Ultrasonographic visualisation of anatomical variation of the medial cutaneous nerve of forearm and its depiction by the novel use of a custom computer program to generate 2D diagrams

Cutaneous nerves display significant anatomical variation, and are therefore vulnerable to iatrogenic injury during various surgical procedures. High-resolution ultrasonography (USG) was used in this study to investigate this variation, and map the course of the medial cutaneous nerve of the forearm (MCNF). We also aimed to develop a method to virtually represent this variation, which could be used to plan procedures involving the MCNF

Temporomandibular joint anatomy: Ultrasonographic appearances and sexual dimorphism

Abstract: Introduction: Temporomandibular joint (TMJ) dysfunction is common, with a greater prevalence in females. While magnetic resonance imaging (MRI) is commonly used for clinical investigation, ultrasonography represents a potential alternative in some clinical scenarios. We designed a protocol for ultrasonographic evaluation of the TMJ and assessed its reliability. Presentation was compared between the sexes to establish whether an anatomical dichotomy underlies the female preponderance of TMJ dysfunction. Materials and methods: Ultrasound imaging of the TMJ was carried out in the longitudinal and oblique planes. Standard images were produced using model skulls and healthy volunteers. Measurements were made between the temporal bone, mandibular condyle, joint capsule and overlying skin, as well as of condylar translation during mouth opening. Both joints were scanned in 50 healthy volunteers. Measurements were repeated to evaluate reliability. A novel classification system was used to assess lateral condylar morphology. Results: The protocol facilitated reliable visualization of key anatomical features of the TMJ (average intraclass correlation coefficient = 0.75, p ¯ = 5.4E‐03). Distribution of condylar morphology differed between the sexes. The capsular‐cutaneous distance (‘joint depth’) and condylar‐temporal bone distance (‘interarticular distance’) were significantly greater in males than in females. Conclusions: Ultrasonography provides reliable views of the TMJ in two planes: longitudinal and oblique. Observed sexual dimorphism in TMJ anatomy might be associated with the female preponderance of dysfunction. With a standardized scanning protocol, ultrasound could provide a rapid, cost‐effective alternative to MRI as a point‐of‐care imaging tool in TMJ clinics

Anaesthetic Challenges in Molar Pregnancy

Gestational Trophoblastic Disease (GTD) is a spectrum of tumours with a wide range of biologic behaviour and potential for metastases, which were often fatal in the past. However, with better understanding of patho-physiology in the last few years, most women can now be cured. A Hydatidiform Mole (or Molar Pregnancy) is a benign Gestational Trophoblastic Disease that originates from the placenta. Treatment consists of vacuum evacuation but rarely hysterectomy may be required. Anaesthetic management is often complicated by the associated derangements

Anaesthetic management of a child with panthothenate kinase-associated neurodegeneration

Panthothenate kinase-associated neurodegeneration (PKAN) (Hallervorden-Spatz disease) is a rare autosomal recessive chromosomal disorder characterised by progressive neuroaxonal dystrophy. The characteristic features include involuntary movements, rigidity, mental retardation, seizures, emaciation. The anaesthetic concerns include difficult airway, aspiration pneumonia, dehydration, and post-operative respiratory, and renal insufficiency. We report successful anaesthetic management of a 9-year-old intellectually disabled male child with PKAN, scheduled for ophthalmic surgery under general anaesthesia

Middle East respiratory syndrome: A new global threat

The outbreak of Middle East respiratory syndrome (MERS) is reported from Saudi Arabia and the Republic of Korea. It is a respiratory disease caused by coronavirus. Camels are considered as a source for MERS transmission in humans, although the exact source is unknown. Human-to-human transmission is reported in the community with droplet and contact spread being the possible modes. Most patients without any underlying diseases remain asymptomatic or develop mild clinical disease, but some patients require critical care for mechanical ventilation, dialysis and other organ support. MERS is a disease with pandemic potential and awareness, and surveillance can prevent such further outbreaks