iosr-JDMS   Volume-11 ~ Issue-1

Abstract: The increasing use of invasive diagnostic and interventional procedures in cardiovascular diseases makes it important to study the vascular variations of upper limb. Awareness of the possible variations will reduce the risk of complications like bleeding during surgical procedures. .Axillary artery is the continuation of subclavian artery, at the outer border of the first rib and from the lower border of teres major it becomes the brachial artery. During its course it is divided into 3 parts by pectoralis minor muscle. Usually 6 branches arise from different parts of the artery .The present study was carried out in 30 cadavers (10 females and 20males)of the department of anatomy v.s.s medical college, burla and all the branches of axillary artery were studied. There are many reports showing variations in the branching pattern of axillary artery. However, in our study some unusual variations were found.

Keywords: Axillary artery , Clumping, Subscapular artery, Variation

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[8] Ronald A. Bergman, Adel K. Afifi, , Ryosuke Miyauchi. Axillary Artery Opus II: Arteries. Cardiovascular System . Illustrated Encyclopedia of Human Anatomic Variation:2006

[9] Saeed M,Rufai AA,Elsayed SE,Sadiq MS. Variations in the subclavian-axillary arterial system.2002;23(2):206-212. [10] Charitou A,AthanasiouT,Morgan IS,Del Stanbridge R.Use of Cough Lok can predispose to axillary artery thrombosis after a Robicsek procedure.Interact Cardiovasc Thorac Surg 2003; 2(1):68-69

Abstract: DWS is hydrocephalus associated with a posterior fossa cyst and dysgenesis of the cerebellum. In USA the incidence of DWS is thought to be between 1 in 25000 – 35000, live births. This is a case of middle aged male patient with large head since birth, which was asymptomatic till 57 yrs of age. After LOC and CT scan he was diagnosed to have DWS. This case was successfully managed with conservative management plan.

Keywords: Large head, Computerized tomography, Ventricular peritoneal shunt, hydrocephalus

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Abstract: Background: - Many aspects of the management of perforated appendicitis in children remain controversial. PATIENT AND METHOD: -Prospective study 86 cases of appendicular perforation in children were carried out from Jan.2007 to Feb.2012 at I.G.M.C Nagpur. RESULTS: - Total of 86 children, 34 females and 52 males diagnosed as a perforated appendicitis were studied prospectively. 43 patients were included randomly in both the group, group-1(early appendectomy after 24hours of diagnosis) and group-2 (Interval appendectomy after 6 to 8 week from diagnosis). The maximum number of patients 55.81% was found in the age group of 11 to 14 years. Intraoperative position of appendix was retrocaecal in 36(41.86%) patients, followed by pelvic in 40(46.51%) patients. The maximum overall adverse effects was observed in group-2 than group-1 patients. overall postoperative scar was better in all patients of group-1 than group-2 patients. Average total government hospital charges per patient including medicine and operation was Rs.1000/-in group-1 patients and Rs.2500/- was in group-2 patients. Average total government hospital cost per patient was Rs.3500/- in group-1and Rs.6500/- was seen in group-2 patients after discharge. Hospital stay was below 4 days in 34(79.07%) patients of group-1and in 16(37.20%) patients of group-2.Minimal morbidity with no mortality were observed in present series and 4 (4.65%) patients were lost to follow up ingroup-2.

CONCLUSION: - The overall adverse event rate after early appendectomy was significantly lower than that after interval appendectomy. Early appendectomy for perforated appendicitis in children significantly reduced the time away from normal activities, overall adverse event rate, hospital cost and charges.

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Abstract: Congenital indirecthyperbilirubinemiaoccurs due to the relative deficiency or absence of the primary conjugating enzyme uridinediphosphate-glucuronyltransferase.The enzyme UDP glucuronyltransferase is responsible for the conjugation of bilirubin in liver. The enzyme is also essential for transport of many other substrates including drugs, hormones, toxins and neurotransmitters. Thus, anaesthetic management of such a case is quite challenging. Avoiding drugs which use this enzyme for its metabolism or excretion during the perioperative period allows safe conduct of anaesthesia for these patients. We report a case of inherited unconjugated hyperbilirubinemiafor an incidental surgery and review the different types of congenital indirect hyperbilirubinemias.

Keywords: Anaesthesia, bilirubin,inheritedunconjugated hyperbilirubinemia, Crigler-Najjar syndrome, Gilbert syndrome

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