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'.
What Causes Acute Tubular Necrosis? The most common cause of ATN is a lack of oxygen reaching the cells of the kidney. When blood cannot reach the tissues and cells of the kidneys due to a blockage or restriction, the kidneys can be damaged or destroyed. A heart attack, stroke, and long-standing diabetes can result in reduced blood flow to the kidneys causing cell death and ATN. Harmful substances in the blood can also damage tubules.