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 are the Causes of Coffin-Lowry Syndrome? Coffin-Lowry syndrome is caused by a mutation in the RPS6KA3 gene found on the X chromosome. The defective gene results in the defect in a protein, which is involved in several important functions of the body including in the brain.