Shyam Shah Medical College Research Articles

Evaluation of outcomes after management of metacarpal and phalangeal fractures of hand

Background: Fracture and dislocation of hand most frequently encounter in orthopaedics injuries fracture of phalanges and metacarpal are approximately 10% of all fracture of skeleton system phalangeal fracture comprise 46% of hand fractures, metacarpal fractures 38% and fifth metacarpal fracture 9.7%, distal phalangeal fractures are most commonly encounter fracture of the hand. The annual incidence of phalangeal fracture in hand is 1% in normal population. And these injuries account for between. 2% and 3% of all patient visiting in accident and emergency unit thumb and middle finger are most frequently injured because they extend most distally during work activity. Aim & Objectives: To evaluate the structural and functional outcomes and the results of operative and conservative management of metacarpal and phalangeal fractures of hand. Methods: The present study comprises of 62 patients of closed fractures of metacarpal and phalanx treated in the Department of Orthopaedic Surgery, Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital Rewa (M.P.) in a span of two years. Evaluation of outcomes after management of metacarpal and phalangeal fractures of hand was done. Results: We achieved 24 (85.7%) excellent and good results in conservative method for metacarpal fractures and 10 (83.33%) operative methods. In Phalangeal fractures 09 (90.0%) excellent and good results were achieved in conservative method and 10 (83.34%) in operative methods. Excellent and good grip strength was noted in 53 (85.33%) cases. Single digit involvement had better TAM then multiple digits involvement. Poor results were noted in metacarpal fractures in 04 (14%) in conservative series and 02 (16.0%) in operative series. Poor results were seen in phalangeal fractures in 01 (10%) in conservative series and 02 (16.66%) in operative series. Most common complication was finger stiffness in conservative method and pin site infection in operative methods. Conclusion: Both conservative and operative methods (surgical stabilization) for metacarpal and phalangeal fractures of hand gave good functional outcomes, depending on the fracture pattern for treatment option, single digit involvement are important determinants to achieve a better grade of total active range of motion.

Study of serum lactate dehydrogenase level as diagnostic and prognostic indicator of megaloblastic anemia

Background: Megaloblastic anaemia is the hematologic manifestation of faulty proliferation of blood cell precursors. The present study was done to facilitate the diagnosis prior to performing any bone marrow aspirate by estimation of the value of serum LDH in the diagnosis of megaloblastic anaemia.Methods: The cases were selected from patients attended the OPD and admitted in Sanjay Gandhi Memorial Hospital & Gandhi Memorial Hospital, Shyam Shah Medical College, Rewa, Madhya Pradesh. Following investigations were then done to classify anaemia and to establish the diagnosis of megaloblastic anaemia like Haemoglobin estimation by cyanmethaemoglobin method, PCV, RBC count and absolute values, general blood picture, reticulocyte count, bone marrow examination and serum LDH estimation before and after treatment.Results: Of the 100 cases, 50 cases (50%) of the cases were microcytic hypochromic anaemia. 15 cases (15%) were normocytic normochromic anaemia; 35 cases (35%) were macrocytic anaemia on the basis of general blood picture and absolute values. The incidence of megaloblastic anaemia in Indian adults was 20%. Maximum number of cases (90%) of the cases had serum LDH level of more than 1000 U/L. Range of serum LDH level was 520 U/L to 4520 U/L. Thus, there was 2 to 20-fold of highest reference value (240 U/L at37 C) rise in serum LDH level in megaloblastic anaemia.Conclusions: Megaloblasatic anaemia is not uncommon in Indian adults and serum LDH levels provide an important means of diagnosis. It is a non-invasive procedure, safe, and does not require any expertise.

Effect of education and socio-economic status on parenting among pre-school and school going children

Background: Parenting is the process of promoting and supporting the physical, emotional, social and intellectual development of a child from infancy to adulthood. Parenting is a complex activity that includes much specific behavior that works individually or together to influence child’s outcomes.Methods: It is prospective observational study carried out in the Department of Pediatrics, Shyam Shah Medical College and associated Gandhi Memorial Hospital, Rewa, Madhya Pradesh, India during the period from July 2008 to June 2010. Parents were interviewed with predesigned proforma. Parenting was graded in to three grades (1, 2 and 3) according to the performance of parents in various aspects of parenting.Results: In this study, 60 parents had 155 children constituting 2.5 children per family and male to female ratio was 1.18:1. We observed that literate parents performed well in all aspects of parenting (i.e. behavioral, physical, emotional, mental, spiritual, nutritional), but illiterate parents could not score on these points especially in spiritual and nutritional aspects. 33% graduate parents fulfilled the criteria for grade 3 parenting in nutritional aspects, 55% intermediate passed parents in nutritional aspects were in grade 3, whereas there were more than 50% parents in behavioral, physical and emotional aspects who had education level up to primary class.Conclusions: Educational status of parents has a positive impact on almost all aspects of parenting and the educational status of mothers appeared to be even more influential. Socioeconomic status of parents and residential area have a great influence on all aspects of parenting.

A one year case control study on oxytocin use in labor and its effect on maternal: fetal outcomes

Background: Oxytocin is a drug commonly administered drug to a pregnant lady during labor, nowadays even without an indication, in the hope that the progress of labor can be improved and the need for cesarean delivery may be reduced. This study emphasizes the need for using safeguards like use of checklists before starting oxytocin augmentation, therefore ensuring its rational use to minimize maternal and neonatal complications when augmenting labor with oxytocin, including rigorous indications, use of minimal useful dose and careful efficacy evaluation.Methods: This is a retrospective, Case-Control, descriptive and analytical study. Study population included women delivering in labor room of Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa, from July 2015 to June 2016, then after data were compiled and assessed in department of pharmacology G.R. Medical College, Gwalior.Results: Results show that the use of oxytocin in labor stimulation can be detrimental to both the mother and the newborn, since they indicate that the use of oxytocin is associated with increased cesarean section rates both in primiparous and multiparous. Furthermore, it was also observed, a significant association between stimulation with oxytocin and low Apgar scores at 1 and 5 minutes both, of the newborns.Conclusions: Therefore, it may conclude that stimulation with oxytocin should not be used without any indication, but only in very specific cases, in which its use is particularly necessary. These results provide to health professionals a better understanding of the effects of the use of oxytocin during labor, which can be useful for decision-making in clinical practice.

Diagnostic Significance of Serum Ascites cholesterol to Differentiate Malignant and non Malignant Ascites

Background: Ascitic fluid usually forms slowly as a result of obstruction of proximal vascular systems (Venous, lymphatic). It may also form directly in response to disease involving the peritoneum. Differentiation between malignancy related and non-malignantascites is a challenge that is not always met satisfactorily. Both malignant and tuberculous ascites are exudative in nature with lymphocytic predominance and low Serum Ascitic Fluid Albumin Gradient values can not be differentiated easily form each other. Studies have shown that parameters like ascitic fluid cholesterol have been superior to the conventional method of ascitic fluid analysis in discriminating ascites caused by malignancy from others. Method: This study was conducted in the Department of Pathology, Shyam Shah Medical College, Rewa during the period from May 2009 to October 2011. The study comprised of 100 patients with different causes of ascites admitted to wards of S.G.M.H. Rewa. Result: Cases were divided in to 3 groups. Groups I consists of patents(39 male and 31 female) with ascites due to chronic liver disease and other non tubercular and non neoplastic diseases, Group II consists of 20 patients (4 male and 16 female) with ascites due to tuberculosis, Group III consists of 10 patients (4 male and 6 female) with ascites due to malignant diseases. Ascitic fluid cholesterol level was found to be 32.9571±7.1183mg%,0.05±9.047gm%, 74.1±16.1707mg% in Group I, Group II and Group III respectively. On comparing Group III with I and II values were found to be highly significant (p 0.05). The value of ascitic fluid cholesterol level found in Group III was comparatively higher (>54.5mg%) than Group I and Group II with an exception in one case, where we found a higher level of cholesterol. Conclusion: In our study we found a significant raised cholesterol level (74.1 ±16.1707mg%) well above the cut off value (54.5mg%) and it has got a good differentiating potential for determining malignant ascites from non-malignant ascites. DOI: 10.21276/APALM.1371

Effectiveness of conservative management of acute fissure in ano: a prospective clinical study of 165 patients

Background: Fissure-in-ano is a common yet troublesome condition; if acute, the severity of patient discomfort and extent of disability far exceed that would be expected from a seemingly trivial lesion. The present study was carried out to study the effectiveness of conservative management in symptom relief in acute fissure in ano.Methods: The study was conducted in 165 patients with acute fissure in ano attending Surgery OPD and/or admitted in surgical wards of Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa during the period from 1st August 2015 to 31st July 2016. It was a prospective clinical study. All the study subjects underwent extensive clinical examination and were prescribed conservative treatment regime. Follow up was done at the end of 2 weeks, 4 weeks and 6 weeks and the data was analyzed. 165 patients diagnosed as having acute fissure in ano. The outcome was assessed based on the following parameters; symptomatic relief, pain relief based on visual analogue scale and healing of ulcer.Results: Most of the patients were young adults with a slight female dominance. Pain during defecation and bleeding per rectum were the major presenting complaints. 73.94% of patients achieved symptom relief within 2 weeks of conservative treatment. At 6 weeks follow up after giving conservative line of management, 97.58% achieved symptom relief with healing of ulcer. Mean pain score was reduced from 9.5±0.71 at the start of therapy to 1.33±0.69 at the end of 6 weeks of conservative therapy.Conclusions: Acute fissure in ano can be easily cured with systematic usage of conservative treatment regime. A proper follow up along with patient education can help to achieve good remission and avoid unnecessary surgical intervention.

Prevalence and pattern of lobular capillary hemangioma in Eastern Madhya Pradesh, India: A clinicopathological analysis.

Lobular capillary hemangioma is a common benign vascular tumor seen in the oral cavity. It occurs in response to various stimuli such as low-grade local irritation, traumatic insult, and hormonal factors or as a response to a wide variety of drugs. All patients presenting to the Department of Dentistry, Shyam Shah Medical College, Rewa, Madhya Pradesh during July 2014 to June 2016, who were diagnosed by histopathologic confirmation as oral lobular capillary hemangioma (OLCH), were evaluated for the area involved, clinicopathologic presentation, demographic features, and treatment. A total of 94 cases were identified as OLCH by histopathologic confirmation during this period. The lesion occurred most commonly in the age group of 21-30 years. A characteristic female predominance (female: male ratio of 2.24:1) was seen. Anterior maxillary labial gingiva was most frequently involved (34.04%) followed by posterior maxillary buccal gingiva (14.89%). The clinicopathologic picture of OLCH found in this study was similar to other studies conducted on same as well different ethnic and geographical populations. Poor oral-dental-hygiene was observed in majority of patients (87.23%) dental health education should be an integral component of imparting oral health care by health providers. Surgical excision as a treatment modality renders good results with low recurrence rate.

Topography and indexing of nutrient foramina of tibia—a study in Vindhya region

Background: Clinically, longitudinal stress fractures are more commonly associated with the tibia. The healing of fractures, as of all injuries, is reliant upon blood supply. So, detailed anatomical study of position and number of nutrient foramina is must. Nutrient foramen is an opening into the bone shaft which gives way to the blood vessels of the medullary cavity of a bone, for its nourishment and growth. Objective: To investigate the number, position, size, and direction of nutrient foramina of tibia and calculation of foraminal index (FI). Materials and Methods: The study was done in Department of Anatomy, Shyam Shah Medical College, Rewa, Madhya Pradesh, India, in 80 adult human tibiae. We have measured all the four parameters in each bone according to standard method. Result: According to FI, most of the nutrient foramina of tibia were situated in the proximal third (type 1) below the soleal line. The mean FI was 32.96 ± 6.06, with the FI ranging between 27.20% and 37.25% of the bone length. Conclusion: To conclude that our detailed study of topographic anatomy and morphology of nutrient foramina of tibia provides additional information to orthopedicians before planning surgeries on tibia.

Abdominal tuberculosis: an epidemiological profile and management of 40 cases in a tertiary set up

Background: Tuberculosis is the most important communicable disease world-wide. It is an important cause of morbidity in India. Abdominal tuberculosis mimicks most abdominal diseases and hence is a difficult diagnosis. This study aims to document the epidemiological profile and management strategies of abdominal tuberculosis according to various sites and surgical pathology. Methods: Forty new cases of abdominal tuberculosis were diagnosed and treated over a period of one year (2014-2015) in surgical wards of Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (M.P). The patients were selected after they were diagnosed as abdominal tuberculosis on the basis of clinical history, thorough clinical examination and clinical picture during surgery. Further diagnosis was confirmed by histopathology and tissue culture studies. All the patients diagnosed with abdominal tuberculosis, were put on ATT for a period of 6 month, and they were asked to present themselves for follow up at regular intervals. Results: Out of 40 patients with abdominal tuberculosis, 26 were males (65%) and 14 (35%) were females. male to female ratio was 1.8:1. Adults in their 3rd decade (37.5%) and 4th decade (22.5%) were most commonly affected. Pain abdomen was the most common presenting complaint present in 82.5% cases. Abdomen distension was the most common sign (75%). Pulmonary tuberculosis was associated with in 22.5% cases. 5% cases of abdominal tuberculosis were co infected with HIV infection. 55% cases underwent surgical management followed by ATT, and 45% cases needed only ATT as treatment. In cases explored surgically, ulcero sclerotic type (ileal stricture with perforation) was the most common pathology seen in 31.8% cases. Ileocecal region was the most common site of involvement with 67.3% occurrence. Mortality rate was 5%. Conclusions: Abdominal tuberculosis is predominantly seen in low socio economic group. Adults in their 3rd and 4th decades are most commonly affected, which is the earning age group and hence can have economic implications. Majority of cases were of primary intestinal type and in some it was secondary to pulmonary tuberculosis. Majority of cases underwent surgical management followed by ATT. Anti tuberculosis therapy is still the treatment of choice in abdominal tuberculosis and surgery is only indicated in various complication of abdominal tuberculosis.

Prevalence and determinants of overweight and obesity among undergraduate medical students of Shyam Shah Medical College, Rewa

Background: Obesity is a major global burden. Low levels of physical activities, watching TV, and dietary patterns are modifiable risk factors for overweight and obesity in adolescent. Objectives: The main objective of the present study was to assess the prevalence of overweight and obesity and their determinants among undergraduate medical students. Materials and Methods: The present study is a cross-sectional study conducted on undergraduate students of Shyam Shah Medical College, Rewa, Central India. All medical students were selected from 2nd prof to Internship, they were interviewed by predesigned questionnaire, between the time period of October 1, 2015 and November 30, 2015 and data were analyzed with the help of Epi-Cal info 2000. Indian guidelines were used to define normal weight, overweight, and obesity. Result: Out of a total 280 medical students, 94 were girls and 186 were boys and it was found that in males 69.89% were normal weight, 21.50% were over-weight, and 8.60% were obese. Similarly, among females 56.38% were normal weight, 31.91% were over-weight, and 11.70% were obese. Stress and physical activities in medical profession and long course and over-expectation from themselves are important determinants in overweight and obesity among students. Conclusion: Overweight and obesity are important emerging problems even in medical profession, it can lead to fatal outcome in later life. Hence, it is important to be notice early and try to control it by changing modifiable risk factor associated with it.

A five year prevalence of HIV among attendees of Integrated Counselling and Testing Centre (ICTC) of a Government Medical College of Central India

Background: Acquired immune deficiency syndrome (AIDS) has been one of the most devastating diseases to have affected mankind. In the past 30 years, AIDS has emerged as a devastatingly fatal disease, assuming pandemic proportions sparing no region of the world, so its early diagnosis and prompt treatment can provide the healthy life for the human immunodeficiency virus (HIV) infected persons. Objective: The purpose of this study was to estimate the prevalence of HIV infection and their gender variance among the clients attending ICTC, situated in microbiology department of S.S.M.C. Rewa, India, for a period of 5 years from 2010 to 2015. Materials and Methods: A total of 44,460 clients attended ICTC, situated in Microbiology Department of Shyam Shah Medical College Rewa, India, from 2011 to 2015. Serum samples were collected after taking informed consent and pretest counseling. In India for all ICTCs, NACO (National AIDS Control Organization), a national guideline has been followed for HIV testing, reporting and release of results with posttest counseling. Result: Of the total 44,460 clients tested for HIV infection, 572 (1.28%) were found to be HIV-1 seropositive. Seropositivity was higher in male clients (i.e., 331 (57.86%)) than female (i.e., 241 (42.13%)). In all these cases pediatric age group (0–14 years) prevalence was 4.19%. Conclusion: HIV prevalence of 3.78% among the clients attending ICTC, situated in S.S.M.C. Rewa, M.P., Central India. Puts light on the burden on HIV in this part of the country and suggests the need for the scaling up of focused prevention efforts in high-risk groups by various modes of IEC activities.

Morphometric study of atypical lumbar vertebrae and its physiological correlation

Background: The fixation of lumbar spine is needed for various spinal problems such as fracture in lumbar spine, resection of tumors in vertebral bodies, gross spondylolisthesis, and lumbar instabilities. Majority of pedicle morphometric studies are based on white population in different parts of the world, whereas only a few studies are available on Indian population. Objective: To report the results of a morphometric study of adult atypical lumbar vertebrae’s pedicles and correlate them physiologically to provide morphometric inputs for the use of this vertebral component in implants fixation in the population of Rewa, Madhya Pradesh, India. Materials and Methods: This study was conducted on 20 dry human atypical lumbar vertebrae obtained from Department of Anatomy, Shyam Shah Medical College, Rewa (Madhya Pradesh, India). Pedicle vertical height (h) and pedicle width (w) were measured with the help of a sliding vernier caliper. Results: Positive correlations have been found between height and width of dry human lumbar vertebrae. Conclusion: Results indicated that in Rewa region of central India, 15-mm Steffee pedicle screw can be used safely for atypical lumbar vertebrae.

English

CONTEXT: Foot complications are one of the most serious and costly complications of diabetes, but are usually neglected. Since most Indians still walk barefoot and are ignorant of foot care, there is an urgent need for preventive clinical measures to reduce the impact of diabetic foot. AIMS: To evaluate micro and macro vascular complications in diabetics as predictors of diabetic foot risk. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Memorial Hospital, Rewa (MP), in 2013 on 200 diabetics. METHODS & MATERIAL: A complete general and systemic examination to be carried out on diabetic subjects, analysing their micro and macrovascular complications and evaluating their risk of developing diabetic foot. Data analysis was done by calculating the p-value using the Chi Square Test. RESULTS: Out of 200 patients, 12 were at a high risk of developing diabetic foot, while 57 and 131 were at low and moderate risk respectively. Demographic profile revealed a higher risk among the older population (p=0.0003), low Socioeconomic strata (p=0.007), rural population (p=0.006) and a lower risk among the literate (p=0.01) and with a shorter history of duration of diabetes (p=0.02). The presence of retinopathy (p=0.01), nephropathy (p=0.02), neuropathy (p=0.0006), and periodontal disease (p=0.006) was significant in those with high risk as was the presence of coronary artery disease (p=0.04), hypertension (p=0.02) and peripheral arterial disease (p=0.0005). Other factors, such as blood glucose control (p=0.0002), waist circumference (p=0.04) and various addictions, were also contributory factors to the risk of diabetic foot. CONCLUSION: Diabetic foot is an advanced complication of diabetes from where there is no turning back. The evaluation of risk factors that contribute to it, also serve as intervention points - their control can retard the development of diabetic foot. Thus, this study reveals such factors, detectable through clinical measures and may be the potential solution of impeding the progress of diabetic foot.

English

CONTEXT: Atrial fibrillation is the most common cardiac arrhythmia in clinical practice. In developing countries like India, the high morbidity and mortality associated with this condition, warrants detailed assessment. AIMS: To find the epidemiological and etiological factors associated with atrial fibrillation. SETTINGS & DESIGN: The study was conducted in Shyam Shah Medical College and associated Sanjay Gandhi Medical Hospital in Rewa (MP), during 2010 and 2011 on 125 patients. METHODS & MATERIAL: A complete general and systemic examination to be carried out on subjects presenting with Atrial Fibrillation on Electrocardiography followed by Echocardiographic analysis. RESULTS: Out of 125 patients, who presented with Atrial Fibrillation (AF), 56.8% were females and 43.2% were males. While 102(81.6%) patients were above 40 years, 23(18.4%) were below 40 years of age. 84% of cases were reported from rural area whereas 16% were from urban area. Most common aetiology associated with AF was rheumatic heart disease (RHD) (45.6%) followed by coronary artery disease (CAD) (18.4%) and hypertension (12%). Most common etiologic factor found among rural population was RHD (51.4%). Among the urban population 30% had CAD while 15% had RHD aetiology. Above 50 years of age, most common etiologic factor associated was CAD (30%), followed by RHD (24%). Echocardiographic Left Atrium (LA) size was more than 4cm in 79.2% of patients. Maximum LA enlargement was found in RHD patients (57.07±10.8mm). Among valvular lesions, maximum LA size was seen with mitral regurgitation (68.7±9.1mm). Coarse AF was present in 48% of patients studied .Of these majority were associated with RHD (63.3%) and 86.6% of these patients had LA size more than 4 cm. LA thrombus was seen in 4.8% patients. CONCLUSION: Most common aetiology associated with atrial fibrillation in our set up is RHD. In our population the disease is more common in rural area having a female predominance and younger age of onset. Risk of atrial fibrillation increases with age, and it is more frequently associated with CAD than RHD. Patients with Echocardiographic LA size more than 4 cm had an increased risk of atrial fibrillation.

Role of PTPN22 and VDR gene polymorphisms in susceptibility to rheumatoid arthritis: a study from central India

Role of PTPN22 and VDR gene polymorphisms in susceptibility to rheumatoid arthritis: a study from central India Smriti Shukla,1 Arvind Kumar Tripathi,1 Jitendra Kumar Tripathi,1 Manoj Indurkar,2 Ugam Kumari Chauhan1 1Centre for Biotechnology Studies, Awadhesh Pratap Singh University, Rewa, Madhya Pradesh, India; 2Department of Medicine, Shyam Shah Medical College, Rewa, Madhya Pradesh, India Abstract: Rheumatoid arthritis (RA) is an autoimmune disorder which can be characterized by chronic inflammation of the joints. All joints of the body are prime targets for RA. Several genes which are associated with immunomodulatory functions could be associated with RA as well. In the present investigation we selected the genes which are involved in immunoregulation such as PTPN22 (protein tyrosine phosphatase, non-receptor type 22 (lymphoid)), and VDR (vitamin D receptor), and investigated the impacts of their polymorphism in RA susceptibility. One hundred and twelve patients were enrolled and 125 controls from similar ethnicity were selected for the present investigation. Genetic polymorphism was detected through the PCR-RFLP (polymerase chain reaction restriction fragment length polymorphism) method. The pattern of genotype, allele distribution, and carriage rate in the disease and control groups suggested a significant association of PTPN22-1858 T (rs2476601) carriage (carriage of “TT” and “CT”) in RA susceptibility. The pattern of genotype and allele distribution in the disease and control groups suggested a lack of association of VDR FokI (rs10735810) in RA susceptibility. Our findings revealed that the PTPN22 polymorphism is associated with RA, while, the VDR polymorphism is not associated with RA susceptibility. Keywords: rheumatoid arthritis, autoimmune disorder, genetic polymorphism, VDR, PTPN22

English

OBJECTIVE: To study the effectiveness of Domiciliary Treatment in severely malnourished children. METHOD: This is a prospective study conducted on 25 severely malnourished children, carried out in the Department of Pediatrics, Shyam Shah Medical College and Gandhi Memorial Hospital, Rewa (M.P), during the period of one year from July 2007 to June 2008. INTERVENTION: Treatment was carried out at home by parents under adequate supervision. They were educated about the nutrition need of the child and how to prepare energy and nutrient dense food. They were also educated to provide sensory stimulation, emotional support, and structured play therapy. Regular follow-up was done for 16 week. RESULTS: Domiciliary treatment of severe uncomplicated malnutrition appears to be satisfactory. Moderate weight gain was observed (Mean rate of weight gain 8.36+2.42gms/kg/day). 40% children could achieve their target weight for length. CONCLUSION: Domiciliary treatment with adequate supervision can be recommended for children with uncomplicated SAM.

A study of formation of abnormal foramina and canal on posterior arch of atlas vertebrae

Background: Atlas vertebra is the first and atypical cervical vertebra. It has anterior and posterior arches and is devoid of body. The posterior arch has a neurovascular groove on the lateral part of superior surface. This groove is sometimes converted into a ring or canal. Atlas vertebra has high degree of variation in morphology. Its knowledge is essential for orthopedic surgeons, neurosurgeons, radiologists, and anthropologists. Aims and Objectives: To study the formation of abnormal foramina and canal on posterior arch of atlas vertebrae. Materials and Methods: The present study was carried out in Shyam Shah Medical College and SGM Hospital, Rewa, Madhya Pradesh, India. During routine demonstration classes in the Department of Anatomy, we found atlas vertebrae with unilateral complete retroarticular ring. There are collections of 34 atlas vertebrae. These vertebrae were examined for evidence of exoostosis from the posterior margin of superior articular facet. Results: On the basis of observations, we found that the formation of retroarticular ring and canal occurs in six stages. Conclusion: Retroarticular groove may convert into ring and canal, knowledge of it is beneficial for neurosurgeons and orthopedicians in the treatment of vertebrobasilar insufficiency. It is also beneficial for an anthropologist in correlating the morphological changes from primate to human species.

Determination of individual's height by post-cranial measurements in Rewa region of Madhya Pradesh

Background: Stature estimation of an individual is an important in anthropological research. The identification of isolated extremities is an issue of great significance and plays a vital role in the investigation of the identity of victims of mass disasters and fatal assaults. Aims & Objectives: To determine individual’s height by post-cranial measurements in Rewa region of Madhya Pradesh. Materials and Methods: Present study is carried out in the Shyam Shah Medical College and S.G. Hospital, at Rewa city of Madhyapradesh. For this study, total 313 subjects were selected randomly which includes 194 males and 119 females, age between 22 to 27 years. Stature, shoulder breadth or biacromial breadth (a-a) Inter anterior superior iliac spine distance. (Inter asis distance) were measured using standard anthropometric instruments. Statistical analysis is done by using test of significance. Correlation, correlation co-efficient and regression equations for estimation of height is derived for males and females separately. Results: Results shows that individual’s height is extremely significantly correlated with biacromion breadth and very significantly correlated with inter anterior superior iliac spine distance. Conclusion: It is clear that if either of the measurement is known the other can be calculated and this fact may be of practical use in Medico-legal investigations and in Anthropometry.

Study of cephalic index in Vindhya region of Madhya Pradesh

Background: Study of an individual’s cephalic length, cephalic breadth and cephalic index is useful in clinical practice, forensic medicine, anthropology and genetic study. It is a useful tool to distinguish race and sex in medico-legal cases. Cephalic index also varies geographically. Aims & Objectives: To study the cephalic index, in Vindhya region of Madhya Pradesh. Materials and Methods: Present study is carried out in the Shyam Shah Medical College and S.G.M. Hospital, Rewa (Madhya Pradesh). For this study, total 309 subjects were selected randomly, which included 191 males and 118 females, between 22 to 27 years of age. Cephalic length and breadth were measured using standard anthropometric instruments and cephalic index was determined using standard methods. Data analysis was done by using statistical method. Results: Cephalic index of males and females belong to the mesocephalic group. In our observations, mean value of cephalic index are 75.8419 for male, 79.05 for female and 77.791 for both sexes. Conclusion: In Vindhya region of Madhya Pradesh, there is predominance of mesocephalic head.

Type 2 diabetes in a central Indian population: association with PPARG2 P121A allele but not ENPP1 K121Q

Type 2 diabetes in a central Indian population: association with PPARG2 P121A allele but not ENPP1 K121Q Arvind Kumar Tripathi,1 Smriti Shukla,1 Mrigendra Kumar Dwivedi,1 Jitendra Kumar Tripathi,1 Ugam Kumari Chauhan,1 Manoj Indurkar,2 Shivam Singh1 1Centre for Biotechnology Studies, Awdhesh Pratap Singh University, 2Department of Medicine, Shyam Shah Medical College, Rewa, India Background: It is known that genetic and environmental factors may influence susceptibility to type 2 diabetes and its complications. Objective: In the investigation reported here we selected the peroxisome proliferator-activated receptor (PPAR) G2 (rs1801282) and ENPP1, also called PC-1 (rs1044498) gene polymorphisms to determine whether there is a genetic association between these, obesity, and type 2 diabetes. We also examined and environmental factors influencing type 2 diabetes. Design and methods: The study was carried out on a central Indian population of 190 diabetics and 210 healthy controls. Anthropometric data were collected during sample collection. A genetic polymorphism study of PPARG2 and ENPP1 was undertaken using a polymerase chain reaction restriction fragment length polymorphism method and the observed genotype frequencies, allele frequencies, and carriage rates of the PPARG2 and ENPP1 polymorphisms were recorded. Results: The patterns of genotype and allele distribution in both groups suggested a significant association between PPARG2 Pro12Ala major allele A carriage (AA carriage) and type 2 diabetes. Further, the results also show the protective effect of the minor allele G. Overall, we found that the distribution of ENPP1 K121Q genotypes was not significantly different between healthy controls and diabetic patients. Thus, ENPP1 polymorphism was not found to be associated with type 2 diabetes in a central Indian population. Body mass index was also found to be significantly higher in female diabetic patient group than in female healthy controls (P = 0.0388), while there was no significant difference in body mass index for males in the case group compared with in the control group. Conclusion: Our study indicates that PPARG2 and obesity have a strong association with type 2 diabetes but ENPP1 polymorphism lacks any association. Keywords: obesity, BMI, polymorphism, restriction fragment length polymorphism, peroxisome proliferator-activated receptors