Comparative Study on Insall-Salvati Index by Radiological and Clinical Methods in a Tertiary Care Centre of North Bengal, India.

INTRODUCTION: Patellar height is an important parameter of patellar stability. Its importance is evident from various attempts to measure it, by different scientists from time to time and many indices have been derived among which Insall-Salvati index (IS index) is the most simple, accurate and easy to measure. In this study a new clinical method has been tried to measure patellar height by applying the same principle of IS index. AIM: To compare clinical method of measurement of IS index with the one derived radiologically and to establish the higher cut off value of the clinical method. MATERIALS AND METHODS: In the present study 186 knee joints (93 subjects) were subjected to measurement of patellar height by both clinical and radiological methods. The IS index was measured bilaterally from lateral view of X-ray plates and it was measured clinically in every knee joint. Both the values were compared using students t-test and higher cut off values were set for normal knee joint for the clinical method. RESULTS: Among 93 study participants majority were females (54.83%), age of the patients varied from 10-68 years with mean age of 28 years and Standard deviation (SD) of 16.4. It was found that, there was no statistically significant difference between the mean values obtained by clinical method of measurement, compared to conventional one (IS Index) for both the genders and age groups on both the sides. A cut off value of 0.98 cm by clinical method gives sensitivity of 80% and specificity of 36% with area under the ROC curve 0.596. CONCLUSION: The subjects with patellar height of less than cut off value by clinical method can avoid radiological investigation as there was no statistically significant difference of IS index between radiological and clinical methods.

Unusual branching pattern of facial artery and a short review.

A detailed knowledge of the facial blood supply is necessary in planning of different types of orofacial surgeries. However abnormal pattern of facial blood supply may modify the result of the treatment, if it is not predicted in advance. Here we report two rare cases of unusual presentation of facial blood supply and the clinical implications of such findings, correlating with the previous studies.

Pubomyoaponeurotic foramen and posterior groin plait for groin hernia.

Sir Astley Paston Cooper stated in 1804 that a sound knowledge of proper anatomy of hernia is vital. But even in the succeeding two centuries, the confusion has only multiplied by varied and overly enthusiastic descriptions, some speculative and others real, by different workers. An attempt has been made to highlight the size of the controversies surrounding the anatomical structures forming the inguinal canal and groin. The inguinal and femoral hernias should be viewed collectively as one entity and together be called groin hernias. Therefore, the passage for their superficial emergence through the anterior abdominal wall is redefined and is called pubomyoaponeurotic foramen. It is uniformly accepted that the strong posterior wall of the groin area is the only preventive factor towards the emergence of hernia; it has been renamed as posterior groin plait. Therefore, proper understanding of its structure towards effective repair and reinforcement is the only safe method, whether the procedure is carried out by anterior or posterior route or laparoscopically. Hence, an attempt has been made to elucidate its true structure. In spite of so many descriptions, the exact anatomy of hernia is yet to be resolved.