International Journal of Integrative Medical Sciences

164-166

Authors: Shruthi B.N, Pavan P. Havaldar, Shaik Hussain Saheb, Henjarappa K S.

Background: The jugular foramen is difficult to understand and to access surgically, Its is difficult to conceptualize because it varies in size and shape in different crania, from side to side in the same cranium, from its intracranial to extra cranial end in the same foramen, because of its complex irregular shape, its curved course, its formation by two bones, and the numerous nerves and venous channels that pass through it. The morphometric measurements of the jugular foramen is very helpful in neurosurgery. Materials and Methods: A total of 500 jugular foramina were examined from 250 adult dry skulls. The present study was undertaken in adult south Indian skulls from different regions of south India, from different medical colleges. We have observed the length, width and area of the jugular foramina were determined. Metric measurements were taken by using Vernier calipers. The mean standard deviation and range of each dimension and derived index were computed. Right and left side differences were analysed. Results: In 71.2% of cases the right foramina were larger than the left, in 20.8% of cases the left foramina were larger than the right and in 8% cases they were equal in size on both sides. The mean length of the foramen on the right and left were 24.48+3.17mm and 21.24+4.51mm; the width measured 7.51+1.56mm and 7.16+1.89mm on the right and left respectively; the mean area on the right was 569.41+91.58cmm and on the left 470.40+115.45mm. Conclusion: There was statistical significance between the two sides in the length and area but there was no significant difference between the two sides in the width. There was a positive correlation between length and width on each side. Statistical analysis did show significant positive correlation between the width and length of the skull and the length of the jugular foramen on both sides. KEY WORDS: Skull, Jugular foramen, Anatomy, Morphometry, Neurosurgery.

170-174

Authors: Prasad Arun, Kapoor Kanchan, Sharma Anshu, Abraham Joseph.

Conjoined twins are a rarely seen congenital anomaly with severe mortality. Among the different variety of conjoined twins, Thoraco-omphalopagus is the most common type, wherein the two foetuses are joined at thorax and upper abdomen region. In this type of twins usually there is single heart, but lungs will be separate. In GIT, the foregut will be separate, but midgut may be shared by both twins. Hindgut will be separate. The exact cause is unknown, but it is mostly considered to be an irregular division of the zygote. One such case was observed during routine foetal autopsy performed in Dept of Anatomy, GMCH-32, and Chandigarh. The mother was 21yrs old prime gravida and the condition was diagnosed at the time of USG examination at 13+6 weeks of gestational age. Autopsy was performed after taking full consent. The foetuses had single umbilical cord and sex of both the foetuses was male. After autopsy it was found that both foetuses shared single heart, stomach, small intestine, large intestine, liver and spleen. However there was development of separate lungs and organs of Genito-urinary system. There are two theory proposed for the formation of the conjoined twins. A fusion theory which is more accepted and other one is fission theory. The exact mechanism of formation of twins, obstetrical and surgical importance and other details will be discussed in detail with the available literature. KEY WORDS: Conjoined Twins, Thoraco-ompahlopagus, Congenital Anomaly.

178-181

Authors: Bhaskar Babu GN, Naresh Y, Shivakrishna G.

Introduction: Bowel obstruction remains one of the most common presentation of acute abdomen encountered by general surgeons in their routine clinical practice. It remains one of the major causes of morbidity and mortality in acute emergencies. Aim of the study: The present study was focused to prospectively evaluate and analyze the various types of clinical manifestations, etiology, management and outcome among patients diagnosed with acute intestinal obstruction pertained to South Indian population admitted in a tertiary care centre, Andhra Pradesh. Materials and Methods: The present cross sectional prospective study includes patients diagnosed with acute intestinal obstruction at Department of General Surgery, SVRGGH, Tirupati, Andhra Pradesh, India. A total of 70 were included to evaluate incidence, causes, symptoms and signs at the time of presentation, associated complications, management and mortality of AIO. Results and Discussion: The mean age at the time of the presentation with AIO was found to be 48±16 years. The most common age group diagnosed with AIO was between 31-40 years (24%). The male to female ratio observed was 2.2:1. Pain abdomen was the most common symptom in 90%, followed by vomiting (80%), abdominal distension (65%), and constipation (52%). The most common cause of admission was post operative adhesions (48%) followed by obstructed hernia (20%). The most common surgical management of adhesions was done by release of adhesions (48%). Complications noticed during the course of the present study include septicemia (6%), wound infection (3%), respiratory tract infection (3%) and wound dehiscence (2%). The results of the present study are in agreement with the earlier studies. KEY WORDS: Acute abdomen, Acute Intestinal obstruction, Post operative adhesions.

186-189

Authors: Sujit Kumar Sarker, Khin Darli Tun, Eliza Omar Eva, Ratna Paul.

Introduction: Grapefruits are large, rounded citrus fruit. The fruits were bred in 18th century as a cross between pomelo and orange. They were given the name grapefruit because of the way they grew in clusters similar to grapes. Grapefruits vary from yellow to pink and red. Its taste also varies from sour or bitter to sweet. Its fleshes are either pink or white colour. Nutritional values: Grapefruits are low in calories but full of nutrients. It provides calories, niacin, ascorbic acid, vitamin A, potassium, phosphorus, calcium, carbohydrate, protein, fat, iron, sodium, riboflavin and thiamine. Grapefruit juice help to lower risk from many diseases and also help to reduce weight. Pharmacology: Certain substances in grapefruit juice inhibit the cytochrome P450 (CYP3A4) and increase plasma concentrations of co-administered drug that can produce toxic effect. Grapefruit juice also lower plasma drug concentrations with few drugs by inhibiting drug absorption catalysed by the organic anion transporting polypeptide (OATP). By inhibition of P-glycoprotein grapefruit juice also increases bioavailability of oral drug. Drug interactions: The opportunity for a food-drug interaction is common for grapefruit juice. It has potential interactions with lipid lowering agents, calcium channel blockers, cytotoxic drugs, antidepressants, antimalarial drugs used in erectile dysfunction and many other drugs as well. Conclusion: As Grapefruits have potential interactions with many medicines so it should be taken cautiously and further research is required for optimal use. KEY WORDS: Grapefruit, Grapefruit juice, Food-Drug interactions, Citrus fruit interactions.