A Study of Early Division of Renal Artery and their Incidence.

The knowledge of arterial supply of the human kidney is of special interest as it is not only having many morphological variations buy also many vascular surgeries are carried out in case of renal artery. The present study was done in 50 embalmed cadavers during the period of one year. We found variations in the form of the number of renal artery supplying the kidney, its level of origin, relation with the renal vein, branching pattern. Knowledge of these variations may help to avoid the clinical complications especially during radiological examinations and/or surgical approaches in this region.

Acute accidental exposure to chlorine gas: Clinical presentation, pulmonary functions and outcomes.

Background. To study the clinical presentation, pulmonary functions and outcomes in subjects who were accidentally exposed to chlorine gas. Methods. Prospective observational study of 64 patients who sustained acute accidental exposure to chlorine gas during a leak in the chlorination system of the public bathing pool of a temple. Results. The major presenting symptoms and signs included acute dyspnoea (100%), chest discomfort (100%), cough (97%), eye irritation (88%), giddiness (72%), vomiting (46%), and heaviness in the head (44%); tachycardia (100%), tachypnoea (96%) and polyphonic wheezing (28%). All patients were managed in the emergency room with humidified oxygen inhalation and beta-2 agonist nebulisation and 52 were discharged within six hours. Twelve patients were severely affected and required hospitalisation; three of them were admitted into the intensive care unit. Three patients developed pulmonary oedema six to eight hours following admission. Pulmonary function testing (n=12) at presentation revealed obstructive defect in eight and mixed obstructive-cum-restrictive defect in four patients. The mean duration of hospital stay was 5.1±2.1 days. None of the patients died. Reactive airway dysfunction syndrome (RADS) was observed in three of the 12 hospitalised patients, who complained of manifested persistent cough that lasted for three months period following discharge. Serial pulmonary functions recovered to normal range by the end of the six months in all patients and remained so at one-year follow-up. Conclusion. Acute exposure to chlorine gas is an uncommon, but important public health hazard and can cause RADS, acute lung injury and pulmonary function abnormalities , which are reversible on prompt and appropriate management.