Dependability of Electrode to Modiolus Distance in Patients Specific Electrode Selection: A Cadaveric Model Study.

OBJECTIVE: This study aims to discern the disparities in the electrode-to-modiolus distance (EMD) between cochleostomy and round window approaches when performed sequentially in the same temporal bone. Additionally, the study seeks to identify the cochlear metrics that contribute to these differences. METHODOLOGY: A cross-sectional study was conducted, involving the sequential insertion of a 12-electrode array through both round window and cochleostomy approaches in cadaveric temporal bones. Postimplantation high-resolution CT scans were employed to calculate various parameters. RESULTS: A total of 12 temporal bones were included in the imaging analysis, revealing a mean cochlear duct length of 32.892 mm. The EMD demonstrated a gradual increase from electrode 1 (C1) in the apex (1.9 ± 0.07 mm; n = 24) to electrode 12 (C12) in the basal turn (4.6 ± 0.24 mm; n = 12; p < 0.01). Significantly higher EMD values were observed in the cochleostomy group. Correlation analysis indicated a strong positive correlation between EMD and cochlear perimeter (CP) (rs = 0.64; n = 12; p = 0.03) and a strong negative correlation with the depth of insertion (DOI) in both the middle and basal turns (rs = - 0.78; n = 20; p < 0.01). Additionally, EMD showed a strong negative correlation with the DOI-CP ratio (rs = -0.81; n = 12; p < 0.01). CONCLUSION: The cochleostomy group exhibited a significantly higher EMD compared with the round window group. The strong negative correlation between EMD and DOI-CP ratio suggests that in larger cochleae with shallower insertions, EMD is greater than in smaller cochleae with deeper insertions. LEVEL OF EVIDENCE: N/A Laryngoscope, 2024.

Going the extra mile: Developing an interactive mobile application for maternal and infant care for tribal birth attendants.

Background: Mobile health applications are an established tool for healthcare management, patient education, and even capacity building for healthcare providers. However, its use among traditional birth attendants (TBAs) is limited. The aim of this study is to explore the needs and bottlenecks of developing an interactive mobile application for maternal and infant care (MAI) of TBAs. Materials and Methods: It is a qualitative study having in-depth interviews (face-to-face approach) conducted among the seekers of MAI services. Setting: This study is conducted in tribal and rural locations in the district Sirohi, Rajasthan. Participants: TBAs and tribal females of reproductive age in tribal-dominated areas have participated. The development of an interactive mobile application MAI has three phases: (1) a need-based approach to identify the needs on the ground; (2) identifying intervention bottlenecks and possible solutions; (3) design and development of the mobile application. Results: Ninety-six tribal females of reproductive age participated in the needs assessment. Eighty percent of them were ≤ 30 years of age and 40% of them were uneducated. Most participants informed that lack of information (culturally/locally appropriate content), peer advocacy, affordability, lack of transportation, and the influence of TBAs are the significant factors for less uptake of maternity and child health services in the tribal and rural areas. Conclusion: The MAI app has culturally/locally appropriate content and is prepared by the local TBAs and Accredited Social Health Activists, with full local character and clothing. MAI app has videos and audio in the local language (Marwari) with pictorial quizzes. Using the MAI app, TBAs may self-educate and guide tribal pregnant women about maternal hygiene and infant healthcare as needed at various stages of pregnancy and childbirth.

Digital eye strain among medical students associated with shifting to e-learning during COVID-19 pandemic: An online survey.

PURPOSE: This study aimed to determine the prevalence, risk factors, symptoms, and awareness of computer vision syndrome (CVS) among medical students during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A cross-sectional observational study was conducted among 283 undergraduate medical students at a tertiary healthcare center. An electronic survey was conducted to collect the data. Data were analyzed using Statistical Package for Social Sciences (SPSS version 23). The Chi-square test (Fisher's exact test when required) was used to study the significance of associations. A P value <0.05 was considered statistically significant. RESULTS: A high prevalence of CVS was observed in which 92% reported at least one symptom while using a digital device, the most frequent being eye strain (49%). Among extraocular complaints, joint pain in the wrist and fingers was most frequent. Significant association (P < 0.05) of CVS was found with increased duration of digital device usage, refractive error, use of glasses or contact lens, preexisting dry eye disease, and use of topical eye drops. 37% of the participants were aware of the 20-20-20 rule, while only 11% followed it. CONCLUSION: CVS is a common health concern among medical students. Hence, to increase the productivity of work, significant risk factors need to be addressed and awareness must be raised.

Systematic Review of Morphometric Analysis of Anterior Cerebral Artery (ACA) Emphasizing on Its Clinical Implications.

Thorough data of morphometric measurements of arteries forming Circle of Willis (CW) is crucial for radiological and neurosurgical interventions. This systematic review has been conducted with the objective to find an effective range of length and diameter of anterior cerebral artery (ACA) and to observe whether there is any change in the length and diameter of ACA depending on age or sex. Articles based on length and diameter of ACA via any mode of study like cadaveric or radiological were considered in this systematic review. A comprehensive literature search using databases Cochrane Library, PubMed, and Scopus for relevant articles was done. Research papers which answered the focused questions were selected for data analysis. It was observed that the range of length and diameter of ACA were 8.1 mm-21 mm and 0.5 Å-3.4 mm, respectively. In majority of the studies, length and diameter of ACA were more in the younger age group (>40 years); and the length of ACA was more in females whereas the diameter of ACA was more in males. These data will be applicable for better construction and decipherment of angiographic images. This will help in the proper and guided treatment of intracranial pathologies.

Morphometric Analysis of parameters of Internal Carotid Artery-Potential Clinical Implications.

BACKGROUND: The study in consideration aimed to do morphometry of internal carotid artery (ICA) and substantiate any differences significant in relation to sex and age on digital subtraction angiography (DSA) imaging. OBJECTIVES: Our study aims to ascertain morphometric parameters of ICA through DSA evaluation and to build a normative data which is accurate enough for the neurovascular procedures to be performed. The study will also carry out correlation of morphometry of intracerebral blood vessels with sex, age, and side-related dimorphism. MATERIAL AND METHODS: Our study, cross-sectional in design was done on 70 patients (>20 years). Diameter of different segments of ICA were measured after imaging was done on DSA using a Philips biplane system clarity (Allura FD20/20). Statistical analysis was done. RESULT AND CONCLUSION: In males, mean diameter of petrous, cavernous, supraclinoid, and choroidal segments of ICA were more when compared to females. Statistically significant differences were found in supraclinoid segment of ICA between males and females. The mean diameter of supraclinoid and choroidal segments of ICA showed a decreasing trend from younger to older age groups. The difference in the mean diameter of petrous segment of ICA with increasing age was statistically significant. The results of our study show that differences were statistically significant in supraclinoid segment of ICA in males and females. Neurosurgeons in order to be confident in tackling the various emergencies in this region need to have in-depth knowledge of morphometery of cerebral arterial circle.

Racial variation on articular surface of talus (astragalus) in North Indian population.

Articular morphology, especially of the lower limb, can be modified by various stresses on bone like adoption of bipedal gait and erect posture resulting in variations of the skeleton. Effects of variations in posture like squatting, which are a part of lifestyle of certain populations, were studied on 147 tali of North Indian population and examined for differences with those from other geographic regions. The modifications were classified into nine types. The lateral squatting facet was the most frequently found variation (65.9%), the medial, combined and continuous squatting facets being 8.2%, 2.04% and 4.1%, respectively. Lateral (32.7%), medial (27.2%) and continuous (4.7%), trochlear extensions, and extensions of medial (39.4%) and lateral (12.9%) articular facets were also observed in the population studied. The findings of the present study were important markers which could help in determining the race of unidentified bones.

Incidence, morphology and clinical relevance of bony canals and vascular grooves in the paracondylar region of adult human skulls.

Most features of the skull are well described in standard anatomy textbooks. There may, however, be variations in the form of minor grooves, canals and foramina that merit documentation. In the present study, morphological diversity in the form of osseous tunnels was seen adjacent to the occipital condyles. These canals were present in the paracondylar region (lateral to the occipital condyle) and are therefore termed paracondylar canals. A total of 304 dry adult human skulls (608 sides) of Indian origin were examined and paracondylar canals were found in 59 of these. Thirty-six (11.8%) were bilateral and 23 (7.6%) unilateral. Vascular grooves were found leading to the canals in 52 sides (15.8%). This may result from normal developmental processes and could be a peculiarity confined to the Indian population, as it has not been reported previously. This variant may serve as a valuable anthropological marker. The results of surgical procedures in this area, such as the paracondylar approach (which is directed through the area lateral to the occipital condyles) and the far lateral supracondylar approach, could be impacted upon by this variation.