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Cadaveric study:-anatomy
Vinodhini Periyasamy1*,Mamatha Hosapatna2,Balakrishnan3, Suhani Sumalatha4, Antony Sylvan D’souza5.
1PG Student,2Assistant professor,3Assistant Surgeon,4Lecturer,5Professor and Head, Department of anatomy,Kasturba medical college,Manipal -576104,India.
Abstract:- Background:- Biceps brachii derives its name from two proximally attached heads. The origin of long head starts within the capsule of the shoulder joint, runs from the supraglenoid tubercle of the scapula at the apex, along with the glenoidal labrum. Theyarch over the humeral head and descend in the intertubercular sulcus. Aim The study was designed to assess the variations in the origin of long head of biceps brachii from the glenoid labrum of the scapula. Materials and methods The shoulder joint cavity of 50 [adult & fetal] male & female cadavers was extensively studied in the Department of Anatomy, Kasturba Medical College and Manipal. Recordings of the percentage of fibers arising from the tubercle, the anterior labrum, and the posterior labrum were assessed. Results 58% all the labral part of the attachment was to the posterior labrum, with few fibers to the anterior labrum,39% equal contributions to anterior and posterior labrum and 3% most attached to the anterior labrum, with a small contribution to the posterior labrum. Conclusion An understanding of these normal anatomical variations is essential in evaluating and treating labral pathology in throwing athletes. Shoulder instability in baseball pitchers is related to forceful contraction of the injured biceps tendon.The pathology correlates with the immense stress placed on the shoulder and the biceps brachialis muscle during the throwing motion. In geriatric population, minimum intervention (debridement, biceps tenodesis/tenotomy) to these lesions resulted in excellent patient satisfaction and outcomes.
Key words: Biceps, Labrum, Baseball Pitchers, SLAP.
Cadaveric Study :-Anatomy
Ambali Manoj P 1 and Jadhav Surekha D 2*
1Professor, MS, Department of Anatomy, Krishna Institute of Medical Sciences Deemed University (KIMSDU) Karad, Maharashtra, India, 415110.
2Associate Professor, MD, Department of Anatomy, P. D. V. V. P. Medical College, Ahmednagar, Maharashtra, India, 414003.
Abstract:- Background: Carotid arteries are main arterial trunks of the head and neck. They are important landmarks defining dissection plane during radical neck surgeries. Generally, these arteries divide at upper border of thyroid cartilage. This position can vary considerable. Variations in the bifurcation levels and branching pattern of common carotid arteries are important during neck surgeries, catheterization, for radiologist in image interpretation. Aim: Aim of present study was to see the point of bifurcation and branches arising from carotid arteries. Material and methods: Hundred adult cadavers (right: 100; left: 100) of unknown sex and age were studied. After careful dissection bifurcation levels and extra branches arising from carotid arteries were noted. Results: The bifurcation level of common carotid arteries were divided into three types: Type I: Normal- at the superior border of thyroid cartilage (57%); Type II: High- above the superior border of thyroid cartilage (42%); Type III: Low- below the superior border of thyroid cartilage (1%). Various branches given from carotid arteries were noted. Conclusion: Present study shows high incidence of higher bifurcating point than lower bifurcating point of common carotid arteries which is almost always associated with variation in branching pattern of these arteries. This knowledge may be useful for surgeons, radiologist and anatomist.
Key words:- Bifurcation level, Catheterization, Common carotid arteries, Thyroid cartilage, Variations.
Review article:-Orthodontics.
Soumya K.M1 , Aravind S Raju 2* ,Shabeer 1,Mahantesh3,Renji K Paul2.
1MDS, Senior Lecturer, Department of Orthodontics, Alazar Dental College, Kerala,India. 2MDS, Senior Lecturer, Department of Orthodontics, St.Gregorios Dental College, Kerala, India.
3MDS, Senior Lecturer, Department of Orthodontics, Ramaiah Dental College & Hospital, Karanataka,India.
Abstract: Human beings are normally nasal breathers. The nasal and oral cavities serve as pathways for respiratory airflow. Ordinarily, the inspiratory and expiratory airstreams are channeled through the nose because the mouth is usually closed. However, in some individuals, because of nasal airway inadequacy or habit, the oral cavity becomes the predominant route for the passage of respiratory airflow. This may affect the growth and development. This article reviews the anatomy, diagnosis, treatment and various aspects of upper airway and its importance in patients undergoing orthodontic treatment.
Key Words: Upper airway, diagnosis, orthodontic.
Research article:- Obstetrics and Gynaecology.
Mangal Puri1*, Anita Singh2, Meenal Patvekar1, Stuty Tyagi1, Pratima Sharma1 & Smita S. Singhania1.
*1Professor, Department of Obstetrics and Gynaecology. Pad. Dr.D.Y. Patil Medical College, hospital and research centre.Dr.D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India.
2Professor and Head, Department of Obstetrics and Gynaecology. Gian Sagar Medical College, Ramnagar , Banur.Patiala, Punjab, India.
Abstract: Background: Vaginal route of hysterectomy is preferred than abdominal, which has increased the chances of vault collection leading to postoperative morbidity. Present study is done to evaluate the prevalence of ultrasonologically detectable vault hematoma after vaginal hysterectomy (VH) and its correlation with postoperative morbidity and to study whether routine postoperative ultrasound following VH can help to reduce it. Materials and Methods: A group of 100 women who underwent vaginal hysterectomy at tertiary care centre and teaching hospital, for benign causes and utero-vaginal prolapse were selected. Transabdominal and transperineal or transvaginal ultrasound examinations were carried out on 3rd, 7th and 9th postoperative days to assess the presence of vault hematomas. Ultrasound findings were correlated with clinical data regarding postoperative morbidity. Results: The incidence of vault hematoma was found to be 8% in present study, 37% had febrile morbidity and 50% patients had postoperative drop in haemoglobin. Association with intra and post operative haemorrhage was noted. Large sized hematomas were drained vaginally under anaesthesia, while all small and medium sized hematomas were managed by anti-fibrinolytics and antibiotics successfully. Conclusion: Postoperative ultrasound need not be a routine procedure but that helps to reduce morbidity in selected patients.
Key Words: Vault hematoma, vaginal hysterectomy, ultrasound evaluation.
Research article:- Pulmonology and Critical Care
Rakesh K Gupta*
*Assistant Professor, Department of Pulmonology and Critical Care, King Fahd Hospital of University , University of Dammam, Kingdom of Saudi Arabia.
Abstract: Background: In recent years non-invasive ventilator modalities have been developed to improve alveolar ventilation and oxygenation with-out the need for an artificial airway. It is found to be an effective modality for the treatment of hypercapnic as well as hypoxic respiratory failure. In some patients however noninvasive ventilation is inadequate and invasive ventilation cannot be avoided. Failure of initial trial of NIPPV may lead to a delay in intubation and associated with significant increase in mortality.
Objectives: To find the base line parameters associated with failure of NIPPV so that individual could be identified who are likely to fail to respond to NIPPV either before or shortly after a trial of therapy.
Methods: Prospective observational study was conducted including hypoxic and hypercapnic respiratory failure and put on NIPPV. The patients ECG, oxygen saturation, blood pressure and respiratory rate were continuously monitored. Arterial blood gas level measured on admission, 1, 4, 12, 36 hours after starting NIPPV.
Result: It was observed that among the hypoxemic patients unsuccessful group had significantly higher heart rate (128±9.98 Vs 115±14.4, p = 0.43) than successfully treated group. ADL score was also found to be significantly low in failure group (1.50±0.54 Vs 2.35±0.67, p = 0.009) in comparison to success group. After 1 hr of administration of NIPPV respiratory rate (27±4.73) and PaO2 (94.2±21.6) in success group improved significantly. In hypercapnic group baseline heart rate (134±8.36 Vs 105±12.3) and respiratory rate (37.4±3.95 Vs 33.5 ±2.32) was significantly higher in failure patients as compared to successful ones. After 1hr of NIPPV trial pH, HR and RR improve significantly in success group as compared to failure group 7.36±0.04 Vs 7.30±7.99, 93±15.1 Vs 135±7.99, 27.9±5.83 Vs 37.1±3.98 respectively.
Conclusion: NIPPV may be useful for avoiding intubation in patients with acute respiratory failure but data available at the time of initiation of NIPPV and after a short period can predict the likelihood of success or failure. So that any delay in intubation can be avoided which itself is associated with significant mortality.