Consistency and percentage agreement of preoperative surface marking of subcutaneous foreign body by colour comet tail artefact with its intra-operative positional findings – A prospective study

Background: Exact surface localization of foreign body is vital prior to its surgical removal. Preoperative localization errors lead to excessive soft tissue exploration, prolonged surgery, increased morbidity and post-surgical complications. Sarkar KN, Mandal SK, Kabiraj P, Mallik R, Gupta DK, Sarkar M. Consistency and percentage agreement of preoperative surface marking of subcutaneous foreign body by colour comet tail artefact with its intra-operative positional findings - A prospective study. IAIM, 2016; 3(6): 32-41. Page 33 Aim: Determination of percentage agreement of preoperative surface marking of subcutaneous foreign body by colour comet tail artefact with its intra-operative positional findings. Materials and methods: Prospective observational study was conducted on 100 patients over duration of eight months from September 2015 to April 2016 at our institution. Preoperative surface marking of foreign body was done using Ultrasound machine PHILIPS HD7 (2.0.1) with 7 MHz linear transducer, Excel mark premium black stamp ink 2oz, Acco smooth steel wire paper clip, Trade mark 45 cm wooden measuring scale and Apsara glass marking pencil. Percentage agreement of preoperative surface marking of subcutaneous foreign body by colour comet tail artefact with its intraoperative positional findings was studied in 100 patients prospectively. All analysis was done by using IBM SSPS statistics 24 and MS Excel. Results: The color tail artifact technique showed percentage agreement of 93.5% for accurate surface marking of vertical line within ≤ 5 mm of actual location and percentage agreement of 92.5% for surface marking of horizontal line within ≤ 5 mm of actual location. Conclusions: Blind surgical procedures of foreign body removal have been replaced by real time ultrasound guided removal under strict sterile conditions in most of the affluent nations. However in developing nations and semi urban places where there is limited and underrated sterilization and disinfection technique, real time ultrasound procedures for foreign body removal remains a challenging option. This study shall suffice to the needs of developing nations and semi urban places with precise preoperative surface localization, advantages of minimal surgical exploration, minimal local tissue injury, reduced patient’s morbidity and no real time ultrasound associated nosocomial infection. The study shall also be helpful with special emphasis to those underserved villages where surgeons still rely on blind foreign body removal procedures, causing massive tissue exploration, increased hospital stay, increased cost of treatment, failure of removal and increased patients morbidity.

Fetal kidney length as a parameter for gestational age determination and its comparative evaluation with other fetal biometric indices

Background: An accurate estimation of foetal gestation age is of utmost clinical significance owing to its vast clinical implications principally in management of high risk pregnancies. Aim: To determine correlation and regression coefficient of foetal kidney length as a parameter for gestational age and to do its comparative evaluation with other foetal biometric indices. Materials and methods: A Prospective observational study was conducted on 200 women aged between 18 to 35 years with normal singleton pregnancies, over a duration of six months from December 2015 to May 2016. Gestational age and fetal kidney length was determined using Ultrasound machine PHILIPS HD7 (2.0.1) with 3- 5 MHz curvilinear transducer. Statistical analysis was done using tests of correlation and simple linear regression. All analysis was done by using IBM SSPS statistics 24and MS excel. Results: Pearson’s correlation coefficient value of 0.99 and regression coefficient or slope 1.0 noted between gestational age and fetal kidney length with a significance P< 0.001. Bardhan J, Ghosh SK, Sarkar KN, Sarkar M. Fetal kidney length as a parameter for gestational age determination and its comparative evaluation with other fetal biometric indices. IAIM, 2016; 3(8): 36-44. Page 37 Conclusions: Fetal kidney length shows a positive correlation with fetal gestational age, with a linear growth rate throughout pregnancy irrespective of underlying medical condition like intrauterine growth retardation. This study shall prove its worth in cases of engaged fetal head, where it is difficult to measure fetal bi parietal diameter and head circumference as well as in cases of intrauterine growth retardation, macrosomia and malformation where abdominal circumference measurement gives false values.