Virk RS, Penubarthi LK, Gupta AK, Jain P, Kaushik E. Bilateral Antrochoanal Polyps: An Analysis from Four Cases. J Postgrad Med Edu Res 2016;50(4):173-175.

Age estimation of dead persons of unknown age and identity from skeletal remains has an important role in legal and forensic investigations. Due to their relatively better ability to withstand the impact of physical forces and agents, the skeletal remains of human mortals provide us with wealth of information in the form of preserved morphological patterns or markings on bones. Out of all bones, morphological features on pubic bones are by far the best indicators. A large-scale study on pubic bones was conducted by a famous anatomist, Todd, in 1920, and since then his method is being followed for the assessment of age.

Cadaveric pubic bones of 204 Northwest Indian adult males aged 18 to 61 years were taken for the study from the archive collection in museum of anatomy. Sixteen morphological features on the symphyseal surface of pubic bones were noted and arranged in 10 phases according to Todd's (1920) method. Frequency of these features present in each phase was calculated. Linear regression analysis was applied to obtain an equation for estimation of age from a pubic bone of an unknown deceased individual.

It was seen that frequency of most morphological features of the pubic bones in the present study age groups (phases) was 100%, i.e., similar to those in Todd's study. There was a significant correlation (r = 0.9, p < 0.001) between the actual age of the pubic bone and age estimated by linear regression equation. Conclusion: Despite numerous improved methods, Todd's method remains the most useful method for determination of age. Appearance of morphological features on the symphyseal surface of pubic bones in the present study were similar to most phases of Todd's study. Thus, Todd's method can be successfully applied for the estimation of age in Northwest Indian adult male population.

Sodhi L, Singh H, Sahni D, Gupta T, Aggarwal A, Chawla K, Kaur H. Estimation of Age from Symphyseal Surface of Cadaveric Pubic Bones of Northwest Indian Male Adults. J Postgrad Med Edu Res 2016;50(4):176-180.

Patients of chronic myeloid leukemia (CML) eventually transform to blast crisis (BC) after a variable length of chronic phase (CP). With improvement in management protocols, many patients of CML-BC are expected to show remission after initial chemotherapy and a better survival. Hence, it becomes imperative to correctly classify the nature of BC for further course of management.

This study retrospectively analyzed cases of CML-BC, over a period of 5 years, with comprehensive immunophenotyping done on flow cytometry.

Fifteen cases of CML-BC with male-to-female ratio of 3:1 and mean age of 40.2 years were included in the study. Flow cytometry revealed 14 cases of myeloid and one case of lymphoid BC. One case each of megakaryocytic and myelomonocytic lineage were seen among the 14 cases of myeloid BC. Aberrant marker expression was a common occurrence. Myeloperoxidase cytochemical stain had shown positivity only in 3 of the 14 cases of myeloid BC.

Immunophenotyping is necessary for assigning specific lineage to blasts in patients of CML-BC and thus providing clinically useful information regarding the treatment protocols and prognosis of the patient.

Narang V, Sachdeva MUS, Bose P, Varma N, Malhotra P, Varma S. Immunophenotyping in Chronic Myeloid Leukemia Blast Crisis: Looking beyond Morphology. J Postgrad Med Edu Res 2016;50(4):181-184

Recent sprint training regimens have used high-speed incline treadmill running to provide enhanced loading of muscles responsible for increasing forward running speed. The purpose of this study was to determine the standard alterations in the lower-limb joint kinematics and gait parameters resulting from changes in treadmill slope during the use of the treadmill as a medical reference.

The subjects of this study were 20 normal, healthy elite football players without any orthopedic, respiratory, or cardiovascular system problems.

The running gait of subjects was analyzed using motion analysis system on an inclined treadmill with three running trials, each for 3 minutes. The gait was measured at incline of 0, 9, and 18%. The speed of the treadmill was fixed at 4.0 m/s in order to maintain a constant running speed.

The subjects’ gait parameters were observed to change significantly between slopes of 0 and 18%. The results showed greater maximum knee flexion, ankle dorsiflexion, and total hip range of motion (ROM) in incline treadmill running compared to level running.

The results of this study can be put in as a predesigned rehabilitation program for sprint training on a treadmill, especially for treadmills with adjustable gradients.

Singh A, Arvind DN, Sandhu JS. A Comparison of an Integrated Three-dimensional Biomechanical Analysis of High-speed Incline and Level Treadmill running in Elite Football Players. J Postgrad Med Edu Res 2016;50(4):185-189.

To estimate the average serum values of vitamin B12 and folate in women with a term pregnancy and the cord blood of their newborns. To find if any correlation exists between the levels of serum B12 and folate in the mother and that of the neonate.

A prospective observational study of serum B12 and folate levels and the respective cord blood concentrations of 51 term, nonanemic, pregnant women and in the cord blood of their newborns at delivery.

Fifteen women were B12 deficient (29.4%) with the mean being 189.25 ± 94.2 ng/mL and 14 neonates were B12 deficient (27.45%) with their mean being 321.86 ± 143.68 ng/mL. One woman was folate deficient (1.96%) with the mean being 13.13 ± 5.15 ng/mL and one neonate was folate deficient (1.96%) with the mean being 15.68 ± 4.61 ng/mL. There was a significant correlation between maternal and neonatal B12 levels with a Pearson's coefficient of 0.74 (p-value of < 0.01) and a significant correlation between maternal and neonatal folate levels with a Pearson's coefficient of 0.44 (p-value of < 0.01).

There is a high incidence of maternal B12 deficiency in the Indian community, which has a positive correlation with neonatal levels. Treatment of B12 and folate deficiency should be a part of routine antenatal treatment, and neonates should be followed up and treated if found to be B12 or folate deficient.

In India, where large numbers of women are anemic, deficiency of vitamin B12 and folate is overlooked when treatment of anemia is undertaken in most hospitals. In addition, women with undetected and subclinical deficiency may transmit it to their newborns with a cycle that is self-perpetuating unless broken with adequate intake or supplementation.

Krishnaswamy PH, Prabhu S, Pandith NA, Shetty A. Serum Vitamin B12 and Folate Levels in Mothers and their Newborns: An Observational Study. J Postgrad Med Edu Res 2016;50(4):190-193.

To establish fusidic acid ointment in the treatment of recurrent epistaxis in children as a local antiseptic.

It was a retrospective study and a total of 184 pediatric patients’ data were analyzed. Ninety-seven patients were found to be fitting in selection criteria. The time of presentation, number of episodes, treatment received, and follow-ups were noted. Results were confirmed over the phone.

Ninety-five patients had simple bleed and were managed on outpatient treatment with fusidic acid ointment and saline nasal drops, while two required admission and underwent electrocautery of offending vessel. Out of the 95 patients, 10 had initial failure of treatment in the 1st month, but with continued treatment were subsequently treated. Fifteen of these 95 had episodes in the next season. The incidence of bleeding was more in summers than winters in children.

Fusidic acid ointments are safe and effective in the treatment of recurrent epistaxis in children. Clinical significance: The effectivity of fusidic acid in epistaxis has never been studied. This study can establish it as an antiseptic ointment in the treatment of recurrent epistaxis.

Khandelwal G, Pathak S, Sharma M. Fusidic Acid Ointment in Treatment of Recurrent Epistaxis in Children. J Postgrad Med Edu Res 2016;50(4):194-196.

Dhillon MS, Virk MS, Dhatt SS. Bilateral Ischial Tuberculosis. J Postgrad Med Edu Res 2016;50(4):197-198.

Cheema YS, Gupta P, Attri S, Jamdagni V, Mittal D. Polymyositis. J Postgrad Med Edu Res 2016;50(4):199-200.

Placenta percreta is rare but may present with life-threatening emergencies.

We present a near-miss case with a placenta percreta presenting with hemoperitoneum and shock and describe how multidisciplinary multimodality management was used to save the lady in a tertiary care center of a low-resource setting. Peripartum hysterectomy with bilateral internal iliac ligation could not completely control the oozing. The general condition of the patient was poor with acidosis, coagulopathy, and hypothermia. Pelvic packing followed by embolization was done along with intensive care to treat metabolic derangements. It helped salvage the patient who later underwent a relaparotomy for pack removal. Conclusion and clinical significance: Role of individualized multimodality multidisciplinary management and intensive care is emphasized.

Chopra S, Siwatch S, Jain K, Aggarwal N, Gorsi U, Kumar N. Successful Multimodality Life-saving Management of Placenta Percreta with Hemoperitoneum in Shock. J Postgrad Med Edu Res 2016;50(4):201-203.