An anthropometric study of intercondylar femur notch with MRI analysis

Background: Anterior cruciate ligament is the most common ligament injury of knee. The bony anatomy of femur and tibia is responsible for normal knee kinematics and static stability. Intercondylar notch dimensions is considered as a significant predictive risk factor for ACL tear. Narrow femoral intercondylar notch width in either sex were major correlating factors. Aim was to evaluate the intercondylar femur notch dimensions in patients of knee injury using magnetic resonance imaging at RD Gardi Medical College, Ujjain, Madhya Pradesh. Methods: This is a prospective study consist of 400 patients carried out from October 2020 to August 2022 in the Department of Orthopaedics, RDGMC Ujjain. All the patients of knee injury including ACL tear and age 18 years to 60 years are included in the study. Patient less than 18 years and more than 60 years were excluded from the study. Dicom radiant software is used as statistical tool to analyse the data. Various intercondylar notch dimensions in different sections are measured using MRI in the dicom software. Results: The cut off values of axial NWI, NSI, NDI as 0.238, 0.662, 0.472 respectively. Conclusions: We conclude that narrow femoral intercondylar notch, lower notch width index increases the risk of an ACL tear in the given population. This would help in identification of people at risk for ACL injuries. Our study provides a comprehensive analysis on the risk factor of ACL tear, which would help in betterment of the patients at danger for anterior cruciate ligament injury. People with decreased notch dimensions should be educated on the high risk of ACL tear and be given proper prophylactic precautions

Can use of pictograms reduce liquid medication administration errors by mothers? : An interventional study

Background Liquid medication dosing errors (LMDE) made by caregivers affect treatment in children, but this is not a well-studied topic in many low-and middle-income countries including in India. Methods An intervention study was conducted among mothers attending a pediatric outpatient clinic of a tertiary care setting in Ujjain, India. The mothers randomly measured 12 volumes of a paracetamol liquid preparation by using a dropper (0.5 and 1 mL), measuring cup (2.5 and 5 mL), and calibrated spoon (2.5 and 5 mL) each with two instructions—oral-only measurement session (OMS) and oral plus pictogram measurement session (OPMS, the intervention). The main outcome was dosing error prevalence. The effectiveness of the intervention was assessed by measuring effect size. Risk factors for maximum LMDE were explored using backward multivariate logistic regression models. A P value of < 0.05 was considered statistically significant. Results In total, 310 mothers [mean (± SD) age, 30.2 (± 4.18) years] were included. LMDE prevalence in the OMS versus OPMS for dropper 0.5 mL was 60% versus 48%; for l mL dropper was 63% versus 54%; for 2.5 mL cup 62% versus 54%; for 2.5 calibrated spoon 66% versus 59%; 5 mL cup 69% versus 57%; and 5 mL calibrated spoon 68% versus 55%. Comparing OMS with OPMS, underdosing was minimum with the calibrated spoon for 2.5 mL (OR 4.39) and maximum with the dropper for 1 mL (OR 9.40), and overdosing was minimum with the dropper for 0.5 mL (OR 7.12) and maximum with the calibrated spoon for 2.5 mL (OR 13.24). The effect size (dCohen) of the intervention OPMS was 1.86–6.4. Risk factors for the most prevalent dosing error, that is, with the calibrated spoon for 2.5 mL, were increasing age of the mother (aOR 1.08; P = 0.026) and nuclear family (aOR 2.83; P = 0.002). The risk of dosing errors decreased with higher education of the mothers. Conclusions Pictograms can effectively minimize LMDE even in less educated mothers