Evaluation and comparison of forehead angulations using cephalometrics between male and female human subjects.

Introduction: Sex identification is one of the important aspects of forensic sciences and many methods have been widely used for the same. Use of cephalometrics to establish age, sex and race has been adopted by forensic odontologists. But forehead angulations and quantitative measurements of its curvature to establish sex have been less explored. With above background a cross-sectional study was designed to evaluate and compare the angulations of the forehead at defined points between human male and female subjects. Materials and Method: Present study was conducted on 100 subjects. Lateral cephalogram obtained from 50 males and 50 females with age range of 18-26 years were transcribed on acetate sheet. Angulations on forehead and one linear measurement were calculated. Data was stored for analysis. Results: Mean values of angle A, B and C were lower and AD segment was higher in male group when compared to female group. Comparison of mean values of angle B and AD segment between males and females showed statistically significant difference (p value < 0.05). Coefficient of variation of AD segment was least among all variables. Conclusion: We concluded that, angle of curvature was higher in females as compared to males supporting the round forehead in female. Further, the proposed hairline in male was found to be slightly higher when compared to female.

Assessment of nerve conduction study to establish most common electrophysiological predictor of lumbosacral radiculopathy among radiologically diagnosed L5S1 neural foramina compression cases.

Magnetic resonance imaging (MRI) and electromyography (EMG) are complimentary investigations in diagnosis of lumbosacral radiculopathy (LSR). With changing pattern of S1 electrodiagnosis by H-reflex study measures, electrophysiological studies were conducted to establish most common electrophysiological predictors of LSR in MRI diagnosed L5S1 neural foramina compression subjects. Fifty subjects, with definite L5S1 neural foramina compression underwent electrophysiological evaluation and the data was analyzed using established electrodiagnostic criteria. Reduced H/ M ratio in combination with absent H response was evident in 74 nerves. H-reflex study was abnormal in 88% subjects. Study concluded that, H/M ratio if used with other H-reflex study variables may be most common predictor of LSR.

Percutaneous autologous bone marrow injection in the treatment of delayed and non-union of long bones.

Context: Bone marrow has been shown to contain osteo-progenitor cells. Percutaneous autologous bone marrow injection (PABMI) encourages early treatment of delayed union and non-union to expedite healing and minimize complications from prolong immobilization. Aims and objectives: To assess the outcome of PABMI treatment in delayed and non-union of long bones. Study design: Prospective study Participants and procedures: 24 cases (33 bones) of Delayed and non-union of long bones were selected. Percutaneous autologous bone marrow injection treatment was adopted for fracture healing. Change in pattern of union was followed after 12 weeks by clinical and radiological study. Results: 90% of tibial fractures, 66.66% of radial fractures and 50% of ulna fractures show clinical and radiological union. 100% of the fractures with no gap at the fracture site united, where the gap was less than 1 cm, 85% of bone united, in only 1 case the gap was more than 1 cm and it failed to unite. 7 out of 9 bones in hypertrophic non-union united, whereas 4 out of 6 bones in atrophic non-union united. Conclusion: Percutaneous autologous bone marrow grafting is an effective and safe method for the treatment of diaphyseal non union. We strongly believe that an injectable preparation that combines marrow with osteoinductive and osteoconductive agents should virtually eliminate the need for open harvesting and operative grafting of the problems associated with fracture healing.

Prevalence of cardiac autonomic neuropathy in patients with diabetes.

Background: Autonomic neuropathy is a serious complication of diabetes mellitus. Cardiac autonomic neuropathy (CAN) is chronic diabetic complication with variable prevalence and clinical manifestations. Prevalence of CAN remains less explored domain among type 2 diabetic population. Aim: To analyse the prevalence of CAN in type 1 and type 2 DM. Materials and methods: A total of 152 cases with DM were selected for the study following strict inclusion and exclusion criteria. All the cases underwent a battery of cardiovascular reflex tests designed by Ewing. Results: We observed that overall prevalence of CAN was 51.9%. Prevalence of sympathetic and parasympathetic CAN was 28.9% and 44% respectively. When compared, prevalence of CAN in type 1 patients was significantly different from type 2. Further, significant difference was noted between parasympathetic and sympathetic CAN in these patients. Conclusion: Study concludes that, prevalence of CAN in type 1 DM is higher than type 2. Parasympathetic CAN prevalence is higher than sympathetic CAN in both groups.

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.

Assessment of nerve conduction in evaluation of radiculopathy among chronic low back pain patients without clinical neurodeficit.

The diagnostic evaluation of chronic low back pain (CLBP) is difficult, as its primary causes are multiple. Clinical, radiological and electrophysiological findings are of limited value in diagnosing radiculopathy as the cause of CLBP in early cases. Current study was undertaken on 50 controls and 50 CLBP patients without clinical neurological deficit to evaluate the potential of nerve conduction studies, particularly H-reflex study for diagnosis of radiculopathy in these cases. We observed that routine nerve conductions in CLBP without clinical neurodeficit showed no significant differences; whereas all the H-reflex parameters, H-threshold, H latency, H amplitude and H/M ratio were significantly different when compared with that of control (P value <0.0001 in each case). We concluded that subclinical cases might not have only partial conduction block but also secondary axonal loss due to compression of nerve roots. We further suggest inclusion of Soleus H-reflex study in evaluation of radiculopathy among early CLBP cases without clinical neurodeficit.