Interim management of Pierre Robin sequence using a custom-made face mask.

Pierre Robin sequence poses a great challenge for anesthesiologists during laryngoscopy and intubation, making oxygenation and ventilation difficult. The role of early surgical intervention is recommended for the improvement of the airway and overall survival of the neonate. The situation becomes even more challenging, when the neonate may not be fit for such surgical interventions. The present case posed such a challenge to the team. To the authors' knowledge, the decision to use a face mask as an interim life-saving measure was considered for the first time. This provided a greater window of opportunity for further course of action, only to be later managed by distraction osteogenesis of the mandible. The unconventional use of orthopedic appliances for the management of threatened airways may provide the clinician with time, where further management may be carried out. The present article will explain such a procedure that was carried out as a life-saving measure.

Zinc solubilization and organic acid production by the entomopathogenic fungus, Metarhizium pingshaense sheds light on its key ecological role in the environment.

We report for the first-time higher zinc (Zn) solubilization efficiency and plant growth promotion by an entomopathogenic fungus (EPF), Metarhizium pingshaense IISR-EPF-14, which was earlier isolated from Conogethes punctiferalis, a pest of global importance. The Zn solubilizing efficiency of the fungus varied depending on the type of insoluble source of Zn used, which was observed to be 1.6 times higher in Zn3(PO4)2-amended media compared to ZnO media. In liquid media, there was a 6.2-fold increase in available Zn in ZnO-amended media, whereas a 20.2-fold increase in available Zn was recorded in Zn3(PO4)2 medium. We ascribe the production of various organic acids such as gluconic, keto-gluconic, oxalic, tartaric, malonic, succinic and formic acids, which in general, interact with insoluble Zn sources and make them soluble by forming metal cations and displacing anions as the major mechanism for Zn solubilization by M. pingshaense. However, the type and amount of organic acid produced in the media varied depending on the source of Zn used and the incubation period. Application of the fungus alone and in combination with insoluble Zn sources enhanced various plant growth parameters in rice and cardamom plants. Moreover, the uptake of Zn in rice plants was enhanced up to ~2.5-fold by fungal application. The fungus also exhibited various other plant growth-promoting traits, such as production of Indole-3-acetic acid, ammonia, siderophores, solubilization of mineral phosphate, and production of hydrolytic enzymes such as α-amylase, protease, and pectinase. Hence, apart from its use as a biological control agent, M. pingshaense has the potential to be used as a bio-fortifier to enhance the solubilization and uptake of Zn from nutrient poor soils under field conditions. Our findings shed light on the broader ecological role played by this fungus and widen its scope for utilization in sustainable agriculture.

Uncertainty evaluation of non-invasive multi-parameter detector measurements in quality assurance of diagnostic radiology.

OBJECTIVE: To optimize the patient dose and image quality through quality assurance (QA) of diagnostic x-ray equipment and to ensure compliance with international and national standards in x-ray specification parameters, the use of contactless and quick non-invasive instruments has gained importance. Considering the importance of equipment qualification and the intervention level for equipment management, it is vital to account for uncertainties in the measurement of parameters in diagnostic radiology. However, the limits and measurement uncertainties associated with the parameter measurement are not well established and many technical and scientific literature provide different tolerance values, either as absolute or in terms of percentage. METHODS AND MATERIALS: In this paper, the authors analyze non-invasive multi-parameter detector measurements with the aim to (i) improve the accuracy in measurement of x-ray parameters (kilovoltage, dose, and exposure time); (ii) estimate the uncertainty associated with such measurements; (iii) analyze the tolerance values prescribed by various professional and regulatory bodies and propose an improvised method of reporting the parameters. The approach adopted in this paper takes into account the uncertainties associated with traditional instruments and the subjectivity in the measurements. RESULTS: Estimated uncertainty for kV measurements in the range between 1.45 kV at 40 kV measurements and 4.88 kV at 150 kV measurements. The MU associated with the dose measurement is estimated to be 6.2% at 110 kVp, 100 mA, and 500 msec. Maximum MU estimated at 10 msec exposure time is 4.5% and with MU of 5% deviation added to 9.5%. CONCLUSIONS: The current practice of reporting the measured mean values deviation without considering the inherent measurement uncertainty may not be a correct quantification procedure in QA. This is evident from the case study that 3% addition to the measured kV, 6.2% addition in the measured dose, and 4.5% to the measured time accounts for measurement uncertainty.

Retromandibular Approach and its Different Variations in the Management of Fracture Condyle: Surgical Experience.

The management of condylar fractures is a controversial topic in maxillofacial surgery. Surgical treatment is the preferred treatment choice nowadays and the article aims to describe different variations of the retromandibular approach with their surgical outcome based on experience. A total of 15 cases were managed with the retromandibular approach and its different variations. We advocate retromandibular approach for the management of condyle fractures, and among which retromandibular retroparotid and retromandibular anteroparotid provide best accessiblity with less bleeding and minimal risk of injury to the facial nerve.

Metarhizium indicum, a new species of entomopathogenic fungus infecting leafhopper, Busoniomimus manjunathi from India.

A new species of entomopathogenic fungus, Metarhizium indicum, which derives its species epithet after its Indian origin is reported here. The fungus was found to cause natural epizootics in leafhopper (Busoniomimus manjunathi) infesting Garcinia gummi-gutta (Malabar tamarind), an evergreen spice tree native to South and Southeast Asia, known for its use as a culinary flavourant, dietary supplement and traditional remedy for various human ailments. The fungus was found to cause more than 60% mortality in field collected insects. The identity of the new species was established based on its distinct morphological characteristics and multi-gene sequence data analyses. Phylogenetic analyses using internal transcribed spacer region (ITS), DNA lyase (APN2) and a concatenated set of four marker genes [translation elongation factor 1-alpha (TEF), ß-tubulin (BTUB), RNA polymerase II largest subunit (RPB1) and RNA polymerase II second largest subunit (RPB2)] along with marked differences in nucleotide composition and genetic distance unambiguously support our claim that the present fungus infecting Garcinia leafhopper is a new addition to the genus Metarhizium.

Effect of minerals and heavy metals in sand samples of Ponnai river, Tamil Nadu, India.

River sand samples have been collected from Ponnai river, Tamil Nadu, India for characterization of minerals and heavy metals by different spectroscopic techniques. Initially, the samples were subjected by Fourier Transform-Infra Red (FT-IR) spectroscopic technique and infra-red absorption bands values are observed in the range of 515-520, 695-700, 775-780 cm-1 which shows the presence of quartz in all the samples. Similarly, infra-red peaks were absorbed for feldspar, kaolinite, calcite, gibbsite and organic carbon and confirmed by X-Ray diffraction (XRD) technique. Additionally, zircon, aragonite, magnetite and kyanite minerals were identified in the samples using only the XRD method. The concentration of heavy metals such as Pb, Cr, Zn, Ni, Hg, As, Mn, Cu has been determined by flame atomic absorption spectrometry (FAAS). An average metal concentration measured in mg kg-1 were: Pb 0.12, As 0.15, Hg 0.13, Cu 2.80, Zn 10.15 Cr 12.70, Ni 2.86 and Mn 104.94 and hence found in the order of Mn > Cr > Zn > Ni > Cu > As > Hg > Pb. These average values do not exceed the world average value and hence potentially do not affect the quality of sand in the river. In addition to that, presences of heavy metals are confirmed by scanning electron microscope equipped with energy dispersive X-ray spectrometry (SEM/EDS) analysis. In order to understand the possible natural and anthropogenic sources of heavy metals, multivariate statistical techniques such as Pearson correlation, principal component and cluster analysis were performed. Results obtained from the statistical techniques were good agreement with each other.

Characterization and biocontrol potential of a naturally occurring isolate of Metarhizium pingshaense infecting Conogethes punctiferalis.

An entomopathogenic fungus was isolated from an infected larva of Conogethes punctiferalis (Guenée) (Crambidae: Lepidoptera), a highly polyphagous pest recorded from more than 120 plants and widely distributed in Asia and Oceanic countries. The fungus was identified as Metarhizium pingshaense Q.T. Chen & H.L. Guo (Ascomycota: Hypocreales) based on morphological characteristics and molecular studies. Scanning electron microscopic studies were conducted to study the infection of C. punctiferalis by M. pingshaense. Bioassay studies with purified conidial suspension proved that the isolate was highly virulent to C. punctiferalis, causing more than 86 % mortality to fifth instar larvae at 1 × 108 spores/mL, under laboratory conditions. The median lethal concentration (LC50) of the fungus against late instar larvae was 9.1 × 105 conidia/mL and the median survival time (MST) of late instar larvae tested at the doses of 1 × 108 and 1 × 107 conidia/mL were 4.7 and 6.4 days, respectively. The optimal temperature for fungal growth and sporulation was found to be 25 ± 1 °C. This is the first report of M. pingshaense naturally infecting C. punctiferalis. Isolation of a highly virulent strain of this fungus holds promise towards development of a potential mycoinsecticide against this pest.

Multifarious plant growth promotion by an entomopathogenic fungus Lecanicillium psalliotae.

An entomopathogenic fungus, Lecanicillium psalliotae strain IISR-EPF-02 previously found infectious to cardamom thrips, Sciothrips cardamomi promoted plant growth in cardamom, Elettaria cardamomum. The isolate exhibited direct plant growth promoting traits by production of indole-3-acetic acid and ammonia and by solubilizing inorganic phosphate and zinc. It also showed indirect plant growth promoting traits by producing siderophores and cell wall-degrading enzymes like, α-amylases, cellulases and proteases. In pot culture experiments, application of the fungus at the root zone of cardamom seedlings significantly increased shoot and root length, shoot and root biomass, number of secondary roots and leaves and leaf chlorophyll content compared to untreated plants. This is the first report on the plant growth promoting traits of this fungus. The entomopathogenic and multifarious growth promoting traits of L. psalliotae strain IISR-EPF-02 suggest that it has great potential for exploitation in sustainable agriculture.

Characterization and virulence of Beauveria bassiana associated with auger beetle (Sinoxylon anale) infesting allspice (Pimenta dioica).

The incidence of auger beetle, Sinoxylon anale Lesne (Bostrichidae: Coleoptera), a destructive pest of cosmopolitan occurrence is reported for the first time on allspice trees, Pimenta dioica (L.) Merr. in Kerala, India. The insects bored through the basal region of fresh twigs resulting in dieback symptoms. Morphological characterization and sequencing of a partially amplified fragment of the mitochondrial CO1 gene (696bp) revealed the insect to be Sinoxylon anale. An entomopathogenic fungus was isolated from infected cadavers of S. anale that was identified as Beauveria bassiana (Bals.-Criv.) Vuill., sensu stricto (s.s.) (Ascomycota: Hypocreales) based on morphological and molecular studies. The partial sequences of the ITS, TUB, TEF and Bloc gene regions were sequenced. The fungus grew well in ambient room temperature conditions (28-32±2°C; 60-70% relative humidity) and the infection process on the insect was documented by scanning electron microscopy. Bioassay studies with the isolate indicated that the fungus was virulent against adult beetles as evidenced by the LC50 (3.6×10(6)conidia/ml) and ST50 values (6.8days at a dose of 1×10(7)conidia/ml and 5.8days at a dose of 1×10(8)conidia/ml, respectively). This is the first record of B. bassiana naturally infecting S. anale and the fungus holds promise to be developed as a mycoinsecticide.

Occurrence and characterization of a tetrahedral nucleopolyhedrovirus from Spilarctia obliqua (Walker).

Spilarctia obliqua Walker (Lepidoptera: Arctiidae) is a polyphagous insect pest damaging pulses, oil seeds, cereals, vegetables and medicinal and aromatic plants in India. The pest also infests turmeric and ginger sporadically in Kerala. We observed an epizootic caused by a nucleopolyhedrovirus (NPV) in field populations of the insects in December 2013. The NPV was purified and characterized. The isolate was tetrahedral in shape and belonged to multicapsid NPV. The REN profile of the SpobNPV genome with Pst I, Xho I and HindIII enzymes showed a genome size of 99.1±3.9 kbp. Partialpolh, lef-8 and lef-9 gene sequences of the isolate showed a close relationship with HycuNPV and SpphNPV. Phylogram and K-2-P distances between similar isolates suggested inclusion of the present SpobNPV isolate to group I NPV. The biological activity of the isolate was tested under laboratory conditions against third instar larvae of S. obliqua and the LC50 was 4.37×10(3)OBs/ml occlusion bodies (OBs) per ml. The median survival time (ST50) was 181 h at a dose of 1×10(6)OBs/ml and 167 h at a dose of 1×10(8)OBs/ml. SpobNPV merits further field evaluation as a potential biological control agent of S. obliqua, a serious pest of many agriculturally important crops in the Oriental region.

Quantitative assessment of the subchondral vascularity of the talar dome: a cadaveric study.

BACKGROUND: The arterial supply to the talus has been extensively studied previously but never to specifically examine the subchondral region of the talar dome, a frequent site of localised pathology. This study aims to analyse and quantify the subchondral vascularity of the talar dome. METHODS: We performed cadaveric arterial injection studies. After processing, the vascularity to the subchondral region of the talar dome was visualised and mapped using three-dimensional computer technology, then quantified and reported using a nine-section anatomical grid. RESULTS: The areas of relative poor perfusion across the talar dome are the posterior/medial, posterior/lateral and middle/medial sections of a nine-section grid. The rest of the subchondral region shows more richly vascularised bone. CONCLUSIONS: The vascularity of the subchondral surface of the talar dome is not uniformly distributed. This may be relevant to the aetiology and management of osteochondral lesions and shows some correlation with their more frequent locations.