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Laryngeal tuberculosis is a rare condition, isolated laryngeal tuberculosis without pulmonary manifestations is even more rare. Patients usually presents with voice change, difficulty in swallowing and other constitutional symptoms. The symptoms and findings can look like malignancy in most of the cases. Here, we present a case of primary laryngeal tuberculosis without pulmonary tuberculosis. A 24 year old man who presented to us with hoarseness of voice with 1 year duration. Laryngoscopic study showed a proliferative growth in the epiglottis, aryepiglottic folds and vocal cords and was diagnosed to have laryngeal tuberculosis on histopathology by the typical appearance of granuloma and caseous necrosis. The patient was started on standard antitubercular therapy and he had an excellent response to the same within 6 months. Isolated laryngeal tuberculosis should be suspected in patients with laryngeal complaints with no pulmonary symptoms, especially in a developing country like India where pulmonary tuberculosis is prevalent. Even though isolated laryngeal tuberculosis cases are rare, we should keep in mind the possibility of tuberculosis in the differential diagnosis of laryngeal tumors, as the incidence of tuberculosis is steadily increasing., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Association of Otolaryngologists of India 2020.)

The COVID-19 pandemic has made the educational institutions to implement the mandatory virtual learning in medical education. It is undeniable that electronic gadget aided learning have a significant role to play during a pandemic. Both faculty and students are getting accustomed to this 'New Normalcy'. Therefore, it is of interest to determine the effectiveness and perception of virtual teaching and learning during the COVID 19 pandemic. A cross-sectional study was conducted in which 336 medical and 336 paramedical students of both the genders with age group of 17 - 21 years participated. The data obtained were analyzed using the SPSS software. The shift from class room teaching to virtual learning has led to many health issues among students such as eye strain, anxiety, depression, musculoskeletal problems and obesity. The students also had inadequate time to interact with faculties. Data shows that virtual learning an alternative mode to traditional method during a pandemic., Competing Interests: The authors declare no conflict of interest., (© 2022 Biomedical Informatics.)

Formation of oil-suspended sediment aggregates (OSAs) is believed to be one of the natural cleaning processes in the marine environment. In this study, we have investigated the formation processes of OSAs under different mixing periods (continuous mixing and with the addition of sediments in between), oil-sediment ratios (1:1, 1:2 and 2:1) and crude oils (Arabian Light (AL), Kuwait (KW) and Murban (MB)). The results revealed that size of OSAs significantly increased (up to ≈ 1.41 mm) with the addition of sediments. Aggregates (total 36) were extracted for n-alkanes and polycyclic aromatic hydrocarbons to quantify and assess their weathering and toxic levels. The maximum n-alkane depletion was 84% (111-02), 94% (212-02) and 84% (321-02) and PAH depletion was ≈ 72% (111-02), 79% (212-02) and 81% (311-03) for the OSAs of AL, KW and MB crude oils, respectively, for the different samples considered, indicating that n-alkanes were depleted relatively higher than the PAHs. The highest depletion of both n-alkane and PAHs has occurred in OSAs of 10-h continuous mixing. The depletion of both n-alkane and PAHs reduced after the addition of sediments, however, escalated the growth of OSAs, resulting in bigger size OSAs. The concentration of PAHs of all 36 OSAs is greater than 5000 ng/g, indicating very high PAH pollution. Though the formation of OSAs helps in cleaning the spill sites, the carcinogenic threat to the marine ecosystem caused by these OSAs cannot be ignored.

Ninety-two patients with metastasis of unknown origin were studied between 1986 and 1997 at Kidwai Memorial Institute of Oncology, India. Treatment included planned primary radical neck dissection followed by radiotherapy. Sixty-seven patients completed our multimodal therapy. Thirty-eight of these patients had a median follow-up pf 35.7 months. Nine patients had a median follow-up of 8.3 months. Twenty patients were lost in follow-up after completing the above protocol. Twenty-five patients did not comply with prescribed therapy. Of the followed up patients 78.9% were disease free. The failure rate was 21%, which comprised of regional failure in 16% and liver metastasis in 5%. Primary manifested at base of tongue in 2 patients. In a third world cancer center like ours, advanced neck disease and unreliable follow-up mandate multimodal therapy to be instituted at the first instance. Manifest primaries should be treated on individual basis.