Radial Artery: Anatomical Variations At Wrist And Clinical Significance

Background: Knowledge regarding the course and termination of the radial artery before harvesting it for coronaryartery bypass graft surgery (CABGS) is important. The brachial artery terminates at the neck of radius into radialand ulnar arteries.Purpose of the study: To know the various patterns of anomalous division ofthe radial artery.Methods: The study included 50 upper limb specimens from the Department of Anatomy, Sree Narayana Instituteof Medical Sciences, Ernakulam. The specimens were fixed with 10% formalin solution and the radial artery wasexposed from its origin till termination and observations were noted down.Results: The present study revealed that, radial artery usually was arising from brachial artery at the level ofneck of radius. The variants observed included high bifurcation of brachial artery, division of radial artery intopalmar and dorsal branches in the forearm and anomalous course of radial artery in the region of anatomicalsnuff box.Conclusion: The present study has revealed the anomalous division and course of radial artery around the wristand anatomical snuff box and the knowledge of such anomalous course is important for diagnostic, interventionaland surgical procedures.

Ergonomics in general dental practice.

An ounce of prevention is better than pounds of cure ……That’s what dental health care workers spend their day telling their patients, but it also applies to working conditions that can cause pain in the neck, shoulder and hand to a dentist. In dental clinics, there are very few activities that can cause sudden injuries, rather it is an accumulation of harmless working positions over months and years, which are repeated so often that they cause irreversible injuries. This article includes Musculoskeletal disorders / Repetitive Strain Injuries (MSDs /RSIs) and the signs, symptoms and risk factors of these types of injuries, so that one can be aware of developing problems and can change his /her approach to work or alter the workstation setup to prevent further injury. The article discusses the important issues of posture and offers different exercises to work with comfort, efficiency and ease.

Management of traumatically intruded permanent incisors.

Intrusive luxation of permanent teeth has great psychologic impact on both parents and children and presents clinical challenge for the dentist, all the more due to severe complications it is difficult to manage this group of dental injuries. This paper describes the management of traumatically intruded permanent maxillary-central incisor in an 11-year-old girl. After 12-month follow-up, it was seen that teeth were fully re-erupted and are in functional alignment with other teeth.

Oat cell carcinoma of the oesophagus--a case report and review of literature.

A 45-year-old male presented with dysphagia, anorexia and progressive weight loss. He was a chronic smoker. Oesophagoscopy showed an ulceroproliferative growth of 25-30 cm size. Histopathology from the biopsy tissue showed small cell (oat cell) carcinoma. He received radiotherapy, but died 9 months later. Small cell carcinoma of the oesophagus constitutes 0.8-2.4% of all the oesophageal carcinoma. The tumour is an aggressive one with a poor prognosis irrespective of the treatment.

Dietary factors in pathogenesis of gallstone disease in southern India--a hospital-based case-control study.

BACKGROUND: Pigment or mixed gallstones are common in southern India. The etiology is not established. Known risk factors include an obese, diabetic female and a nonsmoker male. AIM: To determine the association of dietary factors with mixed/pigment gallstones amongst southern Indian patients. METHODS: Diet details were obtained from 346 patients (178 women) with gallstones and an equal number of healthy controls who were age- and sex-matched attendants of the patients, sharing similar socioeconomic and demographic characteristics, with normal abdominal ultrasonogram. Data recorded included the number of daily meals, nature of cereal used, vegetarianism, oil consumed per month, sugar consumption per day, tamarind (Garcinia camborginia ) usage per week, and per-day beverage consumption. RESULTS: There was no difference between cases and controls in consumption of non-vegetarian food, type of cereal, average oil and sugar consumption, and type of beverage consumed (tea/coffee/milk/combination). Individuals with BMI> 22 were at higher risk to develop gallstones (OR 1.49; 95% CI 1.09, 2.04; p=0.01). There was significant risk of gallstone formation with the use of tamarind when consumed > 3 times a week (OR 1.76; 95% CI 1.05, 2.96; p=0.03). Higher BMI and tamarind use were significant risk factors even on multivariate logistic regression analysis (p=0.02). CONCLUSION: Higher BMI and use of tamarind, a common ingredient of diet in southern India, are risk factors in the formation of gallstones in southern India.

Risk factors for esophageal cancer in Coimbatore, southern India: a hospital-based case-control study.

BACKGROUND: Cancer of the esophagus is common in India. The risk factors predisposing to cancer in southern Indian patients are not known. AIM: To determine the role of smoking, alcohol and their combination, and diet factors in the etiology of cancer of the esophagus. METHODS: Risk factors like alcohol consumption, smoking, tobacco chewing, and pre-illness diet details in 90 patients with cancer of the esophagus were compared with those in age- and sex-matched control subjects. RESULTS: The risk for esophageal cancer was 3.5 times higher with alcohol consumption, 2.5 times higher for tobacco users, and 2.8 times higher each for betel nut chewers and smokers. The calculated odds ratio for the social habits and diet factors was significant amongst cases of cancer esophagus. CONCLUSION: Alcoholism, smoking, and chewing of tobacco are factors predisposing to esophageal cancer in southern India.

Acquired volvulus following Nissen fundoplication.

Nissen fundoplication is the procedure of choice for the management of gastroesophageal reflux disease. We report a case of acquired gastric volvulus following open fundoplication. The mechanism of formation and correction of the volvulus is discussed.

Prevalence and epidemiologic characteristics of opportunistic and non-opportunistic intestinal parasitic infections in HIV positive patients in Manipur.

A survey of the intestinal parasites among the HIV positive asymptomatic injecting drug users (IDUs) in Manipur State in North-east India revealed the presence of three protozoan and two nematode species. Of these, the two opportunistic parasitic protozoans i.e., Cryptosporidium sp. (94.4 percent) and Isospora sp. (10.7 percent) were predominant over Entamoeba histolytica (5.6 percent), while non-opportunistic parasitic nematodes, i.e. Ascaris lumbricoides (4.6 percent) and Ancylostoma sp. (1 percent) were the less frequently detected ones. In all cases, the fungal flora were predominant. Candida sp. was more often encountered compared to Cladosporium and Humicloa. The study also revealed that although these individuals showed no gastro-intestinal disorders like diarrhoea, they still harbour these opportunistic and non-opportunistic parasites and act as carriers, particularly of the former category, in the community via contaminated water and open defaecation practices.

Studies on the effect of intratesticular administration of opioid peptides, naloxone or N-acetyl beta-endorphin antiserum on some testicular parameters in rats.

Opioid peptides have been localized in a variety of peripheral tissues like placenta, thyroid, pancreas, gastrointestinal tract, in the reproductive tract of male and female and in the testes of rats. Immunoassayable material was detected in extracts of gonads, reproductive tract and accessory reproductive organs. Studies with naloxone have suggested that beta-endorphin may have an important role in steroidogenesis and may have a role in regulating transport of luminal material. In our studies met-enkephalin, beta-endorphin, naloxone or N-acetyl beta-endorphin antiserum were microinjected intra testicularly once on alternate days for one week and autopsied 24 h after the last injection. Intratesticular administration of 25, 50 and 100 micrograms doses of naloxone induced significant decrease in in vitro secretion of testosterone per se, which was significantly greater with 50 micrograms dose than with those of the other two doses. A 25 micrograms dose had no effect on hyaluronidase or acid phosphatase activity while 50 micrograms dose significantly decreased the enzyme activity. One hundred micrograms dose also significantly decreased hyaluronidase activity. Intratesticular injection of 10 micrograms met-enkephalin or 1 microgram beta-endorphin significantly decreased hyaluronidase activity whereas 20 microliters N-acetyl beta-endorphin antiserum increased the specific activity of hyaluronidase. There was no change in the weight of the testes on treatment with the above agents.

Cryptosporidiosis in HIV infection.

Preserved faecal specimens (10 per cent Buffer formalin), from 150 HIV infected persons having symptomatic diarrhoea and 50 non-diarrhoeal apparently healthy people aged between 15-30 years were examined to detect the presence of cryptosporidium infection. 70 diarrhoeal patients (46.6 per cent) were found to excrete this pathogen. None of the non-diarrhoeals was found to excrete this parasite. It is evident from the present study that cryptosporidium is highly prevalent amongst the HIV infected persons with symptomatic diarrhoea. All the HIV infected persons were known cases of injected drug users.