Quadriceps Tendon and Patellar Ligament; a morphometric study

Background: Anterior cruciate ligament [ACL] is commonly injured especially in sportsmen. Autografts using tissue from various sources including the quadriceps tendon and patellar ligament are popular but still controversial due to varying degree of success. The morphological characteristics of the quadriceps tendon and the patellar ligament are of prime importance for this purpose

Objectives: This cadaveric study was undertaken to evaluate the morphometric characteristics of the quadriceps tendon and patellar ligament as an autograft for ACL reconstructive surgery

Study design: Qualitative cadaveric study

Material and Methods: The morphometric observations of the quadriceps tendon and patellar ligament on 36 [18 male and 18 female] adult formalin fixed cadavers were recorded by dissection. The observations included the length, breadth and thickness of the quadriceps tendon and the patellar ligament and were recorded on both sides separately in the male and female subjects. The data were tabulated, compared and statistically analyzed

Results: There was no significant difference in measurements on the right and left sides both in the male and in the female specimens. However the length and width of the quadriceps tendon was more in the males as compared to the females. The patellar ligament was significantly longer in the male specimens as was its width. Thickness of the patellar ligament, however, was not significantly different in the two genders

Conclusion: Both the quadriceps tendon and the patellar ligament are safe and convenient sources of autograft tissue for reconstruction of the ACL

Hypotension after spinal anaesthesia; efficacy of ephedrine and phenylephrine for treatment during elective caesarean section

Aim of the study is to compare the efficacy of Ephedrine and Phenylephrine for treatment of hypotension after spinal anaesthesia for elective caesarean section. Randomized Clinical Trial. Operation theatre Department of Anaesthesiology, Combined Military Hospital Quetta. Six month from 16th Sep 2011 to 15th March 2012. Seventy women undergoing LSCS for singleton pregnancy under spinal anesthesia were randomly assigned in group A and B [35 in each group]. All patients preloaded with Lactated Ringer's solution 15ml/kg body weight 10 minutes before administration of spinal anaesthesia. Mean Arterial Pressure [MAP]] was recorded before administration of spinal anaesthesia considered as Base-line MAP and then at 1 Minute, 3 minutes and at 5 minutes after administration of spinal anaesthesia. When hypotension developed [MAP falls >20% from base line], intravenous single dose of ephedrine administered in group A patients, while in group B, Phenylephrine was given. Blood pressure was recorded after 1 minute following drug administration and up to 3 minutes at 1 minute interval. Patient handed over for procedure after 10 minutes of spinal block. The SPSS version 13 was applied to the data. Mean and standard deviation were computed for numerical variables like age, weight, height, systolic blood pressure, Diastolic blood pressure, and Mean Arterial pressure; whereas frequency and percentages were employed to assess the categorical variable like efficacy. Chi-square test was used to compare the efficacy of intravenous bolus of ephedrine and phenylephrine. Statistical significance was taken at p<0.05. There was significant difference in the efficacy of both the drugs, in the treatment of maternal hypotension. 74.29% were successfully treated in group [A] with a single dose of Ephedrine, as compared to group B where 51.43% were successfully treated with a single dose of Phenylephrine. [p-value = 0.048]. Intravenous ephedrine has more efficacy than phenylephrine in the treatment of maternal hypotension after spinal anesthesia for elective cesarean section

PDPH by using gauge of needles

There is increase incidence of Lower Segment Caesarean section [LSCS] being performed under sub-arachnoid block [SAB] because it is relatively safe. One of the complications of SAB is Post Dural Puncture Headache [PDPH] which is very distressing to the patient. To observe the incidence of PDPH by using two different types of spinal needle of 25 gauge in females undergoing LSCS under SAB. Currently, in our setup 25G cutting [quincke] spinal needle is routinely used. Randomized controlled trial. Department of Anesthesia, Officers Family Hospital, Rawalpindi Cantt. 6 months from 15 February 2011 to 15 July 2011. 100 pregnant patients undergoing elective CD under spinal anaesthesia were randomized into two group A and B. Group A received SAB with 25G Quincke needle; Group B-received SAB with 25G pencil-point needle. Follow up was done up to 72 hours after the surgery. Data obtained through study was analysed through computer software SPSS version 12. quantitative variables like age, weight and height are presented as mean and standard deviation. The frequency of PDPH was qualitatively analysed in percentage. The frequency of PDPH was compared between two groups with the application of Chi-square as test of significance at P-value <0.05. It was found that the incidence of PDPH with Quincke [cutting tip] needle was significantly higher [7.%] as compared to pencil point needle [0%]. Pencil-point needle is associated with lesser incidence of PDPH and should be preferred to Quincke needle to achieve SAB in patients undergoing LSCS

Municipal landfill site selection for Isfahan city by use of Fuzzy logic and analytic hierarchy process

Selecting the most suitable site for landfill can avoid any ecological and socio-economical effects. The increase in industrial and economical development along with the increase of population growth in Isfahan city generates tremendous amount of solid waste within the region. Factors such as the scarcity of land, life span of landfill, and environmental considerations warrant that the scientific and fundamental studies are carried in selecting the suitability of a landfill site. The analysis of spatial data and consideration of regulations, and accepted criteria are part of the important elements in the site selection. The present study presents a multi criteria evaluation method using GIS technique for landfill suitability site evaluation. The Analytic Hierarchy Process [AHP] was used for weighing the information layers. By using the fuzzy logic method [classification of suitable areas in the range of 0 to 255 byte scale] the superposing of the information layers related to topography, soil, water table, sensitive ecosystems, land use and geology maps was performed in the study. Only after omission of inappropriate areas, the suitability examination of the residue areas was accomplished. The application of the present method in Isfahan city shows approximately 5% of the south east and north east parts of the study area with the value of more than 220 byte scale, which are suitable for landfill establishment

Efficacy of topical tacrolimus in atopic dermatitis

Mainstay treatments for atopic dermatitis include cutaneous hydration, antihistamines and topical glucocorticoids. To avoid side effects associated with long term and higher potency topical corticosteroids, further topical immunosuppressive agents should be tried. Topical tacrolimus has been extensively studied and shows promise in treatment of inflammatory skin diseases such as atopic dermatitis. To determine the safety and efficacy of tacrolimus in atopic dermatitis. In this randomized, case-control study, out of 60 patients with atopic dermatitis [age ranging 2 to 45 years], 30 [case] were treated with tacrolimus [0.03%] ointment twice daily and 30 [control] were treated with vaseline twice daily for up to 3 weeks. Evaluation included per cent body durface area [%BSA] affected, individual signs of atopic dermatitis, the Severity Score of Atopic dermatitis [SCORAD], and the patient's assessment of pruritus. The outcome variables like erythema, edema/papulation, oozing/crusting, excoriation, pruritus, body surface area involved and SCORAD in the case group improved significantly compared to those in the control group [p< 0.001, <0.001, <0.001, <0.005, <0.001, <0.001 and <0.001, respectively]. After 3 weeks of tacrolimus, all variables except lichenification score responded significantly. Significantly higher number complained of burning sensation in cases [20%] as compared to none in the control group. Topical 0.03% tacrolimus is more effective than the vehicle alone

Linear lichen planus: a case report

Linear lichen planus [LP] is one of the rare variants of disease. We report here a case of linear LP who presented himself in the out-patient clinic with multiple papules and plaques which coalesced in a linear fashion over the left lower extremities extending from foot to thigh

Secular trend is not only acused for the increased incidence of pet, but also for its severity

To determine the role of secular trend in preeclampsia. Both at puberty and in the 3rd trimester of 65 singleton-primigravid preeclapmtics [Group I] and 867 comparable healthy, pregnants [Group II], body mass index [BMI], serum testosterones [total and free], dehydroepiandrosterone sulfate, estradiol and sex hormone-binding globulin levels were measured. Also, the ages at menarche, umbilical S/D ratio, fetal sex and small muscular arteries/high power field [SMA/HPF] were detected. In group I menarche occurred earlier [p<0.001] with higher BMI [p<0.001]. Also, testosterones were significantly higher [p<0.001 for both] both at puberty and during pregnancy, irrespective of fetal sex. Also, S/D ratio was higher with smaller SMA/HPF [p<0.001 for both]. Also, BMI at puberty and testosterone levels; on one hand showed strong +ve correlation to diastolic blood pressure and S/D ratio and strong -ve correlation to SMA/HPF on the other hand. Preeclamptic primigravid showed earlier puberty, significant increase in BMI with significantly higher levels of testosterones than comparable normotensive women, which were associated with more severe disease. This may indicate a significant role for androgens both in the pathogenesis and the severity of PET

Leukemia mimicking juvenile rheumatoid arthritis

Leukemia is the most common childhood cancer and acute lymphoblastic leukemia [ALL] represent about 75% of all cases. All patients who present with arthritis should have thorough investigations otherwise early diagnosis may be missed. This study describes four patients which presented with arthritis but later on they were diagnosed to be suffering from leukemia

Anatomical studies on water hyacinth (Eichhornia crassipes (Mart.) Solms) under the influence of textile wastewater / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Water hyacinth (Eichhornia crassipes (Mart.) Solms) is a prolific free floating aquatic macrohpyte found in tropical and subtropical parts of the earth. The effects of pollutants from textile wastewater on the anatomy of the plant were studied. Water hyacinth exhibits hydrophytic adaptations which include reduced epidermis cells lacking cuticle in most cases, presence of large air spaces (7 approximately 50 microm), reduced vascular tissue and absorbing structures. Textile waste significantly affected the size of root cells. The presence of raphide crystals was noted in parenchyma cells of various organs in treated plants.

Improved serum HDL cholesterol profile among Bangladeshi male students during Ramadan fasting

Effects of Ramadan fasting on serum lipids of 20 healthy males in Bangladesh were assessed. Anthropometric parameters and blood lipids were measured 1 day before Ramadan, day 26 of Ramadan and 1 month after Ramadan. Body weight and body mass index decreased significantly during Ramadan compared with before and after Ramadan. Fat intake was significantly higher during Ramadan than after. High-density lipoprotein [HDL] cholesterol increased significantly during Ramadan. Other lipids were not significantly different. Regression analysis of Ramadan HDL cholesterol levels indicated positive association with pulse rate and fat intake and negative association with systolic blood pressure and weight loss. The findings indicate improved HDL cholesterol profiles during Ramadan

Chronic renal insufficiency in pregnancy

This article attempts to assess the nature, severity and management of the risks associated with pregnancy in chronic renal insufficiency and end-stage renal disease, including dialysis and transplant recipients. Women with serum creatinine levels of >125 mmol/l are at an increased risk for deterioration in renal function, hypertension with superimposed pre-eclampsia and obstetric complications. Rigid control of hypertension is crucial for a successful pregnancy outcome. A range of antihypertensive drugs are available with angiotensin converting enzyme inhibitors being contraindicated. Women on dialysis have low fertility rates that return to normal following renal transplantation. Immunosuppresive drugs are not associated with increased congenital anomalies. Transplant recipients are at an increased risk for infections that may have implications for the fetus. All groups have an increased risk for prematurity and intrauterine growth restriction. The percentage of pregnancies resulting in surviving infants in women with renal insufficiency and transplant recipients ranges from 80-100%. For women who conceive after dialysis, the likelihood of a surviving infant is approximately 50%

Trans-myocardial revascularization by laser, two-year follow-up

The objective of this study was to investigate the effects of Transmyocardial Revascularization by Laser [TMRL] in patients of ischemic heart disease. 50 patients of ischemic heart disease NYHA class III, IV who were not suitable for other methods of revascularization like CABG, PTCA ['No Option' patients] were offered TMRL. These patients were symptomatic on maximum medical treatment. 50 patients of angina NYHA class III, IV [mean 3.44 +/- 0.50] were offered TMRL. Their angina class improved to mean 1.88 +/- 0.74 at 6 month [p=0.00585] and persisted at mean 0.96 +/- 0.77 at 2 years [p =0 0.0150]. Their ETT mean value before operation was 5.036 +/- 1.54 minutes and at 2 years mean was 6.56 +/- 1.79 minutes [p=0.8318]. Kaplan Meier symptoms free survival rate was 83.1% at 6 months [14 censored] and 77.3 at 2 years [24 censored]

Release kinetics of salbutamol sulfate from HPMC based sustained release matrix: I effect of cetyl alcohol and bees wax

In order to search better combination of water insoluble waxy materials with hydrophilic polymer, investigations have been carried out using cetyl alcohol [CA] and bees wax [BW] as additives to the hydrophilic polymer, HPMC. They were added in increasing amount [up to 40% of the waxy materials] to the HPMC based sustained release [SR] matrix tablets. Excellent correlation was found between the concentration of waxy materials and salbutamol sulfate [SS] Release pattern of SS from HPMC - CA combination matrics were found zero order the release rate of SS decreases linearly with the increase in the concentration of CA in the matrics. On the other hand, release pattern of SS from HPMC - BW combination matrices were found to be bi - phasic. The first phase release was initially rapid, however, the extent of release both in the first and second phase were reduced with the increase of the BW concentration

Composition and epidemiology of urolithiasis

Urolithiasis is an important surgical problem in this part of the world. A number of epidemiological factors may be responsible for their prevalence. An effort has been made to find out the risk factors, which will help in prevention of recurrent stones, at least. One hundred ten patients were studied from 1st sept. 1989 to 30th sept. 1990 [13 months] for composition of there stones and epidemiological factors. Their was a predominance of mixed calcium oxylate stones. Low urinary output, poor socioeconomic status, hot weather and a positive family history were the epidemiological factors associated with their high incidence