No abstract
De Winter pattern in anterior leads has been extensively described. However, there is only one case report of this pattern in inferior leads in English literature. Here, we describe a case of acute inferior wall myocardial infarction with thrombotic right coronary artery occlusion who presented with the classical De Winter sign in inferior leads.
Introduction: Intramural course of coronary artery is known as myocardial bridge (MB). Its prevalence is highly variable. Very few studies have been conducted in India, mostly from southern state and that too covering urban population. There are no studies from western India. In this study we aimed to estimate the prevalence of MB in coronary angiogram from rural part of western India. Methods and Results: A total of 4,438 patients underwent coronary angiography for various indications during the study period of 69 months. Mean age of the study population was 53.6 ± 11.2 years. MB was found in 212 (4.77%) of patients, predominantly in males. Unstable angina was the most common presentation among males (28.7%), whereas chronic stable angina was being the most common presentation among females (22.6%). Majority of MBs were seen in left anterior descending artery in its mid part (61%). Mean diameter compression of the affected segment was 32.6% ± 11.8%, with no significant difference seen among males and females or between mid and distal left anterior descending artery. Conclusion: Our study showed the prevalence of MB similar to other Indian studies. Left anterior descending artery was most common artery involved. Mean compression was not statistically significant among either sex.
Context: Distal end radius fractures are among the commonest fractures encountered in public health care. These injuries are associated with osteoporosis, articular damage, comminution and complex fracture pattern. These fractures should be managed according to fracture configuration and functional demand of patient. Material and Methods: 110 patients with distal end radius fractures were managed with different surgical fixation. Out of them 58 were operated by locking plates, 44 were operated by percutaneous k wire pinning and external fixation was done in 8 patients. Mean age of study population was 46.4 year (range 20-75year) with slight male dominance. All patients were assessed post operatively by clinical and radiological methods in forms of DASH score, VAS pain score, range of motion at wrist joint, operative complication of each treatment modality, pinch and grip strength of both hands. Results: Patients managed with plating had significantly better function, strength and range of motion as compared with patients operated with K-wiring or distractor in all 8 types of fractures (p<0.05). Mean DASH score, VAS pain score, range of motion and grip strengths were much better in locking plate group compared to k wire pinning and external fixation. Locking plate was also found better at restoring radiological parameters (radial tilt, radial inclination and radial height) as compared to other methods. Collapse in radial height was more in k-wiring group in patients with osteoporotic bones. Conclusion: Improved understanding of fracture pattern and bone quality by various radiological examination demands proper fixation to get better functional outcomes. Locking plate has superior outcome for osteoporotic bone, articular damage and complex injuries while k wire pinning should be used for good quality bone with less functional demand and external fixation should be reserved for open injuries and poor skin texture.
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