Knowledge and attitude toward organ donation among health-care professionals in a rural town in India.

Organ shortage is the greatest challenge facing the field of organ transplantation today. We aimed to study the attitude and knowledge toward organ donation among health-care professionals (HCPs) in rural India. The study was conducted in a rural town in Konkan region of Maharashtra in India. A questionnaire testing knowledge and attitude about various aspects of organ donation was distributed to HCPs. One hundred percent of the respondents were aware about organ donation. Nearly 40.6% and 21.9% believed that a healthy person and a cardiac dead person can be donors, respectively. Fifty percent believed that a brain dead person can be a donor and 3.1% clearly stated as to be having no idea regarding the health status of a donor. Almost 37.5% were ready to believe a heart beating person declared as "brain dead" as dead. Nearly 15.6% were ready to accept a brain dead person as "legally" dead. Highest awareness was observed regarding eye donation, i.e., 87.5%. High awareness was also observed regarding liver, kidney, heart, skin, and body donations, i.e., 78.1%, 65.6%, 37.5%, 31.3%, and 25.0%, respectively. Awareness regarding organ donation of other tissues and organs was poor. Nearly 46.9% HCPs stated that they felt need for an educational session on organ donation. Awareness regarding concept of organ donation among HCPs in rural India is high. Awareness regarding details of organ donation needs further awareness drives. There is a lack of understanding regarding various aspects of brain death and its importance in organ donation.

Knowledge and attitude toward organ donation among people in Lanja: A rural town in India.

Organ shortage is the greatest challenge facing the field of organ transplantation today. We aimed to study the attitude and knowledge toward body and organ donation among people in rural India. The present study was conducted in a rural town called Lanja, in the Konkan region of Maharashtra in India. A questionnaire covering demographic data, knowledge, and attitude of the participants was distributed to 400 students, middle-aged and senior citizens; 91.5% of the respondents were aware about organ donation. Television (55.2%) and newspaper (45.8%) were the most popular sources of information. About 56.2% and 32.8% believed that a healthy person and a cardiac dead person can be donors, respectively. Nearly 29.4% believed that a brain-dead person can be a donor and 22.4% clearly stated as to be having no idea regarding the health status of a donor. Highest awareness was observed regarding eye donation (92%). High awareness was also observed regarding heart, kidney, and liver donations, that is, 71.1%, 61.2%, and 54.2%, respectively. Awareness regarding donation of other tissues and organs was poor. Only 46.8% believed that the family of the deceased person can give consent for organ donation if the donor had not signed the donor card. Awareness regarding both body and organ donation in rural India is high. However, there is lack of understanding regarding the concept of brain-death. Awareness regarding body and other organ and tissue donations besides eye, kidney, etc., needs further awareness drives.

Study of the course of inferior epigastric artery with reference to laparoscopic portal.

INTRODUCTION: Laparoscopy has been in vogue for more than 2 decades. Making portals in the anterior abdominal wall for introducing laparoscopic instruments is done with trocar and cannula which is a blind procedure. Stab incision and trocar insertion, though safe, at times can lead to injury of blood vessels of anterior abdominal wall more so the inferior epigastric artery (IEA). Trauma to abdominal wall vessels is 0.2%-2% of laparoscopic procedures and said to be 3 per 1000 cases. Injury to IEA is one of the commonest complications seen. Purpose of the present study was to observe the course of IEA in 50 formalin preserved cadavers, by dissection. MATERIALS AND METHODS: In 50 formalin fixed cadavers, IEA was exposed by opening the rectus sheath. Rectus was divided and IEA was exposed. Five reference points A, B, C, D, and E were defined. A was at pubic symphysis, while E at umbilicus. B, C, and D were marked at the distance of 3.5, 7, and 10.5 cm, respectively from pubic symphysis. Distances of the IEA from these midline points were measured with the help of sliding vernier calipers. RESULTS: Significant observation was variations in the length of IEA. It was seen to end at a lower level than normal (three cases on right and four on left side) by piercing rectus. In 14, cadavers artery did not reach up to umbilicus on both sides. Nearest point of entry of IEA in to rectus sheath at the level of pubic symphysis was 1.2 cm on left and 3.2 cm on right side. Farthest point from point A was 6.8 cm on right and 6.9 cm on left side. Width of strip of abdominal wall which was likely to have IEA beneath was up to 4 cm till level C and beyond which it widened up to 5cm on left side and 6 cm on right at umbilicus. DISCUSSION: Present study did reveal notable variations in length and termination of IEA. No uniformity in entry of IEA in to the rectus sheath was observed. Findings did concur with earlier observations but the strip of skin of arterial zone was not equidistant from midline but had moved more medially on left side. Medial limit of this safety zone found to be lesser than 2 cm on left side. However, the lateral limit of the zone was within 7.5 cm. Additional variation was strip of abdominal wall likely to have IEA beneath was up to 4 cm till level C and had diverging limits beyond C. IEA was more notorious in its course. These variations prompt for a preoperative mapping of IEA and thus a useful step in preoperative protocol.

A study of the distribution of the left coronary artery - clinical importance

The object of the present work was to study the origin of the left coronary artery, its branches, and to note any variations in its distribution. Fifty human hearts were procured from dissection-room cadavers of adult age groups. The left coronary arteries were dissected meticulously; their individual branches and any variations encountered were noted. The left coronary artery was seen originating in relation to the left posterior aortic sinus in 100% of the specimens. The incidence of bifurcation of the left coronary artery was found in 64% and trifurcation in 36%. In 26% of hearts the circumflex branch of the left coronary artery crossed the crux, in 20% the SA Nodal artery, and in 24% the AV Nodal artery was seen as a branch of the circumflex artery. 2% incidence of retroaortic course of the left circumflex artery was observed. The left coronary artery and its branches are responsible for the irrigation of most of the left ventricle and part of the right ventricle. In case of trifurcation, where the left diagonal artery takes origin directly from the left coronary artery, the size of infarct on occlusion of the left anterior descending artery would be reduced. The left circumflex artery taking origin from the right sinus of Valsalva is an anomaly which may remain clinically silent, but at times it has been known to get compressed during valve replacement surgery, if not detected preoperatively. In hearts where both SA and AV nodal arteries originated from left coronary artery (8%), occlusion of the left coronary a could severely affect the conducting system (AU)

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