A comparison of 3 different methods for assessment of skeletal age when treating leg-length discrepancies: an inter- and intra-observer study.

Background and purpose - Skeletal maturity is a crucial parameter when calculating remaining growth in children. We compared 3 different methods, 2 manual and 1 automated, in the radiological assessment of bone age with respect to precision and systematic difference. Material and methods - 66 simultaneous examinations of the left hand and left elbow from children treated for leg-length discrepancies were randomly selected for skeletal age assessment. The radiographs were anonymized and assessed twice with at least 3 weeks' interval according to the Greulich and Pyle (GP) and Sauvegrain (SG) methods by 5 radiologists with different levels of experience. The hand radiographs were also assessed for GP bone age by use of the automated BoneXpert (BX) method for comparison. Results - The inter-observer intraclass correlation coefficient (ICC) was 0.96 for the GP and 0.98 for the SG method. The inter- and intra-observer standard error of the measurement (SEm) was 0.41 and 0.32 years for the GP method and 0.27 and 0.21 years for the SG method with a significant difference (p < 0.001) between the methods and between the experienced and the less experienced radiologists for both methods (p = 0.003 and p < 0.001). In 25% of the assessments the discrepancy between the GP and the SG method was > 1 year. There was no systematic difference comparing either manual method with the automatic BX method. Interpretation - With respect to the precision of skeletal age determination, we recommend using the SG method or preferably the automated BX method based on GP assessments in the calculation of remaining growth.

Evaluation of the awareness and perception of professional students in medicine, business and law schools of Karachi, regarding the use of (recreational) cannabis.

OBJECTIVE: To assess the awareness and perception of students attending professional medicine, law and business schools regarding recreational use of cannabis. METHODS: The cross-sectional study was conducted between June 2010 and November 2010. Using convenience sampling, 150 students from medical, business and law schools from both private and public sectors were enrolled. Government institutions included, Sindh Medical College, Institute of Business Administration and S.M. Law College, private schools were Ziauddin Medical College, SZABIST and Lecole for advanced studies. Data was collected through self-administered questionnaire. SPSS 17 was used for statistical analysis. RESULTS: A total of 250 students were approached out of which 150(60%) filled the questionnaire. Of them 91(60.7%) were males and the overall mean age of the respondents was 22 ± 2 years. A total of 68 (45.3%) students were from the medical field, 53 (35.3%) from business and 29 (19.3%) from law. The private and public sectors were equally represented at 75 (50%) each. Overall, 93 (62%) agreed that hashish is a serious problem concerning student population. When asked to identify factors encouraging abstinence, 67 (44.7%) respondents each cited religion and health risks. CONCLUSION: Our youth is not only concerned about the menace of hashish and but want proper awareness to be provided.