<p>INTRODUCTIONThe sciatic nerve is the largest nerve, with a long course in the inferior extremity. Its division into the tibial and common peroneal nerves can occur at any level from the sacral plexus to the inferior part of the popliteal space. These anatomical variations may contribute to clinical conditions such as piriformis syndrome, sciatica and coccygodynia.p><p>METHODSThis study was performed on cadavers in order to study the level of sciatic nerve division. The inferior extremities of 43 cadavers were classified into six groups depending on the level of sciatic nerve division in the gluteal region, the upper, middle and lower parts of the back of the thigh, and the popliteal fossa.p><p>RESULTSThe highest incidence of sciatic nerve division (40.7 percent) was observed in the lower part of the posterior compartment of the thigh. In 34.9 percent of the specimens, the sciatic nerve was divided into tibial and common peroneal nerves in the popliteal fossa. 16.3 percent of extremities showed sciatic nerve division proximal to its entrance in the gluteal region.p><p>CONCLUSIONIn sciatic nerve neuropathies, the extent of neurological deficits depends on the level of sciatic nerve division. Sciatic nerve division into tibial and common peroneal components at a higher level can result in the involvement of only one out of the two divisions from sciatic neuropathy. It can also result in a failure of the sciatic nerve block while performing popliteal block anaesthesia.p>
Cadaver ; Female ; Humans ; India ; Lumbosacral Plexus ; pathology ; Male ; Models, Anatomic ; Models, Neurological ; Piriformis Muscle Syndrome ; pathology ; Reproducibility of Results ; Sciatic Nerve ; anatomy & histology ; physiopathology ; Sciatica ; pathology ; Tibia ; innervation ; pathology

Introduction:Carpal collapse of wrist occurs in disorders like rheumatoid arthritis and Kienbock's disease. Three techniques have been described to measure carpal collapse. First, the carpal height ratio (CHR), measured by dividing carpal height by 3rd metacarpal length. Second, the revised carpal height ratio (RCH ratio), measured by dividing carpal height by length of capitate. Third, capitate radius distance (CR index), measured by shortest distance between distal edge of radius and the proximal edge of capitate. The index publications describe good reliability of all these but which method out of the three is best in terms of intra- and inter-observer variability is not known. The purpose of this study was to find out which method had the least inter- and intra-observer variability for determining carpal collapse. Materials and Methods: Fifty normal wrist postero-anterior radiographs were studied by three assessors who measured CHR, RCH ratio and CR index separately. The measurements were repeated after one month by all the three observers. The results were then statistically analysed. Results: The p-value was <0.001 in all the three assessors in CR index meaning that the intra-observer variability was least in CR index. For the inter-observer variability intra class coefficient of 0.9 indicated that the CR index has the least variability. Conclusion: CR index is the most reproducible method to measure carpal collapse. The method which provides accurate measurement of carpal collapse will allow better staging of carpal disorders.

Delayed wound healing due to extraneous bacterial contamination, antibacterial resistance and other associated factors are of great concern in dealing patients having chronically infected wound. Medicinal properties of certain maggots of Calliphoridae family are known for its effective wound debridement therapy. The objective of the study was to evaluate the wound healing potential of maggots of Lucilia sericata in an experimentally infected cutaneous wound model in Wistar rat. The study was carried out by using male Wistar rats (n=48) by creating excisional wounds and later contaminated with mixed population of gram positive and gram-negative bacteria. Animals were divided randomly in to four groups with 12 individuals each, being denominated as control, antibiotic treated, maggot treated, and antibiotic plus maggot combination treated group. Ten pre-sterilized maggots were applied per centimetre square wound bed for 24 hours. Different wound kinetics in L. sericata maggot treated wounds revealed significant reduction in wound area with maximum contraction, early elimination of bacterial bioburden as compared to group of infected control and group of rats receiving only antibiotic treatment. The histopathological examination of wounded tissue of maggot treated groups showed early and better epithelialization, collagenation and neovascularization with complete healing of wound in two weeks. The maggot effects on healing when used singly or in combination with antibiotic were recorded to be similar. The results of the present study clearly demonstrate that the maggots of L. sericata possesses a definite antibacterial action along with removal of dead tissues and effectively reduced the bacterial bio-burden in infected wound and induced wound healing quickly.