A morphometric study of spinoglenoid notch, subcoracoacromial arch, and spinous process of the scapula on shoulder impingement

Introduction: Morphometric study of spinoglenoid notch, coracoacromial arch, and another measurement of the scapulae are required to understand the reason for spasms of common muscle due to supraspinatus tendinitis, nerve compression over the spinoglenoid notch. Therefore, the aim of this study was to discuss the subcoracoacromial arch, deviation of the spinous process, and measurement of the spinoglenoid notch. Materials and Methods: This study was conducted at the Department of Anatomy, Sri Venkateshwaraa Medical College Hospital & Research Centre, Chennai, Tamil Nadu, India on 70 scapulae that include 58 non-articulated scapulae and 12 articulated scapulae. All the measurements were performed with a vernier caliper and the alignment of the spinous process of the scapula was measured with a goniometer. All the measurements are compared on both sides. Results: All the measurements were performed and presented as mean with standard deviation. We found the variation of diameter between the left and right sides. Spinoglenoid notch diameters were noted as anterior to posterior right 2.97 ± 0.37 cm, left 3.06 ± 0.56 cm and medial to lateral right 1.36 ± 0.14 cm, left 1.4 ± 0.08 cm. Subcoracoacromial arch was observed as right 1.85 ± 0.23 cm and left 1.92 ± 0.4 cm. The direction of the spinous process of the scapula was noted as right 21.50º ± 8.50 and left 18.8º ± 7.89. Conclusion: The present morphometric study findings may give a different approach to supraspinatous tendinits, shoulder instability, and dislocation cases due to morphometric changes present in the spinous process, acromion process, glenoid cavity, and spinoglenoid notch of the scapula. These morphometric studies on scapula can help radiologists, orthopedicians, and physiotherapists to plan patient management.

Imaging Insights into EHPVO Induced Portal Biliopathy and its Grading: Retrospective Study Over A Decade at A Tertiary Care Hospital

Background and Aim: There is limited data on imaging features of extra hepatic portal venous obstruction (EHPVO) induced portal biliopathy. We describe a decade long experience of imaging spectrum of EHPVO induced portal biliopathy using MR/CT in a referral centre for liver diseases. Methods: Retrospective data of patients with primary EHPVO on contrast magnetic resonance imaging MRI/ computed tomography (CT) (n=120) and portal biliopathy (PB) on subsequent magnetic resonance cholangiopancreatography (MRCP) (n=80/120) between June 2009 - 2019 was collected. Categorisation of portal biliopathy was as per the Sarin classification and the corresponding, relevant imaging parameters were studied and analysed. Results: Sarin Type 1 biliopathy was present in 16.3 %, Type 2 in 13.8%, Type 3a in 8.8% and Type 3b in 61.3%patients. The median total serum bilirubin was 1.6 (0.9-3.4) mg/dl with a mean CBD diameter of 6.7 ± 2.9 mm. Bilobar and unilobar IHBRD were observed in 87.5% and 6.3% patients respectively. The mean CBD angle was 138.9 ± 18.8º. CBD showed smooth wall contours (10%), extrinsic indentations (83.8%) and smooth strictures (6.3%). The median CBD stricture length was 26 mm (1.25- 45 mm). Pre-stenotic dilatation was observed in 66.3% with stricture length >16 mm (sensitivity 81.1 % specificity 78%) predisposing to it. Statistically significant associations were tabulated according to the classification of PB. Conclusion: This study provides the decade long experience of imaging findings in EHPVO induced portal biliopathy according to its classification and its clinical implications.

Invasive pulmonary aspergillosis with brain dissemination in an immunocompetent host

Invasive aspergillosis is an uncommon infection, which is mainly seen among immunocompromised patients. In recent years, cases of aspergillosis involving immunocompetent hosts are increasingly being reported. Herein, we report the case of a 27-year-old man with fever, productive cough, shortness of breath, and left hemiparesis. He had suffered trauma to his head 25 days prior. Imaging of the chest showed bilateral cavitary lesions in the lungs, and neuroimaging revealed a space-occupying lesion in the right frontoparietal cerebrum. He was suspected of having an abscess or metastasis. He died on day 3 of hospitalization, and an autopsy was performed. The autopsy revealed the cause of death to be invasive pulmonary aspergillosis, with brain dissemination. Invasive aspergillosis is uncommon in apparently immunocompetent individuals, and we discuss the autopsy findings in detail.

Blunt-chest-trauma-induced acute myocardial infarction

Blunt chest trauma (BCT) is one of the rarest causes of acute myocardial infarction (AMI). This paper reports the case of a young married man who suffered from AMI due to BCT sustained in a fight with his wife. The histopathology examination revealed a rupture of atherosclerotic plaque with superimposed thrombus in the proximal left anterior descending artery. This report also reviews previously reported BCT-induced AMI cases in the literature.

Pulmonary histopathology in fatal paraquat poisoning

Paraquat is a potent herbicide widely used in the Indian agriculture industry. Human fatality due to paraquat poisoning is not uncommon in this country. The primary effect of paraquat is on the lungs, and the resultant pulmonary damage leads to the patient's demise. There is a high mortality rate in paraquat poisoning as the treatment is usually supportive with no known antidote. There are limited human studies that have observed the histopathological changes in lungs in paraquat poisoning. The authors have discussed the time-related histopathological changes in lungs in paraquat poisoning on autopsy subjects. The role of anticoagulants and fibrinolytic agents in the treatment of this poisoning has also been discussed.

Flap Reconstruction Options And Outcomes For Carcinoma Lip - Our Experience

Aim The aim of this study was to review and describe techniques for the reconstruction of defects after resection of lip squamous cell carcinoma with emphasis on cosmetic and functional outcome. Patients and Methods A review of techniques and selected case presentations using different flap designs for the reconstruction of perioral defects following resection of squamous cell carcinoma in 25 patients out of 128 cases of head and neck malignancies was performed in period of 2017-2018 in Regional Cancer Centre,Govt Coimbatore medical college hospital. The Abbe estlander ,Nasolabial flap,Karapandzic flaps5 deltopectoral ,PMMF flap were used for lip defects. Results All reconstructed patients had acceptable functional results and healed without complication. Seven tumors were located in upper lip, Eight tumors in lower lip and Ten tumors in the angle of mouth. The lip defects were easily closed with the Karapandzic flaps, Abbe estlander ,nasolabial ,deltopectoral flap, forehead flap. While cosmesis was acceptable in all cases, the commissure was the most difficult region to reconstruct with a esthetic appearance and functional outcome. There were no flap failures.Oral competence was noted to be better in Karapandzic flaps, Abbe estlander flap,Nasolabial flap than deltopectoral/ forehead flap. Conclusion The Karapandzic,nasolabial and Abbe estlander flaps provide a easy and useful method to reconstruct perioral defects following resection for oral cancer.

A novel indirect ELISA for diagnosis of dengue fever.

Background & objectives: Dengue fever (DF) is associated with significant morbidity and mortality in the tropical and sub-tropical regions of the world. Since there are no effective antiviral drugs for treatment, clinicians often rely on the accurate diagnosis of dengue fever to begin supportive therapy at early stages of the illness. The objective of this study was to develop an in-house dengue virus serotype 2 (DENV-2) non-structural protein- 5 (NS5) based indirect ELISA. Methods: DENV-2 was raised in Vero cells and the viral proteins were separated and subsequently the NS5 protein was eluted. Serum samples from primary and secondary dengue fever patients; and acute and convalescent samples from Japanese encephalitis (JE) and West Nile virus (WNV) cases were used to validate the ELISA. Results: The assay was found to be 100 per cent specific in detecting DENV-2 specific antibodies from patient’s serum. However, in terms of sensitivity, the assay could detect IgM antibodies only from 90 per cent of the primary dengue samples. The IgM/IgG ratio of the primary and secondary samples was 7.24 and 0.64, respectively. Interpretation & conclusions: The results indicate that the DENV-2 NS5 ELISA is dengue group specific and can be used to differentiate dengue infection from other circulating Flavivirus infections. This NS5 ELISA can also be used to distinguish between primary and secondary dengue fever on the basis of IgM/IgG ratios. Further studies with larger sample sizes and different DENV serotypes are required to validate the ELISA.

Identification of molecular markers to study the Garcinia spp. diversity.

The genus Garcinia shows a considerable variation in its morphological characters such as leaf, flower and fruit with taxonomic ambiguity. It is a potential under-exploited multipurpose crop that gained considerable attention for the presence of (-) hydroxycitric acid, an anti-obesity compound, in its fruit rind and leaves. Here, we evaluated the genetic relationship through molecular markers among the selected 9 species commonly available in the Western Ghats and the Northeastern Himalayan foot hills of India. The nucleotide sequence data obtained from two prominent monomorphic bands generated in ISSR profiling of the species was utilized for the study. The selected bands were found to be of ITS region (700 bp) and partial region of KNOX-1 gene (600 bp). The evolutionary cluster was formed using MEGA5 software. The study indicated 2 major clusters, influenced by floral morphology of the species and availability of (-) hydroxycitric acid in their fruit rinds. In the subclusters, one species from the Western Ghats were paired with another from Northeastern Himalayas with relatively similar morphological traits.

Influence of leg dominancy over foot pressure and postural sway in middle age population: an observational study.

Background: The notion of limb dominance has been commonly used in the upper extremity, yet the two lower extremities are often treated as equal for clinical purposes. But both the lower limbs may not be perfectly symmetrical. There are conflicts of results with relation to leg dominancy, postural sway and foot pressure, which aided us to study the effect of lateralization on foot pressure and postural sway in middle age population. Methods: Thirty two normal subjects were recruited based on criteria, whose dominant lower limb was ascertained, Foot Pressure and postural sway was assessed by weighing scale and postural sway meter respectively. Results: Descriptive statistics and two way ANOVA were used as statistical analysis. Foot Pressure showed significant difference (P value <0.05) between dominant and non-dominant leg. On the other hand postural sway showed significant antero-lateral sway towards dominant side (P value <0.001). Conclusions: Lateralization of foot pressure is significant over dominant leg while postural sway is significant over anterolateral dominant side.

A perspective on toxicology ofConusvenom peptides

The evolutionarily unique and ecologically diverse family Conidae presents fundamental opportunities for marine pharmacology research and drug discovery. The focus of this investigation is to summarize the worldwide distribution ofConus and their species diversity with special reference to the Indian coast. In addition, this study will contribute to understanding the structural properties of conotoxin and therapeutic application ofConus venom peptides. Cone snails can inject a mix of various conotoxins and these venoms are their major weapon for prey capture, and may also have other biological purposes, and some of these conotoxins fatal to humans.Conusvenoms contain a remarkable diversity of pharmacologically active small peptides; their targets are an iron channel and receptors in the neuromuscular system. Interspecific divergence is pronounced in venom peptide genes, which is generally attributed to their species specific biotic interactions. There is a notable interspecific divergence observed in venom peptide genes, which can be justified as of biotic interactions that stipulate species peculiar habitat and ecology of cone snails. There are several conopeptides used in clinical trials and one peptide (Ziconotide) has received FDA approval for treatment of pain. This perspective provides a comprehensive overview of the distribution of cone shells and focus on the molecular approach in documenting their taxonomy and diversity with special reference to geographic distribution of Indian cone snails, structure and properties of conopeptide and their pharmacological targets and future directions.

Prevalence of work-related musculoskeletal complaints among dentists in India: A national cross-sectional survey.

Context: Work-related musculoskeletal disorders (WRMSD) had been previously reported to have a high prevalence among dentists in different parts of the world. Aims: The study aimed to assess the prevalence of self-reported WRMSD among dental professionals in India. Material and Methods: A cross-sectional survey of 646 dentists (response rate of 82.97%) was done using self-administered questionnaire which consisted of 27 items based on Nordic questionnaire for screening WRMSDs. Additional items of the questionnaire were added after preliminary content validation from six experienced dentists. Participant socio-demographic characteristics, work-related physical load characteristics, musculoskeletal symptom characteristics were evaluated. Statistical analysis used: All data were analyzed descriptively using percentiles and association between work-related physical load and WRMSD prevalence was done using Chi-square test. Results: All 536 dentists had at least one work-related musculoskeletal symptom in the previous year with an overall period prevalence rate of 100%. The type of symptoms present were pain (99.06%), stiffness (3.35%), fatigue (8.39%), discomfort (12.87%), clicks/sounds (4.1%), and other neurogenic (20.14%). The regions of symptoms were neck (75.74%), wrist/hand (73.13%), lower back (72.01%), shoulder (69.4%), hip (29.85%), upper back (18.65%), ankle (12.31%), and elbow (7.46%). Number of regions affected were two (82.83%), three (51.86%), four, or more (15.11%). Recurrent symptoms were present in 76.11%. Strong association was noted between sustained work postures and symptom regions for pain in WRMSD. Conclusion: The study found an overall one-year period prevalence rate of 100% for WRMSDs among Indian dentists. Measures for improving education and ergonomic evaluations are indicated on a large scale to prevent decline in work performance and incidence of WRMSDs among Indian dentists.

Phytochemical and antibacterial studies on Leucas vestita Wall ex Benth

Objective: In search of alternative herbal medicine for pathogenic microorganism variety of plant species have been identified. However, search of new species are still in progress to reduce the pressure on biological diversity and increase availability of organic compound. In the light of this the present work identified phytochemical property and antibacterial activity of Leucas vestita.Methods:The ethanol extract of L. vestita was used for this study. The phytochemicals present in the extract was identified and the antibacterial activity was tested through disc diffusion method. Results: The phytochemical studies revealed the presence of primary and secondary metabolites which ensuring their herbal properties. Antimicrobial activity showed increasing zone of inhibition with increasing concentration of the extract with Staphylococcus aureus, Bacillus subtilis, Enterobacter aerogenes, Klebsiella pneumoniae and Proteus mirabilis among the other microorganism. Larger zone of inhibition of 14mm was recorded for K. pneumoniae. Conclusions:The study suggests that this extract can be used as a medicine to control some of these pathogenic bacteria.

HIV in Indian MSM: Reasons for a concentrated epidemic & strategies for prevention.

Men who have sex with men (MSM) in India are disproportionately likely to be HIV-infected, and face distinct psychosocial challenges. Understanding the unique socio-cultural issues of MSM in India and how they relate to HIV risk could maximize the utility of future prevention efforts. This review discusses: (i) the importance of addressing co-occurring mental health issues, such as depression, which may interfere with MSM’s ability to benefit from traditional risk reduction counselling, (ii) reducing HIV-related stigma among health providers, policymakers and the lay public, and (iii) the role for nongovernmental organizations that work with the community to play in providing culturally relevant HIV prevention programmes for MSM.

Variability in the origin of the obturator artery

INTRODUCTION: General surgeons dealing with laparoscopic herniorrhaphy should be aware of the aberrant obturator artery that crosses the superior pubic ramus and is susceptible to injuries during dissection of the Bogros space and mesh stapling onto Cooper's ligament. The obturator artery is usually described as a branch of the anterior division of the internal iliac artery, although variations have been reported. MATERIALS AND METHODS: The present study was conducted on 98 pelvic halves of embalmed cadavers, and the origin and course of the obturator artery were traced and noted. RESULTS: In 79 percent of the specimens, the obturator artery was a branch of the internal iliac artery. It branched off at different levels either from the anterior division or posterior division, individually or with other named branches. In 19 percent of the cases, the obturator artery branched off from the external iliac artery as a separate branch or with the inferior epigastric artery. However, in the remaining 2 percent of the specimens, both the internal and the external iliac arteries branched to form an anastomotic structure within the pelvic cavity. CONCLUSION: The data obtained in this study show that it is more common to find an abnormal obturator artery than was reported previously, and this observation has implications for pelvic surgeons and is of academic interest to anatomists. Surgeons dealing with direct, indirect, femoral, or obturator hernias need to be aware of these variations and their close proximity to the femoral ring.