Crossed renal ectopia associated with malrotation of intestine- A rare case report.

Background: Kidneys and ureters demonstrate a wide range of anomalies due to its complex development. One such anomaly would be the crossed renal ectopia which is fusion of both kidneys on to one side and malpositioned at the pelvis. The occurrence of these anomalies, though rare, is due to multifactorial reasons. The renal anomaly was observed in a formalin fixed adult cadaver during the undergraduate medical dissection. The abdominal cavity, on opening, revealed malrotation of the gut with the large intestine on the left side and the small intestinal loops on the right side. The left renal fossa was empty due to fusion of the left kidney with the right kidney forming a lump kidney. The ureter of the left kidney was draining in to its normal position into the urinary bladder. The position of the lump kidney was in the right iliac fossa. It was having arterial feeders from the abdominal aorta and the common iliac arteries and was draining into the inferior vena cava and the right common iliac veins by 5 renal veins. Crossed renal ectopia rarely may be associated with malrotation of the gut. Awareness of such anomalies could be due to incidental finding and helps the surgeons and radiologists in their diagnosis and planning and preventing postoperative complications.

A study of leucorrhoea in reproductive age group women of Nagpur City.

A community based cross-sectional study was conducted in reproductive age group women in an urban community of Nagpur, to assess the prevalence of leucorrhoea and the factors influencing the same in these women. The study participants included 506 females, out of which 149 were unmarried and 357 were married. Detailed history and clinical examination was done in all the females including gynecological examination in all the married females. Leucorrhoea was present in 139 (27.47%) females. Leucorrhoea was found significantly more in married females as compared to unmarried (p < 0.001), pregnant as compared to non-pregnant (OR = 2.10, 95% C.I. = 1.02-4.32), and women of lower socioeconomic status (p < 0.001), women with high parity (p < 0.001). Use of Cu-T was not associated with Leucorrhoea (p > 0.05).

Microsurgical anatomy of the middle cerebral artery.

BACKGROUND: The microsurgical anatomy of the middle cerebral artery (MCA) is of particular interest to the cerebrovascular surgeon. The purpose of this study was to define the microsurgical anatomy of the MCA and its various branches in the Indian population. METHODS: Ten MCAs were studied from five cadaveric brain specimens. The authors studied the outer diameter, length, branches, perforators and site of these on the main trunk (M1), the division of the main trunk, the secondary trunks and their various cortical branches using the operating microscope under 5-20x magnification. RESULTS: The outer diameter of the MCA main trunk ranges from 2.5 to 4 mm with a mean of 3.35 mm. The superolateral branches consisted of polar temporal artery and anterior temporal artery that had a common origin and sometimes the uncal artery or the accessory uncal artery. Perforators or lenticulostriate arteries were seen in the inferomedial surface all along the length of M1. Eight bifurcations and two trifurcations were noted. Cortical branches and their origin are discussed. CONCLUSION: Although the microsurgical anatomy of the MCA in Indian population correlated with the findings in the western literature, some structural and statistical variations were noted.

Role of socio-economic factors and cytology in cervical erosion in reproductive age group women.

A cross-sectional study involving 357 females in the reproductive age group (15-44) was conducted in an urban community of Nagpur with the objective of studying the role of socio-economic factors & cytology in cervical erosion. Cervical erosion was detected in 82 (22.96%) females. Out of these mild dysplasia was seen in 9.75% females & moderate dysplasia in 2.43% females. High percentages of inflammatory smears i.e. (75.68%) were obtained in women with cervical erosion. Cervical erosion was more common in illiterate & women with low literacy status as compared to women with higher education. Majority of cases of cervical erosion (75.6%) were detected in women with high parity. A statistically significant association was found between lower socio-economic status, early age at marriage & ocurrence of cervical erosion (p<0.001 & p<0.01 respectively). The study concludes that socio-economic factors such as illiteracy and low literacy status, lower socio-economic status, early age at marriage and high parity are contributory for the occurrence of cervical erosion and regular cytological screening by Pap smear will help in early detection of carcinoma cervix and thereby reduce the morbidity and mortality caused by the same.

Metabolic responses to repeated infusions of identical doses of norepinephrine in chronically energy deficient human subjects.

The physiological effects of three 30 min infusions of identical doses of norepinephrine (0.15 microgram/kg FFM/min) separated by 60 min intervals were assessed in well nourished (WN; n = 6) and chronically energy deficient (CED; n = 6) subjects. Each subject also underwent control, vehicle infusions with 0.9 per cent saline on a separate day. Oxygen consumption (VO2) was significantly higher during the third infusion of NE as compared to the first in both groups. This increment in VO2 occurred despite similar plasma peak NE levels in both infusions. Increments in plasma glucose and free fatty acids were also similar during the first and third infusions. The study demonstrates that thermogenic potentiation which we had earlier demonstrated in WN subjects, occurs in CED subjects as well. Thermogenic potentiation is not associated with altered plasma NE kinetics or mobilisation of substrates.

Immediate heart rate responses to head-up tilt in healthy human subjects: response characteristics and variability.

Eight healthy adult males underwent three 70* head-up tilts within a nine day period. Immediate heart rate responses were monitored for 30 beats following completion of change to upright posture. The pooled data demonstrates a clearly demarcated bimodal heart rate response with a rise in heart rate by the 20th beat and a subsequent fall by the 30th beat. There is a secondary rise in heart rate with continuation of the tilted position. The bimodal response is at variance with several earlier reports. There is a large variability in the immediate heart rate responses, both between subjects of a homogeneous group and within subjects with repeated measurements. The large variability precludes the use of the immediate heart rate responses to passive tilting in autonomic testing.

Characteristics of norepinephrine stimulated thermogenesis in undernourished subjects.

Thermoregulatory thermogenesis was evaluated in chronically undernourished subjects as well as normally nourished controls by 60 min infusions of norepinephrine at a calculated dose of 0·15 μg/kg fat free mass/min. There was a significant (P<0·05) reduction in the thermogenic response to norepinephrine in the undernourished labourers. When the characteristics of response were evaluated, the baseline and peak responses were comparable in both groups. However, the steepness of the response was greater (P<0·05) in the undernourished subjects. The time to register a threshold response of 5 ml per min increase in oxygen consumption over the baseline after the start of infusion was longer in undernourished (about 20 min) as compared to the controls (about 10 min). It appears that, while the undernourished subjects have a reduced thermogenic component in their energy output, their peak capacity or potential for regulatory thermogenesis is the same as that in control subjects, since their thermogenic response has a greater slope. It is possible that chronically undernourished subjects may have a suppressed response over shorter periods of stimulation (less than 20 min), that is, before steady state thermogenic responses are achieved.

The scalene tubercle.

One hundred and thirty right and 114 left first ribs from a random collection have been studied for the characters of the scalene tubercle and the related structures. The tubercle is not always present but the muscular impression for the insertion of the scalenus anterior muscle on the superior surface of the first rib is almost constant and it generally extends upto the medial third of this surface. The arterial groove, generally shallow, lies behind the tubercle or the muscular impression and generally extends only upto the medial 2/3 of the superior surface. Likewise, the venous groove, mostly shallow, lies in front of the tubercle or the muscular impression and extends, generally, only upto the medial 2/3 of the surface. Normally, there is no separate groove for the lower trunk of the brachial plexus.