Indian Journal of Clinical Anatomy and Physiology

157-160

Authors: Amol A Shinde, Purushottam Rao Manvikar, Vaishaly K. Bharambe

Introduction: Sacral hiatus is the route for caudal epidural block. Dorsal agenesis of sacrum is a known cause for failure of caudal epidural anaesthesia. Material and Methods: 300 dry sacral bones were studied for complete dorsal agenesis, partial dorsal agenesis, elongated sacral hiatus and absent hiatus. Observations and Results: Complete dorsal agenesis was noted in 1.3% bones, elongated sacral hiatus in 3% sacrum and 0.67% bones showed absent sacral hiatus. Conclusion: Variations in the dorsal sacral wall can lead to difficulty in administering caudal blocks. Knowledge of incidence of dorsal agenesis, elongated hiatus and absent hiatus will help anaesthetists to plan for a safer approach.

166-169

Authors: Harleen Kaur, Archana Goel, Nidhi Puri

Obesity is a major contributor to many classes of disease including pulmonary diseases. The purpose of the study to predict the risk of future pulmonary diseases by using indices related to obesity. Various such indices have been used in previous studies but their relative importance remains unknown. The present study utilized four different anthropometric parameters and calculated their correlation with the pulmonary function tests. This study was also carried out to examine the relative importance of these parameters in prediction of pulmonary functions in a group of female students. This cross-sectional study included 200 female medical students. Anthropometric indices used in this study included: Body Mass Index (BMI), Waist to Hip Ratio (WHR), Waist to Height Ratio (WHtR) and Waist Circumference (WC). Pulmonary function tests were performed using a computerized spirometer. Body Mass Index and Waist to Height Ratio showed a significant negative correlation with Forced Expiratory Flow and ratio of Forced Expiratory Volume in one second: Forced Vital Capacity(FEV1: FVC). While Waist Circumference showed a significant negative correlation only with ratio of Forced Expiratory Volume in one second: Forced Vital Capacity. Hence, Body Mass Index, Waist to Height Ratio and Waist circumference can be regarded as most reliable indicators of obesity which leads to decrease in pulmonary functions.

173-175

Authors: Chandni Gupta, Vikram Palimar, Azim Adhir P.

Introduction: The necessity of identification of an individual is paramount important from birth to death as flawed identity can lead to several medico-legal complications. Age and stature of an individual are significant criterion in personal identification. There are age associated variations of the fallopian tube like the length of the fallopian tube increases from pre-reproductive to reproductive age group then it progressively decreases in postmenopausal period. Aim: The aim of this study is to measure length of fallopian tubes and to correlate that with the age and stature of the individual. Materials and Methods: This was a prospective study conducted on dead bodies of 46 females that were autopsied in the mortuary of Forensic Medicine department, Kasturba Medical College, Manipal. The length of both right and left side fallopian tube were measured using measuring tape. Stature was measured using graduated autopsy scale. The age of the deceased was noted down from the autopsy files. The result was analyzed using SPSS software. Results: The mean lengths of right & left fallopian tubes were 4.86 ± 1.91 cms and 5.06 ± 1.94 cms respectively. There was significant correlation of both age and stature with the lengths of fallopian tubes on either side. Conclusion: The result of this study will help the Forensic Pathologist to find the age as well as stature of individual from fallopian tube. Precise information of the normal length of the fallopian tube may aid the gynecologists to adopt suitable diagnosis and management of numerous disorders related with it.

180-185

Authors: Jaya Kadam, Vandana Sharma, Sonia Baweja, Deepak Sharma

Introduction and Aim: The insular cortex is hidden 5th lobe of brain with variable gross anatomical patterns. Insula is situated in operculoinsular compartment of sylvian cistern. Materials and Methods: 58 human formalin fixed cerebral hemispheres were studied for the gyri and sulci variations of insular cortex and their lengths were recorded using digital vernier caliper. This study was done in department of Anatomy, Gandhi medical college Bhopal. Result: The morphological normal and variable pattern, discontinuous sulci and joined gyri were observed. Out of the (85/406) 21% variable pattern we observed (44/406) 10.3% Bifid, (31/406) 7.63%, Hypoplastic Gyri and (10/406) 2.46%Trifid. The Bifid pattern was most commonly seen in Anterior Short Gyrus18 /44 (41%). The Hypoplastic pattern was most commonly seen in Middle Short Gyri 18/31 (58%). There was presence of Transverse Gyri in 13/58 (22.41%) and Accessory gyri in 39/58 (65.51%) cerebral hemispheres. Transverse gyrus & Accessory gyrus both were absent in 19/58 (32.76%) cerebral hemispheres in insular cortex. Total number of gyri in every insula and Mean lengths of gyri were Anterior short=24.54mm, Middle short=25.04, Posterior short=34.08mm, Anterior long=36.87mm, Posterior long=37.1mm measured. The Mean lengths of all insular sulci were Central Insular=35.3mm, Superior Periinsular=52.48mm, Anterior Periinsular=24.5mm, Inferior Periinsular=26.4mm, Posterior Periinsular=12.81mm measured. Conclusion: Variation in morphological pattern of gyri are Bifid, Trifid and Hypoplastic. The Transverse and Accessory gyri were present in anterior lobule, but not observed in each insula. There was variation in number of gyri because of presence of transverse and accessory gyrus. Total number of gyri are more in anterior lobule so it is larger than Posterior lobule. The gyri of anterior lobule are shorter than gyri of Posterior lobule. Such morphological features and variations are important for surgeries.

191-196

Authors: Deepak Sharma, Sonia S Baweja, Vandana A Sharma

Human skeleton and its remains are important material for racial, genetic, anthropological and forensic investigations. Sacrum being the last skeletal remains proves important in sex determination & identification of deceased. The first sacral vertebra is last to decay in the sacrum. This study is to validate the selected morphometric parameterss and indices related to first sacral vertebra and thus sex determination by the available part of human sacrum. Multicentric study on 282 dry human sacra in central india region was conducted after due permission of institution ethics committee. Transverse, anterio-poeterior diameter of S-1 was measured and Index of S-1 was calculated. Mean value of transverse diameter of first sacral vertebra is 4.78 and 4.46 and Anterio-posterio diameter is 3.07 and 2.89 for male and female sacra with t-value of 4.8839 and 4.2262 respectively & P-value highly significant. Mean value for Index of S-1 for male and female is 8.4429 and 8.9327 respectively with t-value 0.0568. This multicentric study provides morphometric values of first sacral vertebra that can be used for determination of sex and forensic identification in Central India region. Morphometric indicators of first sacral vertebra can be used for the anatomical and forensic purpose where partial or broken sacra is only skeletal remains.

202-204

Authors: Aftab Begum, Siraj A. Shirbadgi

Introduction: Pneumosinus dilatans (PD) is a rare craniofacial malformation characterized by unusual hyperaeration of any one of the paranasal sinuses. The etiology and pathogenesis of this condition remain unclear. Here we are presenting a case study on the incidence of Pneumosinus Dilatans Frontalis (PDF) using computed tomography and in south Indian skulls. Materials and Methods: The present study was carried out in 92 dried adult human skull of unknown sex obtained from Department of Anatomy and 120 patients underwent paranasal sinus Computed tomography (CT) for various reasons at Bhasaweshwara Medical college and hospital, Chitradurga, Karnataka. The incidence of unilateral and bilateral PDF was observed and photographed. Results: Out of 90 dried skulls, the incidence of unilateral PDF was found in only one case (1.09%). In the present study, the incidence of bilateral PDF was not found in dried skulls. A total of 120 (240 slices) CT scans of the nose and paranasal sinuses were reviewed. We observed 3 cases (2.5%) of bilateral PDF among them 2 cases were seen in males and one case in female. Conclusions: PD is rare craniofacial deformity affects all paranasal sinus but most commonly affects the frontal sinus. Hence, a detailed anatomical and morphometric knowledge of the region is necessary to perform the successful surgeries and outcome in the region.

210-213

Authors: Sneha K, Girish Babu M, Manjunath ML

Introduction: A woman is most vulnerable at the postpartum period. About 50-70% of maternal deaths occur in the postpartum period, of which 45% deaths occur in the first 24 hours after delivery and more than two thirds during the first week. Between 11-17% maternal deaths occur during child birth itself. There is a direct correlation between haemoglobin, haematocrit and red blood corpuscle values with the amount of blood loss. With increase in blood loss, the incidence of PPH will be more. Materials and Methods: 500 pregnant women of 18-35 years, undergoing vaginal delivery at Mc Gann teaching district hospital, Shivamogga were evaluated for hematological parameters (Hb, Hct, RBC) during their admission for delivery and on first postpartum day. The American College of Obstetrics and Gynecology defines PPH as a 10% change in haematocrit value between the labour admission and postpartum period. Results: There was reduction in the mean values of Hb, Hct, RBC and the results were statistically highly significant (p<0.001). The incidence of primary PPH was 14.8% as determined by 10% decrease in hematocrit level. Conclusion: Laboratory analysis of haematological parameters, being simple and accurate method, has to be followed, even during postpartum period, to assess, to take necessary measures and to prevent primary PPH and thereby decreasing the maternal morbidity and mortality.

217-219

Authors: Sumana. R, Shivakumar .A.H

Introduction: Popliteal artery gains much importance because of the clinical conditions encountered and the surgeries carried out in the region of popliteal fossa. The variations in the branching pattern of popliteal artery is observed and studied by many as the knowledge of its variations will be of relavence during the vascular surgeries, fasciocutaneous flaps and surgeries of knee. Materials and Methods: Present study is conducted on 50 lower limb specimens belonging to the department of Anatomy of Karuna medical college by detailed dissection and tracing of all its branches. Results and Discussion: Two out of 50 specimens showed the presence of superficial sural artery accompanying the sural nerve very rare but very important one. No variation in the course of the popliteal artery was encountered. Trifurcation of popliteal artery was not encountered in the present study. Conclusion: The present study shows the importance of the superficial cutaneous branch of the popliteal artery with respect to the fasciocutaneous flaps an important finding for the plastic surgeons & surgeries where fasciocutaneous free and pedicled flaps can be raised over the superficial cutaneous branches of Popliteal artery.

224-228

Authors: Jayamala A. K., Latha R., Nirmala N., Keerthika G., Saarumathi E.

Introduction: Hypertension is a major contributor to cerebrovascular pathology causing dementia. Visual reaction time gives a better index of the cortical processing of Visual Stimulus. Trail Making Test provides information on visual search, scanning, speed of processing, mental flexibility, and executive functions. Our objective was to compare simple and choice reaction time (SRT & CRT) and trail making scores between hypertensives and normotensives geriatric male subjects. Materials and Methods: The present cross-sectional study was conducted on 60 Male hypertensives and normotensives aged >60 years, with BP <140/90 mm Hg were taken as controls & BP >140/90 mm Hg were considered as hypertensive’s. Computer programme recorded both SRT & CRT using Deary- Liewald Reation Time Tester version 3.10. Trail making test was used as executive function test. Results: Data were analysed using SPSS version- 20, Unpaired t-test showed significant difference in the reaction time scores of normotensives (SRT: M: 366.4 SD: 16.41; CRT: M: 737.6 SD:59.82 ) and hypertensives (SRT: M: 471.4 SD: 21.52 ; CRT: M: 902.4 SD: 55.57). In addition, the executive function showed significant difference between the executive ability of normotensives (TMT-B: M: 97.6, SD: 18.24) and hypertensives (TMT-B: M: 112.24 SD: 20.12). Interpretation and Conclusion: The results showed that the hypertensive elderly males have a lower cognitive performance in comparison to age matched normotensives. Hypertension delays the speed of processing of information in elderly hence they are at higher risk for injuries and its consequences.

233-236

Authors: Balaji W. Ghugare, Mukesh R. Dinkar, Himanshu Chauhan

Introduction: Diabetic neuropathy (DN) is commonest forms of complications observed in type 2 diabetes patients. Due to variations in clinical and electrophysiological diagnostic criteria for polyneuropathies, prevalence of diabetic neuropathy varies in different studies. We used only (Electro diagnostic) EDX criteria for diagnosis of neuropathies in present study. Aim and Objectives: To estimate prevalence of diabetic neuropathy; viz, mononeuropathy, polyneuropathy and mononeuropathy with coexistent polyneuropathy in population of subjects with type 2 diabetes mellitus. Materials and Methods: It was a cross sectional study where total 53 diabetic subjects (30 male, 23 female) in age range 30-60 years were electrophysiologically evaluated for neuropathies during January 2013 to December 2015. Routine and specialized Nerve conduction studies were adopted for evaluation. Data was acquired and stored in Microsoft excel and analyzed using graph pad prism software. Results: Overall prevalence of diabetic neuropathy (DN) was 54.71%. Prevalence of other forms viz. Polyneuropathy only, mononeuropathy only and mononeuropathy with coexistent polyneuropathy are 30.18%, 16.98% and 7.54 % respectively. Median neuropathy at wrist was the only form of mononeuropathy observed in these cases. Severity of mononeuropathy was observed more in diabetes without polyneuropathy cases. Conclusion: Prevalence of different forms of neuropathies observed in present study is similar to previous studies. We observed more severe mononeuropathy in diabetes without polyneuropathy cases. Palm wrist comparison study must be part EDX evaluation in these cases.

241-245

Authors: Hira Lal, Aparna Juneja, Pragati verma, Ashok Kumar, Raghunandan Prasad

Introduction: Knowledge of the normal portal vein anatomy and its variations is imperative for various hepatic interventional procedures and liver surgeries like during creation of transjugular intrahepatic portosystemic shunt (TIPS), partial hepatectomy and Liver transplantation. Aims and Objective: The aim of our study was to determine and analyse the spectrum of variations in the main and right portal vein anatomy and their prevalence in Indian population using MDCT. Materials and Methods: Triple phase abdomen CT of 688 patients done on a 64 slice MDCT scanner between February 2012 and March 2014, were retrospectively evaluated by two radiologists independently. Out of these, 500 patients met the inclusion criteria. Axial images of portal and venous phase along with the maximum-intensity-projection and volume rendered images were reviewed and branching patterns of main and right portal vein were recorded. Results: Normal portal vein anatomy was present in 67% of the patients. Main portal vein (MPV) variations were seen in 15.2% of the patients. The most common variant was Z-type pattern (7.6%). Next common was trifurcation pattern (6.6%). Right portal vein (RPV) variations were seen in 17.8% of patients and the most common pattern was early segmental branching (6.8%). Other RPV branching variations were RPV trifurcation (3.6%), RPV quadrification (3.6%), and superior-inferior division (1.4%). Miscellaneous branching variations of RPV were seen in 2.4% of all patients. Conclusion: Variations in the main portal vein and right portal vein anatomy are quite common and can be clearly detected with MDCT.

250-253

Authors: Shilpa Gantela, A. Hemalatha Devi

Osteoporosis is reported to effect 44 million adults, of whom 80% are women. Exercise appears to influence the osteogenic response and can lead to higher values of Bone mineral density. A minimum research is done on bone mineral density using dual energy x-ray absorptiometry (DEXA) in India. Weight bearing exercises seem to have a better effect than nonweight bearing exercises. Aim: our aim of this retrospective cohort study is to confirm that weight bearing exercise is beneficial to bone mineral density than non weight bearing exercise. Materials and Methods: A total of 50 healthy active women (n=50) doing weight bearing exercises like tennis playing and gym weight workouts for atleast one hour, for 5 days a week were taken. (Group A). A total of 50 healthy walkers with minimum walking of one hour for 5 days a week were taken (Group B). Dual-energy X-ray absorptiometry (DXA) was done to assess the bone mineral density in all the participants. Bone mineral density (BMD) in gram per square centimeter of lumbar spine (L1-L4), surgical neck of right humerus and total body BMD was assessed with a hologic QDR-1000/W pencil-beam bone densitometer, using the spine scan mode. Statistical analysis was done using Statistical package for the social sciences (SPSS software, version 13.0). Analysis of covariance was used to determine whether there were significant differences between groups in bone mineral density, adusting height and weight. Results: The Total body BMD in gm/cm2 in group A is 1.172+ 0.034 and the Total body BMD in gm/cm2 in group B is 1.078+0.053. (P value < 0.001) Lumbar spine BMD in gm/cm2 in Group A is 1.216+0.122 and the Lumbar spine BMD in gm/cm2 in Group B is 0.968+/-0.128. (P value <0.05) Humerus BMD in gm/cm2 in group A is 1.22+0.043 and the BMD in gm/cm2 in group B is 1.110+0.066. (P value < 0.001). Conclusion: since, the Total body BMD, Lumbar spine BMD, Humerus BMD in gm/cm2 is higher in subjects doing weight bearing exercise when compared to the subjects doing non weight bearing exercise. We confirm that weight bearing exercises are beneficial to bones when compared to nonweight bearing exercises.

260-265

Authors: Ajit Holkunde, Supriya Sakhare

In the present observational study, thirty aborted human fetuses of 13-38 weeks gestational age with no obvious congenital abnormality were obtained. To study the histology of spleen in relation to the gestational age, spleen was procured after dissection of fetuses and slides were prepared with H & E staining. The findings were noted under the light microscope. On looking over the literature on development and the important functions served by the spleen as haemopoeitic and lymphoid organ, the following study was undertaken. In the study, the mean body weight of fetuses was 130.83 at 14th week and 3150gm at the age of 38th week. The average crown rump length of fetuses at 14 weeks was 115mm and was 330mm at 38th week. Histologically, at 13th week of age there were large numbers of cells of irregular shape with large nucleus centrally. Few small thin walled vessels are seen. At 20th week of age, clearcut division of red and white pulp was seen. Our study may be regarded as a preliminary study including some detailed results. The histological findings acquired in our study will be beneficial for the evaluations about the fetal spleen.

269-273

Authors: Navneet Kour, Vanita Gupta, Gaurav Agnihotri, Shalika Sharma, Vikrant Singh

Objectives: A profound knowledge of the anatomical organization of adductor muscle compartment is necessary to understand their functions, and to assist in the development of accurate clinical and biomechanical models. This study aims at providing appropriate morphometric measurements of adductor longus muscle. Materials and Methods: The present study was conducted on 50 lower limbs. All limbs were fully dissected and measurements were taken with help of a steel tape. Results: We found Adductor longus muscle in all the 50 dissected lower limbs (100%). The range of length and width of proximal aponeurosis varied from 4.1- 6.8cm and 0.8 -2.5cm respectively. The range of length of fleshy part (muscular belly) varied from 14.4 – 20.7cm. The range of length and width of distal aponeurosis varied from 9.8 – 13.9cm and 2.1 – 4.8cm respectively. Conclusion: Our results would aid educational anatomy dissections, surgical interventions and help in management of many ailments.

278-280

Authors: Venkatesh Kamath, Saroj Kumar, Muhammed Asif , Shivarama Bhat, Md. Tabrej Alam

Aim: To study the topography of clavicular nutrient foramina. Materials and Methods: The topography of nutrient foramina was studied in 71 clavicles. The mean foraminal index was calculated using Hughes formula. The direction of foramen was also observed. Results: The mean foraminal index was 36.31. The foramen was observed in the middle third of the clavicle in 87.32% cases and medial third in 12.68% cases. The foramen was observed in the inferior surface in 49.3% cases and posterior surface in 50.7% cases. No foramina were observed in the superior surface and in the lateral third of the clavicle. Conclusion: The foramina are mainly observed in the middle third of the clavicle. Standard literatures describe that foramen are mainly seen in the inferior surface but in our study, we observed foramina in both inferior and posterior surface in high frequency. This knowledge of distribution of foramina is of great importance for orthopaedic surgeons in surgeries like internal fixation and bone grafting.

286-288

Authors: Arpith M. N., Revathi Devi M. L., Purushothama S. M., Manju Natha S. N

Introduction: Cardiovascular diseases (CVD’s) are rampantly increasing in the Indian population with an increasing trend in the younger patients. Overall cardiovascular diseases showed that almost one-fourth of all deaths in India in 2008. CVD’s were considered as the fastest growing chronic illness between 2005 and 2015, growing at an average of 9.2 % per year. Objectives: (i) To know cardiovascular diseases in patients admitted to MICU; (ii) Categorization of various CVD and associated conditions; (iii) To know the socio demographic profile of the patients. Materials and Methods: The study was retrospective of 3 months duration among patients of age group among 30-50 years admitted in KR Hospital Mysuru. All the patients admitted in the hospital for a minimum duration of 24 hours were included. Data were collected based on standard proforma from the available case record sheets. The analysis of data was based on descriptive statistical analysis. Results: The study found that majority of cases recorded in MICU was cardiovascular related disorders. In that Myocardial infraction (MI) was major cardiovascular disease (CVD)