A Case of Free Flap Reconstruction after Endoscopic Debridemnt for Recalcitrant Nasopharyngeal Osteoradionecrosis Without Facial Incision

High-dose radiation therapy is the treatment of choice for nasopharyngeal cancer, and clinical outcomes have improved in recent decades. A certain proportion of patients, however, suffer from post-radiation nasopharyngeal necrosis (PRNN). Patients with PRNN complain of headache, foul odor, or symptoms of cranial nerve palsies. Clinically, intracranial infection or bleeding from carotid artery damage may lead to sudden death or severe deterioration in quality of life. Although the prognosis of PRNN was poor, endoscopic debridement with local vascularized flap recently showed favorable outcomes, and many centers are using this technique with a nasoseptal flap. However, if the flap fails or does not fully cover necrotized tissues, necrosis inevitably reoccurs. In this situation, free flap transfer with a facial incision using a transmaxillary approach is used, but some drawbacks exist. In this report, we propose a new resurfacing technique for recurrent PRNN using a transoral-cervical free flap tunneling approach into the nasopharynx without a facial incision after endoscopic debridement.

Mask Design for Life in the Midst of COVID-19

Existing medical masks have various disadvantages, such as the environmental damage caused by disposable masks, the discomfort and poor ventilation caused by prolonged mask wearing, and the lack of aesthetic design in mass-produced masks. Thus, this study used quality function deployment, the fuzzy analytic hierarchy process, and fuzzy comprehensive evaluation to research, develop, and design masks. The aforementioned methods were also used to determine the ranking of design requirements. The following priority ranking of design requirements from most to least important was obtained: reducing discomfort at the contact between the mask and the skin (0.265), avoiding foul odor inside the mask (0.187), convenient cleaning and portability (0.166), good airtightness (0.152), suitable aesthetic design for wearing in public and on social occasions (0.130), and reducing waste (0.100). Experts evaluated mask designs, and their opinions were subject to fuzzy analysis. Specifically, 50% of the experts evaluated the designs to be “good” or “very good”. Only 29% of the experts rated the design results as “average”. Thus, the innovative mask designed in this study can meet the needs of users, overcome the drawbacks of existing masks, and provide a feasible solution for the current COVID-19 pandemic.

Smart Dustbin Using IOT Notification

In today's world, we frequently witness rubbish bins or dust bins are located in cities and in public places due to overflowing the daily growth in the garbage. This generates an unsanitary environment for humans and a foul odor in the surrounding area, which contributes to the spread of lethal illness and human diseases. Avoid to this, our purpose is constructing for a "Smart Dustbin Using IOT Notifications." Several rubbish bins may be found all through the cities or even on campuses in this proposed system; those kind of waste can is equipped such as a embedding gadget at a cheap price that supports track the height of the waste cans, as well as this is unique identification for everyone rubbish bin in the city, making it is easy to classify which rubbish bins has been fully mode. That gadget will broadcast is level together with unique ID specified when it hits the threshold limit. These facts can be viewed by concerned authorities over the internet from their location, allowing them to take rapid action to clean the trash cans. The government began a number of projects to improve the country's cleanliness. This paper is beneficial to the government's "SWACHH BHARAT ABHIYAN" project. Waste management is currently one of the world's most pressing issues, regardless of whether a country is developed or developing. The main problem with trash management is that garbage in public locations overflows well before the next cleaning operation begins. It therefore leads to different hazards, such as a faulty door and ugliness in the area, which may be the source of disease transmission. This effort is based on a smart waste system to avoid any potentially dangerous scenarios and to ensure public cleanliness and health. The primary goal for this paper aims to develop an intelligent waste alert system collection by the sending a notification to a municipality web application immediate dust bin clean and a notification to a Municipality web application waste fill levels. These procedures are facilitated with a sensors built of ultrasonic waves these are connected to an UNO (Arduino Uno) and checks the levels of the waste inside the dust bin, sending and a notification to the municipality web application if the bin has been fully mode. The entire procedure is supported by an embedded module that utilities IOT facilitation. With the help of this system, the Municipality authorities can monitor and follow up on the in near real - time, the condition of waste collection. In addition, to the appropriate corrective actions might perhaps be adjusted. To accomplish this, an Android application has been created and connects to the web application. Sends an alarm and from micro - controller to the city workplace and to keep an eye on the removal process from afar performed through the employees, eliminating manual inspection and confirmation procedure to transfer the data, the Wi-Fi chip is required and notifications is to the Android app.

Measuring the Physico-Chemical Impact of Wastewater from the Open Sewer in an Industrial Area: Case of the Kossodo Industrial Area in the City of Ouagadougou in Burkina Faso

Wastewater from industrial units in the Kossodo district in the city of Ouagadougou has a physicochemical impact on the environment and the population. For several years the Kossodo area was famous for the effects of wastewater from industrial units on the environment (a foul odor). We took samples from various points of the open canals in order to determine the physico-chemical parameters of this wastewater. This choice was guided by a concern to measure the physico-chemical impact of wastewater from the open sewer in the industrial zone of Kossodo in the city of Ouagadougou on the one hand and to show the danger represented by this wastewater from industrial units on the environment and public health on the other hand. The objective also guided the choice of the parameters retained for the measurement of the physicochemical impact of the industrial units wastewater of the open sewer of Kossodo zone in the city of Ouagadougou: MES, DCO, BOD5, pH, Potassium, Sodium. The results show that the wastewater from the open sewers of the industrial units of Kossodo in the city of Ouagadougou, has a high physicochemical parameter content than the authorized discharge standard.

Nanocellulose from agricultural waste as an emerging material for nanotechnology applications – an overview

It has been shown that in the last decades nanotechnology plays a key role not only in science but more and more often in industry as well. Recent research has shown that agricultural waste is a possible feedstock to produce nanocellulose which can be used for different applications, such as a biosensor, semiconductor and reinforcing agent. The use of agro-waste as a precursor not only offers advantages for raw material costs, but also for the climate, low processing costs, availability and convenience. It also helps to address environmental issues, such as illness, foul odor and concerns with indoor use. Different processes, such as chemical treatment, mechanical treatment and chemo-mechanical treatment, have been used to extract nanocellulose from agro-waste. This article highlights the latest technologies used to acquire agro-waste nanocellulose, as well as existing advances in and applications of nanocellulose technologies.

Plica polonica: Trichoscopic findings with a brief literature review

Plica polonica is a common but rarely reported acquired condition characterized by sudden onset of irreversible entanglement of the hair. Psychological disturbance is a risk factor for plica formation. Plica polonica was considered a disease of the past caused by poor hygiene and haircare in psychiatric patients. In view of its clinical rarity, we describe the case of a 50-year-old Muslim woman of Kashmiri ethnicity presenting with plica polonica to explain the trichoscopic findings gathered in the process of medical examination. The patient had attempted the treatment of the condition with various shampoos and conditioners but without improvement. There was no history of mental illness either in the patient or the patient’s family. The hair was dry, lusterless, densely adherent, but without discharge, foul odor, or lymphadenopathy. Trichoscopy revealed varying shades of brown and crisscrossing of hair shafts resembling an intertwined mesh of wires with concretions of the hair shafts. The patient was advised to cut the matted hair.

Antibacterial effect of Karna Dhoopana Yoga against Staphylococcus aureus in the management of Puti Karna (CSOM)

Pūti Karna is a Chronic Disease caused by vitiated Kapha and Pitta dosha with its characteristic features of profuse thick Pūti (foul odor), pūya (pus) discharge from the ear with or without pain. This entity can be correlated with the disease specified in modern ENT (ear, nose and throat) known as Chronic Suppurative Otitis Media (CSOM). This disease entity in turn leads to severe complications as facial paralysis, lateral sinus thrombosis, labyrinthitis, meningitis and brain abscess. According to the Ayurveda system of medicine Pūti Karna can be effectively managed by a very effective local modality known as a Karna Dhoopana. This study was carried out at the central laboratory of Gampaha Wickramarachchi University of Indigenous Medicine, Sri Lanka, using specially prepared fumigation instrument. This Karna Dhoopna Churna has mentioned in “Hasthasara Aushada Yoga Samgraha“. According to the observation, results of the study confirmed the fumigation for 30 minutes has a bactericidal effect on Staphylococcus aureus in vitro. This could be due to the bactericidal components present in the fumes of dhupana yoga. Further, this study confirmed that duration of Karna Dhoopana is an important factor. Its clinical effectiveness was confirmed without any reported complications after Karna Dhoopana treatment. Further, the study proved that the temperature of the fumes does not produce any side effects in the ear. Therefore, this study endeavored to validate the clinical data scientifically.

First report of Pectobacterium aroidearum causing bacterial soft rot of carrot in Taiwan

Carrot (Daucus carota) is an important root vegetable planted and consumed worldwide (Stein and Nothnagel 1995). In June 2020, carrots (cv. New Kuroda) showing soft rot symptoms were observed in a 600 sqft plot located in Pitou, Changhua, Taiwan (23°54'00.9"N, 120°28'37.3"E; with around 400 plants). About 10% of the plants on site had similar symptoms; infected taproot tissues were macerated (Figure S1) and emitted a foul odor. In most cases, the peels above the rotten tissues remain intact. Two infected plants were brought to the lab. Macerated tissues were suspended in water and examined under a microscope at 600X (without staining). Rod, motile bacteria were observed in all of the samples and the bacteria were isolated onto nutrient agar. Three bacterial strains were obtained from two taproots; strain Car1 was isolated from one plant, and strains Car2 and Car3 were isolated from the other. Their colonies were translucent, round and convex. All isolates could ferment glucose and induce soft rot symptoms on potato tuber slices (Schaad et al. 2001). They were not able to produce indigoidine on yeast dextrose calcium carbonate agar and were tested negative for phosphatase activity (Schaad et al. 2001). The 16S rDNA of Car1 to Car3 were amplified using primers 27F/1492R (Lane 1991). Cloning and sequencing of their 16S rDNA (GenBank accession no. MT889640) revealed that their sequences shared 99.9% identity (1,463/1,464 bp) with that of Pectobacterium aroidearum CFBP 8168T (SCRI 109T; GenBank accession no. NR_159926.1). Multilocus sequence analyses targeting the three isolates’ dnaX, leuS and recA genes were conducted. The concatenated sequences (1,596 bp) of Car1 to Car3 and those included in a previous work (Portier et al. 2019) were subjected to phylogenetic analysis. The sequences of Car1 to Car3 were identical (GenBank accession nos. MT892671-MT892673). A maximum-likelihood tree showed that the three isolates belonged to the same clade as P. aroidearum CFBP 8168T (GenBank accession nos. MK516971, MK517115 and MK517259; Figure S2). For the concatenated sequences analyzed, the identity between P. aroidearum CFBP 8168T and our three isolates was 99.4% (1,587/1,596 bp). The pathogenicity of these isolates was determined by inoculating the bacteria into carrot (cv. Xiangyang No.2) taproots. Strains Car1 to Car3 were grown on NA for 48 h (28 °C) and cell suspensions with OD600 values of 0.3 (2.4 x 108 CFU/ml; in water) were prepared. The suspensions of each strain (100 μl) were loaded into 200 μl pipette tips. The tips were then pierced into intact carrot taproots (2.4 cm deep), ejected and left on the plants (one tip per plant). Three taproots were tested for each strain. Tips loaded with 100 μl of water were used for the controls (three replicates). The plants were incubated in a sealed plastic container kept in a growth chamber set at 28°C. After 48 h, all of the inoculated taproots produced soft rot symptoms resembling those observed in the field and plants in the control group did not. Bacteria were re-isolated from macerated tissues of the artificially infected plants and found to share the same leuS sequence with Car1 to Car3. Occurrences of carrot soft rot in Taiwan have only been attributed to Dickeya spp. (Erwinia chrysanthemi) in previous studies (Hsu and Tzeng 1981). The present study is the first report of P. aroidearum infecting carrots in Taiwan. The findings may add to our understanding of the diversity of soft rot pathogens affecting carrot production in Taiwan.

Dental prosthetic rehabilitation of Papillon-Lefèvre syndrome: a case report

Papillon-Lefèvre syndrome (PLS) is a rare disorder characterized by palmar plantar hyperkeratosis and rapidly progressive periodontitis with loss of deciduous and permanent dentition at an early age. It is reported to occur in 1 to 4 individuals per million people. This case report presents highlighting features of the rare PLS in a 17-year old male who complained of discomfort while mastication and it was accompanied with symmetrical, sharply demarcated erythematous plaques involving the skin of the palms and soles, which extended to the finger joints, elbows, and knees. Along with the rough and dry skin, hyperhidrosis of lesion with a foul odor and transverse grooving of nails were noted. The past dental history revealed normal eruption of deciduous teeth followed by pre-mature mobility and shedding in 4-6 months. Permanent teeth also showed normal eruption and early shedding in the next 4-5 years. Complete edentulous maxillary and mandibular arches led to a decrease in alveolar bone and facial heights. There was no similar disorder in the patient’s family but family history revealed the consanguineous marriage of the patient’s parents.