Ponticuli In Atlas Vertebrae And Its Clinical Aspect

Background: Atlas, the first cervical vertebra, has an oblique ligament which bridges the groove for vertebralartery. This ligament may ossify sometimes converting groove into foramen. These foramina are called asponticulus posterior or arcuate foramen of the atlas. The ponticuli can distort vertebral artery. They havetendency to cause vertebra basic insufficiency. During any manipulation of cervical spine, these variations ofatlas should be kept in mind.Objectives: To study the presence of ponticuli, their other features like whether complete or incomplete, unilateralor bilateral, sidedness- right or left.Material and Methods: A total of 50 fully dried adult human atlas were collected from the Department ofAnatomy, Government Medical College, Jammu and from the students of the first year MBBS, Government MedicalCollege, Jammu. Bones were intact and free from osteophytes. The superior surface of posterior arch was observedcarefully in each atlas for presence of ponticulus.Results: In the present study, 50 human atlas vertebrae were observed out of which 4 atlas (8%) had ponticuli. Itwas incomplete in 2 vertebrae (4%) and was complete in 2 atlas vertebrae (4%). It was unilateral in 3 atlasvertebrae (6%) and bilateral in 1 atlas vertebra (2%). 2 ponticuli were on the right side, 1 on left side and 2 werefound on both sides. All were ponticuli posterior except one which was lateral ponticulus.Conclusion: The presence of ponticuli can cause cervical pain and pressurize vertebral artery leading tocerebrovascular accidents. Detailed knowledge about the variations in the cervical region is very helpful toneurosurgeons, orthopaedicians and otolaryngologists to avoid any mishap. Spinal surgeons must be fullyaware about these ponticulus to prevent any complications during surgeries

The Floating Upper Limb: Multiple Injuries Involving Ipsilateral, Proximal, Humeral, Supracondylar, and Distal Radial Limb

Floating arm injury represents a common yet complicated injury of the childhood severely associated with limb deformation and even morbidity, if not precisely addressed and credibly operated. Here, we report a rare floating upper limb case of a 9-year-old boy with multiple injuries of ipsilateral proximal humeral, supracondylar and distal radial limb. This is the first report to document such a combined floating elbow and floating arm injury in the same limb. In this report, we discuss the surgical procedures used and recovery of the patient monitored to ascertain the effectiveness of the method in limb reorganisation.

Prevalence of HBsAg and anti-HCV antibodies in poly-transfused- beta-thalassaemia major children in Lahore

To determine the prevalence of HBsAg and Anti-HCV antibodies in polytransfused thalassaemic children at two different Thalassaemia Centres i.e. The Institute of Haematology and Blood Transfusion Service [IHBTS] Punjab, Lahore and The Thalassaemia Centre at Sir Gangaram Hospital, Lahore. To compare the prevalence of these markers between two centres. To determine association of sero-positivity with number of transfusions. It is a cross sectional study. All information was gathered by questionnaire. Blood samples of 150 thalassaemic patients were collected from two different thalassaemia centres and sera were screened for HBsAg and Anti-HCV antibodies by ELISA technique. SPSS version 16 was used to analyze the data. Chi-square was applied to determine the association between number of transfusions and sero-positivity. The prevalence of HBsAg and Anti-HCV antibodies was 0% and 68% respectively among the patients of IHBTS. 1% and 43% patients were positive for HBsAg and Anti-HCV antibodies respectively at Thalassaemia Centre at Sir Gangaram Hospital. The overall prevalence of HBsAg and Anti-HCV antibodies was 0.66% and 51.3% respectively. Prevalence of anti-HCV was more at IHBTS. An association was observed in increasing number of transfusions and increasing positivity of patients for Anti-HCV [p-value = 0.018]. There is a need to focus on our health safety managements. A higher prevalence of Anti-HCV was observed due to weak infrastructure of health care centres or blood banks