Background: Atlantoaxial dislocation refers to a loss of stability between the atlas and axis (C1-C2), resulting in loss of normal articulation. Cervical spine C1-C2 motion segment is the most technically challenging.Methods: This is a prospective and retrospective Study which included 34 patients admitted in King George hospital, Andhra medical college, Visakhapatnam over the past two years (January 2014- January 2016) with AAD.Results: The age of the patients ranged from 3 to 60 years with mean age being 37.67 years. Commonest presenting sign is local tenderness at the back of upper cervical region in 91.17%. Most common procedure done was single sitting trans oral odontoid decompression with posterior occipito cervical fusion with occipital plate and C2, C4 polyaxial screws and lateral mass rods in 18 cases out of 34. The next common procedure performed was C1 lateral mass and C2 pars screw fixation 8 out of 34.Conclusions: Trans oral odentoidectomy and posterior ocipito cervical fusion is ideal and still holds good for irreducible AAD with ventral compressive pathology.
Background: The prevalence of chiari malformation, defined as tonsillar herniations of 3 to 5 mm or greater, is estimated to be in the range of one per 1000 to one per 5000 individuals. The objective was to study the clinical presentation and outcome of ACM syrinx after foramen magnum decompression, c1 posterior arch removal duraplasty and without duraplasty.Methods: The study included 75 cases admitted with ACM with syrinx in neurosurgery ward in King George hospital, Visakhapatnam, Andhra Pradesh, India, during a period of five years.Results: Clinical improvement correlated strongly with enlargement of the subarachnoid cisterns and also correlated with reduction in size of the syrinx cavities. Postoperatively all the patients had decreased neck pain and two third of the patients had improvement in nystagmus, headache and dissociative anaesthesia in few cases.Conclusions: In the available literature, the treatment options offered for ACM syrinx are foramen magnum decompression and c1posterior arch removal, release of compression bands, which were followed in our institute also. We have compared pre-and post of MRI. Clinical improvement has been observed in 2 thirds of patient after a period of 2 year period follow up.
Previously, we showed that the crude methanol extracts of Leucas indica flowers exhibited antioxidant properties and in the current study, crude methanol flower extracts of L. indica showed anticancerous properties as evidenced cytotoxicity (MTT assay test) against the selected cancerous cell lines HeLa, HCT116, HL-60, and MCF-7. Therefore, further analysis was performed to isolate and purify the bioactive compound using activity-guided repeated fractionation of the methanol extract by silica gel column chromatography. After collection of different fractions, all the fractions were subjected to TLC analysis and the fractions which yielded the same compounds on TLC were further analyzed for physicochemical and spectroscopic analyses, e.g., UV, IR, 1H NMR, 13C NMR, COSY, HSQC, and mass spectroscopy. The bioactive compound isolated was elucidated as 6-hydroxy-3-(4-hydroxyphenyl)-7-(3,4,5-trihydroxy-6-)(hydroxymethyl)tetrahydro-2H-pyran-2yl)-4H-chromen-4-one. Based on the antioxidant and anticancerous properties, L. indica might be a promising source of useful natural products and the newly bioactive compound might offer opportunities to develop new anticancerous drugs.
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