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Editorial-Training Good Doctors As Good Teachers

editoranatomy@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Medical education should not be confined to the practice of few skills and techniques devoid of interpersonal relationship that include patient expectations, attitudes, and enhanced patient doctor interaction. The aim of Medical education is not acquiring theoretical or practical knowledge that can be reproduced in an examination but it is the ability to apply that theoretical knowledge coupled with practical skills to the benefit of the patient in real life situations that are frequently suboptimal especially in countries like India.

SURGICAL ANATOMY OF DORSAL ROOT ENTRY ZONE OF CERVICAL SPINAL NERVES : CADAVERIC STUDY

arivalaganarun@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The main purpose of this study is to determine the detailed morphometric data of Dorsal Root Entry Zone (DREZ) of cervical spinal nerves. This knowledge is necessary for diagnosis, treatment and surgical management of pain due to many conditions like brachial plexus avulsion injury, post-herpetic neuralgia, phantom pain and cancer pain involved in cervical myelo-radiculopathy. There are fewer studies reported in this field of DREZ. Materials and Methods: Twenty five adult formalin fixed cadavers are taken for this study. Conventional Spinal cord dissection is followed as per Cunningham’s Dissection Mannual. Findings: The parameters included are Number of dorsal rootlets, Longitudinal Length of DREZ, Distance between two successive DREZ, Length of dorsal rootlets, Distance between right and left DREZ, Distance between DREZ and Ligamentum denticulatum, Cranial angles of Superior & inferior rootlets. Results: Results were noted for all the parameters and are compared with the previous studies. The significant observations are obtained. Conclusion: Surgical anatomy of Dorsal Root Entry Zone (DREZ) of cervical spinal nerves will be useful for the neurosurgeons doing Drezotomy procedure, in which the nociceptive fibres alone are specifically severed with preservation of other sensations.

KEYWORDS:DREZ, Dorsal Root Entry Zone, Cervical Spinal Nerves, Pain

CROSSED FUSED RENAL ECTOPIA MULTIDETECTOR COMPUTED TOMOGRAPHY STUDY

csrameshb@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: Crossed renal ectopia is one of the rarest congenital malformations where a kidney is located on the side opposite to the side of its ureteral insertion into the urinary bladder and is generally fused with the normally located ipsilateral mate. Generally this anomaly remains as a silent clinical entity and is incidentally detected during evaluation for other conditions. We report here three such cases of crossed fused renal ectopia detected by multidetector row contrast enhanced computed tomography. Crossed fused renal ectopia of inferior type was observed in a male on the right side with the ureter of the ectopic left kidney crossing the midline. In two female patients, L-shaped or tandem kidney was noted, one on the right and another on the left side. Over all in two cases the left kidney was ectopic and in one the right kidney. No renal pathologies like urinary tract infection, nephrolithiasis or hematuria were found in our patients.

KEYWORDS:Crossed fused renal ectopia, Tandem kidney, L-shaped kidney, Renal ectopia, Multidetector computed tomography, Renal fusion anomaly

MORPHOLOGICAL STUDY OF HUMAN LIVER AND ITS SURGICAL IMPORTANCE

drsachin6880@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The liver is largest abdominal viscera located in right hypochondrium ,epigastrium and left hypochondrium in upper abdominal cavity. Although the segmental anatomy of the liver has been extensively researched, very few studies have dealt with surface variations of the liver. The major fissures are important landmarks for interpreting the lobar anatomy and locating the liver lesions. Purpose: The purpose of our study was to determine gross anatomical variations of liver and their clinical and surgical implications. Methods and Results: Present morphological study was conducted on 50 embalmed human livers in the Department of Anatomy, Maulana Azad Medical College, New Delhi,India. Different variations in lobes, fissures and accessory lobes or fissures were observed. The liver specimens were also classified according to netter’s six types of liver variations. Conclusion: The findings of our study may be helpful for surgeons and radiologist to avoid possible errors in interpretations and subsequent misdiagnosis, and to assist in planning appropriate surgical approaches.

KEYWORDS:Liver, Quadrate, Caudate, Segment, Hepatectomy

COMMUNICATION BETWEEN RADIAL AND ULNAR NERVE AT A HIGH HUMERAL LEVEL

monika.lalit@yahoo.com — Mon, 30 Jun 2014 08:00:00 +0500

Various communications between the different branches of brachial plexus have been reported by many authors but the communication between the radial and ulnar nerve; the branches of posterior and medial cords of brachial plexus in the arm is very rare. It features the communicating ramus travelling from proximal radial nerve and distal ulnar nerve at a high humeral level in the right arm of a 56 year old male cadaver. Knowledge of such variations may be of importance in the evaluation of certain entrapment phenomenon of ulnar nerve or unexplained sensory loss after trauma or surgical interventions in that particular area is also of clinical significance in anaesthetic blocks

KEYWORDS:Brachial Plexus, Radial Nerve, Ulnar Nerve, Communication

HISTOLOGICAL STUDY OF NEONATAL BOWEL IN ANORECTAL MALFORMATIONS

dramrishtiwari@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Anorectal malformations are the congenital condition, seen in approximately 1 in 5000 live births. It affects male and female in the ratio of 1.3:1. Anorectal malformations include a wide range of malformations, that not only involves the anus and rectum, but it also involves urinary and genital tract. Aims and objectives of the study, was to understand the structures involved in anorectal malformations by histological study of surgically excised segments of involved part of neonatal intestine and to understand the degree and cause of possible structural impairment in different segments of involved parts of neonatal bowel that may help in the surgical management of anorectal malformations. Present study was conducted on surgically excised segments of fifteen cases of anorectal malformations, that have been collected from Department of Paediatrics Surgery, IMS, BHU. After that processing of the samples have been done and blocks have been prepared. Then after sectioning and staining with Hematoxyline and Eosin, findings have been noted under the microscope. Histopathological examination revealed the abnormalities of varying degrees. To conclude this study supports that the malformed segments should be excised, regarding controversial issue of preserving or excising the distal segment of anorectum for better functional outcome.

KEYWORDS:Anorectal malformations, neonatal bowel, histological study

ACCESSORY SPLEEN AND ITS CLINICAL SIGNIFICANCE

neetachhabra86@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Spleen can have a wide range of anomalies in its shape, location, number and size. They can be congenital and acquired. Accessory spleen is a common congenital anomaly which is usually asymptomatic but might present clinically as an abdominal mass related to complications such as torsion, spontaneous rupture, haemorrhage and cyst formation Knowledge of splenic variations and anomalies is important to avoid diagnostic pitfalls and misinterpretations.

KEYWORDS:Accessory spleen, Anomaly, Spleen, Torsion

MEAN TUBULAR DIAMETER (MTD) IN CADAVERIC VERSUS CRYPTORCHID TESTES

drsaifomar@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Cryptorchidism refers to hidden testicle. It is a clinical condition where one or both testicles have been retained from entering the scrotum during the later part of the foetal period. Along with irreversible damage at both gross and cellular levels there is impairment of endocrine and reproductive functions of the testicles. As the incidence of cryptorchidism is very low and previously reported research and data on comparative findings between cadaveric and cryptorchid testes in the state of Bihar was not available this study was undertaken.

KEYWORDS:Cryptorchidism, testicle, scrotum, comparative

BIZARRE CASE OF POLYDACTYLY WITH RIGHT MIRROR FOOT

drsaifomar@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Mirror foot, a form of polydactyly, is a rare congenital anomaly. In this form of congenital anomaly, there are several additional digits with accessory tarsal bones. It may be associated with fibular dimelia, tibial aplasia and tibial dysplasia. Cause of such anomaly is not known. On experimental basis it appears to involve ectopic SHH (Sonic hedgehog) signaling in the limb bud mesenchyme.

KEYWORDS:Polydactyly, Mutation, Autosomal dominant genes, Mirror foot

DIGIT LENGTH DISPLAYS A SIGNIFICANT FRACTION IN STATURE ESTIMATION: A STUDY FROM COASTAL REGION OF SOUTH INDIA

gayathriprabu5@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Relationship that exists between different part of the body and height had been of great interest to anthropologists, forensic and medical scientists for many years. This is because of the increase in the number of catastrophic events causing mass deaths from natural or manmade errors. Such disasters like flooding, tsunamis, earthquakes, plane crashes, train crashes , terrorist attacks usually requires the identification of victims from fragmentary and dismembered human remains. In present paper, study on stature estimation from digit length has been reported. In the present study, 200individuals (96 males and 104 females) belonging to age group of 18 to 25years having no disease or deformity were examined anthropometrically in respect to their height and digit lengths (2D, 3D, 4D, 5D) have been measured. The regression equations have been drawn from the data collected. It has been observed that stature can be estimated from the digit lengths.

KEYWORDS: Digit Length, Stature, Sexual Dimorphism, Estimation, Linear Regression Analysis, Significance

XIPHOID FORAMEN AND ITS CLINICAL IMPLICATION

as.anju@yahoo.in — Mon, 30 Jun 2014 08:00:00 +0500

Background: In this case report, we want to present a case of pear shaped foramina at the xiphoid process of sternum. The context and purpose: Variations and foramen in the xiphoid process of sternum are frequent. They are clinically important due to their proximity to heart, lungs, diaphragm, liver and stomach. Results: The pear shaped foramina was present in the xiphoid process. It resembled the glenoid fossa of scapula in shape. The maximum length of the foramina was 1.6cm and breadth 1.4cm. Conclusions, brief summary and potential implications: A sound knowledge of xiphoid process variations and anomalies is very important during sternal bone marrow aspiration, radiological reporting, acupuncture and assessing injuries during autopsy and post mortem examination

KEYWORDS:Foramen, Sternum, Xiphoid process.

CIRCLE OF WILLIS: VARIANT FORMS AND THEIR EMBRYOLOGY USING GROSS DISSECTION AND MAGNETIC RESONANCE ANGIOGRAPHY

bishwajeetsaikia3@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The circle of Willis is a large arterial anastomotic ring present at the base of the brain uniting the internal carotid and the vertebrobasilar systems. Branches from the internal carotid and vertebral arteries anastomose to form an arterial circle in the basal cisterns and then distribute to supply the brain. The anatomy of the circle is known to vary significantly; the vessels may be absent or sufficiently narrowed altering the hemodynamics of the circle of Willis and affecting its role as a collateral route. These variant forms can be correlated to their phylogeny and embryology. Prior knowledge of these variant forms is important in pathologies and treatment (e.g. parent artery occlusion for carotid aneurysms) resulting occlusion of carotid and vertebral arteries. Context and purpose: Our study was undertaken to observe and compare the morphology of circle of Willis using two entirely different methods; gross dissection (GD) and Magnetic resonance angiography (MRA) and to correlate the variant patterns encountered with the possible underlying developmental events. Gross dissection was carried out in 70 human cadavers and equal numbers of MRA’s of healthy individuals were studied retrospectively. Results: Only 31 cases (22.14%) presented with a complete circle of Willis, out of which 14 (20%) were cadaveric specimen and 17 (24.18%) were in MRA group. Unilateral hypoplastic posterior communicating artery was the most common variation observed in our study (19.28%). Conclusions: The wide variation in completeness of the circle of Willis in general population is similar to earlier observations. Review of phylogeny and embryology makes us familiar with variant forms which would be otherwise difficult to recognize and may be misinterpreted. MRA and gross dissection findings despite certain variations are comparable.

KEYWORDS:Internal carotid artery, vertebral artery, Collateral flow.

MORPHOLOGICAL STUDY OF OBTURATOR ARTERY

editor_anatomy@hotmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The obturator artery normally arises from the anterior trunk of internal iliac artery. High frequency of variations in its origin and course has drawn attention of pelvic surgeons, anatomists and radiologists. Normally, artery inclines anteroinferiorly on the lateral pelvic wall to the upper part of obturator foramen. The obturator artery may origin individually or with the iliolumbar or the superior gluteal branch of the posterior division of the internal iliac artery. However, the literature contains many articles that report variable origins. Interesting variations in the origin and course of the principal arteries have long attracted the attention of anatomists and surgeons. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: The obturator artery presents considerable variation in its origin. It took origin most frequently from the anterior division of internal iliac artery in 36 specimens (72%). Out of which, directly from anterior division in 20 specimens (40%), with ilio-lumbar artery in 5 specimens (10%), with inferior gluteal artery in 3 specimens (6%), with inferior vesical artery in 2 specimens (4%), with middle rectal artery in 1 specimen (2%), with internal pudendal artery in 4 specimens (8%) and with uterine artery in 1 specimen (2%). The obturator artery took origin from the posterior division of internal iliac artery in 9 specimens (18%), from external iliac artery in 1 specimen (2%), from inferior epigastric artery in 3 specimens (6%) and was found to be absent in 1 specimen (2%)

KEYWORDS:Internal iliac artery, Obturator artery, Variations.

MORPHOLOGICAL STUDY OF INTERNAL ILIAC ARTERY

editor_anatomy@hotmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The internal iliac artery is the “artery of the pelvis”. It supplies most of the blood to the pelvic viscera, gluteal region, medial thigh region and perineum. A severe and potentially lethal complication in pelvic surgeries is arterial bleeding commonly involving the branches of internal iliac artery. While operating on pelvic organs, the knowledge of internal iliac artery and its variations is important for surgeons. The present study was conducted to study of morphology of internal iliac artery. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: The classification of branching pattern of internal iliac artery was based on modified Adachi classification. Out of the 50 specimens studied, Type Ia arrangement was found in 52% of the specimens, Type III in 34%, Type IIa and type V was found in 2% each, Type IV was not found in any of the specimens and 10% of the specimens could not be classified because of the absence of inferior gluteal artery in them. Adachi Type Ia arrangement was the most frequent finding. The obturator artery took origin most frequently from the anterior division of internal iliac artery. Middle rectal artery was not constant. Conclusion: The internal iliac artery morphology shows multiple variation the knowledge is very helpful during pelvic surgeries.

KEYWORDS:Internal iliac artery, Obturator artery, Middle rectal artery, Internal pudendal artery.

STUDY OF VARIATIONS IN ANTERIOR DIVISION OF INTERNAL ILIAC ARTERY

editor_anatomy@hotmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The internal iliac artery is the chief pelvic artery. It supplies to the all pelvic viscera, musculoskeletal part of the pelvis. The branches of the anterior trunk of the internal iliac artery are the superior and inferior vesical, middle rectal, vaginal, obturator, uterine, internal pudendal and inferior gluteal. Knowledge of internal iliac artery is very helpful in pelvic surgery practice. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: Middle rectal artery took origin from anterior division in 42 specimens (84%), most frequently with internal pudendal artery in 32 specimens (64%) and was found to be absent in 8 specimens (16%). The obturator artery took origin most frequently from the anterior division of Internal iliac artery in 36 specimens (72%), from posterior division in 9 specimens (18%), from external iliac artery in 1 specimen (2%) and from inferior epigastric artery in 3 specimens (6%). The superior vesical artery, inferior vesical artery, uterine artery, vaginal artery and superior gluteal artery were found to be constant in their origin and course. Conclusions : The branches anterior division of internal iliac artery shows multiple variations, knowledge about these variation are helpful in pelvic surgeries.

KEYWORDS:Middle rectal, Internal pudendal artery, obturator artery, inferior vesicle artery.

A STUDY OF RENAL CALYCES BY USING BARIUM CONTRAST

drroopa28@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Objectives: To know the pelvicalyceal anatomy by radiological method that helps in localizing the calculi or tumors in kidneys. Materials and method: The study was conducted in Sri Devaraj Urs Medical College, Tamaka, Kolar from 2011 to 2013. Forty four adult, formalin embalmed cadaveric kidneys (20 right and 24 left) were injected with 8 to 10 ml of 10% radio opaque barium sulphate solution into the renal pelvis and calyces and radiographs were taken in anteroposterior view. Results: The observations were statistically analyzed. There were 14 extra renal pelves and 30 intra renal pelves. The major calyces were classified into three categories [Double (D), Three (T) and Multiple (M) divisions]. Out of 44 kidneys 20 were right and 24 left.. 23 kidneys presented multiple (more than 4) calyces, 12 had two major calyces and only 9 presented with three major calyces). Typical ‘Y’ arrangement in 03 out of 12 and typical multiple in 03 out of 23 kidneys. There were 14 kidneys (31.8%) presented with extra renal pelvis whereas 30 kidneys (68.2%) presented intrarenal formation of the renal pelvis. Conclusion: Due to the variation in the number of major and minor calyces, position of renal pelvis (intrarenal and extra renal), the knowledge of pelvicalyceal anatomy will help the urologist and nephrologists to pin point the position of renal calyceal calculi or malignant growth for the surgery to be carried out.

KEYWORDS:Renal pelvis, renal calyces, Ureter, Kidneys, Barium sulphate, contrast radiography.

STUDY OF POSTERIOR DIVISION OF INTERNAL ILIAC ARTERY

editor_anatomy@hotmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The internal iliac artery originates from the common iliac artery at the level of sacroiliac joint. The internal iliac artery descends posterior to the greater sciatic foramen thereby dividing into anterior and posterior divisions. The posterior division of the internal iliac artery is known to give rise to three main branches i.e. iliolumbar artery, lateral sacral artery. Accidental haemorrhage is common during erroneous interpretation of anomalous blood vessels. The knowledge of the normal and the abnormal anatomy of the branches of the internal iliac artery is essential for obstetric surgeons. Methods: 50 adult human pelvic halves were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Results: Out of 50 specimens, ilio-lumbar artery took origin from posterior division, directly in 22 specimens (44%), with obturator artery in 5 specimens (10%) and with superior gluteal artery in 2 specimens (4%). From anterior division, with obturator artery in 6 specimens (12%) and with inferior gluteal artery in 1 specimen (2%). From common trunk, as direct branch in 10 specimens (20%), with lateral sacral artery in 1 specimen (2%), with vertebral branch in 1 specimen (2%), with superior gluteal artery in 1 specimen (2%) and was found to be absent in 1 specimen (2%). Posterior division of internal iliac artery given origin directly to superior gluteal artery in 44 specimens (88%), with ilio-lumbar artery in 1 specimen (2%), with obturator artery in 2 specimens (4%). Lateral sacral artery from posterior division was observed in 38 specimens (76%) and unpaired origin was observed in 7 specimens (14%). Conclusion: Internal iliac artery supplies the pelvic viscera and musculature the knowledge of its branches helpful in pelvis surgeries.

KEYWORDS:Internal iliac artery , Superior Gluteal artery, Lateral sacral artery, Ilio lumbar artery.

STUDY OF MEDIAL CIRCUMFLEX ARTERY

editor_anatomy@hotmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The proper knowledge of the course and ramification of blood vessels of lower limbs is very important for surgeons and interventional radiologist. Medial circumflex femoral artery usually originates from posteromedial aspect of the profunda femoris, but often originates from femoral artery itself. It has an important role in supplying blood to femoral neck and head, fatty tissue in acetabular fossa and used in flaps reconstructive surgery. Methods: 50 adult lowerlimbs were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Dissection of femoral triangle was carried out according to Cunningham’s manual. Site and mode of origin of the branches of femoral artery were studied, configuration of the femoral origins of medial and lateral circumflex femoral artery and their prevalence were studied. Results: Out of 50 extremities, Medial circumflex femoral artery took origin from profunda femoris in 41 specimens and from femoral artery in 9 specimens. Conclusion: The knowledge of normal origin and variation of medial circumflex femoral artery is very valuable in preventing iatrogenic injury to these vessels during surgical procedures of femoral triangle.

KEYWORDS:Medial circumflex artery, Femoral artery, Lower limb arteries.

A STUDY OF THE SACRAL INDEX IN WESTERN RAJASTHAN POPULATION IN COMPARISON WITH OTHER RACES

naren_rajasthan@rediffmail.com — Mon, 30 Jun 2014 08:00:00 +0500

This study had a purpose of taking various measurements and calculating sacral index in the population of western Rajasthan. A total of 74 sacra were taken for the study and they were divided into two groups as 42 male sacra and 32 female sacra. Parameters like maximum sacral length and maximum sacral breadth were measured on the sacra and sacral index calculated. Data obtained were statistically analyzed .The results were further compared with similar studies of sacral index in other races.

KEYWORDS:Sacrum, Maximum sacral length, Maximum sacral breadth, Sacral Index

SACRALISATION OF LUMBAR VERTEBRAE

navson_2001@yahoo.co.in — Mon, 30 Jun 2014 08:00:00 +0500

Background: Lumbar backache is a very common problem nowadays. Sacralisation of lumbar vertebrae is one of the cause for that. During routine osteology teaching a sacrum with incomplete attached lumbar 5 vertebrae is seen. Observation: Incompletely fused L 5 vertebrae with sacrum is seen. The bodies of the vertebrae are fused but the transverse process of left side is completely fused with the ala of sacrum.But on the right side is incompletely fused. Conclusion: The person is usually asymptomatic or may present with symptoms which include spinal or radicular pain, disc degeneration, L4/L5 disc prolapse, lumbar scoliosis and lumbar extradural defects. In transitional lumbosacral segmentation, it was observed that the lumbosacral intervertebral disc is significantly narrowed. The incidence of disc herniation is found to be higher and can occur even at young ages. There was also relationship established between transitional vertebrae and the degree of slippage in spondylolytic spondylolisthesis. In addition, this anomaly has known implications in the field of disc surgery.

KEYWORDS:Radicular Pain, Scoliosis, Herniation, Spondylolytic.

PYRAMIDAL LAYER THINNING, SHRUNKEN NEURONS AND DEEP VACUOLATION IN HIPPOCAMPUS DUE TO THE ORGANIC LEAD INDUCED TOXICITY

zulfinaqi@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Lead, a known heavy metal exerts its toxicity on different organ systems of which the neurotoxicity is a considered to a significant consequence. The organic lead exposure on the hippocampus, that plays a significant role in the formation of short and long term memory, navigation and also participates in the limbic system in the brain, was studied. The resulting effects were the thinning of neuron layers, vacuolation and reduction in overall cell population of neurons, thereby showing the primary effect on the pyramidal layers of the hippocampus.

KEYWORDS:Lead acetate, organic lead, neurotoxicity, Charles foster strain, rats, pyramidal layer, hippocampus.

ANOMALOUS ORIGIN OF RIGHT INFERIOR PHRENIC ARTERY

dr.bmitra@yahoo.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: To show the anomalous origin of right inferior phrenic artery from right renal artery and to discuss the embryological basis and surgical significance of such variation. Method: This was found during routine dissection of abdomen in a 61 year old adult male cadaver in the department of anatomy, R.G.Kar Medical College. Results: It was seen that right inferior phrenic artery(RIPA) took its origin from right renal artery. Further distribution of RIPA was normal. Left inferior phrenic artery (LIPA) arose normally from abdominal aorta. Conclusion: Accurate knowledge regarding this is important for carrying out vascular and reconstructive surgery and for evaluation of angiographic images . The RIPA is a major source of collateral arterial supply to hepatocellular carcinoma, second only to the hepatic artery. So a surgically inoperable HCC can be treated by transcatheter embolization of not only the right or left hepatic arteries, but also by embolization of a RIPA, if involved.

KEYWORDS:Right Inferior phrenic artery (RIPA), Right Renal Artery, Left inferior phrenic artery (LIPA).

STUDY OF LATERAL CIRCUMFLEX ARTERY

editor_anatomy@hotmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Background: The lower limb arteries are commonly involved with peripheral occlusive arterial diseases and the femoral artery at femoral triangle is widely used for certain clinical procedures like arterial catheterization, as it can be readily accessed. Lateral circumflex femoral artery is a laterally running branch given off near the root of the profunda femoris. It supplies blood to head and neck of femur, greater trochanter, vastus lateralis and knee. It has many implications in clinical practice, it is used in an anterolateral thigh flap, aortopoplitial bypass, coronary artery bypass surgery, extracranial- intracranial bypass surgery. Methods: 50 adult lowerlimbs were procured from embalmed cadavers of J.J.M. Medical College and S.S.I.M.S & R.C, Davangere, Karnataka, India for the study. Dissection of femoral triangle was carried out according to Cunningham’s manual. Site and mode of origin of the branches of femoral artery were studied, configuration of the femoral origin lateral circumflex femoral artery and its prevalence were studied. Results: out of 50 cases Lateral circumflex femoral artery took origin from profunda femoris in 45 specimens and from the femoral artery in 5 specimens. Conclusion: The knowledge of normal origin and variation of lateral circumflex femoral artery is very valuable in preventing iatrogenic injury to these vessels during surgical procedures of femoral triangle. As medial and lateral circumflex femoral arteries supply blood to head and neck of femur, it is important to avoid injuring them during surgery of hip joint to prevent necrosis of femoral head. Lateral circumflex femoral artery has many implication in clinical practice. It is used in an anterolateral thigh flap.

KEYWORDS:Lateral circumflex artery, Femoral artery, Lower limb arteries.

CRANIAL INDEX IN NORTH INDIAN CRANIA (PREDOMINANTLY HARYANAVI)

vivekmalik98@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Shape of crania is seen by measuring cranial index in 150 (115 male and 35 female) crania. Crania were obtained from the department of Anatomy, Pt. B.D. Sharma PGIMS Rohtak. In males, 91.07 % crania were found dolichocephalic while in females 97.14% crania were dolichocephalic. Few crania were found mesocephalic (6.25% in males and 2.85% in females) in both sexes. None of female crania was seen as brachycephalic. Percentage obtained in present study is quite different from any other population studied as most of the crania were dolichocephalic. So it can be used as a tool to identify crania of this region..

KEYWORDS :Cranial Index, Dolichocelphalic, Howells, Cephalic Index

ANATOMICAL VARIATIONS IN ARTERIAL PATTERN OF LOWER SEGMENTAL ARTERY AND ITS RELATION WITH COLLECTING SYSTEM

gyanprakash.mishra88@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Aim of our study to observe the arterial pattern of lower segmental artery and its relation with collecting system. 50 fresh human Kidneys were studied by corrosion cast method. Moulding granules of butyl butyrate dissolved in acetone for 24 hours and prepared 20% homogenous solution. solution was injected into renal vessel and ureter. Injected Kidney was corroded in concentrated potassium hydroxide solution and cleaned with running water. We observed three dimensional endocasts of collecting system and renal vessel. We found 5 types of variation in arterial pattern of lower segmental artery namely LSAT1, LSAT2, LSAT3, LSAT4, LSAT5 and they were seen in 70%, 4%, 2%, 4% and 20% Kidneys respectively. We also found two types of variation in relation between lower segmental artery and collecting system namely LSAG1 and LSAG2. LSAG1 seen in 80% Kidneys and LSAG2 in 20% Kidneys.The finding of our study is helpful for urosurgeon in intrarenal operations, endourological stone removal, renal trauma management and to avoid post operative complications.

KEYWORDS:Lower Segmental Artery, Collecting System, Kidney, Corrosion Cast, Variation.

REVIEW OF MD (ANATOMY) EXAM PAPERS: IS THE PRESENT SYSTEM OF POSTGRADUATE EVALUATION ADEQUATE?

poojadoc17@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

An ideal education system is in-separable from the evaluation system. There has always been a need for an evaluation system which can determine whether predetermined educational objectives have been achieved. As an exercise last 10 years annual MD question papers (anatomy) of university of Delhi were given to the residents and the Post graduate students of anatomy department, Lady Hardinge Medical College, New Delhi. The analysis of question papers reflected that the emphasis on different parts of the syllabi was not uniform. All the questions were of long and short essay type. Multiple choice questions that are based on recall and problem solving attitude of the students were not at all included. There is need to revise the pattern in which question are being asked that will develop cognitive skills and problem solving attitude among the students. An ideal question paper should give equal weight-age to different content areas/topics and it should include all analytical, objective, long and short answer type questions with an uniform marking scheme for all students. When it comes to medical education, evaluation becomes very important because here lays the responsibility of bringing out the best doctor amongst the best.

KEYWORDS:Medical Education, Evaluation Pattern, Attributes of a Question Paper.

A RARE CASE WITH MULTIPLE VARIATIONS OF LIVER AND ASSOCIATED ARTERIES

monikasatishjain@yahoo.com — Mon, 30 Jun 2014 08:00:00 +0500

Variations of liver, its arterial supply and branching pattern of coeliac trunk are not uncommon as separate entity but this case presents several variations. During routine dissection, a multi-lobular liver, with irregular inferior margin, was observed occupying only right upper quadrant of the abdomen. An extra (accessory) lobe was hanging from its inferior surface. Common hepatic artery was giving eight branches, six on left side and two on right side. Five of the left branches were entering liver but none was passing through porta hepatis. Coeliac trunk showed tetrafurcation; the additional branch was supplying pancreas and transverse colon. Knowledge of these variations or combinations is important in open access surgeries, endoscopic surgeries and diagnostic and interventional radiology of the region.

KEYWORDS:: Liver, Hepatic Arteries, Branching Pattern, Accessory Lobe, Coeliac Trunk (CT), Tetrafurcation, Common Hepatic Artery (CHA)

HISTOPATHOLOGICAL CHANGES IN KIDNEYS OF RABBIT EXPOSED TO HIGH NITRATE IN DRINKING WATER

mannusneha06@yahoo.co.in — Mon, 30 Jun 2014 08:00:00 +0500

INTRODUCTION- In India, especially in Rajasthan people drink water containing high level of nitrates and concentration up to 500 mg of nitrate ion per liter is not unusual. The ingested nitrate is converted to nitrite in the digestive system and absorb in blood causing methemoglobinemia. The peak of methaemoglobin is observed at 45-95 mg/liter of nitrate concentration in water. AIM OF STUDY- To find out the correlation between drinking water nitrate concentration and histopathological changes in kidneys of rabbits of different groups. MATERIAL AND METHODS - An experimental study was conducted in 10 rabbits between three and half month to four month of age having weight ranging 1.310 kg to 10720 kg. Five groups A, B, C, D and E were formed having two rabbits in each group. The control group A was administered water orally having 06 mg/liter. Group B to E (experimental groups) were administered water orally having concentration of 100mg/liter, 200mg/liter, 400mg/liter & 500mg/liter of nitrate respectively for 120 days. Then all rabbits were anaesthetized & sacrificed according to guidelines of ICMR and kidneys were removed & processed for paraffin sections. Hemotoxyllin and eosin staining was done for microscopic observations. RESULTS –During experiment, animals were lethargic on 75th day .Intake in quantity of food and water was not altered in the rabbits. Rabbits of all group i.e. A to E showed continuous increase in heart rate (up to 218/minute in group E) and respiration rate (up to 84/minute in group E) respectively. The microscopic study of kidney showed focal collection of lymphocytes in interstitial tissue, particularly in pericapsular area of kidney which appeared in rabbits of group B. The changes were more pronounced in group C &D in the form of focal collection of plasma cells. The hyaline and cellular casts were observed in proximal & distal tubules which started appearing in animals of group C. The congestion of blood vessels and damaged tubular epithelium were observed in tubules of group E rabbits. DISCUSSION- The Results occurred possibly due to cytochrome b5 reductase activity and its adaptation with increasing water nitrate concentration to compensate methaemoglobinemia.

KEYWORDS:Kidney, Nitrate, rabbits, histopathology, Methemoglobin, Cyanosis.

VARIATION IN THE POSITION SHAPE AND DIRECTION OF MENTAL FORAMEN IN DRY MANDIBLE

priyaproy4@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Aim of the study: Purpose of this study was to find out the most common position shape and direction of mental foramen in dry mandible of Maharashtra region. Background: Study of mental foramen is important for dentists in administering regional anesthesia and performing periapical surgery in the mental region of the mandible. Material and methods: Seventy five adult dry mandibles of unknown sex are studied for position shape and direction of mental foramen. All mandibles are studied for position shape and direction of mental foramen. Results: The most frequent position of mental foramen was in line with the longitudinal axis of the IInd premolar tooth. The shape of mental foramen was round or oval. Conclusions: Knowledge about morphometry of mental foramen is important for various dental procedure involving periapical region.

KEYWORDS:Mental foramen , Dentist, mandible

MORPHOLOGY OF THE SPLEEN IN ADULT ALBINO RATS AFTER WHOLE-BODY EXPOSURE TO LOW-LEVEL OF TOLUENE

vnvoloshin@mail.ru — Mon, 30 Jun 2014 08:00:00 +0500

Background: Spleen is a secondary lymphoid organ that is highly sensitive to different chemicals. Toluene is an aromatic hydrocarbon commonly used as an industrial solvent and can be considered as a potential immunotoxin. Aims and Objects: We aimed to investigate the organometry and histology of spleen from rats exposed to toluene. Materials and Methods: The toxicity of toluene was evaluated in male albino rats (6/group) via whole-body exposure. The animals were exposed to target concentrations of 0 (air control) and 133 parts per million (ppm) of toluene in air for 5 hours/day, 5 days/week, for 2 month. The animals were weighted and decapitated at different time points (one, seven, sixteen, thirty one and sixty one day) post-exposure. The weight, length, width and thickness of the spleen were measured. It was studied absolute and relative weight of the spleen. Histological examination of the spleen was made by light microscope. Results: Statistically significant difference between the mean of body weight from the control and experimental animals was observed seven days after last exposure to toluene. Thus, the body weight of animals exposed to toluene was 254.17 g, that was 7.18% (p = 0.048) below control data. The histological findings showed increased area of the white pulp of spleen from rats exposed to toluene had increases compared to that from the control. The numbers of siderophages were higher in the spleen from rats exposed to toluene. The relative area of germinal centre in the structure of the splenic lymph follicles of rats exposed to toluene increased. We found that in the first and second experimental groups of animals the indication was at the level 10.86% and 10.26% respectively. These are 24.11% (p = 0.002) and 26.04% (p <0.001) above control data, respectively. Inhalation exposures to toluene vapor at 133 ppm produces hyperplasia of lymphoid tissue of the rat spleen. Conclusion: Our data demonstrated that whole-body exposures to low-level of toluene led to hypertrophy of white pulp of the spleen.

KEYWORDS:Toluene; Toxicity; Rats; Spleen; Histology

ELONGATED STYLOID PROCESS: A REPORT OF TWO CADAVERIC CASES

komas2001@yahoo.com — Mon, 30 Jun 2014 08:00:00 +0500

Introduction: Styloid process is a part of temporal bone. It measures 2 to 3 cms in length and lies antero-medial to the mastoid process. An elongated styloid process can compress the vital vessels and nerves close to it. This can lead to pain, foreign body sensation in the pharyngeal region and can also cause dysphagia. Observation: During routine dissection, we encountered elongated styloid process in two cadavers. In one it was unilateral and in another it was bilateral. The measurements of the elongated styloid process were taken using digital Vernier slide calipers. Conclusion: The awareness of the embryological cause and the clinical implications of an elongated styloid process are important for accurate diagnosis and treatment

KEYWORDS:Elongated styloid process, Compression, Dysphagia, Cervical pain, Eagle’s syndrome.

ACCESSORY FISSURE OF RIGHT LUNG: A REPORT OF TWO CASES

drsaritabehera81@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Right lung is divided into upper (superior), middle and lower (Inferior) lobes by an oblique and a horizontal fissure.Oblique fissure passes spirally from posterior border to inferior border deep into the lung separating the lower lobe from upper and middle lobes. A short horizontal fissure passes horizontally forwards from the oblique fissure at midaxillary line to meet the anterior border at 4th costochondral junction. This separates the upper lobe from the middle lobe. During routine dissection in 2010-11 undergraduate batch, we came across two cases of right lungs where an accessory fissure was extending horizontally backwards from the oblique fissure at mid axillary line towards the vertebral part of medial surface. In the 1st case, this accessory fissure was not meeting the normal horizontal fissure where as in the 2nd case it was meeting. This accessory fissure separates the lower lobe into a superior and an inferior segment. Knowledge of different types of accessory fissures is important because it may mislead the radiological findings, may act as a barrier to spread of infection creating a sharply marginated pneumonia which can wrongly be interpretated as atelectasis or consolidation. Identification of completeness of fissure is important prior to lobectomy, because individuals with incomplete fissures are more prone to develop postoperative air leak. Considering the clinical importance of such anomalies, anatomical knowledge and prior awareness of accessory fissures in the lungs may be important for clinicians and radiologists.

KEYWORDS:Accessory fissure of lung, Oblique fissure of lung, Horizontal fissure of lung

A CROSS SECTIONAL MORPHOMETRIC STUDY OF HYPERTENSIVE WITH NORMAL PLACENTAE AND ITS CORRELATION WITH FETAL OUTCOME

drsabita1234@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Introduction: Placenta “the vital organ” for maintaining healthy pregnancy is unique in its development, being derived from both mother and fetus. Thus hypertensive disorder affecting mother has a deleterious impact on placenta which may lead to poor fetal outcome. Aim: A cross-sectional descriptive study was undertaken to analyze and assess the morphological changes in hypertensive placentae and to clinically correlate it with fetal and maternal parameters. Materials and Methods: 50 placentae were freshly collected from pregnancy induced hypertension (PIH) cases (study group) and 50 from normal pregnancy (control group). Study group was divided into three categories depending upon severity of the disease. Observations and Results: 70% in study group were primigravida and were from rural area.46% were in age group of 15 – 20yrs.50% under low socio-economic status and 60% were without any regular antenatal check-up. Preterm, IUGR, still birth and neonatal death accounted to 10%, 12%, 18% and 10% respectively in study group. The average diameter, thickness, volume and number of cotyledons in study group were 15.91±2.11cm, 2.39±.54cm, 297.64±67.90ml and 10.02±4.13respectively. Mean placental weight was 376.41±17.198gm (mild PIH), 330.72±2.90gm (severe PIH), 329.73±3.19gm (eclampsia) and mean birth weight was 2680.29±198.46gm (mild PIH), 2212.06±36.41gm (severe PIH) and 2073.60±9.47gm (eclampsia) respectively in study group. Various pathological changes like retro placental hematoma, infarction and calcification had been noticed. Conclusion: Placental morphometric parameters were significantly reduced (<.001) in study group as compared to control group. Decreased placental weight was associated with reduced birth weight and feto-placental ratio with increase in severity of hypertension significantly (<.001). A significant increase (<.05) in incidence of preterm, IUGR, still birth and neonatal death were found in study group. Assessment of morphological changes and its clinical relevance can be correlated with transactional study so as to provide the safe confinement and reducing the fetal morbidity and mortality.

KEYWORDS:Placental morphometry, Fetoplacental ratio, Placental coefficient, Gravida,Perinataloutcome, Pregnancy induced hypertension (PIH)

AN UNASCENDED RIGHT KIDNEY WITH LEFT SIDED URETERIC CALCULI: A CADAVERIC CASE REPORT

drcharlychackojoseph007@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Anomalies of the urinary system constitute approximately 30% of all the congenital malformations. There are various associated anomalies involving number, size, shape, position and vascularity of the kidneys. Unascended kidneys refers to a halt in the migration of the kidneys during their normal embryological development. Defect in the ascent of the kidneys are closely related with variations in the branching pattern of aorta. Here we report a case of an unilateral unascended right kidney in a male cadaver encountered during routine medical dissection. A left sided ureteric calculi was also seen as an incidental finding in the same cadaver. Ureterolithiasis occurs worldwide in all sets of population with 80% of the stones found in the male sex in the age group of 30-60 years. There are various factors which favour the formation of ureteric calculi which includes geographical, socio-economical as well as the mineral content of water consumed and some general medical causes. An attempt has been made to document the causes for this variation and the preventive measures that can be adopted to prevent the formation of ureteric calculi.

KEYWORDS:Ureteric calculi, Unascended kidney, Metanephros, Renal artery

PRENATAL MORPHOMETRIC ANALYSIS OF SUPRAORBITAL, INFRAORBITAL AND MENTAL FORAMINA IN HUMAN FOETUSES AND THEIR CLINICAL CORRELATIONS TO ANAESTHESIA AND SURGICAL PROCEDURE

khanfazal660@gmail.com — Mon, 30 Jun 2014 08:00:00 +0500

Modern surgical procedures, anesthesia, acupuncture and other invasive procedures on the face require a more precise understanding of the anatomy of important landmarks to prevent subsequent neurovascular complications in the frontal region, upper jaw and lower jaw. Studies on bilateral locational relationship of SOF, IOF and mental foramen in foetal skull are still lacking, so aim of our study was 1) to examine the various morphometric variations (the location and shape) of SOF, IOF and mental foramina of the facial skeleton in human foetuses at different age of gestation 2) to establish whether or not, the location of these foramina get changed as the foetus matures and 3) to establish the pattern of growth of aforesaid foramina. For these 40 formalin-fixed foetuses between 17 and 32 weeks of gestation were studied for SOF, IOF and mental foramina. Foetuses were divided into two groups according to age. It was interesting to note that supra-orbital and mental foramina were placed in the same sagittal plane on both sides of the midline. Infra-orbital foramen was located lateral to sagittal plane for supra-orbital and mental foramina. The shape of SOF was recorded as a notch or rarely a foramen, whereas the shape of IOF and mental foramen were determined as a circular and an oval opening respectively.

KEYWORDS:Supraorbital notch/foramen, infraorbital foramen, mental foramen, surgical landmark, human foetuses.