Innovative Journal of Medical and Health Sciences

Brachial plexus is the nerve plexus which gives innervation to the upper limb. Variation in the formation of brachial plexus is often reported. But variation in the trunk stage of brachial plexus is very rare. In this case report, we report an unusual variation in the formation of trunks of brachial plexus found in an elderly male cadaver during routine dissection. The upper trunk of brachial plexus was normal. The middle and lower trunks fused to form a common trunk. This was observed bilaterally. The upper trunk divided into anterior and posterior divisions. The common trunk divided into three divisions, anteromedial, anterolateral and posterior. The anterolateral division of common trunk joined with the anterior division of upper trunk and formed the lateral cord. The posterior division of common trunk joined with the posterior division of upper trunk and formed the posterior cord and the anteromedial division of common trunk continued as medial cord. The branches arising from the cords were normal.

Background: The initiation and progression of pleural thickening involves the participation of several bioactive substances including matrix metalloproteinases, a class of enzyme that plays a pivotal role in the development of different tissue reactions to insults. Hence, inhibition of matrix metalloproteinase may help in preventing or treating pleural thickening.

Purpose: The purpose of this retrospective  study was to analyze the outcome of ESWL for treatment of renal stone less than 2 cm and to compare the stone free rate and success rate among different stone size groups i.e. less than 10mm, 10 to 15mm and 16 to 20 mm.

Materials and Methods: This was a retrospective hospital record based study. The study population included patients who underwent SWL for a non- obstructive solitary renal calculus < 2 cm without any complications. Patients were divided into three groups according to the size of the calculus. All the patients underwent ESWL as per the departmental protocol.

Results: Mean number of sessions performed was (mean – 1.58, SD +/-1.007) sessions per lithiasis. The success rates for ESWL in solitary renal calculus with size less than 2cm in Upper calyx, Middle calyx, Lower calyx and Renal pelvis were respectively 100%, 97%, 94% and 98%. Overall success rate for solitary renal stone size less than 20 mm was 97%.

Conclusion: ESWL is a safe, non invasive method to treat solitary renal calculus less than 20 mm. Patients with stone size larger than 1.5 cm needs to be discussed for multisession treatment and possible outcome of lower success rate if they are opting for ESWL.