Pathankot, India
Pathankot, India

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Sachdeva K.,Chintpurni Medical College | Singla R.K.,Government Medical College | Kalsey G.,G.I.D.S. | Sharma G.,FMT
Journal of Indian Academy of Forensic Medicine | Year: 2011

The sacrum has always attracted the attention of the medico-legal experts for establishing the sex, because of its contribution to pelvic girdle and associated functional sex differences. The present study was performed to evaluate the reliability of the various parameters of sacrum in this regard. The material for the study comprised of 50 adult sacra (M: F= 40:10), obtained from the Department of Anatomy, Govt. Medical College, Amritsar. Different parameters viz. Midventral straight length, Midventral curved length, Ventral straight breadth, Transverse diameter of base, Transverse diameter of body of S 1, Antero-posterior diameter of body of S 1, Breadth of alae were measured and indices viz. Sacral index, Longitudinal curvature index and Corporobasal index were calculated and statistically analyzed. Out of these Midventral straight length, Midventral curved length, Transverse diameter of base, Antero-posterior diameter of body of S 1 and Breadth of alae were found to be significantly more in males while Sacral index was significantly more in females. Corporobasal index was found to be more in females though statistically insignificant.


Singla R.K.,Government of Punjab | Gupta R.,BPS Government Medical College for Women | Sachdeva K.,Chintpurni Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

During the evolution from the lower animals to man, the upper limbs have acquired a great mobility, but at the cost of their stability. The reverse is true for the lower limbs. The muscular anomalies which are common in the upper limbs are largely explainable on a phylogenetic basis. The same is true for the vascular anomalies. However, such anomalies are usually seen singly and they are never together in the same limb or in two limbs of the same body. The upper limbs which are being reported here had multiple musculovascular anomalies and some of these were bilateral. These include the superficial brachial artery, the accessory head of the biceps brachii, the accessory muscular slips which arose from the common flexor origin and went to the tendons of the flexor digitorum profundus and the flexor pollicis longus separately, bifurcation of the tendon of insertion of the brachioradialis and bifurcated (split) insertion of the third lumbrical on the adjacent fingers. Though all these variations have been described in the standard text books of Anatomy, their occurrence, together in one limb and the bilateral presentations of some of these, have never been encountered. Almost all these variations have been explained phylogenically, thus supporting the dictum, "The ontogeny repeats the phylogeny." Furthermore, their clinical significance has also been discussed.


Sharma T.,Government of Punjab | Singla R.K.,Government of Punjab | Lalit M.,Chintpurni Medical College
Journal of the Nepal Medical Association | Year: 2010

During routine dissection of a 60 years male cadaver, it was observed that the two divisions of sciatic nerve were separate in the gluteal region on both the sides with the tibial nerve passing below the piriformis and the common peroneal nerve piercing the piriformis muscle. The abnormal passage of the sciatic nerve (SN), the common peroneal nerve (CPN), and the tibial nerve (TN), either through the piriformis or below the superior gemellus may facilitate compression of these nerves. Knowledge of such patterns is also important for surgeons dealing with piriformis syndrome which affects 5-6% of patients referred for the treatment of back and leg pain. A high division may also account for frequent failures reported with the popliteal block.


Sachdeva K.,Chintpurni Medical College | Singla R.K.,Government of Punjab
Journal of Clinical and Diagnostic Research | Year: 2012

Variations in the formation of brachial plexus are common and have been reported by several investigators in relation to origin of roots, trunks, cords, divisions and branches. The nerves of the extremities are especially vulnerable to injury because of their long course and superficial distribution. The basic anatomy of median and ulnar nerves in the upper limb is well described in the textbooks. Previously, an ample amount of work has been done upon the communications between the median and ulnar nerves in the forearm and hand. In the present case, an unreported pattern was seen where whole of the ulnar nerve was arising from the median nerve in the arm during routine under graduate dissections, in left upper limb of a 60 year old male. Its phylogeny and clinical implications are discussed in detail. A lack of awareness of variations might complicate surgical repair and may cause ineffective nerve blockade.


Jyoti N.,Chintpurni Medical College | Kaur S.,Chintpurni Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

Material and Methods: A serial prescription audit in four cycles (three months each) was conducted at Jhalawar Medical College and Hospital and at Chintpurni Medical College and Hospital for two years, one year in each hospital. One cycle included the prescriptions which were collected by using a digital camera from the outdoor patients department every month (n=250 per month), for three months regularly. A baseline prescription audit, as a cross-sectional survey, was done on the last date of the first month. Re-audits were done on the last date of the 2nd and 3rd months, which concluded one cycle. One cycle was followed by three months of no prescription audit. In total, four cycles were completed in two years. The parameters which were observed were- (a) the formats of the prescriptions (b) the WHO drug core indicators and (c) the legibility of the prescriptions. The clarity of the prescriptions was decided upon by the consensus group. A continuous evaluation and a feedback process were carried out every month by analyzing the prescriptions, based on the extent of conformity to the "WHO Guide to Good Prescribing" and the updated list of the "WHO Essential Medicines." The data was analyzed by using the Chi-square test. Results: There was a significant improvement in the formats of the prescriptions in terms of the quality of the completeness and the rationality at the end of the 2nd and 3rd months of each cycle. Similarly, the WHO drug core indicators improved with every re-audit in each cycle (p < 0.05). Overall, the total percentage of the core indicators significantly improved in the 2nd and 3rd months as compared to the 1st month in all the cycles (p < 0.05). The clarity of the prescriptions improved in the successive re-audits. There was a sudden decline in the improvement in all the parameters in the first month of the 2nd, 3rd and the 4th cycles as compared to that in the 2nd and 3rd months of the previous cycles. Conclusion: Serial prescription audits and an active feedback definitely improve the prescription behaviours in the therapeutic decision making. But discontinuing the prescription audits begins to reverse the improvement in the prescription behaviours.


Sachdeva K.,Chintpurni Medical College | Singla R.K.,Government of Punjab | Kalsey G.,Government of Punjab
Medicine, Science and the Law | Year: 2011

Understanding sexual dimorphism is very important in studies of human evolution and skeletal biology. The ability to determine sex from unknown skeletal remains is vital and methods to do this on the various bones of the human skeleton have been researched extensively especially in the studies related to forensic anthropology. The distinctive morphology and clear sexual dimorphism of the hip bone makes it an ideal bone for sex determination. Whereas the roles of the parameters of its posterior border (including the greater sciatic notch) are well established, those of the anterior border are not much explored. The present study was designed to establish the morphometric pattern of the anterior border of the hip bone and its role in sexual dimorphism. Material for the current investigation comprised 100 hip bones belonging to 50 cadavers ([M:F = 80:20] and [R:L = 50:50]) obtained from the Department of Anatomy, Government Medical College, Amritsar, Punjab, India. Sixteen parameters of the anterior border were taken and three indices were calculated. Eight parameters were significantly greater in males: (i) straight distance anterior superior iliac spine (ASIS)-symphyseal surface (SS); (ii) straight distance ASIS-pubic tubercle (PT); (iii) straight distance anterior inferior iliac spine (AIIS)-SS; (iv) straight distance AIIS-PT; (v) arch of anterior interspinous notch (ASIS-AIIS); (vi) arch between AIIS and ilio-pubic (IP); (vii) depth of notch between AIIS and IP; (viii) arch of anterior border (ASIS-SS). The results of the present study could be helpful in pronouncing an opinion, for a single specimen, about its origin in general terms or sex.


Sachdeva K.,Chintpurni Medical College | Singla K.K.,Government of Punjab
Journal of Morphological Sciences | Year: 2011

Neural variations of the brachium constitute an important anatomical and clinical entity. Although frequently reported, if accompanied by other anomalies, they deserve special mention in anatomical literature. The nerves of the extremities are especially vulnerable to injury because of their long course and superficial distribution. The variations of the median nerve and the musculocutaneous nerve, like the communication between the two, may prove valuable in the traumatology of the shoulder joint. It may also be correlated to the entrapment syndromes of the musculocutaneous nerve in which a part of the median nerve also passes through the coracobrachialis and may exhibit the symptoms similar to those encountered in the median nerve neuropathy as in the carpal tunnel syndrome. In the present case, in the right upper limb of a 60 year old male, the musculocutaneous nerve after its origin from lateral cord gave a branch to corachobrachialis muscle and then fused completely with median nerve. Later then supplied the other two muscles of the front of forearm, i.e. biceps brachii and brachialis and the lateral cutaneous nerve of arm. Its ontogeny, phylogeny and clinical implications are discussed in detail. A lack of awareness of variations with different patterns might complicate surgical repair and may cause ineffective nerve blockade.


Gupta P.,GGSMC | Khullar M.,GGSMC | Sharma R.,GMC | Singh R.,Chintpurni Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

On dissection of the abdomen of an adult male cadaver, in addition to the normal inferior vena cava on the right side, an unusual venous channel which connected the left renal vein with the left common iliac vein was found; (probably the left inferior vena cava). The left testicular and the left suprarenal veins were opening into the left renal vein as usual. Other than this, a retrocaval ureter was found on the right side. The works of previous authors have highlighted the incidence of a venacaval duplication and its surgical implications, but here, we are presenting a unique case of a double inferior vena cava with an anomalous retrocaval ureter. A conglo meration of such vascular malformations is of immense surgical importance, and it is indicative of a grossly defective angiogenesis. Keeping in mind the clinical relevance of the variations which were observed, an attempt was made to explain them in the light of the embryogenic development.


PubMed | Chintpurni Medical College
Type: Journal Article | Journal: Malaysian orthopaedic journal | Year: 2014

Multifocal osteoarticular tuberculosis is uncommon and accounts for approximately10% of all cases of osteoarticular tuberculosis. Concomitant vertebral and iliac bone tuberculosis has not been reported in the literature to date. We report one such case for its unusual clinical and radiological presentation, which had presentation more similar to a malignant bone tumour than an infection.Skeletal tuberculosis, multifocal osteoarticular tuberculosis.


PubMed | Chintpurni Medical College
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2013

A serial prescription audit in four cycles (three months each) was conducted at Jhalawar Medical College and Hospital and at Chintpurni Medical College and Hospital for two years, one year in each hospital. One cycle included the prescriptions which were collected by using a digital camera from the outdoor patients department every month (n=250 per month), for three months regularly. A baseline prescription audit, as a cross-sectional survey, was done on the last date of the first month. Re-audits were done on the last date of the 2(nd) and 3(rd) months, which concluded one cycle. One cycle was followed by three months of no prescription audit. In total, four cycles were completed in two years. The parameters which were observed were- (a) the formats of the prescriptions (b) the WHO drug core indicators and (c) the legibility of the prescriptions. The clarity of the prescriptions was decided upon by the consensus group. A continuous evaluation and a feedback process were carried out every month by analyzing the prescriptions, based on the extent of conformity to the WHO Guide to Good Prescribing and the updated list of the WHO Essential Medicines. The data was analyzed by using the Chi-square test.There was a significant improvement in the formats of the prescriptions in terms of the quality of the completeness and the rationality at the end of the 2nd and 3rd months of each cycle. Similarly, the WHO drug core indicators improved with every re-audit in each cycle (p < 0.05). Overall, the total percentage of the core indicators significantly improved in the 2nd and 3rd months as compared to the 1st month in all the cycles (p < 0.05). The clarity of the prescriptions improved in the successive re-audits. There was a sudden decline in the improvement in all the parameters in the first month of the 2nd, 3rd and the 4th cycles as compared to that in the 2(nd) and 3(rd) months of the previous cycles.Serial prescription audits and an active feedback definitely improve the prescription behaviours in the therapeutic decision making. But discontinuing the prescription audits begins to reverse the improvement in the prescription behaviours.

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