Khizer Hussain Afroze M

Remains of barley (Hordeum vulgare) grains found at archaeological sites in the Fertile Crescent indicate that about 10,000 years ago the crop was domesticated there from its wild relative Hordeum spontaneum. The domestication history of barley is revisited based on the assumptions that DNA markers effectively measure genetic distances and that wild populations are genetically different and they have not undergone significant change since domestication. The monophyletic nature of barley domestication is demonstrated based on allelic frequencies at 400 AFLP polymorphic loci studied in 317 wild and 57 cultivated lines. The wild populations from Israel-Jordan are molecularly more similar than are any others to the cultivated gene pool. The results provided support for the hypothesis that the Israel-Jordan area is the region in which barley was brought into culture. Moreover, the diagnostic allele I of the homeobox gene BKn-3, rarely but almost exclusively found in Israel H. spontaneum, is pervasive in western landraces and modern cultivated varieties. In landraces from the Himalayas and India, the BKn-3 allele IIIa prevails, indicating that an allelic substitution has taken place during the migration of barley from the Near East to South Asia. Thus, the Himalayas can be considered a region of domesticated barley diversification.

Introduction
 Approximately 20% of patients with tracheostomy are discharged from hospital with the tracheostomy tube in situ. Proper long term care and management of such tracheostomy patients remains as a challenge to care givers. Fracture of metallic tracheostomy tube (TT) with aspiration of the fragment into tracheobronchial airway is a rare complication of tracheostomy.
 Case Report
 Here we are presenting a case of a 42-year-old male patient, presented to the emergency department with complaint of mild respiratory distress following aspiration of fractured metallic TT and a novel method in removing the dislodged fragment.
 Discussion
 A detailed review of literature has been included to discuss different aspects of aspiration of fractured fragment of tracheostomy tube and best practice recommendations for proper tracheostomy care.
 Conclusion
 Educating the care-giver about care of the tracheostomized patient in general and care of the tracheostomy tube in particular, may help reduce accidental complications.

<p class="abstract"><strong>Background:</strong> Uncinate process (UP) is a part of ethmoid bone, which is a thin sickle shaped projection on the lateral wall of nose. UP extends from the frontal recess superiorly and inferiorly to the ethmoid process of inferior turbinate. Various studies have shown that superior attachment of uncinate process (SAUP) is the key to frontal recess region in endoscopic sinus surgeries (ESS). But these studies have yielded conflicting results, showing multiple patterns and classifications of superior attachment of uncinate process. Knowing the anatomic variations of SAUP will help the surgeon to plan the endoscopic sinus surgery and to avoid the unwanted complications. Hence this study was conducted to observe and classify the superior attachment of uncinate process and to localize the frontal sinus outflow tract<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> We did a retrospective cross sectional study, consisting of 100 patients including both sexes, above the age of 10 years. We excluded pregnant ladies, patients with prior sinus surgeries, sinonasal tumours, nasal polyposis, and craniofacial trauma<span lang="EN-IN">. </span></p><p class="abstract"><strong>Results:</strong> We observed Type I SAUP, in 67.5% (n=135) cases, Type II SAUP in 18.5% (n=37), Type III attachment in 9.5% (n =19) and Type IV in 4.5% (n=9). Bilaterally similar attachments observed in 96% cases. Rest of the cases (4%), the attachment patterns was varying between sides<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The site of SAUP is highly variable. The most common type of SAUP is Type I (67.5%) followed by Type II (18.5%), Type III (9.5%) and Type IV (4.5%)<span lang="EN-IN">.</span></p>

<p class="abstract"><strong>Background:</strong> Aplasia or agenesis of frontal sinuses is not uncommon in the literature. Previous studies have shown unilateral aplasia varying from 1-10% and bilateral agenesis of frontal sinus in 3-10% of patients. It is critical for the operating surgeon to be well aware of the normal anatomy and the variations while doing procedures like endoscopic sinus surgeries, cranialisation of frontal sinuses, frontal sinus trephination, and during anterior skull base procedures. The aim of this study is to demonstrate the incidence of anatomic variations of frontal sinus among Indian populations<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> We did a cross sectional study on computed tomography (CT) scan of head, nose and paranasal sinuses in 730 patients above the age of 10 years. We excluded pregnant ladies, patients with prior sinus surgeries, sinonasal tumors, nasal polyposis, craniofacial trauma<span lang="EN-IN">. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">We observed an incidence of 6.2% of unilateral aplasia of frontal sinus (2.2% in males and 4.0% in females, 3.7% right side and 2.5% left side) and 2.5% of bilateral frontal sinus aplasia (0.95% in males and 1.5% in females). </span></p><p class="abstract"><strong>Conclusions:</strong> Frequent occurrence of frontal sinus aplasia highlights the need to gain a thorough knowledge of the normal anatomy and its variations in order to navigate safely through the nose during basic endoscopic sinus or anterior skull base surgeries to avoid complications<span lang="EN-IN">.</span></p>