Abnormal spicules on the inferior aspect of anterior arch of atlas vertebra.

Anterior arch of the atlas vertebra is known to exhibit various developmental anomalies. Bony outgrowths, osteophytes, clefts and aplasia of the anterior and posterior arches of the atlas have received special attention by research workers. To the best of our knowledge, not many osteological studies have defined the spicules on the anterior arch of the atlas. The present study describes an abnormal atlas vertebra with 2 spicules on the inferior aspect, 2 additional facets inferior to the superior articular facets and a peculiar facet to the left of the posterior tubercle. These abnormal spicules may cause dysphagia or involve atlanto-occipital movements. Such anomalies may be misinterpreted in routine X rays as a degenerative disease. However, asymptomatic cases remain undetected throughout life. Such anomalies may be important in radiological, clinical, forensic and anthropological studies.

Accessory Tendon and Tripartite Insertion Pattern of Fibularis Longus Muscle: A Case Report / Tendón Accesorio y Padrón de Inserción Trifurcada del Músculo Fibular Largo: Reporte de Caso

The fibular muscles are the chief everters of foot and play an important role in stabilizing its subtalar motion. In the present case detected incidentally, we report a case of an accessory tendon and tripartite insertion pattern of fibularis longus muscle in the left leg, out of which two slips were attached to plantar and lateral aspects of base of first metatarsal and the third slip was found blending with first dorsal interosseous muscle. Awareness and precise knowledge of such anatomical variants are important to surgeons performing reconstructive procedures.

Los músculos fibulares son los que evierten el pie y juegan un importante rol en la estabilización de los movimientos subtalares. En el presente caso detectado accidentalmente, reportamos un caso de un tendón accesorio e inserción trifurcado del músculo fibular largo en la pierna izquierda, dos de los cuales estaban fijados en las caras plantar y lateral de la base del primer hueso metatarsiano y el tercero fue encontrado mezclándose con el primer músculo interóseo dorsal. El exacto conocimiento de estas variaciones anatómicas son importantes para los cirujanos en los procedimientos reconstructivos.

Effect of diazepam sedation on arterial oxygen saturation during esophagogastroduodenoscopy: a placebo-controlled study.

OBJECTIVE: To determine the effect of sedation using diazepam on hemoglobin oxygen saturation (SpO2) in patients undergoing esophagogastroduodenoscopy (EGD). METHOD: 100 consecutive patients scheduled for EGD were randomly allocated to receive 0.03 mL/Kg of either diazepam (5 mg/mL solution) or normal saline intravenously after topical oropharyngeal anesthesia immediately before the procedure. SpO2 was continuously monitored throughout the procedure by an anesthetist who was unaware of the drug received. RESULTS: Fall in SpO2 exceeding 4% was noted in 78% of patients in the diazepam group and in 38% of patients in the placebo group (p < 0.001). Fall in SpO2 to suboptimal level (89%) was seen in 20% of patients in the diazepam group and in 10% patients in the placebo group (p < 0.001). The duration of suboptimal SpO2 was similar (means +/- SD being 2.47 +/- 0.10 min in diazepam group and 2.86 +/- 0.32 min in placebo group). CONCLUSION: Intravenous diazepam administration before EGD produces a significant fall in SpO2 during the procedure, and so should be avoided; continuous monitoring of SpO2 should be done during EGD.

Congenital bronchial cyst.

A case of congenital bronchial cyst in a young female is reported. Relevant literature has been reviewed.