Sphenoidal emissary foramen and its clinical consideration

Background:Sphenoidal emissary foramen is a small, variable and an inconstant foramen in middle cranial fossa which is located antero-medial to the foramen ovale. Emissary vein passing through it connects the pterygoid venous plexus with the cavernous sinus which has clinical significance because through an extra-cranial infection may reach to cavernous sinus. Aim of present study was to investigate the incidence and shape of sphenoidal emissary foramen, the number of present on one side and the presence of bony septum in it.Methods: Two hundred and fifty (right 250; left-250) dry Indian adult skulls of unknown age and sex were used for this study. Middle cranial fossa of each skull was macroscopically observed for the presence, absence of sphenoidal emissary foramen. Patency was confirmed by inserting a bristle through each probable foramen and only patent foramen were calculated.Results: We observed that sphenoidal emissary foramen was present in 72 (28.8%) skulls. Unilaterally it was present in 17.6% and bilaterally in 11.2% skulls.Conclusions: Incidence of this foramen is variable and therefore recognition of this anatomical structure is important. Knowledge of their variations will be helpful for neurosurgeons and radiologist.

Variations of Lung Fissures: A Cadaveric Study

Background: The presence of fissures in the normal lungs enhances uniform expansion and hence facilitates more air intake. Accessory and incomplete fissures of varying depth can be seen in unusual locations of the lung, delimiting abnormal lobes which correspond to the normal bronchopulmonary segments. The knowledge of anatomical variations of lung fissures is essential for clinicians, surgeons, and for radiologist for recognizing various images of related abnormalities because an accessory or anomalous fissure can be mistaken for a lung lesion or an atypical appearance of pleural effusion. Aims and Objectives: The aim of the present study is to observe the variations of lung fissures in Indian population. Fifty pairs (right- 50; left- 50) of lungs were used for this study. Each lung was studied carefully for number of fissures whether complete or incomplete or absent. Presences of accessory fissures were noted. Results: We observed complete absence of fissures in two right and left lungs. Accessory fissures were present in 38% right lungs and 32% in left lungs. Conclusion: Incidence of absence of oblique fissure and accessory fissure was greater in our present work when compared our results with other authors. Considering this we feel that more elaborative study should be done on this topic which will throw more light on this

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Centrality evolution of the charged-particle pseudorapidity density over a broad pseudorapidity range in Pb-Pb collisions at root s(NN)=2.76TeV

Peer reviewe

A new record of Scolia (Discolia) fasciatopunctata dunensis Betrem (Insecta: Hymenoptera: Scoliidae) from the Western Ghats of Maharashtra, India

Scolia (Discolia) fasciatopunctata dunensis Betrem, 1928 is reported for the first time from the Western Ghats. Diagnostic characters and geographical distribution of this species are discussed in brief. A map showing its distribution in India is also provided. </div

A new record of Scolia (Discolia) fasciatopunctata dunensis Betrem (Insecta: Hymenoptera: Scoliidae) from the Western Ghats of Maharashtra, India

Scolia (Discolia) fasciatopunctata dunensis Betrem, 1928 is reported for the first time from the Western Ghats. Diagnostic characters and geographical distribution of this species are discussed in brief. A map showing its distribution in India is also provided. </div

Risk Based Monitoring (RBM): A global study focusing on perception and merits among clinical investigational sites

Background: Several approaches to clinical trial monitoring, including the Risk Based Monitoring (RBM) are aimed at the protection of the human subjects (safety), improved data quality, and ultimately, reducing the cost of drug development and operations. There exists minimal evidence globally about the perceptions and the level of confidence among the clinical staff on the merits of RBM. The present study assessed the perception among clinical research staff globally (developed and emerging countries) on the applicability and adaptability of RBM. Methods: An electronic questionnaire survey consisting of twelve items was developed, validated, and then circulated globally via email to three thousand clinical research staff members at various investigational sites. This survey collected information on the use of RBM and factors that relate to clinical trial cost, data quality, subject safety, and the readiness to adopt RBM practices. The survey responses were summarized and analyzed by using the information e.g. responder's age, sex, clinical research role, global location, and experience in clinical research trials. Results: Responses were received from ten countries, six emerging and four developed. Of the 3000 surveys sent to emerging (1,000) and developed (2,000) countries, a total response of 595 (261 vs 334) participants was received, respectively. The emerging versus developed group had 100 vs 137 participants with complete responses (CR); 34 vs 35 participants with partial responses (PR); and 127 vs 162 participants were disqualified with no exposure (NE) responses. About 67% of the overall responders were investigators, followed by 23%, 10% coordinator and other staff respectively. There was not significant difference in feedback between the researchers in developing versus emerging countries (p = 0.20) with regards to their perception of RBM reducing the overall cost of conducting a clinical research. Responders from emerging countries had a more favorable response than in the developed countries. Similarly, when asked if RBM will be more effective in addressing data quality (p = 0.006), patient safety (p = 0.05) and findings fraud/fabrication (p = 0.01), researchers from emerging countries indicated more confidence than researchers from developed countries. There was also a significant difference in the readiness to adopt RBM between responders of emerging versus developed markets (p < 0.0001). Conclusion: This unique study performed across ten emerging and developed countries strongly supported the need for systematic global training, education, and implementation of RBM regulatory guidance, with an aim for better safety of subjects and improved quality of clinical trial data. Furthermore, studies with larger sample sizes are recommended to provide an evidence-based approach

Fibularis Tertius Muscle: Cadaveric Study in Indians

Background: Fibularis tertius is a small, unipennate muscle of the anterior compartment of the leg which is peculiar to human. It is highly variable muscle. It acts as a dorsiflexor and evertor of the foot. Fibularis tertius muscle flap is used for transposition and correcting any laxity in the ankle joint by foot surgeons. Distal attachment of it might play important role in causation of torsional stresses as observed in Jones fractures. Aims: It was aimed to study the incidence of fibularis tertius muscle and to observe variations in its proximal and distal attachments in Indian population. Material and Methods: We studied 100 (right: 50; left: 50) cadaveric lower limbs to observe the presence or absence of fibularis tertius muscle and variations in its proximal and distal attachments. Results: Fibularis tertius was absent in 13%. We observed variations in th th distal attachment of it. It was attached to 4 or 5 metatarsal or both. In some cases we observed bifurcated tendon and duplication of tendon of this muscle. Conclusion: Variations of fibularis tertius muscle are more frequent and its distal attachments are not absolutely at a fixed position therefore a precise and detailed knowledge of this muscle is important for foot surgeons and anatomists