgery.

The role of endoscope has been changing from that being an adjuvant during microear surgery to the exclusive endoscopic middle ear surgery. However the only disadvantage of endoscopic ear surgery is its single handed technique as the non-dominant hand is used to hold the endoscope. We propose the concept and design of our portable endoscope holder for two handed endoscopic ear surgery. It is based on the gas spring action and rack and pinion system which act as a third arm to hold the endoscope. The novel portable endoscope holder bears the potential to provide benefits for various two handed endoscopic ear nose and throat surgeries. Level of evidence: Level V. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-022-03246-3.

Parasitoid wasp venom re-programs host behavior through downmodulation of brain central complex activity and motor output.

The parasitoid wasp Ampulex compressa hunts down its host, the American cockroach (Periplaneta americana), and envenomates its brain to make it a behaviorally compliant food supply for its offspring. The primary target of the wasp sting is a locomotory command center called the central complex (CX). In the present study, we employ, for the first time, chronic recordings of patterned cockroach CX activity in real time as the brain is infused with wasp venom. CX envenomation is followed by sequential changes in the pattern of neuronal firing that can be divided into three distinct temporal phases during the 2 h interval after venom injection: (1) reduction in neuronal activity for roughly 10 min immediately after venom injection; (2) rebound of activity lasting up to 25 min; (3) reduction of ongoing activity for up to 2 h. Long-term reduction of CX activity after venom injection is accompanied by decreased activity of both descending interneurons projecting to thoracic locomotory circuitry (DINs) and motor output. Thus, in this study, we provide a plausible chain of events starting in the CX that leads to decreased host locomotion following brain envenomation. We propose that these events account for the onset and maintenance of the prolonged hypokinetic state observed in stung cockroaches.

Rhinogavel™: A Precise and Perfect Hammer for Rhinoplasty.

Nose is very important in standards of beauty because of its central location on face, making any slightest alteration in its appearance vulnerable to appreciation as well as criticism. Osteotomy is one of main steps of rhinoplasty which brings appreciably drastic change in the appearance of the individual after appropriate correction. Many approaches and instruments have since been used for proper correction of width of nasal bridge. Sometimes wrong use of force can even result in comminuted fracture of nasal bones leading to undesired surgical outcome. We have designed a hammer (gavel) made of hylam or bakelite for its precision role and use in rhinoplasty.

Is Chemical Cauterization Safe on Septal Cartilage in Treatment of Recurrent Epistaxis?

Epistaxis is one of the most common emergencies. Topical agents such as silver nitrate, is known to be a strong oxidizing agent and have been widely used, especially in recurrent and refractory cases. The extent of depth of coagulative necrosis is dependent on time of exposure and concentration. 2 mm wide bar of nasal septum from 30 patients was taken and AgNO3 was applied for 10, 20, 40 s. H&E staining was then performed to see depth of penetration and intensity of stain deposits. It was observed that with increase time of application, depth of penetration and density of deposits were increased for both 75% and 100% concentration of solution. Distribution in depth of penetration was significant when 75% concentration was applied for more than 20 s. But when 100% concentration was used, similar findings were found even after 10 s in young age group. Our study shows that when silver nitrate is used for chemical cauterization in different concentrations and for different times, their penetration is different. Moreover, the depth of penetration depends more on the time of contact than concentration of silver nitrate. We would recommend using 75% solution for use with a contact time not more than 20 s in adults and 10 s in children.

Clinicopathological Challenges in Tumors of the Nasal Cavity and Paranasal Sinuses: Our Experience.

Background and objective Nasal and paranasal lesions are one of the most common otorhinolaryngological presentations encountered in clinical practice. Common presenting symptoms of these lesion range from nasal blockades, facial swellings, pain, nasal discharge, and epistaxis to orbital and ear symptoms. Diagnosis can be tricky as these symptoms are common in inflammatory conditions and tumors. The aim of our study was to observe the epidemiology and clinical pathological findings in patients with nasal and paranasal masses presenting to our institute and discuss the challenges in proper diagnosis and management due to similar presentations, and the role of histopathological examination (HPE) and immunohistochemistry (IHC) in overcoming these challenges. Methods The IPD records of 396 patients were taken up for the study. All the specimens were sent in 10% neutral buffered formalin for examination as biopsy for diagnosis or after surgical excision. After adequate fixation, the biopsy specimen was submitted for routine processing, followed by paraffin embedding, and stained with hematoxylin and eosin (H&E). Special stains like periodic acid-Schiff (PAS) and Ziehl-Neelsen (ZN) stains for acid-fast bacilli (AFB) were used as required. IHC was performed in the required samples. IHC markers were performed on representative paraffin-embedded sections according to the streptavidin-biotin immunoperoxidase technique as needed. The findings were noted, and histology was correlated with clinical presentations and investigations, tabulated, and statistically analyzed using SPSS Statistics (IBM, Armonk, NY). Results Of note, 67.92%% were non-neoplastic lesions whereas 18.18% came out to be benign neoplasms and 13.88% were malignant lesions on HPE. Nasal obstruction was the most common presenting symptom (73.23% of patients) followed by nasal mass (64.14% of cases). Inflammatory sinonasal polyps were the most prominent cases in our study, accounting for 41.16% of all lesions; 18.68% fungal RS (mucormycosis) were seen in our study and 4.54% were cases of juvenile nasopharyngeal angiofibroma (JNA). The majority of benign neoplasms encountered were Schneiderian papilloma or inverted papilloma (06.81%). Eighteen (4.54%) cases of squamous cell carcinomas (SCC) were seen in our study and 2.77% (n=11) cases were of adenoid cystic carcinoma. Of 18 cases of SCC, moderately differentiated SCC carcinoma accounted for 10 cases followed by poorly differentiated SCC (5/18) and nonkeratinizing SCC (3/18). IHC for p40 was performed in all the cases of nonkeratinizing SCC, which showed strong and diffuse nuclear positivity. Conclusion The nasal cavity is the site of the most varied presentation of tumors in the upper respiratory tract. Mass in the nose and paranasal sinus (PNS) form a heterogeneous group of lesions with varied histopathological features. The proximity of the area to the eyes and brain warrants early definitive diagnosis so that the lesion is treated before it can involve important and vital centers. Even though malignant nasal tumors have a very low incidence, they cause a lot of morbidity due to their long course and frequent local recurrences. Nasal tumors tend to become polypoidal. Epithelioid papilloma of the nasal cavity often resembles a nasal polyp. Clinical diagnosis can be challenging due to similar presentations and appearances, and hence histological examination is a vital tool for the timely diagnosis of such patients.

Antibiogram guided optimized medical treatment in chronic otitis media: A useful interventional strategy before surgery?

BACKGROUND: Chronic otitis media is a middle ear cleft disease presenting with tympanic membrane perforation and discharge. Wet ear after tympanoplasty and discharging mastoid cavity are problematic in clinical practice. MATERIAL AND METHODS: 1050 patients of age 10 to 50 years presenting with active ear discharge and clinically diagnosed with unilateral chronic suppurative otitis media were included in the study. The patients were equally divided into two equal groups, Group ET, and AT. All patients were prescribed topical ciprofloxacin, oral levocetirizine 5 mg and n-acetyl cysteine 600 mg BD for one week. Swabs of ear discharge were collected in ET groups for antibiogram. Both groups were evaluated on next visit and treatment changed in AT groups and result observed in next visit. Surgical outcome was evaluated at end of 2 yrs. RESULT: A total of 1158 organisms were isolated in culture out of which, 69.94 % were aerobes, 13.47 % anaerobes and 16.58 % were fungi. On the second visit in group AT, treatment of 85.14 % patients was changed in accordance with culture sensitivity report. In patients with mucosal disease, only 46.87 % patients of group ET had a favorable outcome in comparison to 90.28 % patients of group AT while in patients with squamosal disease, 17.56 % patients of group ET and 28.99 % patients in group AT had a dry ear. Surgeries in AT group were found to have statistically significant higher success rate as compared to ET group.

Suppression of host nocifensive behavior by parasitoid wasp venom.

The parasitoid wasp Ampulex compressa envenomates the brain of its host the American cockroach (Periplaneta americana), thereby making it a behaviorally compliant food supply for its offspring. The target of venom injection is a locomotory command center in the brain called the central complex. In this study, we investigate why stung cockroaches do not respond to injuries incurred during the manipulation process by the wasp. In particular, we examine how envenomation compromises nociceptive signaling pathways in the host. Noxious stimuli applied to the cuticle of stung cockroaches fail to evoke escape responses, even though nociceptive interneurons projecting to the brain respond normally. Hence, while nociceptive signals are carried forward to the brain, they fail to trigger robust nocifensive behavior. Electrophysiological recordings from the central complex of stung animals demonstrate decreases in peak firing rate, total firing, and duration of noxious-evoked activity. The single parameter best correlated with altered noxious-evoked behavioral responses of stung cockroaches is reduced duration of the evoked response in the central complex. Our findings demonstrate how the reproductive strategy of a parasitoid wasp is served by venom-mediated elimination of aversive, nocifensive behavior in its host.

Phase-Tuned MoS2 and Its Hybridization with Perovskite Oxide as Bifunctional Catalyst: A Rationale for Highly Stable and Efficient Water Splitting.

The efficient realization of bifunctional catalysts has immense opportunities in energy conversion technologies such as water splitting. Transition metal dichalcogenides (TMDs) are considered excellent hydrogen evolution catalysts owing to their hierarchical atomic-scale layered structure and feasible phase transition. On the other hand, for efficient oxygen evolution, perovskite oxides offer the best performance based on their rational design and flexible compositional structure. A unique way to achieve an efficient hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) in a single-cell configuration is through the hybridization of TMDs with perovskite oxides to form a bifunctional electrocatalyst. Here, we report a simple yet effective strategy to inherently tune the intrinsic properties of a TMD based on MoS2 and its hybridization with LaCoO3 perovskite oxide to deliver enhanced electrocatalytic activity for both the HER and OER. Detailed Raman and XPS measurements highlighted a clear phase transformation of MoS2 from a semiconducting to metallic phase by effectively tailoring the precursor compositions. Based on this, the morphological features yielded an interesting spherical flower-shaped nanostructure with vertically aligned petals of MoS2 with increased surface-active edge sites suitable for the HER. Subsequent hybridization of nanostructured MoS2 with LaCoO3 provides a bifunctional catalytic system with an increased BET surface area of 33.4 m2/g for an overall improvement in water splitting with a low onset potential (HER: 242 mV and OER: 1.6 V @10 mA cm-2) and Tafel slope (HER: 78 mV dec-1; OER: 62.5 mV dec-1). Additionally, the bifunctional catalyst system exhibits long-term stability of up to ∼400 h under continuous operation at a high current density of 50 mA cm-2. These findings will pave the way for developing cost-effective and less complex bifunctional catalysts by simply and inherently tuning the influential material properties for full-cell electrochemical water splitting.

Novel Drill-burr Protection Sheath with Inbuilt Suction-irrigation for Endoscopic Ear Surgery.

Abstract: We have developed a novel instrument which is a drill burr protection sheath with an inbuilt suction-irrigation system for endoscopic ear surgery. It allows simultaneous suction and irrigation. It is a metallic attachment onto the mastoid drill handpiece. It provides protection for the endoscope as well as the external auditory skin during transcanal drilling procedures. It is cost effective. Level of evidence: 5. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-021-02944-8.

Evaluation of Clinical Profile and Various Treatment Modalities in Oral Sub Mucous Fibrosis in North India: Our Experience.

Oral submucous fibrosis is a chronic disease affecting oral cavity and sometimes the pharynx. Etiology seems to be local irritants such as capsaicin, tobacco, areca nut and spicy foods. The main concern in this is the management of trismus and burning sensation of the oral mucosa. The aim of this study was to compare various medical treatment protocol of OSMF. 210 patients were divided randomly in 3 groups. In Group A, patients were given biweekly intralesional Hyaluronidase/Dexamethasone for 6 weeks. Group B patients were given tablet Pentoxifylline 400 mg TDS.Group C patients were given Eprisone hydrochloride. All three groups were given Lycopene 10,000 mcg for period of 6 weeks. All patients were given topical Triamcelone for local application. The examinations for mouth opening were repeated at weekly intervals for a period of 6 weeks.The most common complaint was burning sensation in 75.98% cases, difficulty in mouth opening in77.45% and difficulty in swallowing food in 61.76% cases. Group A showed improvement in 41.17% cases presenting with burning sensation followed by decreased mouth opening 39.70%. Group B showed improvement in 45.58% burning sensation, 17.64% with decreased mouth opening. Group C showed improvement in 48.52% patients having pain with spicy food, 32.35% with decreased mouth opening and 17.64% with difficulty in swallowing. We conclude that patients which received intralesional dexamethasone and hyaluronidase along with oral Lycopene showed better clinical and symptomatic improvement, and at present appears to be best non-surgical treatment.

Novel Concept, Design and Feasibility Test of Hybrid Temporal Bone and Sheep Head Holder.

We present a first feasibility and usability assessment of a novel commercial hybrid temporal and sheep head holder. Feasibility tests were conducted on human cadaveric and sheep temporal bone based on common otologic procedures. Overall practicality of using this device for cadaveric temporal bone dissections was evaluated. Beneficial aspects included ease of usage, handling, fixing and stability, inbuilt irrigation system, compartments for instrument placement, ergonomics and overall satisfaction. The novel hybrid Temporal and sheep bone holder bears the potential to provide benefits for cadaveric and sheep bone dissections. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-021-02612-x.

Styloid Process; Correlation Between Symptoms, Palpability and Measurements on Three Dimensional Computed Tomography.

Styloid process is a long and slender osseous projection protruding downward, forward and slightly medially from the temporal bone and serves as an anchor point for various muscles associated with the tongue and the larynx. The aim of the present study was to record the length and the angle of Styloid process on three dimensional computed tomography in patients with unilateral symptomatic and palpable styloid process and compare the length and the angle of styloid process of symptomatic side to asymptomatic side on three dimensional computed tomography. 3D-CT face reconstruction were perfomed in all 35 patients (17 females, 18 males of age range 25-69 years). The length of the styloid process and its angulation (transverse and sagittal angles) were measured by means of three dimensional and multiplanar reconstruction images. The length of styloid process on symptomatic side had a mean of 33.61 ± 5.08 mm while on asymptomatic side mean was 31.11 ± 5.02 mm. The mean transverse angle on symptomatic sides had a mean of 72.37° ± 4.48° while on asymptomatic side mean was 74.17° ± 4.48°. The mean sagittal angle seen on symptomatic side was 88.11° ± 5.21° while on asymptomatic side was 87.88° ± 5.03°. Symptomatic side has a longer styloid. Length of the styloid process has a statistical correlation with the symptoms and symptomatic side has a longer styloid. Though there was a difference in transverse and sagittal angulation in symptomatic versus asymptomatic side; but it was not statistically significant. On examination of the opposite asymptomatic side, 5 patients had a palpable styloid process therefore we infer that long styloid process may not always be associated with symptoms. Patients with cervicofacial pain should be evaluated for Eagle syndrome by palpation of styloid process in the tonsillar fossa and further by three dimensional computed tomography (3D-CT). 3D CT is an effective tool in evaluating patients with cervicofacial pain and making a diagnosis of Eagle's syndrome. Therefore, 3D CT should be performed while evaluating patients with these symptoms.

Presentations of Pediatric Emergencies in a Tertiary Teaching Hospital in North India: An Overview.

Pediatric otorhinolaryngological emergencies constitute a major portion in emergency room presentations. The etiology of ENT problems in children is different from those in adults. Most of these can be managed conservatively while some need prompt management at a well equipped centre. To analyze the etiology, clinical profile and line of management of pediatric otorhinolaryngological emergencies. Retrospectively, records of 452 children up to the age of 16 years presenting with ENT complaints were included in the study. Out of 452 patients, 148 presented with aural complaints, 129 had nasal problems and 175 patients with throat complaints. They were classified into Trauma 69 (15.26%), Foreign body 278 (61.50%), Infective 82 (08.14%) and allergic/miscellaneous 23 (05.10%) cases. In aural complaints, foreign body insertion seen in 57 (12.17%) cases while earache in 55 (12.15%) patients. In patients with nasal complaints, foreign body was present in 78 (17.26%) cases. Nasal bleeding and discharge or pain and swelling around nose were the other presentations. Respiratory distress was present in 66 (14.60%) patients while 74 (16.37%) patients came with ingestion of some foreign body. Neck swellings were seen in 20 (04.42%) patients and 15 (03.31%) patients came with history of rashes, feeling of choking or allergic reactions. Surgical intervention after admission was the top most intervention in 202 (44.69%) patients followed by conservative management in 110 (24.33%) patients who were treated and then sent home from emergency centre itself. Minor surgical intervention was sufficient to treat 78 (17.25%) patients without admission. Most common ENT emergency was foreign bodies and these cases need operative intervention. Specialist ENT personnel is needed to handle these cases. Parents must be educated to keep likely causes of these foreign bodies out of reach of growing children and also need to be educated about signs like severe pain, dyspnoea, bleeding or unilateral nasal discharge for timely management.

Comparative Evaluation of Hearing in Cartilage Umbrella, Boomerang and Torp in Chronic Otitis Media Cases with Absent Stapes Suprastructure: Our Experience.

Ossicular discontinuity is one of the most common causes of conductive hearing loss. Ossicular chain reconstruction improves conductive hearing loss. With no additional cost, cartilage ossiculoplasty is easy to perform, and also the cartilage is well tolerated being an autograft. In this study we compared the audiological outcome in ossiculoplasty done by cartilage umbrella, cartilage boomerang and alloplastic TORP. 75 patients of age group 10-50 years clinically diagnosed with chronic otitis media with conductive hearing loss and an air bone gap (ABG) of at least 20 dB posted for surgery were included. Ossiculoplasty was done in three groups with autologous cartilage boomerang, cartilage umbrella and alloplastic TORP. In mucosal disease hearing gain was better in umbrella technique (17.66 ± 1.1) dB than Boomerang (16.9 ± 0.8) dB and TORP (10.68 ± 0.9) dB. ABG closure was higher in Boomerang and TORP. Hearing improvement in patients with squamosal disease managed by canal wall up surgery was 25.01 ± 1.1 dB, 27.73 ± 3.1 dB and 20.12 ± 1.8 dB in Boomerang, Umbrella and TORP group respectively showing that umbrella method gave maximum improvement. ABG closure was better in TORP group. In canal wall down surgery patient's maximum improvement was seen in Boomerang (29.51 ± 0.9) dB followed by Umbrella (26.67 ± 1.2) dB and TORP (25.27 ± 0.8) dB group. ABG closure was higher in Boomerang group. Cartilage ossiculoplasty is a reliable and effective method of ossicular chain reconstruction for both mucosal and squamosal disease. Cartilage ossiculoplasty has the added advantage of reduced chances of prosthesis extrusion as compared to TORP.

Oral Submucous Fibrosis: Association of Clinical and Histological Severity with Hearing Loss and Middle Ear Function.

OSMF is a precancerous condition of the oral cavity. Cons umption of Areca nut in quid has been proved to be the most consistent factor. To assess middle ear function in OSMF patients by audiometry and tympanometry. Two Hundred patients of < 40 years of age with OSMF were examined and followed by PTA and impedance audiometry. Impaired mobility was seen in 20(10%) ears, and retraction of tympanic membrane was found in 36(18%) ears. Clinical staging was done in four stages. Majority of the patients were males (58%) in the age group of 21-30 years belonging to stage III (38%) and IV (26%) respectively. PTA showed varying degrees of hearing loss in 73 (36.5%) ears. In Grade I, mild hearing loss was seen in 10 (35.71%) ears and moderately severe hearing loss was in 5 (11.36%) ears whereas in Grade II mild hearing loss in 11(25%) ears. Grade III and IV showed mild hearing loss in 11(14.47%) and 12 (23.07%) respectively. Tympanometry revealed type A curve in 126 (63%) ears followed by C curve in 50 (25%) and B curve in 24 (12%) ears. In patients of OSMF, there is involvement of palatal/paratubal muscles in the fibrosis process, which causes eustachian tube malfunction leading to disturbed middle ear functions and negative middle ear pressure. Most patients of oral submucous fibrosis showed direct association with grade of hearing impairment and eustachian tube dysfunction. Higher clinical grades, both clinically and histologically showed similar findings thereby we concluded that if the disease is treated early, preventing patients from having higher grades of disease, involvement of ear can be avoided, and patients can be saved from hearing impairment.