Indian Journal of Clinical Anatomy and Physiology

250-252

Authors: Present outlook of anatomy in medical education D.N. Sinha

An attempt has been done to bring some of the current facts related to the Anatomy, pertaining to its various issues linked with medical education. The article deals with deep concern about its position & wish this subject of Vesalius will be given more importance being the foundation of the medical sciences. Textbooks, Journals, reference books are all available in compact software. People will shift from dissection hall & class room to computer, holding the mouse in the hand shifting the knowledge here and there to find out what actually they want. It will be detrimental to hand over the complete human brain supremacy to the software material. Google’s and other search system should be used with precise objectives and cautions. Let the brain to discover more by its fruitful exercise and study, otherwise the knowledge will be in process of losing its longevity. Search system should not be allowed to master over human brain.

256-259

Authors: Khundmeer Banu Athani, Rajashekhar R.K.

Pregnancy is associated with profound adaptive changes in maternal haemodynamics. The incidence of Pregnancy Induced Hypertension [PIH] is one of the three main causes of maternal – neonatal morbidity and mortality is 5-7% and prediction of this disorder is very important in maternal and neonatal health. Objective: To study the effect of Isometric handrip test among pregnant (women of first trimester) and non-pregnant women. Materials and Methods: Healthy singleton pregnant women of first trimester and healthy non-pregnant women in the age group of 19 to 29 years were selected for the study. The Isometric handgrip test was performed on singleton pregnant women attending the antenatal clinic of District Civil Hospital BIMS Belagavi. The control group consisted of Medical students and Patient’s attenders of same age group. Blood pressure was measured three times before the procedure and at 1 minute intervals during handgrip. Results: The basal Diastolic blood pressure of first trimester subjects was significantly higher than compared to controls. Statistical Analysis: Student’s ‘t’ test was used. Conclusion: The study concludes that the increased basal DBP of first trimester subjects was due to the increased peripheral resistance in pregnancy.

265-268

Authors: Vidya CS, Vasantha Kuberappa

The caecum is the first part of the large intestine. It begins caudally from the ileocecal valve and ends blindly in the right iliac fossa. Typically the caecum is located intraperitoneally in the right lower abdomen and has a length of 5 to 7 cm. The vermiform appendix is attached dorsomedially to the end of the caecum where all three taeniae converge. It is 2 to 15 cm long and lies often intraperitoneally, variations in anatomical location of appendix can result in different clinical presentation in acute appendicitis and carcinoid tumour. The present study aims to determine the morphological variations of caecum and appendix. Material and method: The study was carried out in 28 cadavers which were available in the department of anatomy JSS medical college. The shape of the caecum, morphometry and ileal opening into caecum was noted, the position and lenth of appendix was also observed. Results: The shape of the caecum was adult in 21 specimens 75% and in 25 specimens ileum opened posteromedially to caecum (89.2%) Fig 1 in 3 specimen’s ileum opened anteromedially to caecum. Conclusion: The identification of caecum and appendix is first step in appendicectomy either in open or laproscopic surgery. The anatomical variations of caecum and appendix is important for surgical gastroenterologists

273-278

Authors: Ambarish Vijayaraghana, Kirthana Kunikullaya, Radhika Kunnavil

Exercise confers good health. Unaccustomed exercise is stressful and has harmful effects. Interleukin-6 (IL-6) is a marker of inflammation which increases with physical stress. We observed the changes in plasma Interleukin-6 and Fasting blood Sugar with different grades of exercise in healthy individuals of varied BMI. Methods: Fifty four healthy volunteers (26 males and 28 females) in the age group 18 to 30 years not used to any form of exercise, were recruited. BMI of the subjects varied between 16.5 to 26.5 kg/m2. Subject performed a bout of moderate exercise; a bout of strenuous exercise, followed by one month regular moderate exercise using Shuttle Walk Test. Plasma IL-6 was estimated before and after exercise by Elisa technique. Exercise protocol used was Standardized Shuttle Walk. FBS was assessed just before moderate exercise on first day and 24 hours after moderate and strenuous exercise and on last day of one month of regular moderate exercise. Results: IL-6 level was significantly higher after a bout of moderate exercise compared to baseline (mean & SD: 32.6 1.9 pg/ml and 63.1 2.8 pg/ml respectively). It increased significantly after strenuous exercise (116.2 4.1pg/ml). IL-6 level dipped significantly after one month of regular moderate exercise (15.9 0.7pg/ml). FBS decreased 24 hours after a bout of moderate exercise (mean & SD: 92.9 mg/dl and 83.2 5.4 mg/dl respectively). It decreased further 24 hours after a bout of strenuous exercise (78.4 5.6 mg/dl). It was lowest after a month of regular moderate exercise (73.96 3.1 mg/dl). There was significant positive correlation between BMI and IL-6 for strenuous exercise for subjects above BMI of 23kg/m2. There was significant positive correlation between FBS and BMI for subjects of BMI above 23kg/m2. Conclusions: Unaccustomed physical stress in form of a bout of moderate or strenuous exercise increases IL-6 level. Regular moderate exercise has a buffering effect by preventing the shoot up of IL-6 when challenged with acute physical stress. Exercise has a good “after effect” on FBS even up to 24 hours. Positive correlation between higher BMI and FBS indicates the importance of maintaining BMI within prescribed limits.

282-286

Authors: Anjalee Govindrao Ovhal, Mohammad Mujahid Ansari, Lakshmi Rajgopal

The External Carotid Artery supplies mostly the scalp, neck and face regions of the body. A detailed knowledge of blood vessels and nerves in this head, neck and face regions is very helpful in various therapeutic and diagnostic procedures such as surgical resection of head, neck, face and oral cancers, radical neck dissection, plastic and reconstructive surgeries related to this vital region. Cerebrovascular strokes due to atherosclerosis, haemorrhage or embolism require radiological investigation like carotid angiogram, surgical procedures like carotid endarterectomy also require a thourough knowledge of anatomy of external carotid artery and its branches. Anomalous branching pattern of the carotid arteries and variations in the relative position of internal and external carotid arteries can also damage cranial nerves related to them. Hence, it was decided to undertake a morphometric study of external carotid artery by meticulous dissection of cadavers. The aim was to study variations in the course, relations and branching pattern of External Carotid Artery. In this study, 60 cadavers embalmed with 10% formalin were used, and thus 120 neck-halves were studied. Of these cadavers 52 were male and 8 were female. These cadavers were obtained from the Department of Anatomy, Seth G.S. Medical College, Parel, Mumbai, Maharashtra. The present study was conducted over the period of two years. Linguofacial trunk was observed to be the commonest variation i.e. in 17 cases (28.33%) on the right side and in 18 cases (30%) on the left side. Thyrolinguofacial trunk was encountered in one case (1.67%) on the left side. Also Accessory branches of ECA such as branches to the parotid gland, submandibulargland, infrahyoid region and pharyngeal muscular branches were found in 6 cases (10%) on the right side and in 5 cases (8.33%) on the left side.

291-296

Authors: Deepali Rajesh Kate, Ajay Chandanwale, Bahetee BH

Several researchers have investigated the angles of Glenoid version and Humerus head version worldwide, however sparsely studied in India. The purpose of the study was to determine the native angles of Glenoid and Humerus head version of adult skeletons and to compare the observation with the findings of other workers in different races while discussing our finding in light of literature. This data would prove of great assistance at the time of actual shoulder replacement surgery for proper alignment and fixation of the implants, as any variance from normal version would alter gleno-humeral mechanics and may predispose to instability and arthropathy. Materials and method: A total of sixty seven adult wet scapulae and sixty three humeri were harvested from cadavers fixed in formalin from the Department of Anatomy BJGMC, Pune. The angles of glenoid and humeral head version were measured using goniometer and compass. Correlation analysis was performed between humeral head version and glenoid version values. Result: This study finds wide distribution of glenoid version ranging from -10º to +6º the mean glenoid version of the left side (n=34) was -1.00±4.06º and on the right side (n=33) was -3.30±3.63º the average humerus version recorded on left (n=31) and the right (n=32) sides were 36.13±7.61º and 37.56±7.8º respectively. Conclusion: We report a significant difference between the mean value of the glenoid version angle of both sides; right being greatly retroverted. A significant positive. Correlation was established between Glenoid version and Humerus head version on the right side.

305-308

Authors: Lalitha B, Ephraim Vikram Rao, Shiny Vinila BH

Knowledge about morphometric measurements related to atlas vertebra are important for neurologists, neurosurgeons and head and neck surgeons who deal with traumatic or non-traumatic conditions which may lead to altanto-axial and atlanto- occipital instability. The aim of the present study was to assess the various parameters on the atlas vertebra which can help to determine the safe sites for the different surgical approaches. Materials and Methods: Study was carried out on 50 dry south Indian adult human atlas vertebrae of unknown sex which were collected from the department of anatomy. Eleven parameters were measured for each atlas using a digital vernier caliper. Results: Range, mean and standard deviations were measured and recorded and bilateral symmetry was observed. Conclusion: The parameters measured in the present study may help surgeons in avoiding and reducing complications such as vertebral artery injury, spinal cord injury during the surgical corrections of atlanto axial or atlanto occipital instability.

318-321

Authors: Monali Prakash Hiwarkar, Yashwant Ramkrishna Kulkarni

To assess knowledge, attitude and practice regarding ‘Body Donation’ among the teaching staff of medical colleges in Nagpur Method: The present study included 100 teaching staff members (professors, associate professors and assistant professors) of medical colleges in Nagpur, Maharashtra. The teaching staff of department of anatomy was specifically excluded. Structured questionnaire was prepared and distributed among the teaching staff. The data was collected, compiled and analysed to evaluate awareness and attitude towards body donation. Results: Merely 22% staff member were aware that body donation is also one of the methods of dead body disposal. 85% staff members were not aware about the anatomy act that governs body donation. 75% staff was unaware of the cadaver donation procedure. Only 50% of the staff members were willing for body donation. Conclusions: · Body donation is a generous and unselfish act for those who wish to be useful to living, even after death · The awareness regarding the altruistic act of body donation is deficient among the medical faculty · There is need for creating awareness about ‘Voluntary Body Donation’ among medical teachers as well as general population

326-331

Authors: Neeraj T. Master, Deepa S. Gupta

Musculocutaneous nerve, a branch from the lateral cord of brachial plexus supply the muscles of the front of the arm. Musculocutaneous nerve has frequent variations in arm. Aim: To analyze the morphological variations between musculocutaneous nerve and median nerve in the arm. Materials and Method: 56 upper limbs belonging to 28 embalmed cadavers (M: F: 20:8) donated over last 3 years in the Anatomy Department, SMIMER Medical Collage, Surat were utilised for this study. The dissections of the upper limbs were performed as per Cunningham’s manual. The variations and/ communications between musculocutaneous nerve and median nerve if any were identified and documented. Results: Variations were encountered in 12 (21.43%) out of 56 upper limbs of the present study. In 6 upper limbs below the coracobrachialis, musculocutaneous nerve and median nerve showed communicating rami. In 1 upper limb musculocutaneous nerve was giving larger communication to median nerve as third root. In 2 upper limbs medial cord formed the median nerve and fibres from musculocutaneous nerve join the median nerve as lateral root below coracobrachialis. In 1 upper limb musculocutaneous nerve completely fused with median nerve after supplying coracobrachialis. In 2 upper limbs muculocutaneous nerve was absent and median nerves was supplying the flexor muscles of the arm and were associated with the 3rd head of biceps brachii muscle. Conclusion: The data obtained from the study were in the mid-range of previous studies. Awareness regarding such variations as well as communications is important for surgeons, orthopaedics and anaesthetist that are treating the lesions of shoulder and arm region

336-338

Authors: Rajani Santhakumari Nagothu, Yogananda Reddy Indla, Rajesh Paluru

Students who took admission in first year MBBS course used to study physiology, anatomy and biochemistry for one and half years. Since a decade the first year course duration was reduced to one year unaltering the syllabus in the three basic subjects. So students are focusing on the easy ways to clear the university exams by accepting the concise books, which is dampening the real quality of the subject knowledge. This study is aimed at understanding the best methods of physiology teaching in the lecture gallery, from the student’s perspective. Materials and methods: The present study was undertaken at a private medical college in southern part of India in Telangana state, on 100 students who took admission in first year MBBS course, in the academic year 2015-2016. Out of 100, 36 are boys and 64 are girl students. Distributed a question paper which is having 2 sets of questions. First question is having three statements regarding the teaching methods namely; chalk and blackboard teaching, over head projection teaching and power point teaching. Students were asked to choose the best statement which they prefer. Second question is consisting of combination of teaching methods and they are; chalk and blackboard with over head projection teaching method, chalk and blackboard with power point presentation. Again the students were asked to choose one of the 2 statements in 2nd question. Results: Students preference of teaching methods for understanding of physiology in percentage; chalk and blackboard-54, over head projection teaching-4, power point presentation-32, chalk and blackboard with over head projection-26, chalk and blackboard with power point presentation-64. Conclusion: Majority of the students are in favor of a combination of chalk and blackboard with power point presentation for better understanding of physiology, next is chalk and blackboard teaching alone.

343-347

Authors: Anjali Krishna Prasad, Satya Narayan Shukla, Abhishek Dinesh Kumar

Greek anthropos means “man” and metron is “measure” therefore measurement of man- provides scientific methods and techniques for taking various measurements and observation on the living being and the skeleton. The word ‘Anthropometry’ was first used in the seventeenth century by German physician Johann Sigismund Elsholtz (1623-88). Anthropometry constitutes the means of giving quantitative expression to the variations which different individuals or traits exhibit. Method and Materials: The cross sectional study was carried out on 200 (100 males and 100 females) medical students of Government Medical College of rural Maharashtra in the age group of 18 – 28 years. The parameters studied were height, length of right and left ulna. The observation were analysed by Pearson’s correlation to examine the relationship between length of ulna and height according to gender for right and left ulna separately. Results: The mean ages of the study subjects (male 21.192±3.25 and female 21.02±3.22) were not significantly different between genders. Mean Ulnar lengths of the male were significantly larger than that of the females of all ages. Positive Correlation was found between total height and ulnar length 0.65 in males and 0.68 in female. Conclusion: Definite proportion exists between the height and ulnar length in all individuals.

351-356

Authors: Sayeda Sadia Sameera, Syeda Nasreen Fatima, Gulam Mustafa Faisal

The present study is to identify the sex of hyoid bone by studying various shapes of hyoid bone, and weight before and after defatting, were taken. Material: The material used in the present study includes 100 hyoid bones of adult male and female of 15-75 years of age group, procured from the cadavers brought to mortuaries for post mortem to Govt. General Hospitals of Hyderabad, and photographs of dried bone, to compare the shapes. Method: The bone was weighed with the help of chemical balance. The various shapes of the hyoid bone were noted and photographed individually and in groups. The readings were tabulated. Result: It was noticed that all the measurement were greater in males than in females. Males have mostly v shaped hyoid bone and females have mostly u shaped hyoid bone. Our findings co-related well with earlier workers, from diverse population groups. Conclusion: Data acquired by this study will contribute to the knowledge available about anthropometric parameters of South Indian population and may hopefully help in racial and medico-legal applications.

373-376

Authors: Shubha Srivastava, Kuldeep Singh

Much progress has been made in establishing Dermatoglyphics as a useful diagnostic tool in medicine, providing important insights into the inheritance and embryological development of medical disorders. The present study attempts to compare the Dermatoglyphics parameters specially palmar angles-angles atd, angle adt and angle dat, in cases of NIDDM with that of controls. Results showed a significant difference in mean values of angle adt and angle atd when put to statistical tests and ‘p’ value calculated.

382-384

Authors: Chaudhary Ramkaran, Brijendra Singh

Primary lumbar hernias although are rare hernias but causes of lumbar hernia may be classified as congenital or acquired, primary or secondary. Lumbar hernias are very uncommon among abdominal wall hernias and very few cases have been reported in the literature. Presentation of case: An old male patient aged about fifty years presented in surgical OPD with complaints of a swelling in left flank region which used to increase in size after standing or physical activities. He was examined thoroughly and it was found to be a reducible hernia on left lumbar region. Patient was advised needful investigations like Ultrasound and CT scan and a diagnosis of primary lumbar hernia was established. This hernia was approached through laparoscopic transabdominal extra peritoneal repair and patient had uneventful post-operative period. Discussion: There are various techniques described in literature about the repair methodologies of lumbar hernia but the minimally invasive techniques are supposed to be far superior in many aspects as compared to open surgical repairs. Conclusion: For primary spontaneous lumbar hernias minimally invasive techniques are preferred over open surgical techniques due to their obvious advantages

387-390

Authors: Nasreen Fatima Syeda, Sadia Sameera Syeda

A sub lingual thyroid anterior to the hyoid bone which is the only thyroid tissue present in the body is a rare entity. It was found due to failure of descent of the thyroid gland to its normal position. Methods: 13-14 yr. old female presented with symptoms of severe sinusitis. CT scan was used to perform this study. Result: A Sublingual thyroid gland present in front of the hyoid bone is observed and there was complete absence of thyroid gland at normal position. Discussion: Incidence of lingual thyroid gland is reported as 1:100,000. It is manifested more in females.1:7 Ectopic thyroid tissue can occur anywhere from foramen caecum to its normal position i.e.; in front & sides of trachea at the level of 5th, 6th, 7th cervical & 1st thoracic vertebrae in the human body. 70% of patients with lingual thyroid are associated with hypothyroidism and 10% suffer from cretinism. Conclusion: A sublingual thyroid due to failure of descent of the thyroid gland with congenital hypothyroidism. No known pathogenesis is present in this case. Thorough examination with follow up is important. A thyroid profile, hemogram, an x-ray of the neck & thyroid scan has to be done regularly with interval of at least once in 6 months. Unless there is need for emergency surgery, it should not be performed. Patient should be treated symptomatically. There should be hormonal essay done for every child born and treated as early as possible to avoid the consequences. Starting of treatment in patients with congenital problems of hormones can help the patient to lead a normal life.