Background The content of the endosperm of the coconut (Cocos nucifera L.) contains “coconut water”. This practically sterile liquid which is prized for its delicate, albeit labile, flavor when fresh, has had a recent dramatic increase in global demand. The organoleptic superiority of water from young coconuts means that degree of maturity at harvesting is the most influential factor in yield and composition. Objective To provide a guide to establishing the authenticity and the potability of samples of coconut water. Method Review and evaluate the literature on the factors that determine the composition and stability of coconut water. Results Data is presented on the variances in natural composition, maturity, processing-induced compositional changes, adulterations, product recalls, classical and instrumental methods of analysis and on the available composition standards of coconut water. Conclusions Advice is provided for official food analysts, and others, on prudent approaches as how to ascertain the authenticity and potability, or otherwise, of coconut water samples.
Complete transection of the sciatic nerve following femoral fracture is extremely rare. In the setting of closed injury it has only been reported in two other cases. Here we present a teenage motorcyclist who sustained a closed left, mid-femoral fracture following a road traffic collision with complete transection of the sciatic nerve. Despite being a closed injury, the obvious limb deformity of the patient and extreme pain prompted immediate nerve block during the primary survey making formal neurological assessment difficult. This case highlights the possibility of complete major nerve transection in closed injuries, and the importance of careful clinical examination alongside repeat imaging.
Introduction: Dysarthria is one of the commonest neurological speech disorders resulting from brain injury. However, hypernasality commonly co-exists in this subgroup of patients and is commonly overlooked. The authors aim to investigate the merit of surgery in improving hypernasality and speech intelligibility in patients with a mixed pattern of dysarthria and hypernasality secondary to brain injury. Materials and Methods: Data was collected from the regional plastic surgery unit over a 10-year period. All patients who underwent a pharyngoplasty for speech improvement following total brain injury from either a traumatic injury or a cerebrovascular accident were included. Patients were followed up post-operatively to assess; improvement in speech rehabilitation, complications and the need for surgical revision. Results: Six patients had a pharyngoplasty for speech improvement. Either a Hynes or Jackson pharyngoplasty was performed, with one patient requiring a hemi-pharyngoplasty. Post-operatively, 1 patient experienced self-limiting sleep apnea which resolved within 1 month. One patient developed obstructive symptoms and required revision. Overall, 83% of patients had clear improvement in speech intelligibility and articulation. Conclusions: The authors have shown that surgical intervention, in the form of a pharyngoplasty, is an effective method of improving speech intelligibility and articulation, by improving hypernasality and restoring communication in this cohort of patients. The aim of this paper is to highlight this option to colleagues and to heighten the awareness that many patients with a total brain injury have a mixed pattern of speech disturbance and not solely the dysarthria that is attributed to this condition.
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