The initial experience of 2495 cases of the ulnar artery as default access for coronary diagnostic and interventional procedures at a single center: An observational study.

INTRODUCTION: Upper limb arterial access is being increasingly used for coronary diagnostic and intervention procedures. Radial artery access is associated with reduced morbidity and mortality as compared to femoral artery access. However, access to the radial artery is not always successful with reported crossover rates to other routes between 3% and 8%. Ulnar artery access is emerging an attractive option both as upfront access and rescue access in case of failure to obtain radial artery access. AIMS -: To assess and document the feasibility and safety of ulnar access as a default strategy. METHODS: 2654 patients planned for coronary diagnostic and intervention procedureswere assessed for inclusion. Inclusion criteria were, all patients planned for coronary angiography (CAG) or percutaneous coronary intervention (PCI) with palpable ulnar pulse. Exclusion criteria included reverse Barbeau test type D, previous procedure resulting in radial artery occlusion/excision, hemodialysis patients having ipsilateral AV fistula and severe forearm deformities. RESULTS: 2525 patients were found eligible, out of which 2495 (98.81%) were successfully cannulated. Procedure was completed in 2414 patients. Local site bleeding in 40 (1.6%) and acute loss of ulnar pulse noted in 33 (1.3%) out of 2495 patients. None of the patients had gangrene of access site, pseudo-aneurysm, arteriovenous fistula or neurological deficit post procedure. CONCLUSION: The Ulnar artery access as a default access is safe and feasible option for patient undergoing coronary diagnostic and interventional procedures.

Sexual dimorphism in ulna: an osteometric study from India.

Determination of sex constitutes the most important element during the identification process of human skeletal remains. Several sex-specific features of human skeleton have been exploited for sex determination with varying reliability. This study aims to obtain sexual dimorphic standards for ulnae of the north Indian population. Eight measurements were obtained on a sample of 106 ulnae (males--80, females--26) in the age range of 25-65 years. The sexual dimorphism index and demarking points were calculated for all the variables. The data were then subjected to stepwise and direct discriminant function analysis. The best discriminator of sex was the maximum length (84.9%) followed by radial notch width (84%). In stepwise analysis, these two variables were selected and provided an accuracy of 88.7% (M-87.5%, F-92.3%). The proximal end provided a classification rate of 81.1% (M-80%, F-84.6%) with selection of the notch length and olecranon width.

A study of sexual dimorphism in the femur among North Indians.

Determination of sex of unknown skeleton remains is the most important step in the identification process. Racial and regional differences in the populations create and maintain specificity in their dimorphic characteristics. Moreover, considering continued secular changes in the population structure, constant revision of osteometric standards becomes mandatory. In an effort to establish osteometric standards for the femur of contemporary North Indian populations, 122 adult femora of known sex (M: 94; F: 28) were collected in the Department of Forensic Medicine, IMS, BHU, Varanasi. Eight standard parameters were measured and analyzed by discriminant function analysis using SPSS 16. The accuracy of sex prediction ranged from 70.5% to 83.6% with single variables. In stepwise analysis, epicondylar breadth, proximal breadth, and antero-posterior diameter of the lateral condyle were found to be the most discriminating variables providing an accuracy of 90.2%. The results clearly indicate the importance of the ends of femur in the determination of sex.

An unusual venous drainage of face--a case report.

Facial region is drained by the maxillary, facial and superficial temporal veins. In the present case, retromandibular venous junction divided into anterior and posterior divisions immediately after its formation and a common venous channel was formed between internal jugular and anterior jugular veins where facial, lingual and submental veins drained.