ABSTRACT:The morphometrical data related to the menisci of the adults have been reported by few authors but data specific to the population of East Goadavari region have not been reported. The aims of the present study were to analyse the external circumference thickness, the width, peripheral and inner border lengths, and the distance between anterior and posterior horns of the menisci and to compare them with those which are available in the literature. The menisci from 100 knee joints of the formalin fixed cadavers which were obtained from the Anatomy department of Rangaraya Medical College, Kakinada and Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram were analysed. The cadavers which had musculoskeletal anomalies were excluded from the study. A vernier calliper of 0.02 mm accuracy and a non-elastic cotton thread were used for the morphometry. After comparing the meniscal dimensions of the present study with the other available literature, we established that there are some morphological differences of meniscus in this set of population.

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The purpose of this study was to determine the safety and efficacy of percutaneous versus open tracheostomy in the pediatric trauma population. A retrospective chart review was conducted of all tracheostomies performed on trauma patients younger than 18 years for an 8-year period. There was no difference in the incidence of brain, chest, or facial injury between the open and percutaneous tracheostomy groups. However, the open group had a significantly lower age (14.2 vs. 15.5 years; P < 0.01) and higher injury severity score (26 vs. 21; P = 0.015). Mean time from injury to tracheostomy was 9.1 days (range, 0 to 16 days) and was not different between the two methods. The majority of open tracheostomies were performed in the operating room and, of percutaneous tracheostomies, at the bedside. Concomitant feeding tube placement did not affect complication rates. There was not a significant difference between complication rates between the two methods of tracheostomy (percutaneous one of 29; open three of 20). Percutaneous tracheostomy can be safely performed in the injured older child.

Objective(s):In an attempt to identify the concerns of vascular fellows regarding their training in vascular surgery, we conducted an anonymous survey consisting of 22 questions at an annual national meeting held yearly in March from 2004 to 2010.Methods: The fellows were asked to assess their endovascular, open, and vascular laboratory experience as excellent, satisfactory, or mixed. They were queried about who trained them in their endovascular skills, the quality of their didactics, and amount of small cases that yielded no learning experience. Of the 466 attendees, 376 (80%) completed the survey. Up to 84% of those surveyed were men. Second-year fellows comprised up to 66% of those surveyed.Results: Most (79%) were satisfied with their endovascular experience during their fellowship, and 81% were satisfied with their experience with open cases. Interventional skills were obtained from a vascular surgeon (84%), an interventional radiologist (9%), a cardiologist (1%), or a mixture (5%). The didactics were felt to be excellent, satisfactory, or required some or much improvement in 20%, 64%, 11%, and 4% respectively. The distribution of nonlearning cases was felt to be excellent, satisfactory, or required some or much improvement in 42%, 45%, 10%, and 3% respectively. However, only 64% thought their vascular laboratory experience was excellent or satisfactory. Only 36% actually performed the vascular duplex examination, and only 47% felt that they would feel comfortable in managing a vascular laboratory. Forty-six percent suggested that finding the type of job they wanted was easy in 46% or moderately difficult in 46%. Most (72%) felt that future demand for manpower in vascular surgery will exceed available manpower. In the 2004 survey, the primary source of training for interventional skill was a vascular surgeon in 77% and this increased to 100% in 2010. No other major significant differences were noted from year to year.Conclusions: The results of this survey suggest that several significant issues are reflected in the minds of vascular trainees. These data suggest that vascular fellows are not being adequately trained in the vascular laboratory. Because the trainees represent the future of our field, we suggest that the vascular laboratory become a specific area of focus in the fellowship training.

Objectives: Non-O blood types are associated with higher levels of von Willebrand factor and factor VIII and with increased risk of coronary, cerebral and peripheral arterial disease and venous thromboembolism. We hypothesize that non-O blood type is a predictor of long-term mortality after vascular surgery, although this effect might be diminished by aspirin and/or Vitamin K Antagonist use.Methods: In 3255 major vascular surgery patients, baseline characteristics, ABO blood type and follow-up (mean 5 years) were obtained. The primary endpoint was all-cause mortality, the secondary endpoint was Major Adverse Cardiac Event (MACE). Multivariate analyses, correcting for gender, medical history, left ventricular dysfunction and smoking, were used to evaluate the impact of ABO blood type on mortality.Results: Cardiovascular risk factors, medication and type of surgery were well balanced between groups. All patients were on chronic ASA/VKA therapy. Within 30 days after surgery, 3.4% of non-O and 3.6% of O patients suffered MACE (OR 0.94; 95%CI 0.65-1.37). In a multivariate model, O blood type was not associated with increased mortality during long-term follow-up (HR 0.98; 95%CI 0.89-1.09).Conclusions: Although associated with atherothrombosis and increased mortality in CAD, non-O blood type is not associated with either short or long-term mortality in vascular surgery patients. This discrepancy might be explained by the high rate of ASA/VKA use in our population.