International Medical Journal

Studies on human proximal femur have been done in different areas of the globe. Variations are found due to different levels of activity, race, genetics, clothing, lifestyle and occupation. Accurate description of femoral morphometry is of great interest for biomedical engineers and orthopedic surgeons, but data from different populations is lacking. Such important data happens to be relevant for surgical issues such as for planning surgery and intervention, correction of neck shaft angle, insertion of surgical screws after a fracture and most importantly for prosthesis and implant design. Adequately shaped implants are critical for fixation of femur after fracture or total hip arthroplasty to reduce implant related complications such as change in leg length, dislocation from improper positioning of implants, implant loosening and dislocation fractures. Significant differences have been noted among African Americans, Caucasians, Chinese and other Asian populations. Femoral head diameter, neck diameter, neck axis length, neck shaft angle, femoral offset are morphological parameters of human proximal femur, taken for diagnosis and surgical intervention.

Acute appendicitis is a very common intra-abdominal surgical emergency in India, with increased use of laparoscopic appendectomy different techniques to secure the appendicular stump are used like Endostapler, Endoloop, Hem-o-Lok clip with their advantages and disadvantages, in our study we have compared Endoloop ligation versus Hem-o-Lok clip to secure the base of the appendix in laparoscopic appendectomy. In this study 100 patients with acute appendicitis were selected according to inclusion and exclusion criteria and were divided into 2 groups of 50 each. Group A was operated by Hem-o-Lok clip and group B by Endoloop and compared for intraoperative complications, post- operative complications, stump closure time, duration of surgery, length of hospital stay and cost effectiveness in two groups. We found that patients operated by Hem-o-Lok clip group had lesser intra and postoperative complications, lesser stump closure time of mean 7.99 minutes, lesser duration of surgery with a mean of 37.92 minutes and duration of hospitalization was lesser with a mean of 1.36 days when compared to Endoloop group with mean stump closure time of 12.81 minutes, mean duration of surgery was 46.42 minutes and mean duration of hospitalization was 1.7 days. Using a Hem-o-Lok clip was cheaper than using an Endoloop. According to our results, patients operated with Hem-o-Lok clip had better results in terms of stump closure time, duration of surgery, cost effectiveness with a stastistical significance and intraoperative and postoperative complications were more in endoloop group without any stastical significance.

SARS-CoV2 (Severe Acute Respiratory Syndrome Coronavirus 2) has been the cause for the pandemic, Coronavirus Disease-2019 (COVID-19). The immune responses exhibited by the individuals to COVID-19 are highly heterogeneous. What is intriguing is the fact that in majority of individuals the immune response seems ineffective and, in few individuals, especially with severe disease there seems to be exaggerated or abnormal immune response. This article has been decided to focus on the understanding the immunopathogenesis caused by SARS-CoV2 infection. The study included 50 articles published in the last 20 years searched in PubMed, EMBASE, Cochrane library, PubMed Central, UpToDate and Medline. The collected articles include original articles, review articles as well as case reports and case series. Since this article was a review article, it did not require ethics approval. Ethics approval was not obtained as it was a review article. SARS-CoV2 virus presents with clinical manifestations ranging from respiratory system to central nervous system manifestations. Presentation is highly heterogeneous varying irrespective of age, sex, presence or absence of comorbid conditions. Inflammatory mechanisms are found to play a role in the severity of the disease. The proinflammatory cytokines and chemokines are activated with increased number in SARS-C0V2 infections. When the extent of viral infection or magnitude of antigen to be handled by the inflammatory response is adequate resulting in recovery. When the viral load is high the anti-inflammatory response is not sufficient to match that of the proinflammatory effects resulting in mortality or prolonged morbidity.

Managing perioperative pain is a challenge for the treating surgeon and anesthesiologist. Transdermal route of drug administration is a novel method to deliver drugs in a simple, non-invasive and compliant way. In this prospective, randomized, double blinded, comparative study, we intent to compare the preemptive use of transdermal Buprenorphine patches of 5 mg and 10 mg, for analgesia, post operatively in lower limb orthopedic surgeries under spinal anesthesia. The results obtained showed that the Numerical Rating scale (NRS) scores were on higher side at all periods of observation in the 5 mg group and this difference was statistically significant. The NRS scores during rest and on movement in the pre- operative period and the period just before surgery were slightly higher in 5 mg group but this difference was not statistically significant. But the 8 hours ,12 hours, 24 hours, 48-hour post-surgery NRS scores were higher in the 5 mg group and this difference was statistically significant (p<0.05) during rest and on movement. The rescue analgesia required by the 5 mg group was also higher than the 10 mg group and was statistically significant. Hence the 10 mg patch was more effective than the 5 mg patch for postoperative analgesia.

Hepatitis B virus (HBV) infection is a serious health problem affecting nearly 400 million people worldwide, which can lead to liver fibrosis. Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) are part of a complete blood count. High MPV and PDW values have been observed in hepatitis B patients with severe liver fibrosis. This study aimed to determine the correlation between degree of liver fibrosis with MPV and PDW in chronic hepatitis B patients. MPV and PDW data were collected from medical records of naive hepatitis B patients who underwent transient elastography (FibroScan) examination at Wahidin Sudirohusodo Hospital Makassar from January 2018 - December 2020. Degree of liver fibrosis determined by FibroScan. The statistical tests used were Pearson's correlation and ANOVA. The results were considered significant if p-value <0.05. This study included 862 subjects consisting of 62.8% male with a mean age of 39.1 ± 13.1 years. The distribution of FibroScan results were 63.1% non-fibrosis, 20.4% significant fibrosis, and 15.5 severe fibrosis. The degree of liver fibrosis has a significant positive relationship with each MPV and PDW, the higher degree of liver fibrosis is in accordance with higher MPV and PDW (each p<0.001). The highest mean of MPV and PDW were found in severe fibrosis (9.2 fl and 13.5 fl). The degree of liver fibrosis has a significant positive relationship with each MPV and PDW in chronic hepatitis B patients.