Prevalence of forward neck posture and influence of smartphones in physiotherapy students

Introduction and Aim: InAsia, the prevalence of forward neck posture is 66%. Forward neck posture is the anterior positioning of cervical spine. This posture is sometimes called as “scholar’s neck. Forward neck posture can lead to musculoskeletal disorders such as injuries in muscles, tendons, and peripheral vessels, vascular vessels caused by repetitive or continuous use of certain body part. In forward neck posture, the sternocleidomastoid muscle and trapezius are largely responsible for turning and nodding the head. When the head moves front, the spine follows, pulling the shoulder blades forward as well.They make contact with the upper ribs and begin to drag it forward with them.Therefore, this study aims to quantify forward neck posture in prolonged smart phone users. Methodology:An observational study was done in smartphone using student population comparing the control group students with forward neck posture studentsfor the duration of 3weeks. This study has included 100 students with forward neck posturewho were recruited fromDr. MGR Educational & Research Institute. Goniometer, Craniovertebral angle and Plumb line were used as the outcome measure. Results:The findings of this research exhibit there is a statistically significant changes inforward neck posture studentscompared with control group and the mean difference is 14.97 in two groups students. Conclusion:The present study concluded that 3 weeks after assessing the students. Forward neck posture students found to have decreased craniovertebral angle and range of motion compared to normal neck posture students and also found that forward neck posture students spent 5-6 hours using smart phones per day.

Space-Occupying Lesions of the Retropharyngeal Space: An Anatomical Study With Application to Postoperative Retropharyngeal Hematomas

Study Design: Cadaver study. Objective: The retropharyngeal space’s (RPS’s) clinical relevance is apparent in anterior cervical spine surgery with respect to postoperative hematoma, which can cause life-threatening airway obstruction. This cadaver study aims to establish guidance toward a better understanding of the tolerance of the RPS to accommodate fluid accumulation. Methods: Five fresh-frozen cadavers were dissected in the supine position. A digital manometer and a 20 Fr Foley catheter were inserted into the RPS via an anterolateral approach. While inflating the Foley catheter, the position of the esophagus/trachea was documented using fluoroscopy, and the retropharyngeal pressure was measured. We quantified the volume required to deviate the esophagus/trachea >1 cm from its original position using fluoroscopy. We also recorded the volume required to cause a visible change to the normal neck contour. Results: A mean volume of 12.5 mL (mean pressure 1.50 mm Hg) was needed to cause >1 cm of esophageal deviation. Tracheal deviation was encountered at a mean volume of 20.0 mL (mean pressure of 2.39 mm Hg). External visible clinical neck contour changes were apparent at a mean volume of 39 mL. Conclusion: A relatively small volume of fluid in the RPS can cause the esophagus/trachea to radiographically deviate. The esophagus is the structure in the RPS to be most influenced by mass effect. The mean volume of fluid required to cause clinically identifiable changes to the normal neck contour was nearly double the volume required to cause 1 cm of esophageal/tracheal deviation in a cadaver model.

Percutaneous ultrasound-guided ethanol ablation for treatment of primary hyperparathyroidism in a cat

Case summaryA 9-year-old male neutered European Shorthair cat was presented owing to vomiting and mild weight loss. Clinical examination was normal, but biochemistry results showed increased concentrations of total calcium (4.05 mmol/l; reference interval [RI] 2.20–2.90 mmol/l) and ionised calcium (iCa) (2.19 mmol/l; RI 1.12–1.40 mmol/l), as well as hypophosphataemia (2.5 mg/dl; RI 3.1–7.5 mg/dl). Parathyroid hormone (PTH) concentration (>1000 pg/ml) was markedly increased, while parathyroid hormone-related protein concentration (<0.8 pmol/l) was normal. Neck ultrasound showed a large left parathyroid mass (13 × 7 × 6 mm). Under general anaesthesia and with ultrasonographic guidance, a fine-needle aspiration of the mass followed by chemical ablation with 2 ml 96% ethanol was performed. The cat was re-evaluated and iCa concentration measured 24 h, 72 h, 5 days, 4 weeks and 4 months post-ablation. Normocalcaemia was reached within 24 h, remained stable throughout the whole evaluation period and the concentration of PTH normalised 4 months later. Vomiting stopped promptly after chemical ablation and a slight change in voice, as well as a mild prolapse of the nictitating membrane, were the only side effects after the treatment but resolved some weeks later.Relevance and novel informationTo our knowledge, this is the first report of successful chemical ablation of a parathyroid mass in a cat with primary hyperparathyroidism. Chemical ablation might therefore be a possible alternative to parathyroidectomy in cats.

Postburn Neck Contracture: Principles of Reconstruction and a Treatment Algorithm

Background Various techniques have been developed for postburn neck reconstruction, but a treatment algorithm is needed. Methods We retrospectively reviewed all patients treated for postburn neck contracture at our institution between February 2008 and December 2015. Necks were divided into one anterior subunit and two lateral subunits marked by the sternocleidomastoid muscle. Deformities were categorized into three types according to their size and location. Type I deformities involve less than one subunit, type II deformities involve at least one subunit but less than two subunits, and type III deformities affect two or more subunits. Type II deformities were further divided into type IIa deformities, which mainly involve the anterior region, and type IIb deformities, which mainly involve the lateral region. Results Local random pattern flaps were constructed for type I deformities. Pedicled flaps from the anterior chest and supraclavicular areas were preferred for type IIa deformities, and pedicled flaps from the back were preferred for type IIb deformities. Pedicled flaps from other areas were the second choice for type II deformities, followed by free and prefabricated flaps. For type III deformities, bipedicled flaps were usually required. At a follow-up of at least 12 months, all patients showed near-normal neck function, and aesthetic features were significantly improved. Conclusion The proposed classification and treatment algorithm for postburn neck reconstruction may help achieve satisfactory outcomes.

Study of neck shaft angle of femur in population of Bihar

Background: Neck shaft angle is the angle formed between the long axis of shaft and long axis of neck. Neck shaft angle of femur is an important parameter considering the biomechanics of hip joint. Neck shaft angle gives important information regarding race to which they belong. Normal neck shaft angle is in the range of 1200 -1400. Objective of the study was to find out the neck shaft angle of femur and correlate with the previous study.Methods: present study was conducted on 60 dry femur collected from different medical colleges of Bihar. The neck shaft angle was measured by Goniometer.Results: In this study the neck shaft angle of femur was 130.820, in male neck shaft angle of femur was 130.280 and in females it was 131.420.Conclusions: There is no significance difference between the male and female neck shaft angle. Orthopaedists use the normal range and mean of the neck shaft angle in diagnosis and treatment of the disease of hip. The angle is increased in poliomyelitis, congenital subluxation and dislocation of hip and decreased in congenital coxa vara.

Endoscopic coblation assisted laryngo pharyngeal corrosive stricture adhesiolysis-the first of its kind

Corrosive pharyngeal strictures without significant damage to esophagus and stomach were rarely reported. Here we report a case of corrosive acid poisoning with laryngopharyngeal strictures suffering for 39 years with difficulty in breathing, swallowing, phonation and sleep for whom endoscopic coblation assisted stricture adhesiolysis was done which was the first of its kind to our knowledge. As early as 5th postoperative day tracheostomy was decannulated, and the patient was able to swallow soft solids without maneuvers, liquids without nasal regurgitation, breathing via naturalis, phonating with normal neck position and a good sleep with no recurrences in 12 months follow up.