Hearing aid fi tment is a routine, usually safe procedure carried out by hearing aid technicians or even audiologists. Hearing aids are often considered the benign, non-surgical alternative to rehabilitate a patient who cannot be helped surgically. It is rare to have to resort surgery to manage a complication resulting from hearing aid fi tting. We report here, a case of otoplast as a foreign body in the middle ear cleft (middle ear cavity and mastoid). The otoplast was used to prepare a mould for the hearing aid and the syringe carrying the otoplast burst splashing the material into the middle ear and the mastoid. This resulted in sudden excruciating pain, further loss of hearing and intractable otorrhea. After several attempts to remove the material elsewhere, our patient underwent a successful mastoid exploration to remove the otoplast resulting in a dry ear after seven years of persistent otorrhea. Patient's professional requirement for good hearing necessitated a myringoplasty on the other (only hearing) ear. He is now happily rehabilitated with a dry but deaf left ear and a normally hearing right ear.

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We implement and compare the Sawtooth (S) and Vcycles in multigrid method (mgd) for the Poisson equation and for the fourth-order 13-point methods derived by Krishnaiah et al. Defect correction in the mgd context is also studied. Computations reveal that the S cycle is much cheaper compared to the V cycle in most of the situations. Defect correction is much cheaper than the direct application of the 13-point formula, giving almost the fourth-order accurate results.

Purpose: The workflow in an office plays a significant role for an effective and efficient work output. It is vital to prepare a strategy for streamlining the work process by eliminating errors and improving workflow for increased efficiency and work output in an architectural practice. To increase operational efficiency, a firm must first understand how to streamline their workflow that add value to their daily tasks and practice time and communication management. The primary purpose of this research is to prepare a strategy for streamlining the workflow within the office and with the consultants for efficient, effective and mistake free work output. Methodology: The research is approached by identifying the current trends of workflow management prevalent in architectural offices; identifying the issues and associated problems and finally developing an organized and streamlined workflow strategy. The research is structured initially with review of existing knowledge on the stakeholder and communication management, study of seven quality tools and their application in the given situation, followed by in-depth semi- structured expert interviews with practicing architects, and survey with a target population of practicing architects. Main Findings: From the analysis, it is evident that the primary issue lies because of communication gap with consultants and subcontractors and lack of coordination within the office, followed by lack of work experience; lack of visibility and inadequate number of projects and Hiring of Team members. The research concludes with a list of recommendations that can be beneficial for effective and efficient workflow management for a startup architectural firm to reduce conflicts at the site and increase work output.