Anomalous Origin of Anterior Interosseous Artery.

Background: The Brachial Artery ,usually a continuation of the axillary artery begins at the distal border of teres major and ends about a centimetre distal to the elbow joint by dividing into the radial and ulnar artery. Objectives: A. To document the origin of anterior interosseous artery from brachial artery. B. To establish embryological and clinico-anatomical correlation of such variations. Methods: These findings were observed after meticulous dissection of the upper limbs of both sides of a 43 year old adult male cadaver in the department of anatomy ,R .G .Kar Medical College ,Kolkata. Results: The brachial artery present in the right limb gave a branch in the upper 1/3 of the arm from its lateral aspect. This branch of brachial artery went downwards and became deep to pronator teres and continued as the anterior interosseous artery. The brachial artery itself descended and remained superficial to pronator teres. Just below the elbow joint it underwent bifurcation into radial and ulnar artery.The subsequent course of those two arteries was normal. And there was absence of common interosseous artery. So the anterior interosseous artery instead of arising from the common interosseous artery which was the branch of the ulnar artery took origin from brachial artery. Conclusion: This variation was explained in the light of embryological development and such variations were useful for physicians, surgeons, nephrologists ,radiologists and interventionist in various surgical procedures and also for diagnostic and therapeutic approaches.

An Assessment of the Benefit of Surgical Face Masks in Preventing Aerosol Droplet Spread during a Simulated Spinal Anaesthetic-a Blinded in vitro Study.

Aims: The purpose of this study was to assess the benefit of wearing a surgical face mask in reducing aerosol contamination of agar plates in a simulated spinal anaesthetic. The contamination of plates with virulent organisms, association of growth with recent upper respiratory tract infection and food intake were also studied. Methods: A poster containing written text was fixed to a wall, with a standard agar plate suspended at its midpoint. Each volunteer (n=30) then read the text from the wall chart to simulate verbal interaction with a patient during a spinal anaesthetic, initially wearing a surgical mask and then once again without a mask. Results: This study revealed an increased risk (p =0.006) of bacterial growth on agar plates when not wearing a surgical face mask. Results also suggest that eating prior to surgical procedures may increase the risk of contamination of the surgical field in the absence of a barrier mask.

A Study of Somatic Nerve Functions in Diabetic and Normal Persons.

This hospital-based case-control study was undertaken among 50 diabetic cases and 50 non-diabetic controls of Burdwan to evaluate neurophysiological changes. Neurophysiological assessment was done with nerve conduction velocity, amplitude and latency of median nerve motor and sensory component of upper arms and tibial motor and sural sensory part of lower limbs. NCV and amplitude had negative correlation where latency had positive correlation with age and duration of diabetes. Independent t-test was done to compare NCV and amplitude among cases and controls and results showed diminished values in cases than controls (p< 0.001). This study reflected that early diagnosis and management of neuropathy by neurophysiological test may retard the progression of neuropathy in diabetic persons.

Study of Hypothyroid Related Atrioventricular Block in Elderly Hypothyroid Patients and Assessment of Any Reversal After L-Thyroxin Therapy.

We intend to study the pattern of atrioventricular conduction blockage in hypothyroidism in elderly population and assessment of any reversal after Lthyroxin therapy. Aims : 1) To detect hypothyroid related AV block in elderly hypothyroid patients. 2) To supplement L-thyroxin for 6 weeksand check whether the AV conduction is restored or not. Settings and design : The proposed study is a hospital based case control study followed by interventional one. Hypothyroid elderly subjects attending OPD over a period of one year were considered for the purposes of observation. Age and gender matched controls were selected simultaneously. Methods and materials : 42 elderly (>60 years) hypothyroid patients were selected as case and 45euthyroid sage and gender matched subjects as control. ECG was done to asses the degree of AV block. Any degree of AV conduction block noted, was supplemented with L-thyroxin for 6 weeks and later resting ECG was done to assess whether the normal AV conduction was restored or not. Statistical analysis : Chi square test done between the case and control group and paired T test done before and after L-thyroxin supplementation. Results : Chi square test revealed that out of 42 cases, a significant proportion of 62% had increased P-R interval (P<.001), whereas 76% out of 45 control had normal P-R interval.After L-thyroxin supplementation in 69% of the cases, normal P-R interval was restored (P< .001, paired T test value 13.484). Conclusion : In hypothyroid patients AV block detected in resting ECG should be a matter of concern, because if the conduction block is reversed to normal sinus rhythm by thyroxin supplementation, unnecessary pacemaker implantation can be avoided.

Role of Non Stress Test in Monitoring High Risk Pregnancy.

Background : Heart rate variations in fetus subjected to adverse environment provides assessment of health status. Aim : The present study is conducted to assess the efficacy of this tool in selecting high risk mother with compromised fetus at an early stage. Methods and Material : Hospital based case control study. High risk pregnancies attending hospital over a period of one year were considered for purpose of test. Normal patient were served as control. 80 high risk and 20 normal patient were considered for the study. The subjects were explained the test, need of the test, done after 28 wks. of gestation. Statistical Analysis : Sensitivity, specificity, negative predictive and positive predictive value, false positive and false negative rate were assessed. Result : Test has high sensitivity and specificity with high negative predictive value.