Antenatal sonographic assessment of cross sectional area of umbilical cord components and its reference value in normal pregnancy

Background: Measuring the cross-sectional area of umbilical components in normal pregnant women helps in assessing the fetal abnormalities. Very few literatures were available on evaluation of reference values of cross sectional areas of umbilical cord components. The present study was conducted with the aim to determine the normal reference values of cross sectional areas of umbilical arteries, umbilical vein and Wharton’s jelly and to correlate them with the gestational age of the fetus.Methods: A cross sectional study was conducted on 300 normal pregnant women at the Department of Radiodiagnosis, Sri Siddhartha Medical College, Tumakuru, Karnataka to assess the reference range of cross sectional areas of umbilical cord arteries, umbilical vein and Wharton’s jelly at different gestational age of the fetus to analyze their growth.Results: A statistically significant correlation was observed between cross sectional areas of umbilical artery and vein and gestational age before and after 34 weeks (p=0.005 and 0.006 respectively) but no significant correlation was noticed with the cross-sectional area of Wharton’s jelly (p=0.088).Conclusions: Cross sectional area measurements of umbilical cord components can be considered as important tools for estimation of fetal growth

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Un caso raro de inserción del coracobraquial asociada con variante del nervio músculocutáneo

We report a rare case of the tendinous insertion of coracobrachialis muscle which has not been reported in the literature. The insertion of the novel coraco-brachialis muscle is usually into the medial border of the humerus in a 3-5cm impression at the mid-shaft level. Contrary to this, in the present case, it was seen getting inserted as a sharp slender tendon in the middle of the medial border of the humerus.  Variable insertion of coracobrachialis muscle may be responsible for the causation of compression of surrounding structures like median nerve, musculocutaneous nerve, and brachial artery. This article aims to point out a rare case of the unusual tendinous insertion of coracobrachialis and its association with musculocutaneous nerve, providing necessary information to surgeons performing surgical reconstruction using coracobrachialis.  Presentamos un caso raro de inserción tendinosa del músculo coracobraquial que no se ha informado en la literatura. La inserción del nuevo músculo coraco-braquial generalmente se realiza en el borde medial del húmero en una impresión de 3-5 cm a nivel del eje medio. Contrariamente a esto, en el presente caso, se observó que se insertaba como un tendón delgado y afilado en el medio del borde medial del húmero. La inserción variable del músculo coracobraquial puede ser responsable de la causa de la compresión de las estructuras circundantes, como el nervio mediano, el nervio musculocutáneo y la arteria braquial. Este artículo tiene como objetivo señalar un caso raro de la inserción tendinosa inusual del coracobraquial y su asociación con el nervio musculocutáneo, brindando la información necesaria a los cirujanos que realizan la reconstrucción quirúrgica usando el coracobraquial

Configuración anatómica diversa del nervio ilioinguinal en relación con el nervio cutáneo femoral lateral

The variability in the formation of Ilioinguinal nerve has been documented in the literature especially related to iliohypogastric nerve. But so far very few cadaveric studies have been documented on variation in the branches of ilioinguinal nerve. A case presented which demonstrates aberrancy of its anatomic position. Although the course of ilioinguinal nerve has been well known, nostudies or report have demonstrated a course in relation to lateral femoral cutaneous nerve. This case report serves as a warning to the surgeon to be aware of such bizarre presentation since the consequences of iatrogenic injury to such structures may be serious.La variabilidad en la formación del nervio ilioinguinal ha sido documentada en la literature especialmente relacionada con el nervio iliohipogástrico. Pero hasta ahora se han  documentado muy pocos estudios cadavéricos sobre la variación en las ramas del nervio ilioinguinal. Se presenta un caso que demuestra una aberrancia de su posición anatómica. Aunque el curso del nervio ilioinguinal es bien conocido, ningún estudio ha documentado una variación de su curso en relación con el nervio cutáneo femoral lateral. Este informe de caso sirve como una advertencia al cirujano para que esté al tanto de una presentación tan extraña, ya que las consecuencias de la lesion iatrogénica en tales estructuras pueden ser graves

A RARE CASE OF TENDINOUS INSERTION OF CORACOBRACHIALIS ASSOCIATED WITH VARIANT MUSCULOCUTANEOUS NERVE

We report a rare case of the tendinous insertion of coracobrachialis muscle which has not been reported in the literature. The insertion of the novel coraco-brachialis muscle is usually into the medial border of the humerus in a 3-5cm impression at the mid-shaft level. Contrary to this, in the present case, it was seen getting inserted as a sharp slender tendon in the middle of the medial border of the humerus.  Variable insertion of coracobrachialis muscle may be responsible for the causation of compression of surrounding structures like median nerve, musculocutaneous nerve, and brachial artery. This article aims to point out a rare case of the unusual tendinous insertion of coracobrachialis and its association with musculocutaneous nerve, providing necessary information to surgeons performing surgical reconstruction using coracobrachialis.  </jats:p

DIVERSE ANATOMICAL CONFIGURATION OF ILIOINGUINAL NERVE IN RELATION TO LATERAL FEMORAL CUTANEOUS NERVE: A CASE REPORT

The variability in the formation of Ilioinguinal nerve has been documented in the literature especially related to iliohypogastric nerve. But so far very few cadaveric studies have been documented on variation in the branches of ilioinguinal nerve. A case presented which demonstrates aberrancy of its anatomic position. Although the course of ilioinguinal nerve has been well known, nostudies or report have demonstrated a course in relation to lateral femoral cutaneous nerve. This case report serves as a warning to the surgeon to be aware of such bizarre presentation since the consequences of iatrogenic injury to such structures may be serious.</jats:p

Spatio-Temporal Context, Correlation Filter and Measurement Estimation Collaboration Based Visual Object Tracking

Despite eminent progress in recent years, various challenges associated with object tracking algorithms such as scale variations, partial or full occlusions, background clutters, illumination variations are still required to be resolved with improved estimation for real-time applications. This paper proposes a robust and fast algorithm for object tracking based on spatio-temporal context (STC). A pyramid representation-based scale correlation filter is incorporated to overcome the STC’s inability on the rapid change of scale of target. It learns appearance induced by variations in the target scale sampled at a different set of scales. During occlusion, most correlation filter trackers start drifting due to the wrong update of samples. To prevent the target model from drift, an occlusion detection and handling mechanism are incorporated. Occlusion is detected from the peak correlation score of the response map. It continuously predicts target location during occlusion and passes it to the STC tracking model. After the successful detection of occlusion, an extended Kalman filter is used for occlusion handling. This decreases the chance of tracking failure as the Kalman filter continuously updates itself and the tracking model. Further improvement to the model is provided by fusion with average peak to correlation energy (APCE) criteria, which automatically update the target model to deal with environmental changes. Extensive calculations on the benchmark datasets indicate the efficacy of the proposed tracking method with state of the art in terms of performance analysis

Spatio-Temporal Context, Correlation Filter and Measurement Estimation Collaboration Based Visual Object Tracking

Despite eminent progress in recent years, various challenges associated with object tracking algorithms such as scale variations, partial or full occlusions, background clutters, illumination variations are still required to be resolved with improved estimation for real-time applications. This paper proposes a robust and fast algorithm for object tracking based on spatio-temporal context (STC). A pyramid representation-based scale correlation filter is incorporated to overcome the STC’s inability on the rapid change of scale of target. It learns appearance induced by variations in the target scale sampled at a different set of scales. During occlusion, most correlation filter trackers start drifting due to the wrong update of samples. To prevent the target model from drift, an occlusion detection and handling mechanism are incorporated. Occlusion is detected from the peak correlation score of the response map. It continuously predicts target location during occlusion and passes it to the STC tracking model. After the successful detection of occlusion, an extended Kalman filter is used for occlusion handling. This decreases the chance of tracking failure as the Kalman filter continuously updates itself and the tracking model. Further improvement to the model is provided by fusion with average peak to correlation energy (APCE) criteria, which automatically update the target model to deal with environmental changes. Extensive calculations on the benchmark datasets indicate the efficacy of the proposed tracking method with state of the art in terms of performance analysis.</jats:p