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   Table of Contents - Current issue
July-September 2021
Volume 70 | Issue 3
Page Nos. 129-187

Online since Thursday, September 23, 2021

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Evolving trends in anatomy teaching across the globe: A new perspective p. 129
Vishram Singh, Rashi Singh
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Educational resources used by 1st-year medical students p. 130
Himel Mondal, Sumita Dutta, Shaikat Mondal, Manas Ranjan Sahoo, Koushik Saha, Sarika Mondal
Introduction: A dynamic teaching–learning environment is being established in Indian medical institutions with the implementation of a competency-based medical education curriculum. This new curriculum may change the previous pattern of usage of educational resources by the medical students. We aimed to explore the pattern of usage of resources by the 1st-year medical students. Material and Methods: We invited 1st-year medical students of three medical colleges for an online survey. There were 17 statements in the questionnaire with 5-point Likert-type response options to collect data on the preference of type of classes, frequency of collection of notes, pattern of reading, and usage of multimedia. Results: A total of 127 (response rate 42.6%) students participated in the survey. Practical classes were the most preferred type of class followed by small group teaching. Students preferred to take notes from 1-h lectures than making notes while reading books. Traditional textbooks were the most preferred material read by the students followed by the question–answer type book. E-book downloaded on the smartphone was preferred over the online e-book. Internet searches and watching YouTube™ videos were popular than watching e-content provided with the textbook. Discussion and Conclusion: In the age of smartphones and the internet, traditional learning resources are still popular among 1st-year medical students. However, learning is reinforced by widely available electronic content. Hence, blended teaching with both traditional and e-resource may be considered by medical teachers.
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Proliferative capacity of retinal progenitor cells in human fetal retina p. 136
Prakash Mane, Anjali Satyen Sabnis
Introduction: Retina is an innermost, delicate, and photosensitive layer of the eyeball, which is composed of 10 layers and 8 specialized cells which are involved in paramount function of the body like vision. Retinal neurogenesis commences from the layers of optic cup, which forms from optic vesicle. Progenitor cells are the tissue-specific cells which give rise to all different types of retinal cells. Progenitor cells in fetal retina proliferate at specific time during development of retina. Knowledge of the highest proliferative capacity interval of progenitor cells will be valuable for transplantation. Material and Methods: Twenty-eight fetuses of spontaneous abortions of 13th–40th week were collected from MGM Hospital after ethical and scientific approval of the institute. After fixation of fetuses, eyeballs were extracted and fixed in buffer solution. Sections were taken and the retina was treated with Ki-67 immunohistochemistry marker to observe proliferative capacity of retinal progenitor cells (RPCs). Seven groups (A to G) of 4 weeks were made and observations of each group were noted. Results: It was observed that the highest proliferative capacity of RPCs was in B group (17–20 weeks) and the highest proliferative capacity of RPCs was maximum at 19th week of gestation. Discussion and Conclusion: Characteristics of progenitor cells in retina are well studied. Their highest proliferation period can be utilized to make the procedure of transplantation more refined.
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Wax versus plastinated models in teaching human anatomy to health-care professionals. A randomized crossover trial p. 140
Rafael Boscolo-Berto, Cinzia Tortorella, Veronica Macchi, Andrea Porzionato, Raffaele De Caro
Introduction: Teaching anatomy moved from teacher-centered to student-centered learning. Three-dimensional models help to improve self-learning of basic concepts other than anatomical spatial relationships. Wax and plastinated models were compared for appropriateness and safety in teaching human anatomy to health-care professionals. Material and Methods: Randomized crossover trial. The CONSORT checklist for randomized crossover trials was followed. Eighteen volunteer physiotherapy students at the University of Padova were randomized into two crossing-over groups applying to wax and plastinated heart models. Final Likert survey scales were administered. Results: They reported that the wax models presented a more pleasant smell, a better chromatic appearance, and superior ease of handling than plastinated models, with a higher degree of perceived biological safety. Wax models were judged less suitable for educational use and for clarifying anatomical doubts, both in assessing external and internal anatomical details. Discussion and Conclusion: Overall, the plastinated models were considered more suitable for educational use in teaching internal and external anatomical details. The wax models showed a better appearance, ease of handling, and a minor perceived biological hazard.
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Three-dimensional evaluation of maxillary sinuses in the Turkmen population, North of Iran p. 146
Arash Mollaali, Mohammad Hadi Gharib, Jahangir Ghorbani, Mohammad Jafar Golalipour
Introduction: Understanding the variation in the size and shape of the paranasal sinuses in detail is a clinically relevant matter for sinusitis patients. This study was performed to determine the right and left maxillary sinus dimensions by computed tomographic (CT) scan based on gender in the Turkmen ethnic groups in Gorgan, northern Iran. Material and Methods: In this descriptive-analytical study, 100 Turkmen subjects (50 males and 50 females) aged 18–45 were measured with 2 mm and 3 mm slices in the coronal and Axial Planes by the CT scanner SOMATOM Emotion of the multi-slice from the SIEMENS model and using the “Syngo software Siemens.” Results: Maximum width, height, and volume of right and left maxillary sinuses in the Turkmen ethnic group were more in males than females (P < 0.05). In the right maxillary sinus; the mean maximum of width in males and females was 29.6 ± 4.91 mm and 26.53 ± 5.26 mm, respectively (P < 0.05). The mean maximum height in males and females was 40.5 ± 4.27 mm and 38.16 ± 5.96 mm, respectively (P < 0.05). In the left maxillary sinus, the mean maximum width in males and females was 29.61 ± 4.31 mm and 26.79 ± 5 mm, respectively (P < 0.05). The mean maximum height in males and females was 40.46 ± 4.55 mm and 38.03 ± 5.4 mm, respectively (P < 0.05). Discussion and Conclusion: Understanding the dimensions of the maxillary sinuses helps for better diagnosis and treatment of patients with maxillary sinuses diseases.
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Variation of the superior articular facet of atlas and their significance p. 151
Neeru Goyal, Anjali Jain
Introduction: Atlas helps in complex biomechanical movements of the skull along with weight transmission of skull to spine. 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 superior articular facet of atlas. Good knowledge of the variations of the facet is important for orthopedicians, physiotherapists, and neurosurgeons. Material and Methods: The study was conducted on 110 dried adult atlas vertebrae. Shape, size, and number of the superior articular facets on each atlas were recorded. Results: Different shapes observed were kidney-shaped, oval-shaped, irregular, rectangular, comma-shaped, sinuous, sole/8-shaped, and two/three separate facets. Length and width of the facet were similar on two sides. In 31.82% of cases, the facets on the two sides were not symmetrical. Discussion and Conclusion: Variations of the superior articular facets have been extensively described. While planning treatment plans in cases of craniovertebral joint dysfunction, morphology and variations of the region should be kept in mind.
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Assessing differences in hand dominance by testing hand preference against hand performance p. 156
Pamela Mandela Idenya, Peter Gichangi, A Ogeng'o Julius
Introduction: Populations are categorized as right-handed, ambidextrous, and left-handed; but handedness must be understood as having borderlines within its continuum. Typical measures of handedness based on hand use preference or hand performance testing give results which indicate no exclusive categories for hand dominance. Training of preclinical medical students in the performance of clinical techniques certainly requires the high levels of manual dexterity and invaluable hand-eye co-ordination, both of which are expected to influence the end result of hand dominance testing. However, the assessment during skills training is mostly subject to the efficiency of carrying out a given procedure, which inevitably depends upon the individual's dominant hand. Material and Methods: In this analytic cross-sectional study, the modified Edinburgh Handedness Inventory for hand preference and the Tapley and Bryden Dot-filling Tasks for hand performance were evaluated one against the other, to conclusively categorize hand dominance amongst 162 preclinical medical students. Results: Hand performance dominance was not dependent on subject gender. Tapley and Bryden Dot-filling Tasks and Geschwind Score (GS) Edinburgh Handedness Inventory (EHI) hand preference categories showed statistically significant differences (χ2 = 142.293, P < 0.001 at 95% confidence interval). Together, hand preference and hand performance testing complemented and reinforced the assessment of hand dominance. Tapley and Bryden Dot Filling Tasks in relation to GS EHI for the right hand had 90.7% sensitivity, 58.3% specificity, 96.5% precision value, and 88.3% accuracy. Discussion and Conclusion: The use of multiple measures to determine hand performance is a stronger predictor for evaluating hand dominance than relying on a unilateral measure. The number of previously performed procedures strongly influences the level of proficiency obtained in performing a specific task. Hand preference and performance must be considered together when assessing for potential differences in hand dominance testing.
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Association of Chiari Type 1 malformation and cervical spine curve changes p. 162
Muhammed Alpaslan, Sercan Ozkacmaz, Yeliz Dadali, Ilyas Ucar
Introduction: In this study, we aimed to examine the association of cervical spine curve abnormalities (loss of cervical lordosis or reversal of cervical curve) with Chiari Type 1 malformation (CM1). Further, a possible relation of syrinx formation in the cervical spinal cord and disc protrusion with CM1 was analyzed. Material and Methods: Cervical spinal magnetic resonance imagings of 998 patients were retrospectively screened for the presence of CM1. The frequency rates of syrinx formation within the spinal cord, cervical spinal curve changes, and cervical disc herniation among CM1+ and CM1− patients were compared. Results: Patients with CM1 have significantly higher rate of loss of cervical lordosis when compared with those who have not CM1. The syrinx formation rate was also found lower in the CM1+ patients with loss of cervical lordosis than in CM1+ patients with either normal cervical lordosis or reversed cervical curve. No significant difference was detected between CM1+ and CM1− patients regarding cervical disc herniation rate. Discussion and Conclusion: As the loss of cervical lordosis rate is higher in CM1, the patients with lateral X-ray findings of cervical lordosis flattening may be evaluated regarding typical neurological symptoms of syringomyelia.
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Harbin's index: Morphological evaluation of caudate-to-right lobe ratio in human cadaveric liver p. 168
Jaikumar B Contractor, Vipul D Patel, VH Vaniya
Introduction: Liver cirrhosis is essentially an end stage liver fibrosis that develops as a continuation of normal wound healing in response to chronic liver injury. While 1/4th of cirrhotic livers are morphologically normal in size and configuration, on computerized tomography, over 1/3rd are diffusely atrophic and almost 50% manifest focal hypertrophy most commonly in the caudate lobe concomitant with segmental atrophy of the right lobe. Aims and Objectives: To analyze the morphometric measurements of the right lobe and determine the C/RL in human cadaveric liver and compare the values of C/RL ratio to previously documented studies in an attempt to provide baseline data. Material and Methods: The study was conducted on 100 human cadaveric livers at Anatomy Department, Medical College Baroda, Vadodara, Gujarat. Morphometric measurements were observed in mm with threads and digital Vernier Caliper. Results: The transverse diameter of the right lobe averaged 78.22 ± 12.17 mm, with values ranging at 55.06–98.30 mm. The longitudinal diameter of the right lobe averaged 126.31 ± 20.24 with values ranging at 90.54–172.18 mm. Harbin's Index was calculated as the ratio of the CT to right lobe, i.e., (CT/RT), and averaged 0.38 ± 0.12 with values ranging at 0.17–0.61. Discussion and Conclusion: While nodular regeneration within liver parenchyma may be difficult to recognize on ultrasonography and any irregularity of the liver surface may be apparent only with macro nodules or ascitic effusion, caudate lobe hypertrophy is a consistent finding with liver cirrhosis or other chronic liver disease.
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A rare case of anomalous origin of bilateral testicular arteries: An anatomical and developmental overview p. 173
Arthi Ganapathy, Aritra Banerjee, Saroj Kaler Jhajhria, Seema Singh
An extensive knowledge of the origin and course of testicular arteries (TAs) is indispensable during various surgical procedures such as renal transplant, intra-abdominal surgeries, and even in orthopedic surgeries such as spine surgery. With the advent of new intra-abdominal therapeutic and diagnostic techniques, the anatomy of TAs has assumed much more significance. Although the variations of the testicular vein are well documented, the variations of the TA are not so frequent in incidence. We report a rare case of bilateral aberrant origin of the TA from polar renal arteries. Though anomalies of the polar arteries supplying the kidney are common, bilateral origin of TAs from them is a rare presentation. We also discuss its developmental basis. Such anomalies if left unnoticed will lead to serious intraoperative complications during procedures on retroperitoneal organs. Any damage to the TAs will compromise the function of the gonads.
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Anophthalmic cyclopia with proboscis, acardia, amelia, sirenomelia – Case report p. 176
Bini Markose, Deepti Shastri, B Rajesh, Jinu Merlin Koshy
True or primary anophthalmic cyclopia is an extremely rare and severe malformation of eye. It is the apparent absence of eyeball in a median orbit and it results from failure of the optic vesicle (optic primordial) to form from the cerebral or prosencephalic vesicles. Proboscis is a skin-covered median tubular appendage above the anophthalmic median orbit. It results from the defective development of the olfactory placodes. Sirenomelia, or mermaid syndrome, is a rare abnormality characterized by complete or incomplete fusion of lower limbs. Acardiacus is a fatal complication of monozygotic twin pregnancy. The acardiacus maintains its circulation through the heart of its normal twin reversed arterial perfusion mate. This manuscript reports on a severely malformed monozygotic stillborn twin with anophthalmic cyclopia, proboscis, acardia, absence of upper limb, sirenomelia, and aprosencephaly; agenesis of diaphragm, respiratory system, genitourinary system, lymphatic system, endocrine system, and external genitalia; and intestinal atresia, liver atresia, vascular atresia, hypoplastic skeletal system, and muscular system. In general, in all these fetal abnormalities, there are various degrees of malformation causing group of groups of anomalies. Probable cause of these anomalies is discussed.
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Bilateral persistent primitive olfactory artery incidentally detected by computed tomography angiography and digital subtraction angiography: An extremely rare case report p. 183
Anshu Mahajan, Apratim Chatterjee, Gaurav Goel
We present a rare case of bilateral persistent primitive olfactory artery incidentally detected on computed tomography angiography and digital subtraction angiography in a 53-year-old female with symptomatic left-sided tight internal carotid artery stenosis. This imaging finding can be useful to the literature.
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A woman with “lobster-claw” hands – Isolated nonsyndromic ectrodactyly of both hands p. 186
HS Kiran, HS Rajani, N Rashmi
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