Squatting Facets and Trochlear Extensions of Talus Bone in Indian Population

Introduction:The talus is a tarsal bone articulated with the tibia, fibula, navicular, and calcaneus bones to form supratalar, pretalar, and subtalar joints, respectively. A squatting facet is a kind of anomaly that forms on the surfaces where the tibia and talus articulate. The squatting facet states the daily activities and living style of society. Squatting is described as the hyperflexion of the hip and the knee and the movement of hyperdorsiflexion between the leg and the ankle. Materials and Methods: In the present cross‑sectional study, 600 dry adult human tali were taken from the osteology laboratory in the Department of Anatomy, King George’s Medical University, UP, Lucknow. Each talus was examined for the presence of various patterns of articular facets on the neck of the talus and extensions of its trochlear surface. Ethical clearance was obtained from the Institutional Ethics Committee, King George’s Medical University, Lucknow, as reference code: 121 ECMIIA/P3. Results: In our study, we observed that the lateral, medial, and combined squatting faces are 282 (47.64%), 49 (8.28%), and 22 (3.72%), respectively. Lateral, medial, and continuous trochlear extensions are 126 (21.12%), 120 (20.58%), and 31 (5.36%), respectively, in the Indian population. Conclusion: Modifications of the neck of the talus (squatting facets and trochlear extensions) are the result of prolonged squatting positions, which is a common habit of the Indian population, and incidences of these variations can be used as an anthropological marker for racial and regional differentiation of unidentified bones.

Association of trisomy 21 with anorectal malformation: a cytogenetic study

Background: Anorectal malformations (ARM) are congenital malformations of digestive system resulting from the disturbed development of hindgut during embryogenesis. ARMs involve both sexes; can occur either isolated or in association with other congenital abnormalities and may be associated with chromosomal abnormalities. Association of trisomy 21 with anorectal malformation is well documented. Present study was conducted to assess prevalence of association of trisomy 21 in patients with anorectal malformation.Methods: Total 48 children with diagnosis of anorectal malformation, who were admitted in Department of Paediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, were selected for the study. Blood samples were collected and their cytogenetic analysis was carried out in the Cytogenetics laboratory, Department of Anatomy, KGMU-U.P, Lucknow, India.Results: Among the 48 study subjects, karyogram could be successfully obtained for 45 cases (93.75%). Numerical anomalies were observed in 8.9% cases. Trisomy 21 was found in 6.7%. The prevalence of trisomy 21 was found to more in males (4.5%) as compared to females (2.2%). Prevalence was highest in birth order 3(20%), followed by birth order 2(7.14%) and lowest in birth order 1(3.85%). Trisomy in association with ARM; was observed in children born to females aged >30 years. It was found unrelated to the history of consanguinity.Conclusions: Prevalence of association of trisomy 21 with ARM was found to be 6.7%. This coexistence emphasizes the need for a thorough investigation of patients with ARM.

To Study the Functional Outcomes of Proximal Fibular Osteotomy in Osteoarthritis Kee

Introduction: Knee osteoarthritis (OA), also known asdegenerative joint disease, is typically the result of wearand tear and progressive loss of articular cartilage leadingto radiologically decreased joint space. Proximal fibularosteotomy (PFO) is an alternative treatment to high tibialosteotomy (HTO). Hence; under the light of above mentioneddata, the present study was undertaken for assessing thefunctional outcomes of proximal fibular osteotomy inosteoarthritis knee.Material and methods: A total of 10 patients with OA ofknee were enrolled in the present study. The patients wereplaced in the supine position after administration of spinalanaesthesia. An approximately 5-cm longitudinal incisionwas made over the lateral aspect of the proximal fibula, andthe fibula exposed between the peroneus muscle and soleusmuscle. PFO was performed under the hands of skilled andexperienced orthopaedic surgeon. Knee pain was assessedusing a Visual analogue scale. Knee ambulation activitieswere recorded using the knee and function subscores of theAmerican Knee Society score (KSS). All the results wererecorded in Microsoft excel sheet and were analyzed by SPSSsoftware. Chi- square test and Mann Whitney U test were usedfor assessment of level of significance.Results: Mean KSS score at pre-operative, postoperative,postoperative 6 weeks and postoperative 9 months werefound to be 44.03, 53.50, 58.60 and 68.14 respectively.Significant results were obtained while comparing the meanKSS at different postoperative time intervals. In the presentstudy, mean VAS score at pre-operative, postoperative,postoperative 6 weeks and postoperative 9 months were foundto be 8.77, 6.96, 4.36 and 2.52 respectively. Significant resultswere obtained while comparing the mean VAS at differentpostoperative time intervals.Conclusion: PFO is a novel alternative method in themanagement of medial compartment arthritis of the knee.

In silico analysis of chili encoded miRNAs targeting Chili leaf curl begomovirus and its associated satellite

Chili leaf curl virus (ChiLCV), a member of the Geminiviridae family (Genus: Begomovirus), is one of themost destructive plant viruses. Micro (mi) RNAs (miRNAs) are the endogenous non-coding small RNAsthat play significant roles in plant growth and stress resistance by degrading targeted mRNA or repressingmRNA translation. Computational methods have identified numerous miRNAs in many plant species, whereasthere is no report of chili miRNAs targeting essential genes of the ChiLCV genome and associated satellites.In this study, we have predicted chili-encoded miRNAs that could be used for silencing against chili leafcurl virus (Accession no. MF737343) infection. We predicted several potential mir-miRNAs, exhibited highcomplementarities with V1 coat protein and C1 (Rep) genes of ChiLCV. Other overlapping genes, such as V2,C2, and C3 were also targeted by mir-miRNAs.

Management of Fracture Distal Femur Using Retrograde Supracondylar Nail: A Prospective Analysis at a Tertiary Care Centre

Background: In the past two decades, the open reduction andinternal fixation has gained good result in the management ofdistal femur fractures. The present study has been undertakento evaluate the overall functional outcome of patients treatedby supracondylar nail.Materials and Methods: The present study was conducted atDepartment of Orthopaedics, Teerthanker Mahaveer MedicalCollege and Research Centre, Moradabad, UP, India. All thepatients admitted in the department of Orthopaedics withfracture distal femur and managed by intramedullarysupracondylar nail were included. Final assessment of resultswas done based on modified Mehrotra's grading based on theassessment of the final functional results and also taking intoconsideration, the complications if any.Results: Average duration between injury and surgery was3.38 days. In only 8% of the cases open reduction by additionalparapatellar incision was required. Average duration of surgerywas 52.6 minutes. Most common complication we encounteredwas knee stiffness in 16 cases followed by local symptom atdistal screw site in 12 cases. Superficial infection was seen in 9& deep infection in 2 cases. In 2 cases shortening was morethan 2.5 cm. Average range of movement at the knee joint inour series was 110.93 with 40 cases having full range ofmovement. Final results were excellent in 61 of the cases.Good in 23% Fair in 11%, Poor in 5%.Conclusion: Finally we conclude that intramedullarysupracondylar nail should be the treatment of choice for distalfemoral fractures. As it has all the advantages of closedtreatment like minimal blood loss, less soft tissue stripping,preservation of fracture haematoma and minimalcomplications. This operation is particularly suited for Type A,C1 & C2 types of fractures as shown by the final functionalresults of this study.

To assess awareness regarding rational drug therapy and fixed dose combinations amongst interns and II MBBS students in tertiary care teaching hospital in Maharashtra, India

Background: The present study was designed to assess awareness regarding rational drug therapy and fixed dose combinations (FDC) amongst interns and II MBBS students in a tertiary-care teaching hospital in Maharashtra, India.Methods: This cross-sectional, questionnaire-based study containing MCQ and analytical questions on rational drug therapy, fixed dose combinations and role of Pharmacist in dispensing correct drug to the patients was carried out in both interns (n=80) and II MBBS students (n=100). The completed questionnaires were then collected and analysed statistically for responses.Results: Mean average score obtained by II MBBS students (score - 36.66marks) was significantly better than interns (score- 20marks) which probably may be due to pharmacology teaching they were undergoing. II MBBS students were found to be better informed as compared to the interns (p<0.05) on questions related to rational drug therapy. On the questions related to rationality of FDC in Yes/No type, interns and II MBBS students were found to be equally informed (p>0.05). However, on question related to justification of FDC, interns were found to be better informed as compared to the II MBBS students (p<0.05). On single question pertaining to role of pharmacist, interns were found to be better informed than II MBBS students possibly due to their better understanding of patient-pharmacist relationship.Conclusions: Our study highlights the significance regarding knowledge of rational drug therapy and fixed dose combination (both rational and irrational), both rational and irrational, amongst both interns and II MBBS students while identifying the possible areas of interventions to make them rational clinicians.

Estimation and Comparison of Erythrocyte and Hemoglobin Levels in Subjects with Healthy Periodontium and Chronic Periodontitis

Objective: To compare and evaluate the relationship between anemia and periodontitis by estimation of peripheral blood between healthy patients and chronic periodontitis patients. Material and Methods: Of the total of 230 outpatients approached to participate in the study, 100 eligible patients were selected as per the selection criteria. After written consent, these patients were divided into two groups according to the clinical parameters as healthy and disease (chronic periodontitis) groups. Under aseptic conditions, venous blood samples were obtained by vein-puncture in the ante-cubital fossa without excessive venous stasis and the mean value of erythrocytes (EC), hemoglobin concentration (HGB), mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were measured. Paired t-test was employed to find the significance of study parameters on continuous scale within the group analysis and unpaired t-test (two tailed, dependent) was used to find the significance of study parameters on continuous scale in the inter group analysis. Results: Generally, the healthy group reported higher levels of EC, HGB, MCV and MCH than the periodontitis group. The mean hemoglobin level was significantly higher (p-value<0.05) in healthy patients (12.66 ±1.41 gm/dl) whereas a slightly lower level of 11.32±1.85 gm/dl was observed in patients with chronic periodontitis. Similarly, the range of erythrocyte count of healthy patients was significantly higher (3.69-5.29 million/µl) than chronic periodontitis patients (3.33-5.97 million/µl). Whilst MCV was higher in healthy patients but non-significant, higher mean MCH of 27.75 ± 3.25 pg/cell was reported in healthy patients compared to mean of 25.73 ± 3.22 pg/cell in patients with chronic periodontitis. Conclusion: Significant hematological differences in EC, HGB, MCV and MCH between healthy periodontium and chronic periodontitis subjects were seen indicating mild anemia.

Retinopathy as a Prognostic Marker in Cerebral Malaria.

Objectives: To study the association between fundal changes (malarial retinopathy) and mortality in children with cerebral malaria. Methods: 50 consecutive children (mean age 8.4 y, 23 males) with cerebral malaria (acute febrile encephalopathy and either peripheral smear or Rapid diagnostic test positive for malaria) were evaluated by a single ophthalmologist for any changes of retinopathy. Children were managed as per standard guidelines for treatment of cerebral malaria. Results: P. vivax infection was seen in one child, P. falciparum infection in 42 children, and a mixed infection in 7. Retinopathy was present in 48% of the children. 13 children died during hospital stay. The mean interval from admission to fundus examination was 11.6 (4.64) h. Presence of ‘any retinopathy’ (P=0.02), and either of papilledema (P=0.02), hemorrhages (P=0.005) or vessel changes (P=0.01), were associated with a significantly higher risk of death. Conclusions: Malarial retinopathy is significantly associated with mortality in children with cerebral malaria. It may be used for both prognostication, and triaging for optimum utilization of intensive care facilities in these children.

Study of coronary artery atherosclerosis in sudden deaths and its medico-legal relevance.

The coronary artery diseases can play a crucial medico- legal role to decide the cause of sudden death whether natural or unnatural. There are certain occasions, when a person dies on the operating table or soon after surgery, and a coronary attack is probably the cause of death. A final coronary episode may sometimes be associated with an operative procedure supposedly due to hypotensive state. During driving or piloting a person may goes into a state of confusion because heart attack. In this state he may lose control and an accident can happen. These conditions indicate that intervention of Forensic Pathologist is significant to decide the actual cause of death apart from injury or disease of vital organs. We examine coronary arteries for atherosclerotic changes in 50 cases of sudden deaths. We observed that there were marked intimal thickening with luminal narrowing ≤ 75% of luminal diameter in 20 cases (40%) in total hearts. In natural deaths 17 cases (48.57%) showed luminal narrowing ≤ 75% of luminal diameter. These findings are suggestive of medico legal intervention to clarify the mode of death in some instances.

Recent advances in the management of multiple myeloma.

Multiple myeloma is a disease of malignant plasma cells in the bone marrow. Interaction of malignant plasma cells with the bone marrow microenvironment plays a key role in the pathogenesis of the disease. The introduction of two new classes of molecules, namely immunomodulators (e.g. thalidomide, lenalidomide), and proteasome inhibitors (e.g. bortezomib) has led to improvement in the management of myeloma. Induction therapy with these novel drugs in combination with dexamethasone is associated with higher response rates including complete response in one-fourth of patients with bortezomib combinations. Further consolidation with intensive chemotherapy supported by autologous stem cell transplant in young, eligible patients results in complete response in 50%–70% of patients with improved survival. Simplified criteria for staging, uniform response criteria, more sensitive methods for detection of residual disease (immunofixation and free light chain assay), and recognition of potential adverse cytogenetic and genomic abnormalities have further refined the management of patients with myeloma. Along with earlier diagnosis, improved treatment and better management of complications have resulted in longer disease control and survival with a better quality of life.