Morphological Study of Small Cardiac Vein, Right Marginal Vein, Posterior Vein of the Left Ventricle, Left Marginal Vein, Oblique Vein of Marshall, and Anterior Cardiac Veins in Human Hearts of Western Region of U.P – Clinical Implication

Introduction:Cardiac venous system is an important system for various cardiac interventional procedures such as cardiac catheterization. Various veins like right marginal vein, small cardiac vein (SCV), posterior vein of the left ventricle, left marginal vein, oblique vein of Marshall drain into coronary sinus. While anterior cardiac veins drain right ventricular wall directly into right atrium. Materials and Methods: An observational cross‑sectional study was conducted on thirty cadaveric hearts during a 2‑year period in Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Anatomy Department. The length, diameter of SCV, left marginal vein, posterior vein of the left ventricle, right marginal vein, and oblique vein of Marshall were taken. Results: The study reveals the length of SCV as 28.12 ± 22.87 mm. The length of right marginal vein and posterior vein of the left ventricle is having a significant correlation with age. The length of oblique vein of Marshall is lower in males as compared to females. A number of ACVs were significantly related to weight of cadaver in males. Conclusions: The present study provides data of cardiac veins for various cardiac interventional procedures.

Comparative study of wound healing following purse-string closure versus conventional linear closure for stoma reversal

Background: Stoma closure is associated with several complications, wound infection being the most common. This study is done to establish that purse string suture closure method for stoma closure is superior to the conventional linear mattress closure and is associated with better wound healing cosmesis. Materials and Methods: This Prospective randomized controlled study enrolled 80 patients who underwent stoma closure from April 2021 to March 2022 in department of General Surgery in IGIMS, Patna. Patients were divided in two groups inclusive of ileostomy and colostomy based on type of closure technique. Conventional linear closure method was applied to Group A and purse-string technique applied to Group B patients. All Patients were followed regularly upto three months after operation. Rate of infection, pain as assessed by VAS score and satisfaction as assessed by POSAS Score were done. Results: Purse string Closure had better outcome in terms of wound infection rate and Cosmetic results over a 3 months follow up. Ten patients in Group A and 2 from Group B out of 40 patients had wound infection. Patients with purse-string suture had statistically significant greater satisfaction over 3 months. Medium operative time of Group A was 100 minutes and that of Group B was 98 minutes. There were no significant difference in regards duration of hospital stay was more in Linear Group than Purse String (Group B). Conclusion: Purse-string closure was associated with better cosmesis and lower infection rate in comparison to Linear conventional closure.

Myoclonus-Ataxia Syndrome Associated with COVID-19

Neurological manifestations of coronavirus disease (COVID-19) have increasingly been reported since the onset of the pandemic. Herein, we report a relatively new presentation. A patient in the convalescence period following a febrile illness with lower respiratory tract infection (fever, myalgia, nonproductive cough) presented with generalized disabling myoclonus, which is phenotypically suggestive of brainstem origin, along with additional truncal cerebellar ataxia. His neurology work-ups, such as brain MRI, electroencephalography, serum autoimmune and paraneoplastic antibody testing, were normal. His CT chest scan revealed right lower lung infiltrates, and serological and other laboratory testing did not show evidence of active infection. COVID-19 titers turned out to be strongly positive, suggestive of post-COVID-19 lung sequelae. He responded partially to antimyoclonic drugs and fully to a course of steroids, suggesting a para- or postinfectious immune-mediated pathophysiology. Myoclonusataxia syndrome appears to be a neurological manifestation of COVID-19 infection, and knowledge regarding this phenomenon should be increased among clinicians for better patient care in a pandemic situation.

Myoclonus-Ataxia Syndrome Associated with COVID-19

Neurological manifestations of coronavirus disease (COVID-19) have increasingly been reported since the onset of the pandemic. Herein, we report a relatively new presentation. A patient in the convalescence period following a febrile illness with lower respiratory tract infection (fever, myalgia, nonproductive cough) presented with generalized disabling myoclonus, which is phenotypically suggestive of brainstem origin, along with additional truncal cerebellar ataxia. His neurology work-ups, such as brain MRI, electroencephalography, serum autoimmune and paraneoplastic antibody testing, were normal. His CT chest scan revealed right lower lung infiltrates, and serological and other laboratory testing did not show evidence of active infection. COVID-19 titers turned out to be strongly positive, suggestive of post-COVID-19 lung sequelae. He responded partially to antimyoclonic drugs and fully to a course of steroids, suggesting a para- or postinfectious immune-mediated pathophysiology. Myoclonusataxia syndrome appears to be a neurological manifestation of COVID-19 infection, and knowledge regarding this phenomenon should be increased among clinicians for better patient care in a pandemic situation.

Topographic Study Of Supraorbital Margins, And Notches In North Indian Human Dry Skulls And Its Clinical Applications

Introduction: The supraorbital notch (SON) is present at the junction of sharp lateral two-thirds and roundedmedial third of supraorbital margin. The neurovascular bundle exit via this notch/foramen. The morphometricvariations of the supraorbital ridge, notch, or foramen are not uncommon. The knowledge of these parameters isimportant to preserve the neurovascular bundle during surgery in this area.Materials and Methods: This study included seventy skulls obtained from department of Anatomy, Doon governmentmedical college Dehradun and Sri Guru Ram Rai Institute of medical and health sciences Dehradun followingstandard guidelines. All the parameters were observed and measured with the help of vernier caliper andreported in the tabulated form.Results: Out of seventy skulls, bilateral supraorbital notch and supraorbital foramen were found in 37.14% and14.28% respectively. Unilateral notch and contralateral foramen was found in eight skulls i.e. 11.42%. notch orforamen was absent in 5.71% skulls. The distance from SON/F to the midline (nasion) and frontozygomaticsuture were 25.86±3.11 and 29.89±2.19 mm. respectively . The mean distance between supraorbital notch orforamen to infraorbital foramen was 42.33 ±3.11 mm.Conclusion: Topographical anatomy of supraorbital ridge, notch and foramen and its variation is important toprevent the complications after surgical procedure in this area.

The study of the effect of C-PAP therapy in type-II diabetic patients with obesity and obstructive sleep apnea

Type II diabetes mellitus (T2DM) is closely associated with Obstructive sleep apnea (OSA) and obesity. Type 2 diabetes and OSA may be pathophysiologically independent conditions although the joint association with obesity or visceral adiposity. There is a consistent relationship between obesity and OSA, which has been reported in 60-90% of OSA patients. The prevalence of obesity increases with a parallel increase in the prevalence of OSA. Continuous positive airway pressure (CPAP) therapy is an effective choice of treatment for OSA, an overnight test, or titration some patients may reduce apnea events by minimizes airway collapse by CPAP. Several studies showed that the effect of drug treatment with 3 months of C-PAP in patients with type 2 diabetes. In the present study, we include 300 patients in different groups, out of the 100 patients undergoing treatment of CPAP therapy minimum for three months. Blood sugar, HbA1c, and lipid profile were measured and an overnight sleep study was done. The obtained data shows the significant effect of therapy on physiological and biochemical parameters. AHI and BMI were highly significant in group II and Group III when compared to group I. FBS, HbA1C, and Lipid profile parameters also gave significance results (p-value <0.001) in group II and group III when compared with healthy subjects (group I).

Oral Clonidine Premedication and its effect on Subarachoid block: A Randomised Study

Oral clonidine has been reported to prolong the sub arachnoid block and postoperative analgesia. The study was conducted to evaluate the effectiveness of oral clonidine as premedication on subarachnoid block. Methods: 100 patients of aged 20-60 years (ASA-1 and ASA-2 ) undergoing infraumbilical surgeries were included in this prospective, double blind randomized study. Patients divided in to two ( n = 50 ) groups. Group Ι patients receiving oral clonidine 150 μg one hour before surgery and Group ΙΙ patients receiving oral placebo. Post-op motor block and pain was assessed by using Bromage Scale and Visual Analogue Scale respectively. Statestical analysis used: Both groups were compared by using paired t test. Results: the onset of sensory block in group II 4.40±0.11 min. Vs 3.58±0.10 min. in group I (p < 0.001) , the onset of motor block 5.47±0.12 min. in group II Vs 5.37±0.15 min. in group I (p < 0.001). the duration of sensory block in group II 154.8±13.01 min VS 211.1±10.37min. of group I duration of motor block 138.9±12.5 min. in group II VS 184.2±11.31 min. of group I. (p< 0.001). Total duration of Analgesia for group I 399.46 ± 6.12 vs 149.92 ± 4.14 for group I (P < 0.001). Conclusion: Clonidine as oral premedication hastens the onset of sensory block, motor block and increases duration of sensory and motor block as well as total duration of analgesia.

Morphometric Evaluation Of Glenoid Cavity And Other Dimensions Of Dry Human Scapulae

Introduction: The scapula (shoulder blade) is a triangular flat bone that lies on the posterolateral aspect of thethorax. The scapula bears various angles namely superior, inferior, lateral, medial, acromial and coracoidangle. The three borders meet strategically to form the referenced three angles (lateral, superior, and inferior. Itslateral angle, truncated and broad, bears the glenoid cavity which articulates with the head of the humerus at theglenohumeral joint. The morphology of the glenoid cavity is highly variable. The glenoid rim presents a notch inits upper and front partMaterials and Methods: This study included thorough observation of 120 dry human scapulae, 67 from left sideand 53 from right side, obtained from department of Anatomy, Sri Guru Ram Rai Institute of medical and healthsciences Dehradun following standard guidelines. All the metric and non metric parameters were observed andrecorded in tabulated form.Results: The mean length of scapula of left side was observed as 127.35±12.35 and right side was 128.10±11.21.Thetotal mean value for length of scapula was noted as 130.21±12.65 . The mean breadth of scapula was recordedas 96.98±7.62mm. The mean value of scapular index was listed as 68.47±3.98 . The mean of infraspinous lengthwas recorded as 99.14±9.54 and the infraspinous index was 99.65±8.32.The mean AP glenoid diameter 1 was24.54±2.65mm, the mean AP glenoid diameter 2 was 16.56±2.45mm and the mean AP glenoid diameter 3 was17.09±2.75 The shape of the glenoid cavity was recorded as type 1(oval) 17.50%, Type2 (pear) 48.14%,Type3(inverted coma) and Type4(other).Conclusion: To summarize, the present study provides a base line data of different scapular dimensions on theleft and right sides. Knowledge of the measurements and indices of various parameters of scapula such aslength, width and various parameters of glenoid cavity can be used for comparative anatomy and also fordefining the race.

Morphological status of assimilated atlas vertebra with occipital bone and its clinical significance.

Background: Atlas is the first cervical vertebra. Sometimes there is partial or complete fusion of atlas with basal part of the occipital bone known as assimilation of atlas or atlanto-occipital fusion. It is normally congenital. It may be associated with the constriction of foramen magnum which may compress the spinal cord or brain stem. Methods: The 1000 human dry skulls were selected from the anthropology museum of department of anatomy, GSVM medical college, Kanpur. The age and sex of the skulls were not taken into consideration. The skulls were examined for the bony union between the atlas and skull and other variations in assimilated atlas. Results: Fused atlas with skull was seen in 20 skulls (2.0%). Partial fusion of anterior arch of atlas with the occipital bone was seen in 1 specimen (5%) and in 10% it was found complete fusion. In 10% skulls the posterior arch fused with the occipital bone. Bilateral fusion of transverse process with occipital bone was noted in 2 (10%) specimen. The incomplete foramen transversarium was found in 1 skull (5%) {bilateral} and in 2 skulls (10%), the transverse process was noted without the foramen transversarium {bilateral}. Conclusion: Out of 1000 examined skulls, fusion of atlas with the occipital bone was noted in 20 skulls (2%). The knowledge of incidence of assimilation of atlas and its variations may be helpful for the embryologist, neurosurgeons and orthopedic surgeons.

Variations in suprascapular notch morphology and its clinical importance.

Background: Suprascapular notch (SSN) is present towards the medial end of superior border of scapula. The morphometric variations of the SSN have been identified. The suprascapular nerve compression is commonly noted at the site of SSN. Methods: The study was carried out in the department of anatomy, SRMS-IMS medical college, Bareilly and SGRRIM-HS Dehradun. The 120 dried scapulae were randomly selected. The age, sex and race of the scapulae were not known. The scapulae were observed carefully for the different shapes of the suprascapular notch. The various dimensions of suprascapular notch were taken by using a digital vernior caliper. Results: In the present study six types of SSN were noted based on the description by Rengachary SS. et al.22 Type I (15.83%); type II (41.66%); type III (25.00%); type iv (12.50%); type v (1.67%) and type VI (3.33%). We also classified the SSN based on the description by M. Polguj et al. 2011,28 the frequencies were: type I (MVD>STD), 20%; type II (MVD=STD=MTD), 3.33%; type III (STD >MVD), 55.83%; type IV (bony foramen), 3.33% and type V (Without a discrete notch), 17.5%. Conclusion: The suprascapular neuropathy may occur at the various anatomical locations of its course and has a variety of causes. Our study is important for clinician because the narrow SSN increase the risk of suprascapular entrapment neuropathy. So the knowledge of these variations should be kept in the mind of clinicians in the diagnosis and treatment of suprascapular neuropathies.

Evaluation of stress contours on a maxillary molar subjected to simulated tooth loads by finite element analysis technique

Forces applied by dental occlusion generate stresses which are transmitted to the surrounding bone via the periodontal ligament causing a tissue response. The purpose of this study was to evaluate the response of a maxillary molar under secondary trauma from occlusion by observing the changes in its stress patterns. In order to visualize the exact pattern of stress distribution, three dimensional finite element analysis models were developed. A force of 3 N, moment of 27 Nmm and a counter rotation moment of 15 Nmm were applied to simulate orthodontic forces. Stresses produced at the periodontal ligament-tooth interface on a maxillary molar model with normal bone height subjected to an orthodontic force were compared with molar models showing bone loss and analyzed using finite element analysis technique. As the bone loss increased, it was observed that, the concentration of stresses at the apical one-third of the tooth also increased and there was high tendency for tooth displacement. The results suggest that an alteration in the magnitude of forces applied may be necessary in teeth with an increased crown to root ratio to maintain a healthy periodontium.

Cochlear Implant Outcomes: A Comparison between Irradiated and Non-irradiated Ears

OBJECTIVES: Radiotherapy for head and neck tumors is known to potentially induce sensorineural hearing loss, which is possibly due to damage to the cochlear and/or auditory pathways. Since the success of cochlear implantation depends on a functional auditory nerve, this paper aims to study the hearing outcomes of cochlear implantation in irradiated ears. METHODS: A retrospective study of cochlear implant recipients from our institution who had previously received radiotherapy for head and neck cancers was performed. A control group with cochlear implants who did not receive radiotherapy was recruited. A review of case records, speech discrimination scores (SDS), and a validated subjective questionnaire in the form of the Abbreviated Profile of Hearing Aid Benefit (APHAB) was administered to the study group who fulfilled the inclusion criteria. Global and category scores in both groups were averaged and statistically compared via non-inferiority (NI) testing. RESULTS: With the control group (n=8) as the reference, the -DeltaNI was defined, and a one-tailed lower 95% confidence interval was used for the irradiated group (n=8). The APHAB degree of improvement (%) results were as follows: global, 28.9% (19.32%, -DeltaNI=16.3%); ease of communication, 67.0% (58.36%, -DeltaNI=37.5%); background noise, 53.2% (44.14%, -DeltaNI=26.8%); reverberation, 41.7% (28.85%, -DeltaNI=32.7%); and aversiveness, -46.2% (-67.80%, -DeltaNI=-56.9%). The SDS was 66.9% (56.02%, -DeltaNI=51.0%). From the results, lower 95% confidence interval limits of global APHAB, SDS, ease of communication, and background noise scores of the irradiated group were within the defined -DeltaNI boundary and hence are not inferior to the control. The categories of reverberation and aversiveness could not be proven, however. CONCLUSION: This study demonstrated marked improvements in hearing measured both objectively and subjectively. The overall hearing outcomes after cochlear implantation for post-irradiated patients were not worse than patients who have had no prior irradiation to ear structures.

Knowledge, attitude, and level of physical activity among medical undergraduate students in Delhi.

Introduction: Physical inactivity has been implicated as a major risk factor for cardiovascular diseases. The healthy lifestyle of medical students could facilitate the formation of healthy physicians who is more likely to give effective preventive counseling to their patients. Therefore, this study was undertaken to assess the knowledge, attitude, and pattern of the physical activity among the medical students. Materials and Methods: A cross-sectional study was conducted amongst 161 eligible sixth semester medical undergraduate students. A pretested questionnaire was used to collect the data. Anthropometric measurements were also taken. The data were fed and coded in Microsoft Excel 2007 and analyzed using SPSS 17.0 and Epi Info software of World Health Organization. Results: Knowledge regarding different types of exercise and anthropometric variables was fairly low among the study participants. Only 9.3% of the students were aware of the recommended level of the physical activity but nearly all (96.27%) were aware of the benefits of it. The attitude of the participants toward the physical activity was favorable, yet only one-third (32.3%) subjects adhered to recommended guidelines. Boys (39.8%) were found to be significantly more active than girls (20.6%) (P = 0.01). Conclusion: The knowledge and practices regarding the physical activity was found to be low amongst the medical students. There is a need to provide an enabling environment for promoting the physical activity amongst them so that can inculcate the same in their patients.

Utility of adsorbents in the purification of drinking water: A review of characterization, efficiency and safety evaluation of various adsorbents.

Clean drinking water is one of the implicit requisites for a healthy human population. However, the growing industrialization and extensive use of chemicals for various concerns, has increased the burden of unwanted pollutants in the drinking water of developing countries like India. The entry of potentially hazardous substances into the biota has been magnifying day by day. In the absence of a possible stoppage of these, otherwise, useful chemicals, the only way to maintain safer water bodies is to develop efficient purifying technologies. One such immensely beneficial procedure that has been in use is that of purification of water using ‘adsorbents’. Indigenous minerals and natural plants products have potential for removing many pollutants viz. fluoride, arsenic, nitrate, heavy metals, pesticides as well as trihalomethanes. Adsorbents which are derived from carbon, alumina, zeolite, clay minerals, iron ores, industrial by products, and natural products viz. parts of the plants, herbs and algal biomass offer promising potential of removal. In the recent years attention has been paid to develop process involving screening / pretreatment / activation / impregnation using alkalies, acids, alum, lime, manganese dioxide, ferric chloride and other chemicals which are found to enhance their adsorbing efficiency. Chemical characterization of these adsorbents recapitulates the mechanism of the process. It is imperative to observe that capacities of the adsorbents may vary depending on the characteristics, chemical modifications and concentration of the individual adsorbent. Removal kinetics is found to be based on the experimental conditions viz. pH, concentration of the adsorbate, quantity of the adsorbent and temperature. It is suggested that isotherm model is suitable tool to assess the adsorption capacities in batch and column modes. Safety evaluation and risk assessment of the process/products may be useful to provide guidelines for its sustainable disposal.

Clastogenic effects of lead on the chromosomal complements of clarias batrachus

The effect of lead, a heavy metal, was found to have clastogenic effects on Clarias batrachus. Chromosomal studies on the fish indicated that the 2n numbers of chromosomes were 50 [18 metacentric, 20 submetacentric and 12 telocentric]. The effects of lead on the catfishes were investigated by constituting four different groups [n=16]. Group A: Control, Group B: 0.010 ppm of Pb [Treatment I], Group C: 0.025 ppm of Pb, [Treatment II], Group D: 0.050 ppm of Pb [Treatment III]. The exposure period was 24 hr, 48 hr and 72 hr for each group. Chromosomal aberrations were observed in the form of ring chromosomes, breakage of chromosomes, dicentric chromosomes and fragments of chromosomes. The highest percentage of metaphase spreads with chromosomal aberrations observed were 78.3 in Treatment I during 24 hr exposure of Pb. Chromosomal aberrations were highest in the form of ring type chromosomes [63.0%] in Treatment I during 48 hr exposure period. Breakage in chromosomes were maximum [57.1%] in Treatment II during 72 hr of exposure period. Maximum numbers of dicentric chromosomes [52.9%] were observed in Treatment I during 72 hr of lead exposure. Finally, the fragmented chromosomes were observed to the maximum [45.2%] after 24 hr of lead exposure in Treatment III. The studies indicated that exposure of lead at different concentrations causes clastogenic effects on the chromosomal complements of C. batrachus and the maximum abnormalities were manifestated in the form of ring chromosomes [63.0%]

Outcome of early cochlear implantation

<p><b>INTRODUCTION</b>Universal newborn hearing screening facilitates early detection of congenital hearing loss. A child found to have severe to profound hearing loss may require a cochlear implant to access sounds in the speech frequency range.</p><p><b>MATERIALS AND METHODS</b>This retrospective study compared the speech perception outcomes of children implanted at 2 years and below (C1) with those implanted later (C3). Baseline and post-implant speech perception scores were recorded using IT-MAIS, TACL-R or PPVT. The percentage of improvement was calculated for each group and statistical significance was determined using the Student's t-test.</p><p><b>RESULTS</b>The median follow-up period for C1 (n = 29) and C3 (n = 29) was 29 months (range, 6 to 29 months) and 20 months (range, 5 to 32 months) respectively, which was not statistically significant. Although both groups recorded post-implant improvement of speech reception scores, the difference in the degrees of improvement was statistically significant (P = 0.034).</p><p><b>CONCLUSION</b>More rapid development of speech perceptive skills was achieved in children who were implanted early. Early implantation therefore, enables children to develop good core listening skills and to potentially develop spoken language at a young age. This enhances successful integration into mainstream pre-schools which provide the environment for the early nurturing of social and cognitive skills.</p>

Biomarkers of monocrotophos in a freshwater fish Channa punctatus (Bloch).

Activity of a few biomarkers have been investigated on freshwater fish Channa punctatus treated with monocrotophos for acute exposure to 18.56 ppm at 96 hr and subacute exposure viz. 0.46 ppm, 0.96 ppm and 1.86 ppm for 30 days. Biomarkers such as total protein, lipid peroxidation and acetylcholinesterase have been measured in different tissues of fish viz. gills, liver, brain and muscles. The protein levels were found to be depleted in all the tissues after pesticide exposure to lethal and sublethal concentration over the control, where as the lipid levels showed an increase under the stress of pesticide monocrotophos. The increased lipid level may be due to inhibition of lipase activity and other biomarkers of lipid metabolism. A significant inhibition of brain acetylcholinesterase (AChE) indicating its effects on nervous system have also been observed. These parameters can be used as biomarkers to predict the early toxicity of monocrotophos added to aquatic ecosystem.