Radiographic Anatomy of the Neck-Shaft Angle of Femur in Nepalese People: Correlation with its Clinical Implication.

Background Neck-shaft angle (NSA) is one of the prominent features in the proximal femur which is an important determinant of fracture of femoral neck. Present study evaluating the value of neck-shaft angle has relied heavily on radiographs. As knowledge of neck-shaft angle is important to orthopaedic surgeons, there is need to elucidate whether there is significant variation of this angle among the two different genders and various age groups of both right and left femora of Nepalese population. Objective To ascertain the value of neck-shaft angle in the Nepalese population by means of a radiographic study and to correlate the values with regard to right neck-shaft angle/ left neck-shaft angle side (RNSA/LNSA), gender and three different age group. Method Normal pelvic radiographs of 148 patients seen at department of orthopedic and radiology, College of Medical Sciences- Teaching Hospital (COMS-TH), Bharatpur, Chitwan from the month of February 2017 to June 2017 were divided into two different gender and three different age groups (21-40 years, 41-60 years and Above 60 years) and their neck-shaft angle of both right and left sides were recorded. Result The average of RNSA and LNSA were found to be 132.96±6.05° and 131.54±13.66° respectively for male and 134±6.57° and 132.98±6.23° respectively for female. In total the average RNSA and LNSA were 133.51±6.32° and 132.26±10.61° respectively. Similarly, the average RNSA and LNSA for three different age groups (21-40 years, 41-60 years and Above 60 years) were found to be 133.76±6.44°, 133.69±6.36° and 132.50±6.06° and the 133.35±6.29°, 132.47±5.85° and 128.84±21.98° respectively. Conclusion The average neck-shaft angle recorded here shows no significant difference in both RNSA and LNSA in males except for a small and significant difference in LNSA in female of three different age groups.

Pure Tethered Cervical Cord and Review of Literature.

Tethering of the spinal cord in the lumbosacral region with myelomeningocele is a well-known phenomenon. Only sporadic cases of tethering along the rest of the neuraxis, including the hindbrain, cervical, and thoracic spinal cord have been documented, always along with some associated congenital malformations (hydrocephalus, Chiari malformation, myelomeningocele, meningocele, hamartomatous stalk, spina bifida occulta, intramedullary lipoma, intradural fibrous adhesions, the fusion of the sixth and seventh cervical vertebrae, split cord malformation, or low-lying cord). In this report, 14-year-old male developed symptoms related to tethering of the cervical spinal cord, but without any associated congenital malformations, that is the pure tethered cervical cord. This causes his moribund status and makes the manuscript unique and contributes to the hitherto literature. The authors discuss the diagnosis, treatment, and postoperative course of this entity. The uniqueness in treatment is that we have operated the case without the help of intraoperative somatosensory evoked potentials and motor evoked potential from posterolateral approach under local anesthesia.

Clinical, laboratory, and management profile in patients of liver abscess from northern India.

Objective. To describe the clinical profile, microbiological aetiologies, and management outcomes in patients with liver abscess. Methods. A cross-sectional study was conducted from May, 2011, to April, 2013, on 200 consecutive liver abscess patients at PGIMER and Dr. RML Hospital, New Delhi. History, examination, and laboratory investigations were recorded. Ultrasound guided aspiration was done and samples were investigated. Chi-square test and multivariate regression analysis were performed to test association. Results. The mean age of patients was 41.13 years. Majority of them were from lower socioeconomic class (67.5%) and alcoholic (72%). The abscesses were predominantly in right lobe (71%) and solitary (65%). Etiology of abscess was 69% amoebic, 18% pyogenic, 7.5% tubercular, 4% mixed, and 1.5% fungal. Percutaneous needle aspiration was done in 79%, pigtail drainage in 17%, and surgical intervention for rupture in 4% patients. Mortality was 2.5%, all reported in surgical group. Solitary abscesses were amoebic and tubercular whereas multiple abscesses were pyogenic (P = 0.001). Right lobe was predominantly involved in amoebic and pyogenic abscesses while in tubercular abscesses left lobe involvement was predominant (P = 0.001). Conclusions. The commonest presentation was young male, alcoholic of low socioeconomic class having right lobe solitary amoebic liver abscess. Appropriate use of minimally invasive drainage techniques reduces mortality.

Retro-inferior coccygeal adventitious bursa (hadoti bursa): a study of three cases.

It is not unusual to encounter callosity at deformed bony pressure points such as at lateral malleolus of ankle or head of first metatarsal in hallux valgus. Herein, we report for the first time posterior inferior coccygeal adventitious bursa (from Hadoti area of Jhalawar in Rajasthan, India) presenting as a painless nonprogressive swelling of significant size encountered in three patients.

Malignant melanoma of scrotal skin.

Black/bluish discolored skin tumor without cuticular covering de novo from site of origin could be a diagnostic feature of melanomas.

A comparative emission profile of an urban area in Madhya Pradesh, India.

This paper emphasizes on mathematical and field work approach to diagnosing the environmental pollution for Indore, India. These applications are based on the time-series statistics and for three semi-industrial as well as residential areas. The generalized additive models finds as a best fit-model in terms of autocorrelation and reduction of over-dispersion. The interdisciplinary study works on the principal of pollutant source, meteorological parameters, pollutant types, emission rates and various chemical processes. Several chemical or industrial processes like iron and steel production, combustion of fossil fuels, biomass burning, thermal power plants are major polluter in most of the mega cities.

A comparative study of air pollution in Indian cities.

Rapid and unplanned industrialization and urbanization has resulted in the deterioration of India's air quality according to air-quality monitoring carried out in seven major Indian cities in industrial and residential areas between 1995 and 2000. Suspended particulate matter (SPM) levels in Indian cities are in the range 50 to 550 microg/m(3). NO(x) values are high in Delhi's residential areas, with values of 33 microg/m(3) in 1995 and 34.6 microg/m(3) in 2000, while in an industrial area values of 29.4 microg/m(3) were found in 1995, increasing to 33.7 microg/m(3) in 2000. SO(2) values are very high in Pune city, ranging from 43.3 microg/m(3) in residential to 43.69 microg/m(3) in an industrial area in 2000.

Physiological patterns during practice of the Transcendental Meditation technique compared with patterns while reading Sanskrit and a modern language.

This study tested the prediction that reading Vedic Sanskrit texts, without knowledge of their meaning, produces a distinct physiological state. We measured EEG, breath rate, heart rate, and skin conductance during: (1) 15-min Transcendental Meditation (TM) practice; (2) 15-min reading verses of the Bhagavad Gita in Sanskrit; and (3) 15-min reading the same verses translated in German, Spanish, or French. The two reading conditions were randomly counterbalanced, and subjects filled out experience forms between each block to reduce carryover effects. Skin conductance levels significantly decreased during both reading Sanskrit and TM practice, and increased slightly during reading a modern language. Alpha power and coherence were significantly higher when reading Sanskrit and during TM practice, compared to reading modern languages. Similar physiological patterns when reading Sanskrit and during practice of the TM technique suggests that the state gained during TM practice may be integrated with active mental processes by reading Sanskrit.

Intra-abdominal symptoms arising from spinal osteophytes.

A case of abdominal pain caused by irritation of a segment of jejunum and another due to irritation of the ureter are reported. In both cases the cause of the irritation was established to be osteophytic growth from the 4th lumbar vertebra. After its excision the symptoms disappeared in both cases. To the best of our knowledge, osteophytes have not been reported before to be the cause of intestinal and ureteric pain, and its is therefore urged that in cases of intractable pain these must be considered as a possible cause.