Morphometric Study Of Distance Between Posterior Superior Iliac Spine And Ischial Tuberosity Of The Human Hip Bone

Objective: To do study the distance between Posterior superior Iliac Spine and Ischial tuberosity (PSIS-IT) of human hip bone for determination of sex. Methods: The study comprised unpaired 272adult human hip bones of known sex. The posterior superior iliac spine and ischial tuberosity were identified in all the hip bones and a slidingcaliper was used to measure the distance between them. Results: The raw data obtained was statistically analyzed. Range, mean, standard deviation and standard error of mean were determined for parameter. Conclusion: It was observed that out of 272 hip bones taken for study 160 were of males and 112 were of females. The Mean distance in males was observed to be greater in comparison to females. Statistically calculated t- test reveals that the parameter taken for study is very highly significant in terms of sex differentiation.

Study of Diaphyseal Dominant and Secondary Nutrient Foramina in Fibula: its Clinical Relevance in Vascular Bone Graft Surgery.

Background: The external opening of the nutrient canal, usually referred to as the nutrient foramen has a particular position in each bone. An understanding of the position and number of the nutrient foramina in fibula is important, as this is one of the most common bones used in bone grafts, vascularized bone microsurgery and mandibular reconstruction. Nowadays fibula flap is the most accepted flaps used in the mandibular reconstruction especially in the malignancy of oral and oropharyngeal regions. Materials and Methods: The present study was conducted in 160 dry human fibula obtained from department of Anatomy, N.S.C.B. Medical college Jabalpur {M.P.}. We have measured the different parameters in each bone according to standard method. Result: In our study we found that 95% bones possess single dominant nutrient foramina. According to Foraminal Index (FI), the position of most of foramina [97%] was fall in Type 2 (middle third of the fibula). The mean foraminal index (FI) was 39.66±5.29. The average total length (TL) of fibula was 35.80±2.53. Conclusion: To conclude that our study provides detailed data about the position and number of nutrient foramina of fibula that is considered as a determining factor for the success of new techniques for bone transplant and resection in orthopaedics.

Genetic polymorphism in Plasmodium falciparum: Differentiation of parasite isolates of high & low virulence by RAPD.

Background & objectives: The increase in Plasmodium falciparum infections which are associated with severe and complicated malaria and drug resistance has made control of malaria a difficult task. Extensive genetic polymorphism in P. falciparum has been reported from several parts of the world which affects the efficacy of sub-unit vaccines. The knowledge of genotypes of the parasite in a geographical region is therefore, important for effective management and control. The aim of the present study was to investigate the usefulness of random amplified polymorphic DNA (RAPD)-PCR technique for differentiation of P. falciparum isolates from patients presenting with severe (cerebral malaria) and mild malaria. Methods: Genetic polymorphism in 21 P. falciparum isolates obtained from patients found positive for P. falciparum by light microscopy was studied by RAPD-PCR analysis. Eleven RAPD primers were used for analysis of 21 P. falciparum isolates obtained from cerebral and non-cerebral malaria patients. Results: Of the 11 primers, only three (E-4, E-8, and R-8) produced useful polymorphic patterns. The cluster analysis based on UPGMA demonstrated that isolates causing cerebral malaria cluster separately from those causing uncomplicated malaria. However, the analysis of phylogenic tree showed that P. falciparum isolates causing non-cerebral and cerebral malaria clustered separately but showed relatedness. Interpretation & conclusions: The results of the present study showed that the RAPD-PCR was able to differentiate the isolates causing severe and mild malaria. The cluster analysis of the phylogenic tree suggested that the virulent strains evolved from less virulent strains as it clustered separately. RAPD technique may be useful in discriminating between the different isolates of the same species resulting in different clinical profiles.

From two-dimensional to three-dimensional conformal radiotherapy in prostate cancer: An Indian experience.

Background: Sparse data from India are available regarding the outcome of prostate cancer treatment. We report our experience in treating prostate cancer with radiotherapy (RT). Materials and Methods: This study included 159 men with locally advanced cancer treated with RT with or without hormone therapy between 1984 and 2004. The median RT dose was 70 Gy over 35 fractions. Eighty-five patients received whole pelvic RT and prostate boost, and 74 patients were treated with 3-dimensional conformal radiotherapy (3DCRT) to prostate and seminal vesicles alone. Results: The median follow-up was 25 months and the freedom from biochemical failure for all the patients at 5 years was 76%, disease-free survival (DFS) 59.1%, and overall survival (OAS) was 70.1%. The risk stratification (91% vs 52%, P < 0.03) and RT dose (72.8% for dose > 66 Gy vs 43.5% for dose < 66 Gy; P = 0.01) affected the DFS. DFS at 5 years was better in the group receiving 3DCRT to prostate and seminal vesicles (78% vs 51.5%; P = 0.001) and was reflected in OAS as well (P = 0.01). Conclusion: CRT technique with dose escalation results in significant benefit in DFS and OAS in locally advanced prostate cancer.

Adjuvant radiation therapy in gall bladder cancers: 10 years experience at Tata Memorial Hospital.

INTRODUCTION AND PURPOSE: In gall bladder cancers, even after curative surgery, survivals are dismal and loco-regional failure accounts for 40-86%. Although these are considered radio-resistant, adjuvant radiation, with or without chemotherapy, has been tried to improve loco-regional control and overall survival rates. With an aim to evaluate the natural history of gall bladder cancers, role of radiation therapy (RT) and prognostication, a retrospective analysis was undertaken. MATERIALS AND METHODS: Between 1991-2000, 60 patients with gall bladder cancer, treated with radical intent, were evaluated. Patients details including history, physical examination, liver function tests, ultrasonography of the abdomen and chest X-ray; and CT scan Abdomen if done, were noted. In patients who underwent surgery, surgical details, histopathology and pathological staging, were recorded. The details of post-operative adjuvant treatment, including radiation therapy details, as well as chemotherapeutic agents, number of cycles and type of infusion [bolus/infusion], were noted. RESULTS: Sixty patients underwent surgery. On histopathological staging, 28 patients (46.5%) had stage II, 19 (32%) had stage III, 12 (20%) had stage-I and 1 patient had stage IV disease. Thirteen (21%) patents did not receive any adjuvant treatment, 32 (53%) patients received adjuvant RT alone, 8(14%) received post-operative CT+RT and 7 (12%) patients received CT alone. With a median follow-up of 18 months (12-124 months), 27 (45%) patients were disease free, 11 (19%) had local failures, 7 (11%) had loco-regional, 7 (11%) loco-regional+distant, 4 (7%) distant and 4 (7%) patients had local+distant failures. The Overall Disease Free Survival (DFS) and overall survival was 30% and 25%, at 5 years, respectively. Stage grouping ('P' = 0.007), Pathological T ('P' = 0.01) had significant impact on DFS on univariate analysis, where as histological grade ('P' = 0.06) showed trend towards significance. CONCLUSION: Gall bladder cancers are aggressive and lethal. Early diagnosis and curative surgery, followed by appropriate adjuvant radiation therapy, may improve survivals, with no established consensus till date. Following curative surgery, pathological T stage and stage grouping, are the significant prognostic factors for outcome.

Shock wave treatment in medicine.

Extracorporeal shock wave therapy in orthopedics and traumatology is still a young therapy method. Since the last few years the development of shock wave therapy has progressed rapidly. Shock waves have changed the treatment of urolithiasis substantially. Today shock waves are the first choice to treat kidney and urethral stones. Urology has long been the only medical field for shock waves in medicine. Meanwhile shock waves have been used in orthopedics and traumatology to treat insertion tendinitis, avascular necrosis of the head of femur and other necrotic bone alterations. Another field of shock wave application is the treatment of tendons, ligaments and bones on horses in veterinary medicine. In the present paper we discuss the basic theory and application of shock waves and its history in medicine. The idea behind using shock wave therapy for orthopedic diseases is the stimulation of healing in tendons, surrounding tissue and bones.

Change in distribution & antifungal susceptibility of Candida species isolated from candidaemia cases in a tertiary care centre during 1996-2000.

BACKGROUND & OBJECTIVES: As a marked increase in the number of patients with candidaemia was reported in the first half (1991-1995) of the last decade at the Postgraduate Institute of Medical Education & Research, Chandigarh, India, the present study was aimed at determining further change if any, in the incidence and distribution of Candida species and their antifungal resistance pattern during the second half (1996-2000) of the same decade. METHODS: The patients with candidaemia were studied to determine the frequency of candidaemia and Candida species isolated during 1996-2000. One hundred Candida strains other than Pichia anomala (C. pelliculosa) were randomly selected from those isolates to evaluate antifungal susceptibility pattern against amphotericin B, 5-fluorocytosine, ketoconazole, fluconazole and itraconazole. The results were compared with our previous study. RESULTS: An increase in the number of patients with candidaemia was observed during 1996 (538) and 1997 (421) compared to 1998-2000 due to P. anomala outbreak. With the control of the outbreak, a substantial decrease in the incidence of candidaemia was observed from 1998 (251 in 1998, 122 in 1999 and 165 in 2000). A higher isolation of non-C. albicans Candida species (89.8%) was observed, with C. tropicalis being the most common (541, 36.1%) agent. No major change in the isolation rate of other non-C. albicans Candida species (C. guilliermondii, C. krusei, C. glabrata and C. parapsilosis) was observed. An emergence of resistance to amphotericin B in 15.4 per cent C. albicans, 8.1 per cent C. tropicalis and 33.3 per cent C. krusei strains was observed. An increase in resistance to ketoconazole (from 0% to 13%) and 5-fluorocytosine (from 1% to 8%) and a decrease to fluconazole (from 13% to 6%) were observed. Resistance to itraconazole was observed in 17 per cent of Candida strains by broth macro-dilution method. INTERPRETATION & CONCLUSION: A change in the isolation of Candida species was observed i.e. in the incidence and isolation of non-C. albicans Candida species. Emergence of resistance to amphotericin B and increase of resistance to most other antifungals are cause for concern.

Solid--cystic papillary tumor of pancreas.

A case of Solid and Cystic Papillary Epithelial Tumor of Pancreas displaying low grade malignancy occurring in a 38 years old female is presented. It is a rare condition and could be diagnosed histopathologically after complete excision.

Retroperitonial, teratoma as fetus in fetu--a case report.

We report a rare case of Retroperitonial teratoma containing Axial Skeleton long bone. Jaw, pelvis & scapula in a 27 yrs old male. Aberration in monozygotic twinning may rarely present as Fetus in Fetu. Rarer is presentation in Adult.

Hodgkin's disease relapse presenting as Pancoast's syndrome.

Among the various infrequent causes of Pancoast's syndrome, Hodgkin's disease is one. A 26 year old man was diagnosed as Hodgkin's disease. Five years later the disease relapsed producing Pancoast's syndrome. The importance of precise aetiological diagnosis before treatment of such cases with similar presentation is emphasized.