Anatomical Variation of Palmaris Longus: Tendinous Origin and Fleshy Insertion.

A tendinous origin and fleshy insertion of palmaris longus muscle was observed in the left forearm during routine dissection which was performed on adult male cadaver in the department of Anatomy, Dr. Rajendra Prasad Government Medical College. It was having long tendinous origin from the medial epicondyle of the humerus and the surrounding deep fascia. It was fusiform at the lower middle of the forearm. The fleshy muscular insertion was noted to the flexor retinaculum and few muscular fibers interdigitate with flexor carpi ulnaris muscle and palmar aponeurosis. The length of tendon was 19 inches and fleshy muscular length was 11inches. Themedian nerve and ulnar nervewas covered by this fleshy insertion. This palmaris longus variation is helpful for the surgeon and the radiologist, orthopaedic, plastic surgeon during any diagnosis of the forearm because this fleshy part of muscle can compress the median nerve and ulnar nerve or it can be mistaken as a tumor or ganglion during radiological or clinical examination.

Validation of a job aid to rule out pregnancy among family planning clients in Nicaragua

In Latin America, one of the most common barriers to family planning access is denial of services to women who present at clinics in the absence of menses. Where pregnancy tests are unavailable, many providers fear that nonmenstruating women may be pregnant and, worrying about possible harm to the fetus, require the woman to await the onset of menses before initiating a contraceptive method. In 2005, during a randomized trial of oral contraceptive users in Nicaragua, we assessed a job aid endorsed by the World Health Organization to help providers exclude pregnancy among family planning clients. Among 263 new, nonmenstruating clients, the job aid ruled out pregnancy for 60 percent of the women. Only 1 percent of the women were pregnant, and no woman identified by the job aid as "not pregnant" was pregnant. Provider fears that nonmenstruating clients are pregnant are usually misplaced, while fears that hormonal methods can harm fetuses are exaggerated.

En América Latina, uno de los obstáculos más frecuentes para acceder a los servicios de planificación familiar es la negativa a atender a las mujeres que se presentan en las clínicas sin menstruación. Cuando no hay pruebas de embarazo disponibles, muchos profesionales piensan que las mujeres sin menstruación visible pueden estar embarazadas y por temor a ocasionar algún daño al feto les exigen esperar hasta el inicio de la menstruación para comenzar con algún método anticonceptivo. En 2005, durante un ensayo aleatorizado con usuarias de anticonceptivos orales en Nicaragua, se evaluó una lista de verificación avalada por la Organización Mundial de la Salud para ayudar a los profesionales sanitarios a descartar el embarazo en las mujeres que solicitan servicios de planificación familiar. Este procedimiento permitió descartar el embarazo en 60 por ciento de las 263 mujeres sin menstruación que solicitaban por primera vez ese servicio. Solamente 1 por ciento de las mujeres estaban embarazadas y ninguna de las identificadas por este procedimiento como "no embarazada" lo estaba. El temor de los profesionales de la salud de que las mujeres sin menstruación estén embarazadas es frecuentemente infundado y los temores de que los métodos hormonales puedan dañar al feto son exagerados.