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Journal of the Anatomical Society of India

Abstracts (351 - 380)

Author(s): Members

Vol. 54, No. 1 (2005-01 - 2005-03)

351. Study of Physical Growth in School Children of Different Socio-Economic Groups

Dr. Malegaonkar Sandeep Subashrao

Department of Anatomy, Government Medical College, Aurangabad.

Abstract: The aim of present study is to know normal growth pattern and its interrelationship with different socioeconomic status in schoolchildren of Aurangabad City (MS).

One thousand four hundred and forty-six students (724 boys and 722 girls) of 6-14 years of age group were examined for different anthropometrical norms.

Out of these students, 240 boys and 240 girls were from below poverty line. Data for these above categories were collected from survey done by Municipal Corporation, Aurangabad in the year 2000.

Out of the various parameters used (total 15 parameters),it was found that height, weight, chest circumference below poverty line boys and girls in all age groups were having less values as compared to above poverty line boys and girls of the same age group.

All these values were statistically significant. Height, weight, chest circumference, biacromial distance, trunk length, arm length and hand length, show steep rise from 10 year onwards in girls as compared to boys.

Occipito-frontal diameter, sternal length, length of superior extremity, forearm length, length of inferior extremity. Thigh length, leg length, foot length show gradual rise from 6-14 year group in both boys and girls.

Biparietal diameter does not increase much with age in both the groups. It was also found that there was definite ratio between different parameters of same student in each of the age group and in boys & girls.

352. Study of Cranial Indices in the Skull of People of Western Orissa

Mishra AK., MS, Professor (Asst) Department of Anatomy, NMC, Nellore (AP) & Chinara PK, MS., Prof and HOD, Anatomy, SCB Medical College, Cuttack.

Abstract: Measurements of skulls and establishment of various cranial indices offer a simple and accurate way of judging similarities and dissimilarities amongst skulls of different racial groups. Reconstruction of skull can be done from such measurements. The present study on the skulls of people of Western Orissa is based on collections from the museums of the departments of Anatomy and Forensic medicine of VSS Medical College, Burla. All this skulls used are of known age and sex. Only adult skulls have been used for our purpose. Fifty skulls belong to adult males and 50 belong to adult females. Each skull was oriented in the Frank-Furt plane and measurements taken there of. The Cephalic Index, Upper facial index and orbital index have been worked out. The cranial index in majority of skulls belongs to Dolicho Cranic Type (80-82%), the Facial Index belongs to Leptine Type (44-52%) and the orbital index belongs to Meso Colich type.

The cranial index of people of western Orissa is similar to that of Bhils observed by Turner. The orbital index is similar to that of Tamils observed by Horrower. In Chaturvedi and Harnija series of observation significant correlation has been found between upper Facial Index and orbital index which tallies with the present observations.

353. Analysis of Various Morphological Features of Femur in Accreditation with Weight Transmission

K. Prabhu, S. Kamalesh, R. Rahim Ahmed, WMS Johnson, S. Kalaivani, S. Premkumar

Sree Balaji Medical College & Hospital, Chennai.

Abstract: The evolutionary status and its adaptive function of any animal determines the morphological features of a bone. Geometrical analysis and bone numerical density of Right and left femur and comparison between them alleviate that left femur is bio-mechanically suited for weight transmission. This has been statistically evaluated.

355. Craniometry in Northwest Indians

Balbir Singh, Kaur B, Kapoor K & Raghwan P.

Department of Anatomy, Government Medical College, Chandigarh.

Abstract: Craniometry has been widely accepted as a means of recording cranio-facial variations as well as for the determination of sex and age in forensic investigations and in studies of past population.

Norma occipitals, frontalis and basalis were studied in 60 human skulls. The skulls were measured according to the metric systems proposed by Howells and Pietrusewsky. Forty-two parameters were measured according to Howell's system while additional thirty parameters were measured according to Pietruswewsky's systems. The data was analyzed statistically to find the sexual dimorphism and it was compared with different populations.

In norma frontalis the statistically significant features were nasio-frontal subtense, supraorbital sub tense and glabella subtense.

Using a dedicated computer program (For disc 2.0) the present population was compared with several other populations of the world. The results showed that northwest Indian male and female skulls were the closest to Andaman male and female skulls. The other races that showed closeness with Indian skulls were Hispanic, Black Americans and Peruvian races.

356. Observations of Non-Metric Traits of Human Skull in NorthWest Indians

Kanchan Kapoor, Kaur H, Singh B & Raghawan, P

Department of Anatomy, Govt. Medical College, Chandigarh.

Abstract: Non-metric evaluation of the skull has been considered a useful tool in population comparison. Extent of non-metric variations is discussed in relation to their frequency in different populations. The present study highlights the presence, shape and size of various epigenetic characters with respect to age and sex.

Norma occipitalis, basalis and frontalis of the human skulls were observed for non-metric study of various characters to note the sexual dimorphism; non-metric traits were studied according to sexing and population affinity system proposed by Larnach, Fredman and Macintosh. According to this system, nine metric traits were noted in norma frontalis while five traits were observed in norma occipitalis and basalis.

The study showed that in norma frontalis, superciliary ridge, sub nasal prognathism, anterior nasal spine, zygomatic trigone, malar tuberosity and rounding of orbital order of malar bone were significantly more developed in males as compared to females. The median frontal ridge was more distinct in females. Lower narial margin was found non anthropine in both males and females. In norma occipitalis, occipital torus, external occipital protuberance and supra mastoid crest were significantly more developed in males as compared to females. Considering the above parameters, it may be possible to determine the sex of a particular skull with 80% accuracy.

357. Unilateral Cervical Rib - A report

Dr. DAVS Sesi, Prof. C. Bhagya Lakshmi

Anatomy, Rangaraya Medical College, Kakinada.

Abstract: A supernumerary rib is a costal element of seventh cervical vertebra. It has head, neck tubercle and a small shaft joining the first rib. It produces neurological and vascular symptoms. Awareness of this anomaly and knowledge for its anatomy is important in surgical excision of cervical rib through dissection of neck for relieving symptoms.

Key words: Cervical Rib, supernumerary rib, costal element

358. Defect in Membranous Ossification of the Fossa for Lacrimal Sac and Frontonasal Ostium - A case report

Th. Naranbabu Singh, BK Das, M Matum Singh, Ch. Rajendra Singh, Prof I. Chandramani Singh.,

Department of Anatomy, Regional Institute of Medical Sciences, Imphal, Manipur

Abstract: Defect in the fossa or lacrimal sac and nasolacrimal canal was encountered on the left side of a dry female skull age about 40-50 years. A bony crest was present at the anterior border of lacrimal bone and a thin membranous bone except for a minute canal communicating with nasolacrimal canal closed the bottom of the fossa for lacrimal sac., the left frontal air sinus had neither an ostium nor a frontonasal canal to communicate with the middle meatus of nasal cavity. As the frontal, lacrimal and maxillary bones developed by membranous ossification, these defects may be attributed to the defect in membranous ossification.

360.Mutations in Hypertrophic Cardiomyopathy - A pilot study in Andhra Pradesh

Pariaplavi Mokkapati*, B Soma Raju **, Syed E. Hasnein***, Prathibha Nallari ****

* Siddhartha Medical College, Vijayawada., **. Care Hospital, Hyderabad.
*** Centre for DNA Finger Pinting & Diagnostics, Hyderabad.,
**** Dept of Genetics, OU, Hyderabad.

Abstract: Hypertrophic cardiomyopathy is a primary cardiac muscle disorder characterized by left ventricular and or septal hypertrophy with/without outflow tract obstruction, histologic disorganization and diastolic dysfunction., there is increased risk of sudden cardiac deaths chiefly due to conduction anomalies.

Despite a rising global concern, there is very little data in the Indian context. A large number of individuals go undetected because they manifest few/no symptoms and because of 20 percent of gene, carriers do not manifest morphological changes.

Over 150 mutations spread over eleven genes coding for sarcomeric and cytoskeletal proteins have been described, about half of which are reported to be located in the gene for cardiac, b-myosin heavy chain alone.

A pilot study at molecular level was carried out to study the genetic aetiology in India. Blood samples from ten cases were taken for DNA isolation, PCR amplification, SSCP and sequencing to examine for mutations in the MYHC - 7 gene. The exons studied are known to be hotspots in western populations.

Surprisingly, it was found that none of the cases exhibited mutations in any of the hotspots studied. Thus, the genetic etiology of the condition in Indian patients seems to be different from earlier reports, which are from other population groups. An in depth evaluation is therefore required.

361. Cytogenetics of Habitual Abortion

Dr. Ashutosh Mangalrigi - lecturer, Dr. Mrs. SA Pathak

- Associate Prof., Dr. Mrs. KG Palikundwar - Prof & Head

Department of Anatomy, Government Medical College, Nagpur.

Abstract: The present cytogenetic study in habitual abortions was carried out in the genetic laboratory, department of anatomy, Government Medical College and Hospital, Nagpur comprised of 20 couples with bad obstetric history.

Aim of the study was to find out whether any specific chromosomal abnormalities exist in couples with recurrent abortions.

Materials used for the study are centrifuge, BOD incubator, double glass distilled water plant, test tubes, T.C, medium RPMI 1640, phytohaemagglutinin etc. Karyotyping with "G" banding was done.

The study revealed that, out of 40 positive metaphases, chromosomal anomaly was seen in one female with history of 6 spontaneous abortions. The incidence of chromosomal anomaly was found to be 2.5 percent in an individual, which was significant. The abnormal karyotype seen was 45XX,t(13;15).In cases of habitual abortions cytogenetic examination of both the partners is routinely justified. In cases of chromosomal aberrations, valuable data can be gained to serve as a basis for genetic counseling.

362. Consanguinity and Genetic Referral

Dr. Aruna N, Dr. Sayee Rajangam

Division of Human Genetics, Department of Anatomy, St. John's Medical College, Bangalore

Abstract: Divisions of Human Genetics, St. John's Medical College are a referral center for karyotyping and counseling since 1976. Analysis of cause of referral and consanguinity from 3028 patients' records referred during the period of April 1996 to Jan 2004 ( 8 years) revealed the following:

1658 individuals were couples (829) referred mainly for bad obstetric history (BOH) and rarely infertility; 813 individuals were referred with multiple congenital anomalies (MCA) with or without mental retardation (MR); 371 females patients with either primary or secondary amenorrhea; 104 males patients with either hypogonadism or male infertility; 31 individuals with miscellaneous causes like ovarian tumor, leukemia etc. Analysis of consanguinity revealed that 238 couples (476 individual) were related to each other and were referred with (BOH); 268 individuals with MR MCA were born to consanguineous union; 122 female patients and 29 male patients were born to consanguineous couples and 14 individual with miscellaneous cause of referral were a result of consanguineous union. Cytogenetic analysis revealed chromosomal abnormality in a total of 395 individuals of which 78 individuals were either born to consanguineous couples or had been married to a relative and presented with BOH. Statistical significance of the same will be disucussed.

363. DNA Fingerprinting Cosmic Basis

LA Mehta, MVL Kothari, M Natarayan

Department of Anatomy, Seth GS Medical College, Parel, Mumbai.

Abstract: It has been a long march from the Bertillon fingerprinting to DNA fingerprinting. The individuality of DNA fingerprint is the ultimate assertion of the principle that variability is the only invariable law in biology.

The tridimensional uniqueness of DNA print is a structural fait accompli that demands an operational mechanism for the same., this paper is an attempt at that.

That DNA, the most complex molecule in the universe, should unfailingly be distinctive in every individual bespeaks of its cosmic, noumental interconnectedness. The one mechanism that can bring this about is the TITL principle - total inclusion allows total exclusion. A corollary to this is that one's genotype is ordered by the cosmic noumenon. Ergo, genes take orders rather than giving them. Here lie the inherent limitations of genetics as a science. The oft-repeated phrase polygenic/multifactorial inheritance is an admission that one's own genes do not direct most normal and abnormal processes in the human body by the corporate genotype of the herd in particular and humanity in general. The now accepted failure of the HuGO project is a case in point.

364. Downs Syndrome - with Mosaicism

Dr. TK Rajasree, Dr. N. Jayasree, Dr. N. Ratnakar Rao, Dr. G. Ravindranath

Kakatiya Medical College, Warangal.

Abstract: Clinically diagnosed Down's syndrome patients were all directed for karyotyping by clinicians. Genetic analysis has been established in many laboratories in twin cities from where the present data has been collected.

During the period of 3 years all, the cases of Down's syndrome have been analyzed with follow-up of cases as far as possible.

It has been observed that each case has some deficiency of features, which were described in standard textbooks in Down's syndrome. This prompted for a correlation and detailed study by conventional karyogram. The results are analyzed and will be discussed in detail.

365. Holoprosencephaly with Median Proboscis - A case report.

Dr. C.Lavanya, I year PG, Dr.Rajeswari, Prof.

Department of Anatomy, Bangalore Medical College, Bangalore

Abstract Aim of Study:

To study the gross anatomy of a stillborn baby with cyclopia and to confirm the ultra sound findings

Material and method:

The study was carried out on a stillborn, 31 weeks old. The stillborn was received from Lady Curzon and Browining Hospital, Bangalore, attached to Bangalore medical College. Dissection was carried out on the still born as per the guidelines given in Cunningham's manual

Results:

On detailed study by dissection, the following features were noted. 1) Two cerebral hemispheres were fused. 2) Surface showed absence of gyri and sulci 3) Cerebellum showed absence of vermis 4) Flax cerebri and falx cerebelli were absent 5) Ethmoidal bone was absent 6) A single nasal cavity was seen with absence of nasal bones 7) A single orbital cavity was seen. Eyeballs were absent 8) Palate showed absence of premaxilla.

Conclusions:

The ultra sound findings were confirmatory. All the features suggested it to be a case of Patan's syndrome presenting with Holoprosencephaly and cyclopia.

366. Iniencephaly - a case report

Dr. Venkataramana Taramati, Dr. SS. Sarada Devi. Prof&Head, Dr. S. Sreelatha, Prof.,

Department of Anatomy, Osmania Medical College, Hyderabad

Abstract: A study was undertaken to detect the neural tube defects of prenatally and also in newborns. Neural tube defects are common cause for perinatal deaths in the newborns. In this background ultrasound, scanning was done for 1000 antenatal mothers and 10,000 live births were analyzed for neural tube defects. Incidentally, a case of iniencephaly was detected during the study. Clinical features embryological significance, aetiology, associated defects and prognosis of the case is discussed.

367. Conjoined Twins - A case Report

Dr. Mangesh S. Selukar, Dr. P.R. Kulkarni

Govt. Medical College & Hospital, Latur (MH)

Abstract: Conjoined twins occurs once in 40,000 births but once in every 200,000 live births. Conjoined occurs more in Indian than China or United States. Asymmetrical conjoined twins, one twin being small less formed, and dependent upon the other is rare. We herewith report such case of stillborn Asymmetrical conjoined twins.

Introduction:

Conjoined twins develop during developing embryo

- Developing embryo begins to split into, identical twinsbut then stops way leaving the partially separated egg to mature into a conjoined fetus. They are more often in female than male.

Conjoined twins may be caused by genetic and environmental conditions, which are responsible for the failure of twins to separate after the 13 th day after fertilization. 75% are still born or die within 24 hours.

Case report:

A 24-year old woman delivered a conjoined twin in our hospital. The delivery was premature and delivered in th month. The conjoined twin was still born. She had first child of three years, which is normal.

On examination, the eyes were not completely developed. The legs and hands of twins were arising from the thorax and abdomen. The detail examination, classification and causes will be discussed at the time of conference.

368. Morphometric Analysis of Neurons of Posterior Horn of Spinal Cords of Different Gestational Ages

Dr BN Rao, Dr. NB Devi, Dr. V Sunitha.

NIMS, Nellimarla. AP

Abstract: Fetuses of different gestational groups from ten weeks to full term are subjected to laminectomy, spinal cords were removed in tact. They are processed and sections of 5 microns thickness are cut and studied under light microscope with H&E and Holme's silver nitrate impregnation methods with regard to their size, shape, number chronological age wise appearance and variations if any will be discussed at the conference.

369. External Genital Aplasia with other Associated Congenital Anomalies - A case report

Dr. SP Thangaraj, Dr. Mohini Sud, Dr. Kumaravel,

Department of Anatomy, Pondicherry Institute of Medical Sciences, Pondicherry.

Abstract: External genital aplasia is very rare anomaly. A 22 weeks female foetus was obtained from obstetrics and gynecology department. It showed absent external genitalia and distended abdomen. Ultrasonography showed distended bladder with absent urethra and external genitalia. Both ureters were distended but kidneys appeared to be normal. Fallopian tubes and ovaries on both sides were rudimentary and bicormuate uterus was present. The distal vagina was found to be absent on both sides and the proximal vagina opened into the dorsal wall of the urinary bladder. There was malrotation of gastrointestinal tract. Bilateral talipes equino varus was observed. Its probable cause of abnormal development shall be discussed.

370. The Study of Number and Size of Hassall's Corpuscles in Relation with Increase in Gestational Age and Crown - Rump Length in Fetuses.

Dr. Sharadkumar P. Sawant, Department of Anatomy,

Seth G.S. Medical College, Parel, Mumbai

Abstract Aim:

To study the number and the size of Hassall's corpuscles in relation with the increase in gestational age and crown - rump length in fetuses.

Material and Methods:

100 foetuses were obtained from the Department of Obstetrics & Gynecology after M.T.P. thymuses were dissected, sectioned and stained for microscopic study.

Conclusion:

It was observed that increase in the number and the size of Hassall's corpuscles with increase in gestational age and crown - rump length in fetuses, indicates the continuous process of cellular degeneration.

373. The Rise of Anatomical Knowledge in Colonial Medical Education in India.

Dr. Jayantha bhattaacharyya*, Dr. Parthapratim Pradhan **, Dr. Samer Deb***

Department of Anatomy, *PGT, NB Medical College, West Bengal. **RG Kar Medical College, and ***NB Medical College, West Bengal.

Abstract: Scientific anatomical knowledge instead of speculative logical knowledge about the body - is connected with the arrival of modern medicine inaugurated by the English colonial powers in India,. The first anatomical dissection in India, being phenomenal in proclaiming the victory of colonial "scientific Knowledge" over the "Indian" body, was greeted by 50-round gun salutes from Fort William Preceding this incident, to remember, the Anatomy Act was passed in the British Parliament in 1832. The sustained effect of this important phenomenon over the acquisition of medical or anatomical knowledge in India is yet to be charged out. We would like to preliminarily focus on two aspects: 1) it entailed in a political marriage between medical education and the colonial state through a singular act - the anatomical dissection of the Indian bodies by the Indians under the surveillance of the British educators, 2) constitution of the professional authority of biomedical practitioners over the indigenous practitioners of traditional medicine, through secular social hierarchy independent of caste or religious belief. In the historical triumph of modern medical knowledge, the lived experience of the body to the designated as the "existential anatomy" was subsumed under the rubric of spatially circumscribed, three-dimensionally owned, objectified and impersonated body over which temporal marks of pathological changes following disease processes were inscribed. In dissecting the cadaver, the student penetrated, surveyed, and appropriated the interior of the body and transformed himself. Anatomical dissection served as the ritual that inducted young men into the cult of medical knowledge. Dissection was a potent method of producing and disseminating knowledge a powerful technology for operating upon the human body but also a powerful metaphor. The dissection or doctor claimed the status of an epistemologically privileged cultural arbiter on the question regarding death and dying. But unlike England, in colonial India this education was intended to produce "capable practitioners" instead of a mix of "capable enquirers and practitioners". Following this trajectory, we would like to ask 1) Was there any confrontation between two knowledge systems the traditional Indian healing practices on the one hand, and; the practice of; modern medicine on the other? 2) What was its nature? 3) How did the community body in India (focus area being colonial Bengal) get metamorphose into the "medical" body, and 4) With what consequences?

374. An Interesting Case Report Of Abnormally Elongated Styloid Process

Dr.Kiran V.Padeyappanavar*, Dr. Mrs. S.P.Jahagirdar**, Dr.P.L.Jahagirdar.***

Postgraduate*, Prof. & Guide** Prof & HOD*** Al-Ameen Medical College, Bijapur

Abstract: Abnormally elongated styloid processes were found in two dried skulls of our department, where the length exceeds more than 5cm. Etiology and clinical implications of the same will be discussed during case presentation.

376. The Study Of Supraorbital Notches And Foramina In Adult Human Skull In Marathwada Region

Dr.Deshmukh AG, Dr.Chavan WM, Dr. Kulkarni PR.

Department of anatomy, Govt. Medical College, Nanded.

Abstract: The knowledge of anatomy of the fore head region is important for those doing forehead and brow lift surgery in order to avoid injury to the neurovascular bundle passing through this notch and foramina.

We studied 97 adult cadaveric skull from dissection hall of Dept. of anatomy, Govt.Medical College, Nanded.

57 male skulls and 39 female skulls were studied for the presence of supraorbital notches and foramina, unilateral notches and foramina and accessory supraorbital foramina in 52% of female skulls and 30.8% of female skulls supra orbital notches were present on both sides.

In 36.9% of male skull and 38.5% of female skulls supraorbital notch on one side and foramina on other side was present. While 15.7% of male skull had accessory foramina on both sides and 31.5% had on one side. 7.7% female skull accessory foramina on both sides.

377. STUDY OF ETHMOIDAL FORAMEN IN DRY HUMAN SKULL

P.R Singh, MK Anand, CJ Raibagkar

Pramukh Swami Medical college, Karamsad, Gujarat

Abstract: A study was carried out on 20 dry human skulls, which were collected from various medical colleges of Gujarat. With the help of scale and compass the location, shape, number, presence and absence of ethmoid foramina of skull was done bilaterally.

These canals transmit the vessels and nerves of their names into the anterior cranial fossa at the lateral edge of the cribriform plate for the nasal cavity.

Anterior ethmoid foramen was present in all of the skulls studied. In 2% of the skulls the foramen was present on only one side. The average size of foramen on both sides was same, the largest being 6mm in size and smallest being 1mm. When compared bilaterally 28% of the skulls showed difference of more than 0.5mm.

Posterior ethmoid foramen was found to be smaller than the anterior ethmoid foramen. It was present in all the skulls studied bilaterally with an average size of 1.86mm, the largest and smallest being 3.5mm and 0.7mm respectively. Also the posterior ethmoid foramen was multiple in 19% of the skulls when compared.

It is very important to know the variation in size, number and location of these foramina as the ethmoidal artery may need to be ligated in certain intractable cases of nasal bleeding. Also it is important for embolisation and endonasal microsurgery in the region of ethmoid and anterior cranial fossa.

378. Presence of Tubercle at Anterior Margin of Foramen Magnum

Dr. Prakash BS & Prof Dr. BR Ramesh

Department of Anatomy, Dr BR Ambedkar Medical College, KG Halli, Bangalore.

Abstract: A series of two hundred dried human skulls were studied for non-metric variations. In one skull, a tubercle was found at anterior margin of foramen magnum projecting posteriorly into foramen magnum. Its incidence, formation and importance will be discussed in detail.

379. Application Of Factor Analysis Method of Statistical Package to Determine the Sex of Unknown Mandibles

Dr. T. Jayachandra Pillai, Dr. RV Subhakar, Dr. R. Sekhar, *Dr KVS Sarma

SV Medical College, Tirupati, *Statistics Department, SV University, Tirupati.

Abstract: Measurements for 22 variables were recorded on 88 adult human mandibles of unknown sex and compared with the values of the known sex. Every parameter independent of other parameters provided a certain percentage of accuracy about the sex of mandible of unknown sex. This percentage of certainty significantly shifted when considered in combination with other parameters. When all the variables are considered together and treated statistically, six factors have been extracted viz., height of right ramus, body thickness, anthropometric arch width, inter incisor width, mandibular index and mandibular angle which could explain 75.2 % of total variations in the data. The results were analyzed using factor analysis technique of statistical package for social sciences (SPSS) and discussed in detail.

380. Estimation of Gestational Age by Measuring the Femur Length: An ultrasonography Study

Dr. Ila J Gujaria*, Dr. UA Puri**

Lecturer, Department of Anatomy*, Consultant Professor,
Department of Anatomy**
TN Medical College & BYL Nair Ch. Hospital, Mumbai.

Abstract: Sonography is a useful and accurate tool for estimating gestational age in cases where the pregnancy cannot be dated accurately by clinical evaluation. The present work was undertaken with a view to study the relationship between the femur length and gestational age. Attempt has been made to estimate gestational age more reliably by taking measurements of foetal femur length.

This study was conducted at the TN Medical College and BYL Nair Ch. Hospital for a period of two years. Patients referred for ultrasound examinations were studied. A real time ultrasound was performed on 215 pregnant women with history of regular menses and knew unequivocally the beginning day of the last menstrual period. The measurements of the biparietal diameter and femur length were made using electronic calipers.

Predictions of gestational age by sonography have been shown to be more accurate than predictions from the date of last menstrual period even if the women are certain of their dates.

Estimation of gestational age is more reliable using femur length because variability is more in biparietal diameter in 2nd and 3rd trimester as compared to length of femur.

Hence, concluded that femur length is a useful substitute when head measurements are unobtainable and can be confirmative when they are available.

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