28 research outputs found
Metopic Suture â Incidence and Morphology in South Indian Human Adult Skulls
Background:In the present study, the objectives were to determine the incidence of persistence of metopic sutures, their shape and extent in south Indian human adult skulls.Methods: The study was conducted on 100 human adult dry skulls which belong to the museum of the department of Forensic medicine & toxicology and the department of Anatomy, JJM Medical College, Davangere, Karnataka. The metopic sutures were classified as complete and incomplete types. The incomplete was divided into linear, âVâ shaped and âUâ shaped, which were further divided into three groups as present in the lower part of the frontal bone, in the upper part, and in the middle part.Results: From our observations, the metopic suture was present in 13 (13%) cases. The complete metopic suture was seen in 6 skulls (6%) and incomplete one in 7 (7%). Among the incomplete ones, linear was found in 5 (5%), âVâ shaped in 1 (1%) and âUâ shaped type in 1 (1%) cases. In 7 (7%), cases it was observed in the lower part of frontal bone, but no suture remnant was found in the upper and lower part of frontal bone.Conclusion: Due to the paucity in the availability of the skulls, a lesser number of sample size was taken in our study. But a good analysis can be done with a larger sample size, to give a constructive data
New MR sequences in daily practice: susceptibility weighted imaging. A pictorial essay
Background Susceptibility-weighted imaging (SWI) is a
relatively new magnetic resonance (MR) technique that
exploits the magnetic susceptibility differences of various
tissues, such as blood, iron and calcification, as a new
source of contrast enhancement. This pictorial review is
aimed at illustrating and discussing its main clinical
applications.
Methods SWI is based on high-resolution, threedimensional
(3D), fully velocity-compensated gradientecho
sequences using both magnitude and phase images.
A phase mask obtained from the MR phase images is
multiplied with magnitude images in order to increase the
visualisation of the smaller veins and other sources of
susceptibility effects, which are displayed at best after postprocessing
of the 3D dataset with the minimal intensity
projection (minIP) algorithm.
Results SWI is very useful in detecting cerebral microbleeds
in ageing and occult low-flow vascular malformations,
in characterising brain tumours and degenerative diseases of the brain, and in recognizing calcifications in
various pathological conditions. The phase images are
especially useful in differentiating between paramagnetic
susceptibility effects of blood and diamagnetic effects of
calcium. SWI can also be used to evaluate changes in iron
content in different neurodegenerative disorders.
Conclusion SWI is useful in differentiating and characterising
diverse brain disorders
Community prevalence of methicillin and vancomycin resistant Staphylococcus aureus in and around Bangalore, southern India
A methodology for assessing the effectiveness of serious games and for inferring player learning outcomes
Family-led rehabilitation after stroke in India (ATTEND): a randomised controlled trial
Background
Most people with stroke in India have no access to organised rehabilitation services. The effectiveness of training family members to provide stroke rehabilitation is uncertain. Our primary objective was to determine whether family-led stroke rehabilitation, initiated in hospital and continued at home, would be superior to usual care in a low-resource setting.
Methods
The Family-led Rehabilitation after Stroke in India (ATTEND) trial was a prospectively randomised open trial with blinded endpoint done across 14 hospitals in India. Patients aged 18 years or older who had had a stroke within the past month, had residual disability and reasonable expectation of survival, and who had an informal family-nominated caregiver were randomly assigned to intervention or usual care by site coordinators using a secure web-based system with minimisation by site and stroke severity. The family members of participants in the intervention group received additional structured rehabilitation trainingâincluding information provision, joint goal setting, carer training, and task-specific trainingâthat was started in hospital and continued at home for up to 2 months. The primary outcome was death or dependency at 6 months, defined by scores 3â6 on the modified Rankin scale (range, 0 [no symptoms] to 6 [death]) as assessed by masked observers. Analyses were by intention to treat. This trial is registered with Clinical Trials Registry-India (CTRI/2013/04/003557), Australian New Zealand Clinical Trials Registry (ACTRN12613000078752), and Universal Trial Number (U1111-1138-6707).
Findings
Between Jan 13, 2014, and Feb 12, 2016, 1250 patients were randomly assigned to intervention (n=623) or control (n=627) groups. 33 patients were lost to follow-up (14 intervention, 19 control) and five patients withdrew (two intervention, three control). At 6 months, 285 (47%) of 607 patients in the intervention group and 287 (47%) of 605 controls were dead or dependent (odds ratio 0·98, 95% CI 0·78â1·23, p=0·87). 72 (12%) patients in the intervention group and 86 (14%) in the control group died (p=0·27), and we observed no difference in rehospitalisation (89 [14%]patients in the intervention group vs 82 [13%] in the control group; p=0·56). We also found no difference in total non-fatal events (112 events in 82 [13%] intervention patients vs 110 events in 79 [13%] control patients; p=0·80).
Interpretation
Although task shifting is an attractive solution for health-care sustainability, our results do not support investment in new stroke rehabilitation services that shift tasks to family caregivers, unless new evidence emerges. A future avenue of research should be to investigate the effects of task shifting to health-care assistants or team-based community care