Tobacco use patterns among women in reproductive age group: a cross sectional study in the rural area of Belgaum district, Karnataka, South India

Background: Tobacco imposes a colossal burden of disease and death leading to catastrophic health, social, economic, and environmental effects. “Tobacco” kills both men and women but sex-specific differences exist. Traditional forms of tobacco like dentifrice or tobacco tooth powder and betel quid, tobacco and lime mixture are commonly used and also, the new products use is increasing not only among men but even among children, teenagers, women of reproductive age. This study was done to know the patterns and other correlates of tobacco use among the rural women in the reproductive age group.Methods: A community based cross sectional study, conducted from January 2011 to December 2011 among 1200 rural women aged between 15 years to 49 years residing in primary health centre, Vantmuri area, Belgaum, Karnataka, India. Statistical analysis was done using rates, ratios and chi-square tests.Results: Tobacco consumption was seen in 9.7% of the study participants. A very high percentage of 79 (67.5%) had more than 10 years of exposure to tobacco amongst the users. Dentifrice was the most common form of tobacco used (85.5%) followed by 32 (27.4%) plain tobacco consumption. However, 49 (4.1%) consumed multiple forms of tobacco, most common being dentifrice along with plain tobacco or paan with beetelquid or used snuff.Conclusions: The distribution of tobacco consumption is likely to maintain, and perhaps increase, the current considerable socioeconomic differentials in health in India. Dual users are at much higher health risks than those who consume the individual tobacco product. It also emphasizes the variations in patterns of using tobacco among rural women. There is a need for periodical surveys using more consistent definitions of tobacco use and eliciting information on different types of tobacco consumed.

The Study On Correlation Of Dermatoglyphics And Schizophrenia

Background: Dermatoglyphics is the study of quantitative and qualitative patterns of ridges in palms and soles.It is being investigated in diseases having genetic basis. The recent evidence from adoption studies has provideda basis for the genetic contributions in schizophrenia. The present conducted to study the finger and palmardermatoglyphic patterns in schizophrenics and to compare dermatoglyphic configurations of schizophrenicswith the normal population.Materials and Methods: The ink and pad method was followed to take finger and the palm prints. The palmarprints of 50 schizophrenic patients and 50 normal individuals of both the sexes were collected for the study.Results: There is statistically significant decrease in frequency of arches in schizophrenics when compared tocontrols, whereas frequency distribution of radial loops, ulnar loops and whorls are not significant. Increase inI4 interdigital pattern is statistically significant in schizophrenics when compared to controls. There is increasein the mean values of total finger ridge count in male, female and combined series of male and femaleschizophrenics and decrease in absolute finger ridge count in male and combined series of male and femaleschizophrenics, while there is decrease in female schizophrenics, when compared to controls. Atd angle isdecreased in both the hands of male schizophrenics and right hand of female schizophrenics as compared tocontrols, whereas it is equal in the left hand of schizophrenics and controls. There is increase in the mean ridgecount in III, IV and V digits in the right hand of male schizophrenics.Conclusion: There are significant differences in the schizophrenics in various dermatoglyphic features, whencompared to controls. Hence it is possible to identify the ‘at risk’ population with the help of dermatoglyphics.

Morphological Study on Shapes of Pterion.

Background: Pterion is defined as an H-shaped small circular area formed by the junction of four bones: frontal, parietal, temporal and sphenoid on norma lateralis of the skull, Pterion junction has been used as a common extra-cranial landmark for surgeons in microsurgical and surgical approaches towards important pathologies of this region. Pterion is an important landmark for anterior branch of middle meningeal artery, Broca’s motor speech area to the left, insula, the lateral cerebral fissure, for the pathologies of optic nerve, orbit, sphenoidal ridge and for the anterior circulation aneurysm and tumors, because of its clinical importance we focused our present study on morphology of shape of pterion. Materials and Methods: A total of 500 pterions were examined from 250 adult dry skulls. The present study was undertaken in adult south Indian skulls from different regions of south India, from different medical colleges. We have observed different shapes of pterion like sphenoparietal frontotemporal, stellate and epipteric. Results: The sutural morphology of the pterion and asterion is important in surgical approaches to the cranial fossae. 250 human skulls of known gender (148 male, 102 female) were examined on both sides. Four types of pterion were observed – sphenoparietal 72.8%, frontotemporal 16.4%, stellate 8.8% and epipteric 2%. Conclusion: The pterion is points of sutural confluence seen in the norma lateralis of the skull. The patterns of formation exhibit population based variations. The sutural morphology of the pterion is important in surgical approaches to the cranial fossae. These findings may helpful in surgical approaches and interventions via the pterion.

A study on complications in ultrasound guided catheterization of the internal jugular vein.

Background: With the advanced knowledge in medical monitoring, ever increasing value has been placed on the establishment of central venous catheter. During the past few years, monitoring of central venous pressure has become an important aid in the management of critically ill patients. Doppler ultrasound was first used to assist central venous catheter insertion in 1984. Ultrasound has been applied to describe the anatomy of the IJV and to evaluate various techniques for percutaneous cannulation. Real time sonography improves access to the vein compared with the traditional method. Ultrasound guided cannulation limits complications and also the decreases the cannulation time. For reducing the complication in traditional method we have conducted the study through ultrasound guide and observed the complications in new method. Methods: Thirty critical care patients were selected for IJV cannulation either by ultrasound guided technique. This study conducted in department of anesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. Results: In our study there was 100% success rate for first attempt cannulation in USG technique. The mean access time in USG technique was 152.50 ± 63.90 sec. in USG technique arrhythmias were noted in 1 (3.3%) case during the study. No cases of haematoma, pneumothorax, haemothorax, nerve Injury, carotid artery puncture and catheter malposition were noted during the study in USG technique. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure.

study on complications in land mark technique catheterization of internal jugular vein.

Background: The traditional methods of using anatomic landmarks to guide cannulation of the IJV have yielded various rates of successful access and complications. Moreover, central venous catheterization requires considerable expertise. Cannulation of the IJV was first described in 1969. Various positions were used to access cannulation but they were frequently associated with complications such as arterial puncture, pneumothorax, neurological damage, infection, dysrhythmias, atrial thrombus, cardiac rupture. Methods: Thirty critical care patients were selected for IJV cannulation either by Land mark technique. This study conducted in department of anaesthesiology and critical care, M. S. Ramaiah medical college, Bangalore. India. Results: In our study there was 83.3% success in LMG technique. The mean access time was 323.23 ± 146.19 sec and the distribution of complications encountered during the study, Carotid artery was accidentally punctured in 1 (3.3%) cases. In LMG technique, there were no cases of arrhythmias, haematoma, pneumothorax, haemothorax, nerve injury and catheter malposition were noted during the study. Conclusion: Land mark technique catheterization of internal jugular vein was shown complications than newly developed ultrasound guided method.

A Comparative Study between Ultrasound Guided Catheterization of the Internal Jugular Vein and Classical Land Mark Technique.

Background: Catheterization of Internal Jugular Vein (IJV) is commonly attempted to obtain central venous access for hemodynamic monitoring, long term administration of fluids, total parenteral nutrition and hemodialysis in critical care patients. The safe puncture of the IJV is achieved by using anatomical land marks on skin surface. Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, decreasing access time and decreasing complications. Material andMethods: Sixty critical care patientswere selected for IJV cannulation either by landmark technique or by ultrasound guided technique in two groups of thirty each. Results: In our study there was 100% success rate for first attempt cannulation in USG technique and where as it was 83.3% in LMG technique. The mean access time in USG technique was 152.50 ± 63.90 sec as against 323.23 ± 146.19 sec in LMG group. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure.

Study of Lateral Circumflex Artery.

Background: The lower limb arteries are commonly involved with peripheral occlusive arterial diseases and the femoral artery at femoral triangle is widely used for certain clinical procedures like arterial catheterization, as it can be readily accessed. Lateral circumflex femoral artery is a laterally running branch given off near the root of the profunda femoris. It supplies blood to head and neck of femur, greater trochanter, vastus lateralis and knee. It has many implications in clinical practice, it is used in an anterolateral thigh flap, aortopoplitial bypass, coronary artery bypass surgery, extracranial- intracranial bypass surgery. Methods: 50 adult lowerlimbs were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Dissection of femoral triangle was carried out according to Cunningham’s manual. Site and mode of origin of the branches of femoral artery were studied, configuration of the femoral origin lateral circumflex femoral artery and its prevalence were studied. Results: out of 50 cases Lateral circumflex femoral artery took origin from profunda femoris in 45 specimens and from the femoral artery in 5 specimens. Conclusion: The knowledge of normal origin and variation of lateral circumflex femoral artery is very valuable in preventing iatrogenic injury to these vessels during surgical procedures of femoral triangle. As medial and lateral circumflex femoral arteries supply blood to head and neck of femur, it is important to avoid injuring them during surgery of hip joint to prevent necrosis of femoral head. Lateral circumflex femoral artery has many implication in clinical practice. It is used in an anterolateral thigh flap.

Study of Medial Circumflex Artery.

Background: The proper knowledge of the course and ramification of blood vessels of lower limbs is very important for surgeons and interventional radiologist. Medial circumflex femoral artery usually originates from posteromedial aspect of the profunda femoris, but often originates from femoral artery itself. It has an important role in supplying blood to femoral neck and head, fatty tissue in acetabular fossa and used in flaps reconstructive surgery. Methods: 50 adult lowerlimbs were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Dissection of femoral triangle was carried out according to Cunningham’s manual. Site and mode of origin of the branches of femoral artery were studied, configuration of the femoral origins of medial and lateral circumflex femoral artery and their prevalence were studied. Results: Out of 50 extremities, Medial circumflex femoral artery took origin from profunda femoris in 41 specimens and from femoral artery in 9 specimens. Conclusion: The knowledge of normal origin and variation of medial circumflex femoral artery is very valuable in preventing iatrogenic injury to these vessels during surgical procedures of femoral triangle.

Study of Posterior Division of Internal Iliac Artery.

Background: The internal iliac artery originates from the common iliac artery at the level of sacroiliac joint. The internal iliac artery descends posterior to the greater sciatic foramen thereby dividing into anterior and posterior divisions. The posterior division of the internal iliac artery is known to give rise to three main branches i.e. iliolumbar artery, lateral sacral artery. Accidental haemorrhage is common during erroneous interpretation of anomalous blood vessels. The knowledge of the normal and the abnormal anatomy of the branches of the internal iliac artery is essential for obstetric surgeons. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: Out of 50 specimens, ilio-lumbar artery took origin from posterior division, directly in 22 specimens (44%), with obturator artery in 5 specimens (10%) and with superior gluteal artery in 2 specimens (4%). From anterior division, with obturator artery in 6 specimens (12%) and with inferior gluteal artery in 1 specimen (2%). From common trunk, as direct branch in 10 specimens (20%), with lateral sacral artery in 1 specimen (2%), with vertebral branch in 1 specimen (2%), with superior gluteal artery in 1 specimen (2%) and was found to be absent in 1 specimen (2%). Posterior division of internal iliac artery given origin directly to superior gluteal artery in 44 specimens (88%), with ilio-lumbar artery in 1 specimen (2%), with obturator artery in 2 specimens (4%). Lateral sacral artery from posterior division was observed in 38 specimens (76%) and unpaired origin was observed in 7 specimens (14%). Conclusion: Internal iliac artery supplies the pelvic viscera and musculature the knowledge of its branches helpful in pelvis surgeries.

Study of Variations In Anterior Division of Internal Iliac Artery.

Background: The internal iliac artery is the chief pelvic artery. It supplies to the all pelvic viscera, musculoskeletal part of the pelvis. The branches of the anterior trunk of the internal iliac artery are the superior and inferior vesical, middle rectal, vaginal, obturator, uterine, internal pudendal and inferior gluteal. Knowledge of internal iliac artery is very helpful in pelvic surgery practice. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: Middle rectal artery took origin from anterior division in 42 specimens (84%), most frequently with internal pudendal artery in 32 specimens (64%) and was found to be absent in 8 specimens (16%). The obturator artery took origin most frequently from the anterior division of Internal iliac artery in 36 specimens (72%), from posterior division in 9 specimens (18%), from external iliac artery in 1 specimen (2%) and from inferior epigastric artery in 3 specimens (6%). The superior vesical artery, inferior vesical artery, uterine artery, vaginal artery and superior gluteal artery were found to be constant in their origin and course. Conclusions : The branches anterior division of internal iliac artery shows multiple variations, knowledge about these variation are helpful in pelvic surgeries.

Morphological Study of Internal Iliac Artery.

Background: The internal iliac artery is the “artery of the pelvis”. It supplies most of the blood to the pelvic viscera, gluteal region, medial thigh region and perineum. A severe and potentially lethal complication in pelvic surgeries is arterial bleeding commonly involving the branches of internal iliac artery. While operating on pelvic organs, the knowledge of internal iliac artery and its variations is important for surgeons. The present study was conducted to study of morphology of internal iliac artery. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: The classification of branching pattern of internal iliac artery was based on modified Adachi classification. Out of the 50 specimens studied, Type Ia arrangement was found in 52% of the specimens, Type III in 34%, Type IIa and type V was found in 2% each, Type IV was not found in any of the specimens and 10% of the specimens could not be classified because of the absence of inferior gluteal artery in them. Adachi Type Ia arrangement was the most frequent finding. The obturator artery took origin most frequently from the anterior division of internal iliac artery. Middle rectal artery was not constant. Conclusion: The internal iliac artery morphology shows multiple variation the knowledge is very helpful during pelvic surgeries.

Morphological Study of Obturator Artery.

Background: The obturator artery normally arises from the anterior trunk of internal iliac artery. High frequency of variations in its origin and course has drawn attention of pelvic surgeons, anatomists and radiologists. Normally, artery inclines anteroinferiorly on the lateral pelvic wall to the upper part of obturator foramen. The obturator artery may origin individually or with the iliolumbar or the superior gluteal branch of the posterior division of the internal iliac artery. However, the literature contains many articles that report variable origins. Interesting variations in the origin and course of the principal arteries have long attracted the attention of anatomists and surgeons. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: The obturator artery presents considerable variation in its origin. It took origin most frequently from the anterior division of internal iliac artery in 36 specimens (72%). Out of which, directly from anterior division in 20 specimens (40%), with ilio-lumbar artery in 5 specimens (10%), with inferior gluteal artery in 3 specimens (6%), with inferior vesical artery in 2 specimens (4%), with middle rectal artery in 1 specimen (2%), with internal pudendal artery in 4 specimens (8%) and with uterine artery in 1 specimen (2%). The obturator artery took origin from the posterior division of internal iliac artery in 9 specimens (18%), from external iliac artery in 1 specimen (2%), from inferior epigastric artery in 3 specimens (6%) and was found to be absent in 1 specimen (2%).

Correlation Between Endocranial Capacity and Size of Foramen Magnum with Special Reference to Sex.

Background: Endocranial capacity is an important parameter in the study of human evolution, race and sex determination of skull. Diameters of foramen magnum are important because vital structures passing through it may endues compression and for sex determination of skulls. Correlation between endocranial capacity and area of foramen magnum was reported in mammals. This relation in human can be used to determine sex of damaged skulls. Methods: 150 dry skulls and 30 CT scan images of living subjects were studied. Endocranial capacity of skulls was measured by modified Breitinger’s method. Diameters of foramen magnum were measured by vernier calipers and its area was calculated by formula endocranial capacity of CT scan images measured by planimetry. Diameters and area of foramen were measured automatically. Results: The Mean endocranial capacity of male and female skulls were 1367.3ml and 1255.2ml respectively by modified Breitinger’smethod and by CT scan image planimetry method were 1347.1ml and 1130ml. The mean longitudinal diameter of foramen magnum in male was 33.4mm and female was 33.1mm and by CT Imaging method in male was 38.5mm and female was 35.2mm. The mean transverse diameter of foramen magnum in male was 28.5mm and female was 27.3mm and by CT Imaging method in male was 29.1mm and female was 27.6mm. Conclusion: Endocranial capacity, transverse diameter and area of foramen magnum of male skulls were greater than females. A significant positive correlation was observed between endocranial capacity and area of foramen magnum in male and female skulls, but highly significant positive correlation was observed when both sexes were considered together. Living subjects showed a significant positive correlation between endocranial capacity and area of foramen magnum when both sexes were considered together.

Morphometric Analysis of Foramen Magnum.

Background: Diameters of foramen magnum are important because vital structures passing through it and for sex determination of skulls. The dimensions of the foramen magnum are clinically important because vital structures passing through it may endure compression such as in cases of foramen magnum herniation, foramen magnum meningiomas and foramen magnum achondroplasia. The knowledge of foramen magnum diameters is needed to determine some malformations such as Arnold Chiari syndrome, which shows expansion of transverse diameter. Objectives: To study longitudinal diameter, transverse diameter and area of foramen magnum in relation to sex. Methods: 150 dry skulls and 30 CT scan images of living subjects were studied. Diameters of foramen magnum were measured by vernier calipers and its area was calculated by formula. Diameters and area of foramen were measured automatically. Results: The mean longitudinal diameter of foramen magnum in male was 33.4mm and female was 33.1mm and by CT Imaging method in male was 38.5mm and female was 35.2mm. The mean transverse diameter of foramen magnum in male was 28.5mm and female was 27.3mm and by CT Imaging method in male was 29.1mm and female was 27.6mm. Conclusion: longitudinal and transverse diameters and area of foramen magnum of male skulls were greater than females.

Morphometric Analysis of Endocranial Capacity.

Background: Endocranial capacity is an important parameter in the study of human evolution, race and sex determination of skull. Endocranial capacity is an important parameter in the study of racial differences and in clinical practice for the study of the abnormalities of cranial size, it is one of the most important variable in the study of the human evolution. The objective of present study is to measure endocranial capacity of skulls. Materials and Methods: 150 dry skulls and 30 CT scan images of living subjects were studied. Endocranial capacity of skulls was measured by modified Breitinger’s method and CT scan imaging by planimetry method. Results: The Mean endocranial capacity of male and female skulls were 1367.3ml and 1255.2ml respectively by modified Breitinger’smethod and by CT scan image planimetry method were 1347.1ml and 1130ml. Conclusion: Endocranial capacity of male skulls were greater than females. The knowledge of endocranial capacities were help in neurosurgical, anthropology and forensic practice.