Study of Cardiovascular Autonomic Dysfunction in Type II Diabetes Mellitus.

Autonomic neuropathy is a common complication of diabetes mellitus which may affect major systems like cardiovascular system that may cause early death in diabetics. In our study attempt was made to asses different cardiovascular autonomic function parameters like change of blood pressure from supine to standing posture (postural BP changes) and ratio of longest and shortest R-R interval during deep expiration and inspiration respectively (E/I ratio) on ECG in type 2 diabetics and age sex matched non diabetic controls. Level of fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1C) were also measured in the same subjects. Diabetics were subdivided into <5 years and >5 years groups. Findings were compared between diabetics and the controls and also between the subgroups of diabetics. Correlation between glycaemic control , duration of disease and autonomic function parameters were tested. We found, a significant difference in postural BP changes and E/I ratios between diabetics and the controls, no significant correlation could be found out between glycaemic control or duration of disease and autonomic function parameters. Therefore, our study concludes that diabetes may lead to autonomic dysfunction that may cause postural hypotension and altered E/I ratio irrespective of the duration of disease and glycemic control.

Level of Maternal Awareness Amongst Mothers who had Undergone Elective C/S.

Caesarian section (C/S) is a very common obstetric procedure. It had many advantages and disadvantages. In this age of consumer awareness, patient has to give an informed consent before the procedure – means merits and demerits of the procedure shall be known to the patient. She also has the right to choose between different procedures, type of incision and anesthesia, where possible. We have studied that status amongst 100 such patients, only 7% of them being illiterate, who had undergone elective C/S in SNP Hospital, a two tier hospital of Kolkata. The result was shocking. 65% of the mothers did not have any idea regarding the procedure they are undergoing. 1/3rd of the patients even did not know why they are having C/S. None of them was given any choice regarding anesthesia and only 9% regarding incision. A detail of the study is presented.

Two rare anatomical variations of external jugular vein: an embryological overview / Dos raras variaciones anatómicas de la vena yugular externa: una visión embriológica

Human anatomy is an ocean of unending variations and its mysteries are being unravelled since ages. Knowledge of variations in the superficial veins of head and neck is essential to carry out successful surgical procedures. During routine dissection of head and neck of two middle aged male cadavers, in the Department of Anatomy, Calcutta National Medical College, Kolkata, India, we came out with some interesting venous architecture. The retromandibular vein on the left side of both the cadavers was found to be undivided and joined with the facial vein in the neck at an acute angle to form a common venous trunk at variable distances from the angle of the mandible. That trunk ultimately drained into the left subclavian vein. This might be the result of disappearance of the cephalic part of the external jugular vein and formation of an additional communication between common facial vein and the external jugular vein in foetal life. In one case, we also came across an extra transverse communication between that common trunk and the internal jugular vein. A detail of those cases with embryological explanation is attempted...

La anatomía humana tiene un sin fin de variaciones y sus misterios se han develado desde el inicio de los tiempos. El conocimiento de las variaciones anatómicas de las venas superficiales de la cabeza y del cuello es fundamental para llevar a cabo con éxito los procedimientos quirúrgicos. Durante una disección de rutina de cabeza y cuello encontramos una arquitectura venosa interesante en dos cadáveres de hombres de mediana edad en el Departamento de Anatomía de la Facultad de Medicina Nacional Calcuta, Calcuta, India. En el lado izquierdo del cuello de ambos cadáveres, la vena retromandibular no se encontraba dividida, y se unía a la vena facial en un ángulo agudo, para formar un tronco venoso común a una distancia variable desde el ángulo de la mandíbula. Ese tronco finalmente drenaba en la vena subclavia izquierda. Esto podría ser el resultado de la desaparición de la parte cefálica de la vena yugular externa y la formación de una comunicación adicional entre la vena facial común y la vena yugular externa en la vida fetal. En un caso, también se encontró con una comunicación adicional transversal entre ese tronco común y la vena yugular interna. Se realiza una descripción en detalle de los casos junto a una explicación embriológica...

Auditory evaluation of the microcephalic children with brain stem evoked response audiometry (BERA).

Microcephaly implies a reduced occipito-frontal circumference (< 2 Standard Deviation of normal) and therefore a small brain size, which is usually associated with different neurodeficit. Intactness of the auditory pathway in microcephalic as well as normal children was assessed by Brain stem Evoked Response Audiometry (BERA) to locate the exact site of lesion resulting in the auditory impairment, so that appropriate early rehabilitative measures can be taken. The study revealed that absolute peak latency of wave V, inter peak latencies of III–V and I–V were significantly higher (P- value <0.05 in each case) in microcephalics than the normal children. Auditory impairment in microcephaly is a common neurodeficit that can be authentically assessed by BERA. The hearing impairment in microcephalics is mostly due to insufficiency of central components of auditory pathway at the level of brainstem, function of peripheral structures being almost within normal limit.