A Case Report of Thoracic Outlet Syndrome with Vascular Complications due to Cervical Rib.

Thoracic outlet syndrome (TOS) is recognized in approximately 8% of the population. Its manifestations may be neurologic or vascular or both, depending on the component of the neurovascular bundle predominantly compressed. The diagnosis is suspected from the clinical picture and investigations. Treatment is initially conservative but persistence of significant symptoms, which occurs in approximately 5% of patients with diagnosed TOS, is an indication for cervical rib and or first rib resection.1 We report the case of a young woman having a left sided cervical rib. She had presented with clinical features of both neurogenic and arterial TOS. Surgical resection of the cervical rib was performed uneventfully through a supraclavicular approach which resulted in complete relief of her symptoms.

A Case Report of Middle Aortic Syndrome: A Rare Vascular Disorder.

The middle aortic syndrome (MAS) is rare (about 0.5-2% of all the cases of aortic coarctation) vascular disorder characterized by severe narrowing in the descending thoracic aorta, abdominal aorta, or both. It can be congenital or acquired due to several conditions.MAS may present clinically as uncontrolled hypertension, abdominal angina or lower limb claudication. Surgical treatment is effective in controlling symptom and improves life expectancy.

Evaluation of Pulmonary Function after Off- Pump Coronary Artery Bypass Graft Surgery with Thoracic Epidural Analgesia.

Background: A substantial reduction of lung volumes and pulmonary function follows cardiac surgery. Pain may prevent effective breathing and coughing, as thoracic epidural analgesia may reduce post operative pain and improve early post operative pulmonary function. We tested the effect of thoracic epidural analgesia (TEA) on pulmonary function after off- pump coronary artery bypass (OPCAB) graft surgery. Methods: 60 patients undergoing off- pump coronary artery bypass (OPCAB) graft surgery were nonrandomized in to two groups. Group-I (30 patients) receiving thoracic epidural analgesia along with general anaesthesia (G/A) but Group-II (30 patients) receiving general anaesthesia alone. Total ventilation time, intensive care unit (ICU) stay, spirometric data, arterial blood gas (ABG) and X-ray chest (CXR) were recorded in postoperative follow-up period. Results: Thirty patients were enrolled in each group. The demographics of the groups were similar. Patients in the epidural group had significantly less pain on the operative day and for the next 2 days. Total ventilation time in hours in Group-I was 6.4±1.0 and in group-II was 10.1±1.8 hours respectively. FVC and FEV1 were significantly different in group-I than group-II. On the postoperative period, ABG was done pre and postoperative period in both groups of patients. Significant differences was found in pao2 and paco2, half an hour after extubation, 1st postoperative day, 2nd postoperative day (p<0.05). Postoperative CXR revealed significant pulmonary complication in group-II than group-I, higher in the epidural group on the first and second postoperative days. There were no complications related to epidural hematoma and no permanent neurologic squeal. Conclusion: Thoracic epidural analgesia yields a slight, but significant improvement in pulmonary function most likely due to a more profound postoperative analgesia.

An epidemiological study of the risk factors of occupational diseases in coal handling plant of a thermal power station.

Anthropometry and morbidity profile of fifty randomly selected workers of coal handling plant at a thermal power station of West Bengal having at least five years experience were studied. The mean value of their age, duration of present job and Body Mass Index (BMI) were 34.8 years, 7.86 years and 19.24 respectively. As they were exposed to coal dust (Av. concentration 300-350 mg/M3 of air), warmth (Ambient temperature 40 +/- 5 degrees C), humidity (Relative humidity 80 +/- 5%) and noise [Av. 80 dB(A)], respiratory system was most commonly (72%) effected followed by greying of hair (5.6%), Cloth dusters used by some could not render any discernable protective effect. Addiction was also prevent (62%). Use of proper protective equipments (PPE) supplemented by adequate preplacement and periodic medical examination followed by successful rehabilitation were suggested.

Enzymes of carbohydrate metabolism in fast-growing Rhizobium grown on hexoses or succinate.

Enzymatic evidence supports that succinate mediates repression of hexose-catabolising enzymes in fast-growing Rhizobium sp. (Cicer arietinum). Enzymes of the Embden-Myerhof-Parnas, Entner-Doudoroff and pentose phosphate pathways were found present in hexose-grown cells but not in succinate-grown cells. These however could be induced by the presence of hexoses.

Role of S gene product of bacteriophage lambda in host cell lysis.

Studies with the induced lysogens of λ S+R+, λS–R+, λS+R– and λS–R– phages have shown that while the S gene product is essential for the action of intracellular R gene product to release the periplasmic alkaline phosphatase in the presence of EDTA, the latter gene product can bring about this effect while acting on Escherichia coli cells from outside, in the absence of functional S gene product; chloroform, could help the intracellular R gene product in effecting bacterial lysis in the absence of S gene product. These result support the premise that the S gene product facilitates the R gene product in crossing the cytoplasmic membrane into the periplasmic space such that the latter can act on the peptidoglycan layer of the host cell thus causing both the release of alkaline phosphatase and cell lysis.