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OBJECTIVE: Despite the availability of an extensive array of antibiotics, musculoskeletal infections are not cured successfully. It is necessary to remove sequestra, infected necrotic tissue, and implants. This study was undertaken to assess the efficacy of poly methyl methacrylate (PMMA) beads and identify the variables that influence eradication and recurrence in the treatment of musculoskeletal infections. METHODS: This study was conducted on 82 patients with chronic osteomyelitis who were treated over a period of 6 years at our tertiary care hospital. We followed up with 71 patients for one year. Clinicoradiological data for the control of infection and bone healing were assessed at the final follow up visit. The correlation between antibiotic sensitivity/resistance and infection was evaluated for Gentamicin + Cefuroxime and Gentamicin + Vancomycin combinations. Chi-squared testing, using SPSS version 16.0, was used for statistical analysis, and a p-value < 0.05 was considered significant. RESULTS: Fifty-three patients (65.4%) had an exogenous route of infection. Fifty-six patients (68.51%) presented with a discharging sinus on first presentation. In 42 patients (59%), the diagnosis was verified with a positive bacterial culture. In addition, we used antibiotic beads of Gentamicin + Cefuroxime in 74 patients (90%), while in 8 patients (10%), we used Gentamicin + Vancomycin, based on culture and sensitivity results. Recurrence was found in five cases of Gentamicin + Cefuroxime and two cases of Gentamicin + Vancomycin (p = 0.065). CONCLUSION: Antibiotics containing PMMA beads are effective in the treatment of chronic osteomyelitis and in preventing the recurrence of infection. It is imperative to identify various factors responsible for the recurrence of infection. This may help clinicians predict the prognosis of the disease and minimise the risk of adverse outcomes.
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Testicular arteries are paired vessels, arising from the abdominal aorta, at the level of second lumbar vertebra. Variations in the origin of these vessels highlight a potential importance regarding the vascular supply to the gonads and kidneys. This study was designed to assess the variations in the origin, course, and distance about the point of origin of the testicular arteries. The posterior abdominal walls of 40 male cadavers were studied on either side, during routine dissection in the Department of Anatomy, Kasturba Medical College, Manipal. A majority had a normal course and the variations were reported as: a) Bilateral origin of gonadal arteries from accessory renal arteries, b) Unilateral origin of the gonadal artery from the left accessory renal artery, and c) Unique origin of the right testicular artery from the right inferior epigastric artery and left testicular artery from descending thoracic aorta above the aortic opening of the diaphragm. Due to the embryological attribution, these variations in the testicular arteries indicate an alarming threat to the radiologists and surgeons during renal transplants and nephrectomies, as these vessels monopolize the vascular supply to the gonads. This study was undertaken to document the incidence of testicular arteries originating from accessory renal arteries.
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INTRODUCTION: Anthropological studies have document differences in craniofacial features as well as in body characteristics among different populations. The variations in the facial morphology arise through a differential growth and they help us in distinguishing one person from another. These are controlled by a number of factors which include genetic heritage, climate and environment in which we live. Very few researchers from India have worked on these facial features with respect to population and environment. The present work was undertaken to determine whether facial variations were subjected to sexual dimorphism. In addition, comparison of facial indices was made, in order to determine possible variations between south and north Indian populations. METHODS: The sample consisted of 200 individuals, 100 each from north and south Indian regions. Various facial parameters were determined on the basis of international anatomical description and facial indices were calculated. RESULTS: North Indian males and females had highest facial height and upper facial height. Facial width of south Indians was more as compared to that of north Indians in both sexes. Regression equation was calculated to compare the probable height with actual height. CONCLUSION: All the facial parameters and facial indices were found to be statistically highly significant and they showed inter-regional and gender variations. These indices will be beneficial in facial reconstruction surgeries, maxillofacial surgeries, and in forensic medicine, for estimating the stature and sex of an individual.
