Background and Objective:The purpose of the study was to evaluate the perception of influence of music among surgeons, anesthesiologist and nurses in our hospital as well as to critically evaluate whether music can be used as an aid in improving the work efficiency of medical personnel in the operation theatre (OT).Materials and Methods:A prospective, questionnaire-based cross-sectional study was conducted. A total of 100 randomly selected subjects were interviewed, which included 44 surgeons, 25 anesthesiologists and 31 nurses. Statistical package for social sciences (SPSS) Windows Version 16 software was used for statistical evaluation.Results:Most of the OT medical personnel were found to be aware of the beneficial effects of music, with 87% consenting to the playing of music in the OT. It was also found that most participants agreed to have heard music on a regular basis in the OT, while 17% had heard it whenever they have been to the OT.Conclusions:Majority of the respondent's preferred playing music in the OT which helped them relax. It improved the cognitive function of the listeners and created a sense of well being among the people and elevated mood in them. Music helped in reducing the autonomic reactivity of theatre personnel in stressful surgeries allowing them to approach their surgeries in a more thoughtful and relaxed manner. Qualitative, objective and comprehensive effect of specific music types varied with different individuals. Music can aid in improving the work efficiency of medical personnel in the OT. The study has reinforced the beneficial effects of playing music in the OT outweighing its deleterious outcomes.

A 25-year-old female presented with complaints of pain and discharge from her left thigh since 5 years. She had a history of fall ten years back at her home and sustained fracture of the left femur. She was operated elsewhere and a plate was implanted. Six months after the surgery, she developed pain, swelling and discharging sinus from the wound site. She was treated with empirical anti-tuberculous treatment. Due to persistence of symptoms, the plate was removed one year later. Since then she has been complaining of discharging sinus on and off. On examination, she was found to have puckered scars and sinuses over the posterolateral aspect of distal third of left thigh. Plain X-ray revealed areas of cortical thickening and sclerosis with intervening cystic lucencies in the diaphysis. Mild periosteal reaction with contour deformity of the bone was also seen [Table/ Fig-1a&b].Debridement, sequesterectomy and saucerisation were done and the specimen was sent to Department of Pathology for histopathological examination. Gross examination revealed multiple cysts folded like a membrane with a glistening grey white cut surface and many bony fragments.Histopathological examination revealed viable and necrotic bone with parts of a cyst wall composed of acellular eosinophilic lamellated material surrounded by fibrosis and dense chronic inflammation with foreign body type of multi-nucleate giant cells [Table/ Fig-2a&b]. A few protoscolices of Echinococcus granulosus with a chain of hooklets were seen in the germinal layer [Table/ Fig-2c&d]. Hence a diagnosis of Hydatid disease was made and the patient was started on co-trimoxazole, praziquantel and albendazole. After 7 months, she presented to us with complaints of discharge from the wound site. Debridement from the left femur revealed necrotic spicules of bone, inflammatory granulation tissue and scolices of Echinococcus granulosus, suggestive of residual disease. Magnetic Resonance Imaging (MRI) of femur showed a few small pockets of T2 hyperintense lesions along the anterior, lateral and posterior aspects of mid and distal femur. A re-debridement was done with hypertonic saline wash and antibiotic laden cement was filled in the cortical window. Two strings of antibiotic beads, one in the soft tissue and one in the medullary canal was also inserted [Table /Fig-3 Hydatid disease caused by the larval form of the parasitic tapeworm, Echinococcus granulosus, commonly affects the liver and lungs. Bone involvement by Hydatid is extremely uncommon and is reported in 1-3% of cases. It is often a dormant disease, presenting at a late stage with non-specific clinical and radiological findings. Usually they occur as an isolated entity without liver/lung involvement and a clinical suspicion of this disease is not possible. We report a rare case of Hydatid cyst of femur in a 25-year-old female, with unresolving non-union of fracture for five years. The occurrence of this disease in atypical locations and lack of a specific radiological sign makes the diagnosis challenging and it is ...

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Purpose: The purpose of this study was to study the effects of ankle position on Doppler measurements of popliteal artery (PA) and posterior tibial arteries (PTA) in healthy individuals. Materials and Methods: PA and PTAs of 20 healthy (questionnaire based and ankle brachial pressure index assessed) subjects (40 limbs) were studied with Doppler ultrasound in neutral and after active ankle joint movements. Results: The mean increase in the velocity of PA from neutral position was more with plantar flexion as compared to dorsiflexion (22 vs. 15 cm/s, respectively). PA showed a significant change in waveform, with the absence of diastolic flow, more with dorsiflexion than plantar flexion (46% and 33%, respectively). Similarly, mean increase in the velocity of PTA was more with plantar flexion as compared to dorsiflexion (mean 36.7 vs. 33.2 cm/s, respectively). PTA showed a significant change from triphasic to biphasic and monophasic on plantar flexion (up to 39.2%). Dorsiflexion also showed similar results, however, to a lesser degree. None of the PA or PTA showed complete absence of flow on these maneuvers. Conclusion: Predominantly, a pattern of increase is seen in the mean velocity on plantar flexion and dorsiflexion in both the arteries. The most common change in the Doppler waveforms was the absence of diastolic flow (biphasic pattern). Our study confirms that waveforms in the popliteal and PTA can even be monophasic depending on the position of the foot in normal healthy individuals, therefore, when biphasic/monophasic in appearance, they should not be interpreted as abnormal or diseased.

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