ABSTRACT
Introduction:Cardiac venous system is an important system for various cardiac interventional procedures such as cardiac catheterization. Various veins like right marginal vein, small cardiac vein (SCV), posterior vein of the left ventricle, left marginal vein, oblique vein of Marshall drain into coronary sinus. While anterior cardiac veins drain right ventricular wall directly into right atrium. Materials and Methods: An observational cross‑sectional study was conducted on thirty cadaveric hearts during a 2‑year period in Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Anatomy Department. The length, diameter of SCV, left marginal vein, posterior vein of the left ventricle, right marginal vein, and oblique vein of Marshall were taken. Results: The study reveals the length of SCV as 28.12 ± 22.87 mm. The length of right marginal vein and posterior vein of the left ventricle is having a significant correlation with age. The length of oblique vein of Marshall is lower in males as compared to females. A number of ACVs were significantly related to weight of cadaver in males. Conclusions: The present study provides data of cardiac veins for various cardiac interventional procedures.
ABSTRACT
Background@#Children with cleft lip and/or palate can be undernourished due to feeding difficulties after birth. A vicious cycle ensues where malnutrition and low body weight precludes the child from having the corrective surgery, in the absence of which the child fails to gain weight. This study aimed to identify the proportion of malnutrition, including the deficiency of major micronutrients, namely iron, folate and vitamin B12, in children with cleft lip and/or palate and thus help in finding out what nutritional interventions can improve the scenario for these children. @*Methods@#All children less than 5 years with cleft lip and/or cleft palate attending our institute were included. On their first visit, following were recorded: demographic data, assessment of malnutrition, investigations: complete blood count and peripheral blood film examination; serum albumin, ferritin, iron, folate, and vitamin B12 levels. @*Results@#Eighty-one children with cleft lip and/or palate were included. Mean age was 25.37± 21.49 months (range, 3–60 months). In 53% of children suffered from moderate to severe wasting, according to World Health Organization (WHO) classification. Iron deficiency state was found in 91.6% of children. In 35.80% of children had vitamin B12 deficiency and 23.45% had folate deficiency. No correlation was found between iron deficiency and the type of deformity. @*Conclusion@#Iron deficiency state is almost universally present in children with cleft lip and palate. Thus, iron and folic acid supplementation should be given at first contact to improve iron reserve and hematological parameters for optimum and safe surgery.
ABSTRACT
Background: Varicose veins are a common condition affecting the lower limbs. Apart from having cosmetic problem, if not treated in time it can have some serious complications and are difficult to treat. Multiple modes of surgical management exist for the disease.Methods: This is a prospective clinical study, done over a period of 5-years, between February 2015 to February 2020. Patients were divided into 2 groups: group I (n=103) included those who underwent open surgical to treatment with venous stripping. Group II (n=104) included those who subjected to Radiofrequency ablation (RFA). Groups were selected with comparable physical parameters. Various parameters like bleeding, hematoma, blood requirement, postoperative inflammation, pain, numbness, mobilization, date of discharge and resuming duties were compared. All patients were followed up for 1y ear.Results: Majority of our patients belongs to age group 20-40 years with mean age of 35year in both groups. Male has dominance over female with male to female ratio 4:1. We noticed significant complication in group I than group II, such as bleeding (20:1), hematoma (5:0), inflammation (60:1) and blood requirement (1:0). In group II, we noticed early mobilization of patient (1day v/s 3 days), discharge from hospital (1day v/s 5 days) and resuming duties (5 days v/s 2 weeks).Conclusion: RFA keeps an edge over open surgical treatment with venous stripping.
ABSTRACT
Introduction: More than 70% of lung cancer comprises nonsmall-cell lung carcinoma and is associated with poor survival outcome owing to late diagnosis. Identification of lung cancer in early stages when no clinical signs or symptoms are evident, can drastically improve the prognosis. To this end, we aimed to evaluate the changes occurring at tissue level by assessing the expression of six microRNAs (miRNAs) in lung adenocarcinoma (AC) and squamous cell carcinoma (SCC). Materials and Methods: Peripheral blood of histopathologically proven cases of lung AC and SCC was collected and processed for the isolation of miRNAs using commercially available kit. Primers against mir-2114, mir-2115, mir-2116, mir-2117, mir-449c, and mir-548q with loading control Caenorhabditis elegans were used. Screening was carried out in thirty cases of both AC and SCC, whereas twenty healthy controls were included. Results:Real-time polymerase chain reaction data revealed that the expression of mir-2114 and mir-449c in AC and mir-2115 in SCC was significantly upregulated. The expression of these miRNAs was also confirmed in lung AC cell line. The differential pattern of expression of these miRNAs can be used for precise diagnosis of lung carcinoma Conclusions: We have used a noninvasive technique to identify the subtype of lung cancer based on molecular genetic signatures. The results suggest that through molecular profiling of miRNA, we can screen high-risk cases for cancer interception
ABSTRACT
Paroxysmal Cold Hemoglobinuria is a rare cause of intravascularhemolysis presenting in children following an acute viral illness. Itis usually self-limiting in nature. We present the details of a 4-year-old boy who presented with rapid onset intravascularhemolysis. Donath Landsteiner antibody test was positive andhemolysis resolved within two weeks of onset.
ABSTRACT
Introduction: Copper is an indispensable trace element required for health and also plays a very important role in successful pregnancy completion. There is insufficiency of data on serum levels of copper and its relation with serum Iron levels in pregnant women, especially in India. This loco regional pilot study was done, keeping in mind the limited information about inter relation of these two important minerals and to provide further insight about interaction of these. Material and Methods: This cross-sectional study comprising of pregnant women, selected by random cluster sampling was conducted in the Rishikesh (Hill regions of Uttarakhand, India). The duration of the study was from 1st Dec, to 31st March 2012. Sixty pregnant women of 18 -35 years age group were included. Serum values of twenty non-anaemic, non-pregnant women volunteers in the age group of 18-35 years with no other accompanying illness were considered as controls. The blood investigations for haemoglobin and serum values of Iron and Copper were done in all these. A Krusskal I-Wallis H test was performed for analysis, followed by a Dunn’s test for multiple comparisons and a p- value of <0.05 was taken as statistically significant. Results: The percentage of anemia among pregnant women of present study was 46.62%. In present study 58.3% of the pregnant women were found to have hypercupremia and 71.42 % of the anemic pregnant women had hypercupremia The relatively increased serum copper in iron deficient anaemic mothers could be a compensatory mechanism to counter-act anemia. Conclusions: A thorough biochemical analysis of haemoglobin, iron and Copper during pregnancy would therefore help us access the specific nutrient role and corrective measures thereof to deal with iron deficiency anaemia and successful pregnancy completion.
ABSTRACT
Neurological deficits are the rare but unacceptable complications of neuraxial blockade. We report three cases of vaginal hysterectomy performed under combined spinal epidural anesthesia [CSE] using 3 mlof 0.5% hyperbaric bupivacaine [15 mg] in subarachnoid space followed by epidural analgesia top up after wearing off of spinal anesthesia. One patient complained of unilateral paresthesia and numbness on left thigh with no motor involvement in the evening postoperatively, two patients developed bilateral paresthesia and numbness over anterior thigh and knees and motor weakness in both lower limbs on next day morning. Epidural catheter was removed immediately and treated with oral tab prednisolone and tab methylcobalamin. All patients had complete recovery and were discharged after a week. Unrecognised mechanical irritation of the nerve roots by epidural catheter is thought to be the cause. We conclude that patients with epidural catheter should be monitored and on appearance of any neurological symptoms the catheter be removed to prevent permanent neurological sequelae
Subject(s)
Middle Aged , Female , Humans , Anesthesia, Spinal , Paresthesia , Catheters , Hysterectomy , Lower ExtremityABSTRACT
BACKGROUND: Hospitalization for fever in cancer patients is associated with considerable morbidity, mortality, and cost. AIM: The aim of this study was to study the bacterial spectrum and susceptibility patterns of pathogens in culture positive patients from the oncology unit of our hospital. METHODS: We retrospectively reviewed the medical records of patients admitted in our cancer center (medical, radiation, and surgical oncology) from January to December 2013. Blood and respiratory secretions from the indoor patients were evaluated. RESULTS: Of the total 693 samples, 76.4% were Gram‑negative and 23.6% were Gram‑positive. The most common bacterial isolates among Gram‑negative organisms in blood were Escherichia coli, Salmonella and among the Gram‑positive organism were Staphylococcus aureus and Enterococcus. Among the blood isolates extended spectrum of beta‑lactamase, multidrug‑resistant (carbapenem‑resistant) and pan resistant bugs were seen in 47%, 15%, and 5% of the blood isolates. Among the Gram‑positive organisms, 25% respiratory isolates were vancomycin‑resistant Enterococci. CONCLUSION: We observed a high incidence of Gram‑negative isolates with clinically significant resistance to first‑line antibiotics such as cephalosporin’s, piperacillin tazobactum, and fluoroquinolones.
ABSTRACT
Zinc (Zn) has been shown to be an essential micronutrient for all organisms including plants, animals and human beings. Deprivation of zinc arrests growth and development and produces multiple system dysfunctions in all these organisms. Because of the involvement of this micronutrient in so many core areas of metabolism, it is common that the features of zinc defi ciency in humans are nonspecifi c with a wide range including growth retardation, alopecia, diarrhea, delayed sexual maturation and impotence, eye and skin lesions and even impaired appetite. Clinical features and laboratory criteria are not always consistent. Th is inconsistency poses a major diffi culty in the search to reliable yet sensitive clinical or functional indicator of zinc status for validation. Further, it has become clear now that the homeostatic mechanisms fall short of perfection and clinically important features of zinc defi ciency can occur with only modest degrees of zinc defi ciency. In this review article we try to look critically at the available tests and various indicators for assessment of zinc’s level for potential requirement and eff ectiveness and try to conclude about the effi cacy of each.
Subject(s)
Humans , Micronutrients , Zinc/administration & dosage , Zinc/blood , Zinc/deficiency , Zinc/metabolism , Zinc/physiologyABSTRACT
Surgical tourniquets are commonly used in orthopaedic and trauma surgery, but these have their complications. Reperfusion injury following simultaneous release of bilateral tourniquets is the most likely explanation of cardiac arrest in this case. We describe an unusual complication experienced by a 40 year old, 65 kg healthy male who underwent surgery for trauma to the lower extremity [bilateral fracture tibia]. Bilateral mid-thigh tourniquets [Esmarch bandage] were applied, which were simultaneously released after 90 min. After 5 min of tourniquet release sudden severe hypotension occurred followed by cardiac arrest. Patient was immediately intubated and cardio pulmonary cerebral resuscitation [CPCR] was started. We conclude that bilateral tourniquet application can be hazardous within the safe limit of tourniquet time [<2 hours] and their simultaneous release should be avoided. Moreover, Esmarch tourniquet may generate very high uncontrolled pressures and should be avoided
ABSTRACT
Postdural puncture headache [PDPH] in children has rarely been registered, but some recent studies indicate that children may also develop headache after lumbar puncture
We report two cases of PDPH that occurred in male children aged 6 yr [20 kg] and 10 yr [25 kg] who received subarachnoid block under sedation for herniotomy using 27 G Quincke spinal needle at L4-L5 space with 0.5% hyperbaric bupivacaine at a dose of 0.3 mg/kg
They developed typical postural headache after 24 hr and 48 hr respectively
They were successfully managed with complete bed rest, forced hydration, coffee drink twice, oral analgesics; and were discharged uneventfully
We conclude that now a days spinal anesthesia is being used in children and PDPH can occur in this population which can be treated on same lines as in adults
We believe that parents need to be informed about PDPH as there is inability of children to verbalise this pain
ABSTRACT
Early assessment of the severity of an acute cerebral lesion secondary to hypoxia-ischemia or other pathologic conditions may provide a very useful basis for preventive or therapeutic decisions in pediatric patients. In the present review, we discuss the diagnostic and prognostic value of a series of biochemical parameters, with special reference to the diagnosis of neonatal HIE. Currently many specific biochemical markers of brain injury are being investigated to assess regional brain damage after perinatal asphyxia in neonates of which serum protein S-100β, brain-specific creatine kinase, neuron-specific enolase, IL6 and urinary uric acid levels appear promising in identifying patients with a risk of developing hypoxic-ischemic encephalopathy. Whether detection of elevated serum concentrations of these proteins reflects long-term neurodevelopmental impairment remains to be investigated.
ABSTRACT
Circumscribed choroidal hemangiomas are rare ophthalmic entities that cause diminution in vision due to accumulation of subretinal and/or intraretinal fluid in the macular area. Various treatment options ranging from conventional laser to photodynamic therapy have been employed to destroy the tumor and reduce the exudation; however, either the inability to penetrate through the exudative fluid or the collateral retinal damage induced by these treatment modalities make them unsuitable for lesions within the macula. We evaluated the role of intravitreal bevacizumab, a pan-vascular endothelial growth factor (VEGF) inhibitor, in reducing the sub- and intraretinal fluid in three patients with circumscribed choroidal hemangiomas. All the patients had complete resolution of the serous retinal detachment that was maintained till at least 12 months after the first injection. Intravitreal bevacizumab may be used in combination with thermal laser or photodynamic therapy in treating circumscribed choroidal hemangiomas with subretinal fluid.