Introduction: Traumatic spine injuries are on the rise. The literature is sparse regarding epidemiology of patients with traumatic spine injuries from this part of the world. Objectives: To analyse the following in patients with traumatic spine injuries with neurological deficits: demographic and social profile, common modes of injury, pre-hospitalisation practices, region of spine affected, severity of neurological deficit and the lay individuals’ awareness about traumatic spine injuries. Methods: The study sample comprised 52 adult patients with traumatic spine injuries with neurological deficits. We collected data on demographic and social characteristics, mode of injury, pre-hospitalisation treatment, interval between injury and presentation, spine region affected and severity of neurological deficits and patient's knowledge about such injuries. Results: The average patient age was 31.32y. The male: female ratio was 2.25:1, and the most common modes of injury were fall from height, followed by traffic accident. More than half of the patients suffered cervical spine injuries, followed by dorsolumbar spine injuries. Only 9.61% of patients received pre-hospitalisation treatment. All patients understood there could be complete functional recovery after treatment for traumatic spine injuries. Conclusion: There is a growing need to improve railway and roadway safety equipment and to make it accessible and affordable to the susceptible economically weaker population. Attempts should be made to increase awareness regarding traumatic spine injuries.

The fissures of lungs are embryologically separating the bronchopulmonary segments, which later on persist in interlobar planes of fully developed lung. Fifty lungs (23 right side and 27 left side), obtained during routine dissection and preserved in formalin constituted the material for present study. In them, variations in fissures and lobes of lung were observed and compared with the previous studies. Seven right sided and 14 left sided lungs showed incomplete oblique fissure. Incomplete horizontal fissure of right lung was observed in eight lungs while it was completely missing in three specimens. A right lung with “lobe of the azygos vein” separated by a supernumerary fissure in medial surface was found. One of the right lung had both superior accessory fissure and inferior accessory fissure and four other right lungs and one left lung presented only with inferior accessory fissure. A vertical notch was found in middle lobe of one right lung. Eight left lungs exhibited with left minor fissure among them two lungs had lingula appearing as a separate lobe. Knowledge of variations in fissures and lobes is of interest to all medical professionals to exactly interpret radiographs, computed tomography scans, to diagnose, plan and modify a surgical procedure depending on the merit of the case and also in certain classical clinical cases pertaining to lung pathologies.
Cadaver* ; Formaldehyde ; Humans* ; Lung ; Pathology

Portal hypertension, a known complication of liver cirrhosis, typically leads to variceal bleeding in the esophagus and stomach. However, ectopic varices can also occur outside the gastroesophageal region and may present with life-threatening massive bleeding. We report a case of bleeding ileal ectopic varices in a patient with cirrhosis that were not detected during routine endoscopy. These varices were ultimately diagnosed with the aid of abdominal computed tomography. A transjugular intrahepatic portosystemic shunt (TIPS) was created to decrease portal pressure, and the TIPS tract was then used to selectively embolize the bleeding ectopic ileal varices.

Portal hypertension, a known complication of liver cirrhosis, typically leads to variceal bleeding in the esophagus and stomach. However, ectopic varices can also occur outside the gastroesophageal region and may present with life-threatening massive bleeding. We report a case of bleeding ileal ectopic varices in a patient with cirrhosis that were not detected during routine endoscopy. These varices were ultimately diagnosed with the aid of abdominal computed tomography. A transjugular intrahepatic portosystemic shunt (TIPS) was created to decrease portal pressure, and the TIPS tract was then used to selectively embolize the bleeding ectopic ileal varices.

Portal hypertension, a known complication of liver cirrhosis, typically leads to variceal bleeding in the esophagus and stomach. However, ectopic varices can also occur outside the gastroesophageal region and may present with life-threatening massive bleeding. We report a case of bleeding ileal ectopic varices in a patient with cirrhosis that were not detected during routine endoscopy. These varices were ultimately diagnosed with the aid of abdominal computed tomography. A transjugular intrahepatic portosystemic shunt (TIPS) was created to decrease portal pressure, and the TIPS tract was then used to selectively embolize the bleeding ectopic ileal varices.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Objectives: Obstructive Sleep apnea (OSA) is characterized by complete or partial obstruction of upper airflow despite the effort to breathe, leading to hypoxemia and hypercapnia. The resultant apnea causes sleep fragmentation, which in turn increases sympathetic activity, decreases insulin sensitivity and glucose uptake, and stimulates hepatic gluconeogenesis that ultimately leads to type 2 diabetes. Most studies exploring the effect of continuous positive airway pressure on insulin sensitivity have showed a positive effect. However, there is no evidence on the effect of mandibular advancement device on insulin resistance (IR). This study was aimed to evaluate the effect of mandibular advancement splint (MAS) on IR in patients with OSA. Methods: The present study was conducted at Department of Prosthodontics, Dental College Azamgarh, from June 2015 to July 2017. Sixty eight dentulous patients with type 2 diabetes and mild to moderate OSA and with stable diabetic regimen were included in the study. A MAS was fabricated and fixed at 70% of the maximum mandibular protrusion recorded. Patients that were comfortable with MAS after one month were assessed for apnea-hypopnea index, mean oxygen saturation, and IR at baseline, 6 months, and 1 year after wearing MAS. Results: An improvement in insulin sensitivity was observed at 6 months for mild OSA patients (p=0.001). For moderate OSA patients, no significant improvement was observed following MAS use (p>0.05). Conclusions The finding suggested that MAS is effective in improving IR in mild OSA patients.

BACKGROUND/AIMS: Although carcinoid tumors usually have good prognosis, early and specific diagnosis is important. Computed tomography and magnetic resonance imaging do not provide findings that are specific for carcinoids, and somatostatin receptor scintigraphy suffers from low spatial resolution. 18-Fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has limited sensitivity for carcinoids due to low uptake of the marker. A PET/CT system that uses the somatostatin receptor-based PET tracer 1,4,7,10-tetraazacyclododecane-N(I),N(II),N(III),N(IIII)-tetraacetic acid (D)-Phe(1)-thy(3)-octreotide ((68)Ga-DOTATOC) has also been used in the evaluation of carcinoids, although information regarding its use for the detection of primary pulmonary carcinoids is limited. Thus, we investigated the value of (68)Ga-DOTATOC PET/CT for the diagnosis of primary pulmonary carcinoid tumors. METHODS: This was a retrospective analysis of patients with primary pulmonary tumors who underwent (68)Ga-DOTATOC PET/CT. All the patients had a histopathologic diagnosis of carcinoid. The rate of detection of primary pulmonary carcinoid tumors using (68)Ga-DOTATOC PET/CT was assessed. RESULTS: Twenty patients were diagnosed as having carcinoid, and 19 tumors showed significant uptake on (68)Ga-DOTATOC (detection rate, 95%). The maximal standardized uptake value (SUV(max)) ranged from 1.1 to 66, with a median value of 21.6. In one patient, (68)Ga-DOTATOC PET/CT revealed additional lesions. CONCLUSIONS: Our results demonstrate that (68)Ga-DOTATOC PET/CT is useful in the evaluation of primary pulmonary carcinoids and should be included in the diagnostic work-up of these patients.
Adolescent ; Adult ; Carcinoid Tumor/*diagnosis/radiography/radionuclide imaging ; Female ; Gallium Radioisotopes/*diagnostic use ; Humans ; Lung Neoplasms/*diagnosis/radiography/radionuclide imaging ; Male ; Middle Aged ; Octreotide/*analogs & derivatives/diagnostic use ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/*diagnostic use ; Retrospective Studies ; Tomography, X-Ray Computed/*methods