Assessment of Relationship Between Neck Shaft Angle and Neck Length with Interepicondylar Distance in Femur.

Background: Femur is the longest and strongest bone of the body. It transmits body weight from hip bone to tibia in standing position. Femoral neck is a constricted part connecting head with shaft at an angle of about 125°- known as angle of inclination or neck shaft angle (NSA); this facilitates the movement of hip joint enabling the limb to swing clear of pelvis. Abnormal femoral neck angle (FNA) may be associated with various clinical problems ranging from harmless in toeing gait in childhood to disabling osteoarthritis in adults. The current study attempted to find out if a co-relation exists between those parameters and other clinically measurable variables like inter-epicondylar distance or distance between greater trochanter to lateral epicondyle. This may help to predict the risk of fracture neck femur without any risk of radiation exposure and proper prophylactic measures can be undertaken (Vit-D, calcium) to decrease risk of fracture. Results: Measurements were taken in dry femora mostly in East Indian population. Variables that were measured in 158 dry femora (85 femora from left side and 73 from the right side) are: - a) Neck shaft angle of femur, b) Neck length of femur, c) Neck circumference of femur, d) Inter-epicondylar distance of femur, e) Distance between lateral epicondyle and greater trochanter of femur. No significant difference was found between the right and left sided femoral groups regarding any of the study variables. From the analysis it was revealed that no positive or negative correlation exists between the study variables. Therefore, it is not possible to predict the value of one or more of them from the magnitude of the other variable(s). Conclusions: Our study attempted to find out if it was possible to predict the risk of fracture neck femur by simple clinical procedure without exposing the subjects to radiation hazards associated with a radiological imaging. A screening test and subsequent prophylactic measures could have been suggested to prevent the fracture. However, at the end of the study, no suitable alternative to the radiological assessment was detected.

Anomalous Branches of Median Nerve In The Arm.

Background: Dissection of right and left upper limbs and demonstration of the origin and the course ofmedian nerve. Result: Median nerve in the right upper limb is formed normally but it supplies brachialis muscle and both head of the biceps in the armwhich is anomalous. In the left arm of the patient the course and supply of median nerve is normal. Conclusion: The patient has unilateral anomalous supply of median nerve in the arm – this can result in trauma to this nerve while undergoing any surgery in right arm.

Electrolyte status in birth asphyxia.

Objective. To study electrolyte status in asphyxiated newborns of different severity in early neonatal period and compare with controls. Methods. Sodium, potassium and total calcium levels were estimated in the serum samples of asphyxiated newborns of different severity and control group immediately after birth. Results. Mean serum sodium level was significantly lower (122.1 ± 6.0 mEq/L vs 138.8 ± 2.7 mEq/L; P < 0.001), mean serum potassium was higher (5.05 ± 0.63 mEq/L vs 4.19 ± 0.40 mEq/L; P < 0.001) and mean serum calcium level was found lower (6.85 ± 0.95 mg/dl vs 9.50 ± 0.51 mg/dl; P < 0.001) in cases than controls. Among cases, a strong positive linear correlation was found between the serum sodium, serum calcium levels and their Apgar scores, between sodium levels and total calcium levels and significant negative linear correlation between Apgar scores and serum potassium level. Conclusion. Among cases, hyponatremia and hypocalcemia developed early and simultaneously and the decrease in their serum levels was directly proportional to each other and to the degree of asphyxia. Though, mean potassium level was within the normal limit, the value was higher among cases than controls and directly proportional to asphyxia.

Urinary uric acid in preterm neonates.

Objective. Study of uric acid level in spot urine of normal preterm AGA (appropriate for gestational age) babies in day one of their life. Methods. Spot urine samples were collected from 45 normal preterm neonates within 24 hours of their birth for estimation of uric acid. Results. The mean uric acid level was 36.50 ± 5.99 mg/dl in normal preterm neonates as compared to 18.40 ± 0.45 mg/dl in normal term babies (documented in another study) (p < 0.001). Also a significant negative linear correlation between body weight and urinary uric acid level was found { r (correlation coefficient) = – 0.970, P (probability) < 0.001}. Conclusion. Higher mean uric acid level was found in spot urine samples of preterm normal neonates than that of normal term babies on day one. Further, urinary uric acid levels were found inversely proportional to the body weight or to the gestational age (as they are AGA) of the babies.