Incidence of Metopic Suture in Adult Human Crania in Uttar Pradesh

Introduction: Failure of ossification in the vertical direction between the two halves of the frontal bone is called a metopic suture; this suture is present in between the superciliary arch and tubers of the frontal bone so it is also called a median frontal suture. At birth, the frontal bone present is two half, in the 1st year they contact each other, and within the 7th to 8th year, they fused together. Sometimes, bones may not be fused completely and it becomes metopic fontanelle. MaterialsandMethods: The goal of the current study was to determine the prevalence of metopic suture in adult human skulls in Uttar Pradesh. One hundred and fifty macerated skulls of undetermined age and sex were used for this. The anatomical departments of Teerthankar Mahaveer Medical College and Research Center (Moradabad), King George Medical College (Lucknow), SRMS Institute of Medical Science (Bareilly), Govt. Medical College Kannauj, and Govt. Medical College Saharanpur provided these skulls. Results: This study has found the incidence of metopic sutures of about 12.90%. The two types of metopic sutures were found in this study, namely complete metopic suture 4.52% and incomplete metopic suture 8.38% in which found 0.64% “V” shape metopic suture. Conclusion: Themorphological study of metopic sutures on adult crania is useful for anatomists, experts in forensic medicine, and neurologists for performing surgical procedures in this area

A Comparative Study of Common Bile Duct Drainage by T-tube and Choledochoduodenostomy in Cases of Common Bile Duct Stones

To study and compare the cases of ‘T’-tube drainage and Choledochoduodenostomy done for Common Bile Duct stones. Methods : A prospective study was conducted from October 2019 – September 2021 (24 months including followup period) in patients diagnosed to have Choledocholithiasis in MGM Medical College and Hospital, Kishanganj, Total 50 patients were Included in this study. Those patients in whom CBD stones detected incidentally on investigation like Ultrasonography upper abdomen done for chronic calculus cholecystitis or detected during surgery for cholecystectomy ie, asymptomatic stones were also included in this study. Results : In the cases of our study, most of the patients (62%) didn’t has sludge. Choledochoduodenostomy was more frequently performed when sludge was present (P=0.043), whereas ‘T’-tube drainage was performed when sludge was absent. only 19 cases (38%) had sludge. And also it was present more commonly with larger diameter CBD (P value =0.016). Conclusion : In this study, both the surgical procedures did not produce any mortality. Some patients developed complications. This could be because much of the study population was elderly and most of the complications were noted in patient with acute cholangitis. In both the group, wound infection was noted to be most common complication. All of the patients treated conservatively successfully.

Factors Differentiating Multisystem Inflammatory Syndrome in Children (MIS-C) From Severe/Critical COVID-19 Infection in Children

Objective: To differentiate severe/critical coronavirus disease 2019 (COVID-19) infection from multisystem inflammatory syndrome in children (MIS-C). Methods: Single-center chart review comparing characteristics of children with MIS-C and ‘severe/critical’ COVID-19 infection. Multivariate logistic regression was performed to create predictive models for predicting MIS-C. Results: Of 68 patients, 28 (41.2%) had MIS-C while 40 (58.8%) had severe/critical COVID-19 infection. MIS-C patients had a higher prevalence of fever, mucocutaneous, cardiac and gastrointestinal involvement and a lower prevalence of respiratory symptoms (P<0.05). Significantly lower hemoglobin, platelet count, serum electrolytes, and significantly elevated inflammatory and coagulation markers were observed in MIS-C cohort. Upon multivariate logistic regression, the best model included Creactive protein (CRP), platelet count, gastrointestinal and mucocutaneus involvement and absence of respiratory involvement (performance of 0.94). CRP>40 mg/L with either platelet count <150x109 or mucocutaneous involvement had specificity of 97.5% to diagnose MIS-C. Conclusion: Elevated CRP, thrombocytopenia and mucocutaneous involvement at presentation are helpful in differentiating MIS-C from severe COVID-19.

Is it really Kocuria kristinae?: [Cartas al Editor] / Es realmente Kocuria kristinae?: [: [Cartas al Editor]

We read with interest the case report "Endocarditis bacteriana por Kocuria kristinae en un paciente inmunocompetente. Reporte de caso" by S.M. Rojas Molina, et al. The authors described about the Kocuria kristinae endocarditis in an immunocompetent woman. We agree that Kocuria kristinae is a rare organism and endocarditis caused by this organism is worth mentioning. However, there are certain questionable points in the report which we would wish to highlight and which need clarification.

Hemos leído con interés el informe de caso "Endocarditis bacteriana por Kocuria kristinae en un paciente inmunocompetente. Reporte de caso" de S.M. Rojas Molina, et al. Los autores describen la endocarditis por Kocuria kristinae en una paciente inmunocompetente. Estamos de acuerdo en que Kocuria kristinae es es un organismo raro y la endocarditis causada por este organismo es digna de mención. Sin embargo, hay ciertos puntos cuestionables puntos dudosos en el informe que nos gustaría destacar y que necesitan ser aclarados.

Analysis of success of vaginal birth after cesarean in relation to indication of primary caesarean section: a tertiary care experience

Background: Apprehensions related to vaginal birth after caesarean (VBAC) has reduced rates of successful vaginal trials over last decade. The objective of this study was to identify the indications of first caesarean section that can lead to a successful trial of labour in subsequent pregnancy.Methods: Retrospective cohort study was done between November 2014 and October 2017. Data from the case records was analysed.Results: Study over 3 years from 2014 to 2017 revealed fetal distress (82.7%),  breech (72.2%), transverse lie (66.7%), antepartum haemorrhage (56.2%) and twins with first non-cephalic (57.9%) have successful outcome of VBAC whereas obstructed labour (19.2%) and failed induction (18.4%) in previous pregnancy have poor outcome for VBAC.Conclusions: Attempts to allow trial of labour after one previous caesarean section with fetal distress, malpresentation and twins as indications of caesarean in previous pregnancy are safe and should be encouraged.

Development of Species-specific Polymerase Chain Reaction (PCR) Targeting on Mitochondrial D-loop for Identification of Buffalo and Goat Raw Meat

Abstract: Today's, consumers are concerned about the meat they eat and also demandaccurate labeling. Mitochondrial Analysis of DNA was the most frequently used DNA, becauseof its highly conserved sequences in various organism species. In this study, a rapid,reproducible and simple method for simultaneous identification of multiple meat species ina single step mitochondrial DNA based test has been developed based on the designing ofspecies-specific primer. Meat samples of goat and buffalo were selected to verify theapplicability of the technique. A species specific forward and reverse primer was designedwith the help of the primer3 tool for amplification of mitochondrial D-loop region. Thespecies-specific primers were verified in silico by SnapGene software. The two pairs ofprimers amplified the expected fragment of 338bp for buffalo and 450bp for goat. The changein the size of the PCR product was due to the existence of highly polymorphic regions withinthe buffalo and goat D-loop region. The tested species gives a unique band pattern for eachspecies by using successful amplification of these polymorphic regions in the D-loop region.Overall, the simplicity of amplification of mitochondrial D-loop region could make thistechnique suitable for meat authentication in routine analysis.

The Knowledge and Practice of Space Management among Dental Practitioners of Central India

Premature loss of primary teeth can result in the space loss leading to malocclusion. Space maintenance forms an integral part of preventive and interceptive orthodontics. Early interception and prevention of malocclusion in deciduous and early mixed dentition prevents the space loss, thereby, reducing or eliminating the need for later orthodontic treatment. Therefore, the present study was conducted to find out the knowledge and practice of space management among dental practitioners of Central India. Methods: A cross-sectional study was conducted among practicing dentist of Central India to find out their knowledge and practice of space management over the time period of 6 months. Ethical approval was obtained from the Ethical Committee. The questionnaire consisted of questions assessing four main categories; (a) Demographic data, (b) knowledge regarding space management, (c) practice of space maintainers. The demographic data included age, gender, educational level. Data were processed and analyzed using Excel (Microsoft Excel, Version 2013) and SPSS version 21.0 programs. Results: In our study total practicing dentist were 320 in which 190(59.37%) were male dentist and 130(40.62%) were female dentist. Participating dentist were of age <25 were 125(39.06%) and of age group 25-40 were 93(29.06%) and of age group 41-60 were 102(31.87%). 210 (65.62%) participating dentist were BDS and 110 (34.37%) participating dentist were MDS. 290(90.62%) participating dentist know when space maintainers were used. 320(100%) participating dentist know that space maintainers require special care wih brushing. 230 (71.87%) participating dentist know what type of food should be avoided when having space maintainers. 180(56.25%) dentist know how often space maintainers will be taken out. 175(54.68%) dentist know if the space maintainer was lost or broken what time is best to go to the dentist. 175(54.68%) dentist practice space management. Conclusion: Our study concluded that maximum number of practicing dentist have knowledge about space management and more than half the dentists who participated in this study practice space management in their practice.

Comparative Evaluation of Efficacy of Interscalene Block vs. Interscalene Block and Superficial Cervical Plexus Block for Fixation of Clavicular Fractures

Introduction: Regional anaesthesia is seldom used forclavicle fractures considering the anatomical location of thebone. We aim to compare the efficacy of two techniques ofregional anaesthesia as sole anaesthesia technique for fixationsof clavicular fractures.Material and methods: 60 Adult patients with claviclefractures were divided randomly in two groups (1 and 2) andwere administered interscalene block (ISB) only or interscaleneblock and superficial cervical plexus block(ISB+SCPB) assole anaesthetic, respectively. Patients were monitored forefficacy of block and adequacy of anaesthesia and analgesiaat the surgical site. Side effects and hemodynamic parameterswere also monitored.Results:. ISB+SCPB provides excellent anaesthesia forclavicle fixation. Only 1 patient in group 2 required GeneralAnaesthesia(GA) whereas in Group 1, 8 patients required someform of supplemental anaesthesia. There was no statisticallysignificant difference in side-effects and hemodynamic profilein both the groups.Conclusion: ISB+SCPB is significantly better than ISB onlyfor anaesthesia for fixation of clavicular surgeries.

Radiological Morphometric Study of Angle of Inclination in Adult Human Femur from North India

Background: The femur is one of the long bones being thoroughly studied anatomically and has three parts; proximal, distal end and a long shaft. The angle between femur neck and angle with the long axis of shaft, are known as neck-shaft angle, collodiaphyseal angle, and also known as cervico-diaphyseal angle, angle of inclination, and femoral carrying angle, Neck – shaft angle is important regarding its stability, control of lateral balance, walking and facilitates hip movement. It varies with age, body structure, width of pelvis, being less in adult in persons short with limbs and in women. Methods: This cross-sectional study was conducted in the Department of Anatomy and department of radiology Government medical college Saharanpur, uttarprades, The antero-posterior view of pelvic radiograph taken from the Department of Radiology Government medical college Saharanpur, uttarprades.the70 samples were included in the study. Results: The mean right angle of inclination was 126.760±4.330 with range 1180-1350 and left angle of inclination was 128.100±5.340 with range 1180-1360. The overall angle of inclination was 127.420±4.530 with range 118.50-1350. Conclusion: The angle of inclination in adult human femur gives a basic structural and functional knowledge to prevent the abnormality with the help of orthopedic surgeon and society and mentian the stability, control of lateral balance, walking and facilitates hip joint movement, helpful to understand different aspect of clinical disease conditions, including changes in osteoporosis, common site of fracture, associated congenital anomalies as well as medicolegal cases.

Metabolic Effect of FOS (Fructooligosaccharide) in Terms of Gut Incretin (GLP-1) Gut Microflora and Weight Reduction in Obese Adults.

In the recent years, obesity has increased beyond imagination. Appropriate dietary strategies which have the potential for weight loss demand patience and strong determination on part of the individual, however inclusion of functional foods like FOS that modulate gut hormones have a promising role in weight management. Methods: A randomized double-blind placebo-controlled trial was used as the study design wherein 65 obese adults were divided into experimental group (which was given 12 g of FOS) and a placebo group (which was fed with 12 g dextrose). The subjects were given the supplements daily for 12 week period. Their plasma samples were anlaysed for GLP-1 and microbial count in fecal samples were determined in terms of lactic acid bacteria, bifidobacteria and enteric pathogens. Hunger scores, dietary intake, and anthropometric parameters were assessed using standard techniques. Results: FOS supplementation resulted in improved plasma GLP-1 level by 17.0%. Significant improvement was observed in hunger score by 3.15% (p<0.05) along with reduction in dietary intake of energy (kcal) by 8%, carbohydrate (g) by 8%, protein (g) by 6% and fat (g) by 2%. Further, reductions were observed in total body weight (kg), BMI, % body fat and waist circumference (cm) levels by 4%, 1.06%, 4% and 1.66% respectively (p<0.001, p<0.001, p<0.001, p<0.05). The mean log counts of beneficial gut microbiota i.e. lactic acid bacteria and bifidobacteria increased significantly by 14 % and 10 % respectively along with 20% reduction in enteric pathogen. Conclusion: Daily intake of 12 gm FOS for 12 weeks helps in improving gut health and weight loss through increased satiety in obese individuals.

Influenza A (H1N1) 2009: a pandemic alarm.

At this critical juncture when the world has not yet recovered from the threat of avian infl uenza, the virus has returned in the disguise of swine infl uenza, a lesser known illness common in pigs. It has reached pandemic proportions in a short time span with health personnel still devising ways to identify the novel H1N1 virus and develop vaccines against it. The H1N1 virus has caused a considerable number of deaths within the short duration since its emergence. Presently, there are no effective methods to contain this newly emerged virus. Therefore, a proper and clear insight is urgently required to prevent an outbreak in the future and make preparations that may be planned well in advance. This review is an attempt to discuss the historical perspective of the swine fl u virus, its epidemiology and route of transmission to better understand the various control measures that may be taken to fi ght the danger of a global pandemic.