A REVIEW ARTICLE ON THE PHYSIOLOGICAL IMPORTANCE OF SAMANA VAYU IN RELATION TO THE ENTERIC NERVOUS SYSTEM

Ayurveda is a science that has been around for thousands of years and has proven to be beneficial to humans. Ayurveda is based on the tridosha theory. Vata, one of three doshas, plays an essential and major part in both healthy and unhealthy conditions, according to acharya sushruta dosha, dhatu and mala maintain our body. There are five types of vata- prana, udan, samana, vyan and apaan vayu. Among these five doshas samana vayu is situated near jatharagni and circulate all over the GIT tract. It helps in the division of essence and waste products, as well as the movement of the gastrointestinal tract, by stimulating the agni. In the body, jatharagni takes the form of pachak pitta, one of the pitta subtypes. Agnimandhya is responsible for all diseases, as we all know. The fire is fueled by samana vayu, who keeps it balanced. As a result, samana vayu might be regarded to play a specialized role in digestion. All of the samana vayu's functions can be compared to the physiological functions of the enteric nervous system and the sympathetic and parasympathetic supply of the Autonomic nervous system to the gastrointestinal tract. In this article, an attempt is made to correlate the physiological activity of samana vayu with the enteric nervous system. Keywords: Samana vayu, Prana vayu, Apan vayu, Sacral Segment.

A case of Bertolotti’s syndrome as a cause of sciatica

Background: Bertolotti’s syndrome (i.e., varying extent of fusion between the last lumbar vertebra and the first sacral segment) or lumbosacral transitional vertebrae is a rare cause of back pain. Notably, this syndrome is one of the differential diagnoses for patients with refractory back pain/sciatica. Case Description: A 71-year-old male presented with low back pain of 3 years duration that radiated into the right lower extremity resulting in numbness in the L5 distribution. He then underwent a minimally invasive approach to resect the L5 “wide” transverse process following the CT diagnosis of Bertolotti’s syndrome. Prior to surgery, patient reported pain that was exacerbated by ambulation that resolved post-operative. Conclusion: Bertolotti’s syndrome is one of the rare causes of sciatica that often goes undiagnosed. Nevertheless, it should be ruled out for patients with back pain without disc herniations or other focal pathology diagnosed on lumbar MR scans.

Effects of Induced Malocclusion on Vertebral Alignment in Rats: A Controlled Study by CBCTs

This study aimed to evaluate with CBCTs the alteration of vertebral alignment over time of induced malocclusion in rats. Crown pads increasing the vertical dimension of 0.5 mm were applied on the upper molars at one randomly selected side of the maxilla in rats (premature contact side) while the opposite side was left untreated (control side). Four groups were organized, ten animals each. In groups A, B, and C, the crowns were applied at time 0 (t-0). In group A, the crowns were removed after 2 weeks (t-2w) and euthanized after two more weeks, while in groups B and C, the animals were euthanized after 2 and 4 weeks (t-4w), respectively. No premature contacts were applied in group D. CBCTs were taken at t-0 in all animals before applying the crowns, at t-2w in group A before removing the crowns, and in all groups before the euthanasia. The changes in the iliac crest angle (ICA) that formed between the superior external margin of the iliac crest and the vertebral spine were evaluated. In groups A and B, after 2 weeks, the changes in ICA were statistically significant at p = 0.028 and p = 0.042, respectively. In group C, and in the control group D, the changes of ICA were not statistically significant (p = 0.058 and p = 0.414, respectively). In conclusion, the incease in monolateral occlusion in the molar region yielded a rotation of the lumbo-sacral segment towards the same side of the occlusal bite-raising.

Anthropometry Study Using Adult Pelvic 3D CT for Determining Sexes at Dr. Soetomo General Hospital, Indonesia

Pelvic bones are the most reliable indicator of sex in adults because of its sexual dimorphism. Medical imaging modalities e.g. Computed Tomography (CT) provide data sources to examine modern human variation quantitatively. This study aims to determine pelvic anthropometry characteristics and logistic regression formula for adult sex identification obtained from pelvic 3D CT. This study was an observational analytical study with retrospective regression and cross-sectional approach. The population was all patients in Radiology Installation of Dr. Soetomo General Hospital, Surabaya, Indonesia, from September to December 2019 who underwent pelvic 3D CT examination. Then, age distribution and pelvic measurements data were obtained. In this case, statistical analysis was conducted for all the data obtained. A number of 204 samples were included in this study. Mean age of the patients was 50.23 ± 14.36 years. All radiologic components were also significantly different between sexes (p < 0.05) except for transverse diameter of sacral segment (p = 0.180). Moreover, eta test was performed and found that APOD, CPID, LIH, TPO, and SPA had the strongest correlation. Those variables were used for making statistical models with logistic regression as sex = (0,125 x CPID) – (0,180 x LIH) + (0,078 x SPA) + 8,912. The calculation result > 0 is a prediction for female while < 0 is a prediction for male. From logistic regression model calculation, a high validity value (91.05%) was found with 100% sensitivity to identify male sex and 81.1% specificity to identify female sex. There were differences on radiometric variable characteristics in pelvic anthropometric study. The regression formula for sex determination in adults using 3D-CT pelvic provides a pelvic model sex determination with higher validity and sensitivity for male identification, as well as higher a specificity for female identification

Anthropometry study using adult Pelvic 3D Ct For Determining Sexes at Dr. Soetomo General Hospital, Indonesia

Background Pelvic bones are the most reliable indicator of sex in adults because of its sexual dimorphism. Medical imaging modalities e.g. Computed Tomography (CT) provide data sources to examine modern human variation quantitatively. This study aims to determine pelvic anthropometry characteristics and logistic regression formula for adult sex identification obtained from pelvic 3D CT. Methods This study was an observational analytical study with retrospective regression and cross-sectional approach. The population was all patients in Radiology Installation of Dr. Soetomo General Hospital, Surabaya, Indonesia, from September to December 2019 who underwent pelvic 3D CT examination. Then, age distribution and pelvic measurements data were obtained. In this case, statistical analysis was conducted for all the data obtained. Results A number of 204 samples were included in this study. Mean age of the patients was 50.23 ± 14.36 years. All radiologic components were also significantly different between sexes (p < 0.05) except for transverse diameter of sacral segment (p = 0.180). Moreover, eta test was performed and found that APOD, CPID, LIH, TPO, and SPA had the strongest correlation. Those variables were used for making statistical models with logistic regression as sex = (0,125 x CPID) – (0,180 x LIH) + (0,078 x SPA) + 8,912. The calculation result > 0 is a prediction for female while < 0 is a prediction for male. From logistic regression model calculation, a high validity value (91.05%) was found with 100% sensitivity to identify male sex and 81.1% specificity to identify female sex. Conclusion There were differences on radiometric variable characteristics in pelvic anthropometric study. The regression formula for sex determination in adults using 3D-CT pelvic provides a pelvic model sex determination with higher validity and sensitivity for male identification, as well as higher a specificity for female identification

SACRAL FRACTURE TREATMENT WITH A VARIATION OF THE LUMBOPELVIC FIXATION TECHNIQUE

ABSTRACT Spinopelvic instability is an uncommon injury that is caused by high-energy traumas. Surgical treatment is used, in the majority of cases, to restore stability and enable early mobilization. Various stabilization techniques have been used in the treatment of spinopelvic instability, and lumbopelvic fixation (LPF) is currently the technique of choice due to its biomechanical superiority. One of its limitations is the fact that the technique does not directly address the lower sacral segment, permitting a residual kyphotic deformity. This deformity has been attributed to unsatisfactory outcomes, including late development of pelvic floor muscle defects and complications during childbirth. We report a case of a patient with spinopelvic instability due to sacral fracture, which was treated using a variation of the LPF technique, in which rods and screws originally developed for cervicothoracic fixation were adapted to correct sacral deformity in the sagittal plane. The upper sacral segment was reduced indirectly using hip extension and femoral traction manoeuvres, associated with distraction manoeuvres via rods. Bone reduction forceps were used to reduce the kyphotic deviation in the lower sacral fragment, enabling its fixation to the lumbopelvic rod and screws system. There were no complications of infection, suture dehiscence, or breakage of the implants, and at the end of the first year of follow-up, the sacral kyphosis was normal and radiographic consolidation was confirmed. Our technique provides a viable and promising alternative to traditional LPF, making it especially useful in fractures with accentuated deviations of the lower sacral fragment. Level of Evidence: 4.Type of study: Case series