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Kerala doctors’ new reconstruction techniques in British medical journal
December 4th 2020

Kerala doctors’ new reconstruction techniques in British medical journal

Kochi: A study containing Innovative Reconstruction Techniques in head and neck surgery developed by a team of Kerala doctors, has been published in a leading British medical journal- The Journal of Plastic, Reconstructive and Aesthetic Surgery [JPRAS], popularly known as the British Journal of Plastic Surgery in its November 2020 edition. 

The study is authored by a team of surgeons led by Dr Shawn T Joseph and  Dr Jose Tharayil and the team includes, Dr Mihir Mohan, Dr Naveen BS and Dr Adharsh Anand of VPS Lakeshore Hospital, Kochi. 

It describes a simplified reconstruction technique for various defects of head and neck area like tongue, palate, jaw, voice box, windpipe and upper part of the food pipe. The technique uses tissue supplied by blood vessels of neck and facial artery. This happens to be the largest published series of such cases and some of the techniques described in the series for larynx and jaw tumours provide new solutions to defects involving these areas. 

The study mentions that compared to existing microvascular surgery, the new technique reduces surgical time for selected defects of head and neck by at least 4 hours and reduces ICU duration by 2-3 days, thereby bringing down treatment expense by at least 30%.

Since the morbidity of surgery is less, patients who have higher risk for long procedures would find the technique particularly useful. Also, the technique being simpler compared to existing reconstruction, can be used even in resource-limited centres.

JPRAS is the official journal of British Plastic Surgery Association and this study is the largest series of facial artery based islanded myomucosal reconstruction published so far. It is also one of the rare studies in head and neck reconstruction published in JPRAS by doctors from India. After the initial technique was published by the same group of doctors, many cancer institutes in different parts of India have started using the technique.
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ErrorException (E_NOTICE)
fwrite(): write of 1853 bytes failed with errno=28 No space left on device ErrorException thrown with message "fwrite(): write of 1853 bytes failed with errno=28 No space left on device" Stacktrace: #11 ErrorException in /home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php:133 #10 fwrite in /home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php:133 #9 Monolog\Handler\StreamHandler:streamWrite in /home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php:119 #8 Monolog\Handler\StreamHandler:write in /home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Handler/AbstractProcessingHandler.php:39 #7 Monolog\Handler\AbstractProcessingHandler:handle in /home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Logger.php:344 #6 Monolog\Logger:addRecord in /home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Logger.php:712 #5 Monolog\Logger:error in /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Log/Writer.php:203 #4 Illuminate\Log\Writer:writeLog in /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Log/Writer.php:114 #3 Illuminate\Log\Writer:error in /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Exceptions/Handler.php:113 #2 Illuminate\Foundation\Exceptions\Handler:report in /home/vpsftps/public_html/app/Exceptions/Handler.php:40 #1 App\Exceptions\Handler:report in /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Bootstrap/HandleExceptions.php:81 #0 Illuminate\Foundation\Bootstrap\HandleExceptions:handleException in [internal]:0
11
ErrorException
/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php133
10
fwrite
/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php133
9
Monolog\Handler\StreamHandler streamWrite
/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php119
8
Monolog\Handler\StreamHandler write
/vendor/monolog/monolog/src/Monolog/Handler/AbstractProcessingHandler.php39
7
Monolog\Handler\AbstractProcessingHandler handle
/vendor/monolog/monolog/src/Monolog/Logger.php344
6
Monolog\Logger addRecord
/vendor/monolog/monolog/src/Monolog/Logger.php712
5
Monolog\Logger error
/vendor/laravel/framework/src/Illuminate/Log/Writer.php203
4
Illuminate\Log\Writer writeLog
/vendor/laravel/framework/src/Illuminate/Log/Writer.php114
3
Illuminate\Log\Writer error
/vendor/laravel/framework/src/Illuminate/Foundation/Exceptions/Handler.php113
2
Illuminate\Foundation\Exceptions\Handler report
/app/Exceptions/Handler.php40
1
App\Exceptions\Handler report
/vendor/laravel/framework/src/Illuminate/Foundation/Bootstrap/HandleExceptions.php81
0
Illuminate\Foundation\Bootstrap\HandleExceptions handleException
[internal]0
/home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php
        if ($this->useLocking) {
            // ignoring errors here, there's not much we can do about them
            flock($this->stream, LOCK_EX);
        }
 
        $this->streamWrite($this->stream, $record);
 
        if ($this->useLocking) {
            flock($this->stream, LOCK_UN);
        }
    }
 
    /**
     * Write to stream
     * @param resource $stream
     * @param array $record
     */
    protected function streamWrite($stream, array $record)
    {
        fwrite($stream, (string) $record['formatted']);
    }
 
    private function customErrorHandler($code, $msg)
    {
        $this->errorMessage = preg_replace('{^(fopen|mkdir)\(.*?\): }', '', $msg);
    }
 
    /**
     * @param string $stream
     *
     * @return null|string
     */
    private function getDirFromStream($stream)
    {
        $pos = strpos($stream, '://');
        if ($pos === false) {
            return dirname($stream);
        }
 
        if ('file://' === substr($stream, 0, 7)) {
Arguments
  1. "fwrite(): write of 1853 bytes failed with errno=28 No space left on device"
    
/home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php
        if ($this->useLocking) {
            // ignoring errors here, there's not much we can do about them
            flock($this->stream, LOCK_EX);
        }
 
        $this->streamWrite($this->stream, $record);
 
        if ($this->useLocking) {
            flock($this->stream, LOCK_UN);
        }
    }
 
    /**
     * Write to stream
     * @param resource $stream
     * @param array $record
     */
    protected function streamWrite($stream, array $record)
    {
        fwrite($stream, (string) $record['formatted']);
    }
 
    private function customErrorHandler($code, $msg)
    {
        $this->errorMessage = preg_replace('{^(fopen|mkdir)\(.*?\): }', '', $msg);
    }
 
    /**
     * @param string $stream
     *
     * @return null|string
     */
    private function getDirFromStream($stream)
    {
        $pos = strpos($stream, '://');
        if ($pos === false) {
            return dirname($stream);
        }
 
        if ('file://' === substr($stream, 0, 7)) {
Arguments
  1. stream resource @424
      timed_out: false
      blocked: true
      eof: false
      wrapper_type: "plainfile"
      stream_type: "STDIO"
      mode: "a"
      unread_bytes: 0
      seekable: true
      uri: "/home/vpsftps/public_html/storage/logs/laravel.log"
      options: []
    }
    
  2. """
    [2024-04-25 14:50:10] local.ERROR: file_put_contents(): write of 292 bytes failed with errno=28 No space left on device {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 292 bytes failed with errno=28 No space left on device at /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
    [stacktrace]\n
    #0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home/vpsftps/p...', 122, Array)\n
    #1 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home/vpsftps/p...', 'a:4:{s:6:\"_toke...', 2)\n
    #2 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home/vpsftps/p...', 'a:4:{s:6:\"_toke...', true)\n
    #3 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(128): Illuminate\\Session\\FileSessionHandler->write('Jwuv837BUSu7b0f...', 'a:4:{s:6:\"_toke...')\n
    #4 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
    #5 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #6 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #7 /home/vpsftps/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
    #8 {main}\n
    "} \n
    """
    
/home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Handler/StreamHandler.php
            $this->errorMessage = null;
            set_error_handler(array($this, 'customErrorHandler'));
            $this->stream = fopen($this->url, 'a');
            if ($this->filePermission !== null) {
                @chmod($this->url, $this->filePermission);
            }
            restore_error_handler();
            if (!is_resource($this->stream)) {
                $this->stream = null;
 
                throw new \UnexpectedValueException(sprintf('The stream or file "%s" could not be opened in append mode: '.$this->errorMessage, $this->url));
            }
        }
 
        if ($this->useLocking) {
            // ignoring errors here, there's not much we can do about them
            flock($this->stream, LOCK_EX);
        }
 
        $this->streamWrite($this->stream, $record);
 
        if ($this->useLocking) {
            flock($this->stream, LOCK_UN);
        }
    }
 
    /**
     * Write to stream
     * @param resource $stream
     * @param array $record
     */
    protected function streamWrite($stream, array $record)
    {
        fwrite($stream, (string) $record['formatted']);
    }
 
    private function customErrorHandler($code, $msg)
    {
        $this->errorMessage = preg_replace('{^(fopen|mkdir)\(.*?\): }', '', $msg);
    }
Arguments
  1. stream resource @424
      timed_out: false
      blocked: true
      eof: false
      wrapper_type: "plainfile"
      stream_type: "STDIO"
      mode: "a"
      unread_bytes: 0
      seekable: true
      uri: "/home/vpsftps/public_html/storage/logs/laravel.log"
      options: []
    }
    
  2. array:8 [
      "message" => "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
      "context" => array:1 [
        "exception" => ErrorException {
          #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
          #code: 0
          #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
          #line: 122
          #severity: E_NOTICE
        }
      ]
      "level" => 400
      "level_name" => "ERROR"
      "channel" => "local"
      "datetime" => DateTime @1714056610 {
        date: 2024-04-25 14:50:10.059797 UTC (+00:00)
      }
      "extra" => []
      "formatted" => """
        [2024-04-25 14:50:10] local.ERROR: file_put_contents(): write of 292 bytes failed with errno=28 No space left on device {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 292 bytes failed with errno=28 No space left on device at /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
        [stacktrace]\n
        #0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home/vpsftps/p...', 122, Array)\n
        #1 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home/vpsftps/p...', 'a:4:{s:6:\"_toke...', 2)\n
        #2 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home/vpsftps/p...', 'a:4:{s:6:\"_toke...', true)\n
        #3 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(128): Illuminate\\Session\\FileSessionHandler->write('Jwuv837BUSu7b0f...', 'a:4:{s:6:\"_toke...')\n
        #4 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
        #5 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #6 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #7 /home/vpsftps/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #8 {main}\n
        "} \n
        """
    ]
    
/home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Handler/AbstractProcessingHandler.php
 *
 * @author Jordi Boggiano <j.boggiano@seld.be>
 * @author Christophe Coevoet <stof@notk.org>
 */
abstract class AbstractProcessingHandler extends AbstractHandler
{
    /**
     * {@inheritdoc}
     */
    public function handle(array $record)
    {
        if (!$this->isHandling($record)) {
            return false;
        }
 
        $record = $this->processRecord($record);
 
        $record['formatted'] = $this->getFormatter()->format($record);
 
        $this->write($record);
 
        return false === $this->bubble;
    }
 
    /**
     * Writes the record down to the log of the implementing handler
     *
     * @param  array $record
     * @return void
     */
    abstract protected function write(array $record);
 
    /**
     * Processes a record.
     *
     * @param  array $record
     * @return array
     */
    protected function processRecord(array $record)
    {
Arguments
  1. array:8 [
      "message" => "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
      "context" => array:1 [
        "exception" => ErrorException {
          #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
          #code: 0
          #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
          #line: 122
          #severity: E_NOTICE
        }
      ]
      "level" => 400
      "level_name" => "ERROR"
      "channel" => "local"
      "datetime" => DateTime @1714056610 {
        date: 2024-04-25 14:50:10.059797 UTC (+00:00)
      }
      "extra" => []
      "formatted" => """
        [2024-04-25 14:50:10] local.ERROR: file_put_contents(): write of 292 bytes failed with errno=28 No space left on device {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 292 bytes failed with errno=28 No space left on device at /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
        [stacktrace]\n
        #0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home/vpsftps/p...', 122, Array)\n
        #1 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home/vpsftps/p...', 'a:4:{s:6:\"_toke...', 2)\n
        #2 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home/vpsftps/p...', 'a:4:{s:6:\"_toke...', true)\n
        #3 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(128): Illuminate\\Session\\FileSessionHandler->write('Jwuv837BUSu7b0f...', 'a:4:{s:6:\"_toke...')\n
        #4 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
        #5 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #6 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #7 /home/vpsftps/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #8 {main}\n
        "} \n
        """
    ]
    
/home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Logger.php
        }
        $ts->setTimezone(static::$timezone);
 
        $record = array(
            'message' => (string) $message,
            'context' => $context,
            'level' => $level,
            'level_name' => $levelName,
            'channel' => $this->name,
            'datetime' => $ts,
            'extra' => array(),
        );
 
        try {
            foreach ($this->processors as $processor) {
                $record = call_user_func($processor, $record);
            }
 
            while ($handler = current($this->handlers)) {
                if (true === $handler->handle($record)) {
                    break;
                }
 
                next($this->handlers);
            }
        } catch (Exception $e) {
            $this->handleException($e, $record);
        }
 
        return true;
    }
 
    /**
     * Ends a log cycle and frees all resources used by handlers.
     *
     * Closing a Handler means flushing all buffers and freeing any open resources/handles.
     * Handlers that have been closed should be able to accept log records again and re-open
     * themselves on demand, but this may not always be possible depending on implementation.
     *
     * This is useful at the end of a request and will be called automatically on every handler
Arguments
  1. array:8 [
      "message" => "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
      "context" => array:1 [
        "exception" => ErrorException {
          #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
          #code: 0
          #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
          #line: 122
          #severity: E_NOTICE
        }
      ]
      "level" => 400
      "level_name" => "ERROR"
      "channel" => "local"
      "datetime" => DateTime @1714056610 {
        date: 2024-04-25 14:50:10.059797 UTC (+00:00)
      }
      "extra" => []
      "formatted" => """
        [2024-04-25 14:50:10] local.ERROR: file_put_contents(): write of 292 bytes failed with errno=28 No space left on device {"exception":"[object] (ErrorException(code: 0): file_put_contents(): write of 292 bytes failed with errno=28 No space left on device at /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:122)\n
        [stacktrace]\n
        #0 [internal function]: Illuminate\\Foundation\\Bootstrap\\HandleExceptions->handleError(8, 'file_put_conten...', '/home/vpsftps/p...', 122, Array)\n
        #1 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php(122): file_put_contents('/home/vpsftps/p...', 'a:4:{s:6:\"_toke...', 2)\n
        #2 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/FileSessionHandler.php(83): Illuminate\\Filesystem\\Filesystem->put('/home/vpsftps/p...', 'a:4:{s:6:\"_toke...', true)\n
        #3 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/Store.php(128): Illuminate\\Session\\FileSessionHandler->write('Jwuv837BUSu7b0f...', 'a:4:{s:6:\"_toke...')\n
        #4 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Session/Middleware/StartSession.php(87): Illuminate\\Session\\Store->save()\n
        #5 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(218): Illuminate\\Session\\Middleware\\StartSession->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #6 /home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Http/Kernel.php(189): Illuminate\\Foundation\\Http\\Kernel->terminateMiddleware(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #7 /home/vpsftps/public_html/public/index.php(60): Illuminate\\Foundation\\Http\\Kernel->terminate(Object(Illuminate\\Http\\Request), Object(Illuminate\\Http\\Response))\n
        #8 {main}\n
        "} \n
        """
    ]
    
/home/vpsftps/public_html/vendor/monolog/monolog/src/Monolog/Logger.php
     * @param  array  $context The log context
     * @return bool   Whether the record has been processed
     */
    public function err($message, array $context = array())
    {
        return $this->addRecord(static::ERROR, $message, $context);
    }
 
    /**
     * Adds a log record at the ERROR level.
     *
     * This method allows for compatibility with common interfaces.
     *
     * @param  string $message The log message
     * @param  array  $context The log context
     * @return bool   Whether the record has been processed
     */
    public function error($message, array $context = array())
    {
        return $this->addRecord(static::ERROR, $message, $context);
    }
 
    /**
     * Adds a log record at the CRITICAL level.
     *
     * This method allows for compatibility with common interfaces.
     *
     * @param  string $message The log message
     * @param  array  $context The log context
     * @return bool   Whether the record has been processed
     */
    public function crit($message, array $context = array())
    {
        return $this->addRecord(static::CRITICAL, $message, $context);
    }
 
    /**
     * Adds a log record at the CRITICAL level.
     *
     * This method allows for compatibility with common interfaces.
Arguments
  1. 400
    
  2. "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
    
  3. array:1 [
      "exception" => ErrorException {
        #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
        #code: 0
        #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
        #line: 122
        #severity: E_NOTICE
      }
    ]
    
/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Log/Writer.php
     * @return void
     */
    public function write($level, $message, array $context = [])
    {
        $this->writeLog($level, $message, $context);
    }
 
    /**
     * Write a message to Monolog.
     *
     * @param  string  $level
     * @param  string  $message
     * @param  array  $context
     * @return void
     */
    protected function writeLog($level, $message, $context)
    {
        $this->fireLogEvent($level, $message = $this->formatMessage($message), $context);
 
        $this->monolog->{$level}($message, $context);
    }
 
    /**
     * Register a file log handler.
     *
     * @param  string  $path
     * @param  string  $level
     * @return void
     */
    public function useFiles($path, $level = 'debug')
    {
        $this->monolog->pushHandler($handler = new StreamHandler($path, $this->parseLevel($level)));
 
        $handler->setFormatter($this->getDefaultFormatter());
    }
 
    /**
     * Register a daily file log handler.
     *
     * @param  string  $path
Arguments
  1. "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
    
  2. array:1 [
      "exception" => ErrorException {
        #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
        #code: 0
        #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
        #line: 122
        #severity: E_NOTICE
      }
    ]
    
/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Log/Writer.php
     *
     * @param  string  $message
     * @param  array  $context
     * @return void
     */
    public function critical($message, array $context = [])
    {
        $this->writeLog(__FUNCTION__, $message, $context);
    }
 
    /**
     * Log an error message to the logs.
     *
     * @param  string  $message
     * @param  array  $context
     * @return void
     */
    public function error($message, array $context = [])
    {
        $this->writeLog(__FUNCTION__, $message, $context);
    }
 
    /**
     * Log a warning message to the logs.
     *
     * @param  string  $message
     * @param  array  $context
     * @return void
     */
    public function warning($message, array $context = [])
    {
        $this->writeLog(__FUNCTION__, $message, $context);
    }
 
    /**
     * Log a notice to the logs.
     *
     * @param  string  $message
     * @param  array  $context
     * @return void
Arguments
  1. "error"
    
  2. "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
    
  3. array:1 [
      "exception" => ErrorException {
        #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
        #code: 0
        #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
        #line: 122
        #severity: E_NOTICE
      }
    ]
    
/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Exceptions/Handler.php
     */
    public function report(Exception $e)
    {
        if ($this->shouldntReport($e)) {
            return;
        }
 
        if (method_exists($e, 'report')) {
            return $e->report();
        }
 
        try {
            $logger = $this->container->make(LoggerInterface::class);
        } catch (Exception $ex) {
            throw $e; // throw the original exception
        }
 
        $logger->error(
            $e->getMessage(),
            array_merge($this->context(), ['exception' => $e]
        ));
    }
 
    /**
     * Determine if the exception should be reported.
     *
     * @param  \Exception  $e
     * @return bool
     */
    public function shouldReport(Exception $e)
    {
        return ! $this->shouldntReport($e);
    }
 
    /**
     * Determine if the exception is in the "do not report" list.
     *
     * @param  \Exception  $e
     * @return bool
     */
Arguments
  1. "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
    
  2. array:1 [
      "exception" => ErrorException {
        #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
        #code: 0
        #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
        #line: 122
        #severity: E_NOTICE
      }
    ]
    
/home/vpsftps/public_html/app/Exceptions/Handler.php
     * A list of the inputs that are never flashed for validation exceptions.
     *
     * @var array
     */
    protected $dontFlash = [
        'password',
        'password_confirmation',
    ];
 
    /**
     * Report or log an exception.
     *
     * This is a great spot to send exceptions to Sentry, Bugsnag, etc.
     *
     * @param  \Exception  $exception
     * @return void
     */
    public function report(Exception $exception)
    {
        parent::report($exception);
    }
 
    /**
     * Render an exception into an HTTP response.
     *
     * @param  \Illuminate\Http\Request  $request
     * @param  \Exception  $exception
     * @return \Illuminate\Http\Response
     */
   public function render($request, Exception $exception)
    {
        // if ($exception instanceof CustomException) {
        //     return response()->view('errors.404', [], 404);
        // }
 
        // return parent::render($request, $exception);
        
        if ($this->isHttpException($exception)) 
        {
            if ($exception->getStatusCode() == 404) 
Arguments
  1. ErrorException {
      #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
      #code: 0
      #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
      #line: 122
      #severity: E_NOTICE
    }
    
/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Foundation/Bootstrap/HandleExceptions.php
    }
 
    /**
     * Handle an uncaught exception from the application.
     *
     * Note: Most exceptions can be handled via the try / catch block in
     * the HTTP and Console kernels. But, fatal error exceptions must
     * be handled differently since they are not normal exceptions.
     *
     * @param  \Throwable  $e
     * @return void
     */
    public function handleException($e)
    {
        if (! $e instanceof Exception) {
            $e = new FatalThrowableError($e);
        }
 
        try {
            $this->getExceptionHandler()->report($e);
        } catch (Exception $e) {
            //
        }
 
        if ($this->app->runningInConsole()) {
            $this->renderForConsole($e);
        } else {
            $this->renderHttpResponse($e);
        }
    }
 
    /**
     * Render an exception to the console.
     *
     * @param  \Exception  $e
     * @return void
     */
    protected function renderForConsole(Exception $e)
    {
        $this->getExceptionHandler()->renderForConsole(new ConsoleOutput, $e);
Arguments
  1. ErrorException {
      #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
      #code: 0
      #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
      #line: 122
      #severity: E_NOTICE
    }
    
[internal]
Arguments
  1. ErrorException {
      #message: "file_put_contents(): write of 292 bytes failed with errno=28 No space left on device"
      #code: 0
      #file: "/home/vpsftps/public_html/vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php"
      #line: 122
      #severity: E_NOTICE
    }
    

Environment & details:

empty
empty
empty
empty
empty
Key Value
CONTEXT_DOCUMENT_ROOT
"/home/vpsftps/public_html/public"
CONTEXT_PREFIX
""
DOCUMENT_ROOT
"/home/vpsftps/public_html/public"
GATEWAY_INTERFACE
"CGI/1.1"
HTTPS
"on"
HTTP_ACCEPT
"*/*"
HTTP_HOST
"www.vpslakeshorehospital.com"
HTTP_USER_AGENT
"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)"
PATH
"/bin:/usr/bin"
PHP_INI_SCAN_DIR
"/opt/cpanel/ea-php74/root/etc:/opt/cpanel/ea-php74/root/etc/php.d:."
QUERY_STRING
""
REDIRECT_HTTPS
"on"
REDIRECT_SSL_TLS_SNI
"www.vpslakeshorehospital.com"
REDIRECT_STATUS
"200"
REDIRECT_UNIQUE_ID
"ZiptoZ-5FaWuVpxxpA2nAgAABAQ"
REDIRECT_URL
"/news/kerala-doctors-new-reconstruction-techniques-in-british-medical-journal"
REMOTE_ADDR
"18.117.153.38"
REMOTE_PORT
"34371"
REQUEST_METHOD
"GET"
REQUEST_SCHEME
"https"
REQUEST_URI
"/news/kerala-doctors-new-reconstruction-techniques-in-british-medical-journal"
SCRIPT_FILENAME
"/home/vpsftps/public_html/public/index.php"
SCRIPT_NAME
"/index.php"
SERVER_ADDR
"72.52.142.236"
SERVER_ADMIN
"webmaster@vpslakeshorehospital.com"
SERVER_NAME
"www.vpslakeshorehospital.com"
SERVER_PORT
"443"
SERVER_PROTOCOL
"HTTP/1.1"
SERVER_SIGNATURE
""
SERVER_SOFTWARE
"Apache"
SSL_TLS_SNI
"www.vpslakeshorehospital.com"
TZ
"Asia/Dubai"
UNIQUE_ID
"ZiptoZ-5FaWuVpxxpA2nAgAABAQ"
PHP_SELF
"/index.php"
REQUEST_TIME_FLOAT
1714056609.8715
REQUEST_TIME
1714056609
argv
[]
argc
0
APP_NAME
"VPS Lakeshore"
APP_ENV
"local"
APP_KEY
"base64:nxWALHNutHxwRR/6qkGa9eVE8rJcO1Lzy+A7+2JwHvw="
APP_DEBUG
"true"
APP_LOG_LEVEL
"debug"
APP_URL
"https://www.vpslakeshorehospital.com/"
DB_CONNECTION
"mysql"
DB_HOST
"127.0.0.1"
DB_PORT
"3306"
DB_DATABASE
"vpsftps_new"
DB_USERNAME
"vpsftps_new"
DB_PASSWORD
"%]28p^v6PE{N"
BROADCAST_DRIVER
"log"
CACHE_DRIVER
"file"
SESSION_DRIVER
"file"
SESSION_LIFETIME
"120"
QUEUE_DRIVER
"sync"
REDIS_HOST
"127.0.0.1"
REDIS_PASSWORD
"null"
REDIS_PORT
"6379"
MAIL_MAILER
"smtp"
MAIL_HOST
"smtp.gmail.com"
MAIL_PORT
"587"
MAIL_USERNAME
"socialmedia@lakeshorehospital.org"
MAIL_PASSWORD
"rzfixaccfyzmmtho"
MAIL_ENCRYPTION
"tls"
MAIL_FROM
"socialmedia@lakeshorehospital.org"
PUSHER_APP_ID
""
PUSHER_APP_KEY
""
PUSHER_APP_SECRET
""
PUSHER_APP_CLUSTER
"mt1"
AYUR_ID
"78"
CAPTCHA_SITEKEY
"6LecBtsbAAAAADVzKUCtuyvxB7QXxe_mf_4KvyyZ"
CAPTCHA_SECRET
"6LecBtsbAAAAAE0VRf82kG6f0NwsQT-gks83zxl9"
Key Value
APP_NAME
"VPS Lakeshore"
APP_ENV
"local"
APP_KEY
"base64:nxWALHNutHxwRR/6qkGa9eVE8rJcO1Lzy+A7+2JwHvw="
APP_DEBUG
"true"
APP_LOG_LEVEL
"debug"
APP_URL
"https://www.vpslakeshorehospital.com/"
DB_CONNECTION
"mysql"
DB_HOST
"127.0.0.1"
DB_PORT
"3306"
DB_DATABASE
"vpsftps_new"
DB_USERNAME
"vpsftps_new"
DB_PASSWORD
"%]28p^v6PE{N"
BROADCAST_DRIVER
"log"
CACHE_DRIVER
"file"
SESSION_DRIVER
"file"
SESSION_LIFETIME
"120"
QUEUE_DRIVER
"sync"
REDIS_HOST
"127.0.0.1"
REDIS_PASSWORD
"null"
REDIS_PORT
"6379"
MAIL_MAILER
"smtp"
MAIL_HOST
"smtp.gmail.com"
MAIL_PORT
"587"
MAIL_USERNAME
"socialmedia@lakeshorehospital.org"
MAIL_PASSWORD
"rzfixaccfyzmmtho"
MAIL_ENCRYPTION
"tls"
MAIL_FROM
"socialmedia@lakeshorehospital.org"
PUSHER_APP_ID
""
PUSHER_APP_KEY
""
PUSHER_APP_SECRET
""
PUSHER_APP_CLUSTER
"mt1"
AYUR_ID
"78"
CAPTCHA_SITEKEY
"6LecBtsbAAAAADVzKUCtuyvxB7QXxe_mf_4KvyyZ"
CAPTCHA_SECRET
"6LecBtsbAAAAAE0VRf82kG6f0NwsQT-gks83zxl9"
0. Whoops\Handler\PrettyPageHandler