ABSTRACT
Foramen ovale, situated in the greater wing of sphenoid, posterolateral to the foramen rotundum, transmits the sensory and motor root of mandibular nerve, accessory meningeal artery, emissary vein and lesser petrosal nerve to the infratemporal fossa. The normal shape of the foramen is oval, but its shape and size is quite variable. It plays an important role in the diagnostic and surgical procedures related to the middle cranial fossa. So, knowledge of the variations, dimensions and the topographic location is of importance to the neurosurgeons while dealing with surgeries in this region. Our study aims at finding the morphological variations in shape, dimensions of foramen ovale and its location in relation to the zygomatic arch.METHODSA cross-sectional observational study was carried out over a period of one year from 1/6/2018 to 31/5/2019, on 46 adult human skulls, taken from the department of Anatomy, RIMS, Ranchi. Fully dried, intact, adult human skulls were included in the study. Foramen ovale was observed for variation in shape, size and location. The presence of any accessory bony structure like bony plate, spine or septa was looked for and prevalence noted. The maximum antero-posterior length and width of foramen ovale and its distance from articular tubercle and the anterior root of zygomatic arch were measured using Vernier callipers. Pathologically malformed and damaged skulls were excluded from the study.RESULTSFour types of shapes were observed – oval (76.08%) , almond (5.43%) , semilunar (8.69%) and triangular (9.78%). The mean anteroposterior dimension of foramen ovale was 6.96 ± 1.17 mm (6.89 ± 1.28 mm on the right side & 7.02 ± 1.05 mm on the left side) and the mean transverse dimension was 3.35 ± 0.66 mm (3.25 ± 0.57 mm on the right side, 3.45 ± 0.73 mm on the left side) . The mean distance of foramen ovale from articular tubercle on zygomatic arch was 32.58 ± 1.29 mm (32.41 ± 1.10 mm on the right side, 32.74 ± 1.45 mm on the left side) and from anterior root of zygomatic arch was 24.75 ± 1.70 (23.91 ± 0.85 mm on the right side, 25.59 ± 1.92 mm on the left side).CONCLUSIONSThere is no significant average difference between FO_AP_RT – FO_AP_LT. There is no significant average difference between FO Width_RT - FO_Width_LT. There is a significant average difference between FO to Art. Tubercle Right - FO to Art Tubercle left. There is a significant average difference FO to ant. root Right - FO to ant. root left.
ABSTRACT
Background: Trauma represents a major challenge worldwide and is the leading cause of morbidity and mortality in young population. There is significant change in trauma related injuries due to urbanization, motorization, industrialization and the socioeconomic changes in India. Road traffic accidents (RTA) pose the largest threat to human lives and have become the number one public hazard all across the world causing morbidity and mortality. The aim of this study is to find out the demographics and to determine the injury pattern of surgical trauma cases presenting to this tertiary care zonal hospital.Methods: A prospective observational study was conducted in a tertiary care zonal hospital from June 2018 to December 2018. Data was collected for 105 patients presented with trauma in surgical emergency centre of this hospital were included in the study which excluded only orthopaedic trauma cases. The data collected was analysed.Results: Out of 105, 76 (72.38%) were male and 29 (27.61%) were female with 21 (20%) in the 31-40 age group. The average age of cases was 40.2 years. RTA was the major cause of trauma i.e. (77.14%) followed by accidental fall and slips (18.09%) and assaults (4.76%). Contusion was the common injury sustained (45.71%) followed by laceration (38.09%), abrasion (35.23%) and fracture (17.14%).Conclusions: There is a need for trauma registries which can help to formulate strategies towards decreasing the burden of trauma and improved outcomes at hospital as well as in public health.
ABSTRACT
The objective of the study was to document the bladder behaviour in response to rehabilitation intervention in patients with traumatic spinal cord injury (SCI) using urodynamic study (UDS). Additionally, it also aimed to compare the nature of the bladder in a rehabilitated and non- rehabilitated neurogenic bladder of traumatic SCI. Study design: The study adopted a prospective follow-up design. Setting: Department of Physical and Rehabilitation Medicine, Jawahar Lal Nehru Medical College and Hospital (JLNMCH), Bhagalpur, Bihar, India. Methods: One hundred and thirty traumatic SCI patients mean age 31.3±7.8 years, 113 males and 17 females, admitted for rehabilitation were done UDS to see the bladder behaviour in response to rehabilitation intervention and compare the nature of bladder of the rehabilitated and that of the non-rehabilitated neurogenic bladder. Result: There were significant changes in the max. cystometric capacity (p=0.019) after rehab intervention in upper motor neuron (UMN) neurogenic bladders. The compliance, Pdet. at first desire to void and Pdet. at max. cystometric capacity were also found to have significant correlations (p=0.010, 0.010 and 0.013 respectively) in those with UMN neurogenic bladders. However, the volume at the first desire to void did not show significant changes after rehabilitation intervention (p=0.54). Significant decrease in amplitude and frequency was found in involuntary contractions (detrusor hyper-reflexia). In lower motor neuron (LMN) neurogenic bladder significant changes after rehabilitation intervention was found only in the max. cystometric capacity (p=0.015). Conclusion: Based on these findings we conclude that the change in the nature of the rehabilitated neurogenic bladder is different with the type of bladder.
ABSTRACT
Background: Planter fasciitis is an injury of unknown origin in more than 80% cases. It affects quality of life as well as daily activity of the patients. Various surgical procedures, autologous blood and steroid injection also have been applied without constant success. Platelets rich plasma have been found effective in various orthopedically disorders like osteoarthritis, tennis elbow etc. That is why the present study was designed to compare the efficacy of platelets rich plasma injections and steroidal injections for the treatment of planter fasciitis. Methods: The present interventional study was conducted fromJuly 2016 to June 2018. Study population was divided into groups. Group I included patients (n=40) of a single ultra sound guided platelets rich plasma injection whereas, group II contained patients (n=40) with a single ultra sound guided depomedrol 40 mg injection. Scores of VAS and AOFAS were recorded at the initial level and follow ups after the injections. Follow up examinations were done at 6 weeks, 6 months and 12 months. Results: There was a significant improvement in mean VAS scores of platelet rich plasma group patients (1.8) compare to corticosteroid injection group patients (3.4) after one year of the treatment. However, results showed that steroids failed to show long term decrease in VAS score (p<0.05). Mean AOFAS was significantly increased (64.4) in the steroid group at 6wks as in comparison of platelet rich plasma group (52.2). Conclusion: Findings of the present study showed that improvement in steroid group was faster but benefits were lost in longer run. In contrast, platelets rich plasma was more effective in sustaining the long term beneficial effects.
ABSTRACT
Background: Gallstone disease is a significant health problem world over (in both developing and developed nations). The incidence of gallstone disease increases after age of 40years and it becomes 4-10 times more common in old age. As many as 16% and 29% of women above the age of 40-49 years and 50-59 years, respectively, had gall stones. Laparoscopic cholecystectomy introduced in 1985 has become the procedure of choice for surgical removal of the gallbladder. The aim is to compare laparoscopic cholecystectomy and open cholecystectomy in patients of cholelithiasis by measuring parameters such as use of post-operative analgesia, operative time, post-operative hospital stays, morbidity, mortality and patient satisfaction.Methods: It is a prospective randomized study of 120 patients of cholelithiasis aged between 20years to 80years operated during 2015-2018 at of Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India. They were divided into open and laparoscopic Cholecystectomy groups by drawing a lottery.Results: The median (range) operation time for laparoscopic cholecystectomy was 55-155 min (mean=102 min) and 40-105 min (mean=72 min) for open cholecystectomy (p <0.001). Form LC group 5 cases had to be converted to OC. Rate of conversion was 5/60=8.3% which is within limits of worldwide laparoscopic cholecystectomy conversion rate of 5% to 10%. LC was found to be superior to OC.Conclusions: Laparoscopic cholecystectomy is better than open cholecystectomy However, open cholecystectomy is preferable in cases of complicated cholecystectomy.
ABSTRACT
Objectives: CLVs play an important role in prevention and treatment of diarrhoea. However, only a small proportion of the cases treated by these semi-literate CLVs are reported and fed into the Health Management Information Systems (HMIS). Micronutrient Initiative capacitated and equipped semiliterate female CLVs to report on childhood diarrhoea cases as part of the ‘Reducing deaths from diarrhoea’ in the Indian state of Bihar. Methods: Simple pictorial reporting tools that could be used by semiliterate CLVs were developed, pilot tested and provided to 42,258 CLVs. Hands-on training was undertaken for the CLVs and their capacities were continuously enhanced through an appropriate supportive supervision mechanism. Results: In 15 demonstration districts between 2011 to 2013, a total of 1,037,910 diarrhoea cases have been reported treated in the public sector of which 55% of the cases were treated by CLVs. Majority of the above cases were not being reported previously. The successful demonstration has encouraged the state government to scale-up the involvement of CLVs in reporting on childhood diarrhoea through use of pictorial tools. However, 64% of CLVs do not report regularly due to non-availability of tools and poor accountability. The programme is considering strengthening of supportive supervision and provision of incentives to improve compliance to reporting. Conclusions: Reporting from CLVs is feasible by providing simple reporting tools and imparting them training to use the tools along with continuous follow-up and handholding. Improved reporting of childhood diarrhoea cases treated by CLVs is useful in informing program decisions and initiating corrective action.
ABSTRACT
Objectives: The Government of India introduced guidelines on therapeutic supplementation of zinc in the management of childhood diarrhoea in the year 2007, but programmatic constraints delayed its introduction into public health programs. Micronutrient Initiative, with support from a donor, initiated a program in 2010 to demonstrate and scale-up the use of zinc through public sector channels, in the state of Bihar. Methods: The project was implemented in 15 demonstration districts with a population of 36 million. Over 40,000 community level health workers were oriented on use of zinc. Support was provided to strengthen procurement and supply chain mechanisms. A robust system of monitoring and evaluation was introduced to track performance. Meaningful engagement with the government ensued throughout the demonstration phase. Results: Use of Community-level volunteers (CLVs) is a pre-requisite to scaling-up access to care. More than one-million children were reported to be provided care. The CLVs need to be engaged through a relevant supportive supervision model. Supply chain mechanisms need to be strengthened to prevent stock-outs at service delivery points. Simple reporting tools need to be introduced for improved case- reporting. Conclusions: It is feasible and viable to introduce and scale-up therapeutic zinc supplementation as an adjuvant to ORS in the management of childhood diarrhea through public sector channels. The community-based approach of service delivery and proactive engagement with the government are key essentials in achieving the above objectives.
ABSTRACT
Objectives: The Government of India introduced guidelines on therapeutic supplementation of zinc in the management of childhood diarrhoea in the year 2007, but programmatic constraints delayed its introduction into public health programs. Micronutrient Initiative, with support from a donor, initiated a program in 2010 to demonstrate and scale-up the use of zinc through public sector channels, in the state of Bihar. Methods: The project was implemented in 15 demonstration districts with a population of 36 million. Over 40,000 community level health workers were oriented on use of zinc. Support was provided to strengthen procurement and supply chain mechanisms. A robust system of monitoring and evaluation was introduced to track performance. Meaningful engagement with the government ensued throughout the demonstration phase. Results: Use of Community-level volunteers (CLVs) is a pre-requisite to scaling-up access to care. More than one-million children were reported to be provided care. The CLVs need to be engaged through a relevant supportive supervision model. Supply chain mechanisms need to be strengthened to prevent stock-outs at service delivery points. Simple reporting tools need to be introduced for improved case- reporting. Conclusions: It is feasible and viable to introduce and scale-up therapeutic zinc supplementation as an adjuvant to ORS in the management of childhood diarrhea through public sector channels. The community-based approach of service delivery and proactive engagement with the government are key essentials in achieving the above objectives.
ABSTRACT
We evaluated the antioxidant status of 82 healthy term low birth weight (LBW) newborns and equal number of gestation and sex matched controls weighing <2500 g by measuring vitamin A and E, superoxide dismutase, catalase and glutathione peroxidase in cord serum. Levels of vitamin A and E, superoxide dismutase and catalase were significantly lower and glutathione peroxidase significantly higher in LBW babies compared to controls, with the lowest levels found in babies showing more severe growth restriction (<2000 g). We conclude that LBW newborns are deficient in several important antioxidants which may predispose them to higher oxidative stress.