1 The processing time does not apply to services where prior approval has to be obtained from authorities in India or elsewhere. For such cases, the processing time is a minimum of thirty (30) business days.  The Consular Officer can at any time call an applicant for a personal interview.
The simian crease is one of the listed signs in Down Syndrome which would imply there's some genetic factor at play. My eldest daughter has a simian crease on one hand and the other hand is 'normal'.
Vocal fold (or cord) paresis and paralysis result from abnormal nerve input to the voice box muscles (laryngeal muscles). Paralysis is the total interruption of nerve impulse, resulting in no movement; paresis is the partial interruption of nerve impulse, resulting in weak or abnormal motion of laryngeal muscles.Paresis/paralysis can happen at any age, from birth to advanced age, in males and females, from a variety of causes.nown reasons can include: Inadvertent injury during surgery: Surgery in the neck (thyroid gland, carotid artery) or in the chest (lungs, esophagus, heart, or large blood vessels) may inadvertently result in RLN paresis or paralysis. The SLN may also be injured during head and neck surgery.