Evaluation of method of cohort research articles using Q-coh assessment tool

Background:Clinical and evidence-based information is very important in the field of clinical sciences including speech and hearing sciences. More and More professionals are resorting to published articles for knowledge on assessment and intervention that are evidence based. Therefore, there is a need of standard evaluation methods for each type of research that is published. The aim of the study is to investigate the quality of the cohort research articles by using the assessment tool Q-coh and thereby checking the reliability of the assessment tool. Methods:The tool Q-coh developed by Jarde etal with the aim to screen the methodological quality of the primary studies with a cohort design was taken for quality assessment of cohort research articles. Q-Coh consists of 26 items and 7 inferences. Assessment was carried out by few reviewers who were blinded to the classification of quality and based on the evaluation received from the reviewers the quality of the articles were determined. Agreement analysis was done to check the proportion of agreement between the raters and reliability of the tool respectively. Results:The research findings indicate that there is a fair to substantial agreement between the raters. Further, the quality of the articles was determined and classified into the class of acceptable and good quality. Conclusions: The present study was conducted to check if the checklist Q-cohis applicable to assess the methodological quality of cohort research studies. The outcomes of the study indicate that the tool is reliable.

Supratrochlear Foramen-anatomical Variations And Its Clinical Implications

Background: The Supratrochlear foramen (STF) is an important anatomical variation resulting from perforationof olecranon-coronoid septum present between two epicondyles of humerus.Material and methods: The study was conducted in 78 (41 left side and 37 right side) human dried humeri ofunknown sex and age. The topographical anatomy of the STF was studied in detail, morphometric measurementswere taken and specimens were photographed. Radiographs of humerus were taken to observe the translucencyof septum and the diameter of intramedullary canal was measured at three levels 1) below the surgical neck 2)junction between upper 2/3rd and lower 1/3rd of shaft 3) above the olecranon fossa.Results: Out of 78 bones studied,15 bones showed the presence of STF. The STF was oval, round and triangular inshape in 7, 5 and 3 bones respectively. The mean transverse and vertical diameters of supratrochlear foramenwere 5.46 mm,5.82 mm and 3.94mm, 3.82mm on the left and right sides respectively. The mean diameter of theintramedullary canal was 4.51mm for the humeri with STF and in the normal humeri it was 5.77mm.Conclusion: The knowledge of STF is essential in diagnostic orthopaedics, in intramedullary nailing of humerusin supracondylar fracture. STF is a radiolucent area in radiographs and this may be misinterpreted as osteolyticor cystic lesion

Anterior Cerebral Artery: An Anatomical Study

Introduction: Anterior cerebral artery (ACA), the smaller terminal branch of the internal carotid artery is significantclinically due to its wide variety of complexity and technical difficulty in surgical procedures.Methods and materials: This study was done in 50 embalmed adult brain hemispheres at Institute of Anatomy,Madras Medical College, Tamilnadu. The study of the anterior cerebral artery was undertaken to observe themode of origin, its course and branches.Results: Anterior cerebral artery originated from the internal carotid artery in 100% of specimens. ACA passedabove optic nerve in 32 specimens (64%), above optic chiasma in 16 specimens (32%) and above optic tract in 2specimens (4%). The average length of A1 segment of right ACA and left ACA were 14.3 mm and 13.7 mm respectively.The difference in diameter of 1mm or more on both sides was observed in 8%. Left A1 segment was duplicated in1 specimen (2%). Median artery of corpus callosum and Azygous anterior cerebral artery were found in onespecimen each. Fenestration of A2 segment was observed in one specimen (4%). Heubner’s artery arose from A2segment in 32 (64%) specimens, from A1 segment in 6 (12%) specimens and from the level of ACoA in 12 (24%)specimens. The orbitofrontal artery originated on an average distance of 5.73mm on right side and average of4.82mm on left side. Frontopolar artery(FPA) originated at a distance of about 20.2mm on right side and 17.6mmon left side. Callosomarginal artery and pericallosal artery were found in all the specimens. In one specimen theright FPA originated from callosomarginal artery.Conclusion: Rapidly advancing fields of vascular neurosurgery and interventional neuroradiology techniquesrequire a thorough understanding of the anatomy. This detailed study done under various parameters wouldbenefit the radiologists and neurosurgeons.

Study of management strategies in ACTH secreting pituitary microadenoma of Cushing disease

Background: Pituitary Microadenomas can be defined as small lesions less than 1 cm in the pituitary and detected as incidentalomas. Partial development or late development around puberty leads to maldevelopment of secondary sexual characteristics due to pituitary adenomas. Clinically this may manifest as secondary amenorrhoea and may lead to hyperprolactinaemia, galactorrhoea and Amenorrhoea. ACTH secreting micro adenomas of the Pituitary Gland is a clinical entity where the role of surgery is contemplated. This study attempted to explore the management options and strategies for pituitary microadenomas. The aim of the study: To highlight the characteristics of Cushing’s disease and discuss the management strategies including trans-sphenoidal surgery to treat ACTH secreting pituitary microadenomas. Materials and methods: This was a non-randomised prospective observational study involving all adrenal tumors from 2007-2017 in Madras Medical College, Chennai. Two adrenocortical adenomas M.S. Senthil Kumar, Rajan Ganesan, A. Nithyanandham, V. Kannan, T. Suresh Babu, K. Prabhakaran. Study of management strategies in ACTH secreting pituitary microadenoma of Cushing’s disease. IAIM, 2019; 6(3): 253-258. Page 254 with virilising features were ruled out and 8 ACTH secreting Cushing's disease with microadenomas were identified. 3 Patients with ACTH secreting microadenomas of Cushing's disease underwent surgery whereas 3 underwent medical treatment based on which this paper attempted to discuss management strategies for Cushings disease. Results: ACTH levels were measurable with an average of 136.71pg/ml (normal 7.2-63.3 pg/ml) Corticotrophin releasing hormone test was planned to evaluate an exaggerated response of serum cortisol consistent with pituitary disease. It was not carried out and inferior petrosal sampling also was not done. Biochemical evaluation confirmed pituitary dependent Cushing’s disease. MRI revealed a prominent circumscribed lesion suggestive of a Pituitary Micro Adenoma in All 6 Cases. Conclusion: Pituitary micro adenomas are operable and in Cushing’s disease offer an effective cure. The outcome is good with minimal complications, but surgeons must have a thorough knowledge of the surrounding anatomy and potential complications.

Softeners for hardness removal.

The depletion of water resources, both surface and subsurface and deterioration of water quality made researchers and policy makers to think of the possible remedies to make water sources potable / wholesome. There is a need to address the problems of hardness and fluoride in subsurface water on priority basis. In this direction, bench scale studies were conducted to evaluate the performance of water softeners. Indepth studies were carried out at University B.D.T College of Engineering, Davangere, Karnataka, to assess the performance of bench scale softeners of D to H ratio 1:2, 1:3, 1:4 in removing hardness of varied concentrations from both synthetic and natural water samples. Studies revealed that irrespective of D to H ratio of softeners, the waters having hardness concentration up to 1000 mg/l can be treated to the same degree (81.68% and above). The findings of regeneration studies and cost economics are also summarized in this paper.