RESUMEN
@#Introduction: The Anterior Cruciate Ligament tends to stabilise the knee in various range of extension and flexion. Precise study of anatomy, attachments and position of bundles is important for successful ACL reconstruction. In our study, we attempt to assess general anatomy of ACL, determine and compare its morphometric data pertaining to length and width and its tibio-femoral foot prints in different gender and secondarily determine changes in the same during ACL dynamics witnessed during knee flexion changes. Materials and methods: A total of 19 knees from 10 cadavers were used in the research with mean age of 61±7 years. After dissecting the skin, muscles, patellar and articular capsule were removed and bundle attachments were studied. Thereafter the relative length, width and stiffness of ACL bundles at 0, 90, 140 (maximum) angles of knee flexion were measured along with maximum horizontal and vertical bundle footprints at tibio-femoral attachments were recorded. Results: Mean length and width of insertion of anteromedial (AM) bundle on the tibial surface was 8.8mm and 9.0mm in males and 8.1mm and 8.8mm in females. Furthermore, that of PL bundle was 9.1mm and 7.8mm in males and 8.9mm and 7.1mm in females. Conclusion: The anteromedial (AM) bundle and posterolateral (PL) bundle of ACL were found to be most relaxed at full extension and were most taut at maximum flexion of 140°. AM bundle underwent greater stretching and change of length in comparison to the PL bundle, indicating that it is comparatively a more dominant bundle.
RESUMEN
To assess the clinical safety of equine rabies immunoglobulin (ERIG) and purified vero cell rabies vaccine (PVRV) administered intradermally in children for post-exposure prophylaxis against rabies, a study was carried out among 1494 children <15 years of age having category III exposure to animal bite at the antirabies clinic of community medicine department of MKCG Medical College Hospital, Berhampur, Orissa from 1st May 2007 to 31st March 2008. The patients received 0.1 ml of PVRV intradermally at two sites on days 0, 3, 7 and 28. The PVRV (Abhayrab) supplied by Government of Orissa had an antigen content of > 2.5 IU per 0.5 ml vial. ERIG (Equirab) was also given on day 0 as per WHO guideline. As much of the immunoglobulin as possible was infiltrated around the wounds after skin test. Side effects were monitored during the follow up visits on days 3, 7 and 28. One hundred & eight children (7.2%) showed positive reaction to the skin test dose of ERIG. These patients could not afford HRIG and were administered ERIG after premedication with oral antihistamine (Levocetrizine). There were no serious systemic side-effects but local side-effects like induration, erythema, pruritus are due to the intradermal rabies vaccination (IDRV) and pain, induration due to ERIG. Low grade fever and malaise were the only systemic side effects observed. None of the children had anaphylaxis or regional lymphadenopathy. Only 3% of children had mild serum sickness like symptoms by days 5 & 7 which subsided with oral analgesics and antihistamines. Our study showed that administration of ERIG & PVRV by intradermal route in children with WHO category-III rabies exposure is safe.
RESUMEN
A hospital based study was conducted in the anti-rabies clinic of a medical college of Orissa during April 1988 to May 2002. Of 24 clinically diagnosed and reported rabies cases during the four years study period, 62.5% were children below 15 years of age, 67% were males, 87.5% were victims of stray dogs, 79% had not taken any anti-rabies treatment though all had undergone treatment by traditional systems of medicine.