Morphometric Analysis Of Typical Thoracic Vertebrae And Its Clinical Relevance

Background: The frequent surgical interventions of thoracic spine are more common due to a wide array oftraumatic, degenerative and neoplastic diseases. For successful surgical management of these conditions, adetailed anatomical knowledge of the thoracic vertebrae is required.Aim: The aim of this study was to present a morphometric reference database for Pedicle morphometry of typicalthoracic vertebrae in Indian population.Material and methods: The study was conducted on 120 dry human typical (T2-T8) thoracic vertebrae selectedfrom the bone bank of the Department of Anatomy, SGT Medical College Hospital and research institute, Gurugram.Linear measurements of the vertebrae were taken with the help of digital Vernier caliper .Statistical Analysis:Mean and standard deviation of the morphometric parameters taken into account were analyzed. The comparisonof morphometric dimensions of the right and left sides was performed using Student’s t-test and p-value wascalculated.Results: The morphometric analysis of the thoracic vertebrae demonstrated that the Pedicle height (PH) was10.35 ± 1.22 mm and Pedicle Width (PW) was 5.65±2.06mm.Conclusion: The results provide a comprehensive database for more accurate modelling and design of vertebralbody implants and instrumentations for Indian population.

Evaluation of Patients of Acute Pain in Abdomen Attending the Emergency Medicine Department at SSG Hospital, Baroda.

Background: Present study was aimed to study the clinical pattern, etiology and management outcomes of patients presenting with acute pain in abdomen in the Emergency Medicine Department (EMD), SSG Hospital. Aims: 1) To study Acute Pain in Abdomen, and various clinical presentation of acute abdominal pain in patients attending casualty at S.S.G.hospital. 2) to compare clinical judgment with radiological, intraoperative, and histopathological findings. Methods: A prospective observational study of total 700 patients was carried out from January 2013 to October 2013. All patients of acute pain in abdomen, except pregnant women & penetrating /blunt abdominal injury, comes to EMD in the casualty, at SSG Hospital were included. Results: Majority of female patients presented with generalised, colicky (predominantly) or dull aching pain, in mild to moderate intensity, within three days of onset of pain; while majority of male patients presented with generalised, dull aching (predominantly) or colicky pain, in severe to excruciating intensity, after the three days of onset of abdominal pain. Conclusion: In our study, majority of patients presenting to EMD with Abdominal Pain were male and belong to age group of 21-50 years. Patients with generalised abdominal pain and Left Upper Quadrant pain were found to be having Nonspecific Abdominal Pain. Patients diagnosed as Acute Pancreatitis had come with pain in periumbilical area, Epigastric region, & back; while patients with Right Upper Quadrant, Right Lower Quadrant and Flank pain turned out to be Acute Cholecystitis, Acute Appendicitis, and Ureteric Colic, respectively. Patients with generalised abdominal pain, nausea, vomiting and fever were found to be having Acute Appendicitis. Patients diagnosed as Bowel Obstruction had come with Abdominal Distension and Constipation; with anorexia, were diagnosed Nonspecific Abdominal Pain; with jaundice, were diagnosed Liver Abscess; with burning micturition, all were diagnosed Nonspecific Abdominal Pain.

Impact of different doses of lead on internal organs of quails.

Lead (Pb) is the most ancient poison known to man. In the present study, amount of accumulation of Pb in liver, kidney, ovary and testes of rain quail was studied using different doses of lead. Spectrophotometric analysis of heavy metal treated organs was carried out to determine the amount of metal accumulation in these organs. LD50 value was 4 ppm. Dose of lead was given in three ranges of low, medium and high. It was observed that testes (< or =6.8 x 10(-6)) mgkg(-1)day(-1) and ovary (< or =7.5 x 10(-6)) mgkg(-1)day(-1), accumulated low amount from different doses when given continuously for 21 days. In contrast to this, liver (< or =9.2 x 10(-6)) mgkg(-1)day(-1) and kidney (< or =9.3 x 10(-6)) mgkg(-1)day(-1) accumulated the maximum amount of metal when treated for the same number of days. This study is quite unique and astonishing as the period for intoxication is short (21 days) as compared to the long ones (91 days and above). Our results show that generally metal accumulation is highest in liver, while it is low in gonad.

Effect of prenatal exposure of alcohol in the morphology of developing rat embryo.

The objective this study was to observe the morphological changes in developing rat embryo exposed to alcohol in utero. Virgin female Wistar rats in experimental group (n=15) were given 20% (v/v) alcohol two weeks before mating and throughout the gestational period through oral route. The controls (n=15) were also maintained and were given the tap water. On gestational day 15 (GD15) and 19 (GD19), five rats from each group were sacrificed by cervical dislocation and the abdomen was incised to expose the uterine horn. The number of implantation sites and resorptions were counted and recorded. The body weight and length of the fetuses were also recorded. The litter size and body weight of the newborn were also recorded at the time of birth from the remaining dam. The incidence of resorption was higher in alcohol treated group than in control which was found to be 25% and 8.7% at days 15 and 19 respectively. The body weight and length of fetuses were found to be decreased and was significant at GD15 (p<0.001 for weight and p<0.05 for length). Similarly, the litter size and body weight of newborn were also found to be decreased significantly (p<0.05 for litter size and p<0.01 for body weight). The present study shows that the maternal consumption of alcohol during pregnancy has adverse effect on fetal viability and development of growing embryo.

Effect of methotrexate (MTX) administration on spermatogenesis: an experimental on animal model.

An experiment was conducted to observe histomorphometric and cellular toxicity on rat testes after sixty days of methotrexate administration intraperitoneally (ip). Total 30 adult male rats were divided into one control and two experimental groups containing 10 rats in each group. Experimental groups received methotrexate in two different doses i.e 25 ig and 50 ig, whereas control one received normal saline intraperitoneally. At the end of the experiment, animals were sacrificed and testes were processed for paraffin sectioning and stained in haematoxylin and eosin. Further microscopic study of seminiferous tubules, interstitial spaces, primary spermatocytes and spermatids were carriedout. Results revealed decreased diameter of seminiferous tubules, increased interstiial spaces in experimental groups in dose dependent manner and found to be statistically significant (p < 0.05) as well as distortion of morphology of Leydig cells in experimental group. Therefore, it can be concluded that these qualitative and quantitative changes in male gonads may alter the reproductive performance of animals.

Nosocomial pneumonia in a pediatric intensive care unit.

BACKGROUND: Nosocomial pneumonia (NP) is the second most common hospital acquired infection. Understanding the pattern of occurrence, risk factors and etiological agents of NP in a PICU, is essential for developing effective infection control measures. This prospective observational study was conducted in a PICU of a tertiary care teaching hospital, to determine the incidence, etiology and risk factors for NP. MATERIALS AND METHODS: Patients admitted to the PICU, over a period of 1 year who had endotracheal (ET) intubation, were enrolled consecutively into the study. Demographic details were recorded at the time of inclusion. Diagnosis of NP was based on CDC criteria (1988).Semiquantiative assay of endotracheal aspirate (ETA) with a colony count of > 10(5) cfu/mL was taken as evidence of infection. Colonisation was defined as isolation of organism with <10(5) cfu/mL. Age, nutritional status, number and duration of intubations, duration of mechanical ventilation, sedation, nasogastric feeding were the risk factors studied for development of NP. Intubation attempts of more than one were defined as reintubation. Risk factors found significant on univariate analysis, were subjected to multiple regression analysis to determine the most important predictors of NP. RESULTS: The study group comprised of 72 children with a median age of 3.7 years and boys: girls ratio of 1.9:1.Twenty two of 72 (30.5%) developed NP; the predominant isolates from ETA were Acinetobacter anitratus(12), Pseudomonas aeruginosa (5), Klebsiella sp(3) and Staphylococcus aureus and E.coli(1) each. Additionally 18(39%) had evidence of ET colonization, with Acinetobacter sp being the commonest 9(50%). Re-intubation, prolonged duration of intubation and mechanical ventilation were the significant risk factors on univariate analysis for development of NP.On multiple regression analysis, reintubation was the only independent risk factor for NP(OR 0.72, 95%CI 0.55-0.94).Overall mortality was 21%(15/72);7(47%)of these deaths were secondary to NP. CONCLUSIONS: NP developed in nearly one third of the intubated patients; Gram negative organisms were the predominant etiological agents and associated with high mortality. Re-intubation, prolonged duration of intubation and mechanical ventilation were the significant risk factors on univariate analysis for development of NP. On multiple regression analysis, reintubation was the only independent risk factor for NP.

Risk factors for renal injury in patients with meningomyelocele.

PATIENTS AND METHODS: Thirty operated patients of myelodysplasia were clinically evaluated for the age at presentation, the extent of lesion and neurological deficit. Urological assessment was done with urine cultures, serum creatinine, radiological (ultrasound of kidney, ureters and bladder, voiding cystourethrogram) and urodynamic (water cystometry) parameters. An objective scoring for bladder (Galloway, et al.) was applied. Dimercapto-succinic acid (DMSA) scan was done in all the patients for evidence of renal scars. The results of above investigations were correlated with presence or absence of renal scars (renal injury) on DMSA scan. None of the patients had received any prior bladder care. RESULTS: Twenty one patients had no renal scars and 9 patients had evidence of renal scarring. Patients with renal scars were older at presentation, they had greater degree of hydroureteronephrosis (P < or = 0.001) and vesicoureteric reflux (P < or = 0.005). The incidence of high leak pressures (>25 cm of water, P < or = 0.05), unacceptable bladder volumes (maximum cystometric capacity < 60% for age, P < or = 0.005) and high risk Galloway's score (> 5, P < or = 0.05) was high in patients with associated renal scarring as compared to their nonscarred counterparts. Three of these patients had serum creatinine >1 mg/dl (P < or = 0.005). The incidence of urinary complaints and positive urine cultures was also higher in these patients (NS). CONCLUSION: Increasing age, evidence of hydroureteronephrosis and vesicoureteric reflux, high leak pressures, low bladder volume and high combined Galloway score (>5) define a high risk bladder in our population and predispose to renal injury in patients of myelodysplasia. Early referral for bladder risk assessment and management of all myelodysplasia patients is recommended.

Development of pharmacophoric model of condensed pyridine and pyrimidine analogs as hydroxymethyl glutaryl coenzyme A reductase inhibitors.

Quantitative structure-activity relationship (QSAR) has been established on a series of thirty-eight compounds of four different sets of condensed pyridine and pyrimidine analogs, for their hydroxymethyl glutaryl coenzyme (HMG-CoA) reductase inhibitor activity, in order to understand the essential structural requirement for binding with receptor, in terms of common biophoric and secondary sites employing APEX-3D software. Among several 3D pharmacophoric models with different sizes and arrangements, one model was selected based on r2 = 0.8, chance<0.001, match equivalent to 0.38 and all the 38 compounds were considered. The results suggest that hydrophobicity, hydrogen acceptor and optimum steric refractivity play a dominant role in the inhibition of HMG-CoA reductase. The information obtained from the present study can be used to design and predict more potent molecules as HMG-CoA reductase inhibitors, prior to their synthesis.

Mucoepidermoid carcinoma of the bronchus: is conservative surgery always justified?

A case of mucoepidermoid carcinoma of the bronchus in a 7-year-old boy is reported. The patient underwent right pneumonectomy. Histologically, the tumor was a low-grade muco-epidermoid carcinoma arising from the bronchus with lymph node metastasis in the drainage area. Presence of lymph node metastasis in this low-grade tumor suggests the possibility of early progression of disease in what has until now been considered a very slow growing tumor. Aggressive surgery may be necessary in these situations.

In vivo hepatoprotective activity of active fraction from ethanolic extract of Eclipta alba leaves.

The alcoholic extract of fresh leaves of the plant Eclipta alba (Ea), previously reported for is hepatoprotective activity was fractionated into three parts to chemically identify the most potent bioactive fraction. The hepatoprotective potential of the fraction prepared from extract was studied in vivo in rats and mice against carbon tetrachloride induced hepatotoxicity. The hepatoprotective activity was determined on the basis of their effects on parameters like hexobarbitone sleep time, zoxazolamine paralysis time, bromosulphaline clearance, serum transaminases and serum bilirubin. Fraction EaII (10-80 mg/kg, p.o.) containing coumestan wedelolactone and desmethylwedelolactone as major components with apigenin, luteolin, 4-hydroxybenzoic acid and protocateuic acid as minor constituents exhibited maximum hepatoprotective activity and is the active fraction for hepatoprotective activity of Eclipta alba leave. The acute toxicity studies have shown that like Ea, Fraction EaII also high safety margin.

Effect of amniotic sac puncture on parturition in rat.

Pregnant Charles Foster rats were subjected to amniotic sac puncture on day 15 of gestation and the effect was observed on parturition. All the control rats as expected delivered on day 22 of gestation. In the group where all the sacs were punctured, only 12.5% rats delivered on day 22 while rest either failed to deliver (62.5%) or died (25%). In the group with unpunctured sacs at vaginal ends, 75% rats delivered on day 21 while 25% on day 22. In the group with unpunctured sacs at ovarian ends, 75% rats delivered on day 23 and rest 25% failed to deliver. The resorption rates ranged between 61 to 94% in different groups. Malformations were observed only in one pup. The results suggest that amniotic sac puncture interferes with parturition in the form of either failure or delayed parturition. Nonpatency of the birth canal due to puncture induced fetal deaths and tissue adhesions were presumed to be the contributing factors.

Angioembolisation in vaginal vascular malformation.

Vaginal arteriovenous malformations are rare entities and their most common presentation is vaginal haemorrhage. This case report describes a 22-year-old woman who presented at 20 weeks of gestation with slow growing soft and tender swelling at anterior vaginal wall. Diagnosis was confirmed as vaginal vascular malformation on contrast enhanced magnetic resonance imaging. The mass did not subside after delivery and patient developed dyspareunia. It was successfully treated by angioembolisation using polyvinyl alcohol particles. Angioembolisation being safe and effective should be the treatment of first choice for symptomatic vaginal vascular malformation.

Platelet serotonin kinetics in acute myocardial infarction before and after thrombolysis.

Platelet count, platelet serotonin uptake and platelet serotonin content were analysed in 21 subjects consisting of 11 patients of evolving acute myocardial infarction (AMI) and 10 matched healthy controls before and after administration of streptokinase. Platelet counts were significantly reduced in AMI with a subsequent rise following thrombolysis. Platelet 5-HT uptake was also significantly increased in AMI and following thrombolysis, it showed a trend towards normalization. Platelet 5-HT content was significantly increased in AMI with no further significant change following thrombolysis. The results suggest that platelet activation as revealed by reduced platelet count and altered platelet serotonin kinetics, occurs in AMI and this activation is inhibited following thrombolysis. Further, it is also apparent that it is not the reperfusion but the thrombolytic agent that is responsible for inhibition of platelet activation.

Antihistaminic activity of quinethindole: a 2-substituted pyrazinopyridoindole derivative.

Quinethindole, a 2-substituted pyrazinopyridoindole, showed specific antihistaminic (H1) activity in various in vivo and in vitro test models. It also inhibited antigen-induced contraction of ileum of sensitized guinea pig. The antihistaminic activity was of competitive nature.

Antiparkinsonian activity and dopamine receptor binding studies of imidazolone derivatives.

Mannich bases and styryl derivatives of imidazolones were evaluated for their antiparkinsonian activity. Two compounds showed potent antiparkinsonian activity. These active compounds also showed binding with dopamine receptors in striatal membrane preparation of rat brain.

Role of cimetidine in prevention and treatment of stress induced gastric bleeding in neonates.

Gastric bleeding from stress ulcers in acutely sick infants frequently signals impending mortality. This study was carried out to evaluate the efficacy of cimetidine in preventing and treating stress ulcers in such neonates. One hundred babies were included in this study. Out of this, 32 babies were given prophylactic cimetidine and 68 neonates acted as controls. It was observed that the babies on prophylactic cimetidine fared better than controls. In the second part of study, 77 neonates with clinical evidence of hemorrhage were included, 43 were put on cimetidine and 34 acted as controls. It was observed that babies on cimetidine therapy showed a better response. The gastric bleeding stopped earlier, and more babies responded favourably to this therapy. Use of cimetidine in stress induced bleeding in high risk neonates is recommended.