Nonmetric analysis of caroticoclinoid foramen in foothills of Himalayas: Its clinicoanatomic perspective

OBJECTIVE OF THE STUDY

Study was conducted to evaluate the incidence of caroticoclinoid foramen in north Indian population. Authors have also endeavoured to discuss its clinical and embryological implications.

MATERIALS AND METHODS

Study was conducted on 108 dry human skulls in department of anatomy SGRR medical college, Dehradun. Incidence of caroticoclinoid foramen was evaluated in accordance with side.

RESULTS

A percentage of 22.22 skulls presented with the caroticoclinoid foramen with maximum incidence of unilateral and incomplete type. Incidence revealed no bias towards side.

CONCLUSION

Anatomical knowledge about CCF may be helpful to radiologists and neurosurgeons in providing an additional insight into the diagnosis and management of various pathologies around sellar region.

Development of a Valid and Reliable Questionnaire to Identify Professional Opinion Regarding Organ Transplantation System

BACKGROUND

Currently, the Nepalese law permits organ donation by an individual who falls into the category of a "close relative" of the recipient. There is a need for expansion of the live organ donor pool beside close relatives. Different systems of organ transplantation are followed by several countries and the professional opinions that underpin these systems need to be studied.

OBJECTIVE

To generate a questionnaire related to different organ transplant systems and validate it so that it can be used to collect mass professional opinions.

METHODS

Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire. The final version of the questionnaire was reviewed by experts for its content validity and then was used twice for participants at a 20-day interval to calculate Cronbach's alpha for testing its internal consistency and Intra-class correlation for testing its test and retest reliability.

RESULTS

The questionnaire was found to be valid and reliable with an overall Cronbach's alpha of 0.701. Intra-class correlation scores for each question in both test and retest were correlated.

CONCLUSION

A valid and reliable questionnaire was developed that can be used to collect mass professional opinions to assist policy makers to establish a better organ transplant system.

Normal and Delayed Fracture Healing: Symphony and Cacophony

The incidence of any fracture in the US is estimated to be 2 704 fractures per 100,000 person-years. Approximately 10 percent of these fractures develop complications of healing. The processes that occur during fracture healing mimic the processes that take place in the growth plate during development. The study of fracture healing represents a window to enhance our understanding of the processes of growth and development of bones and its reparative biology. This review is aimed for clinicians evaluating non-unions as an overview of different factors that inhibit fracture healing.

Three-dimensional printing and patient-specific pre-contoured plate: future of acetabulum fracture fixation?

PURPOSE

Due to the complexity of acetabulum, achieving anatomical contouring intra-operatively is difficult for surgeon. A 3D (dimensional) real model can facilitate us both in contouring the plate pre-operatively and in better pre-operative planning. Patient-specific pre-contoured plate in acetabular fracture has been studied by few researchers but randomized case-control study was lacking. Hence, we conducted a case-control study to evaluate the accuracy of patient-specific pre-contoured plate.

MATERIALS AND METHODS

Prospective randomized case control study was conducted. 21 patients were included. 10 patients were distributed in "case" group and remaining 11 in "control" group.

INCLUSION CRITERIA

Displaced acetabulum fractures with displacement of ≥3 mm in adults who reported within 3 weeks of injury. Exclusion criteria were: Open fractures, associated Morel-Lavallée lesion and patients with >3 weeks old fracture. In case group, patient-specific real 3D model of fractured acetabulum was generated using rapid prototyping technology and plates were contoured pre-operatively. Control group was treated using intra-operative contoured plates. Both the groups were compared using parameters: Blood loss, Surgery time, post-operative reduction on X-ray, post-surgical residual displacement and reduction achieved as evaluated by CT scan.

RESULTS

Reduced blood loss (100 ml less in case group) and surgical time (12 min less in case group) and better post-operative reduction were observed in case than control. In control group, 4 patients even had step of 2-3 mm, which was not seen in case group. All the pre-contoured plates fitted well to the pelvis intra-operatively. Reduction achieved as evaluated by CT was more in "case" group with statistically significant outcomes (p < 0.05).

CONCLUSION

Patient-specific pre-contoured plate made using 3D model is a better implant than intra-operatively contoured plate. Real-time 3D pelvis model is an accurate technique for pre-operative planning in acetabular fractures.

Three-dimensional printing and patient-specific pre-contoured plate: future of acetabulum fracture fixation?

PURPOSE

Due to the complexity of acetabulum, achieving anatomical contouring intra-operatively is difficult for surgeon. A 3D (dimensional) real model can facilitate us both in contouring the plate pre-operatively and in better pre-operative planning. Patient-specific pre-contoured plate in acetabular fracture has been studied by few researchers but randomized case-control study was lacking. Hence, we conducted a case-control study to evaluate the accuracy of patient-specific pre-contoured plate.

MATERIALS AND METHODS

Prospective randomized case control study was conducted. 21 patients were included. 10 patients were distributed in "case" group and remaining 11 in "control" group.

INCLUSION CRITERIA

Displaced acetabulum fractures with displacement of ≥3 mm in adults who reported within 3 weeks of injury. Exclusion criteria were: Open fractures, associated Morel-Lavallée lesion and patients with >3 weeks old fracture. In case group, patient-specific real 3D model of fractured acetabulum was generated using rapid prototyping technology and plates were contoured pre-operatively. Control group was treated using intra-operative contoured plates. Both the groups were compared using parameters: Blood loss, Surgery time, post-operative reduction on X-ray, post-surgical residual displacement and reduction achieved as evaluated by CT scan.

RESULTS

Reduced blood loss (100 ml less in case group) and surgical time (12 min less in case group) and better post-operative reduction were observed in case than control. In control group, 4 patients even had step of 2-3 mm, which was not seen in case group. All the pre-contoured plates fitted well to the pelvis intra-operatively. Reduction achieved as evaluated by CT was more in "case" group with statistically significant outcomes (p < 0.05).

CONCLUSION

Patient-specific pre-contoured plate made using 3D model is a better implant than intra-operatively contoured plate. Real-time 3D pelvis model is an accurate technique for pre-operative planning in acetabular fractures.

Effect of carboxymethylation on physicochemical, micromeritics and release characteristics of Kyllinga nemoralis starch

Lesser usages of native starch has attracted attention in the modification of starch to incorporate its benefits for pharmaceutical application. A work has been carried out to study the influence of carboxymethylation on the morphological, physico-chemical, powder, spectroscopical and drug discharge characteristics of native starch. Various amount of monochloroacetic acid was used to study the influence of degree of substitution (DS) on the diverse characteristics of modified starch. Amylose content was found to be reduced with the increase in degree of substitution. An enhanced degree of structure deformation was observed with the increment in the DS by the help of scanning electron micrographs. The FT-IR spectra established the polysaccharide nature and the carboxymethylation of the chemically modified starch molecules through the new bands at 1602cm^-1, and 1418.69cm^-1. The stability of carboxymethyl starches pertaining to the temperature has been revealed by thermogravimetric analysis. Micromeritics of carboxymethylated starches shows their effectiveness as excipients in tablet formulation. The delayed % release of the drug, with the rise in degree of substitution from the tablets prepared marks that the carboxymethyl derivatives of Kyllinga nemoralis rhizomes starch may be used as a suitable source of excipient for sustained release formulations.

Suicide by self-inflicted stab wound to the heart: a rare case of suicide from Nepal

Suicide, or the deliberate act of killing oneself, accounts for a substantial number of unnatural deaths each year in many countries. Though death by self-stabbing is quite uncommon, the left part of the chest represents one of the elected sites of self-inflicted wounds because of the knowledge of the situation of the heart and that the injuries to the heart are severe. We present a case of suicidal stab to the left thoracic region involving the heart.DOI: http://dx.doi.org/10.3126/jcmsn.v10i2.12952 Journal of College of Medical Sciences-Nepal, 2014, Vol.10(2); 33-35

A case report of Traumatic Asphyxia

Traumatic asphyxia is a condition presenting with cervicofacial cyanosis and edema, subconjunctival hemorrhage, and petechial hemorrhages of the face, neck, and upper chest that occurs due to a compressive force to the thoracoabdominal region.In this case report a 52 years old lady who was brought to the mortuary because of death due to traumatic asphyxia as a result of being stampeded by her own cows upon her chest was discussed. Congestion on both the conjunctiva, cyanosis on chin and adjacent upper left side of neck found with a well demarcated area observed between the cyanosed area over face and the normal area of neck. Hematoma was present in the chin and the adjacent neck region.Apart from quickly eliminating organ pathologies and initiation of supportive therapy in a case of traumatic asphyxia, possibility of formation of hematoma in neck after few hours of getting injured should also be considered, as this type of hematoma may contribute to the cause of death.Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 51-55