Background:The Serratus anterior muscle plane (SAP) block has recently been described for the purpose of perioperative pain management following cases of trauma and breast surgery. It might prove a safer alternative to the other regional thoracic paravertebral and central neuraxial blockade techniques. There are no descriptive cadaveric studies in the pre-existing literature to delineate the anatomical plane for this novel technique. The main objectives for our study were to examine the location of the Serratus anterior muscle belly, assess the efficacy of achieving adequate delineation of the muscle plane utilising ultrasound imaging with agitated water as the contrast agent, and finally, to observe the extent of the cepahlo-caudal spread of the injectate in the SAP.Materials and Methods:Seven cadavers were studied. 20 mls of saline was injected into posterior axillary line (PAL) at the level of the 4-5th rib under ultrasound guidance. This was followed by injection of 10 mls of water with air (8 mls water and 2 mls of air). The presence of hyperechoic air bubbles in the fluid distended SAP (hypoechoic) area demonstrated the spread of water and air.Results:In 36% of cadavers, fully formed Serratus Anterior muscle belly was identified at the midaxillary line (MAL), 14% in PAL, and remaining 50% between PAL and MAL. The lower most limit of air-water spread was identified at the subcostal margin. Cephalad spread of contrast was noted in 2nd intercostal space ICS (7%), 3rd ICS (71%), and 4th ICS (22%).Conclusion:This study describes that the serratus anterior muscle is well-formed near the PAL and the injectate spread can be determined with the help of agitated water contrast on ultrasound. Furthermore, there was variability in the cephalad spread of the injectate.
INTRODUCTION"Disaster, by Oxford dictionary's simple definition is an unexpected event, that kills a lot of people or causes huge damage". 1 The Centre for Research on the Epidemiology of Disaster (CRED) in Brussels, Belgium has come up with a modified definition i.e., "A disaster is a situation or event which overwhelms local capacity, necessitating a request to a national or international level of external assistance".2 As per CRED an event can be classified as a disaster if, it kills more than 10 people/impacts or displaces more than 100 people/it is declared a national emergency/the country had to receive international assistance. The classical characterization of disaster are unfamiliarity, unpredictability, uncertainty, vulnerability, urgency, intensity and danger. Broad objective of the study was to assess the extent of awareness about disasters and their management among school going ABSTRACT Background: The classical characterization of disaster is unfamiliarity, unpredictability, uncertainty, vulnerability, urgency, intensity and danger. Major disasters include earthquake, landslides, volcanic eruptions, floods hurricanes, fires, tornados, blizzards, tsunamis, cyclones. Apart from causing deaths and severe ill health, disasters also lead to large scale displacement, injuries, epidemics and substantial economic losses to the communities. Though every emergency or disaster has it's own characteristics and demands but the basic measures under disaster management include prevention, mitigation, preparedness, response and recovery for which regular training and awareness activities are needed especially among students. The objective of the study was to assess the extent of awareness about disasters and their management among school going children. Methods: It was an educational interventional design with an exploratory research approach adopting nonprobability purposive sampling technique. Kendriya vidhyalaya no: 4 affiliated to CBSE was randomly selected, which is situated in mid of the Gwalior town. Survey method was employed, on 110 participants aged between 12 and 16 years using a pre-tested semi structured questionnaire data sheet. Results: The outcome revealed that out of 110 students 87.2% (before intervention) and 98.2% (after intervention) had knowledge of disaster management. Conclusions: These findings emphasize that the extent of knowledge is not yet satisfactory and there is a severe need of providing knowledge to the school children. Disaster management can be compulsorily included in academic curriculum of all the students. Effective, purposeful training and awareness programmes are to be timely conducted.
Background: Brachytherapy is an integral component of the definitive treatment of locally advanced cancer cervix. Cervical Brachytherapy has evolved from the time when dose prescription was largely empirical, to the image based conformal brachytherapy advocated by Groupe Europeen de Curie Therapie-European society for therapeutic radiology and oncology (GEC-ESTRO) and American brachytherapy society (ABS).
Use of radiation is now a days so common in most of the tertiary care hospitals for diagnostic and therapeutic purpose. The ionizing radiation provides many benefits in both diagnostic as well as therapeutic interventions, but they are also potential harmful. Radiation risks, exposure and mitigation strategies should always be in mind while using to an individual (public, radiation worker, and patient) and the environment should not exceed the prescribed safe limits. Regular monitoring of hospital area and radiation workers is mandatory to assess the quality of radiation safety. This review article emphasis on radiation risks, exposure and prevention and treatment strategies.
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