Indian Journal of Clinical Anatomy and Physiology

395-399

Authors: Acharya Veena Anand, Veerabhadra B. Nandyal

Estimation of stature from bones play an important role in identifying unknown bodies, parts of bodies or skeletal remains. Multiple anthropometric techniques have been used to estimate stature from skeletal remains by anthropologists, anatomists & forensic experts. Since olecranon process and styloid process of ulna are easily felt through the skin, it becomes easy to measure the length of the bone. Objectives: This study was carried out to investigate the relationship between stature and ulna length and to derive a regression formula between the ulna length and height of an individual. Materials and Methods: 300 subjects (150 males & 150 females) aged between 21 and 25 years were included in this study. Measurements of ulna length were taken by using Dividing Calipers and the height was recorded using Stature meter. The data was subjected for statistical analysis using SPSS software. Results: A positive correlation between height and ulna length was observed in both sexes and it was statistically significant. Regression equation for stature estimation was formulated using the ulna length for both sexes. Conclusion: Since simple and easily applicable methods are involved in the determination of stature, it is widely used. The present study thus helps in establishing identity of an individual when only some remains of the body are found as in mass disasters, bomb explosions and accidents.

405-407

Authors: Anitha MR, Bharathi D, Rajitha V, Chaitra BR

The origins of anthropometry are very ancient. As long ago as old Egypt and Greece. The word ‘Anthrapometry’ was first used in the seventeenth century by a German physician J. Sigismund Elshwltz(1623-88). Materials and Methods: This present study was conducted on 300 Medical, Dental and Parmedical male students of Vinayaka Missions University, Salem, Tamil Nadu. The age of the students ranged from 20-23 years who belonged to South Indian region. The length of the tibia is defined as the direct distance between the medial most superficial point on upper border of medial condyle and tip of the medial malleous. The study subject was asked to sit with knee placed in the semi flexed position and the foot partly inverted to relax the soft tissues and facilitate bony landmarks prominent. Then, the bony landmarks are measured with the help of spreading callipers. Further, the measurement is confirmed by using measuring tape. Height was measured by measuring crown to heel standing erect posture with anthropometer. Measurements of length of right and left tibia were taken separately for calculation. Statistical analysis was done using SPSS software. Observations and Results: Linear regression formula was derived for estimation of height from percutanous length of right and left tibia. Y1=94.5+1.8X1 Y2=88.55+1.95X2 Where, y1 and y2 are estimated heights from length of right and left tibia. X1 and X2 represent the length of right and left tibia respectively. Conclusion: Regression formula obtained can be used for the estimation of height from the tibia bone in south Indian population.

412-418

Authors: Satya Narayan Shukla, Sarabpreet Singh, SB Ray

Recent studies have shown that amygdala plays a pivotal role in the emotional processing of pain. Opioids like morphine relieve pain by suppressing both the sensory and emotional components of pain. On chronic morphine administration, tolerance develops decreasing its analgesic effect. The underlying changes in the amygdala during morphine tolerance are not definitely known. Mu opioid receptors are binding sites for morphine while N-type voltage-gated calcium channels (VGCCs) directly control the release of neurotransmitters from presynaptic nerve endings. Aims & Objectives: The present study was designed to investigate the status of mu receptors and N-type VGCCs in the amygdala of morphine tolerant rat by autoradiography and immunohistochemistry respectively. Material & Methods: Wistar rats were made morphine tolerant by repeated administration of morphine for 5 days. Later, the rats were euthanized and cryostat sections of the brain were cut at the region of the amygdala. For autoradiographic localization, the sections were incubated with [3H] labeled DAMGO. For immunohistochemistry, the sections were exposed to primary antibody against N-type VGCCs. Results: Using image analysis software, a significant down-regulation of mu receptors and an up-regulation of N-VGCCs were observed after tolerance. This differential change in expression would indicate a less effective antinociceptive action of morphine through / though higher neurotransmitter release after tolerance. Conclusion: In conclusion, the study suggests that morphine tolerance could be associated with altered functional state of the amygdala.

423-426

Authors: Ezhilarasan S, Muthuvel Vijayan K, Jeyanthi M

Human cadaveric organs obtained from cadavers during routine dissection can be kept as dry specimens for teaching and mounting in museum by this new wax embedding technique. This is an innovative technique developed by us using simple chemicals like acetone, xylene and paraffin wax. The procedures for this technique are very simple, cost effective and no prior training is needed. We developed this technique mainly as an alternative to plastination, which needs high end plastination equipment’s making the total cost higher.

433-435

Authors: Dwivedi SK, Ajit Singh Rajput, Uday Som Shekar

Arterial hypoxia occurs due to perfusion of non-ventilated alveoli; these changes become maximal within 48 -72 hours after operation and usually return to normal within 7 days without ever becoming clinically evident. Objective: To study the efficacy of balloon physiotherapy in comparison to incentive physiotherapy. Methods: A prospective study was conducted among eighty three patients who have undergone major laparotomy operations i.e. opening of abdominal wall. They were divided into two groups. One group received the balloon physiotherapy and the other group received the incentive physiotherapy. Comparison was made between the two groups. Data was analyzed using appropriate statistical tests. Results: At two degree of freedom X square value corresponds to probability 0.05 was 5.99. Calculated value was 0.4884. It was not found to be statistically significant. It was also noted that there was no significant difference noted between two groups of ASA grade. Balloon physiotherapy was found equally effective in comparison to chest physiotherapy. Conclusion: Balloon physiotherapy is cheaper than incentive physiotherapy. It was found to be equally good in comparison with incentive physiotherapy. Hence we recommend use of balloon physiotherapy in low resource settings.

440-444

Authors: Hemamalini, Muddanna S Rao

Centella asiatica is a small medicinal herb, growing in damp soil. In Ayurvedic medicine, Centella asiatica is used extensively as brain tonic to enhance learning and memory power. In the present study, the neuroprotective role of Centella asiatica (CeA) leaf extract on substantia nigra neurons against stress induced neurodegeneration in mice was investigated. Mice were divided into four groups and treated as follows: (i) Normal control (NC) - remained undisturbed in the cage, (ii) Saline control (SC) - treated with saline, (iii) Stressed group (S) – remained in the restrainer for 6 hours/day for 6 weeks, (iv) Stress + Centella asiatica treated group (S+CeA) - stressed and received orally CeA leaf extract throughout the stress period (n=6 in all groups). After 6 weeks, brain was removed and processed for Golgi staining. Substantia nigra neurons were traced using camera lucida focused at 400X magnification. The concentric circle method of Sholl was used to quantify the dendrites. The results showed less number of dendritic branching points and dendritic intersections in stressed group. On the other hand, the number of dendritic branching points and dendritic intersections of substantia nigra neurons in group (iv) were significantly more. The results conclude that, oral intubation of centella asiatica leaves extract increased dendritic branching points and dendritic intersections of substantia nigra neurons.

449-451

Authors: Kalai Anbusudar, S. Dhivya

This study is conducted to record the variations in fissures and lobes of lung which will be helpful for all clinicians and also of academic interest. Materials and Methods: The study was undertaken in 25 pairs of cadaveric specimens. The lungs were exposed to study the morphological features like number, fissures and lobes. Presence of anatomical variations was observed and photographed. Results: 11 right side lungs showed incomplete horizontal fissure. In 5 right lungs there was no horizontal fissure. Incomplete oblique fissure was found in 7 right lungs. 2 right lungs did not have any fissures. 8 left lungs exhibited incomplete oblique fissure. Conclusion: A detailed knowledge of the anatomy of the fissures of lung is essential for the proper interpretation of radiological images like X- ray, CT scan and MRI for the radiologists, cardiothoracic surgeons performing lobectomies, and segmental resections. Furthermore, the knowledge of fissures and lobes of lungs is important for the surgeons to properly manage the potential problems which may be encounterd during surgery.

456-459

Authors: Kalpana Medala, Suhas SH, Smilee Jhoncy

The present study was done to evaluate the effect of Head Down Tilt (HDT) on Blood Pressure (BP) in males and females. The parameters which represent the cardiovascular autonomic function involved the Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Pulse Pressure (PP). Materials and Methods: 100 healthy males and females were selected. There was a limit in the age group from 18-45 years. The effect of HDT on cardiovascular autonomic responses was conducted in them. Parameters like HR and BP were recorded at supine and 300, 600, 800 HDT. In each position the HR was determined by recording the ECG for 5 min in lead II. Niviquire software was used. BP was measured within 20 seconds of the change in tilt position. Observation and Results: On HDT the HR, DBP, MAP, decreased. In contrast the SBP increased on HDT. These results were same in both males and females. Conclusion: This study will help to know the cardiovascular autonomic differences in males and females. By conducting the HDT test it is easy for the medical students and the clinicians to understand and identify the cardiovascular reflex responses in healthy or diseased individuals.

464-466

Authors: Naushi Mujeeb, Berendra Yadava, Ezmat Jalil, Usha Singhal

Dysmenorrhea is a very common problem in females which causes considerable physical as well as psychological distress to them. Pharmacological treatments available for dysmenorrhea are often not effective or associated with adverse effects. Acupuncture is a safe and effective alternative free from side effects. Aims and Objective: the purpose of this study was to determine whether acupuncture is effective in reducing intensity and duration of pain in patients of primary dysmenorrhea. Material and Methods: Hundred patients of primary dysmenorrhea between the age group of 14-45 years were taken for the study. Pain was assessed using Visual Analogue Scale (VAS) before treatment, after each sitting and after completion of treatment as well as after 3 months follow up. Data was analyzed using a standard statistical test. Results: Significant reduction in pain intensity was seen after treatment (p<.001) which was maintained after 3 months follow up. Conclusion: This study showed that acupuncture is effective in treatment of patients with primary dysmenorrhea. More powerful studies with larger number of subjects should be done for confirming the role of acupuncture treatment in dysmenorrhea.

470-473

Authors: Pawan Goyal, Dharmishtha Chawada, Amit Upadhyah, DP Pandit

The global epidemic of overweight and obesity is rapidly becoming a major public health problem in many parts of the world. Rapidly changing diets and lifestyles are fueling the global obesity epidemic. It is associated with an increased risk of developing various non-communicable diseases, including hypertension, coronary heart disease, diabetes, stroke and some forms of cancer. Obesity has been found to be associated with changes in levels of serum cholesterol and it may differ with age, sex, weight, height, BMI (Body Mass Index) and life style groups. This study aims at measuring and correlating values of serum cholesterol level in obese and non-obese individuals. It has been found that obese individuals having increased BMI and sedentary life style had high cholesterol level as compared to non-obese individuals. They are at high risk for CHD, so early detection of alteration in serum triglyceride level will prevent CHD and non-communicable diseases.

478-481

Authors: Rakesh Kumar Verma, Arvind Kumar Pankaj, Anita Rani, Navneet Kumar, Archana Rani

Profunda femoris artery (PFA) normally originates from posterolateral aspect of femoral artery and circumflex arteries arise from profunda femoris artery near its origin. As femoral artery (FA) & PFA are commonly assessed for various procedures for diagnosis and treatment for many diseases, knowledge of its course and branching pattern is very important for clinicians to prevent complications. Methods: The present study was conducted on 38 thighs. The origin, diameter at the point of origin, branching pattern of profunda femoris and circumflex femoral arteries were observed and their distances from mid inguinal point (MIP) was measured and recorded. Results: In 100% cases on both right and left side PFA was arising from FA. The site of origin of PFA was maximally (63.16%) found on posterior surface of FA. The mean distance of origin of PFA was 39.55 mm. In majority of cases, lateral & medial circumflex arteries were originating from PFA i.e. 84.21% and 73.68% respectively and the mean distance from MIP was 52.27 mm and 42.62 mm respectively. The lateral circumflex artery was arising from FA on right side in 22.23% while on left side in 10% cases. The medial circumflex artery was arising directly from FA on right side in 33.33% and on left side in 20% cases. Conclusion: In present study, the most common site of origin of the PFA was from posterior side of FA. The origin of the PFA observed was slightly proximal than noted in other studies. However, the left profunda femoris originates more distally than the right. Lateral & medial circumflex arteries commonly originated from the PFA artery close to its origin. This knowledge is very valuable in preventing injury to these vessels during different procedures.

485-489

Authors: Samata Krishnarao Padaki, Anita Herur, Amrut Aravindrao Dambal

Standard 12-lead ECG is widely used initial screening test for non-invasive detection of cardiovascular changes in obesity. It is seen that obesity is associated with leftward shift of the P wave, QRS and T wave axis, various changes in the P wave morphology, and low QRS voltage, which remain asymptomatic and hence undiagnosed for a longer period of time. Objectives: To study and compare the QRS axis (in degrees), QRS duration (in seconds) and QRS amplitude (in mV) in asymptomatic obese young adults and apparently healthy normal subjects. Material and Methods: Asymptomatic obese 150 young adults in the age group of 18 – 39 years with BMI ≥ 30 kg/m2as study subjects, age and sex matched 150 healthy individuals with BMI <22 kg/m2 were taken as controls from the general population. The weight in kilograms and height in meters was measured and Body Mass Index (BMI), Body Surface Area (BSA) and Waist-Hip Ratio (WHR) were calculated using standard methods. A 12-lead ECG was taken after 10 minutes of rest. Data was expressed in terms of mean ± SD. Unpaired ‘t’-test was done to study the difference in QRS complex. Results: Mean QRS axis (in degrees) in study subjects was 38.9±33.6 vs 56.5±33.4 in controls and was statistically significant. QRS duration (in seconds) in study subjects was 0.09 ± 0.01 vs 0.08±0.01 in controls and was statistically significant. QRS amplitude was increased in cases but was not statistically significant. Conclusion: Our results suggest that obese individuals, being asymptomatic, have higher anthropometric values and abnormal QRS complex, which needs a regular check to reduce the chances of their manifestation, at a future date.

494-497

Authors: Shalini Gupta, Prateek Gautam, Bindu Singh

We all know that “necessity is the mother of all inventions”, this applies very well to this technique. This experiment was carried out to overcome the drawbacks of routine tissue processing like difficult procurement, shrinkage, dull intensity of color, hardening etc. During routine tissue processing paraffin embedding is done before sectioning and the tissue has to undergo the process of fixation and dehydration in order to get prepared for sectioning. Very commonly used dehydrating agent which is considered to be a good one is ethyl alcohol but its purchase is subjected to many restrictions and causes shrinkage and hardening of tissue. Owing to this drawback of ethyl alcohol various other dehydrating agents were launched and used. We have tried a combination of isopropyl alcohol with acetone (3:1) and compared the section with routine tissue processing method. Sections prepared were stained with hematoxylin and eosin. The results obtained were much better than the routine technique when compared as well the modified technique was found to be cost effective as well.

503-506

Authors: Thejaswini KO, Dayananda G

The availability of simple, non-invasive tests for cardiovascular autonomic function has supported an extensive clinical and epidemiologic evolution in the investigation of Cardiac autonomic neuropathy. Such data forms a strong body of evidence in detecting and monitoring impaired autonomic function in patients with diabetes. The proposed study aims at detecting the presence of autonomic neuropathy in an early and possibly stills a reversible phase in Type 2 Diabetes Mellitus (T2DM) individuals in comparison to non T2DM normal individuals. Material and Methods: The cross sectional case control study consisted of 200 subjects, 100 as Cases with T2DM in the age group 35 to 50 years and 100 age and sex matched normal subjects without T2DM as Controls. Resting heart rate, Sinus Arrhythmia and Valsalva Ratio were measured from ECG recorded. Based on these heart rate tests they were grouped into normal, early and definite autonomic neuropathy changes. An informed written consent to participate in the study was taken from the subjects. There was no financial burden on the subjects. The study protocol was approved by the Institutional Ethical Committee. All the quantitative data were summarized and statistically analysed. Results: The basic characteristics with respect to age did not show any significant difference between the T2DM as compared to normals (p<0.05). The HbA1c of diabetics was significantly increased as compared to normals (p<0.05). Amongst the T2DM, 90% showed autonomic neuropathy changes. 70% of those with autonomic neuropathy were early and 20% were definite changes. 15% of the normal individuals also showed autonomic neuropathy changes, of which 14% were early and 1% definite changes. Conclusion: Autonomic dysfunction is prevalent and a serious complication of T2DM. Given the clinical and economic impact of this complication, the present study emphasizes the testing of T2DM individuals for cardiovascular autonomic dysfunction as a part of their standard of care.

510-513

Authors: N. Vinay Kumar, U. Vijayashanmugam, TS Gugapriya, SD Nalinakumari

The suture that persist between frontal bones beyond 8 years of life is termed as “Metopism”. This metopic suture has been shown to exhibit ethnic variability in its incidence with an Asian incidence of up to 5.5%. Previous studies had morphologically classified metopism into complete and incomplete types. The presence of this inter-frontal suture is claimed to alter the development of frontal sinus from asymmetry to complete absence. Methodology: Occurrence of metopic suture among180 adult skulls was studied. The observed suture was further classified morphologically into complete and incomplete types. The skulls with either of the types were further studied radiologically for the presence and symmetry of the frontal sinus. Result: Complete and incomplete metopism was observed in 3.88% and 46.66% of the skulls studied respectively. On radiological examination, absence of frontal sinus was seen more with complete metopism while asymmetry of frontal sinus was noted mainly with incomplete type. Conclusion: The presence of inter-frontal suture in adults with its associated variation in the development of frontal sinuses is of interest for anatomist and significant for radiologist, neurosurgeon and forensic pathologist while examining, operating and reporting of frontal fractures.

518-525

Authors: Kishor Dattatray Khushale, Yuvaraj Jayaprakash Bhosal, K. Shyamkishore

Identification of sex from the available bones has got tremendous value in the medicolegal cases. Anatomists are often asked for expert opinion regarding sex and age of the individual from the skeletal remains found under suspicious conditions. In this respect, metrical studies of the bones are more useful than mere physical examination. The growth factor and the nutrition of the man is widely variable in this world. Based on statistics, Demarking point (DP) are useful to identify the sex of the human clavicles with accuracy. Skeletal remains provide probably the most dependable information for identifying an unknown individual because of their relative durability with which they can be preserved and studied. Aims and Objectives: The identification of an individual from his skeletal remains is of great medicolegal importance The objective of the study was to evaluate the Demarking point (DP) from the hip bone. With this view, the present study has made an attempt to determine the sex of the hip bone from the Demarking point (DP). Material and Method: One hundred and sixty adult hip bones (90 males and 70 females) of known sex were picked up at random from the skeletal collections of the department of Anatomy from various medical colleges in Mumbai. The following measurements were made from dry hip bones which did not show any fracture, pathology or wear and tear. Weight, length and width of the hip bone, length of pubis and length of ischium. Ischiopubic index and coxal index were calculated of each hip bone from the study sample. The instruments used are osteometric board, sliding caliper and ordinary weighing balance sensitive to 0.5 gm. Observation: In this study it was found that ischiopubic index is the best criteria for discriminating sexual dimorphism in hip bones. Also the length of ischium is more useful for identifying male bones and length of pubis for female bones. Combination of these two i. e. the ischiopubic index was found to be the best discriminant parameters for both sexes. Result and Discussion: Earlier workers have studied the actual range and means of certain parameters of bones for assigning sex. In present study seven parameters were studied for determining the sex from the hip bone. The Demarking points (DP) of various parameters if crossed by any hip bone, sex of that hip bone can be identified with certainty. However, it is not necessary for any bone to cross Demarking points (DP) of all parameters for identification of sex. Any single Demarking point (DP) for any of the parameters if crossed, would detect the sex with 100% accuracy. Conclusions: The length of ischium was found to be more in male bones, length of pubis was found more in female bones and ischiopubic index was found to be the best criteria for determining sexual dimorphism in hip bones.

531-537

Authors: Dipu Bhuyan, Pradipta Ray Choudhury, Pramod Agarwala

Mullerian duct anomalies (MDA) consist of a set of structural malformations resulting from abnormal development of the paramesonephric or Mullerian ducts. Mullerian duct is the embryonic structure that develops into the female reproductive tract, including the oviduct, uterus, cervix and upper vagina. The most widely accepted classification system of different mullerian anomalies was established by the American Fertility Society in 1988. This classification chart divides anomalies into seven classes: class I to class VII. Aim: Magnetic Resonance Imaging (MRI) study of the mullerian duct anomalies with different age groups, religions, different classes established by American Fertility Society and associated other anomalies. Materials and Methods: Patients with positive history coming to Radiology Department of Guwahati Medical College and Hospital, Guwahati were included in the study. After preliminary suspected ultrasonography (USG), MRI was done for all the cases. Results: 31 cases of mullerian duct anomalies were included in the study and out of which 70.97% were of class I and 9.67% were of class II and IV mullerian duct anomalies. 48.39% of the cases of mullerian duct anomalies were in age group of 15 years to less than 20 years. 27.27% cases of class I mullerian duct anomaly were associated with other anomalies like renal agenesis, ectopic kidney and ectopic ovary. Conclusion: Class I MDA is found to be most common variety; 15-20 years of age are commonly affected group and Renal anomalies are the commonly associated anomaly.

544-546

Authors: Priyanka Mirdha, Shilpa Solanki, Brijendra Singh

Background and Objectives: In stone crusher workers, one of the major health hazards is respiratory disorder. Globally, it is most common occupational disease and a major cause of morbidity and mortality. Prevalence of respiratory disease depends upon amount of silica exposure and duration of exposure. The present study was carried out to assess the effect of duration of exposure to silica dust on pulmonary function test parameters. Methods: A cross-sectional study was carried out in stone crusher workers. Pulmonary function test were recorded on 50 subjects. Statistical analysis amongst the stone crusher workers was carried out by Analysis of Variance (ANNOVA) test. Results: It was concluded from this study that pulmonary function test decreases as duration of exposure to silica dust increases. Conclusion: Increased duration of exposure to silica dust may increase the risk the respiratory problems.

552-555

Authors: Ranjeet Kumar, Indra Kumar, AK Singh, Pankaj Kumar, PK Sharma, Naresh Chandra

Objective of the study was to determine the normal range of the diameters of three major branches of arch of aorta brachiocephalic trunk (BCT), left common carotid artery (LCCA), left subclavian artery (LSA) and to correlate diameters of branches of aortic arch with each other, age and gender. Material and Method: Multi slice CT scans were performed on 84 subjects (both male and female) in department of Anatomy, in collaboration with department of Radiology of Moti Lal Nehru Medical College, Allahabad and Kriti scanning center, Allahabad. The diameters of BCT, LCCA and LSA were measured at just distal to its origin from arch of aorta. Results: Mean diameter of BCT, LCCA and LSA were 1.14±0.20 cm, 0.71±0.16 cm and 0.93±0.17 cm respectively. Significantly high correlation was found between BCT and LCCA (r=0.62, p<0.001), BCT and LSA (r=0.59, p<0.001) and LCCA and LSA (r=0.59, p<0.001). Mean diameters of all three branches were increasing with the increase of age. Mean diameters of all variables were slightly higher in males as compared to females. Comparing the mean diameters between the two genders, t test revealed similar (p>0.05) diameters between the two genders i.e. not differed statistically. Conclusion: Among, branches of arch of aorta, the mean diameter of brachiocephalic trunk was the highest and left common carotid artery was the least (BCT > LSA > LCCA). Age had significant effect on diameters (diameters of branches of arch of aorta). Knowledge of normal diameters of branches of arch of aorta is helpful in the cardiovascular surgery, such as stenting and aneurysm.

560-562

Authors: Rajasekhar SSSN, K. Aravindhan, V. Gladwin, Parkash Chand

Embalming is a process of preservation of dead body by injecting preservative fluid through arteries. Embalming of dead bodies is done if the body is going to be used either for academic purpose or has to be transported. In the absence of near relative of the deceased, a medical social worker accompanying the deceased requested for funeral embalming to enable transportation through the aeroplane. There are no provisions for funeral embalming in any of the Anatomy Acts enacted in various States in India. So, there is a need to formulate guidelines for transportation of embalmed dead body through air, rail, and road as the procedure is not done routinely like in western countries.