Anatomical variation in the formation and course of median nerve: a cadaveric study

Background: Median nerve is one of the terminal branches of brachial plexus. Its formed by the union of medial root and lateral root coming respectively from medial and lateral cords of brachial plexus. Knowledge of anatomical variations of median nerve at origin and course is important in repair of traumatic injuries and surgical correction of brachial plexus injuries. These conditions need dissection of median nerve and knowledge of its variations.Methods: Present study included 53 cadavers and 106 upper limbs from our department of Anatomy. In this study, anatomically embalmed cadavers which were kept for routine dissection for under graduates were included. The present study we studied the anatomical variations in origin and course of median nerve in arm. We also studied the relation of median nerve with axillary and brachial arteries.Results: In this study we found origin of median nerve from 3 roots in 26.41%, 4 roots from 1.88%. Regarding the relation of median nerve with axillary artery we observed in 8.49% cadavers median nerve lies medial to axillary artery and in 0.94% Median nerve is passing along the lateral side of brachial artery without crossing the artery.Conclusions: This study shows high percentage of deviations from normal anatomy in origin of median nerve. Anatomical variation in brachial plexus and adjacent arteries knowledge is important for anatomist, plastic surgeon and vascular surgeons.

Stereospecific dissolution of inclusion complexes of amlodipine base and its besylate enantiomers with hydroxypropyl-β-cyclodextrin

The objective of this work was the preparation of inclusion complexes of amlodipine base and its besylate salt with hydroxy propyl-β-cyclodextrin (HPBC) to improve the dissolution and to investigate the stereospecific dissolution of amlodipine enantiomers. The prepared inclusion complexes were characterized by FTIR and DSC. Significant improvement in the dissolution was found with S and R enantiomers of amlodipine base where as no improvement was found with enantiomers of amlodipine besylate (p > 0.05) after complexation with HPBC. This indicates the formation of inclusion complexes with only enantiomers of amlodipine base (p 0.05). Stereospecific dissolution was observed with pure enantiomers of amlodipine base when its inclusion complexes were prepared by solvent evaporation method with l:1 and 1:2 molar ratios but not with 1:3 molar ratio.Colegio de Farmacéuticos de la Provincia de Buenos Aire

HIV prevention programmes for female sex workers in Andhra Pradesh, India: outputs, cost and efficiency

BACKGROUND: Female sex workers and their clients play a prominent role in the HIV epidemic in India. Systematic data on the outputs, cost and efficiency for HIV prevention programmes for female sex workers in India are not readily available to understand programme functioning and guide efficient use of resources. METHODS: Detailed output and cost data for the 2002–2003 fiscal year were obtained using standardised methods at 15 HIV prevention programmes for female sex worker in the state of Andhra Pradesh in southern India. The services provided and their relation to the total and unit economic costs were analysed using regression techniques. The trends for the number of sex workers provided services by the programmes since inception up to fiscal year 2004–2005 were examined. RESULTS: The 15 programmes provided services to 33941 sex workers in fiscal year 2002–2003 (range 803–6379, median 1970). Of the total number of contacts with sex workers, 41.6% were by peer educators and 58.4% by other programme staff. The number of sex worker contacts in a year by peer educators varied 74-fold across programmes as compared with a 2.7-fold variation in sex worker contacts by other programme staff. The annual economic cost of providing services to a sex worker varied 6-fold between programmes from Indian Rupees (INR) 221.8 (US$4.58) to INR 1369 (US$ 28.29) with a median of INR 660.9 (US$13.66) and mean of INR 517.8 (US$ 10.70). Personnel salaries made up 34.7% of the total cost, and recurrent goods made up 38.4% of which 82.1% was for condoms. The cost per sex worker provided services had a significant inverse relation with the number of sex workers provided services by a programme (p < 0.001, R(2 )= 0.75; power function). There was no correlation between the full time equivalents of programme staff and the number of sex workers provided services by the programmes, but there was a modest inverse correlation between the number of sex workers served and the average time spent with each sex worker in the year adjusted for the full-time equivalents of programme staff (p = 0.011, R(2 )= 0.40; exponential function). The average number of sex workers provided services annually by the first batch of 7 programmes started in early 1999 plateaued after the fourth fiscal year to 3500, whereas the 8 second-batch programmes started in late 2000 reached an average of 2000 sex workers in 2004–2005 with an increasing trend up to this fourth fiscal year. CONCLUSION: The HIV prevention efforts in this Indian state would benefit from standardisation of the highly variable services provided by peer educators, who form an important part of the sex worker programmes. The cost per sex worker served decreases with increasing number of sex workers served annually, but this has to be weighed against an associated modest trend of decrease in time spent with each sex worker in some programmes

Luminescence dating of loess-palaeosol sequences and coversands: methodological aspects and palaeoclimatic implications

Of the terrestrial archives, loess-palaeosol sequences provide a most complete record of climatic change. This may be compared with the Marine oxygen isotope stratigraphy, and may help in the reconstruction of past atmospheric circulation patterns. Numerical chronometry of loess-palaeosol sequences has generally been based on correlation of variations in climatic proxies (such as magnetic susceptibility and particle sizes) with Marine isotopic data. Such chronometric assignments involve implicit assumptions about the constancy of sedimentation rates and particle fluxes through time. This review presents a brief survey of the present status, methodology, outstanding problems and interpretational aspects of luminescence techniques, and discusses the import of luminescence ages on global land-sea correlations. Statistical analysis of the ages suggests episodicity of loess accumulation with extended periods of quiescence. Recent luminescence dating studies on closely spaced samples also lead to a similar inference. Luminescence ages imply high variability in loess sedimentation rates. This conflicts with the assumption, made in some current attempts to correlate loess records with marine records, of almost constant particle fluxes. A review of source-proximal coversand deposits of northwest Europe is also presented. Evidence of the onset of coversand deposition at 15 ka, with a peak in accretion during the Younger Dryas and subsequent minor reactivation episodes, is discussed

Aggradation history and luminescence chronology of Late Quaternary semi-arid sequences of the Sabarmati basin, Gujarat, Western India

The Gujarat alluvial plain in the semi-arid desert margin of the Thar desert contains a record of continental Quaternary sequences. These sequences were built by drainages originating in the Aravalli Hills and flowing westward into the Indian Ocean. Stratigraphic studies of a part of the Late Quaternary succession in the Sabarmati basin have resulted in a fourfold lithostratigraphic scheme-the Waghpur Formation (Conglomeratic Member; Sand Member); the Mahesana Formation (Lower Heterolithic Member; Upper Sand Member); the Akhaj Formation, and the Sabarmati Formation. Facies analysis, distribution of conglomerates and cross-bed azimuths of the clastic facies of the Waghpur Formation were used to infer NE-SW trending semi-arid alluvial fans. The deposition of the overlying Heterolithic Member took place in ephemeral streams influenced by episodic flows and aeolian reworking. The upper member of the Mahesana Formation represents aeolian and older levee deposits. Feasibility studies of Thermoluminescence (TL) and Infra-red Stimulated Luminescence (IRSL) dating on the Sabarmati succession yielded stratigraphically consistent ages ranging from ~5 ka to ≥300 ka. For two samples, TL ages on quartz and IRSL ages on feldspar separates, were consistent. These results, together with the stratigraphic and petrographic data reveal the following events in the accumulation history of the Sabarmati sequence: 1. (1) Significant aggradation at=300 ka (gravel-sand) and at 58 ka (sand), and 2. (2) Pedogenesis bracketed to 58-39 ka The Sabarmati river in its middle stretches follows a regional slope-deviatory course interpreted previously to be a neotectonic adjustment within the Cambay graben. Our chronological data suggest that this adjustment occurred, possibly, within the past 39 ka

Effect of Aqueous Soluted Nitriding Process on AISI 304 Austenitic Stainless Steel under Dry Sliding Conditions

AISI 304 stainless steel categorized under austenitic, has good resistance to corrosion and applicable for high resistance to pitting and stresses. But it has poor hardness, sterngth and resistance to wear. In order to overcome the above problem, various hardening techniques like nitriding, carburizing, carbonitriding, Cyaniding etc are preferred. In this work, aqueous soluted nitriding process is carried out to improve the surface hardness and wear resistance on AISI 304 specimens. Three specimens in cylindrical shape with a diameter of 10mm and length 35mm are treated with salt bath nitriding process for a time period of 45 minutes, 90 minutes, 120 minutes and named as SBN 1, SBN 2, SBN 3 respectively. One specimen is kept untreated to compare the results with treated specimens. After the heat treatment procedure is completed, pin on disc wear testing instrument was used to conduct a wear test at a constant speed and load. All the specimens were subjected to Scanning Electron Microscope test and the results were compared

Cost and efficiency of public sector sexually transmitted infection clinics in Andhra Pradesh, India

<p>Abstract</p> <p>Background</p> <p>Control of sexually transmitted infections (STIs) is an important part of the effort to reduce the risk of HIV/AIDS. STI clinics in the government hospitals in India provide services predominantly to the poor. Data on the cost and efficiency of providing STI services in India are not available to help guide efficient use of public resources for these services.</p> <p>Methods</p> <p>Standardised methods were used to obtain detailed cost and output data for the 2003–2004 fiscal year from written records and interviews in 14 government STI clinics in the Indian state of Andhra Pradesh. The economic cost per patient receiving STI treatment was calculated, and the variations of total and unit costs across the STI clinics analysed. Multivariate regression technique was used to estimate incremental unit costs. The optimal number of STIs that could be handled by the clinics was estimated.</p> <p>Results</p> <p>18807 STIs were diagnosed and treated at the 14 STI clinics in fiscal year 2003–2004 (range 323–2784, median 1199). The economic cost of treating each STI varied 5-fold from Indian Rupees (INR) 225.5 (US$4.91) to INR 1201.5 (US$ 26.15) between 13 clinics, with one other clinic having a very high cost of INR 2478.5 (US$53.94). The average cost per STI treated for all 14 clinics combined was INR 729.5 (US$ 15.88). Personnel salaries made up 76.2% of the total cost. The number of STIs treated per doctor full-time equivalent and cost-efficiency for each STI treated had a significant direct non-linear relation (p < 0.001, R²= 0.81; power function). With a multiple regression model, apart from the fixed costs, the incremental cost for each STI detected and cost of treatment was INR 55.57 (US$1.21) and for each follow-up visit was INR 3.75 (US$ 0.08). Based on estimates of optimal STI cases that could be handled without compromising quality by each doctor full-time equivalent available, it was projected that at 8 of the 14 clinics substantially more STI cases could be handled, which could increase the total STI cases treated at the 14 clinics combined by 38% at an additional cost of only 3.5% for service provision.</p> <p>Conclusion</p> <p>There is un-utilised capacity in the public sector STI clinics in this Indian state. Efforts to facilitate utilisation of this capacity would be useful, as this would enable more poor patients with STIs to be served at minimal additional cost, and would also reduce the cost per STI treated leading to more efficient use of public resources.</p