Morphometric significance of maxillary arch in sexual dimorphism in North Indian population.

BACKGROUND: Tooth is the hardest and chemically (except mineral contents) the most stable structure in the body, which makes teeth as the first-rate material for genetic and forensic investigations. Sex determination of skeletal remains forms an important part of archaeological and medicolegal examinations. Hence, the aim of the present study was to analyse the morphometric and dimensional variation between male and female in north Indian population using maxillary arch parameters. MATERIALS AND METHODS: Fifty male and fifty female patients of age group 18-35 years were randomly selected after taking detail history. All maxillary impressions were made with alginate and poured in type III dental stone. These casts were measured for maxillary inter-canine width, maxillary first inter-premolar width, anteroposterior palatal width and palatal depth using a digital vernier caliper and findings were correlated with sexual dimorphism. RESULTS: The maxillary inter-canine width, maxillary first inter-premolar width, and palatal depth showed a significant difference with P < 0.05 between the means of two populations. Anteroposterior palatal width showed the comparatively less significant difference between two populations. CONCLUSION: Among north Indian population, maxillary inter-canine width, maxillary first inter-premolar width, and palatal depth can be used for sex assessment. The anteroposterior palatal width parameter is comparatively less significant in sex determination.

Chicago medical response to the 2010 earthquake in Haiti: translating academic collaboration into direct humanitarian response.

On January 12, 2010, a major earthquake in Haiti resulted in approximately 212 000 deaths, 300 000 injuries, and more than 1.2 million internally displaced people, making it the most devastating disaster in Haiti's recorded history. Six academic medical centers from the city of Chicago established an interinstitutional collaborative initiative, the Chicago Medical Response, in partnership with nongovernmental organizations (NGOs) in Haiti that provided a sustainable response, sending medical teams to Haiti on a weekly basis for several months. More than 475 medical volunteers were identified, of whom 158 were deployed to Haiti by April 1, 2010. This article presents the shared experiences, observations, and lessons learned by all of the participating institutions. Specifically, it describes the factors that provided the framework for the collaborative initiative, the communication networks that contributed to the ongoing response, the operational aspects of deploying successive medical teams, and the benefits to the institutions as well as to the NGOs and Haitian medical system, along with the challenges facing those institutions individually and collectively. Academic medical institutions can provide a major reservoir of highly qualified volunteer medical personnel that complement the needs of NGOs in disasters for a sustainable medical response. Support of such collaborative initiatives is required to ensure generalizability and sustainability.

A comprehensive disaster training program to improve emergency physicians' preparedness: a 1-year pilot study.

OBJECTIVES: The main objective of this pilot study was to measure the effectiveness of a 1-year comprehensive training program on the long-term cognitive competence in disaster preparedness among attending emergency physicians (EPs). DESIGN: Ten attending EPs participated in a year-long training program in disaster preparedness and management. A baseline pretraining test and self-evaluation questionnaire were administered to the participants. Post-training written test and self-evaluation questionnaire were repeated at 12 months after the completion of the program. SETTING: The study took place at an urban tertiary care medical center from July 2007 to June 2008. INTERVENTIONS: The training program was divided into three main categories: didactic core topics, formally recognized courses, and a practicum (drill). MAIN OUTCOME MEASURES: Pretraining and posttraining test scores in addition to pretraining and posttraining self-assessments were compared for disaster preparedness in various areas. RESULTS: There was a statistically significant increase in the overall post-test versus pretest scores on the written examination for the entire group (44.4 vs. 29.8, p < 0.005). In addition, statistically significant increases in each area of disaster preparedness were noted for the self-assessments (2.7 +/- 0.82 vs. 3.9 +/- 0.56, p = 0.01), where 1 means not prepared at all and 5 means extremely well prepared. CONCLUSIONS: Disaster preparedness is an essential area of clinical competence for EPs. Participation in a yearlong pilot training program demonstrated a statistically significant increase in cognitive competence among a pilot sample of EPs. More research is needed to validate the content of the training program and its instruments of evaluation.

Cocaine and ethanol: combined effects on coronary artery blood flow and myocardial function in dogs.

OBJECTIVES: In combination, cocaine and ethanol are more cardiotoxic than is either substance alone. These substances together constitute a drug abuse combination that commonly results in fatality. Previously the authors have demonstrated that cardiotoxicity of cocaine and ethanol is in part due to synergistic myocardial-depressant effects. However, it remains unclear whether this myocardial depression is associated with concomitant adverse effects on coronary blood flow in relation to these substances. The aim of this study was to investigate combined effects of cocaine and ethanol on myocardial blood flow, in relation to indices of myocardial function. METHODS: Anesthetized dogs were instrumented for hemodynamic monitoring with Doppler flow probes placed on the circumflex and left anterior descending (LAD) coronary arteries. Dogs were randomized to three groups (each n = 6): ethanol (E, 1.5 g/kg followed by placebo), cocaine (C, placebo followed by cocaine, 7.5 mg/kg IV), or cocaine plus ethanol (C + E). All measurements were made at control, after placebo or ethanol, and then at fixed time intervals after cocaine or placebo bolus over 3 hours. RESULTS: In both the C + E and the C groups, circumflex blood flow (CBF) decreased by 71% (95% confidence interval [CI] = 56% to 85%) and 57% (95% CI = 43% to 72%, both p < 0.04 vs. baseline) immediately after cocaine bolus. This was associated with transient depression of cardiac output, myocardial contractile function, and rate-pressure product (RPP), all indices of myocardial oxygen demand. A subsequent rebound increase of coronary sinus blood flow (CSBF) of 56% (95% CI = 26% to 137%, p < 0.03) compared to baseline occurred only in the C group and was associated with increases of myocardial contractile function and RPP. In the C + E group, 2 hours after drug administration, there was a decrease in CSBF of 49% (95% CI = 32% to 67%; p < 0.01) compared to baseline, which was associated with concomitant numerical decreases of the indices of myocardial oxygen demand and accumulation of cocaethylene. CONCLUSIONS: Acute decreases in myocardial flow secondary to cocaine, and cocaine and ethanol in combination, were similar and temporally associated with cocaine's direct myocardial-depressant effects. Rebound increases in myocardial function and blood flow due to cocaine were attenuated by ethanol. Delayed myocardial depression and decreases in myocardial blood flow were observed only with coadministration of cocaine and ethanol.