ABSTRACT
Introduction: The scapula (shoulder blade) is a triangular flat bone that lies on the posterolateral aspect of thethorax. The scapula bears various angles namely superior, inferior, lateral, medial, acromial and coracoidangle. The three borders meet strategically to form the referenced three angles (lateral, superior, and inferior. Itslateral angle, truncated and broad, bears the glenoid cavity which articulates with the head of the humerus at theglenohumeral joint. The morphology of the glenoid cavity is highly variable. The glenoid rim presents a notch inits upper and front partMaterials and Methods: This study included thorough observation of 120 dry human scapulae, 67 from left sideand 53 from right side, obtained from department of Anatomy, Sri Guru Ram Rai Institute of medical and healthsciences Dehradun following standard guidelines. All the metric and non metric parameters were observed andrecorded in tabulated form.Results: The mean length of scapula of left side was observed as 127.35±12.35 and right side was 128.10±11.21.Thetotal mean value for length of scapula was noted as 130.21±12.65 . The mean breadth of scapula was recordedas 96.98±7.62mm. The mean value of scapular index was listed as 68.47±3.98 . The mean of infraspinous lengthwas recorded as 99.14±9.54 and the infraspinous index was 99.65±8.32.The mean AP glenoid diameter 1 was24.54±2.65mm, the mean AP glenoid diameter 2 was 16.56±2.45mm and the mean AP glenoid diameter 3 was17.09±2.75 The shape of the glenoid cavity was recorded as type 1(oval) 17.50%, Type2 (pear) 48.14%,Type3(inverted coma) and Type4(other).Conclusion: To summarize, the present study provides a base line data of different scapular dimensions on theleft and right sides. Knowledge of the measurements and indices of various parameters of scapula such aslength, width and various parameters of glenoid cavity can be used for comparative anatomy and also fordefining the race.
ABSTRACT
Objective To compare the effectiveness of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of large (>10 cm diameter) liver abscesses. Methods Seventy-two patients with liver abscess (amebic 48, pyogenic 24) were randomly allocated to PCD or PNA (36 each), which were done within 24 hours of admission. Both groups received parenteral antibiotics for at least 10 days. PNA was repeated every third day if the cavity size had not declined to 50% of the original for up to three times. Persistence of cavity or of clinical symptoms was considered failure of treatment. Duration to attain clinical relief, duration of hospital stay, complications, treatment failure, and deaths were recorded. Results PNA was successful in 31 of 36 (86%) patients (one aspiration in 10, two in 18, and three in 3 patients), whereas PCD was successful in 35 (97%) patients (p=ns). Duration to attain clinical relief (10.2 [2.0] vs. 8.1 [2.7] days; p=0.02) and parenteral antibiotics needed (15.5 [1.1] vs. 10.9 [2.7] days; p=0.04) were significantly lower in PCD group. Duration of hospital stay was similar in the two groups. One patient with PNA had a subcapsular hematoma and one with PCD had continuous bile leakage which stopped spontaneously. One patient in PCD group died. Conclusion PCD is a better treatment option than PNA for the management of large liver abscesses of size >10 cm, in terms of duration to attain clinical relief and duration for which parenteral antibiotics are needed.