Morphometric analysis of infraorbital foramen using cone beam computed tomography in a cohort of Sri Lankan adults / Análisis morfométrico del foramen infraorbitario mediante tomografía computarizada de haz cónico en una cohorte de adultos de Sri Lanka

SUMMARY: Infraorbital foramen (IOF) located bilaterally within the maxillary bone about 1 cm inferior to the infraorbital margin is a vital landmark when delivering local anesthesia and during surgical interventions in the midface region. A total of 122 infraorbital foramina in 61 cone beam computed tomographic (CBCT) images of 32 females and 29 males in the age range of 17 to 32 were analyzed to determine the shape, direction, presence of accessory foramina, size and the precise position of IOF in relation to the inferior orbital margin (IOM), maxillary midline (MM), lateral nasal wall (LNW), alveolus (ALV) and maxillary teeth in a group of Sri Lankan people. The IOF was oval in shape (80.3 % and 88.5 % on the right and left side, respectively) in a majority of individuals. The infraorbital foramina were located at a mean distance of 5.56 ± 3.95 and 4.91 ± 2.08 mm, below the IOM on the right and left side, 27.13 ± 2.6 and 26.99 ± 2.73 on the right and left side from the mid maxillary line, 11.96 ± 3.45 mm and 12.18 ± 3.35 from the LNW on the right and left side and 29.59 ± 3.59 and 29.65 ± 3.28 above the alveolar crest on the right and left side. There were no statistically significant differences between the left and right sides or between sexes. Majority of IOF (37.5 % and 55.9 % on the right and left side, respectively) were located in the vertical plane passing though the maxillary second premolar tooth.

RESUMEN: El foramen infraorbitario (FIO) ubicado bilateralmente dentro de la maxila, aproximadamente 1 cm inferior al margen infraorbitario, es un punto de referencia vital cuando se administra anestesia local y durante intervenciones quirúrgicas en la región media de la cara. Se analizaron un total de 122 forámenes infraorbitarios en 61 imágenes de tomografía computarizada de haz cónico (CBCT) de 32 mujeres y 29 hombres en un rango etario de 17 a 32 años para determinar la forma, dirección, presencia de forámenes accesorios, tamaño y posición precisa de FIO en relación con el mar- gen orbitario inferior (MOI), la línea mediana maxilar (MM), la pared nasal lateral (PNL), el alvéolo (ALV) y los dientes maxilares en un grupo de personas de Sri Lanka. En la mayoría de los adultos se observó que el FIO tenía forma ovalada (80,3 % y 88,5 % en el lado derecho e izquierdo, respectivamente) Los forámenes infraorbitarios se ubicaron a una distancia media de 5,56 ± 3,95 y 4,91 ± 2,08 mm, por debajo del MOI en los lados derecho e izquierdo; 27,13 ± 2,6 y 26,99 ± 2,73 en el lado derecho e izquierdo desde la línea maxilar mediana, 11,96 ± 3,45 mm y 12,18 ± 3,35 de la PNL en el lado derecho e izquierdo y 29,59 ± 3,59 y 29,65 ± 3,28 por encima de la cresta alveolar en los lados derecho e izquierdo. No hubo diferencias estadísticamente significativas entre los lados izquierdo y derecho o entre sexos. La mayoría de IOF (37,5 % y 55,9 % en el lado derecho e izquierdo, respectivamente) se ubicaron en el plano vertical que pasa por el segundo premolar maxilar.

Assessment of the age range, where juvenile T inversion pattern in right precordial leads of an ECG changes to the adult upright T wave pattern.

Objective: To determine the age range, where juvenile T inversion pattern in right precordial leads (V1 to V4) in an ECG changes to the adult upright T wave pattern Method: A descriptive cross-sectional study was done in children aged 5 years and above referred to the paediatric cardiology clinic, Teaching Hospital Karapitiya from January 2012 to April 2013. Inclusion criteria were: children with no cardiac lesion or a haemodynamically insignificant cardiac lesion after a full cardiac evaluation.The cohort was divided into six age groups and the presence of juvenile and adult ECG patterns were evaluated. Results: A total number of 1039 children were enrolled. At the age of 13 years 50% depicted both juvenile and adult ECG patterns. At the age range of 13-15 years 78 (60%) of a total of 130 showed the adult ECG pattern compared to 99 (44.4%) of a total of 223 at 11-13 years (X2=8.0; p=0.005). Even after 13 years of age the juvenile ECG pattern persisted in 30-40% of children. Conclusions: Transition of the juvenile T inversion pattern in right precordial leads in an ECG to the adult upright T wave pattern occurs predominantly at the age range of 13-15 years. Presence of juvenile T inversion pattern in an ECG after 13-15 years can be a normal finding as well as may be a pre-symptomatic diagnosis of a cardiomyopathy. Although it is normal to have a juvenile ECG pattern above 13 years it is advisable to perform an echocardiographic evaluation on children above 13 years with juvenile T inversion pattern which may lead to early diagnosis of cardiomyopathy.

An audit on the outcome of children referred to the paediatric cardiology unit with a previous echocardiographic diagnosis of mitral valve prolapse.

Objective: To determine the outcome of children referred to the paediatric cardiology unit with a previous echocardiographic diagnosis of mitral valve prolapse (MVP). Method: This study was carried out at the paediatric cardiology clinic of Teaching Hospital Karapitiya from 1st January 2012 to 31st December 2012. All children (18 years or less) presenting with a previous echocardiographic diagnosis of MVP were included in study. An echocardiographic diagnosis of MVP was reached based on the standard diagnostic criteria using an IE 33 Phillips echocardiography machine. Results: There were 141 children presenting with a previous echocardiographic diagnosis of MVP of whom 50.4% were male. Seventeen percent were below 5 years, 45% 5-9 years, 36% 10-14 years and 2% above 14 years. Of the 141, 53.2% did not have a cardiac murmur, 41.8% had a grade 2 cardiac murmur and 5% had a grade 3 murmur. Only 7 (5%) were confirmed to have MVP using standard diagnostic criteria. Of these 7 cases, 3 did not have a murmur and the remaining 4 had a grade 3 murmur best heard in the mitral area. Out of 141 subjects 57.5% had undergone 2 previous echocardiographic evaluations and 40.4% had 3-6 previous echocardiographic evaluations. Conclusion: This study shows gross over diagnosis of MVP when the standard diagnostic criteria to diagnose MVP are applied.

Glycaemic indices of different varieties of rice grown in Sri Lanka.

OBJECTIVE: Varieties of red raw rice are widely believed to have a better nutritional quality. The physiological effects of consuming different varieties of rice may not be so. The glycaemic index has been developed as an indicator of the physiological effect of foods. It is the glycaemic response of a 50 g carbohydrate portion of food expressed as a percentage of that of a standard. The objective of this study was to determine the glycaemic indices of different varieties of rice grown in Sri Lanka. DESIGN: Digestible carbohydrate content of 11 varieties of rice flour and bread were determined. Fasting blood samples followed by half-hourly samples for two hours were drawn after giving portions of either cooked rice or bread containing 50 g carbohydrate each. SETTING: Fibre mill in Gampaha district. SUBJECTS: Twenty-two fibre mill workers aged between 25 and 50 years. MEASUREMENTS: The area under the blood glucose curve (AUC) for varieties of rice for a subject was calculated. Average AUC of 3 values for bread were calculated. Glycaemic index of each variety of rice was determined from the above variables. RESULTS: Glycaemic indices of varieties of rice differ. The glycaemic indices of varieties of red raw rice varied between 56 and 73 and the variety Bg 350 had the lowest glycaemic index. There was no significant difference between mean glycaemic index of varieties of white raw and some varieties of red raw rice (p = 0.2). Parboiled varieties of red raw rice had a significantly lower glycaemic index than white raw rice (p = 0.04) and some of the red raw rice (p = 0.005). CONCLUSIONS: The glycaemic index cannot be predicted from the colour of the rice grain. Red parboiled varieties of rice and Bg 350 can be recommended for patients with diabetes.