An Observational Study Showing Incidence of Heart Disease in the Male Population from North India.

Background: Structural Heart Disease (SHD) is a preventable cause of mortality. As age advances the morbidity rates due to SHD increases. SHD is more common in rural areas and lower socio-economic status because of poor hygiene and poor nutrition. The aim of this study was to find the incidence of heart disease in a male north Indian population. Method: A team consisting of three doctors examined all the candidates presenting over a period of one and a half years for enrollment at a particular Centre. The age group of this population was between 18 years to 22 years. All candidates underwent medical examination. Candidates having suspicion of SHD were referred to the physician/cardiologist. All those persons whose disability was within permissible limits were taken as fit and the others were taken as unfit. Results: Total 4223 candidates reported in the above period. 334 candidates who had disabilities were lost to follow-up and excluded, leaving a total of 3889 candidates. After specialist review, 1471 candidates were found unfit for various causes, out of which 283 were for cardiac murmurs. Many candidates were found to be suffering from multiples disabilities. Conclusion: Our study found an incidence rate of 72.7 per thousand which is much higher than that of other studies. The possible reasons for this could be that the persons are primarily from rural background and low socioeconomic strata which have a comparatively incidence of SHDs. Also contributing to the higher incidence may be the fact of stricter application of physical standards for enrollment in the army.

An Anatomical Study of Glenoid Cavity: Its Importance in Shoulder Prosthesis.

Introduction: Glenoid cavity of scapula has variable morphology and therefore its anatomy is of enormous importance for orthopaedic surgeon and prosthetic designers. Presence of notch in the antero-superior part of glenoid rim affects the morphology of glenoid labrum. Anatomical variations of glenoid cavity are also important for understanding the various pathologies involving the shoulder joint. Present study aims to determine various anthropometric measurements of scapula and glenoid cavity including the variations of its shape. Materials and Methods: A total of 126 adult dry scapulae available in the Dept. of Anatomy, ACMS Delhi Cantt., India, and also procured from medical colleges in the vicinity were taken for the study. Results: The mean length and breadth of scapula observed were 141.94±12.76 mm 103.65±6.82mm respectively. The mean length of the glenoid observed in the present study was 38.78±3.03 mm. The mean AP glenoid diameter 1 and 2 were 24.93±2.55mm and18.66±2.13 mm respectively. The mean Glenoid cavity Index (GCI) found in the present study was 64.29 ± 9.79 mm. Conclusion: The dimensions of the glenoid observed in the present study were similar to those recorded in the studies done on other populations except for the shape. Higher percentage of glenoid cavities without a definitive notch was recorded in the present study compared to earlier studies. This fact may be taken into consideration while designing glenoid prostheses for the North Indian population.

An anatomic variant caudate lobe in a cadaver.

The liver can present a number of congenital anomalies. Most common among them are the irregularities in shape and the number of lobules. Less common variations include presence of accessory lobes or accessory fissures. The accessory lobe may be attached to the liver through a mesentery or a bridge of hepatic tissue and they are usually asymptomatic. An accessory liver lobe though a very rare occurrence but when it exists it becomes clinically important because of its rarity. We are reporting one such case of accessory caudate lobe of liver found during routine dissection of embalmed cadaver of a 60 year old male. It was separated from the caudate lobe by a well-defined fissure. The quadrate lobe and fissure for ligamentum teres were totally absent. Ligamentum teres was found embedded in the substance of the liver on its inferior surface. The presence of additional lobes and fissures or the absence of normal lobes and fissures might lead to confusion during surgery or clinical misdiagnosis. Knowledge and awareness of these anomalies is useful to the clinician to rule out diseases, surgeons during segmental resection of liver and radiologist when interpreting liver radiologic findings.

High division of sciatic nerve.

Background: The Sciatic nerve is the largest and thickest nerve in the human body with a long course in the inferior extremity. It divides into tibial and common peroneal nerves which can occur at any level from the sacral plexus to the inferior part of the popliteal space. Sciatic nerve variations are relatively common. These variations may contribute to clinical conditions ex sciatica, coccygodynia and piriformis syndrome and have important clinical implications in anaesthesiology, neurology, sports medicine and surgery. Methods: 10 cadavers were dissected with no previous history of trauma/surgery to study the anatomical variations of sciatic nerve. Results: In all except two cadavers, the nerve divided at the apex of the popliteal fossa. In two cadavers the sciatic nerve divided bilaterally in the upper part of thigh. Conclusion: The high division presented in this study can make popliteal nerve blocks partially ineffective. The high division of sciatic nerve must always be borne in mind as they have important clinical implications.

The role of Wobe-Mugos in reducing acute sequele of radiation in head and neck cancers--a clinical phase-III randomized trial.

Oral enzymes act as a potent antiinflammatory, antiedematous agents thereby decreasing acute toxigenic effect of radiation and increasing compliance, quality of life of our patients. Fifty patients were randomized 25 allocated in enzyme and radiotherapy arm, 25 in radiotherapy alone. Pre RT and post RT biopsies were taken from both arms. In our study it was found that there was clinical, histopathological as well as statistical significant difference in both arms. The enzyme arm patients had mucostis of grade I in 76%, grade II in 12%, grade III in 8% while as 8% had grade I, 68% grade II, 24% had grade III in RT arm alone. In enzyme patients skin reactions of grade I in 72%, 20% had grade II, 8% had grade III. In control arm 12% had grade I, 76% had grade II, 8% had grade III skin reaction.

Mortality events amongst non insulin dependent diabetes mellitus patients in Orissa.

In a study over one year, it was observed that mortality amongst hospitalised patients with non insulin dependent diabetes mellitus (NIBDM) was nearly 20%. Those dying within 24 hr were classified as group A, between one day and one week as B, between one week and one month as C, and those after one month as D. There were 31 patients each in groups A and B, 14 in C, and 4 in D. The mean age at death was 61 years in the first three groups. The prevalence of cerebro-vascular accident as a terminal event was similar i.e. 32.2, 35.5 and 35.7 per cent in groups A, B and C respectively; 48% of patients in group A suffered from ischaemic heart disease. Diabetic ketoacidosis was equally prevalent amongst groups A, B and C. Infection was significantly more common in group B (45.2%) than A (P less than 0.05). Nephropathy was observed in 57% of patients in group C as compared to 22.5% in A (P less than 0.02). Cerebrovascular accident and infection were the major causes of mortality in groups B and C (80.7% and 71.4%), whereas ischaemic heart disease and cerebrovascular accident accounted for 80% of deaths in group A.