|
| |
 |
|
| ABSTRACT |
|
| Year : 2019 | Volume
: 68
| Issue : 5 | Page : 1-72 |
|
Oral Presentation
| Date of Web Publication | 21-Oct-2019 |
Correspondence Address:
 Source of Support: None, Conflict of Interest: None
How to cite this article:
. Oral Presentation. J Anat Soc India 2019;68, Suppl S1:1-72 |
| A Biomedical Device Innovation: A Method for Accurate Calculation of Volume (Volumetry) of Irregular Embalmed Osseous and Soft Anatomic Specimens, Including Neural Tissue | |  |
Ahmed Al-Imam
Department of Anatomy and Cellular Biology, College of Medicine, University of Baghdad, Baghdad, Iraq
Objective: Morphometric studies are considered abundant and vital in connection with the scientific investigations of Human Anatomy and Comparative Anatomy. The estimation of volume, also known as Volumetry, is integral to these studies although it is not frequently included. This study will explore the concept of an electronic-based estimation of volume (volumetry).
Methods: Several methods exist to measure the accurate volume of bones and specific soft tissue. These techniques are not limited to replica manufacturing, casting techniques, and the implementation of Archimedes' principles of buoyancy and fluid displacement.
Results: Archimedes method will be explored in connection with a prospective biomedical innovation of a device for the purpose of estimation of the size of bones particularly those of variable shapes, dimensions, and highly irregular shapes.
Conclusion: Prospective biomedical innovation of a device for the purpose of estimation of the size of bones particularly those of variable shapes, dimensions, and highly irregular shapes.
Keywords: Biomedical engineering, cast materials, morphometry, replica techniques, volumetry
| Osteometry of Human Femur and It's Applied Significance | | |
S. Jha
Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India
Objective: Osteometry of femur plays a pivotal role in sex determination which has medicolegal and anthropological significance. It has been postulated that dimensions of femur vary with ethnicity, climate, diet and other topographical factors affecting lifestyle. Osteometric measurements differ due to variation in size and proportion of various populations. The objective of the present study is to calculate and analyse femoral dimensions in North Indian population.
Methods: The study was undertaken in 100 femurs (R=51, L=49) of unknown sex for measuring total length, epicondylar breadth, Neck shaft angle, transverse and vertical diameter of head and anteroposterior diameter of shaft at upper, middle and lower ends.
Results: Average length of femur was 417.9+28.0 mm with mean left side length as 419.2+25.9 mm and mean right side length as 416.7+30.1 mm. The average mean epicondylar breadth was 72.64 ± 6.34 mm with mean right epicondylar breadth as 73.11 ± 6.14 mm and left as 72.16+6.58 mm. The average mean neck shaft angle was 121.1 ± 5.22°, mean right neck shaft angle was 119.01 ± 4.3° and left was 123.26 ± 5.85°. The average mean transverse diameter of head was 35.56 ± 3.76 mm, mean right transverse diameter of head was 35.76 ± 3.70 mm and left was 35.23 ± 3.86 mms. Average AP diameter of shaft at upper, middle and lower part are 26.33±2.24, 26.24±2.2 and 28.58±2.52 mm respectively.
Conclusion: Study provides normative data useful for structuring of prosthesis for femur replacement surgeries, imaging modalities and identification of skeletal remains,. This information is applicable to anatomy, forensic medicine, anthropometry, radiology and orthopaedics.
| Morphometric Analysis of Lumbar Vertebra and Its Applied Clinical Importance | | |
S. Banik, A. Rajkumari, A. J. Devi
Regional Institute of Medical Sciences, Imphal, Manipur, India
Objective: i) To measure average bony dimensions of lumbar vertebra in the form of a) Mid-sagittal diameter b) Interpedicular distance c) Anteroposterior diameter of lateral recess ii) To compare findings with other studies and determine normal limits that can guide in assessment of stenosis and other relevant clinical conditions.
Methods: 10 Sets (50 numbers) of fully ossified lumbar vertebrae from L1 to L5 were collected from department of Anatomy of Regional Institute of Medical Sciences, Imphal. Typical and atypical vertebrae were separated. Mentioned measurements were recorded using a digital vernier calliper (Precision 0.01 mm). Sex and age was not considered.
Results: Mean mid-sagittal diameter of vertebral canal at L1-L5 level ranged from 13.10-14.77 mm. Interpedicular distance and anteroposterior diameter of lateral recess ranged at L1-L5 level from 20.24-24.70 mm and 8.73-8.94 mm respectively. There has been reduction in all the diameters at L3 levels.
Conclusion: Present study shows a decreasing diameter at L2-L4 level, mostly at L3. It might lead to canal stenosis and compression of nerve roots leading to neurological manifestations.
| To Study the Correlation between Stature and Bigonial Diameter of Uttar Pradesh Population | | |
Neha Yadav, Vasundhara Kulshreshtha, Shikky Garg, Anjali Gupta
S. N. Medical College, Agra, Uttar Pradesh, India
Objective: The aim of study is to estimate the stature from Bigonial diameter of Uttar Pradesh population & to compare our study with similar previous studies.
Methods: The study was conducted on 300 medical students of both genders aged between 18 to 25 yrs. in department of anatomy, S.N Medical college, Agra. Stature was measured by anthropometric rod & Bigonial diameter was measured by digital Vernier caliper.
Results: There is moderate degree of positive correlation between Stature & Bigonial diameter. The Pearson correlation coefficient was found to be 0.350 & P value calculated was < 0.0001 which is statistically significant.
Conclusion: From present study it has been concluded that like other part of human body, Bigonial diameter can be used for estimation of stature when facial remains are brought for medicolegal examination. In this study regression equation was developed with good reliability & applicability and can be used in maxillofacial & facial reconstructive surgeries.
Keywords: Bigonial diameter, digital vernier caliper, stature
| Nutrient Foramina in the Fibula | | |
A. Bhar, A. Biswas
Malda Medical College, Malda, West Bengal, India
Objective: To study the location, direction, and number of diaphysial nutrient foramina in the fibula.
Methods: Examination of dry bones of unspecified age and sex. Probes and Vernier calipers were used to examine & measure nutrient foramina.
Results: 100 fibulas were studied to identify the location, direction, and number of diaphysial nutrient foramina. The foramen was single in 85%, double in 11%, absent in 4% of cases, and located on the posterior surface in 83% cases. Foramina were anomalously directed in 13% of bones.
Conclusion: This study provides information about the location and number of nutrient foramina in the fibula in a random sample of the Indian population. It is of relevance in orthopaedic and reconstructive surgery of the leg.
| Study of Nasal and Facial Indices among Healthy Volunteers Aged Eighteen to Twenty Five Years in Medical College, Baroda | | |
Maitreyee Kulkarni, Shital Hathila, Dipal Arya, Dipali Ladani, Ila Suttarwala, S. K. Nagar
Department of Anatomy, Medical College, Baroda, Gujarat, India
Objective: The growing role of medicine in improving facial appearance calls for classification of noses and faces. The nasal index is ratio of nasal width to nasal length multiplied by 100 & classifies noses into leptorrhine (69.9 or less), mesorrhine (70-84.9) & platyrrhine (85 & above). The facial Index is ratio of facial width to facial height multiplied by 100. Accordingly, there are five types: hypereuryproscopic (<80), Euryproscopic (79.0-83.9), Mesoproscopic (84.0-87.9), Leptoproscopic (88.0-92.9) & hyperleptoproscopic (>93). Nasal & facial height, breadth & index were measured in 159 subjects and classified for males & females.
Methods: Nasal Height is the distance between nasion & subnasal point. Nasal width is the distance between two alae of nose. Using Hooten's method, Morphological facial height is the distance between nasion & gnathion & Maximum facial breadth being the distance between the two zygomatic prominences or zygion. All the data was measured using digital vernier calliper in millimetres; documented, analysed with Microsoft excel & presented as mean + SD, range & frequency.
Results: Mean Nasal index is 106.46+6.24 in males & 71.94+8.02 in females. In this study major nose type is mesorrhinic (M:79.59%; F:56.36%) and t test value is -26.725 at CI 95% with P<0.0001 showing highly significant difference in nasal index. Mean Facial index is 95.21+8.53 & 92.17+6.87 in males & females respectively and t value is -2.386 at CI 95% with P=0.0182. Further, hyperleptoprosopic is most common in males (51.02%) and leptoprosopic among females (40%).
Conclusion: It is useful in various branches of medicine such as anatomy, forensics, reconstructive surgery, cosmetology, orthodontics, & anthropology.
| Study of Interorbital and Biorbital Distances in Human Dry Skulls of North Indian Population | | |
Anjali Gupta, Reena, Vasundhara Kulshreshtha, Shikky Garg, Anshu Gupta
Department of Anatomy, S. N. Medical College, Agra, Uttar Pradesh, India
Objective: To study the interorbital and biorbital distances in human adult dry skulls and to compare them with the previous studies to find out geographical and racial variations.
Methods: The study was conducted on 100 human dry skulls in Department of Anatomy, S.N. Medical College, Agra. 100 Interorbital and biorbital distances were measured directly on skulls using digital vernier caliper.
Results: The mean value of Interorbital distance is 19.79 mm + 2.39 mm and the mean value of biorbital distance is 93.24 mm+4.37 mm.
Conclusion: The Interorbital and biorbital distances are significant factors that are needed for maintenance of facial symmetry considered during nasal bridge reconstruction, facial cosmetic surgeries and in the design of spectacle bridges.
Keywords: Biorbital distance, human dry skull, interorbital distance
| Sexual Dimorphism in Hand Anthropometric Measurements: A Study in 300 Haryanavi Brahmins | | |
S. Swami, V. Budhiraja, D. Sharma, R. Gupta, S. Bansal, N. Gaur
Department of Anatomy, Kalpana Chawla Government Medical College, Karnal, Haryana, India
Aim: The aim of the present study is to provide a database on right and left hand anthropometric measurements in Haryanvi Brahmins and evaluating its sex differences.
Methods: The present study was conducted on 300 Haryanvi Brahmins (150 of either sex) of age 18 years and above. Three measurements: hand length, hand breadth & shape index were taken using the sliding calliper. All the data so obtained was recorded, tabulated and statistically analyzed.
Results and Conclusion: Mean values of hand length, hand breadth & shape index was more in males as compared to females in Haryanvi Brahmins. The difference in mean values of hand measurements between males & females was highly significant in Haryanavi Brahmins.
Keywords: Hand measurements, Haryanavi Brahmins, sex, skeletal remains
| Morphometric Analysis of Human Adult Dry Radius Bones of Indian Origin for Sexual Dimorphism | | |
Monalisa, Col Subhendu Pandit, Col Sushil Kumar
Department of Anatomy, AFMC, Pune, Maharashtra, India
Objective: The aim of this study is to derive discriminant function formula from the radius bones of forearm, so as to assist the anthropologist in providing information for answering the question “to whom do these bones belong”.
Materials and Methods: The study was conducted on hundred dried human radius bones of known sex. Adult radius bones with complete fusion of all ossification centers were included in the study.
Results and Conclusion: The single best discriminating variable was the distal breadth of radius (DBR), with 92.50% for females and 91.67% for males, whereas the single worst variable was that of transverse diameter of radial head (TDH-R) with 62.50% for females and 81.67% for males.
| Morphologic and Morphometric Analysis of Foramen Magnum | | |
Rinki Chowdhary, Surajit Ghatak, Ashish K. Nayyar
All India Institute of Medical Science, Jodhpur, Rajasthan, India
Objective: To study morphometric measurements, to analyse sexual dimorphism and to determine the incidence of different morphological types of Foramen Magnum.
Methods: The study was done on 35 dry human skulls (21 male and 14 females) in Department of Anatomy, AIIMS Jodhpur. Morphometric measurements of foramen magnum were taken with Digital Vernier calliper. Six standard parameters were measured. The data thus obtained was analyzed by Discriminant function analysis using SPSS 16. Shape of the foramen magnum was analysed for its morphology.
Results: Males displayed larger mean values than females for all the measured variables. Based on sectioning point derived by the discriminant function, a value higher than the sectioning point was considered to be male and value below it considered to be female. The frequency of oval shape was higher in the morphological types.
Conclusion: The dimensions of foramen magnum are helpful in medico legal cases for sex determination of unknown individual as well as it act as a guide to anatomists and neurosurgeons.
| Morphometric Analysis of Acromion Process | | |
A. Priya, A. Jain
Christian Medical College and Hospital, Ludhiana, Punjab, India
Objective: To study and analyse the morphometric parameters of acromion process of human scapulae.
Methods: One hundred and five adult dry human scapulae of unknown age and sex were studied in Department of Anatomy, Christian Medical College, Ludhiana. The length, breadth, thickness of acromion process, coraco-acromial distance and acromio-glenoid distance were measured in millimeter using digital vernier calipers. The measurements were compared with other studies of acromion process done on different population.
Results: The mean and standard deviation of acromial length was 41.65±7.57 mm, acromial breadth was 24.50±2.91 mm, acromial thickness was 7.62±1.34 mm, coraco-acromial distance was 33.35±6.12 mm and of gleno-acromial distance was 29.41±4.65 mm.
Conclusion: Various morphometric parameters of acromion process must be kept in mind by orthpaedic surgeons while performing surgeries like acromioplasty for treatment of subacromial impingement syndrome and repair of rotator cuff tears. It may also be helpful for anthropologists and for medicolegal investigations.
| Anthropometric Analysis of Subjects with Hypertension in Sub-Himalayan Region | | |
I. Bisht, V. Kalia, S. Yadav, S. K. Goyal1
Department of Anatomy, Dr. Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, 1Independent Researcher, Bharatpur, Rajasthan, India
Objective: Anthropometric analysis of the Sub-Himalayan population suffering from hypertension to calculate the cut-off point to predict hypertension.
Materials and Methods: Cross sectional study was carried out on 63 healthy and 51 hypertensive patients. Hypertension was defined as blood pressure more than 140/90 mmHg as per JNC-7 criteria. The patients' characteristics including body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) were noted. Blood investigations including HbA1c and fasting blood glucose were carried out in the institutional laboratory. Mann Whitney U test was used to compare different variables between 2 groups. Cut-off measurement was calculated using ROC curve analysis. Statistical analysis was performed using SPSS v21.0.
Results: Waist size (P=0.001), BMI (0.007), and WHtR (P=0.001) were significantly higher in the patients with hypertension in comparison to healthy controls. The WC, WHtR and BMI cut-off point to predict hypertension was found to be 93.5 cm, 0.54 and 24.58 kg/m2 in men and 88.5 cm, 0.59 and 25.3 kg/m2 in females respectively.
Conclusion: BMI and WHtR were found to be the best indicators to predict HT in males and females respectively.
| Comparative Study of the Dermatoglyphic Patterns in Type-2 Diabetes Mellitus Patients with Non Diabetics of Central Zone of Indian | | |
Zameer Ahmad, P. C. Jain
N.S.C.B. Medical College, Jabalpur, Madhya Pradesh, India
Introduction: DM-2 results from insulin resistance. It is condition in which there is failure to utilise insulin properly, sometimes it is combined with insulin deficiency.
Aims and Objective: To record finger prints in age group 40-60 years and compare the type of finger prints TFR, a-b ridge count and atd angle in DM-2 and non diabetics control group.
Materials and Methods: 100 DM-2 patients and 100 non diabetics control group of age group 40-60 years from diabetic OPD of N.S.C.B. MC & Hospital, Jabalpur were taken for study. We have compared TFR, a-b ridge count and atd angle in Rt. and Lt. hand by Purvis- Smith method.
Results: Whorl & Arches were significantly higher in DM-2 however loops were higher in control group. Analysis reveals that mean difference of blood sugar fasting and blood sugar post prandial, TFR count Rt. and Lt., a-b ridge count Rt. and Lt. and atd angle Rt. and Lt. were significantly higher among DM-2 as compare to control group. Increase in arch, whorl, TFR, a-b ridge count and atd angle were higher in DM-2 in comparison to control group.
Conclusion: This inference may be applied for mass screening of population as an additional diagnostic tool.
| Study of Facial Morphology among Bengali Speaking Population of West Bengal | | |
S. Bharati, A. K. Ghosal1
Nayagram Superspeciality Hospital, Jharagram, 1Department of Anatomy, I.P.G.M.E and R, Kolkata, West Bengal, India
Objective: Facial morphological studies serve anatomists, anthropologists, archeologists, evolutionary-scientists; could benefit forensic-science, dental and surgical specialties; internists, pediatricians, psychiatrists; industries making helmets, respirators, ventilators, spectacles etc. Facial-recognition-technology depends upon similar database that comes useful in computer and smart-phone science; military, law-enforcement, market and financial sectors as biometric-tool. Eastern India particularly West Bengal lacked similar facial database, thus this cross-sectional observational study was undertaken.
Methods: 1060 male and female Bengali-speaking-volunteers of 18-83 years age-range were selected by convenient sampling from five districts of West Bengal; each representing one of the five morphostratigraphic-zones in the state. Five parameters related to facial morphology i.e. Morphological- Facial-Length (MFL), Bizygomatic-Diameter (BZD), Bigonial-Diameter (BGD), Nasal-Height (NH) and Nasal-Breadth (NB) were measured using calipers after obtaining informed-written-consent. Facial Index (FI) and Nasal Index (NI) were calculated. Data analyses, statistical tests of significance were executed. FI and NI values were classified into standard named-categories and their district-wise distributions were noted.
Results: Males had significantly higher values in all five parameters. NI was significantly higher in males but FI demonstrated no gender difference. Except BGD, values of all parameters and indices were significantly different between five districts. Among young-adults, middle-aged-adults and old-adults significant differences were observed only in NH, NB, FI, NI values. There was increasing nasal height, nasal breadth and nasal index with age. Both genders showed significant difference of distribution of various FI-categories among five districts; regarding NI such couldn't be ascertained.
Conclusion: The study was able to establish facial database of Bengali speakers in West Bengal.
| A Morphometric Study of Dry Human Sacra | | |
S. H. Dakare, P. S. Bhuiyan
Seth G. S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
Objectives: Sacral hiatus is the most important landmark for caudal epidural anaesthesia in obstetrics as well as orthopaedic practice for diagnosis and treatment. The volume of caudal space and sacral canal help to know optimum volume of drugs required to reach the appropriate level in caudal epidural anaesthesia.
The aim of this study is to observe morphometric characteristics of sacral hiatus and measure volume of sacral canal and caudal space.
Materials and Methods: This study was conducted on 109 dry human sacra, obtained from the bone library, Department of Anatomy of a tertiary care teaching institutes.
Results: The most common shape sacral hiatus in the present study is inverted U (51.38 %). Second most common shape of sacral hiatus found was inverted V (29.36%). Absent sacral hiatus was seen 1.83% while complete spina bifida and incomplete spina bifida was seen in 1.83% and 2.75% respectively. Apex of sacral hiatus was seen most commonly at S4 with 66.97%. Level of base of sacral hiatus found most commonly at S4 level in 94.50 %. Mean volume of sacral canal was 27.07 cm3. Mean volume of caudal was 16.02 cm3.
Conclusion: Different variations of shape and level of sacral hiatus found in this study will help anesthetists during caudal epidural anaesthesia. In the present study, the method used to detect sacral hiatus using a triangle formed by bony landmarks and the techniques used for measuring volume of sacral canal and caudal space will help clinicians for giving a safe epidural anaesthesia using newer approaches.
| Study of Morphometry of Scaphoid and Its Vascular Foramina in Central Indian Population | | |
Neha Singh Parihar, R. S. Kushwah, P. C. Jain
NSCB Medical College, Jabalpur, Madhya Pradesh, India
Objective: The purpose of this study was to establish the morphometric data for scaphoid and to describe the distribution of vascular foramina of scaphoid in Central Indian population.
Methods: The study was conducted on 200 (100 right and 100 left) dried scaphoid ofunknown sex and age obtained from Department of Anatomy at NSCB Medical CollegeJabalpur. Morphometric parameters were measured with digital vernier caliper. Number of vascular foramina was observed using a magnifying lens.
Results: Various morphometric parameters – Height and width of distal scaphoidtubercle, length and width of dorsal sulcus, width of waist, length and width of scaphoid body and maximum length of scaphoid were measured. There was no scaphoid withoutvascular foramina distal to mid of waist. Number of vascular foramina is more on the dorsal surface than volar surface. Further details will be discussed at the time of presentation.
Conclusion: The morphometric data of this study is useful to assess the length of the screw for internal fixation of scaphoid fracture. Detailed knowledge of distribution of vascular foramina is useful for surgeons to estimate the risk of vascular damage during surgical approaches and hence the likelihood of avascular necrosis.
| A Study on the Incidence and Topography of Wormian Bones in Adult Dry Skulls in Medical Colleges in and around Krishna District, A.P | | |
D. Anusha, Ch. Ratnaprabha, C. Swathi Poornima
Dr. Pinnamineni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, Andhra Pradesh, India
Introduction: Wormian bones are irregular isolated bones interposed between cranial bones. They are termed differently depending upon site of ossification, location and their contact with the sutures. Review of literature showed surplus studies on wormian bones topography with a major emphasis on significant number of wormian bones (SNWB). SNWB are defined as bones more than 10 in number and arranged in mosaic pattern. Other terminology used to describe wormian bones are ossa suturalia, supernumerary ossicles, intercalary, sutural and intrasutural bones. Large wormian bones at lambda are called inca or goethe's ossicle.
Aim: 1. To estimate the incidence and topography of Wormian bones 2. To estimate Siginificant number of wormian bones (SNWB).
Materials and Methods: The present study was conducted in 52 dry skulls collected and observed at various medical colleges in and around Krishna district.
Results: The present study was carried out in 52 skulls which showed wormian bones in 22 skulls (42.3%) and SNWB was observed in 6 skulls (11.53%). Topographically wormian bones were observed more in lambdoid suture (14 skulls), large wormian bones at lambda region in 5 skulls and 3 skulls showed wormian bones in occipitomastoid suture.
Conclusion: Present study clearly states that presence of wormian bones is a frequent observation in dry human skulls which is of clinical significance. The topographical distribution of wormian bones is useful to radiologists from misinterpreting wormian bones as skull fracture.
| Prevalence of Deranged Anthropometric Indices and Life Style Risk Factors of Coronary Artery Disease among Endogamous Groups of North-West India | | |
K. Ram, N. Puri, D. Sahni
Department of Anatomy, PGIMER, Chandigarh, India
Objectives: Coronary artery disease (CAD) is one of the most common cause of mortality and morbidity in both developed and developing countries. The prevalence of CAD and its risk factors have remarkably increased in India. The objective of the present study was to predict the prevalence of the deranged anthropometric indices and life-style related risk factors of the CAD.
Methods: The present study was conducted on 400 young males of Punjab and Haryana between the age group 18-25 years. Subjects were divided into four endogamous groups; Baniyaa and Jatt Sikhs from Punjab, Baniyaa and Jaats from Haryana with 100 subjects in each group. Anthropometric measurements, blood pressure, life-style related risk factors of CAD were recorded. Subjects were classified according to indices, blood pressure and life-style related risk factors of CAD as per latest guidelines.
Results: The prevalence of the deranged BMI 92.5%, low physical activity 59%, stress 82.5%, alcohol intake 30%, smoking 15.5%, junk food intake 87.5%, prehypertension 33% and genetic history of CAD 28% was found in Baniyaa groups of both states while deranged BMI 61.5%, low physical activity 10.5%, stress 27.5%, alcohol intake 60.5%, smoking 14.5%, junk food intake 32.5%, prehypertension 14.5% and positive genetic history of CAD 5.5% was found among Jatt Sikh and Jaats groups of Punjab and Haryana. Alcohol intake (68%) was higher among Punjabi Jatts Sikhs while smoking (25%) was seen significantly more prevalent among Jaats of Haryana.
Conclusion: Prevalence of deranged anthropometric indices and life-style related risk factors of CAD was more prevalent in subjects from Baniyaa Community as compared to Jatt Sikhs and Jaats of Punjab and Haryana.
| Morphometric Study of Adult Indian Dried Femoral Head and Neck in Western U.P. Population | | |
S. Yadav, R. Patel1
JNMC, AMU, Aligarh, 1SIMS, Hapur, Uttar Pradesh, India
Objectives: In human, the largest of long bone femur, forming the skeleton of thigh is mostly covered by the muscle of thigh but palpable towards its upper and lower end. Femur articulates with the hip bone above and with the tibia below and patella lies in front of its lower end. Several attempts have been made to evaluate the proximal end of femur, because of its importance as being one of the commonest site of surgery in orthopaedic surgical practice. Whereas what is normal has been standardized for Caucasians and Chinese, data for Indian population is not prolific. The present study is proposed to remove this lacuna of information about proximal femoral geometry in Indian population which can be used for designing suitable implant for various corrective orthopaedic surgeries.
Methods: The present study was conducted in the department of anatomy SIMS, Hapur on 100 dry femora to measure femoral head diameter & femoral neck length by using digital vernier caliper.
Results: The data was statisticaly analysed and on comparison of femoral head diameter on right side was 42.49 mm¢t 3.07 (36.08 mm- 48.42 mm), on left side 42.89 mm+2.85 (36.28 mm — 48.23 mm). it was greater on left side in comparison to right side and mean neck length on left side was 34.93 mm, and 34.00 mm on right side.
Conclusion: The clinical importance of the above parameters lies in the diagnosis, treatment and follows up of fractures of neck of femur, trochanteric fracture and neurovascular disorders of lower extremity.
| Superficial Ulnar Artery: Developmental and Clinical Significance | | |
P. Saxena, A. Sharma, G. L. Nigam
Department of Anatomy, L.L.R.M. Medical College, Meerut, Uttar Pradesh, India
Objectives: In the upper limb, variations of ulnar artery are very rare. Our objective is to gain knowledge of these variations as they possess important embryological and clinical significance.
Method: The present report describes a case of variation observed in a 70 year old male cadaver in our department during the routine dissection. The upper extremity was dissected carefully and the variations from the normal pattern were noted.
Result: In our cadaver, the ulnar artery is taking its origin directly from the brachial artery in the distal arm or just above the cubital fossa. It crosses the cubital fossa just beneath the bicipital aponeurosis and runs superficially to the flexors of the forearm taking its position more medially. Further near the wrist, it accompanies the ulnar nerve and passes superficially to the flexor retinaculum. It gives a deep branch to the deep palmer arch and continue as superficial palmer arch which gives one proper and three common digital arteries.
Conclusion: The knowledge of the variant position of the ulnar artery, its high origin and superficial course is very useful in operative management of forearm and hand surgeries. This knowledge is also significant for intravenous sampling and canulations etc as well as in performing cardiac catheterization for angioplasty, pedicle flaps, arterial grafting or brachial pulse. So it is important for surgeons, clinicians and anatomists to be aware of possible anatomical variations to avoid unexpected complications.
| Morphometric and Radiological Appraisal of Human Atlas and Axis Vertebrae | | |
N. Xalxo, V. Mehta, M. Kohli
Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
Objectives: To evaluate the morphometric and radiological details, to compare the right and left sided morphometric values and to explore any morphological variations of Atlas and Axis vertebrae.
Methods: 100 human dry Atlas and Axis vertebrae (50 each) were examined using vernier caliper. Additionally, CT scan examination was performed on the atlas and axis of 30 patients in Vardhman Mahavir Medical College & SJH.
Results: A hook shaped bony projection was observed emanating from the superior aspect of transverse process of atlas vertebra. A small conical projections were detected bilaterally emanating from the posterior end of superior articular facet of atlas vertebra overriding the groove for vertebral artery on the posterior arch. An axis vertebra exhibited transversely concave shaped bilateral superior articular facet. Statistically significant difference were observed in the mean length of the superior articular facets of atlas vertebrae and in the mean distance from the edge of the foramen transversarium to the tip of the transverse process. The mean widths of superior articular and inferior articular facets of the axis vertebra also displayed statistical significant difference.
Conclusion: Precise information pertaining to morphometric details and variations of the first two cervical vertebrae is of great importance to orthopaedic surgeons, neurosurgeons and radiologists. The knowledge of these measurements and the variations may enhance the accuracy of screw fixation and prevents inadvertent injuries to neurovascular structures during spine surgeries.
| Effect of Age on the Indices of Mandible: A Radiomorphometric Study in the North-Indian Population | | |
S. Bathla, S. Agarwal, S. K. Rathee1
Department of Anatomy, Lady Hardinge Medical College, New Delhi, 1Department of Anatomy, Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
Objective: To study the effect of age related variations on two radiomorphometric indices of mandible in the North- Indian population of Haryana.
Materials and Methods: This study was conducted in the Anatomy department, Post Graduate Institute of Medical Sciences, Rohtak using 60 adult human orthopantomographs obtained from the department of Periodontology; which were divided into 6 age groups (35-65 years) with equal number of males and females. Two radiomorphometric indices of mandible were measured along the inferior border of mandible; quantifying the width of mandibular cortical bone in the region of mental foramen-Mental Index i.e. MI and Panoramic Mandibular Index i.e. PMI. The variations observed in the values of these indices across the different age groups were statistically analyzed.
Results: The mean MI values ranged from 5.35 mm ± 0.692 mm to 6.735 mm ± 0.508 mm. Whereas, the mean PMI values ranged from 0.293 ± 0.03 TO 0.371 ± 0.017. Both MI and PMI showed a significant negative correlation with age (r= -0.59, -0.719, respectively; p<0.05).
Conclusion: Age had a profound effect on both the radiomorphometric indices of mandible, i.e. MI and PMI.
| Estimation of Sex from Calcaneus by Discriminant Function Analysis | | |
P. Garg, S. Ghatak, A. Nayyar
All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
Introduction: The building of the antemortem profile of an individual from the skeletal remains is the field of forensic osteology and archaeology. Generally large bone like skull, pelvis, humerus, femur and tibia are used to determine the sex and age from the remains. However, in practice these bones often found fragmented or absent and these kinds of fragments are unsuitable for sex determination. Calcaneus is a weight bearing compact bone and shows large difference between male and female.
Methods: In the present study a total of 59 calcaneus of known sex and age were used. A total of nine variables were measured for each calcaneus and data thus obtained was statistically analysed using SPSS software.
Results: In this study all nine variables were found to be statistically significant for sexual dimorphism. Discriminant function analysis was done to determine sexual accuracy and discriminant function equation was derived using direct and stepwise discriminant function analysis. All independent variables were classified in 2 groups and gender was predicted with the help of these variables.
Conclusion: Calcaneus is largest tarsal bone which is able to withstand high tensile forces therefore it can preserve well and can be used for sex determination.
| Estimation of Stature from Length of Arm in Adult Population of Garhwal Region of Uttarakhand, India | | |
Niyati Airan
Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar Garhwal, Uttarakhand, India
Objectives: Stature is defined as the distance between vertex and heel of an individual while standing erect. It is an important anthropometric parameter for establishing the identity of a person, especially when fragmentary body parts are found. It can be assessed using dimensions of different body parts. The present study was aimed to find the relation between stature and length of arm of an individual and to formulate regression equations for the same for adult male and female population of Garhwal region of Uttarakhand.
Methods: A cross-sectional study was conducted among 400 healthy individuals (201 males and 199 females) aged 18-40 years of Garhwal region of Uttarakhand. Stature and length of arm of individuals were measured. The data was analysed statistically using Statistical Package for Social Sciences 17.
Results: The mean stature was found to be 161.37 cm±9.00 cm, mean length of right arm was 30.56 cm±2.07 cm and mean length of left arm was 30.44 cm±2.07 cm. A highly significant (p < 0.01) strong positive correlation was found between stature and length of arm. Regression equations were formulated.
Conclusion: The length of arm is a good predictor of stature of an individual. These findings will help Anthropologists and Forensic experts in establishing the identity of an unknown individual by estimation of stature from fragmentary body remains.
| A Morphometric Study of Neck Shaft Angle of Femur and Its Clinical Importance | | |
Anil Kumar Dwivedi
Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar Garhwal, Uttarakhand, India
Objective: Femur is the longest and strongest bone of the body. It transmits body weight from to tibia in erect position. The long axis of neck of Femur forms an angle of about 135° with the long axis of shaft known as 'angle of inclination' or 'neck shaft angle'. This angle facilitates the movement of hip joint enabling the limb to swing clear of pelvis. Abnormal neck shaft angle may be associated with various clinical conditions ranging from toeing gait in childhood to osteoarthritis in adults.
Methods: The present study was conducted on 280 femora without any gross pathology from three medical colleges of Maharashtra. Out of total femora, 170 femora were of known sex (95 males and 75 females). The data was tabulated and analyzed statistically using unpaired t-test and Pearson's correlation coefficient.
Results: The mean femoral length was 413.42+ 30.32 mm (416.67+ 30.65 mm of right femur and 410.35+29.80 mm of left femur). The mean neck shaft angle was 125.01+11.17 degree on right side and 125.77+ 5.56 degree on left side. The mean neck shaft angle was 125.45+6.06 degree in males and 124.44+14.48 degree in females.
Conclusion: Statistical analysis using unpaired t-test revealed no significant difference (p >0.05) between neck shaft angle of two sides and between male and female. Knowledge of neck shaft angle is important during management of various pathological conditions of hip Joint. The values obtained in the present study will help Orthopaedicians, Surgeons, Radiologists and Anthropologists.
| Study of Sexual Dimorphism in Body of First Sacral Vertebra of Dry Human Sacra in Central India Region | | |
Deepak Sharma, Vandana A. Sharma, Sonia S. Baweja
Department of Anatomy, Gandhi Medical College, Bhopal, Madhya Pradesh, India
Introduction: Human skeleton remains are important material for racial, genetic, anthropological and forensic investigations. Sacrum being the last skeletal remains proves important in sex determination & identification of deceased and first sacral vertebra is last to decay in the sacrum. This study is to validate the selected morphometric parameters and indices related to first sacral vertebra and thus sex determination by the available part of human sacrum.
Materials and Methods: Multicentric study on 282 dry human sacra in central india region was conducted after due permission of institution ethics committee. Transverse, anterio-posterior diameter of S-1 was measured and Index of S-1 was calculated.
Results: Mean value of transverse diameter of first sacral vertebra is 4.78 and 4.46 and Anterio-posterio diameter is 3.07 and 2.89 for male and female sacra with t-value of 4.8839 and 4.2262 respectively & P-value highly significant. Mean value for Index of S-1 for male and female is 8.4429 and 8.9327 respectively with t-value 0.0568.
Conclusion: This multicentric study provides morphometric values of first sacral vertebra that can be used for determination of sex and forensic identification in Central India region. Morphometric indicators of first sacral vertebra can be used for the anatomical and forensic purpose where partial or broken sacra is only skeletal remains.
| Sexual Dimorphism of Menisco-femoral Ligament in North Indian Population | | |
N. Ghalawat, S. K. Rathee
Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India
Introduction: Menisco-femoral ligament is one of the most important accessory ligament of the knee. It connects the fibro-cartilagenous menisci of the knee to the intercondylar area of femur. Menisco-femoral ligaments are two ligaments that connect posterior horn of lateral meniscus to the lateral aspect of medial femoral condyle. One of these passes anterior to posterior cruciate ligament and is known as ligament of Humphry or anterior menisco-femoral ligament. Other passes posterior to posterior cruciate ligament and is known as ligament of Wrisberg or posterior menisco-femoral ligament.
Objective: To study sexual dimorphism in menisco-femoral ligament.
Materials and Methods: Present study was conducted in department of Anatomy in PGIMS Rohtak on 50 human cadaveric knee joint, in which mid-point thickness was measured in both the sexes in two age group (20-40 and 41-60) using vernier caliper.
Results: Mean thickness was measured in both the sexes in two age group and then the results were compared which came out to be insignificant in age group 20-40 and significant in age group 41-60.
Conclusion: Significant sexual dimorphism was seen in this ligament in older age group.
| Anthropometric Analysis of Various Parameters of Hip Bone in Northern India | | |
S. Gupta, S. K. Rathee, V. S. Malik, S. Chandla
Pt. B.D. Sharma, PGIMS, Rohtak, Haryana, India
Introduction: There are differences displayed usually in morphology of pelvic bone or hip bone in two sexes due to different reproductive functions, which are influenced by sex hormones. Though non-metric methods such as visual examination of bone morphology for sex determination is entirely dependent on experience and expertise but anthropometric comparison of various parameters is also important and creates a data which can be useful for sex determination and various other interesting facts.
Aim: Present study was done to find out sexual dimorphism and comparison of various parameters like Chilotic line, Pubic and Ischial length and anterior border.
Materials and Methods: For the present study, 100 (66 male and 34 female) hip bones were retrieved from Department of Anatomy, PGIMS Rohtak. From these two groups, bones were studied for various metrical parameters of hip bone.
Results: Both distances between anterior superior iliac spine (ASIS) to Iliopubic eminence (IPE).
Mean distance between ASIS to pubic tubercle (PT) were found more in males than females on both sides. Ischial length was found more in males as compared to females on both sides. While Pubic length was found more in females than males on both sides. Also it was revealed that Pelvic segment of Chilotic line is greater in females than in males while reverse is true for sacral segment in both sexes.
Conclusion: Sexual dimorphism and bilateral asymmetry of hip bone is appreciated and pubic length is found more in females to explain more room for reproductive functions.
| A Morphometric Study of Femoral Condyle in Gujarat Region | | |
P. D. Elaviya, N. N. Chavda
Department of Anatomy, Medical College Baroda, Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India
Objective: The study purpose is to conduct direct measurements of dried femur bone to record certain morphometric parameters of the femoral condyles. Knee joint is pivotal role in bipedal locomotion encounter frequent traumatic as well as degenerative threats. Study of the anatomy of the femoral condyle is important for design of total joint replacement and internal fixation material.
Methods: Bicondylar depth and width, intercondylar notch depth and width were measured respectively by a single author using vernier calipers and following standardized methods in all 120 study sample of adult dry femur.
Observation and Results: Mean bicondylar width of 120 study samples observed to be 71.04±6.03 mm. Mean bicondylar depth 54.46±4.66 mm. With P0.39 and 0.26 for both parameters respectively, no significant left and right asymmetry could be demonstrated. Mean intercondylar width 20.82±2.78 mm and mean intercondylar depth 25.52±3.26 mm were revealed, sided dimorphism could not be shown with P0.20 and 0.25 for intercondylar width and depth respectively. Intercondylar notch width index obtained in study as 0.294±0.038 with intercondylar notch depth index 0.469±0.052 none having any significant left vs. right variation.
Conculsion: Present study outcome viz. Bicondylar width, bicondylar depth, intercondylar notch width, intercondylar notch depth along with notch width and depth index will play crucial role in field of prosthesis designing.
| Double Foramen Transversarium in Cervical Vertebrae: An Osteological Study | | |
Namita Lugun, Renu Prasad
Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
Objective: The aim of the present study is to investigate the incidence of double foramen transversaria in the cervical vertebrae and its morphological and clinical importance.
Methods: From 28 sets of human skeleton, 196 dried cervical vertebrae were taken from department of Anatomy, RIMS, Ranchi, Jharkhand. All the vertebrae were observed macroscopically for the presence of double foramina transversaria. The reason of accessory foramen transversarium can be developmental or vascular.
Results: Out of 196 dried cervical vertebrae observed, double foramina transversaria were present in 16 vertebrae (8.16%), unilateral or bilateral. Among 16 vertebrae, the percentage of double foramina transversaria is as follows: C4 (0.51%) unilateral, C5 (2.04%) unilateral and bilateral, C6 (2.55%) unilateral and bilateral and C7 (3.06%) unilateral and bilateral.
Conclusion: Double foramina transversaria are more common in lower cervical vertebrae. This variation can be important for the Neurosurgeon during cervical surgeries as under such conditions the course of vertebral artery may be distorted. It can also be useful for radiological diagnosis.
| A Study on the Effect of Body Mass Index on Health of Clinicians | | |
Harpreet Singh Gulati, U. K. Gupta, Ambica Wadhwa
Department of Anatomy, Punjab Institute of Medical Sciences, Jalandhar, Punjab, India
Objective: Clinicians in the present scenario are always exposed to constant and sustained levels of physical and mental stress. As they form backbone of healthcare setup, the health of clinicians themselves is a very significant factor towards providing good health to all. The objective of the study was to determine the effect of Body Mass Index on work related musculoskeletal discomfort and occupational stress in clinicians. This will establish a relation between obesity and psycho-physical health of clinicians.
Methods: The study was conducted in OPD clinics of various departments at Punjab Institute of Medical Sciences, Jalandhar and various private hospitals and clinics of Jalandhar. BMI was calculated as ratio of Weight (kg) to the square of height (m). Work related musculoskeletal discomfort and occupational stress were determined through reliable and valid questionnaires.
Results: Majority (47%) of the clinicians were found to have moderate musculoskeletal discomfort followed by mild discomfort (36%) while 17% of them exhibited severe discomfort. Male clinicians showed more level of discomfort than female clinicians. BMI has high significance in relation to the questionnaire score. Clinicians with high BMI also showed high percentage of moderate and severe levels of occupational stress.
Conclusion: BMI is positively related to physical as well as mental well being of clinicians, especially in the middle age group. This information serves as an awareness and warning signal for the clinicians to safeguard their own health.
| Morphometric Analysis of Infraorbital Foramen and Its Clinical Relevance in Dry North Indian Skulls | | |
A. Mahajan, R. Verma, S. K. Razdan
Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India
Objective: Indian studies done in past on the infraorbital foramen (IOF) have aimed to determine position, shape, size and incidence in the population. In the present study we have tried to enhance the existing knowledge cited in Literature by studying some new parameters in relation to IOF in Indian Skulls which will help clinicians to prevent complications during surgery and regional block anaesthesia.
Materials and Methods: A total of 60 sides (right and left) of unknown sex and age were used for the study in Department of Anatomy Hamdard Institute Of Medical Sciences and Research New Delhi. We studied the morphology of IOF and certain distances of IOF from different bony landmarks using a Vernier calliper. In addition we did measure few parameters found to be relevant with respect to surgeries around IOF which were not commonly cited in Indian literature.
- The horizontal distances of IOF were measured from the anterior nasal spine and nasion
- The vertical distance of the IOF from different premolars and infraorbital margin
- The distance from the anterior border of the infraorbital groove to the infraorbital margin
- The distance between the anterior and the posterior border of the infraorbital groove
- The IOF entry angle.
Results: Most of the measurements were more on the right side. Oval shape of the foramen was most commonly seen. We saw accessory foramen in few skulls.
Conclusion: The results may provide guidance to the maxillofacial surgeons and anaesthesiologists to localize infraorbital foramen and so contribute to better outcome of diagnostic or therapeutic procedures.
| First Exposure to Cadaver by a MBBS Student: A Psychoanalytical Approach | | |
B. K. Dutta, S. K. Mishra, M. Sar, A. Soy, D. P. Bara, Behera, S. Swain
VIMSAR, Burla, Odisha, India
Objectives: To assess the psychological impact of the initial exposure to cadaver by first year MBBS students.
Materials and Methods: 150 newly admitted first year MBBS students were given a set of questionnaire based on the psychological symptoms normally faced by the students in the initial period of exposure to cadaver in dissection hall. Psychological analysis was done separately for male and female students on first day and after 2 months.
Results: There was a marked decrease in the stress symptoms like fear, anxiety, nausea, shivering of hands, head reeling after 2 months. Nausea (48%) was found to be the main symptom among the female students whereas shivering of hands (30%) was more common in male. After 2 months 72% of female students adjusted well with the environment but the number was less in males (57%).
Conclusion: This study emphasizes on creating stress relieving sessions before the first exposure to cadaver to decrease the dropout rates.
| A Morphometric Study on Nutrient Foramen of Humerus in Western Odisha Population | | |
B. K. Dutta, M. Sar, S. K. Mishra, S. Behera, A. Soy, D. P. Bara
VIMSAR, Burla, Odisha, India
Aim: To do a detailed study on Nutrient foramen of Humerus in western Odisha population.
Materials and Methods: 100 numbers of intact humeri collected from anthropology section of Department of Anatomy of VIMSAR, Burla were studied to find out the number, direction and location of nutrient foramina present in each humerus. The total length of each bone and the distance of the nutrient foramen from its proximal end were measured to calculate the foraminal index using Hughes formula. The antero posterior and transverse diameter of the bones at the level of nutrient foramen were measured to assess statistically significant correlation between number of nutrient foramina and size of bone.
Results: 64% of the Humeri were found to have single nutrient foramen, 28% double foramina, 6% triple foramina and 2% of humeri had four nutrient foramina. It was observed that majority (39.3%) of nutrient foramina were present on the medial border followed by 36.5% on the anteromedial surface and 31 % on the posterior surface and 1.37% each on anterior border and anterolateral sueface of the shaft of the humeri. It was also observed that most of the foramina (96.55%) were present in the zoneII followed by zone I (2.06%) and then by zone III (1.37%). All foramina were found to be directed towards the lower end.
Conclusion: This study will provide important morphological and topographical information about nutrient foramina in humerus for orthopaedics procedures.
| A Study on Morphometry of Glenoid Cavity in Dry Human Scapula of Gujarat Region | | |
N. N. Chavda, P. D. Elaviya
Medical College Baroda, Maharaja Sayajirao University of Baroda, Vadodara, Gujarat, India
Objective: The glenoid cavity of the scapula plays a major role in the formation of the joint, as it has got variable morphology. Anatomical variations of glenoid cavity are important for understanding the various pathologies involving the shoulder joints.
Materials and Methods: The present study was conducted on 100 paired dry human scapula (right: 50 and left: 50) from department of anatomy, Baroda medical college, Baroda. Different parameter superior –inferior, anterior-posterior diameter glenoid cavity have been measured with help of digital vernier calipers and glenoid cavity index was calculated. Different shapes of glenoid cavity were observed and photographs were taken.
Results: Different shapes of glenoid cavity are observed inverted comma shaped, pear shaped & oval shaped. The average superior –inferior diameter on right & left sides were 34.37±5.07 and 32.043±5.36, average Anteroposterior diameter right and left sides were 22.58±3.43 and 20.72±4.09, average glenoid cavity index right and left sides 67.42±4.95 and 65.25±12.25 respectively.
Conclusion: Study suggest that the difference in size of glenoid cavity in Gujarat region may have to taken into consideration while deciding the size of the glenoid component in shoulder arthroplasty in this population.
| Morphometry of Orbit from Adult Dry Skull of Central Indian Population | | |
K. P. Mourya, J. Agrawal, D. Gautam, V. Sontakke
Government Dental College, Raipur, Chhattisgarh, India
Objectives: Human orbits are complex anatomical structure which contains visual apparatus along with its neurovascular structures. Morphometric analysis of orbit is of great significance to anthropologists, forensic experts, maxillofacial and plastic surgeons. Orbital dimensions vary with periods of evolution, development, sex, race, and regions within same race as pointed out in previous studies.
Materials and Methods: Orbital dimensions of 50 dry skulls, collected from Department of Anatomy and Forensic Pt. J.N.M. Medical College, Raipur were measured by digital vernier calipers. Orbital height (OH) and orbital breadth (OB) of both sides were measured and orbital index (OI) calculated by applying formula Ol = OH/OB X 100. Data obtained were statistically analysed and tabulated.
Results: Mean orbital height for right and left side were 33.46 ± 3.12 mm and 33.79 ± 3.46 mm while their breadth were 39.79 ± 4.12 and 39.23 ± 34 mm respectively. The mean orbital index calculated was 86.19 ± 5.12 on right and 84.57 ± 5.12 on left side. Maximum orbits measured were of mesosome category. There was no significant difference between right and left side of orbital parameters.
Conclusion: Orbital dimensions measured in present study provides baseline data for ophthalmological and facial reconstructive cosmetic surgeries. The values shows the diversity of orbital morphology in different geographical areas and also useful in better treatment of orbital pathologies.
| Nasio Facial Anatomy of Meitei Males of Manipur: An Inter-generational Comparison | | |
Thoudam Bedita Devi, Binod Kr. Tamang, Th. Naranbabu Singh, S. Jibonkumar Singh
Sikkim Manipal Institute of Health and Medical Sciences, Gangtok, Sikkim, India
Objective: The present study is to examine if there has been any diachronic inter-generational change in the nasio-facial dimensions among the male Meiteis of Manipur during the time span lapse between two successive generations on the others.
Methods: For the purpose of present study, two nasal characters viz. Nasal Length and Nasal Breadth; three facial characters viz. Morphological Facial Height, Morphological Upper Facial Height and Breadth of the Bizygomatic Arch were measured employing the technique laid down by Weiner and Lourie from randomly selected 100 Meitei male adults from 14 villages of Bishnupur district of Manipur. Based on the data three relevant indices viz. Nasal Index, Morphological Facial Index, and Morphological Upper Facial Index were also calculated. The collected data were subjected to appropriate statistical treatment for a meaningful interpretation.
Results: The findings of the data reveal that facial Anatomy of the Meitei males are characterized by Morphological Facial Height, Morphological Upper Facial Height and Breadth of the Bizygomatic Arch having a dimension of 11.58 ± 0.058 cm, 6.59 ± 0.044 cm and 13.28 ± 0.07 cm respectively. As regards nasal anatomy the mean value of Nasal Breadth and Nasal Length are 3.89 ± 0.03 cm and 4.93 ± 0.03 cm respectively. Based on the findings it is observed that there is a positive secular trend of increasing dimension of Nasal Breadth, Morphological Facial Height, Morphological Facial Index, and Morphological Upper Facial Index while a negative secular trend of decreasing dimensionof Breadth of Bizygomatic Arch.
Conclusion: Analysis of the facial and nasal shape reveals a tendency of change from mesoprosopic to leptoprosopic facial morphology and a slightly increased mean value of nasal index in the present population as compared with the previous generation. These observed factual findings besides having importance in human evolutionary understanding would certainly have clinical applications and significance in forensic and nasio-facial surgery.
| Morphometric Study of Upper End of Tibia in Eastern Indian Population | | |
A. K. Pal, S. Mondal
Medical College, Kolkata, West Bengal, India
Objective: The knee joint is essential in bipedal locomotion and is extremely vulnerable to injury and degenerative changes. Upper end of tibia is a component of knee joint. Morphometric study of upper end of tibia is vital to design knee joint prosthesis that will closely resemble native human anatomy.
Materials and Methods: The present study included 100 dry adult human cadaveric tibiae of known gender. Out of these 50 were male samples (25 of right and 25 of left side) and 50 belonged to female category (25 of right and 25 of left side). The following parameters were selected for measurement. 1. Bicondylar width (BCW) 2. Medial condylar anteroposterior diameter (MCAPD) 3. Lateral condylar anteroposterior diameter (LCAPD) 4. Medial condylar transverse diameter (MCTD) 5. Lateral condylar transverse diameter (LCTD). The data were statistically analyzed and compared.
Results: Mean BCW of male and female tibiae were 74.57±2.59 mm and 66.99±2.35 mm respectively. Mean MCAPD of male and female tibiae were 44.46±2.42 mm and 40.20±2.26 mm respectively. For LCAPD the mean values of male and female samples were 38.44±2.67 mm and 35.61±2.57 mm respectively. Mean MCTD of male and female tibiae were 28.42±2.05 mm and 26.33±1.92 mm respectively whereas the mean values of LCTD in male and female samples were 27.49±2.31 mm and 25.78±2.57 mm respectively. All the parameters were found to be significantly larger in male than in female.
Conclusion: Knowledge of proximal tibial measurements will provide design rationale to biomedical engineers engaged in manufacturing prosthesis and implant materials for Indian population.
| Relevance of Mid Arm Circumference as an Anthropometric Tool in Adolescents | | |
S. N. Dutta, A. Tapadar
Malda Medical College, Malda, West Bengal, India
Objective: The present study aims to measure the MAC in an adolescent population and compare them with the meager available data generated from previous studies in an attempt to formulate a “normal” range for comparison with similar studies.
Methods: The MAC was measured in 130 children between the ages of 12 to 14 years using the girth of the arm at the midpoint between the acromial process of the scapula and the lateral epicondyle of the humerus. The data were compared with available previous studies and reference values, if any.
Result: In the present study, the MAC for 12 year olds varies from 18.81 cm to 20.7 cm, for the 13 year olds from 20.4 cm to 20.82 cm and 14 year olds from 21.12 cm to 21.97 cm.
Conclusion: The present study gives us a range of ~19 cm – 22 cm as the range of values for MAC in adolescent boys and girls. In spite of several studies on the values of the MAC in adolescents, no consensus has been reached regarding the cutoff points for determining under nutrition and overweight. Further studies are required on different groups of children in an attempt to publish the normal cutoff ranges of MAC applicable to the adolescent population of our country.
| Sexual Dimorphism of Foramen Magnum in Chambal Region of M.P | | |
Jehan Massarat
Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
Objective: To find out the reference values of foramen magnum dimensions as an alternate area for gender estimation especially for Chambal region of MP.
Methods: CT images of 200 subjects (100 male, 100 female) of 18-65 years of age group from Chambal region, were collected. The largest Antero-posterior and Transverse diameters of foramen magnum were measured using electronic caliper on DICOM viewing software.
Results: The mean (± SEM) Antero-posterior and Transverse diameter of male was 3.596 ± 0.027 cm and 3.046 ± 0.022 cm respectively which were significantly (p<0.0001) greater than those of female with 3.163 ± 0.029 cm and 2.715 ± 0.018 cm respectively. Using Analysis of variance 84% of male and 81% of female Antero-posterior diameter; and 86% of male and 78% of female transverse diameter were sexed correctly. The overall accuracy of correct diagnosis was 85% in male and 79.5% in females.
Conclusion: The above reference values of foramen magnum dimensions by CT scan can be valuable to differentiate male from female skull to some extent as an additional or only method in skull remains, when other parameters were inconclusive in medico-legal cases. Similar studies can be conducted for other regions as well.
| A Craniometric Study of Adult Dry Human Skulls of Eastern Indian Population | | |
Saha Ankana, Mazumdar Sibani1
Lady Hardinge Medical College, New Delhi, 1CNMC, Kolkata, West Bengal, India
Objective: To measure cranial indices and to study the predominant type of skull of Eastern Indian population mostly West Bengal, Bihar and Orissa.
Methods: 115 dry adult human skulls had been collected and studied over a period of 18 months. The skulls belong to the Department of Anatomy and Forensic Medicine of different Medical Colleges and Science College of Kolkata. Cranial measurements were taken by craniometer and cranial indices were calculated and recorded by standard international formula and classified according to standard classifications.
Results: It was found that maximum cranial index was 127.12 mm and 60.75 mm was minimum. The mean cranial index was 75.38± 6.98. Maximum number of skulls (67) were having cranial index <74.90% and minimum number of skulls (6) were having cranial index >85.
Conclusion: Most predominant type of skull in eastern Indian population is Dolichocephalic. This study result goes with the results of previous studies done for identifying predominant skull type in eastern India.
| Identification of Sex from Inion-Opisthocranium-Asterion Triangle in Indian Skull | | |
S. Pal, A. Pal, A. K. Ghosal
Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
Objective: Determination of sex from human skull is of great importance for anatomists, anthropologists and forensic medical personnel from medico-legal point of view. Present study investigated the presence of sexual dimorphism in the dimensions, area and index of Inion-Opisthocranium-Asterion (IOA) triangle.
Methods: 38 male and 32 female skulls were examined using Vernier slide calliper in the Department of Anatomy, IPGME&R, Kolkata. All the parameters were compared between two sexes.
Results: Male parameters were significantly ('P' < 0.05) higher than female parameters. The left IOA index of male (86.97%) was higher than right (85.73%). All other parameters were higher than right side in both sexes. The total area of IOA triangle was 2998.78 mm2 in female.
Conclusion: The anthropometry of IOA triangle can impart an immense value in sex determination of unknown individual.
| Morphometric and Morphological Analysis for Sex Determination of Dry Human Skull | | |
Maitrayee Mondal, Aradhana Sanga, Abhijit Mukherjee
North Bengal Medical College and Hospital, Darjeeling, West Bengal, India
Introduction: Determination of sex from skull by morphological and morphometric analysis has been of interest among researchers. 35 dry human skull of unknown sex were taken for morphometric and morphological analysis. 5 parameters were taken for measurement from Foramen Magnum and from mastoid region with the help of Vernier caliper and analyzed. 13 morphological parameters were also noted. Forman magnum and the mastoid process were well preserved and less likely to undergo changes. Through Foramen Magnum passed vital structures and any change in its morphometric measurement is of interest from clinical point of view. Morphological parameter was found higher in males then than females hence this could be used for sex determination and biological profile constitution.
Materials and Methods: A morphometric and morphological analytical study was carried out in North Bengal Medical College between November 2017 to May 2018. 35 dry human adult skull of unknown sex which did not have any deformity were studied. Digital Vernier caliper was used for taking measurements of Foramen magnum and of mastoid process in Frankfurt's plane. Antero posterior diameter was measured from basion to opisthion. The transverse diameter was measured from the point of maximum concavity on right and left margin. The length of the mastoid process was measured in Frankfurt's plane from its tip to the upper rim of zygomatic arch of both right and left mastoid process. Along with this 13 morphological parameters were used for sex determination. Each measurement was taken by two observers and the average was taken.
Results: The mean AP diameter of Foramen magnum was 24.63 mm transverse diameter was 20.48 mm and surface area was 436.89 mm2 & mean Foramen magnum index was 83.45.
Conclusion: Forman magnum and mastoid process are well preserved regular structure and can be used for sex determination of unknown skull. Knowledge of these dimensions are helpful for neurosurgeons and radiologists in diagnostic procedures with further emphasis laid down by the 13 morphological parameters.
| Mastoid Process: A Parameter for Sex Determination in Western U.P | | |
Khare Raman, Rajni, R. Mishra
Saraswathi Institiute of Medical Sciences Hapur, Uttar Pradesh, India
Objective: Mastoid process is a conical prominence projecting from the undersurface of mastoid portion of temporal bone. Its size vary, it is larger in males than in females. Mastoid process is smaller during childhood. After puberty the mastoid process enlarges. The important role of this bone is that, it is a point for attachment of several muscle the splenius capitis, longissmus capitis, posterior belly of digastrics and sternocleidomastoid, because of these muscle attachments mastoid tend to be larger in males and smaller in females.
Methods: The present study was conducted in the Department of Anatomy, saraswathi institute of medical sciences Hapur, U.P., on 50 dried cadaveric skull. The mastoid measurements were obtained with sliding caliper to the nearest millimeter as per standard anthropological convention and then the size of mastoid process was calculated. Mastoid length, Mastoid breadth, Antero-posterior diameter, Size of mastoid process were measured.
Results: In our study we found that mean of the mastoid length was 28.62 mm, breadth 12.33 mm, A-P diameter was 17.36 mm and size was 61.46 mm.
Conclusion: Determination of sex through skeletal remains is an age old and time tested method. Skull is considered next only to the pelvis in determining the sex, specially the mastoid process which is last to disintegrate. Such knowledge is applied in time of war, crimes, genocides, or mass disaster.
| Facial Anthropometry in Adult Jaunsari Tribe Population of District Dehradun of Uttarakhand | | |
Mohd Salahuddin Ansari, Mukesh Singla, Kumar Satish Ravi, Divasha
Objectives: To study facial anthropometric parameters in adult Jaunsari Tribe of District Dehradun, Uttarakhand. With objectives 1) To study the facial anthropometric parameters of adult male and female population of Jaunsari Tribe of Dehradun district in Uttarakhand. 2) To analyse the sex difference in the facial anthropometric parameters of Jaunsari Tribe if any. 3) and statistical significance of the difference.
Materials and Methods: The study was carried on 100 adult males and 100 adult females of more than 18 years of age, belonging to Jaunsari Tribe, after due approval from institutional ethical committee and informed consent. The methodology adopted for the anthropometric measurements was of Singh and Bhasin (1968) and concerned measurements were done.
Observation and Results: Important data were obtained, observed and analysed. It provided valuable data for the community for future use. It was found that 4%, 11%, 28%, 37%, 20% males and 5%, 14%, 27%, 32%, 22% females were Hypereuryprosopic, Eurypropsopic, Mesoprosopic, Leptoprosopic and Hyperleptoprosopic respectively with little or no variation with gender (p value - 0.6).
Conclusion: So we conclude that majority of male (57%) and female (54%) population of Jaunsari Tribe are having Leptoprosopic and Hyperleptoprosopic type of face. Mesoprosopic is second dominant face type whereas least dominant face type is Eurypropsopic and Hypereuryprosopic with no statistically significant variation with gender.
| Relation of Low Back Pain With Level of Sacral Hiatus in West Bengal Population: An Osteo-Radiological Study | | |
D. Saha, T. Sett, S. Biswas
Deparment of Anatomy, Nilratan Sircar Medical College, Kolkata, West Bengal, India
Objective: This osteological and radiographic study was designed to identify the variations of sacral hiatus in dry sacral bone and association of the variations of sacral hiatus of the patients presented with low back pain. Sacral hiatus is used as a route for caudal epidural block for anaesthesia and analgesia.
Methods: Three hundred and thirty-eight (173 male and 165 female) undamaged adult dry human sacrum and one hundred and sixty-seven (70 male and 97 female) radiographs of spatient with low back pain were included in the present study.
Results: In dry sacrum, commonly observed shape was inverted U (63.58% in male and 67.28% in female sacra). Apex of sacral hiatus was mostly located at S4 level, 73.41% in male and 72.73% in female sacra in dry bone. In radiograph of patient with low back pain, apex of sacral hiatus was observed mainly in S3 level in 47.14% and 46.39% in male and female respectively. Deficient dorsal wall of sacrum was found in 1.16% in male and 3.03% in female in dry bone and 7.14% in male patient and 11.34% in female patient with low back pain.
Conclusion: The patient with low back pain had a higher percentage of dorsal wall defect and higher incidence of sacral hiatal apex locating at S2 and S3 level.
| Facet Joint Arthrosis in Stenotic and Non-Stenotic Vertebral Levels | | |
R. Sethi, V. Singh1
Heritage Institute of Medical Sciences, Varanasi, 1Santosh Medical College, Ghaziabad, Uttar Pradesh, India
Objective: To assess the prevalence and extent of facet joint arthrosis in stenotic and non-stenotic vertebral levels.
Materials and Methods: The subjects within age range of 20-70 years were categorized as symptomatic and asymptomatic on the basis of low back pain (LBP) questionnaire. T2 weighted images from 50 asymptomatic and 50 symptomatic subjects were used to classify into stenotic and non-stenotic vertebral levels. Henceforth, the vertebral levels were grouped as Group I (stenotic levels in asymptomatic individuals) and Group II (stenotic levels in symptomatic individuals) levels. The corresponding facet joints in both groups were analysed and graded for degenerative changes. The data obtained was tabulated and analysed with respect to age, gender, vertebral level and facet joint arthrosis (FJA) disease severity. SPSS 19 was used for statistical calculations.
Results: A total of 300 vertebral levels (L3-L5) of 100 subjects, 50 asymptomatic and 50 symptomatic (M=46, F=54; mean age =42.03+ 13.75 yrs, p>0.05 for age between genders) were studied. The frequency of FJA was greater in group II with statistically highly significant difference for antero-posterior diameter and FJA severity grades between the groups. It was analysed that there is 60% more probability of getting arthritic changes in facet joints in group II than in group I.
Conclusion: There have been studies to show radiological evidences of spinal canal stenosis in otherwise asymptomatic individuals. The manifestation of symptoms usually starts appearing when spinal stenosis is associated with FJA.
| Determination of Normal Spleen Length by Ultrasonography in Gwalior Adults | | |
Rahul Sharma, Rajendra Gupta
Department of Anatomy, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
Objective: The purpose of this study is to establish guidelines and reference values for normal splenic length and its variations by ultrasonographic method in healthy adults (males and females) of Gwalior region.
Methods: A sample of 120 patients (60 males and 60 females) in the age group of 20-60 years were drawn from G.R. Medical College and J.A. Group of Hospitals, Gwalior (M.P.). The patients selected for the study being evaluated sonographically for abdominal or pelvic problem unrelated to the spleen, most often because of urinary tract infection or abdominal pain.
Results: The maximum splenic length was found to be 12.4 cm and minimum 6.5 cm in both gender. The mean splenic length (Mean±SE) in adult males was 9.64±0.19 cm which was significantly greater than females 8.37±0.17 cm with p value < 0.05.
Conclusion: The present study was an attempt to determine the normal range of the splenic length in Gwalior adults which can provide anthropometric parameter of splenic length by USG for radiologists and clinicians and can be used as a reference value for this population.
| Nasopalatine Line: A Tool for Preoperative Planning for Endoscopic Endonasal Surgery | | |
Suniti Pandey, Shailendra Singh, Namrata Jaiswal
G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India
Aim: The endoscopic endonasal approach to Craniovertebral Junction is a challenging surgery for neurosurgeons because The inferior limit of the extent of surgery is limited and varies in each patient. The present study was conducted to assess the nasopalatine line, joining posterior tip of hard palate and inferior end of nasal bone, as a possible tool for preoperative planning for the patient for the inferior extent of reach possible through endonasal route.
Materials and Methods: The study was conducted on 49 Computerized tomographic scans. The length of imaginary nasopalatine line, nasopalatine angle, length of hard palate, distance of hard palate to odontoid process and the distance of point of intersection of nasopalatine line on spine from the base of odontoid process was measured.
Results: The mean length of imaginary nasopalatine line was 10.75 +/- 0.42 cm, nasopalatine angle 24.98 +/- 1.95 degree, length of hard palate 4.73 +/- 0.22 cm, distance of hard palate to odontoid process 3.49 +/- 0.61 cm and the distance of point of intersection of nasopalatine line on spine from the base of axis was 2.2 +/- 0.61 cm.
Conclusion: The inferior extent of reach varies in each patient and the length of hard palate is the limiting factor. Higher is the the nasopalatine angle, lower is the limit of inferior reach in the patient. Thus nasopalatine line is a good tool for preoperative planning of endoscopic surgery through endonasal route.
| Study of the Normal Anatomy and Variations of Portal Vein in North Indian Population: A MDCT Study | | |
V. Sharma, K. Negi, A. Partap, S. Makhaik, K. Chawla
Department of Anatomy, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
Objective: Knowledge of the anatomy of the portal vein and its variations is important for performing surgical interventions, transplantation and other interventional procedures of the liver. While planning for adult right lobe liver transplantation, preoperative examination of potential donors can be carried out by use of multidetector computed tomography.
Methods: The study was conducted on randomly selected 130 North Indian patients who were routinely coming for CT abdomen in the department of Radio-Diagnosis at IGMC, Shimla. The analysis of MDCT abdomen was done for branching patterns of PV and was classified as described by Covey et al. (2004).
Results: Portal vein (PV) variations were identified in 38 out of 130 patients. The prevalence of PV variations in male and female were 28.8% and 29.5% respectively. Trifurcation (Type II) was the most common variant present in 11.5% cases. The next common variant (Type IV) was observed in 6.9% cases, in which Segment VII branch was a separate branch of the right portal vein. Type III i.e. left portal vein was arising after origin of right anterior portal vein (5.4%) and Type V (segment VI branch as separate branch of right portal vein) was detected in 5.4% cases each.
Conclusion: Preoperative or intraoperative lack of awareness of PV variations can result in injury, and their knowledge can reduce the incidence of complications. So, clinically important PV variants should be reported on CT.
| Relationship b/w Placental Thickness and Femur Length in IInd and IIIrd Trimester in North Indian Population | | |
Fatima Begum, Munish Khanna
Pt Jawahar Lal Nehru Government Medical College, Chamba, Himachal Pradesh, India
Objectives: To determine the normal range of placental thickness in north Indian population and to establish its correlation with femur length (FL) according to gestational age.
Materials and Methods: Transabdominal ultrasonography was done in supine position using GE Logic C5 Premium with a 3.5 MHz curvilinear transducer. One of the growth parameters used in estimating gestational age was FL and additional parameter used was placental thickness.
Results: In the IInd trimester, correlation between placental thickness and femur length was calculated and it was 0.98. This was found to be highly significant; p value =0.0001. In the IIIrd trimester, correlation between placental thickness and femur length was 0.73. This was also highly significant; p value =0.0001.
Conclusion: Placental thickness has a strong positive correlation with femur length in both IInd & IIIrd trimesters. We therefore recommend that measurement of placental thickness be carried out, as an additional growth parameter, during routine obstetric ultrasound scan.
| Ultrasonographic Study of Shape of Yolk Sac and Its Correlation with Spontaneous Abortion | | |
G. Srivastava, M. Nagwani, V. Tewari, S. Kunwar1, S. Khanduri2
Departments of Anatomy, 1Obstetrics and Gynaecology and 2Radiology, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India
Objectives: Of the present study is to study the shape of yolk sac in pregnant females, in the first trimester of pregnancy and to find it's correlation with spontaneous abortion.
Materials and Methods: We studied 72 pregnant females, who were in their first trimester of pregnancy, referred by Department of Obstetrics and Gynaecology. The shape of yolk sac was observed by transvaginal sonography and its correlation with spontaneous abortion was studied.
Results: Yolk sac was present in 70 cases (97.22%) and in two cases (2.78%), it was absent. In 68 (97.14%) cases the shape of yolk sac was circular. It was irregular (1.4%) and oblong (1.4%) in one case each.
Conclusion: In 68 (94.44%) cases, gestation progressed normally, while in 4 (5.56%) cases, pregnancy culminated into abortion. Out of 4 cases of abortion, in 2 cases the yolk sac was not visualized. In rest 2 cases (%), yolk sac was either irregular or oblong in shape. A highly significant correlation was observed between yolk sac shape and spontaneous abortion.
| Study of Splenic Dimensions in Relation to Height in Chhattisgarhi Population Using Ultrasonography | | |
Kushal Chakraborty, Manik Chatterjee, S. B. S. Netam
Pt. Jawaharlal Nehru Memorial Medical College and Dr. B R Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India
Objective: To measure ultrasonographically, the dimensions of spleen in adult patients, with relation to standing height (SH).
Methods: After obtaining permission from the College Ethical Committee, this cross-sectional study was conducted in the Departments of Anatomy and Radiodiagnosis in Pt. J.N.M. Medical College and Dr. B.R.A.M. Hospital, Raipur over a period of 6 months, amongst 400 cases (females=239, males=161), aged 25 to 60 years, who came for routine ultrasonography. Individuals not willing to participate; those with history of hematological disorder or tumor; those with history of trauma; those with diseases related to spleen; and pregnant women were excluded from the study. The SH was measured using stadiometer. The individuals were divided into 6 groups in males, The ultrasonographic examination was performed by GEVolusonS8 machine with 3.5 MHz sector curvilinear transducer probe. The patients were asked to lie in right lateral position. Splenic length, breadth and thickness were entered in master-chart which were present along with proforma for the respective patients. SPSS & MS-Excel were used for statistical analyses.
Result: In males, mean splenic length, breadth and thickness was 87±4.64 mm, 37.44±3.89 mm & 30.22±3.25 mm; 92.66±3.54 mm, 41.72±4.2 mm & 34.83±3.59 mm; 99.2±4.83 mm, 47.31±4.84 mm & 36.61±3.07 mm; 102.21±5.56 mm, 48.8±5.02 mm & 38.07±3.45 mm; 110.16±8.17 mm, 54.33±8.63 mm & 44.5±6.99 mm; 121.88±9.31 mm, 65.33±8.21 mm & 48.55±7 mm; in groups (1 to 6) respectively.
In females, mean splenic length, breadth and thickness was 72±3.74 mm, 39.66±3.39 mm & 24.66±3.39 mm; 83.88±7.41 mm, 38.44±5.2 mm & 28.84±3.73 mm; 93.69±5.18 mm, 45.11±6.36 mm & 34.05±3.76 mm; 93.74±6.09 mm, 48.23±6.77 mm & 34.2±4.08 mm; 96.53±6.02 mm, 51.06±5.67 mm & 35.63±2.94 mm; 95.94±4.9 mm, 52.58±8.43 mm & 35±3.62 mm; 108.5±9.5 mm, 73±5.91 mm & 42±3.53 mm; in groups (1 to 7) respectively.
Conclusion: The splenic dimensions (i.e. length, breadth and thickness) increased with increase in standing height (SH) in both, males and females.
| Sonographic Spectrum in Renal Impairment | | |
P. Datta, R. Roy1, S. Datta2
Diamond Harbour Medical College, South 24 Parganas, 1Medical College, 2AMRI Hospital, Kolkata, West Bengal, India
Objective: To study the sonographic changes in renal insufficiency and the role of ultrasound in detecting the type of renal insufficiency (acute or chronic) and its correlation with biochemical parameters of renal impairment (urea and creatinine).
Methods: A cross sectional analytical study was performed in the age group of 20-80 years including both sexes. Two hundred (200) persons were taken as Control, whereas hundred (100) patients – Fifty (50) from each of acute and chronic renal failure group were considered as cases. Gray scale ultrasound along with power and color doppler was used to assess the parameters like renal dimension, cortical echogenicity and cortico-medullary differentiation in control (normal) individuals. The above mentioned renal parameters were assessed both in acute and chronic renal failure patients.
Results: No significant correlation was found between renal length and serum creatinine or blood urea levels in acute renal failure. Whereas, a statistically significant correlation between kidney length and serum creatinine/blood urea levels in chronic renal failure was established.
A statistically significant relationship was also observed between renal cortical echogenicity and serum creatinine level; but not with blood urea level.
Conclusion: Non- involvement of ionising radiation, wide spread availability with low- cost imaging modality makes Gray Scale Ultrasonography, the cornerstone of imaging in renal parenchymal disease.
| Comparison of Gallbladder Wall Thickness in Cholelithiasis and Cholecystitis Patients with the Help of Ultrasonography in North Indian Population for the Estimation of Epidemiology of Gallbladder | | |
Durgesh Singh, Vishram Singh, Richa Tivari1, Ashutosh Tandon1
Department of Anatomy, Santosh Medical College and Hospital, Santosh University, Ghaziabad, 1Department of Radiology, Government Medical College, Saharanpur, Uttar Pradesh, India
Objective: To compare of gallbladder wall thickness in cholelithiasis and cholecystitis patients with the help of ultrasonography in north Indian population for the estimation of epidemiology of gallbladder.
Methods: This was a hospital based case control study. Patients with cholelithiasis and cholecystitis of age between 15-70 years irrespective of gender were included in the study (cases). They were reminded the night before the patents not to eat or drink. Controls were comprised with other abdominal disease diagnosed by ultrasonography. Gallbladder thickness was determined in the fasting state. A total of 36 cases and 14 controls were included in the study.
Results: More than one third of cases (38.9%) were between 30-40 years and 35.7% of controls belonged to age <30 years. The mean age of cases and controls was 42.22±12.81 and 35.43±11.85 years respectively. More than one third of both cases (36.1%) and controls (35.7%) were males. There was no significant (p>0.05) difference in the personal habits like smoking and drinking habits between the groups. Gallbladder thickness was significantly (p=0.005) higher among the cases (4.06±2.28 mm) than controls (2.22±0.67 mm). Full distention of gallbladder was in more than half of both cases (69.4%) and controls (57.1%). Partial distended was in 11.1% of cases and in 21.4% of controls. Contracted (8.3%) and over distended (2.8%) was only seen among cases.
Conclusion: Significantly increased gallbladder wall thickness was observed among the cases compared to controls. if the incidence of gallstones rises, gallbladder cancer most likely will also increase.
| Clinical Anatomy of Ossified Muscles and Ligaments of Scapulae, Hip Bones and Pelves | | |
S. Agarwal, S. K. Agarwal
Department of Anatomy, Government Doon Medical College, Dehradun, Uttarakhand, India
Objective: Enthesopathy involves bones of both the limbs. These abnormal bony growths may impinge on surrounding structures and blood vessels leading to bulk of clinical or physical complications which vary may vary from site of lesion. Knowledge of Enthesopathy will be of great help to Anatomists, Clinicians, Surgeons, Neurologists, Orthopaedicians and radiologists during further course of application.
Methods: Dried human bones 58 (29 right and 29 left) scapulae, 58 (29 right and 29 left) hip bones and 3 pelves belonging to unidentified sex and age were studied closely to exclude all the abnormal ossifications.
Results: Present study showed the presence of complete Transverse Scapular ligament in 9 (5 right sided and 4 left sided) scapulae with the formation of Supra scapular foramina. 10 scapulae of left side and 16 of right side show the presence of triangular bony projection out growing from the lateral border of scapula. Examined hip bone showed the presence of Transverse Acetabular ligament completely ossified in 4 hip bones 2 of right and 2 of left side. Out of 3 pelves, it was observed in 1 pelvis complete ossification of Erector spinae aponeurosis bilaterally on the dorsal surface of the sacrum. Complete ossification of sacrotuberous ligament of right side and sacrospinous ligament of left side compromising the movements of sacroiliac joint and bilaterally ankylosed sacroiliac joints of the pelvis was also observed. It will be discussed in details at the time of presentation.
Conclusion: Descriptive knowledge of variations of manifestations of Enthesopathy involved site may be of immense help to clinicians, radiologists and surgeons to diagnose the disease and come to differential diagnosis with better and accurate interpretation of CT and MRI scans.
| Role of Yoga as an Adjunct Therapy to Conventional Treatment for Improving the Range of Movements in Frozen Shoulder Patients | | |
P. R. Tripathy, M. Jain, R. Manik, M. R. Gaikwad
Objective: This study was designed to look for the short term effect of yoga therapy in patients with frozen shoulder of mild to moderate severity.
Materials and Methods: A prospective randomized controlled trial study was conducted on patients with frozen shoulder patients between 30 and 60 years of age. They were divided into 2 groups: yoga (Y) and control (NY). A set of Asana called “Standing group of Asana” were practiced by Yoga group in addition to the conventional therapy as received by the control group. The patients were reviewed at 0, 1, 2 and 4 weeks. The pain and functional assessment was done at 4 weeks using Shoulder Pain and Disability Index (SPADI).
Results: At the end of four weeks, the SPADI pain score in Y and NY groups were 20.47 and 20.14 respectively (p=0.666). The SPADI disability scores in Y and NY groups were 20.4 and 19.7 respectively (p=0.599). Overall SPADI scores were 40.67 and 40.03 in Y and NY groups respectively (p=0.736).
Conclusion: Both the groups had significant reduction in SPADI scores of pain and disability. However, there was no significant difference between the groups in terms of SPADI scores.
| A Computerized Tomographic Study of Arrested Pneumatisation of Paranasal Air Sinuses | | |
T. S. Gugapriya, Guru T. Arun1
Department of Anatomy, AIIMS, Nagpur, Maharashtra, 1Department of Radio Diagnosis, Trichy SRM Medical College, Tiruchirappalli, Tamil Nadu, India
Introduction: Recent literature have shown a fat transformational and involutional phase proceeding appearance of air in the sinuses. It has also been documented that a process of unexplained interruption in this process ends in arrested pneumatisation of sinuses. Few available studies have detailed about sphenoid and maxillary sinuses. And so this study was done to observe arrested pneumatization in all sinuses.
Methodology: Retrospective computerized tomographic images from the past six month archives were studied. Images with previous surgery in paranasal region, trauma, malignancy and a chronic nasal mucosal pathology were excluded from the study. Welker's criteria were applied to find out the abnormal ossification in the sinus cavities radiologically.
Results: Out of 100 CT images studied, only 14 cases suggestive of arrested pneumatisation according to welker's criteria were found out. In 3 cases it was observed to have more than single sinus involvement. Maxillary and sphenoid sinuses were observed to exhibit arrested pneumatization frequently compared to other sinuses.
Conclusion: These areas of arrested sinus pneumatizations in radiological imaging need to be understood so as to make a distinction between normal developmental remnant from pathologies like fibrous dysplasia or chondrosarcoma of skull base.
| Impaction of Foreign Body in Upper Digestive Tract: Unravelling the Anatomical Perspective | | |
A. Julka, V. Jain, S. Suri, Y. Gupta
MGM Medical College, Indore, Madhya Pradesh, India
Objectives: To identify the commonest site of impaction of foreign body in upper digestive tract and then study the causative anatomical factors leading to this. Foreign bodies in the upper GI tract are usually swallowed, purposefully or accidentally which are more likely to be impacted at cricopharynx or esophagus. Present study result shows pediatric population to be especially at a high risk of foreign body ingestion and our aim is to highlight the anatomical aspects contributing to this.
Methods: A Retrospective study was conducted in the department of Otorhinolaryngology including previous records from 2014 onwards in tertiary care hospital of central India. A total of 160 patients of digestive tract foreign body were taken and categorized according to age, sex, site of impaction and type of foreign body.
Results: The foremost site of foreign body impaction is at Upper esophageal sphincter followed by upper 1/3rd of esophagus and commonest age group is 1-4 years.
Conclusions: Swallowing is not as coordinated and successful as in planned intake of bolus of food. This clearly affects the opening of UES leading to impaction of the foreign body at this commonest site followed by upper 1/3rd of esophagus and piriform fossa thereafter.
| Use of Carpal Bones as Skeletal Maturity Indicators in Indian Pediatric Age Group | | |
Sumit Tulshidas Patil
Background: Bone age assessment is frequently performed in children and adolescents for the evaluation of growth, management of limb length discrepancies, scoliosis and the diagnosis and management of a multitude of endocrine disorders and paediatric syndromes. Carpals are the most important bones in determining skeletal age. Aim of the study is to find out ossification of carpal bones in Indian children and to find which carpals are more affected in their ossification.
Materials and Methods: The ages of ossification centers of carpals at wrist joint have been studied in pediatric age group in Maharashtra state of India. The study included 306 apparently healthy children belonging to lower economic group of both sexes (161 male and 145 female) up to 14 years of age.
Results: Capitate and hamate were first (during first year) and Pisiform (9-14 years) was the last to ossify. In the Indian children first four ossifying carpals were less affected, while later four carpals ossifying during 4 to 12 years were more affected in their development.
Conclusions: Ossifications of the 8 carpals have a definite relation with age and can be considered as a good indicator for age assessment and skeletal maturation in pediatric age groups.
| Radiological Analysis of Relational Anatomy of Vidian Canal and Foramen Rotundum | | |
M. S. Divya, T. S. Gugapriya1, Guru T. Arun2
Department of Anatomy, Melmaruvathur Adiparasakthi Institute of Medical Sciences, Melmaruvathur, Kanchipuram, 2Department of Radio Diagnosis, Trichy SRM Medical College, Tiruchirappalli, Tamil Nadu, 1Department of Anatomy, AIIMS, Nagpur, Maharashtra, India
Introduction: Recent advances in Endoscopic endonasal and transsphenoidal surgeries have made the necessity to clearly understand the positional relation of different vital structures surrounding the sphenoid sinus. At the base of each medial pterygoid plate a canal allows passage of vidian nerve and artery is observed anterioposteriorly. The maxillary nerve exits through the canal seen in the base of the skull called foramen rotundum. Due to lack of relational anatomical studies that describes the vicinity and relation between this two structures in detail, this study was done.
Methodology: Computerized tomographic archived images of coronal section of sphenoid sinus in 154 patients who underwent radiological examination of paranasal region were subjected to this study. Both genders in adult age group were included but those with gross alteration of the paranasal region due to trauma, malignancy were excluded from the study. The vidian canal and foramen rotundum were study in coronal section. Both were classified according to previous reported types. Morphological indexes were used to study the relational position of these structures.
Results: Type I, III vidian canal were observed in equal frequency while Type II was seen less frequently. Type II foramen rotundum was observed maximally. Bony dehiscence of vidian canal roof was seen in 5% cases. The relational distance between vidian canal and foramen rotundum horizontally, vertically, directly was measured to be 5.8 mm, 6.5 mm, 8.5 mm respectively.
Conclusion: The relational analysis between vidian canal and foramen rotundum could provide better understanding of the regional anatomy of paranasal region preoperatively for endoscopic surgeries.
| 3D Printer Technology to Evaluate the Altered Anatomy in Complex congenittal. Heart Diseases and Difficult Face Reconstructive Surgeries | | |
M. Gopalan, K. Mahesh1
Departments of Medical Illustrations, Clinical Skills Simulations, Digital Health and Telemedicine and 1Paediatric Cardiac Surgery, Amrita Institute of Medical Sciences, Kochi, Kerala, India
Aim and Objective: To establish 3-D computer printing technology, an innovative tool to understand the altered anatomy in complex congenital cardiac diseases (CHD) as well in complicated face reconstructive surgeries for congenital/traumatic disfigured faces. The 3-D Computer model of hearts as well faces show the actual interior structural defects of the heart as well the osteo- musculo-cutaneous defects in the face so that the preoperative planning can be made for a successful post surgical result which otherwise not possible by CT and MRI investigations
Materials and Methods: We used 5 patients with CHD and one patient with a huge maxillary tumor on face. The CT and MRI were done, 3-D Computer Printing software, a 3-D Printer and raw materials for printing. The CT MRI are fed in the computer and 3-D models were made using the software
Results: With the CT and MRI of these patients the surgeons were not in a position to understand the actual defects to make a decision. Physical handling of these models and proper surgical planning, helped for a successful postoperative outcome. The new technology of 3D printing produces advantages in the areas of speed, cost, accuracy & simplicity in reconstructive/ corrective surgical procedures
| Measurement of Normal Reference Values of Spinal Canal Diameter and Space Available for Cord at Mid Sagittal Level in Cervical Spine (C3 to C7) in Adult Eastern Indian Population by MRI and Their Relation with Stenotic Symptoms | | |
Jaita Chowdhury, Rajib Kundu1, Madan Karmakar2
Department of Anatomy, Guru Nanak Institute of Dental Sciences and Research, Panihati, Departments of 1Anatomy and 2Radiodiagnosis, I.P.G.M.E and R, Kolkata, West Bengal, India
Objectives: For assessment of cervical spinal canal stenosis, which is not very uncommon presentation among adult age group, specific measurements like the spinal canal diameter (CAD) and space available for cord (SAC) at mid sagittal level are considered very important. Objective was to ascertain normal anatomical reference values of CAD and SAC at C3 to C7 level among local population and their importance in predicting cervical canal stenosis.
Methods: For the study purpose 100 asymptomatic and 50 symptomatic subjects were selected from the patients referred to the MRI unit of Radiodaignosis Department of I.P.G.M.E&R, Kolkata. Parameters for the study were measured by using T2 weighted axial and sagittal images at the respective vertebral level.
Results: After analyzing all the data statistically, the lower margin of normal values (mean -2SD) of CAD and SAC were calculated which were lowest at C3 level (8.7 mm for CAD and 2.2 mm for SAC) and highest at C7 level (10 mm for CAD and 3.8 mm for SAC); when CAD and SAC both were considered as marker of canal stenosis in predicting symptoms, it showed 82% sensitivity and 87% specificity after relevant statistical analysis.
Conclusion: Knowledge of normal reference values of these two parameters in Indian population will be very helpful for the clinicians to predict canal stenosis as well as to decide for the mode of therapeutic intervention. Relative importance of these two parameters to correlate cervical spinal stenosis will be useful, particularly in situation, where decision for surgical intervention procedure is to be taken.
| Surface and Regional Anatomy of “Marmas” in Hand: a comprehensive Cadaveric study | | |
V. Vijaynath, M. Gopalan1
Government Ayurveda College, Tripunithura, 1Department of Medical Illustrations, Clinical Skills Simulations, Digital Health and Telemedicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India
Objective: Study of the regional anatomical peculiarities of the so called” Marmas”-vital points in the Human body.
Materials and Methods: Regional dissection of the cadaver, observation of surface and regional anatomy co-related with the description of marmas in the hand region as in Ayurveda classic-literature and in modern anatomy books
Observation and Discussion: Marma (Vital Point) is one of the most widely described and debated topics in the Ayurveda texts. Susruta, the father of surgery and the author of the treatise Susruta Samhita has mentioned that there are a total of 107 marmas in the human body. An injury in the site of marma will lead to the disabled state of the individual, even fatal catastrophes. Moreover these points are to be approached with utmost care during surgery. Five of the marmas are located in Hand namely Kshipra (Fast), Koorcha (Brush), Koorchashira (Head of brush), Talahrudaya (Heart of palm) & Manibandha (Wrist). Though the location and the signs and symptoms of injury in this region are available in Susruta Samhita, the descriptions given for the anatomical structures like muscles, ligaments, tendons, arteries, veins and nerves need more clarification.
Conclusion: We could give proper anatomical description of the structures related to these “ Marmas” and interpret the applied aspects after cadaveric dissection
| Anatomical Expertise Displayed by Susrutha in the Design of Ancient Surgical Instruments and It's Influence in the Design of Modern Surgical Instruments | | |
Maya Mukundan, M. Gopalan1
Department of Rachana Sareera (Anatomy), Government Ayurveda College, Kannur, 1Department Medical Illustrations, Clinical Skills Simulations, Digital Health and Telemedicine, Amrita Institute of Medical Sciences, Kochi, Kerala, India
Aim and Objective: To validate the Anatomical expertise of ancient Indian Surgeon-Suhrutha in designing the surgical instruments almost like the most modern ones
Materials and Methods: The old surgical Instruments available in the Ayurvedic Hospitals now, the photographs in the Ayurveda books, the modern surgical instruments. Literatures about the development and usage of such instruments in the past
Observations: Susrutha is probably the first Indian surgeon to systematize surgical instruments and describe the method of manufacture, quality control, maintenance, defects, specific usage in the diagnosis as well treatment of diseases. Susrutha Samhitha gives a list of 101 blunt and 20 sharp instruments, most of them having the shape of faces of birds, animals as well certain armaments in the society. Susrutha had developed the instruments based on his experiences in regional anatomy and it's applied aspects.
Conclusion: Susrutha had expert awareness in human anatomy, without which, such descriptions of the minute details of principles and practices of surgeries as well as design of surgical instruments are impractical. It is also confirmed that most of his instruments have astounding resemblance with the modern surgical instruments.
| Morphometric Analysis of Human Atlas and Axis Vertebrae in North Indian Population: Anatomico-Clinical Insight | | |
N. Bachchan, R. Chauhan, M. Kohli
UCMS and GTB Hospital, Delhi, India
Introduction: The constant evolution of surgical techniques for treatment of instability of occipito-cervical junction, atlanto-axial complex and cervical spine warrants an in-depth study of the dimensions of the vertebrae involved along with associated structures.
Objective: a) Obtain data on C1 and C2 vertebrae in subjects of Indian Origin. b) Comparative Analysis of right and left side
Materials and Methods: In the present study two hundred dry human atlas and axis vertebrae (100 each) were studied in UCMS and GTB Hospital, Delhi. Intact vertebra which were free from osteophytes, tumors, structural deformity were included in the study. Different metric parameters of superior and inferior articular facet, dens and vertebral artery groove were measured with a digital Vernier calipers. The results obtained were analyzed statistically.
Results: Comparison of the right and left sides of C1 and C2 revealed that the mean outer and inner distances of vertebral artery groove, the length and maximum width of superior articular facet, the maximum anteroposterior and transverse diameter of inferior articular facet of C1 and the mean of maximum anteroposterior and transverse diameter of superior and inferior articular facet of C2 were more on the left side. The difference between the two sides was stastically significant.
Conclusion: The study found an increased diameter of the articular facets of C1 and C2 on the left side as compared to the right in North Indian Population. Knowledge of such variation may be considered relevant in providing an additional insight to the management and surgical outcome of the clinical conditions of the two sides individually. Awareness of the various parameters will also aid in successful surgical correction in various pathologies of the vertebrae as their dimensions are directly related to the size of the various surgical implants used for correction on the cervical spine and successful management of complicated cases during treatment of cervical instability.
| Osteoporotic Changes in Trabecular Pattern in Upper End of Femur and It's Correlation with Serum Vitamin D Levels in Postmenopausal Women | | |
Pooja Gautam, P. S. Aneja, A. K. Saxena, B. B. Sharma, K. Kumar
Department of Anatomy and Radiology, Shree Guru Gobind Singh Tricentenary Medical College, Gurugram, Haryana, India
Aims and Objectives: Osteoporosis is a major health problem characterised by low bone mineral density and a reduction in bone strength. It is a worldwide medical abnormality affecting older populations, especially women. The aim of the study is to identify the trabecular pattern radiographically in the upper end of femur by Singh index & to correlate it with the values of vitamin D its influence of age in post menopausal women.
Materials and Methods: The study was conducted on 87 pelvis radiographs of post menopausal women who was age between 45-60 years in the department of radiology, SGT Medical College Gurugram. Baseline values are recorded for all women, including age, weight, height, diet & parity. To determine the trabecular pattern by Singh index (Six point scale from grade VI to I), the AP radiographs of the pelvic region including hip joint was taken at a distance of 100 cm in neutral flexion, abduction & 15 degrees of internal rotation. 5 ml of blood was withdrawn under aseptic conditions for estimation of serum vitamin D. Karl Spearman's & Pearson correlation coefficient was used to analyze the parameters under study.
Results: We determine that the Singh index is insignificantly correlated with values of serum Vitamin D (p<0.304) & age is also insignificantly correlated with the vitamin D levels (p<0.104). The evaluation of the Singh index grades in its self, there was a significant relation among them.
Conclusion: On the basis of our findings we found that the Singh index has no significant Correlation with vitamin D levels in assessing the grade of osteoporosis.
| Thoracic Pedicle Morphometry Study on Cadaver and CT scan with Its Clinical Applications | | |
Ashwini Shetty, Ramakrishna Avadhani
Department of Anatomy, Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, India
Objectives: To determine the morphometry changes related to normal ageing and to analyze the difference between the genders and to develop a mathematical model for generating morphometry data from the CT scan and cadaver for precise surgical procedures.
Materials and Methods: Data were collected from the 100 thoracic spine from the medical colleges. Different parameters like PW, PH, TPW, SA, CL were measured and compared it with CT Scan.
Result: We observed in the chord length a significant difference (p < 0.05) between the two measurements for all the thoracic vertebral level (T1-T12) and it is inferred that direct measurement value is higher compared with CT value. PH of the thoracic spine showed no significant difference (p > 0.05) between the direct measurement and the CT measurement in T3 and T8, but in other vertebral level there is significant difference (p < 0.05) between direct measurement and CT. A significant difference (p < 0.05) between direct measurement and CT measurements in the TPA was observed except at the level of T4.
Conclusion: There is a positive correlation between the direct measurement and CT measurements in most of the vertebral levels for the cadavers used in this study. An attempt was made to establish a relationship between the two measurements (direct and CT measurements) so as to estimate true pedicle morphometry from CT measurements for all the parameters in the different vertebral levels.
| Ultrasonographic Measurement of Renal Dimensions: It's Correlation with Body Surface Area in Adults | | |
B. C. Dutta, J. K. Sarkar
Silchar Medical College and Hospital, Silchar, Assam, India
Objectives: The aim of the present study was to ascertain the renal dimensions in adult by ultrasonography. Our objectives was to correlate the length, breadth and thickness of kidney with somatic parameters like age, sex, height and body surface area in both sexes.
Methods: This study was carried out on 118 patients (51 male & 67 female) taking measurements of 236 kidneys having no radiologic or pathologic evidence of renal diseases. Mean with standard deviations of length, breadth and thickness were calculated. The volume of the kidney was calculated by using the formula: cm3. Renal dimensions of right were compared with the left. The volume of the kidney was correlated with age, sex, height and body surface area.
Results: The present study revealed that the volume of left kidney was more than the right in both male and female. The size of kidney in male was larger than female. The volume of kidney showed linear relationship with the body surface area both in male and female. However, volume of kidneys decreased from sixty years of age.
Conclusion: Measurements of renal dimensions can be obtained quickly and easily with ultrasonography having advantage of not exposing the patients to ionizing radiation. This allowed us to find differences in relation to age, sex, weight and height. There is a gender difference in adult kidney sizes. The renal length is correlated best with height and body surface area.
| Morphometric Study of Anterior Communicating Artery and Posterior Communicating Artery in Patients Undergoing Digital Subtraction Angiography Evaluation | | |
Suyashi, S. G. Dixit, A. K. Nayyar, P. Khera, S. Ghatak
All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
Objectives: Morphometric study of anterior and posterior communicating artery and to establish significant differences, if any, with sex, age and side related dimorphism in patients taken up for Digital Subtraction Angiography evaluation.
Methods: The present cross-sectional study was conducted on 57 patients by Digital Subtraction Angiography in the Department of Anatomy and Radiology at All India Institute of Medical Sciences, Jodhpur. Length and diameter of anterior communicating artery (ACoM) and posterior communicating artery (PCoM) were measured on antero-posterior and lateral projection respectively.
Results: Mean diameters and lengths of ACoM and PCoM (right and left side) were calculated in 57 patients. The data was divided in different age groups 20-40 yrs, 41-60 yrs, >60 yrs and gender wise. There was no significant difference between male and female (ACoM and PCoM) as well as between right and left side PCoM both in diameter and length. Mean length and diameter for ACoM is maximum in age group 40-60 yrs whereas for PCoM its 20-40 yrs. 14% have hypoplastic PCoM artery.
Conclusions: The present study has helped to generate a normative data of Indian population using DSA which remains the most accurate imaging technique for evaluation of cerebrovascular system. ACoM and PCoM aneurysms frequently rupture. PCoM hypoplasia is also a major contributor to the risk of ischemic stroke. Morphometry of these arteries and their correlation with age, sex and side related dimorphism is crucial to plan intravascular and neurosurgical interventions.
| Hydrogen Sulphide is a Unique but Ubiquitous Gasotransmitter: A Solution for Therapeutic Dilemma in Preeclampsia? | | |
Renu Dhingra, Sunil Gupta, Sankat Mochan, Neerja Bhatla1, Kalpana Luthra2, Arundhati Sharma, Pallavi Kshetrapal3, Shobhit Saxena, Pallavi Arora, Neerja Rani
Departments of Anatomy, 1Obstetrics and Gynecology and 2Biochemistry, All India Institute of Medical Sciences, New Delhi, 3Paediatric Biology Centre, Translational Health Science and Technology Institute, Faridabad, Haryana, India
Objectives: To determine and compare the mRNA and protein expression of H2S producing enzymes (CBS and CSE) between preeclamptic patients and normotensive, non-proteinuric controls.
Materials and Methods: A total of 60 women (30 PE patients and 30 normotensive, non-proteinuric controls) were recruited from Department of Obstetrics and Gynaecology, AIIMS, New Delhi after taking permission from Institute Ethics Committee and written informed consents from all the women were taken. ACOG guidelines were followed for the recruitment of PE patients. 5 ml of blood was withdrawn followed by plasma separation. Plasma samples were used subsequently for determination of mRNA levels of CBS and CSE by qRT-PCR. Thirty patients were followed for the collection of placentae (15 PE patients and 15 controls). mRNA levels were determined by qRT-PCR from the tissue samples collected with punch biopsy from central area of placentae and kept in RNA later. Four sections from central area of placenta were also taken, followed by fixation in 4% paraformaldehyde and then processed for paraffin embedding. Five μm sections were cut and stained for determination of protein expression of CBS and CSE by immunohistochemistry and immunofluorescence.
Results: CBS and CSE mRNA levels were significantly down regulated in Preeclamptic patients [plasma samples: CBS (10 folds; p<0.05); CSE (5 folds; p<0.05), placentae: CBS (3 folds; p<0.05); CSE (8 folds; p<0.05)] as compared to normotensive, non-proteinuric controls. In placentae, immunofluorescence and immunohistochemistry staining revealed localization of CBS and CSE in the syncytiotrophoblasts, endothelium of foetal vessels from the chorionic and stem villi and their expressions were raised in controls as compared to patients. Also, CBS expression was seen in Hofbauer cells and CSE in macrophages.
Conclusion: The present study provides novel insights into the expression of H2S producing enzymes in pregnant women with and without preeclampsia. The reduced expression of these enzymes in PE may point towards the role of H2S in the regulation of human placentation and provide insights for pharmacological interventions.
| To Study the Effect of Protein Energy Malnutrition in Children of upto 5 Years of Age | | |
Shelja Sharma, Vivek Mishra, Vasundhara Kulshrestha
Objective: Protein energy malnutrition (PEM) has significant effect on bone maturation delay. Most studies have been done on carpals and metacarpals to show bony maturation delay. This study has been done on tarsals, metatarsals & lower end of tibia & fibula of protein energy malnourished children of upto 5 years of age.
Materials and Methods: study group consisted of 68 malnourished children of various grades of PEM attending OPD and wards of paediatrics Department and equal no.s of healthy control of upto 5 years of age of Agra region. X ray of foot done in both group to show any delay in appearance of ossification centres and surface areas of tarsal bones.
Results: As grade of protein energy malnutrition increases, there is significant delay in age of appearance of tarsals. As talus, calcaneum and cuboid were present at birth, no retardation was seen but there was significant delay in age of appearance of ossification centres in cuneiforms, navicular and lower end of tibia and fibula in PEM of various grades by about one to one & half years as compared to controls. There was also significant decrease in surface area of tarsals in various grades of PEM children.
Conclusions: PEM has significant deleterious effect on bone maturation. In moderate to severe degree of malnutrition, there was significant delay in age of appearance of ossification centres and surface area of tarsals were also reduced in PEM children as compared to healthy controls.
| Study of Anencephaly Using Ultrasonography in Pregnancy | | |
Nivargi Shubha
Department of Anatomy, SIMS and RC, Bengaluru, Karnataka, India
Background: Anencephaly is an embryological malformation of the central nervous system, characterized by the absence of the brain and cranial vault and by other defects of the cranial structures due to the failure of fusion of the cranial neural tube.
Aims and Objectives: The purpose of this work was to study anencephaly in pregnancy using ultrasonography.
Materials and Methods: 50 pregnant women of second trimester were studied using ultrasonography attending the antenatal clinic in the department of OBG who were referred for routine ultrasonography.
Observations: General physical examination of the pregnant women was done. Age of the patient and the gestational age were noted. Fetal head circumference, Fetal abdominal circumference, Fetal biparietal diameter and amniotic fluid index were observed using ultrasonography.
Results: During this study two cases of anencephaly were observed of which both the cases were associated with polyhydramnios. Any associated findings were noted.
Conclusion: Anencephaly is fatal and leads to stillbirth or early neonatal death. Early diagnosis of anencephalic cases either through the biochemical markers or on the ultrasound scan is possible and advised. Most cases of anencephaly are diagnosed and can be managed before viability. Efficient prenatal care can prevent this anomaly.
| Pattern of Alcohol Consumption among Adults and Elderly Men: A Community Study in Uttarakhand | | |
Kumar Satish Ravi
All India Institiute of Medical Sciences, Rishikesh, Uttarakhand, India
Introduction: Alcohol is one of the leading causes of the death and disability globally. About two billion people worldwide consume alcoholic beverages and about one-third (nearly 7.6 million) are likely to have one or more diagnosable alcohol use disorders. In India, the economic returns from alcohol override public health issues- with the situation being one of “getting less and losing more”.
Objectives: To know the case of alcohol depending on age, education, other socio-demographic characteristics, type of drink in Uttarakhand Population.
Materials and Methods: This is a cross sectional study. In the present study we will include four different geographic settings (urban, rural, town and slum) of Uttarakhand. A simple random methodology will be adopted. One hundred cases from each geographical setting will be interviewed to assess the pattern of alcohol consumption.
Results and Outcome: The present study will be significant as we can assess the pattern of alcohol use in Uttarakhand population depending on age, education, type of drink & other population socio-demographic characteristics that are detrimental to health and potentially cause harm, either immediately or can be long term effects. In the absence of a public health driven alcohol policy; waxing and waning implementation of existing legislation and greater influence of the process of globalization, urbanization and migration, the problems due to alcohol use are bound to increase in the coming decades. The present study will indicate the need for different strategies to prevent and control alcohol use problems, particularly in transitional and underprivileged areas of Uttarakhand.
| The Septation of the Sphenoidal Air Sinus: A Cadaveric Investigation | | |
N. P. Ngubane, L. Lazurus, C. O. Rennie, K. S. Satyapal
Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, University of KwaZulu Natal, Durban, South Africa
Objective: The purpose of this study was to investigate the sphenoidal sinus septation in a select South African population, and document the relation of the number and location of the septa to the structures intimately related to the sinus.
Methods: The intersinus and intrasinus septa of the sinus, the number and attachments of the septa were recorded from 45 cadaveric specimens.
Results: The sphenoidal sinus intersinus septa were recorded as follows: Type 0 (absent septum) in 7.5%, Type 1 (single septum) in 65% and Type 2 (double septa) in 27.5% of cases. The incidence of intersinus septa deviating to the left was prevalent (30%), hence, the right sphenoidal sinus was dominant. The occurrence of intrasinus septa was observed in 93.3% of cases, with a higher prevalence in males. The intrasinus septa formed cave like chambers on the sinus walls in 65.6% cases. Incidences of the intersinus septa attaching to sella turcica (ST) (41%) were prevalent compared to cases where they attached to the internal carotid artery (ICA) (5.6%), maxillary (MN) (1.1%) and vidian (VN) (1.1%) nerves. However, the intrasinus septa attached more to the ICA (45.6%) compared to their attachment to the other neurovascular structures (ST – 22.2%; MN – 7.8% and VN – 1.1%).
Conclusion: Surgeons need to be aware of the complex anatomical variations of the sphenoidal sinus septation when performing endoscopic endonasal trans-sphenoidal surgeries.
Keywords: Cadaveric head specimens, endoscopic endonasal trans-sphenoidal procedures, paranasal sinus, septation, sphenoidal air sinus
| Assessment of Portal Vein Diameter in Relation ot BMI and Height in Apparently Healthy Adults: An Ultrasonographic Study | | |
Shikha Singh
Objective: Study aimed at assessing the mean portal vein diameter based on height and body mass index using USG in north Indian population.
Materials and Methods: A total of 300 healthy adults (198 males and 102 females) were included in the study. Portal vein diameter was measured in supine position and normal respiration by grey scale ultrasonography. Participants' heights were measured while standing against a meter rule with the head in Frankfurts' position and weight measured using a weighing scale. The portal vein diameter was correlated with height & body mass index statistically using independent Student's t-test and ANOVA.
Results: A positive correlation was observed between the portal vein diameter and height. In same height category portal vein diameter did not show any significant difference between two sexes. For body mass index negative but non-significant correlation with portal vein diameter was observed. Males showed higher portal vein diameter then females in all body mass index categories.
Conclusion: PV diameter is influenced by anthropometric parameters in the given subset of population. The information will be helpful in prompt diagnosis and management of portal hypertension.
| The Anatomy of the Coronary Ostia and Its Relation to the Sinotubular Junction | | |
J. S. Luckrajh, L. Lazarus, K. S. Satyapal
University of KwaZulu-Natal, Durban, South Africa
Objective: The coronary ostia (CO) lie within the left and right aortic sinuses of Valsalva and are bound by the sinotubular junction (STJ) superiorly. The high frequency of cardiac procedures that require cardiac catheterization has necessitated a reappraisal of the anatomy of the coronary arteries. This study aimed to describe the CO by recording its diameter, shape, and relation to the sinotubular junction.
Materials and Methods: A total of 50 adult cadaveric hearts were dissected.
Results: The average diameter of the right coronary ostium (RCO) was 3.29 mm and the left coronary ostium (LCO) was 3.87 mm. With regard to shape, the RCO was described as circular in 52%, horizontally oval in 24% and vertically oval in 24% of cases. The LCO was circular in 30%, horizontally oval in 60% and vertically oval in 10% of cases. The RCO was located below the STJ in 88% and at the level of the STJ in 12% of cases. The LCO was recorded below the STJ in 64%, at the level of the STJ in 32% and above the STJ in 4% of cases. Multiple ostia were recorded in both the right aortic sinus (12%) and left aortic sinus (2%). In 2%, the RCO was anomalously located in the non-coronary sinus.
Discussion: Variations of CO, although asymptomatic, have been linked to myocardial infarction and sudden cardiac death. It is therefore imperative for the clinician to be aware of variant CO anatomy, which may alert them to the predisposition of cardiac risks.
| Gender and Age Based Comparative Study of Joint Space Width of Hip Joint in Plain Radiographs of Adult Indian Population | | |
K. S. Sindhu, R. Shubha1
Department of Anatomy, St. Johns Medical College, 1Department of Anatomy, Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India
Objectives: Knowledge of the various bony components of the hip joint will be of immense importance to Orthopaedicians in finding the right implant - patient match in hip joint replacements, in construction of suitable prostheses, in early detection of disputed sex by forensic experts etc.
The objectives of this study is to measure Joint Space Width of hip joint in anteroposterior radiographs and it will be compared between the two sides in each gender also between the two genders on each side and lastly between the two genders irrespective of side.
Materials and Methods: X ray of hip joint of 147 males and 117 females, (20-90 years). Using Dicom viewer software for linear measurements. P value ≤ 0.05 significant.
Results: The value of JSW was considered statistically significant only in case of right side of males and females, where the p value was found to be < 0.001. Higher mean joint space width value was recorded on right side when compared to the left side.
Conclusions: From the results it can be concluded that the parameter Joint space width should be taken into consideration during total hip arthroplasty and fixation and treatment of fracture neck of femur.
| Anatomical Variations in Great Saphenous Vein and Related Venous System of Lower Extremity in Varicose Vein Patients: Based on Doppler Sonography Evaluations | | |
Raj Priyanka, Prasad Rashmi
Patna Medical College and Hospital, Patna, Bihar, India
Objective: To assess the anatomical variations in great saphenous vein (GSV) and related venous system in lower extremity (LE) in varicose vein (VV) patients attending Patna Medical College and Hospital, Patna with dopplersonography (USG) evaluations.
Methods: In varicose vein (VV) patients, veins become enlarged and twisted, which are most common in the superficial veins of LE especially in GSV and its tributaries, although it may occur elsewhere. My study conducted on 110 VV patients attending PMCH, Patna, during August 2017 to June 2018. They were followed in their Doppler USG evoluation prospectively. Variations found at various level in lower extremity superficial venous system.
Results: (i) At SaphenoFemoral Junction – In 56/220 LE (26%) External Pudendal Artery (EPA) crossed GSA anteriorly and in 30/220 LE (14%) EPA crossed posteriorly to GSV trunk. In 44/220 LE (20%), bifid LSV was found.(ii) Number of tributaries to GSV varied from 2 to 7. In 130/220 LE (53%) GSV have five tributaries, in 67/220 LE (30%) have three and in 23/220 LE (10%) four tributaries are found. (iii) At SaphenoPopliteal Junction- Short saphenous Vein (SSV) joined popliteal vein of 5 cm above popliteal bend in 146 LE (66%), 12 cm above popliteal bend in 66 LE (30%) and below the popliteal bend in 8 LE (4%). A giacomini vein was found in 4 LE (2%).
Conclusion: Clear and precise understanding of lower extremity (LE) venous anatomical variation is very helpful in adequate and safe surgical treatment of varicose vein. If remain unnoticed, then inadequate surgical treatment may lead to failure and recurrence.
| Variations Observed in Branching Pattern of Brachial Arteries of South Kerala Region | | |
V. Harsha, Praful S. Jevoor
Malabar Medical College and Research Centre, Calicut, Kerala, India
Introduction: Knowledge of the normal and variant anatomy of the arteries of upper extremity is of much clinical importance for the vascular surgeons for interventional and surgical procedures, like percutaneous arterial catheterization, treating cases of aneurysms and abscess drainage in the axilla, for arterio-venous fistula during dialysis, and for the purpose of preventing any complications arising from accidental damage to the vessel. Knowledge of the variations are also important to treat chronic renal failure and for plastic surgeons using flaps for reconstructive surgeries.
Aim: To study the variations in the branching pattern of brachial arteries.
Methods: The present study was undertaken on 50 upper limbs of both sexes from embalmed human cadavers used for undergraduate dissection in the department of Anatomy, Malabar Medical College, Calicut.
Results: In the present study, variations were found in 15 specimens (30%). Among these, ten specimen showed variations in the origin of profunda brachii artery (20%), two specimen showed high division of brachial artery (4%), three specimen showed lower termination below the neck of radius (6%). Among this lower termination, one showed trifurcate termination of brachial artery, one with radial siphon, and another showed ulnar siphon.
Conclusions: Accurate anatomical knowledge of the brachial artery and its branching pattern with their variations are important for physicians, cardiologists, vascular surgeons and interventional radiologists. Study of these variations and its awareness helps in avoiding the injuries of the blood vessels, in treating accidental and traumatic injuries of upper limb and as well in diagnostic procedures, like arteriograms.
| Evaluation of Polymorphisms at 3' Untranslated Region in HLA-G Gene with Susceptibility to Rheumatoid Arthritis | | |
S. Gautam, U. Kanga1, M. Kumar, A. Goswami, U. Kumar2, R. Dada
Department of Anatomy, Laboratory for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, Departments of 1Transplant Immunology and Immunogenetics and 2Rheumatology, All India Institute of Medical Sciences, New Delhi, India
Objective: HLA-G plays a role in the regulation of inflammatory processes and immunomodulation in autoimmune diseases. There are controversial reports concerning the impact of HLA-G gene polymorphism on rheumatoid arthritis (RA). This study was aimed at examining the impact of 14 bp ins/del (rs66554220) and +3142G>C (rs1063320) polymorphism with susceptibility to disease in RA patients in our population cohort.
Methods: Genomic DNA from 90 RA patients and 90 healthy controls was isolated using the salting out method. Genotyping of HLA-G +3142G>C and 14-bp ins/del variants was done by polymerase chain reaction restriction fragment length polymorphism (PCR-RFP) and PCR method, respectively.
Results: The HLAG +3142G>C polymorphism significantly decreased the risk of RA in codominant (OR =1.2, 95% CI =0.63-2.2, p =0.5911, GC versus GG; OR =0.2, 95% CI =0.05-0.7, p =0.0059**, CC versus GG), recessive (OR = 0.2, 95% CI =0.04-0.59, p = 0.0024**, GG + GC versus CC), and allele (OR =0.7, 95% CI =0.5-1.1, p =0.1215, G versus C) inheritance models tested. Our finding did not support an association between HLA-G 14 bp ins/del variant and risk/protection of RA.
Conclusion: In summary, our results showed that HLA-G +3142G>C gene polymorphism might contribute to decrease the risk of RA in our population cohort.
| Ultrasonographic Estimation of Fetal Gestational Age by Fetal Kidney Length, in Tertiary Care Centre Gwalior | | |
Reeta Kushwah, Rajendra Gupta
Department of Anatomy, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India
Objective: In this study we evaluated ultrasonographically the kidney length for the assessment of gestational age and foetal growth and to compare this parameter with other routinely used parameters such as the BPD, FL.
Materials and Methods: This cross-sectional study was done with 100 pregnant women with low risk pregnancy, ranging from 18-40 weeks of gestation at the Department of Radiodiagnosis and Department of Anatomy, G.R. Medical College, Gwalior (M.P.). The period of gestation was calculated by LMP and clinical examination. Further, for all these patients several geometric parameters i.e. biparietal diameter, femur length and kidney length were obtained and compared.
Results: The coefficient of correlation: BPD (R2=0.988, p value < 0.01) and KL (R2=0.962, p value < 0.001) were observed in the present study. They showed high degree of linear progressive relationship with gestational age. Femur length is very reliable and consistent marker of gestational age even when BPD cannot be relied upon, as in late third trimester, after the head is engaged and in cases of hydrocephalus, ancephaly and dolichocephaly. A statistically significant positive correlation was found between the kidney length and gestational age (R2=0.962) indicating it to be a reliable indicator of gestational age especially towards the third trimester.
Discussion: As kidney length is independent of foetal head, it can be a useful alternative parameter in conditions where the foetal head is not accessible as in third trimester deeply engaged head or when head is deformed due to overcrowding such as in multiple pregnancy.
| Assessment of Relationship between Lateral Preferences and Sidedness: A Cross Sectional Questionnaire Based Study | | |
A. Muraleedharan, S. Ragavan, R. Devi
Pondicherry Institute of Medical Sciences, Puducherry, India
Objectives: 1. To assess the prevalence of right, left and mixed sidedness (handedness and footedness). 2. To determine the preference and strength of preference of lateral postures like Arm Folding (AF), Hand Clasping (HC), Leg Folding (LF). 3. To assess the relationship between lateral postures with sidedness.
Methods: The study was done in MBBS and B. Sc Nursing students (n = 258) in the age group 18 – 22 years. Those students with any physical disability were excluded from the study. The subjects were asked to fill a self- assessment questionnaire to determine handedness and footedness. The laterality traits were observed by asking the subjects to do by themselves after an untailored demonstration.
Results: In our study 96.5% (n = 249) were right handed, 0.4% (n=1) were left handed and 3.1% (n=8) were ambidextrous. 79.9% (n = 203) of subjects were right footed, 7.5% (n = 19) were left footed and 12.6% (n = 32) were mixed footed. 50.8 % (n = 131) preferred RHC, 53.9% (n = 118) preferred LAF. 60.6% (n = 2) preferred RLF. A statistically significant correlation existed between foot preference and AF, HC and handedness (p<0.05) and between RHC and LAF (p<0.05).
Conclusion: In our study, we found a significant correlation between Handedness and footedness. Footedness showed significant correlation with most of the lateral postures whereas, handedness did not. RHC was found to have statistically significant correlation with LAF.
| DNA Damage Analysis in Primary Amenorrhea | | |
S. Ramamurthy, P. Chand, L. Chaturvedula
Pondicherry Institute of Medical Sciences, Puducherry, India
Objective: This study aims at evaluating the chromosomal abnormalities and DNA damage by karyotyping and comet assay in primary amenorrhea.
Materials and Methods: 30 Clinically diagnosed cases with primary amenorrhea were recruited from the Dept. of Obs & Gyn. Chromosomal analysis was done by conventional PHA stimulated lymphocyte cell culture technique with GTG banding. Metaphase spreads were screened by automated software, IKAROS Metasystem – Carl Zeiss. Alkaline version of comet assay was used to evaluate DNA damage. Comet parameters were analyzed using Cometscore software. Physical examination was done, and secondary sexual characters were assessed according to Tanner staging.
Results: The chromosomal pattern of 20 subjects (66.7%) was found to be normal (46, XX). 2 Subjects had 46, XY male pattern and 8 subjects had Turner syndrome (45, X or 45, X/46, XX). Most of the subjects had poorly developed secondary sexual characters. The comet parameters were found to be increased among the subjects with Turner karyotype as compared to the rest of the study group. This indicates a high level of DNA damage which leads to the chromosomal aberrations, seen in subjects. The comet parameters were also increased in subjects with Tanner stage 1 when compared to Tanner stage 2.
Conclusion: Increased DNA damage seen in the present study indicates a failure in the DNA repair mechanism which in turn leads to the chromosomal aberrations seen in cases with Primary amenorrhea. DNA damage correlated well with the poorly developed secondary sexual characters.
| Palmar Dermatoglyphic Pattern of Polycystic Ovary Syndrome | | |
S. Ragavan, S. Elizabeth, R. Sankarasubbaiah
Pondicherry Institute of Medical Sciences, Puducherry, India
Objectives: To study the dermatoglyphic pattern of Polycystic Ovary Syndrome females and to compare them with that of normal females & normal males.
Methods: The dermatoglyphic patterns were obtained on a white paper by applying kajal and various parameters such as fingertip patterns, Main Line Formula, Main Line Index, Total Finger Ridge Count, Absolute Finger Ridge Count, Inter digital ridge counts and angles atd, dat & adt were studied by using a magnifying lens. The statistical analysis of the data was done using chi-square test and independent student t-test.
Results: In PCOS females (n=55), the Main Line Formula pattern (I) 9,7,5',4,13, showed a significantly higher occurrence of 13% (n=15/110 hands) compared to control females (n=50). Angle adt was significantly less (p<0.05) in PCOS females when compared with control females and males. PCOS females showed a significantly high c-d ridge count (36.18±5.19) in right hand when compared with control females (33.95±5.33). In few parameters such as Main Line Formula pattern, Main Line Index, angles and inter digital ridge counts, PCOS females had similarities with control males owing to the presence of hyperandrogenism in PCOS females.
Conclusion: The dermatoglyphic findings of PCOS females elucidated from the present study could be considered as one among the screening methods for PCOS. Being a simple, cost effective and reliable method it helps in early diagnosis of PCOS and may be of great help in delaying the onset of its complications.
| Growth Pattern of Human Fetal Skin: Morphometric Analysis | | |
S. Dhingra, A. Asghar, J. Verma, N. Srivastava
Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
Objective: To identify the sequential changes in development of human fetal skin and to identify the growth pattern between thickness of dermis and thickness of epidermis in different age groups of fetuses.
Methods: We conducted a study on 30 stillborn/I.u.d human fetuses which were grouped into six groups starting from 11 weeks upto 40 weeks of gestation. Sample was processed by paraffin embedding method. Staining was done with haematoxylin and eosin. Slides were examined under microscope (high and low power). Measurements of the thickness of epidermis and dermis of abdominal skin was noted.
Results: Mean Abdominal epidermal thickness:
Group 1- 5.04± 0.97 μm; Group 2- 7.6± 0.81 μm; Group 3- 19.02± 4.19 μm; Group 4- 27.82± 2.03 μm; Group 5- 33.44± 1.32 μm; Group 6- 38.48± 2.62 μm.
Mean Abdominal dermal thickness:
Group 1- 683.7± 18.68 μm; Group 2- 781.76± 11.19 μm; Group 3- 875.34± 35.98 μm; Group 4- 946.54± 35.04 μm; Group 5-1011.58± 7.21 μm; Group 6- 1035.02± 16.47 μm. The mean abdominal epidermal and dermal thickness increased from group 1 to group 6.
Conclusion: The mean thickness of epidermis and dermis of abdominal skin increases as the gestational age increases in the different groups. The increase in mean abdominal epidermal thickness is much more than the increase in mean abdominal dermal thickness as seen from group 1 to group 2.
| Acetamiprid Insecticide Exposure Effects on Haematological Parameters in Chick Embryos | | |
Muktyaz Hussein, Vishram Singh1, Kuldeep Singh
Department of Anatomy, Government Medical College, Badaun, 1Santosh Medical College, Ghaziabad, Uttar Pradesh, India
Objective: Acetamiprid is a widely used second generation neonicotinoid of outstanding systemic action and potency. It is used for control of insects on several crops and sucking insects like aphids, bees and mosquitoes. Since the use of acetamiprid is increasing, it is necessary to identify its possible adverse effects on animals.
Methods: The present study was carried out in the department of Anatomy Govt. Medical College, Ambedkar Nagar and Govt. Medical College Budaun on 180 fertile eggs of white leghorn chicken obtained from government poultry farm after taking permission from animal ethical committee. Chicken eggs exposed to Acetamiprid with doses of 5 μg, 10 μg and 20 μg in a volume of 5 μl, 10 μl and 20 μl respectively and control same as test group. The embryos were terminated on 21st day and blood collected directly from heart for analysis of haematological parameters namely Hb, PCV, TLC and TRBC.
Results: Acetamiprid exposure produced changes on hematological parameters in chick embryos showing decrease level of Hb, PCV in all experimental groups and TRBC in higher doses and increase level of TLC in all experimental groups in comparison to control groups.
Conclusion: Comparatively higher doses proved more toxic and caused changes in haematological parameters in chick embryos after exposure to Acetamiprid in comparison to normal saline.
Keywords: Acetamiprid, chicken embryos and haematological parameters
| Parental Karyotype in Recurrent Pregnanacy Loss | | |
Debasis Bandopadhyay, Paresh Singhal<1, Sushil Kumar
Departments of Anatomy and 1Pathology, AFMC, Pune, Maharashtra, India
Introduction: The Genetic causes account for 3-8% of all pregnancy loss. About 2-4% of recurrent pregnancy loss are as a result of existing balanced translocations in either or both parents leading to unbalanced chromosome pattern in the embryo. All patients of recurrent pregnancy loss with no known etiology should be investigated with maternal and paternal karyotype. The parents in whom balanced translocations are identified must be advised in-vitro fertilisation (IVF) with pre-implantation genetic work up. In our study 30 couples with history of recurrent spontaneous abortions as per exclusion/inclusion criteria were evaluated for peripheral blood karyotype to detect balanced translocations or other chromosomal anomalies.
Methodology: Conventional cytogenetics or karyotype was carried out from peripheral blood of both parents. 5 ml of peripheral blood was collected from each parent separately in heparinised syringe and processed for lymphocyte culture for 72 h using readymade culture media PBmax. Thereafter the cells were arrested in metaphase and harvested for giemsa trypsin banding using standard protocol. The metaphases were captured and analyzed using Cytovision software.
Results: 30 male partners reported normal karyotype. In 03 female partners karyotype variation was reported; 01 balanced translocation between chromosome 7 and 14, 01 pericentric inversion of chromosome 9 and 01 heterochromatic polymorphism of 15q.
Discussion: In approximately 2% of the cases the etiology of recurrent pregnancy loss lies in balanced translocation existing in chromosomes of one of the parents. A balanced translocation is a chromosomal rearrangement in which two chromosomes have exchanged segments without a net gain or loss of genetic material. Although individuals who carry balanced translocations are generally healthy, such individuals have a higher risk of conceiving a child with an unbalanced translocation. Parental karyotyping helps in risk assessment of future pregnancies. In our study 01 couple detected to have balanced translocation was advised in-vitro fertilization (IVF) with pre-implantation genetic work up. In the event euploid embryo was not available from the couple they could choose a donor ovum (since male has normal karyotype).
The 02 cases of pericentric inversion of Chromosome 9 and Heterochromatic polymorphism of 15q are common occurrence in general population and unlikely to have impact on pregnancy outcome.
Conclusion: All recurrent pregnancy loss where anatomical, hormonal, blood clotting factors and infectious etiology has been ruled out must be subjected to peripheral blood karyotype of both the parents. Depending on the diagnosis if the risks are high the couples may be advised in vitro fertilization using donor gametes to prevent unbalanced chromosome pattern in embryo leading to recurrent abortions.
| Evaluation of Sperm DNA Fragmentation after Cryopreservation in Ejaculated Spermatozoa | | |
V. D. S. Jamwal, S. Karunakaran, N. Naredi, N. Nagaraj, S. Kumar, S. Jamwal, A. K. Yadav
Department of Anatomy, AFMC, Pune, Maharashtra, India
Introduction: Infertility has been declared as a public health concern by the WHO. Infertility affects approximately 10 to 15% of couples worldwide Male factors contribute significantly to infertility approximately 35% of couples. Semen cryopreservation techniques as a measure of fertility preservation have been shown to increase DNA fragmentation.
Objectives: To study the effects of cryopreservation on sperm DNA fragmentation.
Materials and Methods: The study was conducted in a tertiary care referral hospital for infertility during the period 01 Apr 13 to 31 Mar 14. A total of 100 patients who met the inclusion criteria were included in the study. Sperm DNA fragmentation was done prefreeze and post-thaw by Sperm chromatin dispersion test.
Results: Mean sperm count pre-freeze was 56.6 million per ml (SD=22.5 million) of semen. Lowest concentration of spermatozoa in the study population was 25 million per ml of semen and highest concentration of spermatozoa in the study population was 120 million per ml of semen. Post freeze concentration had mean of 66.1 million (SD=22.4 million). DNA fragmentation in pre-freeze was 3.5% (0.3%) and in post-freeze 3.6 % (0.3%). There was statistically significant difference between prefreeze and post freeze values both in sperm count and DNA fragmentation.
Conclusion: Though cryopreservation increases the DNA fragmentation level of washed sperm significantly but this does not prevent us from utilization of cryopreservation facility because benefits far outweigh the adverse effects of cryopreservation.
| Morphology of Smooth Muscle at Different Gut Segments of Human Fetuses | | |
B. Subhash, S. Singh, S. Saba, J. A. Quadri, A. Anam, V. D. S. Jamwal, N. Rani, K. Dheeraj, D. Aditi, A. Shariff
All India Institute of Medical Sciences, New Delhi, India
Introduction: The gastrointestinal tract is formed from a primitive gut tube that consists of the endoderm, which gives rise to the inner epithelial lining of the gut, and splanchnic mesoderm, which gives rise to the smooth muscle. The generation of functional neuromuscular activity within the gastrointestinal tract requires the synchronized development of enteric neurons, glial cells and smooth muscle.
Aim and Objectives: To determine the morphology of developing gut smooth muscle and its innervation with increasing age of gestation (12 – 22 weeks).
Materials and Methods: Tissue samples of aborted foetuses aged 12– 22 weeks of gestation (WG) were fixed and processed for H&E, Immunohistochemistry (vimentin).
Results: The Gut smooth muscle matured in a rostro caudal direction. Circular muscle developed prior to longitudinal muscle. The outer–longitudinal and the inner–circular muscle layers differentiated in the esophagus by 13 WG. The developmental dynamics of the circular muscle thickness showed an increasing trend from 11WG to 19WG, after that it was static till 26WG in the ascending and sigmoid colon. However, the circular muscle of the esophagus increased in thickness gradually from 11WG to 26WG. The development of longitudinal muscle thickness showed a pattern of continuous, uniform increase in thickness in all segments from 13 to 26 WG.
Conclusion: The knowledge of the development of the smooth muscle and its innervation of different segments of the gut in humans from 12 to 22 WG may help in understanding the pathophysiology of various congenital disorders affecting ENS.
| An Assesment of Quality of Semen Among Young Men with Cigarette Smoking | | |
P. C. Agrawal, P. Agrawal, M. Chatterjee
Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
Objectives: The number of cigarette smokers is rising rapidly worldwide. The exact effect on function of spermatozoa is not assessed yet, though the effect is noticed a long time ago which could be a serious threat to the male as well as his reproductive health.
Methods: The present study is a retrospective cohort study conducted in 6 months period to study the semen parameters of 60 young healthy adult males in age range of 18 – 35 years. They were grouped into Group 1 and Group 2 depending upon the habit of cigarette smoking either as cigarette smokers ( Group 1) & those who do not smoke cigarette (Group 2). Sample was collected by masturbation after 3 days of abstinence, semen analysis was performed, routine semen parameters were noted. The findings of the two groups were tabulated and mean values, standard deviation, along with P-values for Unpaired T Test in group 1 and group 2 were performed.
Results: It was found that the sperm count, motile sperm count, percentage motility, grade of motility, and percentage of morphologically normal sperms, were significantly lowered in group 1 as compared to group 2 (p < 0.05).
Conclusion: We found that the sperm parameters and overall grade of motility were significantly lower in the group cigarette smokers without significant difference in the semen volume.
| AnnexinA2 in Nephrogenesis and Kidney Cancer | | |
Roshni Sadashiv, B. M. Bannur, S. K. Deshpande, U. S. Dinesh, Praveenkumar Shetty
Shri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad, Karnataka, India
Introduction: Renal cell carcinomas are the most common amongst the genitourinary cancers. ANXA2 (36KDA, LIPOCORTIN II) is a multifuctional calcium regulated phospholipid binding protein found in a subset of renal neoplasms. Since the tumor cells usually recapitulates embryonic cells we studied the ontogeny of ANXA2 in developing renal tissues and compared it with those of normal adult, renal cell carcinomas to better understand their role in renal development and tumorigenesis.
Objectives: a) To demonstrate the expression pattern of ANXA2 in fetal kidneys at various gestational age. b) to demonstrate the expression pattern of ANXA2 in adult kidney and renal cell carcinoma. c) to compare the expression pattern of ANXA2 in fetal, adult and renal cell carcinomas.
Methods: This study was conducted in accordance with the principles of institutional ethical committee (SDMCMS&H, Dharwad). ANXA2 expression was evaluated by means of immunohistochemistry technique in paraffin embedded renal tissue sections from various autopsied fetuses, 37 mature kidneys and 37 renal cancer tissues.
Results: The study showed moderate membranous expression of ANXA2 in the ureteric bud and collecting tubules of fetal kidneys in all gestational ages and in the collecting ducts of adult normal renal tissues. It is not often expressed in the proximal convoluted tubules of normal adult kidney, however younger fetal kidneys show moderate expression in the proximal convoluted tubules (thought to be the origin of renal cell carcinoma) and a strong membranous expression in the clear cell carcinoma suggesting a deregulation of the gene during tumorigenesis.
Conclusion: Understanding the molecular expression pattern of ANXA2 during development, later its specific function and dysregulated expression in different renal carcinoma may help in the identification of a developmental molecular biomarker with implication in therapeutic applications.
| Genetic Expression of Neural Tube Defects: A Study | | |
S. Saritha
Department of Anatomy, KAMSRC, Hyderabad, Telangana, India
Introduction: NTDs are the commonest and most severe disorders, affecting 0.5-2 per 1000 established pregnancies, and are second commonest group of birth defects, after congenital heart defects. NTDs constitute a major health problem worldwide and they cause stillbirth, neonatal and infant death or significant lifelong handicap. Neuralization is the process where the neural tube is formed and completed within 28 days after fertilization before many women are aware that they are pregnant. Neural tube defects (NTDs) are caused by the failure of the neural tube closure.
Aim and Objectives: A valuable contribution of this NTDs study, mainly aimed on the prenatal diagnosis in Utero.
Materials and Methods: This comprehensive study was undertaken to know the incidence and detail knowledge of neural tube defects in KAMS & RC Hyderabad, among 2032 births during the period of two years. We found 23 fetuses with neural tube defects involving brain and spinal cord.
Observations and Results: The 23 fetuses were stillbirths and aborted babies between 16 to 32 weeks, presented with neural tube defects 13 fetuses were females and 8 fetuses were males. The spinal defects were 0.4%, cranial defects 0.2% and complete neural tube defects is 0.1%.
Conclusion: This review article discusses the clinical research, embryological aspects & Genetic correlation with the available literatures.
| Comparative Study of Implantation Rate in Cleavage Embryo Transfer versus Blastocyst Transfer Among Couples Undergoing In-Vitro Fertilization for Treatment of Infertility | | |
M. S. Ahuja, R. K. Sharma1, A. Tandon1, S. Pandit
Department of Anatomy, Army College of Medical Sciences, Delhi, 1Department of Anatomy, AFMC, Pune, Maharashtra, India
Background: In-vitro fertilization has conventionally involved transfer of 4 to 8 cell embryo (also called cleavage embryos) into the uterus. This was considered necessary because culture media and lab systems could not support further growth of embryo. However, new and advanced culture media and laboratory techniques now permit in vitro growth up to blastocyst stage. This has generated a healthy debate regarding optimum stage of transfer of embryos into the uterus post-IVF.
Objectives: To study and compare implantation rates of cleavage embryos with blastocyst embryos and determine which would give better pregnancy outcome.
Materials and Methods: One hundred couples reporting for IVF were divided randomly into two groups. Group A comprised fifty couples in whom cleavage embryos were transferred. Group B comprised 50 couples in whom blastocysts were transferred. In both groups couples were in 20-35 yr age group. In both groups maximum two embryos were transferred into the uterus.
Results and Conclusion: The implantation rates in both groups were similar. The abortion rates were also similar. However, in cases where only one embryo was transferred, the implantation rate with balstocyst embryo was double that of the 4-8 cell stage embryo. Thus blastocyst transfer has the potential benefit of reducing incidence of multiple pregnancy frequently seen in IVF pregnancies.
| Screening for Alcohol Metabolizing Gene Polymorphisms in Alcohol Dependent Patients | | |
A. Aryal, R. Singh, A. Ambekar1, S. B. Ray, A. Sharma
Departments of Anatomy and 1Psychiatry, All India Institute of Medical Sciences, New Delhi, India
Introduction: Alcohol dependence (AD) is a complex disorder associated with several social, environmental and genetic causes. Variants such as Single nucleotide polymorphisms (SNP)s have been identified in the genes of alcohol metabolizing enzymes like Alcohol dehydrogenase (ADH) and Aldehyde dehydrogenase (ALDH) which increase vulnerability to AD.
AIM: The present study was conducted to identify possible presence of SNPs in ADH gene in alcohol dependent individuals.
Methodology: 50 alcohol dependent males from NDDTC, AIIMS and 52 healthy males who acted as controls formed the study group. Participants were interviewed using a semi-structured and WHO ASSIST questionnaire. Five ml peripheral blood was drawn after taking informed consent and was processed for DNA isolation. Screening for presence of SNP (Arg272Gln) was done in ADH1C gene using PCR/RFLP.
Results: The percentage distribution of the genotypes - homozygous variant allele (Gln272/ Gln272) was 18% in patients and 6% in controls, heterozygous (Gln272/ Arg272) was observed in 38% patients and 26% controls, and wild type homozygous (Arg272/ Arg272) was seen in 44% patients and 70% controls. Chi-square test showed significant (p=0.03) association of variant allele suggesting increased risk in alcohol dependence patients.
Conclusion: Preliminary results of the study indicate that ADH1C SNP Arg272Gln may influence alcohol intake and subsequent dependence.
| Incidence of Structural Chromosomal Anomalies in AML Patients | | |
R. K. Verma, N. Kumar, A. Rani, S. Rao, A. Archana Kumar, A. K. Pankaj
Introduction: Acute myeloid leukemia (AML) is a tumor of hematopoietic progenitors caused by acquired oncogenic mutations that impede differentiation, leading to the accumulation of immature myeloid blasts in the marrow. The single most important prognostic factor in AML is cytogenetics, which determine the prognosis and probability of relapse after treatment. Hence the cytogenetic analysis of AML patients plays a great role in prognosis and treatment.
Materials and Methods: Karyogram of diagnosed patients of AML was prepared from bone marrow and peripheral blood. This study was conducted in the Cytogenetic Laboratory of the dept. of Anatomy, K.G.M.U., UP, Lucknow. Patients were screened in the Dept. of Pediatrics Medicine and the sample was collected from there.
Observations and Results: We observed the frequency of chromosomal aberrations in different age groups and sex. Out of 22 successful cases 12 cases (54.54%) exhibited abnormal karyogram and 10 cases (45.45%) showed normal karyogram. Among total 22 cases, structural chromosomal abnormalities were observed in 11 cases (50%). Translocation was present in 9 cases (40.90%), p-arm abnormality on chromosome 19 (add 19p) was present in 1 case (4.54%) and q-arm abnormality on chromosome 16 (del 16q) was present in 1 case (4.54%).
Discussion and Conclusion: Translocation was found most common structural anomaly in AML. We observed translocation t(8;21) in 9.09% cases. Other translocation was t(9;22) which was found in 9.09% cases. t(9;11) was observed in 9.09% cases in our study. t(4;7) was noted in 4.54% case in the present study, which was also reported in previous studies of AML cases. t(15;17) was noted in 4.54% case which was also noted by previous authors. In AML t(8;21), t(15;17), inv(16) has good prognosis, intermediate prognosis abnormal 11q23, numerical changes and poor -5, -7, del(5q), abnormal 3q, complex cytogenetic Hence the cytogenetic analysis of AML patients plays a great role in prognosis and treatment.
| Estimation of Fetal Weight: A Ultrasonography Study in Indian Population | | |
Mishra Sanjay Rampravesh, Surajit Ghatak, Pratibha Singh, Dushyant Agrawal, Pawan Garg
All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
Objectives: Fetal growth restriction indicates failure of a fetus to meet its growth potential and is associated with increased perinatal mortality and morbidity. Therefore, antenatal detection of fetal growth restriction is of major importance in an attempt to deliver improved clinical outcomes. The most commonly used approach towards screening for fetal growth restriction is by means of Ultrasonography (USG). Fetal weight is considered small for gestational age, if it is below the 10th percentile for gestational age. Also USG is safe and has low cost therefore most suitable method for estimating fetal weight. Objective of this study was to derive reference chart for normal fetal weight by USG in Indian population. It will help in detection of early intrauterine growth retardation (IUGR) and macrosomia in Indian fetuses which has great impact on mode of delivery and fetal outcome after delivery.
Methods: In this study antenatal ultrasound assessment fetal weight was done in pregnant women (n=170) between 14-40 weeks of gestation with known date of last menstrual period (LMP).
Results: Estimated data for weight was analyzed statistically. Mean value of fetal weight for age group 14-20 weeks, 20-30 weeks and 30-40 weeks were 251.98 gm, 549.39 gm & 2008.34 gm respectively. Reference chart for intrauterine fetal weight to their corresponding gestational age derived and compared with western population study.
Conclusion: The observed fetal weight can be used as reference to assess fetal growth according to gestational age particularly in Indian population. Due to role of racial and ethnic variations among fetal weights, it is important to have separate reference chart for Indian population as compare to western population. This reference chart will help clinician to make right diagnosis of small for gestational age, intrauterine growth retardation (IUGR) and macrosomia, which will further decide the perinatal obstetric management.
| Impact of Yoga Based Lifestyle Intervention on Expression Level of Genes in Base Excision Repair Pathway in Infertile Men | | |
Rajesh Kumar, Manoj Kumar, Rajeev Kumar, Rima Dada
Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
Objective: To study changes in expression levels of OGG1, APE1, XRCC1 and PARP1 genes of BER pathway 5 days, 10 days and 21 days post YBLI in infertile men.
Methods: Two groups comparative preliminary longitudinal study with single blind trial had been done recruiting 75 infertile men doing YBLI (Group 1) and 75 infertile men not doing YBLI (Group 2). Clinical and biomarker assessment and association of pre-and post-yoga based lifestyle intervention had been done. RNA was extracted from blood by Trizol and converted to cDNA. The relative quantification of PARP1, OGG1, XRCC1 and APE1 genes normalized to β-actin was calculated by the Relative quantification method. Study of the expression profile of OGG1, APE1, XRCC1 and PARP1 genes in the sperm and blood genome pre-and post-yoga intervention and its validation via Real-Time PCR had been done. Descriptive and inferential statistics had been used for analyzing associations and determining predictive, treatment response and prognostic biomarkers.
Results: After 21 days of YBLI, expression levels of PARP1, XRCC1 and APE1 were significantly (p < 0.0001) increased in sperm whereas the expression levels of PARP1, XRCC1 and APE1 were significantly (p < 0.0001) decreased in Blood. The expression level of OGG1 was non-significantly decreased in both blood and sperm samples.
Conclusion: YBLI modulates expression levels of BER genes in infertile men. This can significantly improve DNA integrity by reducing oxidative DNA damage.
| Correlation of Number of Previous Abortion and Abnormal Chromosomal Pattern in Couples | | |
N. Saba, R. K. Verma, A. Rani, N. Kumar, U. Singh, M. Faheem
JNMCH, AMU, Aligarh, Uttar Pradesh, India
Introduction: Cytogenetic studies are very useful in couples who have had two or more miscarriages. They carry a structural chromosome abnormality in one of the partners more often, especially in first trimester, as compared to other couples. Hence it has been decided to study the genetic pattern in these cases.
Objectives: The purpose of the present study was to investigate the contribution of chromosomal anomalies and the frequency of a particular type of aberration in couples with recurrent miscarriages.
Methods: A total of 86 couples with recurrent miscarriages were analyzed according to standard cytogenetic methods using G-banding technique.
Results: In the present study, abnormal karyotype was observed in 8.5% (3.38% males and 5.08% females) cases in 59 couples which had 2 previous pregnancy losses, 5.3% females in 19 couples with history of 3 pregnancy losses, 50% females in 4 couples with previous 4 pregnancy loss and 25% males in 4 couples with history of ≥5 pregnancy loss. Total number of abnormal cases was 9 (10.46%). Numerical abnormality was seen with mosaic pattern in 4 couples (4.7%) and structural abnormality was detected in 5 couples (5.8%) having 1 case (1.16%) isochromosome, 2 cases (2.32%) reciprocal translocation & 2 cases (2.32%) of Robertsonian translocation.
Conclusion: The findings of the present study may be useful to obstetricians and gynaecologist and also to physicians in predicting future pregnancy loss due to presence of chromosomal aberrations in balanced form or in the form of mosaics in either partner of a couple with recurrent pregnancy loss.
| Evaluation of Migration of HTR-8/Svneo Cells after H2S Donor Treatment: Impact on Placentation | | |
Sunil Gupta, Sankat Mochan, Neerja Bhatla1, Kalpana Luthra2, Arundhati Sharma, Pallavi Kshetrapal3, Shobhit Saxena, Pallavi Arora, Neerja Rani, Renu Dhingra
Departments of Anatomy, 1Obstetrics and Gynecology and 2Biochemistry, All India Institute of Medical Sciences, New Delhi, 3Paediatric Biology Centre, Translational Health Science and Technology Institute, Faridabad, Haryana, India
Objective: Defective migration and invasion of trophoblastic cells during placentation may affect the spiral artery remodeling leading to adverse pregnancy outcomes like preeclampsia and fetal growth restrictions. The present study was aimed to examine the effect of hydrogen sulphide on migration capacity of trophoblast cells.
Methods: The migration potential of HTR8/SVneo Cells (Trophoblastic cells)) were determined by wound healing assay. The trophoblast cells were divided in following groups : NaHS (H2S donor) group, Hypoxia/Reoxygenation group, Hypoxia/Reoxygenation + NaHS group and control (1% FBS) group. The cells were grown as monolayer on culture dish for wound healing assay. Mitomycin C treatment was given to inhibit the cell proliferation. A wound scratch were created with 2-20 μl pipette tip. The wound area is examined at 0 and 24 hours under Nikon Ti Ec lipse microscope using NIS-AR software. The percentage wound area covered after 24 hours was calculated in the respective groups.
Results: The percentage wound area covered after 24 hours in NaHS group was 67.5% and Hypoxia/Reoxygenation group was 8.7% whereas in Hypoxia/Reoxygenation + NaHS group it was 39.8% and control (1% FBS) group was 32.8%. The migration potential of trophoblastic cells were significantly reduced in Hypoxia/Reoxygenation group which was significantly improved by addition of the mimic of H2S (100 μM NaHS).
Conclusion: These results imply that H2S may promote the migration of trophoblastic cells, which in turn can affect the regulation of the spiral artery remodelling and improve the placental perfusion and thus the pregnancy outcome. The effect of H2S on the various cytoskeletal elements responsible for trophoblast cells migration can be explored in future.
| Cytogenetic Study of Couples with Recurrent Pregnancy Loss: An Experience in Eastern India | | |
Sanchita Roy, Ajanta Halder
Introduction: Approximately 15-20% of all pregnancies in humans are terminated as recurrent spontaneous abortions (RSAs). It continues to be a challenging reproductive problem both for the patient as well as for the clinicians. Therefore, identifying a cytogenetic cause for a miscarriage may be of great significance for the management of patients with recurrent miscarriage. Genetic factors in the form of chromosomal abnormalities, inherited thrombophilia, single gene disorders and other genes involved are the main causes of recurrent reproductive wastage. The aim of this study was to detect chromosomal aberrations in couples with RSAs and to compare our results with those reported previously.
Materials and Methods: In this observational study conducted for 2016 April-2018 June, the pattern of chromosomal aberrations were evaluated in 100 couples who attended genetic OPD of Ramakrishna Mission Seva Pratisthan, Kolkata with the history of recurrent pregnancy loss.
Results: Couples' ages ranged from 20- 45 yrs, with a mean of 26 yrs. Among 100 couples 5.88% men and 2.94% women showed structural chromosomal abnormalities. Polymorphic variants present in 10.29% and 8.82% in women and men respectively. The risk of miscarriage is highest among couples where the woman's age is 35 years or above and men's age is more than 40 years.
Conclusion: This study emphasizes the importance of genetic counselling in these patients with history of recurrent abortions and will definitely help to plan the necessary treatment protocol in these cases.
| Prenatal Development of Human Lung and Expression of FGF10 in Tubulogenesis | | |
Jeelani Kahkashan, Vasudeva Neelam, Mishra Sabita
Maulana Azad Medical College, New Delhi, India
Objective: The developing human lung has five stages embryonic stage, pseudoglandular stage, canalicular stage, saccular stage and alveolar stage. At each stage of development various signalling molecules have been identified. The FGF10 is an important mesenchymal molecule for airway branching. FGF10 signalling is essential for tubulogenesis during development. Absence of FGF10 leads to agenesis and hypoplasia of lung. So, the expression of FGF10 was studied in each stage of human lung development.
Materials and Methods: Lung of ten aborted fetal specimens aged between 14 – 26 weeks of gestation were used following institutional ethical clearance. After fixation in 10% formalin, sections were stained with H&E, masson's trichome, verhoeff's stain and expression of FGF10 was observed by immunohistochemistry.
Results: With advancing gestational age, the amount of mesenchymal tissue and the height of epithelium gradually decreased. The elastic fibers appeared at about 18 weeks around developing tubules and gradually became more prominent as the age advanced. The initial expression of FGF10 was observed at 14 weeks the pseudoglandular stage. The expression of FGF10 was initially found in mesenchyme and gradually its expression shifted towards epithelial lining of tubules, at 20 weeks, the canalicular stage.
Conclusion: By 26th week of Intrauterine life, fetal lung attains morphological maturity so as to support the extra-uterine life of the growing fetus. The expression of FGF10 depicted an essential marker for mesenchymal-epithelial interaction and tubulogenesis.
| Association of MMP2 Polymorphisms in Preeclampsia | | |
Manisha Mishra, Pallavi Arora, Shobhit Saxena, Sunil Gupta, Sankat Mochan, Dheeraj Kasapuram, Seema Singh, Neerja Bhatla1, Arundhati Sharma, Renu Dhingra, Neerja Rani
Departments of Anatomy and 1Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
Objective: Imbalanced matrix metalloproteinase (MMP) expression, including MMP-2, has been demonstrated in pre-eclampsia. However, little is known about the effect of MMP-2 gene polymorphisms on hypertensive disorders of pregnancy. Therefore, we examined matrix metalloproteinase (MMP)-2 gene polymorphisms (g.-735C/T) and its association with preeclampsia (PE) and measured the levels of MMP-2 serum concentrations in PE.
Materials and Methods: 30 preeclamptic and 30 healthy pregnant women were enrolled from department of obstetrics and gynaecology, AIIMS, New Delhi after getting approval from Institute ethical committee. Genomic DNA was extracted from blood and amplified by PCR. MMP2 gene polymorphisms of -735C/T was detected by restriction fragment length polymorphism (RFLP). The levels of MMP2 in sera were measured by ELISA.
Result: The maternal serum MMP2 levels was found to be more in PE patients than in control group (p=0.03). The increased frequency of CT genotype for MMP2 (-735C/T) Single Nucleotide Polymorphism was seen in PE patients as compared to control group. However the difference in genotype frequency was not statistically significant (p=0.35).
Conclusion: These findings may help to understand the relevance of MMP-2 and its genetic polymorphisms to the pathophysiology of hypertensive disorders of pregnancy like preeclampsia and IUGR.
| Association of Trisomy 21 with Anorectal Malformation: A Cytogenetic Study | | |
D. Mishra, A. Rani, R. K. Verma, G. Sehgal, A. Pandey, P. Dwivedi
Department of Anatomy, King George's Medical University, Lucknow, Uttar Pradesh, India
Introduction: Anorectal malformations are congenital malformations of the digestive system resulting from disturbed development of the hindgut during embryogenesis. This anomaly affects both the sexes. Different syndromes have been reported from the cases of anorectal malformation but the association of Downs with anorectal Malformation is very well documented.
Objective: The objective of the present study was to study association of trisomy 21 with anorectal malformation patients.
Materials and Methods: 48 patients of anorectal malformation were selected from Department of Paediatric Surgery, KGMU-U.P, Lucknow. Blood samples were collected and their cytogenetic study was done in the Department of Anatomy, KGMU-U.P, Lucknow. Karyotypes obtained were further studied.
Results: The present study was carried out with an aim to study the incidence of trisomy 21 with anorectal malformations. For this purpose, a total of 48 children with anorectal malformations were included in the study. Out of 48 children enrolled in the study, karyogram could be obtained for 45 cases (93.75%). Trisomy 21 was found in 3 cases (6.6%) out of 45 karyotypes in which 2 were males and one female.
Conclusion: Incidence of trisomy 21 was found in 6.6% cases of ARM which emphasizes the need for a thorough investigation of patients with ARM.
| Correlation of Consanguinity with Prevalence of Chromosomal Anomalies in Patients of Ambiguous Genitalia – Cytogenetic Study | | |
A. Pandey, R. K. Verma, N. Kumar, A. Rani, D. Mishra
Introduction: Ion when the sex of the baby can't be determined and there is variation of genitalia from normal is known as Ambiguous Genitalia. Consanguinity can be defined as blood relationship that exists among individuals that descend from a common ancestor. A single copy of gene which is present in common ancestor might be doubled in the inbred individual due to effect of consanguineous marriage. A recessive gene may thus come to light for the first time in an inbred.
Aims and Objective: the aim of the present study was to see the correlation of consanguinity with prevalence of chromosomal anomalies in patients of ambiguous genitalia.
Materials and Methods: Study was conducted in the cytogenetic laboratory of the Department of Anatomy in of King George's Medical University U.P Lucknow. The patients were screened in the department of pediatrics and pediatric surgery and blood samples were taken. Cytogenetic analysis was done.
Results: Consanguinity could be traced in 4 (18.2%) cases, of whom 3 (75%) had chromosomal anomalies. Out of remaining 18 (81.2%) cases, chromosomal anomalies were seen in 4 (22.2%) cases.
Conclusion: The proportion of cases with anomalies was higher in those positive for consanguinity as compared to those without consanguinity.
| The Effect of Embalming Fluid Fumes on Kidney and Liver of Mouse Pups Following Antenatal Exposure | | |
N. Puri, N. Pipet1, D. Goel1, P. Singh1
Dr YSPGMC Nahan, Nahan, Himachal Pradesh, 1MMIMSR, Mullana, Haryana, India
Objective: Embalming fluid is not only important for cadaver preservation but has deleterious effect on exposure but less literature is available about its effects on fetus. Thus the present study was designed to observe the toxic effect of embalming fluid fumes of known ppm on kidney and liver of mouse pups following antenatal exposure to fumes of embalming fluid and compared with control group.
Materials and Methods: The present study was conducted on 18 female mice The mice Pair mating was done in ratio of 3:1 and after confirming pregnancy mice were divided into three groups. Group I : control group with 6 mice. Group II : exposed to fumes of standardized embalming fluid while Group III exposed to fumes of experimental embalming fluid. Delivered pups were dissected following proper anesthesia and histopathological effects on kidney and liver were studied
Results: On gross examination the kidneys were smaller in size in group II & III as compared to control group. Various stages of degenerative changes were observed on light microscopy in glomeruli as well as proximal convoluted tubules in group II & III. The findings were more in group II followed by group III The histological changes seen in liver were disruption of portal triad, vacuolation of hepatocytes, distorted structure of hepatocytes, infiltration by inflammatory cells and congestion of liver parenchyma were noticeably seen in group II and group III. The changes were significantly higher in group II.
Conclusion: Thus it is concluded that embalming fluid containing higher concentration of formalin has degenerative effects on kidney and liver of mouse pups on antennal exposure to fumes.
| Evaluation of Gestational Age with Fetal Foot Length by Using Vernier Caliper | | |
Pankaj Singh1,2, Vinod Kumar1,2
1Begum Fatima College, 2Saraswati Medical College, Unnao, Uttar Pradesh, India
Objective: Correct assessment of gestational age is a cornerstone of management of any obstetric case. Several anatomical parameters are useful in the assessment of gestational age. The ultimate aim of this study is to determine the fetal gestational age through the measurement of the foot (foot length) and to determine the accuracy of fetal foot length in estimating gestational age.
Methods: There were 80 foetus of 12 week to 40 weeks had been collected from the department of obs and gayne in Saraswati Medical College and Hospitals. The foot length was measured by vernier caliper and gestational age was taken by sonographic records by using the international protocols and guidelines of obstetric ultrasonography. Statistical analysis using regression equation and correlation was obtained.
Results: There was a strong correlation between fetal foot length and gestaional age.
Conclusion: Fetal foot length is a reliable parameter for use in the assessment of gestational age and is particularly useful when other parameters do not accurately predict gestational age.
| Need of Sperm DNA Fragmentation Test in Male Infertility | | |
M. B. Sinha
Department of Anatomy, AIIMS, Raipur, Chhattisgarh, India
Objective: The current study was conducted to find out the frequency of sperm DNA fragmentation in infertile males with normozoospermia and oligozoospermia.
Methods: The study was carried out in the following steps: 1) Selection of patients 2) Clinical evaluation 3) Collection of semen samples and testing with sperm chromatin dispersion test 4) Photomicrography 5) Data tabulation and analysis. Sixty males referred for infertility were included in the study.
Results: DNA fragmentation index was calculated for each sample. We found that males have higher DNA fragmentation Index even with normozoospermia.
Conclusion: This newer sperm chromatin dispersion test for sperm DNA fragmentation is very simple, cost effective and a rapid method to study sperm DNA fragmentation. Therefore, this test could be used as a guide for couples having multiple abortions who have opted for artificial reproduction techniques.
| Establishing Identity from the Skeletal Remains: In Reference of Alum Bheg a Martyr from 1857 Indian Freedom Struggle | | |
S. K. Ghosh, A. Kumar
Department of Anatomy, All India Institute of Medical Sciences, Phulwarisharif, Patna, Bihar, India
Objective: The present study was undertaken to analyze morphological features of a skull supposed to be that of Alum Bheg, a martyr from 1857 Indian Freedom Struggle (also called Sepoy Mutiny), using established methods to validate identity with regards to age and height as available in the note found with the skull (about 32 year and 5 feet 7½ inch).
Methods: Identification of sex of the skull was done based on established criteria. Analysis for closure of skull sutures (cranial and facial) and measurement of orbitomedial (OM) & maxillomedial (MM) facial anthropometric lines were undertaken to provide an estimated age against each examined suture as well as group of sutures through established scoring systems. Further, approximate height of individual was estimated from skull length using regression equations from a reference adult Indian male population
Results: Established criteria confirmed that the skull was of a male individual and skull sutures and age related morphological changes in bones indicate that it belonged to an individual in age range 20 -50 years with an average of 30 years and approximate height between 5 feet 8.2 inch to 6 feet 1.3 inch. Based on our observations we suggest that the skull belonged to a male individual around 30 years of age and height 5 feet 8.2 inch to 6 feet 1.3 inch.
Conclusion: The observed values are in approximation with that mentioned in the historical note and slight differences may be attributed either to gross reporting of original values or limitations of anthropometric analysis.
| Morphometric Study of Proximal End of Dry Adult Femora: Clinical Significance | | |
Mahato Madhumita, Mandal Subhra, Pal Sharmila, Chattopadhyay Jadab Chandra
Medical College, Kolkata, West Bengal, India
Objective: Of present study is to evaluate morphometry of neck of femur in eastern Indian population.
Materials and Methods: The study was conducted on 50 dry adult femora, from the osteology museum of anatomy department, Medical College Kolkata.
Results: Mean & Standard Deviation (SD) of Vertical Length of Head of femur in mm (Rt side:38.56 ± 2.50, Lt side:38.07 ± 3.43 ) ;Mean & SD of Width of Neck of femur (Rt side:28.84±2.71, Lt side:28.09±2.29 ) ; Mean & SD of length of Neck of femur on anterior aspect (Rt side:26.37±2.92, Lt side:26.12± 3.42 ) ; Mean & SD of length of Neck of femur on posterior aspect (Rt side:31.65± 2.75, Lt side:26.69±3.11) and Neck shaft angle on both sides were calculated.
Conclusion: Indian dimensions of proximal end of femur are different as compared to that of the values in other part of the world. Present study will be very useful for crafting suitable implants used for surgical correction of fracture neck femur in Indian population.
| Anatomy and Morphology of Glenoid Cavity: It's Importance in Designing Shoulder Joint Prosthesis | | |
Samaddar Arindam, Mandal Subhra, Pal Sharmila
Government Medical College, Kolkata, West Bengal, India
Objectives: Shoulder joint arthroplasty is performed for therapeutic pain relief in certain resistant cases of shoulder joint arthritis or rotator cuff injuries. Appropriate fixation of glenoid arthroplasty is essential for pain relief but the glenoid cavity is small and allows only a limitted area for fixation devices. Thus precise knowledge of morphology of glenoid cavity is essential in shoulder joint arthroplasty.
Materials and Methods: 100 pcs each of right and left adult, dry, undamaged, unpaired human scapulas obtained from Department of Anatomy, Medical College, Kolkata. Parameters were measured by digital vernier caliper. The data tabulated and statistically analysed.
Results: Present study showed pear shaped glenoid cavity was the most common type followed by inverted comma and oval shaped. The mean supero-inferior glenoid diameter on the right and left sides were (35.18±3.36) mm. and (33.52±3.13) mm. respectively. The mean antero-posterior glenoid diameter of the right and left sides were (24.08±2.40) mm. and (23.15±2.53) mm. respectively. The right and left mean glenoid cavity index were found to be (68.64±5.20) % and (69.09±4.29) % respectively.
Conclusion: All the diameters of glenoid cavity showed a greater value on the right side along with the predominance of pear shape. Precise knowledge of morphology of glenoid cavity is important for anthropologists, anatomists, orthopaedic surgeons and prosthesis designers.
Keywords: Arthroplasty, prosthesis designer, rotator cuff surgery
| Study of Variations in Patterns of Superficial Veins of Cubital Fossa | | |
Sudarshana Smita, Prasad Rashmi
Department of Anatomy, Patna Medical Collage, Patna, Bihar, India
Objective: To observe and describe the variations in anatomical distribution of superficial veins of cubital fossa.
Methods: The study was conducted on 100 volunteers (50 males and 50 females), aged 18 to 25 years selected randomly from medical and dental students of Patna Medical college, Patna. After taking due consent, the superficial veins of cubital fossa were made prominent by firmly tying with tourniquet at mid arm level. The patterns of cubital veins were marked on skin and the conspicuous superficial veins were diagrammatized and photographed with a camera. A total of 200 cubital fossa (100 cases each from right and left upper limbs) were examined.
Results: Six types of venous pattern were observed, the most common (Type I) being Median Cubital vein (MCV) joining with Cephalic vein (CV) and Basilic vein (BV) in 55.5% of total subjects. Among Type I pattern--MCV connecting with CV and BV were found to have three patterns---”Reverse N” pattern (IA), “N” pattern (IB) and “H” pattern (IC) in 40%, 35% and 25% of casesrespectively. The other patterns were: Median vein of forearm (MVF) bifurcating into Median basilic vein (MBV) and Median cephalic vein (MCeV) and then joining BV and CV respectively in “Y” pattern in 33% (Type II), CV terminating in to BV and Accessory Cephalic Vein (ACV) runs separately in 8.5%, (Type III), CV communicating directly with BV by forming cubital venous arch and then giving three superficial branches distally in 1.5% (Type IV), CV and BV running separately while MCV was absent in 1% (Type V), MCV was absent and MBV and MCeV emerging out from BV and CV respectively and then draining independently into deep veins in the cubital fossa in 0.5% (Type VI) of the total cases respectively.
Conclusion: While most of the findings in this study were consistent with other studies, some of the observations found like variations of Type-V and Type VI were uncommon in other studies. This highlights the fact that knowledge of variations in venous patterns is important to the medical and paramedical workers, especially in conditions that require venepuncture, cardiac catheterization and renal haemodialysis.
| A Study on the Bifurcation of Sciatic Nerve with Its Clinical Significance | | |
S. Biswas, S. Majumdar, D. Saha, T. Sett
NRS Medical College, Kolkata, West Bengal, India
Objective: To study bifurcation of sciatic nerve at different levels (e.g. in the pelvis, at the gluteal region, at the back of the thigh, in the popliteal fossa etc.) as the point of bifurcation of sciatic nerve is very much va riable.
Methods: A study was conducted on the division of the sciatic nerve, in the Department of J'l.natomy, NRS Medical College, Kolkata, over two years, from December, 2012 to the November, 2014. 50 inferior extremities of 25 cadavers were dissected for this study. The dissections were done while teaching MBBS Students in the said department. The relevant structures were observed minutely and photographs were taken.
Observations: Among the fifty inferior extremities, in the sciatic nerve was found to be divided into tibial and common peroneal nerves in different levels (in the pelvis, gluteal region etc.)
Results: Out of fifty lower limbs, in forty one cases (82%) the sciatic nerve divided in the back of the thigh, near the apex of the popliteal fossa according to normal anatomy. In nine lower limbs {18% cases), the nerve divided high above, either in the Pelvis {14% cases) or in the gluteal region {4% cases).
Conclusion: This high division of the sciatic nerve may result in nerve injury during deep intramuscular injections in the gluteal region, sciatica, piriformis syndrome etc. So this variation has importance in gross and clinical anatomy.
| Multiple Tendinous Insertions of Extensor Hallucis Longus at the Hallux: A Cross-Sectional Study | | |
R. Mahajan
Amity Institute of Physiotherapy, Amity University, Noida, Uttar Pradesh, India
Objective: Extensor hallucis longus (EHL) is a muscle of extensor compartment of the leg and accessory tendinous slips arising from it have been associated with hallux valgus, hallux varus, pain in forefoot, and have been implicated in reconstructive surgeries of hallux dysfunction. The present study aims to note the incidence of variations and clinical implications of different variants of insertion of EHL at the hallux.
Methods: After proper ethical considerations, the present study was conducted by gross anatomy dissection of 60 lower limbs of 30 embalmed adult human cadavers (20 male and 10 female) of age group 20-85 years, used for routine educational dissection in department of Anatomy, Lady Hardinge Medical College, New Delhi. The extensor muscles of front of leg and dorsum of foot were dissected bilaterally, from their origin till insertion; the variations noted were recorded, photographed, and results were analyzed.
Results: In 4 lower limbs (6.67% cases), an extra tendon arising from Extensor hallucis longus was seen in the middle of the right leg which joined muscle fibres from the main belly, and divided into 2 tendinous slips before its insertion at the base of proximal phalanx, where it joined Extensor hallucis brevis tendon and merged with dorsal digital expansion of right hallux. Other limbs did not show any tendinous variation at the hallux.
Conclusion: The results obtained in the current study can facilitate foot surgeons and orthopaedicians in meticulous planning of tendon repair by grafting, and other reconstructive surgeries for hallux dysfunction.
| Intrahepatic Branching Pattern of the Portal Vein: A Pilot Study | | |
H. R. Singh, S. Rabi
Christian Medical College, Vellore, Tamil Nadu, India
Background and Objective: The normal portal vein anatomy occurs only in 90% of cases. The information regarding the variations in the portal anatomy would help the hepatobiliary surgeons in minimizing iatrogenic complications. The present study aims to determine the variation in the intrahepatic branching pattern of the portal vein by modified corrosion casting technique.
Materials and Methods: Modified corrosion cast technique was done on the portal veins of fifteen formalin fixed livers. After curing, the portal vein was detected by finger fracture dissection technique and its branching pattern was studied.
Results: Variations were noted in the intrahepatic branching pattern of the portal vein. The caudate lobe received a single branch either from the left portal vein or from the point of bifurcation of main portal vein into right and left branches, or dual supply from both right and left portal veins. Other variations like early segmentation of right portal vein supplying segment VIII and early segmentation of right posterior segmental division supplying segment VI were noted. A rare variation where the segment VIII did not received its supply from the right portal vein but from the vertical portion of the left portal vein was noted. In one specimen, the segment IV, in addition to its branches from the left portal vein, also received branches from the right anterior sectoral division.
Conclusion: While variation in the branching pattern of the right portal vein was substantial, the left portal vein anomalies were less frequently encountered.
| A Study of Anatomical Variations in Transverse Foramen of Cervical Vertebrae for Morphological and Clinical Importance | | |
A. P. Singh, A. Tripathi1
Heritage Institute of Medical Sciences, Varanasi, 1Subharti Medical College, Meerut, Uttar Pradesh, India
Introduction: Cervical vertebrae constitute the skeletal framework of vertebral column in the region. The most important feature to identify the cervical vertebra is the presence of foramen transversarium. Vertebral artery, vertebral vein & sympathetic chain run through these foramen as a single unit. Compartmentalization or abscence of the foramen may alter the course of these structures.
Materials and Methods: The study was performed on 240 dry human cervical vertebrae of both sexes, which were collected from Anatomy department of SMC, Meerut & HIMS, Varanasi. The variations in number and shape were observed, recorded and analysed. The intact cervical vertebrae without any degenerative or traumatic disorders were included in this study.
Results: Out of 240 cervical vertebrae, Complete double transverse foramina were observed in 48 vertebrae (20%), out of which unilateral double foramina were found in 29 vertebrae (12%) and bilateral double foramina were found in 19 vertebrae (8%). Incomplete double transverse foramina were observed in 15 vertebrae (6%), of which the foramina were unilateral in 8 vertebrae (4%) and bilateral in 5 vertebrae (2%). Bilateral accessory foramen on posterior arch of one atlas vertebra was also observed.
Conclusions: As per the findings, right sided variations were more frequent than the left. These variations may alter the course of vertebral artery. Presence of compartmentalization suggests the chances of compression of neurovascular bundle and spicules of incomplete septation between the two foramina may pierce the vascular or neural structures resulting into vascular insufficiency or persisting pain. These findings may suggest a cue to the spinal surgeons in planning preoperative procedures for surgeries related to this region.
| Anatomical Patterns of the Pancreatic Ductal System: A Cadaveric Study | | |
M. Prasad, S. Rout, S. Rabi
Christian Medical College, Vellore, Tamil Nadu, India
Objectives: The aim is to identify the different anatomical patterns of the pancreatic ductal system, its associated variations and their prevalence in human adult pancreas specimens.
Materials and Methods: Fifteen adult pancreas specimens with intact second part of duodenum, of unknown age and gender were dissected by piecemeal method. The specimens with mass were excluded from the study.
The anatomical patterns were classified as six different types based on the course of the main pancreatic and accessory duct and its opening in the duodenal wall. Its variations like pancreas divisum, ansa pancreatica and the pattern of the pancreatico-biliary union were studied. The data was statistically analysed.
Results: The major duodenal papilla was present in all the 15 specimens. The minor duodenal papilla was present in 11 (73.3%). The main pancreatic duct was single, had a straight course in (n-7, 46.67%), descending course (n-6, 40%) and sigmoid course (n-2, 13.3%). The accessory duct was present in 10 (66.67%). The most common pattern was Type 3 where the accessory duct was blind (n-7, 46.67%). Ansa pancreatica was seen in one specimen. The pancreatico-biliary union was mostly in the duodenal wall (n-13, 86.67%) and extra-duodenal in 2 (n-2, 13.32%).
Conclusion: The accessory duct was mostly blind at its opening in the duodenal wall or absent. The main pancreatic duct often had a straight course. This might be helpful for the radiologists during interventional procedures.
| Supernumerary Heads of Biceps Brachii in Eastern Indian Population with Its Clinical Significance | | |
R. Praveen Kumar, Pravash Mishra, Manisha R. Gaikwad, Amit Tirpude, Madhusmita Panda1
Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, 1Department of Anatomy, SCB Medical College, Cuttack, Odisha, India
Background: Biceps brachii is the commonest muscle in upper limb showing multiple variations. The multiple heads of biceps brachii confuses the radiologist regarding muscle tear during MRI with history of pain around the shoulder and arm. The supernumerary heads of biceps can be used as flap in case of massive axillary wound repair.
Objectives: To document the incidence and anatomy of the supernumerary heads of biceps brachii in eastern Indian population.
Methods: A total of 50 embalmed upper limbs were dissected and examined for the variation in the origin of biceps brachii.
Results: Out of 50 upper limbs, five upper limbs (10%) show supernumerary heads of biceps with 2% showing bilateral representation. All the supernumerary heads were supplied by musculocutaneous nerve. Muscle bulk of the supernumerary head is approximately 25 % of whole biceps bulk.
Conclusions: Biceps muscle is well known for variation in its origin. Anomalous muscle tear may present as shoulder pain, in these patients MRI may be diagnostic. Detailed anatomy of supernumerary heads serves as a potential tool for graft or flap surgeries with preserving the function of superior extremities. The awareness of supernumerary heads of biceps in relation to adjacent neurovascular bundles is necessary for modern day imaging techniques and surgeries.
| Bony Features Related to Snapping Scapula Syndrome | | |
Ritu Singroha, Usha Verma, S. K. Rathee
Pt. B.D. Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
Objective: Snapping scapula is defined as a palpable, audible and sometimes painful scapulothoracic crepitus. This study aimed at focusing on bony features which are involved in the pathogenesis of snapping scapula and study their incidence, morphology and correlation to gender and side of scapula.
Methods: The study was performed on 50 pairs of human scapula of known sex in Department of Anatomy at PGIMS Rohtak. The parameters recorded were medial scapular border morphology, presence of Luschka's Tubercle and the presence of Teres major tubercle or process.
Results: The most common type of medial scapular border was found to be Convex (73%) followed by Straight and Concave types. Luschka's tubercle was observed in only 5% of the scapula. Teres Major tubercle was present in 29% of the scapula, whereas Teres Major process was present in only 11% of the scapula and the process was curved in only 2% of the scapula.
Conclusion: These findings are of great importance to orthopaedic surgeons in diagnosis and treatment of snapping scapula syndrome.
| Study of Femoral Neck Anteversion Angle in Central Indian Population: A Guide for Orthopaedic Surgeries Including Hip Arthroplasty | | |
D. Dhurandhar, J. Agrawal
Pt. J.N.M Medical College, Raipur, Chhattisgarh, India
Objectives: Femoral neck anteversion angle (FNA) is the angle which measures the anterior rotation of the neck of the femur around the shaft. Its variation in the various population groups is attributed to various factors such as heredity, diet, climatic factors and lifestyle. This angle is clinically significant for orthopedicians while doing hip arthroplasties and osteotomies where it is pertinent to restore the anatomy of proximal femur for stability of the hip joint. Thus, present study acts as a guide for normal values and range of this clinically significant angle.
Methods: 152 dried femora were procured from Department of anatomy consisting of 77 femora of right side and 75 femora of left side. Anteversion angle was recorded using Goniometer. Means were calculated and correlated for laterality using suitable statistical test after p value was obtained.
Results: Mean anteversion angle of right side was found to be 19.03° ± 12.10° (Range from -15 to 43) and that of the left side came out to be 18.62 ± 10.8° ( Range from -15 to 46). Among 152 femora taken, 7 retroverted and 7 neutral verted femora were also found in the study. No significant difference in the values of FNA was found between right and left side, p value > 0.05
Conclusions: So much variation in the angle of anteversion along with the presence of retroversion (4.6%) and neutral version (4.6%) is a challenge for both implant designer companies as well as orthopedicians.
| Morphometry of Tricuspid Valve Complex in Indian Population | | |
S. Maurya, A. Tuli, S. Raheja
Lady Hardinge Medical College, New Delhi, India
Objectives: Morphometry of tricuspid valve will be important for intervention and development of prosthesis during valve replacement in tricuspid regurgitation through parallel percutaneous approach.
Materials and Methods: Thirty formalin fixed hearts without any malformation or pathology were used in the study. The circumference, cross-sectional area, length of annulus, length and height of cusps of tricuspid valves were measured in cm by Vernier caliper and analyzed.
Results: The average circumference of tricuspid valves is 11.54 (range 8.2-14.1). The shape of the anterior leaflet was observed to be roughly semi circular to quadrangular with av.height 2.25 and length 4.3 Posteriorleaflet had 1-3 scallops with the av. Height and length 4.41.04. The septal leaflet was semi-circular in shape with av. length 4.4 and height 1.50.3. The average of area is 10.92.2.
Conclusion: Morphometric data will provide base line data with reference to the severity of the reduction in valvular lumen in cases of stenosis, and in treatment plan.
| Anomalous Origins of the Biceps Brachii Muscle | | |
A. Biswas, A. Bhar
Malda Medical College, Malda, West Bengal, India
Objective: To study the proximal attachments of the biceps brachii muscle.
Methods: Dissection of biceps brachii muscle in cadavers during routine dissection for the M.B.B.S. course. 16 cadavers (32 upper limbs) were dissected over a span of 3 years.
Results: An additional head originating from the anterior surface of the shaft of the humerus was found in the right upper limb of 1 cadaver. Bilateral anomalous origin from the capsule of the shoulder joint, in addition to the usual long and short heads from the supraglenoid tubercle & coracoid process, was observed in 1 cadaver. As far as we could ascertain, this has not been reported previously in the literature.
Conclusion: Two different anomalies were observed in our study. These anomalous attachments may affect the functioning of this muscle, the shoulder joint, as well as neurovascular structures in the vicinity of the muscle, facts that are to be borne in mind during surgery in this region.
| Phenoxetol as a Preservative Agent for Museum Specimens: A Pilot Study | | |
F. Sam, D. V. Francis, J. S. Michael1, S. Rabi
Departments of Anatomy and 1Microbiology, Christian Medical College, Vellorem, Tamil Nadu, India
Objectives: To evaluate the effectiveness of phenoxetol as a preservative agent for museum specimens.
Methods: Six viscera and an upper limb extracted from formalin fixed cadavers was stored in 1% phenoxetol and the similar set in 10 % formalin for a period of 9 months. At the end of 9 months, the colour, appearance, consistency of the specimens and flexibility of joints were evaluated and compared. Microbial assay was done on 12 samples to determine the growth of microorganisms. Questionnaires were given to the staffs handling them.
Results: The colour of the specimens in phenoxetol was enhanced when compared to formalin. There was no sloughing of tissues. The consistency of the specimens was soft in phenoxetol when compared to formalin. The solutions were not renewed during the study period as there were neither exudates nor turbidity. Questionnaires given to the staffs suggested that they have experienced unpleasant smell. No sign of visible growth of molds. Microbial assay at the end of 9 months revealed no growth in both formalin and phenoxetol preserved specimens.
Conclusion: 1% phenoxetol can be satisfactorily used for preserving museum specimens.
| Role of Fingerprint Patterns in the Histopathologically Diagnosed Breast Cancer Females | | |
Sajjad Jafar, Vishram Singh1, NIsha Kaul1, Bindu Singh
BRD Medical College, Gorakhpur, Haryana, 1Santosh Medical College, Ghaziabad, Uttar Pradesh, India
Objective: The purpose of this study is to examine the fingerprint patterns among women with histopathologically breast cancer and control groups.
Materials and Methods: The study was conducted 145 histopathological diagnosed breast cancer women and their fingerprint patterns compared with 145 normal healthy females with no family history of breast cancer. The difference of qualitative data was tested for their significance using the chi square test.
Results: The fingerprints patterns were analyzed between breast cancer and control group of individuals which showed statistically difference. In our study results shows ulnar loops are frequently found in breast cancer patients as compared to control group, which is statistically significance.
Conclusion: According to our study we conclude that dermatoglyphics may help in identifying women with risk of breast cancer. The dermatoglyphics can serve as an inexpensive, noninvasive anatomical and effective tool to determine the individuals with breast cancer in their future. Through this study more women live can be saved and improve the results of diagnosis of breast cancer due to early detection of diseases.
| Incidence of Carotico-Clinoid Foramen in Human Adult Dry Skulls in the Department of Anatomy, JNIMS, Imphal, Manipur | | |
J. Tunglut, T. S. Gurumayum, S. Wahengbam
Jawaharlal Nehru Institute of Medical Sciences Imphal, Manipur, India
Objectives: To conduct a study on the incidence of caroticoclinoid foramen along with side dimorphism in dry human adult skulls.
Materials and Methods: The study was conducted in a forty (40) dry human adult skulls at the Department of Anatomy, JNIMS, Imphal, manipur. The caroticoclinoid foramen were first identified and were observed based on the three following paramaters;
- Presence/ absence
- Complete/ incomplete
- Unilateral/ bilateral
All the observed parameters were photographed and the overall incidence of caroticoclinoid
Foramen was calculated and a comparative discussion was carried out.
Results: Overall incidence of the caroticoclinoid foramen was 10% Four skull bones were observed to have the caroticoclinoid foramen. Complete caroticoclinoid foramen were observed in 2 skull bones and incomplete in 2 bone was observed. Out of 40 skulls, 2 were found to have unilateral and incomplete foramenAnd 2 with complete and bilateral caroticoclinoid foramen.
Conclusion: Knowledge of the presence of caroticoclinoid foramen will help in the diagnostic and surgical approaches of the neurosurgeons during the surgery as the osseous carotico-clinoid foramen is related with important neuronal and vascular structure particularly the internal carotid artery.
| Morphological Variations in Lumbricals of Hand: A Cadaveric Study | | |
Rajni, R. Mishra1
Department of Anatomy, P.D.U. Medical College, Churu, Rajasthan, 1SIMS, Hapur, Uttar Pradesh, India
Objective: The hand is a prehensile organ, it is endowed with grapsing and precision movements for skilled work and acts as chief tectile apparatus. Much of the versality of hand depends upon its intrinsic musculature. The lumbrical muscles constitute an important part of intrinsic muscles of hands. They arise from four tendons of flexor digitorum profundus in the hand and passing on radial side of corresponding metacarpophalangeal joint and are inserted into the dorsal digital expansion of medial four fingers.
Methods: The study was conducted in the department of anatomy SIMS, Pilkhuwa, Hapur, U.P. For this study 30 hands of formaline embalmed cadavers were dissected. For dissecting the hand we were followed Cunnigham, s manual.
Results: Normal origin of lumbricals were present in 22 hand, proximal origin in 2, bipinnate 2nd lumbrical in 3 cases, absent 3rd lumbrical in 2 cases, hypertrophied lumbrical in 1 case. These variations were critically analysed in the light of accessible literature.
Conclusion: Lumbricals are more variable then other muscles and variations are more common in right hand also. These kind of variations in lumbricals were not only important for anatomists but also to orthopaedic surgeons, physiotherapists and radiologists. The above reported variations are very significant during hand surgeries.
| Accessory Renal Vessels | | |
Hema Nagpal, Rajni Patel, Renu Mishra
Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh, India
Objective: With the advent of laparoscopic renal surgeries and donor nephrectomies, it becomes mandatory for the surgeons to understand the abnormality or variations in the renal vasculature. The aim of the study to identify the variation of multiple renal arteries and to highlight the connections between the presence of accessory renal arteries and the coexistence of other variants of vascularization.
Materials and Methods: Material of this study comprised of 25 adult human cadavers (50 sides kidneys). These were dissected to expose the kidneys and their arterial supply. The renal and accessory renal arteries were traced up to their origin from abdominal aorta.
Results: In the present study multiple accessory renal vessels were found in 6 cases (12%). We also found a rare case report with multiple (more than two) accessory renal arteries and origin of inferior phrenic artery from main renal artery.
Conclusion: This study is of particular importance for surgeons, intervention radiologists, nephrologists and vascular surgeons.
| Morphological Study of Zygomaticofacial Foramen in Adult Human Skulls | | |
Gogi Premalatha, K. R. Dakshayani
Mysore Medical College and Research Institute, Mysore, Karnataka, India
Introduction: Zygomaticofacial foramen is present on the lateral aspect of zygomatic bone. The knowledge of incidence and location of zygomaticofacial foramen has surgical importance. The objective of the present study is to observe presence or absence of zygomaticofacial foramen on both sides, to know the number of foraminas, measure the distance of zygomaticofacial foramen from frontozygomatic suture, zygomaticomaxillary suture and inferion orbital margin with vernier caliper
Materials and Methods: 80 skulls of unknown sex were collected from department of Anatomy, Mysore Medical College & Research Institute, Mysore and zygomaticofacial foramens were evaluated on both sides of the skull by physical inspection.
Results: The number of zygomatico facial foramen varied from single to as many as 3 foramen & absence of zygomaticofacial foramen was also noted. Depending on the number of foramen the zygomatic bone was classified into Type I – Type IV for single, double, triple & absence of zygomaticofacial foramen respectively and the frequencies were noted as follows Type I 71.25%(left); 57.5%(right) Type II 18.75%(left) ;31.25%(right), Type III 5%(left) ;7.5%(right), Type IV5%(left) ;2.5%(right). The mean distance of zygomaticofacial foramen from zygomatico maxillary suture is 14.0 mm (left); 12.9 mm (right) nearest part of orbital margin 7.02 mm (left) ; 7.9 mm (right), fronto zygomatic suture 21.7 mm (left) ; 21.3 mm (right) respectively.
Conclusion: Knowledge on these variables will be helpful for surgeons for surgical procedures like orbitozygomatic craniotomy, for nerve block & malar reduction surgeries.
| Study of Anatomical Variations of Profunda Femoris Artery in the Indian Population | | |
M. Angom, D. Bandopadhyay, S. Kumar
AFMC, Pune, Maharashtra, India
Introduction: The femoral artery is commonly used for angiographic procedures. The Profunda femoris artery (PFA) is the largest branch of femoral artery. The knowledge of anatomic variation of PFA is clinically significant in view of most angiographic diagnostic procedures being performed in this region. A high origin of PFA is closely related with femoral nerve and its branches posing immense challenge to revascular surgeries in this region.
Objective: To study the variation of PFA with respect to its origin, distance of origin from mid inguinal point and the direction of origin.
Methods: A total of 30 femoral triangles were dissected in 15 human cadavers. The PFA was identified and its source, site and direction was noted.
Results: The PFA originated from the posterolateral aspect of the femoral artery in 53.33%, lateral aspect in 33.33%, posterior aspect in 10% and from the anterolateral aspect in 3.33% of the cases. The PFA was found to originate from external iliac artery in 10% cases (3 out of 30) out of which the variation was seen bilaterally in one cadaver. The mean distance of origin of PFA from the mid inguinal point is 23 mm.
Conclusion: Knowledge in the anatomical variations of the PFA helps the clinician to avoid iatrogenic injury while performing various procedures like angiography, venous excess for femoral vein, femoral nerve block. Pseudo aneurysms can occur when the puncture site is the PFA or Femoral artery distal to the origin of the PFA.
| The Distance of the Popliteal Artery from Adductor Tubercle and Head of Fibula: A Cadaveric Study in Western Maharashtra | | |
A. Telang, M. Natarajan, P. Bhuiyan
Seth G S Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
Objectives: The popliteal artery is exposed in the popliteal fossa for peripheral vascular disease, aneurysms, thrombotic, neoplastic, inflammatory and traumatic conditions. The popliteal artery is a common recipient site for above or below knee bypass grafts. The aim of this study was to measure the distance of the popliteal artery from the insertion of the hamstring part of adductor magnus muscle on adductor tubercle and biceps femoris muscle on head of fibula.
Methods: Fifty embalmed cadavers were utilized in this study. The popliteal fossa was dissected to expose the popliteal artery from origin to its termination. The insertion of the hamstring part of adductor magnus muscle on the adductor tubercle and insertion of the biceps femoris muscle on the head of fibula was exposed. The distance of the popliteal artery from adductor tubercle and head of fibula was measured.
Results: The data was statistically analysed. It was found that the mean distance between medial margin of popliteal artery and adductor tubercle of femur on the right side was 42.24 mms, and 42.88 mms on the left side. The mean distance between the lateral margin of popliteal artery and head of fibula on the right side was 36.7 mms and 36.9 mms on the left side.
Conclusion: This morphometric data will be helpful for localisation of popliteal artery for various surgical procedures involving knee and popliteal fossa.
| Arcuate Line of Rectus Sheath: Surgical Relevance | | |
Rashmi Patil, Lakshmi Rajgopal
Department of Anatomy, Seth G S Medical College and KEM Hospital, Parel, Mumbai, Maharashtra, India
Objectives: To determine the location of arcuate line with respect to anterior superior iliac spine, umbilicus and pubic symphysis. To study the type of arcuate line. To study the relation of arcuate line and inferior epigastric artery
Methods: The study was conducted on 30 sides in 15 embalmed cadavers during routine dissection for undergraduate students in the department of Anatomy of Seth GS Medical College Mumbai. The abdominal dissection was carried out and the rectus sheath was exposed. The arcuate line was identified on either side and the measurements were taken with the help of divider, scale, pin and thread. The measurements were noted on the proforma sheet and then analysed.
Results: The location of arcuate line was seen to be closer towards the umbilicus and in one case it was seen to lie in the plane joining the two anterior superior iliac spines. The arcuate line was found to be of Type I in 18 sides and type II in 12 sides. The inferior epigastric artery was not found to enter the rectus sheath on both sides of two cadavers.
Conclusions: The location of arcuate line is variable and so are its relation with the bony landmarks and the inferior epigastric artery. The understanding of these variable patterns is mandatory for various surgeries pertaining to the region and more so for the harvesting of a rectus abdominis musculocutaneous flap in the repair of ventral hernia.
| Surface Marking of Deep Inguinal Ring: Is it relevant? | | |
Lakshmi Rajgopal, Rashmi Patil
Department of Anatomy, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
Objectives: Deep inguinal ring is described to be located variably in mid-inguinal point (MIP) or midpoint of inguinal ligament (MPIL) in different text books of Anatomy and Surgery. This study was conducted to A. Measure the distance between
- Anterior superior iliac spine (ASIS) and MIP
- ASIS and MPIL
- ASIS and deep inguinal ring (DIP)
- Pubic tubercle and DIP
- Pubic symphysis and DIP
B. Analyse statistically which landmark does the DIP lie close to.
Methods: 28 inguinal regions from 14 cadavers were meticulously dissected to expose the inguinal canal. MIP and MPIL were noted down after measuring the distance between ASIS and pubic symphysis and that between ASIS and pubic tubercle respectively. The distances between ASIS and MIP, MPIL and DIP were measured. The distances between DIP and pubic tubercle and pubic symphysis were measured.
Results: The mean distance at which DIP lies from ASIS was 6.6 cm; the mean distance between DIP and pubic tubercle was 6 cm and the mean distance between DIP and pubic symphysis was 7.58 cm.
Conclusions: DIP lies between MIP and MPIL and closer to pubic tubercle than to pubic symphysis. When an indirect inguinal hernia develops, there is a traction on DIP, further distorting the distances. Deep inguinal ring occlusion test to differentiate direct inguinal hernia from indirect inguinal hernia may not be relevant.
| Study of Morphological Variations of Fissures and Lobes in Cadaveric Human Lungs | | |
B. Mallika, K. R. Dakshayani
Mysore Medical College and Research Institute, Mysore, Karnataka, India
Introduction: The lungs are divided by fissures into lobes which facilitate movements of lobes in relation to one another during respiration. The arrangement of lung tissue into lobes helps in uniform expansion of whole lung in inspiration.
Objective of the Study: To study the morphological variations of fissures and lobes in cadaveric human lungs under the following headings: 1) presence or absence of fissure. 2) Complete or incomplete fissure. 3) Presence of accessory fissures. 4) Number of lobes.
Materials and Methods: The study was done in 50 lung specimens (25 - right side and 25 left) which are collected from 10% formalin fixed adult cadavers of unknown sex in the Anatomy Department, Mysore Medical college & Research Institute, Mysore. The thoracic cage was dissected according to the Cunningham's manual and observed for the patterns of lobes and fissures on both sides.
Results: Right lung variations- 9 (36%) lungs showed only 2 lobes. Horizontal fissures was absent in 8 (32%) specimens, incomplete horizontal fissure was in 11 (44%) specimens, incomplete oblique fissure was in 9 (36%) specimens. 6 (24%) specimens had accessory fissures. Left lung variations-3 lobes was observed in 1 (4%) lungs, horizontal fissure was observed in 1 (4%), 8 (32%) had incomplete oblique fissures. Accessory fissures were observed in 8 (32%) specimens.
Conclusion: The knowledge of such anatomical variations is very much useful for surgeons who are planning for lobectomies & surgical resections involving individual segments to avoid post-operative complications. It is also useful for radiologists for interpreting radiological images, and for physicians to appreciate spread of diseases.
| Embalming with Modified Embalming Machine and Modified Newer Fluid Composition | | |
S. Deshpande Asha, K. Deshpande Subhash, Suresh Managutti
Sri Dharmasthala Manjunatheshwara College of Medical Sciences and Hospital, Dharwad, Karnataka, India
Objective: To reduce the cost of embalming machine and embalming fluid.
Methods: A new embalming machine devised at SDMCMS&H Dharwad, used for embalming voluntarily donated cadavers with a modified cost effective embalming fluid. Totally 40 cadavers embalmed with this modified technique using modified embalming fluid.
Results: We have got good results with this modified embalming machine and modified composition of embalming fluid.
Conclusion: Certainly the cost of embalming a cadaver can be reduced by modified embalming machine and modified embalming fluid composition.
| Structural Asymmetry of Superior Articular Facet of Atlas | | |
N. Goyal, A. Jain
Christian Medical College, Ludhiana, Punjab, India
Objectives: Gross observations of the variations of superior articular facet of atlas have been extensively described. Still more is being added to it day by day due to its contribution to the movements of head. Recent developments in fixation technologies and minimally invasive surgical approaches have encouraged further studies of the region. Objectives of this study are to explore the shape, size and symmetry of the facet.
Methods: The present study was conducted on 75 atlas vertebrae available in the Department of Anatomy, Christian Medical College, Ludhiana. All the specimen were dry with intact superior articular facets and no regard was given to age or gender. Damaged and pathologically abnormal bones were excluded from the study. Shape, size and number of superior articular facets on each atlas were recorded to determine symmetry.
Results: Shape of the superior articular facet was found to be different on right and left sides in all the specimens, so none of the facets observed were mirror images of each other. Different shapes of the facet observed were kidney shaped, oval, irregular, 8-shaped etc. Another variation observed was the presence of two small facets separated by a non-articular area instead of a single large facet.
Conclusions: Asymmetry in the superior articular facet should be considered as the normal feature of the atlas and should not be considered as a variation. This asymmetry should be kept in mind while assessing the range of movement at the atlanto-occipital joint.
| Study of Variations in Talar Articular Facets of Human Calcanei in Central Indian Population | | |
Geslin Varghese
Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
Objective: The aim of the present study was to determine the various patterns of the talar facets of calcanei and their clinical implications in Central Indian population.
Methods: 200 dry calcanei of unknown sex and age available in the Department of Anatomy, Netaji Subash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India were studied. Observations were made with naked eye. Separation between the anterior and middle facets were measured with the help of vernier calipers.
Results: Literature describes 5 types of calcaneal facets. But only 3 types were observed in present study. Type I with fused middle and anterior facets were predominant (59.27%), followed by Type II with anterior and middle facets separated (33.33%). Type III with absence of anterior facets was found in 7.4 %. The work is still being carried out, so further details will be discussed at the time of presentation.
Conclusion: Study population (Central India) may be at greater risk of developing subtalar arthritis due to predominantType I calcanei as compared to the Europeans who present Type II. This fact necessitates the Indian orthopedic surgeons to modify western surgical techniques when they perform calcaneal osteotomy in correcting foot deformities.
| Morphological Study of Middle Cardiac Vein In Human Hearts | | |
Agarwal Jolly, Kumar Virendra
SRMS IMS, Bareilly, Uttar Pradesh, India
Objective: The aim of present work is a) to study the morphology of middle cardiac vein b) to study effect of weight of cadaver on the length of GCV.
Methods: The hearts were procured from the cadavers (age ranging from 15 to 65 years) available in the department of Anatomy SRMS IMS, Bareilly. The length and morphology of middle cardiac veins were noticed.
Results: In the present study, we found that in two hearts MCV reaches up to apex of heart (6.66%). And in one heart MCV was tortuous. The MCV was formed by many tributaries, in one heart two tributaries of MCV were enclosing posterior interventricular artery, and before draining into coronary sinus they form trunk (3.33%). In eight hearts the MCV and SCV together form common trunk and drain into coronary sinus (26.66%). We also found statistically significant relationship between length of MCV and weight of cadaver (r = 0.36, p value = 0.031).
Conclusions: The knowledge of anatomy of coronary venous system is important for the therapeutic options of arrhythmias and heart failure. Further, MCV can be used for radiofrequency ablation of a posteroseptal accessory pathway.
| An Anatomical Study of the Origin of the Recurrent Branch of the Median Nerve in Cadavers | | |
P. Iyer, L. Rajgopal
Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
Objective: The recurrent branch of the median nerve supplies the vital thenar muscles. A knowledge of its origin and relations is paramount for performing hand surgeries. Hence this research was carried out with the objective of studying the variations in the origin the recurrent branch of the median nerve and its relation to the flexor retinaculum.
Method: Ninety-seven embalmed upper limbs from 51 cadavers were used for the study. Distal part of the forearm and the entire palm was dissected to expose the flexor retinaculum and branches of the median nerve in the hand. The level of origin of the recurrent branch was measured from the proximal border of the flexor retinaculum and its relation with the flexor retinaculum and thenar muscles was noted.
Results: The mean distance between the proximal border of flexor retinaculum and the site of origin of the recurrent branch from the median nerve was found to be 24.44 mm on the right side and 24.30 mm on the left side. The recurrent branch of the median nerve arose from the lateral terminal branch of the median nerve in three cases. It originated deep to the flexor retinaculum in three cases.
Conclusion: A knowledge of the mean distance from flexor retinaculum and variations in the origin of the recurrent branch of the median nerve and its relation to the flexor retinaculum will help prevent iatrogenic injuries to it while performing hand surgeries.
| The Segmental Branching of the Hepatic Arteries in the Liver: A Cadaveric Study | | |
S. Garg, D. Sahni, T. D. Yadav, A. Aggarwal, T. Gupta
Postgraduate Institute of Medical Education and Research, Chandigarh, India
Objective: To evaluate the hepatic arterial sectorial and segmental branching (second and third order branching) in the right and left hemiliver as applicable to vascular mapping for various endovascular procedures in the liver.
Methods: The study was conducted on 100 formalin fixed adult cadaveric livers. The arterial anatomy of the liver was dissected from the origin of hepatic arteries up to their segmental branching.
Results: The conventional segmental branching of both right and left hepatic arteries was seen in 25% livers only and in the remaining livers, segmental branching of one or both the hepatic arteries was different from that given in anatomy texts. The branching of the right and left hepatic arteries were anatomically classified into seven and six patterns respectively mainly on the basis of their sectorial and segmental anatomy.
Conclusions: The present study gives the details of highly diverse segmental arterial anatomy of the liver. The information thus provided has important implications for procedures involving selective catheterization of segmental arteries.
| The Anatomy of the Coronary Ostia and Its Relation to the Sinotubular Junction | | |
J. S. Luckrajh, L. Lazarus, K. S. Satyapal
University of KwaZulu-Natal, Durban, South Africa
The coronary ostia (CO) lie within the left and right aortic sinuses of Valsalva and are bound by the sinotubular junction (STJ) superiorly. The high frequency of cardiac procedures that require cardiac catheterization has necessitated a reappraisal of the anatomy of the coronary arteries. This study aimed to describe the CO by recording its diameter, shape, and relation to the sinotubular junction.
A total of 50 adult cadaveric hearts were dissected. The average diameter of the right coronary ostium (RCO) was 3.29 mm and the left coronary ostium (LCO) was 3.87 mm. With regard to shape, the RCO was described as circular in 52%, horizontally oval in 24% and vertically oval in 24% of cases. The LCO was circular in 30%, horizontally oval in 60% and vertically oval in 10% of cases. The RCO was located below the STJ in 88% and at the level of the STJ in 12% of cases. The LCO was recorded below the STJ in 64%, at the level of the STJ in 32% and above the STJ in 4% of cases. Multiple ostia were recorded in both the right aortic sinus (12%) and left aortic sinus (2%). In 2%, the RCO was anomalously located in the non-coronary sinus.
Variations of CO, although asymptomatic, have been linked to myocardial infarction and sudden cardiac death. It is therefore imperative for the clinician to be aware of variant CO anatomy, which may alert them to the predisposition of cardiac risks.
| Phenoxyethanol: Efficacy as a Preservative | | |
S. M. Rustagi, M. S. Ahuja
Army College of Medical Sciences, Delhi, India
Objective: Formaldehyde has been declared as a potential carcinogen. To reduce its harmful effects like respiratory distress, red eyes, nose and throat irritation in the dissection Hall 1% Phenoxyethanol (PE) has been used as an alternative preservative for embalmed bodies. PE (ethylene glycol monophenyl eher) is a non-toxic lightly scented, common chemical often used in cosmetic and first-aid products. This study evaluates PE as an alternative to formaldehyde for preservation of cadavers and human tissues.
Methods: Tissue samples preserved in 5% formaldehyde were compared with those in 1% PE (prefixed in formaldehyde) over a year.
Results: The cadavers and specimens preserved were soft in consistency and retained their colour. They were found to be suitable for display purposes and dissection. Fungal growth on these specimens was rare. No bacteria could be cultured after incubation period of 72 hrs. The students found experience with cadavers preserved in PE pleasant as it has a fruity smell as compared to the offensive odour of formaldehyde.
Conclusion: This review summarizes the uses and efficacy of Phenoxyethanol as a preservative for specimens and embalmed bodies. Dilute phenoxyethanol (1%) is relatively inexpensive, non-flammable, slow to evaporate, effectively antimicrobial and an excellent tissue preservative and softener.
| A Study on Variation of Nutrient Foramen of Humerus with Its Clinical Implication | | |
J. R. Keshri Ravi
Department of Anatomy, RIMS, Ranchi, Jharkhand, India
Objective: To determine the number, location and direction of nutrient foramen and whether the nutrient foramen obey the rule of ossification, that is directed away from the growing end of bone or not.
Methods: The present study consists of 100 (46 right and 54 left ) dried humeri excluding any fracture or pathlogical abnormalities in Department Of Anatomy Rims Ranchi. Number, direction and location of nutrient foramina were observed in each humerus.
Result: It has been observed that single nutrient foramen is present in 58.87% of humeri. Double is present in 30.85% humeri. Triple is present in 2.98% of humeri and four is present in 2.98% of humeri and 2.98% humeri did not have any nutrient foramina. It was observed that majority (86.86%) of nutrient foramen were present on the antero-medial surface, 7.52% on the anterolateral surface and 5.62% on the posterior surface of the shaft of the humeri. All the foramina were directed towards the lower end of humeri.
Conclusion: By knowing the number and location of nutrient foramina in humerus would be useful in preventing surgical injury to nutrient artery during orthopedic, plastic and renconstructive surgeries and it is also relevant in medicolegal practice.
| Morphological Variations of Jugular Foramen in Human Adult Skulls of Jharkhand Population | | |
C. Chanda, R. Prasad
Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
Aim: To study the morphological variations of the Jugular foramen and find their incidence in Jharkhand population.
Objective: To have the knowledge of these variations as distinctive anatomical entities that may have clinical implications with respect to the vascular and neural structures traversing the foramen.
Materials and Methods: A Prospective Observational study was carried out over a period of one year (from 1/6/2017 to 31/5/2018) on 30 adult human skulls, obtained from the Department of Anatomy, RIMS, Ranchi. Specimens included for the study were fully dried, intact, adult human skulls. Specimens excluded from the study were pathologically malformed and damaged skulls. Jugular foramina were observed for – 1. Variation in size of left and right sides (maximum antero-posterior and medio-lateral diameters measured with Vernier Caliper), 2. Variation in shape and location, 3. Bridging pattern (Partial/Complete), 4. Presence of well formed dome of jugular fossa, 5. Presence of accessory foramina.
Results: The jugular foramen was found to be larger on the right side in 76.67% skulls, larger on the left side in 13.33% skulls and of almost equal size in 10% skulls. Right side foramen of one skull (3.33%) was found to be of oval shape with regular margin, shifted posteriorly and located transversely. Incidence of complete bony septation was found in 16.66%, partial bony septation in 43.33% and absence of septation in 40%. Partial septation was seen in 33.33% on right side, in 30% on left side and 13.33% bilaterally; complete bony septation resulting in bipartite foramen was observed in 13.33%, tripartite foramen in 3.33%. Incidence of well formed dome was found bilaterally in 53.3% of skulls, unilaterally in 36.6% and absent in 13.33%. Accessory foramina were found in 46.66% of skulls; 14.28% on right side, 35.71% skulls on left side and 50% bilaterally, most of them were seen communicating with posterior condylar canal.
Conclusion: The foramen was found larger on the right side in accordance with the fact that most of the venous blood gets drained from superior sagittal sinus via right transverse and sigmoid sinus into right internal jugular vein. The bony bridging patterns can cause compression of vascular and neural structures passing through the foramen. The accessory foramina could indicate the need for passage of additional emissary veins connecting sigmoid sinus with occipital veins. So, the variations observed are of clinical importance to neurosurgeons and ENT surgeons in surgical procedures involving middle ear and skull base.
| Cadaveric Study of Renal Vasculature Variations: Implications During Diagnostic and Operative Procedures | | |
A. Rohilla, K. Singh, P. Parmar
Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
Objective: Variations in the origin, course and branching pattern of the renal artery occur frequently and are of special interest to the urologists, nephrologists, surgeons and radiologists, with respect to the diseases associated with them. Since the accurate knowledge about variations in renal arteries was lacking, hence this study was undertaken to study renal vasculature arrangement & its variations in human cadavers.
Method: Sixty-four formalised kidney specimens were studied in the Department of Anatomy, Pt. B. D. Sharma PGIMS, Rohtak for renal hilar vessels and their variations.
Results: Four kidney specimens were observed to have anomalous vasculatures: triple renal veins in addition to an accessory renal artery, inferior phrenic artery originating from renal artery, double and triple renal arteries.
Conclusion: The present study thus adds to anatomical data and contributes in creating an awareness of morphology and topography of anomalous renal vasculature for the safe diagnostic & operative procedures especially renal transplant surgeries.
| Morphometric Study of Oval Window: An Anatomical Study | | |
A. Singal, T. Gupta1, D. Sahni1, A. Aggarwal1, A. Gupta2
Department of Anatomy, Bhojia Dental College and Hospital, Baddi, Himachal Pradesh, Departments of 1Anatomy and 2Otorhinolaryngology and Head-Neck Surgery, PGIMER, Chandigarh, India
Objective: The objective of this investigation was to do the morphometric measurements of oval window (OW). The oval window is key structure while performing surgeries in relation to stapes.
Methods: Sixty non-pathological formalin preserved cadaveric temporal bones of known age; sex and side were micro-dissected to expose the medial wall of the middle ear. The maximum height and width of oval window was measured. The shape of oval window was noticed.
Results: The mean value for maximum height and maximum width of OW was 1.31 ± 0.28 mm and 2.67 ± 0.42 mm respectively. The height of OW ranged between 1 mm and 1.5 mm in majority and the width of OW was found between 2 mm and 3 mm in majority (83.3%). Oval window was found to be oval shaped in majority, other shapes like kidney, D shaped, rectangular or trapezoidal were also observed.
Conclusion: The knowledge of oval window size and shape may help in preoperative assessment and surgical planning, as the variations in its size, may influence various surgical procedures like stapedotomy and placement of implants within and around the OW niche.
| Sex Determination by Incus | | |
K. Singh, A. Rohilla
Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
Objective: The determination of sex from skeletal remains is an indispensable tool in forensic medicine and in physical anthropology regardless of the state of preservation. The Incus is housed in the middle ear; so, it remains well protected even in the mutilated bodies. Differences in the dimensions of bone lead to the development of discriminant functions for the determination of sex.
Method: Sixty pairs of incus bones were retrieved from unclaimed bodies and were studied in the Department of Anatomy, Pt. B. D. Sharma PGIMS, Rohtak for sexual dimorphism in North Indian population by discriminant function analysis.
Results: No statistical significance was observed on comparing morphometric parameters of incus of both the sexes for left & right side respectively. But, discriminant function analysis of the different parameters of incus showed that these parameters provide us a good criterion in determining the group centroids and significance of percentage accuracy in determination of sex.
Conclusion: It is observed that study of normal dimensions and indices will provide insight in to reconstruction of ossicular chain for the surgeons, which may have been congenitally absent, malformed, fixed, disrupted or destroyed by trauma or disease.
| OGA-041 | | |
| Variations of the Aortic Arch: A CT and Cadaveric Study | | |
U. G. Pandalai, M. Pillay, T. T. Sukumaran
Department of Anatomy, Amrita School of Medicine, Amrita Vishwa Vidhyapeetham, AIMS, Kochi, Kerala, India
Objective: Despite adequate preparations and accurate preoperative assessment unrecognized variation of the vascular anatomy of the AA can lead to unexpected situations during vascular surgery. In this context, an attempt has been made to figure out the variations of aortic arch and its branching pattern from CT images as well as 17 cadavers available in the Department of Anatomy.
Methods: A total of 4000 CT chest contrast images (2400 male and 1600 female) and 17 cadavers (13 male and 4 female) were studied. Chest CT images were obtained from the Radiology Department, of patients who were referred from other clinical departments for undertaking a CT scan for various clinical indications. Aortic arch and its branches were dissected and exposed in the cadaver and results were documented by digital photography.
Results: A total of 27 variations were observed amongst 4000 CT images. This includes aberrant right subclavian artery 7, bovine arch 1, bovine origin of left vertebral artery from arch1, bronchial artery of anomalous origin 1, double aortic arch 1, and right sided aortic arch 16. Out of 17 cadavers dissected only in one case the left vertebral artery was seen arising from the aortic arch as the 3rd branch between left common carotid artery and subclavian artery.
Conclusions: Aortic arch and its branching pattern are subject to a number of variations courtesy its development and the awareness of these can avoid complications in diagnostic and surgical procedures of thorax and neck.
| Anatomy of Infrarenal Lumbar Splanchnic Nerves as Relevant to Retroperitoneal Nerve Sparing Surgery: A Cadaveric Study | | |
D. Sharma, A. Aggarwal, T. Gupta, C. Kumari, D. Sahni
PGIMER, Chandigarh, India
Objective: Retroperitoneal surgeries are often associated with post-operative ejaculatory dysfunctions. For successful nerve sparing surgery detailed knowledge of anatomy of lumbar splanchnic nerves (LSN) is mandatory. The present study was aimed to record number and positional variability of infrarenal lumbar splanchnic nerves.
Methods: The study was conducted on 15 embalmed adult human cadavers. Lumbar part of sympathetic chain, corresponding splanchnic nerves were dissected from the level of left renal vein to pelvic inlet. Number and origin of the lumbar splanchnic nerves from the sympathetic trunk were noted.
Results: Total 71 LSNs (nRIGHT= 35, nLEFT=36) were identified joining the cords of aortic plexus. Number of LSN joining the cord below the level of left renal vein varied from 2-4 cm. Second LSN was most consistently present and the 4th LSN was present in 4 cadavers only. Position of each LSN varied greatly. Centre of the superior hypogastric plexuses was shifted to the left of aortic bifurcation in 33 % cadavers and the average width of the plexus was 1.21 cm.
Conclusion: Collective knowledge about LSN gathered from this study would help the surgeon in minimizing post operative complication related to ejaculatory dysfunction.
| Measurement of Carrying Angle in North Indian Children | | |
M. Aggarwal, A. Soni, S. Gupta, P. Singh
Dayanand Medical College and Hospital, Ludhiana, Punjab, India
Objectives: Fractures around the elbow are the second most common fractures in children. Post traumatic deformity can either increase or decrease the carrying angle leading to cubitus valgus or varus respectively. It is important to know the carrying angle in specific age groups for evaluation of deformity, which may be seen after treatment of fractures. The angle develops in response to pronation and is dependent on the length of forearm. Also, carrying angle will change with complete ossification of bones. The main objective of the study was to find the carrying angle for North Indian children which will provide us the values required for treatment and evaluation of the deformity.
Methods: The study was carried on 50 children (5-9 years). The age, sex, height and weight were noted. The length of forearm was measured by keeping one point on the medial epicondyle and other on the styloid process of ulna. The carrying angle was measured with a goniometer. Carrying angle and length of forearm was measured on both sides. All measurements were taken thrice and mean recorded to minimise error.
Results and Conclusion: The mean angles measured from dominant arms were significantly greater than those of the contralateral side in both sexes. Our results are consistent with the literature data showing that carrying angle is always greater on the dominant side in both sexes.
| An Osteological Study of Vertebral Synostosis with its Phylogenetic, Embryological and Clinical Implications | | |
Rashmi Bhardwaj
Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India
Objective: Vertebral synostosis or block vertebrae is a condition where incomplete segmentation of somites results in fusion of adjacent vertebrae. Vertebral synostosis are of interest not only to anatomists but also to orthopaedicians, neurologists, forensic pathologist. Our aim is to find out the incidence of vertebral synostosis at different levels.
Methods: The present study was conducted on 40 dried adult vertebral columns obtained from the Anatomy department of Teerthanker Mahaveer Medical College, Moradabad. The vertebrae of all the regions were studied to see if there is any abnormal fusion between contiguous vertebral bodies, pedicles, laminae, spines or transverse processes.
Results and Observation: In present study, Six different specimens of fused vertebrae were identified.
-Assimilation of Atlas: Fusion of atlas with Basiocciput.
-Cervical Vertebral Synostosis: Fusion of C2 – C3 cervical vertebrae.
-Thoracic Vertebral Synostosis: Fusion of T9-T10, T11- T12 thoracic vertebrae
-Thoraco-Lumbar Vertebral Synostosis: Fusion of T12, L1 & L2 vertebrae.
-Fusion of Sacrum with Ilium.
The features of these block vertebrae were analysed in detail and photographed from different aspects.
The Phylogenetic, embryology, clinical implication and Incidences of such synostosis as reported by various authors at various levels have been discussed in this paper.
Conclusion: The block vertebrae in different regions of vertebral column can lead to a variety of symptoms or may be asymptomatic, depending upon the degree of compression exerted by them on adjoining structures like spinal nerves, blood vessels or spinal cord.
It may cause restricted movements, premature degenerative changes and associated neurological and musculoskeletal abnormalities.
| Study of External Occipital Protuberance in Dry Human Skulls | | |
R. K. Diwan, R. K. Verma, A. K. Pankaj, A. Rani, N. Kumar
K.G. Medical University, Lucknow, Uttar Pradesh, India
Objective: The aim of the present study is to analyze the incidence of enlarged external occipital protuberance and determine different shape on the basis of anteriorposterior and transverse diameter of the external occipital protuberance. In this study, eight skulls showed enlarged external occipital protuberance. The external occipital protuberance (EOP) size was defined as the distance from the most superior point of the EOP (origin) to a point on the EOP that is most distal from the skull. A prominence on the outer surface of the occipital bone midway between the upper border and the foramen magnum that with the external occipital crest gives attachment to the ligamentum nuchae — called also external occipital protuberance.
Materials and Methods: This study was carried out on 78 dry human skull of unknown sex and origin, which were collected from osteology lab of anatomy department of K.G. Medical University, Lucknow, U.P. The shape and diameter of external protuberance in dry human skulls were measured by using digital caliper. Each skull closely observed for presence of enlarged external protuberance.
Observation and Results: In the present study, there were Five shape of the enlarged EOP was observed ie Round, Triangular, Triangular with projection, lunate and beak. The shape on the basis of anteriorposterior and transverse diameter of the external occipital protuberance were observed. The total eight skulls showed enlarged external occipital protuberance. The anteroposterior diameter of triangular shape is 10.46 mm and transverse diameter is 44.55 mm. The anteroposterior diameter of triangular shape with projection is 8.86 mm and transverse diameter is 25.27 mm. The anteroposterior diameter of lunate shape is 6.80 mm and transverse diameter is 29.40 mm. The anteroposterior diameter of round shape is 3.06 mm and transverse diameter is 8.18 mm. The external occipital protuberance cause occipital headache in general but especially in tree climbers and basketball players during vertical biomechanical movements of the neck.
Conclusion: The knowledge of this external occipital protuberance may be beneficial to Anatomist, Neurologists, Radiologists, Forensic expert and Anthropologist.
| Morphology of Vermian Fossa in Adult Human Dry Skull in Medical College, Baroda, Gujarat | | |
Shital Hathila, Maitreyee Kulkarni, Dipali Ladani, V. H. Vaniya, S. K. Nagar
Medical College, Baroda, Gujarat, India
Objective: The Vermian fossa is a shallow depression found in the lower part of the internal occipital crest. It lodges inferior part of the vermis of the cerebellum. The study is aimed to find the morphology of vermian fossa and to classify them according their shapes.
Methods: The study was conducted on 45 dry adult human skulls among which of 16 cranial bases from which vault were removed and 29 occipital bones. This study was conducted in Anatomy Department, Medical College, Baroda, Gujarat. All the skull were examined and shape of each vermian fossa was observed. Photographs of all the specimen were taken. The fossae were classified as triangular, quadrangular and atypical. Triangular shape is consider as Type 1, quadrangular shape is consider as Type 2 and atypical shape is consider as Type 3. The data was documented, analysed with Microsoft excel & presented as frequency and percentage.
Results: The vermian fossae were observed in 45 specimens. It was triangular shaped (type 1) in 36 specimens (80%) and quadrangular (type 2) in 2 (4.44%) specimens. In 7 (15.5%) specimens it was having unusual morphology and considered as atypical (type 3).
Conclusion: It is useful in various branches of medicine such as anatomy, neurology, forensics, reconstructive surgery, cosmetology, orthopaedic, & anthropology. It was triangular in shape in majority of the specimens. The findings may give an idea about the inferior cerebellar vermis of the brain. This data has critical importance in performing quantitative morphometric analysis in the study of diseases of the posterior cranial fossa.
| Variation in the Formation of Median Nerve and Its Clinical Correlation | | |
M. J. Akhtar, S. Kumar, R. Ratnesh, A. Kumar, B. Kumar, R. R. Sinha, V. Kumar
Department of Anatomy, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
Objectives: To study the different anatomical variation in the formation of median nerve in the population of Bihar.
Methods: We studied different variation regarding formation of the median nerve in 42 formalin preserved cadavers in which 28 belongs to male & 14 belongs to females i.e. total 84 upper limbs.
Results: We observed median nerve were formed by the union of two roots in 70.24% cases, three roots in 23.81% cases & four roots only in 5.96% cases. The additional roots derived either from lateral cord and/or from musculocutaneous nerve. In males, three roots were found in 16.66% cases while four roots were reported only in case of 3.58% of cases. While in females, three roots were found in 7.1% cases while four roots were present only in 2.38% of cases. The median nerve was formed in axilla in 88.09% of cases while in arm 11.91% of cases. In axilla, median nerve was formed lateral to the axillary artery in 80.95% of cases, medial to the artery in 4.77% cases & anterior to the artery only in 2.38% of cases.
Conclusions: The variation of formation of median nerve is important not only for the academic purposes but also very helpful in better understanding of clinical and surgical procedures around the axilla & to reduces the failure rate of nerve block around the infraclavicular part of the brachial plexus during surgeries involving this area.
| Morphomertic Study of Human Cadaveric Spleen in Population of Bihar | | |
R. Ratnesh, S. Kumar, Md. J. Akhtar, A. Kumar, V. Kumar
Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
Objective: The objective of this study was to find out the morphometric variations of spleen with its clinical significance and compare this study with those of previous study.
Methods: The descriptive type of study was conducted on 40 Spleen, obtained from Anatomy department of Indira Gandhi Institute of Medical Sciences, Patna and also from other medical colleges of Bihar during routine dissection of first year medical students over 2 years. Morphological features such as length, width and thickness were measured by verniers caliper and weight of the spleen was measured by electronic weighing machine. The spleen were also studied for their shapes.
Results: The mean weight of the spleen was 143.17 ± 40.08 g which shows a variations ranging from 42 g to 282 g. the mean length was 11.44 ± 1.42 g ranging from 6.8 to 13.5 cm, mean breadth of spleen were 7.17 ± 1.33 cm varies between 4.2 to 11.5 cm and mean thickness were 4.2 ± 0.59 varies between 2.3 to 6.4 cm. The wedge shaped spleen was the most common (57.5%).
Conclusion: The study of morphometric variation of spleen is important not only for academic point of view but also for physicians to access the progression of certain diseases and surgeons for planning of partial or total splenectomy. It is also helpful in the radiological diagnosis of disease related to spleen.
| Study of Wormian Bones in Adult Human Cadaver Skulls | | |
Rajapur Parashuram, K. R. Dakshayani
Mysore Medical College and Research Institute, Mysore, Karnataka, India
Objectives: To study the 1) Proportions 2) Morphology/ Shapes & 3) Location of wormian bones.
Methods: The study was carried out on 100 adult human cadaver skulls of unknown sex, collected from department of Anatomy, Mysore medical college and research institute, Mysore. Karnataka. The present study was observed for presence of wormian bones, tabulated & analysed.
Results: The wormian bones were observed in 44 skulls (44%). A total of 158 wormian bones were observed out of which 111 (Rt- 63 & Lt- 48) wormian bones were present at Lambdoid suture, 15 wormian bones were present at Sagittal suture, 20 wormian bones were present at Lambda, 10 wormian bones were present at Pterion, 01 wormian bone was present at coronal suture (left side), 01 wormian bone was present at Asterion (left side) and Nil at Bregma. 45 oval, 25 triangular and 88 irregular shaped wormian bones were observed.
Conclusion: Wormian bones are very common in human skulls. They can mislead in the diagnosis of fractures. The knowledge of wormian bones, is enlightening for the radiologists & neurosurgeons to arrive at an early diagnosis and timely management of disorders associated with it. Thorough knowledge of Anatomy of wormian bones is also very important for Anatomists, Forensic experts, Orthopaedicians & Physical Anthropologists.
| Fate of Gubernaculum Testes Revisited | | |
A. Ganapathy1,2, J. P. Jessy1,2, S. Kaler1,2, K. Kapoor1,2, M. K. Sharma1,2, S. Singh1,2
1All India Institute of Medical Sciences, New Delhi, 2Government Medical College and Hospital, Chandigarh, India
Objective: Gubernaculum testes is the most important parameter in migration of testes. Histologically it consists of mesenchymal tissue, abundant extracellular matrix and fibroblast. Studies have shown changes in tissue components of gubernaculum during fetal period. This varies from presence of muscle tissue in early fetal life to predominance of elastic fibres in later periods. At the end of migration it is essentially fibrous structure. Hence after birth it is named as scrotal ligament. There is still controversies as to what is the further fate of scrotal ligament. It has implications in testicular torsion and cryptorchidism.
Methods: Sixteen testicular specimens from 8 adult cadavers were observed in the department of anatomy AIIMS New Delhi and 14 specimens from 7 fetuses of different ages from the Department of Anatomy GMCH, Chandigarh.
In adult cadavers meticulous dissection of scrotum was done. Length of scrotal ligament if present, site of its proximal and distal attachment were noted. Tissue specimens were collected and Masson's trichrome staining was done. In case of fetuses, dissection of abdomen and scrotum was done and same parameters were observed.
Results: All histological specimens showed presence of loose connective tissue arrangement. Within this network presence of patchy areas with dense regular arrangement of collagen fibres could be appreciated. Specimens varied in the density of this arrangement of collagen fibres.
Conclusion: Histological structure of scrotal ligament and gubernaculum testes are variable. Term ligament does not appropriately describe the structure, as scrotal ligament does not have specific characters of dense regular connective tissue.
| A Comparative Study of Morphology of Nutrient Foramen of Tibia and Fibula | | |
Sachin Kumar, Renu Prasad
RIMS, Ranchi, Jharkhand, India
Objective: To determine the number and location of Nutrient Foramen of tibia and fibula
Methods: The present study consist of 50 dried sample of tibia and 50 dried samples of fibula excluding any fracture or pathological abnormalities in Department of Anatomy Rims Ranchi. Number and location of nutrient foramina were observed in each bone. Mean foraminal index was calculated using hughes formula.
Result: It was observed that six percent fibula bones had no appearent nutrient foramen.94% fibula bones had nutrient foramen present on middle one third of the shaft. Mean foraminal index of fibula was 48. Four percent of tibia had two nutrient foramen. Ninety six percent of tibia had single nutrient foramen. 10% of tibia had nutrient foramen on middle one third of the shaft and Ninety percent of tibia had nutrient foramen on upper one third of shaft. Mean foraminal index of tibia was 31 using Hughes formula.
Conclusion: By knowing the number and location of nutrient foramina in tibia and fibula prevention of surgical injury during lower limb operations is possible and taking fibular bone graft from safe location can be done.
| A Study of Arterial Pattern of Normal Placenta by Corrosion Cast Method and to Correlate it with Umbilical Cord Insertion | | |
Anshu Gupta, Bhawna, Pradeep Singh, Vasundhara Kulshreshtha, Saro Singh
S.N.M.C, Agra, Uttar Pradesh, India
Objective: The placenta is a mirror of maternal and fetal status. The aim of this study is to find out the arterial patterns of normal placenta by corrosion cast method and to correlate arterial pattern with umbilical cord insertion.
Materials and Methods: The study was conducted in the department of Anatomy, S.N. Medical college on 100 normal placenta, collected from the Department of Obstetrics and Gynaecology, S.N. Medical College and Lady Lyall Hospital, Agra. We prepared the cast by using injection technique, after washing the placenta and sqeezing out the blood thoroughly.
Results: Among 100 placentae, which were studied, dispersedvariety of arterial pattern is found in 68 placentae and magestrialvariety of arterial pattern is found in 32 placentae.
Attachment of cord in normal placentae with dispersed pattern was central in 76% cases, eccentric in 24% cases and with magestrial pattern was central in 11% cases, eccentric in 78% cases and marginal in 11% cases.
Conclusion: The umbilical cord insertion is mainly central in dispersed pattern and mainly eccentric in magestrial pattern.
| Accessory Foramen Ovale: Its Gender and Age Correlate along with Etiological Elucidation | | |
Deepika
MAMC, Delhi, India
Objective: The aim of this osteologic study was to provide data regarding incidence of the accessory foramen ovale. An attempt is made to explain the probable cause of this variation.
Materials and Methods: 150 dried adult skulls and 30 dried sphenoid bones were studied to report the incidence of accessory foramen ovale. All the measurements were taken using software ImageJ.
Results: We report the incidence of accessory foramen ovale to be 20.58 %. Bilateral variants (13.97%) were more common than the unilateral variants (6.617%). The bilateral incidence reported in the current study is higher than those previously reported. The accessory foramen ovale was frequent on the left side. The dimensions of the accessory foramen ovale were 1.02 mm on the left and 1.12 mm on the right side. In the skulls with unilateral variation, statistical correlation was checked between the dimensions of main foramen ovale with the foramen on the other side without variant foramen, the difference was statistically significant.
Conclusion: Comprehensive knowledge of normal and variant anatomy of accessory foramen ovale must alert intervention radiologist about the likelihood of getting reduced size foramen ovale and hence difficult percutaneous intracranial procedures.
| Comparative Morphometrical Study in North Indian Orbits of Human Skull | | |
Roli Joshi, Pankaj Singh, Vinod Kumar, Fatima Begum
Saraswati Medical College, Unnao, Uttar Pradesh, India
Objectives: Bony orbit lodges the visual apparatus, important not only for anatomists but also for ophthalmologists, maxillofacial surgeons and forensic experts. The Present study is to provide the normal reference orbital parameters for north Indian population.
Materials and Methods: 215 dry skulls (83 female & 132 males) from the department of anatomy from GSVM Kanpur, KGMC Lucknow, SMC Unnao. Orbital height (OH), orbital width (OW) has been taken of both side skulls in both gender. Orbital index (OI) was calculated by OH/OW × 100= OI. All these measurements are taken by digital vernier caliper.
Result: the orbital index was 83.45 and 77.96 in male then after in female. All values are found to be statically highly significant. Height of right and left sided skull was 32.37 ± 1.08, 30.96 ± 0.85 while breadth was 40.31 ± 2.28 and 40.28 ± 2.02. Orbital index was 80.75 ± 5.60 and 80.67 ± 5.31. Orbital height has highly significant value and width and index having nonsignifacant value.
Conclusion: Right and male orbits have higher values comparitively to opposite side and sex having more value. Study also tells that male skull is categorized under mesoseme and female in microseme of north Indian populations. Further population based studies be carried out in different geographical locations.
| A Comparative Study of Fresh and Old Embalmed Human Lungs Using Plastination: Qualitative and Quantitative Approach | | |
Sankat Mochan, Renu Dhingra1
Department of Anatomy, Maulana Azad Medical College, 1Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
Objectives: To plastinate the fresh and old embalmed lungs by standard S10 procedure and by a variation of S10 technique (using xylene as a solvent). Also, to compare and correlate the results obtained by the two methods.
Methods: A total of 36 specimens [21 (fresh lung specimens) from the Department of forensic medicine, AIIMS, New Delhi and 15 from the Department of Anatomy (old embalmed lung specimens), AIIMS, New Delhi] were collected for the study after taking permission from Institute Ethics Committee. Both fresh and old embalmed lung specimens were further subdivided into three groups based on the variation of usage of the polymer mixture during forced impregnation. The quality of plastinated lung specimens and the amount of shrinkage was compared (before and after plastination/different stages of plastination) with respect to circumference along hilum, surface area and volume of the lungs.
Results: The mean percentage shrinkage in surface area, volume and circumference was much lower in specimens where 50% of xylene was added to polymer impregnating mixture as compared to 25% or no xylene in both the old and fresh lungs but was not statistically significant. The colour preservation and flexibility of fresh lungs were found to be superior to that of old embalmed specimens.
Conclusion: The successfully plastinated long term formalin fixed lungs can be a valuable teaching material in case of non-availability of fresh lungs and can be used for indefinite period. The present study although does not reflect much deviation in the procedure followed for the two groups but the use of xylene reduced the shrinkage in both old and fresh lung specimens. However, the aesthetic qualities of freshly plastinated lungs were certainly better than those of old embalmed lungs.
| Anomaly in the Branching Pattern of Profunda Femoris Artery with Incomplete Transposition of Femoral Vein in Femoral Triangle: A Rare Anatomical Variation | | |
Y. Lakshmisha Rao, Mangala M. Pai, Kostubh Singh1, Massand Amit
Manipal Academy of Higher Education, Manipal, 1Kasturba Medical College, Mangalore, Karnataka, India
Objectives: To report a variation in the vascular structures in the femoral triangle observed in the right lower limb of a female cadaver.
Methods: During the routine dissection procedure, it was observed that the Profunda femoris artery was taking a high origin from the femoral artery and Great saphenous vein was arching over the femoral artery to drain into the femoral vein which was located lateral to it.
Conclusion: This type of vascular variation is enlightening to the surgeons and radiologists.
| Re-evaluation of Brachialis Muscle for Segmental Innervations | | |
Shalini Chaudhary, Sarvesh1, A. P. S. Batra, Nisha Goyal
Departments of Anatomy and 1Anaesthesia, B.P.S.G.M.C, Haryana, India
Introduction and Objectives: There have been inconsistent description of the brachialis muscle anatomy in literature. In the present study an attempt has been made to describe gross morphology & innervations of brachialis muscle in order to refine surgical approaches to humerus.
Materials and Methods: In the present study 40 upper limbs of embalmed cadavers were dissected. We also noted the course of nerve branches after they arose from main trunk.
Results and Conclusion: it was found that all specimen of the muscle has 2 heads, superficial and deep. The larger superficial head had more proximal origin and distal insertion than deep head. In all specimens, brachialis was supplied by musculocutaneous nerve while only 70% cases received branches from radial nerve. Branches from the radial nerve observed to enter in 5% specimen of superficial head in upper third part and 65% specimen of deep head in lower two third part. These anatomical facts have implication for humeral surgery.
| Morphological Study of Superficial Palmar Arches of Hand: A Clinico-Anatomical Insight | | |
P. Dawani, A. Mahajan, N. Vasudeva, S. Mishra
Maulana Azad Medical College, New Delhi, India
Introduction: The superficial palmar arch is an important site of anastomosis between radial and ulnar arteries in the hand. With recent advances in microsurgical techniques in reconstructive hand surgery, the knowledge of variations in the pattern of superficial arterial arch and its branches, has become more important for surgeons. In radial artery harvesting for myocardial revascularization, ischemia can occur in absence of anastomosis between radial and ulnar arteries in the hand. Thus, a background of detailed anatomical knowledge derived from gross dissection is essential before performing any vascular procedure on the upper extremity.
Materials and Methods: 30 hands from formalin fixed cadavers were dissected in Department of Anatomy, Maulana Azad Medical College. Branching pattern of superficial palmar arches and their variations were noted.
Results: In 29 hands, complete superficial palmar arches were found where there was an anastomosis between the arteries forming the arch. In 1 hand, the radial and ulnar arteries did not anastomose with each other. One of the complete arch was, medianoulnar type, where median artery participated to complete the arch. The arches were classified according to arteries contributing and branching patterns.
Conclusion: The anastomosis between radial and ulnar arteries was found in most cases of superficial palmar arches. Few important variations were noted and it may be considered safe to sacrifice radial artery in procedures like radial artery harvesting and radial artery flap transfer.
| Anatomical Multiple Variations of Coronary Arteries and Myocardial Bridges in Human Hearts: A Cadaveric Study from Rajasthan | | |
Neha Saini, Vasanta Leela1, Dhiraj Saxena
Department of Anatomy, SMS Medical College, RUHS, Jaipur, Rajasthan, 1Department of Anatomy, Narayana Medical College, Nellore, Andhra Pradesh, India
Introduction: Coronary artery disease is one of the major causes of death in developed as well as developing countries. The increasing use of diagnostic and therapeutic interventional procedures necessitates that a sound, basic knowledge of the coronary artery pattern is essential.
Materials and Methods: The present study was undertaken in the Department of Anatomy, SMS Medical College included 50 cadaveric human hearts. After simple dissecting procedure coronary arteries and myocardial bridges over them were noted.
Results: Right coronary artery was originating from right anterior aortic sinus in 94% of the total human hearts and in 3% cases from left anterior aortic sinus. It terminates at the point between right border-crux in 80% cases. The left coronary artery bifurcated in 64% cases also, quadrifurcation was observed in 10% of hearts. It gets terminated at anterior apex in 68%, and in 6% cases it reaches upto > 5 Cms up in the posterior interventricular sulcus. Out of 50 examined cadaveric human hearts, myocardial bridges were found in 22 numbers of hearts. Myocardial bridges were more observed on left coronary artery than the right coronary artery. Posterior interventricular branch in both coronary arteries had maximum number of myocardial bridges. The maximum length of myocardial bridge - 38 mm and minimum 10 mm was observed.
Conclusion: The precise knowledge of coronary arteries and myocardial bridges is required for the angiographers and cardiothoracic surgeons for an efficient management of coronary disease and other cardiac ailments.
| Quantifying Gender Related Shape Variation in the Mastoid Region of Temporal Bone in North Indian Dry Skulls | | |
Passey Jigyasa
Maulana Azad Medical College, New Delhi, India
Objective: The aim of this study is to determine sexual dimorphism of skull by multivariate analysis of anthropometric data and to assess the reliability of the mastoid's morphometric parameters in determining the gender.
Material 1. Dry skulls 2. Digital Vernier caliper 3. Digital camera for illustrations
Methods: The sex of the skulls was established on the basis of gross appearance by comparing external features.
The following parameters were measured:
- Mastoid length
- Mastoid breadth (medio-lateral diameter)
- Anteroposterior diameter of the mastoid process
- Size of the mastoid process = (length *antero-posterior diameter*breadth)/100.
Basic statistics and discriminant functional analysis were performed.
Results: The mastoid length - 30.6±0.81 mm on right side and 28.62±0.2 on left side in males and 26.15±1.04 on right and 24.92±1.21 on left side in females.
The mastoid breadth- 11.41±1.08 mm on right side and 10.45±1.08 mm on left side in males and 26.15±1.04 on right and 24.92±1.21 on left side in females.
The Antero-Posterior Diameter -17.01+/-1.19 mm and 16.81+/-1.06 mm on left side in males and 15.00+/-1.17 mm on right side and 14.39+/-0.07 on left side in females.
Mastoid Size of the mastoid process = 60.59±31.33 mm2 on right side and 31.48 ±19.22 mm2 on left side.
Conclusion: It was observed that mean mastoid parameters was more in skulls of male individuals as compared to skulls of female individuals irrespective of race or region in manual method.
| A Study of Intercommunications between the Nerves of Brachial Plexus | | |
S. Yaseen, M. Annapurna, M. Imran, N. Waghray
Shadan Institute of Medical Sciences, Hyderabad, Telangana, India
Objective: The main objective of the present study was to observe the intercommunications between the nerves of brachial plexus. The knowledge of these intercommunications is important for surgeons, as these nerves are vulnerable to injuries during surgeries of axilla and upper arm.
Methods: Present study was done on twenty five properly embalmed and formalin fixed adult human cadavers during routine dissection practice for undergraduate students at Department of Anatomy, Shadan Institute of Medical Sciences, Hyderabad, during the period of 2012 to 2014. Intercommunications between the branches of the brachial plexus were observed in axilla and upper arm.
Results: Out of fifty brachial plexus, intercommunications were found in 6 cases (12%). Intercommunication between Musculocutaneous nerve and Median nerve was found in 3 cases, between Median nerve and Ulnar nerve in 2 cases and between Ulnar nerve and Radial nerve in 1 case.
Conclusion: All the nerves of brachial plexus are formed and lie in two planes, anterior and posterior. Anastomosis is frequently encountered within these planes. These anatomical variations should be taken into consideration by a clinician while trying to explain unusual symptoms which may occur during examination of upper limb nerve injury and also by surgeons as these communicating nerves are likely to get injured during surgical exploration.
| Bone Retrieval from Human Cadavers by Ghatak: Nayyar Method | | |
A. K. Nayyar, S. Ghatak
ll India Institute of Medical Sciences, Jodhpur, Rajasthan, India
Objective: To standardize a method of retrieving bones from cadavers (or animals) using a combination of various bone cleaning techniques for anatomical studies.
Methods:
- Removal of soft tissue: Scrub and gently scrape away loosened muscles, ligaments and soft tissues
- Maceration: Soak the bones in tap water and boil
- Bleaching: Soak the bones in Hydrogen Peroxide (H2O2)
- Degreasing: Wash and soak the bones in Acetone
- Drying: Spread the bones on blotting paper and let the bones dry
- Finishing: Painting.
Result: There has been considerable debate among anatomists and anthropologists as to how the remains of human cadavers should be macerated. However, we have been experimenting with this method and feel that boiling, when carefully applied, is far superior and quicker to no-heat or low- heat methods, beetles, and caustics (bleach, ammonia). Soft tissues and grease are best removed through simmering and boiling.
Conclusion: We conclude that retrieval of bones using Ghatak – Nayyar method is very effective combining various bone cleaning techniques for anatomical studies. The yield of the bones thus retrieved by this method is of very superior quality in terms of morphological details and can be used for anthropological and morphometric studies.
| An Approach to Know Effective Techniques in Processing and Cleaning of Bones | | |
Nikita Chaudhary
AIIMS, Raipur, Chhattisgarh, India
Objective: As a part of anatomy teaching curriculum and three dimensional demonstrations in Osteology, preparation of bones play an important role. Also to bring more information regarding sites of muscular attachments & course of neurovascular structures in a region, study of bones consistently maintain its own essentiality. Osteology is an important aspect of forensic anatomy. To accomplish the above motives, a number of techniques have been employed over the decades in preparation of bones.
Materials and Methods: In department of Anatomy, AIIMS Raipur, under the ongoing body donation programme, many donated bodies are being studied. After dissection in dissection hall, cadavers which have been buried for a period of about one year are dugout for the remains. Bone are collected with the help of technicians and have been put in different solutions like H2O2 (concentration of 1:0.5, 1:1, 1:2), quick lime, NaOH and other alkaline solutions. Bones are being processed under various methods like boiling, maceration with enzymes & bugs and by natural methods like burial under soil.
Conclusion: We are able to conclude about the optimum concentration of H2O2 at which bones are being easily cleaned and afterward application of lime putty gives desired result. Also we are able to find out the most suitable organic method by which bones can be prepared with least damage and for a good presentable appearance.
| Clinically Relevant Variations in the Branching Pattern of Arch of Aorta: An Anatomical Study | | |
Chitra Ramasamy
Siddhartha Medical College, Vijayawada, Andhra Pradesh, India
Objectives: Variations in the branching pattern of the aortic arch are not rare. The objective of this study is to find the anatomical variations in the branching pattern of arch of aorta.
Materials and Methods: The cadavers (Total: 50, M: 42, F: 8) allotted for routine educational dissection of undergraduate students in our department of anatomy in the academic years (2011-2018) were dissected for this study. The arteries of the thoracic region were dissected following the standard dissection procedures.
Results: The branching pattern of the aortic arch was normal with three branches- brachiocephalic trunk, left common carotid artery and left subclavian artery in 44 cadavers. In 3 cadavers, the two branches were- the common trunk of brachiocephalic and left common carotid artery in addition to left subclavian artery. In a female cadaver, the three branches were- the common trunk of brachiocephalic and left common carotid artery, left vertebral artery and left subclavian artery. In another male cadaver, the branches were four including the origin of left vertebral artery from arch of aorta.
Conclusion: Identification of these vascular variations before diagnostic interventions is crucial in order to avoid complications. Computerized angiography is a reliable imaging method for demonstrating anatomical variations of the aortic arch.
| Relative Locations of Ventral Branches of Abdominal Aorta and Left Renal Artery as a Guide for Angiographic Procedures | | |
R. K. Rohatgi, S. L. Jethani
Himalayan Institute of Medical Sciences, SRHU, Dehradun, Uttarakhand, India
Aim of the Study: To determine the relative locations of the ventral branches of the abdominal aorta observed from the extravascular space in North Indian cadavers to facilitate angiography in clinical settings.
Materials and Methods: A total of 30 cadavers were observed in the study in the last 3 years. Cadavers with anatomical variations of the ventral branches or aortic aneurysms were excluded from the study. Vertebral levels and the distances from the aortic bifurcation were observed for the origins of coeliac trunk, superior mesenteric and inferior mesenteric arteries. Since the left renal artery is accepted as an important landmark in abdominal aortography, its vertebral level of origin and the distance from the aortic bifurcation was also observed.
Results: The mean distances of the coeliac trunk, superior mesenteric, inferior mesentric and left renal arteries from the apex of the inferior angle of aortic bifurcation were observed to be 105.75 ± 12.07, 93.35 ± 11.42, 31.49 ± 8.41 and 80.95 ± 12.01 mm. The angle of aortic bifurcation was observed to be 63.47 ± 9.39°. The vertebral levels of the origin of the above arteries varied in terms of upper, middle, lower 1/3 or at the disc levels.
Conclusion: These measurements should contribute to improving the skills in the field of interventional radiography.
| Relationship of Anatomical Length of Fibula to the Length of Femur in Healthy Subjects | | |
Mohd Salahuddin Ansari, Tarun Goyal, Shobha S. Arora, Rashmi Malhotra, Kumar Satish Ravi, Brijendra Singh
AIIMS, Rishikesh, Utrakhand, India
Background: The commonest procedure for adult diaphyseal femoral fractures is intramedullary nailing. A thorough preoperative examination of facture pattern and its morphology are necessary. Previous studies are non-homogenous and with conflicting results.
Aims and Objectives: So the study was planned to find out, any relation between femur and fibular length and its association with height/ arm span and upper segment/lower segment ratios in an individual, with its statistical validity.
Materials and Methods: The study was carried on 75 male and 75 female students of more than 18 years of age, studying at AIIMS Rishikesh after taking their informed consent and ethical approval. The fibular length and the length of femur were measured as per protocol, by simple measuring tape.
Results: The fibular length and the length of femur were 42.85 (SD, ±1.89) and 45.88 (SD, ±2.95) cm, respectively with the mean difference between these 2 measurements of 3.03±2.42 in male volunteers. Their 95% Confidence Level and Range were found to be 1.960 and 42.43 - 43.28 cm. The mean fibular length and femoral length were 39.56 (SD, ±1.69) and 40.96 (SD, ± 2.75) cm, respectively with the mean difference between these two measurements of 1.38 (SD ± 2.23) with 95% Confidence Level and Range of 1.960 and 39.17- 39.94 cm, in female volunteers. The Pearson correlation co efficient and p value 0.5751, 0.0001 and 0.5856, 0.0001 in male and female respectively. There was no significant variation with height, upper segment and lower segment ratios.
Conclusion: So we conclude that there is extremely significant correlation between the length of fibula and the length of femur of the individuals. The fibular length represents the maximum length of the nail to be used in femur. The length of the femur nail can be definitely predicted by the fibular length in both sexes but it has to be different in both, for the same femoral fracture and there is no significant variation in the femur length with height, upper segment and lower segment variation in the same individual.
| Suprascapular Notch: Study of Morphological Variations | | |
Alok Prakash Acharya, V. D. S. Jamwal, S. Kumar, S. Jamwal1
Department of Anatomy, AFMC, Pune, Maharashtra, India, 1J and K Health Services
Objective: To study the anatomy of the suprascapular notch and its variations as this has clinical relevance in the fields of plastic and reconstructive surgery. The course followed by the suprascapular nerve predisposes it to compression in the suprascapular notch resulting in suprascapular nerve entrapment syndrome.
Methods: The study was carried out on ninety one dry completely ossified scapulae of undetermined age and sex available in the bone bank of the Anatomy department. The superior transverse diameter and maximum depth was measured by Vernier's digital Calipers. The suprascapular notches were classified according to the classification given by Rengachary et al.
Results: In our study, Type III suprascapular notch as per the Rengachary classification was the most commonly observed, Type II and Type IV suprascapular notch were the least commonly observed variation as only one case of each type was reported. In six cases, suprascapular ligament was completely ossified to convert it into a suprascapular foramen which is classified as Type VI.
Conclusion: Knowledge of variations of the morphology of suprascapular notch is helpful to surgeons to attain adequate access to the suprascapular nerve. Adequate access is a prerequisite to effective decompression of this nerve in all cases of suprascapular nerve entrapment neuropathies.
| Morphology of Plantaris Longus with Special Reference to its Clinical Importance in Reconstructive Surgery | | |
Savita Kumari, Anita Tuli, Sneh Agarwal, Shashi Raheja, Sohinder Kaur
Lady Hardinge Medical College, New Delhi, India
Objective: Plantaris is small fusiform muscle, with its long, slender tendon. Actually a vestigial muscle in human beings hence its rupture does not result in any significant loss of function. Muscle tear associated with bleeding and swelling leads to a posterior compartment syndrome. It can mimic other serious conditions like DVT, ruptured baker's cyst and calf neoplasms.
The present study aims to find out the various patterns of proximal and distal attachment of plantaris muscle, which will help the Plastic & orthopedic surgeons for different types of reconstructive surgeries.
Materials and Methods: Forty eight limbs from 24 embalmed cadavers of known sex & age (40-75 years) were dissected in the department of anatomy of Lady Hardinge medical college, New Delhi during 2016-2017. Plantaris muscle identified with its proximal and distal attachment. Length of muscle belly & tendon were recorded.
Results: In the present study out of 48 limbs specimens, Plantaris muscle was absent in 12.5%. Its proximal attachment to lateral supracondylar ridges observed in 29% & with lateral head of gastrocenimus muscle & fibrous capsule in 58.3%. Its distal attachment deep to tendocalcaneus was noted in 54% and superficial to tendocalcaneus in 33.3%. Length of muscle belly was 7- 9 cm in 37% and tendon length was 34- 36 cm in 37.5%.
Conclusion: The Morphological aspects of the attachment of plantaris play a significant role in the Pathologies associated with Calf & knee region. Their exact attachment is importance for reconstructive surgeries to the repair of ankle joint injury, Flexor tendon replacement in hand.
Keywords: Morphology, plantaris muscle
| Morphometric Analysis of the Anterior Clinoid Process of Sphenoid with its Clinical Implications in Neurosurgeries | | |
M. Janardhan Rao, S. Saritha
Kamineni Academy of Medical Sciences and Research Center, Hyderabad, Telangana, India
Introduction: Morphometric analysis of the anterior clinoid process would help the neurosurgeons while performing extradural or intradural anterior clinoidectomy which is widely used to increase the clinoid space for the treatment of internal carotid artery or ophthalmic artery aneurysms, tumors of this region, and cavernous sinus pathology.
Materials and Methods: The present study was consisting of 100 anterior clinoid processes in 50 adult human skulls of South Indian origin. All the parameters were measured by using digital vernier calipers and the measurements were recorded.
Results: The mean distance between the tips of the right and the left anterior clinoid processes, the medial margins of the right and the left optic canals, the lateral margins of the right and the left optic canals were 23.93 ± 1.69 mm, 13.58 ± 2.15 mm, and 19.75 ± 2.77 mm respectively. There was no significant difference between the right and the left sides with respect to the distance from the tip of the anterior clinoid process to the medial margin of the optic canal, the distance from the tip of anterior clinoid process to the lateral margin of the optic canals, the distance from the medial margin of the optic canal to the lateral edge of the anterior clinoid process, the distance from the lateral margin of the optic canal to the lateral edge of the anterior clinoid process and the vertical dimension of the anterior clinoid process.
Conclusion: The results of the present study would be of great help to the neurosurgeons while performing intra or extradural anterior clinoidectomy for various clinical conditions such as internal carotid artery or ophthalmic artery aneurysms, neoplasms of this region and also useful to the approach the optic nerve, cavernous sinus, clinoidal space and apex of orbit.
| Overview of Vascular Foramina on Talus: A Guide to Avascular Necrosis | | |
S. Gandhi, P. Shrivastava, A. Dubey, G. Rath
NDMC Medical College and Hindu Rao Hospital, Delhi, India
Objectives: Talus is a unique bone which has complex arrangement of blood vessels around its neck. The purpose of our study is to analyse the morphology of vascular foramina of talus and its relevant clinical significance.
Methods: This study was done on 30 adult human talus irrespective of sex and side obtained from Department of Anatomy, NDMC Medical College, Hindu Rao hospital, Delhi. The neck of tali were examined using hand lens to determine the number, location, size, shape and depth of vascular foramina. The data obtained was statistically analysed.
Results: The vascular foramina were present on dorsal, plantar, medial and lateral aspects of neck of talus. 70% of foramina were noticed in the talar canal, 20% on dorsal aspect and remaining 10% on the medial and lateral aspects of neck. Some canals were regular in shape & prominent while other canals were very minute. The canals were traced by inserting needle in multiple sections. In 60% of cases, canals were extending up to 2/3rd of total thickness and in 30% cases, up to 1/3rd of thickness. Rest of canals were very small and could not be traced.
Conclusion: This study highlights the importance of vascular foramina in dried human bones. The tali having lesser number of vascular foramina around the neck indicate scanty blood supply flowing through canaliculi of bone. This may result in devastating consequences including avascular necrosis leading to stress fracture.
| Anatomical Variations in the Morphology of Lumbar Sympathetic Ganglia in Human Cadavers | | |
K. R. Gandhi, . Joshi
AIIMS, Bhopal, Madhya Pradesh, India
Objective: Lumbar sympathetic ganglion block and neurolysis have been used in vascular disease, chronic pain and hyperhidrosis of the lower extremity. To perform safe procedure, an accurate knowledge of the relationship between the lumbar sympathetic ganglia to the vertebral bodies is needed to avoid complications. The anatomic variations in this region hence gains immense importance for the operating surgeons and consulting radiologists.
The purpose of this study is to investigate the precise morphology of lumbar sympathetic ganglia and its relation to lumbar vertebrae.
Methods: A total of 60 retroperitoneal regions of the cadavers were included in the study. The study was conducted on thirty (28 males and 6 females) formalin embalmed cadavers, available in the department. After retracting the abdominal aorta and the inferior venacava medially on their respective sides, the location of lumbar ganglia was noted in relation to the lumbar vertebra.
Results: The total 238 ganglia were found in 60 lumbar sympathetic trunks. The number of ganglia in a single lumbar sympathetic trunk ranged from 2-6. The mean length of the ganglia was 17 mm, range (6 mm to 33 mm). The mean width measured was 5 mm (3 mm to 12 mm). These findings along with clinical significance of LSG will be discussed at the time of oral presentation.
Conclusion: The surgeon should be well verse with the morphology of LSG to perform safe and accurate lumbar sympathectomy by open and endoscopic approaches.
| Variation in Formation of Median Nerve with Relation to Axillary Artery and its Branches | | |
Parmatma Mishra, Anshu Mishra1, Hari Prasad, Neeraj Pandey
TSM Medical College and Hospital, 1Integral Institute of Medical Sciences and Research, Lucknow, Uttar Pradesh, India
Objective: Variation of Neurovascular bundle in the axilla are clinically important for various procedures. Hence the study was conducted to find out variation in this region. The present study was conducted in North Indian population.
Materials and Methods: 30 cadavers were dissected during routine dissection in last two years of M.B.B.S. 1st year in T.S.M. Medical College & Hospital, Lucknow. Brachial plexus was exposed & cleaned from roots to branches of cords. Median nerve and Axillary artery with its branches were identified. Photographs were taken.
Results: Clinically significant variations were detected & finding shall be discussed in conference.
Conclusion: Variation in median nerve formation was seen in cadavers.
| Maintenance of Mitochondrial Integrity by Yoga: Implications in Autoimmune Inflammatory Arthritis | | |
S. Gautam, U. Kumar1, M. Kumar, A. Goswami, P. Chaurasia, R. Dada
Department of Anatomy, Laboratory for Molecular Reproduction and Genetics, 1Department of Rheumatology, All India Institute of Medical Sciences, New Delhi, India
Objective: Citrullination is an essential contributor to the pathogenesis of rheumatoid arthritis (RA). This post-translational modification requires peptidyl arginine deiminase enzymes (PADs) which are calcium (Ca2+) dependent. One of the underlying factors may be dysregulation of mitochondrial Ca2+ homeostasis i.e. inability of mitochondrial uptake of Ca2+ during physiological signaling. Specific drugs that act on mitochondrial Ca2+ homeostasis are being developed which may open the way to new biochemically designed therapeutic approaches in the treatment of RA. Hence, this study was aimed at examining the impact of yoga-based lifestyle intervention (YBLI) on mitochondrial integrity via cytochrome c oxidase (COX) activity.
Methods: Blood samples of 45 patients were collected at base line (day 0) and after 21 days of YBLI. Mitochondria were isolated from the fresh blood samples and COX activity was measured by colorimetric assay on day 0 and day 21.
Results: YBLI participants showed significant increase in the COX activity pre and post yoga [0.5±0.06 vs 0.8±0.08 unit/mg mito protein; p=0.03*].
Conclusion: YBLI improves mitochondrial integrity as evident from increased COX activity. Improvement in mitochondrial integrity with normal Ca2+ levels by maintaining homeostasis, thus prevent activation of PAD and citrullination of tissue fibrinogen. This may prevent numerous sequelae of excessive citrullination and unregulated expression of genes. Thus, we believe that activation of PAD may be due to loss of mitochondrial integrity secondary to OS. This simple lifestyle intervention may maintain optimal ROS levels, mitochondrial integrity, Ca2+ homeostasis and prevent activation of PADs and thus reduce the incidence of RA.
| Age and Sex Related Changes in Cells of Human Pineal Gland: A Histological Study | | |
K. G. Arunkumar, A. Amar Jayanthi1
Department of Anatomy, Government Medical College, Thrissur, 1Government Medical College, Idukki, Kerala, India
Objective: Pinealocytes and glial cells, the cells in pineal gland are arranged in the form of lobules. This work was done to find out influence of age and sex in the cells of human pineal gland.
Methods: Ninety adult pineal gland specimens (fifty male, forty female) were collected from human subjects during autopsy. Total sample size was one hundred and two with twelve fetal pineal specimens. After fixation in Bouin's fluid and tissue processing for light microscopy, four micrometre sections were prepared and mounted sections were stained with routine Haematoxylin & Eosin staining and Mallory's phosphotungstic acid haematoxylin (PTAH) for neuroglial cells. During light microscopy, distinction between the two types of cells was made according to staining characteristics of their nuclei. From each slide, three fields were analyzed and number of pinealocytes and neuroglial cells were calculated by taking average of the values obtained. Data collected were entered in Microsoft Excel work sheet and subjected to statistical analysis.
Results: The glial cells were less in number than pinealocytes. The average number of pinealocytes per field was 184.6 ± 29.41 and that of glial cells was 7.20 ± 2.65. The number of the two different types of cells did not show any statistically significant changes with regard to age or sex.
Conclusion: Our study does not support statement of Khavinson and Linkova that the total number of pinealocytes decreases by 18% with aging. Whether changes in the cellular arrangement of human pineal gland has any implication on melatonin secretion by pinealocytes need further histochemical analysis.
| Histopathological and Histomorphometric Studies on the Effects of Olanzapine on Testis: An Experimental Study in Albino Rats | | |
W. Akram, N. A. Faruqi, M. T. Zaidi
Jawaharlal Nehru Medical College and Hospital, A.M.U, Aligarh, Uttar Pradesh, India
Objective: Olanzapine is an atypical antipsychotic approved by the U.S. food and drug administration for schizophrenia and bipolar disorder. Its affinity for D2 receptors, muscarinic receptors, alpha 1 and alpha 2 receptors, 5-HT 1D and 5-HT 1A receptors pose danger to wide range of organs in the body including testis. Few studies address sexual dysfunction associated with antipsychotic use but the detailed histopathological studies on the testis is lacking in Literature.
Methods: Tissue from the testis of both experimental and control were processed by Wax embedding technique and sections were stained by hematoxylin and eosin.
Results: Experimental testis shows intra and interlobular edema, compressed seminiferous tubules, thinning and fragmentation of basement membrane. Spermatogenic cells are smudgy and compressed by edema fluid. Blood vessels show inflammatory cells in the lumen.
Conclusion: Olanzapine induced testicular degeneration might lead to reduced libido, a fact of great social impact.
| Correlation of Expression Pattern of CD161 on T-Cells and IL-17 Secretion with the Stage of Knee Osteoarthritis | | |
A. Aggarwal, M. Sachdeva, R. Sharma, A. Aggarwal, A. Randhawa, D. Sahni, J. Jacob, V. Sharma
Department of Anatomy, Post Graduate Institute of Medical Education and Research, Chandigarh, India
Objectives: The aim of present study was to evaluate the local and systemic inflammation during Osteoarthritis (OA) disease progression and to identify a potential phenotypic marker so as to distinguish early and advanced cases of OA.
Methods: The study was performed in 37 OA patients (27 early and 10 advanced) and 11 healthy controls. The serum and synovial fluid (SF) samples were analyzed for the levels of inflammatory cytokines by flowcytometry and ELISA. The frequency of immune cells and expression of CD161 was measured by flowcytometry.
Results: In both serum and synovial fluid of OA patient, levels of IL-1β, IL-6 and IL-10 were significantly higher as compared to healthy control's serum. The expression of CD161 on T cells was significantly higher in SF than peripheral blood of OA patients and healthy controls. The advanced cases had significant up regulation of CD161 than early cases. The CD161 expression had significant positive correlation with IL-17 in the serum of OA cases. The ROC curves of CD161 expression on T cells significantly distinguished early and advanced patients.
Conclusions: An elevated CD161 expression on T cells in circulation and synovial compartment clearly distinguished early and advanced OA warranting studies to assess its role as a contributing factor towards advancement of OA.
| Histopathology and Clinical Correlation of Appendectomy Specimens | | |
R. M. More, M. P. More, . Shedge
K. J. Somaiya Medical College, Mumbai, Maharashtra, India
Objectives: To co-relate the histopathological diagnosis with gross examination and clinical diagnosis in cases of appendicitis.
Methods: A study was conducted over a period of 6 months to correlate the histopathological diagnosis with the gross examination and clinical features in 39 cases of appendectomy. The study included detailed clinical history, physical examination and relevant blood and radiological investigations.
Results: Out of the 39 appendectomy specimens, 20 cases were found in males and 19 in females. Most cases (35.89%) were found in the age group 21 to 30 years. Acute appendicitis was the histopathological diagnosis in 17 (43.58%) cases. The other cases were diagnosed as Acute gangrenous - 5 cases (12.82 %), Recurrent -2 cases (5.12%) & Chronic appendicitis – 15 cases (38.46%).
Conclusion: Advances in imaging modalities in cases of appendicitis has significantly improved the diagnosis and justified surgical treatment of the same. Confirmation of the clinical and radiological diagnosis by histopathological diagnosis is necessary in all cases of appendectomy to rule out the diagnosis other than the routine cases.
| Histological Comparison of IUGR Placenta With Normal Term Placenta | | |
Soni Kumari
Objective: Healthy development of Fetus is dependent on normal development and adequate perfusion of placenta. Alteration in placental development and inadequate perfusion of placenta is main factor for IUGR. Present Study compare the Histological features of IUGR placenta with normal term placenta.
Materials and Methods: This study was done in Department of Anatomy, Patna Medical College from June 2017 to Octobers 2018. Total 30 Placenta were studied, of which 15 placenta belonged to IUGR group and 15 placenta belonged to normal term pregnancy. IUGR cases confirmed on the basis of Ultrasound and follow up. Gross study of placenta was done and after that which each placenta weighed. About 1 cm thickness of both normal and growth retarded placental tissue was cut and processed for histological study.
Results: Infarction rate, thrombosis, tissue ischaemia, Intervillous hemorrhage and Intervillous fibrin deposition were higher in IUGR Placenta. Mean placenta weight were lower in IUGR placenta.
Conclusion: Placenta of IUGR Newborn were smaller with more Infarction. Finding suggest chronic ischaemia and associated secondary changes leads to improper perfusion and leads to IUGR, Gross and Microscopic features of placenta provide proper information about IUGR. This study indicates that study of fetal blood supply by Doppler study and other tests for fetal well being must be done during ANC.
| Bisphenol A Produces Structural Changes in Lungs by Producing Oxidative Stress in the Rats | | |
M. K. Pant, J. Pant1, M. Pandey2, A. H. Ahmed3
Department of Anatomy, Government Doon Medical College, Dehradun, 1Department of Physiology, AIIMS, Rishikesh, 3Department of Pharmacology and Toxicology, CVASc, G.B. Pant University, Pantnagar, Uttarakhand, India, 2Junior Research Fellow in Project Funded by UCOST
Objectives: Bisphenol A (BPA) is used in the manufacturing of plastic wares. BPA is an estrogenic compound and produce a number of toxic effects. It leaches out in the aqueous medium at high temperature and acidic pH and gets into our body through oral route. Since leaching of BPA occurs from the plastic wares, hence the effect of oral ingestion of BPA was seen in the rats.
Methods: Adult rats of Wistar strain were used for the present study. The rats were divided into 2 groups. In the first group (control; n= 6) the rats were allowed to take normal food and tap water ad libitum. In the second group, (BPA treated; n=6), the rats were ingested with BPA (20 μg/kg body weight) orally. The animals were maintained in this treatment for 30 days in both the groups. After 30 days, blood was withdrawn and the rats were sacrificed and lungs were excised. The excised lungs were used for histopathological study and oxidative stress studies were performed.
Results: There was cytoarchitectural damage to the lungs. Further increased lipid peroxidation, glutathione and catalase activity were also noted which marks the high oxidative stress activity.
Conclusion: Ingestion of BPA produces cytoarchitectural changes by producing oxidative stress in rats.
| Comparison of Toxic Effects of Pyrethroid and Herbal Based Mosquito Vaporizers on Multiple Organs of Wistar Albino Rats: A Light Microscopic Study | | |
A. K. Pankaj, Manisha Pandey, Navneet Kumar
King George's Medical University, Lucknow, Uttar Pradesh, India
Objectives: To compare the histological changes due to pyrethroid and herbal based mosquito vaporizers on different organs and compare the effect of withdrawal of these vaporizers on histology of different organs of male wistar albino rats.
Methods: total 26 well preserved male albino rats were dissected and organs were separated and categorized in 3 groups:
Results: Most of the organs were showing gross destruction in their histology and these changes were more marked in pyrethroid vaporizer exposed group than in herbal based mosquito vaporizer.
Also some of the normal histological features were recovered after withdrawal of chemicals and reversal was better in herbal based mosquito vaporizer.
Conclusion: Histological findings of present study suggests that pyrethroid (Transfluthrin) based mosquito repellents are harmful to the vital organs like spinal cord, liver, kidney, heart, testis, pancreas, adrenal glands and spleen probably due to induction of oxidative stress. Herbal based mosquito repellent also showed damage though the severity was mild as compared to pyrethroid. Reversal changes were much better in herbal withdrawal group than the pyrethroid withdrawal group.
| Effect of Mobile Phone Radiation on Pancreatic Tissues of Rats | | |
Shalini Gupta, Prateek Gautam
BRD Medical College, Gorakhpur, Haryana, India
Aims and Objective: To study the effect of mobile phone radiations on various changes occuring in pancreatic tissues of male spargue dawley rats.
Methods: Male rats of weight 90-110 gms which were divided into two groups ie control and experimental were subjected to mobile phone radiations for a duration of 3 months continiously for one hour daily in specially designed cage for exposing them to radiations. At the end of each month both the group of rats were sacrificed and pancreatic tissues were collected and underwent processing to obtain histological slides stained with H& E. Also fasting blood glucose level was measured of both the group of rats.
Results: Control group of rats showed the normal histological picture ie well formed acini and islet of langerhans. However rats sacrified from experimental group of first month also showed more or less normal histological picture as that of control group. Rats sacrificed after second month of radiation doses showed changes in the histological picture as the acini showed disturbances in architecture also the blood vessels showed engorgement. A completely distorted histological picture which could be very well appreciated was observed after the study of slides obtained by the sacrifice of rats which underwent 3 months of radiation exposure. As far as the fasting glucose level is concerned it also showed a continious increase with increase in the dose of radiation which may be due to effect of radition on beta cells of pancreas.
Conclusion: The radiation which is emitted from the mobile phone has a damaging effect on pancreatic tissues of rats and hence its metabolism.
| Isolation and Culture of Mesenchymal Stem Cell from Adult Mouse Bone Marrow | | |
Bishwajeet Saikia, Asima Bhattacharyya, Pranjal Saikia
North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India
Objectives: To successfully culture the mesenchymal stem cells from adult mouse Bone Marrow. To identify the cultured cells morphologically. Stain and evaluate the culture through immune-phenotyping for identification.
Methods: Bone marrow from mice (6–8 weeks old) was isolated. Cells obtained were identified were counted on a hemocytometer. Bone Marrow cells were cultured in culture dishes in DMEM by incubating at 370C with 5% CO2. The adherent cells were washed, and fresh medium was added with changing of the media every 3 days till 80% confluence was achieved. Cells from the culture were identified for fibro-blastoid morphology. The cultured cells are wil be further identified by immunophenotyping.
Results: The cells were observed under the Inverted microscope (10X). A heterotrophic cell population in the culture was seen of which cells with spindle shaped or fibro-blastoid morphology, suggestive of “Mesenchymal stem cells” were present. The spindle cells were progressively showing elongation and branching consistent with the mesenchymal cell morphology. The subsequent passaging was done on day 14th. The first passage is still awaited for immuno-phenotyping once a more homogenous cell population is obtained.
Conclusion: After standardizing the protocol for culturing a more homogenous mesenchymal stem cell line, further attempts will be made to maintain the cell line for various pre-clinical and clinical trials.
| A Preliminary Study to Establish the Type of Myeloid Derived Suppressor Cells Present in Patients with Pancreatic Ductal Adenocarcinoma | | |
V. Sharma, A. Aggarwal, V. Gupta, N. Sachdeva, R. Nada, D. Sahni
Department of Anatomy, PGIMER, Chandigarh, India
Objective: There is evidence that myelopoiesis is greatly altered under the influence of inflammatory mediators in tumor microenvironment which leads to accumulation of myeloid derived suppressor cells (MDSCs). MDSCs have characteristic property of suppressing host anti tumor immunity. Though MDSC have been found in pancreatic cancer however, detailed characterization in pancreatic adenocarcioma is still lacking. The present study was aimed to assess phenotypic and functional characterization of MDSCs in pancreatic duct adenocarcinoma patients.
Methodology: Peripheral blood mononuclear cells (PBMCs) and tumor cell suspension of pancreatic ductal adenocarcinoma patients (n=5) stained with florochrome labeled monoclonal antibodies (CD15, CD14, CD11b, CD33, HLA-DR) directed against MDSCs. The frequency of stained cells was analyzed by flow cytometry using BD FACS Diva software. Isolated MDSC were further stained with PDL 1 and ARGINASE to assess their immunosuppressive nature.
Results: The frequency of monocytic MDSCs ranged between 12 to 22 % in the tumor tissue suspension while 20 to 40% in the peripheral blood. In healthy controls, the frequency ranged from 1-10%. The frequency of granulocytic MDSCs was 5-15% in both tissue suspension and peripheral blood. Additionally monocytic MDSCs exhibited higher expression of immunosuppressive markers (PDL 1 and ARGINASE) compared to granulocytic MDSCs.
Conclusion: Monocytic MDSCs are more immunosuppressive in nature than its granulocytic counterpart and this property could be exploited to assess severity of this malignancy.
| Comparison of Histological Features of Human Placental Tissue in Normal Pregnancy and Preeclampsia | | |
Pallavi Arora, Sankat Mochan, Sunil Gupta, Shobhit Saxena, Neerja Bhatla1, Kalpana Luthra2, Arundhati Sharma, Pallavi Kshetrapal3, Neerja Rani, Renu Dhingra
Departments of Anatomy, 1Obstetrics and Gynecology and 2Biochemistry, All India Institute of Medical Sciences, New Delhi, 3Paediatric Biology Centre, Translational Health Science and Technology Institute, Faridabad, Haryana, India
Objectives: To demonstrate and compare the histological changes of human placental tissue in preeclamptic and normotensive, non-proteinuric pregnancies.
Materials and Methods: A total of 30 women (15 PE patients and 15 normotensive, non-proteinuric controls) were recruited from Department of Obstetrics and Gynaecology, AIIMS, New Delhi after taking permission from Institute Ethics Committee. 30 term placentae were collected after taking informed consent. After delivery of the placentae, they were washed with 0.1 M, 1 X PBS to remove any clotted blood. Four sections from central area of placenta were taken followed by fixation in 4% paraformaldehyde. After fixation, samples were processed for paraffin embedding. 5 μm sections were cut and stained with Haematoxylin and Eosin (H and E) and Masson's trichrome (MT). Images were captured in Nikon microscope.
Results: H and E staining revealed that normotensive, non-proteinuric placentae showed chorionic villi covered by syncytiotrophoblasts and separated by adequate intervillous spaces whereas PE placentae showed crowded degenerating villi with decreased intervillous spaces, intravillous and perivillous fibrinoid deposition. Hemorrhage in the intervillous spaces were noticed in PE group. MT stain revealed delicate collagen fibers within villous stroma and around fetal blood capillaries in controls whereas collagen fibers were dense in PE placentae.
Conclusion: Progressive worsening of these placental histological features leads to clear participation of placenta in PE pathophysiology however, to maximize information gained from the present study, we must direct meticulous attention to several issues of analysis and diagnosis.
| Effect of Iso-Caloric and Hyperlipidemic Diet on Multiple Organs Histopthology and Biochemical Alteration in Albino Wister Rats | | |
Bheemshetty S. Patil, G. S. Kadakol, R. S. Bulagouda, I. B. Bagoji, S. R. Mudanur1, P. B. Jaju1
Department of Anatomy, Laboratory of Genetics, Shri B M Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), 1Department of Obstratics and Gynacology, Shri B M Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University), Vijayapura, Karnataka, India
Background: Hyperlipidaemia is the key factor in the development of atherosclerosis, liver disorders and oxidative stress. For treatment of atherosclerosis and various cardiovascular diseases.
Aims and Objective: The aim of the present study was to assess the effect of multiple organs histological alteration and biochemical alterations of albino rats fed with high fat diet.
Materials and Methods: Rats fed with normal and high fat diet and divided in to seversl groups, Group 1 served as normal control fed with water and addlibitum Group 2 served as Iso-Caloric diet. Group 3 Fed with Hyperlipidimic diet.
Results: % body weight gain in group 2 and group 3 were significantly altered in Iso-caloric and hyperlipidemic (high fat diet fed) rats There was significant changes were observed in histopthologcal changes and alteration in the values of biochemical markers.
Conclusion: It can be summarized that Isocaloric diet is good, high fat diet may cause the metabolic variation.
| Role of Vitamin D on Histopathological Alterations in Liver and Pancreas in STZ Induced Diabetes in Type 2 Diabetic Rats | | |
Gurudatta Moharir, Akram Naikwadi, Leela Hugar, Anant Khot, Savitri1
Departments of Pharmacology and 1Pathology, Shri B M Patil Medical College, Hospital and Research Centre, BLDE (Deemed to be University) Vijayapura, Karnataka, India
Introduction: Diabetes Mellitus is a chronic generalized disorder due to insulin insufficiency or resistance. Skeletal muscles represent one of the most important target organs that is affected by insulin signaling.
Aim: The aim of the current work was to investigate the effect of STZ versus vitamin D in type 2 diabetic (T2D) rats its effect on liver and pancreas.
Materials and Methods: Thirty six male rats constituted the animal model and have been divided into five groups: Control, Diabetic, Diabetic+Vitamin D,Vitamin D, Diabetic+Vit-D+Metformin. Blood samples and tissue were collected for biochemical investigation just before the rats are sacrificied.
Results: Histopathological changes in STZ group of liver and pancreas showed significant alteration. majority of the distorted 'lobular' architecture of liver parenchyma, little swollen hepatocytes, vacuolated microvesicular and eosinophilic cytoplasm beside increase in number of mitotic figures. Foci of fatty change and ballooning degeneration with necrosis of hepatocytes were found in zone 3 (centrilobular) areas. Moderate proliferation of portal area along with fibrous tissue and infiltration of mixed acute and chronic inflammatory cells were also noticed, diffuse hyperplasia of centroacinar and intercalated duct cells and diffuse atrophy of acinar cells with sporadic apoptosis were observed in pancreas,
Conclusions: Oral administration of vitamin D alone or in combination with oral antidiabetic agents improved histopathology with reverse back of biochemical parameter.
| Ameliorative Effect of BTE Polyphenols on Indomethacin-Induced Histopathological and Histochemical Alterations in Prostate of Albino Rats | | |
Ishwar B. Bagoji, G. A. Hadimani, Sangamesh Rakaraddi1, Sanjeev Kolagi1, Kusal K. Das2
Departments of Anatomy and 2Physiology, Shri B M Patil Medical College and RC, BLDE University, Vijayapura, 1Department of Anatomy, SNMC, Bagalkot, Karnataka, India
Introduction: Indomethacin is an anti-inflammatory drug used to relieve pain, swelling, and joint stiffness caused by arthritis, gout, bursitis, and tendonitis.
Aim and Objective: The present study is undertaken to evaluate the effect of indomethacin in prostate of albino rats and the ameliorative role of black tea polyphenols.
Materials and Methods: Treating rats with indomethacin (5 mg/Kg b.w) daily for 21 days caused distinct histological alterations in prostate gland compared with control group.
Results: The epithelial cells of prostatic acini exhibited degeneration. Hyperplasias were projected into the lumens of the prostatic acini or to the outside stroma. Most of the intertubular blood vessels were congested. Epithelial cells were significantly reduced and the thickness of smooth muscle layer increased. Histochemical changes in Prostate gland of animals treated with indomethacin showed gradual decrease in the polysaccharide, and protein contents. Treating animals with combined doses of indomethacin and BTE in rat showed an improvement in the histological structure as well as histochemical components of the prostate gland.
Conclusions: It is suggested that the ameliorative effect of BTE polyphenols against the histological and histochemical changes induced by indomethacin may be due to its rich antioxidant properties.
| Effect of Exogenous Resveratrol on Oxidative Stress Parameters and Hippocampal (CA-1) Cytoarchitecture in Mice Chronically Exposed to Arsenic Trioxide | | |
K. Mehta, K. K. Pandey, B. Kaur, P. Dhar
Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
Objective of the Study: Oxidative stress has been suggested as one of the mechanisms underlying Arsenic induced toxicity. The present study focused on the role of antioxidant (Resveratrol) supplementation on cytoarchitectural and biochemical alterations with context to mice hippocampus (CA-1) following Arsenic trioxide (As2O3) administration.
Materials and Methods: Adult female mice of reproductive maturity (assessed by monitoring estrus cycle) were divided into control and experimental groups. As2O3 (2 and 4 mg/kg bw) alone or along with Resveratrol (40 mg/kg bw) was administered to experimental groups by oral (p.o) route for 45 days whereas the control groups received either no treatment or vehicle for Resveratrol. At the end of experimental period (Day 46), the animals were sacrificed either by perfusion fixation or cervical dislocation and the brain tissues from these animals were processed for observation of cytoarchitectural features and estimation of Oxidative stress marker levels.
Results: The cytoarchitectural observations revealed significant reduction in layer (Stratum Pyramidale) thickness along with decrease in neuronal density and neuronal area of Pyramidal cells in As2O3 alone exposed groups when compared to controls and other experimental groups. The hippocampal GSH and Nitric Oxide levels were found to be downregulated and upregulated respectively in As2O3 (2 mg/kgbw) alone treated animals, thereby suggestive of As2O3 induced oxidative stress in these exposed animals. Resveratrol co-treated animals showed substantial reversal in these observations.
Conclusion: These observations provide preliminary evidence of beneficial role of Resveratrol on alterations pertaining to biochemical and structural parameters of mice hippocampus following As2O3 exposure.
| Pericyte Degeneration, Capillary Changes and the Possible Mechanisms of Choriocapillaris Drop-out with Aging | | |
T. C. Nag, C. Kumari, S. Gorla, T. S. Roy
Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
Objectives: The choriocapillaris of choroid delivers oxygen and nutrients to outer retina. It is prominently altered in diseases that leads to capillary loss via endothelial cell damage. However, changes in pericytes with aging, if any, in choriocapillaris loss are unknown.
Methods: We procured human donor eyes (age: 50-94 years; N=20) from National Eye Bank (AIIMS, New Delhi) via Institute ethics approval and processed the choroids by transmission electron microscopy.
Results: Both endothelium and pericytes appeared morphologically well-organized below 70 years of age. By eighth decade (71-80 years), pericytes appeared dark and shrunken, when the endothelium was almost unaltered. With advanced aging (>80 years), pericytes suffered destabilization, as was evident from their cytoplasmic anomalies. The endothelium then contracted and lost its support from the basal lamina that was rather fragmentary. This stimulated both endothelium and pericytes to extend their processes in attempts to re-establish their association. Activated microglia and macrophages present in the vicinity could have played a role in pericyte degeneration. Fibrotic changes were common at the capillary walls lacking pericytes. Fibroblast cells attempted to stabilize the surviving vessels by adhering to their wall and restoring the damaged endothelial basal lamina. Capillary loss was seen in both submacular and mid-peripheral region.
Conclusions: The data suggest that the age-related pericyte alterations pave the way for endothelial damage and choriocapillaris loss, the possible sequences of which are illustrated. Future research should decode the mechanisms of normal maintenance of pericytes of the choriocapillaris.
| Revelation of Microanatomy of Nerve to Iliacus and its Clinical Significance | | |
Rajani Singh, Rajkumar1, Naresh Chandra2, Kavita Gupta3, M. S. Ansari
Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Dehradun, Uttarakhand, 1Department of Pediatric Neurosurgery, SGPGI, 2Department of Anatomy, Hind Institute of Medical Sciences, Lucknow, 3Department of Physiology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
Introduction: The Iliacus muscle, exactly fitting in iliac fossa innervated chiefly by nerves to iliacus and femoral nerve, extends caudally as tendon fusing with the tendon of psoas major forming iliopsoas. As theiliacus/iliopsoas is responsible for flexing of the thigh and the forward tilting of the pelvis, body posture, Olympic lifts, daily activities like walking and running, so impairment of above functions due to Spinal Cord Injury, or injury to nerves to iliacus, remained a grey area to explore manifestation of nerve lesions together with neurosurgical repair at fascicular level for a neurosurgeon and to uncover macro and microanatomy for an anatomist.
Methods: Therefore an experimental study was designed to map the complex fascicular pathways suffering from splits, fusions and plexiformscoupled withmeasurement of distances of closely sampled histological slides. Tracking, correlation and interpretation of fascicles of a cropped femoral nerve in iliacus region from a 70 year old female cadaver was analyzed.
Results and Conclusions: The study resulted in three schematic models of 3 nerves to iliacus and 2 tabular models of 2 remaining nerves to iliacusrevealing complete picture of composite fascicular pathways interrupted by dynamic transformational processes. These results would facilitate not only MRI neurographic interpretation at fascicular level and neurosurgical treatment but also would discover anatomical complications through identification and location of injury. Besides, the huge data volume evolved off this experiment would not only open up grey area for neuroanatomical research but also would revolutionize the neurosurgical repair and grafting.
| A Study on Sufficiency and Relevancy of Knowledge of Genetics: A General Practitioners Perspective | | |
Kulkarni Saurabh Prakash
Objective: Modern diagnostic policies recommend evaluation of genetic susceptibility of common diseases. With the advances in genetic research many genetic tests are available for prevention and early diagnosis of such diseases. General practitioners perform key role in primary screening and directing patients for diagnosis. Awareness amongst them about application of fundamental principles of hereditary and appropriate referral system can help society in decreasing burden of such diseases. But lack of this orientation in GPs as noted by many authors demands educational intervention at training level as well as for improving competency of practitioners.
Hence study is directed to evaluate genetic knowledge of GPs on behaviour and attitude scale.
Methods: Prevalidated questionnaire was used to obtain perceptions of GPs for their knowledge, attitude and behaviour through true/false questions and Lickerts scale.
Results: GPs are deficient in evaluating risk factors and prompt referral for diagnostic techniques. They lack required knowledge for associating fundamental principles of genetic with clinical conditions. Their behaviour toward record keeping and sensitizing patients was inappropriate. Their attitude needs to be changed so that they can understand gravity of genetic disorder and use of advanced genetic techniques.
Conclusion: Educational interventions for case-based and competency based medical education modules at training level and continuous medical education programme on genetic issue are indicated for improving GPs knowledge, behaviour and attitude regarding application of genetic principles in management of patients.
| A Study of Awareness and Willingness Regarding Organ/Body Donation in Population of Kalaburagi | | |
Sundip H. Charmode
Background: The purpose of this study is to assess the awareness and willingness regarding organ and body donation in population of Kalaburagi region followed by counseling session to encourage them towards organ and body donation.
Aim: To study the awareness and willingness towards Organ and Body donation in population of Kalaburagi.
Materials and Methods: A cross-sectional study using a specially designed, validated questionnaire containing mcq's was done amongst Medical, Dental, Ayurveda and Nursing students, staff and patients of ESIC Institute Gulbarga after taking their informed consent. It was followed by a counseling session where queries regarding organ and body donation were solved and procedure of registration for the same was explained.
Results: Amongst the 1000 study participants surveyed,
- 511 participants (63.39 %) amongst total 806 participants shown awareness towards organ donation
- 565 participants (70.09 %) amongst total 806 participants shown awareness towards body donation
- 317 participants (39.33 %) amongst total 806 participants shown willingness for organ donation
- Only 137 participants (16.99 %) amongst total 806 participants shown willingness towards body donation.
Conclusions: Highest awareness was observed amongst medical students for organ and body donation compared to other categories of study participants. Least awareness was observed amongst general public/ patients for organ and body donation compared to other categories of study participants. Female respondents of all categories have shown higher degree of awareness towards organ/body donation compared to their male counterparts. Female respondents of all categories also showed more willingness for organ donation than male participants.
| Assessing the Views of Generation X Faculty about Generation Y Medical Students: A Questionnaire Based Study | | |
G. Shivhare, V. Chayal1, A. Goel, R. Gupta, K. Kapoor2
Adesh Medical College and Hospital, Mohri, 1Post Graduate Institute of Medical Sciences, Rohtak, Haryana, 2Government Medical College and Hospital, Chandigarh, India
Objective: To discuss the opinions of present medical faculty of generation X about generation Y medical students and to enlist the ways to bridge the gap between two generations to maximise the productivity of teaching and learning process.
Methods: The method used for the study was in form of a written questionnaire, filled by generation X teaching medical faculty of various departments of medical colleges of Haryana and Chandigarh. Data collected after an interview schedule was entered in Microsoft excel sheet and appropriate statistical tests were applied to analyse it. Questionnaire comprised of socio-demographic profile of the medical faculty and their opinions about major behavioural difference in generation Y students. The opinions expressed and suggestions given by faculty were discussed.
Results: There were many differences that generation X observed between themselves and the generation Y students. However, the majority of the teachers were open to learning new methods to bridge the gap.
Conclusion: Bridging the gap, accepting the new generation as they are and moulding our self to match their needs can be productive to the present practices of medical education.
| Cross Sectional Comparative Pilot Study of Students' Score in Objective Structured Practical Examination versus Traditional Practical Examination in Anatomy | | |
Narkhede Jyoti, S. G. Kamkhedkar, S. Kartikeyan
Rajiv Gandhi Medical College, Kalwa, Thane, Maharashtra, India
Objective: This Cross Sectional Comparative Pilot Study was conducted with the objective of comparing the scores obtained by first MBBS students in objective structured practical examination (OSPE) with that in Traditional Practical Examination.(TPE) in Anatomy.
Methods: After obtaining approval of the Institutional Ethics Committee, written informed consent was obtained from students (n=60) after explaining them about the pattern of OSPE. TPE was conducted as per the university pattern on dissected soft parts and osteology. Prevalidated check lists were used by the same set of examiners for conducting OSPE on same topics. TPE and OSPE marks (out of 20) were tabulated and statistically analysed (EpiInfo 7.0 software) and the statistical significance was determined at p<0.05.
Results: (a) Dissected soft parts: The average marks in OSPE were 7.72 ± 4.13 while that for TPE was 12.53 ± 1.74. The difference in overall marks was highly significant.(Z= 8.325;p<0.0001). The gender difference in score was not significant. (b) Osteology: The average marks in OSPE were 3.80 ± 2.34 while that for TPE was 9.34 ± 3.08. The difference in overall marks was highly significant.(Z= 11.097;p<0.0001). The gender difference in score was not significant.
Conclusion: The significantly higher scores in TPE without significant gender difference may indicate leniency on part of the examiners since TPE scores are not performance specific. Alternatively, the significantly lower scores in OSPE without significant gender difference may indicate that the participating students lacked the specific knowledge that is expected in an OSPE.
| Lessons from the History of Anatomy | | |
A. Buch Hasmukh
Faculty of Dental Science, Dharmsinh Desai University, Nadiad, Gujarat, India
Edmund Burke said: “Those who don't know history are doomed to repeat it.”
Surely, we do not want repetition of 'Bad' history. “The farther backward you can look the farther forward you are likely to see.” – Winston Churchill
The very first lesson is all history is not humbug if one consults authentic sources; easier said than done. Teaching of history leaves a lot to be desired and it competes with the subject of Anatomy regarding its boring potential.
We have to learn to cultivate healthy disrespect for the existing anatomical facts as the history has taught us that from Galen to Gray, none is infallible. Even Vesalius found it challenging to undo Galenic Anatomy. Further, even for your correct research finding, you may be ridiculed by the contemporary medical and nonmedical fraternity like Harvey was.
Who wants to learn and/ or teach History and Ethics? There are many who want to include teaching of Ethics in the curriculum. It is difficult not to accept that we- at least the Anatomists- are historically unethical; 'Burking' and Professor Knox illustrate the point. We have always attached more importance to the ends over the means. Sometimes we are puzzled as to whether Anatomy is a branch of Medicine
or Medisin. It is still not unequivocally established whether Herophilus-the Father of Anatomy-was a human vivisector but without adequate knowledge of Anatomy, our future surgeons may become so.
Serendipity in Anatomy- is extremely rare and even for that to happen, a prepared mind is a must.
| Effectiveness of Blended-Learning Module in Radiological Anatomy for First Year MBBS Students | | |
B. Y. Shyamala, N. Chitra, R. Yogitha, S. Nachiket, T. A. Lakshmi
St John's Medical College, Bengaluru, Karnataka, India
Objectives: To estimate the difference in pre and post-test scores after exposure to five radiological anatomy modules among first MBBS students.
Methods: The study was conducted after clearance from the institutional ethics committee and obtaining written informed consent from the participants. Five radiological anatomy modules for the upper limb, lower limb, head and neck, thorax, and abdomen and pelvis were developed. Each module focused mainly on the normal anatomical features observed on plain and contrast radiographs followed by a self-assessment quiz with feedback. The content of all the modules was uploaded into a learning management system called TYRO. During the classroom session, the students were instructed to go through the modules and answer the self-assessment quiz. The teacher in the classroom acted as a facilitator and was available to the students for any clarifications. A multiple choice pre and post-test was administered to the students before and after exposure to the modules respectively. A paired T test was used to estimate differences in the pre-and post-test scores.
Results: One hundred students attended both the tests. The mean pre and post- test scores were 17±5.5 and 26±7.6 respectively. The difference between the pre and post-test scores was significant (p<0.001).
Conclusion: A significant improvement in the knowledge of radiological anatomy was noted among the participants after exposure to five modules of radiological anatomy. The methodology may be of interest to anatomy educators to improve the teaching and learning of radiological anatomy among first year MBBS students.
| Anatomy Journal Metrics | | |
N. Chitra, T. A. Lakshmi
Department of Anatomy, St. Johns Medical College, Bengaluru, Karnataka, India
Objective: To classify anatomy journals depending Impact factor.
Methodology: Study design: Secondary Data analysis and classification as available on internet.
Inclusion Criteria: Anatomy based scientific journals which are indexed in Scopus, Pubmed/Medline, Embase/Experta medica, Index medicus and Index Copernicus. The journals selected for evaluation have gained acceptance among anatomists as prospective journals to publish their research.
Results: Top 5 journals ranking according to RG impact factor [Table 1].
Conclusion: Impact factor of a journal is a tool to guide the author to choose the articles for reference or to publish research papers. It also helps to avoid publication in predatory journals. The ultimate aim of this study is to help anatomists publish their research in accepted journals.
| Students Perception towards Animation Videos Aided Embryology Lectures | | |
M. Malhotra, S. Joshi, S. Agarwal, A. Tuli, S. Raheja
Lady Hardinge Medical College, New Delhi, India
Introduction and Objective: Embryology is the study of series of events from fertilization to birth. Embryology teaching in Anatomy curriculum has always been a challenge for the teacher as well as for the students. Composite teaching tools like animation videos and labelled photographs of models were introduced during Embryology lectures for the better understanding of the subject.
Materials and Methods: In Systemic Embryology, Development of Cardiovascular system and Gastrointestinal tract were taught by inclusion of animation videos and labelled photographs of models, along with the conventional teaching. Rest of the systemic Embryology was taught by only conventional method. After completion of Systemic Embryology lectures consent was taken by 120 MBBS students voluntarily. Feedback was taken in the form of reliable and validated questionnaire.
Results: Majority of students preferred the new animation video supplementation along with the chalk and talk and 3D models teaching.
90% students admitted that there was improvement in understanding embryology with animation videos and labelled photographs of models. 70% students were able to correlate with embryological basis associated with clinical conditions.
Conclusion: Computer assisted teaching in the form of animation videos and photographs of models can be used as the supplementary tool for better Embryology lectures.
| An Analysis of Factors Influencing Handwriting Patterns of I MBBS Students | | |
M. C. D'Souza e Dias, . Rataboli
Goa Medical College, Bambolim, Goa, India
Objective: The aim of the present work was to study the influence of certain factors on handwriting of MBBS students.
Methods: All 150 first MBBS students voluntarily took part in this study wherein they were asked to fill a Handwriting questionnaire which was later evaluated.
Results: 55% of students spoke Konkani as their first language English being next at 22% while for 72% English was their first written language. Most students reported that they tend to converse with their parents in a local dialect but converse more in English with their siblings and friends. Almost all students said they prefer English for reading as well as writing at home and in school and even just for pleasure reading. Dreaming had more of a mixed response for the use of the English language. 55% of students felt that overall their best language was English. Majority of the students found English to be comfortable to use while reading, speaking and writing as well. 146 students were Right handed, 2 were left handed and 2 were Ambidextrous. Factors given by the students for influencing their handwriting were mood, time, speed, pen, situation, others handwriting, energy and pen grip among others in order of importance. 38 (25%) of students had heard of the ergonomic pattern of pen holding out of which 21 had tried to adopt it unsuccessfully. 76% students had an English medium of instruction school background. 114 (76%) students had cursive style 34 (22.6%) had print-cursive style and 2 (1.3%) had mixed styles of writing. 129 (86%) students felt that good handwriting scores better marks at examinations while 21 (14%) thought otherwise.
Conclusion: students coming from a local dialect background seem to have to adjust to having a command in English in order to pursue a course in MBBS. Though most of the students spoke in local dialect most of them preferred English for reading and writing as well. Among factors affecting their handwriting students felt mood, time and speed were most important. Most students wanted to improve their handwriting as they felt that good handwriting scored better at written examinations.
| Communities of Practice: A New Methodology in Anatomical Research and Teaching | | |
L. Lazarus, R. Sookrajh1, K. S. Satyapal
Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, 1Department of Curriculum Studies, School of Education, University of KwaZulu Natal, Durban, South Africa
Communities of practice are formed by people who engage in a process of collective learning in a shared domain of human endeavour. To become an official community member, an individual must work in the relevant domain and express buy-in or commitment. Members of the community value their joint competence and learn from each other. In this study the 'community of practice' refers to the interdisciplinary collaboration with co-authors well as national and international faculty-based at other higher education institutions in South Africa. The aim of this paper was to examine the views and perceptions of fellow colleagues regarding research in the domain of clinically applied anatomy and how this has impacted on their teaching practices using our collaborative work. Participants were identified as those individuals who were involved as co-authors (n=10) on co-written papers. Semi-structured one-on-one interviews were conducted with research team members. Interviews were audiotaped and transcribed verbatim. This methodology allowed the first author (LL) to critically reflect on her role as a basic scientist in this research team. Themes that emerged from the data were (i) Value of research collaboration, (ii) Impact of human anatomical variations, (iii) Association with medical and non-medical collaborators and (iv) Teaching practice emanating from collaborative research. We see collaboration to advance anatomy research as a good strategy to overcome some of the globally felt challenges to anatomy education. The community of practice involving co-authors provides an opportunity for institutions and health centres involved to benefit from sharing of experiences and resources, capitalising on each other's strengths.
| Goals, Roles and Aspects of Learning of Indian Medical Graduate: A Study of Student's Perspective | | |
A. Jaiswal, A. Kaushik1, A. K. Singh
Departments of Anatomy and 1Pathology, Government Medical College, Haldwani, Uttarakhand, India
Introduction: Medical education in India is traditionally knowledge based. Newer challenges like negligence, mistrust and ethical issues are emerging, along with increasing demand of good clinical skill, accountability, transparency and quality assurance. MCI is bringing new medical curriculum, the student is the learner and their perspective regarding current medical education is very important but unfortunately study involving student perspective are lacking.
Aim: To study student perspective about goals, roles and aspects of learning of Indian medical graduate.
Methods: This study was conducted among 288 students of Government Medical College, Haldwani. A multiple-choice questioner was provided to the students about goals, roles of IMG, important aspect of learning, what teachers are assessing, on what faculty should emphasize and feedback.
Result: A total of 193/288 (67.01%) students were aware of the goal of IMG as doctor of first contact in community. 211/288 students ticked lifelong learner, followed by clinician (162/288), communicator (116/288), and professional (102/288) but only 16/288 only ticked all the roles of IMG. Among aspects of learning, knowledge (170/288) and skill (160/288) are still considered important and students think that teacher should emphasize on knowledge (102/288) and skill (169/288). Most of students think assessment method used checks their knowledge (225/288). 145/288 students think that teacher gives feedback about knowledge only.
Conclusion: This study highlights that students were not familiar about goals and roles of IMG. The medical education from student's perspective is also knowledge centric and to a certain extent to skill, but important aspect like attitude, communication and ethics are lagging. Study provides a sense of introspection to teachers and an urgent need in change in medical curriculum for making a doctor of first contact of the community while being globally relevant.
| Motivating and Improving the Performance of Repeater and Detained/Supplementary 1st Year MBBS Students through Lecture Demonstrations | | |
B. Pangtey, P. Goswami, N. Vasudeva, S. Mishra
Department of Anatomy, Maulana Azad Medical College, New Delhi, India
Objective: The aim of this study was to identify the problem areas affecting both the personal and academic domain of repeater and detained students, leading to failure in 1st MBBS Annual Examination and to improve their academic performance by teaching, guidance and counselling through lecture demonstrations.
Methods: The study was conducted on 46 first year MBBS students including 18 repeater batch students ranging from admission year 2010-15 and 28 detained / supplementary students of batch 2016-17. The students were provided with a detailed questionnaire aimed at elucidating the cause (personal and academic), which was then analyzed and assessed to determine the core problem. The academic performance was then improved by targeting their problem areas by encouraging them to attend classes, building a positive attitude, motivating and facilitating effective learning process through lecture demonstrations for a period of 1 month after the annual result declaration.
Results: The personal issues affecting the students were observed to be language barrier (English), attendance deficit, social-economic and individual factors. The academic performance improved with passing percentage of 66.7 % (12 out of 18) in repeater students and 92.9% (26 out of 28) in detained / supplementary batch 2016-17 in 1st year MBBS Annual Examination. The total marks secured ranged from 56.5% - 64.5 % in repeater students and 56%-70% in detained / supplementary students.
Conclusion: An active teaching learning module is essential for the holistic development of detained / repeater students addressing their personal and academic needs.
| First Exposure to Cadaver by a MBBS Student: A Psychoanalytical Approach | | |
B. K. Dutta, S. K. Mishra, M. Sar, A. Soy, D. P. Bara, Behera, S. Swain
VIMSAR, Burla, Odisha, India
Aims and Objectives: To assess the psychological impact of the initial exposure to cadaver by first year MBBS students.
Materials and Methods: 150 newly admitted first year MBBS students were given a set of questionnaire based on the psychological symptoms normally faced by the students in the initial period of exposure to cadaver in dissection hall. Psychological analysis was done separately for male and female students on first day and after 2 months.
Results: There was a marked decrease in the stress symptoms like fear, anxiety, nausea, shivering of hands, head reeling after 2 months. Nausea (48%) was found to be the main symptom among the female students whereas shivering of hands (30%) was more common in male. After 2 months 72% of female students adjusted well with the environment but the number was less in males (57%).
Conclusion: This study emphasizes on creating stress relieving sessions before the first exposure to cadaver to decrease the dropout rates.
| A Morphometric Study on Nutrient Foramen of Humerus in Western Odisha Population | | |
B. K Dutta, M. Sar, S. K. Mishra, S. Behera, A. Soy, D. P. Bara
VIMSAR, Burla, Odisha, India
Aim: To do a detailed study on Nutrient foramen of Humerus in western Odisha population.
Materials and Methods: 100 numbers of intact humeri collected from anthropology section of Department of Anatomy of VIMSAR, Burla were studied to find out the number, direction and location of nutrient foramina present in each humerus. The total length of each bone and the distance of the nutrient foramen from its proximal end were measured to calculate the foraminal index using Hughes formula. The antero posterior and transverse diameter of the bones at the level of nutrient foramen were measured to assess statistically significant correlation between number of nutrient foramina and size of bone.
Results: 64% of the Humeri were found to have single nutrient foramen, 28% double foramina, 6% triple foramina and 2% of humeri had four nutrient foramina. It was observed that majority (39.3%) of nutrient foramina were present on the medial border followed by 36.5% on the anteromedial surface and 31% on the posterior surface and 1.37% each on anterior border and anterolateral sueface of the shaft of the humeri. It was also observed that most of the foramina (96.55%) were present in the zoneII followed by zone I (2.06%) and then by zone III (1.37%). All foramina were found to be directed towards the lower end.
Conclusion: This study will provide important morphological and topographical information about nutrient foramina in humerus for orthopaedics procedures.
| Cadaveric Workshop: Its Importance in Surgical Discipline | | |
Pravash Mishra, Manisha R. Gaikwad, Amit Tirpude, Prabhas R. Tripathy
Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
Background: Lack of uniformity in teaching practices across India, has led to gross differences in skill level of resident doctors. We report the effectiveness of the cadaveric workshop organized by Department of Anatomy in collaboration with different department at AIIMS Bhubaneswar in last two years in improving the skills of resident doctors.
Materials and Methods: The workshop consisted of series of structured lectures, cadaveric dissection and demonstration followed by hands on cadaveric training by experts.
Results: The workshop involved Departments like ENT, Orthopedics, Neurosurgery and Physical Medicine and Rehabilitation of AIIMS Bhubaneswar. The participant (n) for various surgeries like functional endoscopic sinus surgery (n = 27), Head and neck reconstruction surgery (n = 23), technique of using drill (n = 21) and Total knee replacement (36) were from all the medical colleges and hospitals of Odisha and neighboring states. Some of these workshops were conducted twice and it was found that many participants were repeaters.
Conclusion: The workshop focused on limited participants to allow adequate hands on training. The aim was to deliver up to date information related to a particular surgery. The workshop aids in understanding of knowledge, awareness and skill enhancement with minimum utilization of human resources.
| Attitude and Perception of Learning Anatomy through Cadaveric Dissection versus Virtual Anatomy Table – A Comparative Study in Undergraduate MBBS Students | | |
S. Bindhu, R. Avadhani, Meera Jacob
Department of Anatomy, Yenepoya Medical College, Mangalore, Karnataka, India
Objectives: To compare and document the attitude and perception of MBBS students on cadaveric dissection & virtual anatomy table.
Methodology: A semi structured questionnaire containing advantages and disadvantages of cadaveric dissection VS virtual anatomy table with three options was administered to a group of 150 second year MBBS students at Yenepoya Medical College, Mangalore. The obtained data was analyzed through descriptive statistics.
Results: The result shows that the students were equally excited during their first visit to dissection hall as well as in simulation centre. 90% of students strongly agreed that learning clinical anatomy is more effective and easy in 3D virtual anatomy table when compared to learning from dissected cadaver. 86% of the students agreed that integrated teaching is more effective in virtual anatomy table. 78% of the students strongly insisted to include virtual anatomy table and simulation teaching in MBBS syllabus. But 84% of the students did not agree that computer-based training programmes, can substitute for dissection of cadavers in future. 86% of the students insisted to have both cadaveric dissection and virtual anatomy table in their curriculum.
Conclusion: Since the students expressed positive attitudes towards both cadaveric dissection as well as the virtual anatomy table this study insists that both have to be included in the first year curriculum.
| Case Based Learning as a Self Directed Learning Tool in Anatomy: Perception of Students and Faculty | | |
D. Nirmala
Department of Anatomy, J.J.M. Medical College, Davangere, Karnataka, India
Objective: Ist year MBBS students are taught by didactic lectures and practical sessions of dissection and histology routinely. Anatomy teaching can be made more interesting when clinical cases are included. Students can actively involve in self directed learning and learn better when interesting cases are presented and they find learning Anatomy more relevant. Hence case based learning was introduced and the perception regarding introducing cases to facilitate learning Anatomy, of faculty and of students were analyzed.
Methods: After obtaining ethical clearance and consent from the students, 118 Ist MBBS students of 2017-18 batch were included. They were divided into two groups A and B. Each group was presented with clinical cases on paper separately. They were encouraged to refer the text and interact with the facilitator, after which they actively participated in question answer session. Outcome was measured with a pretest and a posttest and a retention test after 3 weeks. The feedback of these sessions were taken from the students and the faculty.
Results: Mean of posttest score were higher than the pretest scores and was statistically significant for both groups, A and B. More than 75 % of students and faculty opined case based learning was interesting and 55% of the students opined case based learning sessions encouraged them to self directed learning and they wanted it to be conducted for other topics as well.
Conclusions: Case based learning is perceived favorably by both students and faculty. It improves student interaction and enhances student knowledge acquisition and performance.
| Morphology and Cytoarchitecture of Developing Human Cochlear Nucleus | | |
S. Saini, T. G. Jacob, A. Thakar1, K. K. Roy2, T. S. Roy
Departments of Anatomy, 1Otorhinolaryngology and 2Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi, India
Objectives: Hence, we examined the morphology and cytoarchitecture of thehuman cochlear nucleus (CN) in prenatal and postnatal periods.
Materials and Methods: Twenty-three human brains from fetuses of 10-weeks of gestation (WG) to 34 WG and one 5-day old neonate were obtained with prior approval of the Institute Ethics Committee and informed consent from legal representatives. The brainstems were dissected and fixed in 4% buffered paraformaldehyde (0.1M phosphate buffer, pH 7.4), cryopreserved in 30% sucrose and sectioned to obtain 40 μm-thick, serial sections, of which, every fifth to tenth section were stained with cresyl-violet and observed and photographed with a light microscope.
Results: The developing CN was located lateral to the Inferior cerebellar peduncle at 10WG. At 10-16 WG there were no features in the cells by which they could be identified as either belonging to the neuronal or glial lineage. At 16-20WG some of the cells had scanty cytoplasm and round euchromatic nuclei. From 20 WG the dorsal CN (DCN) and ventral CN (VCN) could be identified and theDCN had a tri-laminar organization. Eight major cell types could be identified from 26 WG. Pyramidal and multipolar cells were mainly found in the DCN. Ovoid, globular, octopus, giant and small cells and granule cells were found both in the DCN and VCN. This classification and identification excluded many immature cells that displayed no characteristics of the mature neuronal morphology.
Conclusions: In our study, the developing CN shows major phase of growth after 20WG which overlaps with the onset of the intra-uterine physiological responses to sound.
| A Study of M1 Segment of Middle Cerebral Artery in Human Cadaveric Brains and Clinical Implications | | |
N. Hema
Introduction: Human brain gets its nutrition from carotid and vertebro-basilar system of vessels. MCA, being the larger terminal branch of ICA supplies the cortical areas of brain concerned with speech and language. It is the most commonly involved artery in cerebro-vascular accidents as in stroke which is characterised by suden onset of focal neurological deficit. The anatomical study is of utmost important to neurovascular surgeons.
Aims and Objectives: 1. To measure the length and diameter M1 segment of MCA bilaterally and to compare its diameter with the the diameter of ICA at its terminal branches. 2. To quantify the number of lenticulostriate branches from M1 segment bilaterally. 3. To note the incidence and variations in the course of early branch of middle cerebral artery on both the sides.
Materials and Methods: The present study was undertaken in 140 cadaveric human brain hemispheres of 70 formalin fixed brains from Department of Anatomy and Forensic medicine of Mysore medical college and ESIC MC and PGIMSR, Bangalore. Fixed brains were sagitally bisected into right and left halves by brain cutting knife. Meninges were cleared and MCA was identified which was the larger and direct branch of ICA. Measurements of ICA and MCA was taken using thread and measuring scale. LSAs arising from MI segment MCA were counted using hand lens. Any early branch if present was noted.
Results: The mean of length of M1 was found slightly more on the left side (20.9 mms) in comparison to right side (19.0 mms). The mean diameter of M1 segment of MCA was more on the left side (3.52 mms), in comparison to right side (3.17 mms). The mean diameter of left MCA (3.52 mms) and left ICA (3.59 mms) were of the same size. The mean diameter of right MCA (3.17 mms) and right ICA (3.23 mms) were almost of the same size. The number of LSAs were more on left side (5.9) in comparison to right side (5.67). Early branches were found to be more on right side (5) than left side (3).
Conclusion: Observations made on MCA revealed greater length of MCA carrying greater proportion of blood flow to the left side – a feature which supports the concept of vascular asymmetry. The knowledge of lenticulostriate arteries and early branch arising from proximal segment of MCA helps neurovascular surgeons to make a fairer decision in treatment of cerebrovascular diseases. The authors felt the necessity of presentation of data inferred by our study as there are very few articles on MCA found published in Indian literature.
| Surgical Anatomy and Landmarks of Tympanomastoid Segment of Facial Nerve Using Morphometry as a Measurement Technique: Cadaveric Temporal Bone Dissection Study | | |
Shrivastava Tripti, Rajguru Renu1, D. Baruah2, Sushil Kumar
Departments of Anatomy and 2Pathology, AFMC, Pune, 1Department of ENT, INHS Ashwini, Mumbai, Maharashtra, India
Introduction: Facial nerve is unique in terms of a long and tortuous course in a bony canal within the temporal bone. The intricate course of the nerve through the temporal bone is of vital concern to all otologic surgeons as it traverses the surgical field and course of the tympanomastoid segment is of great importance as maximum otological surgeries involve this portion of the temporal bone. While removing the disease, surgeons need to pay attention to the adjacent structures which serve as reliable landmarks, to ensure complete removal of disease while avoiding injury to the facial nerve. Hence it is extremely important that surgeons are well versed with the surgical anatomy of facial nerve and various landmarks for its identification.
Aim: To study the tympanomastoid course of facial nerve and to determine its effective surgical landmarks using morphometry.
Materials and Methods: The present study was conducted in the temporal bone dissection laboratory in the Department of Otorhinolaryngology, AFMC, Pune on 20 temporal bones (ten left and ten right) harvested from cadavers from the Department of Anatomy, AFMC Pune. The temporal bones were dissected under Karl Ziess Operating microscope with an inbuilt camera. In order to find the variations in the surgical anatomy, temporal bones were dissected using the standard transmastoid surgical approaches of cortical mastoidectomy, facial recess, canal wall down mastoidectomy followed by facial nerve decompression and images were captured at each stage to define the relationship of various landmarks with the facial nerve. Morphometric analysis of the recorded images was then performed with image analysis software.
Observations and Results: Standard surgical approach was commenced with cortical mastoidectomy followed by facial recess approach. The distance between the facial and chorda tympani nerve narrows down as one drills inferiorly towards the origin of the chorda tympani.
Subsequently posterior canal wall was removed to study the relationship of Lateral semicircular canal and ossicles with the facial nerve. This relationship is very important to prevent inadvertent injury to facial nerve which may be dehiscent especially while clearing granulations or cholesteatoma.
During mastoidectomy it is possible to encounter cases in which disease process has destroyed ossicles and a dehiscent facial nerve is lying exposed amidst granulations and cholesteatoma. In those cases structures like lateral semicircular canal, cochleariform process and pyramid may guide the surgeon regarding position of the facial nerve.
Normal surgical landmarks are often distorted in the diseased mastoid and hence positive identification of vital structures is mandatory to perform a successful procedure. Therefore, the surgeon should use as many of the available anatomical landmarks which act as a frame of reference for the facial nerve location.
Conclusion: We found that cochleariform process, distance of tympanic segment of facial nerve from the dome of lateral semicircular canal, short process of incus and pyramid to be constant landmarks. The stapes head, incudostapedial joint, origin of chorda tympani, exit at stylomastoid foramen, angulation of 2nd genu were found to vary. However in chronic otitis media, the ossicles may be eroded. In those cases cochleariform process, lateral semicircular canal and pyramid are effective landmarks.
| Prenatal Aspirin Induced Toxic Changes in Cerebellum of Swiss Albino Mice | | |
S. Yadav, S. N. Shama
Department of Anatomy, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
Aims and Objective: Aspirin, a non-steroidal anti-inflammatory drug having antipyretic, analgesic and anti-inflammatory actions. It is also used in prevention of myocardial infarction. The antithrombotic effectiveness of aspirin is related to its inhibition of the cyclooxygenase (COX) enzyme that metabolizes arachidonic acid to a variety of prostanoids, including thromboxane A2. With the inhibition of platelet COX-1 activity, there is a decrease in platelet aggregation, leading to a reduced thromboembolic potential and a commensurate prolonged bleeding time. Thus, it is not surprising that the major risks associated with aspirin relate to bleeding complications. Looking at very few and inconclusive reports about the teratogenicity of aspirin and histopathological changes induced by it in the cerebellum of developing embryo, the present study has been undertaken.
Materials and Methods: Aspirin was given to pregnant mice in the dose of 100 mg/kg body weight and the cerebellum of 19th day fetus was studied for any microscopic changes.
Observation and Results: The treated cerebellum shows thinning as well as loss of cohesion in the cells inside molecular layer. Spaces between the different layers are also increased. The cellularity in each layer is also reduced considerably. Disappearance of cells and cohesion of smaller vacuolated spaces give rise to the spongiform appearance of the treated cerebellar cortex.
Conclusion: Aspirin has toxic effects on cerebellum of developing embryo so should be used with caution in pregnancy.
| Expressional Analysis of Reelin in Mesial Temporal Lobe Epilepsy – A Preliminary Study | | |
M. Kaur, T. Gupta, D. Sahni
PGIMER, Chandigarh, India
Objective: Granule cell dispersion (GCD) is considered to be pathognomonic of hippocampal sclerosis seen in mesial temporal lobe epilepsy (MTLE). Current animal studies indicate that deficiency of Reelin, an extracellular matrix protein, is associated with abnormal granule cell migration leading to GCD. Reelin inhibition has been found to induce temporal lobe epilepsy in mice. Moreover, the infusion of exogenous reelin decreased the GCD in epilepsy mice model. The present study aims to evaluate whether reelin deficiency is related to MTLE in human tissue.
Methods: H&E staining was done to identify the mesial temporal lobe epilepsy. Gene expression profiles of Reelin & its receptors (Very low density lipoprotein receptor-VLDLR & Apolipoprotein E receptor 2- ApoER2) were compared in normal and epileptic human tissue. Quantitative Real-time PCR was done to determine the gene expression in the hippocampus and anterior temporal lobe of 5 patients of drug resistant mesial temporal lobe epilepsy.
Results: Typical features of mesial temporal lobe epilepsy were seen histologically. The threshold cycle (Ct) values of Reelin and its receptors were found to be between 30-35 which indicates its lower expression as compared to the housekeeping gene-GAPDH. Thus, this data suggests the causative role of Reelin and its receptors in MTLE.
Conclusion: This is a preliminary study to find out the relation between reelin and MTLE. If the causative role of Reelin in MTLE can be established in human tissue, it might have therapeutic potential.
| The Effect of Long-term Practice of Mindfulness Based Meditation on the Gray Matter Volume: A Systematic Review | | |
M. Patnaik
AIIMS, Bhubaneswar, Odisha, India
Objective: The objective of the present study is to understand the effect of long-term practice of Mindfulness based Meditation practices on the global gray matter volume as well as on the gray matter volume of certain areas of the brain.
Methods: The papers reviewed were accessed online and from Pubmed/Medline indexed journals. The studies included were cross-sectional in design; and had used higher neuro-imaging techniques to identify the regions of the brain which showed changes in gray matter volume due to mindfulness based meditation practices. These studies had compared the brain images of long-term meditation practitioners with well matched control group.
Results: The literature review showed that mindfulness based meditation practices produced changes in the gray matter volume in regions of the brain concerned with functions like learning, memory, and emotion regulation.
Conclusion: Rigorous longitudinal studies in normal population is essential to establish a definite link between mindfulness based meditation practices and changes in the gray matter volume. Research is needed to understand the neurological mechanisms involved in the same.
[Table 1]
|
