Traumatic posterior dislocation of the sternoclavicular joint is an unusual injury. We report a rare, late complication in the form of a thoracic outlet syndrome. Resection of the first rib resulted in prompt and complete resolution of the symptoms and would appear to be the appropriate treatment, avoiding the complications associated with resection of the clavicle.

BACKGROUND AND AIMAirway management is the medical process of ensuring an open pathway for patient's lungs and ensuring the lungs are safe from aspiration. This study was conducted to investigate the effect of combination of low-dose Fentanyl-Midazolam premeditation on speed of insertion of laryngeal mask airway and to evaluate the laryngeal mask airway easy insertion conditions.

Arterial supply to the humans hand is the most important earning tools, is derived from two arterial anastomotic arches, superficial and deep formed by the anastomosis between two main arteries of forearm. Usually the palmar arterial arches are typical but several variations can occur. For example, the superficial palmar arch may be formed by the ulnar artery alone. So, this study is designed to find out the pattern of palmar arterial arches in the hand. AIMS AND OBJECTIVES: The objective of this study is to evaluate the morphology of the palmar arterial arches and its variation if present so that it may help Anatomists, Micro vascular surgeons &orthopedic surgeons. MATERIALS AND METHODS: 40 upper limbs of 20 cadavers were studied in the Department of Anatomy Nalanda Medical College, Patna. These human cadavers fixed in 10% formaldehyde solution. The male cadavers were 14 and female were 06 in number. Normal pattern of palmar arterial arches and its variation were observed. RESULTS: Superficial Palmar Arch: 40 limbs studied, in which single superficial palmar arch found in 38 limbs, 02 cases deviate from normal which shows double superficial palmar arches. Out of 38 limbs with single SPA, 32 limbs with a complete arch and 06 limbs with an incomplete arch, in the complete arch classical radio-ulnar type found in 31 cases where as in one case it was ulnar type of arch. In complete arch group, 04 limbs (10%) had a blood supply from both ulnar artery & superficial palmar branch of radial artery but without an anastomosis with each other, while in 02 limbs, instead of superficial palmar branch of radial, it was median artery was a source of blood supply along with ulnar artery again without anastomosis with each other. Deep Palmar Arch: In all the 40 limbs, it was a complete arch. The ulnar artery gave 02 deep palmar branches in all cases. In 22 limbs, it was only inferior deep palmar branch of ulnar artery which formed deep palmar arch, the superior branch which contributed to formation of deep palmar arch. It was only 04 cases, both the branches contributed to the formation of deep palmar arch. In one limb the radial artery dipped in 2 nd intermetacarpal space and took part in formation of deep palmar arch with superior deep palmar branch of ulnar artery.

PHACE syndrome was first described by Dr. Ilonia Frieden and colleagues in 1996. It is an under-recognized rather than a very rare condition among patients with large facial hemangiomas. It is challenging as it has significant neurological, vascular and airway implications. Vascular malformations compromising cerebral blood flow predispose the patient to strokes and seizures. Subglottic hemangiomas, if present, could bleed during intubation. Meticulous neurological monitoring is mandatory in those undergoing repair of the great vessels. We describe the perioperative management of a child with PHACE syndrome subjected to dental treatment under general anesthesia.