Exploring the Substantive Significance of Laryngoscopic Observations as Reliable Prognostic Indicators for the Therapeutic Efficacy in Cases of Laryngopharyngeal Reflux

Laryngopharyngeal reflux (LPR) can be defined as the regurgitation of gastric acid and peptic substances into the laryngeal and hypopharyngeal regions, even in the case of a singular occurrence. A substantial body of recent research underscores the significance of non-acid reflux as a notable contributor to LPR symptoms. This current investigation delves into the assessment of laryngoscopic observations in their predictive capacity regarding the therapeutic outcomes of empirically administered proton pump inhibitor (PPI) therapy in the context of LPR. In this study, 145 patients who had received a clinical diagnosis of laryngopharyngeal reflux (LPR) underwent rigorous laryngoscopic examinations. These patients were subsequently categorized into three distinct groups based on the Belafsky reflux findings score, which included the criteria for normal (scores ranging from 0 to 7), mild to moderate (scores ranging from 8 to 16), and moderate to severe (scores ranging from 17 to 26). Among the participants, 12 individuals from the normal group, 44 from the mild to moderate group, and 31 from the moderate to severe group reported experiencing a noteworthy alleviation of symptoms following a three-month period of proton pump inhibitor (PPI) therapy and lifestyle adjustments. It is important to note that these findings yielded statistically significant results. Preliminary laryngoscopic observations hold significant potential as predictors of favourable treatment outcomes in the context of empirical proton pump inhibitor (PPI) therapy for laryngopharyngeal reflux (LPR).

Effect of Rhinoplasty on Various Angles of Nose on Ideal Position and Alignment in Indian Population

Study of anthropometric measurements of the nose makes possible a qualitative and quantitative analysis of surgical results. Analysis of pre- and post-operative changes in nasal tip projection, rotation and nasofrontal angle may also emphasize the fact of over correction or under correction of deformed nose to surgeon. Aim of our study to compare preoperative and postoperative nasal tip projection, rotation and nasofrontal angle after rhinoplasty. The present study was a 1.5 years prospective interventional study conducted at SMS Medical College, Jaipur, India from January 2021 to July 2022. Total 51 patients with external nasal deformity were included in our study. Pre-operative, immediate post-operative and 6 months follow-up nasofrontal, projection and nasolabial angle were recorded, compared and analyzed objectively. In our study significant improvements were observed in the nasolabial angle from 92.9 ± 16.4 to 101.6 ± 10.4 and 110.3 ± 9.8 and nasal tip projection from 0.74 ± 0.17 to 0.58 ± 0.11 and 0.52 ± 0.09 immediate post-op and at 6-months follow up respectively. Mean Nasofrontal angle at pre-op, intra-op and post-op 6 months was 132.5 ± 11.9, 135.4 ± 9.6 and 134.8 ± 9.4 and this difference was not found to be statistically significant. We would like to conclude that Indian noses which are predominantly small and shorter, our surgical procedure aimed at making them more prominent aesthetically on the face, so in the present study results were satisfactory in term of anthropometric parameter.

A Comparative Study of Surgical Outcomes in Children with Cochlear Implantation Using Posterior Tympanotomy & Modified Veria Technique

Purpose: To compare the two common approaches of cochlear implantations i.e., mastoidectomy with posterior tympanotomy approach (MPTA) and modified veria technique and to know whether veria technique and its later modifications are as efficacious as the classic approach in terms of duration of procedure, gain in hearing and acquisition and incidence of complications if any. Methods: A prospective comparative study was undertaken at a tertiary care teaching institute. 30 children were selected and randomised into 2 groups who then underwent surgery from the same surgeon after proper evaluation but with 2 different approaches. Their outcomes were then observed and compared in terms of surgical technique and complications and hearing outcomes. Results: 30 children were operated with 15 in each group. In the study, patients under Group A (MPTA) had mean surgical duration of 139.67 ± 16.53 min while Group B (modified Veria) had of 84.67 ± 11.72 min, which was statistically significant (p < 0.05). 1 patient in Group A suffered House Brackman grade 4 facial nerve injury that recovered over 3 months and another had discolouration of the skin flap. No complications were observed in group B. During follow-up CAP and SIR scores were compared and were found to be statistically non-significant between the 2 groups (p value > 0.05), but the paired differences within each group showed statistical significance (P value- <0.001). Conclusion: Veria Technique (and its later modifications) for cochlear implantation is a simple, safe and easy procedure, which is as efficacious as MPTA with added benefits of consuming lesser surgical duration.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-022-03399-1.

Traditional and Coblation Tonsillectomy in Pediatrics Population: A Comparative Study

Tonsillectomy is still surrounded by controversy, especially regarding choice of surgical technique. Despite numerous surgical techniques are present, post-operative pain remains significant postoperative morbidities. An ideal method would lessen complications and minimize operative time and costs. This is a randomized double blinded interventional study. We enrolled 70 subjects and divided into two groups of 35 subjects in each. One group underwent traditional tonsillectomy and another underwent coblation tonsillectomy. We compared operating time, intraoperative blood loss, post-operative pain, return to normal activities and diet and post-operative hemorrhage. Mean operating time in coblation group was 18.24 ± 5.37 min and in traditional group 30.04 ± 7.08 min. The mean blood loss in coblation tonsillectomy group was 82.79 ± 21.13 ml and in traditional tonsillectomy 150.4 ± 37.91 ml. The mean of post-operative pain score in coblation tonsillectomy group was 3.2 ± 1.47 and in traditional tonsillectomy group 6.11 ± 1.61. The mean day of regaining activity in coblation tonsillectomy group was 6.26 ± 0.92 days and in traditional tonsillectomy group 8.26 ± 1.09 days. Mean time by which patients of coblation tonsillectomy group regained their diet was 4.11 ± 0.87 days whereas in traditional tonsillectomy group it was 6.14 ± 1.14 days. There was no case observed with episode of primary or secondary hemorrhage. We conclude from this study that coblation tonsillectomy takes less operating time with less blood loss, also associated with less post-operative pain, less time taken to achieve normal diet and activities.

Lateral Skull Base Lesions: Our Experience of 15 Years

To analyse and report various aspects of lateral skull base surgery by describing the incidence and demographic variables, diagnostic and management challenges, surgical choices along with complications and their management and the long term morbidity and survival outcomes in our experience of 15 years. Retrospective review of complete records of all cases operated for lateral skull base tumors at a tertiary care teaching institution in India between timespan of 15 years from 2003 to 2018 was undertaken. 53 cases were selected and analysed. Those having follow up of less than 6 months were excluded. Outcomes were assessed in terms of incidence of types of tumors, benign or malignant, age and sex variation of the patients, staging status at presentation, status of facial and other lower cranial nerves pre-operatively, surgical techniques with complications if any, recurrences and survival. Of 35 benign tumors, tympanojugular paragangliomas were most common. Average age for these was 53 years with 19 females and 14 males. All were non-functional. Tinnitus and hearing loss were most common presentations. Class B2 and C1 tumors were most commonly encountered and the ITF A approach was most commonly used. Hearing loss and Facial palsy were commonest complication post-operatively. There were 2 recurrences. 18 malignancies were observed. Most were stage IV at presentation. Otorrhea and otalgia were most common presenting symptoms followed by hearing loss. 5 year survival was 55%. Successful treatment of lateral skull base lesions requires a multimodality therapy with team approach. Surgical resection is the primary management choice with variable approaches. ICA status related to the tumor is the most important consideration. Malignancies require more aggressive treatment for obtaining clear margins along with pre/post-op chemoradiation. Good results with acceptable complications can be obtained even with advanced tumors.

Sublabial Approach Versus Modified Denker's Procedure: A Comparative Study of Pre-maxillary Tissue Clearance in Covid-Associated Mucormycosis

To compare the efficacy of the sublabial and modified Denker's procedure in clearance of fungal disease from the anterior wall of maxilla and the pre-maxillary area i.e. the difficult areas of maxillary sinus. A prospective observational study was conducted over a period of 2 months (April 21-June 21) in the ENT department of Sawai Man Singh hospital, Jaipur. All the patients with clinical involvement of the premaxilla or the cheek abutting the anterior wall of maxilla were included in the study population. Cases matched in both groups were subjected to debridement either by the sublabial or the modified denker's approach. Outcomes were measured by assessing the daily CRP values, post-operative DNE every 3 days after pack removal, and imaging at the end of 1 month. Repeat biopsies were performed in patients that still had persistent symptoms after getting operated on. 16 of the 60 patients (26.6%) operated on by the endoscopic approach showed evidence of residual disease on follow-up whereas only 5 patients (9.6%) in the other category had a similar outcome. Most of the recidivism was seen in the anterior maxilla. Lower rates of complications were found following debridement by the sublabial approach. Since the sublabial approach is the most direct approach for the key areas of fungal involvement of maxillary sinus, it is recommended over the modified Denker's procedure for disease clearance from pre maxilla and the anterior wall of maxillary sinus. This view is also supported by the lower rates of complications encountered following the former.

Diagnostic Efficacy of Thyrotropin to Thyroglobulin Ratio in Correlation with Histopathology of Euthyroid Patient Having Solitary Thyroid Nodule

In patients with solitary thyroid nodules, the first course of action is to determine whether the nodule is benign or malignant. Many investigations are used to differentiate between benign and malignant nodules so as to avoid surgery in those who don't need it. Among these, FNAC and USG are commonly used in association with clinical features but there are drawbacks of each technique. The present study was undertaken to assess the diagnostic effectivity of thyrotropin (also known as TSH) to thyroglobulin ratio in correlation with histopathology in euthyroid patients having solitary thyroid nodule. This is a prospective study carried out on 48 euthyroid cases of solitary thyroid nodule. All patients subjected to FNAC, USG, thyrotropin and thyroglobulin assay. Then, they underwent surgery and histopathological examination (HPE) of the specimens done. Finally, the histopathology reports were correlated with the thyrotropin to thyroglobulin ratio in order to evaluate their sensitivity and specificity by statistical methods. The sensitivity and specificity of thyrotropin to thyroglobulin ratio was 100% and 100% respectively. All malignant lesions according to thyrotropin to thyroglobulin ratio were confirmed by histopathology indicating its excellence. Therefore, TSH to thyroglobulin ratio helps in planning the correct management and avoids second surgery. It was found that serum TSH:Tg is a safe, reliable and effective diagnostic modality with a high sensitivity and specificity and is the single best investigation for preoperative evaluation of solitary thyroid nodule to differentiate between benign and malignant nodules.

Invasive Fungal Infections in Dengue Recovered Patients: A New Phenomenon in the Covid-19 Era

Invasive fungal rhinosinusitis was seen to rise to epidemic levels after the 2nd wave of ongoing Covid pandemic, especially in tropical countries, maximally in India. A similar trend is being observed for cases who have recently recovered from dengue virus infection. Post dengue invasive fungal infection is a new presentation and any associations between it and Covid pandemic need to be studied in detail to help prepare for any complications. 3 patients presented to the out-patient department of E.N.T at a tertiary level teaching hospital in East India with complains similar to rhinosinusitis. These patients were then evaluated and diagnosed to be infected from Mucormycosis and Aspergillosis fungal sinusitis after which they were managed with surgical debridement and systemic antifungal therapy. All had a recent history of recovery from Dengue virus infection and a possible association could be suspected. 3 patients presented with complains of pain over upper jaw with orbital swelling and loss of vision developing over a period of 24 days. Two of them had ulceration of hard palate. They were then subjected to Contrast MRI along with CT scan of the Paranasal sinuses which depicted pansinus involvement with intracranial extension in two patients. These were then planned for diagnostic nasal endoscopies along with biopsies which turned out to be Invasive fungal sinusitis in the form of Aspergillosis and Mucormycosis. All the 3 patients had recent history of recovery from Dengue virus infection and did not have any other co-morbidities. Covid Associated Mucormycosis (CAM) is a well-known entity now but no reports of Dengue associated Invasive fungal sinusitis are yet reported. Whether this new phenomenon has anything to do with the interactions between dengue virus and coronavirus is not known at present and needs to be studied in detail so appropriate management protocols can be formulated.

Correlation of Preoperative High-resolution Computed Tomography Temporal Bone Findings with Intra-operative Findings in Various Ear Pathologies

High resolution computed tomography (HRCT) is a tool which provide fine details of temporal bone and its associated pathologies which are of extreme use in making diagnosis, to evaluate extension of disease and most important to plan surgical approach. Aim of the present study was to correlate HRCT findings with operative findings in different ear pathologies. This observational, prospective study enrolled 70 patients of different ear pathologies required surgical intervention. They were subjected to HRCT temporal bone and its findings were correlated with surgical findings. Mean age of the study population was 20.3 ± 12.04 years with M: F = 1.12: 1. HRCT showed specificity and sensitivity of 100% and 92.31% respectively in detecting ossicular erosion. It was 100% sensitive and 98.51% specific in detecting LSCC erosion, 85.71% sensitive and 96.83% specific in detecting facial canal dehiscence, 100% sensitive and 98.11% specific in detecting scutum erosion, 75% sensitive and 96.97% specific to detect tegmen erosion, 100% sensitive and 97.01% specific in detecting sinus plate erosion, 100% sensitive and 95.38% specific in detecting high jugular bulb, sensitivity and specificity both are 100% in detecting labyrinthitis ossificans and 100% sensitive in detecting otosclerotic foci. HRCT findings showed a good association with operative findings in terms of sensitivity and specificity. Thus, HRCT is a acceptable tool to make diagnosis and to plan surgical approach.

Methods for assessing the quality of AM fungal bio-fertilizer: Retrospect and future directions

In the recent past, the mass production of arbuscular mycorrhizal (AM) fungi has bloomed into a large biofertilizer industry. Due to their obligate symbiotic nature, these fungi are propagated on living roots in substrate-based pot cultures and RiTDNA in in vitro or root organ culture systems. The quality assessment of AM inocula remains critical for the production and efficacy evaluation of AM fungi. The vigour of AM inocula are assessed through microscopic methods such as inoculum potential, infectivity potential/infection units, most probable number (MPN) and spore density. These methods marginally depend on the researcher's skill. The signature lipids specific to AM fungi, e.g. 16:1ω5cis ester-linked, phospholipid, and neutral lipid fatty acids provide more robustness and reproducibility. The quantitative real-time PCR of AM fungal taxa specific primers and probes analyzing gene copy number is also increasingly used. This article intends to sensitize AM fungal researchers and inoculum manufacturers to various methods of assessing the quality of AM inocula addressing their merits and demerits. This will help AM producers to fulfil the regulatory requirements ensuring the supply of high-quality AM inocula to end-users, and tap a new dimension of AM research in the commercial production of AM fungi and its application in sustainable plant production systems.

Vertical Strut Ossiculoplasty: A Versatile Alternate to Conventional Techniques-A Randomized study

INTRODUCTION

Various ossicular reconstruction materials and techniques have been described in literature using autologous ossicle, cortical bone, autologous cartilage, synthetic materials and implants like total/partial ossicular replacement prosthesis (TORP/PORP) etc., but it has always been a topic of controversy in terms of the efficacy, longevity and complications of the material or method used.

MATERIAL AND METHODS

This is a prospective, interventional, comparative, double-blind randomized control study which was done at a tertiary care center to compare outcomes of conventional and carved conchal cartilage (vertical strut) type III Tympanoplasty in terms of graft uptake and hearing gain. A total number of 52 cases were enrolled, randomized and allocated to 2 groups (26 each) i.e. group A (conventional type III) and group B (vertical strut technique).

RESULTS

Graft uptake was seen in 25 (96.16%) patients in group B while it was observed in 23 (88.5%) cases in group A. Hearing gains were also better in group B.

CONCLUSION

This study suggests that Vertical Strut technique can be studied further as it gives better gains in Air Conduction threshold and A-B Gap along with graft uptake as it provides better middle ear space and ossicular / tympanic membrane interface resulting in better hearing.

Data-Inspired and Physics-Driven Model Reduction for Dissociation: Application to the O2 + O System

This work presents an in-depth discussion on the nonequilibrium dissociation of O₂ molecules colliding with O atoms, combining quasi-classical trajectory calculations, master equation, and dimensionality reduction. A rovibrationally resolved database for all of the elementary collisional processes is constructed by including all nine adiabatic electronic states of O₃ in the QCT calculations. A detailed analysis of the ab initio data set reveals that for a rovibrational level, the probability of dissociating is mostly dictated by its deficit in internal energy compared to the centrifugal barrier. Because of the assumption of rotational equilibrium, the conventional vibrational-specific calculations fail to characterize such a dependence. Based on this observation, a new physics-based grouping strategy for application to coarse-grained models is proposed. By relying on a hybrid technique made of rovibrationally resolved excitation coupled to coarse-grained dissociation, the new approach is compared to the vibrational-specific model and the direct solution of the rovibrational state-to-state master equation. Simulations are performed in a zero-dimensional isothermal and isochoric chemical reactor for a wide range of temperatures (1500-20,000 K). The study shows that the main contribution to the model inadequacy of vibrational-specific approaches originates from the incapability of characterizing dissociation, rather than the energy transfers. Even when constructed with only twenty groups, the new reduced-order model outperforms the vibrational-specific one in predicting all of the QoIs related to dissociation kinetics. At the highest temperature, the accuracy in the mole fraction is improved by 2000%.

Modified Veria Technique for Cochlear Implantation by Postaural Approach

There are various surgical techniques for cochlear implantation, classical one being mastoidectomy and posterior tympanotomy which has some disadvantages and complications like extensive bone work, violation of mastoid air cell system and fear of injury to vital structures like facial nerve. To minimize these problems, various modifications in cochlear implantation surgery has been done which includes introduction of Veria technique which also has certain disadvantages like extensive dissection and prolonged surgical time. In this article we are introducing an innovative technique of cochlear implantation where we have modified the pre-existing Veria technique that has been described in detail in the coming sections. Total 9 cases have been done so far with this modified Veria technique. This technique includes postaural approach with minimal soft tissue and bone work, making the cochlear implantation simple, easily doable, with less operating time, with minimal morbidity, faster healing due to smaller incision and avoiding facial nerve injury.

Is thyroid excision mandatory with laryngectomy in carcinoma larynx?

Background

Advanced stage operable cancers of larynx are treated with total laryngectomy including thyroid resection in most of the cases, which may expose patient to hypothyroidism and hypoparathyroidism. The requirement of thyroidectomy during Total Laryngectomy is controversial.

Methods

A cross sectional observational study was set out to review preoperative clinical and radiological assessment; intraoperative and histopathological findings; and follow-up data to predict thyroid gland invasion in the setting of squamous cell carcinoma of the Larynx.

Results

11 (16%) out of 69 patients had thyroid gland involvement on histopathological examination with mean age 63 years. Out of these 11 cases, 8 (72%) underwent primary total laryngectomy. 90% patients with thyroid gland involvement were male. 9 cases with thyroid gland involvement were staged as T4a preoperatively.

Conclusion

Invasion of thyroid gland by laryngeal cancer is uncommon. Unnecessary hemithyroidectomies lead to hypothyroidism and hypoparathyroidism. The study points out the clear indications of thyroid excision in patients undergoing total laryngectomy. We can suggest that total thyroidectomy should be done with total laryngectomy in cases which have gross clinical, radiological or intraoperative thyroid gland involvement, subglottic extension and thyroid cartilage invasion. This can save the patients from the brunt of unnecessary morbid hypothyroidism and hypoparathyroidism.

Construction and characterization of protein-based cysteine nanosensor for the real time measurement of cysteine level in living cells

Cysteine plays a critical role in maintaining normal human metabolism, redox homeostasis, and immune regulation. Despite its functional versatility, cysteine metabolism in the human body is not well understood because of the lack of a robust tool for real-time measurement of cysteine at the cellular and sub-cellular level. In the present study, a genetically encoded nanosensor was developed using Cj0982 protein of Campylobacter jejuni, Enhanced Cyan Fluorescent Protein (ECFP) and Venus. The Cj0982 was sandwiched between ECFP and Venus for the construction of the nanosensor, named as Cys-FS (Cysteine-Fluorescent-Sensor). The Cys-FS is pH stable, specific to cysteine and has an affinity of 1.2 × 10^-5 M. A range of affinity mutants were also developed with a cumulative cysteine detection range from 800 nM to 3.5 mM. The Cys-FS nanosensor was expressed in bacterial, yeast and mammalian cells, and the dynamics of cysteine level was measured in living cells using the confocal microscopy. The results showed that the Cys-FS nanosensor successfully monitored the dynamics of cysteine in both prokaryotic and eukaryotic systems without disrupting the cell. Thus, this study presents a novel nanosensor that can measure cysteine in living cells. This nanosensor is minimally invasive and non-toxic.

Long-term prediction of greenhouse gas risk to the Chinese hydropower reservoirs

China is undergoing an extensive hydropower development, but the magnitude of greenhouse gas (GHG) emissions risk to reservoirs is not well known. Electricity generation from hydropower is a challenging issue when it comes to sustainable development. In this study, the data on Chinese hydropower reservoirs (n = 12) were collected from the literature and is used as in input to Greenhouse Gas Risk Assessment Tool (GRAT) to predict long-term GHG (CO₂ & CH₄) risk to the hydropower reservoirs and its associated lifecycle GHG emissions (GHG-LCA). The model predicted that till recently (i.e., year 2018) the hydropower reservoirs found under medium risk (i.e., 109 < CO₂ ≤ 628 and 3 < CH₄ ≤ 45 mg·m^-2·d^-1) which will reduce slowly over a period of 100 years. Out of 12 hydropower reservoirs studied, TGR presently under high risk of CH₄ (i.e., 47 mg·m^-2·d^-1) and medium CO₂ risk. Therefore, assessment is required to know the magnitude of CH₄ and its effect on regional climate so that mitigation measures could be taken in advance. The carbon emissions as CO₂eq of the studied reservoirs are found as 134.69 ± 225.23 Gg yr^-1, with a large share from CH₄ emission. The associated life cycle GHG emissions are also estimated as 0.06 ± 0.09 gCO₂eq·kWh^-1, which is higher than the global estimates (i.e. 0.015 gCO₂eq·kWh^-1).

Status and trend of acute encephalitis syndrome and Japanese encephalitis in Bihar, India

Background.

Acute encephalitis syndrome (AES) is a clinical condition, of which the most common cause is Japanese encephalitis (JE). Though there is deficiency of data on AES and JE from Bihar, the state ranks third in the reporting of JE cases after Uttar Pradesh and Assam. We aimed to assess the status and trends of AES and JE cases in Bihar and to know the status of the disease in the districts.

Methods.

We collected monthly epidemiological data for AES and JE for the period 2009-2014.

Results.

A total of 4400 cases (733 cases/year) with an average case fatality rate (CFR) of 30% for AES for the entire study period. A total of 396 cases of JE were reported with approximately 14% CFR. The disease peaks were during the start and end of the Indian summer and monsoon months for AES and JE, respectively. Districts such as Patna, Jehanabad, Nawada, Gaya and East Champaran reported the maximum number of AES and JE cases with annual incidence rates of 4.7-25.0 and 0.546-1.78 per 100 000 population, respectively.

Conclusion.

Since 2009, the incidence of AES and JE cases has been increasing in Bihar.

Cochlear implant in Thalassemia patient - Case report

INTRODUCTION

Beta-thalassemias are a group of hereditary blood disorders characterized by anomalies in the synthesis of the beta chains of hemoglobin. Iron overload occurs in thalassemia, with blood transfusion therapy being the major cause. Deferoxamine continues to be the mainstay of therapy to remove excess iron in patients requiring long-term transfusions. One of the most important complications of deferoxamine therapy is neurosensory toxicity, including sensorineural hearing loss (SNHL). Labyrinthine hemmorhage (LH) is thought to result from altered capillary hemodynamics or reperfusion injury. It is theorized that LH incites a reparative response that cascades from fibrosis to sclerosis and ultimately ossification of the inner ear structures.

CASE PRESENTATION

We present a case of 3-year-old thalassemic child with bilateral profound sensorineural hearing loss. Patient was on regular blood transfusions with chelation therapy. HRCT temporal bone and MRI brain and temporal bone had features of labyrinthitis ossificans (LO). Child underwent uniateral cochlear implantation and postimplantation speech perception and production outcomes were normal.

DISCUSSION

This case illustrates the unique feature of labyrinthitis ossificans in a thalassemia patient which has not yet reported in the English literature. Hearing screening of all thalassemia patients and therefore early diagnosis of SNHL prompts early intervention and improved quality of life.

Cochlear Implantation in Children with Anomalous Cochleovestibular Anatomy: Our Experience

To report operative findings, postoperative course, and postimplantation performance in patients with cochlear malformations who underwent cochlear implantation. Seventeen patients with malformations which included enlarged vestibular aqueduct (n = 6), Mondini's dysplasia (n = 5) common cavity deformity (n = 3) and incomplete partition type 2 (n = 3) underwent cochlear implantation with Nucleus 22 straight array device at our center. Operative findings described facial nerve anatomy and cerebrospinal fluid leak. Standard tests of speech perception were used to evaluate the postoperative performance for each subject. Operative findings included cerebrospinal fluid leak (thirteen patients) all of which were repaired successfully with graft. None had abnormal facial nerve anatomy. No surgical complications occurred. All the patients except two with common cavity had complete insertion. Electrode thresholds and discomfort levels were variable for several months after implantation. All patients demonstrated improved performance after implantation. Patients with enlarged vestibular aqueduct fared better than patients with other inner ear malformations. Cochlear implantation can be a successful method of rehabilitation in patients with congenital deafness who have cochlear malformations.

Estimation of green house gas emissions from Koteshwar hydropower reservoir, India

The emissions of greenhouse gas (GHG) from soils are of significant importance for global warming. The biological and physico-chemical characteristics of soil affect the GHG emissions from soils of different land use types. Methane (CH₄), nitrous oxide (N₂O), and carbon dioxide (CO₂) production rates from six forest and agricultural soil types in the Koteshwar hydropower reservoir catchments located in the Uttarakhand, India, were estimated and their relations with physico-chemical characteristics of soils were examined. The samples of different land use types were flooded and incubated under anaerobic condition at 30 °C for 60 days. The cumulative GHG production rates in reservoir catchment are found as 1.52 ± 0.26, 0.13 ± 0.02, and 0.0004 ± 0.0001 μg g soil^-1 day^-1 for CO₂, CH₄, and N₂O, respectively, which is lower than global reservoirs located in the same eco-region. The significant positive correlation between CO₂ productions and labile organic carbon (LOC), CH₄ and C/N ratio, while N₂O and N/P ratio, while pH of soils is negatively correlated, conforms their key role in GHG emissions. Carbon available as LOC in the reservoir catchment is found as 3-14% of the total ‟C" available in soils and 0-23% is retained in the soil after the completion of incubation. The key objective of this study to signify the C, N, and P ratios, LOC, and pH with GHG production rate by creating an incubation experiment (as in the case of benthic soil/sediment) in the lab for 60 days. In summary, the results suggest that carbon, as LOC were more sensitive indicators for CO₂ emissions and significant C, N, and P ratios, affects the GHG emissions. This study is useful for the hydropower industry to know the GHG production rates after the construction of reservoir so that its effect could be minimized by taking care of catchment area treatment plan.

Carbon stock estimation in the catchment of Kotli Bhel 1A hydroelectric reservoir, Uttarakhand, India

Constructions of dams/reservoirs all over the world are reported to emit significant amount of greenhouse gases (GHGs) and are considered as environmental polluters. Organic carbon is contributed by the forest in the catchment, part of soil organic carbon is transported through the runoffs to the reservoir and undergoes aerobic and anaerobic degradation with time to release GHGs to the atmosphere. Literature reveals that no work is available on the estimation of 'C' stock of trees of forest catchment for assessing/predicting the GHGs emissions from the reservoirs to atmosphere. To assess the GHGs emission potential of the reservoir, an attempt is made in the study to estimate the 'C' stock in the forest catchment of Kotli Bhel 1A hydroelectric reservoir located in Tehri Garhwal district of Uttarakhand, India. For this purpose, the selected area was categorized into the site-I, II and III along the Bhagirathi River based on type of forest available in the catchment. The total carbon density (TCD) of tree species of different forest types was calculated using diameter at breast height (dbh) and trees height. The results found that the TCD of forest catchment was found 76.96MgCha^-1 as the highest at the site-II and 29.93MgCha^-1 as lowest at site-I with mean of 51.50MgCha^-1. The estimated forest 'C' stock shall be used to know the amount of carbon present before and after construction of the dam and to predict net GHGs emissions. The results may be helpful to study the potential of a given reservoir to release GHG and its subsequent impacts on global warming/climate challenges.